Kikuchi-Fujimoto disease, a rare benign disease with atypical histomorphology: more than meets the eye

Kikuchi-Fujimoto disease (KFD) is a benign self-limiting condition primarily affecting young females. It usually presents with fever and cervical lymphadenopathy of unknown aetiology with a preponderance of the Asian population. Histopathology is critical in making an accurate diagnosis. While the typical microscopic features include paracortical necrosis with debris, histiocytosis with immunoblasts, and absent neutrophils, rarely, KFD can show atypical features like marked immunoblastic proliferation mimicking lymphoma, demonstrate vasculitis mimicking lupus erythematosus, etc. The diagnosis is extremely challenging if such features occur in cases with generalised lymphadenopathy, which is infrequent in KFD. The study aims to describe the morphological, clinical, and immunohistochemical features of KFD and determine the frequency of the atypical features. We also analysed the subtle histological and immunohistochemical features that aid in the diagnosis of atypical cases. Cases reported as KFD over a period of 6 years were retrieved from the archives of histopathology. The morphological features were categorised as typical and atypical. In the atypical cases, the features that aided in the correct diagnosis of KFD were analysed. Out of the 42 cases evaluated, 23.9% (n=10) had generalised lymphadenopathy; 57.2% (n=24) were women with a median age of 25 years. Leukopenia was observed in 42% (n=13) of patients. Typical features were present in 76.2% (n=32) cases and 23.8% (n=10) presented with atypical features. Eight cases were antinuclear antibody-positive. Atypical features included five (50%) cases with vasculitis and panniculitis, and three (30%) cases with large, atypical cells for which immunohistochemistry (IHC) was performed. In two of these cases, the patent sinuses, absence of neutrophils, and IHC with CD68 aided the diagnosis. There is an overlap of clinical and histopathological features between KFD and malignant lymphomas and systemic lupus erythematosus. Given the fact that the atypical features (23.8%) are not rare occurrences in KFD, correlations with clinical findings and ancillary studies are essential to avoid misdiagnosis and inadvertent therapy.

Role of histopathology in severity assessments of post-COVID-19 rhino-orbital cerebral mucormycosis - A case-control study

BACKGROUND

There was an upsurge in rhino-orbital-cerebral mucormycosis (ROCM) during the second wave of the COVID-19 pandemic in India. Histopathological examination of the biopsies witnessed greater tissue invasion in these cases. The present study aimed to evaluate the histopathological scoring system in the severity assessment and to compare the scores between ROCM that required orbital exenteration (cases) and those that were treated conservatively (controls).

MATERIAL AND METHODS

A retrospective study was conducted to analyze the histopathological features using a scoring system in patients diagnosed with mucormycosis on sino nasal biopsies. The scoring was based on the following parameters: the extent of necrosis (score 1 <50% and score 2 >50%), degree of angioinvasion (score 1 <3 vessels in 10 fields and score 2 > 3 vessels in 10 fields), degree of inflammation (mild, moderate or severe), and fungal load(score 1 to 4), based on which three grades (I to III) were given. The scores were compared between the case group and the control group. The data obtained were analyzed statistically.

RESULTS

The study included 40 controls and 10 cases. The median age of patients in the control group was 52 with 82.5%males (n = 43) and 17.5 % females (n = 7) while in the case group, the median age was 51 years, and all were males. The predominant inflammatory response was of mixed suppurative type (70 %, n = 28). The degree of necrosis was scored 2 in 57.5 % (n = 23) of controls and 70 %(n = 7) in the case group. All the samples in the case group showed scores of 2 for angioinvasion and scores of 3 and 4 for fungal load. There was a statistically significant difference in the degree of necrosis, angioinvasion, the severity of neutrophilic infiltrates, and fungal load between the cases and controls (p-value <0.05).

CONCLUSION

The present study analyses the predictive role of histopathology in invasive mucormycosis. Higher fungal load, degree of angioinvasion, and the absence of granulomas are associated with advanced disease in sinonasal mucormycosis. The study findings recommend incorporating the histopathological scoring criteria in evaluating patients with sinonasal mucormycosis.

Saturated and asymmetric saturated control for projective synchronization of inertial neural networks with delays and discontinuous activations through matrix measure method

The projective synchronization work presented in this article is focused on a class of nonlinear discontinuous coupled inertial neural networks with mixed time-varying delays and a cluster topological structure. The synchronization problem for discontinuous coupled inertial neural networks with clustering topology is examined in consideration with the mismatched parameters and the mutual influence among various clusters. To determine the required conditions for network convergence under the influence of an extensive range of impulses, the matrix measure technique and the average impulsive intervals are employed. To illustrate the effectiveness of the theoretical findings, graphical representation of varied impulsive ranges for multiple cases are provided using numerical simulations.

Impact of COVID-19 on heart failure hospitalization and outcome in India - A cardiological society of India study (CSI-HF in COVID 19 times study - "The COVID C-HF study")

OBJECTIVES

The presentation and outcomes of acute decompensated heart failure (ADHF) during COVID times (June 2020 to Dec 2020) were compared with the historical control during the same period in 2019.

METHODS

Data of 4806 consecutive patients of acute HF admitted in 22 centres in the country were collected during this period. The admission patterns, aetiology, outcomes, prescription of guideline-directed medical therapy (GDMT) and interventions were analysed in this retrospective study.

RESULTS

Admissions for acute heart failure during the pandemic period in 2020 decreased by 20% compared to the corresponding six-month period in 2019, with numbers dropping from 2675 to 2131. However, no difference in the epidemiology was seen. The mean age of presentation in 2019 was 61.75 (±13.7) years, and 59.97 (±14.6) years in 2020. There was a significant decrease in the mean age of presentation (p = 0.001). Also. the proportion of male patients decreased significantly from 68.67% to 65.84% (p = 0.037). The in-hospital mortality for acute heart failure did not differ significantly between 2019 and 2020 (4.19% and 4.,97%) respectively (p = 0.19). The proportion of patients with HFrEF did not change in 2020 compared to 2019 (76.82% vs 75.74%, respectively). The average duration of hospital stay was 6.5 days.

CONCLUSION

The outcomes of ADHF patients admitted during the Covid pandemic did not differ significantly. The length of hospital stay remained the same. The study highlighted the sub-optimal use of GDMT, though slightly improving over the last few years.

The application of the proposed Sydney system for reporting lymph node cytopathology: A five year experience of an academic institution in south India

INTRODUCTION

Fine needle aspiration biopsy (FNAB) is a routinely used investigation in the evaluation of lymph node pathologies. However, there exists a lack of uniformity in cytopathology reporting owing to the non-availability of standard guidelines. Recently, a novel system for reporting lymph node cytopathology has been proposed. The present study aimed to analyze the utility of the proposed system in cytopathology reporting in our institution.

MATERIALS

FNAB of lymph nodes performed over a period of 5 years were categorized as per the proposed Sydney system. The diagnoses on cytopathology were correlated with histopathologic diagnoses to assess the diagnostic accuracy. The rate of malignancy (ROM) for each category was calculated.

RESULTS

A total of 747 lymph node FNABs were included in the study. Histopathology was available in 262 cases. ROM in categories I-V was 26.3%, 7.2%, 76.9%, 82.3%, and 100.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent benign cytopathology were 84.2%, 97.5%, 97.1%, and 86.2%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of FNAB when considering category L3 to represent malignant cytopathology were 92.56%, 95.08%, 94.9%, and 92.8% respectively.

CONCLUSION

The study substantiates the usefulness of the proposed Sydney system in lymph node cytopathology in enhancing better communication between clinicians and cytopathologists. The use of ancillary techniques like immunocytochemistry and flow cytometry will aid in arriving at a more precise diagnosis.

Utility of the pattern-based approach using BIOCHIP-indirect immunofluorescence in the evaluation of subepidermal bullous disorders

BACKGROUND

Subepidermal bullous disorders (SEBD) are a heterogeneous group of vesiculobullous diseases because of antibody-mediated destruction of proteins of the dermo-epidermal junction. Direct immunofluorescence (DIF) is the gold standard for diagnosis. BIOCHIP-indirect immunofluorescence (IIF) is a novel serological test that combines multiple target antigens in a single field. The present study aimed to evaluate the utility of the pattern-based approach in BIOCHIP-IIF for the diagnosis of SEBD.

METHODS

Seventy cases of BIOCHIP-IIF that showed clinical, histopathological, and/or DIF features favoring SEBD were included in the study. The interpretation in the BIOCHIP was categorized into one of the following patterns. Pattern I: basement membrane zone (BMZ) staining in monkey esophagus (ME), primate salt-split skin (SSS)-roof staining, BP180+ and/or BP230+; Pattern II: roof staining in SSS, BP180- and BP230- with or without BMZ staining in ME; Pattern III: floor staining in SSS, BP180- and BP230-; and pattern IV: negative in SSS and other substrates. The findings were correlated with histopathology and/or DIF.

RESULTS

Fifty (71.5%) cases showed pattern I or the typical bullous pemphigoid (BP) pattern. Eight (11.4%) cases showed pattern II. Patterns III and IV were observed in seven (10%) and five (7.1%) cases, respectively. BP was the most common diagnosis in patterns I and II, while anti-p200 pemphigoid was most common in pattern III, as confirmed by immunoblotting. The sensitivity of pattern I in the diagnosis of BP was 96%.

CONCLUSION

BIOCHIP-IIF showed a good correlation with DIF and histopathology in the diagnosis of SEBD. This can be used as a first-line investigation in case of bullous disorders.

Efficacy of Sagittal Split Fix Plates with Adjustable Slider for Intra-operative Identification and Correction of Condylar Sag in Sagittal Split Osteotomy-a Pilot Study

Aim

To assess the efficacy of sagittal split plate with adjustable slider for intra-operative correction of condylar sag after bilateral sagittal split osteotomy.

Subjects and Methods

Patients reporting for correction of mandibular skeletal deformities for correction with sagittal split osteotomy (SSRO) were enrolled in the study. Simple randomization method was followed for patient allocation. Patients in group A had undergone fixation sagittal split fix plates; in group B, miniplate fixation with monocortical screws was used. Occlusion was the key indicator of condylar sage that was checked at different time frames (intra-operatively T0, immediate T1, 6 months postoperatively T2). Preoperative, immediate and late postoperative (at 6 months and 1-year interval) and lateral cephalometric assessment was used to assess their stability.

Results

Thirty-three patients were enrolled and 20 patients were included in the study. One patient of group A presented with central condylar sag that was identified intra-operatively and addressed immediately. All the patients in group B presented with type 2 peripheral condylar sag that was addressed by inter-maxillary elastics and orthodontics. Two patients in group A presented with mild degree of relapse at 6 months, which was comparable to the control group indicating good stability.

Conclusion

Sagittal split plates appear to be efficacious for intra-operative identification and correction of condylar sag is associated with SSRO.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12663-022-01782-7.

The Value of Duodenal Biopsies in the Evaluation of Megaloblastic Anemia

Introduction Megaloblastic anemia is one of the common causes of anemia in India. Duodenal biopsies are routinely performed in the investigation of megaloblastic anemia. The present study was undertaken to analyze the value of duodenal biopsy in megaloblastic anemia and to correlate endoscopic findings with biopsy. As a secondary aim, the study has also analyzed the hematological profile and vitamin B ₁₂ and folate status of these patients.

Materials and Methods All the cases of megaloblastic anemia with bone marrow studies diagnosed at PSG Institute of Medical Sciences and Research during the two year period from January 2016 to December 2017 were retrieved. Clinical and laboratory findings (serum vitamin B ₁₂ and folate levels) and endoscopic findings were retrieved from hospital records of the patients. Duodenal biopsies of these patients reported in the histopathology department were retrieved and reviewed. Statistical analysis was done using SPSS software 20.0.

Results There were 93 cases of megaloblastic anemia diagnosed on bone marrow biopsies. Tropical sprue was diagnosed in 49.5% of cases, followed by intraepithelial lymphocytosis (17.2%), peptic duodenitis (17.2%), and no significant pathology in 16% of cases. Pancytopenia was present in 54.8% of cases. Isolated vitamin B ₁₂ deficiency including low levels was present in 48.38% and folate deficiency was seen in 4.3% cases; 34.48% cases had both vitamin B ₁₂ and folate deficiency.

Conclusion The incidence of tropical sprue in megaloblastic anemia is 49.5% in the study. Duodenal biopsy is valuable in the work up of megaloblastic anemia, irrespective of the endoscopic changes in identifying the etiology.

The role of the IAC Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy and the ACR Breast Imaging-Reporting and Data System in the evaluation of breast lesions

BACKGROUND

Stratification of breast lesions for appropriate management is achieved through an integration of clinical examination, imaging, and fine needle aspiration biopsy (FNAB). The current study aimed to evaluate the combined effectiveness of the widely used Breast Imaging-Reporting and Data System (BI-RADS) with the recently proposed International Academy of Cytology (IAC) Yokohama System for Reporting Breast Fine Needle Aspiration Biopsy Cytopathology.

METHODS

A retrospective analysis was done on all breast FNABs from 2016 through 2020. The cases were categorised according to the IAC Yokohama System. Histopathological correlation of the BI-RADS and IAC Yokohama System was performed. The rate of malignancy (ROM) for each category of the BI-RADS and IAC Yokohama System was calculated.

RESULTS

The ROM values for categories I to V were 38%, 0.6%, 21.9%, 100%, and 97%, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of FNAB with category III assumed as malignant were 98.9%, 85%, 76.1%, 99.3%, and 89.5%, respectively. With category III assumed as benign, these indices were 90.8%, 98.9%, 97.5%, 95.7%, and 96.2%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of BI-RADS were 91.5%, 81.9%, 72%, 95%, and 85.1%, respectively.

CONCLUSIONS

FNAB is still an indispensable test in the evaluation of breast lesions. The utilisation of the IAC Yokohama reporting system for breast cytology in conjunction with ACR BI-RADS aids in better stratification of lesions.

Evaluation of serum metal ion levels in dental implant patients: A prospective study

Introduction:

Titanium is the most commonly used bio-inert implant material. Nevertheless, there is a possibility of systemic release of metal ions, which could have clinical implications like implant failure and toxicity. This prospective study focuses on the evaluation of serum metal ion levels in patients receiving dental implants. The aim of the study is to evaluate the release of titanium, aluminium, and vanadium from dental implants by comparing the preoperative and postoperative serum levels of these ions.

Methodology:

Serum samples were collected from 30 patients undergoing dental implant placement preoperatively and postoperatively at intervals of 6 weeks, 3, 6, and 12 months. These samples were analyzed for titanium, aluminium, and vanadium levels using Inductively Coupled Plasma Optical Emission Spectrometry. The difference in preoperative and postoperative serum levels was measured and statistically analyzed using the paired t-test.

Results:

There was a slight difference in the postoperative levels of titanium and aluminium (2.30 and 4.07 mg/dl) as compared to the preoperative levels (2.28 and 2.30 mg/dl), which was statistically insignificant (P > 0.5). The serum levels of vanadium were too insignificant to be detected by the instrument (<0.0088 mg/dl).

Discussion:

Mild increase in the titanium and aluminium levels in blood serum was noted. These metallic ion levels might increase significantly due to which further clinical research with larger sample sizes and a long-term follow-up period is required to evaluate the clinical effects of metallic ion release from dental implants. There is no significant difference in the serum metal ion levels before and after the implant placement, although a little increase is observed in the aluminium ion levels after the implant placement.

Immunohistochemical profile and distribution of Non-Hodgkin and Hodgkin lymphoma - An experience in a medical college hospital in Tamil Nadu

Context: The subtype distribution of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) shows distinct pattern across geographic regions. This study analyzes the subtype distribution of lymphomas based on the WHO 2017 Classification using immunohistochemistry (IHC) and also investigates the IHC profile of various lymphomas. Subjects and Methods: Fifty consecutive cases of lymphoma diagnosed in the department of pathology in a medical college hospital were included in the study. The cases were subcategorized using panels of IHC based on the light microscopic findings. Results: The ratio of NHL to HL was 4.5:1. B-NHL formed 78.5% (n = 32), while T-cell NHL formed 21.5% (n = 9). Among the B-NHL cases, small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) (34.4%) was the most common, followed by diffuse large B-cell lymphoma, NOS (DLBCL NOS) (31.2%), follicular lymphoma (FL) (25%), and then by Burkitt's lymphoma (BL) constituting 9.4%. Peripheral T-cell lymphoma, NOS (PTCL NOS) (14.1%) (n = 6) was the most common T-cell NHL, followed by angioimmunoblastic T-cell lymphoma (4.8%), and then by lymphoblastic lymphoma (T-LL) (2.4%). Among Hodgkin lymphomas, mixed cellularity (MC) accounted for 55.6% (n = 5), lymphocyte depleted type (LD) being 22.2%, while nodular lymphocyte predominant and lymphocyte rich type each constituted 11.1%. Conclusion: SLL/CLL was the most common lymphoma reported in the study followed by DLBCL which is different from the other Indian studies where DLBCL was most common. CD5 expression was noted in 21% of FLs. PTCL-NOS constituted the most common T-cell lymphoma and MC, the most frequent subtype of classical HL. Further replication studies including larger sample size will be needed to understand the difference in subtype distribution in our population.

Malignant peripheral nerve sheath tumor of the thorax: Unusual location of a rare tumor

Malignant peripheral nerve sheath tumor (MPNST) is a rare variety as sporadic tumor but more common when associated with neurofibromatosis, and its usual site of origin lies in the extremities. MPNST of thoracic cavity is a rare site of origin with only anecdotal reports in literature. Progression to a large size without distant metastases is even rarer owing to its high metastatic potential. We present a case of thoracic MPNST highlighting its rarity and the treatment options available to provide a best possible outcome.

Xeroderma Pigmentosum and Bone Marrow Aplasia: A Rare Association

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by hypersensitivity to ultraviolet rays and predisposition to cutaneous malignancies. Hematological disorders associated with XP include myelodysplastic syndrome and acute leukemia. We report a 7-year-old child with XP along with squamous cell carcinoma and bone marrow aplasia.

Isolation and Identification of <i>Vibrio</i> sp. in the Hepatopancreas of Cultured White Pacific Shrimp (<i>Litopenaeus vannamei</i>)

The Vibrio is the most common genera with crustaceans often causing various diseases in Aquaculture and significant economic losses. Many Vibrio species are pathogenic to human and have been implicated in food borne diseases. The present study was carried out, the isolation and identification of pathogenic bacterial flora were isolated from infected in hepatopancreas of vannamei. The SPDS Oceanic farm, RS Aqua farm of and Valli vilas Aqua farm Vellar estuary, Cuddalore District, Tamil Nadu, during the period of (September 2013 to November 2013). The collected samples were plated on TCBS- (Thiosulfate-Citrate-Bile salt-Sucrose) agar medium. The present study, totally 253 green colonies were isolated from TCBS agar plates and among these, 175colonies were identified by using the biochemical tests showed the V. parahaemolyticus, V. mimicus, V. vulnificus, V.damsela and P.shigelloides. The maximum species was recorded in V.parahaemolyticus (83.4 %) and minimum was observed in V.mimicus (1.7 %).

Isolation and Identification of Vibrio sp. in the Hepatopancreas of Cultured White Pacific Shrimp (Litopenaeus vannamei)

The Vibrio is the most common genera with crustaceans often causing various diseases in Aquaculture and significant economic losses. Many Vibrio species are pathogenic to human and have been implicated in food borne diseases. The present study was carried out, the isolation and identification of pathogenic bacterial flora were isolated from infected in hepatopancreas of vannamei. The SPDS Oceanic farm, RS Aqua farm of and Valli vilas Aqua farm Vellar estuary, Cuddalore District, Tamil Nadu, during the period of (September 2013 to November 2013). The collected samples were plated on TCBS- (Thiosulfate-Citrate-Bile salt-Sucrose) agar medium. The present study, totally 253 green colonies were isolated from TCBS agar plates and among these, 175colonies were identified by using the biochemical tests showed the V. parahaemolyticus, V. mimicus, V. vulnificus, V.damsela and P.shigelloides. The maximum species was recorded in V.parahaemolyticus (83.4 %) and minimum was observed in V.mimicus (1.7 %).

Determination of Ammonia, Nitrate and Nitrite Concentrations in Marine Water Samples with Cultured Marine Ornamental Fish Water Sample Analysis

The present studies were concentration of ammonia, nitrite, nitrate, dissolved oxygen, temperature, salinity and pH. For seven physicochemical parameters were determined in marine water samples along with marine ornamental fish water sources from CAS in marine biology laboratory conditions at Parangipettai. Water sample have been studied at a marine water sources. The study concentrations of parameters like ammonia, nitrite, nitrate, dissolved oxygen, temperature, salinity, and pH. And physicochemical parameters have been calculated. The data showed the difference of the investigated parameters in samples as follows; Concentration of water quality parameters like ammonia was maximum level above 1.158 μmol¯1, nitrite was ranging from 0.811 to 0.922 μmol¯1, nitrate was range maximum level above 4.84 μmol¯1, dissolved oxygen content was maximum level above 2.4 mg¯1, temperature was ranging from 32.3 to 100 °C, salinity values ranging from 0 to 36ppt and pH was ranging from 6.5 to 8.0. During the study period of from July 2013 to June 2014 we investigated concentration of seven physicochemical parameters value Marine water samples with cultured fish species in presence of water from CAS in Marine Biology laboratory Annamalai University at Parangipettai.

Determination of Ammonia, Nitrate and Nitrite Concentrations in Marine Water Samples with Cultured Marine Ornamental Fish Water Sample Analysis

The present studies were concentration of ammonia, nitrite, nitrate, dissolved oxygen, temperature, salinity and pH. For seven physicochemical parameters were determined in marine water samples along with marine ornamental fish water sources from CAS in marine biology laboratory conditions at Parangipettai. Water sample have been studied at a marine water sources. The study concentrations of parameters like ammonia, nitrite, nitrate, dissolved oxygen, temperature, salinity, and pH. And physicochemical parameters have been calculated. The data showed the difference of the investigated parameters in samples as follows; Concentration of water quality parameters like ammonia was maximum level above 1.158 μmol¯1, nitrite was ranging from 0.811 to 0.922 μmol¯1, nitrate was range maximum level above 4.84 μmol¯1, dissolved oxygen content was maximum level above 2.4 mg¯1, temperature was ranging from 32.3 to 100 °C, salinity values ranging from 0 to 36ppt and pH was ranging from 6.5 to 8.0. During the study period of from July 2013 to June 2014 we investigated concentration of seven physicochemical parameters value Marine water samples with cultured fish species in presence of water from CAS in Marine Biology laboratory Annamalai University at Parangipettai.

Preoperative and Postoperative CT Scan Assessment of Pterygomaxillary Junction in Patients Undergoing Le Fort I Osteotomy: Comparison of Pterygomaxillary Dysjunction Technique and Trimble Technique-A Pilot Study

PURPOSE

To determine the rate of complications and occurrence of pterygoid plate fractures comparing two techniques of Le Fort I osteotomy i.e., Classic Pterygomaxillary Dysjunction technique and Trimble technique and to know whether the dimensions of pterygomaxillary junction [determined preoperatively by computed tomography (CT) scan] have any influence on pterygomaxillary separation achieved during surgery.

MATERIALS AND METHODS

The study group consisted of eight South Indian patients with maxillary excess. A total of 16 sides were examined by CT. Preoperative CT was analyzed for all the patients. The thickness and width of the pterygomaxillary junction and the distance of the greater palatine canal from the pterygomaxillary junction was noted. Pterygomaxillary dysjunction was achieved by two techniques, the classic pterygomaxillary dysjunction technique (Group I) and Trimble technique (Group II). Patients were selected randomly and equally for both the techniques. Dysjunction was analyzed by postoperative CT.

RESULTS

The average thickness of the pterygomaxillary junction on 16 sides was 4.5 ± 1.2 mm. Untoward pterygoid plate fractures occurred in Group I in 3 sides out of 8. In Trimble technique (Group II), no pterygoid plate fractures were noted. The average width of the pterygomaxillary junction was 7.8 ± 1.5 mm, distance of the greater palatine canal from pterygomaxillary junction was 7.4 ± 1.6 mm and the length of fusion of pterygomaxillary junction was 8.0 ± 1.9 mm.

DISCUSSION

The Le Fort I osteotomy has become a standard procedure for correcting various dentofacial deformities. In an attempt to make Le Fort I osteotomy safer and avoid the problems associated with sectioning with an osteotome between the maxillary tuberosity and the pterygoid plates, Trimble suggested sectioning across the posterior aspect of the maxillary tuberosity itself. In our study, comparison between the classic pterygomaxillary dysjunction technique and the Trimble technique was made by using postoperative CT scan. It was found that unfavorable pterygoid plate fractures occurred only in dysjunction group and not in Trimble technique group. Preoperative CT scan assessment was done for all the patients to determine the dimension of the pterygomaxillary region. Preoperative CT scan proved to be helpful in not only determining the dimensions of the pterygomaxillary region but we also found out that thickness of the pterygomaxillary junction was an important parameter which may influence the separation at the pterygomaxillary region.

CONCLUSION

No untoward fractures of the pterygoid plates were seen in Trimble technique (Group II) which makes it a safer technique than classic dysjunction technique. It was noted that pterygoid plate fractures occurred in patients in whom the thickness of the pterygomaxillary junction was <3.6 mm (preoperatively). Therefore, preoperative evaluation is important, on the basis of which we can decide upon the technique to be selected for safer and acceptable separation of pterygomaxillary region.

Cone-beam computed tomography in the management of dentigerous cyst of the jaws: A report of two cases

Cone-beam computed tomography (CBCT) is an emerging technology finding application in all branches of dentistry. The current series highlights the application of CBCT in the preoperative assessment of dentigerous cyst of the jaws.

Transglutaminase 2 as a novel activator of LRP6/β-catenin signaling

The β-catenin signaling axis is critical for normal embryonic development and tissue homeostasis in adults. We have previously shown that extracellular enzyme transglutaminase 2 (TG2) activates β-catenin signaling in vascular smooth muscle cells (VSMCs). In this study, we provide several lines of evidence that TG2 functions as an activating ligand of the LRP5/6 receptors. Specifically, we show that TG2 synergizes with LRP6 in the activation of β-catenin-dependent gene expression in Cos-7 cells. Interfering with the LRP5/6 receptors attenuates TG2-induced activation of β-catenin in Cos-7 cells. Further, we show that TG2 binds directly to the extracellular domain of LRP6, which is also able to act as a substrate for TG2-mediated protein cross-linking. Furthermore, inhibitors of TG2 protein cross-linking quench the observed TG2-induced β-catenin activation, implicating protein cross-linking as a novel regulatory mechanism for this pathway. Together, our findings identify and characterize a new activating ligand of the LRP5/6 receptors and uncover a novel activity of TG2 as an agonist of β-catenin signaling, contributing to the understanding of diverse developmental events and pathological conditions in which transglutaminase and β-catenin signaling are implicated.

Characterization and in vitro cytocompatibility of piezoelectric electrospun scaffolds

Previous studies have shown that electrical charges influence cell behavior (e.g. enhancement of nerve regeneration, cell adhesion, cell morphology). Thus, piezoelectric scaffolds might be useful for various tissue engineering applications. Fibrous scaffolds were successfully fabricated from permanent piezoelectric poly(vinylidene fluoride-trifluoroethylene) (PVDF-TrFE) by the electrospinning technique. Scanning electron microscopy and capillary flow analyses verified that the fiber mats had an average fiber diameter of 970 +/- 480 nm and a mean pore diameter of 1.7 microm, respectively. Thermally stimulated depolarization current spectroscopy measurements confirmed the piezoelectric property of the PVDF-TrFE fibrous scaffolds by the generation of a spontaneous current with the increase in temperature in the absence of an electric field, which was not detected in the unprocessed PVDF-TrFE powder. Differential scanning calorimetry, thermogravimetric analysis, X-ray diffraction and Fourier transform infrared spectroscopy results showed that the electrospinning process increased the crystallinity and presence of the polar, beta-phase crystal compared with the unprocessed powder. Confocal fluorescence microscopy and a cell proliferation assay demonstrated spreading and increased cell numbers (human skin fibroblasts) over time on PVDF-TrFE scaffolds, which was comparable with tissue culture polystyrene. The relative quantity of gene expression for focal adhesion proteins (measured by real-time RT-PCR) increased in the following order: paxillin < vinculin < focal adhesion kinase < talin. However, no differences could be seen among the TCPS surface and the fibrous scaffolds. Future studies will focus on possible applications of these cytocompatible PVDF-TrFE scaffolds in the field of regenerative medicine.

Early developmental and stress responsive ESTs from mungbean, Vigna radiata (L.) Wilczek, seedlings

Although mungbean (Vigna radiata (L.) Wilczek) is commonly used as human food; the genomic resources of this species available in databases are limited. This study aims to develop expressed sequence tag (EST) resources for mungbean genes informative to early seedling development and chilling response. Two mungbean varieties that differ in disease resistance were found to also differ in their susceptibility to chilling temperatures. A total of 1,198 ESTs were obtained from one cDNA library and four PCR-select cDNA subtraction libraries; among these 523 were clustered into 136 contigs and 675 were singletons. The 811 non-redundant uniESTs were compared to GenBank using the Basic Local Alignment Search Tool (BLAST) and WU-BLAST algorithms, of these only 489 uniESTs had significant sequence homology, which may be involved in resuming the metabolic activity of seedlings, switching on photomorphogenesis, fuelling photosynthesis and/or initiating the unique developmental programs. Their encoded proteins may associate with regulatory proteins to trigger a direct stress response or participate in acclimation to environmental stressors. The uniEST platform reported will enrich the genomic resources of mungbean for functional genomic research on seedling development and chilling response of tropical crops and provide targets for improving the chilling tolerance of the tropical crops.