Myopericytoma of neck region - A case report

A 42-year-old male presented with a history of an enlarging painless swelling on the right side of neck for 15 days. It recurred within three months of partial excision. Immunohistochemistry showed positivity for Smooth Muscle Actin [SMA]. This newly described entity is being reported for its unusual histological features and its differential diagnosis with other spindle cell and vascular lesions of soft tissues.

Implementation of a high-sensitivity Micro-Angiographic Fluoroscope (HS-MAF) for in-vivo endovascular image guided interventions (EIGI) and region-of-interest computed tomography (ROI-CT)

New advances in catheter technology and remote actuation for minimally invasive procedures are continuously increasing the demand for better x-ray imaging technology. The new x-ray high-sensitivity Micro-Angiographic Fluoroscope (HS-MAF) detector offers high resolution and real-time image-guided capabilities which are unique when compared with commercially available detectors. This detector consists of a 300 μm CsI input phosphor coupled to a dual stage GEN2 micro-channel plate light image intensifier (LII), followed by minifying fiber-optic taper coupled to a CCD chip. The HS-MAF detector image array is 1024×1024 pixels, with a 12 bit depth capable of imaging at 30 frames per second. The detector has a round field of view with 4 cm diameter and 35 microns pixels. The LII has a large variable gain which allows usage of the detector at very low exposures characteristic of fluoroscopic ranges while maintaining very good image quality. The custom acquisition program allows real-time image display and data storage. We designed a set of in-vivo experimental interventions in which placement of specially designed endovascular stents were evaluated with the new detector and with a standard x-ray image intensifier (XII). Capabilities such fluoroscopy, angiography and ROI-CT reconstruction using rotational angiography data were implemented and verified. The images obtained during interventions under radiographic control with the HS-MAF detector were superior to those with the XII. In general, the device feature markers, the device structures, and the vessel geometry were better identified with the new detector. High-resolution detectors such as HS-MAF can vastly improve the accuracy of localization and tracking of devices such stents or catheters.

Design and development of a mucoadhesive buccal film bearing progesterone

The purpose of this research was to develop and evaluate mucoadhesive films for buccal administration of progesterone using film-forming and mucoadhesive polymers. Buccal films of chitosan bearing progesterone were prepared by solvent casting technique. The films have been evaluated in terms of film weight, thickness, density, surface pH, FT-IR, X-ray diffraction analysis, bioadhesion, swelling properties, in vitro drug release and in vivo studies. It was found that the film formulations of 2 cm2 size having weight in the range of 239 +/- 0.32 to 290 +/- 3.23 mg and film thickness were in the range of 0.49 +/- 0.21 to 0.60 +/- 0.26 mm. Density of the films was found to be 0.108 to 0.139 g/mL. Drug content was found to be uniform in a range of 9.21 +/- 0.051 to 9.67 +/- 0.086 mg/cm2 for formulation F1 to F4. Maximum bioadhesion force was recorded for PVP buccal films (formulation F2) i.e. 0.45 +/- 0.53 N as compared to other films. In vitro residence time was in range of 1.85 +/- 0.08 to 8.94 +/- 0.08 h. The drug release studies revealed that formulations follows non-fickian diffusion. In vivo residence time data confirmed that none of the polymers detached from the oral mucosa over the study period, which indicated that the bioadhesion values of all polymers were satisfactory to retain the film on the buccal mucosa. These mucoadhesive formulations could offer many advantages in comparison to traditional treatments and their efficacy as an effective contraception is assessed.

Intra-operative 3D guidance in prostate brachytherapy using a non-isocentric C-arm

Intra-operative guidance in Transrectal Ultrasound (TRUS) guided prostate brachytherapy requires localization of inserted radioactive seeds relative to the prostate. Seeds were reconstructed using a typical C-arm, and exported to a commercial brachytherapy system for dosimetry analysis. Technical obstacles for 3D reconstruction on a non-isocentric C-arm included pose-dependent C-arm calibration; distortion correction; pose estimation of C-arm images; seed reconstruction; and C-arm to TRUS registration. In precision-machined hard phantoms with 40-100 seeds, we correctly reconstructed 99.8% seeds with a mean 3D accuracy of 0.68 mm. In soft tissue phantoms with 45-87 seeds and clinically realistic 15 degrees C-arm motion, we correctly reconstructed 100% seeds with an accuracy of 1.3 mm. The reconstructed 3D seed positions were then registered to the prostate segmented from TRUS. In a Phase-1 clinical trial, so far on 4 patients with 66-84 seeds, we achieved intra-operative monitoring of seed distribution and dosimetry. We optimized the 100% prescribed iso-dose contour by inserting an average of 3.75 additional seeds, making intra-operative dosimetry possible on a typical C-arm, at negligible additional cost to the existing clinical installation.

Acquired Blaschkoid dermatitis

Acquired Blaschkoid dermatitis characterised by unilateral relapsing inflammatory disease along the lines of Blaschko. A 40-year-old Indian male presented with unilateral erythematous, itchy grouped papules on the left side of the chest, abdomen, back and left arm of 15 days duration. The eruption stopped abruptly at the midline of the torso, completely sparing the right side of the body. The lesions were arranged in whorls and streaks corresponding to the lines of Blaschko. Skin biopsy showed hyperkeratosis and features suggestive of sub-acute spongiotic dermatitis with lymphocytic infiltrate around the blood vessels in the dermis. Patient was diagnosed as a case of Blaschkoid dermatitis. To the best of our knowledge, this is the first case of this condition being reported from India.

Living-donor liver transplantation in the United States: identifying donors at risk for perioperative complications

Donor safety has been scrutinized by both the medical community and the media. Variability exists in reported donor complications and associated risk factors are ill defined. Use of administrative data can overcome the bias of single-center studies and explore variables associated with untoward events. A retrospective cohort study identifying living liver donors in two large healthcare registries yielded 433 right and left lobe donors from 13 centers between 2001 and 2005. Perioperative complications were identified using International Classification of Diseases, 9th Revision (ICD-9) coding data and classified according to the Clavien system. Logistic regression models identified factors associated with complications. There was one perioperative death (0.23%). The overall complication rate was 29.1% and major complication rate defined by a Clavien grade >or=3 was 3.5%. Center living-donor volume (OR = 0.97, 95% CI = 0.95-0.99) and the ratio of living-donors to all donors (living and deceased) (OR = 0.94, 95% CI = 0.92-0.96) were associated with a lower risk of all complications. Donor age >50 years (OR = 4.25, 95% CI = 1.22-14.87) was associated with a higher risk of major complications. Living liver donation is currently performed with a low risk of major morbidity. Use of administrative data represents an important tool to facilitate a better understanding of donor risk factors.

Genetic diversity and bottleneck analysis of Indian bellary sheep by microsatellite markers

Bellary sheep population variability and structure was investigated genetically utilizing FAO recommended microsatellite markers. Genetic variation at 20 microsatellite loci, population structure, and genetic bottleneck hypothesis were examined. Estimates of genetic variability such as effective number of alleles and gene diversities revealed substantial genetic variation frequently displayed by microsatellite markers. A total of 133 alleles were detected. Average polymorphism across the studied loci and expected gene diversity in the population were 1.419 +/- 0.405 and 0.684 +/- 0.140, respectively. No significant genotypic linkage disequilibrium was detected across population, suggesting no evidence of linkage between loci. The population was observed to be significantly differentiated into different groups, showed fairly high level of inbreeding (f = 0.253 +/- 0.050) and global heterozygote deficit. Population structure analysis indicated the intermixing/introduction of unique/rare alleles in these migrating flocks. A normal L-shaped distribution of mode-shift test, non-significant heterozygosity excess on the basis of different models, as revealed from Sign, Standardized differences and Wilcoxon sign rank tests suggested that there was no recent bottleneck. The study revealed that even breed with increasing population trend needs genetic management for the conservation and improvement.

QSAR Analysis of Indazole Estrogens as Selective β-Estrogen Receptor Ligands: Rationalization of Physicochemical Properties

Quantification of structure activity relationships was performed on a series of indazole estrogen analogs, for their relative beta estrogenic receptor agonist activity, in order to understand the essential structural requirements for selectivity of indazole estrogen analogs for beta-estrogenic receptor over alpha-estrogenic receptor. The de novo and Hansch approach suggested that the 3(rd) position of indazole nucleus (R(1)) is decisive for the selectivity of molecules towards beta-estrogenic receptor over alpha-estrogenic receptor. The study also depicted that the substitution of polar group at R(1) position might prove helpful in the beta-estrogenic receptor selectivity (ER(beta/alpha )).