BKV in Simultaneous Pancreas-Kidney Transplant Recipients: A Leading Cause of Renal Graft Loss in First 2 Years Post-Transplant

With the introduction of more potent immunosuppressive agents, rejection has decreased in simultaneous pancreas/kidney transplant (SPK) recipients. However, as a consequence, opportunistic infections have increased. The purpose of this report is to outline the course of SPK patients who developed polyomavirus-associated nephropathy (PVAN). A retrospective review of 146 consecutive SPK recipients from January 1, 1996 to December 31, 2002 was performed. Immunosuppression, rejection and development of PVAN were reviewed. Nine patients were identified. All received induction with either OKT3 or thymoglobulin. Immunosuppression included tacrolimus/cyclosporine, MMF/azathioprine and sirolimus/prednisone. Two patients were treated for kidney rejection prior to the diagnosis of PVAN. Time to diagnosis was an average of 359.3 days post-transplantation. Immunosuppression was decreased but five ultimately lost function. However, none developed pancreatic abnormalities as demonstrated by normal glucose and amylase. Two underwent renal retransplantation after PVAN diagnosis and both have normal kidney function. PVAN was the leading cause of renal loss in SPK patients in the first 2 years after transplantation and is a serious concern for SPK recipients. The pancreas, however, is spared from evidence of infection, and no pancreatic rejection occurred when immunosuppression was decreased.     

Radioprotective effect of podophyllotoxin in Saccharomyces cerevisiae.

Recent reports showed that whole extract of Podophyllum hexandrum was radioprotective in mice. Podophyllotoxin is one of the major constituents of the whole extract of Podophyllum. In this study we report on the radioprotective action of podophyllotoxin in Saccharomyces cerevisiae yeast. Proliferating yeast cells pretreated with podophyllotoxin (2.5-5.0 microg/mL) for > or =3 hours showed a higher surviving fraction after (60)Co-gamma-irradiation (200-600 Gy) than did the irradiated cells not pretreated with podophyllotoxin. The maximum increase (2.0 times) in surviving fraction was observed in cells treated with 2.5 microg/mL podophyllotoxin, 5 hours before (60)Co-gamma-irradiation (400 Gy). Podophyllotoxin was not mutagenic or recombinogenic at radioprotective doses (2.5 microg/mL). A post-irradiation decrease in revertants and gene convertants was observed in cells treated with podophyllotoxin (2.5 microg/mL podophyllotoxin, -5 hours, 400 Gy). This study indicates that podophyllotoxin is radioprotective in yeast, and its radioprotective effects in higher eukaryotes would be worth investigating.     

Characterization of a subtype of primary osteoclastoma: Extracellular calcium but not calcitonin inhibits aggressive HLA-DR-positive osteoclastoma possessing ‘functional’ calcitonin receptors

We report here a case of primary osteoclastoma that despite possessing HLA-DR-positive status and ‘functional’ calcitonin receptors, exhibited aggressive in vitro and in vivo bone resorptive activity. In the osteoclast bone slice assay employing scanning electron microscopy, the giant cell-mediated bone resorption was uninhibited by salmon calcitonin (10 nM) and significantly inhibited by raised extracellular calcium (20 mM). In Fura-2AM based microspectrofluorimetric assays, the presence of the ‘functional’ calcitonin receptors was ascertained by a rise in intracellular calcium induced by calcitonin and high extracellular calcium. These findings provide evidence for a hitherto unrecognized subtype of giant cells that have HLA-DR-positive status, exhibit avid bone resorptive activity, but remain insensitive to calcitonin despite possessing calcitonin receptors.     

Isolated pure lipoma of the uterus--a case report

Lipoma primary to uterus is a rare entity among uterine fatty tumors. These create preoperative diagnostic confusion and their histogenesis is still unclear. Only a few cases of pure lipoma of uterus have been reported in the last few decades. A case of isolated pure lipoma primary to uterus diagnosed postoperatively by pathological examination is presented.     

Cytological diagnosis of nonulcerative penile neoplasms: report of two cases

Nonulcerative penile mass lesions are rare. Pathological diagnosis of these lesions would traditionally be a biopsy. We report two such primary penile lesions which were diagnosed by fine-needle aspiration cytology (FNAC). Both lesions were present in the shaft and were diagnosed as squamous cell carcinoma (SCC). The first patient had a recurrence on the penile stump of partial amputation without any ulceration. The second had a primary urethral carcinoma on the terminal penile shaft infiltrating the corpora cavernosa dorsally. Open biopsies were avoided in both cases. FNAC was associated with very little and tolerable discomfort. There were no complications. The aspirate yield was sufficient for cytological diagnosis. FNAC of nonulcerated penile lesions is safe, well tolerated, and capable of providing a cytological diagnosis. Hence, it is a very useful outpatient procedure and could be the procedure of choice for diagnosis.     

Nutrition and health education through I.C.D.S

Summary results and discussion were provided for an Integrated Child Development Service (ICDS) survey of 52 anganwadi community workers (AWWs) and 156 mothers of ICDS beneficiary children. The project was implemented in Nelamangala, Bangalore, India, in order to ascertain the practices of mothers in managing diarrhea and respiratory infections and nutrition. The results would be applied to improving health education and developing appropriate and effective communication about nutrition and health between the AWW and the mother. The results of the AWWs survey showed that the 96.16% of AWWs had education up to the high school level and 2 graduated from high school. 69.2% weighed children correctly and 53.84% plotted growth charts satisfactorily. 53.50% of the 2507 growth charts were satisfactorily graphed. 94% reported weighing all children every month, however, the work load made this activity very difficult. Only 5.7% plotted the growth chart immediately after weighing. 38.46% found the visual record of growth good tool of health and nutrition education. 86.92% correctly identified a flattened curve as an indicator of growth failure. 71.15% were aware that additional feeding was needed. 17.30% suggested treatment with tonics and 3.84% suggested treatment for worm infestations. The responses from the mothers indicated that 51.92% were illiterate, agricultural laborers. 92% of mothers had a per capita income of less than Rs. 300/month. 86.53% were aware of the growth monitoring of the AWWS and 61% knew it was conducted monthly. 20.53% had participated in weighing sessions and 42% reported that AWWs explained the meaning of growth monitoring and the importance of weighing procedures. 28.84% reported that AWWs showed comparisons of present and previous weights and explained the significance. 38.64% considered the information meaningful, but only 3.84% could correctly interpret a flattened curve. 63.43% were misinformed about diarrhea causes and treatment. The recommendation was for use of arm circumference tapes for measuring malnutrition, for better training of AWWs in promoting extra feeding for malnutrition, for promoting continued breast feeding during diarrhea bouts, and discouraging use of over-the-counter drugs for treatment of respiratory infections.