Laparoscopic staging in gallbladder cancer.

Purpose: Laparoscopy is beneficial in the staging of pancreatic and upper gastrointestinal malignancies but its role in gallbladder cancer has not been investigated. We evaluated the role of laparoscopy in the staging of gallbladder cancer.

Methods: From 1989 through 2001, 91 patients with gallbladder cancer, without any evidence of metastatic disease on imaging (ultrasound and/or computed tomographic scan), underwent staging laparoscopy.

Djinn Lite: a tool for customised gene transcript modelling, annotation-data enrichment and exploration.

Background: There is an ever increasing rate of data made available on genetic variation, transcriptomes and proteomes. Similarly, a growing variety of bioinformatic programs are becoming available from many diverse sources, designed to identify a myriad of sequence patterns considered to have potential biological importance within inter-genic regions, genes, transcripts, and proteins. However, biologists require easy to use, uncomplicated tools to integrate this information, visualise and print gene annotations.

Cycloxygenase-2 inhibition augments the efficacy of a cancer vaccine.

Tumor-derived cyclooxygenase-2 (COX-2) and its product, prostaglandin E2, exert strong immunoinhibitory effects that block dendritic cell function and CD4+ and CD8+ T-cell proliferation and function. We have shown previously that the addition of an oral COX-2 inhibitor to immunogene therapy using IFN-beta markedly augmented therapeutic efficacy in murine tumor models. In this study, we hypothesized that COX-2 inhibition might also augment an antitumor vaccination strategy.

Activation of tumor-associated macrophages by the vascular disrupting agent 5,6-dimethylxanthenone-4-acetic acid induces an effective CD8+ T-cell-mediated antitumor immune response in murine models of lung cancer and mesothelioma.

5,6-Dimethylxanthenone-4-acetic acid (DMXAA) is a small molecule in the flavanoid class that has antitumor activity thought to be due to ability to induce high local levels of tumor necrosis factor (TNF)-alpha that disrupt established blood vessels within tumors. The drug has completed phase 1 testing in humans and is currently in phase 2 trials in combination with chemotherapy. Although characterized as a "vascular disrupting agent," there are some studies suggesting that DMXAA also has effects on the immune system that are important for its efficacy.

Carrier frequency of F508del mutation of cystic fibrosis in Indian population.

Background: Cystic fibrosis (CF) is considered to be very rare in Indian subcontinent. Based on reports of CF in migrants from Indian subcontinent to United Kingdom and United States of America, the prevalence of CF is estimated to be between 1/10,000 and 1/40,000 in this ethnic group. The present study was done to estimate the carrier frequency of F508del mutation among neonates using cord blood samples to reflect the prevalence of CF in the study population.

Genetic immunization with LYVE-1 cDNA yields function-blocking antibodies against native protein.

LYVE-1 is a surface bound hyaluronic acid (HA) receptor that is preferentially expressed by lymphatic endothelial cells (LEC). cDNA encoding full-length human LYVE-1 was coated onto gold particles that were then delivered via helium-assisted jet propulsion (gene gun) into the skin of Balb/C mice. LYVE-1 antisera, but not control pre-immune sera, recognized LYVE-1-transfected 293T cells by flow cytometry.

Progressive cubitus varus due to a bony physeal bar in a 4-year-old girl following a supracondylar fracture: a case report.

We report a case of progressive cubitus varus deformity caused by a physeal bar following a supracondylar humeral fracture in a 4-year-old girl. Malreduction is thought to be the commonest cause of this deformity, which is nonprogressive. A corrective osteotomy in cases like ours should be deferred until skeletal maturity.

Lymphopenia and interleukin-2 therapy alter homeostasis of CD4+CD25+ regulatory T cells.

CD4(+)CD25(+) regulatory T (T(reg)) cells have a crucial role in maintaining immune tolerance. Mice and humans born lacking T(reg) cells develop severe autoimmune disease, and depletion of T(reg) cells in lymphopenic mice induces autoimmunity. Interleukin (IL)-2 signaling is required for thymic development, peripheral expansion and suppressive activity of T(reg) cells.

Gemcitabine selectively eliminates splenic Gr-1+/CD11b+ myeloid suppressor cells in tumor-bearing animals and enhances antitumor immune activity.

Purpose: Myeloid suppressor (Gr-1(+)/CD11b(+)) cells accumulate in the spleens of tumor-bearing mice where they contribute to immunosuppression by inhibiting the function of CD8(+) T cells and by promoting tumor angiogenesis. Elimination of these myeloid suppressor cells may thus significantly improve antitumor responses and enhance effects of cancer immunotherapy, although to date few practical options exist.

Experimental Design: The effect of the chemotherapy drug gemcitabine on the number of (Gr-1(+)/CD11b(+)) cells in the spleens of animals bearing large tumors derived from five cancer lines grown in both C57Bl/6 and BALB/c mice was analyzed.

Intrapulmonary IFN-beta gene therapy using an adenoviral vector is highly effective in a murine orthotopic model of bronchogenic adenocarcinoma of the lung.

Given previous work showing that an adenoviral vector expressing IFN-beta (Ad.IFNbeta) was highly effective in eradicating i.p.

Utilisation of redundant time on trauma list for carpal tunnel decompression.

This audit reviewed the trauma theatre time utilisation during April 2000 to March 2001. Instead of a scheduled 8 30 am start, first patient was on the table by only 9 40 am because of various reasons. To use this redundant time carpal tunnel release was started under local anaesthesia, as first case.

Flexible intramedullary nailing of displaced diaphyseal forearm fractures in children.

Introduction: This study analyses the results of 50 displaced diaphyseal forearm fractures in children treated with flexible intramedullary nailing.

Methods: Between 1999 and 2002 we treated 50 children aged between 5 and 15 years, with diaphyseal fractures of the forearm using Flexible intramedullary nailing (FIN). Both bones were fractures in 45 patients, radius only in 4 and ulna only in 1.

An audit of postoperative radiotherapy after non-curative resection for cancer of the oesophagus.

Aims: The role of postoperative radiotherapy (PORT) after non-curative resections for cancer oesophagus is not well defined. A policy of offering PORT after non-curative resections for cancer oesophagus has been followed at our institution, and we report an audit of our experience.

Material And Methods: Between March 1990 and September 2002, 139 patients underwent resections for cancer oesophagus.

Does the use of a flap during abdominoperineal resection decrease pelvic wound morbidity?

We hypothesized that the use of muscle flaps, known as tissue transfer (TT), at the time of abdominoperineal resection (APR) reduces perineal wound complications. A restrospective review of patients undergoing an APR at the University of Washington (1984-2003) was conducted. Perineal wound complications and eventual wound healing were compared in patients with and without TT.

Termination of psychotherapy: a training perspective.

Given the constraints of the prevailing mental health system in the United States, it has become very challenging for psychiatrists to offer psychotherapy services to patients in need of this modality of treatment. In spite of this situation, the profession has made a consistent effort not only to retain this type of psychiatric care but also to train psychiatric residents in this psychiatric intervention technique and its appropriate indications. In this article, the authors highlight a very important aspect of psychotherapy treatment-the termination phase.

Xanthogranulomatous cholecystitis: differentiation from associated gall bladder carcinoma.

Xanthogranulomatous cholecystitis (XGC) is a destructive form of chronic cholecystitis. In some patients it coexists with gall bladder carcinoma (GBC) and is often difficult to differentiate between the two. Present study was performed with an aim to identify differentiating features of XGC and those of XGC with associated Gall bladder carcinoma (XGC ass.

MUC 1 core protein as a marker of gallbladder malignancy.

Aim: The significance of MUC 1 expression in the gallbladder tissues in relation to cancer and non-cancer disease is not well understood. The aim of this study was to clarify the significance of MUC 1 expression.

Materials And Methods: A monoclonal antibody (CA 15--3; DF 3) was applied to stain MUC 1 core protein in surgical specimens.

Quantification of glycine and taurine conjugated bile acids in human bile using 1H NMR spectroscopy.

A simple method for quantification of conjugated bile acids in human bile using (1)H NMR spectroscopy is presented. Bile acids in human bile are essentially conjugated with either glycine or taurine. The amide NH resonances from the conjugated bile acids are invariably devoid of interfering signals in (1)H NMR spectra.

Bile leaks following surgery for hepatic hydatid disease.

Background: Conservative surgery (cyst evacuation and partial pericystectomy) for hydatid cysts of the liver is known to be safe but is often associated with bile leak and its sequelae.

Methods: Case records of 86 patients undergoing surgery for hydatid cysts of the liver at a tertiary-care center in northern India over a 14-year period were reviewed retrospectively.

Results: Sixteen (18%) patients had jaundice and 36 (42%) had a cyst-biliary communication detected at surgery.

Type IV-A choledochal cysts: a challenge.

Background/purpose: Type IV-A choledochal cysts are characterized by congenital cystic dilatation of the biliary tree extending to involve the intrahepatic biliary channels also. A single-center experience of the management of type IV-A choledochal cysts is presented.

Methods: Thirty-five out of 105 (33%) patients with choledochal cysts, who underwent surgery at a tertiary care center in northern India from January 1989 to December 2002, were found to have a type IV-A (Todani's classification) cyst.

Should laparoscopic cholecystectomy be performed in patients with thick-walled gallbladder?

Background/purpose: Laparoscopic cholecystectomy is the procedure of choice for patients with symptomatic cholelithiasis. This procedure is contraindicated in patients with gall-bladder cancer (GBC) because of fear of dissemination of the disease. One of the findings raising the suspicion of GBC is a thick-walled gallbladder (TWGB).