Rehabilitation of patients with spina bifida

Patients with spina bifida present with multifarious problems requiring multi-disciplinary approach for their rehabilitation. 172 patients of spina bifida attending the Department of Physical Medicine and Rehabilitation at A.I.I.M.S., New Delhi, were studied retrospectively to ascertain the problems posed by them while presenting for rehabilitation. Male:female ratio was 1.23:1. Lumbo-sacral lesion comprised 41.3% followed by lumbar (26.1%) and sacral (22.1%). Common spinal deformities observed were Kyphoscoliosis (62.2%) and increased lumbar lordosis (19.2%). Clinically, active signs and symptoms of hydrocephalus were found in 47.7% associated with mental subnormality in 22.1%. Varying degrees of weakness of the muscles of lower limbs were detected in 98.3% cases, spasticity was found in 10.5% and ataxia in 2.9%. Improvement of muscle power was noticed in 45.3% during first three years and deterioration in 10.5% due to various complications. Foot deformities were commonest amongst deformities. Mobility was affected in 55.8% while 62.2% could attain independence. Bladder symptoms were present in 75% cases and bowel symptoms in 26.7%. Anxiety and guilt amongst parents was high in the families. Main hindering factors in vocational rehabilitation were bladder control, ambulation and pressure sores.

Risk factors for cerebral palsy

Cerebral palsy is a major cause of crippling in children, but it's etiology is poorly understood. This case control study was done to assess some of the identified risk factors for cerebral palsy, 125 cerebral palsy cases selected from hospital clinic and 125 age and sex matched neighbourhood controls, all aged less than 5 years and residing in Delhi (India) were studied. Information regarding antenatal, natal and postnatal period was collected by mother's interview, and wherever available, from hospital records with the study subjects. Most common type of cerebral palsy was spastic (88%). Quadriplegia was the commonest topographical subtype (86.4%). Birth asphyxia was found to be present in only 25.6% of cases. The commonest risk factor amongst cases was low birth weight (28.8%). The multivariate odds ratios (confidence limits) for the risk factors found to be significantly associated with cerebral palsy were 36.1 (7.76-160) for birth asphyxia, 13.8 (4.95-38.3) for low birth weight, 37.4 (4.47-313) for neonatal convulsion, 23 (4.7-112) for neonatal jaundice, 14.4 (3.69-56.4) for neonatal infection, 24.9 (2.78-223) for instrument assisted delivery and 15.4 (1.57-152) for antepartum hemorrhage. Precipitate labour, caesarean section, twins, toxemia, breech delivery and head injury were not found to be significantly associated with cerebral palsy. Thus birth asphyxia, low birth weight, neonatal convulsions, neonatal jaundice, neonatal infection, instrument assisted delivery and antepartum hemorrhage are significant risk factors for cerebral palsy.

Transcription initiation is controlled by three core promoter elements in the hgl5 gene of the protozoan parasite Entamoeba histolytica

Entamoeba histolytica is a single cell eukaryote that is the etiologic agent of amoebic colitis. Core promoter elements of E. histolytica protein encoding genes include a TATA-like sequence (GTATTTAAAG/C) at -30, a novel element designated GAAC (GAACT) that has a variable location between TATA and the site of transcription initiation, and a putative initiator (Inr) element (AAAAATTCA) overlying the site of transcription initiation. The presence of three separate conserved sequences in a eukaryotic core promoter is unprecedented and prompted examination of their roles in regulating transcription initiation. Alterations of all three regions in the hgl5 gene decreased reporter gene activity with the greatest effect seen by mutation of the GAAC element. Positional analysis of the TATA box demonstrated that transcription initiated consistently 30-31 bases downstream of the TATA region. Mutation of either the TATA or GAAC elements resulted in the appearance of new transcription start sites upstream of +1 in the promoter of the hgl5 gene. Mutation of the Inr element resulted in no change in the site of transcription initiation; however, in the presence of a mutated TATA and GAAC regions, the Inr element controlled the site of transcription initiation. We conclude that all three elements play a role in determining the site of transcription initiation. The variable position of the GAAC element relative to the site of transcription initiation, and the multiple transcription initiations that resulted from its mutation, indicate that the GAAC element has an important and apparently novel role in transcriptional control in E. histolytica.

Oxidation of low-density lipoproteins produces levuglandin-protein adducts

Free-radical oxidation of human low-density lipoprotein (LDL) produces levuglandin (LG)-protein adducts that were detected with an enzyme-linked immunosorbent assay using LGE2-KLH antibodies which recognize LGE2-derived pyrroles. The level of immunoreactivity increases with time of oxidation and reaches a maximum by 8 h. The yield of pyrrole varies nonlinearly with the level of LG adduction to LDL. At low LG:LDL ratios, such as those detected in oxidized LDL, the reaction of primary amino groups with LGE2 produces mostly non-pyrrole adducts that are not immunoreactive. Concomitant phospholipolysis must occur if the generation of immunoreactive epitopes in LDL involves oxidation of arachidonyl phospholipids. Thus, since a protein adduct prepared from synthetic LGE2-2-lysophosphatidylcholine ester showed, at most, only 0.5% cross-reactivity with the LGE2-KLH antibodies, the epitopes detected in oxidized LDL are almost certainly not protein adducts of LG-phospholipid esters. As expected, hydrolysis of the carboxylic ester in the protein adduct of LGE2-2-lysophosphatidylcholine ester by treatment with phospholipase A2 produced a fully immunoreactive LGE2-protein adduct.

Appraisal of equipment used in physical medicine and rehabilitation

There is a wide variety of equipment, used in the practice of Physical Medicine and Rehabilitation (PMR). These equipment may be classified as Diagnostic and Therapeutic. In this paper, the basic essential equipment to run a PMR department in a community/district level hospital are presented. The basic equipment are discussed vis-a-vis benefits, obtained from the modern high-tech equipment by way of cost-benefit studies. It was found that some equipment are desirable at a teaching/referral hospital level, but most of the equipment simply add to the glamour rather than serving any useful purposes when compared to the exorbitant cost. Most of the equipment e.g. LASER, IFT, some diathermies. Combnation units do not show any appreciable therapeutic benefits when compared to placebos. The question arises, whether these equipment are essential, when accepting such equipment, do we have any authentic studies showing their significant benefits or we are simply playing puppets in the hands of manufacturers and vendors. In conclusion, barring a few basic essentials and some precise evaluation equipment, most of the equipment these days are marketed in the name of therapeutic PMR equipment have a questionable cost to benefit profile as compared to therapy given manually by a therapist with (in some cases 0 a little help of the so called out dated conventional equipment e.g. exercise table, weights & pulleys, hot packs etc. The Dictum: "A tablet of aspirin to kill pain is always beneficial to any electrotherapy or thermo therapy," should always be kept in mind while prescribing a therapeutic modality to the patient or ordering an equipment for the PMR department.

Wegener's granulomatosis: a case with laryngeal involvement

A patient of Wegener's granulomatosis (WG) with laryngeal involvement and respiratory difficulty has been described. Direct laryngoscopic biopsy led to the diagnosis of Wegener's granulomatosis. The patient underwent a tracheostomy and was subsequently treated with cyclophosphamide and corticosteroids to which he responded.

Isolation and purification of penicillin G acylase obtained from Escherichia coli (NCIM-2400) and immobilisation on Eupergit C for the production of 6 amino penicillanic acid

Penicillin G-Acylase is produced by submerged cultivation of E. Coli (NCIM-2400) and extracted from the harvested fermented broth, purified (affinity chromatography) and immobilised on Eupergit C (Synthetic polymer in bead form). The immobilised penicillin G acylase properties are studied and compared with soluble penicillin G-acylase. The control parameters for conversion of penicillin G-K to 6 APA are optimised [e.g. substrate (Pen G-K) concentration ratio to immobilised penicillin G-acylase, temperature, pH etc.] in a stirred tank reactor. Our findings suggest that immobilised penicillin G-acylase can be used commercially and the productivity of 1 kg. of immobilised enzyme is around 400 kg of 6 APA under given desired stipulated conditions.

(S)-13-[(dimethylamino)methyl]-10,11,14,15-tetrahydro-4,9:16, 21-dimetheno-1H, 13H-dibenzo[e,k]pyrrolo[3,4-h][1,4,13]oxadiazacyclohexadecene-1,3(2H)-d ione (LY333531) and related analogues: isozyme selective inhibitors of protein kinase C beta

Protein kinase C (PKC) is a family of closely related serine and threonine kinases. Overactivation of some PKC isozymes has been postulated to occur in several diseases states, including diabetic complications. Selective inhibition of overactivated PKC isozymes may offer a unique therapeutic approach to disease states such as diabetic retinopathy. A novel series of 14-membered macrocycles containing a N-N'-bridged bisindolylmaleimide moiety is described. A panel of eight cloned human PKC isozymes (alpha, beta I, beta II, gamma, delta, epsilon, sigma, eta) was used to identify the series and optimize the structure and associated activity relationship. The dimethylamine analogue LY333531 (1), (S)-13-[(dimethylamino)methyl]-10,11,14,15-tetrahydro-4,9:16, 21-dimetheno-1H, 13H-dibenzo[e,k]pyrrolo[3,4-h][1,4,13]oxadiazacyclohexadecene++ +-1,3(2H)-dione, inhibits the PKC beta I (IC50 = 4.7 nM) and PKC beta II (IC50 = 5.9 nM) isozymes and was 76- and 61-fold selective for inhibition of PKC beta I and PKC beta II in comparison to PKC alpha, respectively. The additional analogues described in the series are also selective inhibitors of PKC beta. LY333531 (1) exhibits ATP dependent competitive inhibition of PKC beta I and is selective for PKC in comparison to other ATP dependent kinases (protein kinase A, calcium calmodulin, caesin kinase, src tyrosine kinase). The cellular activity of the series was assessed using bovine retinal capillary endothelial cells. Retinal endothelial cell dysfunction has been implicated in the development of diabetic retinopathy. Plasminogen activator activity stimulated by a phorbol ester (4 beta-phorbol 12,13-dibutyrate) in endothelial cells was inhibited by the compounds in the series with ED50 values ranging from 7.5 to 0.21 microM. A comparison of the PKC isozyme and related ATP dependent kinase inhibition profiles is provided for the series and compared to the profile for staurosporine, a nonselective PKC inhibitor. The cellular activity of the series is compared with that of the kinase inhibitor staurosporine.

Phytic acid, in vitro protein digestibility, dietary fiber, and minerals of pulses as influenced by processing methods

The objective of this project was to determine the effect of various types of processing on selected nutrition related parameters of commonly consumed Indian pulses and soybean. Germination reduced the phytic acid content of chickpea and pigeonpea seeds by over 60%, and that of mung bean, urd bean, and soybean by about 40%. Fermentation reduced phytic acid contents by 26-39% in all these legumes with the exception of pigeonpea in which it was reduced by more than 50%. Autoclaving and roasting were more effective in reducing phytic acid in chickpea and pigeonpea than in urd bean, mung bean, and soybean. Germination and fermentation greatly increased the in vitro protein digestibility (IVPD). IVPD was only slightly increased by roasting and autoclaving of all legumes. Germination and fermentation also remarkably decreased the total dietary fiber (TDF) in all legumes. Autoclaving and roasting resulted in slight increases in TDF values. All the processing treatments had little effect on calcium, magnesium and iron contents.

Infectious etiologies of rhabdomyolysis: three case reports and review

Rhabdomyolysis can be precipitated by trauma, ischemia, metabolic defects, electrolyte abnormalities, drugs, and a wide variety of infectious diseases. At our institution, recent cases of rhabdomyolysis induced by influenza prompted us to review the infectious etiologies of this entity. In addition, a thorough literature search revealed numerous case reports but no general review on this subject. This study describes representative recent cases from our institution and details the wide variety of infections that can cause muscle damage. The pathophysiological mechanisms, muscle histology, and correlation with renal dysfunction are also discussed.

Proximate determinants of fertility in eastern Uttar Pradesh

Our main objective here is to examine and discuss the effects of some sociocultural and economic factors on the proximate determinants of fertility in rural areas of eastern Uttar Pradesh (population more than 40 million persons). The region is known for its present demographic trends because the crude birth, death, and infant mortality rates are among the highest for India. The determinants considered are age at marriage of female, postpartum amenorrhea (PPA), fecundability and sterility, and menopause. The sociocultural and economic factors studied are caste, education, breast-feeding status, and social status of the currently married females in the reproductive age group. The study population is predominantly Hindu, among whom caste is a strong indicator of socioeconomic conditions. The average age of the female at return marriage (RM) is below 18 years in each religion or caste group but has been increasing over time. Median durations of breast feeding and PPA differ significantly among various socioeconomic and demographic subgroups. These are longest in scheduled castes and shortest in upper-caste Hindus. As the social status of the household increases, the median durations of breast feeding and PPA decrease. The estimates of fecundability consistently decrease with age, whereas those of sterility increase with age after 35 years. The smallest estimate of sterility is 4%, corresponding to the 25-30-year age group in each religion or caste group. Occurrence of menopause is rare before age 35, and it increases with the age of the female irrespective of religion or caste. However, the risk is minimum for females in upper castes and maximum for those in scheduled castes.

Haematological profile in typhoid fever

The haematological profile in 20 culture proven patients with typhoid fever of varying age and of both sexes was studied. Significant changes observed were anaemia, leucopenia, eosinopenia, thrombocytopenia and sub-clinical disseminated intravascular coagulation. The bone marrow of typhoid patients showed myeloid maturation arrest, decrease in the number of erythroblasts and megakaryocytes with increased phagocytic activity of histiocytes.

Effect of low energy diet and weight loss on major risk factors, central obesity and associated disturbances in patients with essential hypertension

Obesity, especially central, increases the risk of hypertension, hypertriglyceridaemia and diabetes to a significant extent. To determine whether dietary weight reduction can reduce blood pressure (BP) and other cardiovascular risk factors, 217 hypertensives were randomised to receive either 1600 Kcal/day diet (group A, n = 108) or the usual 2100 Kcal/day diet (group B, n = 109). Sodium intake and physical activity were kept similar in both groups. After 16 weeks of follow-up, patients in group A received significantly less energy leading to a 2.8 kg net reduction in mean weight in association with a significant net decrease in mean SBP and DBP (7.5/6.5 mm Hg) compared with nonsignificant changes in group B. There was a significant net decrease in mean total cholesterol (7.0%), low-density lipoprotein (LDL)-cholesterol (7.9%) and triglycerides (8.0%), with a significant net increase in high-density lipoprotein (HDL)-cholesterol (4.0%) in group A compared with group B. New risk factors such as glucose intolerance (8.0%) and central obesity (waist-hip girth ratio, 0.021) showed a significant net reduction compared with group B. Patients with central obesity and other associated disturbances showed maximal reduction in BP and other cardiovascular risk factors with a significantly greater increase in HDL-cholesterol. Mean doses of drugs were similar at entry to the study as well as after 16 weeks in both groups. It is possible that weight reduction due to a low caloric diet can moderate central obesity and associated disturbances in hypertensive subjects.

Variability in phytic acid content and protein digestibility of grain legumes

Several genotypes, number given within parenthesis, of chickpea, pigeonpea, urd bean, mung bean and soybean, differing in seed characteristics were analyzed for phytic acid, in vitro protein digestibility (IVPD), protein, total phosphorus, and seed size. Phytic acid contents and IVPD values differed significantly among and within these species. Phytic acid content (mg/g) was the highest in soybean (36.4) followed by urd bean (13.7), pigeonpea (12.7), mung bean (12.0) and chickpea (9.6). On an average, phytic acid constituted 78.2 percent of the total phosphorus content and this percentage figure was the highest in soybean and the lowest in mung bean. In vitro protein digestibility (IVPD) of pigeonpea and chickpea genotypes varied from 60.4 to 74.4 percent and 65.3 to 79.4 percent, respectively. The IVPD values of genotypes of mung bean, urd bean and soybean ranged from 67.2 to 72.2 percent, 55.7 to 63.3 percent and 62.7 to 71.6 percent, respectively. There was a significant negative correlation between phytic acid and IVPD of these genotypes. Phytic acid was significantly and positively correlated with protein but the magnitude of correlation was very low in chickpea and pigeonpea. Results indicate that the genotypes of pulses with low phytic acid content could be identified and used in breeding program to improve their nutritive value and utilization.

Quantitation of T cells in venous blood of healthy neonates

Quantitation of T Cells in blood is the part of the diagnostic workup for cellular immunity. Specimens of venous blood were collected within 24 hours of birth from 51 healthy, appropriate for gestational age infants. T lymphocytes were identified on the basis of their ability to form rosettes with sheep erythrocytes. The lymphocytes were harvested from peripheral venous blood, which is considered to be more representative of the immune status in the newborn than the cord blood. In the newborn infants the proportion in T cells was found to be considerably diminished in comparison to previously reported values for adults. Preterm infants, especially those with gestational age of 34 wk or less had significantly lower percentage of T cells in their blood as compared with term infants. The proportion of T cells was statistically reduced in infants weighing 2000 g or less in contrast to those weighing 2500 g or more.

Clinical, hematological and electrophysiologic study of megaloblastic anemias

Thirty one cases of megaloblastic anaemia were studied clinically and electrophysiologically. Eight patients had clinical evidence of peripheral neuropathy. MNCV, distal sensory latency, la fibre conduction velocity, proximal conduction velocity and H-reflex amplitude and latency were compared with fourteen age and sex matched healthy controls. MNCV, proximal conduction velocity and H-reflex amplitude were significantly decreased in anaemic subjects while distal sensory latency was increased. No change was seen in la fibre conduction velocity and H-reflex latency. There was no correlation between severity of anaemia and the electrophysiologic abnormalities. MNCV and la fibre conduction velocity improved after correction of anemia.

Physiochemical characteristics of flours of faba bean as influenced by processing methods

Wet- and dry-processing with and without heating treatments were used to dehull faba beans for preparation of flours from the cotyledons. Flour qualities were assessed by levels of tannin and trypsin inhibitor and other measures of proximate composition. High roasting temperature and shorter process time that improved the recovered cotyledon yields were verified significant by path analysis methodologies. In turn, the higher cotyledon recoveries correlated with higher protein levels and inversely with the measured tannin levels. Ash reductions were correlated to the wet processing options in hull removal while reductions in the insoluble dietary fiber were notably influenced by level of heating temperatures applied. Trypsin inhibitor levels ranged from 42 to 56% of the original with reductions tied to applications of wet and/or heat processing in each case improved by increased durations and temperatures of treatments.

Hypotensive infarction of the spinal cord

Four patients developed infarction of the lumbar cord as a result of induced hypotension. All patients showed a lesion in the territory of the artery of Adamkiewicz. The pathophysiology of the blood supply of the spinal cord is discussed, and in particular the anatomy of the artery of Adamkiewicz. The reason why this artery is so vulnerable to hypotension is discussed.

Phenol block in the management of spastic cerebral palsy

In the present series 116 cases of spastic cerebral palsy were selected; in whom perineal care and ambulation was affected. These cases were given peripheral nerve block (obturator 110, posterior tibial 134 and median nerve 2) with 6% aqueous phenol solution. The block relieved the spastic condition, allowed better nursing care, freed the patient from the embarrassment of a contorted limb, allowed voluntary movement to take place and eased in fitment of caliper to aid further ambulation. The period of effectiveness ranged from 3 months to 18 months, with an average of 13 months. Paraesthesia occurred following 5 nerve blocks. Eleven nerve blocks had to be repeated. Ease, simplicity, safety, therapeutic benefits and economic advantages of peripheral nerve block using phenol in cerebral palsy warrant its more widespread use.

Clinico-haematological profile in acute and chronic Plasmodium falciparum malaria in children

The clinicohaematological findings of acute state (Group A, 30 patients) and chronic state (Group B, 34 patients) of falciparum malaria in paediatric patients are compared. The children with chronic falciparum malaria were apyrexic and presented with features of moderate to severe anaemia with hepato-splenomegaly. Greater severity of anaemia and haemolysis, higher incidence and severity of neutropenia, atypical lymphocytosis, monocytosis and thrombocytopenia were observed in patients with chronic falciparum malaria as compared to patients with acute falciparum malaria despite lesser degree of parasitaemia in the former as compared to the latter. While mechanical destruction of parasitised RBC's, ineffective and dysplastic erythropoiesis either due to unmasking of border line dierty folic acid deficiency or otherwise, transient hypoplasia of bone marrow, impaired utilization of iron and immune destruction of RBCs with hypersplenism may be the mechanisms for anaemia, transient hypoplasia of bone marrow and hypersplenism may be the factors responsible for thrombocytopenia and neutropenia.

Simulation of the effect of chilling injury and nitrogen supply on floret fertility and yield in rice

Evidence exists that night temperatures <18�C immediately preceding flowering in rice crops can adversely affect floret fertility and, hence, yields. It has been suggested that sterility induced by low temperature is also influenced by floodwater depth and nitrogen (N) rate. In southern New South Wales, low night-time temperatures are believed to be a major constraint to the achievement of consistently high yields. The availability of a comprehensive model of rice growth and yield that is sensitive to this constraint would aid the development of better management practices. CERES RICE is a comprehensive model that simulates the phasic development of a rice crop, the growth of its leaves, stems, roots, and panicles, and their response to weather. It also simulates the water and N balances of the crop and the effects of stresses of water and N on the yield-forming processes. The model has been extensively tested in many rice-growing systems in both tropical and temperate environments. However, the original model was unable to simulate the level of chilling injury evident from yield data from southern New South Wales. This paper reports modifications made in the model to simulate these effects and the evaluation of the model in environments of low night temperature. Inclusion of the chilling injury effect greatly improved the accuracy of estimated yields from treatments in an extensive field experiment. However, additional testing with a wider range of data sets is needed to confirm the international applicability of the modifications.

Circanual variation of sperm count and motility in men

Seasonal variation in rhythmicity of spermatogenesis might be due to external temperature fluctuation which could partially be responsible for decreased sperm counts in summer. Other factor like exposure to light might contribute for the reduction in sperm counts. These facts should be taken into account before diagnosing male fertility.

Enrichment of vitronectin- and fibronectin-like proteins in NaCI-adapted plant cells and evidence for their involvement in plasma membrane-cell wall adhesion

Cells of tobacco adapted to grow in high concentrations of NaCl develop tight zones of adhesion between the plasma membrane and cell wall, revealed by concave plasmolysis in osmotic solutions. Unadapted cells exhibit mostly convex plasmolysis and exhibit little or no adhesive character. Wall-less protoplasts isolated from the adapted cells retain the complementary adhesive character and adhere tightly to each other, whereas protoplasts from unadapted cells do not. The hexapeptide gly-arg-gly-asp-ser-pro, in which the arg-gly-asp represents the integrin-binding domain of several animal extracellular matrix proteins,specifically blocks adhesion of the protoplasts. A control hexapeptide, gly-arg-gly-glu-ser-pro, is ineffective in blocking adhesion. Tobacco proteins immunologically related to human vitronectin were found in cell walls and membranes of unadapted and NaCI adapted cells, but the total extractable vitronectin-like protein was enriched in the adapted cells. Tobacco proteins immunologically related to human fibronectin were found in membranes and cell walls of NaCI adapted cells but not in those from unadapted cells.Our observations indicate that plant cells possess cell-matrix adhesion complexes similar to animal cells, and these adhesion complexes accumulate ingrowth-limited cells adapted to saline stress.

Protein quality of pigeonpea (Cajanus cajan (L.) Millsp.) as influenced by seed polyphenols and cooking process

True protein digestibility (TD), biological value (BV), and net protein utilization (NPU) of low-polyphenol pigeonpea cultivars (Nylon, BDN 2, and ICPL 87067) were significantly higher than those of the high polyphenol cultivars (C 11, ICPL 87, and ICPL 151) when whole-seed samples were compared. Most of the polyphenols (80-90%) were concentrated in the seed-coat. Dhal (decorticated split cotyledons) samples of low (Nylon) and high (C 11) polyphenol cultivars revealed no large differences in TD, BV, and NPU values of these cultivars. This indicated an adverse affect of seed-coat polyphenols on protein quality of pigeonpea whole-seed. The cooking process significantly increased TD in both whole seed and dhal samples. BV of both whole-seed and dhal samples was reduced remarkably by cooking. However, NPU of the cooked whole-seed and dhal samples was significantly higher than in the raw samples. No noticeable differences due to cooking were observed in amino acid composition of whole-seed and dhal samples of these cultivars.

Site-specific frameshift mutagenesis by a propanodeoxyguanosine adduct positioned in the (CpG)4 hot-spot of Salmonella typhimurium hisD3052 carried on an M13 vector

Malondialdehyde induces frameshift mutations in Salmonella typhimurium strain hisD3052. The ability of propanodeoxyguanosine (PdG), a structural analog of the major malondialdehyde-deoxyguanosine adduct, to induce site-specific frameshift mutations was tested in the (CpG)4 hot-spot of hisD3052 carried on an M13 vector (M13MB102). PdG was introduced at position 6248 of duplex M13MB102 by ligation of the oligonucleotide 5'-CGC(PdG)CGGCATG-3' into a heteroduplex containing an 11-nucleotide gap in the (-)-strand between the SphI and BssHII restriction sites and deoxyuridine in place of thymidine in the (+)-strand. Ligation proceeded with 70% efficiency, and closed circular duplex DNA molecules were isolated in 40% yield. The adducted genome was sensitive to cleavage by SphI but resistant to cleavage by BssHII. Transformation of Escherichia coli strain JM105 with adducted M13MB102 led to 25% reduced survival relative to unadducted M13MB102 and produced frameshift mutations in 2.5% of the progeny phage. All of the mutations were deletions, and 70% occurred by deletion of CpG. Unadducted genomes exhibited a 40-fold lower mutation frequency, and all the mutations were single-base deletions at the sites of ligation of the 11-mer. These results illustrate that PdG, a structural analog of the major malondialdehyde-deoxyguanosine adduct, induces frameshift mutations in M13MB102 and that single-stranded nicks are efficient premutagenic lesions in this recombinant bacteriophage.

Lipid-laden macrophages in bone marrow of leprosy patients

While conducting a study to observe bone marrow cytomorphological changes in multibacillary leprosy, lipid laden macrophages as seen in sphingolipidoses were noted. The present study was planned to observe the occurrence and morphological characterization of these macrophages in various types of leprosy. Bone marrow records from 48 cases of paucibacillary and 72 cases of multibacillary leprosy were analysed. The macrophages accounting at the most for 3.5% of marrow cells were observed in 5 cases of paucibacillary and 43 cases of multibacillary leprosy with a maximum incidence being observed in patients with ENL (16/17). The lipid present in the cytoplasm of these cells could be derived from the lipid of the cell wall of Mycobacterium leprae. To the best of our knowledge, these cells have not been reported in leprosy so far.

Prevalence & spectrum of congenital malformations in a prospective study at a teaching hospital

A prospective survey for congenital malformations at birth, at a teaching hospital, over a period of two and half years on 9405 consecutive single births has shown that prevalence of major congenital malformations in live births was 1.6 per cent and in still births 16.4 per cent. There was no significant difference in the prevalence of congenital malformations between Hindus (2.0%) and Muslims (2.7%) but amongst Muslims with consanguinity the prevalence of congenital malformation was 4.6 per cent compared to 2.3 per cent in non-consanguineous Muslim spouses (P less than 0.05). Open neural tube defect was the single most common anomaly (31.7% of all malformations) occurring at a rate of 4.7 per 1000 single births, with equal prevalence of anencephaly and meningomyelocoele. Case control study showed that history of concomitant medical illness, drug intake during the first trimester, threatened abortion, hydramnios and pre-eclamptic toxaemia in the current pregnancy were significantly associated with the occurrence of congenital malformations.

Sulfhydryl-dependent attachment of Treponema denticola to laminin and other proteins

Attachment of Treponema denticola ATCC 35405 to laminin, a major basement membrane protein, and to other proteins was studied. Microdilution plates were coated with the proteins, and the attachment of T. denticola was measured by the enzyme-linked immunosorbent assay technique. Compared with bovine serum albumin (BSA), T. denticola had a high affinity to laminin, fibronectin, fibrinogen, and gelatin, as well as to type I and type IV collagens. Attachment to RGD peptide (Gly-Arg-Gly-Asp-Ser, the integrin recognition sequence) was only about 30% of that to laminin and was comparable to attachment to BSA. Tests with laminin fragments obtained through elastase digestion showed that the spirochetes attached well to an A-chain 140-kDa fragment involved in eukaryote cell attachment but did not attach to a 50-kDa fragment that includes the heparin binding site. Pretreatment of T. denticola with soluble laminin, fibronectin, gelatin, BSA, or fibrinogen had no effect on the attachment of the bacteria to laminin or fibronectin. A wide variety of compounds were tested for their possible inhibitory actions on the attachment. While most treatments of T. denticola ATCC 35405 had little or no effect on the attachment to proteins, sulfhydryl reagents p-chloromercuribenzoic acid (pCMBA) and oxidized glutathione inhibited the attachment by 70 to 99%, depending on the protein. When T. denticola was first allowed to attach to proteins, addition of pCMBA or oxidized glutathione could no longer reverse the attachment. Heat treatment of the spirochetes also markedly reduced the attachment to laminin, gelatin, and fibrinogen but not to BSA. Mixed glycosidase treatment of the spirochetes inhibited the attachment by 20 to 80%. None of the above treatments of the substrate proteins had any marked effect on the spirochete attachment. The results indicate that T. denticola has the capacity to bind to many different kinds of proteins by utilizing specific attachment mechanisms. The binding appears to involve protein SH groups and/or carbohydrate residues on the surface of T. denticola.

Isoproterenol fails to produce myocardial necrosis in streptozotocin-induced diabetic rats

Biochemical alterations in the hearts of non-diabetic and 5 weeks of streptozotocin-induced diabetic rats following isoproterenol (ISO) administration were compared. Serum lactate dehydrogenase (LDH) and myocardial adenosine triphosphate (ATP), creatine phosphate (CP), lactate and glycogen were used as indices of myocardial injury. Hearts from diabetic rats (blood glucose greater than 350 mg/dl), before ISO administration, had normal lactate levels but significantly low high-energy phosphate (HEP) levels and high glycogen levels in comparison to non-diabetic rats. No difference was observed in serum LDH levels between these two groups. ISO administration to non-diabetic rats caused myocardial necrosis as evidenced by a significant depletion of myocardial glycogen and HEPs along with significant myocardial lactate accumulation and an increase in serum LDH. However, the hearts from diabetic rats failed to show any significant HEP depletion, accumulation of lactate and leakage of LDH into serum following ISO-administration, though myocardial glycogen level was significantly lowered. These observations, in conjunction with earlier reports, point to the hypothesis that, in diabetes, there are certain alterations in the sarcolemma which hamper the process by which ISO causes myocardial necrosis.

Patterns of erythropoiesis and anaemia in leprosy

A total of 128 leprosy patients were investigated for the morphological type of anaemia, the underlying disturbances in iron metabolism and patterns of erythropoiesis and other cytomorphological changes in the bone marrow. The anaemia was a mild to moderate degree in paucibacillary (PB) leprosy, while in multibacillary (MB) leprosy it was of a severe degree. Iron deficiency was observed in only a few patients. Impaired iron utilization as observed in a anaemia of a chronic disorder was a common finding in MB leprosy (41.7%) and more so in new cases (50%). Megaloblastic erythropoiesis was also more frequent in MB leprosy (45.2%) as compared to PB leprosy (16%), accounting for the severe degree of anaemia in the former type. In 17.2% of the total patients (MB, 21.4%; PB, 9%) both megaloblastic erythropoiesis and features of impaired iron utilization were observed in bone marrow. Disturbances in iron metabolism and erythropoiesis were also observed but to a lesser degree in patients receiving specific antileprosy treatment. Irrespective of the type of disease and duration of treatment, increasing frequency of acid-fast bacillia (AFB) positivity and granulomas was observed in the bone marrow with an increasing severity of anaemia.

Hypermagnesemia following aluminum phosphide poisoning

Aluminum phosphide (ALP) is highly toxic to the lungs, heart and blood vessels causing pulmonary edema, shock and arrhythmias. There is massive focal myocardial damage resulting in raised cardiac enzymes. This study included 92 patients of proven ALP poisoning. The age varied between 20-50 years and the majority (74) were females. Clinical manifestations were nausea and vomiting (92), dyspnea and palpitation (72 each), cyanosis (54), hypotension (32) and shock (46) etc. Cardiac arrhythmias were present in 80 cases and hypermagnesemia in 78 patients. Mean serum magnesium level (1.95 +/- 0.18 mE/l) was significantly (p less than 0.01) raised compared to mean magnesium level in control subjects (1.62 +/- 0.26 mEq/l). Hypermagnesemia results from myocardial and liver damage and to our knowledge has not been described in the literature. Of 92 cases studied, 66 died, 60 of whom died within 24 hours of ALP ingestion. Treatment is supportive.

Expression of IgG Fc receptor antigens in placenta and on endothelial cells in humans. An immunohistochemical study

Expression of leukocyte IgG Fc receptor (Fc gamma R) antigens by placenta, endothelial cells (EC) of normal tissues, and ECs of kidney and skin from subjects with immune complex diseases was studied immunohistochemically using anti-Fc gamma R monoclonal antibodies (MAb). Monoclonal antibodies against all three leukocyte Fc gamma R classes stained placental villous macrophages. Placental villous trophoblasts were stained intensely by anti-Fc gamma RIII MAb 3G8, while both anti-Fc gamma RI (MAb 32) and anti-Fc gamma RII MAbs IV3, KU79, CIKM5, 2E1, KB61, and 41H16) antibodies did not react with these cells. Anti-Fc gamma RII MAbs IV3, KU79, CIKM5, 2E1, KB61, and 41H16 immunostained placental villous capillary EC, in contrast to anti-Fc gamma RI MAb 32 and anti-Fc gamma RIII MAb 3G8, CLB-Granl, and B73.1, which did not bind. Anti-Fc gamma RI MAb 32, anti-Fc gamma RII MAb IV3 and CIKM5, and anti-Fc gamma RIII MAb 3G8 did not react with the ECs of tonsil, liver, kidney, spleen, intestine, lung, or uterus. Similarly no EC staining was seen with these four MAbs in 14 skin and 14 kidney biopsies from subjects with immune-complex diseases. Fc gamma R antigens are expressed constitutively only by placental villous ECs and are not induced on nonplacental ECs by immune-complex-mediated diseases.

Patterns of erythropoiesis and anaemia in malaria

Of 138 patients with malaria, 90 were found to be having Plasmodium falciparum in their peripheral blood smears. Megaloblastosis alone or in combination with the other patterns of erythropoiesis was observed in 82.1 percent cases of chronic P. falciparum malaria as compared to 36.3 and 26.5 per cent cases of acute P. falciparum and P. vivax malaria respectively. Iron deficiency was observed in 15.5 percent cases of chronic P. falciparum, 18.2 per cent cases of acute P. falciparum and 13.3 per cent patients of P. vivax infection. Of patients with chronic falciparum malaria, 33.3 percent revealed features of both megaloblastosis and defective iron utilization and transient hypoplasia of marrow was observed in 8.9 per cent of these cases.

Comparative evaluation of marginal leakage of different types of silver amalgam alloys in vitro--a microfluoroscopic study

A study was carried out in vitro to evaluate the amount of microleakage using seven different Silver amalgam alloy using Fluorescein dye. Among the high copper alloy used in this study, the admixed alloy showed least marginal leakage followed by the high copper lathecut alloy and the high copper spherical alloy. It was also observed that the marginal penetration of the conventional alloy are much more than the high copper alloy.

Choline deficiency activates phospholipases A2 and C in rat liver without affecting the activity of protein kinase C

There is evidence to suggest that liver tumor promoters exert their effect through the interference of signal transduction in hepatic cells. Both phospholipase A(2) and phospholipase C play important roles in the generation of second messengers and in the activation of Ca(2+), phospholipid-dependent protein kinase C. Using male Sprague-Dawley rats, we investigated whether liver tumor-promoting regimens of a choline-deficient diet and phenobarbital alter the activities of phospholipase A(2) and phospholipase C in the liver, and extended the study to determine the effect of a choline-deficient diet on protein kinase C activities. Feeding a choline-deficient diet for 1 week increased the activities of both phospholipase A(2) (50%) and phospholipase C (22%), and the activities of both enzymes were more than doubled after 4 weeks. Feeding a phenobarbital diet resulted in a slight decrease in phospholipase A(2) activities at 4 weeks but no significant changes in PLC activities. The protein kinase C activities and its distribution between soluble and particulate fractions remained unchanged after 1, 2, and 4 weeks feeding of a choline-deficient diet. Thus, activation of both phospholipase A(2) and C is distinct for a choline-deficient diet, not shared by phenobarbital diet. Increased activities of these enzymes were not associated with the activation of protein kinase C under the present experimental condition.

Clara cell 10 kDa protein (CC10): comparison of structure and function to uteroglobin

The cellular localization, functional activities and structures of rat and human Clara cell 10 kDa proteins (CC10) are compared to rabbit uteroglobin. CC10 is present exclusively in the non-ciliated cells of the surface epithelium of the pulmonary airways, whereas uteroglobin is reported to be present in the lung and reproductive organs. There is about 55% identity between the amino acid sequences of rat CC10 and either rabbit uteroglobin or human CC10. The latter two have 61% identity. Using the known structure of uteroglobin as the model, correlations between the structure and function for this group of proteins are made. Substitution of the residues for the rat and human CC10 into the structure of uteroglobin suggests that these proteins may be members of a structurally homologous family. Some of the functional differences may be due to distortion of the hydrophobic pocket in the dimeric protein and a surface hypervariability located on one contiguous helix and beta turn. Rat CC10 and rabbit uteroglobin both, nearly equally, inhibit papain and bind progesterone. Human CC10 does not inhibit papain and has markedly lower progesterone binding (4.6% of rabbit uteroglobin). Antiinflammatory activity of synthetic peptides corresponding to a homologous sequence region of uteroglobin and the two Clara cell proteins was tested. The region chosen has sequence similarity to lipocortin I. The peptides not only failed to inhibit carrageenan-induced foot pad swelling but exacerbated it. All three proteins inhibit pancreatic phospholipase A2. The phospholipase A2 inhibitory effect of CC10 may be important in regulating the inflammatory responses in the lung.

Circulating iso and auto antibodies to human spermatozoa in infertility

Blood samples from 50 couples of unexplained primary infertility and 25 healthy fertile couples were tested for antispermatozoa antibodies (ASA) by gelatin agglutination test and sperm immobilising complement dependent cytotoxicity test. The incidence of sperm agglutinating and sperm immobilising antibodies was found to be 14 per cent and 10 per cent respectively in infertile couples. Agglutinating antibodies were detected in 18 per cent males and 16 per cent of females while cytotoxic antibodies were found in 14 per cent males and 10 per cent of females. Only 4 per cent of the normal fertile couples taken as a control group showed positive ASA, hence the difference in incidence of positive ASA between the infertile and fertile couples was found to be statistically significant. Also, the agglutination test was observed to be more sensitive than the cytotoxicity test.

Effects of a choline-deficient diet and a hypolipidemic agent on single glutathione S-transferase placental form-positive hepatocytes in rat liver

Using the placental form of glutathione S-transferase (GST-P) as a marker of carcinogen-initiated hepatocytes, we investigated how a choline-deficient (CD) diet and BR931, a carcinogenic hypolipidemic agent, modify populations of single GST-P-positive hepatocytes. The liver of male Fischer rats (6-7 weeks old) fed a CS or basal diet contained mostly single or double GST-P-positive hepatocytes. Feeding a CD diet for 2-4 weeks led to increases in the number of aggregates of two and three GST-P-positive hepatocytes. By 8-12 weeks, there was an emergence of discrete foci of GST-P-positive hepatocytes consisting of more than 20 hepatocytes. Feeding a BR931 diet for 4-8 weeks resulted in no significant change in the number of single GST-P-positive hepatocytes in the liver as compared to feeding a basal diet. It is suggested that single GST-P-positive hepatocytes in the liver of relatively young rats maintained on a commercial diet may represent endogenously initiated cells. A CD diet promotes endogenously initiated cells to form larger aggregates or foci of GST-P-positive cells.