Regenerative medicine, organ bioengineering and transplantation.

BACKGROUND: Organ transplantation is predicted to increase as life expectancy and the incidence of chronic diseases rises. Regenerative medicine-inspired technologies challenge the efficacy of the current allograft transplantation model. METHODS: A literature review was conducted using the PubMed interface of MEDLINE from the National Library of Medicine. Results were examined for relevance to innovations of organ bioengineering to inform analysis of advances in regenerative medicine affecting organ transplantation. Data reports from the Scientific Registry of Transplant Recipient and Organ Procurement Transplantation Network from 2008 to 2019 of kidney, pancreas, liver, heart, lung and intestine transplants performed, and patients currently on waiting lists for respective organs, were reviewed to demonstrate the shortage and need for transplantable organs. RESULTS: Regenerative medicine technologies aim to repair and regenerate poorly functioning organs. One goal is to achieve an immunosuppression-free state to improve quality of life, reduce complications and toxicities, and eliminate the cost of lifelong antirejection therapy. Innovative strategies include decellularization to fabricate acellular scaffolds that will be used as a template for organ manufacturing, three-dimensional printing and interspecies blastocyst complementation. Induced pluripotent stem cells are an innovation in stem cell technology which mitigate both the ethical concerns associated with embryonic stem cells and the limitation of other progenitor cells, which lack pluripotency. Regenerative medicine technologies hold promise in a wide array of fields and applications, such as promoting regeneration of native cell lines, growth of new tissue or organs, modelling of disease states, and augmenting the viability of existing ex vivo transplanted organs. CONCLUSION: The future of organ bioengineering relies on furthering understanding of organogenesis, in vivo regeneration, regenerative immunology and long-term monitoring of implanted bioengineered organs.

Evaluating CO2 flux and recharge source in geothermal springs, Garhwal Himalaya, India: stable isotope systematics and geochemical proxies.

Evaluation of geogenic carbon fluxes between solid Earth and its atmosphere is essential to understand the global geological carbon cycle. Some of the key geogenic CO2 suppliers are the magmatic mantle and metamorphic degassing from active and quiescent volcanoes, fault zones, geothermal systems and CO2 rich groundwater. Indian Himalayan geothermal field hosts about 340 geothermal springs in natural as well as artesian condition that eject hot waters and volatiles with varied temperature and chemical composition. These sites provide an opportunity to analyse tectonically driven gas emissions and their impact on regional and global climate. Here we adopt a method for direct measurement of Dissolved Inorganic Carbon (DIC ≈ HCO3) concentration in the geothermal springs to estimate geogenic CO2 flux from an active region based on water discharge and area of geothermal system between the tectonic boundaries of the Main Central Thrust (MCT) and Main Boundary Thrust (MBT) of the Garhwal (Northwest) Himalaya. In the study area, geothermal spring water contain high δ13CDIC ratio (- 8.5‰ to + 4.0‰ VPDB), and among the major ions, bicarbonate (HCO3-) varies by an order of magnitude from 1697 to 21,553 µEq/L; chloride and sodium vary from 90 to 19,171 µEq/L and 436 to 23181 µEq/L. The elevated concentration of Cl- and Na+ in geothermal spring waters suggests affinity towards their deeper origin. These geothermal springs cover a large area of nearly 10,000 km2 of the Garhwal region showing a significant discharge of CO2 rich water with an estimated carbon dioxide degassing flux of ~7.2 × 106 mol/year to the atmosphere. Considering widespread occurrences of geothermal springs in tectonically active areas worldwide, the proposed direct measurement of DIC may be used as a reliable tool to estimate CO2 fluxes in different active orogenic settings within the Earth system. Results of stable isotopes of δ18O (VSMOW) and δD (VSMOW) in these geothermal spring waters follow the Global Meteoric Water Line (GMWL), suggesting affinity of their recharge through the meteoric origin.

Intraguild interactions between five congeneric species of Thaparocleidus (Monogenoidea) from the freshwater shark Wallago attu, Lucknow, India.

The fish host (Wallago attu) and monogenoid parasite (Thaparocleidus sp.) have been recorded during 2 years (2011 and 2012) to investigate intra/interspecific interactions among query species (T. sudhakari (Gusev, 1976) Lim, 1996; T. indicus (Kulkarni, 1969) Lim, 1996; T. gomtius (Jain, 1952) Lim, 1996; T. yogendraii Agrawal, 1981 and T. wallagonius Jain, 1952) in the light of parasitic worm burden, morphological and molecular data. Each species is highly host specific (oioxenous), with a specialized functional niche. Being niche specialists, they exhibit niche overlapping along with co-existence due to reproductive barrier. Furthermore, a molecular marker, affirming clear-cut genetic variation in spite of structural entities, provides evidence for infra-speciation as well as co-speciation.

Novel association of achalasia with hereditary sensory and motor neuropathy with sensorineural deafness.

Achalasia is a primary esophageal motility disorder. Unlike diffuse esophageal spasm, it has not previously been described in association with hereditary sensory and motor neuropathy (HSMN). An 18-year-old-male with HSMN with sensorineural deafness presented with a 2-day history of dysphagia to solids and liquids. Achalasia was diagnosed after extensive investigations, and his symptoms resolved with endoscopic and definitive surgical management. His monozygotic twin brother had also been diagnosed with HSMN and suffered from chronic dysphagia, which was also subsequently diagnosed with achalasia. This is the first case to illustrate an association between HSMN with sensorineural deafness and achalasia.

Irritable bowel syndrome in quiescent inflammatory bowel disease: a review.

Ongoing troublesome bowel symptoms despite quiescent inflammatory disease are a frequent management challenge when caring for patients with inflammatory bowel disease (IBD). Even when active disease has been excluded the prevalence of residual gastrointestinal symptoms is surprisingly high and the cause often obscure. The presence of a concurrent functional disorder such as irritable bowel syndrome (IBS) is associated with worse quality of life, worse physical functioning, higher prevalence of anxiety and greater health care utilization. Potential etiological mechanisms leading to the development of IBS like symptoms include the development of visceral hypersensitivity following the original inflammatory insult, alteration in cortical processing, dysbiosis and residual subacute inflammation. Therapeutic options for managing IBS in patients with IBD include dietary modification, interventions targeted at correction of visceral sensory dysfunction or cortical processing and modulation of the gut microbiota. As there are few studies specifically examining the treatment of IBS in patients with IBD, the majority of therapeutic interventions are extrapolated from the IBS literature. Given the frequency of residual functional symptoms in IBS, significantly more research is warranted in this field.

Vancomycin-resistant Enterococcus faecium: report of two cases.

Vancomycin-resistant Enterococci (VRE), especially Enterococcus faecium has emerged as an important nososcomial pathogen and represents a serious threat to patients with impaired host defense. Early detection of patients colonised or infected with VRE is an essential component of any hospital program designed to prevent nosocomial transmission of this organism. The authors report two cases of VRE isolated from blood and surgical site pus of two neonates admitted in the same neonatal unit, highlighting that early detection, prompt and appropriate infection control measures were keys to successful containment of this dreaded pathogen.

Mixed pulmonary infection in an immunocompromised patient: a rare case report.

Patients who are immunocompromised are predisposed to a variety of common and uncommon pulmonary infections. We report a case of mixed pulmonary infection by drug resistant tuberculosis with a nocardiosis in a 49-year-old man who was a known case of chronic obstructive pulmonary disease, on prolonged corticosteroid use with diabetes mellitus. Chronic use of corticosteroids is a predisposing factor for opportunistic infections, such as nocardiosis or tuberculosis. Since such a mixed infection is rare, maybe a combined approach to therapy early in the course of disease would be effective in such cases.

Odds ratio of risk factors for oral submucous fibrosis in a case control model.

Our aim was to calculate the odds ratio (OR) of various epidemiological, social, behavioural, and dietary risk factors for oral submucous fibrosis in a population-based case control study. We did this in rural and urban Lucknow by organising oral health camps in the community, where a total of 3136 subjects were enrolled. Panmasala, a dry commercial preparation containing areca nut, slaked lime, catechu, and condiments, with or without tobacco, was the most important aetiological factor for the disease. The 95% confidence interval (CI) of the OR for tobaccoless panmasala ranged from 4.77 to 6.88 and for tobacco panmasala from 4.55 to 9.71. OR using multivariate analysis was 14.09 for tobaccoless panmasala and 5.39 for tobacco panmasala. Patients who use panmasala are at high risk of developing oral submucous fibrosis.

Variations in the formation of the median nerve and its clinical correlation.

Variations in the formation of the median nerve are of interest to anatomists, radiologists, and surgeons. These variations may be vulnerable to damage in surgical operations, but their knowledge also helps in the interpretation of a nervous compression having unexplained clinical symptoms. We studied the variation in the formation of the median nerve in 87 cadavers, i.e. 174 upper limbs of formalin preserved cadavers at the department of Anatomy, Subharti medical college. We observed an additional root taking part in the formation of the median nerve in 26.4% of upper limbs, unusual low formation of the median nerve in the arm in front of the brachial artery in 18.4% of upper limbs, and median nerve formation medial to the axillary artery in 10.3% of upper limbs. Knowledge of such anatomical variations is of interest to the anatomist and clinician alike. Surgeons who perform procedures involving neoplasm or trauma repair need to be aware of these variations.

Multicolored and white-light phosphors based on doped GdF3 nanoparticles and their potential bio-applications.

Rare-earth-doped gadolinium fluoride nanocrystals were synthesized by a single step synthesis employing ethylene glycol as solvent. Based on X-ray diffraction studies, stabilization of hexagonal modification of GdF(3) has been inferred. The microscopic studies show formation of uniformly distributed nanocrystals (~15 nm). The nanoparticles are readily dispersible in water and show bright luminescence in colloidal solution. The luminescence properties have been investigated as a function of activator concentrations, and enhanced optical properties have been attributed to efficient energy transfer from the Gd(3+) to the activator RE(3+) ions, which has further been confirmed by steady-state and time-resolved optical studies. It has been demonstrated that on doping appropriate amount of activators in host GdF(3), a novel white-light-emitting phosphor is obtained with CIE co-ordinates and correlated color temperature (CCT) very close to broad daylight. This can have promising applications as phosphor for white-light ultraviolet-light-emitting diodes (UV-LEDs). Our experiments showed efficient labeling of human breast carcinoma cells (MCF-7) by Tb(3+)-doped GdF(3) nanoparticles. The fluorescence intensity was found to be dependent on the surface modifying/coating agent, and the results were validated using confocal microscopy in terms of localization of these functionalized nanoparticles.

Variant origin of superior polar artery and unusual hilar branching pattern of renal artery with clinical correlation.

Classically, a single renal artery arising from the abdominal aorta supplies the respective kidney on each side. Near the hilum of the kidney each renal artery divides into anterior and posterior branchs, which in turn divide into segmental arteries supplying the different renal segments. A total of 84 formalin fixed cadavers (73 male and 11 female, 168 kidneys in total) constituted the material for the study. During routine abdominal dissection conducted for medical undergraduates, the kidneys and their arteries were explored and variations in morphological patterns of renal arteries were noted. We observed superior polar renal artery in 22.6% cases. Superior polar renal arteries had different sources of origin. In 10.7% of cases it came directly from the abdominal aorta as an accessory renal artery; in 5.4% of cases as a direct branch from the main renal artery; in 3.6% of cases from the superior hilar renal artery (from one of the duplicated renal arteries); and in 3.0% of cases from a segmental branch of the renal artery. We also observed unusual hilar branching patterns of renal arteries, which included a fork pattern in 11.3% of cases, ladder pattern in 7.7% of cases, net pattern in 5.9% of cases, and triplicate in 3.0% of cases. Understanding the anatomy of vascular variations of the kidney is essential for the clinician to be able to perform procedures such as renal transplantation, interventional radiological procedures, and renal vascular operations more safely and efficiently.

In situ observation of size-scale effects on the mechanical properties of ZnO nanowires.

In this investigation, the size-scale in mechanical properties of individual [0001] ZnO nanowires and the correlation with atomic-scale arrangements were explored via in situ high-resolution transmission electron microscopy (TEM) equipped with atomic force microscopy (AFM) and nanoindentation (NI) systems. The Young's modulus was determined to be size-scale-dependent for nanowires with diameter, d, in the range of 40 nm ≤ d ≤ 110 nm, and reached the maximum of ∼ 249 GPa for d = 40 nm. However, this phenomenon was not observed for nanowires in the range of 200 nm ≤ d ≤ 400 nm, where an average constant Young's modulus of ∼ 147.3 GPa was detected, close to the modulus value of bulk ZnO. A size-scale dependence in the failure of nanowires was also observed. The thick ZnO nanowires (d ≥ 200 nm) were brittle, while the thin nanowires (d ≤ 110 nm) were highly flexible. The diameter effect and enhanced Young's modulus observed in thin ZnO nanowires are due to the combined effects of surface relaxation and long-range interactions present in ionic crystals, which leads to much stiffer surfaces than bulk wires. The brittle failure in thicker ZnO wires was initiated from the outermost layer, where the maximum tensile stress operates and propagates along the (0001) planes. After a number of loading and unloading cycles, the highly compressed region of the thinner nanowires was transformed from a crystalline to an amorphous phase, and the region near the neutral zone was converted into a mixture of disordered atomic planes and bent lattice fringes as revealed by high-resolution images.

Micropathological changes in the sub-epidermal zone of normal appearing skin in leprosy.

Leprosy is a chronic inflammatory disease caused by Mycobacterium leprae, which affects not only the peripheral nerves and skin but also various internal viscera through the hematogenous spread, especially in lepromatous cases. The micropathological changes in epidermis, nerves and skin appendages from lesioned skin reported by various authors but reports of involvement of apparently normal sites are few. We investigated skin biopsy material taken from 130 patients with clinically diagnosed leprosy. Biopsies were taken at least 10 cm away from site of lesion. Hematoxylin and Eosin staining and Harada's modified Allochrome method for acid-fast bacilli were applied for histological investigations. The pattern of leprosy among the patients were indeterminate in 53 cases (40.8%), tuberculoid in 29 cases (22.3%), borderline tuberculoid in 14 cases (10.8%), borderline leprosy in ten cases (7.7%), borderline lepromatous in nine cases (6.9%) and lepromatous leprosy in 15 cases (11.5%). The changes were seen in sub-epidermal zone of normal appearing skin in all type of leprosy, but involvement was greater at the lepromatous end of the spectrum compared to tuberculoid end. Acid-fast bacillus (AFB) was seen in subepidermal zone of normal appearing site. Presence of AFB is significant as far as dissemination and transmission of disease is concerned.

Renal artery variations: embryological basis and surgical correlation.

Understanding anatomy of the vascular variations of kidney is essential for the clinician to perform procedures such as renal transplantation, interventional radiological procedures and renal vascular operations more safely and efficiently. In order to facilitate the clinical approaches, we studied renal arterial pattern in 50 formalin-fixed cadavers, on 100 kidneys. We observed prehilar multiple branching patterns in 11 (11.66%) cases, duplication of renal artery in eight (8.33%) cases and superior polar artery in seven (6.66%) cases. In the present study findings discussed with its clinical correlation.

Accidental intestinal myiasis caused by genus Sarcophaga.

Myiasis of different organs has been reported off and on from various regions in the world. We report a human case of intestinal myiasis caused by larvae of Sarcophaga. A 25 - year - old male presented with symptom of passage of live worms in stool. Following diagnosis and treatment the patient improved completely with cessation of maggots in stool.

Dendrimeric nanoarchitectures mediated transdermal and oral delivery of bioactives.

Transdermal route is an evolving panorama in novel drug deliverance and with oral route they proffer immense potential. Most recently there is hastening in approaches for delivering bioactives via these routes, amongst them revolution has been made by dendrimers. Encapsulation and conjugation of bioactives with these virus sized robots have shown immense employment for delivery of hydrophobic and labile remedies. Transport of these nano-cruises from corner to corner of skin and through epithelial hurdle of gastrointestinal tract depends upon dendrimer characteristics. An improved thoughtful of these characteristics is an obligation for their use in these rambling fields. These characteristics embrace generation size, molecular weight, surface charge, incubation time and concentration. This context demarcates the imperative role of dendrimers in transdermal and oral drug delivery. This review also highlights concerning mechanism of convey of nanoarrays via epithelial hurdle of GIT.

Pulmonary hydatidosis: an unusual cause of haemoptysis.

A 28-year-old female patient was referred to us with complaints of massive haemoptysis and cough with expectoration, of two years' duration. Her chest radiograph, computed tomography scan and video-bronchoscopy revealed a cystic lesion in the right upper and lower zones of the lungs. Aspiration from the cyst fluid was grossly hemorrhagic and full of inflammatory cells. On digestion of the fluid with potassium hydroxide, it showed plenty of hooklets and scolices of Echinococcus granulosus. An intact brood capsule was also seen. Diagnosis of hydatidosis was further confirmed by a positive serological and therapeutic response to albendazole.

Recurrence of carcinoma cervix in the scar of previous cesarean section: a case report.

Although rare, reports of carcinoma cervix recurring in abdominal incision, episiotomy scars, laparoscopic port sites, and drain sites are available. However, recurrence in the scar of a previous cesarean section (CS) is unreported. A 49-year-old female with a diagnosis of keratinizing squamous cell carcinoma (SCC) of cervix, stage IIB, was treated by radical radiotherapy. She had undergone CS, through midline abdominal incision, for three previous deliveries. Twenty months later, she presented with a nodule of size 2.5 x 2 cm(2) on the 26-year-old abdominal CS scar. Infiltration of the skin and extension into the deeper structures of the abdominal wall was present in an area of 5 x 4 cm(2). There was no evidence of disease on the cervix. A fine-needle aspiration cytologic examination from the nodule revealed keratinizing SCC. Ultrasonography and computerized tomography scan revealed a mass lesion along the abdominal CS scar with subcutaneous nodule and peritoneal extension. Multiple metastatic lesions were present in the liver. She was treated with chemotherapy and radiotherapy. The patient has lived for more than 12.5 months. The first report of recurrence of carcinoma cervix in a CS scar is presented. Literature on surgical scar recurrence in carcinoma cervix is reviewed.

Hand preference in patients with allergy, juvenile cancer, and schizophrenia.

Patients with allergy (n = 50), juvenile cancer (n = 50), and schizophrenia (n = 37), and nonpatient controls (n = 200) were asked to indicate their hand preferences on a 7-point scale (1 = left always, 7 = right always) for the 32-item Waterloo Handedness Questionnaire. Except for patients with schizophrenia, who exhibited a higher incidence of mixed hand preference, groups showed a clear rightward bias. Further analyses suggested that mixed hand preference in schizophrenia was evident more often for unskilled than skilled hand activities.