Incremental Value of Three-Dimensional Echocardiography Over Transesophageal Multiplane Two-Dimensional Echocardiography in Qualitative and Quantitative Assessment of Cardiac Masses and Defects

In the present study, we compared three-dimensionally (3-D) reconstructed images with multiplane two-dimensional (2-D) transesophageal echocardiographic (TEE) images in 17 patients with various cardiac masses and defects. To overcome the problem of making measurements from 3-D reconstructed images, we carefully "dissected" the 3-D dataset using paraplane and anyplane 2-D sections, which were then used to obtain the maximum sizes of the cardiac masses and defects. Of the 15 vegetations and 9 abscesses detected by 3-D TEE in 7 patients, only 8 (53%) vegetations and 4 (44%) abscesses were detected by multiplane 2-D TEE (P < 0.02). Also, the exact anatomical location, shape, geometry, and extent of various cardiac masses and defects were more clearly delineated by 3-D than 2-D TEE. The maximum dimensions of cardiac masses and defects were larger by 3-D than by 2-D TEE in 17 (89%) of the 19 lesions available for comparison (P < 0.002). In addition, 3-D TEE correlated more closely than 2-D TEE when compared to surgical measurements in three patients in whom they were available. Thus, it would appear that in several instances, the exact size of the cardiac lesion could only be assessed by analysis of the 3-D volumetric dataset. Out preliminary study has demonstrated the superiority of transesophageal 3-D reconstruction over multiplane 2-D TEE in both qualitative and quantitative assessment of various cardiac mass lesions and pathological defects.     

Intestinal motility responses to neuropeptide γ in vitro and in vivo in the rat: comparison with neurokinin 1 and neurokinin 2 receptor agonists

We have studied the effect of a novel tachykinin, neuropeptide γ(NPγ) on small intestinal motility in the rat. Experiments were done in vitro on longitudinal muscle strips of duodenum, and in vivo on the migrating myoelectric complex (MMC) of the small intestine. In vitro, contractile effects of NPγ were compared with those of a selective neurokinin 1 (NK1) receptor agonist, substance P methyl ester (SPME), and a selective neurokinin 2 (NK2) receptor agonist, Nle¹⁰-NKA(4–10)(NleNKA). NPγ, SPME and NleNKA caused concentration-dependent contractions (P < 0.001). NPγ was eight-fold more potent than NleNKA, and 118-fold more potent than SPME. Contractile responses to NPγ were reduced by hexamethonium (P < 0.01) and atropine (P < 0.05). The non-selective NK receptor antagonist spantide I only slightly reduced the contractile response to NPγ, as did the selective NK1 antagonist GR 82334, and the selective NK2 antagonist L-659877 and MEN 10376. In vivo, effects of NPγ on the MMC were compared with those of the natural tachykinins substance P (SP) and neurokinin A (NKA). NPy disrupted the MMC and induced irregular spiking in a dose-dependent manner from 25 to 100 pmol kg^-1 min^-1 i.v. (P < 0.05). The effect of NPγ was more prominent than that of NKA at equal doses, while SP had no effect. Our findings show that NPγ exerts potent stimulatory effects on small intestinal motility, most likely mediated directly via distinct NK receptors on smooth muscle cells, but also indirectly via a cholinergic link.     

Infection of cardiac mural thrombus associated with left ventricular aneurysm

Infection is a rare complication of cardiac mural thrombus andmay prove difficult to diagnose and treat. We describe a patientwith infected thrombus associated with a left ventricular aneurysm,involving Salmonella typhimurium. Cross-sectional echocardiographyproved helpful in establishing the diagnosis.     

Improvement method for cervical cancer detection: A comparative analysis

Cervical cancer is a prevalent and deadly cancer that affects women all over the world. It affects about 0.5 million women anually and results in over 0.3 million fatalities. Diagnosis of this cancer was previously done manually, which could result in false positives or negatives. The researchers are still contemplating how to detect cervical cancer automatically and how to evaluate Pap smear images. Hence, this paper has reviewed several detection methods from the previous researches that has been done before. This paper reviews pre-processing, detection method framework for nucleus detection, and analysis performance of the method selected. There are four methods based on a reviewed technique from previous studies that have been running through the experimental procedure using Matlab, and the dataset used is established Herlev Dataset. The results show that the highest performance assessment metric values obtain from Method 1: Thresholding and Trace region boundaries in a binary image with the values of precision 1.0, sensitivity 98.77%, specificity 98.76%, accuracy 98.77% and PSNR 25.74% for a single type of cell. Meanwhile, the average values of precision were 0.99, sensitivity 90.71%, specificity 96.55%, accuracy 92.91% and PSNR 16.22%. The experimental results are then compared to the existing methods from previous studies. They show that the improvement method is able to detect the nucleus of the cell with higher performance assessment values. On the other hand, the majority of current approaches can be used with either a single or a large number of cervical cancer smear images. This study might persuade other researchers to recognize the value of some of the existing detection techniques and offer a strong approach for developing and implementing new solutions.     

Infliximab (Remicade®): from bench to clinical practice. A paradigm shift in rheumatology practice

Infliximab (Remicade®) is a chimeric monoclonal antibody that binds tumour necrosis factor–alpha (TNF‐α) and inhibits its biologic activity. Infliximab has been approved by the FDA for the treatment of a variety of immune‐mediated inflammatory diseases (IMIDs), such as rheumatoid arthritis (RA), Crohn's disease (CD), ankylosing spondylitis (AS), ulcerative colitis (UC), and psoriatic arthritis (PsA). This is a brief review of the development of infliximab primarily in RA and CD; the pathogenesis of RA and CD as applicable to TNF‐α activity; conventional therapies available for RA and CD; early clinical trials and those leading to approval for RA, CD and other indications; coadministration with methotrexate (MTX), and the safety of infliximab as a therapeutic agent for IMIDs.     

Effects of soybean peptide on immune function, brain function, and neurochemistry in healthy volunteers

ObjectiveSoybeans, an excellent source of dietary peptides, have beneficial effects on health. We investigated the effect of the soybean peptide on immune function, brain function, and neurochemistry in healthy volunteers.MethodsNear-infrared spectroscopy (NIRS) was used to analyze brain cerebral blood flow. The A and DA levels in the serum were analyzed by ELISA kit. The total number of leukocytes was recorded with a standard counter. Flow cytometry was used to assess lymphocyte subset levels.ResultsCell numbers were upregulated in the group that had fewer leukocytes but downregulated in the group with more leukocytes. For the lymphocyte-rich type, lymphocyte counts tended to decrease, accompanied by an increase in granulocyte numbers. For the granulocyte-rich type, granulocyte counts tended to increase, but lymphocyte counts also increased. The numbers of CD11b⁺ cells and CD56⁺ cells increased significantly. Soybean peptide decreased the adrenalin level in plasma but increased the level of dopamine. Near-infrared spectroscopy showed significant increases in the amplitudes of θ, α-2, and β-L frequency bands after the ingestion of peptides.ConclusionSoybean peptides can modulate cellular immune systems, regulate neurotransmitters, and boost brain function.     

Performance of the preliminary definition of improvement in juvenile idiopathic arthritis patients treated with methotrexate: experience from Bangladesh

Objective: To evaluate the performance of Preliminary Definition of Improvement (PDI) in juvenile idiopathic arthritis (JIA) patients treated with methotrexate (MTX). Methods: This was a prospective observational study done in the paediatric department of Bangabandhu Sheikh Mujib Medical University (BSMMU) during April 2005–August 2006. All the patients fulfilling the International League of Associations for Rheumatology classification criteria had the American College of Rheumatology core set of variables assessed at baseline and follow‐up at the 4th, 12th and 24th week of treatment. Variables in the core set are: (1) physician's global assessment of disease activity; (2) parents’ or patients’ global assessment of disease activity; (3) functional ability; (4) number of joints with active arthritis; (5) number of joints with limited range of motion; and (6) erythrocyte sedimentation rate. Patients were classified as improved or not improved according to PDI. The following definition of improvement was selected: 30% improvement from baseline in three of any six variables in the core set with no more than one of the remaining variables worsening by > 30%. Results: A total of 40 children with JIA, completed 6 months treatment. At the end of 6 months, most of the patients (92.5%) had been declared as improved according to PDI. Among the core set variables, active arthritis, physicians’ and patients’ global assessment of disease activity, detected the highest percentage of patients improved (92.5%) and functional assessment detected the lowest (37%). Conclusion: The PDI identified that a maximum number of JIA patients treated with MTX had improved.     

Can mothers identify malnutrition in their children?

To assess mothers' perceptions about malnutrition and theirability to identify malnutrition in their own children, 339children aged 3–35 months and their mothers were studiedin two urban hospitals in Dhaka, Bangladesh, and in a communityclinic. The weight, height, and mid-upper arm circumferenceof the children were measured, and their mothers were interviewed.Child nutritional status according to their mother's statementand anthropometrically assessed nutritional status were compared.Sixty per cent of the mothers correctly identified better nutritionalstatus (weight/age >75% of NCHS median) and 67% mothers correctlyidentified malnutrition (weight/age < 75% of NCHS median)in their children. Sixty-one per cent of mothers with less than5 years of formal education correctly identified better nutrition(weight/age >75%) whereas 38% mothers with more than 5 yearsof education correctly identified better nutrition. Correctidentification of malnutrition was made by 70% of mothers withless than 5 years of formal education, and 74% of educated mothersdid the same. As regards causes of malnutrition, 33% of mothers stated thatlack of food at home resulted in undernutri-tion in their children(mean weight-for-age of these children was 65% of the NCHS median).Mothers' suggestions for improving child health were: betterfood in 31% cases; treatment of illnesses in 22% cases; andboth in 42% cases. The results suggest that most of the mothersare able to identify malnutrition in their children, and 95%of them are aware of ways to improve it, and that the provisionof adequate food and health care may improve child nutritionalstatus.     

Control of cerebrospinal meningitis epidemics with sulfadimidine and penicillin; report on an experiment in mass chemoprophylaxis in the Sudan

Four villages in Kordofan Province of the Sudan were selected by the authors to determine the effectiveness of mass prophylactic treatment with sulfa drugs and penicillin in controlling cerebrospinal meningitis epidemics in rural areas with highly primitive living conditions. Sulfadimidine was given orally in two of the villages, and procaine penicillin G in oil with 2% aluminium monostearate (PAM) was given intramuscularly in the other two. The population of the villages was classified by age and by sex and given the following prophylactic doses: in Kaldung village, where 93% of the population was treated, 4 g of sulfadimidine were given to persons over 15 years of age, 2.5 g to those between 15 and 5, and 1.5 g to those under 5; in Korongo Abdulla, the same age-groups received 2.0 g, 1.0 g, and 0.5 g, respectively, and 34% of the population was treated; in El Machicha and Miri Bara villages, PAM was given to 38% and 90% of the respective populations in the dosage of 150,000 units to those over 15 years of age, 100,000 units to those between 15 and 5, and 75,000 to those under 5.