Synchronous mucosa-associated lymphoid tissue (MALT) lymphomas involving bilateral orbits and breasts: a rare clinical entity

Primary orbital and primary breast lymphomas comprise very small subgroups of extranodal lymphomas. Clinical presentation at both these sites together is extremely rare. We describe a case of bilateral orbital and bilateral breast mucosa-associated lymphoid tissue (MALT) lymphomas with bilateral pre-auricular lymph nodal metastasis. The case history, staging and management for this unusual entity are discussed.     

Comparison of intense pulsed light to 595-nm long-pulsed pulsed dye laser for treatment of hypertrophic surgical scars: a pilot study

BACKGROUND: The short-pulsed pulsed dye laser (PDL) has been previously reported to improve the appearance of hypertrophic scars. Prolonged purpura following treatment led to the development of the newer long-pulsed pulsed dye laser (LPDL). Intense pulsed light (IPL) has been extensively used to improve the various components of photo damage and to reduce the incidence of purpura, but its effect on scars has not been analyzed. The objective of this pilot study was to prospectively determine and compare the safety and efficacy of LPDL and IPL on surgically induced scars. METHODS: Breast reduction scars (N = 10 scars) and abdominoplasty scars (N=5 scars) were treated using both LPDL and IPL. For breast reduction scars, one side was treated with each technique. For abdominoplasty scars, one half of the scar was treated with each device. Two treatments were performed 2 months apart. Physician global assessment scores of improvement were determined by side-by-side comparison of preoperative and randomly presented postoperative photographs. Patient pain scores during treatment were also obtained and the presence of post, treatment purpura was assessed. RESULTS: Mean improvement on a 0 to 3 point scale was 2.2 (55%) after the first LPDL treatment and 3.2 (80%) after the second. Mean improvement was 1.8 (45%) after the first IPL treatment and 2.6 (65%) after the second. Differences in improvement between the LPDL and IPL sides were not statistically significant. Patients rated IPL as more painful than LPDL. The incidence of post-treatment purpura was lower with IPL. CONCLUSIONS: This pilot study suggests that LPDL and IPL are equally effective in improving the appearance of hypertrophic surgical scars. IPL offers a novel method of treating scars that minimizes the risk of purpura.     

A perspective on protein profiling of blood

Protein profiling of blood is going to lead to huge changes in the development of biomarkers and perhaps also in producing targets for the medical treatment of cancer. Experts in this field from Los Angeles have written an outstanding mini‐review about this topic. Renal cancer has been an area of interest to all of those involved in urological oncology, particularly from the point of view of adjuvant medical treatment either to prevent metastatic disease or to treat it. Authors from Los Angeles have produced a review of great interest on this subject. There are three other reviews on important issues. Authors from Paris have written about microsatellite instability and TCC of the upper urinary tract, and authors from Bristol have written a mini‐review about the options available when considering orthotopic bladder reconstruction. Finally, authors from Dublin have written about a significant problem in renal transplantation, delayed graft function.     

Role of alpha and beta adrenoceptors in locus coeruleus stimulation-induced reduction in rapid eye movement sleep in freely moving rats

Based on the results of independent studies the involvement of norepinephrine in REM sleep regulation was known. Isolated studies showed that the effect could be mediated through either one or more subtypes of adrenoceptors. Earlier we have reported that REM-OFF neurons continue firing during REM sleep deprivation and mild but continuous stimulation of locus coeruleus (LC) or picrotoxin injection into the LC, that did not allow the REM-OFF neurons in the LC to stop firing, reduced REM sleep. However, the mechanism of action and type of adrenoreceptors involved in REM sleep regulation were unknown. The possible mechanism of action has been investigated in this study. It was proposed that if LC stimulation-induced decrease in REM sleep was due to norepinephrine, adrenergic antagonist must prevent the effect. Therefore, in this study, the effects of alpha1, alpha2 and beta-antagonists, viz. prazosin, yohimbine and propranolol, respectively, and alpha2 agonist, clonidine, on LC stimulation-induced reduction in REM sleep were investigated. The results showed that stimulation of LC inhibited REM sleep by reducing the frequency of generation of REM sleep, although the duration per episode remained unaffected. This decrease in the frequency of REM sleep was blocked by beta-antagonist propranolol while the duration of REM sleep per episode was blocked by alpha1-antagonist, prazosin. Also, a critical level of norepinephrine in the system was required for the generation of REM sleep, however, a higher level may be inhibitory. Based on the results of this study and our earlier studies, an interaction between neurons, containing different neurotransmitters and their subtypes of receptors for LC-mediated regulation of REM sleep has been proposed.     

Basal fractures of the femoral neck: intra- or extra-capsular

The method of treatment and outcome for 83 patients presenting with a basal fracture of the femoral neck were determined. This represented 2.3% of all hip fractures admitted to one institution. The mean age of patients was 80 years, 25% were male. Seventy-one fractures were treated with a sliding hip screw, one of which cut-out. No other failures of fixation occurred or re-operations were required. Two fractures were fixed with cancellous screws, one healed in varus and the other fixation failed requiring re-operation. Six were managed with an arthroplasty and four treated conservatively. At 1-year from injury 29% of patients had died. For the survivors 87% were able to return home and only 6% had significant residual pain.     

A review of the epidemiology, pathogenesis and management of tetanus

Tetanus remains an important disease worldwide. In the United Kingdom, the elderly and intravenous drug users are at particular risk of acquiring clinical tetanus. Tetanus is associated with a high morbidity and mortality. Once the diagnosis of tetanus is suspected, intensive management is necessary. In this article we review the history, epidemiology, microbiology, clinical features, mode of transmission, pathogenesis, differential diagnosis, management, complications and prevention of this life threatening disease.     

Antioxidative role of nitric oxide on copper toxicity to a chlorophycean alga, Chlorella

The response of Chlorella vulgaris to copper exposure was investigated under laboratory batch culture conditions. Increased toxicity of Cu with respect to photosynthetic carbon fixation, O(2) evolution, chlorophyll fluorescence, and oxidative burst was observed for N-NH(4)(+)-grown cultures. The addition of sodium nitroprusside, a nitric oxide (NO) donor, in combination with Cu to N-NH(4)(+)-grown Chlorella not only lowered the inhibition levels of carbon fixation, O(2) evolution, and maximum quantum yield of PS II, but also significantly reduced the oxidative burst. The protective action of sodium nitroprusside was, however, arrested in cultures in which sodium nitroprusside was supplemented in combination with 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide, a specific scavenger of NO in the experimental system. The N-NO(3)(-)-grown Chlorella depicted less sensitivity to Cu compared to its N-NH(4)(+)-grown counterpart. The N-NO(3)(-)-, N-NH(4)(+)-, and N-NH(4)(+)+sodium nitroprusside-grown Chlorella did not show any significant differences with respect to their Cu uptake potential. The role of NO as an antioxidant is discussed.     

Dissolution behaviour of nalidixic acid solid dispersions using water soluble dispersion carriers

The oral bioavailability of nalidixic acid (NA) is low due to its poor solubility and slow dissolution. Solid dispersions of NA containing varying concentrations of polyvinylpyrrolidone (PVP), beta-cyclodextrin (BCD) and sodium starch glycolate (SSG) were prepared by solvent evaporation technique in an attempt to improve dissolution rate of NA. Physical characterization of NA, physical mixtures (PM) and solid dispersions were investigated by a variety of analytical methods including scanning electron microscopy (SEM), infrared (IR) spectroscopy and powder X-ray diffraction (XRD). SEM was useful in the verification of possible nalidixic acid inclusion in the dispersion system by studying its surface and shape characteristics of different samples. IR analysis demonstrated no strong interaction between the drug and the carrier exists in the solid dispersions. The degree of crystallinity of nalidixic acid decreased and also differed with the dispersion systems of different carriers. Disolution studies indicated that the dissolution rate and percent dissolution efficiency (DE) were significantly increased in the solid dispersions compared with drug alone. The relative potency of the carriers to enhance the dissolution rate of nalidixic acid was in the order: BCD > PVP > SSG. The dissolution rate of the drug in the solid dispersions was faster when the ration of the drug to carrier was smaller. F-test suggests that first order model may be used for explaining the kinetics of drug release from all the solid dispersion systems.