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Peripheral blood can provide valuable information on an individual's immune status. Cell-based assays typically target leukocytes and their products. Characterization of leukocytes from whole blood requires their separation from the far more numerous red blood cells.1 Current methods to classify leukocytes, such as recovery on antibody-coated beads or fluorescence-activated cell sorting require long sample preparation times and relatively large sample volumes.2 A simple method that enables the characterization of cells from a small peripheral whole blood sample could overcome limitations of current analytical techniques. We describe the development of a simple graphene oxide surface coated with single-domain antibody fragments. This format allows quick and efficient capture of distinct WBC subpopulations from small samples (∼30 μL) of whole blood in a geometry that does not require any specialized equipment such as cell sorters or microfluidic devices., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objectives: To assess and compare the effect of conventional and sugar free pediatric syrup formulations on primary tooth enamel hardness over a period of 14 days., Materials and Methods: An in vitro study was done on 40 noncarious deciduous teeth. 10 teeth in each group were dipped in 4 pediatric medicinal syrups (1 sugarfree and 3 conventional) for 1 min thrice daily for 14 days and the enamel surface micro hardness was checked at baseline, 7 th day and 14 th day by Vickers hardness testing machine. The pH, titratable acidity and buffering capacity of the syrups were assessed., Results: The pH of syrups were above critical pH for demineralization of the tooth but tiratable acidity and buffering capacity differed. ANOVA test indicated that the reduction in mean micro hardness was maximum in Group D (Conventional Analgesic syrup) and least in Group A (Sugarfree cough syrup) on 7 th and 14 th day. On intergroup comparison there was no difference (P > 0.05) in micro hardness between Group B (Conventional Cough syrup) and Group C (Conventional Antibiotic). However, highly significant (P < 0.01) difference between the either pair of Group B with Group D, and Group C with Group D on 14 th day. The percentage reduction in micro hardness on 14 th day was maximum for Group D (24.4 ± 2.2) and minimum for Group A (14.0 ± 1.3) which was statistically significant (P < 0.01)., Conclusion: Sugar free pediatric medicines can be effective in reducing dental erosion and efforts should be made to incorporate sugar substitutes in formulation of pediatric medicines.

Background: Forensic odontologists are often confronted with the problem of estimating age for the identification of unknown bodies or skeletal remains of accidents, crimes and disaster victims. Teeth have the benefit of being preserved long after other tissues have disintegrated and present the only means for age estimation. Different techniques have been published for dental age estimation with variable accuracy, precision and reliability. The search for optimal method by forensic odontologists has continued over the years until the present day., Aim: The present study was aimed at evaluating and comparing the accuracy of age estimation using translucent dentin and cemental annulations., Materials and Methods: A total of 150 freshly extracted teeth were obtained and longitudinal ground sections were prepared. The length of the translucent dentin was measured and cemental annulations were counted in each section and the age was calculated separately for both the methods., Results and Conclusion: The present study suggests that both the methods are reliable in the middle age groups; whereas the large error obtained in the extreme age groups indicate that translucent dentin method should be preferred in older age group and cemental annulations method in the younger age group before the formation of translucent dentin.

Background: Long-segment ureteral injuries may have different etiologies. Although multiple procedures have been previously used for ureteral replacement, none of them had optimum results, and replacement of long segments of injured ureter is still a challenging surgical problem. In this article, we have hypothesized that it may be possible to use intestinal seromuscular tunneling as a novel method for ureteral replacement., Methods: This experimental study was conducted on eight dogs. After cutting the ureter at about its mid-part and ligating the distal part, a 10-cm tunnel was made in the seromuscular layer of small intestine using a metallic probe, and a catheter was passed through it. Proximal and distal ends of the tunnel were anastomosed to proximal end of ureter and urinary bladder, respectively. After 8 weeks, the dogs were killed, and their whole urinary system was sent for histopathologic examinations., Results: No complication was noted during the post-op period. Histopathologic examinations confirmed that the seromuscular tunnel was well patent, lined by pseudostratified transitional epithelium and without any inflammatory reaction., Conclusion: Our study shows that ureteral replacement by intestinal seromuscular tunneling is anatomically possible at least in animal model. However, more well-designed prospective studies are needed to confirm its long-term functional results.

This manuscript presents the analysis of current meter records at Kollam and Kannur along the 20-m isobaths during November-December 2005. Currents in the coastal waters are strongly influenced by winds (both local and remote forcing), tides, propagation of coastal Kelvin and Rossby waves, etc. We hypothesize that the mesoscale (spatial scales of 10-500 km and temporal scale of 10-100 days) features in ocean are also competent to alter the characteristics of coastal currents to a large extent. Analysis of sea level anomaly from the merged altimeter data reveals the existence of a large anticyclonic eddy in the southeastern Arabian Sea during the winter monsoon. The eddy moves westward with an average speed of ∼15 km day(-1) corresponding to an increase in sea level amplitude up to 28 cm. Off southwest India, the poleward flow is along the western flank of this anticyclonic eddy and the geostrophic current completes the circulation around the eddy. The eastward component of the geostrophic current at the northern edge of the eddy is bifurcated at ∼9° N: one flowing towards north and the other towards south. Current meter records at station Kollam revealed a dominant southward current due to the bifurcated southward component. The bifurcated northward component coalesced with the poleward flow along the western flank of the anticyclonic eddy. At Kannur, a poleward flow along the coast is responsible for a predominant northward trend in the observed current pattern during the initial phase of observation. A reversal in the current direction is caused by the southward-flowing geostrophic current along the eastern flank of the subsequent anticyclonic eddy centered at 73.5° E and 13° N. The stations were located at the eastern periphery of these anticyclonic eddies, where the mesoscale features overwhelm the seasonal characteristics of the West India Coastal Current (WICC).

Background: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study compared the diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions., Materials and Methods: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, using hematoxylin and eosin (H and E), immunohistochemistry, and, on certain occasions cytochemistry. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology and Laboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test., Results: Of 127 cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5%) malignant lesions and 32 (30.5%) benign lesions. FNA and CNB findings were in complete agreement in 63 cases (60%). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3% (CI: 79.3-90.7) and 93.2% (CI: 87.3- 96.0 ) respectively. For epithelial malignant neoplasms, a definitive diagnosis was made in 44.8% of cases by FNA and 80.6% by CNB. The diagnostic accuracy of CNB for nonepithelial malignant neoplasms was 83.3% compared with 50% for FNA. Of the 32 benign cases, we made specific diagnoses in 16 with diagnostic accuracy of 81.3% and 6.3% for CNB and FNA, respectively., Conclusions: Our findings suggest that FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy of CNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumors and examining tumor origin, immunohistochemical work up plays an important role.

Despite the vast exploration of rhizospheric microbial wealth for crop yield enhancement, knowledge about the efficacy of microbial agents as biocontrol weapons against root-knot disease is scarce, especially in medicinal plants, viz., Bacopa monnieri. In the present investigation, rhizospheric microbes, viz., Bacillus megaterium, Glomus intraradices, Trichoderma harzianum ThU, and their combinations were evaluated for the management of Meloidogyne incognita (Kofoid and White) Chitwood and bacoside content enhancement in B. monnieri var CIM-Jagriti. A novel validated method Fourier transform near infrared was used for rapid estimation of total bacoside content. A significant reduction (2.75-fold) in root-knot indices was observed in the combined treatment of B. megaterium and T. harzianum ThU in comparison to untreated control plants. The same treatment also showed significant enhancement (1.40-fold) in total bacoside contents (plant active molecule) content using Fourier transform near-infrared (FT-NIR) method that analyses samples rapidly in an hour without solvent usage and provides ample scope for natural product studies.

Binding of a cyclic organoselenium compound, DL-trans-3,4-dihydroxy-1-selenolane (DHSred) with gold nanoparticles (GNP) of different sizes was studied by absorption spectroscopy, dynamic light scattering (DLS), transmission electron microscope (TEM), surface enhanced Raman spectroscopy (SERS) and zeta-potential (ζ) measurements. GNP of different size were synthesized by varying the reaction conditions and their size was determined by DLS and TEM techniques. The absorption spectral data showed red shift in the surface plasmon resonance (SPR) band indicating increase in the size of GNP on binding to DHSred. SERS studies confirmed that the binding of DHSred with GNP is through selenium center with planar orientation of DHSred on the GNP surface. The product of the number of binding sites (n) in GNP and the binding constant (K) was estimated for GNP of different particle size. The zeta potential (ζ) value of GNP decreased marginally in the presence of DHSred. Further, the binding of DHSred with GNP was found to enhance its reactivity with 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) radicals (ABTS(·-)) and the reactivity increased with decrease in the GNP size. Such enhancement in the reducing ability may have a greater impact on the antioxidant activity of DHSred., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The excellent physical and semiconducting properties of transition metal dichalcogenide (TMDC) monolayers make them promising materials for many applications. The TMDC monolayer MoS2 has gained significant attention as a channel material for next-generation transistors. However, while n-type single-layer MoS2 devices can be made with relative ease, fabrication of p-type transistors remains a challenge as the Fermi-level of elemental metals used as contacts are pinned close to the conduction band leading to large p-type Schottky barrier heights (SBH). Here, we propose the utilization of graphene oxide (GO) as an efficient hole injection layer for single-layer MoS2-based electronic and optoelectronic devices. Using first-principles computations, we demonstrate that GO forms a p-type contact with monolayer MoS2, and that the p-type SBH can be made smaller by increasing the oxygen concentration and the fraction of epoxy functional groups in GO. Our analysis shows that this is possible due to the high work function of GO and the relatively weak Fermi-level pinning at the MoS2/GO interfaces compared to traditional MoS2/metal systems (common metals are Ag, Al, Au, Ir, Pd, Pt). The combination of easy-to-fabricate and inexpensive GO with MoS2 could be promising for the development of hybrid all-2D p-type electronic and optoelectronic devices on flexible substrates.

A cryptic Badnavirus species complex, known as banana streak viruses (BSV) poses a serious threat to banana production and genetic improvement worldwide. Due to the presence of integrated BSV sequences in the banana genome, routine detection is largely based on serological and nucleo-serological diagnostic methods which require high titre specific polyclonal antiserum. Viral structural proteins like coat protein (CP) are the best target for in vitro expression, to be used as antigen for antiserum production. However, in badnaviruses precise CP sequences are not known. In this study, two putative CP coding regions (p48 and p37) of Banana streak MY virus (BSMYV) were identified in silico by comparison with caulimoviruses, retroviruses and Rice tungro bacilliform virus. The putative CP coding region (p37) was in vitro expressed in pMAL system and affinity purified. The purified fusion protein was used as antigen for raising polyclonal antiserum in rabbit. The specificity of antiserum was confirmed in Western blots, immunosorbent electron microscopy (ISEM) and antigen coated plate-enzyme linked immunosorbent assay (ACP-ELISA). The antiserum (1:2000) was successfully used in ACP-ELISA for specific detection of BSMYV infection in field and tissue culture raised banana plants. The antiserum was also utilized in immuno-capture PCR (IC-PCR) based indexing of episomal BSMYV infection. This is the first report of in silico identification of putative CP region of BSMYV, production of polyclonal antiserum against recombinant p37 and its successful use in immunodetection., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: To study the use of fine needle aspiration (FNA) cytology in neonatal biliary atresia (BA)., Methods: Twelve female and nine male patients (age range, 3-7 months; mean age, 4.5 months) with a pre-operative diagnosis of BA, who were scheduled for Kasia portoenterostomy and selected for intraoperative FNA, were studied., Results: Cholestasis, bile deposits, bile infarcts, hepatitic rosettes enclosing bile plugs, feathery degeneration of hepatocytes and inflammatory cells were seen in the cytological slides. Bile infarcts, rosette formation and inflammatory cells were mainly noticed in type 3 BA. Bile infarcts and hepatitic rosettes are surrogate findings for the diagnosis of the obstructive type of cholestasis., Conclusion: With the help of imaging studies, FNA in a multidisciplinary setting can be diagnostic of neonatal BA when cytological features suggest the obstructive nature of cholestasis, but this procedure cannot replace completely liver biopsy for this diagnosis., (© 2013 John Wiley & Sons Ltd.)

Aim: This study aimed to assess the efficacy of thalidomide for treatment of experimental endometriosis., Methods: This study was a parallel-group, double-blind, stratified, randomized controlled animal trial with 1:1 allocation ratio. Endometriosis was induced experimentally in 23 mature, nulligravid, female Sprague-Dawley rats, weighing approximately 200 g and aged 2 months. A checkpoint surgery was performed 6 weeks later. Then, the rats were randomly allocated into the thalidomide (22 mg/day p.o.) and control (0.5 mL saline 0.9%/day p.o.) groups of nine. After 6 weeks, they were killed. Before each laparotomy, blood for leukocyte and lymphocyte counts and during them, implants for histopathology and peritoneal fluid for interleukin (IL)-6, tumor necrosis factor-α and vascular endothelial growth factor (VEGF)-A concentrations (by enzyme-linked immunoassay) were collected. Allocation and stratified randomization were done using a computer, based on the obtained histopathology scores of the implants of the checkpoint surgery., Results: The histopathology scores (the main outcome measure) were 2.00 ± 1.55 versus 0.44 ± 1.01 (P = 0.035). The comparisons of after-treatment counts of leukocytes, lymphocytes, VEGF-A and IL-6 between the two groups were statistically significant., Conclusion: The results of this study are in favor of therapeutic implication of thalidomide in experimental endometriosis in rats. This is the first time thalidomide has been evaluated on endometriosis in an animal model., (© 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.)

Chemical functionalization of graphene is promising for a variety of next-generation technologies. Although graphene oxide (GO) is a versatile material in this direction, its use is limited by the production of metastable, chemically inhomogeneous and spatially disordered GO structures under current synthetic protocols, which results in poor optoelectronic properties. Here, we present a mild thermal annealing procedure, with no chemical treatments involved, to manipulate as-synthesized GO on a large scale to enhance sheet properties with the oxygen content preserved. Using experiments supported by atomistic calculations, we demonstrate that GO structures undergo a phase transformation into prominent oxidized and graphitic domains by temperature-driven oxygen diffusion. Consequently, as-synthesized GO that absorbs mainly in the ultraviolet region becomes strongly absorbing in the visible region, photoluminescence is blue shifted and electronic conductivity increases by up to four orders of magnitude. Our thermal processing method offers a suitable way to tune and enhance the properties of GO, which creates opportunities for various applications.

Objective: To describe the findings in fine needle aspiration (FNA) of an amebic liver abscess (ALA)., Study Design: Seven patients (6 men and 1 woman between 52 and 60 years of age) treated for amebic dysentery with multiple liver lesions were selected for ultrasound (US)-guided FNA. The clinical differential diagnosis was malignancy. Abdominal US of the patients revealed multiple, variably sized, well-defined, hypoechoic, cystic liver lesions. FNA of these lesions was performed., Results: Smears of the aspirated material showed necrotic material with mixed inflammatory cells and Entamoeba histolytica trophozoites consisting of round blue bodies with well-defined borders containing a single, eccentrically located nucleus with central karyosome and engulfed red blood cells in the cytoplasm. There were also Charcot-Leyden crystals. ALA was diagnosed., Conclusion: FNA can yield the correct diagnosis of ALA and allows early initiation of treatment. ALA should be considered in the differential diagnosis of space-occupying lesions of the liver., (© 2014 S. Karger AG, Basel.)

The present study aims to develop and explore the use of PEGylated rapamycin (RP-MPEG) micelles for the treatment of gastric cancer. RP-MPEG was synthesized and characterized by using IR, H(1) NMR and C(13) NMR. RP-MPEG was prepared in the form of micelles and characterized by using field emission scanning electron microscopy, dynamic light scattering, zeta sizer, chromatographic analyses and photostability studies. The cytotoxicity studies of RP-MPEG micelles were conducted on specific CRL 1739 human gastric adenocarcinoma and CRL 1658 NIH-3T3 mouse embryonic fibroblast cell lines. RP-MPEG micelles showed the particle size distribution of 125±0.26 nm with narrow size distribution (polydispersity index 0.127±0.01). The surface charge of RP-MPEG micelles was found to be -12.3 mV showing enhanced anticancer activity against the CRL 1739 human gastric adenocarcinoma cell lines with an IC50 value of 1 mcg/ml.

Aim: The preparation of novel PEGylated PAMAM (poly-amidoamine) dendrimers for delivery of anti-HIV drug Efavirenz is reported., Method and Materials: About 5.0 G PAMAM dendrimers are prepared by ethylene diamine core via Michael addition by divergent method. PEGylation is done by polyethylene glycol 600 using epichlorhydrin as linker. PEGylated 5.0 G PAMAM dendrimers loaded with Efavirenz (EFV) are evaluated for FTIR, DSC, SEM, drug release, and stability studies., Results and Conclusion: From the results it is proved that this method is less time consuming, inexpensive, and reproducible. Drug-release studies indicate, PEGylated 5.0 G PAMAM-EFV dendrimers have shown prolonged drug-release property.

Background: Muscles are important "sensors of the joint instability". The aim of this study was to identify the neuro-motor control strategies adopted by patients with anterior shoulder instability during overhead shoulder elevation in two planes., Methods: The onset, time of peak activation, and peak magnitude of seven shoulder muscles (posterior deltoid, bilateral upper trapezius, biceps brachii, infraspinatus, supraspinatus and teres major) were identified using electromyography as 19 pre-operative patients with anterior shoulder instability (mean 27.95 years, SD = 7.796) and 25 age-matched asymptomatic control subjects (mean 23.07 years, SD = 2.952) elevated their arm above 90 degrees in the sagittal and coronal planes., Results: Temporal characteristics of time of muscle onsets were significantly different between groups expect for teres major in the coronal plane (t = 1.1220, p = 0.2646) Patients recruited the rotator cuff muscles earlier and delayed the onset of ipsilateral upper trapezius compared with subjects (p<0.001) that control subjects. Furthermore, significant alliances existed between the onsets of infraspinatus and supraspinatus (sagittal: r = 0.720; coronal: r = 0.756 at p<0.001) and ipsilateral upper trapezius and infraspinatus (sagittal: r = -0.760, coronal: r = -0.818 at p<0.001). The peak activation of all seven muscles occurred in the mid-range of elevation among patients with anterior shoulder instability whereas subjects spread peak activation of all 7 muscles throughout range. Peak magnitude of patients' infraspinatus muscle was six times higher (sagittal: t = -8.6428, coronal: t = -54.1578 at p<0.001) but magnitude of their supraspinatus was lower (sagittal: t = 36.2507, coronal: t = 35.9350 at p<0.001) that subjects., Conclusions: Patients with anterior shoulder instability adopted a "stability before mobility" neuro-motor control strategy to initiate elevation and a "stability at all cost" strategy to ensure concavity compression in the mid-to-150 degrees of elevation in both sagittal and coronal planes.

Purpose: To assess the effects of levamisole on experimental endometriosis in rats through the histopathology of the implants, the blood leukocyte and lymphocyte counts and the concentrations of interleukin-6, vascular endothelial growth factor-A and tumor necrosis factor-alpha in the peritoneal environment at the three healthy, endometriotic and post-treatment milestones., Methods: Twenty-two 8-week-old Sprague-Dawley rats with normal estrus cycles were recruited in a prospective, parallel-group, placebo-controlled, double-blind, stratified-randomized animal trial with the equal allocation ratio of 1:1 challenging the efficacy of levamisole. Endometriosis was induced. After 6 weeks, laparotomy was performed to randomly excise one implant for histopathology assessment. Based on the results, they were stratified randomized and allocated (by software) to two groups of nine: levamisole (5 mg/rat/day) or placebo. After 6 weeks, necropsy was done. Two days before each laparotomy, blood samples and during the procedure, peritoneal wash were collected for ELISA., Results: Seven rats showed success in treatment in the levamisole group, while three did in the other group. The histopathology results descriptively revealed a drop in the levamisole group, which was not meaningful statistically (0.66 ± 1.32 vs. 2.00 ± 1.50, p = 0.065). The comparisons of the post-treatment leukocytes and lymphocytes in the groups showed significant differences (11088.88 ± 5869.50 vs. 4677.77 ± 3476.98, p = 0.008, and 8588.88 ± 5721.32 vs. 3511.11 ± 2835.24, p = 0.014, respectively). The results of the cytokines were mostly, but not completely, in favor of the efficacy of levamisole., Conclusion: This study indicates a possible successful role for levamisole in the treatment of experimental endometriosis. Further studies to assess the effects of high dose levamisole on endometriosis are recommended.

Osteochondromas are common benign bone tumours. They usually occur in the patients who are below thirty years of age. They probably are developmental malformations rather than true neoplasms. They are believed to originate within the periosteum as small cartilaginous nodules. The foot is rarely a common site of presentation for these tumours. The calcaneum is one of the most unusual regions for the occurrence of osteochondromas 1. The osteochondromas which arise from the calcaneum, especially those which project onto the plantar surface, pose considerable problem to the ambulation. Malignant transformations are seen in less than 1% to 2% of the patients with solitary osteochondromas 2. We herewith present a case of osteochondroma which arose from the calcaneum, which was surgically excised to improve the patient's daily functioning. The patient was followed up for a period of one year. She is now able to walk comfortably.

Background: Kala-azar is a multisystem infection of the reticuloendothelial system. Various hematologic abnormalities have been described in kala-azar including hemophagocytic syndrome (HPS). , Methods: We reviewed bone marrow aspirate smears from 18 documented cases of kala-azar complicated by HPS. , Results: The bone marrow smears were hypercellular with erythroid hyperplasia. Megaloblastic changes, foamy macrophages, activated macrophages with cytoplasmic vacuoles and elongated cytoplasmic process, intra- and extracellular amastigotes, cytoplasmic fragments (blue bodies), plasma cells with inclusions and hemophagocytic cells were seen. Leishman bodies (amastigotes) were also found in some hemophagocytic cells., Conclusion: Kala-azar should be considered as an etiology of HPS, particularly in endemic areas.

Mesenteric cysts are heterogeneous groups of lesions. Most of them are developmental cysts of lymphatic and enteric origin or cystic neoplasm such as mesothelioma or cystic teratoma. Urogenital cysts are a subcategory of developmental cysts of the mesentery. They are thought to arise from vestigial remnants of urogenital apparatus. These cysts may show evidence of mesonephric or metanephric differentiation. An 11 -year -old boy was presented with undescended testis. During preoperative work- up, an incidental cystic lesion was discovered which was attached to the ileum. Aspiration cytology of the cyst content revealed cuboidal to columnar cells; some of them were ciliated. Histologic examination showed a cyst with fibromuscular wall, lined by Mullerian type ciliated epithelium; so the diagnosis of urogenital mesenteric cyst of Mullerian type was made. Urogenital cysts are rare lesions, but they should be considered in differential diagnosis of any cystic lesion of the mesentery. Cytology could be a useful method for evaluation and revealing the nature of these cysts.

Peptides designed from osteoprotegerin (OPG) have previously been shown to inhibit receptor activator of NF-κB ligand (RANKL) and prevent bone loss without significantly inhibiting inflammation. The objective of this study was to develop a novel peptide with dual inhibitory activity against bone loss and inflammation using site-directed mutagenesis. Out of the three putative sites (i.e., Tyr70-Asp78, Tyr82-Glu96, and Leu113-Arg122) available on OPG for RANKL binding, Leu113-Arg122 was used as a template for peptide synthesis. Peptide mutants of the template sequence (112YLEIEFCLKHR122) were synthesized and initially screened for their inhibitory effect on RANK-RANKL binding by competitive ELISA. The most active peptide was further evaluated in vitro for RANKL induced osteoclastogenesis in mouse macrophage cells, and in vivo for Freund's complete adjuvant induced arthritis (AIA) in Lewis rats. The efficacy of the candidate peptide was compared with that of the standard drug celecoxib. The peptide YR-11 (YLEIEFSLKHR), obtained by direct substitution of cysteine with a serine residue in the template sequence, significantly (p<0.05) inhibited RANK-RANKL binding, and RANKL induced TRAP activity and formation of multinucleated osteoclasts without any cytotoxicity. Administration of YR-11 peptide at the dose of 30mg/kg (i.p.) ameliorated both bone loss and inflammation in AIA rats. To elucidate the mechanism for inhibition of inflammation in arthritic rats, serum and tissue cytokines (TNF-α, IL-1β, and IL-6) were analyzed by ELISA and RT-PCR methods. Results confirmed that YR-11 peptide inhibited pro-inflammatory cytokines in the sera and hind paw tissues of AIA rats through its suppressive effect on RANKL induced nuclear translocation of NF-κB. The results obtained in this study substantiate the therapeutic benefit of this novel peptide in the prevention of bone loss and inflammation in rheumatoid arthritis with reduced side effects., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Reduced graphene oxide (rGO) is a promising material for a variety of thin-film optoelectronic applications. Two main barriers to its widespread use are the lack of (1) fabrication protocols leading to tailored functionalization of the graphene sheet with oxygen-containing chemical groups, and (2) understanding of the impact of such functional groups on the stability and on the optical and electronic properties of rGO. We carry out classical molecular dynamics and density functional theory calculations on a large set of realistic rGO structures to decompose the effects of different functional groups on the stability, work function, and photoluminescence. Our calculations indicate the metastable nature of carbonyl-rich rGO and its favorable transformation to hydroxyl-rich rGO at room temperature via carbonyl-to-hydroxyl conversion reactions near carbon vacancies and holes. We demonstrate a significant tunability in the work function of rGO up to 2.5 eV by altering the composition of oxygen-containing functional groups for a fixed oxygen concentration, and of the photoluminescence emission by modulating the fraction of epoxy and carbonyl groups. Taken together, our results guide the application of tailored rGO structures in devices for optoelectronics and renewable energy.

Background. Extracorporeal shock wave lithotripsy has been widely used to treat renal stones. The procedure is relatively safe with minor complications. Case. The patient is a 32-year-old man who presented with left sided pleural effusion after extracorporeal shock wave lithotripsy. Results. The pleural effusion study revealed an exudative fluid rich in eosinophils (30%). So, the diagnosis of eosinophilic pleural effusion as a complication of lithotripsy was made. Conclusion. Extracorporeal shock wave lithotripsy should be regarded as an etiology of unexplained eosinophilic pleural effusion after this procedure.

Primary liver liposarcoma is a rare disease. The knowledge of the clinical course, management, and prognosis of primary liver liposarcoma are all limited because of its rarity. Twelve cases of primary liposarcoma of the liver have been previously reported. We present the thirteenth case, which occurred in an adult male patient. A 42-year-old male patient came to our outpatient department with complaints of pain abdomen, mass per abdomen, and weight loss. Ultrasonography showed a mass arising from the the left lobe of liver. CT abdomen showed a heterogenous enhancing mass from left lobe of liver with multiple cystic and necrotic areas compressing the stomach and spleen with no evidence of metastasis. Differential diagnosis included adenoma and primary malignancy. Exploratory laparotomy and resection were done. HPE was found to be pleomorphic liposarcoma of liver.

Gastric cancer (GC) is very common in Iran. Daily consumption of pickled vegetables is a routine dietary habit in most areas of Iran. Because pickled vegetables have been associated with GC it can be of importance to study the relationship between the two. We have therefore studied the histo-morphological effects of pickled vegetables on the Rabbit gastric mucosa. Forty and twenty healthy male rabbits were respectively allocated in the experimental and control groups. The rabbits were fed freely with pickled (experimental group) and fresh vegetables (control group) for 1 yr. The gastric mucosa of rabbits was examined and the results were compared. In addition to all the rabbits of the control group, 14 rabbits (35%) of the experimental group had normal gastric mucosa. The rest showed abnormal changes including atypia-so called indefinite for dysplasia-in 10 (25%), low-grade dysplasia in 14 (35%), and high-grade dysplasia in 2 (5%). The analysis showed significant difference between results of the 2 groups (P < 0.001). Daily consumption of pickled vegetables can produce atypical and dysplastic changes in the gastric mucosa. Such preneoplastic changes can potentially transform to gastric carcinoma. This process could be prevented by reduction or cessation of daily pickled food consumption.

Carbon materials are excellent candidates for photovoltaic solar cells: they are Earth-abundant, possess high optical absorption, and maintain superior thermal and photostability. Here we report on solar cells with active layers made solely of carbon nanomaterials that present the same advantages of conjugated polymer-based solar cells, namely, solution processable, potentially flexible, and chemically tunable, but with increased photostability and the possibility to revert photodegradation. The device active layer composition is optimized using ab initio density functional theory calculations to predict type-II band alignment and Schottky barrier formation. The best device fabricated is composed of PC(70)BM fullerene, semiconducting single-walled carbon nanotubes, and reduced graphene oxide. This active-layer composition achieves a power conversion efficiency of 1.3%-a record for solar cells based on carbon as the active material-and we calculate efficiency limits of up to 13% for the devices fabricated in this work, comparable to those predicted for polymer solar cells employing PCBM as the acceptor. There is great promise for improving carbon-based solar cells considering the novelty of this type of device, the high photostability, and the availability of a large number of carbon materials with yet untapped potential for photovoltaics. Our results indicate a new strategy for efficient carbon-based, solution-processable, thin film, photostable solar cells.

Cardiac and aortic pseudoaneurysms are rare complications following myocardial infarction or cardiac surgery. They are characterized by a contained cardiac or aortic rupture within surrounding tissue and have a high mortality rate if left untreated. Percutaneous treatment of cardiac pseudoaneurysms might be a feasible treatment option in patients who are at high risk of reoperative surgery. There is limited literature on the outcomes and the approaches to percutaneous treatment of these pseudoaneurysms. We review nine cases of cardiac and aortic pseudoaneurysms and percutaneous techniques for closure. Pseudoaneurysms were categorized anatomically as left ventricular posterior (posterobasal or posterolateral), left ventricular outflow tract, left ventricular apical, and ascending aortic pseudoaneurysms. Two patients with posterior pseudoaneurysms (one posterobasal treated with an Amplatzer Septal Occluder device, and one wide-mouthed posterolateral pseudoaneurysm which was not closed, are described. We further describe two left ventricular outflow tract pseudoaneurysms treated successfully with percutaneous coil embolization, one left ventricular apical pseudoaneurysm treated with coils, and three ascending aortic pseudoaneurysms treated with a septal occluder device or vascular plug. We review the technical approaches, device selection strategies, outcomes, and complications with these percutaneous treatment options. The size of the pseudoaneurysm dimensions of its neck and relative anatomy, particularly to the coronaries and valves, are critical issues to be addressed before percutaneous treatment of these pseudoaneurysms., (Copyright © 2012 Wiley Periodicals, Inc.)

The synthesis and structure-activity relationship (SAR) study of a series of 2-(substituted benzylidene)-7-(4-fluorophenyl)-5-(furan-2-yl)-2H-thiazolo[3,2-a]pyrimidin-3(7H)-one (4a-4j) derivatives as anticancer agents are described. This series of thiazolopyrimidines were synthesized by the reaction of 7-(4-fluoro phenyl)-5-(furan-2-yl)-2H-thiazolo[3,2-a] pyrimidin-3(7H)-one (3) with appropriate substituted aldehydes in the presence of anhydrous sodium acetate and glacial acetic acid. Their structures were confirmed by IR, (1)H-NMR, mass, and elemental analyses. These novel thiazolopyrimidine derivatives were screened for their anticancer activity on the U937 human histocytic lymphoma cell line by 3-(4,5-dimethyl thiazole-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay. The comparison of anticancer activity of thiazolopyrimidine was performed considering their structures. This study was done using 2-(substituted benzylidene)-7-(4-fluorophenyl)-5-(furan-2-yl)-2H-thiazolo[3,2-a]pyrimidin-3(7H)-one (4a-4j) as a basic model, showing that i) presence of a hydrogen donor/acceptor domain [thiazolo[3,2-a]pyrimidin-3(7H)-one] on the thiazolopyrimidine ring; ii) presence of a hydrophobic [(4-fluorophenyl)] aryl ring system on the thiazolopyrimidine ring; iii) presence of an electron donor moiety [5-(furan-2-yl)] on the thiazolopyrimidine ring; iv) ortho and para substitution of the distal aryl ring [2-(substituted benzylidene)] function strongly influenced anticancer activity. Among these compounds (4a-4j) para substituted derivatives 4c, 4e, 4f, 4g, 4h, and 4j showed significant anticancer activity.

Polymer membranes were prepared by blending high density polyethylene (HDPE) with ethylene propylene diene terpolymer rubber (EPDM). These blend membranes were evaluated for the selective separation of n-hexane from acetone. The flux and selectivity of the membranes were determined both as a function of the blend composition and feed mixture composition. Results showed that polymer blending method could be very useful to develop new membranes with improved selectivity. Pervaporation properties could be optimized by adjusting the blend composition. The effects of blend ratio, feed composition, and penetrant size on the pervaporation process were analyzed. The permeation properties have been explained on the basis of interaction between the membrane and solvents and blend morphology. Flux increases with increasing alkane content in the feed composition., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Submitral aneurysm is a rare cardiac pathology of uncertain origin with varied clinical manifestations. Recent studies have revealed a congenital basis of this pathology, although genetic link has been suspected because of the racial predilection. The other suggested aetiologies are infection and inflammation. The case reported here is that of a young female with a large submitral aneurysm presenting in a state of cardiogenic shock. In addition, the presence of raised inflammatory parameters indicates that the cause of origin of this aneurysm is related to inflammation., (Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)

Background: Pemphigus vulgaris (PV) is an autoimmune bullous lesion of the skin and mucous membranes characterized by suprabasal clefting and acantholysis. The responsible autoantibody is desmoglein 3, a protein constituent of the desmosome. The diagnosis of PV is based on histological examination and immunofluorescence study. In addition, cytological smears could also be informative for the initial diagnosis of PV., Cases: Fifteen patients, 7 men and 8 women, with skin bullous disease clinically suspected of being PV were selected for cytological study. The bullae were ruptured and two smears were prepared from the fluid and stained with the Wright-Giemsa and Papanicolaou methods. The smears were taken from both new and old bullae. They showed acantholytic cells (Tzanck cells), some with amoeboid-like cytoplasmic projections, eosinophils, basophils, various forms of typical and atypical lymphocytes with irregular nuclear borders and cerebriform nuclei and dysplastic acantholytic cells with a high nucleo-cytoplasmic ratio and prominent nucleoli. The dysplastic cells were seen only in the old bullae. Histological examination and immunofluorescence study of the lesions confirmed the diagnosis of PV., Conclusion: PV can be diagnosed by cytology. Without a clinical history of PV, the presence of atypical lymphocytes and dysplastic cells may lead to a false diagnosis of malignancy., (Copyright © 2012 S. Karger AG, Basel.)

Background: Myositis ossificans (MO) is a rare non-neoplastic heterotopic ossification of soft tissue. Histological examination is the gold standard method for diagnosis, but fine needle aspiration (FNA) cytology may aid in presumptive diagnosis of this lesion., Cases: Nine patients with chief complaint of soft tissue mass with clinically suspected MO were selected. FNA of the mass showed low to hypercellular smears, composed of some amorphous pink to bluish material on Wright-Giemsa stain. The predominant cells were oval to spindle-shaped, resembling fibroblasts. Some cells had a high nucleo-cytoplasmic ratio with hyperchromatic nuclei, an irregular nuclear border and prominent nucleoli. Bland-looking osteoblasts and uni- and binucleated chondrocytes were also noted. FNA diagnosis of 4 patients was suggestive of osteosarcoma and of 2 patients suggestive of chondrosarcoma, 2 patients were diagnosed with a benign process and 1 was deferred due to hypocellularity of the smears. Histological examination of the corresponding surgical specimen confirmed the diagnosis of MO., Conclusion: MO cannot be diagnosed on FNA smears without analyzing the clinical and radiological findings. Experience shows that otherwise MO is mostly misdiagnosed as a malignant lesion., (Copyright © 2012 S. Karger AG, Basel.)

We evaluated the prognostic significance of myocardial dysfunction and associated cardiac troponin I elevation in patients with subarachnoid hemorrhage (SAH). Forty-one patients with no prior cardiac history and who presented with spontaneous SAH were prospectively studied. The LV ejection fraction (LVEF) and regional wall motion by echocardiogram were studied upon admission (Day 0), Day 1 and Day 3 following SAH. Serial troponin I levels, admission Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) were compared in patients with and without LV wall motion abnormality (WMA). Eight patients (20%) had evidence of WMA, of which five (63%) had global hypokinesis and the rest had regional WMA. Patients with WMA had significantly lower LVEF (30% vs 62%, p<0.001) at Day 0, significantly higher troponin I (0.938 vs 0.077, p<0.001) and significantly lower admission GCS (8.2 vs 14.1, p<0.001) compared to those without WMA. LV systolic function improved in 25% of patients by Day 3. Neurologic outcome (GOS) was adversely related to increase in troponin I levels (p=0.04), whereas WMA predicted poor neurologic status (GCS) (P<0.01) and increased hospital stay (P<0.01). Cardiac troponin I levels appear to be a sensitive marker of myocardial dysfunction, which occurred in 20% of patients with SAH, and helps predict poor neurologic outcome.

In this study, a simple and novel microdialysis sampling technique incorporating hollow fiber liquid phase microextraction (HF-LPME) coupled online to high-performance liquid chromatography (HPLC) for the one-step sample pretreatment and direct determination of alachlor (2-chloro-2',6'-diethyl-N -(methoxymethyl)acetanilide) and its metabolite 2,6-diethylaniline (2,6-DEA) in microbial culture medium has been developed. A reversed-phase C-18 column was utilized to separate alachlor and 2,6-DEA from other species using an acetonitrile/water mixture (1:1) containing 0.1 M phosphate buffer solution at pH 7.0 as the mobile phase. Detection was carried out with a UV detector operated at 210 nm. Parameters that influenced the enrichment efficiency of online HF-LPME sampling, including the length of the hollow fiber, the perfusion solvent and its flow rate, the pH, and the salt added in sample solution, as well as chromatographic conditions were thoroughly optimized. Under optimal conditions, excellent enrichment efficiency was achieved by the microdialysis of a sample solution (pH 7.0) using hexane as perfusate at the flow rate of 4 μL/min. Detection limits were 72 and 14 ng/mL for alachlor and 2,6-DEA, respectively. The enrichment factors were 403 and 386 (RSD < 5%) for alachlor and 2,6-DEA, respectively, when extraction was performed by using a 40 cm regenerated cellulose hollow fiber and hexane as perfusion solvent at the flow rate of 0.1 μL/min. The proposed method provides a sensitive, flexible, fast, and eco-friendly procedure to enrich and determine alachlor and its metabolite (2,6-DEA) in microbial culture medium.

Attempts were made to evolve an efficient technique for quality assessment of tea (Camellia sinensis) using a tyrosinase based biosensor to detect polyphenols (PP). Tyrosinase catalyzes the polymerization of PP to form theaflavins (Tf) and thearubigins (Tr) contributing to the colour and astringency of tea, which determine tea quality. Variation in biosensor response of tea infusions gave an indication of differential amount of Tf and Tr. A comparative study of quality attributes of 8 varieties of commercially available brands of tea (A-H) was done using biosensor and results were compared with conventional techniques such as spectrophotometry, high performance liquid chromatography (HPLC), Commission Internationale de I'Eclairage (CIE) system and sensory evaluation. Considerable correlation was observed among the biosensor, sensory and spectrophotometric evaluation of tea samples. Sample A showed high Tf content and also showed a relative high biosensor response whereas sample G showed relatively poor response. Application of biosensors would serve as a basis for the evaluation of market value of tea in the near future.

Metabolites of synthetic pyrethroids such as cis-3-(2,2-dibromovinyl)-2,2-di-methylcyclo-propane-1-carboxylic acid, cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid), 3-phenoxybenzoic acid (3-PBA), and 4-fluoro-3-PBA are biomarkers for exposure to phenothrin, tetramethrin, cyfluthrin, cypermethrin, deltamethrin, and permethrin. In this study, the pyrethroid metabolites in workers' urine samples were monitored for the first time with a novel sample pretreatment process combining hollow fiber liquid phase microextraction (HF-LPME) and in-syringe derivatization (ISD) followed by gas chromatography-electron capture detector (GC-ECD) analysis. A micro-syringe pre-filled with derivatizing agents and syringe needle connected to an extracting solvent impregnated hollow fiber segment was used as the LPME probe. Pyrethroid metabolites were extracted and enriched simultaneously from urine samples by HF-LPME sampling and acid hydrolysis at 70 °C for 10 min. After sampling, the ISD was performed by mixing the extracting solution and derivatizing agents through plunger movements, followed by GC-ECD analysis. Parameters influencing the HF-LPME efficiency and ISD were investigated and optimized. Under optimum conditions, the method provided enrichment factors of 69.8-154.6, repeatability from 5.0 to 12% (n = 5), and good linearity (R(2) = 0.9980-0.9998) for interested analytes spiked in urine samples. The method detection limits ranged from 1.6 to 17 ng/mL. A comparison was performed between the proposed method and conventional methods. The proposed method was applied to analyze pyrethroid metabolites in the urine samples collected from workers of pesticide formulation plants. The results suggested that the proposed HF-LPME coupled ISD method was a rapid, simple, efficient, and eco-friendly technique in the biomonitoring of metabolites of pyrethroids in workers' urine.

A number of compounds have been prepared in order to improve pharmacological roles of antihyperglycemic activity. In the present paper, a series of 3-benzyl-2-(4'-substituted phenyl)-4(5H)-(4″-nitrophenyl amino)-1,3-oxazolidines (6a-e) were tested against hyperglycemia. Their antihyperglycemic activity was evaluated by streptozotocin (STZ) and sucrose-loaded (SLM) models. Compounds 6a, b, c, d, and e displayed significant reductions in blood glucose in the streptozotocin and sucrose loaded rat models. The purity of the synthesized compounds was characterized by means of IR, (1)H-NMR, mass spectral and elemental analysis.

Objectives: To compare the 30-day, six-month, and one-year outcomes of carotid artery stenting (CAS) and carotid endarterectomy (CEA) in male veterans, and to identify any predictors of adverse outcomes. CAS has been shown to be non-inferior to CEA in patients at high-risk for CEA. The outcome of CAS compared to low-risk CEA is less clear., Methods: Retrospective analysis of 96 consecutive patients who underwent CAS (N = 31) or CEA (N = 65). The cumulative 30-day, six-month, and one-year incidence of ipsilateral transient ischemic attack (TIA) or stroke, restenosis or reocclusion, need for target vessel revascularization, non-fatal myocardial infarction (MI), and death were compared., Results: All patients in the CAS group were at high risk for CEA. Among the CEA group, 50 (76.9%) were at high risk and the remaining 15 (23.1%) were considered to be at low risk. The cumulative incidence of adverse outcomes with CAS and CEA, respectively, at 30 days (3.2% vs 9.2%, P = ns), six months (3.2 vs 18.5%, P = 0.047), and one year (9.7% vs 18.5%, P = ns) favored CAS. This difference was primarily due to adverse events in the high-risk CEA patients. There was no significant difference in outcome between the CAS and low-risk CEA groups. The independent significant predictors for adverse outcomes within six months were the group (P = 0.047) and number of risk factors (P = 0.01). Interestingly, the use of angiotensin-converting enzyme inhibitors (ACE-I) predicted adverse outcomes within one year (P = 0.01)., Conclusion: CAS may be superior to high-risk CEA with better six-month outcomes. The outcomes with CAS were not significantly different compared to low-risk CEA, suggesting that CAS may be non-inferior to low-risk CEA.

The series of 6,7,8,9-tetrahydro-5H-5-(2'-hydroxyphenyl)-2-(4'-substituted benzylidine)thiazolo(2,3-b)quinazolin-3(2H)-ones (4a-j) and 6,7,8,9-tetrahydro-5H-5-(2'-hydroxyphenyl)-2-(4'-substituted benzylidine)-3-(4-nitrophenyl amino)thiazoloquinazolines (5a-j) were synthesized by the reported method and evaluated for their phosphodiesterase inhibitory activity. All test compounds exhibited good activity. The structure-activity relationships were also studied. In both series of compounds, electron-withdrawing substitutions showed higher activity. Among the tested compounds, 6,7,8,9-tetrahydro-5H-5-(2'-hydroxyphenyl)-2-(4'-fluorobenzylidine)-3-(4-nitrophenylamino)thiazoloquinazoline (5e), 6,7,8,9-tetrahydro-5H-5-(2'-hydroxyphenyl)-2-(4'-nitrobenzylidine)-3-(4-nitrophenylamino)thiazoloquinazoline (5j) and 6,7,8,9-tetrahydro-5H-5-(2'-hydroxyphenyl)-2-(4'-chlorobenzylidine)-3-(4-nitrophenylamino)thiazoloquinazoline (5f) were found to be more potent than theophylline (IC50 in mmol L-1 of 1.34 ± 0.09 for 5f, 1.44 ± 0.02 for 5e, 1.52 ± 0.05 for 5jvs. 1.72 ± 0.09 for theophylline).

The immunopathogenesis of neurocysticercosis (NCC) largely remains unknown. We analyzed the immune response to different fractions of Taenia solium cyst fluid antigens in patients with NCC. Lymphocytes were separated from 48 patients with NCC-related active epilepsy and 30 healthy controls. T. solium (isolated from pig muscles) antigens (crude lysate, CL; cyst wall, CW and cyst fluid, CF) at 20 μg/well concentrations were used to stimulate the cells in a lymphocyte transformation test (LTT). Only CF antigen stimulated cell proliferation significantly greater than control (p<0.001), hence cyst fluid antigens were further studied. The CF antigens were electro-blotted on nitrocellulose membrane (NC), cut at 0.5 cm distance and particulate antigens were prepared. A total of 12 fractions, designated F1 to F12 according to molecular weight were tested in-vitro for LTT. After 72 h of stimulation by the different fractions, Th1 (IL-1β, TNF-α, IL-2) and Th2 (IL-4, IL-10) cytokine responses were determined in culture supernatants by ELISA. Low molecular weight fractions F1 through F4 (Mol. wt.<25 kDa) were found to be potent inducers of cytokines. Fractions F1, F3 and F4 induced the production of Th1 (IL-1β, TNF-α, IL-2), whereas F2 induced the production of Th2 (IL-4 and IL-10) cytokine. The study shows that the low molecular weight fractions of CF antigens are immuno-dominant. Most of these fractions (F1, F3, F4) induce strong Th1 immune response except F2 which induces Th2 response. Further studies are needed to identify the different antigens present in these fractions to determine the molecules responsible for the immune response., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Several novel 6,7,8,9-tetrahydro-5H-5-phenyl-2-benzylidine-3-substituted hydrazine thiazolo (2,3-b) quinazoline derivatives were synthesized and evaluated for their anthelmintic activity in a passive avoidance test. Chemical structures of all of the newly synthesized compounds were confirmed by infrared spectroscopy, (1)H-nuclear magnetic resonance, mass spectroscopy, and elemental analyses. Out of 15 compounds, only 6e and 6o had good anthelmintic activity. Experimental data led to the conclusion that the synthesized compounds have anthelmintic activity.

Background: Infantile hepatic hemangioendothelioma is a rare tumor. Cytologic and histologic differentiation from other hepatic tumors is necessary to determine appropriate therapy. Fine needle aspiration cytology of this rare tumor has not been reported in the literature before., Case: A 5-month-old female infant presented with hepatomegaly. Computed tomography revealed numerous nodules occupying the entire liver parenchyma that were considered to be metastatic tumors. However, the primary tumor was not detected. Cytology smears revealed numerous clusters of and isolated, benign-looking, cuboidal, round cells that were diagnosed as benign tumors, and a laparotomy was advised. Histology of the nodules showed infantile hepatic hemangioendothelioma. The patient is alive and undergoing supportive therapy., Conclusion: A vascular lesion should be considered in a fine needle aspiration biopsy of liver masses in infants, especially when the clinical features are not consistent with a metastatic malignancy. Immunoreactivity for factor VII-related antigen, CD34 and cytokeratin-7 is helpful in establishing the diagnosis.