Potential contribution of monoamine oxidase a gene variants in ADHD and behavioral co-morbidities: scenario in eastern Indian probands

Attention deficit hyperactivity disorder (ADHD) is the most frequently diagnosed behavioral disorder in children with a high frequency of co-morbid conditions like conduct disorder (CD) and oppositional defiant disorder (ODD). These traits are controlled by neurotransmitters like dopamine, serotonin and norepinephrine. Monoamine oxidase A (MAOA), a mitochondrial enzyme involved in the degradation of amines, has been reported to be associated with aggression, impulsivity, depression, and mood changes. We hypothesized that MAOA can have a potential role in ADHD associated CD/ODD and analyzed 24 markers in a group of Indo-Caucasoid subjects. ADHD probands and controls (N = 150 each) matched for ethnicity and gender were recruited following the Diagnostic and Statistical Manual for Mental Disorders-IV. Appropriate scales were used for measuring CD and ODD traits. Markers were genotyped by PCR-based methods and data obtained analyzed using the Cocaphase program under UNPHASED. Only eight markers were found to be polymorphic. rs6323 "G" allele showed higher frequencies in ADHD (P = 0.0023), ADHD + CD (P = 0.03) and ADHD + ODD (P = 0.01) as compared to controls. Haplotype analysis revealed statistically significant difference for three haplotypes in ADHD cases (P < 0.02). Statistically significant differences were also noticed for haplotypes in ADHD + CD and ADHD + ODD cases (P < 0.01). LD analysis showed significant variation in different groups. Multidimensionality reduction analysis showed independent as well as interactive effects of markers. Genotypes showed correlation with behavioral problems in ADHD and ADHD + CD. We interpret that MAOA gene variants may contribute to the etiology of ADHD as well as associated co-morbid CD and ODD in this ethnic group.

Mitochondrial electron transport chain complexes, catalase and markers of oxidative stress in platelets of patients with severe aluminum phosphide poisoning

Aluminum phosphide (ALP), a widely used fumigant and rodenticide, leads to high mortality if ingested. Its toxicity is due to phosphine that is liberated when it comes in contact with moisture. The exact site or mechanism of action of phosphine is not known, although it is widely believed that it affects mitochondrial oxidative phosphorylation. Basic serum biochemical parameters, activity of mitochondrial complexes, antioxidant enzymes and parameters of oxidative stress were estimated in the platelets of 21 patients who developed severe poisoning following ALP ingestion. These parameters were compared with 32 healthy controls and with 22 patients with shock due to other causes (cardiogenic shock (11), septic shock (9) and hemorrhagic shock (2)). The serum levels of creatine kinase-muscle brain and lactate dehydrogenase were higher in patients poisoned with ALP, whereas a significant decrease was observed in the activities of mitochondrial complexes I, II and IV. The activity of catalase was lower but the activities of superoxide dismutase and glutathione peroxidase were unaffected in them. A significant increase in lipid peroxidation and protein carbonylation was observed, whereas total blood thiol levels were lower. In patients severely poisoned with ALP, not only cytochrome c oxidase but also other complexes are involved in mitochondrial electron transport, and enzymes are also inhibited.

Minocycline, levodopa and MnTMPyP induced changes in the mitochondrial proteome profile of MPTP and maneb and paraquat mice models of Parkinson's disease

Mitochondrial dysfunction is the foremost perpetrator of the nigrostriatal dopaminergic neurodegeneration leading to Parkinson's disease (PD). However, the roles played by majority of the mitochondrial proteins in PD pathogenesis have not yet been deciphered. The present study investigated the effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and combined maneb and paraquat on the mitochondrial proteome of the nigrostriatal tissues in the presence or absence of minocycline, levodopa and manganese (III) tetrakis (1-methyl-4-pyridyl) porphyrin (MnTMPyP). The differentially expressed proteins were identified and proteome profiles were correlated with the pathological and biochemical anomalies induced by MPTP and maneb and paraquat. MPTP altered the expression of twelve while combined maneb and paraquat altered the expression of fourteen proteins. Minocycline, levodopa and MnTMPyP, respectively, restored the expression of three, seven and eight proteins in MPTP and seven, eight and eight proteins in maneb- and paraquat-treated groups. Although levodopa and MnTMPyP rescued from MPTP- and maneb- and paraquat-mediated increase in the microglial activation and decrease in manganese-superoxide dismutase expression and complex I activity, dopamine content and number of dopaminergic neurons, minocycline defended mainly against maneb- and paraquat-mediated alterations. The results demonstrate that MPTP and combined maneb and paraquat induce mitochondrial dysfunction and microglial activation and alter the expression of a bunch of mitochondrial proteins leading to the nigrostriatal dopaminergic neurodegeneration and minocycline, levodopa or MnTMPyP variably offset scores of such changes.

NPY controls fear conditioning and fear extinction by combined action on Y₁ and Y₂ receptors

BACKGROUND AND PURPOSE

Neuropeptide Y (NPY) and its receptors have been implicated in the control of emotional-affective processing, but the mechanism is unclear. While it is increasingly evident that stimulation of Y₁ and inhibition of Y₂ receptors produce prominent anxiolytic and antidepressant effects, the contribution of the individual NPY receptor subtypes in the acquisition and extinction of learned fear are unknown.

EXPERIMENTAL APPROACH

Here we performed Pavlovian fear conditioning and extinction in NPY knockout (KO) and in NPY receptor KO mice.

KEY RESULTS

NPY KO mice display a dramatically accelerated acquisition of conditioned fear. Deletion of Y₁ receptors revealed only a moderately accelerated acquisition of conditioned fear, while lack of Y₂ receptors was without any effect on fear learning. However, the strong phenotype seen in NPY KO mice was reproduced in mice lacking both Y₁ and Y₂ receptors. In addition, NPY KO mice showed excessive recall of conditioned fear and impaired fear extinction. This behaviour was replicated only after deletion of both Y₁ and Y₂ receptors. In Y₁ receptor single KO mice, fear extinction was delayed and was unchanged in Y₂ receptor KO mice. Deletion of NPY and particularly Y₂ receptors resulted in a generalization of conditioned fear.

CONCLUSIONS AND IMPLICATIONS

Our data demonstrate that NPY delays the acquisition, reduces the expression of conditioned fear while promoting fear extinction. Although these effects appear to be primarily mediated by Y₁ receptors, the pronounced phenotype of Y₁Y₂ receptor double KO mice suggests a synergistic role of Y₂ receptors in fear acquisition and in fear extinction.

Molecular structure, spectral studies, intra and intermolecular interactions analyses in a novel ethyl 4-[3-(2-chloro-phenyl)-acryloyl]-3,5-dimethyl-1H-pyrrole-2-carboxylate and its dimer: A combined DFT and AIM approach

A newly synthesized chalcone, Ethyl 4-[3-(2-chloro-phenyl)-acryloyl]-3,5-dimethyl-1H-pyrrole-2-carboxylate (ECPADMPC) has been characterized by (1)H NMR, (13)C NMR, UV-Vis, FT-IR, Mass spectroscopy and elemental analysis. Quantum chemical calculations have been performed by DFT level of theory using B3LYP functional and 6-31G(d,p) as basis set. The time dependent density functional theory (TD-DFT) is used to find the various electronic transitions within molecule. A combined theoretical and experimental wavenumber analysis confirms the existence of dimer. Topological parameters-electron density (ρ(BCP)), Laplacian of electron density (∇(2)ρ(BCP)), energetic parameters-kinetic electron energy density (G(BCP)), potential electron density (V(BCP)) and the total electron energy density (H(BCP)) at the bond critical points (BCP) have been analyzed by 'Atoms in molecules' AIM theory in detail. The intermolecular hydrogen bond energy of dimer is calculated as -12.3kcal/mol using AIM calculations. AIM ellipticity analysis is carried out to confirm the presence of resonance assisted intermolecular hydrogen bonds in stabilization of dimer. The analysis clearly depicts the presence of different kind of interactions in dimer. This dimer may work as model system to understand the H-bonding interaction in biomolecules. The local reactivity descriptor analysis is performed to find the reactive sites within molecule.

Molecular structure, heteronuclear resonance assisted hydrogen bond analysis, chemical reactivity and first hyperpolarizability of a novel ethyl-4-{[(2,4-dinitrophenyl)-hydrazono]-ethyl}-3,5-dimethyl-1H-pyrrole-2-carboxylate: a combined DFT and AIM approach

A new ethyl-4-{[(2,4-dinitrophenyl)-hydrazono]-ethyl}-3,5-dimethyl-1H-pyrrole-2-carboxylate (EDPHEDPC) has been synthesized and characterized by FT-IR, (1)H NMR, UV-vis, DART-Mass spectroscopy and elemental analysis. Quantum chemical calculations have been performed by DFT level of theory using B3LYP functional and 6-31G(d,p) as basis set. The (1)H NMR chemical shifts are calculated using gauge including atomic orbitals (GIAO) approach in DMSO as solvent. The time dependent density functional theory (TD-DFT) is used to find the various electronic transitions and their nature within molecule. A combined theoretical and experimental wavenumber analysis confirms the existence of dimer. Topological parameters such as electron density (ρ(BCP)), Laplacian of electron density (nabla(2)ρ(BCP)), kinetic electron energy density (G(BCP)), potential electron density (V(BCP)) and the total electron energy density (H(BCP)) at bond critical points (BCP) have been analyzed by Bader's 'Atoms in molecules' AIM theory in detail. The intermolecular hydrogen bond energy of dimer is calculated as -12.51 kcal/mol using AIM calculations. AIM ellipticity analysis is carried out to confirm the presence of resonance assisted intra and intermolecular hydrogen bonds in dimer. The calculated thermodynamic parameters show that reaction is exothermic and non-spontaneous at room temperature. The local reactivity descriptors such as Fukui functions (f(k)(+), f(k)(-)), local softnesses (s(k)(-), s(k)(+)) and electrophilicity indices (ω(k)(+), ω(k)(-)) analyses are performed to determine the reactive sites within molecule. Nonlinear optical (NLO) behavior of title compound is investigated by the computed value of first hyperpolarizability (β(0)).

Synthesis, molecular structure and spectral analysis of ethyl 4-[(3,5-dinitrobenzoyl)-hydrazonomethyl]-3,5-dimethyl-1H-pyrrole-2-carboxylate: a combined experimental and quantum chemical approach

A new hydrazone, ethyl 4-[(3,5-dinitrobenzoyl)-hydrazonomethyl]-3,5-dimethyl-1H-pyrrole-2-carboxylate (PDNBAH) has been synthesized and characterized by FT-IR, (1)H NMR, UV-visible spectroscopy. All the quantum chemical calculations have been performed by density functional theory (DFT), using B3LYP functional and 6-31G(d,p) as basis set. The calculated and experimental wavenumber analyses confirm the existence of dimer of PDNBAH. The calculated binding energies of dimer using DFT and Bader's atoms in molecules (AIM) theory are -14.32 and -15.41 kcal/mol respectively. The intermolecular hydrogen bond energy of dimer due to the involvement of intermolecular hetero-nuclear double hydrogen bonds (N-H···O=C) through pyrrolic N-H and C=O of ester is also calculated to be equal to -12.29 kcal/mol using AIM calculation. The strength and the nature of hydrogen bonding and weak interactions in dimer have been analyzed by AIM theory in detail. The presence of resonance assisted hydrogen bonds (RAHB) has been confirmed by calculated ellipticity parameters using AIM calculation. The calculated thermodynamic parameters show that the reaction is non spontaneous at room temperature. The local reactivity descriptors show that C(13) is most reactive site for nucleophilic attack.

An Efficient One-Pot Green Protocol for the Synthesis of 5-Unsubstituted 3,4-Dihydropyrimidin-2(1H)-Ones Using Recyclable Amberlyst 15 DRY as a Heterogeneous Catalyst via Three-Component Biginelli-Like Reaction

An environmentally benign green protocol for the synthesis of 5-unsubstituted 3,4-dihydropyrimidin-2(1H)-ones using Amberlyst 15 DRY as a recyclable catalyst has been developed. The use of resinous, nontoxic, thermally stable, and inexpensive Amberlyst 15 DRY, as a recyclable heterogeneous catalyst, makes the process simple with negligible chemical waste. Among the various solid acid catalysts Amberlyst 15 DRY was found to be the most efficient catalyst with regard to reaction time, yield, and ease of work-up procedure.

Bilateral symmetrical facial swelling owing to tuberculous gummas

Metastatic tuberculous abscesses and gummas are unusual forms of cutaneous tuberculosis. They result from haematogeneous spread of the mycobacterium from a primary focus during a period of impaired immunity. A 5-year-old boy is reported who presented with spinal tuberculosis and bilateral subcutaneous swelling of the cheeks owing to tuberculous gummas.

Prognostic value of FLT3 mutations among different cytogenetic subgroups in acute myeloid leukemia (AML)

7015

Background: Mutations of the FLT3 gene (in special internal tandem duplication -ITD) are common in normal karyotype AML (NK-AML) and are associated with shorter relapse free and overall survival (OS). The frequency of FLT3 mutations is lower in other cytogenetic subgroups and the impact on outcome is unclear. Methods: The records of patients (pts) with newly diagnosed AML (from 2003 to 2007) were reviewed. Pts were divided among three cytogenetic subgroups: Good-risk (t(8;21), Inv(16)/t(16;16)) Intermediate-Risk (Diploid,-Y) and Poor Risk (-5,-7, 11q abnormalities). FLT3 ITD and tyrosine kinase domain (TKD) mutations were determined on baseline DNA samples by a PCR based method with 1% sensitivity. Since the frequencies of FLT3 mutations were lower in good- and poor-risk subgroups, ITD/TKD mutations were considered together in the analysis, while in the intermediate risk group they were analyzed separately. Survival curves stratified by FLT3 mutation were estimated by Kaplan Meier plots and compared by logrank test. A Cox model was fit for OS, and non-significant variables were eliminated in a step-down fashion with a p- value cut-off of p = .10. Results: A total of 481 pts were included (65 pts=good risk, 272 pts=intermediate risk and 144 pts= poor risk). Prevalence of FLT3 mutations is shown in the Table. No difference was found in median OS between FLT3-mutated and FLT3- wild type pts in the good risk group (not reached (NR) vs NR, P = 0.57) nor in the poor risk group (55 vs 24 weeks, P = 0.44). In intermediate risk, OS was worse in FLT3-ITD positive pts (33 vs 89 weeks, P < 0.0001) but not in FLT3-TKD positive pts (77 vs 70 weeks, P = 0.89). In the Cox model, FLT3 mutations were prognostic for OS only in intermediate risk pts with FLT3-ITD (HR 2.63, P < 0.0001). Conclusions: In our cohort of pts, FLT3 mutations did not have a prognostic impact in AML with good and poor risk karyotype.

[Table: see text]

No significant financial relationships to disclose.

Chronic myeloid leukemia (CML) with e1a2 BCR-ABL fusion transcript type: Analysis of characteristics, outcomes, and prognostic significance

7030

Background: The most common BCR-ABL fusion transcripts in CML are e13a2 (b2a2) and e14a2 (b3a2). Rarely, other transcripts like e1a2 are seen. Currently, there is no published series of data on efficacy of imatinib or other tyrosine kinase inhibitors (TKIs) in CML with e1a2. Methods: We analyzed records of 1,292 CML patients treated with TKI at our institution between January 2000 and November 2008. Results: 14 CML patients with e1a2 transcripts were identified, 9 in chronic phase (CP), 1 in accelerated phase (AP), and 4 in blast phase (BP). Median age at diagnosis was 60 (range 28–86) years, median follow-up 39.5 (range 2–109) months. Of the 9 in CP, 3 received interferon and then imatinib after interferon failure, 6 received TKI as first-line therapy (5 imatinib, 1 nilotinib): 5 achieved CHR only, 1 CCyR, 1 MCyR, 1 PCyR, and 1 did not respond to imatinib. 5 patients (2 post-interferon failure - 1 in CHR, 1 in PCyR; 3 frontline imatinib - 1 in CHR, 1 in CCyR, 1 non-responder) progressed to advanced phases (3 myeloid BP, 1 lymphoid BP, 1 AP) at a median 48 (range 4–92) months after CML diagnosis; with only 1 alive and in CMR after allogeneic SCT. AP patient received various TKIs sequentially and achieved only CHR with disappearance of clonal evolution. BP patients received Hyper-CVAD+imatinib/dasatinib or idarubicin+Ara-C; 2 did not respond, 1 had CCyR lasting 12 months with Hyper-CVAD+Imatinib and 1 had CMR after allogeneic SCT lasting 2 months. In all 14 patients, cytogenetic responses lasted 1–9 months before being lost and none (except 2) achieved MMR or CMR on imatinib or other TKI therapy. Six patients (5 CP, 1 AP) were alive at a median 39 (range 2–85) months after initial diagnosis: 4 with CHR (2 on imatinib, 1 nilotinib, 1 bosutinib), 1 with MCyR on imatinib, and 1 with CMR after allogeneic SCT. Conclusions: CML with e1a2 BCR-ABL fusion transcripts is rare and is associated with an inferior outcome to therapy with TKI, with responses being usually short-lived. These patients need to be identified as high-risk patients and monitored closely for efficacy during therapy with TKI.

No significant financial relationships to disclose.

An animal model for studying endoscopic ultrasound changes of early chronic pancreatitis with histologic correlation: a pilot study

BACKGROUND AND STUDY AIMS

Due to the difficulty in obtaining pancreatic tissue for histology in humans, we developed an animal model for studying endoscopic ultrasound (EUS) changes of early chronic pancreatitis. This report on the animal model describes the serial changes of early chronic pancreatitis by EUS and correlates results with histology.

MATERIALS AND METHODS

Four 60 - 80-lb dogs were used in the study. Pancreatic EUS was performed to provide baseline images prior to any procedure. At laparotomy, a guide wire was passed into the pancreatic duct, and a 5-Fr pancreatic stent was introduced over the wire into the pancreatic duct. Animals were divided into two survival groups - 2 weeks and 4 weeks. In each group, EUS examination was performed under anesthesia to image the pancreas and then followed by euthanasia. Sequential pancreatic sections were taken from the head, body, and tail of the pancreas. EUS findings were correlated with histologic results with respect to degree of fibrosis, inflammation, and edema.

RESULTS

At baseline EUS, the pancreas appeared homogeneous with only a few echogenic septations and echogenic margins of the main pancreatic duct. At 2 and 4 weeks poststenting, EUS images showed the following changes: lobularity, hyper and hypoechoic foci, increased echogenic septations, visible pancreatic duct side branches, and irregular margins of the main pancreatic duct.

CONCLUSIONS

The dog model for chronic pancreatitis appears to be a promising method for studying sequential changes of chronic pancreatitis by EUS and correlating results with histology.

Radicular cyst associated with a deciduous molar: A case report with unusual clinical presentation

This article presents case report of a patient with radicular cyst associated with a primary molar with an unusual clinical presentation. The management comprised of enucleation of the cystic sac under general anesthesia.

Structural and functional analysis of a salt stress inducible gene encoding voltage dependent anion channel (VDAC) from pearl millet (Pennisetum glaucum)

We have cloned and characterized a gene encoding voltage-dependent anion channel from Pennisetum glaucum (PgVDAC). PgVDAC was identified while isolating genes that were differentially up-regulated following salt stress. The genomic organization of PgVDAC clone was well conserved compared to other plant VDAC genes in terms of number of introns, their position and phasing, however, the primary amino acid sequence of voltage dependent anion channel (VDAC) proteins did not show much conservation with other plant VDACs but their secondary and tertiary structures are well conserved as predicted by in silico structural and CD spectra analyses and results show it to be a typical membrane-spanning beta-barrel leading to the formation of pore in the membrane. The heterologous expression of PgVDAC protein in yeast strain lacking the endogenous mitochondrial VDAC gene could not functionally complement it as was also previously observed for the potato VDAC. Using real-time quantitative PCR analysis it was found that transcript expression profile of PgVDAC was quantitatively and kinetically up-regulated in response to salinity, desiccation, cold and exogenous application of salicylic acid (SA); however, there was no effect of exogenous application of abscisic acid (ABA) on its expression. Constitutive over-expression of PgVDAC appears to be deleterious in transgenic rice plant; however, low level of up-regulation imparted salinity stress adaptive response. A search for a more suitable inducible transgene system is currently under way to understand PgVDAC expression levels in plant development and its role in stress adaptation.

Virtual reality simulator for vitreoretinal surgery

AIM

To develop computer simulation of steps in vitreoretinal surgery using virtual reality technology.

MATERIAL AND METHODS

A workstation with three-dimensional position tracking stylus was attached to a Pentium II desktop PC with a graphic accelerator. Computer algorithms were developed using Open GL and Microsoft Visual C++ languages to control the interaction and update the visual feedback tracking the instruments. Soft tissue computer modelling was carried out to mimic the removal of a vitreous opacity. Lens touch with the instruments was also detected. Mathematical modelling to allow for lens distortion was taken into account.

RESULTS

A virtual reality computer model has been developed that can simulate initial steps of vitreoretinal surgery. Soft tissue modelling of the vitreous opacity and its removal by the vitrector was successfully simulated. The movements of the active and passive instruments in the dummy eye corresponded to the movements on the computer screen. On evaluation of the system, there was a minimal but discernable time lag between the stylus movement and the visual feedback. There was no tactile feedback when the lens touch was simulated. No further complex vitreoretinal surgery simulation was possible at this stage.

Evaluation of posturing in macular hole surgery

AIM

To objectively evaluate the postoperative face down posturing in macular hole surgery.

MATERIALS AND METHODS

An electronic device called 'Maculog' was developed consisting of three basic components, a mercury switch triggered by the angle of tilt placed inside an earpiece, a data-recording device connected to the earpiece with cables and a windows based software program, specially written to analyse the recorded data in the form of tables and graphs. Ten patients undergoing macular hole surgery were fitted with the device on the first postoperative day before discharge. They were also asked for a subjective record of their posturing times. Four patients were given a posturing chair to take home. The device was retrieved after the first week and the data were downloaded to a PC for analysis. The actual posturing times recorded on the device were compared to the patients' own recollections. Results In all ten patients the actual posturing time was less than the time they had recorded themselves. The average actual posturing time was 48% of the perceived posturing time. The worst time for posturing, as expected, was between midnight and early morning. The compliance was better in patients who used the posturing chair.

CONCLUSIONS

It is feasible to quantify the time of posturing using an electronic device and computer analysis. The study has shown that the actual posturing time is significantly less than the perceived posturing time. A further large study using 'Maculog' is now planned to correlate actual posturing time to the results of macular hole surgery.

Telemedicine in ophthalmology

Comprehensive telemedicine promises a world of medicine freed of geographic borders, time zones, and personnel shortages. It could open the door to more accessible medical delivery systems and economical widespread screening for disease. No region of the world would be too remote or too poor to receive high quality medical care. This article traces the development and current applications and initiatives in the field of telemedicine as applied to ophthalmology in the wider sense. Uses for clinical diagnosis and management, screening, research, education and peer interaction are discussed.

Prognostic significance of apoptosis in squamous cell carcinoma of oral cavity with special reference to TNM stage, histological grade and survival

Apoptotic count was assessed in 38 cases of squamous cell carcinoma of oral cavity by light microscopy and correlated with TNM stage, histological grade and survival. A direct correlation with the TNM stage (p = 0.0166) and an inverse correlation with the histological grade (p = 0.03) was found, however no correlation was found with the survival. Apoptotic count was significantly different between well and moderately differentiated carcinoma (p = 0.347) and well and poorly differentiated carcinoma (p = 0.0190). Thus apoptotic count may have prognostic value particularly in combination with staging and histological grade.

[Testing a computer-assisted bending machine for manufacturing orthodontic treatment elements]

The use of suitable orthodontic devices producing desired defined force systems is of importance for successful orthodontic treatment. Bending loops can be difficult and time-consuming. Computerised fabrication would enable very precise reproduction of individual loops. A bending machine has now been developed within the framework of a computer-assisted treatment concept. In this study, a prototype machine was used to fabricate U-, T- and delta loops made of stainless steel, cobalt chromium and titanium molybdenum wire. The various geometric parameters of each loop were measured to determine how precisely they had been produced. Furthermore, the force system of each loop were experimentally investigated during simulated activation in an orthodontic measurement and simulation system. The results indicate that the geometric parameters had an average error of 2.8 degrees for angles and 0.9 mm for lengths. Owing to the fabrication errors, loops of the same type produced different force systems. Overall, the new bending machine can fabricate different types of loop, but the requirements of very precise fabrication are currently not met. This fact, together with further limitations in terms of configuration, means that the machine cannot be used routinely at present. However, the machine can nevertheless be considered a good basis for further development.

Ischemic retinitis as a result of acute episodic blood loss

Acute episodic blood loss leads to a sudden change in the haemodynamics leading to a number of ocular and systemic effects. Occurrence of ischemic retinitis secondary to acute blood loss is of a very rare occurrence. This communication presents a case of infarction of the nerve fibre layer secondary to acute blood loss in a 55-year-old male.

Stress induced phosphate solubilization in bacteria isolated from alkaline soils

Phosphate solubilizing bacteria NBRI0603, NBRI2601, NBRI3246 and NBRI4003 were isolated from the rhizosphere of chickpea and alkaline soils. All four strains demonstrated diverse levels of phosphate solubilization activity under in vitro conditions in the presence of various carbon and nitrogen sources. Acid production may have contributed to phosphate solubilization, but was not the only reason for phosphate release into the medium. Among the four strains, NBRI2601 was the most efficient strain in terms of its capability to solubilize phosphorus in the presence of 10% salt, pH 12, or 45 degrees C. The strains showed varied levels of phosphate solubilization when the effects of different sources of nitrogen were examined during growth. The presence of low levels of Ca(2+) and EDTA in the medium enhanced phosphate solubilization.

The 5HT3 receptors and the descending nociceptive pathway--a review

There has been a huge and exciting increase in our recent understanding of the pathogenesis of pain. Neurophysiological and pharmacological evidence have demonstrated that 5-HT now plays an important albeit discrete role in pain transmission at various levels of the pain pathway. Although 5-HT is clearly involved in spinal analgesia, its mode of action is still obscure and perplexing perhaps because it has multiple and often opposing effects mediated by its multiple receptor subtypes. The involvement of 5-HT3 antagonists and agonists have been found to either facilitate or inhibit nociceptive processing in the dorsal horn cells. Thus the understanding of the descending serotonergic analgesic system may enable the development of new non-opioid, non-addictive analgesics.

Management of ocular perforations resulting from peribulbar anaesthesia

PURPOSE

To analyze the clinical presentation and outcome of treatment for globe perforation secondary to peri-bulbar anaesthesia.

METHODS

Eight patients (3 females and 5 males) aged 66-84 years were included in the study. Ocular perforations were suspected in 3 cases before or during surgery, in 4 cases diagnosis was established within one week and in one case at 3 weeks. Three patients underwent indirect argon laser photocoagulation to seal the retinal break, one patient had cryotherapy, 3 patients underwent a pars plana vitrectomy with fluid gas exchange and endo-laser; and one patient refused any further treatment.

RESULTS

The final visual acuity after a mean follow up of 14 months was better than 6/9 in 2 patients, between 6/9-6/12 in 4 patients, and perception of light in 2 patients.

CONCLUSION

If diagnosed early and treated adequately, a majority of patients with globe perforation during periocular anaesthetic could be saved.

Recurrent amaurosis fugax without haemodynamically significant ipsilateral carotid stenosis

PURPOSE

This study was performed to investigate the causes of recurrent amaurosis fugax in patients without haemodynamically significant carotid stenosis.

METHODS

Pulsatile ocular blood flow (POBF), ocular pulse amplitude (PA) and ocular perfusion pressure (OPP) were recorded for 15 patients and 15 age-matched controls.

RESULTS

No significant difference in OPP or POBF was found between the two groups. However, the PA was significantly greater in the control group (p=0.01).

CONCLUSION

The results of this study suggest that for some patients with recurrent amaurosis fugax, their symptoms may occur secondary to ocular small vessel disease.

Survey of diabetic retinopathy screening services in England and Wales

A postal survey of diabetologists was conducted regarding the provision of diabetic retinopathy screening services in England and Wales. About 2.5 million people had no existing or planned screening service. For the rest, the perceived percentage of patients with diabetes screened varied from less than 25% to more than 90%. Multiple modes of screening were used in most units. Lack of funding was identified as the major reason for non-provision of an adequate screening service. About 18% of the units had to use research or charitable funds for screening. Only 50% of the units using optometrists for screening had standard protocols for referral. The average wait before an ophthalmologist's opinion on sight threatening retinopathy detected by screening was unacceptably high in some units. We would suggest that establishment of identical screening protocols and provision of adequate funding on a national basis ought to be the priority if incidence of blindness from diabetic retinopathy is to be reduced according to the St Vincent Declaration.

Bilateral glaucomatocyclitic crisis in a patient with Holmes Adie syndrome

A patient with pre-existing bilateral tonic pupils presented with simultaneous bilateral glaucomatocyclitic crisis. Deep tendon reflexes were absent although they were documented to be present 6 years ago. A possibility of a progressive autonomic dysfunction in both these conditions is discussed.

Dietary intake of trace elements and minerals among adults in underprivileged communities of rural Rajasthan, India

In developing countries, data on dietary intake of trace elements, and even major elements, is limited. The dietary intake of 1277 adults of underprivileged communities of rural Rajasthan was studied. Intake was assessed by the 24-h dietary recall method from which the average daily intake of macronutrients, some major elements, and trace elements was computed. The zinc intake was 69.7 and 49.7% of the recommended daily allowance in males and non-pregnant non-lactating females, respectively. The intakes of manganese and molybdenum were adequate when compared with the suggested daily intakes. Element intake during the physiological stress conditions of pregnancy and lactation was 42.4 and 53.0% for zinc, 36.5 and 29.8% for copper, and 21.0 and 23.1% for calcium, respectively. The intake of iron was less than 20 mg/day for all female subjects studied. No significant difference was observed in the trace element intake of subjects with different grades of malnutrition. Assessment of dietary intake may provide a useful indication of the possible status of major and trace elements among adult subjects.

Workplace organizational correlates of lost-time accident rates in manufacturing

We report the results of a questionnaire survey of manufacturing workplaces related to the lost-time frequency rates (LTFR) for Workers' Compensation claims. Six types of industry were chosen.' metal articles, plastic articles, grain products, textile manufacturing, printing, and automobile manufacturing. LTFR were standardized by type of industry. Stratifying simultaneously by number of employees and LTFR category, we sampled 718 workplaces. A mail questionnaire to labor and management representatives provided at least some information on 58%. Response rates were similar across LTFR categories, and telephone interviews of non-responders showed little difference in their replies from those obtained in completed questionnaires. A large number of variables were examined. Apart from statistical significance, we looked for consistency in trends across LTFR categories and in patterns for similar questions. Significant associations grouped into several areas. Lower LTFR were associated with: concrete demonstration by management of its concern for the workforce; greater involvement of workers in general decision-making; greater willingness of the Joint Health and Safety Committee to solve problems internally; and greater experience of the workforce. Variables that were not significant included profitability and financial performance. A final stepwise multiple regression explained 19% of the variance in LTFR, although this analysis suffered from several limitations.

Breast-feeding practices in Schedule Caste communities in Haryana state

A study was conducted to assess exclusive breast-feeding, continued breast-feeding, bottle-feeding, predominant breast-feeding, timely complementary feeding and other breast-feeding practices in 818 children in the age group of 0-3 years belonging to the Schedule Caste communities of Haryana. The exclusive breast-feeding rate was 0.15 and the predominant breast-feeding rate 0.75 in children < 4 months. Timely complementary feeding rate was 0.42. The continued breast-feeding rate at 1 year and 2 years was 0.84 and 0.58, respectively. The bottle-feeding rate, ever breast-fed rate, timely first-suckling rate and exclusive breast-feeding rate by mother were 0.09, 1.0, 0.0 and 0.15, respectively. The median duration of breast-feeding was 16 months.

Pathogenesis of diabetic retinopathy--the missing link?

Release of angiogenic factors in response to the ischaemic retina is currently the most favoured hypothesis for the pathogenesis of proliferative diabetic retinopathy. Reducing the stimulus for angiogenesis by destroying the ischaemic retina also forms the basis of the most effective treatment of diabetic retinopathy by photocoagulation. Though ischaemia is undoubtedly important for neovascularization, there is recent evidence which cast doubts on ischemia being the sole mechanism for diabetic retinopathy. Many clinical observations viz. the protective effects of glaucoma, myopia, unilateral carotid stenosis on diabetic retinopathy; and its worsening after cataract extraction are not adequately explained by the present hypothesis. Moreover, the recent in vitro culture studies on retinal pigment epithelial cells have suggested an alternative explanation for the effectiveness of photocoagulation in proliferative diabetic retinopathy. Furthermore, hyperglycemia has been strongly correlated with the incidence and progression of diabetic retinopathy, but has only been indirectly indicted in its pathogenesis. These facts can be integrated into a more plausible hypothesis for the pathogenesis of diabetic retinopathy. It is hypothesized that a relative reduction in intra-ocular pressure caused by persistent or intermittent hyperglycemia may be the missing link that induces certain morphological changes in the retinal pigment epithelium. These changes, in addition to the ischaemic retina, may be important for the pathogenesis of diabetic retinopathy. Such a hypothesis also explains most of the hitherto unexplained features of diabetic retinopathy.

Analysis of underlying and multiple-cause mortality data

"A variety of life table models were used for the analysis of the (1984-86) Kuwaiti cause-specific mortality data. These models comprised total mortality, multiple-decrement, cause-elimination, cause-delay and disease dependency. The models were illustrated by application to a set of four chronic diseases: hypertensive, ischaemic heart, cerebrovascular and diabetes mellitus. The life table methods quantify the relative weights of different diseases as hazards to mortality after adjustment for other causes. They can also evaluate the extent of dependency between underlying cause of death and other causes mentioned on [the] death certificate using an extended underlying-cause model." (SUMMARY IN FRE AND ITA)

Aeromonas trota sp. nov., an ampicillin-susceptible species isolated from clinical specimens

Previous DNA hybridization studies established 12 Aeromonas genospecies, from which nine phenotypic species have been proposed: Aeromonas hydrophila, A. sobria, A. caviae, A. media, A. veronii, A. schubertii, A. salmonicida, A. eucrenophila, and A. jandaei. We have delineated a new Aeromonas genospecies, A. trota, on the basis of 13 strains isolated primarily from fecal specimens from southern and southeastern Asia. All strains were highly related to the proposed type strain, AH2 (ATCC 49657T): 51 to 100% (60 degrees C) and 49 to 99% (75 degrees C), with 0.2 to 2.2 divergence. AH2 was only 16 to 41% (60 degrees C) related to all other Aeromonas type strains and DNA group definition strains. The unique profile of A. trota includes negative reactions for esculin hydrolysis, arabinose fermentation, and the Voges-Proskauer test, positive reactions for cellobiose fermentation, lysine decarboxylation, and citrate utilization, and susceptibility to ampicillin, as determined by the broth microdilution MIC method and the Bauer-Kirby disk diffusion method (10 micrograms). Nine of the A. trota strains were from a single study of 165 geographically diverse aeromonads. This finding questions the efficacy of screening fecal specimens for Aeromonas spp. with ampicillin-containing media and suggests a previously unrecognized prevalence of this new species.