Dentinogenic Ghost Cell Tumor in a Sumatran Rhinoceros.

An adult female Sumatran rhinoceros was observed with a swelling in the left infraorbital region in March 2017. The swelling rapidly grew into a mass. A radiograph revealed a cystic radiolucent area in the left maxilla. In June 2017, the rhinoceros was euthanized. At necropsy, the infraorbital mass measured 21 cm × 30 cm. Samples of the infraorbital mass, left parotid gland, and left masseter muscle were collected for histopathology (Hematoxylin & Eosin, Von Kossa, Masson's trichrome, cytokeratin AE1/AE3, EMA, p53, and S-100). Numerous neoplastic epithelial cells showing pleomorphism and infiltration were observed. Islands of dentinoid material containing ghost cells and keratin pearls were observed with the aid of the two special histochemistry stains. Mitotic figures were rarely observed. All the neoplastic odontogenic cells and keratin pearls showed an intense positive stain for cytokeratin AE1/AE3, while some keratin pearls showed mild positive stains for S-100. All samples were negative for p53 and S-100 immunodetection. The mass was diagnosed as a dentinogenic ghost cell tumor.

Response of plantain (Plantago lanceolata L.) supplementation on nutritional, endo-parasitic, and endocrine status in lambs.

The aim of the present study was to assess the effects of plantain herb (Plantago lanceolata L.) supplementation on growth, plasma metabolites, liver enzymatic activity, hormonal status, gastrointestinal parasites, and carcass characteristics of lambs. A total of 24 lambs, aged 6 months weighing 8.0 ± 0.5 kg were randomly allocated to one of two dietary treatments: (1) CL diet-roadside grass and concentrate mixture; (2) PL diet-CL diet + 5% fresh plantain supplementation on a DM basis. The PL diet group exhibited 23% higher (P = 0.01) average daily gain and 15% improved (P = 0.03) feed conversion efficiency. Circulating cholesterol concentrations were suppressed by 9% (P = 0.03), and liver enzyme activity was improved by 5-25% (P < 0.05) in the lamb fed PL diet, compared with CL diet only. The inclusion of plantain in the diet was highly effective at suppressing the parasites, Paramphistomum spp. (P = 0.003) and coccidial parasites (P = 0.04), but not stomach worms. Moreover, plantain supplementation increased growth hormone and insulin concentrations in plasma level, whereas decreased carcass fat by 32.7%. Therefore, supplementation of the lambs' diet with plantain showed some beneficial effects on productivity and parasitic infection, while it led to a leaner carcass.

Fifteen years of sector-wide approach (SWAp) in Bangladesh health sector: an assessment of progress.

The Ministry of Health and Family Welfare (MOHFW) of the Government of Bangladesh embarked on a sector-wide approach (SWAp) modality for the health, nutrition and population (HNP) sector in 1998. This programmatic shift initiated a different set of planning disciplines and practices along with institutional changes in the MOHFW. Over the years, the SWAp modality has evolved in Bangladesh as the MOHFW has learnt from its implementation and refined the program design. This article explores the progress made, both in terms of achievement of health outcomes and systems strengthening results, since the implementation of the SWAp for Bangladesh's health sector. Secondary analyses of survey data from 1993 to 2011 as well as a literature review of published and grey literature on health SWAp in Bangladesh was conducted for this assessment. Results of the assessment indicate that the MOHFW made substantial progress in health outcomes and health systems strengthening. SWAps facilitated the alignment of funding and technical support around national priorities, and improved the government's role in program design as well as in implementation and development partner coordination. Notable systemic improvements have taken place in the country systems with regards to monitoring and evaluation, procurement and service provision, which have improved functionality of health facilities to provide essential care. Implementation of the SWAp has, therefore, contributed to an accelerated improvement in key health outcomes in Bangladesh over the last 15 years. The health SWAp in Bangladesh offers an example of a successful adaptation of such an approach in a complex administrative structure. Based on the lessons learned from SWAp implementation in Bangladesh, the MOHFW needs to play a stronger stewardship and regulatory role to reap the full benefits of a SWAp in its subsequent programming.

A systematic review of FDG-PET in breast cancer.

OBJECTIVE: To assess the safety and efficacy of FDG-PET in breast cancer in the diagnostic of primary tumours, lymph node staging, the detection of recurrent disease/metastases, and the assessment of chemotherapy treatment. METHODS: A systematic review was undertaken. A search was made for primary studies, other systematic reviews, and health technology assessment reports in different databases. RESULTS: A total of 73 reports were included. FDG-PET does not appear to be sufficiently accurate to be used in isolation for ruling out the presence of a primary tumour. In lymph gland staging, FDG-PET does not appear to be accurate enough to detect occult axillary metastases or micrometastases (sensitivity 20 and 50%, respectively); sentinel node biopsy is required for confirmation. In the detection of bone metastases, FDG-PET should be complemented with other tests such as bone gammagraphy or SPECT. The assessment of response to chemotherapy, there seems to be no uniform criterion for establishing a standardized uptake value (SUV) for FDG that would allow responders and non-responders to be distinguished. CONCLUSIONS: FDG-PET is insufficiently sensitive to rule out small primary tumours. Due to the high number of false positives returned, it cannot replace axillary dissection in axillary lymph gland staging. A complete biochemical response identified by FDG-PET should not be relied upon to mean an absence of disease since the technique cannot detect residual microscopic elements.

Satisfaction with and psychological impact of immediate and deferred breast reconstruction.

BACKGROUND: The present work assesses the effect of immediate breast reconstruction (IBR), deferred breast reconstruction (DBR), and no breast reconstruction on the psychological impact. PATIENTS AND METHODS: Standard questionnaires were used to determine the psychological impact suffered by patients who underwent IBR, DBR and no reconstruction, their degree of satisfaction with the results achieved, and their postprocedure opinions regarding reconstruction options. RESULTS: A total of 526 women underwent mastectomy. The response rate to the questionnaires was 71.67%. A significantly greater proportion of the women who underwent no reconstruction suffered psychological problems than those who underwent reconstruction of some type (P = 0.01). Some 94.77% of the women who underwent IBR maintained a postprocedure preference for this option; in contrast, some 87.27% of the DBR and 56.14% of the no-reconstruction patients declared a postprocedure preference for IBR. In all, 63.49% of the women who underwent reconstruction were moderately very satisfied with the aesthetic results achieved, while only 22.80% of the no-reconstruction patients declared such satisfaction (P = 0.0001). CONCLUSIONS: The women who underwent no breast reconstruction suffered more emotional problems than those who underwent a reconstruction procedure. In general, all groups reported a postprocedure preference for IBR in their questionnaire answers. The aesthetic results achieved by IBR seem to be those best accepted.

Systematic review of laparoscopic versus open surgery for colorectal cancer.

BACKGROUND: This study compares the efficacy and safety of laparoscopic surgery (LS) and open surgery (OS) for colorectal cancer. METHODS: An electronic search of the literature was undertaken to identify primary studies and systematic reviews. Information on the efficacy and safety of LS versus OS was analysed. A meta-analysis was conducted to examine long-term outcomes. RESULTS: A systematic review published in 2000 and 12 more recent randomized clinical trials were identified. Compared with OS, LS reduced blood loss and pain, and resulted in a faster return of bowel function and earlier resumption of normal diet. Hospital stay was up to 2 days shorter after LS. No significant differences between the techniques were noted in the incidence of complications or postoperative mortality. The time required to complete LS was significantly longer (0.5-1.0 h more). No significant differences were found between the two procedures in terms of overall mortality, cancer-related mortality or disease recurrence. CONCLUSION: LS takes longer than OS but offers several short-term benefits. However, complication rates are similar for both procedures and no differences were found in long-term outcomes.

Type IV collagen production by rat pulmonary alveolar epithelial cells.

Maintenance and repair of the pulmonary alveolar basement membrane are critical processes for preserving normal alveolar structure and function. To elucidate the mechanisms that control type IV collagen production by pulmonary alveolar epithelial cells, type II pneumocytes from rat lungs were isolated and maintained in tissue culture as monolayers. Using Northern blot analysis and metabolic labeling, we found that the cultured epithelial cells express type IV collagen mRNA and incorporate [3H]proline into type IV collagen. To determine the effects of phenotype on control of type IV collagen synthesis, we took advantage of the well-described observation that isolated type II cells lose their distinctive type II features when cultured on plastic in serum-containing medium for 7 days and assume an appearance more like that of type I epithelial cells. We found that [3H]proline incorporation into type IV collagen increased from day 1 to day 2 and thereafter decreased gradually up to day 7. Despite this decrease in [3H]proline incorporation, type IV collagen mRNA increased over the same period. If the loss of type II cell characteristics was prevented by culturing the cells in EHS matrix, a basement membrane-like extracellular matrix, there was little increase in relative abundance of type IV collagen mRNA as compared with cells cultured on plastic. We therefore conclude that type IV collagen production by isolated pulmonary alveolar epithelial cells is controlled, at least in part, by translational or post-translational mechanisms. Furthermore, the full type II cell phenotype is not required for expression of type IV collagen genes.(ABSTRACT TRUNCATED AT 250 WORDS)

Injury of rat pulmonary alveolar epithelial cells by H2O2: dependence on phenotype and catalase.

In a variety of inflammatory lung diseases, type I alveolar epithelial cells are more likely to be injured than are type II cells. Because oxidants have been implicated as a cause of injury in various inflammatory lung diseases, we evaluated the effects of differentiation on alveolar epithelial cell susceptibility to H2O2-induced injury. With the use of isolated rat type II cells in culture, we found that the cytotoxic effect of H2O2 increased between days 2 and 7, when type II cells are known to lose their distinctive type II properties and assume a more type I-like appearance. We previously reported that type II cells utilized both intracellular catalase and glutathione-dependent reactions to protect against H2O2. We therefore examined whether alterations in either of these protective mechanisms were responsible for the differentiation-dependent changes in sensitivity to H2O2. We found that catalase activity within alveolar epithelial cells decreased between 2 and 7 days in culture, whereas no changes were detected in glutathione-dependent systems. We then used a histochemical technique that detects catalase activity and found that type II cells within rat lungs possessed numerous catalase-containing peroxisomes, whereas very few were detected in type I cells. These findings demonstrate that as type II cells assume a type I-like phenotype, they become more susceptible to H2O2-induced injury. This increased susceptibility is associated with reductions in intracellular catalase activity, both in vitro and in vivo.