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1.
Hernia ; 28(3): 839-846, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38366238

ABSTRACT

INTRODUCTION: Subcostal hernias are categorized as L1 based on the European Hernia Society (EHS) classification and frequently involve M1, M2, and L2 sites. These are common after hepatopancreatic and biliary surgeries. The literature on subcostal hernias mostly comprises of retrospective reviews of small heterogenous cohorts, unsurprisingly leading to no consensus or guidelines. Given the limited literature and lack of consensus or guidelines for dealing with these hernias, we planned for a Delphi consensus to aid in decision making to repair subcostal hernias. METHODS: We adopted a modified Delphi technique to establish consensus regarding the definition, characteristics, and surgical aspects of managing subcostal hernias (SCH). It was a four-phase Delphi study reflecting the widely accepted model, consisting of: 1. Creating a query. 2. Building an expert panel. 3. Executing the Delphi rounds. 4. Analysing, presenting, and reporting the Delphi results. More than 70% of agreement was defined as a consensus statement. RESULTS: The 22 experts who agreed to participate in this Delphi process for Subcostal Hernias (SCH) comprised 7 UK surgeons, 6 mainland European surgeons, 4 Indians, 3 from the USA, and 2 from Southeast Asia. This Delphi study on subcostal hernias achieved consensus on the following areas-use of mesh in elective cases; the retromuscular position with strong discouragement for onlay mesh; use of macroporous medium-weight polypropylene mesh; use of the subcostal incision over midline incision if there is no previous midline incision; TAR over ACST; defect closure where MAS is used; transverse suturing over vertical suturing for closure of circular defects; and use of peritoneal flap when necessary. CONCLUSION: This Delphi consensus defines subcostal hernias and gives insight into the consensus for incision, dissection plane, mesh placement, mesh type, and mesh fixation for these hernias.


Subject(s)
Consensus , Delphi Technique , Herniorrhaphy , Surgical Mesh , Humans , Herniorrhaphy/methods
2.
BMC Plant Biol ; 19(1): 10, 2019 Jan 07.
Article in English | MEDLINE | ID: mdl-30616590

ABSTRACT

BACKGROUND: Meiotic abnormalities lead to morphological and genetic variations which caused not only to evolution but also intraspecific reproductive barriers. During present study of detailed meiotic course in dicotyledonous plants sampled from Indian cold deserts, various meiotic abnormalities have been detected. For this, the plant materials fixed in Carnoy's fixative and studied detailed meiotic course by standard squash method in 1% acetocarmine. RESULTS: Meiotic abnormalities have been presently detected in 71 species which include multiple associations in diploids (Achillea millefolium L.), multivalents and univalents in polyploids (4 species), cytomixis (40 species), chromosome stickiness (20 species), nonsynchronous disjunction of bivalents (32 species), interbivalent connections (15 species), synaptic mutants (2 species), syncyte meiocytes (2 species), abnormal spindles (7 species), and fusion of pollen grains (1 species), laggards and chromatin bridges, hypo-, hyperploid PMCs, monads, dyads, triads, tetrads with micronuclei and polyads. CONCLUSIONS: Consequently, variable sized apparently fertile pollen grains and considerable amount of sterile pollen grains are resulted as end products which lead to different genetic constitution (aneuploids and polyploids) and curtailed sexual reproductive success in these species.


Subject(s)
Meiosis , Plants/genetics , Pollen/genetics , Chromosomes, Plant/genetics , Chromosomes, Plant/physiology , Cold Temperature , Desert Climate , Diploidy , India , Pollen/physiology , Polyploidy
3.
Tsitol Genet ; 47(2): 56-65, 2013.
Article in English | MEDLINE | ID: mdl-23745363

ABSTRACT

In this work we studied the meiotic chromosome number and details of secondary chromosomal associations recorded for the first time in Geranium pratense L. from the alpine environments in the cold deserts of Lahaul-Spiti (India). All the presently studied individuals of the species existed at 4x level (x = 14). The present chromosome count of n = 28 in the species adds a new cytotype to the already existing diploid chromosome count of 2n = 28 from the Eastern Himalayas and outside of India. Out of the six accessions scored presently four showed normal meiotic course. However, two accessions investigated from Mud, 3800 m and Koksar, 3140 m depicted abnormal meiotic course due to the presence of multivalents and univalents, and secondary associations of bivalents/chromosomes. The secondary chromosomal associations in the species existed among bivalents/chromosomes were noticed in the PMCs at prophase-1 (diakinesis) and persisted till the separation of sister chromatids at M-II. The variation in the number of bivalents/chromosomes involved in the secondary associations at M-I (2-8) and A-I/M-II (2-12) has also been recorded. The occurrence of such secondary associations of bivalents/chromosomes in G. pratense which existed at 4x level indicated the secondary polyploid nature of the species.


Subject(s)
Chromosomes, Plant/genetics , Geranium/growth & development , Geranium/genetics , Polyploidy , Chromosomes, Plant/ultrastructure , Cold Climate , Desert Climate , Fertility/genetics , India , Meiosis/genetics , Pollen/genetics , Pollen/growth & development , Sister Chromatid Exchange
4.
J Biosci ; 33(3): 371-80, 2008 Sep.
Article in English | MEDLINE | ID: mdl-19005237

ABSTRACT

We report the occurrence of cytomixis in wild populations of Himalayan poppy (Meconopsis aculeata Royle),which is considered to be an important and threatened medicinal plant growing in the high hills of the Himalayas. The impact of cytomixis on meiotic behaviour, reduced pollen viability and heterogeneous-sized pollen grains was also studied. Cytological studies in the seven wild populations from the high hills of Himachal Pradesh revealed that all the Himalayan populations exist uniformly at the tetraploid level (2n=56) on x=14. The phenomenon of chromatin transfer among the proximate pollen mother cells (PMCs) in six populations caused various meiotic abnormalities. Chromatin transfer also resulted in the formation of coenocytes, aneuploid, polyploid and anucleated PMCs. Among individuals that showed chromatin transfer, chromosome stickiness and interbivalent connections were frequently observed in some PMCs. The phenomenon of cytomixis in the species seems to be directly under genetic control; it affects the meiotic course considerably and results in reduced pollen viability.


Subject(s)
Chromatin/metabolism , Chromosomes, Plant , Meiosis , Papaveraceae/physiology , Pollen/physiology , Karyotyping
5.
Cleft Palate Craniofac J ; 38(5): 519-24, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11522174

ABSTRACT

OBJECTIVE: This prospective study examined the effect of lactation instruction and palatal obturation in decreasing time to feed, increasing intake, and on growth in eight breast milk bottle-fed newborn infants with cleft lip, cleft palate, or both. DESIGN: An A, B1, C1, B2, and C2 reversal design was used with eight mothers. In A, baseline data on minutes fed by breast were recorded. In B1, baseline on minutes fed with a Haberman bottle was recorded. In C1, minutes fed following lactation education and palatal obturation were documented. Lactation education was information given to mothers to recognize infant feeding cues and to have infant-led feedings. The palatal obturator was a passive molding appliance. In B2, the obturator was removed and minutes fed noted. In C2, the obturator was returned and lactation support provided. Mothers kept feeding logs, satisfaction was assessed, and infant breast milk intake and flow rate were recorded during each study phase. Routine nutrition evaluation of weight, height, weight for height, and feed volume was completed by a registered dietitian during and following completion of the study. RESULTS: Feeding times decreased with all infants, volume consumed increased with seven of eight infants, and flow rate increased with all infants. Mean feeding times during B1 and B2 phases (Haberman bottle only) were 34.4 and 32.3 minutes, respectively. Mean feeding times during C1 and C2 phases (obturation and lactation education) were 15.1 and 15.6 minutes. Volume of milk consumed during B1 and B2 feedings averaged 36.5 and 37 mL, compared with 67 mL and 76 mL during C1 and C2 phases. Growth as measured by height, weight gain, and weight for height during the study and the first 2 years of life compared favorably with that of children born without clefts. CONCLUSIONS: The combined use of a palatal obturator and lactation education reduced feeding time and increased volume intake and was associated with good growth. Mothers who had desired to breast-feed elected to use the obturator to support high-volume intake, decrease infant fatigue, and provide breast milk for nutrition.


Subject(s)
Cleft Lip/physiopathology , Cleft Palate/physiopathology , Eating , Infant Behavior , Lactation , Mothers/education , Palatal Obturators , Analysis of Variance , Body Height/physiology , Body Weight/physiology , Bottle Feeding , Cleft Lip/therapy , Cleft Palate/therapy , Confidence Intervals , Eating/physiology , Female , Follow-Up Studies , Growth/physiology , Humans , Infant Nutritional Physiological Phenomena , Infant, Newborn , Medical Records , Milk, Human , Prospective Studies , Satiation/physiology , Statistics as Topic , Time Factors , Weight Gain
7.
J Craniofac Surg ; 9(3): 234-9, 1998 May.
Article in English | MEDLINE | ID: mdl-9693554

ABSTRACT

Although craniosynostosis alters brain growth direction resulting in compensatory changes in the neurocranium, it has been suggested that such compensations occur with little reduction in intracranial volume (ICV). This hypothesis was tested in a rabbit model with nonsyndromic, familial coronal suture synostosis. Cross-sectional three-dimensional computed tomographic head scans were obtained from 79 rabbits (25 normal, 28 with delayed-onset synostosis, and 26 with early-onset synostosis) at 25, 42, and 126 days of age. Intracranial contents were reconstructed and indirect ICV was calculated. Results revealed that by 25 days of age the intracranial contents from early-onset synostosed rabbit skulls showed rostral (anterior) constrictions and a "beaten copper" morphology in the parietal and temporal regions compared with the other two groups. These deformities increased in severity with age. Quantitatively, ICV was significantly reduced (P < 0.05) by 7% in rabbits with early-onset synostosis compared with both control rabbits and rabbits with delayed-onset synostosis at 25 days of age. By 126 days of age, ICV in rabbits with synostosis was significantly reduced (p < 0.05) by 11% in early-onset synostosis and by 8% in delayed-onset synostosis compared with normal rabbits. Results suggest that in rabbits with uncorrected craniosynostosis, compensatory changes in the neurocranium were not adequate to allow normal expansion of the neurocapsular matrix. Further research is needed to determine if ICV reduction is correlated with cerebral atrophy or cerebral spinal fluid (i.e., ventricular or subarachnoid) space compression in this model.


Subject(s)
Brain/pathology , Craniosynostoses/pathology , Age of Onset , Analysis of Variance , Animals , Body Weight , Cephalometry , Rabbits , Statistics, Nonparametric , Tomography, X-Ray Computed
8.
Plast Reconstr Surg ; 100(5): 1121-8; 1129-30, 1997 Oct.
Article in English | MEDLINE | ID: mdl-9326772

ABSTRACT

Neurocapsular growth is highly heritable and determines neurocranial form. Although craniosynostosis alters brain growth direction, resulting in compensatory changes in the neurocranium, it is believed that such compensations occur without reduction in intracranial volume. This hypothesis was tested in a rabbit model with nonsyndromic, familial coronal suture synostosis. Skulls of 56 rabbits (20 normals, 20 with delayed onset synostosis, and 16 with complete synostosis) were scanned using three-dimensional computed tomography at 6 and 18 weeks of age. Intracranial contents were reconstructed, and indirect intracranial volume was calculated. Qualitatively, re-formations of intracranial contents from completely synostosed rabbit skulls exhibited the typical "copper beaten" morphology. Quantitatively, intracranial volume was significantly (p < 0.05) reduced in rabbit skulls with complete synostosis compared with both control rabbit skulls and rabbit skulls with delayed onset synostosis at 6 weeks by 11 percent and 14 percent, respectively). By 18 weeks, intracranial volume in rabbit skulls with synostosis was significantly (p < 0.05) reduced (by 12 percent in complete synostosis and 8 percent in delayed onset synostosis) compared with normal rabbits. Results suggest that in rabbits with uncorrected craniosynostosis, compensatory changes in the neurocranium were not adequate to allow normal expansion of the neurocapsular matrix. Further research is needed to determine whether reduction in intracranial volume was a result of neural tissue deficiency or cerebrospinal fluid (i.e., ventricular or subarachnoid) space compression in this model.


Subject(s)
Craniosynostoses/pathology , Skull/growth & development , Aging , Animals , Craniosynostoses/diagnostic imaging , Craniosynostoses/physiopathology , Image Processing, Computer-Assisted , Rabbits , Skull/diagnostic imaging , Skull/pathology , Tomography, X-Ray Computed
9.
Indian J Chest Dis Allied Sci ; 39(4): 213-20, 1997.
Article in English | MEDLINE | ID: mdl-9654817

ABSTRACT

A retrospective series of 25 patients with AIDS and tuberculosis is presented. Their clinical presentation, absolute lymphocyte count, CD4+ and CD8+ lymphocyte counts, treatment details and outcome are detailed. Commonest method of acquiring HIV infection was through heterosexual contact (10 of the 25; 40%) and blood transfusion (10 of the 25; 40%). More than 50% of the patients (14 of the 25) had extrapulmonary tuberculosis. Eighteen of the 19 patients for whom values were available had CD4+ lymphocyte count < 200/mm3. Four of the 18 patients for whom follow-up details were available died.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Tuberculosis, Pulmonary/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , Adolescent , Adult , Age Distribution , Aged , Female , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Risk Factors , Sex Distribution , Survival Rate , Tuberculosis, Pulmonary/drug therapy
10.
J Craniofac Surg ; 7(2): 107-10, 1996 Mar.
Article in English | MEDLINE | ID: mdl-8949836

ABSTRACT

Fronto-orbital advancement is the procedure of choice for correction of fronto-orbital recession resulting from coronal synostosis in children. However, long-term follow-up evaluations often reveal "undercorrection" of the deformity with development of recurrent recession of lateral supraorbital regions. One factor that may contribute to this process is devascularization of the fronto-orbital bar during its reshaping and advancement. If subsequent revascularization is suboptimal, excessive resorption or inadequate growth of the bar may lead to supraorbital recession. On the basis of studies of temporal bone grafts, which have shown that vascularized grafts are superior to free bone grafts in terms of bone graft survival, we postulated that maintaining vascularization of the fronto-orbital bar would favor better healing and growth that would translate to more favorable aesthetic results. Herein, we review the vascular anatomy of the fronto-orbital region and report the application in six patients of a technique for fronto-orbital advancement that preserves a significant portion of this blood supply. Technical caveats involved in the successful application of this approach are discussed. The attachment of the periosteum to the lateral two thirds of the supraorbital bar allows additional stability. This prevented the use of plates and screws in these patients.


Subject(s)
Bone Transplantation/methods , Craniosynostoses/surgery , Frontal Bone/blood supply , Orbit/blood supply , Bone Transplantation/physiology , Humans , Infant , Periosteum/blood supply , Surgical Flaps/blood supply , Treatment Outcome
11.
Hum Mol Genet ; 4(8): 1387-90, 1995 Aug.
Article in English | MEDLINE | ID: mdl-7581378

ABSTRACT

Dominant mutations in the fibroblast growth factor receptor 2 (FGFR2) gene have been recently identified as causes of four phenotypically distinct craniosynostosis syndromes, including Crouzon, Jackson-Weiss, Pfeiffer, and Apert syndromes. These data suggest that the genetics of the craniosynostosis syndromes is more complex than would be expected from their simple autosomal-dominant inheritance pattern. Identical mutations in the FGFR2 gene have been reported to cause both Pfeiffer and Crouzon syndrome phenotypes. We now report the finding of a mutation in exon IIIc of the FGFR2 gene in a kindred affected with Crouzon syndrome (C1043 to G; Ala344Gly) that is identical to the mutation previously associated with Jackson-Weiss syndrome. We also report finding in a Crouzon kindred a mutation in the 3' end of exon IIIu (formerly referred to as exon 5, exon 7, or exon U) (A878 to C; Gln289Pro) which encodes the amino terminal portion of the Ig-like III domain of the FGFR2 protein. This exon is common to both the FGFR2 and the KGFR spliceoforms of the FGFR2 gene, unlike all previously reported Crouzon mutations, which have been found only in the FGFR2 spliceoform. These findings reveal further unexpected complexity in the molecular genetics of these craniosynostosis syndromes. The data implies that second-site mutations in FGFR2 itself (outside of exon IIIc) or in other genes may determine specific aspects of the phenotypes of craniosynostosis syndromes.


Subject(s)
Craniofacial Dysostosis/genetics , Mutation , Receptor Protein-Tyrosine Kinases/genetics , Receptors, Fibroblast Growth Factor/genetics , Base Sequence , DNA Primers/genetics , Exons , Female , Humans , Male , Molecular Sequence Data , Phenotype , Point Mutation , RNA Splicing/genetics , Receptor, Fibroblast Growth Factor, Type 2 , Syndrome
12.
J Indian Med Assoc ; 89(5): 120-3, 1991 May.
Article in English | MEDLINE | ID: mdl-1748775

ABSTRACT

In the present study 90 cases of carcinoma penis were studied. The disease is more common after the age of 40 years; phimosis was found to be most important predisposing factor. Most common presentation was proliferative lesion with commonest involvement of glans penis. All the cases were of squamous cell carcinoma except one case of malignant melanoma. Clinical determination of lymph node metastasis is falacious as there was discrepancy between clinical and histopathological stage of the disease in 26.67% of cases. Therefore lymph node biopsy at the time of primary surgery is advocated. The result of total amputation is better than other mode of treatment.


Subject(s)
Carcinoma, Squamous Cell/pathology , Penile Neoplasms/pathology , Adult , Age Factors , Aged , Carcinoma, Squamous Cell/therapy , Humans , Lymphatic Metastasis , Male , Melanoma/pathology , Melanoma/therapy , Middle Aged , Penile Neoplasms/therapy , Phimosis/complications
13.
Indian J Biochem Biophys ; 26(1): 14-8, 1989 Feb.
Article in English | MEDLINE | ID: mdl-2777309

ABSTRACT

The interaction of native and modified bovine serum albumin (BSA) with catechin, a flavanoid having vitamin P activity, has been studied using equilibrium dialysis, pH-metric, viscosity and spectrophotometric methods. The order of reactivity of catechin binding to proteins was found to be: esterified BSA greater than BSA greater than formylated BSA greater than acetylated BSA with log K values of 3.778, 3.879, 3.748 and 3.813 and free energy change equal to -5.11, -5.16, -5.07 and -5.15 kcal/mole, respectively.


Subject(s)
Catechin/metabolism , Serum Albumin, Bovine/metabolism , Dialysis , Hydrogen-Ion Concentration , Kinetics , Protein Binding , Spectrophotometry , Viscosity
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