Meniscus instability in a thin elastic film

A new kind of meniscus instability leading to the formation of stationary fingers with a well-defined spacing has been observed in experiments with elastomeric films confined between a plane rigid glass and a thin curved glass plate. The wavelength of the instability increases linearly with the thickness of the confined film, but it is remarkably insensitive to the compliance and the energetics of the system. However, lateral amplitude (length) of the fingers depends on the compliance of the system and on the radius of curvature of the glass plate. A simple linear stability analysis is used to explain the underlying physics and the key observed features of the instability.

Glutamine nutrition and metabolism: where do we go from here ?

Glutamine, a "nonessential" amino acid, is attracting widespread attention because of its relevance to numerous metabolic processes and its potential role in the treatment and prevention of critical illness. In this paper we review some key concepts of glutamine biochemistry, metabolism, and nutrition. We then discuss several studies in the area of glutamine metabolism and nutrition that are primed for further investigation.

Selective activation of angiotensin AT2 receptors attenuates progression of pulmonary hypertension and inhibits cardiopulmonary fibrosis

BACKGROUND AND PURPOSE

Pulmonary hypertension (PH) is a devastating disease characterized by increased pulmonary arterial pressure, which progressively leads to right-heart failure and death. A dys-regulated renin angiotensin system (RAS) has been implicated in the development and progression of PH. However, the role of the angiotensin AT2 receptor in PH has not been fully elucidated. We have taken advantage of a recently identified non-peptide AT2 receptor agonist, Compound 21 (C21), to investigate its effects on the well-established monocrotaline (MCT) rat model of PH.

EXPERIMENTAL APPROACH

A single s.c. injection of MCT (50 mg·kg(-1) ) was used to induce PH in 8-week-old male Sprague Dawley rats. After 2 weeks of MCT administration, a subset of animals began receiving either 0.03 mg·kg(-1) C21, 3 mg·kg(-1) PD-123319 or 0.5 mg·kg(-1) A779 for an additional 2 weeks, after which right ventricular haemodynamic parameters were measured and tissues were collected for gene expression and histological analyses.

KEY RESULTS

Initiation of C21 treatment significantly attenuated much of the pathophysiology associated with MCT-induced PH. Most notably, C21 reversed pulmonary fibrosis and prevented right ventricular fibrosis. These beneficial effects were associated with improvement in right heart function, decreased pulmonary vessel wall thickness, reduced pro-inflammatory cytokines and favourable modulation of the lung RAS. Conversely, co-administration of the AT2 receptor antagonist, PD-123319, or the Mas antagonist, A779, abolished the protective actions of C21.

CONCLUSIONS AND IMPLICATIONS

Taken together, our results suggest that the AT2 receptor agonist, C21, may hold promise for patients with PH.

17beta-Estradiol modulates local cardiac renin-angiotensin system to prevent cardiac remodeling in the DOCA-salt model of hypertension in rats

Ventricular remodeling can play a detrimental role in the progression of cardiovascular diseases, leading to heart failure. The current study was designed to investigate the effects of 17beta-estradiol (E2) on cardiac remodeling. Cardiac fibrosis and hypertrophy were examined in deoxycorticosterone acetate (DOCA)-salt treated rats with chronic, six-week administration of two different doses of E2. Bilaterally ovariectomized (Ovex) female Sprague-Dawley rats were randomly assigned to one of the following groups: Ovex-control; Ovex-DOCA; Ovex-DOCA+low-dose E2 (1.66 microg/day); or Ovex-DOCA+high-dose E2 (2.38 microg/day). All DOCA-treated rats were uninephrectomized and drinking water was replaced by 0.15M NaCl solution for the remainder of the study period. DOCA-salt treatment resulted in a significant increase in blood pressure, which was not altered by estrogen replacement. Histological examinations revealed marked cardiac remodeling (both ventricular hypertrophy and interstitial fibrosis) with DOCA treatment, which was attenuated in animals receiving estrogen therapy. Western blot analysis demonstrated increased cardiac levels of angiotensin converting enzyme (ACE) with DOCA treatment, which was attenuated by E2 replacement. Furthermore, increased levels of cardiac angiotensin converting enzyme 2 (ACE2) protein were observed in animals receiving high-dose E2 replacement. These findings suggest that physiologically relevant estrogen replacement therapy has blood pressure-independent cardioprotective effects, which are possibly mediated through modulation of the cardiac renin-angiotensin system.

Pattern Formation in a Thin Solid Film with Interactions

We investigate a new type of surface instability of a thin elastic film subjected to surface interactions such as van der Waals and electrostatic forces from another solid surface in its vicinity. It is found that a sufficiently soft (shear modulus <10 MPa) and nearly incompressible film deforms to form an undulating pattern without any mass transport. A novel feature is that the characteristic length scale of the pattern is nearly independent of the nature and magnitude of the external force, but varies linearly with the film thickness. These results explain some recent experiments and are applicable to problems such as adhesion and friction at soft solid interfaces, peeling of adhesives, patterning of solid surfaces, etc.

Endoscopic ultrasound miniprobe-guided steroid injection for treatment of refractory esophageal strictures

Local injection of corticosteroids into refractory esophageal strictures to decrease the restenosis rate has been reported. Here we report our efforts in three patients to render the delivery of steroids more precise, by injecting them in the thickest segment of the stricture with the guidance of a high frequency ultrasound miniprobe passed through a regular upper endoscope. Steroid injection under ultrasound miniprobe guidance may be indicated for patients who do not respond to a "blind" steroid injection without miniprobe guidance.

Molecular characterization of some Indian Basmati and other elite rice genotypes using fluorescent-AFLP

Cultivated rice is a high-volume, low-value cereal crop providing staple food to more than 50% of the world populace. A small group of rice cultivars, traditionally produced on the Indo-Gangetic plains and popularly known as Basmati, have exquisite quality grain characteristics and are a prized commercial commodity. Efforts to improve the yield potential of Basmati have led to the development of several crossbred Basmati-like cultivars. In this study we have analysed the genetic diversity and interrelationships among 33 rice genotypes consisting of the traditional Basmati, improved Basmati-like genotypes developed in India and elsewhere, American long-grain rice and a few non-aromatic rice using a DNA marker-based approach - fluorescent-amplified fragment length polymorphism (f-AFLP). Using a set of nine primer-pairs we scored a total of 10,672 data points over all of the genotypes in the size range of 75-500 bp. The scored data points corresponded to a total of 501 AFLP markers (putative loci/genome landmarks) of which 327 markers (65%) were polymorphic. The f-AFLP marker data, which were analysed using different clustering algorithms and principal component analysis, indicate that: (1) considerable genetic variability exists in the analysed genotypes; (2) traditional Basmati cultivars could be distinctly separated from the crossbred Basmati-like genotypes as well as from the non-aromatic rice; (3) the crossbred Basmati-like cultivars from the subcontinent and elsewhere are genetically very distinct; (4) f-AFLP-based clustering, in general, conforms to the putative pedigree of the improved genotypes. Moreover, analysis to ascertain the scope of AFLP as a technique suggests that the polymorphism revealed by three selective primer-pair combinations is sufficient to obtain reliable estimates of genetic diversity for the type of material used in this study. However, its utility to identify group-specific DNA markers was discounted due to a low frequency of observed group-specific discrete markers.

Ontogeny of glutamine synthetase in rat small intestine

Glutamine synthetase (GS) is a key enzyme involved in the endogenous biosynthesis of glutamine, an amino acid known to be essential for small intestinal metabolism and function. This study describes the ontogeny of rat small intestinal GS from fetal life through adulthood with enzyme activities, protein immunoblotting, and steady state levels of GS mRNA by RNA gel blots and dot blots. Enzyme activities progressively increased from 21 d of fetal life to 32 d postnatally, then decreased in adulthood. The amount of GS immunoreactive protein in the small intestine increased from fetal life to 10-day-old infants and persisted into adulthood. GS mRNA, as quantified by dot blots was highest at 19 d postnatally. The ontogenic changes in rat small intestinal GS appear to correspond temporally with rapid growth and weaning. The steady increase in GS enzyme activity up to 32 d of age with a subsequent drop in adulthood is not paralleled by an increase in GS mRNA or protein. These findings suggest an apparent complex regulation of the enzyme activity at a transcriptional or translational levels.

Characterization of glutaminase in the developing rat small intestine

As a primary substrate in the small intestine, glutamine is a very important source of energy. Glutaminase (GA) is the enzyme involved in the deamination of glutamine to glutamate, which is utilized for energy production via the TCA cycle. Although the enzymatic activity of GA in the small intestine is known to undergo maturational changes, the tissue localization of the protein and its mRNA, the intracellular processing of this enzyme and levels of its mRNA in the small intestine at different maturational stages have not yet been described. In this study, using immuno-histochemical staining, we confirm previous studies using other techniques that suggested GA is localized in the epithelial layer of the rat small intestine. Some GA is also found in cells of the lamina propria and crypt epithelium. Using in situ hybridization studies, we have corroborated the presence of the protein in the epithelial cells of the villi by localizing the mRNA of this protein to the same layer and its precursor layer in the crypt region. An ontogenic analysis of GA mRNA and protein from rat small intestines, using RNA dot blots, gel blots and protein immunoblotting revealed differences in immunoreactive GA protein and mRNA during maturation. Immunoreactive GA and steady-state levels of GA mRNA increased around the 3rd wk of life, coincident with weaning and the endogenous glucocorticoid surge. Whether these findings have nutritional or pathophysiological implications remains speculative.

Double-lumen esophagus: formation of a new lumen or septation of the existing one?

Presented here are two cases in which two esophageal lumens were identified at endoscopy. One patient had a history of antireflux surgery and both patients had received esophageal dilations. Both patients have done poorly with standard esophageal dilation and are not considered likely to gain from surgery. The mechanism of formation of the second lumen is not certain in Case 1, but in Case 2 a self-contained perforation appears to be the likely mechanism. There is no clear definition of "double-lumen esophagus" in the literature. The term is used at times interchangeably with esophagogastric fistula. We propose that the phrase "double-lumen esophagus" is a morphologic description and should be used only when the two lumens are of nearly equal diameter. The term "fistula" should be used whenever that is the likely mechanism. Hence, Case 1 of our report is the true double-lumen esophagus, while Case 2 is an esophagogastric fistula. Since patients do poorly with standard dilation, newer endoscopic modalities may have a role in the management of these rare but difficult cases.

Ontogeny of small intestinal glutaminase and glutamine synthetase in the rat: response to dexamethasone

The ontogeny of small intestinal glutaminase (GA) and glutamine synthetase (GS) was studied with relation to the maternal administration of dexamethasone (DEX). Pregnant Sprague-Dawley rats were administered 0.2 mg/kg of DEX or saline twice daily on days 19 and 20 of gestation. Activity of GA did not increase from the fetus to the 10-day-old rat; however, GS activity increased 7-fold. DEX induced doubling of GA activity and mRNA, but only a slight increase is GS activity and mRNA was observed in the fetus. GA and GS activities appear to be regulated by different mechanisms.

Association of Demographic, Clinical and Laboratory Parameters with Clinical Outcome of COVID-19 Patients of Bangalore: A Cross-sectional Study

Introduction: Although the Coronavirus Disease-2019 (COVID-19) pandemic is creating a major global health crisis, the risk factors for mortality and the detailed clinical course of disease has not yet established. Aim: To determine association of the demographic data of COVID-19 patients with clinical profile and disease outcomes. Materials and Methods: The cross-sectional single-center study considered adults patients of both the gender from March to June 2020 with an estimated sample size of 2000 patients diagnosed with COVID-19 infection by Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) technique. Necessary demographic and clinical data were collected and selected subjects were followed-up until discharge or death. Subjects were classified as those who survived (1839 patients) and succumbed (138 patients) to death. T-test was used for comparing continuous variables and chi-square test for categorical data between the groups. Results: The study included 1977 patients with a male-to-female ratio of 1:0.62. Fever, dyspnea and cough were noted as the major symptoms prevalent among patients who succumbed to death when compared to those who survived (p-value <0.001). Statistically significant variables noted between the groups were age (survived mean age- 42.74±15.15 years vs mean age 59.12±12.95 in those who succumbed to death, p-value <0.001), age groups (p-value <0.001), gender (p-value 0.042), haemoglobin, Total Leucocyte Count (TLC), neutrophil, lymphocytes, Neutrophil to Lymphocyte Ratio (NLR), Lactate Dehydrogenase (LDH), ferritin, all the comorbidity variables and the asymptomatic status. Variables identified as significant predictors of disease outcomes were Haemoglobin (Hb), TLC, neutrophils, lymphocytes, NLR, LDH and ferritin (p-value <0.001). Most of the subjects belonging to the mortality group required oxygen and other Intensive Care Unit (ICU) facilities when compared to the survival group (p-value <0.001). The mean days of viral clearance noted in COVID subjects was around 8.98±3.54 days. Conclusion: Hb, TLC, neutrophils, lymphocytes, NLR, LDH and ferritin are noted as significant predictors of COVID-19 outcome. Biochemical monitoring of COVID-19 patients helps in identifying critically ill patients early and can reduce mortality and improve the recovery.

Is massage following dye injection necessary in sentinel node biopsy in breast cancer?

In sentinel node biopsy of breast cancer, massaging of the dye injection site following subdermal injection of blue dye does not improve sentinel node detection rate or the time needed for sentinel node biopsy. It may reduce the number of false negative sentinel nodes.

Placental Mesenchymal Dysplasia, An Exceedingly Rare Entity and Challenging Diagnosis

Introduction/Objective

Placental mesenchymal dysplasia (PMD) is an extremely rare entity with an incidence of only 0.02/1000 deliveries.

Methods/Case Report

We present a case of a 26 year-old female Gravida 3, Para 1 with intrauterine pregnancy at 37 weeks of gestation. Fetal ultrasound showed mildly cystic upper portion of the placenta. The noninvasive prenatal testing was negative for triploidy. A viable healthy female infant was delivered with no maternal complications.

On gross examination, placenta was heavy with approximately 25% incomplete cotyledons. Placental maternal surface showed, spongiform cut surfaces admixed with multiple cystic structures ranging in size from 0.5 to 1.5 cm and markedly dilated blood vessels.

Histopathologic examination revealed markedly enlarged villi, mesenchymal hyperplasia, and hyper vascularity of small vessels. No trophoblast proliferation was identified. Subsequently, the diagnosis of PMD was made.

Results (if a Case Study enter NA)

NA

Conclusion

PMD is a rare anomaly which is characterized by placentomegaly and grape like vesicles resembling molar pregnancy. Etiologies include imbalance of paternal and maternal alleles, androgenetic and bi-parental mosaicism, and Beckwith Weidman Syndrome (BWS). Differential diagnosis includes partial molar pregnancy, complete mole with co-existing normal fetus, hemangioma, subchorionic hematoma, confined placental mosaicism and hydropic complications. Histologic features, ancillary studies including immunohistochemistry and genetic testing are helpful in differentiating PMD. PMD is an underdiagnosed entity with increased risk of premature delivery and intrauterine fetal death. It is pertinent for the clinicians to be aware of this entity for optimal patient management.

Acinetobacter sepsis in neonates

Twenty-six neonates were diagnosed to have acinetobacter sepsis during 1986-90, representing 6.5% of all cases of bacteriologically proven sepsis. Of these 19 neonates were low birth weight (LBW) 12 were small for gestational age (SGA). Nineteen neonates had early-onset sepsis. The male to female ratio was 9:17. The hematological profile was suggestive of sepsis in 17 cases. All infants had clinical evidence of multi system infection. Eleven babies died; the cases-fatality rate was 42.3%. Only 15/25 culture isolates were sensitive to gentamicin and resistance to other antibiotics was even more frequent. Acinetobacter was cultured from other sites: eye swabs, skin pustules and umbilical catheter tips. Environmental nursery surveillance cultures done during the study period yielded Acinetobacter once from a crib, but no cases of sepsis occurred around that time. The epidemiological features of this organism illustrate the value of vigilance and precautionary measures.