Generation and characterization of neutralizing monoclonal antibodies against baculo-expressed HPV 16 VLPs

Human papillomavirus (HPV) is the well-known second most cause of cervical cancer in women worldwide. According to the WHO survey, 70% of the total cervical cancers are associated with types HPV 16 and 18. Presently used prophylactic vaccine for HPV contains mainly capsid protein of L1 virus like particles (VLPs). Correct folding of VLPs and display of neutralizing epitopes are the major constraint for VLP-based vaccines. Further, monoclonal antibodies (mAbs) play a vital role in developing therapeutics and diagnostics. mAbs are also useful for the demonstration of VLP conformation, virus typing and product process assessment as well. In the present study, we have explored the usefulness of mAbs generated against sf-9 expressed HPV 16 VLPs demonstrated as type-specific and conformational dependent against HPV 16 VLPs by ELISA. High affinity and high pseudovirion neutralization titer of mAbs indicated their potential for the development of prophylactic vaccines for HPV. Also, the type-specific and conformational reactivity of the mAbs to HPV 16 VLPs in sf-9 cells by immunofluorescence assay proved their diagnostic potential.

Development of anti-bovine IgA single chain variable fragment and its application in diagnosis of foot-and-mouth disease

Recombinant antibody fragments like single chain variable fragments (scFvs) represent an attractive yet powerful alternative to immunoglobulins and hold great potential in the development of clinical diagnostic/therapeutic reagents. Structurally, scFvs are the smallest antibody fragments capable of retaining the antigen-binding capacity of whole antibodies and are composed of an immunoglobulin (Ig) variable light (VL) and variable heavy (VH) chain joined by a flexible polypeptide linker. In the present study, we constructed a scFv against bovine IgA from a hybridoma cell line IL-A71 that secretes a monoclonal antibody against bovine IgA using recombinant DNA technology. The scFv was expressed in Escherichia coli and purified using immobilized metal affinity chromatography (IMAC). The binding activity and specificity of the scFv was established by its non-reactivity toward other classes of immunoglobulins as determined by enzyme-linked immunosorbent assay (ELISA) and immunoblot analysis. Kinetic measurement of the scFv indicated that the recombinant antibody fragment had an affinity in picomolar range toward purified IgA. Furthermore, the scFv was used to develop a sensitive ELISA for the detection of foot and mouth disease virus (FMDV) carrier animals.

Preparation and storage stability of retort processed Chettinad chicken

Chettinad chicken was prepared using boneless meat derived from spent hen and boiler breeder packed in retort pouches (250 g) and processed in retort at the product temperature of 121.1 °C and the corresponding F0 value of 5.2. The product was stored at ambient temperature (35 ± 2 °C) up to 180 days. The sensory scores for texture of the Chettinad chicken prepared from spent hen and broiler breeder meat decreased significantly however the scores were rated very acceptable even on 180th day. The thiobarbituric acid (TBA), tyrosine values and acid value increased gradually during storage but E. coli, Salmonella spp, Clostridium spp, Staphylococci spp, Streptococci spp, yeast and mould could not be detected during the entire storage period. The cost of production of Chettinad chicken (250 g) prepared from spent hen meat and broiler breeder meat was Rs.37 and Rs.50, respectively. It was concluded that the retort processed Chettinad chicken prepared from spent hen and broiler breeder meat can be safely stored up to 180 days at ambient temperature.

Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended?

BACKGROUND

A multidisciplinary team (MDT) approach to breast cancer management is the gold standard. The aim is to evaluate MDT decision making in a modern breast unit.

METHODS

All referrals to the breast MDT where breast cancer was diagnosed from 1 July 2009 to 30 June 2011 were included. Multidisciplinary team decisions were compared with subsequent patient management and classified as concordant or discordant.

RESULTS

Over the study period, there were 3230 MDT decisions relating to 705 patients. Overall, 91.5% (2956 out of 3230) of decisions were concordant, 4.5% (146 out of 3230), were discordant and 4% (128 out of 3230) had no MDT decision. Of 146 discordant decisions, 26 (17.8%) were considered 'unjustifiable' as there was no additional information available after the MDT to account for the change in management. The remaining 120 discordant MDT decisions were considered 'justifiable', as management was altered due to patient choice (n=61), additional information available after MDT (n=54) or MDT error (n=5).

CONCLUSION

The vast majority of MDT decisions are implemented. Management alteration was most often due to patient choice or additional information available after the MDT. A minority of management alterations were 'unjustifiable' and the authors recommend that any patient whose treatment is subsequently changed should have MDT rediscussion prior to treatment.

Near-room-temperature colossal magnetodielectricity and multiglass properties in partially disordered La2NiMnO6

We report magnetic, dielectric, and magnetodielectric responses of the pure monoclinic bulk phase of partially disordered La2NiMnO6, exhibiting a spectrum of unusual properties and establish that this compound is an intrinsically multiglass system with a large magnetodielectric coupling (8%-20%) over a wide range of temperatures (150-300 K). Specifically, our results establish a unique way to obtain colossal magnetodielectricity, independent of any striction effects, by engineering the asymmetric hopping contribution to the dielectric constant via the tuning of the relative-spin orientations between neighboring magnetic ions in a transition-metal oxide system. We discuss the role of antisite (Ni-Mn) disorder in emergence of these unusual properties.

Comparison of PCR based marker systems for genetic analysis in different cultivars of mango

Native diversity is well represented in northern and eastern parts of India for mango. We evaluated three important polymerase chain reaction (PCR) based marker techniques viz., random amplified polymorphic DNA (RAPD), inter simple sequence repeat (ISSR) and directed amplified mini satellite DNA (DAMD) and examined their suitability for depicting genetic relationships and discrimination among closely related group of 46 mango varieties grown in the different agro-ecological zones in Uttar Pradesh, Bihar and West Bengal. Nine RAPD, eleven ISSR and four DAMD primers generated 110, 160 and 43 discrete fragments, respectively, accounting for polymorphism of 87.3, 79.83 and 83.72%, respectively. Cumulative analysis of these markers resulted in comprehensive UPGMA based dendrogram where in native mangoes representing important breeding lines and varieties from Uttar Pradesh fall more or less in separate cluster, while Bihar and West Bengal cultivars represent genetically different lineage forming distinct separate cluster. The prime focus on the study was towards identification of genetic variability that warrants establishing origin and molecular evolution of mango cultivars of eastern and northern India because they are the rich gene pool for conservation. Highest diversity index (DI) and polymorphic information content (PIC) values were found in DAMD indicating it to be more informative than others. Similarly, high effective multiplex ratio (EMR) and marker index (MI) were recorded by ISSR reflecting ability to simultaneously detect a large number of bands. The study accomplished establishing genetic relationship and also DNA fingerprint development. The data is also useful for mapping studies for gene identification.

Congenital infiltrating lipomatosis of the face with exophytic temporomandibular joint ankylosis: a case report and review of the literature

Congenital infiltrating lipomatosis of the face (CIL-F) is a rare lipomatous lesion with diffuse fatty infiltration of tissues and hyperplasia of underlying bone. We report clinical and CT findings in an unusual case of CIL-F presenting with progressive hemifacial asymmetry, manifesting as severely restricted mouth opening owing to exophytic temporomandibular joint ankylosis. The role of imaging in diagnosis is presented with a review of the literature. Differential diagnosis of CIL-F and its exclusion as a cause of hemifacial hyperplasia are also discussed.

Antifungal activity of Aegle marmelos (L.) Correa (Rutaceae) leaf extract on dermatophytes

OBJECTIVE

To evaluate the in vitro antifungal activity of Aegle marmelos leaf extracts and fractions on the clinical isolates of dermatophytic fungi like Trichophyton mentagrophytes, Trichophyton rubrum, Microsporum canis, Microsporum gypseum and Epidermophyton floccosum.

METHODS

The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of various extracts and fractions of the leaves of Aegle marmelos were measured using method of National Committee for Clinical Laboratory Standards (NCCLS).

RESULTS

Aegle marmelos leaf extracts and fractions were found to have fungicidal activity against various clinical isolates of dermatophytic fungi. The MIC and MFC was found to be high in water and ethyl alcohol extracts and methanol fractions (200µg/mL) against dermatophytic fungi studied.

CONCLUSIONS

Aegle marmelos leaf extracts significantly inhibites the growth of all dermatophytic fungi studied. If this activity is confirmed by in vivo studies and if the compound is isolated and identified, it could be a remedy for dermatophytosis.

A Validated RP-HPLC Method for Simultaneous Estimation of Nebivolol and Hydrochlorothiazide in Tablets

A simple, selective, rapid, precise and economical reverse phase high pressure liquid chromatographic method has been developed for the simultaneous estimation of nebivolol and hydrochlorthiazide from pharmaceutical formulation. Phenomenex Gemini C₁₈ (25 cm×4.6 mm i.d., 5 μ) column with a mobile phase consisting of acetonitrile: 50mM ammonium acetate (adjusted to pH 3.5 using orthophosphoric acid) (70:30 v/v) at a flow rate of 1.0 ml/min was used. Detection was carried out at 254 nm. Probenecid was used as an internal standard. The retention times of probenecid, nebivolol and hydrochlorthiazide were 13.05, 3.32 and 4.25 min, respectively. The developed method was validated in terms of accuracy, precision, linearity, limit of detection, limit of quantitation and solution stability. The proposed method can be used for the estimation of these drugs in combined dosage forms.

Pathologic outcomes in patients with clinically low-risk prostate cancer deemed eligible for active surveillance

110

Background: Active surveillance (AS) is becoming increasingly popular as a treatment option for men with clinically localized low-risk prostate cancer. Gleason score ≤ 6 and clinical stage ≤ T2a are selection criteria for AS. However, Gleason upgrading or upstaging from the diagnostic biopsy to the surgical specimen is not uncommon. We thus sought to identify risk factors that could more accurately predict Gleason upgrading and/or upstaging in AS-eligible men.

Methods: 786 patients from our prospective database of 2,412 men who underwent robotic-assisted radical prostatectomy by a single surgeon from January 2005 to August 2010 would have fulfilled standard AS criteria (Gleason sum ≤ 6, clinical stage ≤T2a disease, PSA <10ng/ml, <3 positive cores and ≤50% cancer present in a single core). This formed the basis of our study cohort. Clinicopathologic parameters, including number of cores at initial biopsy, biopsy cancer volume, preoperative PSA, number of cancer-positive cores, body mass index, and prostate volume were recorded prospectively. Data were evaluated using chi- square and multivariate logistic regression analyses. Receiver operator characteristic curves (ROC) were constructed to determine the optimal cutoff values.

Results: 320 of 786 AS-eligible patients (40.7%) had Gleason upgrading at final pathology following radical prostatectomy. Upstaging was present in 591 patients (75.1%). 626 patients (79.6%) had Gleason upgrading and/or upstaging. On univariate analysis, BMI, PSA density, preoperative PSA, lower prostate volume and maximum percentage of cancer in biopsy cores were predictors of Gleason upgrading and/or upstaging. On multivariate analysis, all variables, except for BMI and PSA density, lost statistical significance. PSA density > 0.1 ng/ml/cm3 and BMI >29 kg/m2 are the optimal cutoff values based on ROC analysis.

Conclusions: PSA density and BMI are significant predictors of Gleason upgrading and/or upstaging, and should be incorporated into contemporary selection criteria for AS protocols.

No significant financial relationships to disclose.

Nomograms to predict 3-year biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy based on preoperative and perioperative variables of 774 patients

115

Background: Predictors of biochemical recurrence after robotic-assisted laparoscopic radical prostatectomy (RALP) are not well reported in the literature. We wanted to investigate preoperative predictors as well as the influence of nerve sparing and positive surgical margin status on 3-year biochemical recurrence.

Methods: 774 patients with at least 3 year follow up had undergone RALP by a single surgeon at our institution. Biochemcial recurrence was defined as a postoperative PSA >0.2 ng/ml. Multivariable logistic regression models were used to develop the biochemical recurrence predictive nomograms: nomogram 1- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion; nomogram 2- age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, perineural invasion, nerve sparing, positive surgical margins (none, unifocal, or multifocal). The predictive accuracy of the models was assessed in terms of discrimination and calibration.

Results: Both nomograms discriminated well between patients that recurred and those that did not (bootstrap corrected c-indices of 0.766 and 0.806 for nomograms 1 and 2 respectively). Nomogram 1 was well calibrated, but nomogram 2 over- predicted the probability of biochemical recurrence in patients at >30% risk.

Conclusions: Our nomogram based on age, BMI, PSA density, clinical stage, biopsy Gleason, percent positive cores, and perineural invasion on preoperative biopsy has a good predictive ability to differentiate between RALP-treated patients that biochemically recur by 3 years from those that do not. Adding nerve sparing and surgical margin status further improved discriminatory ability but at the expense of over-prediction for patients at high risk. These nomograms may be used to guide the use of nerve sparing and the management of positive margins in men undergoing RALP for clinically localized prostate cancer.

No significant financial relationships to disclose.

The relationship between prostate volume and histopathologic criteria of known prognostic importance in 2,207 men with prostate cancer

197

Background: There is a paucity of data investigating the relationship between histopathologic variables of oncologic importance and prostate volume, and we aimed to investigate this.

Methods: 2,207 consecutive patients who underwent robotic-assisted radical prostatectomy (RARP) were studied. Preoperative demographic and both pre- and post-operative histopathologic parameters were compared among the small prostate (< 40cc), intermediate size (40-70cc), and large prostate (> 70cc) groups.

Results: Patients with smaller prostates were younger, had slightly lower BMIs, and lower PSAs than those with smaller prostates (p < 0.001). They also had worse histopathologic criteria (Gleason, core positivity, and maximum percent cancer) on preoperative biopsy and had worse radical specimen Gleason sums (p < 0.001), percent cancer (p < 0.001), and pathologic stage (p = 0.016). 11.5% of men in the small prostate group suffered a positive surgical margin (PSM) compared to 8.3% and 5.6% in the intermediate and large prostate groups, respectively (p = 0.008; Table). Basilar, posterolateral, and multifocal PSMs were commoner in the small prostate group.

Conclusions: Younger men have smaller prostates and worse preoperative histopathologic parameters despite lower PSAs. Men with small prostates undergoing RARP have worse final Gleason sums, tumor volume, extraprostatic extension (EPE), and PSM rates than those with larger prostates. We would thus caution against conservative management of men with clinically localized prostate cancer who have small prostates.

[Table: see text]

No significant financial relationships to disclose.

Use of a novel absorbable barbed plastic surgical suture enables a "self-cinching" technique of vesicourethral anastomosis during robot-assisted prostatectomy and improves anastomotic times

PURPOSE

To demonstrate a novel technique of self-cinching anastomosis using a barbed and looped suture during robot-assisted radical prostatectomy (RARP).

PATIENTS AND METHODS

This is a feasibility study of 50 consecutive patients who underwent this novel self-cinching anastomotic technique using a V-Loc™ 180 absorbable barbed suture after RARP for clinically localized prostate cancer. The results were then compared with 50 consecutive patients who underwent RARP by the same surgeon before this new technique. We examined whether this novel technique had any effects on posterior reconstruction time, vesicourethral anastomosis time, and thus total reconstruction and operative time by inference.

RESULTS

The V-Loc 180 group had significantly shorter posterior reconstruction (40 seconds vs 60 seconds; P ≤ 0.001) and vesicourethral anastomotic times (7 min vs 12 min; P ≤ 0.001). By inference, this meant that total reconstruction and operative times were also significantly less (8 minutes vs 13.5 min; P ≤ 0.001 and 106 min vs 114.5 minutes; P ≤ 0.001, respectively).

CONCLUSION

We have shown that this technique is feasible and improves posterior reconstruction and anastomotic times. Further follow-up will determine any benefits of this technique on anastomotic urinary leak rates, continence, and catheter removal times.

Dermal burns associated with bipolar radiofrequency ablation in the subacromial space

This article presents iatrogenic dermal burn injury as a complication of using a vented bipolar radiofrequency (RF) ablative device in shoulder arthroscopy. We have encountered 4 patients who have sustained second-degree skin burns after shoulder arthroscopy. The burns occurred from arthroscopic shoulder surgeries performed from 2004 to 2008. In each case a vented bipolar RF device was used to help perform a subacromial decompression. The burns appeared to be the result of heated effluent from the outflow tubing of the RF device exposed to the skin of the patients. This case report shows that care should be taken to avoid exposing patients to the elevated temperatures of bipolar RF device effluent to reduce the risk of dermal burn injury.