The Outcome of Treatment in Second Branchial Cleft Anomalies: A Case Series

Background Branchial-cleft anomalies are second only to thyroglossal duct anomalies among congenital malformations of the neck, and second branchial-cleft anomalies are the most common. These include branchial cysts, branchial sinuses, and branchial fistulas. Clinical symptoms include neck swelling and a discharging sinus or fistula opening. In a small number of cases, they can lead to major complications like abscesses or malignant changes. Surgical resection is the treatment of choice. Various approaches to resection and sclerotherapy have been tried. In this study, we present our treatment outcome with branchial cleft anomalies at a rural tertiary medical care hospital. Objectives To document the various presentations, clinical features, and outcomes of treatment with second branchial cleft anomalies. Methods This retrospective observational study included 16 patients operated on for second branchial-cleft anomalies. A detailed medical history was elicited, and an accurate clinical examination was done. A contrast-enhanced computed tomography (CECT) scan was done in all cases. A few cases required a fistulogram. The cysts, sinuses, or fistulas were resected en bloc by a single neck crease incision. Primary closure was done in all cases. A recurrence or pharyngocutaneous fistula required axial flap reconstruction. The complications and recurrences were documented. Result There were six children and 10 adults in our study. Seven cysts, five sinuses, and four fistulas were present, of which four were iatrogenic. In seven patients, imaging could not show the entire tract. There were four fistulas from the oropharynx to a cutaneous opening in the neck. A complete resection was done for all. Two pharyngocutaneous fistulas were treated with a pectoralis major myocutaneous (PMMC) flap. Three patients had wound dehiscence postoperatively. None of the patients had neurological or vascular injuries. Conclusion Second branchial cleft anomalies can be completely excised by a single neck crease incision. Meticulous surgery results in a low recurrence or complication rate. Following complete excision, in type IV anomalies, a purse-string suture at the pharyngeal opening ensures good closure and no recurrences.

The Outcome of Treatment for Thyroglossal Tract Anomalies

Background Thyroglossal tract anomalies are the most common cause of midline neck swelling. Thyroglossal cysts present between the base of the tongue and cricoid cartilage as painless, midline swelling that moves on deglutition and protrusion of the tongue. If the thyroglossal cyst gets infected or is violated surgically, it can result in a thyroglossal sinus or fistula. Investigations in patients with suspected thyroglossal cysts include a thyroid function test, ultrasonography of the neck, and fine needle aspiration cytology (FNAC). Computed tomography (CT) or magnetic resonance imaging (MRI) can be done for larger cysts or suspected malignancies. The gold standard treatment is Sistrunk surgery. Recurrence rates with Sistrunk surgery are lower when the surgery is performed accurately. This study was conducted to document the clinical presentation and treatment outcome in patients treated for thyroglossal tract anomalies. Methods This is a retrospective analysis of 46 medical case records of patients operated on for thyroglossal tract anomalies at a rural tertiary care hospital from April 1995 to April 2021. Patients fulfilling the inclusion and exclusion criteria were evaluated with a detailed history, various clinical presentations, location, extent of anomalies, and thyroid function test results documented. Ultrasound images were reviewed, and the findings were documented. All patients have consent, and they underwent Sistrunk surgery. Patients in whom the normal thyroid gland was found to be absent were started on replacement thyroxine after surgery. The specimen was subjected to histopathological examination by a senior pathologist. The outcome regarding complications, recurrence, and further treatment were reviewed. The outcome of the thyroglossal fistula was compared with that of thyroglossal cysts, and the outcome of infrahyoid thyroglossal tract anomalies was compared with that of suprahyoid thyroglossal tract anomalies. Results In this study, among the 46 patients, 24 (52.2%) were female and 22 (47.8%) were male. The minimum age was three years, the maximum was 58, and the mean was 20.6 years. In this study, 71.7% of the patients were diagnosed with thyroglossal cysts, 10.9% had thyroglossal fistulas, and two had lingual thyroids. The most common location of the cyst was infrahyoid (73.9%). 44 patients underwent Sistrunk surgery, and two patients diagnosed with lingual thyroid underwent excision. Three patients had complications (two pharyngo-cutaneous fistulas, one wound dehiscence), and all were managed conservatively. There were no recurrences in our study. Conclusion Thyroglossal tract anomalies are the most common congenital cervical anomalies. A complete Sistrunk procedure includes the removal of the entire thyroglossal tract, inclusive of the body of the hyoid bone along with the cuff of base tongue tissue, and gives the best result for thyroglossal tract anomalies.

Clinical Spectrum and Treatment Response of Malignant Otitis Externa Patients: A Rural Tertiary Care Centre Experience

INTRODUCTION

Malignant otitis externa (MOE) is an invasive external ear infection that has a tendency to spread through the temporal bone and can further progress to involve intracranial structures. Though the prevalence of MOE is rare, high morbidity and mortality are often associated. Complications of advanced MOE include cranial nerve involvement, most commonly facial nerve, and intracranial infections such as abscesses and meningitis.

MATERIALS AND METHODS

In this retrospective case series of nine patients diagnosed with MOE, demographic data, clinical presentations, laboratory data, and radiological findings were reviewed. All patients were followed up for a minimum period of three months after discharge. Outcomes were measured in terms of reduction in obnoxious ear pain (Visual Analogue Scale), ear discharge, tinnitus, need for re-hospitalization, recurrence of disease, and overall survival.

RESULTS

In our case series of nine patients (seven males and two females), six underwent surgery, and three patients were managed with a medical line of treatment. All patients had a significant reduction in otorrhea, otalgia, random venous blood sugars, and improvement of facial palsy implicating good response to treatment.

CONCLUSION

Prompt diagnosis of MOE warrants clinical expertise and aids in preventing complications. A prolonged course of intravenous anti-microbial agents is the mainstay of treatment, but timely surgical interventions in treatment-resistant cases can prevent complications.

Extra-Parotid Pleomorphic Adenoma and Low-Grade Salivary Malignancy in the Head and Neck Region

Background and objective Pleomorphic adenoma is the most common major salivary gland neoplasm. Around 80% of them arise in the parotid glands, whereas 10% originate in the minor salivary glands. The pleomorphic adenoma of the extra-parotid site is defined by its location outside the primary salivary gland. The minor salivary gland adenomas occur at the hard and soft palate, lips, tongue, lacrimal glands, pharynx, larynx, paranasal sinus, and nasal cavity. Pleomorphic adenoma in parapharyngeal space may occur de novo or as an extension of the deep lobe of the parotid tumors. Our objective in this study was to assess the location and presentations of extra-parotid pleomorphic adenoma and frequency of low-grade salivary gland malignancy diagnosed as pleomorphic adenoma via fine-needle aspiration cytology (FNAC) in the head and neck region and the treatment outcomes after the resection of the tumors. Materials and methods This was a retrospective observational study. All patients with FNAC-diagnosed pleomorphic adenoma of extra-parotid locations of the head and neck region who underwent curative surgery in the Department of Otorhinolaryngology and Head and Neck Surgery at a rural tertiary care center between August 1997 and August 2022 were included in the study. Data on the symptoms, FNAC report, surgical techniques, pathological results, adjuvant therapy, and any recurrence were documented. Data were entered into a Microsoft Excel sheet and analyzed using IBM SPSS Statistics version 22 software (IBM Corp., Armonk, NY). Results Our study included 23 patients, of which 14 were females and nine were males. The various sites of involvement were as follows: parapharyngeal space (four), larynx (one), nasal septum (two), hard palate (five), soft palate (four), hard and soft palate (three), and submandibular salivary gland (four). Of note, 17.3% of the patients had local recurrence with an average time frame of three years post-surgery: 20% in patients with low-grade malignancy and 16.6% in patients with pleomorphic adenoma. Conclusion Extra-parotid pleomorphic adenomas are common and have a high malignant potential. The preferred choice of treatment for extra-parotid salivary tumors is complete resection with adequate clearance. Malignant pleomorphic adenomas may require staging neck dissection and adjuvant treatment for a better prognosis.

Spring Wheat's Ability to Utilize Nitrogen More Effectively Is Influenced by Root Phene Variation

Genetic improvement for nitrogen use efficiency (NUE) can play a very crucial role in sustainable agriculture. Root traits have hardly been explored in major wheat breeding programs, more so in spring germplasm, largely because of the difficulty in their scoring. A total of 175 advanced/improved Indian spring wheat genotypes were screened for root traits and nitrogen uptake and nitrogen utilization at varying nitrogen levels in hydroponic conditions to dissect the complex NUE trait into its component traits and to study the extent of variability that exists for those traits in Indian germplasm. Analysis of genetic variance showed a considerable amount of genetic variability for nitrogen uptake efficiency (NUpE), nitrogen utilization efficiency (NUtE), and most of the root and shoot traits. Improved spring wheat breeding lines were found to have very large variability for maximum root length (MRL) and root dry weights (RDW) with strong genetic advance. In contrast to high nitrogen (HN), a low nitrogen (LN) environment was more effective in differentiating wheat genotypes for NUE and its component traits. Shoot dry weight (SDW), RDW, MRL, and NUpE were found to have a strong association with NUE. Further study revealed the role of root surface area (RSA) and total root length (TRL) in RDW formation as well as in nitrogen uptake and therefore can be targeted for selection to further the genetic gain for grain yield under high input or sustainable agriculture under limited inputs.

Genome-wide association studies reveal putative QTLs for physiological traits under contrasting phosphorous conditions in wheat (Triticum aestivum L.)

A Genome-wide association (GWAS) study was conducted for phosphorous (P)-use responsive physiological traits in bread wheat at the seedling stage under contrasting P regimes. A panel of 158 diverse advanced breeding lines and released varieties, and a set of 10,800 filtered single nucleotide polymorphism (SNP) markers were used to study marker-trait associations over the eight shoot traits. Principle component analysis separated the two environments (P regimes) because of the differential response of the traits indicating the essentiality of the separate breeding programmes for each environment. Significant variations for genotypic, environmental, and genotype × environment (GEI) effects were observed for all the traits in the combined analysis of variance with moderately high broad sense heritability traits (0.50–0.73). With the different algorithms of association mapping viz., BLINK, FarmCPU, and MLM, 38 unique QTLs under non-limiting P (NLP) and 45 QTLs for limiting P (LP) conditions for various shoot traits were identified. Some of these QTLs were captured by all three algorithms. Interestingly, a Q.iari.dt.sdw.1 on chromosome 1D was found to explain the significant variations in three important physiological traits under non-limiting phosphorus (NLP) conditions. We identified the putative candidate genes for QTLs namely Q.iari.dt.chl.1, Q.iari.dt.sdw.16, Q.iari.dt.sdw.9 and Q.iari.dt.tpc.1 which are potentially involved in the mechanism regulating phosphorus use efficiency through improved P absorption due to improved root architectural traits and better mobilization such as sulfotransferase involved in postembryonic root development, WALLS ARE THIN1 (WAT1), a plant-specific protein that facilitates auxin export; lectin receptor-like kinase essentially involved in plant development, stress response during germination and lateral root development and F-box component of the SKP-Cullin-F box E3 ubiquitin ligase complex and strigolactone signal perception. Expression profiling of putative genes located in identified genomic regions against the wheat expression atlas revealed their significance based on the expression of these genes for stress response and growth development processes in wheat. Our results thus provide an important insight into understanding the genetic basis for improving PUE under phosphorus stress conditions and can shape the future breeding programme by developing and integrating molecular markers for these difficult-to-score important traits.

Choanal Polyps Originating from Unusual Sites: A Rural Tertiary Care Center Experience

Introduction Choanal polyps are benign lesions arising from the sinonasal mucosa, extending through the choana into the nasopharynx. Though polyps arising from the maxillary sinus and extending to the choana are common, polyps arising from the sphenoid sinus ostium, posterior part of middle turbinate, and inferior and middle meatus are quite uncommon.

Objective To document the site of origin of choanal polyps arising from unusual sites; their clinical, radiological, and histopathological characteristics, as well as diagnostic challenges and management.

Methods This retrospective, single-center study included 14 patients aged 16 to 75-years-old with choanal polyps. After obtaining informed consent, their clinical, radiological and surgical details and histopathology reports were reviewed. Patients were followed for at least 6 months after surgery.

Results The predominant symptoms were unilateral nasal obstruction (n = 9), snoring, rhinorrhea, and epistaxis. Though anterior rhinoscopy was unremarkable, a mass could be visualized during posterior rhinoscopy in the nasopharynx in 11 patients, and a mass could be directly visualized in the oropharynx in 2 patients. After diagnostic by nasal endoscopy, these polyps were noted to arise from the posterior aspect of the middle meatus (n = 6), middle turbinate (n = 3), posterior septum (n = 3), sphenoid sinus ostium (n = 1), and inferior meatus (n = 1). All patients were managed surgically. The histopathological examination revealed inflammatory polyp (n = 12), actinomycosis (n = 1), and rhinosporidiosis (n = 1). Patients were followed up for 6 to 22 months. We observed no complications or recurrence.

Conclusion Diagnostic nasal endoscopy should be performed in all patients presenting with nasal obstruction, to rule out choanal polyps arising from unusual sites. Complete polyp removal and appropriate treatment based on histopathology prevents recurrence.

Deciphering the change in root system architectural traits under limiting and non-limiting phosphorus in Indian bread wheat germplasm

The root system architectures (RSAs) largely decide the phosphorus use efficiency (PUE) of plants by influencing the phosphorus uptake. Very limited information is available on wheat's RSAs and their deciding factors affecting phosphorus uptake efficiency (PupE) due to difficulties in adopting scoring values used for evaluating root traits. Based on our earlier research experience on nitrogen uptake efficiency screening under, hydroponics and soil-filled pot conditions, a comprehensive study on 182 Indian bread wheat genotypes was carried out under hydroponics with limited P (LP) and non-limiting P (NLP) conditions. The findings revealed a significant genetic variation, root traits correlation, and moderate to high heritability for RSAs traits namely primary root length (PRL), total root length (TRL), total root surface area (TSA), root average diameter (RAD), total root volume (TRV), total root tips (TRT) and total root forks (TRF). In LP, the expressions of TRL, TRV, TSA, TRT and TRF were enhanced while PRL and RAD were diminished. An almost similar pattern of correlations among the RSAs was also observed in both conditions except for RAD. RAD exhibited significant negative correlations with PRL, TRL, TSA, TRT and TRF under LP (r = -0.45, r = -0.35, r = -0.16, r = -0.30, and r = -0.28 respectively). The subclass of TRL, TSA, TRV and TRT representing the 0-0.5 mm diameter had a higher root distribution percentage in LP than NLP. Comparatively wide range of H' value i.e. 0.43 to 0.97 in LP than NLP indicates that expression pattern of these traits are highly influenced by the level of P. In which, RAD (0.43) expression was reduced in LP, and expressions of TRF (0.91) and TSA (0.97) were significantly enhanced. The principal component analysis for grouping of traits and genotypes over LP and NLP revealed a high PC1 score indicating the presence of non-crossover interactions. Based on the comprehensive P response index value (CPRI value), the top five highly P efficient wheat genotypes namely BW 181, BW 103, BW 104, BW 143 and BW 66, were identified. Considering the future need for developing resource-efficient wheat varieties, these genotypes would serve as valuable genetic sources for improving P efficiency in wheat cultivars. This set of genotypes would also help in understanding the genetic architecture of a complex trait like P use efficiency.

An adult plant stripe rust resistance gene maps on chromosome 7A of Australian wheat cultivar Axe

An adult plant stripe rust resistance gene Yr75 was located on the long arm of chromosome 7A. Fine mapping of the region identified markers closely linked with Yr75. Australian wheat cultivar Axe produced resistant to moderately resistant stripe rust responses under field conditions and was exhibiting seedling responses varying from 33C to 3+ under greenhouse conditions. Experiments covering tests at different growth stages (2nd, 3rd and 4th leaf stages) demonstrated the clear expression of resistance at the 4th leaf stage under controlled-environment greenhouse conditions. A recombinant inbred line (RIL) population was developed from the Axe/Nyabing-3 (Nyb) cross. Genetic analysis of Axe/Nyb RIL population in the greenhouse at the 4th leaf stage showed monogenic inheritance of stripe rust resistance. Selective genotyping using the iSelect 90 K Infinium SNP genotyping array was performed, and the resistance locus was mapped to the long arm of chromosome 7A and named Yr75. The Axe/Nyb RIL population was genotyped using a targeted genotype-by-sequencing assay, and the resistance-linked SNPs were converted into kompetitive allele-specific PCR (KASP) markers. These markers were tested on the entire Axe/Nyb RIL population, and markers sunKASP_430 and sunKASP_427 showed close association with Yr75 in the Axe/Nyb RIL population. A high-resolution mapping family of 1032 F₂ plants from the Axe/Nyb cross was developed and genotyped with sunKASP_430 and sunKASP_427, and these markers flanked Yr75 at 0.3 cM and 0.4 cM, respectively. These markers cover 1.24 Mb of the physical map of Chinese Spring, and this information will be useful for map-based cloning of Yr75.

A Correlation Study between Tri-Guna and Emotional Style: A Theoretical Approach toward Developing a Working Model to Integrate Tri-Guna with Affective Neuroscience and Well-Being

BACKGROUND

Science of well-being is getting focused across all walks of life from health care to organizational behavior. Indian psychological principles of Tri-Guna offer a universal theoretical framework to understand the behavioral aspects of emotions and well-being, whereas affective neurosciences have explored neural circuits underlying few universal emotional styles. Both Tri-Guna and emotional styles are dynamic and vulnerable for modifications with training. Hence, establishing a relation between Tri-Guna and emotional style offers a novel insight to explore neural basis of Tri-Guna and its application in health and behavioral sciences.

AIMS

To establish the correlation between Tri-Guna and emotional styles in healthy adult subjects.

MATERIALS AND METHODS

Healthy adults (n = 121, 18-21 years) of both genders were individually administered with questionnaires to assess Tri-Guna (Vedic personality inventory) and emotional style (emotional style questionnaire). The relationship between Tri Guna (Sattva, Rajas and Tamas) and Six dimensions of emotional styles (attention, self awareness, outlook, resilience, social intuition and sensitivity to context) were assessed using Pearson's correlation coefficient.

RESULTS

All the emotional styles showed a positive correlation with Sattva and negative with Rajas and Tamas, except resilience. Resilience showed a negative correlation with Sattva and positive with Rajas and Tamas. Further, between Rajas and Tamas, emotional styles showed a stronger correlation with Tamas.

CONCLUSIONS

Sattva guna showed an association with emotional styles that favors to develop a positive emotional pattern. Having fairly understood neural circuitry of emotional styles, this first preliminary correlation data will provide a theoretical framework to explore neural circuitry involved in understanding emotional aspects of Tri-Guna.

Genetic Gain in Yield and Associated Changes in Agronomic Traits in Wheat Cultivars Developed Between 1900 and 2016 for Irrigated Ecosystems of Northwestern Plain Zone of India

Knowledge about the yield gain over the years due to associated changes in the yield component traits is essential for a critical understanding of yield-limiting factors. To estimate genetic gain in grain yield (GY) and component agronomic traits of wheat varieties released between 1900 and 2016 for northwestern plain zone (NWPZ) of India and to identify agronomic and/or genetic basis of the realized gains, two sets of wheat varieties comprising mega varieties and two recently developed varieties were evaluated under timely sown, tilled, and early sown conservation agriculture (CA) conditions for four consecutive years under irrigated conditions. The average annual genetic gain in GY since 1,905 under timely sown irrigated conditions was found to be 0.544% yr^-1 over the average of all varieties and 0.822% yr^-1 (24.27 kg ha^-1 yr^-1) over the first released variety, NP4. The realized mean yield increased from 2,950 kg ha^-1 of the variety NP4 released in 1,905-5,649 kg ha^-1 of HD3086 released in 2014. Regression analysis revealed a linear reduction in height and peduncle length (PL) over the years with a simultaneous and linear increase in biomass at the rate of 43.9 kg ha^-1 yr^-1 or relatively at 0.368% yr^-1 mainly because of delayed heading and increased crop duration. Regression analysis showed no linear trend for tiller number and thousand-grain weight (TGW). Though harvest index (HI) was found to linearly increase relatively at the rate of 0.198% per annum, polynomial regression improved the fitness of data with the indication of no increase in HI since 1982. Interestingly, genetic gain evaluation under early sown CA conditions for 4 years showed similar relative gain (RG) [a relative improvement in varieties across breeding periods (BP)] (0.544% yr^-1) but with a higher absolute value (29.28 kg ha^-1 yr^-1). Major mega varieties like Kalyan Sona, HD2009, PBW 343, HD2967, and HD3086, which occupied a comparatively larger area, were found highly plastic to the improvements in the production environment under timely sown conditions.

Application of Genomics Tools in Wheat Breeding to Attain Durable Rust Resistance

Wheat is an important source of dietary protein and calories for the majority of the world's population. It is one of the largest grown cereal in the world occupying over 215 M ha. Wheat production globally is challenged by biotic stresses such as pests and diseases. Of the 50 diseases of wheat that are of economic importance, the three rust diseases are the most ubiquitous causing significant yield losses in the majority of wheat production environments. Under severe epidemics they can lead to food insecurity threats amid the continuous evolution of new races of the pathogens, shifts in population dynamics and their virulence patterns, thereby rendering several effective resistance genes deployed in wheat breeding programs vulnerable. This emphasizes the need to identify, characterize, and deploy effective rust-resistant genes from diverse sources into pre-breeding lines and future wheat varieties. The use of genetic resistance has been marked as eco-friendly and to curb the further evolution of rust pathogens. Deployment of multiple rust resistance genes including major and minor genes in wheat lines could enhance the durability of resistance thereby reducing pathogen evolution. Advances in next-generation sequencing (NGS) platforms and associated bioinformatics tools have revolutionized wheat genomics. The sequence alignment of the wheat genome is the most important landmark which will enable genomics to identify marker-trait associations, candidate genes and enhanced breeding values in genomic selection (GS) studies. High throughput genotyping platforms have demonstrated their role in the estimation of genetic diversity, construction of the high-density genetic maps, dissecting polygenic traits, and better understanding their interactions through GWAS (genome-wide association studies) and QTL mapping, and isolation of R genes. Application of breeder's friendly KASP assays in the wheat breeding program has expedited the identification and pyramiding of rust resistance alleles/genes in elite lines. The present review covers the evolutionary trends of the rust pathogen and contemporary wheat varieties, and how these research strategies galvanized to control the wheat killer genus Puccinia. It will also highlight the outcome and research impact of cost-effective NGS technologies and cloning of rust resistance genes amid the public availability of common and tetraploid wheat reference genomes.

In vitro efficacy and in silico analysis of cefixime-ofloxacin combination for Salmonella Typhi from bloodstream infection

AIMS

Recently, the cefixime-ofloxacin combination is approved by Drug Controller General of India to treat typhoid fever. We sought to evaluate the antimicrobial activity of cefixime-ofloxacin combination against Salmonella Typhi.

METHODS AND RESULTS

A total of 283 nonduplicate S. Typhi isolates collected during 2012-2014 were included in this study. Minimum inhibitory concentration (MIC) of cefixime and ofloxacin was determined by using broth microdilution method. Combinational testing was performed by using checkerboard assay. In checkerboard assay, synergistic activity was seen in 11% of isolates, while the majority of the isolate showed indifference and none of them showed antagonism. An in silico strategy, an alternative to the animal model, was carried out to understand drug interaction and toxicity. Molecular docking results elucidated that cefixime and ofloxacin are capable of inhibiting the cell wall synthesis and DNA replication, respectively. Computational ADMET analysis showed no toxicity and no drug-drug interaction between cefixime and ofloxacin.

CONCLUSION

Cefixime-ofloxacin combination could be effective against moderately susceptible fluoroquinolone S. Typhi but not fluoroquinolone-resistant isolates.

SIGNIFICANCE AND IMPACT OF THE STUDY

Cefixime-ofloxacin combination with no drug-drug interaction and nontoxic predicted through computational analysis did not show antagonism against S. Typhi in in vitro. Although this study showed no adverse effects with the cefixime-ofloxacin combination, further studies on pharmacokinetic and pharmacodynamic (PK-PD) parameters of cefixime and ofloxacin combination are warranted.

Microsurgical free muscle flaps for reconstruction of post-traumatic complex tissue defects of foot

BACKGROUND

Crush injuries of the foot often result in complex tissue loss with exposed bones and tendons. These three-dimensional defects ideally require flexible well-perfused flaps to fill the space, afford resistance to infections, and to provide supple, durable weight- and pressure-bearing surfaces. Free muscle flaps with split thickness skin graft cover have been found to have several advantages in covering three-dimensional defects with exposed tendons and bones.

METHODS

All patients with post-traumatic composite tissue defects of the foot exposing bones and tendons, who presented to a tertiary care center during a 40-month period, were reconstructed with free muscle flaps as the first option. Gracilis muscle flap was used for eight patients and latissimus dorsi muscle for two patients. Decision regarding the choice of muscle was based on the size of the defect. The patients were followed up for 1 year and observed for return to activity, ability to wear footwear, requirement of secondary procedures, and any other complications.

RESULTS

Ten patients presented with composite post-traumatic tissue defects in the foot. All were male, with age ranging from 25 to 76 years. The defects ranged from 25 cm(2) to 225 cm(2). Free muscle transfer was successful in nine patients. Even though four required secondary flap contouring, all patients had normal weight-bearing ambulation and returned to their normal activities at 1-year follow-up.

CONCLUSION

Free muscle flaps merit consideration as primary reconstructive option for post-traumatic composite tissue defects of foot.

Emerging roles for modulation of microRNA signatures in cancer chemoprevention

miRNAs are small endogenous non-coding RNAs, approximately 21-nucleotides in length, which are shown to regulate an array of cellular processes such as differentiation, cell cycle, cell proliferation, apoptosis, and angiogenesis which are important in cancer. miRNAs can function as both tumor promoters (oncomiRs) or tumor suppressors by their ability to target numerous biomolecules that are important in carcinogenesis. Aberrant expression of miRNAs is correlated with the development and progression of tumors, and the reversal of their expression has been shown to modulate the cancer phenotype suggesting the potential of miRNAs as targets for anti-cancer drugs. Several chemopreventive phytochemicals like epigallocatechin-3-gallate, curcumin, isoflavones, indole-3-carbinol, resveratrol, and isothiocyanate have been shown to modulate the expression of numerous miRNAs in cancer cells that lead to either abrogation of tumor growth or sensitization of cancer cells to chemotherapeutic agents. This review focuses on the putative role(s) of miRNAs in different aspects of tumorigenesis and at various stages of early drug discovery that makes them a promising class of drug targets for chemopreventive intervention in cancer. We summarize the current progress in the development of strategies for miRNA-based anti-cancer therapies. We also explore the modulation of miRNAs by various cancer chemopreventive agents and the role of miRNAs in drug metabolism. We will discuss the role of miRNAs in cancer stem cells and epithelial-to-mesenchymal transition; and talk about how modulation of miRNA expression relates to altered glycosylation patterns in cancer cells. In addition, we consider the role of altered miRNA expression in carcinogenesis induced by various agents including genotoxic and epigenetic carcinogens. Finally, we will end with a discussion on the potential involvement of miRNAs in the development of cancer chemoresistance. Taken together, a better understanding of the complex role(s) of miRNAs in cancer may help in designing better strategies for biomarker discovery or drug targeting of miRNAs and/or their putative protein targets.

Structural and luminescence properties of Ho(3+)/Yb(3+)-doped Lu3Ga5O12 nano-garnets for phosphor applications

Lu3Ga5O12 nano-garnet powders doped with Ho(3+)/Yb(3+) ions have been prepared using a citrate sol-gel technique. The structural and morphological properties have been investigated by X-ray diffraction, scanning electron microscopy and Fourier transform infrared spectroscopy. The materials are found to exist in single phase of cubic garnet structure with an average particle size of around 45 nm. The Ho(3+)/Yb(3+)-doped Lu3Ga5O12 nano-garnet powders give rise to an intense green and weak red emission of Ho3+ ions under 457.5 nm direct excitation. Moreover, when the Yb3+ ions are excited at 950 nm a very bright green luminescence of the Ho3+ ions is observed by the naked eyes even for such low laser power as 10 mW and the intensity of the red emission have been increased compared to that found under direct excitation of the Ho3+ ions. The power dependency and dynamics of the infrared-to-visible upconverted luminescence confirm the existence of different two-photon energy transfer processes. All these results have been compared with those obtained for other garnets doped with similar lanthanide ions which suggest that the Lu3Ga5O12 nano-garnets are potential materials for light emitting devices.

White light generation in Dy(3+)-doped oxyfluoride glass and transparent glass-ceramics containing CaF2 nanocrystals

The radiative emission properties of the Dy3+ ions in an oxyfluoride glass and glass-ceramics have been studied for the generation of white light. The x-ray diffraction pattern of the glass-ceramics shows the formation of CaF2 fluorite-type nanocrystals in the glass matrix after a suitable thermal treatment of the precursor glass, whereas time-resolved optical measurements show the incorporation of the Dy3+ ions in the CaF2 nanocrystals. Intense white light has been observed when the samples are excited with 451 nm laser light. From the visible emission spectra, yellow to blue intensity ratios and the chromaticity color coordinates have been determined. All the color coordinates are found to lie in the white light region of the chromaticity color diagram.

Frequency of lactose malabsorption among healthy southern and northern Indian populations by genetic analysis and lactose hydrogen breath and tolerance tests

BACKGROUND

Lactose malabsorption (LM), the inability to break down lactose into glucose and galactose, is due to a deficiency in the small intestinal lactase phlorizin hydrolase enzyme. Ethnic and geographic variations of LM are known.

OBJECTIVE

The aim of this study was to compare the frequency of LM in healthy southern and northern Indian populations.

DESIGN

A total of 153 healthy volunteers (76 from southern and 77 from northern India) were evaluated for LM by using a lactose tolerance test (LTT), a lactose hydrogen breath test (lactose HBT), and polymerase chain reaction-restriction fragment length polymorphism to identify the lactase gene C/T-13910 polymorphism (confirmed by sequencing).

RESULTS

Volunteers from southern and northern India were comparable in age and sex. The LTT result was abnormal in 88.2% of southern Indians and in 66.2% of northern Indians (P = 0.001). The lactose HBT result was abnormal in 78.9% of southern Indians and in 57.1% of northern Indians (P = 0.003). The CC genotype was present in 86.8% and 67.5% (P = 0.002), the CT genotype was present in 13.2% and 26.0% (P = 0.036), and the TT genotype was present in 0% and 6.5% (P = 0.03) of southern and northern Indians, respectively. The frequency of symptoms after the lactose load (47.4% compared with 15.6%; P < 0.001) and peak concentrations of breath hydrogen (88.5 +/- 71.9 compared with 55.4 +/- 61.9 ppm; P = 0.003), both of which might indicate the degree of lactase deficiency, were higher in southern than in northern Indians.

CONCLUSION

The frequency and degree of LM is higher in southern than in northern Indian healthy populations because of genetic differences in these populations.

Luminescence properties of Sm(3+)-doped P(2)O(5)-PbO-Nb(2)O(5) glass under high pressure

Samarium doped lead phosphate glass modified with niobium having a composition (in mol%) of 55P(2)O(5)+39.5PbO+5Nb(2)O(5)+0.5Sm(2)O(3) has been prepared by the conventional melt quenching technique. The emission spectra and the decay curves for the (4)G(5/2) level of Sm(3+) ions have been measured as a function of pressure up to 23.6 GPa at room temperature. A discontinuity in the observed shifts and crystal-field splittings as a function of pressure around 9-10 GPa suggests that a phase transition is taking place in the glass matrix. The [Formula: see text], (6)H(7/2) and (6)H(9/2) transitions are shifted towards the lower energy side with magnitudes of -7.1, -7.6 and -5.5 cm(-1) GPa(-1) up to 8.9 GPa (phase 1) and -5.6, -4.9 and -4.4 cm(-1) GPa(-1) beyond 10.3 GPa (phase 2), respectively. A much stronger increase in the splitting of the [Formula: see text] and [Formula: see text] Stark levels with pressure is observed in phase 1 than in phase 2. The lifetime of the (4)G(5/2) level decreases from 2.29 ms (0 GPa) to 0.64 ms (23.6 GPa) with pressure. The decay curves of the (4)G(5/2) level exhibit non-exponential behavior for all the pressures and were fitted by the generalized Yokota-Tanimoto model to probe the nature of the energy transfer process. The best fits with S = 6 indicate that the energy transfer between donor and acceptor is of dipole-dipole type. The crystal-field splitting experienced by the Sm(3+) ions in the title glass are found to be larger than those found in borate, K-Ba-Al phosphate and tellurite glasses.

Fluorescence properties of Nd3+-doped tellurite glasses

The compositional and concentration dependence of luminescence of the (4)F(3/2)-->(4)I(J) (J=13/2, 11/2 and 9/2) transitions in four Nd(3+)-doped tellurite based glasses has been studied. The free-ion energy levels obtained for 60TeO(2)+39ZnO(2)+1.0Nd(2)O(3) (TZN10) glass have been analysed using the free-ion Hamiltonian model and compared with similar results obtained for Nd(3+):glass systems. The absorption spectrum of TZN10 glass has been analysed using the Judd-Ofelt theory. Relatively longer decay rates have been obtained for Nd(3+)-doped phosphotellurite glasses. The emission characteristics of the (4)F(3/2)-->(4)I(11/2) transition, of the Nd(3+):TZN10 glass, are found to be comparable to those obtained for Nd(3+):phosphate laser glasses. The non-exponential shape of the emission decay curves for the (4)F(3/2)-->(4)I(11/2) transition is attributed to the presence of energy transfer processes between the Nd(3+) ions.

Luminescence and optical absorption properties of Nd(3+) ions in K-Mg-Al phosphate and fluorophosphate glasses

Absorption and emission properties and fluorescence lifetimes for the [Formula: see text] transition of Nd(3+) ions embedded in P(2)O(5)-K(2)O-MgO-Al(2)O(3) (PKMA)-based glasses modified with AlF(3) and BaF(2) are reported at room temperature. The observed energy levels of Nd(3+) ions in these glasses have been analysed through a semi-empirical free-ion Hamiltonian model. The spin-orbit interaction and net electrostatic interaction experienced by the Nd(3+) ions follow the trend as PKMA>PKMA+AlF(3)> PKMA+BaF(2) glasses. Judd-Ofelt analysis has been carried out on the absorption spectra of 1.0 mol% Nd(3+)-doped glasses to predict the radiative properties for the fluorescent levels of the Nd(3+) ion. Branching ratios and stimulated emission cross-sections show that the [Formula: see text] transition of the glasses under investigation has the potential for laser applications. The Inokuti-Hirayama model has been applied to investigate the non-radiative relaxation of the Nd(3+) ion emitting state, (4)F(3/2). Based on the decay curve analysis, concentration quenching of the (4)F(3/2) emission has been attributed to a cross-relaxation process between the Nd(3+) ions.

Photoluminescence from the (5)D(0) level of Eu(3+) ions in a phosphate glass under pressure

The pressure dependence of the luminescence from [Formula: see text] transitions of Eu(3+) ions in 58.5P(2)O(5)-9Al(2)O(3)-14.5BaO-17K(2)O-1Eu(2)O(3) glass has been investigated up to 38.3 GPa at room temperature. The relative luminescence intensity ratio of [Formula: see text] to [Formula: see text] transitions of the Eu(3+) ions is found to decrease with increasing pressure, indicating a lowering of the asymmetry around the Eu(3+) ions with pressure. The [Formula: see text] transitions exhibit pressure-induced red shifts of different magnitude, which suggests a decrease in Slater parameters (F(k)) and in the spin-orbit coupling parameters (ζ) for the Eu(3+) ions. Stark components of the (7)F(1) level have been used to evaluate the crystal-field (CF) parameters B(20) and B(22), which are in turn used to estimate the CF strength experienced by the Eu(3+) ions in the glass. The observed increase in the CF strength parameter is found to have an almost cubic dependence on pressure. Luminescence decay curves for the [Formula: see text] transition are found to be single exponential over the entire pressure range studied. The lifetime did not change under pressure up to 5 GPa, although a significant change in the CF strength is noticed in this pressure range. The reduction of lifetime observed at pressures above 5 GPa could be partially due to an increase of pressure-induced defect centres. Such a process can then explain the hysteresis observed in the variation of lifetime and crystal-field strength on the release of pressure.

Fluorescence properties of Eu3+ ions doped borate and fluoroborate glasses containing lithium, zinc and lead

The influence of glass composition on the fluorescence properties of Eu3+ ions doped borate and fluoroborate glasses modified with Li+, Zn2+ and Pb2+ cations have been investigated. The magnitude of splittings of 7F1 levels are analyzed using crystal-field (CF) analysis. The relative intensities of 5D0 --> 7F2 to 5D0 --> 7F1 transitions, crystal-field strength parameters and decay times of the 5D0 level have been determined and are found to be lower for Pb based glasses than those of Zn/Li based glasses. The lifetimes of 5D0 level are found to increase when borate glasses are modified with pure fluorides than with oxides and oxyfluorides. The fluorescence decay of 5D0 level fits perfect single exponential in the Eu3+:glass systems studied which indicates the absence of energy transfer between Eu3+ ions in these glasses.

Pyrene-derived novel one- and two-component organogelators

A new class of alkyl-chain-appended pyrene derivatives 4-14 were synthesized and evaluated for their gelation abilities. Depending on the nature of the linking group, these compounds gelated a number of organic solvents, either in the presence or in the absence of the acceptor molecule 2,4,7-trinitrofluorenone (TNF). Compounds with ester, ether, or alkyl linkages gelated a number of hydroxylic and hydrocarbon solvents by means of a charge-transfer interaction with TNF, while compounds with amide, urethane and urea linkers formed gels on their own in a variety of solvents by means of pi-pi stacking and hydrogen-bonding interactions. The Xray crystal structure of urethane (S)-12 showed hydrogen-bonding and stacking features, as suggested by the model. The gels obtained were investigated by spectroscopic and electron microscopic techniques which provided structural insights.

Surfactant-induced lipid peroxidation in a tropical euryhaline teleost Oreochromis mossambicus (Tilapia) adapted to fresh water

Exposure to anionic (sodium dodecyl sulfate, SDS), cationic (cetyl trimethyl ammonium bromide CTAB) and non ionic (Triton X-100) surfactants at a sub lethal concentration of 1 ppm resulted in severe oxidative stress in the hepatic, renal and cardiac tissues of fresh water adapted Oreochromis mossambicus. Hepatic catalase showed significant increase (P<0.001) in all the surfactant exposed fish, but the renal enzyme was significantly increased only in CTAB dosed fish (P<0.001) and the cardiac enzyme showed significant increase in Triton (P<0.05) and CTAB dosed fish (P<0.001). SOD levels were significantly increased (P<0.001) in hepatic, renal and cardiac tissues of all the surfactant-treated fish. Glutathione reductase also was significantly increased (P<0.001) in the hepatic and renal tissues of surfactant dosed fish except cardiac tissues of CTAB exposed animals. Glutathione levels in the tissues studied were significantly higher in the surfactant treated animals (P<0.001) whereas malondialdehyde levels were significantly elevated only in the hepatic tissues of animals exposed to Triton (P<0.001). The surfactants based on their charge, antioxidant profile and in vivo metabolism may be arranged in the order of decreasing toxicity as CTAB > Triton > SDS. Thus it may be inferred from the present study that the antioxidant defenses and the in vivo metabolism of the surfactants are key factors in deciding the surfactant toxicity.

Transection of common bile duct following blunt injury to abdomen

Isolated complete transection of the common bile duct due to blunt abdominal trauma is rare. We report such a case following an assault.

Studies on transvection at the bithorax complex in Drosophila melanogaster

We have studied the influence of some mutations in the bithorax complex on the observed synapsis dependent phenotype of the genotypes Cbx1Ubx1/+ and bx3 4e/Ubx1. The effect of these mutations is similar to that introduced by disruption of pairing or by the za mutation. Among the bx mutations, we find that bx8 behaves differently from most other bx mutations in its influence on the synapsis dependent phenotype. This observation induced us to map the position of bx8 with respect to other bx mutations; we find that it maps between bx3 4e and bx3. We show how some of the observations reported here can be fitted into a model of activation of the bithorax complex proposed by one of us.

Mutagen sensitivity of kynureninase mutants of the nematode Caenorhabditis elegans

Mutants in the gene flu-2 of the free-living nematode Caenorhabditis elegans are characterised by an altered autofluorescence of the intestine cells, from the light blue of wild-type to a dull green colour. The properties of flu-2 mutants have been investigated. L-kynureninase activity has been detected in wild-type C. elegans. The flu-2 mutants have markedly reduced kynureninase activity, as predicted earlier from chromatographic analysis of tryptophan catabolites of wild-type and mutant worms. Associated with this enzymatic block, all flu-2 mutants have enhanced sensitivity to ethyl methane sulfonate (EMS) and gamma-rays.

Genetic mosaics of Caenorhabditis elegans: a tissue-specific fluorescent mutant

Genetic mosaics can be generated by x-irradiation in the simple nematode Caenorhabditis elegans. A mutation in the gene flu-3 alters the characteristic autofluorescence of intestinal cells under ultraviolet light and can be used as a cell- and tissue-specific marker. Embryos heterozygous for flu-3 give rise to adults with patches of these altered intestinal cells. The previously established intestinal cell lineage in Caenorhabditis elegans and the distribution and sizes of the fluorescent patches are consistent with a somatic segregation of the flu-3 allele.

Kynurenine hydroxylase mutants of the nematode Caenorhabditis elegans

The relation of intestinal autofluorescence to tryptophan catabolism in the free-living nematode Caenorhabditis elegans has been investigated. L-Kynurenine hydroxylase (EC 1.14.13.9) activity has been detected in normal (wild-type) individuals. Mutants in the gene flu-1 which are characterized by an altered autofluorescence of the intestine cells, i.e., more intense than wild type and bluish purple instead of light blue have also been examined. They show a markedly reduced activity of kynurenine hydroxylase. The finding supports the previously proposed model for altered fluorescence based on chromatographic identification of tryptophan catabolites present.

Early developmental subdivisions of the wing disk in Drosophila

The properties of the mutation wingless discovered by Sharma are discussed. It appears that this mutation interferes with a step leading to normal wing-notum compartmentation of the wing disk. From the study of mutational mosaics in the wingless locus we conclude that mutations in this gene can be autonomous in mosaics.