Hyalinizing clear cell carcinoma of the base of tongue: a distinct and rare entity.

Hyalinizing clear cell carcinoma (HCCC) of tongue is a rare neoplasm originating from minor salivary glands. We present a case of HCCC involving the base of tongue, in a 73-year-old male, clinically diagnosed as fibroma. Laser excision of the mass was done. Histopathological examination showed an infiltrating lesion composed predominantly of clear cells. The differential diagnosis included other salivary gland lesions having a clear cell component and metastatic clear cell renal carcinoma. Immunohistochemistry was useful in ruling out these lesions exhibiting clear cell component from clear cell carcinoma. Imaging studies revealed no lesion in either kidney. Since, HCCC has a better prognosis and the adequate treatment is wide excision, it needs to be differentiated from other carcinomas with clear cells. No further therapy was given to the patient. One year after the surgery, the patient is symptom free without local recurrence and on regular follow up.

A short, stereoselective, and common approach for the synthesis of 4,5-disubstituted delta-lactones simplactone B and its C-5 analogue.

A short, stereoselective, and a common approach for the synthesis of 4,5-disubstituted delta-lactones simplactone B and its analogue using Evans protocol is described.

Comparative study of percutaneous dilatational tracheostomy and conventional tracheostomy in the intensive care unit.

OBJECTIVE: Tracheostomy is a one of the earliest described surgical procedure dating back to 2000 B.C. Percutaneous tracheostomy is becoming increasingly popular as an alternative method for conventional tracheostomy in the intensive care unit. In this study we compare the results of the use of these 2 techniques in 32 patients who underwent elective tracheostomy in the intensive care unit. STUDY DESIGN: Prospective randomized comparative study. SETTING: Tertiary care hospital. PATIENTS: Adult intubated patients selected randomly in the intensive care unit with normal cervical soft tissue, laryngeal framework, palpable cricoid cartilage and normal coagulation parameters. RESULTS: 17 patients underwent conventional tracheostomy and 15 patients underwent percutaneous dilatational tracheostomy. Demographic data and duration of intubation comparable between two groups. The mean operative time, blood loss and complications were lower in percutaneous than in conventional tracheostomy. CONCLUSIONS: PDT is quicker to perform and has lower blood loss and complication rates compared to conventional tracheostomy. However percutaneous tracheostomy is not indicated in emergencies and in children. The cost of the percutaneous kit and use of bronchoscopy adds to the cost. It is a good alternative to conventional tracheostomy in properly selected patients.

Appendage deformity syndrome--a nutritional disease of Macrobrachium rosenbergii.

Culture of the freshwater prawn Macrobrachium rosenbergii as an alternative to penaeid shrimp has recently increased in coastal areas of southern India in order to avoid numerous problems, particularly with white spot syndrome virus (WSSV). However, M. rosenbergii culture is now threatened by a new disease, appendage deformity syndrome (ADS), that also results in high mortality. Analysis of ADS prawns for viruses such as WSSV, monodon baculovirus (MBV) and infectious hypodermal and hematopoeitic necrosis virus (IHHNV) gave negative results. ADS prawns were also negative for bacterial pathogens and affected animals did not respond to antibiotic therapy. A study of potential nutritional deficiency revealed that carotenoid supplementation in the diet led to a significant decrease in ADS prawns.

Otological manifestations in head injury and their management - a case report.

32 year old male presented with right facial palsy following head injury. Clinical evaluation showed hemotympanum on right with moderately severe conductive hearing loss, grade III LMN facial palsy and BPPV. HRCT of temporal bone demonstrated fracture base of skull involving the roof of mastoid with no evidence of bony injury to fallopian canal. Conservative management of head trauma resulted in satisfactory outcome except for conductive hearing loss and faciel palsy. Facial palsy was managed conservatively [physiotherapy and oral steroids] with full recovery of function after 4 weeks. Conductive hearing loss was managed by combined approach tympanaplasty. Preoperutively incudostapedial joint dislocation and fracture anterior crus of stapes were noted. Type II tympanoplasty with horizontal incus repositioning was carried out.PTA after 6 weeks showed 15-20 dB air-bone gap compared to 50-55dB air-bone gap preoperatively. BPPV recovered spontaneously. This case is reported to highlight:Importance of imaging of temporal bone.Spontaneous recovery of facial nerve function in neuropraxtc injury.Timely and appropriate surgical intervention of ossicular damage following head injury resulting in satisfatctory outcome.

Endogenous sodium-potassium ATPase inhibition related biochemical cascade in trisomy 21 and Huntington's disease: neural regulation of genomic function.

The isoprenoid pathway related cascade was assessed in trisomy 21 and Huntington's disease. Membrane Na+-K+ ATPase activity, serum magnesium and ubiquinone were decreased while HMG CoA reductase activity, serum digoxin and dolichol levels were increased in both the disorders. There were increased levels of tryptophan catabolites (nicotine, strychnine, quinolinic acid and serotonin) and decreased levels of tyrosine catabolites (dopamine, noradrenaline and morphine) in both trisomy 21 and Huntington's disease. There was an increase in dolichol levels, carbohydrate residues of glycoproteins, glycolipids, total/individual GAG fractions and lysosomal enzymes in both disorders. Reduced levels of ubiquinone, reduced glutathione and free radical scavenging enzymes as well as increased lipid peroxidation products and nitric oxide were noticed in both the disorders. The role of hypothalamic digoxin and a disordered isoprenoid pathway in the pathogenesis of trisomy 21 and Huntington's disease is discussed.

Hypothalamic digoxin and regulation of body mass index.

The hypothalamus produces digoxin, an endogenous membrane Na+-K+ ATPase inhibitor and regulator of neurotransmission. Digoxin being a steroidal glycoside, is synthesised by the isoprenoid pathway. In view of the reports of elevated digoxin levels in metabolic syndrome X with high body mass index, the isoprenoid pathway mediated biochemical cascade was assessed in individuals with high and low body mass index. It was also assessed in individuals with differing hemispheric dominance to find out the relationship between digoxin status, body mass index and hemispheric dominance. The isoprenoid pathway metabolites, tryptophan / tyrosine catabolic patterns and membrane composition were assessed. In individuals with high body mass index an upregulated isoprenoid pathway with increased HMG CoA reductase activity, serum digoxin and dolichol levels and low ubiquinone levels were observed. The RBC membrane Na+-K+ ATPase activity and serum magnesium levels were decreased. The tyrosine catabolites (dopamine, morphine, epinephrine and norepinephrine) were reduced and the tryptophan catabolites (serotonin, quinolinic acid, strychnine and nicotine) were increased. There was an increase in membrane cholesterol : phospholipid ratio and a reduction in membrane glycoconjugates in individuals with high body mass index. The reverse patterns were seen in individuals with low body mass index. The patterns in individuals with high body mass index and low body mass index correlated with right hemispheric dominance and left hemispheric dominance respectively. Hemispheric dominance and digoxin status regulates the differential metabolic pattern observed in individuals with high and low body mass index.