Search

A rare case of pan-subepithelial dystrophic calcium deposition and bone marrow formation in hydronephrosis secondary to obstructive urolithiasis is reported and discussed. An elderly gentleman presented with accelerated hypertension, a nonfunctioning left kidney secondary to obstructive nephrolithiasis with additional pancalyceal calcification. His left retroperitoneoscopic nephrectomy specimen revealed sterile hydronephrosis secondary to an impacted ureteropelvic junction stone and pan-subepithelial fibrocalcific lamellar deposition. Special stains confirmed end-stage renal disease with chronic pyelonephritis with subepithelial dystrophic calcium deposition and evidence of bone marrow formation., (Copyright © 2012 S. Karger AG, Basel.)

Purpose: Fluctuations in female sex hormones result in changes in the gingival and periodontal tissues. The purpose of this study was to compare the periodontal status of premenopausal women at different time points during their menstrual cycle and to find the associated subgingival microbiota., Materials and Methods: One hundred premenopausal women participated in the study and were divided into two groups: group I consisted of 50 subjects with clinically healthy gingival, and group II consisted of 50 subjects with chronic gingivitis. Group II was further divided into group IIa and group IIb. Group IIa consisted of 25 subjects who did not receive any periodontal therapy during the study period. All the examinations were performed at three points during the menstrual cycle: ovulation (OV), pre-menstruation (PM) and menstruation (M). Plaque Index (PI), Gingival Index (GI), Papillary Bleeding Index (PBI), probing depth (PD), subgingival temperature (ST) recording, gingival crevicular fluid (GCF) collection, and estimation and microbiological examination using the benzoyl-DL-arginine-naphthylamide (BANA) test was carried out. For group IIb subjects, all the examinations were performed again during the next menstrual cycle, which followed 4 weeks after periodontal therapy., Results: Women with clinically healthy gingiva exhibited negligible changes throughout the menstrual cycle, whereas women with gingivitis showed aggravated inflammation during ovulation and pre-menstruation as compared to menstruation. However, there was no alteration in subgingival microbiota. After treating gingivitis, the next menstrual cycle following 4 weeks after periodontal therapy was monitored, and no periodontal changes were detected., Conclusion: Ovarian hormones have a negligible effect on clinically healthy periodontium. However, these hormones may exaggerate pre-existing inflammation in gingival tissues, but the clinical significance of these changes remains uncertain.

Modified tetrapyrroles such as chlorophyll, heme, siroheme, vitamin B(12), coenzyme F(430), and heme d(1) underpin a wide range of essential biological functions in all domains of life, and it is therefore surprising that the syntheses of many of these life pigments remain poorly understood. It is known that the construction of the central molecular framework of modified tetrapyrroles is mediated via a common, core pathway. Herein a further branch of the modified tetrapyrrole biosynthesis pathway is described in denitrifying and sulfate-reducing bacteria as well as the Archaea. This process entails the hijacking of siroheme, the prosthetic group of sulfite and nitrite reductase, and its processing into heme and d(1) heme. The initial step in these transformations involves the decarboxylation of siroheme to give didecarboxysiroheme. For d(1) heme synthesis this intermediate has to undergo the replacement of two propionate side chains with oxygen functionalities and the introduction of a double bond into a further peripheral side chain. For heme synthesis didecarboxysiroheme is converted into Fe-coproporphyrin by oxidative loss of two acetic acid side chains. Fe-coproporphyrin is then transformed into heme by the oxidative decarboxylation of two propionate side chains. The mechanisms of these reactions are discussed and the evolutionary significance of another role for siroheme is examined.

Unlabelled: We report intraoperative capsular block syndrome occuring during the first 50 femtosecond laser-assisted cataract surgeries performed in our facility. Two patients had uneventful combined laser fragmentation, capsulotomy, and corneal incision procedures. In both cases, following transfer to the operating room and manual removal of the laser-cut capsulotomy, posterior capsule rupture was noted during hydrodissection, resulting in posterior dislocation of the lens. Pars plana vitrectomy, removal of the crystalline lens, and sulcus implantation of an intraocular lens were performed in both patients with good visual outcomes. Femtosecond laser-assisted cataract surgery changes the intraoperative environment with the generation of intracapsular gas and laser-induced changes in the cortex. With awareness of the changed intraocular environment following laser lens fragmentation and capsulotomy and a modification of the surgical technique, no additional cases of intraoperative CBS have been seen in more than 600 laser-assisted cataract surgery procedures performed to date at our facility., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes., (Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Otitis media with effusion (OME) is the commonest cause of hearing loss in children, yet the underlying genetic pathways and mechanisms involved are incompletely understood. Ventilation of the middle ear with tympanostomy tubes is the commonest surgical procedure in children and the best treatment for chronic OME, but the mechanism by which they work remains uncertain. As hypoxia is a common feature of inflamed microenvironments, moderation of hypoxia may be a significant contributory mechanism. We have investigated the occurrence of hypoxia and hypoxia-inducible factor (HIF) mediated responses in Junbo and Jeff mouse mutant models, which develop spontaneous chronic otitis media. We found that Jeff and Junbo mice labeled in vivo with pimonidazole showed cellular hypoxia in inflammatory cells in the bulla lumen, and in Junbo the middle ear mucosa was also hypoxic. The bulla fluid inflammatory cell numbers were greater and the upregulation of inflammatory gene networks were more pronounced in Junbo than Jeff. Hif-1α gene expression was elevated in bulla fluid inflammatory cells, and there was upregulation of its target genes including Vegfa in Junbo and Jeff. We therefore investigated the effects in Junbo of small-molecule inhibitors of VEGFR signaling (PTK787, SU-11248, and BAY 43-9006) and destabilizing HIF by inhibiting its chaperone HSP90 with 17-DMAG. We found that both classes of inhibitor significantly reduced hearing loss and the occurrence of bulla fluid and that VEGFR inhibitors moderated angiogenesis and lymphangiogenesis in the inflamed middle ear mucosa. The effectiveness of HSP90 and VEGFR signaling inhibitors in suppressing OM in the Junbo model implicates HIF-mediated VEGF as playing a pivotal role in OM pathogenesis. Our analysis of the Junbo and Jeff mutants highlights the role of hypoxia and HIF-mediated pathways, and we conclude that targeting molecules in HIF-VEGF signaling pathways has therapeutic potential in the treatment of chronic OM., Competing Interests: The authors have declared that no competing interests exist.

Peiponen et al. [Opt. Lett.35, 4108 (2010)] have expressed concern that a theoretical model we proposed in Calhoun et al. [Opt. Lett.35, 1224 (2010)] for total internal reflection from a turbid medium may be inconsistent with the experimental data, in the sense that the model fails to take into account unexplained oscillations in our data. We show that their concern arises from misinterpretation of our data and theory, and is, therefore, unfounded. NOTE: Optics Letters apologizes to the authors for the delay in the publication of this Reply., (© 2011 Optical Society of America)

The cytochrome cd₁ nitrite reductase from Paracoccus pantotrophus catalyses the one electron reduction of nitrite to nitric oxide using two heme cofactors. The site of nitrite reduction is the d₁ heme, which is synthesized under anaerobic conditions by using nirECFD-LGHJN gene products. In vivo studies with an unmarked deletion strain, ΔnirF, showed that this gene is essential for cd₁ assembly and consequently for denitrification, which was restored when the ΔnirF strain was complemented with wild-type, plasmid-borne, nirF. Removal of a signal sequence and deletion of a conserved N-terminal Gly-rich motif from the NirF coded on a plasmid resulted in loss of in vivo NirF activity. We demonstrate here that the product of the nirF gene is a periplasmic protein and, hence, must be involved in a late stage of the cofactor biosynthesis. In vitro studies with purified NirF established that it could bind d₁ heme. It is concluded that His41 of NirF, which aligns with His200 of the d₁ heme domain of cd₁, is essential both for this binding and for the production of d₁ heme; replacement of His41 by Ala, Cys, Lys and Met all gave nonfunctional proteins. Potential functions of NirF are discussed., (© 2010 The Authors Journal compilation © 2010 FEBS.)

We demonstrate a first simultaneous measurement of both the refractive index and the attenuation coefficient (defined as the sum of the scattering and absorption coefficients) of highly turbid milk and milk-cream mixtures. We achieve this by observing the real-time reflectance profile of a divergent laser beam made incident on the surface of the milk sample. The experiments were carried out on commercial milk samples with fat volume concentrations of 0.5 or less, 1.6, and 3.3%, and on milk-cream mixtures with fat volume concentrations of 10 and 33.3%, without any dilutions of these samples. We find that the reflectance data are well described, for the first time without any empirical fit-parameters, by Fresnel theory that correctly includes the effect of angle-dependent penetration into the turbid medium on the total internally reflected signal. Therefore, our method provides the most accurate determination to date of the refractive index and attenuation coefficient of milk and milk-cream mixtures. Our sensor is compact, portable, and inexpensive., (Copyright (c) 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Iron in various iron-oxide aerogel and xerogel catalyst formulations (> or =85% Fe(2)O(3); < or =10% K, Co, Cu, or Pd) developed for possible use in Fischer-Tropsch synthesis (FTS) or the water-gas-shift (WGS) reaction has been examined by (57)Fe Mössbauer spectroscopy. The seventeen samples consisted of both as-prepared and calcined aerogels and xerogels and their products after use as catalysts for FTS or the WGS reaction. Complementary XAFS spectra were obtained on the occurrence of the secondary elements in some of the same materials. A broad, slightly asymmetric, two-peak Mössbauer spectrum was obtained from the different as-prepared and calcined catalyst formulations in the majority of cases. Such spectra could only be satisfactorily fit with three quadrupole doublet components, but no systematic trends in the isomer shift and quadrupole splitting parameters and area ratios of the individual components could be discerned that reflected variations in the composition or preparation of the aerogel or xerogel materials. However, significant reductions were noted in the Mössbauer effective thickness (recoilless absorption effect per unit mass of iron) parameter, chi(eff)/g, determined at room temperature, for aerogels and xerogels compared to bulk iron oxides, reflecting the openness and lack of rigidity of the aerogel and xerogel structures. Mössbauer measurements for two aerogels over the range from 15 to 292K confirmed the greatly diminished nature of this parameter at room temperature. Major increases in the effective thickness parameter were observed when the open structure of the aerogel or xerogel collapsed during calcination resulting in the formation of iron oxides (hematite, spinel ferrite). Similar structural changes were indicated by increases in this parameter after use of iron-oxide aerogels as catalysts for FTS or the WGS reaction, during which the iron-oxide aerogel was converted to a mixture of nonstoichiometric magnetite and the Hägg carbide, chi-Fe(5)C(2), or nonstoichiometric magnetite, respectively., (Copyright 2010 Elsevier B.V. All rights reserved.)

We demonstrate a first simultaneous measurement of the real and imaginary parts of the refractive index of a highly turbid medium by observing the real-time reflectance profile of a divergent laser beam made incident on the surface of the turbid medium. We find that the reflectance data are well described by Fresnel theory that correctly includes the effect on total internal reflection of angle-dependent penetration into the turbid medium.

The synthesis of the modified tetrapyrrole known as d(1) haem requires several dedicated proteins which are coded for by a set of genes that are often found adjacent to the structural gene, nirS, for cytochrome cd(1) nitrite reductase. NirE, the product of the first gene in the nir biogenesis operon, was anticipated to catalyse the conversion of uroporphyrinogen III into precorrin-2; this was confirmed, but it was shown that this enzyme is less sensitive to product inhibition than similar enzymes that function in other biosynthetic pathways. Sequence analysis suggesting that one of these proteins, NirN, is a c-type cytochrome, and has similarity to the part of cytochrome cd(1) that binds d(1), was validated by recombinant production and characterization of NirN. A NirN-d(1) haem complex was demonstrated to release the cofactor to a semi-apo form of cytochrome cd(1) from which d(1) was extracted, suggesting a role for NirN in the assembly of cytochrome cd(1) (NirS). However, inactivation of nirN surprisingly led to only a marginal attenuation of growth of Paracoccus pantotrophus under anaerobic denitrifying conditions. As predicted, NirC is a c-type cytochrome; it was shown in vitro to be an electron donor to the NirN-d(1) complex.

Background: There has been considerable investment in efforts to improve postoperative pain management, including the introduction of acute pain teams. There have also been a number of guidelines published on postoperative pain management and there is widespread agreement on how pain should be practically managed. Despite these advances, there is no apparent improvement in the number of patients experiencing moderately severe or extreme pain after surgery. This highlights significant scope for improvement in acute postoperative pain management., Scope: In January 2009, a multidisciplinary UK expert panel met to define and agree a practical framework to encourage implementation of the numerous guidelines and fundamentals of pain management at a local level. The panel recognised that to do this, there was a need to organise the information and guidelines into a simplified, accessible and easy-to-implement system based on their practical clinical experience. Given the volume of literature in this area, the Chair recommended that key international guidelines from professional bodies should be distributed and then reviewed during the meeting to form the basis of the framework. Consensus was reached by unanimous agreement of all ten participants., Findings: This report provides a framework for the key themes, including consensus recommendations based upon practical experience agreed during the meeting, with the aim of consolidating the key guidelines to provide a fundamental framework which is simple to teach and implement in all areas. Key priorities that emerged were: Responsibility, Anticipation, Discussion, Assessment and Response. This formed the basis of RADAR, a novel framework to help pain specialists educate the wider care team on understanding and prioritising the management of acute pain., Conclusion: Acute postoperative pain can be more effectively managed if it is prioritised and anticipated by a well-informed care team who are educated with regard to appropriate analgesic options and understand what the long-term benefits of pain relief are. The principles of RADAR provide structure to help with training and implementation of good practice, to achieve effective postoperative pain management.

Introduction: An epidemic of viral hepatitis occurred in Mandi Gobindgarh town of Punjab in northern India during year 2005-06. An attempt was made to study the outbreak clinically, serologically, and etiologically., Methods: Line listing and spot mapping of all cases of jaundice presented to civil hospital was done. An active search of cases was made through house-to-house visit with the help of 33 teams and 6 supervisors. Twenty two blood samples collected from acute cases were tested for anti-HAV IgM and anti-HEV IgM by ELISA. HEV specific PCR was also carried out. Sanitary survey was also done and water samples were tested for coliforms., Results: In house to house survey 3170 cases of jaundice were reported; of them 2171 (68.5%) were males. Mean age was 28.8 years. Overall attack rate was 5.2%. The epidemic continued for more than a year and bimodal peak was observed. Civil hospital campus which has separate water supply had no jaundice case. About 95% blood samples from icteric patients were found to be positive for IgM and IgG antibodies of HEV. Eighteen persons died during the epidemic, mostly in old age group. Case fatality ratio was 0.57%. No deaths occurred among 17 pregnant women who had developed hepatitis., Conclusion: The epidemic was caused by hepatitis E virus, which was transmitted due to faecal contamination of municipal water supply.

We conducted a study to ascertain the acceptability and feasibility of consultation by mobile phone in a rural area of northern India. The mobile phone number of a community physician was advertised to the general public and people were invited to telephone at any time for a medical consultation. Details of the calls received were recorded. During a seven-month study, 660 calls were received. The mean call duration was 2.7 min. Eighty percent of calls were made by men. Forty-eight percent of calls were made during office hours. A total of 417 (63%) calls were for seeking advice, 146 (22%) were for outpatient follow-up, 23 (4%) were for seeking appointments and the remaining 74 (11%) for other reasons. The most common problems were skin, respiratory, mental health and sexual problems. Of the 387 callers who were interviewed at follow-up, 302 (78%) stated that they had followed the advice provided. Of these, 91% found the advice very helpful in managing their health problems. About 96% of users wished to continue to use the service in future. The majority of calls made were of a primary care nature which could easily be dealt with by phone. The concept of using mobile phones for medical consultation seemed to be acceptable to people in rural Haryana.

Mycolactone, a polyketide toxin responsible for the extensive tissue destruction seen in Buruli ulcer, is assembled on a modular polyketide synthase (PKS). Despite operating on structurally different intermediates during synthesis, many of the ketoreductase (KR) domains of the mycolactone (MLS) PKS have identical sequences. This suggests that these enzymes might exhibit an unusually high level of substrate promiscuity. However, we show here that when recombinant mycolactone KR domains are tested with a range of surrogate substrates, their specificity closely matches that of KR domains derived from other PKS systems. In addition, our findings reinforce the role of substrate tethering for achieving stereochemical control in modular PKSs by affecting the delicate energetics of ketoreduction.

We present a refractometer based on the principle of total internal reflection that can sensitively record, in real time, the refractive index of fluids over a wide range of refractive indices. The device uses a divergent laser beam and a linear diode array, and has no mechanical or optical moving parts, enabling us to achieve the measurement of a refractive index at a sensitivity level of 10(-6). Our refractometer does not rely on interferometry, thus enabling the device to be compact, portable, and inexpensive. To the best of our knowledge, this is the first time a noninterferometric device that performs real-time differential refractometry with a sensitivity of better than 10(-5) has been demonstrated in the literature. We show that our experimental results agree very well with Fresnel theory. We establish a theoretical limit on the sensitivity of this class of refractometers.

A male infant is reported with bilateral low-set dysplastic ears, a severe cardiac defect, rib and vertebral anomalies, and intestinal malrotation. Karyotype and metabolic investigations were normal. Some clinical overlap with Goldenhar syndrome is observed but the symmetry of the facial features makes this diagnosis difficult to sustain. We feel this case may represent a previously undescribed condition, arising from abnormal development of the first and second branchial arches during embryonic life.

Recombinant ketoreductase (KR) domains derived from antibiotic-producing modular polyketide synthases (PKSs) have been examined as potential catalysts for the enantioselective reduction of non-polyketide substrates. KR domains from two modular PKSs show significant activity toward alternative substrates, particularly those that incorporate cyclohexyl moieties. Through site-directed mutagenesis of the amino acid motifs previously implicated in stereocontrol by KRs, we have identified mutants with improved activity toward such compounds. These results suggest that PKS KRs could potentially be used as biotransformation catalysts for the production of chiral alcohols.

Studies have shown no benefit of a subcutaneous fat stitch when closing hip wounds, but all have been in the presence of a drain. Our aim was to determine whether, in the absence of a drain, suturing or not of the subcutaneous fat layer in hip hemiarthroplasty wounds had any significant effect on wound complication rate. We performed a prospective cohort study of 45 hip hemiarthroplasty patients who had a fat stitch and 40 who did not. No drains were used in either group. There were 44 patients in the fat stitch group and 35 in the no fat stitch group after six patients were excluded. The infection rate was 2% for the fat stitch group, and 20% for the no fat stitch group (p=0.02). There were no cases of deep dehiscence in the fat stitch group, but four cases (11%) in the no fat stitch group (p=0.035). The overall complication rate in the fat stitch group was 6.8% compared to 33% in the no fat stitch group (p=0.007). In the absence of a drain, we have found a significant increase in hip hemiarthroplasty wound complications when the subcutaneous fat is not sutured.

A system is reported for the recombinant expression of individual ketoreductase (KR) domains from modular polyketide synthases (PKSs) and scrutiny of their intrinsic specificity and stereospecificity toward surrogate diketide substrates. The eryKR(1) and the tylKR(1) domains, derived from the first extension module of the erythromycin PKS and the tylosin PKS, respectively, both catalyzed reduction of (2R, S)-2-methyl-3-oxopentanoic acid N-acetylcysteamine thioester, with complete stereoselectivity and stereospecificity, even though the substrate is not tethered to an acyl carrier protein or an intact PKS multienzyme. In contrast, and to varying degrees, the isolated enzymes eryKR(2), eryKR(5), and eryKR(6) exercised poorer control over substrate selection and the stereochemical course of ketoreduction. These data, together with modeling of diketide binding to KR(1) and KR(2), demonstrate the fine energetic balance between alternative modes of presentation of ketoacylthioester substrates to KR active sites.

We have made what we believe is the first observation of phase-dependent temporal correlations in the fluorescent field emitted by coherently driven two-level atoms in free space. We measured the temporal fluctuations of the fluorescent field when the resonant driving field was in phase and out of phase with the local-oscillator field.

We present experimental evidence that the intensity correlations of light scattered from a cold-atom cloud are sensitive to the presence of small amounts of radiation trapping in an atomic sample of density 6 x 10(8)/cm3, with an optical depth (for a resonant light beam) of 0.4. This density and optical depth are approximately an order of magnitude less than the density and on-resonance optical depth at which effects of multiple scattering in cold-atom clouds have been previously observed [Phys. Rev. Lett. 64, 408 (1990)].

A case of Osteomyelitis of the frontal bone with a subperiosteal absces s, an extrudural abscess and a frontal sinus fistula is presented here for its rarity. A brief review of literature and management of the condition is also discussed.

We use an all-optical trap to confine a strongly attractive two-state mixture of lithium fermions. By measuring the rate of evaporation from the trap, we determine the effective elastic scattering cross section 4pia(2) to show that the magnitude of the scattering length |a| is very large, in agreement with predictions. We show that the mixture is stable against inelastic decay provided that a small bias magnetic field is applied. For this system, the s-wave interaction is widely tunable at low magnetic field, and can be turned on and off rapidly via a Raman pi pulse. Hence, this mixture is well suited for fundamental studies of an interacting Fermi gas.

We demonstrate time-resolved measurement of optical phase-space distributions as a new probe for investigating the propagation of light in disordered media. Phase-space techniques measure the joint transverse position and momentum distribution of the scattered light, and are sensitive to the spatially varying phase and amplitude of the field. Using this method we investigate light backscattered from a random medium. The measurements indicate that the weakly localized component is a phase conjugate of the incident light field. A new model of backscatter, based on Wigner phase-space distributions, elucidates the spatial and angular behavior of the localized and unlocalized components.

We demonstrate a two-window heterodyne method for measuring the x-p cross correlation, ??(*)(x)? (p)?, of an optical field ? for transverse position x and transverse momentum p. This scheme permits independent control of the x and p resolution. A simple linear transform of the x-p correlation function yields the Wigner phase-space distribution. This technique is useful for both coherent and low-coherence light sources and may permit new biological imaging techniques based on transverse coherence measurement with time gating. We point out an interesting analogy between x-p correlation measurements for classical-wave and quantum fields.

Advances in optical coherence tomography (OCT) rely on the availability of broadband light that is spatially coherent. We present a technique to characterize coherence properties of broadband light using optical phase-space contours in transverse momentum and position. We demonstrate that these contour plots can be directly measured by a simple heterodyne imaging scheme possessing high dynamic range (130 dB) and 0.1 fW sensitivity (for mW input beams). These phase space distributions are shown to yield quantitative information on the longitudinal and transverse coherence and the wavefront curvature of the light beam. We apply this technique to characterize the light emitted by a novel high-power extended-bandwidth superluminescent diode (SLD) recently developed at the David Sarnoff Research Center. Its performance is compared to that of standard commercially available SLDs. © 1999 Society of Photo-Optical Instrumentation Engineers.

Using a novel heterodyne technique, we measure optical phase-space distributions in momentum and position for low-coherence light. Quantitative information is obtained simultaneously about the longitudinal and the transverse coherence properties as well as the wave-front curvature of the light field. This method can be used to monitor these optical parameters directly for signal fields scattered from samples of interest, for tomographic imaging.

This study was undertaken to determine the coagulation profile of women with pregnancy induced hypertension and to evaluate the changes in the level of AT-III in pre-eclampsia and eclampsia and its correlation with severity of disease in order to evaluate if it can be used as a marker for severity of PIH. 119 women with PIH in the third trimester of pregnancy constituted the study group. Age and parity matched 25 normal pregnant and 25 non-pregnant women were taken as control group. No significant difference between the coagulation profile of non-pregnant and normal pregnant women was seen. There is evidence of consumption coagulopathy in PIH patients and AT-III activity shows a gradual and almost linear reduction in various groups ranging from normal pregnant women to eclampsia. Reduction in AT-III activity has positive correlation with PIH and it can be a useful marker for severity of PIH.

It was shown that the effects of halothane anaesthesia in the dromedary are similar to those of large domestic ruminants. As a general rule the equipment and techniques used for adult cattle may also be used in the dromedary. Endotracheal intubation may be more difficult in camels because of their narrow oral cavities. Involuntary regurgitation is a particular hazard in dromedaries and every effort should be made to avoid this potentially life threatening complication.