Images in Clinical Practice: Pituitary Macroadenoma

No Abstract Available Annals of African Medicine Vol.3(2) 2004: 93-9

Analisis Kelayakan Finansial Usaha Perikanan Tangkap dengan Alat Tangkap Trammel Net di Kabupaten Rembang

Penelitian ini bertujuan untuk mengetahui karakteristik usaha perikanan tangkap trammel net dan untuk menganalisis kelayakan usaha sisi finansial dari usaha perikanan tangkap trammel net di Kabupaten Rembang. Variabel kelayakan usaha finansial yang diteliti dalam penelitian ini adalah NPV (net present value), IRR (internal rate of return), dan payback periods. Penelitian ini menggunakan kombinasi data primer dan sekunder. Hasil penelitian menunjukkan bahwa usaha perikanan tangkap trammel net di Kabupaten Rembang merupakan usaha berskala mikro, dengan nilai investasi perahu rata-rata sebesar Rp 22,3 juta, nilai investasi alat tangkap rata-rata sebesar Rp 5,05 juta, dan nilai investasi mesin rata-rata sebesar Rp 4,92 juta, sedangkan biaya perawatan aset rata-rata sebesar Rp. 4,10 juta/tahun, biaya BBM rata-rata sebesar Rp. 12,96 juta/tahun, biaya es rata-rata sebesar Rp. 0,99 juta/tahun, biaya perbekalan rata-rata sebesar Rp. 6,40 juta/tahun dan raman kotor rata-rata sebesar Rp. 42,31 juta/tahun. Selain itu, juga dapat diambil kesimpulan bahwa usaha perikanan tangkap trammel net di Kabupaten Rembang bersifat feasible karena NPV bernilai positif (Rp 44,3 juta) dalam 10 tahun periode operasi penangkapan ikan, IRR (52%) lebih besar dari suku bunga yang ditetapkan dan payback periods (2,77 tahun) lebih cepat dari target waktu yang ditetapkan. This research aims to identified a characteristic of fishing business using trammel net and to analysed a financial feasibilty study to fishing business using trammel net in Regency of Rembang. Variable of research were NPV, IRR and payback periods. This research also used a primary and secondary data. This research proved if fishing business used trammel net in Rembang Regency could classify in micro-business, with investment cost average are Rp 22.3 million to boat, Rp 5.05 million to trammel net, and Rp 4.92 million to machine. Fishing business used trammel net in Rembang Regency also need Rp. 4.10 million/year to average of maintenance cost, Rp. 12.96 million/year to average of energy cost, Rp. 0.99 million/year to average of ice procurement cost, and Rp. 6.40 million/year to average of accomodation cost. The average of gross income in fishing business using trammel net was Rp. 42.31 million/year. This research proved if fishing business used trammel net was feasible, value of NPV was positive (Rp 44.3 million) in 10 years business operation, IRR (52%) greater than the target and payback periods (2.77 years) faster than the target

Neurosurgical infections

The central nervous system is a very delicate and vulnerable organ which enjoys protection by layers of coverings. It is described as an immunological vacuum, and when afflicted by infections the outcome ismost often devastating. Factors leading to compromise of the host defense play a major role in establishing neurosurgical infections. A number of such factors can either be avoided or minimized. Over the past decades, these infections have been fatal. However, more recently, the advent of newermore effective antibiotics, improved bacteriological studies, advanced imaging facilities, and meticulous surgical techniques have turned around the outcomes. This article will review infections of the central nervous system of neurosurgical significance

Posterior Surgical Approach to Tuberculous Spondylitis

Objectives: Foraminotomy is a simple posterior surgical approach useful for treatment of radicular (nerve root) pain in TB spondylitis. It doesn't affect the stability of the facet joint, requires neither fusion nor implants. It is therefore cheap and affordable for patients with low income. We describe a simple form of posterior spinal surgery for patients with tuberculous spondylitis. Methods: Out of the 45 cases of Pott's disease managed from Jan 2006-Jan 2008, three patients had foraminotomy due to failed medical treatment. An additional discectomy was performed in one patient. Foraminotomy involves the removal of lateral half of adjacent laminae and medical half of the facet joint. The ligamentum flavum and the epidural fat are cleared to free the nerve root. No implant or fusion is required. Results: All the three patients improved post operatively. Physiotherapy was started on 7th day after surgery. The pain completely resolved in two patients while the third one had a remarkable improvement at discharge. They were all able to walk without support. One patient is still on regular follow up and has a power of 5/5 in both lower limbs while the remaining two were lost to follow up at 5 and 8 months post surgery. They both had power of 4/5 at the time they defaulted. Conclusion: Foraminotomy with or without discectomy is a simple posterior surgical approach to T B spine with good neurological outcome. It is adapted to our environment because no fusion or implant is required. Key words: Tuberculosis, Spondylitis, Posterior approac

Betacellulin Induces Increased Retinal Vascular Permeability in Mice

BACKGROUND: Diabetic maculopathy, the leading cause of vision loss in patients with type 2 diabetes, is characterized by hyper-permeability of retinal blood vessels with subsequent formation of macular edema and hard exudates. The degree of hyperglycemia and duration of diabetes have been suggested to be good predictors of retinal complications. Intervention studies have determined that while intensive treatment of diabetes reduced the development of proliferative diabetic retinopathy it was associated with a two to three-fold increased risk of severe hypoglycemia. Thus we hypothesized the need to identify downstream glycemic targets, which induce retinal vascular permeability that could be targeted therapeutically without the additional risks associated with intensive treatment of the hyperglycemia. Betacellulin is a 32 kD member of the epidermal growth factor family with mitogenic properties for the retinal pigment epithelial cells. This led us to hypothesize a role for betacellulin in the retinal vascular complications associated with diabetes. METHODS AND FINDINGS: In this study, using a mouse model of diabetes, we demonstrate that diabetic mice have accentuated retinal vascular permeability with a concomitant increased expression of a cleaved soluble form of betacellulin (s-Btc) in the retina. Intravitreal injection of soluble betacellulin induced retinal vascular permeability in normoglycemic and hyperglycemic mice. Western blot analysis of retinas from patients with diabetic retinopathy showed an increase in the active soluble form of betacellulin. In addition, an increase in the levels of A disintegrin and metalloproteinase (ADAM)-10 which plays a role in the cleavage of betacellulin was seen in the retinas of diabetic mice and humans. CONCLUSIONS: These results suggest that excessive amounts of betacellulin in the retina may contribute to the pathogenesis of diabetic macular edema

Esomeprazole for the treatment of erosive esophagitis in children: an international, multicenter, randomized, parallel-group, double-blind (for dose) study

<p>Abstract</p> <p>Background</p> <p>Acid suppression with a proton pump inhibitor is standard treatment for gastroesophageal reflux disease and erosive esophagitis in adults and increasingly is becoming first-line therapy for children aged 1-17 years. We evaluated endoscopic healing of erosive esophagitis with esomeprazole in young children with gastroesophageal reflux disease and described esophageal histology.</p> <p>Methods</p> <p>Children aged 1-11 years with endoscopically or histologically confirmed gastroesophageal reflux disease were randomized to esomeprazole 5 or 10 mg daily (< 20 kg) or 10 or 20 mg daily (≥ 20 kg) for 8 weeks. Patients with erosive esophagitis underwent an endoscopy after 8 weeks to assess healing of erosions.</p> <p>Results</p> <p>Of 109 patients, 49% had erosive esophagitis and 51% had histologic evidence of reflux esophagitis without erosive esophagitis. Of the 45 patients who had erosive esophagitis and underwent follow-up endoscopy, 89% experienced erosion resolution. Dilation of intercellular space was reported in 24% of patients with histologic examination.</p> <p>Conclusions</p> <p>Esomeprazole (0.2-1.0 mg/kg) effectively heals macroscopic and microscopic erosive esophagitis in this pediatric population with gastroesophageal reflux disease. Dilation of intercellular space may be an important histologic marker of erosive esophagitis in children.</p> <p>Trial Registration</p> <p>D9614C00097; ClinicalTrials.gov identifier NCT00228527.</p

Regulation of CEACAM1 transcription in human breast epithelial cells

<p>Abstract</p> <p>Background</p> <p>Carcinoembryonic antigen cell adhesion molecule 1 (CEACAM1) is a transmembrane protein with multiple functions in different cell types. CEACAM1 expression is frequently mis-regulated in cancer, with down-regulation reported in several tumors of epithelial origin and <it>de novo </it>expression of CEACAM1 in lung cancer and malignant melanoma. In this report we analyzed the regulation of CEACAM1 expression in three breast cancer cell lines that varied in CEACAM1 expression from none (MCF7) to moderate (MDA-MB-468) to high (MCF10A, comparable to normal breast).</p> <p>Results</p> <p>Using <it>in vivo </it>footprinting and chromatin immunoprecipitation experiments we show that the <it>CEACAM1 </it>proximal promoter in breast cells is bound in its active state by SP1, USF1/USF2, and IRF1/2. When down-regulated the <it>CEACAM1 </it>promoter remains accessible to USF2 and partially accessible to USF1. Interferon-γ up-regulates CEACAM1 mRNA by a mechanism involving further induction of IRF-1 and USF1 binding at the promoter. As predicted by this analysis, silencing of IRF1 and USF1 but not USF2 by RNAi resulted in a significant decrease in CEACAM1 protein expression in MDA-MB-468 cells. The inactive <it>CEACAM1 </it>promoter in MCF7 cells exhibits decreased histone acetylation at the promoter region, with no evidence of H3K9 or H3K27 trimethylation, histone modifications often linked to condensed chromatin structure.</p> <p>Conclusions</p> <p>Our data suggest that transcription activators USF1 and IRF1 interact to modulate CEACAM1 expression and that the chromatin structure of the promoter is likely maintained in a poised state that can promote rapid induction under appropriate conditions.</p

Atypical glandular cells in conventional cervical smears: Incidence and follow-up

BACKGROUND: Atypical glandular cells on cervical smears are often associated with clinically significant uterine lesions. The frequency and accuracy of AGC-NOS (i.e. atypical glandular cells, not otherwise specified) diagnoses, regardless of the gland cell type or the degree of suspicion, and their outcome were investigated. METHODS: From January 1, 1990 to December 31, 1999 a total of 261 patients had an AGC-NOS diagnosis made by conventional cervical Papanicolaou smear interpretation representing 0.05% of all Pap-smears analyzed at the national level. 191 (73.2%) patients had a subsequent histological examination, 8 samples were not representative by origin and were excluded. RESULTS: Out of 183 AGC-NOS diagnosed, 56.3% (103/183) were associated with tissue-proven precancerous and/or cancerous lesions, 44% being of endocervical and 56% of endometrial origin. 75% of all AGC-patients were asymptomatic. 66.7% (6/9) of the patients with subsequent invasive endocervical adenocarcinoma (AC) and 56% (28/50) of those patients with invasive endometrial AC were without clinical symptoms. 3 patients out of 9 with an invasive endocervical AC were 35 years of age or less. 10.1% and 12.3% of all 'new' tissue-proven invasive endocervical or endometrial AC respectively recorded by the national Morphologic Tumour Registry (MTR) were first identified by a cytological AGC-NOS diagnosis. CONCLUSION: Our findings emphasize the importance of the cytological AGC-category even in the absence of a precise origin or cell type specification. 56% of the AGC-diagnoses being associated with significant cancerous or precancerous conditions, a complete and careful evaluation is required