Skeletal muscle transcriptomics of sheep acclimated to cold desert and tropical regions identifies genes and pathways accentuating their diversity.

The current study attempts to investigate the differences in gene expression in longissimus thoracis muscles between sheep breeds acclimated to diverse environments. Changthangi sheep inhabits the cold arid plateau of Ladakh, at an altitude above 3000 m with prevalence of rarefied atmosphere. Muzzafarnagri sheep, on the other hand is found in the sub-tropical hot and humid plains at an altitude of about 250 m. Comparative transcriptomics was used to provide a molecular perspective of the differential adaptation of the two breeds. RNA sequencing data was generated from four biological replicates of the longissimus thoracis muscles from both breeds. The common genes expressed in both breeds were involved in muscle contraction and muscle fibre organization. The most significant pathways enriched in Changthangi muscles were glycogen metabolism, reduction of cytosolic Ca++ levels and NFE2L2 regulating anti-oxidant, while those in Muzzafarnagri were extracellular matrix organization and collagen formation. The hub genes identified in Changthangi were involved in hematopoiesis and HIF signaling pathway, suggesting the molecular acclimatization of Changthangi to the high altitude cold desert of Ladakh. The nodal genes discovered in Muzzafarnagri sheep were associated with the extracellular matrix which accentuates its significance in the development, growth and repair of muscles. The observed transcriptomic differences underscore the morphological and adaptive disparity between the two breeds. The candidate genes and pathways identified in this study will form the basis for future research on adaptation to high altitude and body size in small ruminants.

Morphometric indices of native sheep breeds of the Himalayan region of India using multivariate principal component analysis.

This study was performed to analyze the morphometric traits and indices in 3000 animals of five registered sheep breeds in the Himalayan region under a multivariate approach. Data were recorded under field conditions with equal coverage of the five breeds, viz., Karnah, Gurez, Poonchi, Bakerwal and Changthangi on body length (BL), height at withers (HW), chest girth (CG), ear length (EL), and tail length (TL). Furthermore, four derived traits (indices) were studied, which included an index of body frame (IBF), an index of thorax development (ITD), a Baron-Crevat index (BCI), and an index of body weight (IBW). Multivariate principal component analysis (PCA) was undertaken on nine morphometric traits. Kaiser's criterion was used to reduce the number of principal components for further analysis and interpretation. The adequacy of sampling was evaluated using Kaiser-Meyer-Olkin (KMO) test and Bartlett's test of sphericity. The mean BL ranged from 52.15 (Changthangi) to 71.13 (Gurez). The estimates of HW, CG, EL and TL were highest in Gurez (63.49), Bakerwal (84.82), Bakerwal (7.26), and Karnah (8.18) breeds, respectively. Among the derived traits, the highest IBF was observed in the Gurez breed with an estimate of 112.22. Upon multivariate PCA on the dataset, the first four principal components were able to explain 92.117% of the total variance. The KMO test, Bartlett's test of sphericity and estimated communalities showed the appropriateness of PCA on the evaluated traits. Four eigenvalues were greater than one and were extracted for further analysis. Morphometric traits were highly correlated, except for EL and TL that showed lower correlation estimates with other traits. The Changthangi population showed the lowest estimates of BL, HW, CG and rectangular body frame. The present study ascertained important morphometric traits/indices that can help in developing selection criteria and formulating sustainable breeding and conservation plans vis-à-vis the unique sheep breeds of the temperate Himalayas.

Recurrence of moderately dysplastic nevi with positive histologic margins.

BACKGROUND: The Pigmented Lesion Subcommittee of the Melanoma Prevention Working Group recently published a consensus statement that incompletely excised moderately dysplastic nevi (MDN) without clinical residual pigmentation can be observed and not re-excised. However, data regarding recurrence of MDN with positive histologic margins are quite scant. OBJECTIVE: We sought to extend the reported findings with a study to determine the recurrence rate of MDN with positive histologic margins. METHODS: We performed a retrospective study on MDN with positive histologic margins that were not re-excised and for which at least 1 year of clinical follow-up was available. RESULTS: We found a total of 147 such nevi from January 1, 2007, to December 31, 2013. Six MDN (5 compound and 1 junctional) or 4% recurred with an average recurrence time of 1.7 years. All of these MDN were evaluated by shave biopsies. LIMITATIONS: Subjectivity in grading of atypia is a limitation of this study. CONCLUSION: These data from a large study focusing exclusively on recurrence of MDN with positive histologic margins support the conclusion of the Pigmented Lesion Subcommittee that incompletely excised MDN do not require re-excision.

Persistent blaschkitis responsive to high potency topical steroids.

Blaschkitis is an acquired, rare dermatosis distributed along the lines of Blaschko. The papulovesicular eruption generally resolves in weeks and shows minimal response to topical steroids. Herein, we present a case of blaschkitis in an adult male who had lesions present for one year, which showed significant improvement after two weeks of topical clobetasol ointment.

Zosteriform metastasis of rectal adenocarcinoma: a case report.

Cutaneous metastases manifesting as zosteriform eruptions are uncommon. To our knowledge, we report the second case of zosteriform cutaneous metastasis arising from a rectal carcinoma in a 58-year-old man who presented with a painless popular eruption in the T12 dermatomal distribution nine months after his primary diagnosis of rectal carcinoma was made. Furthermore, we discuss a review of the literature regarding zosteriform cutaneous metastases and the possible pathogenesis of these lesions.

Effect of incorporation of walnut cake (Juglans regia) in concentrate mixture on degradation of dry matter, organic matter and production of microbial biomass in vitro in goat.

AIM: This study was carried out to investigate the effect of incorporation of different level of walnut cake in concentrate mixture on in vitro dry matter degradation in order to determine its level of supplementation in ruminant ration. MATERIALS AND METHODS: Walnut cake was used @ 0, 10, 15, 20, 25 and 30% level to formulate an iso-nitrogenous concentrate mixtures and designated as T1, T2, T3, T4, T5 and T6 respectively. The different formulae of concentrate mixtures were used for in vitro gas production studies using goat rumen liquor with wheat straw in 40:60 ratio. Proximate composition, fiber fractionation and calcium and phosphrous content of walnut cake were estimated. RESULT: The per cent IVDMD value of T1 and T2 diets was 68.42 ± 1.20 and 67.25 ± 1.37 respectively which was found highest (P<0.05) T3, T4, T5 and T6. Similar trend was also found for TDOM and MBP. Inclusion of walnut cake at 10% level in the concentrate mixture does not affect in vitro dry matter digestibility (IVDMD), truly degradable organic matter (TDOM, mg/200 mg DM), total gas production, microbial biomass production (MBP) and efficiency of microbial biomass production (EMP). CONCLUSION: It is concluded that walnut cake incorporation up to 10% level in the iso -nitrogenous concentrate mixture has no any negative effect on in vitro digestibility of dry matter (DM), TDOM, MBP, EMP and total gas production in goat.

The rate of melanoma transection with various biopsy techniques and the influence of tumor transection on patient survival.

BACKGROUND: Depth of melanoma invasion is critical because it dictates patient treatment and prognosis. Recent reports indicate melanoma transection with initial biopsy does not impact patient survival; however, tumor transection can lead to misdiagnosis and inaccurate staging. OBJECTIVE: This study assessed the rate of melanoma transection with various biopsy techniques and the impact of tumor transection on patient survival. METHODS: We conducted a retrospective review of all melanoma cases at our institution between 2000 and 2008. Of the 490 melanoma cases identified, 479 met inclusion criteria for the study. The transection rates of biopsy techniques were determined. Cases of transected tumors were matched with nontransected cases in a retrospective case-control fashion to evaluate survival. RESULTS: The rate of melanoma transection was 1.5% for excisional biopsies, 4.1% for punch biopsies, and 9.0% for saucerization biopsies. The means of disease-free survival for the control and transected groups were 911 days and 832.7 days, respectively (P value .67). Overall survival for the control group was 1073.7 days versus 1012.4 days for the transected group (P value .72). LIMITATIONS: The study used a select population. The sample size of transected biopsies was limited, in turn limiting the power of the study. Residents performed the majority of biopsies. CONCLUSION: Punch and saucerization biopsies were more likely to transect tumors than excisional biopsies. The transection of melanoma did not affect overall disease-free survival or mortality in the population studied.

Use of preputial skin for coverage of post-burn contractures of fingers in children.

OBJECTIVE: Hand burns are common injuries. Children frequently sustain burn injuries, especially to their hands. Contractures are a common sequel of severe burns around joints. The prepuce, or foreskin, has been used as a skin graft for a number of indications. We conducted this study to evaluate the feasibility of utilising the preputial skin for the management of post-burn contractures of fingers in uncircumcised male children. MATERIALS AND METHODS: Preputial skin was used for the coverage of released contractures of fingers in 12 patients aged 2-6 years. The aetiology of burns was "Kangri" burn in eight patients and scalding in four patients. Six patients had contracture in two fingers, four patients in one finger, and two patients had contractures in three fingers. RESULTS: None of the patients had graft loss, and all the wounds healed within 2 weeks. All patients had complete release of contractures without any recurrence. Hyperpigmentation of the grafts was observed over a period of time, which was well accepted by the parents. CONCLUSIONS: Preputial skin can be used successfully for male children with mild-to-moderate contractures of 2-3 fingers for restoration of the hand function, minimal donor site morbidity.

Frequency of thrombocytopenia in psoriasis patients treated with tumor necrosis factor-a inhibitors.

Tumor necrosis factor-? (TNF-?) inhibitors are biologic agents that are currently in wide use for the treatment of psoriasis as well as other inflammatory diseases. Following reports of thrombocytopenia as a potential adverse effect of anti-TNF-? therapy, we performed a retrospective study to determine the frequency of thrombocytopenia, defined as a platelet count <50x109 cells/L, in a cohort of 187 psoriatic patients treated with anti-TNF-? agents over a nine-year period. Although none of our patients met serologic criteria for thrombocytopenia or displayed clinical manifestations of thrombocytopenia, two patients developed platelet counts below 100×109 cells/L. Thrombocytopenia induced by anti-TNF-? agents is a potential adverse effect, it is a rare occurrence that will require further investigation in large, placebo-controlled, double-blind, prospective studies.

Pretibial mucinosis in a patient without Graves disease.

Although an uncommon location, cutaneous mucinoses may present in the pretibial area in distinct clinical circumstances. The terms pretibial myxedema and pretibial mucinosis often are used interchangeably, but pretibial myxedema should be regarded as a type of pretibial mucinosis. We present a case of cutaneous mucinosis localized to the pretibial area of a patient without Graves disease.

Coronary artery bypass grafting (CABG) in patients with immune thrombocytopenia (ITP): a community hospital experience and review of the literature.

We reviewed the records of 51 patients with Immune Thrombocytopenia (ITP) who underwent Coronary Artery Bypass Grafting (CABG) at Charleston Area Medical Center between June 1992 and September 2005. There were 41 males and 10 females with a median age of 68 years (range 49-87). Four patients had a previous splenectomy, one of whom had it performed concomitantly with the CABG. Three patients were on chronic corticosteroids on admission. The median pump time was 114 minutes (range: 42-244 minutes). The median cross-clamp time was 62 minutes (range 22-192 minutes). The median total chest tube drainage postoperatively was 1,346 cc (range: 265-9875cc). The mean preoperative and 24 hour postoperative platelet count was 126,000 (range 58,000-323,000) and 99,000/mm3 (range: 27,000-194,000), respectively. Twenty-one (40%) patients received platelet transfusions. Platelets were given intraoperatively or postoperatively in all but two of those patients. The median number of units of platelets given was 10 (range: 6-52). Twenty-seven (53%) received packed red cells intraoperatively or postoperatively. The median number of red cells given was 2 (range: 1-34). Other hemostatic agents given intraoperatively/ postoperatively included aprotinin (8 patients), aminocaproic acid (10 patients), DDAVP (5 patients), and intravenous gammaglobulin (IgG) in 3 patients. Thirteen patients were given corticosteroids preoperatively with little improvement in platelet count. CABG may be successfully performed in ITP patients with moderate thrombocytopenia (> or = 50,000/mm3) using conventional therapies (e.g., transfusions, IV IgG, hematinics) without the need for preoperative splenectomy or prolongation of hospital stay. However, a prospective study on the ideal management of ITP patients undergoing CABG would be beneficial.

Candida krusei fungemia in an immunocompromised patient.

Candida krusei is an emerging fungal pathogen found primarily in immunocompromised patients. Intrinsic resistance to fluconazole and decreasing susceptibility to other anti-fungal agents are problematic. When colonization occurs, dissemination may follow rapidly. We present a case of a patient with acute lymphoblastic leukemia who, despite being treated prophylactically with fluconazole, developed disseminated C. krusei.

Vogt-Koyanagi-Harada syndrome: Association with alopecia areata.

Vogt-Koyanagi-Harada (VKH) syndrome is an inflammatory condition characterized by bilateral uveitis, vitiligo, poliosis, alopecia, and dysacousia. The syndrome results from a T cell mediated autoimmune attack on melanocytes in genetically susceptible individuals. We present a case of VKH syndrome and propose that the alopecia and poliosis described in the original reports by ophthalmologists could instead be alopecia areata with re-growth of white hair.