Normative Data on Dehydroepiandrosterone Sulphate (DHEAS) and its Attributes in Healthy Indian Children and Adolescents.

Dehydroepiandrosterone sulphate (DHEAS), the biochemical indicator of adrenarche and pubarche, is of paramount importance in the evaluation of puberty-related disorders. The reference range of DHEAS should be ethnicity, age, sex, pubarche and Tanner stage specific. Anthropometry, puberty assessment and hormonal parameters were estimated using electrochemiluminescence assay. Bone age was estimated using the BoneXpert software. Of 2191 healthy Indian children aged 5-18 y screened at Chandigarh, 1919 were included in the final analysis (994 boys). The median DHEAS levels at pubarche stage P2 were 82.10 (55.0-129.0) g/dl in girls and 132.50 (95.12-205.50) g/dl in boys. By ROC analysis, the level of DHEAS at pubarche was 63.7 g/dl (sensitivity 72.6%, specificity 64.4%) in girls and 82.2 g/dl (sensitivity 81.8%, specificity 68.8%) in boys. The median age at adrenarche was 9.5 y in both sexes. On multivariate regression analysis; bone age, body mass index (BMI), gonadal steroids, and insulin-like growth factor-1 (IGF-1) significantly correlated with serum DHEAS levels in either sex.

NIR-Active Porphyrin-Decorated Lipid Microbubbles for Enhanced Therapeutic Activity Enabled by Photodynamic Effect and Ultrasound in 3D Tumor Models of Breast Cancer Cell Line and Zebrafish Larvae.

Porphyrin is known to enable the photodynamic effect during cancer drug delivery and molecular imaging. However, its hydrophobicity and tendency to aggregate in an aqueous medium create a significant hurdle for its use as an anticancer drug. Loading porphyrin onto biocompatible delivery vehicles can enhance its efficacy. This can be achieved by using gas-filled microbubbles that can be administered intravenously. This study aimed at developing near-infrared (NIR)-active porphyrin-loaded lipid microbubbles with anticancer activity enhanced by sonodynamic and photodynamic effects. The porphyrin-loaded microbubbles were studied for their cell toxicity, cellular uptake of porphyrin, and effect on cellular three-dimensional (3D) invasion of breast cancer cells (MDA-MB-231) in cellulo. Toxicity studies in zebrafish larvae (Danio rerio) in the presence and absence of photodynamic and sonodynamic therapy were also conducted. The results suggest that with a higher concentration of porphyrin loaded on microbubbles, the porphyrin-loaded microbubbles display a higher therapeutic effect facilitated by photodynamic and sonodynamic therapy, which results in enhanced cellular uptake and cellular toxicity. A lower concentration of loaded porphyrin microbubbles exhibits high cellular viability and good fluorescence intensity in the NIR region, which can be exploited for bioimaging applications.

A Case Report of Adolescent Bicondylar Conjoint Hoffa Fracture with Patellar Fracture and Dislocation: A Rare Combination.

Introduction: Bicondylar Conjoint Hoffa fractures, where both the fractured femoral condyles joined by the bony bridge at intercondylar notch, are extremely rare with only 7 cases reported so far in the literature. We present a first case of such fracture along with patellar fracture dislocation where a fractured fragment was incarcerated between the femoral condyles. Case Presentation: 18 years old boy after road side accident presented with knee swelling and pain. Computed tomography revealed this rare combination of the fractures and was appropriately managed. Conclusion: High index of suspicion in trauma victims with described mechanism of injury like in this report is needed to not miss the Hoffa fracture and to differentiate conjoint variety from bicondylar unconjoint and deciding appropriate surgical. Non- contrast computed tomography NCCT is a must to look for fracture geometry and associated fractures.

Impact of edaphic factors and nutrient management on the hepatoprotective efficiency of Carlinoside purified from pigeon pea leaves: An evaluation of UGT1A1 activity in hepatitis induced organelles.

Carlinoside is a unique compound well-known for its excellent curative potential in hepatitis. There is a substantial research gap regarding the medicinal use of carlinoside, as its concentrations are greatly variable (depending on locality). We cultivated Cajanus cajan using vermicompost as a major organic amendment at two locations (Sonitpur and Birbhum) with different soil types, but identical climate conditions. Sonitpur soils were richer in soil organic C (SOC), enzyme activation, and N/P content than Birbhum. However, vermi-treatment improved many soil properties (bulk density, water retention, pH, N/P/K, and enzyme activity) to narrow the locational gap in soil quality by 15-28%. We also recorded a many-fold increment in SOC storage capacities in both locations, which was significantly correlated with carlinoside, total phenol, and flavonoid contents in Cajanus leaves. This significantly up-regulated the carlinoside induced expression of the bilirubin-solubilizing UGT1A1enzyme in HepG2 cell and rat liver. Leaf extracts of vermicompost-aided plants could cure hepatitis in affected rat livers and in the HepG2 cell line. Accordingly, vermi-treatment is an effective route for the growth of Cajanus as a cash crop for biomedical applications and can produce a concurrent improvement in soil quality.

Characterisation and evaluation of Metarhizium anisopliae (Metsch.) Sorokin strains for their temperature tolerance.

Entomopathogenic fungal species from the genera Beauveria, Metarhizium and Lecanicillium are important components in biological control of insect pests. However, temperature, humidity and UV radiation are among the important abiotic factors, which limit their effective usage. In this study, four local isolates of Metarhizium were isolated from different crop rhiospheres of Telangana and Andhra Pradesh states of India, identified and tested for their temperature tolerance in terms of radial growth, conidial yield per 10 mm disc and rate of conidial germination at different incubation temperatures. The results revealed that strains LaMa1 and MaAICRP performed well in terms of radial growth, conidial yield and rate of conidial germination, even at 35°C temperature. The role of such temperature tolerant strains in agriculture is discussed.

Shallow versus deep endotracheal suctioning in young rabbits: pathologic effects on the tracheobronchial wall.

The traditional technique for endotracheal suctioning of intubated neonates consists of inserting a catheter until resistance is met, withdrawing slightly, and applying suction. The extent of tissue damage caused by the traditional (deep) technique v that caused by an alternative shallow technique was studied with an animal model. Six 3-week-old rabbits were anesthetized, intubated, and suctioned every 15 minutes for six hours by neonatal intensive care unit nurses who were unaware of the study purpose. Three rabbits were suctioned by means of the deep technique, whereas the other three received shallow suctioning achieved by inserting the catheter no further than a premeasured distance. Light microscopy showed significantly increased necrosis and inflammation following deep suctioning. Electron microscopy revealed greater loss of cilia and increased mucus with the deep technique. To confirm our initial assumption that the deep technique is still used extensively by neonatal intensive care units throughout the country, a mail survey was conducted. Of the 405 (43%) neonatal intensive care unit physicians who responded, 82% reported frequent or exclusive use of the deep technique for routine suctioning. In this study, the fact that deep suctioning results in significantly more tracheobronchial pathology than does a shallow, premeasured technique is shown. It is recommended that nurseries change their current practice and adopt the shallow technique for routine suctioning of intubated neonates.

Myocardial contrast echocardiography without significant hemodynamic effects or reactive hyperemia: a major advantage in the imaging of regional myocardial perfusion.

All agents used for myocardial contrast echocardiography to date produce adverse hemodynamic effects and alter coronary blood flow. It was hypothesized that because 5% human albumin, when sonicated for use as a contrast agent, is neither hyperosmolar nor a calcium chelator, it would not have significant effects on coronary blood flow, left ventricular function or systemic hemodynamics. Albumin microbubbles of two distinct sizes (mean size 2.9 and 5.8 micron) were produced and compared with nonsonicated albumin, nonsonicated Renografin, sonicated Renografin and hand-agitated Renografin for their effects on hemodynamics, coronary blood flow and regional left ventricular systolic thickening in 15 open chest anesthetized dogs. None of the albumin solutions significantly altered left atrial, left ventricular systolic and end-diastolic and mean aortic pressures. These agents did not cause a coronary hyperemic response or alter left ventricular systolic thickening, but slightly lowered the peak positive left ventricular maximal rate of rise in pressure (dP/dt) (-4.1 +/- 5.4%, p less than 0.01). In contrast, all the Renografin solutions caused significant changes in all these variables (p less than 0.02). In six dogs. albumin solutions did not alter these variables even in the presence of critical coronary stenosis. The contrast opacification produced by 5.8 micron albumin microbubbles was equivalent to that produced by sonicated Renografin. Compared with an equivalent amount of saline and nonsonicated albumin solutions, 10 ml of sonicated albumin did not produce any evidence of infarction, embolization or hemorrhage in the myocardium, brain or kidneys of rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial extension of mitral annular calcification mimicking intracardiac tumor.

Liquefaction necrosis of mitral annular calcification occurs in 3% of autopsied cases. The liquified material can spread intramurally in various directions creating suspicious appearing mass lesions on chest x-ray or echocardiography. An incidential finding of an echogenic left atrial calcified mass in a 57-year-old woman was suspected to be an intracardiac tumor for which she underwent exploratory cardiotomy. Instead, culture-negative liquified pasty material was removed from the posterior left atrial wall adjacent to the calcified mitral annulus. This case illustrates that liquefaction necrosis of mitral annular calcification may spread to contiguous structures and masquerade as an intracardiac tumor. This relatively unknown aspect of mitral annular calcification should be considered in the differential diagnosis of echogenic left atrial mass lesions.

Sonographic findings in the prenatal diagnosis of cephalothoracopagus syncephalus. A case report.

The ultrasonic intrauterine diagnosis of cephalothoracopagus, a form of conjoined twinning, can be made when a monochorionic monoamniotic gestation contains a single head and torso accompanied by eight limbs. This is the second reported case of the syncephalus variety of cephalothoracopagus twins associated with clomiphene citrate use; however, the association is believed to be coincidental rather than causative.

Healed dissection confused with temporal arteritis. Extensive neovascularization--a distinguishing feature.

A diagnosis of healed arteritis was made on a right temporal artery biopsy from a 65-year-old woman. She died shortly thereafter despite prednisone therapy. At autopsy, a healing dissection of the entire aorta with extension into the right innominate, right subclavian, right common carotid, right renal, and both iliac arteries was found. There was no underlying aortitis. Review of the temporal artery biopsy showed numerous thick-walled proliferated capillaries in the media of the temporal artery. The stroma was scant and the capillaries were surrounded by endothelial cells. The extensive medial neovascularization represented healed aortic dissection that had extended into the right common carotid, right external carotid, and the right superficial temporal artery. The histologic lesion in dissection is distinctive and should not be confused with temporal arteritis.

Pathologic features of familial visceral myopathy.

Familial visceral myopathy is the most common cause of chronic primary (idiopathic) intestinal pseudo-obstruction. We studied four family groups with this disease and found that it has a characteristic morphologic appearance. Grossly, there is segmental dilatation of the alimentary tract, often involving multiple sites and most commonly producing a megaduodenum. Microscopically, the involved areas show a characteristic change consisting of degenerating muscle cells and fibrosis, which may involve the full thickness of the muscularis propria but is often more prominent in or limited to the external layer. Degenerating muscle cells appear pale, poorly defined, and fragmented. As residual thread-like remnants become surrounded by collagen or as muscle cells are destroyed, leaving apparent spaces surrounded by collagen, the longitudinal and circular muscles take on a vacuolated appearance easily recognized at low magnifications. Recognition of this change is greatly facilitated by use of a trichrome stain, and mild lesions may be recognized only with such stains. The nondilated segments of intestine show similar changes but of a less severe degree. Neural and vascular structures are apparently normal. Although the lesion most closely resembles progressive systemic sclerosis, the degenerating muscle cells and vacuolated appearance of the muscle serve to distinguish familial visceral myopathy from the latter entity.

Meningeal carcinomatosis 21 years following bronchiolo-alveolar carcinoma: diagnosis by cisternal CSF examination.

An unusual case is described of pure meningeal carcinomatosis in the absence of other evidence of tumor occurring 21 years after lobectomy for a localized bronchiolo-alveolar carcinoma. The metastatic disease was confined to the leptomeninges and was documented only by a cisternal cerebrospinal fluid (CSF) examination. Four previous lumbar punctures had shown hypoglycorrachia as the only CSF abnormality.