Charcot's Elbow Following Syringomyelia: Revisited

Neuropathic arthropathy of the elbow joint is uncommon with a reported incidence of 3-8%only. The natural history, pathogenesis and management approaches are debatable with an absence of clear guidelines. We report two cases of Charcot's elbow following syringomyelia with ulnar nerve manifestations. One patient required debulkingsynovectomy and ulnar nerve decompression while the other was managed conservatively. The article aims to enrich the limited knowledge of managing Charcot's elbow.

Anti-inflammatory effect of Pueraria tuberosa extracts through improvement in activity of red blood cell anti-oxidant enzymes

Changing life style and over-nutrition causes low-grade inflammation (LGI), with obesity and hyper-lipidemia as basic factors. The physiological state polarizes macrophages to classical type (M1), which is pro-inflammatory and promotes ectopic fat deposition in the body. Both factors induce inflammatory cascade, where free radicals (FRs) play an important role. Thus, pharmacological and non-pharmacological interventions would be effective in the management of LGI and plant products would be used as food supplement or as a drug. Previously, a study has reported the anti-oxidant potential of methanolic extract of tubers of Pueraria tuberosa (PTME) and inhibitory role of tuberosin on lipopolysaccharides-induced expression of inducible nitric oxide synthase in macrophages in an in vitro study model. Here, the effect of PTME has been explored on carrageenan-induced inflammatory changes in rats. The activity of antioxidant enzymes in red blood cell hemolysate has been assessed. PTME was orally given to rats for 9 days and periodical changes (every 3^rd day) in the activity/concentration of superoxide dismutase (SOD), catalase, reduced glutathione (GSH), lipid peroxides (LPO), and C-reactive proteins (CRP) were monitored. The PTME significantly prevented carrageenan-induced decline in GSH content, lowering of catalase and SOD activity, and rise in LPO and CRP in rats in a time-dependent, sequential manner. Thus, it could be suggested that the anti-inflammatory role of PTME is primarily mediated through its FR scavenging potential.

Bifurcated intraarticular long head of biceps tendon

Though rare, many anomalous origins of long head of the biceps tendon (LHBT) have been reported in the literature. Anatomic variations commonly explained are a third humeral head, anomalous insertion, congenital absence and adherence to the rotator cuff. We report a rare case who underwent shoulder arthroscopy with impingement symptoms where in LHBT was found to be bifurcated with a part attached to superior labrum and the other part to the posterior capsule of joint. Furthermore, intraarticular portion of LHBT was adherent to the undersurface of the supraspinatus tendon. Awareness of such an anatomical aberration during the shoulder arthroscopy is of great importance as it can potentially avoid unnecessary confusion and surgery.

Mucoid degeneration of the anterior cruciate ligament: Management and outcome

BACKGROUND

Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Mucinous material within the substance of ACL produces pain and limited motion in the knee. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes.

MATERIALS AND METHODS

During a period of 3 years, 11 patients were included based upon the clinical suspicion, magnetic resonance imaging (MRI) findings, arthroscopic features and histopathologic confirmation of MD of ACL.

RESULT

Six patients were male and five were female with median age of 40 years (range 21-59 years). All patients complained of knee pain with median duration of 5 months (range 1-24 months). All patients had painful deep flexion with 63.6% (N = 7) reporting trivial trauma before the onset of symptoms. MRI revealed MD of ACL in all with associated cyst in three patients. Partial debridement of ACL was done in ten and complete in one patient. None of them required notchplasty. Histopathology confirmed the diagnosis in all of them. At the mean followup of 13.81 months (range 6-28 months), all patients regained complete flexion and none complained of instability.

CONCLUSION

Prior knowledge of condition with high index of suspicion and careful interpretation of MRI can establish the diagnosis preoperatively. It responds well to partial debridement of ACL and mucinous material without development of instability.

Impacts of increasing ozone on Indian plants

Increasing anthropogenic and biogenic emissions of precursor compounds have led to high tropospheric ozone concentrations in India particularly in Indo-Gangetic Plains, which is the most fertile and cultivated area of this rapidly developing country. Current ozone risk models, based on European and North American data, provide inaccurate estimations for crop losses in India. During the past decade, several ozone experiments have been conducted with the most important Indian crop species (e.g. wheat, rice, mustard, mung bean). Experimental work started in natural field conditions around Varanasi area in early 2000's, and the use of open top chambers and EDU (ethylene diurea) applications has now facilitated more advanced studies e.g. for intra-species sensitivity screening and mechanisms of tolerance. In this review, we identify and discuss the most important gaps of knowledge and future needs of action, e.g. more systematic nationwide monitoring for precursor and ozone formation over Indian region.

Nonfatal air embolism during shoulder arthroscopy

An air embolism is a rare but potentially fatal complication of shoulder arthroscopy. In this article, we report the case of a patient who developed a nonfatal air embolism during shoulder arthroscopy for an acute bony Bankart lesion and a greater tuberosity avulsion fracture. The venous air embolism occurred immediately after the joint was insufflated with air for diagnostic air arthroscopy. The diagnosis was based on a drop in end-tidal carbon dioxide and blood pressure and presence of mill wheel (waterwheel) murmur over the right heart. Supportive treatment was initiated immediately. The patient recovered fully and had no further complications of air embolism. This patient's case emphasizes the importance of being aware that air embolisms can occur during shoulder arthroscopy performed for acute intra-articular fractures of the shoulder. Monitoring end tidal carbon dioxide can be very useful in early detection of air embolisms.

Trefoil factor 1 suppression of E-CADHERIN enhances prostate carcinoma cell invasiveness and metastasis

Metastasis is the primary mediator of prostate cancer (PCA) lethality and poses a significant clinical obstacle. The identification of factors involved in the metastasis of PCA is imperative. We demonstrate herein that trefoil factor 1 (TFF1) promotes PCA cell migration and invasion in vitro and metastasis in vivo. The capacity of TFF1 to enhance cell migration/invasion is mediated by transcriptional repression of E-CADHERIN. Consideration of targeted inhibition of TFF1 to prevent metastasis of prostate carcinoma is warranted.

Obesity and endoplasmic reticulum (ER) stresses

In obesity, the adipose cells behave as inflammatory source and result to low grade inflammation. This systemic inflammation along with oxidative stress is a silent killer and damages other vital organs also. High metabolic process, induced due to high nutritional intake, results to endoplasmic reticulum (ER) stress and mitochondrial stress. This review describes the triggering factor and basic mechanism behind the obesity mediated these stresses in relation to inflammation. Efforts have been made to describe the effect-response cycle between adipocytes and non-adipocyte cells with reference to metabolic syndrome (MS).

MENISCAL ABNORMALITIES: DISCOID MENISCUS

The discoid meniscus is the most common meniscal variant. The likely etiology being congenital, the condition usually affects the lateral meniscus. Poorly vascularized, thicker and unstable, the discoid lateral meniscus (DLM) is more prone to tears due to abnormal shearing forces. Watanabe et al. (1979) classified the discoid lateral meniscus into three types: Complete, incomplete and Wrisberg type; Monllau et al. (1998) added the ring type as the fourth variant. Pain and clicks/thud are the most common presentations. Plain radiograph and magnetic resonance imaging are helpful in confirming the diagnosis. Asymptomatic DLM is best left alone. For symptomatic complete and incomplete types, partial arthroscopic saucerization is the treatment of choice leaving behind a stable rim. The Wrisberg type needs peripheral stabilization with resection of excess rim, if any. Total meniscectomy should be avoided unless inevitable. Short term results after partial meniscectomy are good.

Physiological effects of arsenate on transplant thalli of the lichen Pyxine cocoes (Sw.) Nyl

INTRODUCTION

The changes in photosynthetic pigments, chlorophyll fluorescence, protein content, and antioxidant enzymes were investigated in a foliose lichen Pyxine cocoes, which was subjected to increasing concentrations of arsenate.

METHODS

The arsenate concentrations of 10, 25, 50, 75, 100, and 200 μM were sprayed every alternate day on the lichen thallus. The thalli were then harvested on 10, 20, 30, and 45 days.

RESULTS

The quantity of photosynthetic pigments exhibited a decreasing trend till 20 days but increased from 30 days onwards. Concomitantly, chlorophyll fluorescence also showed a decreasing trend with increasing arsenic treatment duration as well as concentration. The higher concentration of arsenate was found to be deleterious to the photosynthesis of lichen as the chlorophyll fluorescence and the amount of pigments decreased significantly. The protein content of lichen increased uninterruptedly as the concentration of arsenate as well as duration of treatment increased. The activities of superoxide dismutase and ascorbate peroxide increased initially at lower concentration of arsenate but declined at higher concentrations and longer duration of treatment.

CONCLUSIONS

The catalase activity was found to be most susceptible to arsenate stress as its activity started declining from very beginning of the experiment. P. cocoes also proved to be an excellent accumulator of arsenate whose concentration increased in the thallus corresponding to its increase in the treatment and duration. Thus, it can be utilized for active biomonitoring of arsenic pollution.

Physiological and proteomic responses of cotton (Gossypium herbaceum L.) to drought stress

Cotton genotype RAHS 187 was analyzed for changes in physiology, biochemistry and proteome due to drought stress. The deleterious effect of drought in cotton plants was mainly targeted towards photosynthesis. The gas-exchange parameters of net photosynthesis (A), stomatal conductance (g(s)) and transpiration (E) showed a decreasing trend as the drought intensity increased. The fluorescence parameters of, effective quantum yield of PSII (Φ(PSII)), and electron transport rates (ETR), also showed a declining trend. As the intensity of drought increased, both H(2)O(2) and MDA levels increased indicating oxidative stress. Anthocyanin levels were increased by more than four folds in the droughted plants. Two-dimensional gel electrophoresis detected more than 550 protein spots. Significantly expressed proteins were analyzed by peptide mass fingerprinting (PMF) using MALDI-TOF-TOF. The number of up-regulated spots was found to be 16 while 6 spots were down-regulated. The reasonable implications in drought response of the identified proteins vis-à-vis physiological changes are discussed. Results provide some additional information that can lead to a better understanding of the molecular basis of drought-sensitivity in cotton plants.

Staged arthroscopic reconstructive surgery for multiple ligament injuries of the knee

PURPOSE

To review treatment outcome of our staged protocol for multiple ligament injuries of the knee.

METHODS

21 men who were treated for multiple ligament injuries of the knee and had completed at least one year of rehabilitation were evaluated. Patients were examined under anaesthesia and then by diagnostic arthroscopy. Arthroscopic reconstructive procedures for injured cruciate ligaments were performed after a minimum 110º flexion and full extension were regained. Collateral ligaments injuries were treated first, followed by posterior cruciate ligament (PCL) and then anterior cruciate ligament (ACL) tears. Outcome was evaluated using the Lysholm knee score and International Knee Documentation Committee (IKDC) knee ligament evaluation form.

RESULTS

19 patients aged 24 to 55 (mean, 36) years were followed up for a mean of 22 (range, 14-33) months. The mean Lysholm score was 92. The mean scores for patients treated within and after 3 weeks were 93 and 90, respectively. The overall IKDC grading was B in 15 knees and C and D each in 2 knees. For the 2 patients with grade D, one presented 19 months after the injury and had persistent posterior sag (secondary to capsular contracture). His Lysholm score was 82. The second patient developed a deep infection and endured a flexion loss of 30º but had a satisfactory Lysholm score of 94. There was no significant difference between early and delayed treatments and between low- and high-velocity injuries in terms of the Lysholm score, the IKDC grade, the range of movement, and the functional outcome.

CONCLUSION

Staged management of multiple ligament injuries of the knee enabled satisfactory restoration of function, stability, and range of movement in most of our patients. By staging the procedures, the need for subsequent ACL reconstruction can be better evaluated, as ACL reconstruction is not necessary in patients not undertaking strenuous activities.

Internal jugular thrombosis post venoplasty for chronic cerebrospinal venous insufficiency

Chronic cerebrospinal venous insufficiency (CCSVI) is a hypothesis through which cerebral venous drainage abnormalities contribute towards the pathogenesis of multiple sclerosis. CCSVI venoplasty is already practised worldwide. We report the case of a 33-year-old lady with multiple sclerosis who underwent left internal jugular venoplasty resulting in iatrogenic jugular thrombosis requiring open thrombectomy for symptom relief. This occurred without insertion of a stent and while fully anticoagulated. Clinicians should be aware that endovenous treatment of CCSVI could cause paradoxical deterioration of cerebral venous drainage. Patients with complications post venoplasty are now presenting to geographically distant vascular units.

A highly stable Cu/Zn superoxide dismutase from Withania somnifera plant: gene cloning, expression and characterization of the recombinant protein

A gene from Withania somnifera (winter cherry), encoding a highly stable chloroplastic Cu/Zn superoxide dismutase (SOD), was cloned and expressed in Escherichia coli. The recombinant enzyme (specific activity of ~4,200 U mg(-1)) was purified and characterized. It retained ~90 and ~70% residual activities after 1 h at 80 and 95 °C, respectively. At 95 °C, thermal inactivation rate constant (K (d)) of the enzyme was 2.46 × 10(-3) min(-1) and half-life of heat inactivation was 4.68 h. The enzyme was stable against a broad pH range (2.5-11.0). It also showed a high degree of resistance to detergent, ethanol and protease digestion. This recombinant Cu/Zn SOD could therefore have useful applications.

Femoral tunnel-interference screw divergence in anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: A comparison of two techniques

BACKGROUND

Interference screw is a popular fixation device used to rigidly fix bone-patellar tendon-bone (B-PT-B) graft both in femoral and tibial tunnels in anterior cruciate ligament (ACL) reconstruction. Parallel placement of screw is difficult in transtibially drilled femoral tunnel but always desired as it affects pullout strength of the graft. Commonly, interference screw into the femoral tunnel is inserted through the anteromedial (AM) or accessory AM portal. These portals are not-in-line with the transtibially drilled femoral tunnel. Furthermore, these portals increase the divergence of the interference screw in the femoral tunnel. We hypothesized that interference screw placement through patellar tendon (PT) portal (through donor defect) in transtibially drilled femoral tunnel can be less divergent. We report the prospective randomized study to investigate the difference of divergence of interference screw placed through PT portal and AM portal and its clinical relevance.

MATERIALS AND METHODS

Forty-one patients underwent femoral tunnel B-PT-B graft fixation through AM portal (group 1) and other 41 (group 2) through PT portal. Femoral tunnel-interference screw divergence was measured on postoperative digital lateral X-rays. Ha's method was used to grade divergence. The clinical outcome was assessed by postoperative intervention knee documentation committee grading (IKDC) and Lysholm score at 2 years followup.

RESULTS

Mean tunnel-screw divergence in sagittal plane through AM portal was 13.38° (95% CI: 12.34-14.41) and through PT portal was 7.20° (95% CI: 6.25-8.16) (P<0.0001). In AM portal group, 82.9% patients had divergence in either grade 3 or 4 category, whereas in PT portal group, 82.9% patients were in grade 1 or 2 category (P<0.0001). Mean Lysholm score were 92.8 and 94.5 at two-year follow-up in both groups which were statistically not significant. The International knee documentation committee grades of patients in both groups were similar and had no statistical significance.

CONCLUSION

Femoral interference screw placement through the PT portal leads to significantly less screw divergence as compared with screw placement through the AM portal. However, this difference in divergence is not reflected in clinical outcome.

Desiccation-induced physiological and biochemical changes in resurrection plant, Selaginella bryopteris

Selaginella bryopteris is a lycophyte resurrection plant, which incurves during desiccation and recovers on availability of moisture. The aim of the study was to test and understand the various physiological and biochemical changes the fronds undergo during desiccation and rehydration, to get an insight as to how this plant adapts and survives through the dry phase. Upon desiccation, S. bryopteris fronds showed drastic inhibition in net photosynthesis (A) and maximal photochemical efficiency of PSII (F(v)/F(m)) however, chlorophyll content did not show much variation. Dark respiration (R(d)) continued even at 10% relative water content (RWC), and showed a burst after rehydration, which is proposed to be crucial to establish protection mechanisms. Desiccation caused an enhanced production of reactive oxygen species (ROS) and increased lipid peroxidation. Proline accumulation increased substantially by 11-fold. Sucrose and starch contents decreased upon desiccation as compared to control. The antioxidative enzymes viz. superoxide dismutase (SOD), ascorbate peroxidase (APX) and catalase (CAT) along with soluble acid invertase increased during desiccation. S. bryopteris shows mechanical as well as physiological mechanisms for tolerance to extreme levels of desiccation stress. The rapid and almost complete recovery of F(v)/F(m) after rehydration clearly indicates the absence of marked photoinhibitory or thermal injury to PSII during desiccation. This along with the homoiochlorophyllous characteristics enables S. bryopteris to recover its A. The antioxidant metabolism further plays an important role in the desiccation tolerance of S. bryopteris.

Burkholderia pseudomallei musculoskeletal infections (melioidosis) in India

Melioidosis, an infection due to gram negative Burkholderia pseudomallei, is an important cause of sepsis in east Asia especially Thailand and northern Australia. It usually causes abscesses in lung, liver, spleen, skeletal muscle and parotids especially in patients with diabetes, chronic renal failure and thalassemia. Musculoskeletal melioidosis is not common in India even though sporadic cases have been reported mostly involving soft tissues. During a two-year-period, we had five patients with musculoskeletal melioidosis. All patients presented with multifocal osteomyelitis, recurrent osteomyelitis or septic arthritis. One patient died early because of septicemia and multi-organ failure. All patients were diagnosed on the basis of positive pus culture. All patients were treated by surgical debridement followed by a combination of antibiotics; (ceftazidime, amoxy-clavulanic acid, co-trimoxazole and doxycycline) for six months except for one who died due to fulminant septicemia. All other patients recovered completely with no recurrences. With increasing awareness and better diagnostic facilities, probably musculoskeletal melioidosis will be increasingly diagnosed in future.

Chromium effect on ROS generation and detoxification in pea (Pisum sativum) leaf chloroplasts

Pea plants were exposed to 0, 20, 50, and 100 microM chromium [Cr(VI)] to investigate oxidative stress in isolated chloroplasts. Leaf area and biomass accumulation were significantly reduced at higher Cr supply. Generation of superoxide, hydrogen peroxide, and *OH radical generation was enhanced in the chloroplasts isolated from Cr-exposed pea plants. Cr(VI) significantly reduced F(v)/F(m) ratio of chlorophyll (Chl) fluorescence, Chl content, and whole chain electron transport rate. Superoxide dismutase (SOD) activity increased at lower Cr supply while it decreased at higher Cr supply. Ascorbate peroxidase (APX) was found to be most sensitive to Cr stress. Monodehydroascorbate reductase activity remained higher at 20 and 50 microM Cr but decreased at 100 microM Cr. Increased activities of dehydroascorbate reductase (DHAR) and glutathione reductase (GR) in the isolated chloroplasts were observed during the initial 3 days of Cr exposure of pea plants. Activities of DHAR and GR were increased up to day 3 only. Ascorbate and glutathione (GSH) pools showed similar decrease that was more evident in the GSH pool as the duration of Cr treatment increased. Observed changes in reactive oxygen species concentration, photosynthetic characteristics, and antioxidant system indicate that chloroplasts in Cr-exposed pea plants are an important target of oxidative stress.

Artemin is oncogenic for human mammary carcinoma cells

We report that artemin, a member of the glial cell line-derived neurotrophic factor family of ligands, is oncogenic for human mammary carcinoma. Artemin is expressed in numerous human mammary carcinoma cell lines. Forced expression of artemin in mammary carcinoma cells results in increased anchorage-independent growth, increased colony formation in soft agar and in three-dimensional Matrigel, and also promotes a scattered cell phenotype with enhanced migration and invasion. Moreover, forced expression of artemin increases tumor size in xenograft models and leads to highly proliferative, poorly differentiated and invasive tumors. Expression data in Oncomine indicate that high artemin expression is significantly associated with residual disease after chemotherapy, metastasis, relapse and death. Artemin protein is detectable in 65% of mammary carcinoma and its expression correlates to decreased overall survival in the cohort of patients. Depletion of endogenous artemin with small interfering RNA, or antibody inhibition of artemin, decreases the oncogenicity and invasiveness of mammary carcinoma cells. Artemin is therefore oncogenic for human mammary carcinoma, and targeted therapeutic approaches to inhibit artemin function in mammary carcinoma warrant consideration.

Chromium (VI) induced changes in growth and root plasma membrane redox activities in pea plants

The effect of chromium (Cr) on growth as well as root plasma membrane redox reactions and superoxide radical production was studied in pea (Pisum sativum L. cv. Azad) plants exposed for 7 days to 20 and 200 microM Cr (VI), respectively, supplied as potassium dichromate. The growth of pea plants declined significantly at 200 microM Cr, as indicated by reduced leaf area and biomass. Relative to the control plants (no Cr exposure), the Cr content of roots increased significantly, both at 20 and 200 microM Cr. Following exposure to 200 microM Cr, there was a significant increase in root lipid peroxidation and hydrogen peroxide (H(2)O(2)) content, while both the Fv/Fm ratio and chlorophyll content were reduced. Exposure to Cr increased NADPH-dependent superoxide production in pea root plasma membrane vesicles, with the effect being more significant at 200 microM Cr than at 20 microM Cr. Treatment with Cr rapidly increased the activities of NADPH oxidase: relative to the controls, plants exposed to 20 microM Cr showed approximately a 67% increase in activity while there was a threefold increase in those plants exposed to 200 microM Cr. NADH-ferricyanide oxido-reductase activity was found to be inhibited by 16 and 51% at 20 and 200 microM Cr, respectively. The results of this study suggest that exposure to excess Cr damages pea root plasma membrane structure and function, resulting in decreased photosynthesis and poor plant growth.

Evaluation of immunoprophylactic efficacy of Brugia malayi transglutaminase (BmTGA) in single and multiple antigen vaccination with BmALT-2 and BmTPX for human lymphatic filariasis

An attempt was made to study the immunoprophylactic efficacy of recombinant Brugia malayi transglutaminase (BmTGA) as protein vaccine along with two other recombinant proteins, Brugia malayi abundant larval transcript-2 (BmALT-2) and Brugia malayi thioredoxin peroxidase (BmTPX), in single and multiple antigen form for human lymphatic filariasis. Parasite challenge studies in jirds exhibited protection of 30%, 69%, and 43% against BmTGA, BmALT-2, and BmTPX, respectively, in single antigen vaccination mode. The protective efficacy of BmTGA was enhanced significantly (74%) by immunizing the jirds in multiple antigen vaccination mode along with BmTPX, whereas immunizing with the combination of BmTGA and BmALT2 conferred only 47% protection. The same protection profiles were obtained by in vitro antibody-dependent cellular cytotoxicity, using live microfilariae and L3 stage larvae. The immune response was Th2 biased, irrespective of single or multiple vaccinations. The combination of BmTGA and BmTPX seems to be a promising vaccine candidate against lymphatic filariasis.

The pelvic digit "eleventh finger"

Described as asymptomatic and an incidental finding on a plain x-ray film, the "pelvic digit" is a rare congenital anomaly. A 35-year-old man is of a rare symptomatic pelvic digit that warranted surgical excision. Its importance lies in its differentiation from acquired abnormalities due to trauma such as myositis ossificans and avulsion injuries of pelvis. If this entity is kept in mind, unnecessary investigations or interventions can be avoided.

Monocular blindness due to central retinal artery occlusion in bipolar hemireplacement arthroplasty of the hip

Though rare, perioperative loss of vision after non-ocular surgeries is a disastrous complication. This has been reported after spine surgery or cardiopulmonary bypass surgery. We present an otherwise healthy 54-year-old man who underwent bipolar hemireplacement for a fractured neck of femur, and developed perioperative monocular visual loss due to central retinal artery occlusion, a complication hitherto unreported in hip replacement surgeries. The possible aetiological factors and the measures to prevent this complication are discussed.

The role of polymerase chain reaction in the management of osteoarticular tuberculosis

A dependable method for the rapid diagnosis of osteoarticular tuberculosis has become increasingly important, as routine methods are neither very sensitive nor very specific. The objective of this study is to verify the reliability of polymerase chain reaction (PCR) in the diagnosis and management of osteoarticular tuberculosis. This investigation was a prospective study conducted at the Kasturba Medical College, Manipal, India. Tissue samples of 74 patients suspected of osteoarticular tuberculosis were sent for PCR and histopathologic examination. Taking histopathology as the gold standard, PCR has a sensitivity of 73.07% and a specificity of 93.75% (with 95% confidence interval [CI] 62.97; 83.17).The positive agreement between histology and PCR was 0.693, indicating good agreement. PCR showed a sensitivity of 90% with spinal samples. It has a low false positivity of 13.63%. We conclude that conventional methods are neither sensitive nor specific enough and are also time consuming. PCR is an effective method for diagnosing tuberculosis and antitubercular treatment can be started if PCR is positive, since false-positive rates are very low.

Aetiology and management of chronic granulomatous osteomyelitis: look before you leap

We report a rare difficult-to-manage case of chronic granulomatous osteomyelitis due to Burkholderia pseudomallei, the category two organism with atypical sensitivity pattern. The patient was a 29-year-old who presented with a history of dull aching pain in the left thigh region for one year. Local examination revealed a diffuse swelling and tenderness. Any similar presentation should therefore always be supported by microbiological opinion to prevent prolonged morbidity, especially in immunocompromised patients.

Antioxidative responses in relation to growth of mustard (Brassica juncea cv. Pusa Jaikisan) plants exposed to hexavalent chromium

Effect of hexavalent chromium (Cr6+) was seen on Brassica juncea cv. Pusa Jaikisan grown for 15 days in hydroponic culture supplemented with 0.2, 2 and 20 microM Cr. The inhibitory response of Cr6+ on growth of B. juncea was concentration and time dependent. The stimulation of plant growth, observed in response to exposure to 0.2 microM Cr6+, during initial 5 days was reversed on prolonged treatment and at higher Cr6+ concentrations (2 and 20 microM Cr6+). Despite reduction in growth, chlorophyll content increased substantially on 15 days exposure to 20 microM Cr6+. Significant increases in lipid peroxidation and tissue concentration of H2O2 occurred in plants exposed to 2 and 20 microM Cr6+. Effect of Cr6+ on antioxidative enzymes in roots and leaves was differential. SOD and CAT activities at lower levels of Cr6+ supply remained higher all through the treatment. While APX was very susceptible to excess Cr6+, GR and GST increased at elevated levels of Cr6+. The results suggested Cr6+ induced depression in plant growth of B. juncea to be a function of increased cellular accumulation of Cr despite increase in the activities of some of the antioxidative enzymes.

Training for Infrainguinal Bypass Surgery

BACKGROUND

Despite satisfactory results for surgery performed by trainees, vascular surgeons need to improve training methods to ensure that aspiring surgeons are adequately trained with less clinical exposure during fewer dedicated years of training.

OBJECTIVES

To review the wide range of workshop, laboratory and seminar-room based methods available to train for the diverse range of skills required for distal arterial revascularisation. Training methods include anastomotic suturing skills with bench-top training apparatus, working with realistic plastic models and prosthetic conduits, cadaveric dissections and virtual-reality simulations. Many of these also provide excellent opportunities for objective assessment of technical skills and trainees' progress.

DESIGN AND METHODS

A review of the literature on surgical education, surgical skills training and assessment. An evaluation of some of the apparatus, facilities, training curricula and courses, currently available to European trainees, is carried out.

CONCLUSIONS

Many methods are now available to allow focused training for particular skills in non-clinical settings. Objective tools are also available that allow assessment of trainees at many levels or practicing surgeons. These technical skills assessment methods are important for trainees and surgeons who, in the future, will increasingly need to demonstrate competence in vascular surgery.

Heavy metal accumulation in lichens from the Hetauda industrial area Narayani zone Makwanpur District, Nepal

Abstract. Lichen samples collected in and around Hetauda Industrial area, (HIA) Narayani zone, Makwanpur district, Nepal, were analyzed for Cr, Ni, Pb, Zn, Ca, Mn, Fe, Si, and Al. The samples from the location inside the industrial area have higher levels of metal than the outside areas. Pyxine meissnerina growing inside the industrial area accumulated higher levels of all the metals analyzed.

Differential antioxidative responses to cadmium in roots and leaves of pea (Pisum sativum L. cv. Azad)

Pea (Pisum sativum L. cv. Azad) plants exposed to 4 and 40 microM of Cd for 7 d in hydroponic culture were analysed with reference to the distribution of metal, the accumulation of biomass and the metal's effects on antioxidants and antioxidative enzymes in roots and leaves. Cd-induced a decrease in plant biomass. The maximum accumulation of Cd occurred in roots followed by stems and leaves. An enhanced level of lipid peroxidation and an increased tissue concentration of hydrogen peroxide (H2O2) in both roots and leaves indicated that Cd caused oxidative stress in pea plants. Roots and leaves of pea plants responded differently to Cd with reference to the induction of enhanced activities of most of the enzymes monitored in the present study. These differential responses to Cd were further found to be associated with levels of Cd to which the plants were exposed. Cd-induced enhancement in superoxide dismutase (SOD) activity was more at 40 microM than at 4 microM in leaves. While catalase (CAT) prominently increased in leaves both at 4 and 40 microM Cd, ascorbate peroxidase (APX) showed maximum stimulation at 40 microM Cd in roots. Enhancement in glutathione reductase (GR) activity was also more at 40 microM than at 4 microM Cd in roots. While glutathione peroxidase (GPOX) activity decreased in roots and remained almost unmodified in leaves, glutathione S-transferase (GST) showed pronounced stimulation in both roots and leaves of pea plants exposed to 40 microM Cd. Increased activities of antioxidative enzymes in Cd-treated plants suggest that they have some additive function in the mechanism of metal tolerance in pea plants.

Immediate and neurotoxic effects of HIV protein gp120 act through CXCR4 receptor

Primary rat hippocampal neurones show pronounced elevations of intracellular calcium within minutes of exposure to the HIV coat protein gp120. Culture of hippocampal neurones with gp120 causes significant neurotoxicity. We find that the peptide VSLSYRCPCRFF, a competitive inhibitor of the CXCR4 chemokine receptor, markedly inhibits toxicity and eliminates the acute calcium elevation. CXCR4 receptors are thought to signal to the Gi/Go family of trimeric GTP binding proteins. Pretreatment of hippocampal neurones with pertussis toxin to inactivate Gi/Go proteins markedly reduced gp120 neurotoxicity. These results indicate that both short and long term effects of gp120 are the result of activation of the CXCR4 receptor.

Monitoring of auto exhaust pollution by roadside plants

The changing levels of SO2 and Pb in the air and vegetation, along ten road transections of Lucknow city (having varying traffic densities) have been investigated, with a view to authenticate a possible correlation between SO2 and Pb concentration in air and sulphate and lead accumulation in the foliage of avenue trees. The study showed that the road transection at Alambagh (traffic density 4835 for 2 h) revealed the highest level of pollutants (SO2, 202 µg m(-3); SPM, 1080 µg m(-3); and lead, 2.96 µg m(-3), 2 h average) in air, as well as in the foliage of plants, whereas the road stretches with less traffic density correspondingly showed lower levels of pollutants. Pb and sulphate in leaves were found to be positively correlated with Pb and SO2 pollution in the air. Results suggest that Dalbergia sissoo and Calotropis procera are the ideal plant species to monitor as indications of Pb and SO2, respectively, in the air.

Purification and nucleic acid binding properties of a fragment of type C1/C2 heterogeneous nuclear ribonucleoprotein from thymic nuclear extracts

A single-strand nucleic acid binding protein (C/F) that has an apparent molecular weight of 12,000 on SDS-polyacrylamide gel electrophoresis and that was originally thought to be the 12-kDa alpha-subunit of the AB form of terminal deoxynucleotidyl transferase (TdT) from calf thymus has been purified and identified as a fragment of the type C1/C2 hnRNP proteins. On the basis of NH2-terminal sequencing and mass spectrometric analysis, C/F contains approximately 94 residues and spans from residue 9 to approximately residue 102 in the type C1/C2 hnRNP proteins. C/F is presumably produced in vitro via limited proteolysis of the type C1/C2 hnRNP proteins following cell disruption. Since C/F corresponds almost exactly to the approximately 90-residue conserved ribonucleoprotein binding domain (RBD) that is shared by many eukaryotic RNA binding proteins, it provided an opportunity to better characterize the domain structure of the type C1/C2 hnRNP proteins and to compare the nucleic acid binding properties of the type C1/C2 and A1 [see Shamoo et al. (1994) Biochemistry, preceding paper in this issue] RNA binding domains. Like the type A1 RBD, the type C1/C2 RBD has an apparent occluded site size of 6-7 nucleotides. The type C1/C2 RBD binds non-cooperatively to homopolynucleotides and has preferential affinity for RNA and for single as opposed to double-stranded nucleic acids. The type C1/C2 RBD has about a 100-fold higher affinity than the type A1 RBD does for RNA and some of this increased affinity results from additional ionic interactions. The latter account for approximately 50% of the free energy of binding of the type C1/C2 RBD. While the type C1/C2 hnRNP proteins exist in vivo as a very tight tetramer with the structure (C1)3C2 [Barnett et al. (1989) Mol. Cell. Biol. 9, 492-498], the isolated type C1/C2 RBD is a monomer. Hence, the determinants for tetramerization appear to lie outside the type C1/C2 RBD. Phenylalanine 19 was identified as the only point of photochemical cross-linking of the type C1/C2 RBD to [d(T)]8. This residue corresponds to the major site of cross-linking of the A1 RBD to [d(T)]8 [Merrill, B. M., Stone, K. L., Cobianchi, F., Wilson, S. H., & Williams, K. R. (1988) J. Biol. Chem. 263, 3307-3313].(ABSTRACT TRUNCATED AT 400 WORDS)