Asterlingulatosides C and D, cytotoxic triterpenoid saponins from Aster lingulatus

Over the last few decades, European courses in which 'classical' tropical medicine (i.e. parasitology, entomology, and clinical aspects of tropical diseases) is taught have largely become anachronisms. Most countries in the tropics have their own medical schools and few have much need of expatriate doctors. There do, however, appear to be other ways in which Europeans may still help improve health in the tropics. One is to control the quality of the expatriate nurses who are still in demand in the tropics (often as cheaper, generally less demanding substitutes for doctors). This may be achieved by only training the best, insisting they spend some time after graduation gaining maturity before they leave for the tropics, ensuring they realise that their clinical skills will probably be inferior to their local counterparts in the tropics, and encouraging them to continue studying once abroad. The second way Europeans may help is to change the bias of their courses from teaching to training. There seems little doubt that the intellectual personalities of the brightest young men and women in the tropics often develop far better when they spend a period in a foreign environment, especially when they are allowed to function within a team, with trainees and trainers from other countries. Some 'international' courses may offer such benefits, especially if closely tailored to the needs of the trainees and their home countries.     

Eccrine syringofibroadenoma surrounding a squamous cell carcinoma: a case report

In adult mammals fever is associated with the reduction of blood plasma iron level. Immature mammals, however, show either a decrease (precocial animals such as guinea pig neonates) or a lack of reduction (altricial animals such as human neonates) of plasma iron in response to endotoxin. In order to determine whether this difference is connected with maturity just after delivery, plasma iron concentration, hematocrit, body temperature and body mass were measured in rat pups injected with E. coli endotoxin in doses of 50 or 200 micrograms kg-1. Rat pups, like human neonates, are altricial animals. In 7-day-old rats injection of LPS led to a dose-dependent decrease in plasma iron level. The fall in plasma iron was accompanied by changes in body temperature and body mass. The results showed that plasma iron response to endotoxin in altricial rat neonates is similar to that observed in precocial guinea pig pups.     

GM1 ganglioside administration partially counteracts the morphological changes associated with haloperidol treatment within the dorsal striatum of the rat

OBJECTIVE: To study the effectiveness of combining DNA ploidy and the blood-group related membrane antigen Tn as bladder tumour markers which have been individually associated with high tumour grade and poor prognosis. In particular to (i) determine whether use of these two markers would improve tumour detection compared with either alone, particularly of high grade disease and (ii) determine whether intermediate rates of marker expression would occur in bladder cancer patients with no current tumour compared with those with a tumour and a control group with benign prostatic hypertrophy. PATIENTS AND METHODS: A total of 102 patients undergoing cystoscopic monitoring for either benign prostatic hyperplasia (BPH) or for transitional cell carcinoma (TCC) at the Repatriation Hospital and Flinders Medical Centre were included in the study. The patients comprised three study groups, those with BPH (n = 37), with TCC but no tumour present (n = 38) and those with TCC and a tumour present at cystoscopy (n = 27). Exfoliated cells obtained from bladder washings at cystoscopy were double-labelled using a monoclonal antibody to the Tn antigen and a DNA stain, propidium iodide and examined by flow cytometry. RESULTS: Rates of marker expression in 27 patients with tumours were 30% for Tn antigen, 30% for aneuploidy and 48% for either marker. Marker expression was strongly associated with tumour grade, with no expression at grade 1, 38% (3/8) tumours at grade 2 and 90% (9/10) at grade 3. In patients with a history of bladder tumours but no current tumour, rates were intermediate (30%) compared with patients with current transitional cell carcinoma (42%) and control patients (19%). CONCLUSION: The use of Tn antigen combined with DNA flow cytometry can increase tumour detection, particularly of high grade, aggressive disease. Gradation of expression of these markers across patient groups at increasing risk of a tumour, with intermediate expression in patients with no current tumour, suggests that marker expression may be detecting a preneoplastic stage of the disease, which is not possible with cytology. Given two parallel disease processes for superficial papillary and for high grade disease with invasive potential, the expression of high grade tumour markers in cells from cystoscopically normal bladders may represent a pre-clinical stage of aggressive disease. The identification of patients at risk of invasive disease using combinations of tumour markers may offer advantages in clinical management, particularly when no tumour is present and therefore no histopathological assessment is made.     

Neurotoxicity of CI-980, a novel mitotic inhibitor

PURPOSE: To compare the simulated keratometric results of the PAR CTS and the EyeSys corneal imaging systems with Javal keratometer readings in keratoconus eyes, in eyes after corneal grafting, and in healthy eyes. SETTING: Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA. METHODS: This prospective study evaluated 69 patients divided into three groups (keratoconus; 6 to 12 months postkeratoplasty; normal corneas) treated at the cornea service. The eyes were measured with each of the three instruments. Keratometry results and number of attempts needed to obtain the results were collected. RESULTS: Thirty keratoconus, 18 transplanted, and 21 normal corneas were examined. The PAR CTS Imaged all corneas and the EyeSys, 86% (P = .000627). The PAR CTS and Javal flat and steep K-readings in all three groups were the same. The EyeSys simulated keratometry results were lower than those of Javal keratometer in the flat K (P < .00001) and steep K (P < .00001) in the normal group and in the steep K in the transplanted cornea group (P = .00823). The EyeSys also measured less astigmatism than the Javal in the normal (P = .00124) and transplanted cornea groups (P = .00376). CONCLUSION: The PAR CTS was better able than the EyeSys to provide keratometric values that agreed with those obtained with the Javal keratometer.     

Outcome in elderly injured patients: injury severity versus host factors

To evaluate the differences between the outcome of elderly patients with severe injuries and that of their contemporaries with a less severe injury, we reviewed 42 severely injured elderly patients and compared them with 76 patients with a femoral neck fracture. We analysed the influence of injury severity and host factors (age, sex and pre-injury medical status) on outcome. The in-hospital mortality rate was 31 per cent in the severely injured patients and 3 per cent in those with a femoral neck fracture. Home was the main discharge destination in the severely injured elderly (34 per cent) and a nursing home in patients with a femoral neck fracture (65 per cent). Functional outcome 1 year after injury was better in the severely injured elderly group. Long-term survival was mainly determined by host factors and not by injury severity. Physicians and policy makers should be careful in predicting the outcome of elderly injured patients merely on the basis of injury severity, because host factors are of greater importance.     

Use of 2'-fluoro-5-methyl-beta-L-arabinofuranosyluracil as a novel antiviral agent for hepatitis B virus and Epstein-Barr virus

A novel anti-hepatitis B virus (anti-HBV) agent, 2'-fluoro-5-methyl-beta-L-arabinofuranosyluracil (L-FMAU), was synthesized and found to be a potent anti-HBV and anti-Epstein-Barr virus agent. Its in vitro potency was evaluated in 2.2.15 and H1 cells for anti-HBV and anti-Epstein-Barr virus activities, respectively. In vitro cytotoxicity in MT2, CEM, 2.2.15, and H1 cells was also assessed, and the results indicated high antiviral selectivities of L-FMAU in these cells.