Chondromatous Metaplasia of Oropharynx: A Rare Occurrence

We discuss a case of 53 year old man who presented with dysphagia and a pink mass behind the soft palate. He was a chronic smoker and alcoholic and had no co morbidities. The patient underwent surgical excision of the mass under general anesthesia. Mass was excised fully and histopathology determined it as a chondromatous metaplasia of larynx. Post operative period was uneventful and there was no recurrence of the lesion. We believe that chondromatous metaplasia of oropharynx is extremely rare.

Combined Conventional and Endoscopic Microdebrider-Assisted Adenoidectomy: A Tertiary Centre Experience

INTRODUCTION

Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy.

AIM

To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure.

MATERIALS AND METHODS

This is a prospective study of 60 child patients who underwent combined conventional and endoscopic microdebrider-assisted adenoidectomy. The study was conducted from September 2013 to September 2015. Only child patients with grade 3 and grade 4 Adenoid Hypertrophy (AH) was included in the study. At the end of conventional adenoidectomy and after combined procedure, the AH was graded again. Post-operative complications like neck pain, hypernasality and swallowing problems were noted. Their symptom score was reviewed before surgery and after one month and one year of surgery. The duration of surgery and amount of blood loss was recorded.

RESULTS

By this technique, complete clearance of adenoid tissue was obtained in all 60 (100%) cases. The mean pre-operative symptom score for AH was 3.7, which improved to 0 after one month of combined conventional and endoscopic microdebrider-assisted adenoidectomy. All child patients were symptom-free at the end of one month and one year. The duration of conventional adenoidectomy was 5 minutes 12 seconds while total duration of the combined conventional and endoscopic microdebrider-assisted adenoidectomy was 14 minutes 45 seconds. There was no significant blood loss (15±3 ml approximately). There were no major complications in this study.

CONCLUSION

The combined approach of conventional curette along with endoscopic microdebrider-assisted adenoidectomy is a safe and effective method for complete and accurate removal of large adenoids.

Outcomes of Capsular Dissection Technique with Use of Bipolar Electrocautery in Total Thyroidectomy: A Rural Tertiary Center Experience

INTRODUCTION

Total thyroidectomy is one of the most routinely performed head and neck surgical procedures with extremely low mortality. This procedure has been associated with two major complications such as recurrent laryngeal nerve injury and hypocalcaemia due to parathyroid insufficiency. The use of bipolar electrocautery has not been widely accepted in view of thermal damage to adjacent structures.

AIM

To study the outcomes and complications of capsular dissection technique along with use of bipolar electrocautery in total thyroidectomy.

MATERIALS AND METHODS

The study was conducted from May 2013 to May 2016. The study was performed at Department of ENT Otorhinolayngology, DM WIMS Hospital, Wayanad, Kerala, India. This retrospective descriptive study analysed the outcome of 130 patients who underwent total thyroidectomy by capsular dissection technique along with use of bipolar electrocautery for cauterization of vascular pedicles, at our institution over a 3 year period.

RESULTS

The incidence of permanent unilateral vocal cord palsy was 1.5% and permanent hypocalcaemia was 2.3%. There was no case of haemorrhage or haematoma in this study.

CONCLUSION

Total thyroidectomy by capsular dissection technique along with the use of bipolar electrocautery has very low incidence of recurrent laryngeal nerve and parathyroid injury, as per our data. Hence, we recommend this technique along with routine use of bipolar electrocautery for total thyroidectomy.

Handheld Fluorometers for Lab-on-a-Chip Applications

We describe the design, fabrication, and performance of a class of simple handheld fluorometers. The devices consist of a sensor along with an integrated optical filter packaged in a handheld format. The sensor is a differential active pixel sensor with in-pixel correlated double sampling fabricated in a 0.5-mu m 2-poly 3-metal complementary metal-oxide semiconductor process and has a readout noise of 175.3 muV, reset noise of 360 muV, dynamic range of 59 dB, and conversion gain of 530 nV/e(-) . The filter is a high rejection chromophore embedded in a polymer film which is cast onto the chip. We show the results of bioassays utilizing two different single color fluorometers constructed by using the chromophores 2-(2'-hydroxy 5'-methylphenyl) benzotriazole and Sudan II with long-pass wavelengths of 400 nm and 540 nm, respectively. The bioassays measures metabolic activity and viability of biological cells, which are useful for cytotoxicity and pathogen detection applications.

252. Regulated nuclear import of TATA binding protein associated factor 9 (TAF9) in spermatogenesis

Spermatogenesis, the differentiation process resulting in the production of haploid germ cells able to fertilise an oocyte, is driven by nuclear transcription factors, and changes in nuclear morphology and function itself. Signal-dependent transport into and out of the nucleus is mediated by members of the importin (IMP) superfamily of transporters, which we have previously shown to change dynamically in expression profile during spermatogenesis. One IMP family member, IMPα2, is expressed during mid to late phase spermatogenesis, implying that it may transport specific cargoes important for these stages, with a potential cargo of significance identified in a yeast 2-hybrid screen being TAF9 (TATA-Binding Protein Associated Factor 9). TAF9 is an integral part of transcription initiation for many genes, such as those with a Downstream Promoter Element in the core promoter and those with activators such as SOX18, p53, HSF1, NF-IL6 or NF-κB. In addition it participates in histone acetylation complexes which have been previously described to be important for the completion of spermatogenesis. Our preliminary data confirm the interaction of IMPα2 and TAF9 using a cotransfection approach. We have also shown that the expression of these proteins in the testis is correlated using both publically available Affymetrix data, and immunohistochemistry staining. TAF9, like IMPα2, is expressed in the nucleus of elongating spermatids of the adult rodent testis. Our data are thus consistent with the idea that specific nuclear import of TAF9 by IMPα2 may be a critical step in the later stages of spermatogenesis.

Optimization of culture conditions for the production of haloalkaliphilic thermostable protease from an extremely halophilic archaeon Halogeometricum sp. TSS101

AIMS

Isolation and screening of extreme halophilic archaeon producing extracellular haloalkaliphilic protease and optimization of culture conditions for its maximum production.

METHODS AND RESULTS

Halogeometricum sp. TSS101 was isolated from salt samples and screened for the secretion of protease on gelatin and casein plates containing 20% NaCl. The archaeon was grown aerobically in a 250 ml flask containing 50 ml of (w/v) NaCl 20%; MgCl(2) 1%; KCl 0.5%; trisodium citrate 0.3%; and peptone 1%; pH 7.2 at 40 degrees C on rotary shaker. The production of enzyme was investigated at various pH, temperatures, NaCl concentrations, metal ions and different carbon and nitrogen sources. The partially purified protease had activity in a broad pH range (7.0-10.0) with optimum activity at pH 10.0 and a temperature (60 degrees C). The enzyme was thermostable and retained 70% initial activity at 80 degrees C. Maximum protease production occurred at 40 degrees C in a medium containing 20% NaCl (w/v) and 1% skim milk powder after 84 h in shaking culture. Enzyme secretion was observed at a broad pH range of 7.0-10.0. Addition of CaCl(2) (200 mmol) to the culture medium enhanced the production of protease. Protein rich flours proved to be cheap and good alternative source for enzyme production. Different osmolytes were tested for the growth and production of haloalkaliphilc protease and found that betaine and glycerol enhanced growth without secretion of the protease. Immobilization studies showed that whole cells immobilized in 2% alginate beads were stable up to 10 batches and able to secrete the protease, which attained maximum production within 60 h under shaking conditions.

CONCLUSIONS

Halogeometricum sp. TSS101 secreted an extracellular haloalkaliphilic and thermostable protease. The optimum conditions required for maximum production are 20% NaCl, 1% skim milk powder and temperature at 40 degrees C. Addition of CaCl(2) (200 mmol) enhanced the enzyme production. Immobilization of whole cells in absence of NaCl proved to be useful for continuous production of haloalkaliphilic protease.

SIGNIFICANCE AND IMPACT OF THE STUDY

The low cost protein rich flours were used as an alternative carbon and nitrogen sources for enzyme production. Immobilization of halophilic cells in alginate beads can be used in continuous production of halophilic enzyme. The halophilic and thermostable protease from Halogeometricum sp. TSS101 is good source for industrial applications and can be a suitable source for preparation of fish sauce.