Pancreatic cancer is still considered to be one of the leading causes of cancer deaths. The most common of all the different types of pancreatic cancer is ductal original malignant tumors, and their clinical features are commonly characterized. However, for the rare tumors in the pancreatic region, the clinical features often vary, and detection of the cancers are detected late. Limited data are available to guide the management of very rare neoplasms of the pancreas. Therefore, to recognize or detect the rare tumors in the pancreatic region are of importance for the clinical practice.

Human being living in constant contact with microbes and pathogen and in the process has developed a recognition pattern of pathogenic structure in the immune cells. The gut lumen has high density of microbes thus the immune response is slightly tolerable to certain microbes, known as commensal flora. These microbes along with other innocuous agents do not cause any inflammation response normally, and are considered as harmless by the immune cells. In immune hypersensitivity condition, such as colitis or food allergy, this mechanism is disturbed. T cell immunoglobulin and mucin domain (TIM)-4 is a phosphatidylserine receptor expressed in mature antigen presenting cells. It is shown that TIM-4 and its ligand TIM-1 are associated in intestinal immune response. However the characteristic of TIM-4 sometimes seems to be two-faced and there is a possibility that TIM-4 also bind to other ligands.

Procathepsin D is a major glycoprotein that is secreted from numerous types of cancer cells including breast, lung and prostrate carcinomas. It affects multiple stages of tumorigenesis that include proliferation, invasion, metastasis and apoptosis. Previous studies showed that the mitogenic effect of procathepsin D on cancer cells was mediated through its propeptide or activation peptide. Recent studies have also implicated the possible use of procathepsin D/activation peptide as a marker of cancer progression. Considering the broad range of functions of procathepsin D, the present review summarizes the three major potentials of procathepsin D-cancer progression, tumor marker and wound healing.

Background: E-cadherin is expressed in most normal epithelial tissues. Selective loss of E-cadherin can cause dedifferentiation and invasiveness in human carcinomas, leading E-cadherin to be classified as a tumor suppressor. Loss of E-cadherin has been demonstrated in invasive lobular carcinoma of the breast, but the relationship between E-cadherin expression and breast cancer histopathology and prognosis is less clear. Aim: Our objective was to assess loss of E-cadherin as a diagnostic breast cancer biomarker and as an aid to the sub-classification of invasive breast cancer. We also correlated the loss of expression of E-cadherin with various clinical and pathologic prognostic factors. Material and Methods: Breast cancer specimens after modified radical mastectomy were obtained from women who underwent surgery at Grant Medical College and Sir J.J Group of Hospitals, Mumbai, India between May 2007 and October 2010. We stained 276 breast cancers specimens with monoclonal antibodies to E-cadherin. The breast cancers were classified by histopathological type. Results: A statistical correlation of E-cadherin loss with a positive diagnosis of invasive lobular carcinoma was found, but there was no correlation with any prognostic tumor variables. A negative E-cadherin stain was a sensitive and specific biomarker to confirm the diagnosis of invasive lobular carcinoma (specificity 97.7%; negative predictive value 96.8%; sensitivity 88.1%; and positive predictive value 91.2%). Positive E-cadherin expression was also associated with tubulolobular carcinomas. Conclusions: E-cadherin immunohistochemistry is helpful in classifying breast cancer cases with indeterminate histopathologic features. E-cadherin loss is uncommon in non-lobular carcinomas but shows no correlation to currently established prognostic variables.

Background: Frequent exposure to premium motor spirit (PMS) is common and could be a risk factor for liver dysfunction in those occupationally exposed. A possible association between PMS fumes and plasma total antioxidant status as well as plasma levels of zinc, manganese, copper and selenium using a rodent model could provide new insights into the pathology of the liver where cellular dysfunction is an established risk factor. Aim: This study aimed to determine the total antioxidant status and plasma levels of zinc, copper, selenium and manganese in those occupationally exposed using rodent model. Materials and Methods: 25 albino Wistar rats of both sexes were used for this study. The animals were divided into five groups of five rats in each group. Group 1 rats were not exposed to PMS fumes (control group), group 2 rats were exposed for 1 hour daily, group 3 for 3 hours daily, group 4 for 5 hours daily and group 5 for 7 hours daily. The experiment lasted for a period of 4 weeks. Blood samples obtained from all the groups after 4 weeks of exposure were used for the determination of plasma total antioxidant status as well as plasma levels of zinc, manganese, copper and selenium. Results: Results showed significant increases in means of plasma copper (69.70±0.99 for test and 69.20±1.02 for control, P < 0.05) and selenium (72.70±1.58 for test and 68.20±0.86 for control, P < 0.05) in the exposed rats when respective mean values were compared with those of corresponding controls. Mean body weight index (BWI) and percentage weight increase (PWI) were significantly lower (P < 0.05) in exposed rats when compared with the unexposed group. The mean plasma levels of zinc (137.40±4.06 for test and 147.80±2.52 for control) and manganese (65.75±1.02 for test and 70.00±0.71 for control) showed significant decrease (P < 0.05) when compared with control. Plasma level of total antioxidant status (TAS) did not differ significantly in exposed rats when compared with the control group. Conclusion: This study showed that frequent exposure to PMS fumes may lead to increase plasma levels of copper and selenium probably due to liver dysfunction and decrease in plasma levels of zinc and manganese probably as a result of interference in their metabolic pathway of the exposed groups.

Background : Viral hepatitis during pregnancy is associated with high risk of maternal complications and has become a leading cause of foetal death. Aims : This study aimed at determining the prevalence of hepatitis B and C viral infections among pregnant women attending the antenatal clinic of the University of Benin Teaching Hospital. Patients and Methods: This was a hospital based cross-sectional study that included 5760 pregnant women who attended the antenatal clinic of the hospital during the periods of October 2009 - October 2010. Relevant data was gathered and women having history of previous liver diseases, diabetes and pre-eclamptic toxemia were excluded from the study. Rapid diagnostic test kits were used to screen for Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus (HCV) antibodies. Results : 720 (12.5%) and 206 (3.6%) out of 5,760 pregnant women included in the study were found to be positive for Serum antibodies to hepatitis B and C respectively. 33 (0.57%) were found to have mixed infections of hepatitis B and C. None of the expected risk factors had significant outcome. Conclusion : This study showed that the prevalence of the Hepatitis B virus (HBV) among pregnant women in this study area is of intermediate endemicity (12.5%).

Background: Hypertension in developing setting is often attributed to westernization of life style and stresses of urbanization, some of these increases have been noted in Nigeria. Aim: This is a study on rural-urban differences on the blood pressure, obesity and anthropometrics among a major ethnic group in Nigeria. Patients and Method: A total of 325 men and 242 women aged 20 to 80 years, of the Igbo ethnicity were selected for this study. The samples were selected from the rural and urban subgroups of the Igbo population. Systolic and diastolic blood pressure, body mass index, waist- hip ratio, waist-height ratio, waist circumference, triceps, subscapular, calf and sum of the three skin fold thicknesses and other anthropometric measurements were obtained using standard procedures. Result: Blood pressure correlated with age and most of the anthropometric parameters (p< 0.05 ). All adiposity and blood pressure indicators were higher in the urban than in the rural sample. Women showed higher predisposition to both general and abdominal obesities in both samples. High blood pressure occurred more often in the urban sample than the rural. Urban men had the highest mean blood pressure (p< 0.05). High blood pressure appeared much connected with the pressures of city life. Regression formulae were derived for all the adiposity measures of Igbos in both rural and urban locations. Conclusion: High rates of obesity and hypertension are noted among Igbos in both rural and urban areas. This is especially in the urban setting. The finding is indicative of a low level of attention on hypertension and obesity in the Igbos. The data reported here call for intervention programs on the risks, preventions and management of obesity and obesity related conditions.

Context : Infection of following total hip arthroplasties can be classified based on the timing of infection. Late infections with Actinomyces israelii are extremely rare with only 3 previously reported cases in literature. We present another case of a late infection with Actinomyces israelii in a total hip arthroplasty 9 years following implantation. Case Report : A 71-year-old male with diabetes mellitus presented with right hip pain 9 years following a total hip arthroplasty. Physical examination revealed localised pain and biochemical investigations showed elevated inflammatory markers. X-rays were suspicious for infection and a collection around the prosthesis was confirmed by MRI scan. The patient underwent debridement and removal of prosthesis. Peri-operative specimen cultures isolated Actinomyces israelii. The patient responded to a combination of vancomycin followed by ciprofloxacin and linezolid therapy before undergoing a successful second-stage reimplantation surgery. Conclusion : This is the first reported case of late haematogenous infection by Actinomyces israelii in a total hip arthroplasty in a patient with diabetes mellitus as the only risk factor. The patient was successfully treated with antibiotic therapy and two-stage reimplantation arthroplasty.

Context : Xanthogranulomatous pyelonephritis is an extremely rare but known entity resulting from prolonged suppuration of the kidney. The disease may be focal or diffuse and may pose considerable diagnostic dilemma at times. Surgery is curable and remains optimal treatment of choice. Owing to its rarity and clinical curiosity we report such a rare case encountered in our clinical practice. Case Report: We report a case of non-functioning kidney suggestive of either Tuberculosis or xanthogranulomatous pyelonephritis in the pre-operative period depending upon the clinical aqumen and investigations available and nephrectomy was done. It was confirmed as xanthogranulomatous pyelonephritis histopathologically. Conclusion : Preoperative diagnosis of xanthogranulomatous pyelonephritis may pose difficulty and nephrectomy remains the treatment of choice especially in diffuse cases of xanthogranulomatous pyelonephritis.

Context: Discoid lupus erythematosus is a chronic inflammatory skin disorder presenting with scarring lesions that occur predominately on sun exposed areas of the face and scalp. Case Report: A 22-year-old male was evaluated after presenting with reddish-purple, atrophic and erythematous plaques on the scalp, with loss of hair within the plaques. Biopsies for hematoxylin and eosin examination, direct immunofluorescence and immunohistochemistry analysis were performed. The hematoxylin and eosin staining demonstrated classic features of cutaneous lupus. Direct immunofluorescence revealed strong deposits of immunoglobulins IgG and IgM, fibrinogen and Complement/C3, present in 1) a shaggy pattern at the epidermal basement membrane zone, and 2) focal pericytoplasmic and perinuclear staining within epidermal keratynocytes. Immunohistochemisty staining revealed strongly positive staining with antibodies to cyclooxygenase-2, Zeta-chain-associated protein kinase 70, and HLA-DPDQDR in areas where the inflammatory infiltrate was predominant, as well as around dermal blood vessels and within the dermal extracellular matrix. Conclusions : Noting the autoimmune nature of lupus and its strong inflammatory component, we present a patient with active discoid lupus erythematosus and strong expression of Zeta-chain-associated protein kinase 70, cyclo-oxygenase-2, and HLA-DPDQDR in the inflammatory areas. We suggest that these molecules may play a significant role in the immune response of discoid cutaneous lupus, possibly including 1) the biosynthesis of the prostanoids and 2) activation of the signaling cascade in response to T-lymphocyte receptor stimulation.