Clinico-radiological evaluation and management of type II radial ray defect in a young female from rural India: case report

Radial Ray Defect (RRD) is a rare disorder, and the etiology of this disorder is still under discussion. RRD is associated with many medical conditions for which prenatal counselling is of paramount importance. Any association with the family history is still unknown. The patient is a 16-year-old female who came to the orthopaedic clinic complaining of tingling and weakness in the right forearm. On examination, there was a gross deformity in the right forearm with radial deviation of the hand. An X-ray revealed radial ray defect type-2. She previously had a history of perinatal infection during early childhood. Surgery was successfully achieved, and positive results were accomplished. Radial Ray Defect can be focal or associated with other clinical manifestations. The timing of antenatal ultrasound for detecting this musculoskeletal anomaly is crucial. When RRD is associated with other syndromes, counselling to the parents about the quality of life and morbidity comes into play. Treatment is primarily surgical.

Organo-Zintl Clusters [P7R4]: A New Class of Superalkalis

Zintl ions composed of Group 13, 14, and 15 elements are multiply charged cluster anions that form the building blocks of the Zintl phase. Superalkalis, on the other hand, are cationic clusters that mimic the chemistry of the alkali atoms. It is, therefore, counterintuitive to expect that Zintl anions can be used as a core to construct superalkalis. In this paper, using density functional theory, we show that this is indeed possible. The results are compared with calculations at the MP2 level of theory. A systematic study of a P7(3-) Zintl core decorated with organic ligands [R = Me, CH2Me, CH(Me)2 and C(Me)3] shows that the ionization energies of some of the P7R4 species are smaller than those of the alkali atoms and hence can be classified as superalkalis. This opens the door to the design and synthesis of a new class of superalkali moieties apart from the traditional ones composed of only inorganic elements.

A rare variation in the formation of the lower trunk of the brachial plexus its embryological basis and clinical importance - a case report

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727

Development and validation of a liquid chromatographic method for monitoring of process-related synthetic organic impurities of profenofos in technical products

A simple and rapid reversed-phase high-performance liquid chromatographic method for the monitoring of process-related synthetic organic impurities of profenofos (PFS) is developed. Impurities are separated and determined on a reversed-phase Hypersil C(18) column using gradient elution of 50 mM ammonium formate buffer-acetonitrile as a mobile phase and detection at 230 nm at ambient temperature. The method is validated with respect to accuracy, precision, linearity, and limits of detection and quantitation. The method is found to be suitable not only for monitoring the reactions involved in the process development of PFS, but also quality assurance, as it can detect impurities at the level of 1.5 x 10(-8) g.

Massive osteolysis of the skull and upper cervical spine. Case report and review of the literature

Massive osteolysis is a type of idiopathic osteolysis in which there is spontaneous onset of bone resorption. Almost any bone in the body can be affected. The authors present the case of a 62-year-old man diagnosed with massive osteolysis of the occipital bone and the upper two cervical vertebrae. Despite extensive pneumocephalus, no neurological sign or spinal instability was evident. In this case 4000 cGy of radiation in 200-cGy fractions was administered to the diseased area while the patient was kept in a Miami-J collar. At the 2-year follow-up examination, arrest of the disease process and new bone formation was evident on radiographic studies.

Positron emission tomography in drug evaluation: influence of three different catechol-O-methyltransferase inhibitors on metabolism of [NCA] 6-[18F]fluoro-L-dopa in rhesus monkey

We compared the influence of three different catechol-O-methyltransferase (COMT) inhibitors (CGP 28014, OR-611 and Ro 40-7592) on the metabolism of no-carrier-added (NCA) 6-[18F]fluoro-L-dopa (6-FDOPA) in one Rhesus monkey. All three COMT inhibitors improved 6-FDOPA availability in plasma, increased the specific uptake in the brain and thus improved 6-FDOPA uptake measurements using positron emission tomography (PET). Best results were obtained with Ro 40-7592.

Functional roles of in vivo footprinted DNA motifs within an alpha-globin enhancer. Erythroid lineage and developmental stage specificities

Transcriptional regulation of the human alpha-like globin genes, embryonic zeta 2 and adult alpha, during erythroid development is mediated by a distal enhancer, HS-40. Previous protein-DNA binding studies have shown that HS-40 consists of multiple nuclear factor binding motifs that are occupied in vivo in an erythroid lineage- and developmental stage-specific manner. We have systematically analyzed the functional roles of these factor binding motifs of HS-40 by site-directed mutagenesis and transient expression assay in erythroid cell cultures. Three of these HS-40 enhancer motifs, 5'NF-E2/AP1, GT II, and GATA-1(c), positively regulate the zeta 2-globin promoter activity in embryonic/fetal erythroid K562 cells and the adult alpha-globin promoter activity in adult erythroid MEL cells. On the other hand, the 3'NF-E2/AP1 motif is able to exert both positive and negative regulatory effects on the zeta 2-globin promoter activity in K562 cells, and this dual function appears to be modulated through differential binding of the ubiquitous AP1 factors and the erythroid-enriched NF-E2 factor. Mutation in the GATA-1(d) motif, which exhibits an adult erythroid-specific genomic footprint, decreases the HS-40 enhancer function in dimethyl sulfoxide-induced MEL cells but not in K562 cells. These studies have defined the regulatory roles of the different HS-40 motifs. The remarkable correlation between genomic footprinting data and the mutagenesis results also suggests that the erythroid lineage- and developmental stage-specific regulation of human alpha-like globin promoters is indeed modulated by stable binding of specific nuclear factors in vivo.

Evaluation of osteoporosis in patients with fracture neck of femur using conventional radiography

Osteoporosis was assessed at the hip (Singh's index) and calcaneus (calcaneal index) using conventional radiography in 80 patients (31 men, 49 women) with fracture neck of femur. Forty four patients had intracapsular fracture neck of femur (ICFN), and 36 extracapsular fracture neck of femur (ECFN). Fractures occurred more with increasing age in both groups, with female preponderance in the older age group. Osteoporosis was more severe as age advanced. Singh's index decreased from 5.2 to 3 (ICFN), and from 4.1 to 2.65 (ECFN) with age. Calcaneal index decreased from 4.4 to 2.9 (ICFN) and from 4.1 to 2.6 (ECFN) with age. In summary degree of osteoporosis, assessed at the hip and calcaneus, increased with increasing age. Other recent studies have shown that calcaneal bone density is a valid method to predict future risk of hip fracture.

Quality assurance and quality control methods for animal and human applications of no-carrier-added 6-[18F]fluorodopa for PET investigations of dopaminergic systems

No-Carrier-Added (NCA) 6-[18F]fluoro-L-dopa (6-FDOPA) is being produced routinely for PET investigations of dopaminergic systems at our Institute. We describe here in detail the quality assurance methods involved in its multi-step developmental stage as a radiopharmaceutical. A method to remove toxic copper ions to prepare an injectable solution is described. The stability and shelf-life of NCA 6-FDOPA was also examined and results are discussed. Quality control involved three major aspects: (a) chemical purity, (b) radiochemical purity and (c) enantiomeric excess. A method for quick quality control of individual batch preparations is described.

Progressive unilateral hydrocephalus in adults

Unilateral dilatation of the lateral ventricle in adults is rare. We report 2 cases of unilateral hydrocephalus with obstruction at the foramen of Monro. Both patients presented with symptoms of raised intracranial pressure.

Evaluation of brainstem auditory evoked responses in congenital hydrocephalus

Brainstem auditory evoked responses (BAER) were studied in 20 children with clinically diagnosed and CT-confirmed congenital hydrocephalus before and after shunt surgery. Ninety-five percent of the children showed abnormal responses preoperatively. Prolonged wave V latency was the most common abnormality, followed by increased interwave latencies. Total absence of evoked responses was more common in children with communicating hydrocephalus. Following shunt surgery 50% of cases returned to normal and 20% showed a significant improvement. Abnormalities persisted in 10% of cases. BAER abnormalities referrable to caudal brainstem dysfunction recovered first, following CSF diversion. Study of BAER is useful for identifying physiological brainstem abnormalities in hydrocephalic children and promises to be a sensitive non-invasive diagnostic tool for the detection of "non-infective complications" of shunt surgery, if performed serially during follow up.

Benign subarachnoid haemorrhage (subarachnoid haemorrhage of unknown aetiology)

Forty three patients of subarachnoid haemorrhage of unknown aetiology have been studied for their clinical presentation, rebleed rate, morbidity and mortality. The results have been compared with other similar studies. The present study and those of others indicate a very good prognosis in acute stage. The rebleed rate ranged between 0 and 7% over a period of two to three years. The mortality rate ranged between 0 and 5% during the same period of follow-up. Majority of the patients returned to their full working capacity. The benign nature of this subgroup as compared to the poor outcome of subarachnoid haemorrhage as a whole prompted us to call it "Benign subarachnoid haemorrhage".

Intraspinal arachnoid cysts

Arachnoid cysts are rare lesions responsible for spinal cord compression. Five cases of congenital intraspinal arachnoid cysts are reported. Three cases of thoracic and two cases of thoracolumbar region were encountered. The clinical presentation was one of progressive spastic paraparesis. The characteristic radiological features are described. Surgery was successful in all cases.

A variable pulse-burst electromagnetic generator for electrical stimulation of biological systems

A variable frequency-burst type, electromagnetic pulse generator has been developed to optimize the effect of electrical stimulation on bone growth. Using a pair of coils, with 100 turns and 18-gauge wire, the instrument can generate a maximum magnetic field of 300 Gauss. Its pulse repetition frequency can be varied from 10 Hz to 2 KHz and the duty cycle, consisting of several short carrier frequency pulses, can be varied up to 95%. This design also permits the period of the carrier pulse to be changed.

Intracranial trigeminal nerve granular cell myoblastoma. Case report

The clinicopathological features of an unusual granular cell myoblastoma involving the fifth cranial nerve are presented. Evidence incriminating the Schwann cell as the source of the granular cell is also discussed.

A pulsed electromagnetic stimulator for bone-growth studies

A variable-pulse electromagnetic pulse generator has been developed to study the effect of the magnetic field on bone growth. The unit's repetition frequency can be varied from 2 to 200 Hz, and the peak current that it can drive is 10 A. The duty cycle of the pulse can be varied in steps of 10, 12.5, 17, 25, 50, 75, 83, 87.5, and 90% and is independent of the repetition frequency. The trailing edge of the output pulse can be controlled to produce any desired voltage-time pulse characteristic. This decay adjustment makes it possible to generate a variable-pulse frequency spectrum.

Possession syndrome: an epidemiological study in west karnataka

A house to house survey was conducted for a population of 1158 in west Karnataka to determine the prevalence of possession syndrome and to study people's attitude towards the same. One year period prevalence was found to be 3.7%. 90% of the respondents believed in possession. Women more than men shared this belief. Spirit possession was reported to be troublesome but God possession as helpful. Number of God possession cases exceeded tint of spirit possession. Female sex, young age, low education appeared to predispose an individual to get possessed in such atmosphere.

Post-traumatic psychiatric disturbances: patterns and predictors of outcome

A prospective follow-up study of 60 randomly selected cases of closed adult civilian head injuries was conducted for three months from the time of head injury to assess the frequency, patterns, and factors related to post-traumatic psychiatric disturbances. Eighty per cent of the cases had a neuropsychiatric disturbance as assessed at 1 1/2 months. The commonest was post-concussional syndrome (43 per cent). The extent of social dysfunction was directly related to the severity of head injury. However, the total number of symptoms (largely subjective) correlated highly with pre-traumatic neuroticism. The inter-relatedness of organic and personality factors in the post-traumatic syndrome, and their predictive value, are discussed.

Chronic subdural hematoma in the cerebellopontine angle

A 32-year-old man had the clinical and radiological features of a mass lesion in the left cerebellopontine angle. Surgical exploration revealed a cyst containing 20 ml of altered blood. Microscopic examination of the cyst wall showed the structure of an organizing hematoma in the subdural space. The patient, on repeated questioning, denied a history of head injury.

A comparative study of two preoperative radiation regimens with cystectomy for bladder cancer

This report surveys the results of two programs of preoperative irradiation with radical cystectomy for bladder cancer in 205 patients. Irradiating the true pelvis to 4000 rads in 4 weeks with radical cystectomy after 6 weeks was implemented in 119 patients (Group 1) from 1959 to 1965; 2000 rads given in 1 week to the true pelvis and radical cystectomy within the following week was implemented in 86 patients (Group 2) from 1966 to 1970. Determinate survival without evidence of recurrence at 5 years was 43% in Group 1 and 42% in Group 2. Mortality with recurrence of bladder cancer in 5 or more years was 44% in group 1 and 42% in group 2. Pelvic complications occurred in 13% of group 1 and 9% of group 2.

Influence of early passages on the character of freshly isolated strains of Tahyna virus

The plaque size, thermostability, virulence, and average lethal time of uncloned freshly isolated strains of Tahyna virus were studied in the course of 3 passages in suckling mice. All of the 10 strains were in the 1st passage thermostable (indices 4 degrees/50 degrees C less than 1.0 log10) and highly virulent (indices ic/sc less than 1.0 log10). They differed significantly in plaque size only. The effect of 3 passages in suckling mice was manifested by titre increase and plaque size reduction. The differences in thermostability and virulence were too small as to be distinctly significant, but at least they indicated the heterogeneity of the strains. The variability in behaviour of uncloned strains and significance of changes observed during passages are discussed.

A 47,XXq-Y Klinefelter male

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A clinical and biochemical survey of 729 cases of mental subnormality

It has been estimated (Zellweger, 1961) that less than 5 per cent of all cases of mental subnormality have a hereditary metabolic defect. This is a figure which requires confirmation, and is one that is likely to vary in different parts of the world. We have accordingly carried out a systematic clinical and biochemical screening of the cases of mental subnormality (IQ lower than 70) attending the out-patient department of the Mental Hospital, Bangalore. A total of 729 patients (439 males and 290 females) were available for this study.