Free Radical Scavenging Activity of Leaves of Alocasia indica (Linn).

The free radical scavenging potential of the plant Alocasia indica(Linn.) was studied by using different antioxidant models of screening like scavenging of 1,1-diphenyl-2-picryl hydrazyl radical, nitric oxide radical, superoxide anion radical, hydroxyl radical, iron chelating activity, total antioxidant capacity, non-enzymatic glycosylation of haemoglobin, rapid screening for antioxidant compounds by thin layer chromatography. The hydroalcoholic extract at 1000 mug/ml showed maximum scavenging of superoxide radical (87.17) by riboflavin-NBT-system, followed by scavenging of stable radical 1,1-diphenyl-2-picryl hydrazyl radical (83.48%), nitric oxide radical (74.09%) hydroxyl radical (60.96%) at the same concentration. However the extract showed only moderate activity by iron chelation (68.26%). That could be due to higher phenolic content in the extract. This finding suggests that hydro alcoholic extract of A. indica possess potent in vitro antioxidant activity as compared to the standard ascorbic acid. The results justify the therapeutic applications of the plant in the indigenous system of medicine, augmenting its therapeutic value.

Developing new services using fuzzy QFD: a LIFENET case study.

PURPOSE: The purpose of this paper is to suggest the fuzzy quality function deployment (QFD) method to assess LIFENET customers' spoken and unspoken needs in order to achieve the various objectives like: how to decide optimum portfolio for health services strategically; how to assess competitors' market position in order to reckon the market position of LIFENET; and how to set the revised target in order to satisfy the customers' demand and to fetch profit in order to satisfy managers' mission and vision in a competitive market. DESIGN/METHODOLOGY/APPROACH: A fuzzy QFD method has been devised to take care of the various LIFENET objectives. Fuzzy logic's use has been recommended to remove the uncertainty, vagueness, and impreciseness from data obtained to assess customers' spoken and unspoken needs. Symmetric triangular fuzzy numbers (STFNs) may be used to assess various needs to enhance data accuracy. House of quality (HOQ), an in-built QFD matrix, may be constructed to take care of LIFENET's various requirements in order to satisfy internal and external customers. FINDINGS: Fuzzy QFD plays a vital role in assessing customers' need in terms of WHATs. Various WHATs thus obtained can be accomplished by incorporating technical parameter HOWs'. The QFD HOQ offers various vital comparisons for instance, WHATs vs HOWs, HOWs vs HOWs, NOWs vs WHATs, etc. to obtain important inferences, which help to revise target to remain competitive in the market Fuzzy QFD helps devise a management strategy to follow customers' needs in health industry successfully. ORIGINALITY/VALUE: Accessing Indian customers' needs poses many challenges as the decision to opt for a given healthcare service is most uncertain because it varies from person to person. The set of parameters that influence individual decisions to opt for healthcare services are costs, treatment response time, disease/risk, and health service satisfaction. Fuzzy QFD may help LIFENET promoters to consider customers' favored health services thereby helping strategically in their attempt for major expansion, in order to get the most benefits of becoming first-movers in the sector. Fuzzy QFD may also help LIFENET to avert major investment decisions that looked attractive in short-term, but in fact were unfruitful, in long-term.

LIFENET hospitals (India): developing new services' case study.

PURPOSE: Indian healthcare is in the process of offering a plethora of services to customers hailing largely from India and from neighboring countries. The Indian hospital sector consists of private "nursing homes" and government and charitable missionary hospitals. Government and missionary hospitals determine their charges according to patients' income levels and treat poor patients freely. Nursing homes charged higher, market-determined rates. They offer services in just a few medical specialties, owned and operated by physicians who worked with them. Nursing homes cannot afford the latest medical technology, but they provide more intimate settings than government hospitals. This case study aims to demonstrate the various strategic options available to a for-profit hospital, in an emerging economy with a burgeoning middle-class population and how it can choose which services that it can best offer to its target population. DESIGN/METHODOLOGY/APPROACH: Diagnosing and treating complex ailments in nursing homes could be a time-consuming and expensive proposition as visits to several nursing homes with different specialties may be necessary. This paper demonstrates how an hospital can develop new customer-oriented services and eliminate the hassle for patients needing to run around different healthcare outlets even for minor ailments. FINDINGS: The paper finds that large government hospitals generally have better facilities than nursing homes, but they were widely believed to provide poor-quality care. They failed to keep up with advanced equipment, train their technicians adequately and did not publicize their capabilities to doctors who might refer patients. Many missionary and charitable hospitals were undercapitalized and did not offer all services. These conditions left an unsatisfied demand for high-quality medical care. In 1983, LIFENET opened in Madras, becoming the first comprehensive, for-profit hospital in India. LIFENET, invested in a cardiology laboratory and clinics with capacity to diagnose heart and lung ailments, which grew through referrals it received from other doctors. ORIGINALITY/VALUE: Out of promoters' shared vision and the persistence to overcome financial and regulatory hurdles, LIFENET turned into a super specialty hospital. In early 2004, LIFENET promoters considered several options for expansion. In addition to building more hospitals, they considered licensing the brand name and establishing India's first health maintenance organization.

Simultaneous strumal ovarii and lymphoma with emphasis on the diagnostic usefulness of immunohistochemical stains.

Strumal ovarii has been rarely associated with other tumors, such as carcinoid tumor, carcinoma, and primary ovarian malignant lymphoma. We report the coexistence of a strumal ovarii and ovarian involvement by malignant lymphoma in a 70-year-old woman. The tumors were detected 10 years following exposure to ionizing radiation during the Chernobyl nuclear tragedy.

Detection of HIV in oral mucosal cells.

OBJECTIVE: To determine the prevalence of HIV DNA and RNA and the morphologic localization of HIV in the oral cavity of HIV-seropositive subjects. DESIGN: A cross-sectional analysis of saliva, buccal scrapings and buccal biopsies from HIV-seropositive injecting drug users (IDUs). SUBJECTS AND METHODS: Whole saliva, buccal mucosal scrapings and buccal biopsies were obtained from HIV-seropositive and seronegative IDUs. Presence of HIV DNA and RNA was assessed by polymerase chain reaction (PCR) and reverse transcriptase PCR (RT-PCR). RT in situ PCR was used to detect HIV tat/rev RNA in buccal mucosal scrapings. Host-cell integrated HIV-proviral DNA in buccal biopsies was detected by in situ PCR. Presence of intact HIV viral particles in buccal scrapings was assessed by electron microscopy. RESULTS: HIV DNA was detected in 40% (18/45) and HIV RNA in 69.2% (25/36) of saliva samples from HIV-seropositive IDUs. Viral particles consistent with HIV were localized in inter-epithelial spaces by electron microscopy. RT in situ PCR revealed the presence of HIV tat/rev RNA in 36% (8/22) of the seropositive samples tested. CONCLUSIONS: Our results suggest that epithelial cells can be productively infected by HIV. Epithelial cells in buccal mucosa may acquire HIV in the basal layers through contact with submucosal HIV-positive lymphocytes and/or Langerhans' cells. HIV infection may also spread by inter-epithelial cell contact. As HIV infected cells mature they travel to more superficial layers and are shed into the oral cavity.

Cyclopia: craniofacial appearance on MR and three-dimensional CT.

In a case of alobar holoprosencephaly, a neonate who died several minutes after birth was found to have multiple facial and intracranial malformations, including cyclopia. Postmortem MR and CT findings included a single midline orbit, with two globes that contained separate lenses supplied by a single optic nerve. There were two separate superior orbital fissures and two separate lateral rectus muscles.

Oral HIV-I recovery in the presence of periodontal disease.

OBJECTIVE: To determine whether a significant association occurs between the presence of various periodontal diseases and recoverable infectious HIV-I in the saliva of injecting drug users. DESIGN: Five hundred and fifty-one injecting drug users were recruited from various programs associated with the Beth Israel Medical Center. Examiners were 'blinded' to the subject's HIV-I serostatus. A socio-economic and risk factors' survey was conducted and a complete oral examination, including periodontal disease indices was performed. Whole saliva and blood were collected for virus culture. MAIN OUTCOME MEASUREMENTS: Recovery of infectious HIV-I in saliva related to presence of periodontal diseases. RESULTS: Those HIV-I seropositive subjects with periodontal diseases did not differ from those HIV-I seropositive subjects without periodontal disease in mean age and immune status. Less than 1% of the HIV-I seropositive subjects had cultivable HIV-I in their saliva while it was present in 78% of PBMCs and 35% of the sera. There was no significant association between infectious HIV-I in saliva, serum, or PBMCs and any of the various periodontal diseases. CONCLUSIONS: The presence of periodontal disease in HIV-I seropositive injecting drug users does not appear to be a potential risk factor for infectious HIV-I in saliva, probably due to the various anti-viral components of saliva.

Infection of oral mucosal cells by human immunodeficiency virus type 1 in seropositive persons.

Molecular studies have revealed significant amounts of human immunodeficiency virus type 1 (HIV-1) provirus DNA in saliva of HIV-infected persons. However, cellular localization has not been determined. In situ polymerase chain reaction (IS-PCR) was done on saliva-associated cells for localization of HIV-1 provirus DNA. Results indicate its presence in the nuclei of saliva-associated epithelial cells in 29 (83%) of 35 HIV-1-seropositive subjects. In 24 (83%) of the 29 IS-PCR-positive samples, 0.1%-4.0% of the mucosal epithelial cells exhibited nuclear localization of HIV-1 DNA. In addition, HIV-1 provirus DNA was detected in monocytes or lymphocytes of all salivary samples from the 35 subjects. The localization of HIV-1 provirus DNA indicates that epithelial cells are another cell type infected by HIV-1 in vivo. These findings suggest epithelial cells in other body sites might also be infected with HIV-1.

Disinfection efficacy in an integrated ultraviolet light contact lens care system.

We evaluated a new integrated contact lens care system that combines fluid turbulence for lens cleaning with ultraviolet (UV) light for solution sterilization. The ultraviolet light system was used to clean and disinfect 42 soft contact lenses (water contents: 38.6%, 43%, 55%, and 70%) and two rigid gas permeable lenses. Test lenses were contaminated with 10(6) cells/mL of Bacillus pumilus, Aspergillus niger, Pseudomonas aeruginosa, and Acanthamoeba castellanii and subjected to a 15-minute cleaning-disinfection cycle. Bathing solutions and contact lenses were cultured at various time intervals and at the end of the cycle. All bathing solutions and all lenses but one were found to be sterile after one cycle. All units effectively disinfected solutions and contact lenses. This device may be an effective alternative to existing contact lens care systems.

The number of CD1a+ large low-density cells with dendritic cell features is increased in the peripheral blood of HIV+ patients.

Employing a discontinuous Percoll gradient following Ficoll-Hypaque separation of peripheral blood mononuclear cells from normal subjects (n = 14) and patients with HIV-1 infection (n = 50), we separated a population of low-density cells consisting of monocytoid cells, lymphocytes, and some granulocytes. In cytospin preparations, less than 5% of the monocytoid cells were positive for nonspecific esterase and CD14. However, CD1a was positive in 5-20% of these cells. Ultrastructurally, CD1a-labeled immunogold particles were demonstrated on the monocytoid cells which bore some features of dendritic cells. Flow cytometry of the low-density cells identified a subset of buoyant, large cell population, which excluded lymphocytes. This large low-density cell (LLDC) population was significantly expanded in patients with HIV infection and comprised 32.3 +/- 21.3% of low-density cells compared to 7.0 +/- 2.8% in normal subjects (P < 0.0001). Of the LLDC population 45.2 +/- 23.4% were CD1a+ in patients compared to 17.5 +/- 13.3% in normal subjects (P < or = 0.0001). HLA-DR and HLA-DQ were coexpressed in approximately 70 and 50% of these CD1a+ LLDC, respectively. A simple nonculture assay method employed by us facilitates rapid screening of infected blood specimens for the CD1a+ large low-density cells with dendritic cell features, which could be an additional parameter to monitor HIV disease progression.

Differential binding capacity and internalisation of bacterial substrates as factors in growth rate of Acanthamoeba spp.

Acanthamoeba spp. are free-living predators that selectively feed on bacteria. Adherence of the bacterial food source to the trophozoite membrane is followed by internalisation and digestion. Through co-cultivation of A. castellanii and A. polyphaga, individually, with Xanthomonas maltophilia, Escherichia coli, Staphylococcus epidermidis and Pseudomonas aeruginosa (despite the amoebicidal properties of the latter organism), specificity with regard to the preferred bacterial substrate was judged. X. maltophilia and P. aeruginosa adhered almost immediately forming a multilayered mantle of bacilli around trophozoites of both species of amoebae. E. coli adhered to fewer trophozoites and in smaller numbers. X. maltophilia was readily internalised after co-cultivation for 8 h, whereas P. aeruginosa, E. coli and S. epidermidis were not internalised even after co-cultivation for 24 h. These data suggest that the suitability of a bacterial food source for the Acanthamoeba spp. studied is associated not only with the proclivity with which the bacterial species binds to the trophozoite surface, but also with the rate of its internalisation.

Expression of cell adhesion molecules associated with germinal center in Hodgkin's disease: an immunohistochemical study. The germinal center related complex and histologic subtypes.

BACKGROUND: Of the four elements known to be associated with germinal center formation--B-cells, follicular dendritic cells, T-cells, and the cell adhesion molecules--the first three have been well studied in Hodgkin's disease, especially the nodular lymphocytic predominance subtype, established as a tumor of germinal center origin. However, no study has been done on the expression of the cell adhesion molecules associated with germinal center formation in Hodgkin's disease. METHODS: Using the avidin-biodin peroxidase complex method, we studied the staining patterns for CD11a (lymphocyte function-associated antigen 1), CD54 (intercellular cell adhesion molecule 1), and very late antigen 4 (VLA-4) in frozen sections from 24 cases of Hodgkin's disease, along with those for follicular dendritic cell and cell surface markers for lymphocytes. RESULTS: Reed-Sternberg cells and their variants and histiocytic cells stained for CD54. Lymphocytes stained for CD11a. Lymphocytes either formed patchy aggregates or dispersed without forming aggregates. Aggregating lymphocytes expressed CD20 (L-26), whereas dispersed, nonaggregating lymphocytes expressed CD3/CD4, or CD3/CD8. Extracellular matrices of these CD20+ B-cell aggregates stained for CD54, VLA-4, and follicular dendritic cells. CD54 staining revealed four patterns of reaction products deposits: discretely patchy, confluent, predominantly diffuse, and diffuse only. The discrete-patch predominance pattern was seen in the lymphocytic predominance type, both nodular (n = 3) and diffuse (n = 2), and in classic nodular sclerosis with broad collagen bands (n = 4). The confluent pattern was seen in tumors with features of cellular-phase nodular sclerosis versus mixed cellularity type (n = 3). The predominantly diffuse was observed in the remainder of nodular sclerosis type with infrequent, narrow collagen bands (n = 5), in cellular-phase nodular sclerosis (n = 1), in cellular-phase nodular sclerosis versus mixed cellularity type (n = 2), and in mixed cellularity (n = 2). The diffuse-only pattern occurred in mixed cellularity with abundant fibrohistiocytoid stromal cells (n = 2). CONCLUSIONS: The cell adhesion molecules associated with germinal center formation were expressed in the great majority of cases of Hodgkin's disease. The expression was closely associated with the occurrence of distinctive CD20+ B-cell aggregates and follicular dendritic cell networks, forming a germinal center-related complex, and the presence of the complex correlated with nodular sclerosing features.

A peptide inhibitor of human immunodeficiency virus infection binds to novel human cell surface polypeptides.

Putative cell surface human immunodeficiency virus (HIV) gp41 receptor proteins of 45 and 80 kDa (p45 and p80, respectively) were identified on human cells using a 17-amino acid peptide, referred to as CS3. In contrast, murine P815 cells expressed a peptide binding protein of 80 kDa only. A segment of 8 amino acids within CS3 contains the minimum sequence able to inhibit binding of radiolabeled CS3 to p80 and p45, as shown by competitive binding studies. Human p45 was purified from CD4+ RH9 cells by CS3 peptide affinity chromatography. Human p80 was partially purified from RH9 cell lysates by size exclusion chromatography followed by SDS-polyacrylamide gel electrophoresis; a rabbit polyclonal antibody was raised against this preparation. Anti-p80 antibody inhibited HIV infection in a dose-dependent manner. The CS3 region of gp41 has been been shown previously to be exposed on viral particles and envelope-expressing cells predominately after conformational changes in the HIV envelope occur due to the interaction of CD4 with gp120. These results, together with those from previous studies, suggest that following the interaction of gp120 with CD4, there may be a second receptor interaction necessary for virus entry/fusion.

Inhibition of Acanthamoeba species by Pseudomonas aeruginosa: rationale for their selective exclusion in corneal ulcers and contact lens care systems.

Cocultivation of Acanthamoeba castellanii and Acanthamoeba polyphaga with live Pseudomonas aeruginosa and with broth filtrates of P. aeruginosa proved equally lethal to the Acanthamoeba spp. The P. aeruginosa-induced amebicidal activity is apparently toxin mediated and has two operative modes: it can function through binding of P. aeruginosa to the ameba membrane and in the presence of one or more P. aeruginosa exoproducts.

Acanthamoeba keratitis: synergy between amebic and bacterial cocontaminants in contact lens care systems as a prelude to infection.

We encountered a patient with Acanthamoeba keratitis whose contact lens care solution contained numerous trophozoites and cysts admixed with Xanthomonas maltophilia organisms, many of which were adherent to the trophozoite surface and internalized within endocytic vacuoles. Because of this finding, we investigated the role of bacterial cocontaminants in contact lens care systems as substrates for the growth of Acanthamoeba spp. Individual cocultivation of Acanthamoeba castellanii and A. polyphaga with X. maltophilia, Flavobacterium breve, and Pseudomonas paucimobilis showed better enhancement (1.5x) of ameba growth after 96 h than that obtained in the presence of Staphylococcus aureus, S. epidermidis, and Escherichia coli, the standard cocultivation species used for isolation of amebae from clinical specimens. Our data suggest that contamination of contact lens care systems with Acanthamoeba spp. and a bacterial species capable of supporting amebic growth may be the first step in the pathogenesis of ameba-induced keratitis by the provision of large inocula of amebae.