Resiliencies of soil phosphorus fractions after natural summer fire are governed by microbial activity and cation availability in a semi-arid Inceptisol

The unintended impact of natural summer fire on soil is complicated and rather less studied than its above-ground impact. Recognising the impact of a fire on silvopastoral soils and their resilience can aid in improving the management of silvopastoral systems. We studied the immediate (after 1 week (W)) and short-term (after 3 months (M)) recovery of different soil biological and chemical properties after the natural fire, with specific emphasis on phosphorus (P) dynamics. Soil samples were collected from four different layers (0-15, 15-30, 30-45, and 45-60 cm) of Morus alba, Leucaena leucocephala, and Ficus infectoria based silvopastoral systems. In the 0-15 cm soil layer, soil organic carbon (SOC) declined by ∼37, 42, and 30% after the fire in Morus-, Leucaena-, and Ficus-based systems, respectively within 1W of fire. However, after 3M of fire, Morus and Leucaena regained ∼6 and 11.5% SOC as compared to their status after 1W in the 0-15 cm soil layer. After 1W of the fire, soil nitrogen (N), sulfur (S), and potassium availability declined significantly at 0-15 cm soil layer in all systems. Iron and manganese availability improved significantly after 1W of the fire. Saloid bound P and aluminium bound P declined significantly immediately after the fire, increasing availability in all systems. However, calcium bound P did not change significantly after the fire. Dehydrogenase and alkaline phosphatase activity declined significantly after the fire, however, phenol oxidase and peroxidase activity were unaltered. Resiliencies of these soil properties were significantly impacted by soil depth and time. Path analysis indicated microbial activity and cationic micronutrients majorly governed the resilience of soil P fractions and P availability. Pasture yield was not significantly improved after the fire, so natural summer fire must be prevented to avoid loss of SOC, N, and S.

Synthesis and anticancer evaluation of sulfur containing 9-anilinoacridines

BACKGROUND

DNA topoisomerases are a class of enzymes that play a critical role in fundamental biological processes of replication, transcription, recombination, repair and chromatin remodeling. Amsacrine (m-AMSA), the best-known compound of 9-anilinoacridines series was one of the first DNA-intercalating agents to be considered as a Topoisomerase II inhibitor.

OBJECTIVE

A series of sulfur containing 9-anilinoacridines related to amsacrine were synthesized and evaluated for their anticancer activity.

METHODS

Cell viability was assessed by the MTT assay. The topoisomerase II inhibitory assay was performed using the Human topoisomerase II Assay kit and flow cytometry was used to evaluate the effects on cell cycle of K562 cells. Molecular docking was performed using Schrödinger Maestro program.

RESULTS

Compound 36 was found to be the most cytotoxic of the sulfide series against SW620, K562, and MCF-7. The limited SAR suggested the importance of the methansulfonamidoacetamide side chain functionality, the lipophilicity and relative metabolic stability of 36 in contributing to the cytotoxicity. Topoisomerase II α inhibitory activity appeared to be involved in the cytotoxicity of 36 through inhibition of decatenation of kinetoplast DNA (kDNA) in a concentration dependent manner. Cell cycle analysis further showed the Topo II inhibition through accumulation of K562 cells in G2/M phase of cell cycle. Docking of 36 into the Topo II α-DNA complex suggested that it may be an allosteric inhibitor of Topo II α.

CONCLUSION

Compound 36 exhibits anticancer activity by inhibiting topoisomerase II and it could further be evaluated in in vivo models.

Structural and biological aspects of natural bridged macrobicyclic peptides from marine resources

Among peptide-based drugs, naturally occurring bicyclic compounds have been established as molecules with unique therapeutic potential. The diverse pharmacological activities associated with bicyclic peptides from marine tunicates, sponges, and bacteria render them suitable to be employed as effective surrogate between complex and small therapeutic moieties. Bicyclic peptides possess greater conformational rigidity and higher metabolic stability as compared with linear and monocyclic peptides. The antibody-like affinity and specificity of bicyclic peptides enable their binding to the challenging drug targets. Bridged macrobicyclic peptides from natural marine resources represent an underexplored class of molecules that provides promising platforms for drug development owing to their biocompatibility, similarity, and chemical diversity to proteins. The present review explores major marine-derived bicyclic peptides including disulfide-bridged, histidinotyrosine-bridged, or histidinoalanine-bridged macrobicyclic peptides along with their structural characteristics, synthesis, structure-activity relationship, and bioproperties.The comparison of these macrobicyclic congeners with linear/monocyclic peptides along with their therapeutic potential are also briefly discussed.

Adoption of Gla-100 in India and its Impact on Insulin Usage Patterns

Fueled by perceptions regarding Indian dietary patterns and premixed insulin's claim to fame of providing dual fasting and post-prandial control, there was a greater inclination towards using premixed insulins in clinical practice until the last decade. However, the advent of insulin glargine 100 U/mL (Gla-100) opened up a new dimension in insulin therapy landscape in India. The data from the last 5 years reveal that Gla-100 has gained more traction among Indian clinical practitioners. Basis evidences that have emerged from various clinical studies, this present review elaborates on certain key issues which have helped Gla-100 carve its own niche and effected a progressive shift in insulin prescription pattern in India.

Long-term in situ moisture conservation in horti-pasture system improves biological health of degraded land

In situ moisture conservation practices can conserve fertile topsoil and enhance available water in soil profile. We hypothesised that reclaiming degraded land ecologically through tree + pasture + in situ moisture conservation practices would significantly improve soil organic carbon (SOC) and health. Hence, the objectives were a) to identify changes in nutrient cycling enzymes and SOC status due to different in situ soil moisture conservation options in surface and subsurface soil layers, and b) to test the potentiality of soil enzymes to determine long-term nutrient availability. We conducted a long-term experiment involving aonla (Emblica officinalis) trees + pasture (Cenchrus ciliaris + Stylosanthes seabrana) + in situ soil moisture conservation measures viz. staggered contour trenches (T1), continuous contour trenches (T2), stone mulch (T3), vegetative barriers (T4), control (T5) and fallow land (T6) since 2007. Recommended dose of nitrogen (N), phosphorus (P) and potassium (K) were added to all treatments, except T6. SOC concentration increased by ~51 and 31% in T1 and T2, respectively, over T5 in surface (0-15 cm) soil. Culturable bacterial and fungal populations increased by ~20 and 95% in T1 over T5 in surface soil. Activities of all soil enzymes increased in T1 and T2 (ranging from 42 to 289%) over T5 and T6 in both surface and sub-surface (15-30 cm) layers. However, specific activity of phenol oxidase was ~25% lower for T1 than T6, suggesting more efficient SOC sequestration in T1. Moreover, geometric mean enzyme activity of T1 was ~65 and 33% higher than T5 and T3, respectively, in surface soil. Treated soil quality index (T-SQI) of T1 was ~184% higher than T5. Soil functional diversity was also ~1.24 and 1.22 times higher in T1 and T2 than T5, respectively. Peroxidase was the major C degrading enzyme in this ecosystem. Protease, urease and phosphatase significantly influenced N and P availability along with fruit and pasture yields. Importantly, ~96, 62 and 82% variability of SOC, N and P concentrations, respectively, could be attributed to their corresponding enzyme activities. Principal components analysis (PCA) revealed one-way operational role of soil enzymes. Thus, enzymes are potentially important for recycling nutrients from litters, root biomass of fruit trees and grasses to boost their availability in the long run. Adoption of horti-pasture system combined with moisture conservation practices and staggered contour trenches or continuous contour trenches ensured higher above ground biomass yield, SOC, nutrient availability and soil quality. Thus, long-term use of these practices could be recommended for reclamation and improving soil health and crop productivity of degraded lands of central India.

Mechanistic studies on the biosorption of Pb(II) by Pseudomonas aeruginosa

The biosorption of Pb(II) ions from aqueous solution has been studied using both the intact and thermolyzed cells of Pseudomonas aeruginosa. Further, the role of the major cell wall components, namely DNA, protein, polysaccharide, and lipid, in Pb(II) binding has been assessed using an enzymatic treatment method. The Pb(II) bioremediation capability of P. aeruginosa cells has been investigated by varying the parameters of pH, time of interaction, amount of biomass, and concentration of Pb(II). The complete bioremoval of Pb(II) using intact cells has been achieved for an initial Pb(II) concentration of 12.4 mg L^-1 at pH 6.2 and temperature 29 ± 1 °C. The biosorption isotherm follows Langmuirian behavior with a Gibbs free energy of -30.7 kJ mol^-1, indicative of chemisorption. The biosorption kinetics is consistent with a pseudo-second-order model. The possible Pb(II) binding mechanisms of P. aeruginosa cells are discussed based on characterization using zeta potential measurements, Fourier transform infra-red spectroscopy, and energy dispersive X-ray spectroscopy. The results confirm that among the major cell wall components studied, polysaccharide shows the highest contribution towards Pb(II) binding, followed by DNA, lipid, and protein. Similar studies using thermolyzed cells show higher Pb(II) uptake compared to the intact cells both before and after enzymatic treatment.

Performance optimization of LSCF/Gd:CeO2 composite cathodes via single-step inkjet printing infiltration

Abstract

The effect of solid oxide fuel cell cathode microstructure modification on its electrochemical activity is investigated. Inkjet printing infiltration was used to develop a nano-decoration pattern on the composite cathode scaffolds. Two types of composite La_0.6Sr_0.4Co_0.2Fe_0.8O_3-δ:Ce_0.9Gd_0.1O_1.9 cathodes with different volume ratios (60:40 and 40:60 vol%) were fabricated using inkjet printing of suspension inks. The electrodes were altered by single-step inkjet printing infiltration of ethanol-based Ce_0.9Gd_0.1O_1.9 ink. After heat treatments in air at 550 °C the cathodes' surfaces were shown to be nano-decorated with Ce_0.9Gd_0.1O_1.9 particles (~20-120 nm in size) dispersed uniformly onto the electrode scaffold. The nano-engineered microstructure enhanced the active triple phase boundary of the electrode and promoted the surface exchange reaction of oxygen. Electrochemical impedance tests conducted on symmetrical cells showed a reduction in the polarization resistance of between 1.3 and 2.9 times. The effect was found to be more pronounced in the 60:40 vol% composite cathodes. Ageing of infiltrated electrodes up to 60 h in air revealed enhanced stability of gadolinium doped ceria nanoparticles decorated electrodes ascribed to the suppression of SrO surface segregation. This work demonstrated that single-step inkjet printing infiltration can produce reproducible performance enhancements and thus offers a cost-effective route for commercial solid oxide fuel cell infiltration processing.

Graphical abstract

No evidence of association of xenotropic murine leukemia virus-related virus with oral cancers: Experience from a tertiary care center in South India

BACKGROUND

Development of oral cancer, a widely prevalent cancer in India, is multifactorial with increased risk in those habituated to smoking, consuming alcohol and chewing paan and tobacco. This does not preclude other etiological factors in the causation of this cancer. Exploratory studies on several oncogenic viruses have found varied associations with oral cancers.

AIM

The aim of this study was to explore the association of xenotropic murine leukemia virus-related virus, (XMRV) a retrovirus recently implicated in oncogenesis in humans, with oral cancers.

SETTINGS AND DESIGN

The presence of XMRV proviral deoxyribonucleic acid (DNA) was evaluated by standard nucleic acid amplification from DNA extracted from representative bits of tumor tissues and adjacent normal tissues from surgically resected specimens sent post-operatively for routine histopathological testing.

MATERIALS AND METHODS

This prospective study comprised 109 patients with a provisional diagnosis of oral cancer who were operated at the Oral Oncology Department of Kidwai Memorial Institute of Oncology, over a period of 10 months.

RESULTS

XMRV was not found in any of the tumor tissues (squamous cell carcinomas - 98; verrucous carcinomas - 4) nor in any of the normal tissues. It is thus important that the absence of this oncogenic virus in all the cases makes the association of XMRV with oral cancers very unlikely.

CONCLUSIONS

There is a need to investigate potentially oncogenic viruses in other solid tumors and in larger sample sizes. Any such association could have implications in detecting, preventing and treating these cancers.

Complex pseudoaneurysm of ascending aorta: Unusual cause of right heart dysfunction-implications to the anesthesiologist

Pseudoaneurysm of ascending aorta (PAA) is a rare complication occurring after cardiac surgery. Because of rarity of the condition, most standard teaching and anesthetic literature do not highlight on these postoperative aortic complications. Right heart dysfunction associated with PAA is scarcely reported. We describe here two cases of PAA with right heart involvement and discuss the possible anesthetic challenges.

Adult type 3 Gaucher disease as manifestation of R463C/Rec Nci I mutation: first reported case in the world literature

Gaucher disease is the most common lysosomal storage disorder. It is autosomal recessive in nature and results from mutations in the GBA gene coding for acid beta glucosidase. It is classified into three types based on CNS involvement and its severity. Type 3, or chronic neuronopathic Gaucher disease, generally has an onset in childhood and by definition, includes all patients with any form of neurologic involvement who have survived the first few years of life. Here we present a 36 year old male patient presenting with hip pain showing bilateral avascular necrosis of femoral head with massive splenomegaly and on evaluation, showed mental retardation, seizures, bilateral vertical and horizontal gaze palsies and eventually turned out to be type 3b Gaucher disease. This is the first case of Type 3 Gaucher disease being reported from India with mutation analysis and only case of Type 3 Gaucher disease in world literature showing R463C/Rec Nci I mutation.

A Stability-Indicating RP-HPLC Assay Method for 5-Fluorouracil

The present study describes the development of a validated RP-HPLC method for the determination of 5-fluorouracil in presence of its degradation products or other pharmaceutical excipients. Stress studies were performed on 5-fluorouracil and it was found that it degrades sufficiently in alkaline conditions, while negligible degradation was observed in acidic, neutral, oxidative and photolytic conditions. The peaks of the degradation products were not observed in the chromatogram due to the nonchromophoric nature of the degradation moiety formed. The separations were carried out on a C-18 reversed phase column (Phenomenex; Prodigy ODS3V, 250x4.6 mm, 5 mu) using 50mM KH(2)PO(4) (pH, 5.0) as mobile phase at a flow rate of 1.2 ml/min and temperature of 30 degrees . The wavelength of detection was 254 nm. A retention time of nearly 6 minutes was obtained. Analytical validation parameters such as specificity and selectivity, linearity, accuracy and precision were evaluated. The calibration curve for 5-fluorouracil was linear (r(2)=0.999+/-0.0005) from range of 10 mug/ml to 100 mug/ml. Relative standard deviation values for all the key parameters, was less than 2.0 %. The recovery of the drug after standard addition to the degraded sample was found to be 104.69%. Thus, the developed RP-HPLC method was found to be suitable for the determination of 5-fluorouracil in bulk as well as stability samples of the pharmaceutical dosage forms containing various excipients.

A simple and sensitive stability-indicating RP-HPLC assay method for the determination of aceclofenac

The aim of the present study is to develop a stability-indicating assay method for the determination of aceclofenac after being subjected to different International Conference on Harmonization prescribed stress conditions, such as hydrolysis, oxidation, heat, and photolysis. Aceclofenac (2-[2-[2-(2,6-dichlorophenyl)aminophenyl]acetyl]oxyacetic acid) is decomposed under hydrolytic stress (neutral, acidic, and alkaline) and also on exposure to light (in solution form). The compound is stable to oxidative stress, heat, and photolytic stress (in solid form). The major degradation product is diclofenac, which is confirmed through comparison with the standard. Separation of the drug from major and minor degradation products is achieved on a C-18 column using methanol-0.02% of ortho phosphoric acid in a ratio of 70:30. The method is linear over the concentration range of 17-100 microg/mL (r(2) = 0.9988). The detection wavelength is 275 nm. The method is validated for linearity, range, precision, accuracy, specificity, and selectivity.

Human papillomavirus, p53 and cyclin D1 expression in oropharyngeal carcinoma

Forty-two specimens from oropharyngeal (tonsil and base of tongue) squamous cell carcinoma patients (SCC) were studied for presence of HPV 16 by in situ hybridization and by immunohistochemistry for p53 and Cyclin D1 protein overexpression. Thirty-one per cent of cases were HPV-16 positive, which correlates with the prevalence reported worldwide. 74% of cases showed p53 protein overexpression and 79% showed Cyclin D1 overexpression. There was no correlation between HPV status and either p53 or Cyclin D1 overexpression (P>0.05). These three variables also did not correlate with factors such as grade of the tumour, stage of the disease or lymph nodal metastasis at presentation.

Giant Morgagnian hernia masquerading as pleural effusion

Morgagnian hernia is a congenital diaphragmatic hernia which occurs through anteromedial defect in the diaphragm. A 58-year-old lady was referred for surgical management of chronic massive pleural effusion. High-resolution CT scan of the chest demonstrated an anteromedial defect in the diaphragm and with contents being colon and great omentum. She required anterolateral thoracotomy and reduction of hernia with repair of formen of Morgagni with prolene mesh. Blind needle aspiration would have punctured the colon; hence the case is being reported to highlight the necessity of CT scan/ultrasound of chest in investigating a chronic massive pleural effusion much before a needle is put for aspiration blindly.

Human papillomavirus, p53 and cyclin D1 expression in oropharyngeal carcinoma

Forty-two specimens from oropharyngeal (tonsil and base of tongue) squamous cell carcinoma patients (SCC) were studied for presence of HPV 16 by in situ hybridization and by immunohistochemistry for p53 and Cyclin D1 protein overexpression. Thirty-one per cent of cases were HPV-16 positive, which correlates with the prevalence reported worldwide. 74% of cases showed p53 protein overexpression and 79% showed Cyclin D1 overexpression. There was no correlation between HPV status and either p53 or Cyclin D1 overexpression (P>0.05). These three variables also did not correlate with factors such as grade of the tumour, stage of the disease or lymph nodal metastasis at presentation.

Genetics of a new male-sterility locus in pigeonpea (Cajanus cajan [L.] Millsp.)

A natural male-sterile mutant was found in the population of a short-duration pigeonpea (Cajanus cajan[L.] Millsp.) cultivar ICPL 85010. This mutant is characterized by light yellow anthers of reduced size that are devoid of pollen grains. This mutant was crossed with two pigeonpea cultivars to study its inheritance. The F1, F2, and test cross data of the two crosses suggested that this male sterility trait is genetic in origin and is controlled by a single recessivegene. The F1 (mutant x ICPL 85010) plants were crossed with translucent (ms1) and arrowhead type (ms2) genetic male steriles reported earlier to study their allelic relationships. Segregation in the three-way cross F1 and F2 populations revealed that the mutant male-sterile gene was nonallelic to ms1 and ms2 loci and it is designated ms3. The new male sterility sources in pigeonpea will help in producing high-yielding hybrids and populations in diverse phenological groups.

Parotid tuberculosis simulating malignancy

An interesting case of parotid tumour simulating malignancy is reported. The rarity of this lesion and the associated clinical and diagnostic problems are emphasized together with the relevant literature.

Improved blood substitute: evaluation of its effects on human endothelial cells

The authors have previously documented that appropriate chemical and pharmacologic modification of the hemoglobin molecule are required to attenuate certain pathophysiologic reactions of the reticuloendothelium. The current study further investigates the molecular responses of human coronary artery endothelial cells to a high concentration (0.4 mmol) of 1) unmodified bovine hemoglobin; and 2) an improved blood substitute that comprises hemoglobin cross-linked intramolecularly with o-adenosine triphosphate and intermolecularly with o-adenosine, and conjugated with reduced glutathione. In this study, the scavenging effect of hemoglobins toward nitric oxide (NO) was evaluated by the measurement of nitrite (NO2-) and nitrate (NO3-) formation. The pro-oxidant effect of hemoglobin on endothelial cells was examined by the measurement of intracellular reduced glutathione, and by monitoring the formation of lipid hydroperoxides and 8-iso prostaglandin F2alpha, a novel potent vasoconstrictor, which is produced by a noncyclooxygenase mechanism involving free radical catalyzed peroxidation of arachidonic acid. The inflammatory reactions of endothelial cells were evaluated by the expression of the adhesion molecule, intracellular adhesion molecule-1, and the activation of nuclear transcription factor, nuclear factor kappaB. In additional, endothelial cell responses were investigated by analysis of intracellular ionized calcium concentrations. Results indicate that unmodified hemoglobin in a concentration of 0.4 mmol/L can aggravate endothelial cell oxidative and inflammatory responses. This hemoglobin produced a significant (p < 0.01) depletion of reduced glutathione, acceleration of lipid peroxidation, and a greater influx of Ca2+. The formation of 8-iso prostaglandin F2alpha increased compared with the control cells (p < 0.01). Unmodified hemoglobin was found to be a potent scavenger of NO, great activator of nuclear factor kappaB, and a stimulator of intracellular adhesion molecule-1 expression. Contrarily, the improved blood substitute did not appear to induce oxidative stress nor to increase the intracellular Ca2+. The concentration of 8-iso prostaglandin F2alpha was similar to that in the control cells, whereas the formation of NO2-/NO3- was much lower (p < 0.05) than in the unmodified hemoglobin group. The effect of an improved blood substitute can be linked with the anti-inflammatory and cytoprotective properties of adenosine, which is used as a cross-linker and surface modifier, and the type of the chemical modification procedure that lowers hemoglobin pro-oxidant potential.

Osteosarcoma of the jaw bones

Osteosarcoma of the jaw bone is comparatively rare and accounts for about 6.5% of all osteosarcomas. We treated eight cases of osteosarcoma of the jaw bone involving the mandible and maxilla in equal proportions between 1986-1992. The median age was 31 years and male: female ratio was 5:3. Swelling and bony expansion were the most common presentations. Radiologically six patients had lytic lesions, and histopathologically they were osteoblastic (n = 4), chondroblastic (n = 3) and fibroblastic (n = 1). Three patients, two with mandibular and one with maxillary osteosarcoma underwent radical surgery and six courses of cisplatinum-based chemotherapy. All were alive and disease free 24, 30, and 54 months after treatment. Histologically all three were chondroblastic. Five patients had incomplete or palliative treatment. All patients died of progressive or locally recurrent disease within 2 years.

Atrioventricular septal defect and tetralogy of Fallot: a 15-year experience

AIM

Atrioventricular septal defect and tetralogy of Fallot is a relatively uncommon lesion in which there is a risk of right ventricular dysfunction related to inlet and outlet valve problems. For this reason, conservative management involving an initial palliative procedure is often chosen. The aim of this report is to retrospectively review our experience with this lesion.

PATIENT POPULATION

35 patients with atrioventricular septal defect and tetralogy of Fallot have been surgically managed at this institution between January 1980 and June 1995. Twenty-one (60%) of these patients underwent 28 initial palliative shunt procedures. Fourteen (40%) patients underwent primary definitive repair. The criteria for choosing one management strategy over another was based on a number of factors, including age at presentation, anatomy of the lesion, and severity of symptoms. Of the 21 patients who underwent an initial shunt procedure, 15 have undergone definitive operation. Of the 6 patients who did not undergo definitive operation, three died (two directly related to complications of the shunt procedure), two are awaiting operation, and one was lost to follow-up.

RESULTS

The primary indication for operation in all patients was cyanosis. Freedom from reoperation at 5 years after definitive operation was 65.1% for all patients; most reoperations were related to left atrioventricular valve regurgitation or residual leaks across the ventricular septal defect patch. The operative mortality at definitive operation was 10.3% (70% CL 4.5-20%) for all patients. The actuarial estimate of survival 7 years following definitive repair was 77.3% (70% CL 68.7-85.9%) for all patients. The actuarial estimate of survival at 7 years was 84.4% (70% CL 73.8-95%) in the patients undergoing primary repair and 65% (70% CL 52.4-77.6%) in patients initially palliated if the mortality of the palliative shunt procedure is included (P = 0.35).

CONCLUSION

Patients with atrioventricular septal defect and tetralogy of Fallot can be successfully managed with a variety of surgical strategies. Primary repair may be a reasonable option in carefully selected patients, as this eliminates the morbidity and mortality of an initial shunt procedure and the subsequent interval between initial palliation and definitive repair.

Diagnosis of clival chordoma by fine needle aspiration of an oropharyngeal mass. A case report

A sphenooccipital chordoma presenting as a large nasopharyngeal mass extending into the oropharynx was diagnosed by transoral fine needle aspiration biopsy (FNAB) and confirmed by subsequent histologic studies. The cytologic features of chordoma are presented, and the diagnostic utility of FNAB in evaluating similar lesions in the head and neck region is discussed.

Cytogenetic and viral studies in nasopharyngeal carcinomas in patients of Indian origin

Four cases of undifferentiated nasopharyngeal carcinomas (NPC) (grade III-IV) in patients of Indian origin were investigated for specific chromosome markers and evidence of Epstein-Barr virus (EBV) positivity. Abnormalities involving chromosome #3, like del (3) (p24-pter) and 3q+(q27-qter) were found in these patients, similar to earlier reports in patients of Chinese and Kenyan origin2,4,13 who however were EBV positive, unlike the patients in this study who were EBV negative. Implications of the cytogenetic and serological data in Indian patients with NPC, available for the first time, may throw some light on the etiology of the disease in this ethnic group where nasopharyngeal carcinoma is also endemic.

Donor-gifted allograft lithiasis: extracorporeal shockwave lithotripsy with over table module using the Lithostar Plus

Allograft lithiasis is usually secondary. Donor-graft lithiasis is a rare cause and only 5 cases have been reported. We report 2 such cases which are the first in the live-related transplantation programme. The pressing need to increase the donor pool in developing countries, safety of therapy in graft lithiasis coupled with minimal estimated risk of lithiasis recurrence in the donor are the main justifications for accepting calculi bearing kidney for transplantation. The 2 cases underwent extracorporeal shockwave lithotripsy using the overhead table module of the Lithostar Plus. The technical ease of lithotripsy using an on-line ultrasound module in these 'ectopically' placed kidneys is discussed. The effect of shockwaves on allograft function was studied by a pre- and post-renal scan (99Tc-DTPA) and serum creatinine. No adverse effect of shockwave on allograft function was noted both on short- and long-term follow-up.

Should elderly donors be accepted in a live related renal transplant program?

It is a matter of concern that the elderly donor may have increased risks in the peri-operative period due to age-related changes in various organ. Nephrosclerosis, atherosclerosis and low GFR of an elderly kidney may portend a poor graft outcome. A retrospective analysis of our live related renal transplant program (from June 1989 to December 1993) revealed that 27 of the donors were above 60 years of age. 21 of the recipients have been followed up for more than 1 year. These patients were compared with a cohort of 25 patients (donor age < 45 years) with similar HLA match, immunosuppressive protocol, and follow-up period more than 1 year. Graft survival at 1 year was 86% and 88% in the recipients from elderly and younger donors respectively; 1 patient in the control group died of fulminant sepsis. Mean follow-up was 21.6 months in the study group and 22.8 months in the control group. Allograft function was evaluated by serum creatinine and differential GFR by Tc DTPA scan. Serum creatinine (mg%) was 1.3 +/- 0.2 and 1.4 +/- 0.2 in the study group and 1.3 +/- 0.3, 1.2 +/- 0.3 in the control group at 3 and 12 months respectively. Glomerular filtration rate (ml/min) was 36.5 +/- 11.6 and 43.7 +/- 12.4 in the recipients from elderly donors whereas those from the younger donors had GFR (ml/min) of 40.6 +/- 9.6 and 49.6 +/- 14.2 at 3 and 12 months respectively, GFR continued to improve in both groups with follow-up. There was no difference in incidence or severity of ATN In the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Ureterovaginal fistula: an unusual complication of stone fragments after extracorporeal shock wave lithotripsy in situ

We report a case of impaction of stone fragments in the lower ureter after extracorporeal shock wave lithotripsy in situ of an upper ureteral calculus resulted in a ureterovaginal fistula. Ureteroscopic retrieval of fragments and stenting provided symptomatic relief. The pathogenesis of this complication, which to our knowledge has not been reported previously, is discussed.

Should upper ureteral calculi be manipulated before extracorporeal shock wave lithotripsy? A prospective controlled trial

Whether all upper ureteral stones must be manipulated before extracorporeal shock wave lithotripsy (ESWL*) is an ongoing controversy. In a prospective trial, symptomatic patients with solitary upper ureteral calculi less than 1 year in duration were alternated between ESWL in situ and pre-ESWL stone manipulation. Pretreatment excretory urograms were assessed for stone size and degree of proximal hydroureteronephrosis, which was graded from zero (no dilatation) to 3 (severe dilatation). Stone manipulation was done with the patient under intravenous sedation and local anesthesia. A total of 4,000 shock waves was given in a single session using Siemens Lithostar Plus, and treatment was repeated on days 4, 15 and 30 if required. The patients were evaluated 3 months after onset of therapy with excretory urogram and urine culture. Seventy patients qualified for the study (group 1-35 in situ and group 2-35 stone manipulation) and were comparable in relation to age and sex, stone size and degree of hydronephrosis. There was no significant difference between the 2 groups regarding the number of sessions (group 1-1.86 +/- 1.2 and group 2-2.03 +/- 1.2) or shock wave requirement (group 1-5,705.8 +/- 3,536.9 and group 2-5,549.1 +/- 3,837.2) for stone fragmentation. The degree of proximal dilatation did not contribute significantly towards the outcome (F ratio 0.675, p = 0.57). A total of 30 patients (85.5%) in group 1 had a satisfactory outcome at 3 months, while 3 (8.5%) had significant residual calculi and 2 stones could not be fragmented. Of the manipulated stones 33 (94%) were successfully cleared, while 2 patients required auxiliary procedures. Ureteroscopy was required in 1 patient for upward migration of the stent. Morbidity in both groups was comparable. We conclude that upper ureteral stones should be treated in situ to avoid the morbidity of manipulation.

Fine needle aspiration cytology of chondroblastoma and chondromyxoid fibroma. A report of two cases

The fine needle aspiration cytology in two cases of chondroblastoma and chondromyxoid fibroma are described. The diagnosis of chondroblastoma was made on a recurrent tumor of which the histopathology was known, whereas chondromyxoid fibroma was diagnosed initially on fine needle aspiration cytology. The radiologic appearances and differential diagnoses of these chondroid neoplasms are discussed.

Sclerosing stromal tumour of the ovary

Sclerosing stromal tumour (SST) of the ovary is a rare entity. It is a benign neoplasm which forms a distinct subgroup separate from the other ovarian stromal tumours, including thecomafibromas, by virtue of its unique histology. One such tumour in a 25-year old female is reported.

Endopyelotomy and pyeloplasty: face to face

46 symptomatic adult patients with documented ureteropelvic junction obstruction were treated with pyeloplasty (n = 23) or endopyelotomy (n = 23). Basic characteristics in both the groups were comparable. The technical aspects, complications and outcome, in the form of improvement in function and drainage patterns, were compared in both the groups. Endopyelotomy enjoyed the significant advantages of a shorter operating time and hospital stay, and obviously better cosmetic acceptance. The major complications in the endopyelotomy groups were related to external drainage and secondary infection in the form of fever, secondary hemorrhage and slippage of tubes in 44, 9 and 13% of cases, respectively. Complications associated with pyeloplasty were prolonged urinary leak, wound infection and urinary tract infection in 12, 17 and 22% of cases, respectively. Using 99Tc-DTPA diuretic scan, an improvement of more than 10% in split renal function could not be documented for any case from either group. In none of the patients did the function deteriorate either. Of all evaluable cases, only 1 in the pyeloplasty group showed a persistent obstructive pattern. The rest all demonstrated adequate drainage across the ureteropelvic junction. Overall in 12 cases (8 pyeloplasty, 4 endopyelotomy) drainage could not be determined postoperatively due to poor radionuclide uptake. A nephrostogram and/or pressure flow study, however, demonstrated a nonobstructive pattern in all these patients. It is concluded that endopyelotomy scores over pyeloplasty with a shorter operating time and hospital stay. The complication rate and outcome following surgery, however, are comparable in both the groups. Using external drainage following endopyelotomy, early resumption of work, however, could not be obtained.

Mycotic pulmonary artery aneurysm following pulmonary artery banding

A neonate with situs inversus, transposition of the great arteries, ventricular septal defect, criss-cross ventricles and hypoplastic right ventricle underwent pulmonary artery banding at the age of 7 days. The course was complicated by septicaemia and subsequently the development of an aneurysm of the pulmonary artery. Serratia marcessans was grown from the band site. The pulmonary artery aneurysm was resected and the pulmonary artery was repaired. The literature is reviewed with the emphasis on diagnosis, natural history and surgical management.

Interjugular neck dissection and post-operative irradiation for neck control in advanced glottic cancers--are we justified?

At the Kidwai Memorial Institute of Oncology, advanced laryngeal cancers are subjected routinely to primary surgery and/or post-operative radiotherapy (RT). The surgery consists of wide field laryngectomy which entails total laryngectomy, ipsilateral/bilateral thyroid lobectomy, bilateral paratracheal clearance, and bilateral clearance of levels 2, 3 and 4 lymphatics. Post-operative RT is indicated in event of the following histopathological (HPE) situations to consolidate local-regional control: (1) T4 primary; (2) significant subglottic extension; and (3) jugular/paratracheal metastatic deposits. This prospective study highlights the therapeutic efficacy of this protocol at our centre in 45 consecutive T4/T3 glottic cancers and specifically evaluates the role of interjugular dissection and/or post-operative RT in prevention of regional recurrence. Fifty-two per cent of primary lesions needed a post-surgical upstaging as against 14 per cent of the neck lesions. Accordingly 91 per cent of the cases (41/45) qualified for post-operative RT and 82 per cent (37/41) complied with the prescribed schedule. Recurrent disease in the lateral neck was noted in 2/37 who received the prescribed schedule and 1/4 non-compliant cases; while a recurrent central neck disease was noted in 1/37 and 1/4 of these cases respectively. All cases were followed-up for a period of two years and 66 per cent of the evaluable cases for a period of five years. This study confirms conclusively that our treatment schedule yields extremely gratifying two-year local-regional control rates of 89 per cent which translates into a two and five-year actuarial survival rate of 92 and 70 per cent respectively.

Salivary duct carcinoma

Salivary duct carcinoma is an uncommon malignant tumor that occurs mainly in the parotid gland of elderly men. The 11 cases of salivary duct carcinoma which are included in this study occurred in older men (mean age 56 years) and were located in the parotid (7), submandibular salivary gland (2), and the minor salivary glands in the maxilla (2). The maximum tumor dimension ranged from 3 to 9 cm. Microscopically, all had infiltrating margins, with circumscribed groups of epithelial cells arranged in various patterns; the invasive component was embedded in a desmoplastic stroma. Perineural invasion and lymph node metastasis were noted in seven and three cases, respectively, at the time of initial surgery. Radical surgery was offered to ten patients and postoperative radiotherapy to nine patients. Salivary duct carcinoma appears to be an aggressive tumor with distinctive histological features, which has not been described in the minor salivary glands of the maxilla to date. The clinicopathologic features of these tumors are presented, with a review of the literature.

Fine needle aspiration biopsy cytology of chondrosarcoma

The cytomorphological appearances of bone and soft tissue tumours, when combined with radiology and clinical presentation, can lead to a positive diagnosis in the majority of cases. Our experience with fine needle aspiration biopsy of 13 cases of chondrosarcoma, encountered over a four year period is presented, in correlation with their radiological appearances. It is concluded that. FNAB is a valuable pre-operative tool in characterising chondroid neoplasms in soft tissue and bone.

Aspiration biopsy cytology of primary bone lesions

Fine needle aspiration cytology of 79 primary bone lesions was done, and the clinical and radiologic features were correlated with cytopathology. Seventy-four of these cases were primary malignant bone tumors, two cases each were tumor-like or inflammatory lesions, and one case was a benign bone tumor. Osteosarcoma (37.7%) and Ewing's sarcoma (15.6%) were the most common primary lesions. Correlation with histopathology was possible in 37 cases, and an accuracy rate of 94.1% was achieved. There was an 89% correlation between radiologic and cytologic diagnoses. It was concluded that in this oncology center a working diagnosis based on cytology was possible in almost all cases after correlating with the radiologic findings. However, when there was a discrepancy between the clinical, radiologic and cytologic diagnoses, an open biopsy was mandatory.

Antidiabetic effect of a glycoside of pelargonidin isolated from the bark of Ficus bengalensis Linn

The antidiabetic effect of a dimethoxy derivative of perlargonidin 3-O-alpha-L rhamnoside (250 mg/kg, single dose study and 100 mg/kg/day long term study) isolated from the bark of Ficus bengalensis Linn. has been compared with that of glibenclamide (2 mg/kg and 0.5 mg/kg/day respectively) in moderately diabetic rats. The single dose glycoside treatment decreased fasting blood glucose by 19% and improved glucose tolerance by 29%. The corresponding effects of glibenclamide were 25% and 66% respectively over the control values. On one-month treatment the fasting blood glucose levels went down almost to half of the pretreatment levels in both the groups and their glucose tolerance improved by 41% in glibenclamide group and by 15% in glycoside treated group. Urine sugar decreased to traces in both the groups and they appeared healthy. In vitro studies showed that insulin secretion by beta-cells was more in presence of the pelargonidin derivative than in presence of a leucocyanidin derivative, reported to be a good anti-diabetic agent.

Frozen sections--a retrospective study

Two hundred and forty-four (244) specimens were examined by frozen section (FS) from 1987 through 1988 at the Kidwal Memorial Institute of Oncology. Of these, eleven (11) were performed for evaluation of the surgical margin of tumours and fifty four (54) for detection of lymph node metastasis. All these examinations (65) proved to be hundred percent (100%) accurate. The remaining 179 frozen sections were performed for the diagnosis of an unknown pathologic process. Of these, 44.69 percent were precisely diagnosed, in 41.9 percent the pathologic process was correctly but not precisely diagnosed, in 11.17 per cent the diagnosis was deferred and remaining 2.24 percent were incorrectly diagnosed with no harmful consequences to the patients. By eliminating the cases where diagnosis was deferred and combining results of "precise diagnosis" with those of "correct pathologic process", the overall accuracy rate was 98.2 percent. Thus, FS has greater benefit when used for the general diagnosis of an unknown pathologic process rather than for an exact or precise diagnosis.