Morphological Features of Tyrosine Hydroxylase Immunoreactive Cells in the Mouse Islets of Langerhans

The current immunohistochemical study used the antibody against tyrosine hydroxylase (TH) to observe the immunoreactive elements in the mouse pancreas. The results indicated the presence of immunoreactive nerve fibers and endocrine cells. The immunopositive nerve fibers appeared as thick and thin bundles; thick bundles were seen to run along the blood vessels giving out fine fibers to the wall. Varicose nerve fibers were seen in the islets of Langerhans and also in close association with the exocrine endpieces. The TH immunoreactive cells were oval-round in shape and some showed the central non-staining area and the dense staining peripheral zone. More than 80% of the islets of Langerhans contained the immunoreactive cells. Individual islet showed between 3-10 immunopositive cells and a few contained 1-2 cells. The TH immunopositive cells were widely distributed in the islets; they were seen in the centre, at the intermediate position and at the periphery of the islets. The exact role of the TH immunoreactive cells in the islets of Langerhans is not known. It is possible that they secrete tyrosine hydroxylase that may have some paracrine influence to the endocrine cells. Wide distribution of these cells in the islets indicates that they may regulate the entire population of the islets cells.Keywords: Balb/c mouse, Pancreas, Islet of Langerhans, Tyrosine Hydroxylase, Immunohistochemistr

Effect of trimethoprim-sulphamethoxazole on the risk of malaria in HIV-infected Ugandan children living in an area of widespread antifolate resistance

<p>Abstract</p> <p>Background</p> <p>Daily trimethoprim-sulfamethoxazole (TS) protects against malaria, but efficacy may be diminished as anti-folate resistance increases. This study assessed the incidence of falciparum malaria and the prevalence of resistance-conferring <it>Plasmodium falciparum </it>mutations in HIV-infected children receiving daily TS and HIV-uninfected children not taking TS.</p> <p>Materials and methods</p> <p>Subjects were 292 HIV-infected and 517 uninfected children from two cohort studies in Kampala, Uganda observed from August 2006 to December 2008. Daily TS was given to HIV-infected, but not HIV-uninfected children and all participants were provided an insecticide-treated bed net. Standardized protocols were used to measure the incidence of malaria and identify markers of antifolate resistance.</p> <p>Results</p> <p>Sixty-five episodes of falciparum malaria occurred in HIV-infected and 491 episodes in uninfected children during the observation period. TS was associated with a protective efficacy of 80% (0.10 vs. 0.45 episodes per person year, p < 0.001), and efficacy did not vary over three consecutive 9.5 month periods (81%, 74%, 80% respectively, p = 0.506). The prevalences of <it>dhfr </it>51I, 108N, and 59R and <it>dhps </it>437G and 540E mutations were each over 90% among parasites infecting both HIV-infected and uninfected children. Prevalence of the <it>dhfr </it>164L mutation, which is associated with high-level resistance, was significantly higher in parasites from HIV-infected compared to uninfected children (8% vs. 1%, p = 0.001). Sequencing of the <it>dhfr </it>and <it>dhps </it>genes identified only one additional polymorphism, <it>dhps </it>581G, in 2 of 30 samples from HIV-infected and 0 of 54 samples from uninfected children.</p> <p>Conclusion</p> <p>Despite high prevalence of known anti-folate resistance-mediating mutations, TS prophylaxis was highly effective against malaria, but was associated with presence of <it>dhfr </it>164L mutation.</p

High Resistance of Plasmodium falciparum to Sulphadoxine/Pyrimethamine in Northern Tanzania and the Emergence of dhps Resistance Mutation at Codon 581

BACKGROUND: Sulphadoxine-pyrimethamine (SP) a widely used treatment for uncomplicated malaria and recommended for intermittent preventive treatment of malaria in pregnancy, is being investigated for intermittent preventive treatment of malaria in infants (IPTi). High levels of drug resistance to SP have been reported from north-eastern Tanzania associated with mutations in parasite genes. This study compared the in vivo efficacy of SP in symptomatic 6-59 month children with uncomplicated malaria and in asymptomatic 2-10 month old infants. METHODOLOGY AND PRINCIPAL FINDINGS: An open label single arm (SP) standard 28 day in vivo WHO antimalarial efficacy protocol was used in 6 to 59 months old symptomatic children and a modified protocol used in 2 to 10 months old asymptomatic infants. Enrolment was stopped early (87 in the symptomatic and 25 in the asymptomatic studies) due to the high failure rate. Molecular markers were examined for recrudescence, re-infection and markers of drug resistance and a review of literature of studies looking for the 581G dhps mutation was carried out. In symptomatic children PCR-corrected early treatment failure was 38.8% (95% CI 26.8-50.8) and total failures by day 28 were 82.2% (95% CI 72.5-92.0). There was no significant difference in treatment failures between asymptomatic and symptomatic children. 96% of samples carried parasites with mutations at codons 51, 59 and 108 in the dhfr gene and 63% carried a double mutation at codons 437 and 540. 55% carried a third mutation with the addition of a mutation at codon 581 in the dhps gene. This triple: triple haplotype maybe associated with earlier treatment failure. CONCLUSION: In northern Tanzania SP is a failed drug for treatment and its utility for prophylaxis is doubtful. The study found a new combination of parasite mutations that maybe associated with increased and earlier failure. TRIAL REGISTRATION: ClinicalTrials.gov NCT00361114

Multiple renal anomalies associated with encapsulated swellings of the sciatic nerve

The current observation reports the occurrence of the left renal anomalies and encapsulated swellings involving the left sciatic nerve in a 47 years old male cadaver. Renal anomalies consisted of left double kidney, left bifid ureter and double arterial supply to the left kidney. The double kidney consisted of the two upper and lower segments that were separated by a deep furrow internally; externally the surface appeared smooth and there was no evidence for the presence of two segments. The left renal hilum showed two ureters that appeared to arise separately from the pelves of the upper and lower segments. They remained separated in most of their course in the abdomen and pelvis; at the last 0.6cm the two ureters joined to form a common channel that entered the urinary bladder. The double kidney was supplied by two renal vessels that arose separately from the abdominal aorta. Dissection of the left lower limb of the same individual revealed multiple encapsulated swellings that were attached at the sides of the left sciatic nerve. The swellings were oval-round in shape and the largest one measured about 10cm long and 6.5cm wide. Individual swellings appeared to be surrounded by a thick capsule that enclosed brown looking firm materials which had a uniform consistency and there was no evidence of tissue necrosis. To the authors knowledge this is the first report on concomitant appearance of renal anomalies with multiple peripheral nerve swellings. The current observations are considered to be incidental findings, but future observations are needed to verify that we are not missing this association

Bilateral bifid occipital condyles presenting with the right accessory articular surface

The current observation reports the anomalies involving the occipital condyles in a 38 years old male as seen during dissection. Both condyles presented with a transverse cleft measuring about 2mm wide that divided the occipital condyles into rostral and caudal segments. The caudal segments were oval-cuboidal in shape and on average they measured 1.8cm long and 1.5cm wide. The rostral segment appeared elongate in shape and measured 0.5cm wide and 2cm long. Unlike the left occipital condyle the right occipital condyle contained an additional oblique cleft that separated the left caudal occipital segment into the inner main portion and the outer accessory articular surface. The accessory articular surface was concave in shape and covered with the articular cartilage. The exact mechanism that resulted into formation of reported anomalies are notknown and awaits future research. The craniovertebral junction is embryologically very dynamic region and subject to variations that can give rise into different types of congenital anomalies. Anomalies of the occipital condyles and other elements of craniovertebral junction are in many cases associated with neurological symptoms, therefore, continued documentation of such anomalies remains to be important not only for anatomists but also to clinicians

Bilateral anomalies of renal pelves presenting with supernumerary left testicular vein

The current observation presents a case of right duplicated renal pelvis and anomalies of right and left renal vessels. The duplicated pelves formed anterior and posterior segments which entered the renal substance separately and each had its own set of renal major calyces. The anterior segment appeared dilated, measuring about 1.3cm wide and was  associated with three major calyces. The posterior segment had a straight course and appeared narrower than the anterior segment; it measured 0.75cm wide and it was associated with one major calyx. Both anterior and posterior segments joined into a common channel that formed the ureter.The left kidney was observed to have dilated triangular renal pelvis with a base measuring 4cm, it was associated with supernumerary testicular veins both which drained into the left renal vein. Congenital anomalies of therenal pelvis can lead to pelvicoureteric obstruction, urinary tract infection, stone and cancer formation. Supernumerary testicular vein are very rare anomalies ad have been commonly observed in females than in the males. Ontological significance of such anomalies is not clearly known, but continuous documentation of congenital abnormalities of the urinary  system remains to be important in medical and surgical practiceKEY WORDS: Kidney, Renal pelvis, Testicular vein, Congenital anomalie

An unusual case of postaxial polydactyly of the feet

Polydactyly is a fairly common congenital anomaly characterized by additional fingers and/or toes, generally divided into three groups: medial ray (preaxial) and central and lateral ray (postaxial). We present a case of postaxial (fibular) polydactyly of the feet, assaying its clinical and radiological features and the method of surgical correction. Clinical outcomes after initial surgery were excellent in both feet. This surgical case shows that a careful individual preoperative planning is necessary to achieve good functional and cosmetic outcome. Level of Evidence: Level V, therapeutic study. © 2013 Springer-Verlag Berlin Heidelberg