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Malakoplakia is a rare inflammatory condition seen in transplant patients. There are two previously reported cases of malakoplakia involving the gastrointestinal tract in liver transplant patients. The present paper reports a case of colonic malakoplakia in a 58-year-old woman, a liver transplant recipient who was receiving immunosuppressive drugs. She presented with chronic diarrhea while on tacrolimus. There was no history of antecedent infection. Colonoscopy showed patchy mucosal edema, but no discrete yellow plaques or nodules. The diagnosis was made by colon biopsies, which showed chronic inflammation with many histiocytes containing Michaelis-Gutmann bodies. Although rare, malakoplakia is one of many potential causes of diarrhea in a transplant patient. The present case indicates that malakoplakia may be associated with chronic diarrhea, even if there are no macroscopic lesions seen during colonoscopy.

This paper reports on a prospective observational study that evaluated the frequency of prosthetic infections after total knee arthroplasty. During a six-year observational period, 171 patients underwent knee arthroplasty. Single shot prophylaxis with teicoplanin was administered to all patients. Nine patients (5.3%) had a followup of less than four weeks; the remaining 162 had a follow-up of at least 12 weeks. Of these, 155 completed the 24-month observational period. In the end, three patients developed early prosthetic joint infection which produced infection rates of 1.85% and 1.93% when the follow-up was ≥12 weeks and ≥24 months, respectively. The mean time from surgery to infection was 54 days (range, 14–87). All three infections were caused by Staphylococcus aureus susceptible to methicillin. Fever, pain, effusion and secretion were present in all cases. In this cohort of patients, no cases of delayed infection were observed. Thorough reporting is the first step in reducing the incidence of post-surgical infective complications and can contribute to more productive prophylactic protocols.

Molecularly targeted cancer drugs are often developed with companion diagnostics that attempt to identify which patients will have better outcome on the new drug than the control regimen. Such predictive biomarkers are playing an increasingly important role in precision oncology. For diagnostic tests, sensitivity, specificity, positive predictive value, and negative predictive are usually used as performance measures. This paper discusses these indices for predictive biomarkers, provides methods for their calculation with survival or response endpoints, and describes assumptions involved in their use.

This paper reports the availability of a high-resolution atlas of the adult rat. The atlas is composed of 9475 cryosectional images captured in 4600 x 2580 x 24-bit TIFF format, constructed using serial cryosection-milling techniques. Cryosection images were segmented, labelled and reconstructed into three-dimensional (3D) computerized models. These images, 3D models, technical details, relevant software and further information are available at our website, http://vchibp.vicp.net/vch/mice/.

The main axons of mammalian sensory neurons are usually viewed as passive transmitters of sensory information. However, the spindle afferents of jaw-closing muscles behave as if action potential traffic along their central axons is phasically regulated during rhythmic jaw movements. In this paper, we used brainstem slices containing the cell bodies, stem axons, and central axons of these sensory afferents to show that GABA applied to the descending central (caudal) axon often abolished antidromic action potentials that were elicited by electrical stimulation of the tract containing the caudal axons of the recorded cells. This effect of GABA was most often not associated with a change in membrane potential of the soma and was still present in a calcium-free medium. It was mimicked by local applications of muscimol on the axons and was blocked by bath applications of picrotoxin, suggesting activation of GABAAreceptors located on the descending axon. Antidromic action potentials could also be blocked by electrical stimulation of local interneurons, and this effect was prevented by bath application of picrotoxin, suggesting that it results from the activation of GABAAreceptors after the release of endogenous GABA. We suggest that blockage is caused mainly by shunting within the caudal axon and that motor command circuits use this mechanism to disconnect the rostral and caudal compartments of the central axon, which allows the two parts of the neuron to perform different functions during movement.

Functional tricuspid regurgitation (FTR) is a neglected and underestimated pathology. It occurs mostly from annular dilatation and right ventricular enlargement, which is frequent secondary to left-sided heart failure from myocardial or valvular causes, right ventricular volume and pressure overload, and dilatation of the cardiac chambers. Moderate-to-severe FTR should be corrected to improve short- and long-term outcomes in patients undergoing surgery for left-sided valvular diseases. Tricuspid annuloplasty is a safe and effective surgical option for FTR and seems to be associated with an improvement in both functional status and survival. I read with great interest the paper by Iida et al. [1]. They described a novel technique of adjustable annuloplasty for FTR employed in 11 patients. In their technique, an expanded polytetrafluoroethylene thread was passed inside the cover cloth of a flexible annuloplasty band. They tightened the thread with extracardiac control on beating heart under observation by transoesophageal echocardiography (TEE) after weaning off cardiopulmonary bypass (CPB). I would like to add a short comment on this annuloplasty technique. For the last four decades, various repair techniques have been described for the surgical correction of FTR with severe tricuspid annular dilatation. These broadly include ring annuloplasties (flexible and rigid prosthetic rings or three-dimensional rings, flexible prosthetic bands) and suture annuloplasties such as bicuspidization (Kay annuloplasty) or semicircular (De Vega annulopasty). Other approaches may include the edge-to-edge technique (Alfieri-type) or anterior tricuspid leaflet augmentation to increase leaflet coaptation and relief of tethered leaflets [2]. The selection of the appropriate repair is the most important issue in the management of FTR. Although ring annuloplasty seems to increase durability of valve repair, the De Vega annuloplasty modifications are still advocated because of their good results. To adjust the constriction of tricuspid annulus on the beating heart, after discontinuation of CPB, Alonso-Lej [3] described an adjustable modification of the De Vega annuloplasty. Herein, extracardiac control of suture annuloplasty was gained by taking both ends of the suture through the wall of the right atrium after weaning off CPB. The degree of tricuspid regurgitation now is evaluated solely with TEE rather than with digital palpation [3]. Adjustable segmental tricuspid annuloplasty is a new modified technique that tries to reduce the incidence of failure in the De Vega annuloplasty and adjusts and distributes the pursing forces in the more dilated area. Sarraj et al. [4] have used two separate sutures, and they have chosen the middle point between the anteroseptal commissure and posteroseptal commissure to perform the purse-string technique. These new modifications make the technique more selective in the remodelling of the tricuspid annulus. Choi et al. [5] described a modified technique of tricuspid ring annuloplasty to reduce postoperative residual regurgitation in patients with FTR; first, an adjustable segmental tricuspid annuloplasty is performed to obtain coaptation of the valve leaflets with two 5-0 monofilament annular sutures, and then a prosthetic ring of the same size as the competent valve area is implanted with continuous 3-0 poly㯲opylene sutures. Finally, I think that continued follow-up should be mandatory for confirming the effectiveness of these tricuspid annuloplasty techniques. Conflict of interest: none declared

We have read with interest the paper by Kawada and colleagues focusing on the preoperative marking of small lung nodules resectable by thoracoscopic wedge resection [1]. As the authors underline, various marking procedures for localization have been already described. However, each one of these techniques is affected by different disadvantages [2]. When a preoperative marker is needed, we usually use the percutaneous CT-guided hook-wire placement method. We are conscious that this procedure is affected by possible complications such as pneumothorax, haemothorax, air embolism, and the disadvantages of an additional radiation exposure. In our experience with hook-wire placement, we only observed pneumothorax, usually low entity. However, chest tube placement is always required to avoid tension pneumothorax during mechanical ventilation at the subsequent surgical operation. Therefore, we think that the first advantage of the intrathoracic stamping method proposed by Kawada and colleagues is avoidance of the risks associated with visceral pleural puncture. The second possible advantage we identify in this method is that the use of an opaque marker lying on the skin, instead of a percutaneous hook-wire, reduces the possibility of accidental marker removal before surgery, and allows placement one or two days before operation. Lastly, although we do not have experience with the stamping method, we think that, in the event of adhesions, thoracoscopic pleural debridement could be performed more easily without a hook-wire inside the chest cavity. We identified as a possible disadvantage, the need to place the patient in the same position during CT scan and surgery, with the risk of dye spreading inside the pleural cavity, hence losing marking precision. In conclusion, we congratulate the authors who have described this new method. More data should be useful to definitively confirm its utility and safety. Conflict of interest: none declared

The relative risk (RR) of smoking and mortality of lung cancer in British doctors was previously reported to have increased throughout a 40-yr period. Here, we evaluated this RR based on the incidence of lung cancer in Korean men using a longer follow-up period. We compared our data to the RR reported in a study using a 10-yr follow-up period; the subjects and methods were identical to those of the previous paper with the exception of the follow-up period, which ended on December 31, 2008. We found that the RR of smoking habits in patients with lung cancer did not increase, and that the data showed narrowing 95% confidence intervals over a longer observation in Korean men. Estimated lung cancers attributable to smoking were 55.6%. These results highlight the need for an intervention program to help patients quit smoking in Korea.

Water is one of the prime necessities of life. We can hardly live for a few days without water. In a man's body, 70-80% is water. Cell, blood, and bones contain 90%, 75%, and 22% water, respectively. The general survey reveals that the total surface area of earth is 51 crore km(2) out of which 36.1 crore km(2) is covered sea. In addition to this, we get water from rivers, lakes, tanks, and now on hills. In spite of such abundance, there is a shortage of soft water in the world. Physicochemical parameter of any water body plays a very important role in maintaining the fragile ecosystem that maintains various life forms. Present research paper deals with various water quality parameter, chlorides, dissolved oxygen, total iron, nitrate, water temperature, pH, total phosphorous, fecal coli form bacteria, and adverse effect of these parameters on human being.

Lactic acid bacteria are considered indigenous members of the gastrointestinal microflora in a number of animal species (Savage 1977a). Some intestinal strains of lactobacilli and streptococci are aWe to adhere to stratified squamous epithelium of some animals (Tannock et al. 1987), in the non-secreting part of the stomach of piglets (Barrow et al. 1980, Fuller et al. 1978) and rodents (Tannock et al. 1982), and in the crop of poultry (Fuller 1978). The presence of lactic acid bacteria in the digestive tract is believed to be of beneficial value to the host animal (Fuller 1989). The production of organic acids in the stomach or the crop helps maintaining a low pH which may be important for inhibiting the colonization of potentially pathogenic bacteria, particularly in the newborn animal (Barrow et al 1980, Fuller 1977, Fuller 1978). The adhesion of lactobacilli to squamous epithelium is host specific: strains capable of adhering to the epithelium of piglets are usually not able to adhere in rodents or poultry and vice versa (Fuller 1978, Lin & Savage 1984, Tannock et al 1982). Adhesion of lactic acid bacterial strains to other epithelia than stratified squamous epithelium has been reported. Thus, the attachment of lactobacilli to cells from the secreting epithelium of the murine stomach (Kotarski & Savage 1979), to intestinal cells of humans (Goldin & Gorbach 1987), and to columnar epithelial cells of piglets and calves (Mayra-Makinen et al 1983) has been demonstrated using in vitro methods. In another study the in vivo attachment of Enterococcus faecium to duodenal epithelium of gnotobi-otic chickens was demonstrated (Fuller et al 1981). Recent research indicated that in adult mink lactic acid bacteria are not indigenous members of the intestinal flora, and they do not attach to epithelium in any part of the gastrointestinal tract (Federsen & Jorgensen 1992). The present paper presents evidence that Gram positive cocci may colonize the gut of suckling mink kits and attach to the gut mucosa.

The role of liquid-crystalline (mesophase) structures in extra-cellular morphogenesis is widely recognized. This paper summarizes a model for the more unusual case of intra-cellular mesophases. In the nascent mammalian hair cortex, cell differentiation is correlated with different mesophase textures within tactoids that are composed of intermediate filaments (IFs), and which form by a concerted process of unit-length-filament (ULF) polymerization and phase separation. Nematic and double-twist textures arise from differences in mesogen orientation and length in apposed tactoids. The model explains features of mature structures such as the fibril-matrix ratios in different cell types. The rapidity of IF formation suggests that a sudden-transition equilibrium polymerization, involving a high-energy initiating species, obeying the same statistical model as several other biological transitions, may be involved. This leads to an appealing symmetry, with the key factor in both polymerization and mesophase stability being the retention of protein head-group entropy.

Keratin associated proteins (KAPs) are a class of proteins that associate with keratin intermediate filament proteins through disulphide linkages to give fibres such as hair and wool their unique properties. Up to 90 proteins from some 25 families have been identified and this does not include polymorphic variants of individual proteins within these families. The existence of this diverse group of proteins has been known for some 75 years but, despite this, there is still no universally accepted nomenclature for them. This paper sets out the case for revising the current system to deal with this nomenclature issue.

This paper proposes a method to intra-operatively visualize the process of tumour resection until complete resection is accomplished. A fuzzy connectedness method that is robust against image noises was used to identify the tumour position and volume. Based on the tumour segmentation results, the removed area and the residual tumour tissues were examined with reference to the electrocautery trace log. Unique processes that are specific to glioma resection were introduced in the method to improve the accuracy of estimation. Invalid data in the trace log were excluded, and the tumour region surrounded by valid log points was included in the removed area. The proposed system also produces an alarm to indicate whether the electrocautery is being accurately performed within the tumour area. Thus, this surgical navigation system can assist surgeons in intuitively monitoring the tumour resection process and properly removing tumour remnants. Preliminary experiments and a clinical pilot study showed the feasible application of this method.

The generalized Shwartzman's reaction (GSR), which is best known in humans and experimental rabbits, is patho-morphologically characterized by widespread microthrombosis and necrotic mural lesions in arteries at various sites, the kidneys frequently being target organs. The resulting renal parenchymal damage dis bilateral cortical necrosis (BCN), which is considered as the identifying lesion of GSR (Thomas 1959). Spontaneous porcine cases of BCN have previously been recognized in association with hog cholera (Röhrer 1932); BCN has also been induced experimentally in pigs in this laboratory by intravenous injections of disintegrated cells of Haemophilus, Salmonella and Escherichia coli (for references see Teige et al. 1973). Recently BCN has also been seen in association with coli-enterotoxaemia (Teige et al. in preparation). The present paper gives a brief description of a porcine case of GSR associated with erysipelas.

Background: Nosocomial infections (NIs) are one of the most important health issues, particularly in developing countries, because these infections cause high mortality and morbidity, and economic and human resource loss as a consequence. To date, most surveillance studies have been conducted in developed countries, and only a few have been performed in Iran. All of the few Iranian studies have been performed using paper-based collection forms, and none was conducted with the aid of an electronic patient data retrieving and collecting tool. The aim of this study is to determine the incidence of NIs in a big university hospital of Shiraz, with the help of specifically programmed surveillance software merging electronically the available patient data and the infection results input manually. Methods: The study was conducted prospectively through 6 months from 21 st March up to 22 nd September 2006, in a 374-bedded educational hospital. All patients admitted during this period were included in the study and examined everyday for detecting four types of NIs: surgical site infection (SSI), urinary tract infection (UTI), pneumonia (PNEU), and blood stream infection (BSI). Centres for Disease Control and Prevention National Nosocomial Infection Surveillance system criteria were applied. Results: 4013 patients were admitted in the hospital. The overall infection rate was 4.14, and UTI, SSI, BSI, and PNEU rates were 1.82, 1.22, 0.5, and 0.5, respectively, per 1000 patient days of admission. Conclusions: The results of this study showed that the frequency of NI in the investigated hospital was not higher than in many other reported surveillance results from other countries. This, however, might be a bias as the administration of antibiotics was very high in this study and the quality of microbiological investigation might have influenced significantly, resulting in more false-negative results than expected. Overall, the use of the Iranian National Nosocomial Infection Surveillance System Software proved to be useful and allowed both rapid data collection and detailed data analysis.