Pelvic haemophilic pseudotumour: management of a patient with high level of inhibitors

Haemophilic pseudotumour (HP) is a rare but very serious complication of haemophilia. HP affects mainly patients with severe haemophilia and those who have developed antibodies to factor VIII or factor IX. We report on a 45-year-old man with haemophilia A and high titres of inhibitors who developed an extensive HP with progressive destruction of the right ilium over a period of 12 years. The different therapeutic options (conservative management by replacement therapy, surgical approach, radiotherapy, percutaneous evacuation with secondary refilled cavity and transcatheter arterial embolization) are reviewed.     

SEM preparation and observations of the hen's oviduct

The surface patterns of the oviduct of Gallus domesticus were examined by scanning electron microscopy (SEM) using several preparatory techniques. Ciliated epithelial cells predominate throughout the oviduct with nonciliated cells approaching an equal proportion in the magnum and isthmus. Short, randomly oriented mucosal folds which characterize the infundibulum increase in height and longitudinal orientation as they approach the magnum. Here and in the isthmus they broaden and become dimpled with glandular apertures. The folds narrow again in the uterus and vagina. Cryofracture followed by SEM demonstrate the deeper mucosal folds and submucosal tubular system.     

Effects of BCG Vaccination on Evolution of Leprosy

Background

BCG vaccine is considered to have immunoprophylactic potential in leprosy. However controversy exists about the extent of prophylaxis it provides. In view of this, a study was undertaken to see the evolution of disease in established cases of leprosy who were already vaccinated with BCG and to compare it with the cases of leprosy who were not vaccinated with BCG.

Methods

114 newly diagnosed cases of leprosy were studied. Patients were divided into two groups-BCG vaccinated and non-vaccinated. Clinical diagnosis of leprosy was confirmed by bacteriological and histopathological studies in each case. All patients were given standard anti leprosy treatment and were evaluated monthly for a minimum period of one year.

Results

All the cases were males in the age group of 20 to 50 years. 25.4% of cases had received BCG vaccine and 74.6% were not vaccinated for the same. No significant difference was observed in the incidence of different types of leprosy in vaccinated and non-vaccinated groups. 25.9% cases in non-vaccinated group developed lepra reaction as compared to 13.8% in vaccinated group. The incidence of deformities and disabilities in vaccinated group was only 10.3% as against 18.8% in non-vaccinated group. The rate of bacillary clearance appeared faster in vaccinated group.

Conclusions

Although there is no significant difference in the pattern of different types of leprosy in BCG vaccinated and non-vaccinated cases, there is reduction in the incidence of reactions as well as deformities and disabilities in BCG vaccinated cases as compared to non-vaccinated cases.Key Words: BCG Vaccine, Leprosy     

Dietary fiber and fat are associated with excess weight in young and middle-aged US adults

OBJECTIVE: To examine relative associations of dietary composition variables with body mass index (BMI; calculated as kg/m2) among young and middle-aged US adults. We hypothesized that in subjects with physiologically plausible reported energy intakes, fiber intake would be inversely associated with BMI, independent of other dietary composition and sociodemographic variables. SUBJECTS AND DESIGN: Data from adults age 20 to 59 years in the Continuing Survey of Food Intakes by Individuals (CSFII) 1994-1996 were used. Exclusions were pregnancy or lactation, food insecurity, missing weight or height data, or having only one dietary recall. Based on our previously published methods, a physiologically plausible reported energy intake was calculated as being within +/-22% of predicted energy requirements for the mean of two 24-hour recalls. RESULTS: Reporting plausibility ([reported energy intake/predicted energy requirements]x100) averaged 83% in the total sample (N=4,539) and increased to 96% in the plausible sample (n=1,932). Only approximately 5% of the plausible sample consumed the Adequate Intake for fiber. In plausibly reporting women, fiber, its interaction with percentage energy from fat, and energy density were independently associated with BMI. Only percentage energy from fat was associated with BMI in men reporting plausibly. Compared with the total sample, stronger relationships between diet and BMI were observed among the plausible reporters. In women, a low-fiber (< 1.5 g/MJ), high-fat (> or = 35% energy) diet was associated with the greatest increase in risk of overweight or obesity compared with a high-fiber, low-fat diet. CONCLUSIONS: Weight control advice for US women should place greater emphasis on consumption of fiber.     

Multiple bilateral parotid sialoliths in a patient with mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) of the salivary glands

Multiple sialoliths in the major salivary glands is uncommon. Sjogren's syndrome (SS) is a chronic autoimmune disorder characterized by lymphocyte-mediated destruction of exocrine glands. There is an increased incidence of malignant lymphoma in patients with Sjogren's syndrome. We present a patient with MALT lymphoma of the salivary glands who also had multiple calculi in the parotid glands. Multiple sialoliths in the major salivary glands in the presence of MALT lymphoma has not previously been reported.     

Scintigraphic diagnosis of tricuspid regurgitation

The authors describe a simple technique for diagnosis of tricuspid regurgitation. Red blood cells were labeled in vivo with 99mTc and 22 patients were studied with ECG-gated blood-pool imaging of the liver. A single region of interest was manually drawn around the liver and a time-activity curve obtained. The per cent change in liver counts during the cardiac cycle was found to be significantly higher in the 12 patients with tricuspid regurgitation (Group I) (mean, 4.04 +/- 1.6%; range, 1.3-21.4%) compared with the 10 controls (Group II) (mean, 0.35 +/- 0.16%; range, 0.013-1.3%) (p less than 0.05). Using a 1% change in liver counts as the criterion of a positive study, all 12 cases in Group I were diagnosed correctly, but there was one false positive in Group II; thus the sensitivity was 100% and the specificity 90%.     

Targeting quantum dots to surface proteins in living cells with biotin ligase

Escherichia coli biotin ligase site-specifically biotinylates a lysine side chain within a 15-amino acid acceptor peptide (AP) sequence. We show that mammalian cell surface proteins tagged with AP can be biotinylated by biotin ligase added to the medium, while endogenous proteins remain unmodified. The biotin group then serves as a handle for targeting streptavidin-conjugated quantum dots (QDs). This labeling method helps to address the two major deficiencies of antibody-based labeling, which is currently the most common method for targeting QDs to cells: the size of the QD conjugate after antibody attachment and the instability of many antibody-antigen interactions. To demonstrate the versatility of our method, we targeted QDs to cell surface cyan fluorescent protein and epidermal growth factor receptor in HeLa cells and to alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) receptors in neurons. Labeling requires only 2 min, is extremely specific for the AP-tagged protein, and is highly sensitive. We performed time-lapse imaging of single QDs bound to AMPA receptors in neurons, and we compared the trafficking of different AMPA receptor subunits by using two-color pulse-chase labeling.