Oral administration of milk from cows immunized with human intestinal bacteria leads to significant improvements of symptoms and signs in patients with oral submucous fibrosis.

BACKGROUND: Previous studies have shown that the local and systemic upregulation of fibrogenic cytokines and downregulation of antifibrotic cytokine are central to the pathogenesis of oral submucous fibrosis (OSF). The milk from cows immunized with human intestinal bacteria (immune milk) contains an anti-inflammatory component that may suppress the inflammatory reaction and modulate cytokine production. Therefore, it was decided to test whether immune milk may have some beneficial effects on controlling the symptoms and signs in OSF patients. METHODS: In this preliminary study, 26 OSF patients who received immune milk treatment (45 g of immune milk powder twice a day) for 3 months and oral habit intervention were included in the experimental group. Another 20 OSF patients who received only oral habit intervention served as the control group. RESULTS: We found that the interincisor distance was significantly improved (> or =3 mm of the baseline measurement) in 18 of the 26 (69.2%) OSF patients in the experimental group at exit. However, in the control group none of the OSF patients had an increase in interincisor distance greater than 2 mm. In addition, disappearance or significant improvement of symptoms at exit was observed in 80% (16/20) of the patients with intolerance to spicy foods (P < 0.001) and 72.2% (13/18) of the patients with xerostomia (P < 0.005) in the experimental group, compared with 17.6% (3/17) of the patients with improvement of intolerance to spicy foods and 15.4% (2/13) of the patients with improvement of xerostomia in the control group. Partial regression of concomitant oral leukoplakia or erythroplakia (judged from the size reduction of the lesions) at exit was noted in 71.4% (5/7) of the patients in the experimental group (P < 0.05), compared with none (0/5) of the patients with improvement in the control group. CONCLUSION: We conclude that oral administration of immune milk leads to significant improvements of symptoms and signs in OSF patients.

Inflammatory pseudotumor of the liver in a patient with human immunodeficiency virus infection.

A 31 year-old male was admitted for investigation of a hepatic tumor, which was incidentally found during abdominal sonography. Abdominal ultrasound revealed a large heterogeneous hyperechoic mass, 4x6x5cm in size, located at the inferior portion of the medial segment of the liver. Abdominal computed tomography without enhancement showed a hepatic tumor, 6 cm in size, in the medial segment of the liver. Malignancy was suspected in the light of radiological presentation. Therefore, wedge resection of the hepatic tumor was performed. The pathological findings revealed that the hepatic tumor was composed of dense fibrous tissue, plump spindle cells, foamy histiocytes, abundant lymphocytes, plasma cells and macrophages which led to the diagnosis of inflammatory tumor of the liver. The post-operative course was uneventful, and the patient was discharged two weeks after operation. Unfortunately, high fever and persisting headache were noted one week after discharge, thus the patient was re-admitted. The infectious focus was investigated during the second admission. Serological test for anti-human immunodeficiency virus was positive. Computed tomography of the brain revealed inflammatory changes over the territory of right middle cerebral artery. The patient died two weeks after the onset of encephalitis. We believe this to be the first case of inflammatory pseudotumor of the liver associated with human immunodeficiency virus infection.

Actin mutations in dilated cardiomyopathy, a heritable form of heart failure.

To test the hypothesis that actin dysfunction leads to heart failure, patients with hereditary idiopathic dilated cardiomyopathy (IDC) were examined for mutations in the cardiac actin gene (ACTC). Missense mutations in ACTC that cosegregate with IDC were identified in two unrelated families. Both mutations affect universally conserved amino acids in domains of actin that attach to Z bands and intercalated discs. Coupled with previous data showing that dystrophin mutations also cause dilated cardiomyopathy, these results raise the possibility that defective transmission of force in cardiac myocytes is a mechanism underlying heart failure.