Dendritic Cells and the Establishment of Fetomaternal Tolerance for Successful Human Pregnancy.

Pregnancy is a remarkable event where the semi-allogeneic fetus develops in the mother's uterus, despite genetic and immunological differences. The antigen handling and processing at the maternal-fetal interface during pregnancy appear to be crucial for the adaptation of the maternal immune system and for tolerance to the developing fetus and placenta. Maternal antigen-presenting cells (APCs), such as macrophages (Mφs) and dendritic cells (DCs), are present at the maternal-fetal interface throughout pregnancy and are believed to play a crucial role in this process. Despite numerous studies focusing on the significance of Mφs, there is limited knowledge regarding the contribution of DCs in fetomaternal tolerance during pregnancy, making it a relatively new and growing field of research. This review focuses on how the behavior of DCs at the maternal-fetal interface adapts to pregnancy's unique demands. Moreover, it discusses how DCs interact with other cells in the decidual leukocyte network to regulate uterine and placental homeostasis and the local maternal immune responses to the fetus. The review particularly examines the different cell lineages of DCs with specific surface markers, which have not been critically reviewed in previous publications. Additionally, it emphasizes the impact that even minor disruptions in DC functions can have on pregnancy-related complications and proposes further research into the potential therapeutic benefits of targeting DCs to manage these complications.

A Giant Frontoethmoidal Ivory Osteoma Causing Cosmetic and Visual Problem: A Case Report.

Osteomas are slow growing fibro-osseous lesions. Very rare to occur in paranasal sinuses. Small osteomas don't require any intervention. Giant osteomas may require surgical intervention due to its cosmetic and functional compromises. A 28 year old male presented with swelling over forehead and left orbit for more than 4 years. The swelling is around 6 × 5 cm with gross lateral and inferior deviation of left eyeball. Extradural fronto-ethmoidectomy was done with combined external and endoscopic approach. There was pearly white bony hard, fixed tumor mass seen infiltrating anterior and posterior table of frontal bone. All the tumors removed in piecemeals. Wait and watch policy is the usual treatment policy for small and asymptomatic osteomas. Combine external and endoscopic approach is the treatment of choice for giant frontoethmoid osteoma.

Molecular complexity of mammary glands development: a review of lactogenic differentiation in epithelial cells.

The mammary gland is a dynamic organ with various physiological processes like cellular proliferation, differentiation, and apoptosis during the pregnancy-lactation-involution cycle. It is essential to understand the molecular changes during the lactogenic differentiation of mammary epithelial cells (MECs, the milk-synthesizing cells). The MECs are organized as luminal milk-secreting cells and basal myoepithelial cells (responsible for milk ejection by contraction) that form the alveoli. The branching morphogenesis and lactogenic differentiation of the MECs prepare the gland for lactation. This process is governed by many molecular mediators including hormones, growth factors, cytokines, miRNAs, regulatory proteins, etc. Interestingly, various signalling pathways guide lactation and understanding these molecular transitions from pregnancy to lactation will help researchers design further research. Manipulation of genes responsible for milk synthesis and secretion will promote augmentation of milk yield in dairy animals. Identifying protein signatures of lactation will help develop strategies for persistent lactation and shortening the dry period in farm animals. The present review article discusses in details the physiological and molecular changes occurring during lactogenic differentiation of MECs and the associated hormones, regulatory proteins, miRNAs, and signalling pathways. An in-depth knowledge of the molecular events will aid in developing engineered cellular models for studies related to mammary gland diseases of humans and animals.

Seborrhoeic Keratosis of External Auditory Canal & its Management.

Introduction: Seborrhoeic keratosis (SK) is a benign neoplasm of the skin. They are usually found to occur anywhere in the body except palms, soles and mucous membranes. The skin of the external auditory canal is an extremely rare site for the occurrence of this benign neoplasm. Malignant transformation rarely occurs in this benign condition. It should be differentiated from other malignant condition like squamous cell carcinoma, basal cell carcinoma, Bowen's disease, malignant melanoma or keratoacanthoma. Surgery is the mainstay of treatment though recurrence is very common. It can be removed by cryotherapy using liquid nitrogen or curettage, light fulgaration, shave removal or painting with pure TCA if the lesion is small. Diathermy shoul be used as minimal as possible to avoid scar formation. Case Report: An elderly female presented to ENT OPD with left ear blood-stained discharge. On inspection there was irregular blackish mass filling the entire left external auditory canal, fine needle aspiration cytology came to be seborrhoeic keratosis. Since on imaging the tumor was confined to the external auditory canal, it was excised completely by transcanal route. Surprisingly histopathology came to be squamous cell carcinoma. Considering the age and limited confinement of the tumor, she was kept on regular follow up. Conclusion: Seborrhoeic keratosis though a common benign tumor, malignant transformation may occur. Treatment is patient specific and may be modified considering the age and comorbidity of the patient.

Necrotising Fasciitis of Head and Neck in Infants.

Necrotising fasciitis (NF) is a rapidly progressing soft tissue infection having high risk of morbidity and mortality. Though it is a common condition encounter in surgical practice for adults, it's incidence in children are very low. In children also abdomen is the most common site for NF. It's involvement in head and neck is extremely rare. Here we discuss the clinical features and management of three cases of NFs in head and neck region of infants and also look for the etiology, clinical presentation and management for same.

Citelli's Abscess Following Otitis Media: A Case Report.

INTRODUCTION: Citelli's abscess is an extratemporal complication of otitis media. It occurs when pus from the mastoid tip trickles down along the posterior belly of the digastric muscle to the occipital and cervical region. It is a very unusual presenting complication of chronic otitis media with no available data in the until now. CASE REPORT: A 10-year-old female was presented to our outpatient department with a 1 month history of hi-grade fever and headache and pain around the left half of the face. During physical examination a huge swelling present in the left temporal and occipital region was observed. The swelling crossed the midline, was tender to touch, and was fluctuant. During otological examination left sided chronic suppurative otitis media, of the attico-antral type with cholesteatoma, and a profuse foul smelling purulent discharge was observed. After complete investigation, drainage of the patient's abscess was performed under general anesthesia. A postaural incision was administered and around 500 ml of pus drained out. Immediately after the operation, the patient showed signs of recovery. After 3 weeks of parenteral antibiotic therapy, the primary focus was debrided by performing left modified radical mastoidectomy. CONCLUSION: Citelli's abscess is a rare complication of otitis media. Urgent radiology, followed by drainage of pus is performed to reduce pain and further progression of the infective process. The primary ear pathology is managed surgically after adequate treatment with intra venous antibiotics.