Giant complicated glosso-cervical arterio venous malformation managed with external carotid artery ligation and serial injection sclerotherapy: a case report and review of literature

Giant arterio venous malformation (AVM) of the tongue and floor of mouth are rare. They become life threatening when ignored by the patients. Treatment protocols are not well established. This report describes the treatment of a 35 years old female who presented to us with complains of swelling of tongue, floor of mouth and left sub mandibular region since 15 years causing dysphagia, and oral bleed since one day. Magnetic resonance Angiography revealed a giant AVM at the above site with dilated left external carotid artery (ECA) and left lingual artery. Patient underwent ECA ligation under general anaesthesia and serial injection sclerotherapy at the local site. After 3 months and 6 cycles of sclerotherapy, the patient had a satisfactory outcome. A detailed report with review of literature is presented.

An Experience with a Different Conservative Management of Keratocystic Odontogenic Tumor.

Background: The aim of our study is to share our experience with conservative management of odontogenic keratocyst, and also to study the role of carnoy’s solution in prevention of recurrence of small keratocystic odontogenic tumour (KCOT). Methods: 29 consecutive patients with 30 KCOT treated in department of Oral & Maxillofacial Surgery in Teerthanker Mahaveer Dental college, Moradabad, UP. Initial biopsy was carried out in all patients and the OKCs were diagnosed after histological examination by the Oral Pathology Department. Out of 26 KCOT which were treated with enucleation alone, 14 patients were subjected to additional burning of cyst epithelium by carnoy’s solution. 4 large OKC which might undergone pathological fracture were treated by two stage surgery marsupialization followed by enucleation. Results: The majority of the lesions (17 patients, 56.7%) occurred in the mandibular third molar region. Recurrence occurred in 4 patients, in which 3 of them were from enucleation group and one of marsuplization and enucleation group.All the caseswere monitored continuously with panoramic radiographies and clinical evaluations.curettage of the remaining lesion. The average follow-up was 15 months. Conclusion: Use of carnoy’s solution with enucleation has definite advantage over the conventional enucleation. Further large KCOT can be conservatively treated with low morbidity with Marsupilization followed by enucleation successfully. The systematic and long-term post-surgical follow-up is considered to be a key element for successful results.

Purified dextransucrase from Pediococcus pentosaceus CRAG3 as food additive.

The extracellular crude dextransucrase (0.67 U/mg) from P. pentosaceus CRAG3 (GenBank accession number JX679020) after PEG-1500 fractionation gave specific activity, 20.0 U/mg which by gel filtration resulted in 46.0 U/mg. The purified dextransucrase displayed molecular size of approximately, 224 kDa. The optimum assay conditions for dextransucrase activity were 5% sucrose in 20 mM sodium acetate buffer (pH 5.4) and 30 oC. The dextransucrase was stable up to 40 oC and at pH range of 5.4-7.0. The metal ions such as Co2+, Ca2+, Mg2+ and Zn2+ stimulated the dextransucrase activity by 56, 44, 14 and 12%, respectively. It was most stable at -20 oC with half-life of 307 days. Amongst various additives used, glycerol and Tween 80 provided significant stability to the enzyme with half-life 15.5 and 85.5 h, respectively as compared to control (6.9 h). The solidification of sucrose supplemented milk by purified dextransucrase due to dextran synthesis displayed its application as additive for improving the texture of dairy products.

Optimization of Fermentation Medium for Enhanced Glucansucrase and Glucan Production from Weissella confusa

A glucan producing Weissella confusa isolated from fermented cabbage, as identified earlier, was used for optimization of its fermentation medium. The effects of various macronutrients such as sucrose, glucose as cosubstrate, yeast extract, beef extract, peptone, sodium acetate, K2HPO4 and Tween 80 were studied on glucansucrase and glucan production from Weissella confusa. The medium used as control gave 6.0 U/ml enzyme activity and 34 mg/ml glucan concentration. Sucrose (5 percent), glucose as cosubstrate (5 percent for glucansucrase and 3 percent for glucan production), Tween 80 (0.1 percent), yeast extract (1.5 percent), Peptone (2.0 percent) and K2HPO4 (1.5 percent) were effective nutrients displaying higher glucansucrase and glucan production giving 18.2, 18.0, 7.0, 6.4, 6.2 and 6.4 U/ml enzyme activity and 103, 100, 46, 41, 39 and 37 mg/ml glucan concentration, respectively. Sodium acetate and beef extract were not effective for enzyme and glucan production. The new strain Weissella confusa can be used for commercial production of glucansucrase and glucan using optimized medium.

Scale up of dextran production from a mutant of Pediococcus pentosaceus (SPAm) using optimized medium in a bioreactor

The mutant of Pediococcus pentosaceus (SPAm) produced earlier by UV-mutagenesis exhibiting higher dextransucrase activity as compared to wild-type was used. The generated mutant SPAm gave 12.2 mg/ml, a 20 percent higher dextran than wild-type. Response surface methodology was carried out for further enhancement of dextran production. To enhance dextran production by the mutant SPAm, Plackett-Burman Design and a 2² full factorial Central Composite Design was employed. After response optimization, the optimum concentration of sucrose and yeast extract was 5.115 percent (w/v) and 0.635 percent (w/v), respectively. The experimental values of dextran 36.0 mg/ml at flask level and 35.0 mg/ml at bioreactor level were in good agreement with the predicted value of 40.8 mg/ml. The increase in dextran production by the mutant SPAm using the optimized medium was 3 fold higher as compared to unoptimized medium.