Genetically marked hepatocytes from dipeptidyl peptidase (DPP) IV؉ Fischer 344 rats were transplanted into the liver of DPPIV ؊ mutant Fischer 344 rats after a combined treatment with retrorsine , a pyrrolizidine alkaloid that blocks the hepatocyte cell cycle, and two-thirds partial hepatectomy. In female rats , clusters of proliferated DPPIV ؉ hepatocytes containing 20 to 50 cells/cluster , mostly derived from single transplanted cells , were evident at 2 weeks , increasing in size to hundreds of cells per cluster at 1 month and 1000 to several thousand cells per cluster at 2 months, representing 40 to 60% of total hepatocyte mass. This level of hepatocyte replacement remained constant for up to 1 year , the duration of experiments conducted. In male rats , liver replacement occurred more rapidly and was more extensive , with transplanted hepatocytes representing 10 to 15% of hepatocyte mass at 2 weeks , 40 to 50% at 1 month , 90 to 95% at 2 months , 98% at 4 months , and 99% at 9 months.

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Older people on lithium-especially those requiring supportive care-are at risk of severe hypernatraemia after an acute illness or if their fluid intake is restricted.

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20015 Background: Acute Lymphatic Leukemia in children is a curable disease in the range of 80–90 % in developed Countries by aggressive protocol like BFM, St. Judes’. In developing Countries like ours, patients can’t tolerate those aggressive protocol because of Socio- economic and nutritional factors. The less aggressive Protocol like INCTR (International Network for Cancer Treatment & Research) are suitable in developing Countries like ours. The aim of our study was to see outcome of childhood ALL patient with INCTR protocol and tolerability of the protocol in Indian-asian population. Methods: We treated 480 Children (age range 1–25 years, median age of 11 yrs) with INCTR Protocol at Netaji Subhash Chandra Bose Cancer Research Institute, Kolkata, India, a tertiary cancer centre from Eastern India during period from April ’99 to Dec ’06. There was female preponderance in the study. Fever 283 (58.9%), lymphadenopathy 211 (43.9%) and haepatosplenomegaly 153 (31.8%) were the major clinical presentation. Forty-three (8.9%) patients were present with hyper Leukocytosis. C-ALL phenotype were the largest group though the incidence of the T-ALL were quite high (27.9%). Results: Remission induction were seen in 446 (92.9%) of the patient. In a follow-up period of 88 months (with an average of 54 months) the disease-free survival ( DFS) was 66.8% (321 patients) with an overall survival of 73.9% (355 patients). The isolated bone marrow relapse was seen in majority of the cases 40 (8.33%) and the major relapse was in maintenance and first 6 months of completion of therapy. The major cause of morbidity was infection 316 (65.8%) followed metabolic complications 81 (16.8%), hemorrhage 52 (10.8%), neurologic 10 (2.08%), hepatitis 6 (1.25%) and pancreatitis 5 (1.04%). The major cause of the mortality was infection 75%(360 patients) followed progressive disease 7.91% (38 patients) and Hemorrhage 5.83%( 28 patients). Conclusions: The data of acute lymphatic leukemia from a developing country is encouraging. The protocol was well tolerated by India- asian population. No significant financial relationships to disclose.

This is an open learning study pack which aims to improve the teaching skills of clinical tutors and other tutors. Topics covered include junior doctors' educational skills and their provision, the funding and management of resources, managing change, and the operation of postgraduate centres.

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