Blunt force thoracic trauma: a case study of pericardial rupture and associated cardiac herniation.

Pericardial rupture, with associated cardiac herniation, is generally fatal. Diagnosis is difficult and frequently missed due to the subtlety of identifying characteristics. We report a case of a left sided pericardial rupture and cardiac herniation resulting from a high speed motorcycle collision. This report describes the course of treatment from the emergent admission to the diagnosis of the pericardial tear to retrospective CT analysis and rupture identification. In addition the difficulties of initial diagnosis, key symptoms, and identification of CT images are presented and discussed.

Extended spectrum beta lactamase peritonitis: Time for innovation?

Extended spectrum beta lactamase (ESBL) producing bacteria that are capable of hydrolyzing even third generation cephalosporin are emerging as a potent threat. We report a seven-year-old child on continuous ambulatory peritoneal dialysis, who developed ESBL producing Klebsiella pneumoniae peritonitis. The bacterium was resistant to the usual intraperitoneal antibiotics. We successfully treated the child with intravenous meropenem along with oral cotrimoxazole. The case highlights the menace of ESBL peritonitis, as also a need for the development of guidelines for such a scenario, which is becoming increasingly common in India.

A study of obliquity of femoral shaft in Eastern Indian population.

In the erect posture, femur is not absolute vertical, being separated above from its fellow by a considerable interval, which corresponds to the breadth of the pelvis, and inclines gradually medially and downward, so as to approach its fellow, for the purpose of bringing the knee joints near the line of gravity of the body. In the present study obliquity of femoral shaft measured in 127 dry femora. Mean obliquity of femoral shaft for 62 left sided femora found 8.431 degrees with standard deviation of 2.361 degrees whereas for 65 right sided femora were found to be 7.708 degrees with standard deviation of 2.425 degrees. When total 127 femora considered, mean bicondylar angle of 8.061 +/- 2.412 degrees was obtained. Though statistically insignificant, mean bicondylar angle determined on left side was higher than that on the right side.

Long term effect of monosodium glutamate in liver of albino mice after neo-natal exposure.

Mono Sodium Glutamate (MSG) is a naturally occurring excitatory neurotransmitter. It is extensively used as a food additive and flavoring agent for its UMAMI taste. Simultaneously it is being implicated for varied pathological condition like obesity, gonadal dysfunction, learning difficulty etc. It produces oxygen derived free radicals and metabolized in liver. Neonate mice are sensitive and suffer from adverse effects. Present work was undertaken to study the long term effects on histology of liver following MSG injection in neonates. The changes in the liver parenchyma of 75 days old mice showed variable changes. Areas around central vein were most affected. The liver cords were disrupted, dilated sinusoids, prominent Kupffer cells with accumulation of particulate matter.There were inflammatory cells around central vein. The hepatocyte cell membrane were disrupted, cytoplasm vacuolated, nucleus were pyknotic. Even the normal looking cells showed depletion of PAS +ve material in the cytoplasm.The long term effect on histology showed moderate and patchy hepatocellular damage.

True palmar pattern in vitiligo--a case control study.

Characteristic epidermal ridges formed on the finger pad and on the palm by the end of the second trimester and remain unchanged thereafter and those are responsible for the highly specific finger prints of each individual. These ridges are nither influenced by later prenatal period nor they subject to any influence in the postnatal environmental factors because the formation of ridge patterns gets already completed by about the eighteenth week of gestation. Dermatoglyphics is a scientific study of such epidermal ridges. Dermatoglyphic study of both palms of clinically diagnosed vitiligo patients and control subjects were carried out and statisticaltly analysed in respect to sex and side of hands. The study revealed variable number of deviations of this patterns in Vitiligo patients when compared with that of control. Increased number of true palmar patterns in right hypothenar, right thenar and both inter digital areas 2 (ID-2) and decreased TPP in Rt. ID3, Rt. ID4 in vitiligo male patients and increased TPP in Rt. Hypothenar and Rt. ID1 and decreased TPP in Rt. ID2 and Lt. ID 3 in vitiligo female patients while compared with that of the control group. Some of the variations observed were stastically significant.

Prospective study of application of biological communication (cybernatics) in management of chronic low back pain--a preliminary report.

To observe the effects of application of cybernetics (theories of communication). This is an open level prospective study, involving patients with chronic low back pain of more than 3 months. Assessment were done before the start of therapy and after the completion of therapy every day for consecutive 6 days of treatment protocol. A total of 8 patients were enrolled (4 male, 4 female). The Visual Analogue Scale (VAS) was used to assess pain, Oswestry Disability Scale (ODI) was applied for scoring disability. ODI was scored at the start of treatment on 1st day and at the end of the treatment on 6th day. Mean VAS reduced from 8.12 to 6.93 after 1st day, which was also statistically significant (p < .01) .This trend continued and there was very significant reduction (p < .001) of VAS in the end when means were compared with pretreatment value. Mean Oswestry disability index reduced from 49.875 to 18.44 at the end of treatment which was statistically very significant (p < 0.001). There were significant improvements in all the outcome measured after Scrambler therapy.

Prevalence and causes of low birth weight in India.

INTRODUCTION: The aims of the study are (i) to understand inter-zone and interstate variation of low birth weight (LBW) and (ii) to determine the key variables to reduce LBW in India. METHODS: Using the latest National Family Health Survey (NFHS) data of 2005-06 which showed the percentage distribution of LBW infants, ANOVA and post-hoc test were performed to determine the spatial variation of birth weight. The covariates which influence LBW fell into three categories: (i) social variables which included location, mother's education, religion, access of mothers to newspapers, television and family structure; (ii) economic variable namely, the wealth index, and (iii) biological variables which consisted of sex of the children, birth order, and mother's body mass index (BMI). Three models of Logistic regression were carried out to examine the influence of the combinations of these direct and indirect factors. RESULTS: In India, nearly 20% of new borns have LBW. Males have less frequency of LBW than females. The North-east zone has the lowest prevalence of LBW while the north zone has the highest. Mother's education, access to TV and nuclear family, and intake of iron tablets are the most important socio-economic influences on the determination of birth weight in India. CONCLUSION: It is essential to provide proper diet and nutritional care of mothers during pregnancy. Increased education of mothers through programmes in TV and newspapers articles have significant roles to play in reducing LBW in India.

Evidence for a role of the N terminus and leucine-rich repeat region of the Mi gene product in regulation of localized cell death.

The tomato Mi gene confers resistance against root-knot nematodes and potato aphids. Chimeric constructs of the functional gene, Mi-1. 2, with a homolog, Mi-1.1, were produced, and their phenotypes were examined in Agrobacterium rhizogenes-transformed roots. Exchange of the leucine-rich repeat (LRR) region of Mi-1.1 into Mi-1.2 resulted in the loss of ability to confer nematode resistance, as did substitution of a 6-amino acid sequence from the Mi-1.1 LRR into Mi-1.2. Introduction of the Mi-1.2 LRR-encoding region into Mi-1.1 resulted in a lethal phenotype, as did substitution of the fragment encoding the N-terminal 161 amino acids of Mi-1.1 into Mi-1.2. Transient expression of the latter two chimeric constructs in Nicotiana benthamiana leaves produced localized cell death. The cell death caused by the N-terminal exchange was suppressed by coinfiltration with a construct expressing the N-terminal 161 amino acids of Mi-1.2. The phenotypes of these and other constructs indicate that the LRR region of Mi-1.2 has a role in signaling localized cell death and that the N-terminal 161 amino acids have a role in regulating this death.

Drainage and Coalescence in Standing Foams

A theoretical model is presented for the drainage, collapse, and coalescence in standing foams. The foam is assumed to consist of pentagonal dodecahedra and coalescence is assumed to occur due to a variation in the sizes of the films which constitute the faces of these polyhedra. Even in a monodispersed foam containing bubbles having the same volume, the film areas are not identical, but are distributed randomly about a mean. This leads to a nonuniformity of film-drainage rates and hence of film thicknesses within any volume element in the foam. Smaller films drain faster and rupture earlier, causing the bubbles containing them to coalesce. The evolution of coalescence is monitored via the mean bubble volume which varies in the vertical direction. The model is also able to predict the evolution of the surfactant concentration profile as it changes due to coalescence and collapse. Simulations are performed to examine the effect of various parameters, such as the apparent diffusion coefficient of the surfactant, the distribution of film sizes, and the concentrations of surfactant and salt in the foaming solution on the drainage and collapse behavior of the foam.

Interaction of cycloalkanoprogesterones with mammalian progesterone receptor: binding of pregna-D'-pentaranes in the calf uterine cytosol.

Pregna-D'-pentaranes (pentaranes) are modified progesterones with demonstrable progestational activity and contraceptive effect. We have examined the steroid binding characteristics of the two newly synthesized progesterone analogs, Pentarane A (16 alpha, 17 alpha-cyclohexanoprogesterone) and Pentarane B (6 alpha-methyl, 16 alpha, 17 alpha-cyclohexanoprogesterone), and studied the nature of their interaction with progesterone receptor (PR) from the chicken oviduct and the calf uterine cytosols. Pregna-D'-pentaranes exhibited no affinity for the chick PR but interacted with the calf uterine PR as did R5020. The pentaranes, however, bound PR less tightly. R5020- or pentarane-bound PR sedimented as an 8S moiety in 8-30% linear glycerol gradients. Thermal transformation of receptor resulted in the reduction of the 8S form, and caused an increase in the binding of R5020- and progesterone-bound PR complexes to DNA-cellulose. The pentarane-bound PR bound poorly, if at all, to DNA-cellulose. Our data suggest that pentaranes exhibit both similarities and differences with natural and synthetic progestins with respect to their interaction with calf uterine PR. The lack of pentarane binding to chicken PR is reminiscent of the general phenomenon that antiprogestins (RU486, ZK98299, and Org 31710 and Org 31806) do not interact with chicken PR. Pentaranes, therefore, represent unique steroid analogs to investigate the molecular mechanism of steroid hormone action.

Phosphorylation of chicken oviduct progesterone receptor by cAMP-dependent protein kinase.

Phosphorylation of immunopurified chicken oviduct progesterone receptor (PR) was studied in intact cells and under cell-free conditions. Cytosol PR was isolated by incubation with anti-PR monoclonal antibody alpha PR22 adsorbed to protein A-Sepharose and suspended in a reaction mixture containing 10 mM Mg2+, 0.1 mM [gamma-32P]ATP, and the catalytic subunit of cAMP-dependent protein kinase (cAMP-PK) from bovine heart. All three major proteins of avian PR (PR-A, 79 kDa; PR-B, 110 kDa; 90 kDa) incorporated 32P-radioactivity on serine residues. The phosphorylation reaction was inhibited by synthetic inhibitors of protein kinases, H-8 and 20-residue peptide IP20. A 40 degrees C preexposure of PR oligomer increased phosphorylation of the 90-kDa protein, known to be a heat-shock protein (hsp-90). The extent of the phosphorylation reaction was temperature-dependent as the 32P-incorporation into PR-A and PR-B increased gradually, showing a maximum at 37 degrees C. Multiple phosphopeptides (4-7) were resolved by two-dimensional electrophoresis chromatography following cleavage of 32P-labeled peptides with trypsin. Both A and B forms of receptor showed similar phosphorylation patterns with B receptor digestion exhibiting two to three additional peptides. Under physiological conditions, preincubation of oviduct mince with forskolin, a regulator of intracellular cAMP levels, caused a greater extent of phosphorylation of PR-A and PR-B proteins. The results of this study demonstrate that chicken oviduct PR is an excellent substrate for the action of cAMP-PK in vitro and that this enzyme may be a physiological regulator of progesterone action in the oviduct.

Novel antiprogestins Org 31806 and 31710: interaction with mammalian progesterone receptor and DNA binding of antisteroid receptor complexes.

We have examined steroid binding parameters and transformation of calf uterine progesterone receptor (PR) liganded with progestins (progesterone and R5020) and the newly synthesized antiprogestins (Org 31806 and 31710). Species specificity analysis indicated that [3H]R5020 binding in the chicken oviduct cytosol could be eliminated in the presence of 100-fold excess radioinert progesterone and R5020 but not Org 31806 and 31710. In the calf uterine cytosol, the progestins and the antiprogestins appeared to interact with the same PR as revealed by the displacement of [3H]R5020 by all of the above steroids. When the extent of [3H]R5020 binding was examined in the presence of different concentrations of radioinert steroids, the relative affinity with which these compounds interacted with the uterine PR was found to be comparable. A 23 degrees C incubation of cytosol transformed the progestin-bound PR complexes increasing their binding to DNA-cellulose from 5 (0 degrees C, nontransformed) to 35%. Under these conditions, 20% Org 31710- and RU486-occupied PR complexes bound to DNA-cellulose whereas only 10% Org 31806-receptor complexes were retained by the resin. Transformation (23 degrees C) of cytosol receptor caused a loss of the larger 8 S form and an increase in the smaller 4 S form. In its unliganded state or when it was complexed with R5020 or the antiprogestins, incubation of PR at 23 degrees C led to dissociation of the receptor-associated 90 kDa heat-shock protein (hsp90). The PR-hsp90 association was stabilized in the presence of 10 mM iodoacetamide when the ligand binding site was occupied by Org 31806 and 31710. The R5020-receptor complexes, however, allowed release of hsp90 under the above transforming conditions. Our results indicate that although Org 31806 and 31710 show no affinity for the avian PR, these steroids interact with the mammalian PR. We propose that the reported antiprogestational effects of Org 31806 and 31710 are mediated via their interaction with PR which appears similar to one that exists between PR and RU486.

ZK98299--a new antiprogesterone: biochemical characterization of steroid binding parameters in the calf uterine cytosol.

We have examined steroid binding characteristics of a newly synthesized antisteroid, ZK98299 [onapristone, 11 beta-(4-dimethylaminophenyl)-17 alpha-hydroxy-17 beta-(3-hydroxypropyl)- 13 alpha-methyl-4,9-gonadien-3-one], in the calf uterus cytosol and compared the nature of this interaction with the binding of progesterone receptor (PR) agonist R5020 [promegestone, 17,21-dimethylpregna-4,9-diene-3,20-dione]. In the freshly prepared cytosol, [3H]ZK98299 interacted specifically with a macromolecule: the binding was abolished in the presence of excess progestins (R5020 and progesterone) and the antiprogesterone ZK98299. The high affinity (Kd = 2.5 nM) interaction between [3H]ZK98299 and PR was temperature- and time-dependent, reaching an optimum by 2-3 h at 0 degrees C, and was facilitated by 20 mM Na2MoO4. Under nontransforming conditions, [3H]ZK98299-receptor complexes sedimented as 8 S species in 8-30% linear glycerol gradients. Upon salt or thermal transformation, there was a loss of the 8 S form, with only a small fraction of total complexes (5-7%) binding to DNA-cellulose. In contrast, transformed [3H]R5020-receptor complexes exhibited a greater extent of binding (25-55%) to DNA-cellulose. [3H]ZK98299-receptor complexes could be resolved into two ionic species over DEAE-Sephacel following incubation of the complexes at 0 or 23 degrees C. [3H]ZK98299 binding was sensitive to sulfhydryl group modification as beta-mercaptoethanol increased the extent of steroid binding. Although treatment with iodoacetamide (IA) abolished [3H]R5020 binding, there was a significant (nearly twofold) increase in the [3H]ZK98299 binding. The results of this study point to similarities and differences between the steroid binding properties of the uterine PR occupied by R5020 and ZK98299: both steroids appear to bind the same 8 S receptor but exhibit differential DNA binding and sensitivity to IA. The reported antagonist properties of ZK98299 may, therefore, be explained on the basis of a distinct receptor conformation induced by the antisteroid.

ZK98299, a novel antiprogesterone that does not interact with chicken oviduct progesterone receptor.

Steroid antagonists, at receptor level, are valuable tools for elucidating the mechanism of steroid hormone action. We have examined and compared the interaction of avian and mammalian progesterone receptors with progestins; progesterone and R5020, and a newly synthesized antiprogesterone ZK98299. In the chicken oviduct cytosol, [3H]R5020 binding to macromolecule(s) could be eliminated with prior incubation of cytosol with excess radioinert steroids progesterone or R5020 but not ZK98299. Alternatively, [3H]ZK98299 binding in the chicken oviduct was not abolished in the presence of excess progesterone, R5020, or ZK98299. In the calf uterine cytosol, [3H]R5020 or [3H]ZK98299 binding was competeable with progesterone, R5020 and ZK98299 but not estradiol, DHT or cortisol. Furthermore, immunoprecipitation and protein A-Sepharose adsorption analysis revealed that in the calf uterine cytosol, the [3H]R5020-receptor complexes were recognized by anti-progesterone receptor monoclonal antibody PR6. This antibody, however, did not recognize [3H]ZK98299-receptor complexes. When phosphorylation of progesterone receptor was attempted in the chicken oviduct mince, presence of progesterone resulted in an increased phosphorylation of the known components A (79 kDa) and B (110 kDa) receptor proteins. Presence of ZK98299 neither enhanced the extent of phosphorylation of A and B proteins nor did it reverse the progesterone-dependent increase in the phosphorylation. The avian progesterone receptor, therefore, has unique steroid binding site(s) that exclude(s) interaction with ZK98299. The lack of immunorecognition of calf uterine [3H]ZK98299-receptor complexes, suggests that ZK98299 is either interacting with macromolecule(s) other than the progesterone receptor or with another site on the same protein. Alternatively, the antisteroid binds to the R5020 binding site but the complex adopts a conformation that is not recognized by the PRG antibodies.