Bacillus tequilensis influences metabolite production in tomato and restores soil microbial diversity during Fusarium oxysporum infection

This study evaluates cellular damage, metabolite profiling, and defence-related gene expression in tomato plants and soil microflora during Fusarium wilt disease after treatment with B. tequilensis PBE-1. Histochemical analysis showed that PBE-1 was the primary line of defence through lignin deposition and reduced cell damage. GC-MS revealed that PBE-1 treatment ameliorated stress caused by F. oxysporum infection. PBE-1 also improved transpiration, photosynthesis, and stomatal conductance in tomato. qRT-PCR suggested that the defence-related genes FLS2, SERK, NOS, WRKYT, NHO, SAUR, and MYC2, which spread infection, were highly upregulated during F. oxysporum infection, but either downregulated or expressed normally in PBE-1 + P treated plants. This indicates that the plant not only perceives the bio-control agent as a non-pathogen entity but its presence in normal metabolism and gene expression within the host plant is maintained. The study further corroborated findings that application of PBE-1 does not cause ecological disturbances in the rhizosphere. Activity of soil microflora across four treatments, measured by Average Well Colour Development (AWCD), showed continuous increases from weeks 1 to 4 post-pathogen infection, with distinct substrate usage patterns like tannic and fumaric acids impacting microbial energy source utilization and diversity. Principal Component Analysis (PCA) and diversity indices like McIntosh, Shannon, and Simpson further illustrated significant microbial community shifts over the study period. In conclusion, our findings demonstrate that B. tequilensis PBE-1 is an ideal bio-agent for field application during Fusarium wilt disease management in tomato.

The prevalence of osteoporosis and its association with serum testosterone and serum vitamin D in the elderly male population: A cross-sectional study

Background

Male osteoporosis is under-diagnosed and poorly studied. With the ageing population, osteoporotic fracture in men is an emerging health problem. The aim of this study was to study the prevalence of osteoporosis and its association with serum testosterone and serum vitamin D in elderly men (>60 years old) attending the outpatient department (OPD).

Methods

An observational cross-sectional study was performed in elderly men (>60 years old) attending OPD of a tertiary care hospital of Western Maharashtra between April 2017 and June 2019. Patients with rheumatological disorders, history of vertebral/femoral fractures, chronic kidney disease, chronic liver disease, thyroid disorders and alcohol dependence were excluded. Data were analysed using the chi-square test and descriptive statistics.

Results

In total, 408 male patients were included. The mean age was 68.33 years. Osteoporosis was seen in 39.5% of patients (161/408) with a T score of ≤2.5. Osteopenia was noted in 48.3% of patients (197/408). T and Z scores had significant correlation (p = <0.001). Only 12% of elderly men had normal bone mineral density score. Serum testosterone, chronic obstructive pulmonary disease (COPD) and benign prostatic hypertrophy (BPH) were significantly associated with male osteoporosis with a p-value of 0.019, 0.016 and 0.010, respectively. Vitamin D levels, type 2 diabetes mellitus, hypertension and coronary artery disease did not show any significant association with male osteoporosis.

Conclusion

Osteoporosis was noted in 39.5% of the elderly men. In addition, decreased testosterone, COPD and BPH were significantly associated with male osteoporosis. It is important to screen elderly men to diagnose osteoporosis early and prevent osteoporotic fractures.

Seasonal dynamics and impact factors of atmospheric CO2 concentration over subtropical forest canopies: observation from eddy covariance tower and OCO-2 satellite in Northwest Himalaya, India

Carbon dioxide (CO₂) is the key atmospheric gas that controls the earth's greenhouse effect, and forests play a major role in abating the atmospheric CO₂ by storing carbon as biomass. Therefore, it is vital to understand the role of different forests in regulating the spatiotemporal dynamics of atmospheric CO₂ concentration. In this study, we have used eddy covariance (EC) tower-based atmospheric CO₂ concentration measurements and satellite-retrieved column average CO₂ concentration of 2018 to understand the diurnal and seasonal dynamics of atmospheric CO₂ concentration over the sub-tropical forest in the foothills of northwest Himalaya, Uttarakhand, India. EC study revealed that the CO₂ concentration over the forest canopy peaks during mid-night to early morning and drop to a minimum during the afternoon. On a monthly scale, peak atmospheric CO₂ concentration was observed during July in both the sites, which was a result of more release of CO₂ by the forest ecosystem through ecosystem respiration and microbial decomposition. Enhanced photosynthetic activities during the late monsoon and post-monsoon resulted in the decrease of atmospheric CO₂ concentration over the forest ecosystem. Among the meteorological variables, rainfall was found to have the highest control over the seasonal variability of the atmospheric CO₂ concentration. Orbiting Carbon Observatory-2 (OCO-2) satellite-retrieved column average CO₂ (XCO₂) was also examined to comprehend its reliability on an ecosystem scale. The OCO-2 retrieved XCO₂ value was higher than the EC carbon flux tower-measured atmospheric CO₂ concentration, which might be due to differences in the vertical resolution of the CO₂ column and scale difference. However, the monthly atmospheric XCO₂ retrieved from OCO-2 strongly adheres with the ground-measured monthly pattern. Our study highlights that forests with varying functional traits within the same climatic conditions show variability in the regulation of atmospheric CO₂ concentration.

Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study

BACKGROUND

This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery.

METHODS

This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery.

RESULTS

A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498).

CONCLUSION

There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.

Peptidoglycan-treated tumor antigen-pulsed dendritic cells impart complete resistance against tumor rechallenge

Solid tumors elicit suppressive T cell responses which impair antigen-presenting cell (APC) functions. Such immune suppression results in uncontrolled tumor growth and mortality. Addressing APC dysfunction, dendritic cell (DC)-mediated anti-tumor vaccination was extensively investigated in both mice and humans. These studies never achieved full resistance to tumor relapse. Herein, we describe a repetitive RM-1 murine tumor rechallenge model for recurrence in humans. Using this newly developed model, we show that priming with tumor antigen-pulsed, Toll-like receptor (TLR)2 ligand-activated DCs elicits a host-protective anti-tumor immune response in C57BL/6 mice. Upon stimulation with the TLR2 ligand peptidoglycan (PGN), the tumor antigen-pulsed DCs induce complete resistance to repetitive tumor challenges. Intra-tumoral injection of PGN reduces tumor growth. The tumor resistance is accompanied by increased expression of interleukin (IL)-27, T-box transcription factor TBX21 (T-bet), IL-12, tumor necrosis factor (TNF)-α and interferon (IFN)-γ, along with heightened cytotoxic T lymphocyte (CTL) functions. Mice primed four times with PGN-stimulated tumor antigen-pulsed DCs remain entirely resistant to repeat challenges with RM-1 tumor cells, suggesting complete prevention of relapse and recurrence of tumor. Adoptive transfer of T cells from these mice, which were fully protected from RM-1 rechallenge, confers anti-tumor immunity to syngeneic naive recipient mice upon RM-1 challenge. These observations indicate that PGN-activated DCs induce robust host-protective anti-tumor T cells that completely resist tumor growth and recurrence.

Pronator teres accessorius: A new variant in flexor antebrachial musculature

Muscles of flexor compartment of forearm have a common origin from medial epicondyle of humerus. Additional bellies of flexor muscles are commonly reported but presence of supernumerary muscles is an infrequent phenomenon. The present study describes an unusual muscle mass in flexor compartment of forearm simulating pronator teres. During routine dissection the upper limb of a 50 years old male cadaver, a supernumerary muscle was found on left side of the upper limb in the flexor compartment. The origin of the muscle was 2cm wide and aponeurotic in nature and attached to an oblique line extending from the inferior surface of the medial epicondyle and the medial surface of the trochlea. It was inserted on an oblique line 2.5cm wide on the radius in area between supinator superiorly and flexor digitorum profundus inferiorly. Existence of accessory muscles, which connect flexor muscles, could be explained embryologically by incomplete cleavage of flexor mass during development. The flexor muscles of the forearm develop from the flexor mass which subsequently divides into two layers: superficial and deep. The deep layer gives rise to flexor digitorum superficialis, flexor digitorum profundus and flexor pollicis longus. These supernumerary muscles are extremely rare entities and probably represent deranged embryological development or the process of atavism in which the anomalous part persist for a longer time in the tree of evolution.

BIOBETTERS: THE BETTER BIOLOGICS AND THEIR REGULATORY OVERVIEW

The continuous innovation of the biopharmaceutical industry has led to development of a new category of biopharmaceuticals i.e. Biobetters or Biosuperiors. Biobetters may have better efficacy, a longer half-life, lower dosing frequency, a reduced risk of immunogenicity, reduced toxicity and side effects along with lower early-stage research risk and development costs. Biobetters rather than biosimilars may capture significant share of market and are the next wave for companies to ride on. Although it sounds intuitive, biobetters will have to face various ordeals like identification of the apparent unmet need, quantification of the potential market opportunity, expensive investment in clinical trials, challenging regulatory approval, pressures of price erosion and patent litigations. Thus, development of biobetters truly requires the right balance between providing life-changing medical management for patients and maintaining an innovative pipeline for continued business success. This review will focus on technical and regulatory prospects of biobetters.

Redundant and regulatory roles for Toll-like receptors in Leishmania infection

Toll-like receptors (TLRs) are germline-encoded, non-clonal innate immune receptors, which are often the first receptors to recognize the molecular patterns on pathogens. Therefore, the immune response initiated by TLRs has far-reaching consequences on the outcome of an infection. As soon as the cell surface TLRs and other receptors recognize a pathogen, the pathogen is phagocytosed. Inclusion of TLRs in the phagosome results in quicker phagosomal maturation and stronger adaptive immune response, as TLRs influence co-stimulatory molecule expression and determinant selection by major histocompatibility complex (MHC) class II and MHC class I for cross-presentation. The signals delivered by the TCR-peptide-MHC complex and co-stimulatory molecules are indispensable for optimal T cell activation. In addition, the cytokines induced by TLRs can skew the differentiation of activated T cells to different effector T cell subsets. However, the potential of TLRs to influence adaptive immune response into different patterns is severely restricted by multiple factors: gross specificity for the molecular patterns, lack of receptor rearrangements, sharing of limited number of adaptors that assemble signalling complexes and redundancy in ligand recognition. These features of apparent redundancy and regulation in the functioning of TLRs characterize them as important and probable contributory factors in the resistance or susceptibility to an infection.

Nonmetric analysis of caroticoclinoid foramen in foothills of Himalayas: Its clinicoanatomic perspective

OBJECTIVE OF THE STUDY

Study was conducted to evaluate the incidence of caroticoclinoid foramen in north Indian population. Authors have also endeavoured to discuss its clinical and embryological implications.

MATERIALS AND METHODS

Study was conducted on 108 dry human skulls in department of anatomy SGRR medical college, Dehradun. Incidence of caroticoclinoid foramen was evaluated in accordance with side.

RESULTS

A percentage of 22.22 skulls presented with the caroticoclinoid foramen with maximum incidence of unilateral and incomplete type. Incidence revealed no bias towards side.

CONCLUSION

Anatomical knowledge about CCF may be helpful to radiologists and neurosurgeons in providing an additional insight into the diagnosis and management of various pathologies around sellar region.

Quality and Acceptability of Meat Nuggets with Fresh Aloe vera Gel

Aloe vera has been used worldwide for pharmaceutical, food, and cosmetic industries due to its wide biological activities. However, quality improvement of low fat meat products and their acceptability with added Aloe vera gel (AVG) is scanty. The aim of this study was to explore the feasibility of using fresh AVG on physicochemical, textural, sensory and nutritive qualities of goat meat nuggets. The products were prepared with 0%, 2.5%, and 5% fresh AVG replacing goat meat and were analyzed for proximate composition, physicochemical and textural properties, fatty acid profile and sensory parameters. Changes in lipid oxidation and microbial growth of nuggets were also evaluated over 9 days of refrigerated storage. The results showed that AVG significantly (p<0.05) decreased the pH value and protein content of meat emulsion and nuggets. Product yield was affected at 5% level of gel. Addition of AVG in the formulation significantly affected the values of texture profile analysis. The AVG reduced the lipid oxidation and microbial growth in nuggets during storage. Sensory panelists preferred nuggets with 2.5% AVG over nuggets with 5% AVG. Therefore, AVG up to 2.5% level could be used for quality improvement in goat meat nuggets without affecting its sensorial, textural and nutritive values.

Role of physicochemical properties in the estimation of skin permeability: in vitro data assessment by Partial Least-Squares Regression

Skin provides passage for the delivery of drugs. The in vitro and in vivo testing of chemicals for estimation of dermal absorption is very time consuming, costly and has many ethical difficulties related to human and animal testing. The solution to the problem is Quantitative structure-permeability relationships. This method relates dermal penetration properties of a range of chemical compounds to their physicochemical parameters. In the present study, an effort has been made to develop models for the accurate prediction of skin permeability using a large, diverse dataset through the combination of various regression methods coupled with the Genetic Algorithm (GA)/Interval Partial Least-Squares Algorithm (iPLS). The descriptors were calculated using e-DRAGON and ADME Pharma Algorithms-Abrahams descriptors. The original dataset was divided into a training set and a testing set using the Kennard-Stone Algorithm. The selection of descriptors was made by the GA and iPLS. The model applicability domain was determined. The results showed that a three-parameter model built through Partial Least-squares Regression was most accurate with r(2) of 0.936.

Evaluation of low dose ACTH stimulation test in suspected secondary adrenocortical insufficiency

BACKGROUND

Several studies in the last few years have shown that the standard 250 micro g dose used in ACTH stimulation test may be very high and have suggested that a dose of 1 micro g may be sufficient for evaluating hypothalamo-pituitary adrenal (HPA) axis.

AIMS

To evaluate the role of low dose ACTH stimulation test in patients with suspected Secondary Adrenal Insufficiency (SAI).

SUBJECTS AND METHODS

Thirty-one patients of suspected SAI with a documented pituitary lesion and seven normal healthy controls were included in the study. All the subjects underwent ACTH stimulation test with standard high dose (HD= 250 microg) and low dose (LD= 1 microg) ACTH. Insulin Induced Hypoglycaemia (IIH) test was done in 7 out of 9 patients in whom the results of the two tests were discordant. The cut off for normal HD stimulation test was taken as peak cortisol response > 18 microg/dl and for LD test, either a cortisol response of > 18 microg/dl or an increment of more than 7 micro g/dl over the basal value at any time during the test, on the basis of response observed in controls.

RESULTS

22/31 patients (74%) in SAI group showed concordant results with both tests, whereas nine patients had discordant results. These nine patients showed AI with LD ACTH, but HD ACTH test showed a normal response. In 7 of these 9 patients who underwent IIH, AI was confirmed in 6.

CONCLUSION

The LD ACTH stimulation test seems to be better than HD ACTH stimulation test for evaluating HPA axis in patients with suspected SAI. When basal cortisol is normal, LD ACTH stimulation test detects subtle SAI.

Hepatic amyloidosis in intravenous drug abusers and AIDS patients

The clinical and pathological features of four liver biopsies and 12 autopsies from 1981-1990 with hepatic amyloidosis were reviewed. All of the patients had a history of both intravenous and subcutaneous cocaine and heroin use with chronic suppurative skin ulcers. Five patients were proven to have the acquired immunodeficiency syndrome at autopsy. Systemic amyloidosis was diagnosed in only five out of the 16 patients prior to death. Hepatomegaly was present in 12 patients. The amyloid protein was AA in 14 and AL in one case. Definitive characterization of the amyloid substance was not possible in one case. There was no evidence of multiple myeloma or a plasma cell dyscrasia in the one patient with AL amyloid. The amyloid distribution in the liver was both parenchymal and vascular in 12 cases. Cholestasis, which appeared to occur preterminally, was the only histological finding that correlated with the patient's clinical condition. The histological pattern of amyloid in the liver could not predict the type of amyloid protein that was identified. Amyloidosis should be considered in the differential diagnosis of unexplained hepatomegaly in the acquired immunodeficiency syndrome with chronic suppurative infections.

Breast and cervical cancer screening of poor, elderly, black women: clinical results and implications. Harlem Study Team

Our objective is to describe the clinical findings from a nurse-practitioner-based breast and cervical cancer screening program for poor, elderly, black women. We designed a cross-sectional descriptive study set at an urban public hospital medical clinic. All women 65 years of age and older were eligible to be screened. We measured these main outcomes: rates of participation, abnormal tests, and neoplasia. Women were offered screening during a routine visit. Of 689 women, 491 (71%) participated. Mammography was completed by 66% of women; one had stage 1 cancer, and 76% were negative. Among the women (24%) with abnormal mammograms, the overwhelming majority were diagnosed with benign lesions. For ten of 450 women completing Papanicolaou (Pap) smears, results were suspicious or positive for malignancy, for a prevalence rate of 22.2/1,000 (95% confidence interval [CI] = 8.6/1,000 to 35.8/1,000). Three were subsequently designated falsely positive; five had confirmed cervical neoplasia; and two had other reproductive malignancies. Two women with negative smears also had neoplasia: one with vulvar cancer and one with human papilloma virus (HPV) infection and cervical neoplasia, for a total of six cervical neoplasias. Interestingly, one-fifth of women with a hysterectomy had an intact cervix, including one with cervical neoplasia. Nearly one-third of women with abnormal Paps or mammograms failed to complete follow-up. Success of screening programs for the elderly will depend on the risk group targeted, careful examination, degree of sensitivity and specificity of the tests, and acceptability of follow-up diagnosis and treatment.

A nurse practitioner intervention to increase breast and cervical cancer screening for poor, elderly black women. The Harlem Study Team

OBJECTIVE

To compare nurse practitioner (NP) and physician rates of breast and cervical cancer screening among poor, elderly black women.

DESIGN

A quasi-experimental design was used to compare pre- and postintervention annual screening rates. Rates were determined by medical record audits.

SETTING

Two urban public hospital primary care clinics served as the study sites.

PATIENTS

All women aged 65 years or more were eligible to participate.

INTERVENTIONS

Women were offered screening by a NP during a routine visit in the intervention site; a physician reminder system was used in the control site.

MAIN RESULTS

Baseline annual screening rates were comparable in the two study sites. At the end of the study period, rates were significantly higher in the NP site, compared with the control. In the NP clinic, the annual rate of Pap tests increased to 56.9% from the baseline of 17.8%, and mammographies increased to 40% from 18.3%. In comparison, rates remained low in the control site, increasing only to 18.2% of women receiving Pap tests from a baseline of 11.8%, and remaining at 18% for mammography.

CONCLUSIONS

Use of a NP to deliver same-day screening is an effective strategy to target poor, elderly black women for breast and cervical cancer screening. However, even with the substantial increases in rates obtained with the NP intervention, screening in this vulnerable population remains below nationally targeted levels.

Defective mannosylation of glycosylphosphatidylinositol in Lec35 Chinese hamster ovary cells

The Lec35 mutation (previously designated PIR) of Chinese hamster ovary cells is a recessive mutation that affects the participation of mannose-P-dolichol (MPD) in dolichol-P-P-oligosaccharide biosynthesis in vivo, even though MPD and the respective MPD-dependent mannosyltransferases are present. The Lec35 phenotype can be partially corrected by disrupting Lec35 cells and performing the transferase reactions in vitro, suggesting that the defect may be related to mislocalization of MPD. In this study, we examined the effect of the Lec35 mutation on glycosylphosphatidylinositol (GPI) lipid biosynthesis, another pathway that requires MPD. Our data indicate that the first mannosylation reaction of GPI lipid biosynthesis is defective in Lec35 cells, with the accumulation of glucosaminylphosphatidylinositol having a fatty acyl group on inositol and a base-resistant alkyl group attached to glycerol. The same intermediate accumulates in Lec15 (MPD synthase-defective) cells. The defective mannosylation reaction of Lec35 cells was corrected in vitro and shown to require MPD. These results demonstrate that the Lec35 gene governs a general aspect of MPD metabolism affecting both GPI lipid and dolichol-P-P-oligosaccharide biosynthesis. To provide additional insight into the role of the Lec35 gene, we give evidence for an inefficient pool of MPD in Lec35 membranes.

Is human papillomavirus associated with cervical neoplasia in the elderly?

There have been no studies in the United States of human papillomavirus (HPV) in elderly women. This paper presents cross-sectional data on HPV and cervical neoplasia among 232 women age 65 or more. HPV deoxyribonucleic acid (DNA) testing was performed using a modified dot-blot hybridization technique. The prevalence of HPV DNA positivity was 3.5% (95% confidence interval (CI) 0.9%, 6.0%). There were six cases of histologic cervical neoplasia. The crude odds ratio for cervical neoplasia among HPV DNA positives was 18.3 (95% CI 2.8, 120.3). The adjusted odds, controlling for age, prior screening history, current sexual activity, and past contraception use, were 12.2 (95% CI 1.2, 122.9). Ever having had a Papanicolaou smear was protective, and there was a trend for the odds of having neoplasia to increase with age. Additional studies with larger samples of elderly women are needed. If confirmed, the results suggest that, independent of past screening, HPV may increase the risk of having cervical neoplasia for elderly women.

Hydroxyethyl starch macromolecules reduce myocardial reperfusion injury

We assessed the value of a fraction of hydroxyethyl starch (HES Pz) in reducing the myocardial reperfusion injury in a canine open-chest model in which 1 hour of left anterior descending coronary artery occlusion was followed by 24 hours of reperfusion. Three treatment infusions (5% of blood volume) were compared: Ringer's lactate, serum albumin, and HES Pz (70% of the macromolecules between 100,000 and 1,000,000 d). When compared with Ringer's lactate and albumin, HES Pz significantly reduced the ratio of 24-hour infarct size to pretreatment area at risk (3% vs 19% and 16%, respectively) and myocardial water content (0.5% vs 3% and 1%). Potassium content differences between injured and normal myocardium were significantly less in the infarct regions of animals receiving HES Pz. In the canine model, HES Pz reduced 1-hour myocardial ischemia reperfusion injury significantly.

A New Prenylated Flavanone from Erythrina suberosa Roots

The roots of ERYTHRINA SUBEROSA were found to contain a new prenylated flavanone by combined physico-chemical studies.

The effects of maternal cigarette smoking on placental morphology, histomorphometry, and biochemistry

We related cigarette smoking during pregnancy to the macroscopic and microscopic morphology, histomorphometry, and biochemistry of the placenta among participants in The Prenatal Project, a randomized, controlled trial of nutritional supplementation during pregnancy. The aim was to ascertain if the harmful effects of cigarette smoking on the fetus were reflected, and possibly mediated, by changes in the placenta, and whether such changes might be modified by the nutritional supplements, parallel to the nutritional reversal of birthweight depression among heavy smokers. Maternal smoking was associated with increased alkaline ribonuclease (RNase) levels, possibly resulting in disturbed protein synthesis. More smokers had placentas with villous hyperplasia on histologic examination. This was accompanied by biochemical evidence of significantly increased cellularity (increased DNA/gm of placental mass and decreased protein/DNA ratios) and (nonsignificant) trends to reduced syncytial villous cell size on histomorphometry. There were joint effects of cigarette smoking and use of either form of nutritional supplementation on the fibrin and stoma components of the villi, but such changes are not necessarily pathologic. The significant reduction in pathology of the stem villi among smokers was confined to those who were nutritionally supplemented, particularly heavy smokers. This change may thus have reflected the protective effects of supplementation on the birthweight of the offspring of these heavy smokers.

The effects of dietary supplementation during pregnancy on placental morphology, pathology, and histomorphometry

We related the macroscopic and microscopic morphology and the histomorphometry of the placenta to prenatal nutritional supplementation. In the Prenatal Project, a controlled clinical trial, three dietary treatments (supplement, a high-protein beverage; complement, a balanced protein-calorie beverage, or routine vitamin and mineral tablets) were randomly allocated to poor Black pregnant women, and the outcome was assessed. Herein we report the effects on placental morphology and histomorphometry. There were significantly fewer preterm deliveries in the complement group, and this was reflected by an increase in the size of decidual cells, an index associated with placental aging. Several other characteristics of the placentas of the complement group may have been more directly associated with improved perinatal outcome: decreased intervillous fibrin, lower incidence of gross surface infarct, and smaller (and presumably less edematous) cells of the villous stroma, may have mediated increased placental perfusion. There was no evidence of any placental change associated with the increase in very preterm delivery and the highly significant depressed birth weight among preterm deliveries in the supplement group. The significantly lower incidence of meconium staining of Wharton's jelly among controls seems likely to have been a chance finding. While there were several other indices that reflected placental aging, the significantly increased chorioamnionitis, acute funisitis , and acute decidual inflammation among placentas of those who delivered prematurely [the former two associated with very early delivery (less than 35 wk gestation)] were likely to have been involved as causes of premature delivery.

Intracranial subdural sarcoid granuloma. Case report

A patient is reported in whom a subdural sarcoid granuloma caused symptoms of an intracranial mass lesion, and disappeared following steroid therapy. Twenty-three previous cases with large intracranial sarcoid granulomas have been documented, a review of these 24 cases leads the authors to conclude that: 1) neither symptoms nor nonhistological diagnostic studies, including computerized tomography, differentiate sarcoid from cerebral neoplasms or other central nervous granulomas; and 2) because sarcoid mass lesions frequently respond well to corticosteroid therapy, surgery should probably be reserved for cases in which there is diagnostic uncertainty, a need for emergency decompression, or lack of response to steroids.