Accuracy of brain imaging in the diagnosis of idiopathic intracranial hypertension

AIM

To investigate the accuracy of individual and combinations of signs on brain magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) in the diagnosis of idiopathic intracranial hypertension (IIH).

MATERIALS AND METHODS

This study was approved by the institutional research ethics board without informed consent. Forty-three patients and 43 control subjects were retrospectively identified. Each patient and control had undergone brain MRI and MRV. Images were anonymized and reviewed by three neuroradiologists, blinded to clinical data, for the presence or absence of findings associated with IIH. The severity of stenosis in each transverse sinus was graded and summed to generate a combined stenosis score (CSS). The sensitivity, specificity, and likelihood ratios (LR) were calculated for individual and combinations of signs.

RESULTS

Partially empty sella (specificity 95.3%, p < 0.0001), flattening of the posterior globes (specificity 100%, p < 0.0001), and CSS <4 (specificity 100%, p < 0.0001) were highly specific for IIH. The presence of one sign, or any combination, significantly increased the odds of a diagnosis of IIH (LR+ 18.5 to 46, p < 0.0001). Their absence, however, did not rule out IIH.

CONCLUSIONS

Brain MRI with venography significantly increased the diagnostic certainty for IIH if there was no evidence of a mass, hydrocephalus, or sinus thrombosis and one of the following signs was present: flattening of the posterior globes, partially empty sella, CSS <4. However, absence of these signs did not exclude a diagnosis of IIH.

Mathematical modeling of drug release profiles for modified hydrophobic HPMC based gels

Hydroxypropyl methylcellulose (HPMC) is now available in modified hydrophobic forms (Sangelose). In this paper, the effect of viscosity grade and HPMC concentration on in vitro release kinetics of a topically applied drug were studied using gel formulations of a nonsteroidal anti-inflammatory drug (NSAID), diclofenac potassium (DP), with different viscosity grades of the polymer (60L, 60 M, 90 M for hydrophobic HPMC and 50 cPs for conventional hydrophilic HPMC) in different proportions. It was found that hydrophobic HPMC-based gels having a higher viscosity and lower polymer concentration release a notably higher amount of drug compared with hydrophilic HPMC-based gels containing a higher concentration of polymer but with lower viscosity. For gels, the suitability of different common empirical (zero-order, first-order, and Higuchi), and semi-empirical (Ritger-Peppas and Peppas-Sahlin) models, and some new statistical (logistic, log-logistic, Weibull, Gumbel, and generalized extreme value distribution) models to describe the drug release profile were tested through non-linear least-square curve fitting. A general purpose mathematical analysis tool MATLAB was used. Further, instead of the widely used transformed linear fit method, direct fitting was used in the paper to avoid any form of truncation and transformation errors. The results revealed that the log-logistic distribution, amongst all the models investigated, was the best fit for hydrophobic formulations. For hydrophilic ones, the semi-empirical models and Weibull distribution worked best, although log-logistic also showed a close fit. The shape parameter for the log-logistic and Weibull distribution conveys vital information about the rate of release and helps improve understanding of drug release profiles.

Angiogenin functionally interacts with p53 and regulates p53-mediated apoptosis and cell survival

Angiogenin, a 14-kDa multi-functional pro-angiogenic growth factor, is up-regulated in several types of cancers. Anti-angiogenin monoclonal antibodies used as antagonists inhibited the establishment, progression, and metastasis of human cancer cells in athymic mice (Olson et al. 1994). Silencing angiogenin and inhibition of angiogenin’s nuclear translocation blocked cell survival and induced cell death in B-lymphoma and endothelial cells latently infected with Kaposi sarcoma associated herpesvirus (KSHV) (Sadagopan et al. 2009) suggesting that actively proliferating cancer cells could be inducing angiogenin for inhibiting apoptotic pathways. However, the mechanism of cell survival and apoptosis regulation by angiogenin and their functional significance in cancer is not known. We demonstrate that angiogenin interacts with p53 and colocalizes in the nucleus. Silencing endogenous angiogenin induced p53 promoter activation and p53 target gene (p53, p21 and Bax) expression, down-regulated anti-apoptotic Bcl-2 gene expression and increased p53 mediated cell death. In contrast, angiogenin expression blocked pro-apoptotic Bax and p21 expression, induced Bcl-2 and blocked cell death. Angiogenin also co-immunoprecipitated with p53 regulator protein Mdm2. Angiogenin expression resulted in the inhibition of p53 phosphorylation, increased p53-Mdm2 interaction, and consequently increased ubiquitination of p53. Taken together these studies demonstrate that angiogenin promotes the inhibition of p53 function to mediate anti-apoptosis and cell survival. Our results reveal for the first time a novel p53 interacting function of angiogenin in anti-apoptosis and survival of cancer cells and suggest that targeting angiogenin could be an effective therapy for several cancers.

Self-referenced rectangular path cyclic interferometer with polarization phase shifting

A polarization phase shifting interferometer using a cyclic path configuration for measurement of phase nonuniformities in transparent samples is presented. A cube beam splitter masked by two linear polarizers is used to split the source wavefront into two counter propagating linearly polarized beams that pass through the sample. At the output of the interferometer, the two orthogonally polarized beams are rendered circularly polarized in the opposite sense through the use of a quarter wave plate. Finally, phase shifting is achieved by rotating a linear polarizer before the recording plane. In a rectangular path interferometer, although the two counter propagating wavefronts are laterally folded with respect to each other in the interferometer arms, the beams finally emerge mutually unfolded at the output of the interferometer. This phenomenon is utilized to create a reference if the sample is introduced in one lateral half of the beam in any one of the interferometer arms. The polarization phase shifting technique is used to generate four phase-shifted interferograms, which are utilized to evaluate the phase profile of the phase sample. Experimental results presented validate the proposed technique.

Prevalence and causes of low birth weight in India

INTRODUCTION

The aims of the study are (i) to understand inter-zone and interstate variation of low birth weight (LBW) and (ii) to determine the key variables to reduce LBW in India.

METHODS

Using the latest National Family Health Survey (NFHS) data of 2005-06 which showed the percentage distribution of LBW infants, ANOVA and post-hoc test were performed to determine the spatial variation of birth weight. The covariates which influence LBW fell into three categories: (i) social variables which included location, mother's education, religion, access of mothers to newspapers, television and family structure; (ii) economic variable namely, the wealth index, and (iii) biological variables which consisted of sex of the children, birth order, and mother's body mass index (BMI). Three models of Logistic regression were carried out to examine the influence of the combinations of these direct and indirect factors.

RESULTS

In India, nearly 20% of new borns have LBW. Males have less frequency of LBW than females. The North-east zone has the lowest prevalence of LBW while the north zone has the highest. Mother's education, access to TV and nuclear family, and intake of iron tablets are the most important socio-economic influences on the determination of birth weight in India.

CONCLUSION

It is essential to provide proper diet and nutritional care of mothers during pregnancy. Increased education of mothers through programmes in TV and newspapers articles have significant roles to play in reducing LBW in India.

Adsorption kinetics of a fluorescent dye in a long chain fatty acid matrix

This work reports the adsorption kinetics of a highly fluorescent laser dye rhodamine B (RhB) in a preformed stearic acid (SA) Langmuir monolayer. The reaction kinetics was studied by surface pressure-time (π-t) curve at constant area and in situ fluorescence imaging microscopy (FIM). Increase in surface pressure (at constant area) with time as well as increase in surface coverage of monolayer film at air-water interface provide direct evidence for the interaction. ATR-FTIR spectra also supported the interaction and consequent complexation in the complex films. UV-vis absorption and Fluorescence spectra of the complex Langmuir-Blodgett (LB) films confirm the presence of RhB molecules in the complex films transferred onto solid substrates. The outcome of this work clearly shows successful incorporation of RhB molecules into SA matrix without changing the photophysical characteristics of the dye, thus making the dye material as LB compatible.

QRDR mutations, efflux system & antimicrobial resistance genes in enterotoxigenic Escherichia coli isolated from an outbreak of diarrhoea in Ahmedabad, India

BACKGROUND & OBJECTIVES

Diverse mechanisms have been identified in enteric bacteria for their adaptation and survival against multiple classes of antimicrobial agents. Resistance of bacteria to the most effective fluoroquinolones have increasingly been reported in many countries. We have identified that most of the enterotoxigenic Escherichia coli (ETEC) were resistant to several antimicrobials in a diarrhoea outbreak at Ahmedabad during 2000. The present study was done to identify several genes responsible for antimicrobial resistance and mobile genetic elements in the ETEC strains.

METHODS

Seventeen ETEC strains isolated from diarrhoeal patients were included in this study. The antimicrobial resistance was confirmed by conventional disc diffusion method. PCR and DNA sequencing were performed for the identification of mutation in the quinolone resistance-determining regions (QRDRs). Efflux pump was tested by inhibiting the proton-motive force. DNA hybridization assay was made for the detection of integrase genes and the resistance gene cassettes were identified by direct sequencing of the PCR amplicons.

RESULTS

Majority of the ETEC had GyrA mutations at codons 83 and 87 and in ParC at codon 80. Six strains had an additional mutation in ParC at codon 108 and two had at position 84. Plasmid-borne qnr gene alleles that encode quinolone resistance were not detected but the newly described aac(6')-Ib-cr gene encoding a fluoroquinolne-modifying enzyme was detected in 64.7 per cent of the ETEC. Class 1 (intI1) and class 2 (intI2) integrons were detected in six (35.3%) and three (17.6%) strains, respectively. Four strains (23.5%) had both the classes of integrons. Sequence analysis revealed presence of dfrA17, aadA1, aadA5 in class 1, and dfrA1, sat1, aadA1 in class 2 integrons. In addition, the other resistance genes such as tet gene alleles (94.1%), catAI (70.6%), strA (58.8%), bla TEM-1 (35.2%), and aphA1-Ia (29.4%) were detected in most of the strains.

INTERPRETATION & CONCLUSIONS

Innate gene mutations and acquisition of multidrug resistance genes through mobile genetic elements might have contributed to the emergence of multidrug resistance (MDR) in ETEC. This study reinforces the necessity of utilizing molecular techniques in the epidemiological studies to understand the nature of resistance responsible for antimicrobial resistance in different species of pathogenic bacteria.

Dynamic 'Spot Sign' Resolution following INR Correction in a Patient with Warfarin-Associated Intracerebral Hemorrhage

Hematoma expansion in intracerebral hemorrhage is associated with poor clinical outcome. The ‘spot sign’ is a radiological marker that is associated with hematoma expansion, and thought to represent active extravasation of contrast. This case demonstrates the use of dynamic CT angiography in identifying the time-dependent appearance of a spot sign in a patient with warfarin-associated intracerebral hemorrhage. Repeat imaging is also presented which verified cessation of the spot sign after INR correction.

Emergence and present status of Lu-177 in targeted radiotherapy: the Indian scenario

177Lu is presently considered to be a potential radionuclide for the development of agents for radionuclide therapy owing to its favorable nuclear decay characteristics [T 1/2 = 6.65 d, E β(max) = 0.497 MeV, E γ = 113 KeV (6.4%) and 208 KeV (11%)]. While the long half-life of this promising radioisotope offers distinct logistic advantage, particularly, in countries having limited reactor facilities, the feasibility of its large-scale production with adequate specific activity and excellent radionuclidic purity in medium flux research reactors constitute yet another desirable feature. Extensive studies have been carried out to optimize the production of this isotope, with high specific activity and radionuclidic purity by the (n,γ) route using the highest available flux and the optimum irradiation time. The gradual evolution of clin ical grade 177LuCl3 as a new radiochemical, ready for commercial deployment by Radiopharmaceuticals Division, Bhabha Atomic Research Centre, to nuclear medicine centers all over India was accomplished in 2010 in a stepwise manner with the commencement of the production of high specific activity 177Lu from enriched target in 2001. Research on 177Lu has demonstrated its immense potential in radiotherapeutic applications, a direct outcome of which has resulted in indigenous development of two agents viz. 177Lu-EDTMP and 177Lu-DOTA-TATE presently being evaluated in human patients for palliative care of bone pain due to skeletal metastases and treatment of malignancies of neuroendocrine origin, respectively. Using locally produced 177Lu, the radiolabeling of a plethora of other molecules with potential applicability in radiation synovectomy and targeted therapy of malignant tumors have been successfully demonstrated. A few of these agent such as a novel 177Lu-labeled porphyrin has shown considerable promise in initial studies and is presently evaluated. In the present article, our research efforts toward standardization of production methodology of 177Lu in high specific activity and its utilization in the devel opment of agents for targeted radiotherapy are being reported.

Can point doses predict volumetric dose to rectum and bladder: a CT-based planning study in high dose rate intracavitary brachytherapy of cervical carcinoma?

OBJECTIVE

Point doses, as defined by the International Commission on Radiation Units and Measurements (ICRU), are classically used to evaluate doses to the rectum and bladder in high dose rate intracavitary brachytherapy (HDR-ICBT) in cervical cancer. Several studies have shown good correlation between the ICRU point doses and the volumetric doses to these organs. In the present study we attempted to evaluate whether this correlation could be used to predict the volumetric doses to these organs.

METHODS

A total of 150 HDR-ICBT insertions performed between December 2006 and June 2008 were randomly divided into two groups. Group A (n=50) was used to derive the correlation between the point and volumetric doses using regression analysis. This was tested in Group B (n=100) insertions using studentised residuals and Bland-Altman plots.

RESULTS

Significant correlations were obtained for all volumetric doses and ICRU point doses for rectum and bladder in Group A insertions. The strongest correlation was found for the dose to 2 cc volumes (D(2cc)). The correlation coefficients for bladder and rectal D(2cc) versus the respective ICRU point doses were 0.82 and 0.77, respectively (p<0.001). Statistical validation of equations generated in Group B showed mean studentised residual values of 0.001 and 0.000 for the bladder and rectum. However, Bland-Altman analysis showed that the error range for these equations for bladder and rectum were ±64% and ±41% of the point A dose, respectively, which makes these equations unreliable for clinical use.

CONCLUSION

Volumetric imaging is essential to obtain proper information about volumetric doses.

Second primary cancers and their prognostic significance in patients with renal cell carcinoma

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Background: To study the overall and site specific risk and prognostic significance of second primary cancers (SPC) in patients diagnosed with renal cell carcinoma (RCC).

Methods: The Surveillance Epidemiology and End Results (SEER) database was queried for all patients with RCC as the first cancer and one or more SPC (1973-2006). SPC diagnosed within 1 month of diagnosis of RCC or at autopsy/death were excluded. Deidentified information was obtained to analyze the effect of SPC on overall survival (OS) of RCC patients.

Results: A total of 3,795 patients with RCC and ≥ 1 SPC were identified. The ratio of observed/expected cases (O/E ratio) of RCC and ≥ 1 SPCs was 1.18 (95% C.I. 1.15-1.22), significantly greater than the general population (p<0.05). The overall age-adjusted rate of SPC was 0.6 per 100,000 and rate of SPCs was higher in males and in blacks. The O/E ratio of SPCs was significantly higher in younger patients (6.6 vs. 1.3 and 1.13 for those aged <30, 30-59 and ≥60 yrs respectively), in blacks (1.38 vs. 1.15 in whites), for larger tumors (1.3, 1.2 and 1.05 for tumors <5cm, 5-<10cm and ≥10cm in diameter), and those who did not receive radiation. The risk was similar for both genders. There was variation in the site-specific risk of SPC depending on age at time of RCC diagnosis, gender, race, size of the tumor and presence or lack of radiation therapy. Patients with SPC had longer OS than those with RCC as the only primary tumor on univariate but not multivariate analysis. Older age (≥60yrs), radiation therapy, and a short interval (<12 mo) between the diagnosis of RCC and a SPC were associated with significantly shorter OS in RCC patients with SPC on multivariate analysis.

Conclusions: Our comprehensive analysis of SPCs in patients with RCC as the first primary malignancy using SEER data suggests that about 10% of RCC patients develop SPC and that several patient, tumor and treatment-related factors affect the risk of SPC at specific sites. Further, SPC can adversely influence the prognosis of patients with RCC, especially those >60 years old, receiving radiation or diagnosed with a SPC within 1 year after RCC diagnosis. These results may have significance in planning surveillance strategies to improve the survival of patients with RCC.

No significant financial relationships to disclose.

Activated KrasG¹²D is associated with invasion and metastasis of pancreatic cancer cells through inhibition of E-cadherin

Background:

Pancreatic cancer (PC) harbours an activated point mutation (Kras^G12D) in the Kras proto-oncogene that has been demonstrated to promote the development of PC.

Methods:

This study was designed to investigate the effect of the oncogenic Kras^G12D allele on aggressiveness and metastatic potential of PC cells. We silenced the oncogenic Kras^G12D allele expression in CD18/HPAF and ASPC1 cell lines by stable expression of shRNA specific to the Kras^G12Dallele.

Results:

The Kras^G12D knockdown cells exhibited a significant decrease in motility (P<0.0001), invasion (P<0.0001), anchorage-dependent (P<0.0001) and anchorage-independent growth (P<0.0001), proliferation (P<0.005) and an increase in cell doubling time (P<0.005) in vitro and a decrease in the incidence of metastases upon orthotopic implantation into nude mice. The knockdown of the Kras^G12D allele led to a significant increase in the expression of E-cadherin (mRNA and protein) both in vitro and in vivo. This was associated with a decrease in the expression of phoshpo-ERK-1/2, NF-κB and MMP-9, and transcription factors such as δEF1, Snail and ETV4. Furthermore, the expression of several proteins involved in cell survival, invasion and metastasis was decreased in the Kras^G12D knockdown cells.

Conclusions:

The results of this study suggest that the Kras^G12D allele promotes metastasis in PC cells partly through the downregulation of E-cadherin.

Dynamic nature of the CT angiographic "spot sign"

The "spot sign", first described in 2007, has shown that a focal area of contrast extravasation within an intracerebral haematoma (ICH) can be correlated with haematoma expansion. We describe a case where time-resolved dynamic CT angiography (dCTA) shows the appearance of the "spot sign" only in later images. This finding highlights the importance of timing of the static CT angiogram which, if performed too early, might result in a false-negative diagnosis.

Heavy metal uptake and its effect on macronutrients, chlorophyll, protein, and peroxidase activity of Paspalum distichum grown on sludge-dosed soils. Heavy metal uptake and its effect on P. distichum

This study assessed the heavy metal (Cr, Mn, Ni, Cu, Zn, and Pb) uptake and its effect on biochemical parameters in Paspalum distichum, a wetland plant. Sludge collected from Bhalswa waste dump, New Delhi, was used as heavy metal source and dosed in different proportions viz. 20%, 40%, 60%, and 80% to the garden soil. The plants accumulated metals mostly in belowground organs. The metal accumulation followed the order: Cr>Mn>Cu>Zn>Ni>Pb. The range of heavy metal concentration in tissue of belowground organs after 180 days of growth was 1,778.65-4,288.01 ppm Cr, 828.11-1,360 ppm Mn, 236.52-330.07 ppm Ni, 155.79-282.35 ppm Cu, 27.05-91.16 ppm Zn, and 27.09-50.87 ppm Pb. The biochemical parameters viz. chlorophyll and protein contents and peroxidase (POD) activity exhibited no considerable adverse effect indicating the plants' tolerance towards heavy metals. The high POD activity and synthesis of new protein bands at high sludge-dosed plants were also in support of this fact.

Effect of nano-clay platelets on the J-aggregation of thiacyanine dye organized in Langmuir-Blodgett films: a spectroscopic investigation

In this paper we report the effect of the incorporation of nano-dimensional clay platelets, laponite, on the J-aggregation of a thiacyanine dye N,N'-dioctadecyl thiacyanine perchlorate (NK) assembled into Langmuir-Blodgett (LB) monolayers. pi-A isotherms and atomic force microscopic studies confirm the successful incorporation of clay platelets into the Langmuir monolayer of NK. J-aggregates of NK remain present in LB films lifted at lower as well as higher surface pressures in the absence of laponite clay platelets. However, with the incorporation of clay platelets, J-aggregates are formed only in LB films lifted at higher surface pressure of 30 mN/m and totally absent in the films lifted at lower surface pressures of 10 and 15 mN/m. This may be due to the formation of nano-trapping level by overlapping of clay platelets at higher surface pressure. NK molecules may get squeezed to these nano-trapping to form J-aggregates.

Cerebral haemorrhage from a remote varix in the venous outflow of an arteriovenous malformation treated successfully by embolisation

We describe a case of intracerebral haemorrhage in the temporal lobe arising from a distal varix related to the venous outflow of an ipsilateral frontal arteriovenous malformation (AVM). AVM itself and associated arterial aneurysms are well-known risk factors for haemorrhage. In this patient, haemorrhage had occurred from a distal varix. This is the first reported case of successful endovascular embolisation of a frontal AVM with spontaneous regression of an associated remote varix. [corrected].

Fusarium culmorum is a single phylogenetic species based on multilocus sequence analysis

Fusarium culmorum is a major pathogen of wheat and barley causing head blight and crown rot in cooler temperate climates of Australia, Europe, West Asia and North Africa. To better understand its evolutionary history we partially sequenced single copy nuclear genes encoding translation elongation factor 1-α (TEF), reductase (RED) and phosphate permease (PHO) in 100 F. culmorum isolates with 11 isolates of Fusarium crookwellense, Fusarium graminearum and Fusarium pseudograminearum. Phylogenetic analysis of multilocus sequence (MLS) data using Bayesian inference and maximum parsimony analysis showed that F. culmorum from wheat is a single phylogenetic species with no significant linkage disequilibrium and little or no lineage development along geographic origin. Both MLS and TEF and RED gene sequence analysis separated the four Fusarium species used and delineated three to four groups within the F. culmorum clade. But the PHO gene could not completely resolve isolates into their respective species. Fixation index and gene flow suggest significant genetic exchange between the isolates from distant geographic regions. A lack of strong lineage structure despite the geographic separation of the three collections indicates a frequently recombining species and/or widespread distribution of genotypes due to international trade, tourism and long-range dispersal of macroconidia. Moreover, the two mating type genes were present in equal proportion among the F. culmorum collection used in this study, leaving open the possibility of sexual reproduction.

Biodegradation of phenol by native microorganisms isolated from coke processing wastewater

The present investigation was undertaken to assess the biodegradation of phenol by native bacteria strains isolated from coke oven processing wastewater. The strains were designated ESDSPB1, ESDSPB2 and ESDSPB3 and examined for colony morphology Gram stain characters and biochemical tests. Phenol degrading performance of all the strains was evaluated initially. One of the strains namely ESDSPB2 was found to be highly effective for the removal of phenol, which was used as sole carbon and energy source. From an initial concentration of 200 mg I(-1) it degraded to 79.84 +/- 1.23 mg l(-1). In turn the effect of temperature (20 to 45 degrees C), pH (5-10) and glucose concentration (0, 0.25 and 0.5%) on the rate of phenol degradation by that particular strain was investigated. Observations revealed that the rate of phenol biodegradation was significantly affected by pH, temperature of incubation and glucose concentration. The optimal conditions for phenol removal were found to be pH of 7 (84.63% removal), temperature, 30 degrees C (76.69% removal) and 0.25% supplemented glucose level (97.88% removal). The main significance of the study is the utilization of native bacterial strains from the waste water itself having potential of bioremediation.

Using an automated recruitment process to generate an unbiased study sample of multiple sclerosis patients

The objective of this study was to test the efficiency of an automated recruitment methodology developed as a component of a practical controlled trial to assess the benefits of a Web-based personal health site to guide self-management of multiple sclerosis symptoms called Mellen Center Care On-line. We describe the study's automated recruitment methodology using clinical and administrative databases and assess the comparability between subjects who completed informed consent (IC) forms, and individuals who were invited to participate but did not reply, designated as patient nonresponders (PNR). The IC and PNR groups were compared on demographics, number of physician or advanced practice nurse/physician assistant visits during the 12 months prior to the initial invitation, and level of disability as measured by the Charlson Comorbidity Index (CCI). Out of a total dynamic potential pool of 2,421 patients, 2,041 had been invited to participate, 309 had become ineligible to participate during the study, and 71 individuals remained in the pool at the end of recruitment. The IC group had a slightly greater proportion of females. Both groups were predominantly white with comparable marital status. The groups had comparable mean household income, education level, and commercial insurance. The computed mean CCI was similar between the groups. The only significant difference was that the PNR group had fewer clinic visits in the preceding 12 months. The subjects were highly representative of the target population, indicating that there was little bias in our selection process despite a constantly changing pool of eligible individuals.

Isolation of a bacteriophage specific for CS7-expressing strains of enterotoxigenic Escherichia coli

Enterotoxigenic Escherichia coli (ETEC) is the most common bacterial cause of childhood diarrhoea in Bangladesh. Among the virulence factors of ETEC, toxins and colonization factors (CFs) play a major role in pathogenesis. Unlike Vibrio cholerae, the relationship between ETEC and ETEC-specific phages is poorly understood and the possible role of ETEC phages in the evolution of ETEC strains in the environment is yet to be established. This study was designed specifically to isolate phages that are specific for ETEC virulence factors. Among the 49 phages isolated from 12 different surface water samples, 13 were tested against 211 ETEC strains collected from clinical and environmental sources. One phage, designated IMM-001, showed a significant specificity towards CS7 CF as it attacked all the CS7-expressing ETEC. Electron microscopic analyses showed that the isolated phage possessed an isomeric hexagonal head and a long filamentous tail. An antibody blocking method and phage neutralization assay confirmed that CS7 pilus is required for the phage infection process, indicating the role of CS7 fimbrial protein as a potential receptor for IMM-001. In summary, this study showed the presence of a lytic phage in environmental water that is specific for the CS7 CF of ETEC.

Optical-ellipsometric study of the nematic-to-smectic transition in 8CB films adsorbed on silicon

The nematic-to-smectic-A (NA) transition in 8CB (4-octyl-4'-cyanobiphenyl) is especially interesting because experimentally, it has been observed to be second order, but theoretically, it has been predicted that it must have a latent heat. The effect on the NA transition due to confinement in an adsorbed film has hitherto not been investigated. Previous study of adsorbed 8CB films on silicon for coverages less than 100 nm showed the existence of a broad coexistence region, identified by the formation of thick and thin islands on the surface that extends between the bulk NA and the isotropic-to-nematic transition temperatures. In this paper, optical and ellipsometric measurements of 8CB films as a function of temperature are used to identify the location of the NA transition in the film in relation to the coexistence region. The NA transition temperature in the film is found to occur at 32.2+/-0.4 degrees C independent of film thickness for films between 62 to 270 nm thick, based on the decrease in the film anisotropy. This decrease in the anisotropy is found to be surprisingly abrupt. For thicknesses below 62 nm, the NA transition line is joined to the thin-thick coexistence region found previously.

Fluorescence Resonance Energy Transfer between organic dyes adsorbed onto nano-clay and Langmuir-Blodgett (LB) films

In this communication we investigate two dyes N,N'-dioctadecyl thiacyanine perchlorate (NK) and octadecyl rhodamine B chloride (RhB) in Langmuir and Langmuir-Blodgett (LB) films with or with out a synthetic clay laponite. Observed changes in isotherms of RhB in absence and presence of nano-clay platelets indicate the incorporation of clay platelets onto RhB-clay hybrid films. AFM images confirm the incorporation of clay into hybrid films. FRET is observed in clay dispersion and LB films with and without clay. Efficiency of energy transfer is maximum in LB films with clay.

A novel [109Pd] palladium labeled porphyrin for possible use in targeted radiotherapy

The preferential accumulation of porphyrins in malignant tumor cells has been adequately documented. Hence, porphyrin derivatives radiolabeled with a suitable therapeutic radionuclide could be envisaged as potential agents for targeted tumor radiotherapy. Working in this direction, we have radiolabeled a porphyrin derivative, namely, 5,10,15,20-tetrakis[3,4-bis(carboethoxymethyleneoxy)phenyl]-porphyrin, synthesized in-house, with 109Pd [E β(max)=1.12 MeV, E γ=88 keV 3.6(%), T 1/2 = 13.7 h]. The envisaged rationale towards designing of this agent is based on the assumption that 109Pd would complex with the tetrapyrrole donor array constituting the porphyrin core, thereby providing a highly stable chelated complex, and the peripheral ester groups would impart optimum lipophilicity needed for sufficiently high tumor accumulation and retention therein. 109Pd was produced with a specific activity of ∼1.85 GBq/mg and radionuclidic purity of 100% by the thermal neutron bombardment of enriched (98% in 108Pd) metallic Pd target at a flux of 3×1013 n/cm2s1 for 3 d. The porphyrin derivative was synthesized by a multi-step reaction and characterized by normal spectroscopic techniques. 109Pd complex of the synthesized porphyrin derivative was prepared with excellent radiochemical purity (>98%) and the complex was observed to be stable upto 24 h at room temperature. Biodistribution studies carried out in Swiss mice bearing fibrosarcoma tumors revealed good tumor uptake [(5.28±1.46)% injected activity (IA)/g] within 30 min post-injection (p.i.). The complex exhibited favorable tumor/blood and tumor/muscle ratios [1.69±0.23 and 5.00±1.54, respectively at 3 h p.i.], albeit with high liver uptake throughout the time of study (>20% IA).

Biological and molecular characterization of a begomovirus associated with yellow mosaic vein mosaic disease of pumpkin from Northern India

The biological and molecular properties of Squash leaf curl China virus from Varanasi, India (SLCCNV-IN[IN:Var:Pum]) were characterized. SLCCNV-IN[IN:Var:Pum] could be transmitted by grafting and through whitefly transmission. The complete DNA-A and DNA-B components were amplified through PCR using specific DNA-A and DNA-B primers. The DNA-A of the isolate was comprised of 2,738 nucleotides, encoding typical six open reading frames, and DNA-B of 2,704 nucleotides, encoding two ORFs. Genome organization of the isolate was typical of an old world bipartite begomovirus. Comparisons showed that DNA-A and its intergenic region have the highest sequence identity (97.6 and 97.4%, respectively) with the SLCCNV-IN[IN:Luc:Pum]; (DQ026296). This data suggested that the isolate is a same begomovirus species for which the name Squash leaf curl China virus-India[India:Varanasi:Pumpkin] is proposed. DNA-B showed maximum sequence identity (89.2%) with SLCCNV-IN[IN:Coi:Pum] (AY184488). Phylogenetic analysis of the present isolate showed close relationship to other cucurbit-infecting geminiviruses. This is the first evidence of occurrence of the bipartite Squash leaf curl China virus associated with severe yellow mosaic disease of pumpkin in northern India.

A New Begomovirus Species Causing Tomato Leaf Curl Disease in Patna, India

During December of 2007, a severe leaf curl disease of tomato (ToLCD) occurred in tomato-growing areas in the Patna District of Bihar, India. Viral DNA was isolated from symptomatic tomato plants (2) and begomovirus association was confirmed by PCR using DNA-A degenerate primers (3). Isolated viral DNA was restricted with KpnI and full-length genome was cloned in pUC18. DNA-β was amplified using degenerate primers (1) and cloned in pTZ57RT. Partial tandem repeats of viral genome and DNA-β could infect Nicotiana benthamiana and tomato through Agrobacterium-mediated inoculation. Infected test plants exhibited typical symptoms characteristic of ToLCD. Full-length viral genome (GenBank Accession No. EU862323) consists of 2,752 nt and showed the highest identity (85.8%) with Tomato leaf curl Laos virus-[Laos] (GenBank Accession No. AF195782). The satellite DNA-β component (GenBank Accession No. EU862324) consists of 1,349 nt and showed the highest identity (75.8%) with Tomato leaf curl Joydebpur betasatellite (GenBank Accession No. AJ966244). On the basis of the ICTV species demarcation criteria of 89% of DNA-A sequence identity, the present isolate was considered as a new begomovirus species and named Tomato leaf curl Patna virus (ToLCPaV). Since the isolated DNA-β satellite shares less than 78% identity, it is considered a new species of betasatellite and the name, Tomato leaf curl Patna betasatellite (ToLCPaB) is proposed. These results show that severe ToLCD in Patna is caused by a newly identified species of begomovirus and betasatellite. References: (1) R. W. Briddon et al. Mol. Biotechnol 20:315, 2002. (2) S. Chakraborty et al. Phytopathology 93:1485, 2003. (3) S. D. Wyatt and J. K. Brown. Phytopathology 86:1288, 1996.

Generation of Bessel beams using a terahertz quantum cascade laser

We report the generation of Bessel beams using polytetrafluoroethene conical lenses and a quantum cascade laser emitting at 2.8 THz. The formation of a central beam spot that retains its size over distances exceeding the characteristic Rayleigh range is demonstrated, and the power transport properties of these beams are compared with those obtained using parabolic reflectors. These lenses could provide an attractive alternative to parabolic reflectors for terahertz imaging applications where a large depth of focus and/or efficient and controllable coupling of radiation onto a small target are desirable.

Cervical spine motion during flexible bronchoscopy compared with the Lo-Pro GlideScope

BACKGROUND

The most appropriate device for tracheal intubation in patients with potential cervical spine injury remains controversial. We hypothesized that the Lo-Pro GlideScope (LP-G) videolaryngoscope would not cause significantly greater cervical spine movement than fibreoptic bronchoscopy even in the non-immobilized spine.

METHODS

Twenty-eight healthy adults requiring intubation for radiographic procedures were randomized to either the LP-G or the flexible bronchoscope (FB) devices. Continuous fluoroscopy was used to assess cervical spine movement during tracheal intubation. The point of maximum movement was compared with baseline for change in angulation between Occiput (Occ)-C1, Occ-C2, Occ-C4, Occ-C5, C1-2, C2-4, and C4-5. Measurements were made by two independent observers. The change in angulation was also measured for tongue pull and jaw thrust, manoeuvres for enlarging the pharyngeal space, before FB intubation.

RESULTS

LP-G resulted in greater cervical extension compared with FB for every angle calculated, statistically significant between Occ-C1 (P<0.05), Occ-C2 (P<0.05), and Occ-C4 (P<0.01). Tongue pull resulted in significantly less cervical spine motion than FB intubation at Occ-C1, Occ-C2, Occ-C4, and Occ-C5 (P<0.05). When jaw thrust was added to tongue pull, there was a tendency for greater movement than FB intubation at Occ-C1, Occ-C2, and Occ-C3. This was statistically significant at Occ-C1 and Occ-C3 (P<0.05) for one of the two observers.

CONCLUSIONS

During intubation under general anaesthesia, LP-G resulted in greater cervical movement than FB when no cervical immobilization was used in adults without cervical disease. Airway manoeuvres performed before FB, especially jaw thrust, also resulted in cervical spine movement.

Vertebral artery dissection with a normal-appearing lumen at multisection CT angiography: the importance of identifying wall hematoma

BACKGROUND AND PURPOSE

CT angiography (CTA) is widely used and may be the only vascular imaging technique ordered for emergent evaluation of neurovascular disease. With thin-section multisection CTA, the resolution of vessel wall imaging has improved. We describe cases of acute vertebral artery dissection (VAD) in which the only abnormality on CTA was a characteristic thickening of the wall of the V3 portion of the vertebral artery (VA). The arterial lumen at the dissection site was normal in caliber. This type of dissection is easily overlooked if only lumen-opacifying studies such as contrast MR angiography (MRA) or conventional angiography are performed. We highlight the importance of recognizing this finding, the "suboccipital rind" sign, in the V3 portion, a segment commonly affected in VAD. The purpose of our study was to review the CTA imaging characteristics of patients with VAD in the V3 portion compared with normal controls.

MATERIALS AND METHODS

Our imaging data base was reviewed for cases of acute VAD and the presence of a "suboccipital rind" sign. A control group of 50 patients was randomly recruited from a group of patients undergoing CTA. The VA luminal diameter, the wall thickness (total diameter-luminal diameter), and the ratio of luminal diameter/total diameter were measured along 5 adjacent V3 segments and were compared between the 2 groups.

RESULTS

There was no evidence of luminal tapering or narrowing in the dissected VAs compared with controls (P = .1). The average wall thickness of the dissection group was 2.96 mm greater than that for the control group (P < .001; 95% confidence interval, 2.6-3.3). There was a significant difference in the ratio of lumen diameter/lumen+wall diameter in dissected segments compared with controls (P < .001).

CONCLUSIONS

Cross-sectional vascular imaging is often performed with multisection helical CTA for a variety of concerns, some without neurologic symptoms. Our study confirms that in cases of the "suboccipital rind" sign, the lumen appears normal in caliber, with wall thickening as the only imaging sign of VAD. In our center, this clinically occult VAD would influence management, with patients usually treated with antiplatelet agents. We caution against using only luminal-opacifying techniques such as contrast-enhanced MRA or conventional angiography to exclude VAD because they are limited in the evaluation of mural hematoma.

Phytoremediation efficiency of Portulaca tuberosa rox and Portulaca oleracea L. naturally growing in an industrial effluent irrigated area in Vadodra, Gujrat, India

Phytoremediation is a novel, solar-driven and cost-effective technology for the remediation of heavy metal contaminated environments through exploitation of plants ability to accumulate heavy metals in their harvestable shoot parts. In the present investigation, we collected plants of two species of Portulaca i.e. P. tuberosa and P. oleracea from field sites in Vadodra, Gujrat, India. At one site, field was being irrigated with industrial effluent while at other with tube well water. Analysis of heavy metals was performed in industrial effluent, tube well water, soils irrigated with them, and in different parts viz., roots, stem, leaves and flowers of the plant samples. Industrial effluent and soil irrigated with it had very high level of heavy metals (Fe, Zn, Cd, Cr and As) as compared to the tube well water and soil irrigated with that. Plants of both the species growing in effluent irrigated soils showed high accumulation of metals in all plant parts with the maximum being in roots and the least in flowers. Interestingly, both species of Portulaca hyperaccumulated more than one heavy metal viz., Cd, Cr and As. The total shoot concentrations (microg g(-1) dw) of Cd, Cr and As in P. tuberosa were 1,571, 7,957 and 3,118, respectively while in P. oleracea, these were 1,128, 7,552 and 2,476, respectively. Portulaca plants have good biomass and high regeneration potential; hence appear to be suitable for the remediation of effluent (metal) contaminated areas.

Isolation and characterization of high quality DNA from marine benthic macroalgae

The isolation of high quality DNA is essential for many molecular biology applications including polymerase chain reaction (PCR) and endonuclease restriction digestion based techniques. An easy and inexpensive protocol has been developed for extracting genomic DNA from seven species of algae viz. Lola capillaries, Enteromorpha intestinalis, Ulva lactuca and Rhizoclonium sp belonging to Chlorophyceae, Catenella nipae, Polysiphonia mollis belonging to Rhodophyceae and Dictyota ceylanica belonging to Phaeophyceae group were collected from the coastal regions of Sunderban delta in West Bengal, India dominantly growing on mud flats, bark of different mangrove trees, pneumatophores, stilt roots, concrete surfaces, wooden and bamboo poles, sides of the boats and other water vehicles inundated during high tides. The DNA was found suitable for restriction endonuclease digestion and PCR amplification with randomely amplified polymorphic DNA (RAPD) primers. The A260/A280 ratio of 1.15 0.14 to 1.94 indicated little contamination from proteins and polysaccharides. The PCR amplification with RAPD primers showed its suitability in PCR based techniques and the restriction digestion with Eco RV confirmed its suitability for hybridization based techniques. The protocol is equally good for isolating DNA from both fresh as well as preserved materials.

Comparison of arsenic concentrations in simultaneously-collected groundwater and aquifer particles from Bangladesh, India, Vietnam, and Nepal

One of the reasons the processes resulting in As release to groundwater in southern Asia remain poorly understood is the high degree of spatial variability of physical and chemical properties in shallow aquifers. In an attempt to overcome this difficulty, a simple device that collects groundwater and sediment as a slurry from precisely the same interval was developed in Bangladesh. Recently published results from Bangladesh and India relying on the needle-sampler are augmented here with new data from 37 intervals of grey aquifer material of likely Holocene age in Vietnam and Nepal. A total of 145 samples of filtered groundwater ranging in depth from 3 to 36 m that were analyzed for As (1-1000 mug/L), Fe (0.01-40 mg/L), Mn (0.2-4 mg/L) and S (0.04-14 mg/L) are compared. The P-extractable (0.01-36 mg/kg) and HCl-extractable As (0.04-36 mg/kg) content of the particulate phase was determined in the same suite of samples, in addition to Fe(II)/Fe ratios (0.2-1.0) in the acid-leachable fraction of the particulate phase. Needle-sampler data from Bangladesh indicated a relationship between dissolved As in groundwater and P-extractable As in the particulate phase that was interpreted as an indication of adsorptive equilibrium, under sufficiently reducing conditions, across 3 orders of magnitude in concentrations according to a distribution coefficient of 4 mL/g. The more recent observations from India, Vietnam and Nepal show groundwater As concentrations that are often an order of magnitude lower at a given level of P-extractable As compared to Bangladesh, even if only the subset of particularly reducing intervals characterized by leachable Fe(II)/Fe >0.5 and dissolved Fe >0.2 mg/L are considered. Without attempting to explain why As appears to be particularly mobile in reducing aquifers of Bangladesh compared to the other regions, the consequences of increasing the distribution coefficient for As between the particulate and dissolved phase to 40 mL/g for the flushing of shallow aquifers of their initial As content are explored.

Comparison of arsenic concentrations in simultaneously-collected groundwater and aquifer particles from Bangladesh, India, Vietnam, and Nepal

One of the reasons the processes resulting in As release to groundwater in southern Asia remain poorly understood is the high degree of spatial variability of physical and chemical properties in shallow aquifers. In an attempt to overcome this difficulty, a simple device that collects groundwater and sediment as a slurry from precisely the same interval was developed in Bangladesh. Recently published results from Bangladesh and India relying on the needle-sampler are augmented here with new data from 37 intervals of grey aquifer material of likely Holocene age in Vietnam and Nepal. A total of 145 samples of filtered groundwater ranging in depth from 3 to 36 m that were analyzed for As (1-1000 mug/L), Fe (0.01-40 mg/L), Mn (0.2-4 mg/L) and S (0.04-14 mg/L) are compared. The P-extractable (0.01-36 mg/kg) and HCl-extractable As (0.04-36 mg/kg) content of the particulate phase was determined in the same suite of samples, in addition to Fe(II)/Fe ratios (0.2-1.0) in the acid-leachable fraction of the particulate phase. Needle-sampler data from Bangladesh indicated a relationship between dissolved As in groundwater and P-extractable As in the particulate phase that was interpreted as an indication of adsorptive equilibrium, under sufficiently reducing conditions, across 3 orders of magnitude in concentrations according to a distribution coefficient of 4 mL/g. The more recent observations from India, Vietnam and Nepal show groundwater As concentrations that are often an order of magnitude lower at a given level of P-extractable As compared to Bangladesh, even if only the subset of particularly reducing intervals characterized by leachable Fe(II)/Fe >0.5 and dissolved Fe >0.2 mg/L are considered. Without attempting to explain why As appears to be particularly mobile in reducing aquifers of Bangladesh compared to the other regions, the consequences of increasing the distribution coefficient for As between the particulate and dissolved phase to 40 mL/g for the flushing of shallow aquifers of their initial As content are explored.

To dope Mn2+ in a semiconducting nanocrystal

It has been an outstanding problem that a semiconducting host in the bulk form can be doped to a large extent, while the same host in the nanocrystal form is found to resist any appreciable level of doping rather stubbornly, this problem being more acute in the wurtzite form compared to the zinc blende one. In contrast, our results based on the lattice parameter tuning in a Zn(x)Cd(1-x)S alloy nanocrystal system achieves approximately 7.5% Mn(2+) doping in a wurtzite nanocrystal, such a concentration being substantially higher compared to earlier reports even for nanocrystal hosts with the "favorable" zinc-blende structure. These results prove a consequence of local strains due to a size mismatch between the dopant and the host that can be avoided by optimizing the composition of the alloyed host. Additionally, the present approach opens up a new route to dope such nanocrystals to a macroscopic extent as required for many applications. Photophysical studies show that the quantum efficiency per Mn(2+) ion decreases exponentially with the average number of Mn(2+) ions per nanocrystal; en route, a high quantum efficiency of approximately 25% is achieved for a range of compositions.

Early diagnosis of pancreatic cancer: neutrophil gelatinase-associated lipocalin as a marker of pancreatic intraepithelial neoplasia

Pancreatic cancer is a highly lethal malignancy with a dismal 5-year survival of less than 5%. The scarcity of early biomarkers has considerably hindered our ability to launch preventive measures for this malignancy in a timely manner. Neutrophil gelatinase-associated lipocalin (NGAL), a 24-kDa glycoprotein, was reported to be upregulated nearly 27-fold in pancreatic cancer cells compared to normal ductal cells in a microarray analysis. Given the need for biomarkers in the early diagnosis of pancreatic cancer, we investigated the expression of NGAL in tissues with the objective of examining if NGAL immunostaining could be used to identify foci of pancreatic intraepithelial neoplasia, premalignant lesions preceding invasive cancer. To examine a possible correlation between NGAL expression and the degree of differentiation, we also analysed NGAL levels in pancreatic cancer cell lines with varying grades of differentiation. Although NGAL expression was strongly upregulated in pancreatic cancer, and moderately in pancreatitis, only a weak expression could be detected in the healthy pancreas. The average composite score for adenocarcinoma (4.26+/-2.44) was significantly higher than that for the normal pancreas (1.0) or pancreatitis (1.0) (P<0.0001). Further, although both well- and moderately differentiated pancreatic cancer were positive for NGAL, poorly differentiated adenocarcinoma was uniformly negative. Importantly, NGAL expression was detected as early as the PanIN-1 stage, suggesting that it could be a marker of the earliest premalignant changes in the pancreas. Further, we examined NGAL levels in serum samples. Serum NGAL levels were above the cutoff for healthy individuals in 94% of pancreatic cancer and 62.5% each of acute and chronic pancreatitis samples. However, the difference between NGAL levels in pancreatitis and pancreatic cancer was not significant. A ROC curve analysis revealed that ELISA for NGAL is fairly accurate in distinguishing pancreatic cancer from non-cancer cases (area under curve=0.75). In conclusion, NGAL is highly expressed in early dysplastic lesions in the pancreas, suggesting a possible role as an early diagnostic marker for pancreatic cancer. Further, serum NGAL measurement could be investigated as a possible biomarker in pancreatitis and pancreatic adenocarcinoma.

Avonex Combination Trial in relapsing—remitting MS: rationale, design and baseline data

Objective To review the rationale, design and baseline data of the Avonex Combination Trial (ACT), an investigator-run study of intramuscular interferon beta-1a (IM IFNβ-1a) combined with methotrexate (MTX) and/or IV methylprednisolone (IVMP) in relapsing—remitting multiple sclerosis (RRMS) patients with continued disease activity on IM IFNβ-1a monotherapy.

Methods Eligibility criteria included RRMS, Expanded Disability Status Scale score 0—5.5, and ≥1 relapse or gadolinium-enhancing MRI lesion in the prior year while on IM IFNβ-1a monotherapy. Subjects continued IFNβ-1a 30 mcg IM weekly and were randomized in a 2 × 2 factorial design to adjunctive weekly placebo or MTX 20 mg PO, with or without IVMP 1000 mg/day for three days every other month. ACT was industry-supported, and collaboratively designed and governed by an Investigator Steering Committee with independent Advisory and Data Safety Monitoring Committees. Study operations, MRI analysis and aggregated data were managed by the Cleveland Clinic MS Academic Coordinating Center.

Results In total 313 subjects were enrolled with clinical and MRI characteristics typical of RRMS. Most subjects (86.9%) qualified with a clinical relapse, with or without an enhancing MRI lesion, in the preceding year. At baseline, 21.4% had enhancing lesions, and 5.1% had anti-IFNβ neutralizing antibodies. ACT's management and operational structures functioned well.

Conclusion This study provides an innovative model for academic—industry collaborative MS research and will enhance understanding of the utility of combination therapy for RRMS patients with continued disease activity on an established first-line treatment. Multiple Sclerosis 2008; 14: 370—382. http://msj.sagepub.com