Gunshot fetal injury

A stray bullet hit a pregnant woman. The uterus, being close to the abdominal wall, shielded the other viscera and received the bullet with fatal thoraco-abdominal fetal injury. The literature is reviewed.     

Ecological effects of antibiotic production by dermatophyte fungi.

Antibiotic production by dermatophyte fungi has been demonstrated in vivo in the lesions of patients with dermatomycoses. Patients infected with antibiotic-producing strains more frequently carried cocci resistant to penicillin and other antibiotics than did patients infected with non-producer strains. The total bacterial load was less in lesions caused by producer fungi. In vitro studies demonstrated the selection of penicillin-resistant S. aureus from mixed populations of resistant and sensitive cells.     

Tinidazole in treatment of amoebic liver abscess in children

Tinidazole as a single drug therapy given in a single dose daily for 5 or 3 days was put to rigorous test in malnourished children. Of 25 children with amoebic liver abscess, 23 were cured. The 2 remaining cases required surgical drainage followed by other amoebicides, one subsequently dying from complicating bronchopneumonia.     

Leptin,its Implication in Physical Exercise and Training: A Short Review

Leptin, a hormone synthesized by fat tissue had been noted to regulate energy balance and metabolism and thus to influence body weight. The influence of acute exercise and chronic exercise training on circulating leptin and its relationship with hormonal and metabolic changes that induce energy balance are presented. Research that has examined the influence of exercise under various experimental conditions on leptin and the conflicts in the literature are presented. It appears that a significant caloric perturbation (> 800 kcals) is necessary for acute exercise to result in a significant reduction in leptin. In contrast, exercise training can result in a leptin decline but typically this manifests a reduction in adipose tissue stores. In addition, future directions are presented.

Key Points

• Physical exercise and training have both inhibitory and stimulatory effects on leptin.
• Exercise with energy expenditure higher than 800 kcal can decrease leptinemia.
• Acute training may cause a decline in circulating leptin levels.

Key words: Leptin, exercise, training, hormones     

Cytochrome P450-based gene therapy for cancer treatment: from concept to the clinic

In the last 16 years, more than a dozen gene-directed enzyme prodrug therapies for cancer treatment have been evaluated in preclinical studies. However, only few of them have evolved to the stage of clinical trial. This review assesses current knowledge in the area of cancer gene therapy, emphasizing cytochrome p450 (CYP)-based prodrug activation systems. This approach is intuitively highly suitable for the treatment of cancers, since several major anticancer drugs are activated by liver CYP enzymes. Important features of this strategy include: 1) use of human CYP genes to avoid immune complications that may hamper expression of therapeutic genes of non-human origin and thereby inhibit prodrug activation, 2). use of well established and clinically effective anticancer prodrugs, 3). strong bystander cytotoxic effect seen with all liver-activated CYP prodrugs, 4). the potential to inhibit liver CYP activity and expression to increase the bioavailability of prodrugs for CYP-transduced tumors, 5). possible extension to many CYP enzymes and their potential anticancer prodrug substrates, and 6). it can be used to arm therapeutic conditionally replicating viruses. Historically, this strategy utilized CYP 2B1 to activate oxazaphosphorines. It is now becoming clear that the repertoire of prodrugs is expandable and that CYP gene candidates are not limited to naturally occurring CYP genes, but may also encompass engineered CYP enzymes, improved by site directed mutagenesis or other approaches. Encouraging results from a recent phase I/II clinical trial that have implemented this strategy, as well as emerging problems related to gene delivery are discussed in this review.     

Clofazimine enteropathy in a pediatric bone marrow transplant recipient

Clofazimine, previously used in the treatment of leprosy, is now used for treatment of Mycobacterium avium complex infection in patients with acquired immune deficiency syndrome, dermatologic disorders, and graft-versus-host disease. An 11-year-old boy developed a severe enteropathy 2 years after initiation of clofazimine treatment for graft-versus-host disease. Clofazimine enteropathy caused by crystal deposition can be life-threatening.