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The aim of this study was to test the association of self-reported sleep symptoms to those identified with severe hypertension in a nationally representative sample of adults. Self-reported and study-measured health and sleep characteristics were collected by the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. Of 10,526 individuals with completed sleep surveys participating in the study, the authors identified 379 patients with severe hypertension defined as those treated with ≥ 3 antihypertensive medications including a diuretic; 110 of these had resistant hypertension (RHTN) despite therapy, while 269 were controlled for severe hypertension (CSHTN). Patients with RHTN were more likely to be married, less educated, smoke, and self-report unsatisfactory health and diabetes when compared with patients with CSHTN. Multivariate analyses showed that poorly controlled diabetes (glycated hemoglobin >7%) was the strongest predictor of RHTN (odds ratio, 3.0; 95% confidence interval, 1.2-7.9). Unsatisfactory health (odds ratio, 1.7; 95% confidence interval, 1.7-2.7) was also associated with RHTN. Poorly controlled diabetes and self-reported unsatisfactory heath showed significant association with RHTN. Contrary to expectations, there was no significant association between self-reported snoring/snorting and RHTN, when other factors were examined. The association between poorly controlled diabetes and RHTN warrants further emphasis on strict control of diabetes in these individuals., (© 2012 Wiley Periodicals, Inc.)

Drought is the major environmental factor limiting crop productivity worldwide. We hypothesized that it is possible to enhance drought tolerance by delaying stress-induced senescence through the stress-induced synthesis of cytokinins in crop-plants. We generated transgenic rice (Oryza sativa) plants expressing an isopentenyltransferase (IPT) gene driven by P(SARK) , a stress- and maturation-induced promoter. Plants were tested for drought tolerance at two yield-sensitive developmental stages: pre- and post-anthesis. Under both treatments, the transgenic rice plants exhibited delayed response to stress with significantly higher grain yield (GY) when compared to wild-type plants. Gene expression analysis revealed a significant shift in expression of hormone-associated genes in the transgenic plants. During water-stress (WS), P(SARK)::IPT plants displayed increased expression of brassinosteroid-related genes and repression of jasmonate-related genes. Changes in hormone homeostasis were associated with resource(s) mobilization during stress. The transgenic plants displayed differential expression of genes encoding enzymes associated with hormone synthesis and hormone-regulated pathways. These changes and associated hormonal crosstalk resulted in the modification of source/sink relationships and a stronger sink capacity of the P(SARK)::IPT plants during WS. As a result, the transgenic plants had higher GY with improved quality (nutrients and starch content)., (© 2011 The Authors. Plant Biotechnology Journal © 2011 Society for Experimental Biology, Association of Applied Biologists and Blackwell Publishing Ltd.)

Cardiac arrhythmias have been reported in up to half of individuals with obstructive sleep apnea (OSA) and have been proposed to be one of the factors contributing to their increased mortality. Several studies have demonstrated evidence of an association between OSA and a number of cardiac arrhythmias. The mechanisms of arrhythmogenesis in OSA may be due to enhanced vagal output triggered by a combination of apnea and hypoxemia. This case demonstrates a dose-dependent reduction in atrial ectopy with increasing continuous positive airway pressure (CPAP) in the setting of mild sleep apnea.

In the present study, two chloroform extracts of fruits of Terminalia chebula viz. "CHL1" and "CHL 2" prepared by maceration and sequential method respectively was compared for their antioxidant efficacy and phenolic content. The extraction procedure of plant material plays an important role in the activity of phytochemicals. Also, the assessment of antioxidant capacity of phytochemicals cannot be executed precisely by any single method due to complex nature of phytochemicals as multiple reaction characteristics and mechanisms can be involved. So, no single assay could accurately reflect comparison in a mixed or complex system. Therefore in the present study the comparison of extracts was done by using most widely used assays viz. DPPH, deoxyribose, reducing power, chelating power and lipid peroxidation assay. Furthermore, the UV-Vis spectrum of both extracts and the correlation between total phenolic content was examined in order to give an orientation to the search of phytochemicals responsible for their activity. From the results, it was concluded that antioxidant activity and phenolic compounds were predominant in the 'CHL 2' prepared by sequential method. The present study enlightening the useful extraction procedure of plant material.

Rice (Oryza sativa) is a staple food for more than half the world and a model for studies of monocotyledonous species, which include cereal crops and candidate bioenergy grasses. A major limitation of crop production is imposed by a suite of abiotic and biotic stresses resulting in 30%-60% yield losses globally each year. To elucidate stress response signaling networks, we constructed an interactome of 100 proteins by yeast two-hybrid (Y2H) assays around key regulators of the rice biotic and abiotic stress responses. We validated the interactome using protein-protein interaction (PPI) assays, co-expression of transcripts, and phenotypic analyses. Using this interactome-guided prediction and phenotype validation, we identified ten novel regulators of stress tolerance, including two from protein classes not previously known to function in stress responses. Several lines of evidence support cross-talk between biotic and abiotic stress responses. The combination of focused interactome and systems analyses described here represents significant progress toward elucidating the molecular basis of traits of agronomic importance., Competing Interests: The authors have declared that no competing interests exist.

Elevated salinity imposes osmotic and ion toxicity stresses on living cells and requires a multitude of responses in order to enable plant survival. Building on earlier work profiling transcript levels in rice (Oryza sativa) shoots of FL478, a salt-tolerant indica recombinant inbred line, and IR29, a salt-sensitive cultivar, transcript levels were compared in roots of these two accessions as well as in the roots of two additional salt-tolerant indica genotypes, the landrace Pokkali and the recombinant inbred line IR63731. The aim of this study was to compare transcripts in the sensitive and the tolerant lines in order to identify genes likely to be involved in plant salinity tolerance, rather than in responses to salinity per se. Transcript profiles of several gene families with known links to salinity tolerance are described (e.g. HKTs, NHXs). The putative function of a set of genes identified through their salt responsiveness, transcript levels, and/or chromosomal location (i.e. underneath QTLs for salinity tolerance) is also discussed. Finally, the parental origin of the Saltol region in FL478 is further investigated. Overall, the dataset presented appears to be robust and it seems likely that this system could provide a reliable strategy for the discovery of novel genes involved in salinity tolerance.

Proteins play major roles in most biological processes; as a consequence, protein expression levels are highly regulated. While extensive post-transcriptional, translational and protein degradation control clearly influence protein concentration and functionality, it is often thought that protein abundances are primarily determined by the abundances of the corresponding mRNAs. Hence surprisingly, a recent study showed that abundances of orthologous nematode and fly proteins correlate better than their corresponding mRNA abundances. We tested if this phenomenon is general by collecting and testing matching large-scale protein and mRNA expression data sets from seven different species: two bacteria, yeast, nematode, fly, human, and rice. We find that steady-state abundances of proteins show significantly higher correlation across these diverse phylogenetic taxa than the abundances of their corresponding mRNAs (p=0.0008, paired Wilcoxon). These data support the presence of strong selective pressure to maintain protein abundances during evolution, even when mRNA abundances diverge.

Stored starch generally consists of two d-glucose homopolymers, the linear polymer amylose and a highly branched glucan amylopectin that connects linear chains. Amylopectin structurally contributes to the crystalline organization of the starch granule in cereals. In the endosperm, amylopectin biosynthesis requires the proper execution of a coordinated series of enzymatic reactions involving ADP glucose pyrophosphorylase (AGPase), soluble starch synthase (SS), starch branching enzyme (BE), and starch debranching enzyme (DBE), whereas amylose is synthesized by AGPase and granule-bound starch synthase (GBSS). It is highly possible that plastidial starch phosphorylase (Pho1) plays an important role in the formation of primers for starch biosynthesis in the endosperm. Recent advances in our understanding of the functions of individual enzyme isoforms have provided new insights into how linear polymer chains and branch linkages are synthesized in cereals. In particular, genetic analyses of a suite of mutants have formed the basis of a new model outlining the role of various enzyme isoforms in cereal starch production. In our current review, we summarize the recent research findings related to starch biosynthesis in cereal endosperm, with a particular focus on rice.

We previously characterized the rice (Oryza sativa) Submergence1 (Sub1) locus encoding three ethylene-responsive factor (ERF) transcriptional regulators. Genotypes carrying the Sub1A-1 allele are tolerant of prolonged submergence. To elucidate the mechanism of Sub1A-1-mediated tolerance, we performed transcriptome analyses comparing the temporal submergence response of Sub1A-1-containing tolerant M202(Sub1) with the intolerant isoline M202 lacking this gene. We identified 898 genes displaying Sub1A-1-dependent regulation. Integration of the expression data with publicly available metabolic pathway data identified submergence tolerance-associated pathways governing anaerobic respiration, hormone responses, and antioxidant systems. Of particular interest were a set of APETALA2 (AP2)/ERF family transcriptional regulators that are associated with the Sub1A-1-mediated response upon submergence. Visualization of expression patterns of the AP2/ERF superfamily members in a phylogenetic context resolved 12 submergence-regulated AP2/ERFs into three putative functional groups: (1) anaerobic respiration and cytokinin-mediated delay in senescence via ethylene accumulation during submergence (three ERFs); (2) negative regulation of ethylene-dependent gene expression (five ERFs); and (3) negative regulation of gibberellin-mediated shoot elongation (four ERFs). These results confirm that the presence of Sub1A-1 impacts multiple pathways of response to submergence.

Background: Rice and barley are both members of Poaceae (grass family) but have a marked difference in salt tolerance. The molecular mechanism underlying this difference was previously unexplored. This study employs a comparative genomics approach to identify analogous and contrasting gene expression patterns between rice and barley., Results: A hierarchical clustering approach identified several interesting expression trajectories among rice and barley genotypes. There were no major conserved expression patterns between the two species in response to salt stress. A wheat salt-stress dataset was queried for comparison with rice and barley. Roughly one-third of the salt-stress responses of barley were conserved with wheat while overlap between wheat and rice was minimal. These results demonstrate that, at transcriptome level, rice is strikingly different compared to the more closely related barley and wheat. This apparent lack of analogous transcriptional programs in response to salt stress is further highlighted through close examination of genes associated with root growth and development., Conclusion: The analysis provides support for the hypothesis that conservation of transcriptional signatures in response to environmental cues depends on the genetic similarity among the genotypes within a species, and on the phylogenetic distance between the species.

Postzygotic lethality of interspecies hybrids can result from differences in gene expression, copy number, or coding sequence and can be overcome by altering parental genome dosage. In crosses between Arabidopsis thaliana and A. arenosa, embryo arrest is associated with endosperm hyperproliferation and delayed development similar to paternal-excess interploidy crosses and polycomb-repressive complex (PRC) mutants. Failure is accompanied by parent-specific loss of gene silencing including the dysregulation of three genes suppressed by PRC. Increasing the maternal genome dosage rescues seed development and gene silencing. A gene set upregulated in the failing seed transcriptome encoded putative AGAMOUS-LIKE MADS domain transcription factors (AGL) that were expressed in normal early endosperm and were shown to interact in a previous yeast 2-hybrid analysis. Suppression of these AGL's expression upon cellularization required PRC. Preceding seed failure, expression of the PRC member FIS2 decreased concomitant with overexpression of the AGL cluster. Inactivating two members, AGL62 and AGL90, attenuated the postzygotic barrier between A. thaliana and A. arenosa. We present a model where dosage-sensitive loss of PRC function results in a dysregulated AGL network, which is detrimental for early seed development.

Background: A large number of genetic variations have been identified in rice. Such variations must in many cases control phenotypic differences in abiotic stress tolerance and other traits. A single feature polymorphism (SFP) is an oligonucleotide array-based polymorphism which can be used for identification of SNPs or insertion/deletions (INDELs) for high throughput genotyping and high density mapping. Here we applied SFP markers to a lingering question about the source of salt tolerance in a particular rice recombinant inbred line (RIL) derived from a salt tolerant and salt sensitive parent., Results: Expression data obtained by hybridizing RNA to an oligonucleotide array were analyzed using a statistical method called robustified projection pursuit (RPP). By applying the RPP method, a total of 1208 SFP probes were detected between two presumed parental genotypes (Pokkali and IR29) of a RIL population segregating for salt tolerance. We focused on the Saltol region, a major salt tolerance QTL. Analysis of FL478, a salt tolerant RIL, revealed a small (< 1 Mb) region carrying alleles from the presumed salt tolerant parent, flanked by alleles matching the salt sensitive parent IR29. Sequencing of putative SFP-containing amplicons from this region and other positions in the genome yielded a validation rate more than 95%., Conclusion: Recombinant inbred line FL478 contains a small (< 1 Mb) segment from the salt tolerant parent in the Saltol region. The Affymetrix rice genome array provides a satisfactory platform for high resolution mapping in rice using RNA hybridization and the RPP method of SFP analysis.

Trafficking in women and children is a gross violation of human rights. However, this does not prevent an estimated 800 000 women and children to be trafficked each year across international borders. Eighty per cent of trafficked persons end in forced sex work. India has been identified as one of the Asian countries where trafficking for commercial sexual exploitation has reached alarming levels. While there is a considerable amount of internal trafficking from one state to another or within states, India has also emerged as a international supplier of trafficked women and children to the Gulf States and South East Asia, as well as a destination country for women and girls trafficked for commercial sexual exploitation from Nepal and Bangladesh. Trafficking for commercial sexual exploitation is a highly profitable and low risk business that preys on particularly vulnerable populations. This paper presents an overview of the trafficking of women and girls for sexual exploitation (CSE) in India; identifies the health impacts of CSE; and suggest strategies to respond to trafficking and related issues.

Barley (Hordeum vulgare L.) is a salt-tolerant member of the Triticeae. Recent transcriptome studies on salinity stress response in barley revealed regulation of jasmonic acid (JA) biosynthesis and JA-responsive genes by salt stress. From that observation and several other physiological reports, it was hypothesized that JA is involved in the adaptation of barley to salt stress. Here we tested that hypothesis by applying JA to barley plants and observing the physiological responses and transcriptome changes. Photosynthetic and sodium ion accumulation responses were compared after (1) salinity stress, (2) JA treatment and (3) JA pre-treatment followed by salinity stress. The JA-pre-treated salt-stressed plants accumulated strikingly low levels of Na(+) in the shoot tissue compared with untreated salt-stressed plants after several days of exposure to stress. In addition, pre-treatment with JA partially alleviated photosynthetic inhibition caused by salinity stress. Expression profiling after a short-term exposure to salinity stress indicated a considerable overlap between genes regulated by salinity stress and JA application. Three JA-regulated genes, arginine decarboxylase, ribulose 1.5-bisphosphate carboxylase/oxygenase (Rubisco) activase and apoplastic invertase are possibly involved in salinity tolerance mediated by JA. This work provides a reference data set for further study of the role of JA in salinity tolerance in barley and other plants species.

Background: Golden Promise is a salt-tolerant spring barley closely related to Maythorpe. Salt tolerance in Golden Promise has been attributed to a single mutation at the Ari-e locus (on 5H) resulting from irradiation of Maythorpe. Golden Promise accumulates lower shoot Na+ compared to Maythorpe when growing under saline conditions. This study focused on elucidating the genetic basis and mechanisms involved in this difference., Results: The level of polymorphism between the two genotypes was explored using the Barley1 GeneChip for single feature polymorphisms (SFPs) and an oligonucleotide pool assay for single nucleotide polymorphisms (SNPs). Polymorphism analyses revealed three haplotype blocks spanning 6.4 cM on chromosome 1H, 23.7 cM on chromosome 4H and 3.0 cM on 5H. The Barley1 GeneChip was used to examine transcript abundance in different tissues and stages during development. Several genes within the polymorphic haplotype blocks were differentially regulated. Additionally, a more global difference in the jasmonic acid pathway regulation was detected between the two genotypes., Conclusion: The results confirm that Golden Promise and Maythorpe are genetically very closely related but establish that they are not isogenic, as previously reported, due to three polymorphic haplotype blocks. Transcriptome analysis indicates that the response of the two genotypes to salinity stress is quite different. Additionally, the response to salinity stress in the roots and shoot tissue is strikingly different.

Rice yield is most sensitive to salinity stress imposed during the panicle initiation (PI) stage. In this study, we have focused on physiological and transcriptional responses of four rice genotypes exposed to salinity stress during PI. The genotypes selected included a pair of indicas (IR63731 and IR29) and a pair of japonica (Agami and M103) rice subspecies with contrasting salt tolerance. Physiological characterization showed that tolerant genotypes maintained a much lower shoot Na+ concentration relative to sensitive genotypes under salinity stress. Global gene expression analysis revealed a strikingly large number of genes which are induced by salinity stress in sensitive genotypes, IR29 and M103 relative to tolerant lines. We found 19 probe sets to be commonly induced in all four genotypes. We found several salinity modulated, ion homeostasis related genes from our analysis. We also studied the expression of SKC1, a cation transporter reported by others as a major source of variation in salt tolerance in rice. The transcript abundance of SKC1 did not change in response to salinity stress at PI stage in the shoot tissue of all four genotypes. However, we found the transcript abundance of SKC1 to be significantly higher in tolerant japonica Agami relative to sensitive japonica M103 under control and stressed conditions during PI stage.

Barley (Hordeum vulgare L.) is a salt-tolerant crop species with considerable economic importance in salinity-affected arid and semiarid regions of the world. In this work, barley cultivar Morex was used for transcriptional profiling during salinity stress using a microarray containing approximately 22,750 probe sets. The experiment was designed to target the early responses of genes to a salinity stress at seedling stage. We found a comparable number of probe sets up-regulated and down-regulated in response to salinity. The differentially expressed genes were broadly characterized using gene ontology and through expression-based hierarchical clustering to identify interesting features in the data. A prominent feature of the response to salinity was the induction of genes involved in jasmonic acid biosynthesis and genes known to respond to jasmonic acid treatment. A large number of abiotic stress (heat, drought, and low temperature) related genes were also found to be responsive to salinity stress. Our results also indicate osmoprotection to be an early response of barley under salinity stress. Additionally, we compared the results of our studies with two other reports characterizing gene expression of barley under salinity stress and found very few genes in common.

More than 2,000 genome-wide barley single nucleotide polymorphisms (SNPs) were developed by resequencing unigene fragments from eight diverse accessions. The average genome-wide SNP frequency observed in 877 unigenes was 1 SNP per 200 bp. However, SNP frequency was highly variable with the least number of SNP and SNP haplotypes observed within European cultivated germplasm reflecting effects of breeding history on genetic diversity. More than 300 SNP loci were mapped genetically in three experimental mapping populations which allowed the construction of an integrated SNP map incorporating a large number of RFLP, AFLP and SSR markers (1,237 loci in total). The genes used for SNP discovery were selected based on their transcriptional response to a variety of abiotic stresses. A set of known barley abiotic stress QTL was positioned on the linkage map, while the available sequence and gene expression information facilitated the identification of genes potentially associated with these traits. Comparison of the sequenced SNP loci to the rice genome sequence identified several regions of highly conserved gene order providing a framework for marker saturation in barley genomic regions of interest. The integration of genome-wide SNP and expression data with available genetic and phenotypic information will facilitate the identification of gene function in barley and other non-model organisms.

Rice (Oryza sativa), a salt-sensitive species, has considerable genetic variation for salt tolerance within the cultivated gene pool. Two indica rice genotypes, FL478, a recombinant inbred line derived from a population developed for salinity tolerance studies, and IR29, the sensitive parent of the population, were selected for this study. We used the Affymetrix rice genome array containing 55,515 probe sets to explore the transcriptome of the salt-tolerant and salt-sensitive genotypes under control and salinity-stressed conditions during vegetative growth. Response of the sensitive genotype IR29 is characterized by induction of a relatively large number of probe sets compared to tolerant FL478. Salinity stress induced a number of genes involved in the flavonoid biosynthesis pathway in IR29 but not in FL478. Cell wall-related genes were responsive in both genotypes, suggesting cell wall restructuring is a general adaptive mechanism during salinity stress, although the two genotypes also had some differences. Additionally, the expression of genes mapping to the Saltol region of chromosome 1 were examined in both genotypes. Single-feature polymorphism analysis of expression data revealed that IR29 was the source of the Saltol region in FL478, contrary to expectation. This study provides a genome-wide transcriptional analysis of two well-characterized, genetically related rice genotypes differing in salinity tolerance during a gradually imposed salinity stress under greenhouse conditions.

Fifty canals of extracted single-rooted teeth were prepared to a size 50 master apical file, sterilized in ethylene oxide, and inoculated with a known quantity of Bacillus stearothermophilus spores. Five groups of 10 canals each were used. The control group received no treatment. The four treatment groups were exposed to pulsed Nd:YAG laser radiation or 0.5% NaOCl alone and in combination. The root canals were flushed with sterile distilled water to recover spores, and serial dilutions were incubated on blood agar and the number of colony-forming units recovered was determined. Analysis of the data indicated a 2-log reduction in colony-forming units among the four treatment groups as compared with the controls; however, no significant differences were observed among the treatment groups. In none of the treatment groups were the root canals sterilized.

Objective: To review unusual presenting features and diagnostic difficulties of abdominal tuberculosis in an endemic region., Design: Retrospective clinical study from 1984 to 1989, illustrated by case reports., Setting: A single hospital in Kuwait., Patients: Fifty patients with abdominal tuberculosis established by the standard histologic and bacteriologic demonstration of acid-fast bacilli or tuberculous granulomas., Main Outcome Measures: Site of disease and unusual features at presentation., Results: Tubercular lesions are most commonly seen in the ileocecal region. They are also common in the ileum but are less common in the appendix and jejunum. Involvement of the ascending colon, rectum and upper gastrointestinal tract is rare. Abdominal tuberculosis presents in many ways depending on the degrees of ulceration, fibrous healing, infection and caseating abscess formation., Conclusions: Abdominal tuberculosis should be considered in immigrants from regions where this disease is endemic who present with abdominal signs and symptoms. Imaging studies, endoscopy and laparoscopy may preclude laparotomy for the diagnosis of abdominal tuberculosis. Antituberculosis chemotherapy is the mainstay of treatment.

The osseous reaction of IRM and EBA cement were studied utilizing an intraosseous implant technique in rats. Samples of IRM, EBA cement, and amalgam were placed into polyethylene tubes and subsequently introduced surgically into rat tibias. Specimens of each were evaluated histologically after 7, 14, 21, 56, and 100 days. The IRM and amalgam samples demonstrated essentially complete healing at 56 days. The EBA cement samples displayed a slightly greater inflammatory response up to the 56-day interval; however, they also showed complete healing by 100 days. A favorable osseous reaction was seen with both of these zinc oxide-eugenol materials.

Prevalence and morphologic features of the apical delta in the canine teeth of dogs were determined to assist clinicians in the endodontic treatment of these teeth. Eighty-two canine teeth from mixed-breed dogs were cleared and dyed to outline root canal ramifications. Apical deltas were classified according to location in the dental arch, number of ramifications, and vertical extent of these ramifications from the apical terminus. A classification system was devised to aid in identification and treatment of the delta. Recommendations were made regarding indications for conventional and/or surgical endodontic therapy depending on the type of delta encountered. Apical deltas were detected in 69.5% of the canine teeth studied. Surgical endodontic intervention should be seriously considered when the delta is found to extend a distance > 1 mm from the apical terminus.

This study was conducted to determine the biological effects on the periradicular tissues of Nd:YAG laser endodontic treatment in dogs. Twelve vital teeth (24 roots) of two mongrel dogs were randomly selected to receive conventional or Nd:YAG laser endodontic treatment. Endodontic therapy was performed on the second, third, or fourth, right or left, mandibular premolars. The teeth were evaluated radiographically and histologically at 1, 15, and 30 days after endodontic treatment. The remaining teeth served as untreated controls. The results of this study revealed laser treatment causes cell necrosis in the periodontal ligament 1 day after treatment. Conventionally prepared teeth displayed no evidence of cell necrosis in the periodontal ligament. At 15 days posttreatment, both the laser and conventionally treated teeth showed increased size and numbers of osteocytes and osteoclasts in the periradicular bone. Additionally, laser-treated teeth showed signs of initial bone resorption. At 30 days posttreatment, conventionally treated teeth began to return to normal morphology. The laser-treated teeth exhibited ankylosis, cemental lysis, and major bone remodeling.

Cholesterol granulomas are common in the mastoid region but have rarely been reported in other areas. The authors report the case of a 40-year-old man who had a cholesterol granuloma of the peritoneum. They discuss the morphology of the condition and the difficulties of diagnosis. It is likely that chronic or recurrent inflammation plays a major role in the pathogenesis and that, when dealing with such lesions preoperatively or intraoperatively, a radical approach may not be necessary.

Forty-two cases of abdominal tuberculosis seen between June 1984 and June 1988 at Amiri Hospital in Kuwait were reviewed retrospectively. The clinical diagnosis was correct in only 35%. Nine patients presented as an emergency, but in none was a diagnosis of tuberculosis considered. Abdominal pain and tenderness were the commonest clinical findings; "doughy abdomen" and a mass in right iliac fossa were uncommon. Thus, symptoms were vague, signs nonspecific and investigations nonpathognomonic. In spite of this, abdominal tuberculosis should be considered in any patient who has obscure abdominal symptoms, weight loss and lethargy. Laparoscopy and colonoscopy with biopsy for histologic and bacteriologic study led to a definitive diagnosis in 66% of cases, obviating the need for exploratory laparotomy in many. Histologic examination was the surest way to establish the diagnosis.

Intrasplenic abscess is an uncommon but potentially lethal condition. Seven cases of splenic abscess were seen between 1985 and 1988. There are no specific clinical findings; symptoms and signs of fever, abdominal pain and tenderness were present in all seven cases but were only helpful in diagnosing splenic abscess in three cases. Computed tomographic scanning probably at present offers the most direct way of evaluating the spleen and making an early diagnosis. Splenectomy was done in three cases and antibiotics were used in four cases with equally successful results. Contrary to the prevalent opinion, we believe that medical management is an important addition to the surgeon's armamentarium and offers a viable alternative in selected cases of splenic abscess. A successful outcome is dependent on a high degree of clinical alertness, an aggressive diagnostic approach and prompt effective treatment.

The thermal effects of continuous wave carbon dioxide laser irradiation on human teeth were investigated. Internal temperature changes were monitored by means of electrical thermistors implanted within the pulp chambers of 20 extracted, unerupted human molar teeth. One-hundred test exposures at various powers and durations were obtained. Linear regression/correlation analysis of the data suggests a direct relationship between the independent variable, exposure energy (joules), and the dependent variable, internal temperature, under the conditions of this study.

Abnormalities in bile ducts pattern occur frequently enough to merit importance during cholecystectomy. A patient with anomalous insertion of both hepatic ducts into the gall-bladder with the cystic duct replacing the common bile duct is described. This case, and related anomalies of the bile ducts, are sufficiently important for us to ascertain their location and pattern prior to removal of the gall-bladder. Inadvertent injury to a normal or aberrant bile duct can result in morbidity and even mortality. Knowledge of the embryogenesis of these anomalies helps in the understanding of the location and pattern of these malformations. Almost all of these unusual bile duct arrangements can be recognised by following the rules of meticulous dissection and accurate knowledge of these anatomical aberrations.

Fungal (cryptococcal) mastitis in a young woman seemed to be a systemic manifestation of the infection, since it recurred contralaterally within 4 months. Diagnostic problems are discussed. Only two previous reports of deep mammary mycosis were found. In addition to excision, ketoconazole is recommended to prevent recurrence or serious complications.

The case records 50 patients with abdominal pain and hyperamylasemia were studied in detail. Ten cases of gallstone induced hyperamylasemia, in which no evidence of pancreatitis was found at operation, were excluded. The etiological factors in the remaining group of forty cases of acute pancreatitis, in a community practicing alcohol abstinence, were reviewed. Both alcoholic and idiopathic pancreatitis were insignificant factors in the etiology of acute pancreatitis. Eighty percent of cases of acute pancreatitis were due to biliary tract disease. A younger age-group and female preponderance, as well as biochemical evidence of cholestasis, was observed in this group. An inverse relationship between preoperative serum amylase levels and the severity of the disease was noted. A more aggressive diagnostic work-up is, however, warranted to identify these cases, for which early surgery is advocated. There was no mortality in operated cases of biliary pancreatitis.

A case of eosinophilic granuloma of the gastrointestinal tract with free perforation is described. The authors believe this is the first such case to be published. The patient, a 60-year-old woman, had no history of allergy. At laparotomy, 100 ml of pus was aspirated. A 42-cm section of small bowel, containing multiple punched-out ulcers, was excised. The mucosa and submucosa of the operative specimen were edematous; there was a moderate inflammatory infiltrate containing numerous eosinophils and neutrophils. The lesion appeared to represent a local reaction to some antigen with resultant eosinophilic infiltration.