Endometrial stromal neoplasms are immunoreactive with WT-1 antibody.

WT-1 positivity has previously been noted in nonneoplastic endometrial stroma. In this study we examined WT-1 expression in endometrial stromal neoplasms to ascertain whether these tumors are immunoreactive and whether this antibody might be of value in the diagnosis of these lesions. We also stained cases of cellular and highly cellular leiomyomas to investigate whether WT-1 might be of value in distinguishing these from an endometrial stromal neoplasm. We compared WT-1 staining with CD10, desmin, alpha smooth muscle actin, h-caldesmon, and AE1/3, many of these antibodies being commonly used to distinguish between an endometrial stromal and a smooth muscle phenotype. Cases of ESN (n = 5), low grade ESS (n = 14), and cellular or highly cellular leiomyoma (n = 14) were stained with the aforementioned antibodies. Cases were scored on a scale of 0 to 4+, with 4+ cases exhibiting positivity of >50% of cells. Sixteen of 19 endometrial stromal neoplasms were positive with WT-1, most (14 of 16) with 4+ positivity. Staining was nuclear (5 cases), cytoplasmic (5 cases), or combined nuclear and cytoplasmic (6 cases). All endometrial stromal neoplasms exhibited 4+ staining with CD10. Staining for alpha smooth muscle actin was present in most cases (14 of 19) and desmin and h-caldesmon were positive in a smaller number of cases (8 and 2 respectively). There was 4+ positivity with desmin in only 1 case. The 2 cases that were h-caldesmon positive both exhibited 1+ staining (<5% cells positive). Six cases were positive with AE1/3, 1 with 4+ staining. Leiomyomatous neoplasms always exhibited 4+ staining with desmin and alpha smooth muscle actin and in most cases (12 of 14) with h-caldesmon. The other 2 cases exhibited 2+ positivity. Most cases (12 of 14) were positive with WT-1 (7 of 14 with 4+ staining) and CD10 (5 of 14 with 4+ positivity). One case was positive with AE1/3. We conclude that diffuse WT-1 positivity is characteristic of endometrial stromal neoplasms and that this may be of value in diagnosis. However, WT-1 is of limited use in the distinction between an endometrial stromal and a cellular leiomyomatous neoplasm because many of the latter are also positive. This study confirms the value of h-caldesmon in the distinction between an endometrial stromal neoplasm (almost always h-caldesmon negative) and a cellular leiomyomatous neoplasm (h-caldesmon positive). Although CD10 is positive in endometrial stromal neoplasms, the commonly observed immunoreactivity of cellular and highly cellular leiomyomas with this antibody limits its diagnostic usefulness. Desmin is useful as all leiomyomatous neoplasms exhibited diffuse positivity, whereas only a small number of endometrial stromal neoplasms were focally positive and only 1 case exhibited 4+ positivity. Smooth muscle actin is of limited value since most neoplasms studied were positive. The overlapping immunophenotype of endometrial stromal and leiomyomatous neoplasms may reflect the origin of both cell types from a common progenitor within the uterus.     

Controversies in tuberculosis

Tuberculous infection among children continues to be a significant cause of morbidity. The symptom complex are so variable among children that the final diagnosis often rests on the laboratory tests. Proper interpretation of the tests, specially tuberculin test and radiographic studies, are necessary for establishing correct diagnosis. The usefulness of tuberculin test in both unimmunized and BCG vaccinated children is highlighted. BCG accelerated response as a test should be reserved for identifying serious form of pulmonary disease or CNS tuberculosis when the tuberculin test is negative. Radiographic assessment may be sensitive in some instances but not always specific and hence needs cautious interpretation. Tuberculosis among BCG vaccinated children though not uncommon, needs proper documentation. Current trends in the management of tuberculosis including CNS forms are briefly outlined.     

Physico-chemical characteristics,nutritional quality and shelf-life of pearl millet based extrusion cooked supplementary foods

The process variables for extrusion cooking of pearl millet were standardized and some of the physicochemical characteristics of the millet extrudates and also the nutritional qualities of the millet and legume-based extruded supplementary foods were determined. The millet grits less than 355 µm in size, equilibrated to 18±1% moisture content, extruded at 150±5°C temperature and at 200±10 rpm of the barrel of a twin-screw extruder yielded the extrudates of 1.75±0.21 expansion ratio and 7.5±1.5 kg breaking strength. The cold and cooked paste viscosity, the melt energy and also the carbohydrate digestibility of the extrudates indicated that the products were pre-cooked and were of ready-to-eat nature. The millet was blended with grain legumes (30%) and also with defatted soy (15%) separately and extruded to prepare ready-to-eat nutritious foods suitable as food supplements to children and mothers. The foods based on the millet and legumes and also the millet and soy contained 14.7% and 16.0% protein with 2.0 and 2.1 protein efficiency ratio values, respectively. The shelf-life of the foods was about 6 months in different flexible pouches at ambient storage conditions. The study showed that applications of extrusion cooking technology to pearl millet have promise for preparation of diversified and value-added food products from the millet.     

Prosthetic rehabilitation of an orbital and facial defect: a clinical report

For patients undergoing radical head and neck surgery, the deformity or physical defect adds to the agony. Rehabilitation of patients with such deformities is a challenge for the maxillofacial prosthodontist to enhance the esthetics and give psychological strength to the patient. This clinical report describes the rehabilitation, using a silicone prosthesis, of a large facial and orbital defect due to mucoepidermoid carcinoma.     

Auditory temporal envelope processing in a patient with left-hemisphere damage

Abstract

Auditory temporal envelope processing was investigated in a patient showing a mild speech identification impairment following left-hemisphere damage. Three tasks evaluated the patient's ability to: (1) detect a sinusoidal amplitude modulation (SAM) applied to a white noise, as a function of modulation rate (i.e. her ‘temporal modulation transfer function’ or TMTF); (2) discriminate between two white noises amplitude modulated by time-reversed temporally asymmetric envelopes; and (3) identify white noises amplitude modulated by the temporal envelope of speech stimuli. Measurements of intensity discrimination thresholds were performed as a control task. Compared to normal data, the results obtained with the brain-damaged patient showed: (1) increased thresholds for the detection of SAM; (2) increased thresholds for the discrimination of temporal asymmetry; and (3) a deficit in the identification of speechenvelope noise stimuli. In contrast, intensity discrimination thresholds were within the normal range. Taken together, the results indicate a general impairment in auditory temporal acuity, which is now specified as a deficit in the coding of envelope rate and shape, and a deficit in the ability to use temporal envelope cues in speech processing. These results support the hypothesis that left-hemisphere damage is associated with an impairment in time analysis, which may cause, in turn, speech intelligibility disorders.     

Miliary tuberculosis in human immunodeficiency virus infected patients not on antiretroviral therapy: clinical profile and response to shortcourse chemotherapy

BACKGROUND: An increase in tuberculosis (TB) incidence has been associated with human immunodeficiency virus (HIV). AIMS: To describe the clinical characteristics and treatment outcome of patients with HIV and miliary TB treated with short-course intermittent chemotherapy in the absence of access to highly active antiretroviral therapy (HAART). SETTINGS AND DESIGN: Prospective study of HIV infected adults referred to a TB clinic between July 1999 and July 2004. MATERIALS AND METHODS: On diagnosis of miliary TB, patients were treated with a standard regimen of two months of isoniazid, rifampicin, ethambutol and pyrazinamide followed by four months of isoniazid and rifampicin (2EHRZ 3 /4RH 3 ) thrice weekly and followed up for 24 months. Patients were reviewed clinically every month and two sputa were collected. Chest radiographs and blood investigations were done at two months, end of treatment and every six months thereafter. RESULTS: Of 498 patients with HIV and tuberculosis, 31 (6%) were diagnosed as miliary tuberculosis. At diagnosis, sputum smear was positive for acid-fast bacilli (AFB) in 14 patients (45%) and Mycobacterium tuberculosis was isolated in 21 (68%). The mean CD4 cell count was 129 +/- 125 cells/mm3 . Twenty-five patients were declared cured at the end of treatment (81%) while one (3%) died and five (16%) failed. The recurrence rate was 19.4/100 person-years and the median survival was 17 months (95% CI 14 to 20). None of the patients received antiretroviral therapy. CONCLUSIONS: Miliary TB tends to occur among HIV infected patients with severe immunosuppression. Though the initial response to short-course chemotherapy was encouraging, a high recurrence rate and mortality was observed indicating poor prognosis in HIV.     

Antimicrobial,DNA cleavage,and antioxidant properties of new series of metal(II) complexes derived from naphthofuran-2-carbohydrazide Schiff base: synthesis and physico-chemical studies

Metal complexes of the type [NiL₂Cl₂]·H₂O and ML₂Cl₂ [M = Co(II), Cu(II), Cd(II), Zn(II), and Hg(II)] where L = Schiff base, derived from condensation of naphthofuran-2-carbohydrazide and 2-chloro-3-formylquinoline have been synthesized. The chelation of the complexes have been inferred through elemental analyses, IR, electronic mass, ¹H NMR, ESR spectral data, magnetic and thermal studies. The measured low molar conductance values in DMF indicate the complexes to be non-electrolytic in nature. The cyclic voltammetric investigation suggested that, the Cu(II) complex is of single electron transfer quasi-reversible nature. The free ligand and its complexes have been evaluated for their in vitro antibacterial and antifungal activities by minimum inhibitory concentration method. The influence of DNA cleavage on all the complexes was analyzed by agarose gel electrophoresis method. The free ligand with its complexes has been studied for their antioxidant activity by DPPH method. The results of bioassay revealed that, the metal complexes are active than the free ligand and their biological activity increases on complexation.