Evaluation of utility of Invasive Electroencephalography for definitive surgery in patients with Drug-Resistant epilepsy: A Systematic Review and Meta-analysis

When non-invasive tests are unable to define the epileptogenic zone in patients, intracranial electroencephalography (iEEG) is a method of localising the epileptogenic zone. Compared to non-invasive evaluations, it offers more precise information about patterns of epileptiform activity, which results in useful diagnostic information that supports surgical decision-making. The primary aim of the present study was to assess the utility of iEEG for definitive surgery for patients suffering from drug-resistant epilepsy (DRE). Online databases like PubMed, Medline, Embase, Scopus, Cochrane Library, Web of Science and IEEE explorer were searched for MeSH terms and free-text keywords. ROBINS I critical appraisal tool was used for quality assessment. Prevalence from different studies was pooled together using the inverse variance heterogeneity method. Eggers regression analysis and funnel plot were used to evaluate publication bias. The systematic review included eighteen studies, while the meta-analysis included ten studies to estimate the prevalence of seizure freedom (class I Engel) in patients undergoing surgery after iEEG. There were 526 patients in all that were included in the meta-analysis. The period of follow-up ranged from one to ten years. The overall pooled estimate of the prevalence of seizure freedom (class I Engel) in patients undergoing surgery after iEEG was 53% (95% CI: 44, 62). The results additionally demonstrated that twelve studies had a moderate risk of bias, whereas six studies had a low risk. Future studies are crucial to enhance our understanding of iEEG, guiding patient choices and unraveling their implications.

Efficacy of the three-point cuff palpation technique in preventing endobronchial tube migration during positioning in robotic pelvic surgeries

Background and Aims

During robotic pelvic surgeries, the shortening of endotracheal tube (ETT) tip-to-carina distance (D_TC) during pneumoperitoneum with 45° Trendelenburg position can result in endobronchial tube migration. In the three-point ETT cuff palpation (TPP) technique, maximal ETT cuff distension is felt over the tracheal segment located between the cricoid-thyroid membrane and suprasternal notch, which is likely to provide optimal placement. However, the reproducibility and reliability of the TPP technique in preventing endobronchial tube migration are yet to be evaluated. Hence, we compared three ETT placement techniques: TPP technique, intubation guide mark (IGM) technique and Varshney's formula (VF) for the prevention of endobronchial tube migration during robotic pelvic surgeries.

Methods

ETT placement by TPP was compared with IGM and VF techniques in 100 American Society of Anesthesiologists physical class II-III patients, by assessing the serial changes in D_TC and incidence of endobronchial tube migration throughout the different phases of pneumoperitoneum and Trendelenburg position using t-test and Chi-square test. Changes in the D_TC during various phases were also measured.

Results

D_TC (mean ± standard deviation) at baseline and during pneumoperitoneum was significantly better in TPP technique (2.80 ± 0.62 cm and 1.96 ± 0.66 cm) as compared to both IGM (2.50 ± 1.27 cm and 1.41 ± 1.29 cm) and VF techniques (1.83 ± 1.13 cm and 0.98 ± 1.18 cm), P < 0.001. During pneumoperitoneum, the mean shortening of D_TC was 0.84 ± 0.20 cm, and no endobronchial tube migration was found in TPP technique compared to 20% in IGM and 25% in VF techniques, P < 0.001.

Conclusion

TPP is a simple and reliable technique, which provides optimal ETT placement and prevents endobronchial tube migration throughout the different phases of robotic pelvic surgeries.

Acceleration of Wound Healing in Diabetic Rats through Poly Dimethylaminoethyl Acrylate-Hyaluronic Acid Polymeric Hydrogel Impregnated with a Didymocarpus pedicellatus Plant Extract

Wound is the major health problem associated with skin damages and arises because of various types of topical injuries. Furthermore, wounds in patients with diabetes take a relatively long time to heal. Currently, herbal medicines have been extensively used for wound care and management. Here, we engineered polymeric hybrid hydrogel of dimethylaminoethyl acrylate and hyaluronic acid (pDMAEMA-HA), which was impregnated with a herbal extract of Didymocarpus pedicellatus. The developed polymeric hybrid hydrogel system can be used for effective therapy of incurable wounds. Therefore, the development of D. pedicellatus-impregnated pDMAEMA-HA (pDPi-DMAEMA-HA) hybrid hydrogel was accomplished by the synthesis of pDMAEMA-HA hydrogel via the optimization of various reaction parameters followed by impregnation of herbal drugs D. pedicellatus. The developed hydrogel composite was well characterized via various techniques, and swelling kinetics was performed to analyze the water uptake property. The swelling ratio was found to be 1600% in both types of hydrogels. To evaluate the wound healing of these polymeric hydrogels, the Wistar rats full-thickness excision wound model was utilized. The healing strength of hydrogels was determined using measurement of wound contraction and histopathological study. The results of wound healing by these polymeric hydrogels revealed that animals treated with the pDPi-DMAEMA-HA hybrid hydrogel group were found to have a higher level of wound closure as compared to marketed formulation as well as polymeric hybrid hydrogel. The histopathologic examinations implied that pDPi-DMAEMA-HA hybrid hydrogel and polymeric hybrid hydrogel-treated groups exhibited enhanced cutaneous wound repair as well as high level of cellular repair and maintenance compared to the standard group because of hyaluronic acid roles in various stages of wound repair.

Functional analysis of vocal folds by transcutaneous laryngeal ultrasonography in patients undergoing thyroidectomy

BACKGROUND

Transcutaneous laryngeal ultrasound (TCLUS) can assess Vocal folds (VF) by subjectively identifying mobility or objectively by calculating vocal fold displacement velocity (VFDV). Optimal diagnostic approach (subjective assessment, VFDV estimation or a combination of both) is unresolved; hence, we conducted this prospective study in patients undergoing thyroidectomy.

METHOD

Two anaesthetists performed TCLUS pre- and post-operatively for functional assessment of 200 VFs on 100 patients. Their findings were compared with pre-operative flexible laryngoscope (FL) performed by surgeons and with post-operative C-Mac video laryngoscope (C-Mac VL) by another independent anaesthetist. Correlation between FL and TCLUS findings and inter-rater agreement between TCLUS findings of both anaesthetists was analysed. Decision curve analysis (DCA) was performed to compare clinical benefit of hoarseness, subjective VF movement, VFDV, and combined assessment for detecting disabled VFs.

RESULTS

We found good correlation between VF mobility on TCLUS and FL (Spearman's r = 0.93, P < 0.0001) as well as C-Mac VL (Spearman's r = 0.83, P < 0.0001) with excellent inter-rater agreement between both anaesthetists. DCA showed combined assessment to have marginally higher clinical benefit than other diagnostic approaches at intermediate threshold probabilities while its benefit was similar to subjective evaluation at higher threshold probabilities.

CONCLUSION

Provided achievement of optimal acoustic window, TCLUS can reliably assess disabled VFs with FL reserved for their confirmation or doubtful cases. Subjective assessment of VF mobility should suffice in most cases with additional VFDV estimation reserved pre-operatively for situations with higher risk of VFs disability, and post-operatively when subjective VF assessment findings are discordant from pre-operative status.

Fractal and multifractal characteristics of swift heavy ion induced self-affine nanostructured BaF2 thin film surfaces

Fractal and multifractal characteristics of self-affine surfaces of BaF2 thin films, deposited on crystalline Si ⟨1 1 1⟩ substrate at room temperature, were studied. Self-affine surfaces were prepared by irradiation of 120 MeV Ag(9+) ions which modified the surface morphology at nanometer scale. The surface morphology of virgin thin film and those irradiated with different ion fluences are characterized by atomic force microscopy technique. The surface roughness (interface width) shows monotonic decrease with ion fluences, while the other parameters, such as lateral correlation length, roughness exponent, and fractal dimension, did not show either monotonic decrease or increase in nature. The self-affine nature of the films is further confirmed by autocorrelation function. The power spectral density of thin films surfaces exhibits inverse power law variation with spatial frequency, suggesting the existence of fractal component in surface morphology. The multifractal detrended fluctuation analysis based on the partition function approach is also performed on virgin and irradiated thin films. It is found that the partition function exhibits the power law behavior with the segment size. Moreover, it is also seen that the scaling exponents vary nonlinearly with the moment, thereby exhibiting the multifractal nature.

Chronic lymphocytic leukemia cells in a lymph node microenvironment depict molecular signature associated with an aggressive disease

Chronic lymphocytic leukemia (CLL) cells survive longer in vivo than in vitro, suggesting that the tissue microenvironment provides prosurvival signals to tumor cells. Primary and secondary lymphoid tissues are involved in the pathogenesis of CLL, and the role of these tissue microenvironments has not been explored completely. To elucidate host-tumor interactions, we performed gene expression profiling (GEP) of purified CLL cells from peripheral blood (PB; n = 20), bone marrow (BM; n = 18), and lymph node (LN; n = 15) and validated key pathway genes by real-time polymerase chain reaction, immunohistochemistry and/or TCL1 trans-genic mice. Gene signatures representing several pathways critical for survival and activation of B cells were altered in CLL cells from different tissue compartments. Molecules associated with the B-cell receptor (BCR), B cell-activating factor/a proliferation-inducing ligand (BAFF/APRIL), nuclear factor (NF)-κB pathway and immune suppression signature were enriched in LN-CLL, suggesting LNs as the primary site for tumor growth. Immune suppression genes may help LN-CLL cells to modulate antigen-presenting and T-cell behavior to suppress antitumor activity. PB CLL cells overexpressed chemokine receptors, and their cognate ligands were enriched in LN and BM, suggesting that a chemokine gradient instructs B cells to migrate toward LN or BM. Of several chemokine ligands, the expression of CCL3 was associated with poor prognostic factors. The BM gene signature was enriched with antiapoptotic, cytoskeleton and adhesion molecules. Interestingly, PB cells from lymphadenopathy patients shared GEP with LN cells. In Eμ-TCL1 transgenic mice (the mouse model of the disease), a high percentage of leukemic cells from the lymphoid compartment express key BCR and NF-κB molecules. Together, our findings demonstrate that the lymphoid microenvironment promotes survival, proliferation and progression of CLL cells via chronic activation of BCR, BAFF/APRIL and NF-κB activation while suppressing the immune response.

Removal of indigenous coliphages and enteric viruses during riverbank filtration from highly polluted river water in Delhi (India)

Emerging countries frequently afflicted by waterborne diseases require safe and cost-efficient production of drinking water, a task that is becoming more challenging as many rivers carry a high degree of pollution. A study was conducted on the banks of the Yamuna River, Delhi, India, to ascertain if riverbank filtration (RBF) can significantly improve the quality of the highly polluted surface water in terms of virus removal (coliphages, enteric viruses). Human adenoviruses and noroviruses, both present in the Yamuna River in the range of 10(5) genomes/100 mL, were undetectable after 50 m infiltration and approximately 119 days of underground passage. Indigenous somatic coliphages, used as surrogates of human pathogenic viruses, underwent approximately 5 log10 removal after only 3.8 m of RBF. The initial removal after 1 m was 3.3 log10, and the removal between 1 and 2.4 m and between 2.4 and 3.8 m was 0.7 log10 each. RBF is therefore an excellent candidate to improve the water situation in emerging countries with respect to virus removal.

Role of CTLA4 in the proliferation and survival of chronic lymphocytic leukemia

Earlier, we reported that CTLA4 expression is inversely correlated with CD38 expression in chronic lymphocytic leukemia (CLL) cells. However, the specific role of CTLA4 in CLL pathogenesis remains unknown. Therefore, to elucidate the possible role of CTLA4 in CLL pathogenesis, CTLA4 was down-regulated in primary CLL cells. We then evaluated proliferation/survival in these cells using MTT, (3)H-thymidine uptake and Annexin-V apoptosis assays. We also measured expression levels of downstream molecules involved in B-cell proliferation/survival signaling including STAT1, NFATC2, c-Fos, c-Myc, and Bcl-2 using microarray, PCR, western blotting analyses, and a stromal cell culture system. CLL cells with CTLA4 down-regulation demonstrated a significant increase in proliferation and survival along with an increased expression of STAT1, STAT1 phosphorylation, NFATC2, c-Fos phosphorylation, c-Myc, Ki-67 and Bcl-2 molecules. In addition, compared to controls, the CTLA4-downregulated CLL cells showed a decreased frequency of apoptosis, which also correlated with increased expression of Bcl-2. Interestingly, CLL cells from lymph node and CLL cells co-cultured on stroma expressed lower levels of CTLA4 and higher levels of c-Fos, c-Myc, and Bcl-2 compared to CLL control cells. These results indicate that microenvironment-controlled-CTLA4 expression mediates proliferation/survival of CLL cells by regulating the expression/activation of STAT1, NFATC2, c-Fos, c-Myc, and/or Bcl-2.

Candidate tumor suppressor and pVHL partner Jade-1 binds and inhibits AKT in renal cell carcinoma

The von Hippel-Lindau (VHL) tumor suppressor pVHL is lost in the majority of clear-cell renal cell carcinomas (RCC). Activation of the PI3K/AKT/mTOR pathway is also common in RCC, with PTEN loss occurring in approximately 30% of the cases, but other mechanisms responsible for activating AKT at a wider level in this setting are undefined. Plant homeodomain protein Jade-1 (PHF17) is a candidate renal tumor suppressor stabilized by pVHL. Here, using kinase arrays, we identified phospho-AKT1 as an important target of Jade-1. Overexpressing or silencing Jade-1 in RCC cells increased or decreased levels of endogenous phospho-AKT/AKT1. Furthermore, reintroducing pVHL into RCC cells increased endogenous Jade-1 and suppressed endogenous levels of phospho-AKT, which colocalized with and bound to Jade-1. The N-terminus of Jade-1 bound both the catalytic domain and the C-terminal regulatory tail of AKT, suggesting a mechanism through which Jade-1 inhibited AKT kinase activity. Intriguingly, RCC precursor cells where Jade-1 was silenced exhibited an increased capacity for AKT-dependent anchorage-independent growth, in support of a tumor suppressor function for Jade-1 in RCC. In support of this concept, an in silico expression analysis suggested that reduced Jade-1 expression is a poor prognostic factor in clear-cell RCC that is associated with activation of an AKT1 target gene signature. Taken together, our results identify 2 mechanisms for Jade-1 fine control of AKT/AKT1 in RCC, through loss of pVHL, which decreases Jade-1 protein, or through attenuation in Jade-1 expression. These findings help explain the pathologic cooperativity in clear-cell RCC between PTEN inactivation and pVHL loss, which leads to decreased Jade-1 levels that superactivate AKT. In addition, they prompt further investigation of Jade-1 as a candidate biomarker and tumor suppressor in clear-cell RCC.

Removal mechanism of cationic dye (Safranin O) from the aqueous phase by dead macro fungus biosorbent

Batch biosorption parametric experiments were carried out to delineate the removal mechanism of cationic dye, namely, Safranin O, from the aqueous phase using biosorbent prepared from wood rotting dead macro fungus 'Fomitopsis carnea'. Experimental data of the kinetic experiments at various temperatures (19, 27 and 35 °C) were well described using pseudo-second order kinetic models. Raising temperature from 19 to 35 °C enhanced the dye uptake potential of the biosorbent from 1,000 to 1,250 mg/g. The other variables studied were the effect of common salt (NaCl) and pH on the dye removal potential of the biosorbent. Decreased dye removal (%) efficiency at higher salt concentration suggests involvement of an ion-exchange type sorption mechanism. The pH study revealed that dye removal may occur due to the existence of an electrostatic attraction force between negatively charged biosorbent particles and dye cation. However desorption using mineral acid (H2SO4 and HCl) exhibited the highest desorption up to 76%, followed by organic acid (52%) and distilled water (not more than 2%) indicating the possibility of ion-exchange as the dominating dye sorption mechanism. Fourier transform infrared (FT-IR) spectroscopy analysis of the biosorbent, Safranin O and Safranin O loaded biosorbent also supported the possibility of ion-exchange as the dominating mechanism due to the presence of major peaks of Safranin O on the IR spectra of Safranin O loaded biosorbent, indicating that the Safranin O was present in its unaltered form on the surface of the biosorbent.

Novel therapy for therapy-resistant mantle cell lymphoma: multipronged approach with targeting of hedgehog signaling

Mantle cell lymphoma (MCL) is one of the most aggressive B-cell lymphomas with a median patient survival of only 5-7 years. The failure of existing therapies is mainly due to disease relapse when therapy-resistant tumor cells remain after chemotherapy. Therefore, development and testing of novel therapeutic strategies to target these therapy-resistant MCL are needed. Here, we developed an in vivo model of therapy-resistant MCL by transplanting a patient-derived MCL cell line (Granta 519) into NOD/SCID mice followed by treatment with combination chemotherapy. Cytomorphologic, immunophenotypic, in vitro and in vivo growth analyses of these therapy-resistant MCL cells confirm their MCL origin and resistance to chemotherapy. Moreover, quantitative real-time PCR revealed the upregulation of GLI transcription factors, which are mediators of the hedgehog signaling pathway, in these therapy-resistant MCL cells. Therefore, we developed an effective therapeutic strategy for resistant MCL by treating the NOD/SCID mice bearing Granta 519 MCL with CHOP chemotherapy to reduce tumor burden combined with GLI-antisense oligonucleotides or bortezomib, a proteosome inhibitor, to target therapy-resistant MCL cells that remained after chemotherapy. This regimen was followed by treatment with MCL-specific cytotoxic T lymphocytes to eliminate all detectable leftover minimal residual disease. Mice treated with this strategy showed a significantly increased survival and decreased tumor burden compared to the mice in all other groups. Such therapeutic strategies that combine chemotherapy with targeted therapy followed by tumor-specific immunotherapy are effective and have excellent potential for clinical application to provide long-term, disease-free survival in MCL patients.

Lymph node-induced immune tolerance in chronic lymphocytic leukaemia: a role for caveolin-1

Emerging evidence indicates that the tumour microenvironment (TME) regulates the behaviour of chronic lymphocytic leukaemia (CLL). However, the precise mechanism and molecules involved in this process remain unknown. Gene expression profiles of CLL cells from lymph node (LN), bone marrow (BM) and peripheral blood (PB) indicate overexpression of a tolerogenic signature in CLL cells in lymph nodes (LN-CLL). Based on their role in B cell biology, the progression of CLL, or immune regulation, a few genes of this 83-gene signature were selected for further analyses. We observed a significant correlation between the clinical outcomes and the expression of CAV1 (P = 0·041), FGFR1 isoform 8 (P = 0·032), PTPN6 (P = 0·031) and ZWINT (P < 0·001). CAV1, a molecule involved in the regulation of tumour progression in other cancers, was seven-fold higher in LN-CLL cells compared to BM- and PB-CLL cells. Knockdown of CAV1 expression in CLL cells resulted in significantly decreased migration (P = 0·016) and proliferation (P = 0·04). When CAV1 was knocked down in B and T cell lines, we observed an inability to form immune synapses. Furthermore, CAV1 knockdown in CLL cells impaired their ability to form immune synapses with autologous T lymphocytes and allogeneic, healthy T cells. Subsequent analyses of microarray data showed differential expression of cytoskeletal genes, specifically those involved in actin polymerization. Therefore, we report a novel role for CAV1 in tumour-induced immunosuppression during the progression of CLL.

Characterization of biofilm of a rotating biological contactor treating synthetic wastewater

A four-stage rotating biological contactor (RBC) was designed and operated to treat synthetic wastewater containing 1,000 mg/l chemical oxygen demand (COD) and 112 mg/l NH(4)(+)-N. A mixed culture bacterial biofilm was developed consisting of a heterotrophic bacterium Paracoccus pantotrophus, nitrifiers and other heterotrophs. Applying the peculiar characteristics of P. pantotrophus of simultaneous heterotrophic nitrification and aerobic denitrification, high simultaneous removal of carbon and nitrogen could be achieved in the fully aerobic RBC. The microbial community structure of the RBC biofilm was categorized based on the nitrate reduction, biochemical reactions, gram staining and morphology. The presence of P. pantotrophus within the RBC biofilm was confirmed with an array of biochemical tests. Isolates from the four stages of RBC were grouped into complete denitrifiers, incomplete denitrifiers and non-denitrifiers. This categorization showed a higher relative abundance of P. pantotrophus in the first stage as compared with subsequent stages, in which other nitrifiers and heterotrophs were significantly present. High total nitrogen removal of upto 68% was in conformity with observations made using microbial categorization and biochemical tests. The high relative abundance of P. pantotrophus in the biofilm revealed that it could successfully compete with other heterotrophs and autotrophic nitrifiers in mixed bacterial biomass.

Toxicity and treatability of leachate: application of UASB reactor for leachate treatment from Okhla landfill, New Delhi

This study reports applicability of upflow anaerobic sludge blanket (UASB) process to treat the leachate from a municipal landfill located in Delhi. A laboratory scale reactor was operated at an organic loading rate of 3.00 kg chemical oxygen demand (COD)/m(3) d corresponding to a hydraulic retention time (HRT) of 12 h for over 8 months. The effect of toxicity of leachate, and feed composition on the treatability of leachate was evaluated. Average COD of the leachate, during the study period varied between 8,880 and 66,420 mg/l. Toxicity of the leachate used during a period of 8 months varied from LC50 1.22 to 12.35 for 96 h. The removal efficiency of soluble COD ranged between 91 and 67% for fresh leachate and decreased drastically from 90 to 35% for old leachate having high toxicity. The efficiency varied from 81 to 65%. The reactor performed more efficiently for the treatment of fresh leachate (less toxic, LC50 11.64, 12.35, and 12.15 for 96 h) as compared with old leachate (more toxic, LC50 1.22 for 96 h). Toxicity of the leachate affected its treatment potential by the UASB.

Tumor-specific peptide-based vaccines containing the conformationally biased, response-selective C5a agonists EP54 and EP67 protect against aggressive large B cell lymphoma in a syngeneic murine model

Vaccines to large B cell lymphoma were made by the covalent attachment of an epitope from the gp70 glycoprotein (SSWDFITV) to the N-termini of the conformationally biased, response-selective C5a agonists EP54 (YSFKPMPLaR) and EP67 (YSFKDMP(MeL)aR). Syngeneic Balb/c mice were immunized with these EP54/EP67-containing vaccines and challenged with a lethal dose of the highly liver metastatic and gp70-expressing lymphoma cell line RAW117-H10 to evaluate the ability of these vaccines to induce protective immune outcomes. All mice immunized with SSWDFITVRRYSFKPMPLaR (Vaccine 2) and SSWDFITVRRYSFKDMP(MeL)aR (Vaccine 3) were protected to a lethal challenge of RAW117-H10 lymphoma (>170 days survival) and exhibited no lymphoma infiltration or solid tumor nodules in the liver relative to unvaccinated controls (<18 days survival). Vaccines 2 and 3 contained the protease-sensitive double-Arg (RR) linker sequence between the epitope and the EP54/EP67 moieties in order to provide a site for intracellular proteases to separate the epitope from the EP54/EP67 moieties once internalized by the APC and, consequently, enhance epitope presentation in the context of MHC I/II. These protected mice exhibited an immune outcome consistent with increased involvement of CD8(+) and/or CD4(+) T lymphocytes relative to controls and mice that did not survive or showed low survival rates as with Vaccines 1 and 4, which lacked the RR linker sequence. CD8(+) T lymphocytes activated in response to Vaccines 2 and 3 express cytotoxic specificity for gp70-expressing RAW117-H10 lymphoma cells, but not antigen-irrelevant MDA-MB231A human breast cancer cells. Results are discussed against the backdrop of the ability of EP54/EP67 to selectively target antigens to and activate C5a receptor-bearing antigen presenting cells and the prospects of using such vaccines therapeutically against lymphoma and other cancers.

Surface ultrastructure of gill arches and gill rakers in relation to feeding of an Indian major carp, Cirrhinus mrigala

The surface ultrastructure of the gill arches and the gill rakers of an herbivorous fish, Cirrhinus mrigala was investigated by scanning electron microscopy. These structures show significant adaptive modifications associated with the food and feeding ecology of the fish. Closely lying short gill rakers and narrow inter-raker channels on the gill arches are associated to filter and retain food particles. Prominent epithelial protuberances on the gill rakers and the gill arches enable the taste buds, located at their summit, to project well above the surface of the epithelium. This could increase the efficiency of the taste buds in selective sorting of palatable food. Surface specializations of the postlingual organ are recognized adaptive modifications for selecting, trapping or holding food particles. Prominent molariform teeth born on the lower pharyngeal jaw, and the chewing pad opposite it, are associated to work together as an efficient pharyngeal mill. Mucous goblet cells are considered to elaborate mucus secretions to trap, glue and lubricate food particles for their smooth transport for swallowing.

Hedgehog-induced survival of B-cell chronic lymphocytic leukemia cells in a stromal cell microenvironment: a potential new therapeutic target

B-cell chronic lymphocytic leukemia (B-CLL) is characterized by an accumulation of neoplastic B cells due to their resistance to apoptosis and increased survival. Among various factors, the tumor microenvironment is known to play a role in the regulation of cell proliferation and survival of many cancers. However, it remains unclear how the tumor microenvironment contributes to the increased survival of B-CLL cells. Therefore, we studied the influence of bone marrow stromal cell-induced hedgehog (Hh) signaling on the survival of B-CLL cells. Our results show that a Hh signaling inhibitor, cyclopamine, inhibits bone marrow stromal cell-induced survival of B-CLL cells, suggesting a role for Hh signaling in the survival of B-CLL cells. Furthermore, gene expression profiling of primary B-CLL cells (n = 48) indicates that the expression of Hh signaling molecules, such as GLI1, GLI2, SUFU, and BCL2, is significantly increased and correlates with disease progression of B-CLL patients with clinical outcome. In addition, SUFU and GLI1 transcripts, as determined by real-time PCR, are significantly overexpressed and correlate with adverse indicators of clinical outcome in B-CLL patients, such as cytogenetics or CD38 expression. Furthermore, selective down-regulation of GLI1 by antisense oligodeoxynucleotides (GLI1-ASO) results in decreased BCL2 expression and cell survival, suggesting that GLI1 may regulate BCL2 and, thereby, modulate cell survival in B-CLL. In addition, there was significantly increased apoptosis of B-CLL cells when cultured in the presence of GLI1-ASO and fludarabine. Together, these results reveal that Hh signaling is important in the pathogenesis of B-CLL and, hence, may be a potential therapeutic target.

Molecular basis of aggressive disease in chronic lymphocytic leukemia patients with 11q deletion and trisomy 12 chromosomal abnormalities

In B-cell chronic lymphocytic leukemia (CLL), Rai stage, immunoglobulin gene mutational status, chromosomal abnormalities, CD38 and ZAP-70 expression were used as prognostic markers. In this study, to understand the molecular basis of chromosomal abnormalities leading to tumor progression, 90 CLL patients were grouped into poor prognosis (with 11q deletion and trisomy 12) and good prognosis (with normal karyotype and 13q deletion) and their clinical outcome was assessed. Gene expression profiles of 35 CLL samples with poor outcome (11q deletion, n=9; trisomy 12, n=5) and good outcome (13q deletion, n=13; normal karyotype, n=8) were analyzed using oligonucleotide microarray. Significance analysis of microarray (SAM) identified 27 differentially expressed genes between these two subgroups with significant overexpression of ATF5 and underexpression of CDC16, PCDH8, SLAM, MNDA and ATF2 in CLL patients with poor outcome. ATF5 gene expression in CLL was further studied because of its role in the regulation of cell cycle progression/differentiation and apoptosis. The overexpression of ATF5 was confirmed by real-time PCR using 39 CLL samples from the poor and good outcome groups. ATF5 was significantly (p<0.001) overexpressed in the poor outcome group. Furthermore, ATF5 expression was significantly higher in the 11q deletion as well as trisomy 12 group alone compared to the 13q deletion and normal karyotype groups. ATF5 overexpression was also associated with significantly (p=0.04) shorter time to treatment. Similarly, expression of five underexpressed genes also correlated with longer time to treatment. Thus, this report demonstrates that ATF5 may be one of the key genes involved in increased proliferation and survival in 11q deletion or trisomy 12, whereas CD16, CD86, SLAM, MNDA and ATF2 may be involved in the decreased proliferation of CLL cells with 13q deletion or normal karyotype.

ATM, CTLA4, MNDA, and HEM1 in High versus Low CD38–Expressing B-Cell Chronic Lymphocytic Leukemia

PURPOSE

In B-cell chronic lymphocytic leukemia (CLL), high CD38 expression has been associated with unfavorable clinical course, advanced disease, resistance to therapy, shorter time to first treatment, and shorter survival. However, the genes associated with CLL patient subgroups with high and low CD38 expression and their potential role in disease progression is not known.

EXPERIMENTAL DESIGN

To identify the genes associated with the clinical disparity in CLL patients with high versus low CD38 expression, transcriptional profiles were obtained from CLL cells from 39 different patients using oligonucleotide microarray. Gene expression was also compared between CLL cells and B cells from healthy individuals.

RESULTS

Gene expression analysis identified 76 differentially expressed genes in CD38 high versus low groups. Out of these genes, HEM1, CTLA4, and MNDA were selected for further studies and their differential expression was confirmed by real-time PCR. HEM1 overexpression was associated with poor outcome, whereas the overexpression of CTLA4 and MNDA was associated with good outcome. Down-regulation of HEM1 expression in patient CLL cells resulted in a significant increase in their susceptibility to fludarabine-mediated killing. In addition, when gene expression patterns in CD38 high and low CLL cells were compared with normal B-cell profiles, ATM expression was found to be significantly lower in CD38 high compared with CD38 low CLL as confirmed by real-time reverse transcription-PCR.

CONCLUSIONS

These results identify the possible genes that may be involved in cell proliferation and survival and, thus, determining the clinical behavior of CLL patients expressing high or low CD38.

Urban water tariff structure and cost recovery opportunities in India

Given the high level of capital investment and the history of government subsidized services, full cost pricing of water services has yet to take hold in India. As a result, it remains broadly underpriced leading to public perception that water is "free" The current tariff levels in India are too low to cover even operating costs. This paper examines the existing Indian urban water tariff models (fixed tariff, volumetric tariff, increasing block tariff etc.), their relevance and problems. It was found that none of the tariff structures could satisfy all the design objectives (cost recovery, economic efficiency, equity, affordability etc.). Also subsidies are not explicit and well targeted for poor population. There are several studies and issues that do demonstrate the opportunities for tariff increase and improved cost recovery. This paper highlights the results of such studies and brings out issues needing consideration. Improved cost recovery would lead to improved financial status of the water utilities. Also, subsidies, if designed suitably and well targeted, would serve the concerns of the economically weaker sections. Such reform process would eventually lead to socio-economic sustainability.

Testicular development and its relationship to semen production in Murrah buffalo bulls

The objectives of this study were to determine the relationship of age and body weight to testicular development and to establish norms for breeding soundness evaluations of Murrah buffalo bulls. Testicular measurements of 133 Murrah buffalo bulls of various ages were recorded with a caliper and a tape. Semen was collected twice a week for 5 weeks from groups of bulls which were 25-36 (n=17), 37-48 (n=16), 49-60 (n=14), of >60 (n=10) months of age. After examining volume, sperm concentration, and progressive motility semen was diluted in Tris-citric acid-egg yolk-fructose extender and frozen in 0.5 ml French straws. Testicular measurements of buffalo bulls were lower than those recorded for European breeds of cattle bulls. Nevertheless, like cattle bulls, scrotal circumference was highly correlated with other testicular measurements. Also, it had a significant positive relationship with semen volume and sperm concentration per ejaculate. Average sperm output per week in order of increasing age group was 15.3, 18.2, 19.8 and 23.6 x 10(9). Corresponding values for sperm output per week per gram of testis were 59.1, 45.8, 41.1, 36.2 x 10(6) indicating a reduction in spermatogenesis per unit of testis with advancing age. Compared to European breeds, daily sperm output in Murrah bulls was nearly 45% lower, presumably due to their nearly 40% lower scrotal circumference than Holstein bulls of the same age. These results indicate that in buffalo, as in cattle, scrotal circumference is a useful indicator of potential sperm output and may serve as an important criterion for selecting young bulls as AI sires.

Health risk assessment of urban suspended particulate matter with special reference to polycyclic aromatic hydrocarbons: a review

Airborne suspended particulate matter is an important marker of air quality. The term 'particulates' includes organic and inorganic matter, nitrogen compounds, sulphur compounds, polycyclic aromatic hydrocarbons (PAHs), several heavy metals, and radionuclides. The health risks from the 'classic' pollutants sulfur dioxide, nitrogen dioxide, ozone, carbon monoxide, and particulates have been comprehensively reviewed. Alarming levels of non-classic pollutants like the PAHs have been reported globally. PAHs have been found in placental tissues of women and in umbilical cord blood samples from newborn babies. The damaged DNA in cord blood is a indication of the fate of these pollutants in the environment. Hence, a need exists for a comprehensive investigation of the human health-related aspects of exposure to particulates and PAHs in the urban environment. This paper reviews the literature on PAHs in conjunction with particulate matter on a global perspective.

Histochemical analysis of glycoproteins in the unicellar glands in the epidermis of an Indian freshwater fish Mastacembelus pancalus (Hamilton)

The unicellular glands in the epidermis of the Indian freshwater fish Mastacembelus pancalus consist of three types of mucous cells and sacciform cells. The histochemical properties of their secretory glycoproteins have been analysed by means of a battery of histochemical methods. These included methods for the identification and simultaneous visualization of oxidizable vicinal diols, O-acyl sugars, O-sulphate esters and sialic acid residues with or without side-chain O-acyl variants. Four general classes of glycoproteins (GPs) were identified. These included (i) GPs with O-sulphate esters and oxidizable vicinal diols, (ii) GPs with oxidizable vicinal diols and sialic acid residues with or without O-acyl substitution at C7, (iii) GPs mainly with O-sulphate esters, low moieties of GPs with oxidizable vicinal diols, O-acyl sugars and sialic acid residues with side-chain O-acyl variant predominantly at C8 (or which are di- or tri-substituted) or C9 and in traces of sialic acid residues without O-acyl substitution or with O-acyl substitution at C7, and (iv) GPs with traces of oxidizable vicinal diols, O-acyl sugars and sialic acid residues with O-acyl substitution at C8 (or which are di- or tri-substituted) or C9. The physiological significances of these GP classes and their release on the surface of the epidermis are discussed with special reference to their role in lubrication, protection and inhibition of the invasion and proliferation of pathogenic microorganisms in the epidermis, as adapted to the peculiar mode of life of the fish.

HID-AB2.5-PAS and HID-PAS methods for the histochemical analyses of a variety of carbohydrates

The high iron diamine (HID) staining procedure was combined with alcian blue pH 2.5 (AB2.5) and periodic acid-Schiff (PAS) methods for the simultaneous demonstration of carbohydrates containing sulfate esters, carboxyl groups and oxidizable vicinal diols, whereas it was sequentially employed with PAS alone to differentiate sulfate esters from oxidizable vicinal diols. A variety of rat tissues and the epidermis of four fish species were utilized to test the specificity or selectivity of these methods. The HID-AB2.5-PAS sequence largely coloured carbohydrates containing sulfate esters, carboxyl groups and oxidizable vicinal diols in brownish black, turquoise and magenta shades respectively. The HID-PAS sequence coloured sulfate esters brownish black and oxidizable vicinal diols magenta. On the basis of the experimental and control studies on the both staining techniques, these staining methods could be postulated to represent efficient and useful techniques for precise histochemical analyses and simultaneous differentiations of a variety of carbohydrates in light microscopy.

Observations on the function of mucous cells in the epidermis of the cat-fish Clarias batrachus exposed to sodium dodecyl sulfate

Response of mucous cells, in the epidermis of the catfish Clarias batrachus, to a sublethal concentration of sodium dodecyl sulfate was studied and correlated with the alteration in the status of their secretory activity after different durations of the treatment. At 4h, 8h, 24h, 48h and 72h of the detergent treatment, most mucous cells attained voluminous dimensions and appeared closely approximating to or even overlapping the adjacent ones. At 12h, 36h, and 60h, in contrast, the mucous cells appeared small and slender, and seemed to be located at greater intervals. These changes in dimensions were responsible for the apparent increase or decrease in the density of mucous cells after different durations of detergent treatment. Statistically, however, no significant change was observed in the total number of the mucous cells throughout the experiment. The mucous cells appeared enlarged towards the end of the experiment signifying increased mucus production. This is considered as an adaptation, for protection, assisting the fish to adjust to the changed environment. A shift in the histochemical nature of the secretory contents at the middle and basal parts of the mucous cells, from a mixture of neutral and acid glycoproteins to neutral glycoproteins, during the early stages of the treatment suggests that acid moities could not simultaneously be synthesized as an immediate response to enhanced mucous secretion. The apical parts of the mucous cells, however, showed no histochemical change throughout the experiment.

Role of dietary fibre on platelet adhesiveness

Fifty five adult patients of diabetes mellitus and fourteen normal healthy subjects matched for age and sex were studied to see the effect of dietary fibre on platelet adhesiveness. In patients of diabetes mellitus the platelet adhesiveness 2 1/2 hrs. after a load of glucose was significantly higher (p = less than 0.001) as compared to normal individuals under the same conditions. After a glucose load with fibre the platelet adhesiveness in patients with diabetes mellitus fell significantly (p = less than 0.001). Although there was a fall in platelet adhesiveness in normal subjects also, it was statistically not significant. Supplements of fibre in the diet of diabetic patients may prevent or delay the vascular complications.

Ionic control of locomotion and shape of epithelial cells: I. Role of calcium influx

The role of calcium in the induction of locomotion, control of direction of locomotion, and modulation of shape of epithelial cells derived from Xenopus laevis tadpole epidermis is investigated. Local influx of calcium is achieved by electrophoretic release of small amounts of calcium from a micropipette (tip diameter 0.1-0.5 micron) closely apposed to the cell body or lamella. The cells are made permeable for calcium by calcium ionophore A23187, and they are kept in Ca++-free, Mg++-rich EGTA Ringer. Another method used to induce Ca++ influx is local application of A23187 while cells move in normal culture medium. Influx of Ca++ into the lamella induces a localised increase in thickness and enlargement of the lamella. Stationary cells become active and show movement in the direction of the Ca++ gradient. Fried-egg-shaped cells tend to acquire a semicircular shape and start moving. Moving cells change the direction of their locomotion, following the direction of Ca++ release. Influx of Ca++ in the cell body region induces its contraction concomitant with an increase in lamellar area. These observations suggest the presence of two different Ca++-sensitive components: an actomyosin meshwork in the cell body and an actin gel in the lamella. Influx of Ca++ induces contraction of actomyosin and solation of actin gel. Interaction of these two systems would explain modulation of shape and generation of locomotion in epithelial cells.

Keratinization of fish skin with special reference to the catfish Bagarius bagarius

Histochemical reactions indicating keratinization have previously been demonstrated in parts of the epidermis of Bagarius bagarius. Fluorescence histochemistry and electron microscopy have now confirmed these results. Elevated areas of the epidermis are capped by a layer of dead cells with altered contents. On the outer aspect of these cells a dense layer, 18 nm thick, beneath the plasma membrane corresponds to the resistant envelope found in keratinized cells in tetrapod vertebrates. In Bagarius this layer does not extend to all faces of the keratinized cells, but a similar envelope has been detected in two other sites of piscine keratinized epidermis investigated, namely in the breeding tubercles of Phoxinus phoxinus and in the teeth of Lampetral fluviatilis. In the elevated areas of Bagarius-epidermis, the epithelial cells undergo progressive changes in cytoplasmic organization as they ;ecome more superficial. The second tier from the surface is sealed by tight junctions and is separated from the overlying keratinized cells by a sub-corneal space resembling that found in keratinized amphibian epidermis. Histochemical evidence of a high lipid content in the outer layers of the epidermis correlates with the presence of lipid inclusions and lamellated membranous profiles in the material studied by electron microscopy. Histochemical results show that the fin skin of Blennius pholis is not keratinized, but secretes a cuticle, histochemically reactive for both proteins and glycoproteins.

Lipids in the skin of a cat-fish Heteropneustes fossilis (Bloch) (Heteropneustidae, Pisces). A histochemical investigation

Localization and characterization of different lipids in the cellular constituents of the skin of Heteropneustes fossilis has been made using several histochemical techniques. High contents of cholesterol, its esters and phospholipids have been correlated with the metabolically active state of the basal cells undergoing cell proliferation and differentiation. The polygonal cells in the outermost layer of the epidermis, though rich in phospholipid contain small amounts of cholesterol and its esters. This has been correlated with the metabolically less active state of theses cells. Neutral lipids and phospholipids in the polygonal cells of the outermost layer may contribute to the contents of surface slime and act as an efficient barrier for the penetration of water through the skin. The deposits of neutral lipids in the subcutis may provide energy during the period of fasting, act as a barrier for water diffusion through the skin and serve as shock absorbing pads protecting the fish from mechanical injury.

Bone scan in chronic dialysis patients with evidence of secondary hyperparathyroidism and renal osteodystrophy

Bone scans in 13 of 14 patients on chronic dialysis were found to be abnormal. Symmetrical increased activity was noted in the calvarium, mandible, sternum, shoulders, vertebrae, and the distal aspects of the femur and tibia, as well as the patella. The scan abnormality is felt to be most likely the result of secondary hyperparathyroidism because of clinical and laboratory data, and, in four, confirmatory tissue diagnoses. The scan findings support the data of some earlier investigations on bone isotopic accretion in hyperparathyroidism. However, co-existing osteomalacia giving rise to abnormal activity in some of the patients cannot be excluded. Dihydrotachysterol may have minimized the extent of osteomalacia in these patients. Osteoporosis was probably present in some patients, but it appears differently on scan. Osteosclerosis was not detected on radiographic examination. Scan manifestations, especially mandibular activity, were pronounced and appeared earlier than the radiographic changes. The degree and extent of abnormal activity correlated with the length of dialysis and the level of alkaline phosphatase.

Histochemistry and the structure of the skin of a murrel, Channa striata (Bloch, 1797) (Channiformes, Channidae). II. Dermis and subcutis

The structure and the cytochemistry of the dermis and the subcutis of Channa striata, which buries in mud to survive droughts, is described and correlated with its habitat. The dermis consists of an outer stratum laxum and an inner stratum compactum. The stratum laxum is mainly composed of well-developed scales lodged in connective tissue pockets which are characterized by the presence of huge deposits of lipids. These lipids may play important roles: in supplying energy during the period of fasting, acting as a barrier for water diffusion through the skin, and serving as shock absorbers, protecting the body from mechanical injury during burrowing. The presence of sulfated acid-mucopolysaccharides, the substantia amorpha in the stratum laxum, has been described as an adaptation to prevent desiccation. Alkaline phosphatase, sulfated acid-mucopolysaccharides, and calcium are closely associated in the osseous layer of the scales and probably play an important role in calcification. Numerous fine collagen fiber strands connecting the basement membrane to the scales provide firm attachment of the epidermis to the dermis. The presence of a relatively thin subcutis may be correlated with the well-developed layer of fat cells in the stratum laxum.

Histochemistry and the structure of the skin of a murrel, Channa striata (Bloch, 1797) (Channiformes, Channidae). I. Epidermis

The functional organization and cytochemistry of the epidermis of an air-breathing fish, Channa striata, is described. In the basal cells a dense population of mitochondria, strong alkaline phosphatase, and succinic dehydrogenase activity indicates high metabolic activity. In the outermost layer, polygonal cells showed strong succinic dehydrogenase activity and elaborated sulfated acid mucopolysaccharides and lipids. Mucous cells were also numerous. A new term, 'sacciform granulated cells,' is proposed for the 'sacciform cells' or 'granular cells.' The contents of these cells are basic proteins. A thick coat of slime containing mucopolysaccharides, lipids, and basic proteins is probably important in keeping the skin moist for cutaneous respiration, retarding the rate of water loss by evaporation, facilitating burrowing in the mud and swimming movement in water, and protecting the skin from bacterial and fungal attacks. A relatively thin epidermis (32 μm on the general surface, 18 μm at the posterior free margins, and 6 μm below the scales) in conjunction with vascularization of the stratum laxum probably assists cutaneous respiration.

Succinic dehydrogenase activity of the respiratory muscles of a fresh-water teleost, Bagarius bagarius (Ham.) (Sisoridae, Pisces)

Functional morphology including the origin, insertion, and innervation of the respiratory muscles in relation to buccal pressure pump and opercular suction pumps in a fresh-water bottom dwelling siluroid fish, Bagarius bagarius have been studied. Histochemical studies were made on the succinic dehydrogenase activity of adductor mandibulae, retractor tentaculi, levator operculi, dilatator operculi, adductor operculi, intermandibularis, interhyoideus, hyohyoideus superior and constrictor branchialis. The intensity of reaction reveals the presence of three types of muscle fibres in some of the respiratory muscles. The muscle containing red muscle fibres are mostly innervated by the branches of the VIIth cranial nerve. The retractor tentaculi consists of superficial white muscle fibres and the interior part is dominated by red muscle fibres. The muscles (adductor operculi, levator operculi, dilatator operculi, interhyoideus, hyohyoideus superior) concerned with the opercular suction pumps are of mixed type and consist of white and red muscle fibres, whereas adductor mandibulae and intermandibularis are made up entirely of white muscle fibres. The adductor muscle bundles of the constrictor branchialis, which are responsible for movement of gill filaments, are dominated by the red muscle fibres. The abductor part, however, is made up entirely of white muscle fibres.

Combined papillary muscle and left ventricular wall dysfunction as a cause of mitral regurgitation. An experimental study

Papillary muscle infarction was produced in 16 mongrel dogs by placing sutures around the base of one of the papillary muscles. In addition, patchy infarction of the adjacent left ventricular wall was produced by placing an Ameroid constrictor around the appropriate coronary artery. Mitral insufficiency developed in 14 of these animals; it was severe in four and mild to moderate in ten. Mitral insufficiency was not produced by isolated infarction of a papillary muscle or by isolated infarction of the left ventricular wall.

It is concluded that papillary muscle infarction alone does not lead to mitral regurgitation, but that papillary; muscle dysfunction acts in concert with left ventricular wall dyskinesia or dilatation to produce mitral valve incompetency.