Correlation of pulmonary function tests with body fat percentage in young individuals

The present study was planned to assess the correlation of pulmonary functions with body fat percentage in young individuals. A total of 132 (males--68, females--64) young students (18 to 21 years) with moderately sedentary lifestyle were recruited in this study. Their height, weight, body mass index (BMI) and waist to hip ratio (WHR) were measured. Pulmonary function tests (static and dynamic) were recorded on a computerized portable Schiller lung function unit SP-1. The percentage of body fat was estimated by measuring skin fold thickness at four sites (4SFT-biceps, triceps, subscapular and suprailiac) with the help of Harpenden's caliper. In males body fat % showed negative correlation with expiratory reserve volume (ERV), forced vital capacity (FVC), maximum ventilatory volume (MVV), peak expiratory flow rate (PEFR) and forced expiratory volume at the end of first second (FEV1). It was observed that in females body fat % had negative correlation with ERV, FVC, and MVV. These results indicate that increase in percentage of body fat and central pattern of fat distribution may affect the pulmonary function tests.

Cervical thymic cyst: a case report

Cervical thymic cysts are rare benign lesions. It should be considered in the differential diagnosis of cervical cysts in paediatric age group. This paper presents a case of a 6 years male child who presented with gradually increasing painless mass on right side of neck. Surgical excision was done. Histopathological study revealed features diagnostic of thymic cyst. It was clinically diagnosed as branchial cleft cyst. Though rare, thymic cysts should be included in the differential diagnosis of neck masses, especially in children.

Microcystic adenoma of pancreas: a case report

Microcystic adenomas of the pancreas are rare benign neoplasms that occur most frequently in elderly females. Characteristically, the tumors have a spongy gross appearance and are composed of innumerable cysts lined by flat, and cuboidal cells which are rich in glycogen. They commonly present with abdominal discomfort or pain. In this case report, we present a cystic neoplasm of pancreas in a 65-year-old lady who clinically presented with discomfort in the abdomen and hyperglycaemia. Proximal pancreatectomy was done. Histopathological examination of surgical specimen confirmed the diagnosis of "Microcystic Adenoma ofPancreas". Despite of the rarity, microcystic adenoma should kept in the mind as the differential diagnosis of cystic lesions of pancreas.

A vascular ring variant: an unusual case of vocal cord palsy due to an anomalous left carotid artery arising from a retrotracheal arch of the aorta

We present the case of an unusual vascular ring in a 23-year-old male patient who presented for CT examination of the chest for diagnostic work up for unilateral vocal cord palsy. Contrast-enhanced CT revealed the left common carotid artery to be arising from the ascending part of a retrotracheal arch of aorta and traversing anterior to the trachea in the retromanubrial space.

Variations in serum glucose, urea, creatinine and sodium and potassium as a consequence of delayed transport/processing of samples and delay in assays

Fifty blood samples were drawn in replicates and brought to the laboratory. One batch of the samples was processed immediately and the glucose, urea, creatinine and the electrolytes, sodium and potassium were assayed. The batch of replicate samples were processed after three hours and the assays performed. The assays for the above analytes were again performed from the replicate samples after twenty-four hours of serum-clot contact. The variations of the values of the above analytes were scrutinized. Glucose values showed significant variation with time. There was significant decrease in the glucose values after three hours and after further twenty-four hours of serum-clot contact the values reduced significantly. The variations in the values of urea and creatinine and also sodium after processing the samples after three hours and also further twenty-four of serum-clot contact were insignificant. The values of potassium after processing after three hours were insignificant but the values however increased significantly after further twenty-four hours of serum-clot contact.

Magnetic resonance urography (MRU) versus intravenous urography (IVU) in obstructive uropathy: a prospective study of 30 cases

AIM

Intravenous Urography (IVU) as a diagnostic modality has limitations in patients of obstructive uropathy with impaired renal function. Our aim was to study the technique and diagnostic accuracy of Magnetic Resonance Urography (MRU) in obstructive uropathy and to correlate the findings with IVU.

METHODOLOGY

Forty-eight patients, selected over a six-month period, based on mild to severe pelvicalyceal dilatation on screening ultrasonography, underwent an IVU; those having non-obstructive dilatation were excluded (18 patients). Thirty patients (age range 10 to 75 years) with definite obstructive dilatation underwent MRU. These were obtained using an open MRI unit (Siemens Magnetom Open Viva) with low-dose gadolinium-DTPA (0.01 mmol/kg body weight) using various MRI sequences. MRU studies were classified as 'excellent' or 'diagnostic' and data generated was compared with that of IVU.

RESULTS

MRU studies were 'excellent' in twelve and 'diagnostic' in eighteen patients. Of the sixty pelvicalyceal systems (PCS) evaluated in thirty patients, there were thirty-seven calculi, nine pelvi-ureteric junction (PUJ) obstructions, six with impaired renal function, four malrotated kidneys and one each of horseshoe kidney, pancake kidney, pelvic mass (endometriomas), duplex moieties, ureterocele and vesico-ureteric reflux. MRU better depicted moderate-severe PCS dilatation, staghorn and urethral calculi, impaired renal function, extrinsic ureteric and PUJ obstruction. IVU better depicted small calculi and mild PCS dilatation.

CONCLUSIONS

In these thirty patients of obstructive uropathy, low magnetic field, open MRI units and low-dose Gd-DTPA provided cost-effective MRU studies with excellent diagnostic utility. MRU scored over IVU in patients with moderate-severe dilatation, staghorn and urethral calculi, impaired renal function, extrinsic ureteric and PUJ obstruction.

Aortic arch variation: a unique case with anomalous origin of both vertebral arteries as additional branches of the aortic arch distal to left subclavian artery

We present the case of bilateral anomalous origin of both vertebral arteries (VAs) in a 20-year-old male patient who presented for routine contrast-enhanced CT follow-up examination of the chest. Contrast-enhanced CT revealed abnormal origins of both the VAs from the aortic arch distal to the origin of the left subclavian artery. Following this, CT angiography was performed, which confirmed the findings. To our knowledge, this is the first report of anomalous origins of both VAs beyond the origin of the left subclavian artery. The possible embryonic mechanism and the clinical importance of this variant is also reviewed.

Virtual bronchoscopy for diagnosis of inhalation injury in burnt patients

Virtual bronchoscopy using a multislice CT scanner, is a new non-invasive imaging technique and its utility in the diagnosis of inhalation injury in burnt patients has not been reported in literature yet. Initial experience of technique is encouraging and it merits more interest. It overcomes many of the limitations of the presently established procedure of fibreoptic bronchoscopy. Ten burned patients with clinical suspicion of inhalation injury underwent this investigation and in eight of these the diagnosis was confirmed.

Role of multidetector CT virtual bronchoscopy in the evaluation of post-tracheostomy tracheal stenosis--a preliminary study

AIM

To study the technique and utility of virtual bronchoscopy (virtual reality endobronchial simulation, VRES) as a tool to evaluate post-tracheostomy tracheal stenoses and to correlate the findings of virtual and invasive bronchoscopy and to follow-up treated lesions or those currently under treatment that were initially diagnosed with VRES.

METHODOLOGY

This prospective study comprised nine patients in the age group 13 to 65 years presenting with breathlessness and stridor following one or multiple tracheostomies. They underwent plain CT using a multidetector CT (MDCT) scanner (Siemens Volume Zoom) using narrow (1 mm) collimation. These thin slice images were post-processed using an Irix-based workstation with a 'Fly-Through' endoscopy application. These patients also underwent a rigid (three patients) or fiberoptic (six patients) bronchoscopy.

RESULTS

Of the nine patients that underwent VRES, five were found to have stenoses, three had obstructing granulation tissue, one had an obstructing membrane and one had synechiae. The invasive bronchoscopic findings supported the VRES diagnosis in all but one case of stenosis, one of granulation tissue and the case with synechiae. Membranes and synechiae were relatively difficult to diagnose without the corresponding axial and multiplanar images. VRES achieved a higher sensitivity, while invasive bronchoscopy a higher specificity.

CONCLUSIONS

VRES proved to be comparable to invasive bronchoscopy in the depiction of post-tracheostomy tracheal stenoses, with a notable advantage in critical stenoses in that the airway distal to the stenosis could be assessed with VRES but not with invasive bronchoscopy. A preliminary VRES was found to be of assistance in the selection of patients for the more invasive therapeutic procedures such as laser ablation of granulation tissue and its follow-up.

Tuberculous mastoiditis

A 14 month old child with intractable painless otorrhoea resistant to conventional treatment with sadden onset facial palsy was referred to us for HRCT of temporal bone. A rare diagnosis of tuberculous mastoiditis was made which was confirmed by histopathological reports. In this case the use of a Multislice CT scanner (Siemens Volume Zoom) in demonstrating the intricate involvement of the middle and inner ear structures by the disease is accentuated.

Indigenous knowledge and uses of medicinal plants by local communities of the Kali Gandaki Watershed Area, Nepal

A field survey was conducted in the villages of Ramdi, Malunga, Balam, Beltari, Mirmi, Burgha and Ridi in the Kali Gandaki watershed, Nepal; 48 medicinal plants belonging to 31 families were reported, each with local names, traditional uses, methods of preparation and route of administration. Traditional medicine remains an integral part of the health system in these areas. Local people have remarkable knowledge of species identity and their uses as crude drugs.

Management of severe cicatricial entropion using shared mucosal grafts

OBJECTIVE

To retrospectively analyze our experience using nasal turbinate and hard palate mucosal grafts as shared buttress grafts between the upper and lower eyelid for reconstruction in severe cicatricial entropion.

SURGICAL TECHNIQUES

A horizontal tarsectomy is performed in the upper and lower eyelid approximately 2 mm posterior to the gray line. The distal tarsal segments are then dissected and rotated 180 degrees. A graft of nasal turbinate mucosa or hard palate mucosa measuring 1.5 x 3 cm is harvested. The graft is sutured to the cut edge of tarsus in the upper and lower eyelid. The rotated distal tarsal segment is stabilized against the graft using 5 mattress sutures. After 3 weeks, the graft is split by sharp dissection between the upper and lower eyelids.

METHODS

The medical records of 12 consecutive patients, representing 15 shared buttress grafts, were reviewed. There were 5 hard palate and 10 nasal turbinate mucosal grafts placed. Follow-up ranged from 2 months to 7 years.

RESULTS

The amount of corneal stipple, as well as subjective patient comfort, improved after eyelid margin reconstruction in 12 of the 15 eyes. One patient's visual acuity improved by more than 2 lines after surgery. There were no cases of failure of graft survival and no complications directly related to the shared graft technique. Recurrent entropion and trichiasis were noted in 3 eyelids more than a year after graft placement, reflecting ongoing cicatrization in these eyelids. Hard palate mucosal grafts were irritating to the corneal surface, requiring removal of the epithelium using a diamond burr and bandage contact lens wear. Nasal turbinate mucosal grafts were better tolerated by the corneal surface and had the added benefit of mucous production.

CONCLUSIONS

Eyelid reconstruction using nasal turbinate and hard palate mucosal tissues as a shared buttress graft is a viable treatment option for patients with severe cicatricial entropion. Resolution of trichiasis and mechanical corneal abrasion was noted in 13 (86%) of 15 patients with no specific complications related to the technique. The shared buttress technique successfully autostents the healing eyelid margins, makes good use of the large turbinate mucosal graft, and minimizes trips to the operating room. When the mechanical requirements of eyelid margin reconstruction do not require the sturdiness of hard palate mucosa, nasal turbinate mucosa is a preferable graft tissue because it is better tolerated by the corneal surface and produces mucous.

Site-directed mutagenesis of predicted active site residues in glutamate carboxypeptidase II

Glutamate carboxypeptidase II (GCP II) catalyzes the extracellular hydrolysis of the neuromodulator N-acetyl-aspartylglutamate to N-acetyl-aspartate and glutamate. GCP II also hydrolyzes gamma-glutamyl bonds in folylpolyglutamate. The predicted amino acid sequence of GCP II displays similarities to aminopeptidases from Streptomyces griseus and Vibrio proteolyticus, whose crystal structures have been determined. These aminopeptidases are cocatalytic zinc metallopeptidases belonging to the peptidase family M28. Specific zinc and substrate ligands have been proposed in GCP II based on the amino acid sequence alignment to these M28 family members. In the present study, site-directed mutagenesis has been used to test the assignment of these putative ligands in human GCP II. Substitutions to the five putative zinc ligands resulted in severely reduced enzyme activity, although mutant protein was expressed as demonstrated by immunoblot analysis. In addition, substitutions of amino acids near the putative zinc ligands have identified other specific residues important for enzyme structure and/or function. Substitutions to putative substrate ligands were less perturbing, and increases in Km were observed for substitutions that introduced a large charge perturbation (e.g., Lys to Glu). The results from substitutions at the proposed zinc and substrate ligands are consistent with the assignment of these residues and suggest that GCP II has a three-dimensional structure similar to other members of the peptidase family M28.

The retina: genetic studies of several retinopathies located on the short arm of chromosome 17

The short arm of chromosome 17 has emerged as a hot spot where several phenotypically distinct retinal disorders have been mapped in the past year. An autosomal dominant retinitis pigmentosa, Leber's congenital amaurosis, autosomal dominant cone degeneration, central areolar choroidal dystrophy and Sjogren-Larsson syndrome were all recently mapped to chromosome 17p. These disorders, their genetic linkage, possible candidate genes and the possibility that several of these disorders may share candidate genes are discussed.

Alterations in brain tumor DNA detected by a fingerprinting probe

We used a novel DNA fingerprinting probe O-chi-1 (ref. 1) to detect differences in the hybridization pattern of brain tumor DNA and paired normal tissue of a given individual. Representatives of meningiomas (two), glioblastoma multeforme (three) and astrocytoma (one) were studied. Alterations, which included amplification as well as the loss of a normal band in tumor DNA, were observed in four of the six tumours. While the increased intensity of a band can be taken to imply increased copy number, the disappearance of bands could either be due to loss of DNA sequence or rearrangement resulting in different sized bands.

Effect of Azadirachta indica leaves on testis and its recovery in albino rats

Histological and biochemical changes in the testis of rats treated with the leaf powder of A. indica are reported. The pattern of recovery is also studied at 8, 16 and 24 day after withdrawal of the treatment. In the treated rats, a general reduction in the diameters of seminiferous tubule, nuclei of the germinal elements and a mass atrophy of the spermatogenic elements has been observed. The Leydig cells are found to be atrophic. Biochemically, a decrease in the protein content and the activity of acid phosphatase and an increase in the total free sugar, glycogen, cholesterol contents and the activities of alkaline phosphatase and lactate dehydrogenase have been observed. A gradual recovery is observed in both the histological and biochemical parameters after 8.16 and 24 day of cessation of the treatment. The result suggest a possible reversible antiandrogenic property of the leaves of A. indica in male albino rats.

Maternal schooling and child health: preliminary analysis of the intervening mechanisms in rural Nepal

This article provides evidence from a community-level study in rural Nepal of the mechanisms by which schooling affects maternal behaviour and infant and child health. Two hypotheses concerning the mechanisms are identified and tested. It was found that schooling equips women with specific skills and dispositions or identity which significantly predict two principal domains of health-care behaviour: use of medical services; and changes in household health behaviour. It was also found that women with schooling had healthier children using height-for-age as an indicator of health.

Inhibition of ornithine decarboxylase in human fibroblast cells by type I and type II interferons

Dilution of human fibroblast GM2767 cell cultures into fresh serum-containing growth medium induces ornithine decarboxylase activity 45-fold over a six-hour interval. When the fibroblast cultures are supplemented with human fibroblast alpha-, beta-, or gamma-interferon at the time of dilution into fresh growth medium, the induction of ornithine decarboxylase is inhibited 61%, 90%, and 65%, respectively. beta-Interferon is the most effective type of interferon to inhibit induction of ornithine decarboxylase.