Snare assisted manual small-incision cataract surgery: Single solution for any grade of cataract

Cataract surgery is constantly evolving with new techniques, machines, and procedures entering the lexicon. With the modernization, the cost of surgery is increasing with respect to the surgeon, patient, and the society. Early rehabilitation with modern minimal access techniques reduces the societal cost of intervention. Manual small-incision surgery is simple, safer, and cheaper when contrasted with the cost and steep learning curve of machine-driven surgeries. A nucleus of a normal size is 6 mm, which can be bisected; 3 mm longitudinal fragments can be removed through 3.5 to 4.5 mm incision, and a large nucleus of 9.0 mm can trisected and removed through 3.5 to 4.5 mm. The limbal tunnel incision is 3.5 mm, which is close to 2.8 mm phacoincision, so it gives all the advantages of modern phacosurgery. The search of an ideal technique for manual phaco-fragmentation leads us to this specially designed snare (designed by the first author AS) which can tackle any grade nucleus. The nucleus can be bisected or trisected with ease. The technique has been around for 2 decades. There is a small learning curve. The complications are few and can be minimized with practice and simulation. It is a safe, valid, repeatable, and generalizable surgical procedure.

Serum Neurofilament Light Chain Is Associated with Incident Lacunes in Progressive Cerebral Small Vessel Disease / 대한뇌졸중학회지

Background@#and Purpose Serum neurofilament light (NfL)-chain is a circulating marker for neuroaxonal injury and is also associated with severity of cerebral small vessel disease (SVD) cross-sectionally. Here we explored the association of serum-NfL with imaging and cognitive measures in SVD longitudinally. @*Methods@#From 503 subjects with SVD, baseline and follow-up magnetic resonance imaging (MRI) was available for 264 participants (follow-up 8.7±0.2 years). Baseline serum-NfL was measured by an ultrasensitive single-molecule-assay. SVD-MRI-markers including white matter hyperintensity (WMH)-volume, mean diffusivity (MD), lacunes, and microbleeds were assessed at both timepoints. Cognitive testing was performed in 336 participants, including SVD-related domains as well as global cognition and memory. Associations with NfL were assessed using linear regression analyses and analysis of covariance (ANCOVA). @*Results@#Serum-NfL was associated with baseline WMH-volume, MD-values and presence of lacunes and microbleeds. SVD-related MRI- and cognitive measures showed progression during follow-up. NfL-levels were associated with future MRI-markers of SVD, including WMH, MD and lacunes. For the latter, this association was independent of baseline lacunes. Furthermore, NfL was associated with incident lacunes during follow-up (P=0.040). NfL-levels were associated with future SVD-related cognitive impairment (processing speed: β=–0.159; 95% confidence interval [CI], –0.242 to –0.068; P=0.001; executive function β=–0.095; 95% CI, –0.170 to –0.007; P=0.033), adjusted for age, sex, education, and depression. Dementia-risk increased with higher NfL-levels (hazard ratio, 5.0; 95% CI, 2.6 to 9.4; P<0.001), however not after adjusting for age. @*Conclusions@#Longitudinally, serum-NfL is associated with markers of SVD, especially with incident lacunes, and future cognitive impairment affecting various domains. NfL may potentially serve as an additional marker for disease monitoring and outcome in SVD, potentially capturing both vascular and neurodegenerative processes in the elderly.

Epigallocatechin gallate induces the steady state mRNA levels of pS2 and PR genes in MCF-7 breast cancer cells.

Investigations using in vitro and in vivo models of breast carcinogenesis have demonstrated anti-neoplastic activity of the green tea polyphenol, epigallocatechin gallate (EGCG). Although a number of molecular targets of EGCG have been identified, its impact on the expression of estrogen target genes is not completely understood. Here, we examined the mRNA expression levels of two estrogen target genes, namely Trefoil Factor 1 (pS2) and Progesterone Receptor (PR) in MCF-7 cells treated with EGCG. We observed that treatment with 40 µM EGCG, which caused only 20% decrease in cell viability, resulted in increased steady state expression levels of pS2 and PR mRNA. This suggests that EGCG may exert its biological activities, at least in part, by influencing the expression of estrogen target genes.

Comparative evaluation of serum folic acid levels in smokers and non-smokers with chronic periodontitis.

Objectives: Folic acid is a vitamin which belongs to the B-complex group. It is critical to cellular division and new cell production because it is an essential co-factor in DNA synthesis. Repair and maintenance of periodontal tissue generates a high turnover rate of squamous epithelium. Without folic acid, epithelial cells do not divide properly. Cigarette smoking is one of the factors that affect the folic acid levels. The aim of this study was to compare the serum folic acid levels in patients with chronic periodontal disease in relation to the patients’ smoking habits. Materials and Methods: A total of 60 subjects were included in the study with 30 subjects in each of the following groups, I - patients who have chronic periodontitis and are smokers and II - patients who have chronic periodontitis and are non-smokers. Clinical parameters like gingival index (GI), plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical gingival attachment levels (CAL) were recorded for all the patients. Blood was collected and tested in the laboratory for folic acid levels using a fully automated serum analyser. The results were statistically analysed. Results: The results suggested that serum folic acid levels of smokers were significantly lower than that of non-smokers (p < 0.05). PI, PD and CAL means were significantly higher in Group I (chronic periodontitis and smokers) than Group II (chronic periodontitis and non-smokers). GI and BOP was lower in smokers. Conclusion: Among patients with periodontal disease the serum folic acid level is lower in smokers compared with non-smokers.

Changes in gene expression following androgen receptor blockade is not equivalent to androgen ablation by castration in the rat ventral prostate.

Involution of the rat ventral prostate and concomitant modulation of gene expression post-castration is a well- documented phenomenon. While the rat castration model has been extensively used to study androgen regulation of gene expression in the ventral prostate,it is not clear whether all the gene expression changes post-castration are due to androgen depletion alone. To obtain insights into this, we performed differential display reverse transcriptase polymerase chain reaction (DD-RT-PCR) which resulted in the identification of castration and/or flutamide-regulated genes in the rat ventral prostate. These include clusterin, methionine adenosyl transferase II alpha, and prostate-specific transcripts such as PBPC1BS, S100RVP and A7. While clusterin, PBPC1BS and methionine adenosyl transferase II alpha are regulated by both castration and flutamide, S100 RVP and A7 are regulated by castration alone. Interestingly, we show that flutamide, unlike castration, does not induce apoptosis in the rat ventral prostate epithelium, which could be an underlying cause for the differential effects of castration and flutamide treatment. We propose that castration leads to enrichment and depletion of stromal and epithelial cell types, respectively, resulting in erroneous conclusions on some of the cell type-specific transcripts as being androgen regulated.

Demographic profile, clinical presentation, management options in cranio-cerebral trauma: an experience of a rural hospital in Central India

Head injury is a common condition that can result in either obvious neurological sequelae or imaging findings. The purpose of this study was to find out the epidemiology, clinical presentation and management options in patients with head injury at a rural centre of central India. In this retrospective study, data of all patients who attended the Department of Surgery, ABMH, Sawangi [Meghe], Wardha for cranio-cerebral trauma were included and a total of 200 patients were reviewed. Epidemiological and clinical details including investigations were noted for all the patients. Management offered to the patients was studied and outcome was analyzed. This study enrolled 200 patients. Male were more common than female. Young patients were commonly affected. Common presenting features were loss of consciousness and vomiting. Mild head injury was most common. Majority of patients were treated conservatively and indications for surgery were compound depressed fractures and significant intracranial haematomas. Cranio-cerebral injury patterns in developing countries particularly in rural area are no different from developed countries and knowledge of its causative factors, management and potential complications will help to plan active interventions that may improve outcome. It will also help in developing preventive measures

Novel flutamide regulated genes in the rat ventral prostate: differential modulation of their expression by castration and flutamide treatments / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To identify flutamide regulated genes in the rat ventral prostate.</p><p><b>METHODS</b>Total RNA from ventral prostates of control and flutamide treated rats were isolated. Differentially expressed transcripts were identified using differential display reverse transcriptase polymerase chain reaction. The effect of castration on the expression of flutamide-regulated transcripts was studied.</p><p><b>RESULTS</b>We have identified beta2-microglobulin, cytoplasmic FMR1 interacting protein 2 and pumilio 1 as flutamide induced and spermine binding protein and ribophorin II as flutamide repressed targets in the rat ventral prostate. Although flutamide treatment caused an induction of pumilio 1 mRNA, castration had no effect.</p><p><b>CONCLUSION</b>Castration and flutamide treatments exert differential effects on gene expression. Flutamide might also have direct AR independent effects, which might have implications in the emergence of androgen independent prostate cancer and the failure of flutamide therapy.</p>