Microfluidic Diffusional Sizing (MDS) Measurements of Secretory Neutralizing Antibody Affinity Against SARS-CoV-2

SARS-CoV-2 has rampantly spread around the globe and continues to cause unprecedented loss through ongoing waves of (re)infection. Increasing our understanding of the protection against infection with SARS-CoV-2 is critical to ending the pandemic. Serological assays have been widely used to assess immune responses, but secretory antibodies, the essential first line of defense, have been studied to only a limited extent. Of particular interest and importance are neutralizing antibodies, which block the binding of the spike protein of SARS-CoV-2 to the human receptor angiotensin-converting enzyme-2 (ACE2) and thus are essential for immune defense. Here, we employed Microfluidic Diffusional Sizing (MDS), an immobilization-free technology, to characterize neutralizing antibody affinity to SARS-CoV-2 spike receptor-binding domain (RBD) and spike trimer in saliva. Affinity measurement was obtained through a contrived sample and buffer using recombinant SARS-CoV-2 RBD and monoclonal antibody. Limited saliva samples demonstrated that MDS applies to saliva neutralizing antibody measurement. The ability to disrupt a complex of ACE2-Fc and spike trimer is shown. Using a quantitative assay on the patient sample, we determined the affinity and binding site concentration of the neutralizing antibodies.

Certain heterozygous variants in the kinase domain of the serine/threonine kinase NEK8 can cause an autosomal dominant form of polycystic kidney disease

Autosomal dominant polycystic kidney disease (ADPKD) resulting from pathogenic variants in PKD1 and PKD2 is the most common form of PKD, but other genetic causes tied to primary cilia function have been identified. Biallelic pathogenic variants in the serine/threonine kinase NEK8 cause a syndromic ciliopathy with extra-kidney manifestations. Here we identify NEK8 as a disease gene for ADPKD in 12 families. Clinical evaluation was combined with functional studies using fibroblasts and tubuloids from affected individuals. Nek8 knockout mouse kidney epithelial (IMCD3) cells transfected with wild type or variant NEK8 were further used to study ciliogenesis, ciliary trafficking, kinase function, and DNA damage responses. Twenty-one affected monoallelic individuals uniformly exhibited cystic kidney disease (mostly neonatal) without consistent extra-kidney manifestations. Recurrent de novo mutations of the NEK8 missense variant p.Arg45Trp, including mosaicism, were seen in ten families. Missense variants elsewhere within the kinase domain (p.Ile150Met and p.Lys157Gln) were also identified. Functional studies demonstrated normal localization of the NEK8 protein to the proximal cilium and no consistent cilia formation defects in patient-derived cells. NEK8-wild type protein and all variant forms of the protein expressed in Nek8 knockout IMCD3 cells were localized to cilia and supported ciliogenesis. However, Nek8 knockout IMCD3 cells expressing NEK8-p.Arg45Trp and NEK8-p.Lys157Gln showed significantly decreased polycystin-2 but normal ANKS6 localization in cilia. Moreover, p.Arg45Trp NEK8 exhibited reduced kinase activity in vitro. In patient derived tubuloids and IMCD3 cells expressing NEK8-p.Arg45Trp, DNA damage signaling was increased compared to healthy passage-matched controls. Thus, we propose a dominant-negative effect for specific heterozygous missense variants in the NEK8 kinase domain as a new cause of PKD.

Evaluation of Flow Rate, pH, and Buffering Capacity of Saliva in Children with Caries, Fluorosis, and Caries with Fluorosis

Background

Saliva is one of the most important aids in the diagnosis of various oral diseases. Few physicochemical properties of saliva such as flow rate, pH, and buffering capacity often vary with the occurrence of dental caries, fluorosis, and other systemic conditions.

Purpose

The aim of the study was to evaluate the relationship between the salivary flow rate, pH, and buffering capacity in healthy children, children with caries, children with fluorosis, and children with both caries + fluorosis.

Materials and methods

The study population consisted of 144 children aged 7-14 years and were divided into four groups of 36 children each. Group I, 36 healthy children with no caries and fluorosis; group II, 36 children with caries (dmfs ≤ 10); group III, 36 children with fluorosis (moderate to severe); and group IV, 36 children with caries + fluorosis. Unstimulated saliva is collected from all the selected subjects and evaluated for the salivary flow rate, pH, and buffering capacity. The recorded data were tabulated and statistically analyzed using a paired t-test.

Results

The mean salivary flow rate and buffering capacity were found to be highest in group III when compared with all the other groups. The mean pH was greater in group I when compared with groups I, II, and III.

Conclusion

The physicochemical properties of saliva like pH, buffering capacity, and salivary flow rate alter with caries and fluorosis conditions. Hence, more clinical and laboratory studies are needed to determine the exact relationship between these physicochemical properties of saliva in dental caries and fluorosis.

How to cite this article

E RR, S S, M K, et al. Evaluation of Flow Rate, pH, and Buffering Capacity of Saliva in Children with Caries, Fluorosis, and Caries with Fluorosis. Int J Clin Pediatr Dent 2023;16(4):587-590.

Sleep disturbances in Phelan-McDermid syndrome: Clinical and metabolic profiling of 56 individuals

Phelan-McDermid Syndrome (PMS) is caused by deletions at chromosome 22q13.3 or pathogenic/likely pathogenic SHANK3 variants. The clinical presentation is extremely variable and includes global developmental delay/intellectual disability (ID), seizures, neonatal hypotonia, and sleep disturbances, among others. This study investigated the prevalence of sleep disturbances, and the genetic and metabolic features associated with them, in a cohort of 56 individuals with PMS. Sleep data were collected via standardized observer/caregiver questionnaires, while genetic data from array-CGH and sequencing of 9 candidate genes within the 22q13.3 region, and metabolic profiling utilized the Biolog Phenotype Mammalian MicroArray plates. Sleep disturbances were present in 64.3% of individuals with PMS, with the most common problem being waking during the night (39%). Sleep disturbances were more prevalent in individuals with a SHANK3 pathogenic variant (89%) compared to subjects with 22q13.3 deletions of any size (59.6%). Distinct metabolic profiles for individuals with PMS with and without sleep disturbances were also identified. These data are helpful information for recognizing and managing sleep disturbances in individuals with PMS, outlining the main candidate gene for this neurological manifestation, and highlighting potential biomarkers for early identification of at-risk subjects and molecular targets for novel treatment approaches.

Identification and diagnosis of long COVID-19: A scoping review

Long COVID-19 (LC-19) is a condition that has affected a high percentage of the population that recovered from the initial disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). LC-19 diagnosis is currently poorly defined because of its variable, multisystem, episodic symptoms, and lack of uniformity in the critical time points associated with the disease. Considering the number of cases, workers' compromised efficiency or inability to return to their duties can affect organizations and impact economies. LC-19 represents a significant burden on multiple levels and effectively reduces quality of life. These factors necessitate the establishment of firm parameters of diagnoses to provide a foundation for ongoing and future studies of clinical characteristics, epidemiology, risk factors, and therapy. In this scoping review, we conducted a literature search across multiple publication sites to identify papers of interest regarding the diagnosis of LC-19. We identified 225 records of interest and categorized them into seven categories. Based on our findings, there are only 11 original papers that outline the diagnostic process in detail with little overlap. This scoping review highlights the lack of consensus regarding the definition and, thereby, the LC-19 diagnosis processes. Due to no clear directive and considering the many unknowns surrounding the natural history of the disease and further recovery/sequelae from COVID-19, continued discussion and agreement on a definition/diagnosis will help future research and management of these patients.

Functional assessment of homozygous ALDH18A1 variants reveals alterations in amino acid and antioxidant metabolism

Mono- and bi-allelic variants in ALDH18A1 cause a spectrum of human disorders associated with cutaneous and neurological findings that overlap with both cutis laxa and spastic paraplegia. ALDH18A1 encodes the bifunctional enzyme pyrroline-5-carboxylate synthetase (P5CS) that plays a role in the de novo biosynthesis of proline and ornithine. Here we characterize a previously unreported homozygous ALDH18A1 variant (p.Thr331Pro) in four affected probands from two unrelated families, and demonstrate broad-based alterations in amino acid and antioxidant metabolism. These four patients exhibit variable developmental delay, neurological deficits and loose skin. Functional characterization of the p.Thr331Pro variant demonstrated a lack of any impact on the steady-state level of the P5CS monomer or mitochondrial localization of the enzyme, but reduced incorporation of the monomer into P5CS oligomers. Using an unlabeled NMR-based metabolomics approach in patient fibroblasts and ALDH18A1-null human embryonic kidney cells expressing the variant P5CS, we identified reduced abundance of glutamate and several metabolites derived from glutamate, including proline and glutathione. Biosynthesis of the polyamine putrescine, derived from ornithine, was also decreased in patient fibroblasts, highlighting the functional consequence on another metabolic pathway involved in antioxidant responses in the cell. RNA sequencing of patient fibroblasts revealed transcript abundance changes in several metabolic and extracellular matrix-related genes, adding further insight into pathogenic processes associated with impaired P5CS function. Together these findings shed new light on amino acid and antioxidant pathways associated with ALDH18A1-related disorders, and underscore the value of metabolomic and transcriptomic profiling to discover new pathways that impact disease pathogenesis.

Clinical and functional characterization of germline PIK3CA variants in patients with PIK3CA-related overgrowth Spectrum disorders

Mosaic variants in the PIK3CA gene, encoding the catalytic subunit of phosphatidylinositol 3-kinase (PI3K), produce constitutive PI3K activation which causes PIK3CA-related overgrowth spectrum (PROS) disorders. To date, fewer than 20 patients have been described with germline alterations in PIK3CA. In this study, we describe three unrelated individuals with overgrowth and germline PIK3CA variants. These variants were discovered through whole-exome sequencing and confirmed as germline by testing multiple tissue types, when available. Functional analysis using Patient 1’s fibroblast cell line and two previously reported patients’ cell lines showed increased phosphorylation of AKT during cellular starvation revealing constitutive activation of the PI3K/AKT/mTOR pathway. Alternatively, stimulation of the cells by fetal bovine serum produced a reduced response, indicating an activated status of the PI3K complex reducing the pathway response to further external stimulation. Additional studies utilizing Biolog Phenotype Microarray technology indicated reduced energy production when cells were exposed to growth factors stimulating the PI3K/AKT/mTOR pathway, confirming the trend observed in the AKT phosphorylation test after stimulation. Furthermore, treatment with inhibitors of the PI3K/AKT/mTOR pathway rescued the normal energy response in the patients’ cells. Collectively, these data demonstrate that disease-causing germline PIK3CA variants have a functional consequence, similar to mosaic variants in the PI3K/AKT/mTOR pathway.

Ray tracing biometry in post radial keratotomy eye

OBJECTIVE

To report a case of post radial keratotomy (RK) cataract in a 55-year-old lady wherein biometry was done by ray-tracing method incorporated in scheimpflug topographer (Sirius + Scheimpflug Analyzer, CSO, Italy).

METHOD

In our case, we performed intraocular lens (IOL) power calculation using a recent concept of ray tracing with scheimpflug topographer and compared with traditional methods available at American Society of Cataract and Refractive Surgery(ASCRS) website (www.ascrs.org) for eyes with prior RK. Phacoemulsification was performed and a monofocal + 24.5D IOL implanted in the capsular bag.

RESULT

Manifest refraction at six weeks postoperative period was + 1.0DS/-2.0DC × 75° with spherical equivalence of 0. On comparison of all the methods used to calculate IOL power, the absolute errors of ray tracing and Barrett true K were found to be the least, 0.14 and 0.18 respectively.

CONCLUSION

Ray tracing biometry with scheimpflug topographer seems to provide accurate IOL power in post RK eyes.

Survey on Diagnosing CORONA VIRUS from Radiography Chest X-ray Images Using Convolutional Neural Networks

Corona Virus continues to harms its effects on the people lives across the globe. The screening of infected persons has to be identified is a vital step because it is a fast and low-cost way. Certain above mentioned things can be recognized by chest X-ray images that plays a significant role and also used for examining in detection of CORONA VIRUS(COVID-19). Here radiological chest X-rays are easily available with low cost only. In this survey paper, Convolutional Neural Network(CNN) based solution that will benefit in detection of the Covid-19 positive patients using radiography chest X-Ray images. To test the efficiency of the solution, using data sets of publicly available X-Ray images of Corona virus positive cases and negative cases. Images of positive Corona Virus patients and pictures of healthy person images are divided into testing images and trainable images. The solution which are providing the good results with classification accuracy within the test set-up. Then GUI based application supports for medical examination areas. This GUI application can be used on any computer and performed by any medical examiner or technician to determine Corona Virus positive patients using radiography X-ray images. The result will be precisely obtaining the Covid-19 Patient analysis through the chest X-ray images and also results may be retrieve within a few seconds.

Genetic and metabolic profiling of individuals with Phelan-McDermid syndrome presenting with seizures

Phelan-McDermid syndrome (PMS) (OMIM*606232) is a rare genetic disorder characterized by intellectual disability, autistic features, speech delay, minor dysmorphia, and seizures. This study was conducted to investigate the prevalence of seizures and the association with genetic and metabolic features since there has been little research related to seizures in PMS. For 57 individuals, seizure data was collected from caregiver interviews, genetic data from existing cytogenetic records and Sanger sequencing for nine 22q13 genes, and metabolic profiling from the Phenotype Mammalian MicroArray (PM-M) developed by Biolog. Results showed that 46% of individuals had seizures with the most common type being absence and grand-mal seizures. Seizures were most prevalent in individuals with pathogenic SHANK3 mutations (70%), those with deletion sizes >4 Mb (16%), and those with deletion sizes <4 Mb (71%) suggesting involvement of genes in addition to SHANK3. Additionally, a 3 Mb genomic region on 22q13.31 containing the gene TBC1D22A, was found to be significantly associated with seizure prevalence. A distinct metabolic profile was identified for individuals with PMS with seizures and suggested among other features a disrupted utilization of main energy sources using Biolog plates. The results of this study will be helpful for clinicians and families in anticipating seizures in these children and for researchers to identify candidate genes for the seizure phenotype.

Position effects of 22q13 rearrangements on candidate genes in Phelan-McDermid syndrome

Phelan-McDermid syndrome (PMS) is a multi-system disorder characterized by significant variability in clinical presentation. The genetic etiology is also variable with differing sizes of deletions in the chromosome 22q13 region and types of genetic abnormalities (e.g., terminal or interstitial deletions, translocations, ring chromosomes, or SHANK3 variants). Position effects have been shown to affect gene expression and function and play a role in the clinical presentation of various genetic conditions. This study employed a topologically associating domain (TAD) analysis approach to investigate position effects of chromosomal rearrangements on selected candidate genes mapped to 22q13 in 81 individuals with PMS. Data collected were correlated with clinical information from these individuals and with expression and metabolic profiles of lymphoblastoid cells from selected cases. The data confirmed TAD predictions for genes encompassed in the deletions and the clinical and molecular data indicated clear differences among individuals with different 22q13 deletion sizes. The results of the study indicate a positive correlation between deletion size and phenotype severity in PMS and provide evidence of the contribution of other genes to the clinical variability in this developmental disorder by reduced gene expression and altered metabolomics.

Individuals with SATB2-associated syndrome with and without autism have a recognizable metabolic profile and distinctive cellular energy metabolism alterations

SATB2-associated syndrome (SAS) is a multisystemic disorder characterized by developmental delay often with concurrent autistic tendencies. This study aimed to characterize cellular metabolic pathways and energy metabolism from cells derived from individuals with SAS. The cellular production of NADH (nicotinamide adenine dinucleotide, reduced form) as determined by the Phenotype Mammalian MicroArrays was measured in lymphoblastoid cell lines derived from 11 subjects with a molecularly confirmed diagnosis of SAS and compared to a control population of 50 age-matched typically developing individuals. All patients were evaluated clinically by a multidisciplinary team. Eleven individuals (five in a screening cohort and six in the validation cohort, mean age 6.1 years) were recruited to the study. All individuals had developmental delay and the diagnosis of autism was previously established in five of them. Key metabolic findings included reduced NADH production in the presence of phosphorylated carbohydrates (with corresponding increased production in the presence of alternative carbon-based energy sources), increased response to certain hormones (β-estradiol in particular), and significantly reduced levels of NADH in wells containing tryptophan. The individual analysis revealed no particular differences among the SAS subjects based on molecular findings or phenotypic features. In conclusion, individuals with SAS have a common and recognizable metabolic profile. A lower capacity to utilize glucose as an energy substrate could be contributing to the neurodevelopment phenotype of SAS. The identified abnormalities offer previously unexplored insight into the potential pathophysiology of common SAS phenotypic features.

Efficacy and Safety of Eberconazole vs Sertaconazole in Localised Tinea Infection

BACKGROUND

Topical antifungals especially azole group of drugs are effective agents in the treatment of dermatophytoses producing 100% clinical and mycological cure. Each of them vary having specific characteristics to tackle several clinical challenges like high relapse rate, recurrences and quality of life.

AIMS AND OBJECTIVES

To compare the efficacy and safety of Eberconazole and Sertaconazole in tinea infection.

MATERIALS AND METHODS

This was a randomized, observer-blinded, parallel-group study conducted at a dermatology out-patient department (OPD) of tertiary care teaching hospital in Puducherry. 85 patients with tinea corporis and tinea cruris infections who visited the dermatology OPD were enrolled in this study. The treatment phase involved two groups receiving either Sertaconazole 2% cream or Eberconazole 1% applied topically twice daily for 4 weeks. At the end of treatment phase, there was a 'follow-up phase' at the end of 4 weeks, where the patients were assessed clinically and mycologically. The data were analyzed using descriptive statistics using MS Excel version 2019 and SPSS version 15 for Windows.

RESULTS

The primary efficacy variables namely change in pruritus, erythema, induration, scaling and mycological cure significantly improved in both the groups, as compared to baseline (P < 0.001), in the treatment phase and follow-up phase. Intergroup comparison with respect to pruritus and scaling showed significant difference (P < 0.001), suggestive of better reduction of pruritus and scaling scores at 4 weeks with Sertaconazole when compared to Eberconazole.

CONCLUSIONS

Sertaconazole was better than Eberconazole in relieving signs and symptoms of dermatophytoses, especially pruritus, thereby improving patients' quality of life.

Effect of Digitalized Previsit Imagery on Behavior of Children in the Dental Operatory

Aim and objective

The present study was aimed to determine the impact of exposure to digitalized previsit imagery technique on the anticipatory dental anxiety levels of children.

Design

40 children, aged 4-8 years requiring noninvasive dental treatment were included in the study. Preintervention anxiety levels were assessed using Venham picture test (VPT) in the waiting room and randomly divided into two groups. The study group was exposed to the digitalized previsit imagery technique which included a customized cartoon video of dental operatory and the concerned pediatric dentist in his/her own voice through WhatsApp messenger. The other group was dealt with the conventional approach using verbal and nonverbal communication. Postintervention anxiety was assessed in both the groups and the difference was compared.

Result

A significant difference in anticipatory dental anxiety was found between the two groups (p<0.001) using SPSS software. There was no marked relation of age and sex with the reduction of anxiety levels after exposure to digitalized previsit imagery.

Conclusion

The idea of digitalizing previsit imagery can be a time saving approach which is helpful in managing anxious children before entering the dental operatory.

How to cite this article

Reddy RE, Merum K, Mudusu SP, et al. Effect of Digitalized Previsit Imagery on Behavior of Children in the Dental Operatory. Int J Clin Pediatr Dent 2021;14(S-2):S124-S130.

Abnormalities in the genes that encode Large Amino Acid Transporters increase the risk of Autism Spectrum Disorder

Background

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder whose molecular mechanisms are largely unknown. Several studies have shown an association between ASD and abnormalities in the metabolism of amino acids, specifically tryptophan and branched‐chain amino acids (BCAAs).

Methods

Ninety‐seven patients with ASD were screened by Sanger sequencing the genes encoding the heavy (SLC3A2) and light subunits (SLC7A5 and SLC7A8) of the large amino acid transporters (LAT) 1 and 2. LAT1 and 2 are responsible for the transportation of tryptophan and BCAA across the blood–brain barrier and are expressed both in blood and brain. Functional studies were performed employing the Biolog Phenotype Microarray Mammalian (PM‐M) technology to investigate the metabolic profiling in lymphoblastoid cell lines from 43 patients with ASD and 50 controls with particular focus on the amino acid substrates of LATs.

Results

We detected nine likely pathogenic variants in 11 of 97 patients (11.3%): three in SLC3A2, three in SLC7A5, and three in SLC7A8. Six variants of unknown significance were detected in eight patients, two of which also carrying a likely pathogenic variant.

The functional studies showed a consistently reduced utilization of tryptophan, accompanied by evidence of reduced utilization of other large aromatic amino acids (LAAs), either alone or as part of a dipeptide.

Conclusion

Coding variants in the LAT genes were detected in 17 of 97 patients with ASD (17.5%). Metabolic assays indicate that such abnormalities affect the utilization of certain amino acids, particularly tryptophan and other LAAs, with potential consequences on their transport across the blood barrier and their availability during brain development. Therefore, abnormalities in the LAT1 and two transporters are likely associated with an increased risk of developing ASD.

Design of a Pilot SOFC System for the Combined Production of Hydrogen and Electricity under Refueling Station Requirements

The objective of the current work is to support the design of a pilot hydrogen and electricity producing plant that uses natural gas (or biomethane) as raw material, as a transition option towards a 100% renewable transportation system. The plant, with a solid oxide fuel cell (SOFC) as principal technology, is intended to be the main unit of an electric vehicle station. The refueling station has to work at different operation periods characterized by the hydrogen demand and the electricity needed for supply and self-consumption. The same set of heat exchangers has to satisfy the heating and cooling needs of the different operation periods. In order to optimize the operating variables of the pilot plant and to provide the best heat exchanger network, the applied methodology follows a systematic procedure for multi-objective, i.e. maximum plant efficiency and minimum number of heat exchanger matches, and multi-period optimization. The solving strategy combines process flow modeling in steady state, superstructure-based mathematical programming and the use of an evolutionary-based algorithm for optimization. The results show that the plant can reach a daily weighted efficiency exceeding 60%, up to 80% when considering heat utilization.

Genome-scale network model of metabolism and histone acetylation reveals metabolic dependencies of histone deacetylase inhibitors

Histone acetylation plays a central role in gene regulation and is sensitive to the levels of metabolic intermediates. However, predicting the impact of metabolic alterations on acetylation in pathological conditions is a significant challenge. Here, we present a genome-scale network model that predicts the impact of nutritional environment and genetic alterations on histone acetylation. It identifies cell types that are sensitive to histone deacetylase inhibitors based on their metabolic state, and we validate metabolites that alter drug sensitivity. Our model provides a mechanistic framework for predicting how metabolic perturbations contribute to epigenetic changes and sensitivity to deacetylase inhibitors.

Variability in Phelan-McDermid syndrome: The impact of the PNPLA3 p.I148M polymorphism

The PNPLA3 gene maps in the 22q13 region and can have modifying effects on the phenotype of patients with Phelan-McDermid syndrome (PMS). The PNPLA3 p.I148M variant was detected in two PMS patients presenting with refractory seizures, gastrointestinal issues, and liver dysfunction. The p.I148M variant leads to macrovescicular steaosis and predisposes to liver disorders from steatohepatitis to fibrosis. Accumulation of lipid macrovescicles in the hepatocytes affects several pathways, including the metabolismof anti-epileptics, possibly leading to the lack of response to anti-epileptic treatments reported in the two cases. Screening for the p.I148M variant can identify PMS patients at higher risk for liver dyfunction and help designing personalized therapeutic protocols.

Tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx: A study of 206 cases

INTRODUCTION

The nasal cavity, paranasal sinuses, and nasopharynx though in continuity form a complex system of upper respiratory tract; this region is endowed with a variety of elements such as epithelial, glandular, lymphoid, cartilage, and bone and is also exposed to a variety of infections, tumor-like and true neoplastic conditions.

AIMS AND OBJECTIVES

To find out the frequency of various tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx.

MATERIALS AND METHODS

The present study is an analysis of 206 tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx diagnosed during a period of 5 years.

RESULTS

The patients' age ranged from 14 months to 85 years. Benign lesions were predominant in the second and third decades, with 30 cases (68.1%) occurring in that age group. Malignancies occurred predominantly in the sixth and seventh decades with 28 (60.9%) cases in this age group. Benign lesions in the nasopharynx comprised 75% cases and malignancies 25%. Eighty-three (71.5%) tumor-like conditions occurred in the nose and antrochoanal region.

CONCLUSION

Angiofibroma was the most common benign tumor accounting for 25.55% of all neoplastic lesions. Squamous cell carcinoma was the most common malignancy at this site constituting 50% of all malignancies.

Hemostatic/Fibrinolytic Protein Changes in C3H/HeN Mice Infected with Rickettsia conorii

Changes in plasma hemostatic and fibrinolytic proteins were determined during courses of a murine model of fatal and non-fatal Rocky Mountain spotted fever. C3H/HeN mice were infected with Rickettsia conorii and coagulation and histopathologic studies were performed at prescribed periods of time. A significant decrease in plasma factor VIII activity and rise in plasma factor V procoagulant activity correlated with a fatal infection. Factor VII levels were unchanged; factor XI levels dropped early in the course in the lethally infected animals, but returned to normal. Factor XII, high molecular weight kininogen, and prekallikrein levels were unchanged by the sublethal infection. Prekallikrein levels fell during the lethal infection. Antithrombin concentrations were decreased significantly in all animals, but plasma plasminogen levels did not change in either group of animals. Nonocclusive thrombi were microscopically observed rarely and only in animals surviving a sublethal infection. A fall in tissue plasminogen activator activity and a rise in plasminogen activator inhibitor activity highly correlated with a lethal outcome. Lethal infection with R. conorii is associated with primary endothelial cell injury resulting in decreased tissue plasminogen activator and increased plasminogen activator inhibitor.

Thrombostatin Inhibits Induced Canine Coronary Thrombosis

Thrombostatin (RPPGF), an angiotensin converting enzyme metabolite of bradykinin, is an inhibitor of α-thrombin’s ability to activate platelets. We examined the in vivo pharmacokinetics and pharmacodynamics of thrombostatin in rabbits and its ability to inhibit coronary thrombosis induced by electrolytic injury in dogs. Plasma half-life of thrombostatin had a t1/2α of 2.6 min and a t1/2β of 24 min in rabbits. Ligating the renal arteries did not prolong clearance (t1/2α = 2.4 min; t1/2β = 12 min). Thrombostatin produced a prolonged in vivo antiplatelet effect. At 30 min after a single intravenous administration in rabbits, thrombostatin’s plasma concentration was <8.7 μM (5 μg/ml). However, ex vivo 20 and 40 nM γ-thrombin-induced platelet aggregation of these rabbits’ platelets was inhibited 40% for 2.75 and 1 h, respectively. In vitro, flow cytometry studies revealed that thrombostatin specifically bound to human platelets and washed human platelets treated with thrombostatin were less responsive to γ-thrombin than control platelets. Using electrolytic injury to induce coronary artery thrombosis, dogs treated with thrombostatin, aspirin, or combined thrombostatin and aspirin occluded in 62 ± 25 (mean ± SD), 62 ± 36, or 89 ± 32 min versus untreated animals which occluded at 39 ± 27 min, (p <0.01, p <0.01 and p <0.001, respectively). These studies show that thrombostatin binds to platelets and can delay coronary occlusion in vivo.

Abbreviations: RPPGF: thrombostatin; PAR1: protease activated receptor 1, the first cloned thrombin receptor; PRP: platelet-rich plasma; PPP: plateletpoor plasma; LCX: left circumflex coronary artery; APTT: activated partial thromboplastin time; PT: prothrombin time

Histopathological analysis of meningioma and its variants: A study of fifty cases

BACKGROUND

The study was conducted to know the various histopathological variants of meningiomas, the age incidence and sex ratio.

MATERIALS AND METHODS

A retrospective and prospective analysis of all the samples sent for histopathology for 2 years during June 2013-May 2015 was done to diagnose meningioma and its variants. Cases were analyzed in detail about the complete clinical history, exact location, and clinical and radiological diagnosis. The majority of the cases were clinically and radiologically diagnosed as meningioma.

RESULTS

Of 50 cases which were diagnosed as meningiomas, 21 were meningothelial variant, 15 were psammomatous, 8 were fibroblastic, 4 were transitional, and 1 case each of anaplastic and atypical variant. The most common age group was between 41 and 50 years. The youngest age group was 16 years and oldest was 70. The male:female ratio was 1:1.5.

CONCLUSION

The majority of the meningiomas have been observed between 41 and 50 years. Their proper recognition is therefore important to allow appropriate treatment. Histopathological study plays a major role by which we can diagnose the lesion. Meningiomas typically develop in middle-aged individuals and occur more frequently in women than men. These lesions may also occur in children.

Augmentation of bacterial homeostasis by regulating in situ buffer capacity: Significance of total dissolved salts over acidogenic metabolism

During anaerobic fermentation, consequent accumulation of acidic fermented products leads to the failure of pH homeostasis. The present study aimed to comprehend the changes in buffering capacity with addition of sodium salts of hydroxide, bicarbonate and phosphate. The results showed notable augmentation in buffer capacity and cumulative hydrogen production (CHP) compared to control. The influential factor is the amount of undissociated volatile fatty acids released that affected the cell metabolism and consequently biohydrogen generation. It is inferred that among the tested salts, sodium bicarbonate has substantial buffering capacity (β, 0.035± mol) ensuing maximum CHP (468± mL). Besides, bioelectrochemical analysis revealed variations in redox currents that aligned with biohydrogen production. The study provides valuable information on the role of inorganic dissolved salts that would be required to regulate H₂ generation and acidogenesis in the aspects of acid-gas phase system.

Erythema Necroticans - A Case Report

Erythema Nodosum Leprosum (ENL) is characterized by evanescent, erythematous, painful raised nodules which fade within 48-72 hours. Necrotic and ulcerative forms are rare presentations of severe ENL. A 27 year old male patient presented with multiple erythematous nodules on trunk and extremities associated with high grade fever, joint pain and pedal edema. Patient developed ulceration of nodules associated with pain and burning sensation over another 3 days. Slit smear showed clumps of granular bacilli. Biopsy showed superficial dermis showing edema with dense focal perivascular infiltrate of lymphocytes, macrophages and few scattered neutrophils. Fite-Faraco stain was negative. Patient was diagnosed as a case of erythema necroticans and started on oral steroids and thalidomide. The histological findings illustrate the need to consider leprosy diagnosis in necrotizing vasculitis even when Virchow's cells are not found in the infiltrate. Thalidomide is the drug of choice in such cases. This patient showed a marked response to the drug with healing of all ulcers within 2 weeks of starting thalidomide.

Spectrum of cervical lesions observed in 500 cases: Carcinoma cervix the leading cause of death in females

INTRODUCTION

The present study was done to know the various histopathological variants in cervical lesions, to know the age incidence and to know the preventive measures and early detection of cervical cancer.

MATERIALS AND METHODS

This is a retrospective and prospective study done on all the hysterectomy specimens and on punch biopsy samples sent for histopathology. We studied a total of 500 cases for a period of 3 years.

RESULTS

Out of the 500 cases, 395 cases were non-neoplastic and 105 cases were neoplastic lesions. Chronic cervicitis was the most common non-neoplastic lesion and large cell non-keratinizing squamous cell carcinoma was the most common malignant lesion.

CONCLUSION

The main aim of presenting this study is to highlight the various histopthological variants, age incidence and to educate about the preventive measures and early detection of cervical cancer.

A distinct X-linked syndrome involving joint contractures, keloids, large optic cup-to-disc ratio, and renal stones results from a filamin A (FLNA) mutation

We further evaluated a previously reported family with an apparently undescribed X-linked syndrome involving joint contractures, keloids, an increased optic cup-to-disc ratio, and renal stones to elucidate the genetic cause. To do this, we obtained medical histories and performed physical examination on 14 individuals in the family, five of whom are affected males and three are obligate carrier females. Linkage analysis was performed on all but one individual and chromosome X-exome sequencing was done on two affected males. The analysis localized the putative gene to Xq27-qter and chromosome X-exome sequencing revealed a mutation in exon 28 (c.4726G>A) of the filamin A (FLNA) gene, predicting that a conserved glycine had been replaced by arginine at amino acid 1576 (p.G1576R). Segregation analysis demonstrated that all known carrier females tested were heterozygous (G/A), all affected males were hemizygous for the mutation (A allele) and all normal males were hemizygous for the normal G allele. The data and the bioinformatic analysis indicate that the G1576R mutation in the FLNA gene is very likely pathogenic in this family. The syndrome affecting the family shares phenotypic overlap with other syndromes caused by FLNA mutations, but appears to be a distinct phenotype, likely representing a unique genetic syndrome.

The Role of ORAI1 in the Odontogenic Differentiation of Human Dental Pulp Stem Cells

Pulp capping, or placing dental materials directly onto the vital pulp tissues of affected teeth, is a dental procedure that aims to regenerate reparative dentin. Several pulp capping materials are clinically being used, and calcium ion (Ca(2+)) released from these materials is known to mediate reparative dentin formation. ORAI1 is an essential pore subunit of store-operated Ca(2+) entry (SOCE), which is a major Ca(2+) influx pathway in most nonexcitable cells. Here, we evaluated the role of ORAI1 in mediating the odontogenic differentiation and mineralization of dental pulp stem cells (DPSCs). During the odontogenic differentiation of DPSCs, the expression of ORAI1 increased in a time-dependent manner. DPSCs knocked down with ORAI1 shRNA (DPSC/ORAI1sh) or overexpressed with dominant negative mutant ORAI1(E106Q) (DPSC/E106Q) exhibited the inhibition of Ca(2+) influx and suppression of odontogenic differentiation and mineralization as demonstrated by alkaline phosphatase (ALP) activity/staining as well as alizarin red S staining when compared with DPSCs of their respective control groups (DPSC/CTLsh and DPSC/CTL). The gene expression for odontogenic differentiation markers such as osteocalcin, bone sialoprotein, and dentin matrix protein 1 (DMP1) was also suppressed. When DPSC/CTL or DPSC/E106Q cells were subcutaneously transplanted into nude mice, DPSC/CTL cells induced mineralized tissue formation with significant increases in ALP and DMP1 staining in vivo, whereas DPSC/E106Q cells did not. Collectively, our data showed that ORAI1 plays critical roles in the odontogenic differentiation and mineralization of DPSCs by regulating Ca(2+) influx and that ORAI1 may be a therapeutic target to enhance reparative dentin formation.

Algal biocathode for in situ terminal electron acceptor (TEA) production: synergetic association of bacteria-microalgae metabolism for the functioning of biofuel cell

Replacement of energy intensive mechanical aeration with sustainable oxygenic photosynthesis by microalgae at cathode was studied in dual-chambered microbial fuel cell (MFC). The synergistic association between bacterial fermentation at anode and the oxygenic photosynthesis of microalgae at cathode facilitated good power output as well as treatment efficiency. However, MFC operation during spring showed higher bioelectrogenic activity (57.0 mW/m(2)) over summer (1.1 mW/m(2)) due to the higher oxygenic photosynthetic activity of microalgae and respective dissolved oxygen (DO) levels. This can be attributed to RuBisCO inactivation under high temperatures and light intensity of summer, which prevented rich algal biomass growth as well as their photosynthetic activity. Unlike abiotic cathode, the algal cathode potential increased with operation time due to the algal biomass growth during spring but was negligible during summer. The catalytic currents on voltammetric signatures and the bioprocess parameters also corroborated well with the observed power output.

Cysticercosis: The day to day public health problem and the various sites affected by it - A one year study

Introduction:

The present study is done to highlight the various regions in the body affected by cysticercosis and to educate the people about the personal hygiene and prevention of the parasite.

Materials and Methods:

This is a study done on patients who were referred for swelling in the body, which were diagnosed as cysticercosis in one of their differential diagnosis clinically.

Results:

During the 1 year study (from October 2011 to September 2012) we diagnosed seven cases of cysticercosis involving the various sites in the body. Our cases highlight the rare presentation of cysticercus infestation as cause of treatablelymphadenopathy.

Conclusions:

Cysticercosis should be included in the differential diagnosis of cervical swellings especially in endemic regions. Timely diagnosis and intervention help in preventing fatal complications.

Knowledge attitude and practice of pesticide use among agricultural workers in Puducherry, South India

OBJECTIVES

To study the level of knowledge and practice related to pesticides and their adverse effects among agricultural workers.

MATERIALS AND METHODS

A cross sectional study among 100 randomly selected agricultural workers, using or ever used pesticide within last one year was conducted in Puducherry, South India. The questionnaire was adapted from WHO field surveys of 'Exposure to Pesticides Standard Protocol' and similar studies. Data were collected by face to face interview.

RESULTS

All the participants were male with mean age of 54.3 yrs. While 70% of respondents perceived pesticide spraying affects a person's health, only 40% were aware that it affects the environment. Two thirds of the respondents (62%) were aware that pesticide enters the body through nose and affects lungs. Awareness on other modes of entry was less. Majority (76%) of them was aware of training programs conducted by government agriculture department on pest management. About 42% of farmers had good knowledge regarding pesticide. Between 40% and 70% of respondents were not using any protective equipments during pesticide spraying. Around 68% of farmers indiscriminately disposed empty containers while 48% buried the leftover pesticides. Significant association (p < 0.05) was observed between knowledge of the farmers and their practices related to pesticides.

CONCLUSION

Overall awareness of agricultural workers on pesticide was inadequate. Improper disposal of pesticides and its container can produce harm to the environment. The findings of the study emphasize the need to educate agricultural workers regarding safe and adequate use of pesticides to prevent health and environmental hazards.

Microaerophilic microenvironment at biocathode enhances electrogenesis with simultaneous synthesis of polyhydroxyalkanoates (PHA) in bioelectrochemical system (BES)

Microaerophilic microenvironment at biocathode was evaluated for electrogenesis along with the polyhydroxyalkanoates (PHA) accumulation in bio-electrochemical system (BES). The electrogenic activity (512 mV; 15.2 mW/m(2)) was extended for longer periods (144 h) which might be attributed to the lowering of losses due to the controlled microbial metabolism. Growth limiting stress at cathode due to lower oxygen levels and its effective utilization by the protons and electrons coming from anode, might have diverted the microbial metabolism towards PHA synthesis instead of oxidation. PHA accumulation (19% of dry cell weight (DCW)) was observed with higher hydroxy butyrate (HB) (89%) concentration at 48 th h in the cathodic biocatalyst and was re-utilized by the end of experiment. Bio-electro kinetics studied through voltammetry and Tafel analysis further supported the observed electrogenesis in microaerophilic reduction microenvironment, in terms of redox catalytic currents, Tafel slopes, exchange current densities and polarization resistance.

Influence of terminal electron acceptor availability to the anodic oxidation on the electrogenic activity of microbial fuel cell (MFC)

The electrogenic activity of microbial fuel cell (MFC) with the function of anode placement from the terminal electron acceptor (TEA) was evaluated. Shorter anode distances from TEA showed higher electrogenesis due to the feasibility of higher electron acceptance as well as their discharge towards TEA. Substrate degradation was also higher at shorter anode placements from TEA due to the optimum substrate availability to the anodic biofilm. Bio-electro kinetics showed significant variation in the catalytic currents and exchange current densities with the function of anode placement indicating its role in electron acceptance and their transfer to the cathode. Anode placement of 3cm showed higher electrogenesis (406.38mW/m(2)) and substrate degradation (63.12%) along with significantly reduced polarization (6.72Ω) and charge transfer resistances compared to other anodic placements. The spacing between electrodes is crucial in accepting electrons as well as their discharge towards TEA which ultimately governs the power generation efficacy.

Change in electrogenic activity of the microbial fuel cell (MFC) with the function of biocathode microenvironment as terminal electron accepting condition: influence on overpotentials and bio-electro kinetics

Influence of biocathode microenvironment as terminal electron accepting process (TEAP) on the electrogenic activity of the microbial fuel cell (MFC)/bio-electrochemical system (BES) was evaluated in concurrence with the internal losses and bio-electro kinetics. Aerobic metabolism as TEAP showed power output (37.5 ± 2.7 mW/m(2)) for extended time (240 h) over abiotic (42.5 ± 1.5 mW/m(2)) electron accepting process. On the contrary, anaerobic metabolism as TEAP showed negligible power output in spite of increased retention time due to the absence of electron acceptor. Presence of strong electron acceptor conditions in aerobic metabolism facilitated gradual and stable reduction of electrons which helped to overcome the activation over potential and other potential losses. Voltammetric and amperometric analysis witnessed higher and sustainable electron discharge against the aerobic metabolism at cathode. Bio-electro kinetic analysis also showed lower Tafel slope and electron transfer co-efficient indicating the positive impact of aerobic metabolism at cathode in decreasing the internal losses.

Genomic characterization of explant tumorgraft models derived from fresh patient tumor tissue

Background

There is resurgence within drug and biomarker development communities for the use of primary tumorgraft models as improved predictors of patient tumor response to novel therapeutic strategies. Despite perceived advantages over cell line derived xenograft models, there is limited data comparing the genotype and phenotype of tumorgrafts to the donor patient tumor, limiting the determination of molecular relevance of the tumorgraft model. This report directly compares the genomic characteristics of patient tumors and the derived tumorgraft models, including gene expression, and oncogenic mutation status.

Methods

Fresh tumor tissues from 182 cancer patients were implanted subcutaneously into immune-compromised mice for the development of primary patient tumorgraft models. Histological assessment was performed on both patient tumors and the resulting tumorgraft models. Somatic mutations in key oncogenes and gene expression levels of resulting tumorgrafts were compared to the matched patient tumors using the OncoCarta (Sequenom, San Diego, CA) and human gene microarray (Affymetrix, Santa Clara, CA) platforms respectively. The genomic stability of the established tumorgrafts was assessed across serial in vivo generations in a representative subset of models. The genomes of patient tumors that formed tumorgrafts were compared to those that did not to identify the possible molecular basis to successful engraftment or rejection.

Results

Fresh tumor tissues from 182 cancer patients were implanted into immune-compromised mice with forty-nine tumorgraft models that have been successfully established, exhibiting strong histological and genomic fidelity to the originating patient tumors. Comparison of the transcriptomes and oncogenic mutations between the tumorgrafts and the matched patient tumors were found to be stable across four tumorgraft generations. Not only did the various tumors retain the differentiation pattern, but supporting stromal elements were preserved. Those genes down-regulated specifically in tumorgrafts were enriched in biological pathways involved in host immune response, consistent with the immune deficiency status of the host. Patient tumors that successfully formed tumorgrafts were enriched for cell signaling, cell cycle, and cytoskeleton pathways and exhibited evidence of reduced immunogenicity.

Conclusions

The preservation of the patient’s tumor genomic profile and tumor microenvironment supports the view that primary patient tumorgrafts provide a relevant model to support the translation of new therapeutic strategies and personalized medicine approaches in oncology.

Endocrine disruptive estrogens role in electron transfer: bio-electrochemical remediation with microbial mediated electrogenesis

Bioremediation of selected endocrine disrupting compounds (EDCs)/estrogens viz. estriol (E3) and ethynylestradiol (EE2) was evaluated in bio-electrochemical treatment (BET) system with simultaneous power generation. Estrogens supplementation along with wastewater documented enhanced electrogenic activity indicating their function in electron transfer between biocatalyst and anode as electron shuttler. EE2 addition showed more positive impact on the electrogenic activity compared to E3 supplementation. Higher estrogen concentration showed inhibitory effect on the BET performance. Poising potential during start up phase showed a marginal influence on the power output. The electrons generated during substrate degradation might have been utilized for the EDCs break down. Fuel cell behavior and anodic oxidation potential supported the observed electrogenic activity with the function of estrogens removal. Voltammetric profiles, dehydrogenase and phosphatase enzyme activities were also found to be in agreement with the power generation, electron discharge and estrogens removal.