Clinical Relevance of Sternal Foramina: A Morphometric Study.

Objectives: The present study aimed at determining the incidence of sternal foramina in adult dry bones of North Indian descent. We also aimed to determine the number, precise location of the sternal foramina with a standard reference point which might have considerable importance with regard to procedures involving sternal puncture. Methods: This cross sectional descriptive study was conducted on 72 dry adult human sternums. Various measurements in relation to the sternal foramina were taken with a non-stretchable measuring tape and digital vernier calliper and expressed as: [A]-total sternal length, [B]-distance between the jugular notches to the foramen, [C]-distance between the angle of Louis to the foramen and [D]-distance of the foramen from the mid sternal plane. Statistical analysis was performed with Microsoft Excel version 2019. A p-value of <0.05 was considered significant. Results: We found 6.94% (5 out of 72 sternums) incidence of sternal foramina which corroborates well with the existing literature. Mean sternal length was 127.7 ± 09 mm. The mean distance of the foramina from suprasternal notch, sternal angle and from the median plane were 118.12 ± 0.3 mm, 116.7 mm and 2.4 mm respectively. Incidence of sternal foramina was almost similar to previously reported studies. Conclusions: The precise knowledge about the expected location of sternal foramina is imperative to avoid intra-thoracic visceral injury during commonly performed acupuncture needle insertion and while doing bone marrow aspiration for diagnostic evaluation.

Bilateral Bifid Tendon of Palmaris Longus - Advantageous in Tendon Transfer?

Background: Variable insertions of Palmaris longus (PL) muscle tendon is described by various authors. Presence of extra PL tendon is also described in literature. As autologus tendon grafting is a blooming arena of clinical research at present time, an additional tendinous slip of PL has promising scope for use as an autograft. Case Report: We report here bilateral bitendinous distal attachment of PL muscle encountered during routine cadaveric dissection. The additional PL tendon in a multitendinous insertion pattern with optimum length and thickness is indeed an additional advantage from the point of view of autograft harvesting. This has also importance in understanding the unusual, altered symptomatology in compressive conditions. Conclusion: Although relatively common, surgeons should be well aware of the various possible aversion of distal attachment of PL which might have significant impact in alteration of symptomatology of neurovascular compressions in the forearm and hand and while choosing an appropriate tendon autograft.

Complete Ossification of Transverse Acetabular Ligament - Embryological and Clinical Perspective.

Abstract: Transverse acetabular ligament (TAL) is one of the important ligaments, which provide stability to the hip joint. On rare occasions, it can get ossified leading to limited mobility of the hip joint. Ossified TAL also converts acetabular notch to a foramen and neurovascular structures passing through the notch can get compressed leading to ischaemic symptoms. During routine demonstration of hip bone to undergraduate students, complete ossification of TAL was found in a right sided hip bone. Present case report with this rare finding also includes a short review of literature impressing on embryological and clinical perspectives of ossified TAL. Ossification of this ligament can be caused by defective ossification of hip bone as three secondary ossification centres develop around the acetabulum in triradiate carti-lage. Also, this can be caused due to heterotopic ossification of TAL after an inflammatory or traumatic injury. This ligament is extremely important in total hip replacement surgery being utilised in determining the position of the acetabular component. Anatomical knowledge of abnormal ossification of TAL is imperative in diagnosis and treatment of various pathologies of the hip joint.

Clinical Relevance of Nutrient Foramina of Fibula: A Morphometric Study.

Background: The fibula is a long bone located at the lateral aspect of the leg. Diaphysis of fibula is supplied by one or more nutrient arteries through an opening referred to as the nutrient foramen. Mor-phometric studies of the nutrient foramina of fibulae are very sparse in literature. Materials and Methods: This cross-sectional descriptive study was conducted on 51 dry adult human fibulae housed in the department of anatomy, AIIMS, New Delhi. Total fibular length along with the number and location of all nutrient foramina present were recorded. Foraminal indexes (FI) of the fibulae were calculated as well. Results: The study revealed that the average length of fibulae was 35.48 ± 1.76 cm. 94% fibulae had a single nutrient foramen and 6 % had two. In fibula with single foramen, the most common location was on the medial crest (50%), followed by between medial crest and posterior border (35%), between the medial crest and interosseous border (8%) and on posterior border (6%). Nutrient foramen was located in middle 1/3rd of shaft in 98 % and in inferior 1/3rd of shaft in 2 % of fibulae. The average foraminal index was 44.85 ± 6.67% with a range of 35.7 to 63.8%. Conclusion: Most common location of nutrient foramen in fibula is middle 1/3rd of shaft on the medial crest with dual nutrient foramina in 6% of fibulae. These parameters show variability in different geographical location and population groups. These data may be helpful for anthropologists, forensic experts, radiologists and might guide in harvesting vascularised fibular bone graft.

Origin of triple right coronary with separate ostium.

This report highlights a coronary artery anomaly (CAA) involving three right coronary arteries (RCAs) arising from the anterior aortic sinus and a single left coronary artery (LCA) from the left posterior aortic sinus. Furthermore, each of the three RCAs originated with separate ostia. The 1st RCA was the right conus artery which originated through the anterior ostium. The 2nd RCA from the middle ostium mimicked a typical RCA. The 3rd RCA that originated from the posterior ostium had an initial retro-aortic course and then ran between the ascending aorta and atria. It eventually terminated as the circumflex artery after reaching the left end of the posterior coronary sulcus. The LCA was normal anatomically except that it did not give the circumflex branch. The knowledge of this type of unusual branching pattern of the coronary artery may be useful to clinicians.

An Atypical Case of Meckel's Diverticulum with Small Bowel Obstruction: Surgical Anatomy, Embryology and Clinical Implications.

Abstract: Meckel's diverticulum (MD) is the most frequent congenital anomaly of the gastrointestinal (GI) tract. Atypical presentations with life threatening complications include intestinal obstruction, intussusceptions, peritonitis, foreign body lodgement in the MD, perforated viscera etc. which require prompt diagnosis. Ectopic gastric and pancreatic tissues are found in up to half of the cases which can escalate the complications. However clinical diagnosis is not easy especially when the presentation is atypical. A high index of clinical suspicion is required to diagnose elusive MD with associated complications. Surgical resection is safe and the gold standard treatment for complicated MD. A case of Meckel's diverticulum with concomitant mesodiverticular band (MDB) in a 13 years old male child presented as intestinal obstruction to emergency department is described which was promptly managed surgically with required pre-operative investigations. The aim of this report is to make clinicians aware about a complicated MD with MDB clinically presenting as small bowel obstruction.

Ossification of Superior Transverse Scapular Ligament - Incidence, Embryology and Association with Suprascapular Neuropathy.

Introduction: Suprascapular notch is present at superior border of scapula just medial to coracoid process. This is covered by superior transverse scapular ligament (STSL). Suprascapular nerve passes below this ligament while suprascapular vessels pass above it. STSL ossification is a rare finding with variable incidences in different population groups. Materials and Methods: We observed 60 dry bony scapulae, 30 prosected formalin fixed upper limbs with scapula and 10 embalmed cadavers for the presence of ossified STSL. Results: There were complete ossification of STSL in two dried bony specimens of sacpula. Conclusion: Ossified STSL may be the causative factor for suprascapular neuropathy. The mainstay of management in cases of neuropathy or compression of suprascapular nerve is release of suprascapular ligament by either open or arthroscopic surgical approach. So, it is extremely important to know this type of variation to minimize any damage to related structure and plan the management accordingly.

Yoga: A Natural Solution to Decrease Disease Burden in Children of MTHFR Deficient Parents.

Introduction: MTHFR being a key regulatory enzyme of 1-carbon metabolism pathway serves critical function of generation of SAM, replenishment of glutathione and nucleotide synthesis and finally methylation of the bio molecules. MTHFR gene mutation is a rare au-tosomal recessive inborn error of metabolism and presents with severe hyperhomocysteinemia. MTHFR polymorphisms on the other hand are commonly encountered of which two 677 C>T and 1298 A>C have been most widely studied and reported to increase the vulnerability to neural tube defects, congenital heart disease, various neuropsychiatric disorders like autism spectrum diseases and attention deficit hyperactiv-ity disease, cleft lip/ palate, acute leukaemia, cardiovascular diseases, occlusive vascular disease in children. Methods: We conducted this prospective clinical trial to examine whether yoga practice can up regulate MTHFR gene expression. Considering the prevalence of MTHFR polymorphism, varied spectrum of its implications in disease causation including male infertility, we conducted the trial involving 30 infertile men who underwent 3 weeks of supervised YBLI. Pre and post intervention assessment of the blood and semen sample was done to see the effects. Results: We have found more than fivefold up-regulation in the expression of MTHFR gene with significant reduction of seminal free radical levels after 3 weeks of yoga practice. Interestingly we noticed significantly higher MTHFR polymorphic variants in infertile male patients compared to healthy fertile controls. Conclusion: MTHFR polymorphisms are also independently associated with many paediatric diseases. Diagnosing MTHFR deficiency in children is a challenging job and requires high index of suspicion and continuous vigilance. Yoga based lifestyle may be adopted both by parents planning conception and also by adolescent children who are sufferers of this condition to halt the consequences of mild to moderate MTHFR deficiency.

Anatomical diversity of inferior belly of the omohyoid muscle - Anatomical, physiological and surgical paradigm.

Omohyoid muscle is one of the infrahyoid muscles of the neck which consists of two bellies combined at an angle by an intermediate tendon. The inferior belly is a flat, narrow band, which inclines forwards and upwards in the lower part of the neck. It generally originates from the upper border of the scapula, medial to scapular notch. The present case showed unilateral anomalous attachment of the inferior belly of the omohyoid on the medial part of clavicle on left side. Inferior belly was 2.2cm lateral to left sternoclavicular joint with 3.2 and 1.5cm in length and breadth, innervated by ansa cervicalis. Only 3% of this type of variation has been observed until now according to previous literature. Anterior and posterior triangles of neck on both sides of the cadaver were dissected during routine dissection for undergraduate teaching. There was no scapular attachment of inferior belly of the omohyoid on the left side. It was directly originating from the upper surface of the medial side of the left clavicle. Variation in the attachment of inferior belly can have a direct impact on the internal jugular vein and brachial plexus during neck surgeries or trauma due to its close relation to the mentioned structures. This variation should also be taken care during infrahyoid myocutaneus flap extraction for reconstruction surgery of tongue in cases of lingual carcinoma.

Bioremediation: an alternative approach for detoxification of polymers from the contaminated environment.

The industries and metropolitan wastes produced by anthropogenic activities are of great concern for nature as it causes soil contamination and deteriorate the environment. Plastic utilization is rapidly enhancing globally with passing days that last for a more extended period in the environment due to slow decomposition and natural degradation. Excessive use of polymer has risked the life of both marine, freshwater and terrestrial organisms. Lack of proper waste management and inappropriate disposal leads to environmental threats. Bioremediation processes involve microbes such as fungi, bacteria, etc. which contribute a crucial role in the breakdown of plastics. Extremophiles secrete extremozymes that are functionally active in extreme conditions and are highly crucial for polymer disaggregation in those conditions.

The mid genes of Rhizobium sp strain TAL1145 are required for degradation of mimosine into 3-hydroxy-4-pyridone and are inducible by mimosine.

Mimosine is a toxin present in the tree-legume leucaena (Leucaena leucocephala), including its root nodules and the root exudates. The leucaena-nodulating Rhizobium sp. strain TAL1145 degrades mimosine (Mid(+)) and utilizes it as a source of carbon and nitrogen. Twelve TAL1145 mutants defective in mimosine degradation (Mid(-)) were made through Tn3Hogus, TnphoA or kanamycin-resistance-cassette insertions. A 5.0 kb PstI fragment of TAL1145, subcloned from a cosmid clone containing mid genes for mimosine degradation, complemented most of the Mid(-) mutants. Sequencing this fragment and the adjacent 0.9 kb PstI fragment identified five genes, midA, midB, midC, midD and midR, of which the first three genes encode ABC transporter proteins involved in mimosine uptake, while midD encodes an aminotransferase required for degrading mimosine into 3-hydroxy-4-pyridone, and midR is a regulatory gene encoding a LysR-type transcriptional activator. The location of MidA in the periplasm was shown by making two midA : : phoA fusions, which made active alkaline phosphatase in the periplasm. The various mid : : gus and midA : : phoA fusions were inducible by mimosine, and a midD : : gus fusion mutant showed beta-glucuronidase activity in the leucaena nodules, indicating that midD is expressed in the nodules. Similarly, a midA : : phoA fusion expressed alkaline phosphatase activity in the leucaena nodules, indicating that mimosine induces midA transcription in the bacteroids. mid genes are specific for the Mid(+) strains of leucaena Rhizobium and are absent in strains of other Rhizobium, Sinorhizobium and Bradyrhizobium spp.

Diversity among Bradyrhizobium isolates nodulating yardlong bean and sunnhemp in Guam.

AIMS: To isolate and characterize bradyrhizobia that nodulate yardlong bean and sunnhemp in Guam. METHODS AND RESULTS: Bradyrhizobia populations that nodulate yardlong bean and sunnhemp in Guam were examined for genetic diversity and their relatedness to Bradyrhizobium japonicum and B. elkanii reference strains. Genomic DNA of 58 isolates of Bradyrhizobium spp. was hybridized with B. japonicum nodY and B. elkanii nodK genes. Based on the hybridization patterns, the isolates were classified into three nodY-nodK hybridizing groups. Group I comprised the majority of the isolates and hybridized with nodY whereas group II isolates hybridized with nodK. The group III isolates, that did not hybridize with either nodY or nodK, formed nitrogen-fixing nodules on cowpea but did not nodulate soybean. DNA sequence analysis of a 280-bp fragment of the variable region of the 16S rRNA gene of a few group III isolates showed that these isolates were more similar to Bradyrhizobium spp. than to B. japonicum or B. elkanii. CONCLUSIONS: The majority of the isolates nodulating yardlong bean and sunnhemp in Guam are similar to B. japonicum, although some isolates are similar to Bradyrhizobium spp. that nodulate a miscellaneous group of legumes including cowpea. SIGNIFICANCE AND IMPACT OF THE STUDY: Since both yardlong bean and sunnhemp are nodulated by a range of bradyrhizobia, selection of superior strains may be based on nodulation effectiveness on both legumes.

Comparison of molecular and antibiotic resistance profile methods for the population analysis of Bradyrhizobium spp. (TGx) isolates that nodulate the new TGx soybean cultivars in Africa.

AIMS: Comparison of molecular and antibiotic resistance profile methods to identify an easy method that can differentiate between strains of introduced Bradyrhizobium japonicum and the indigenous Bradyrhizobium spp. (TGx) isolates which nodulate the newly developed TGx soybean cultivars in Africa. METHODS AND RESULTS: Restriction fragment length polymorphism (RFLP) of 16S rDNA generated by five restriction enzymes, banding patterns in Southern hybridization using nod and nif genes as probes, and resistance patterns of the isolates to nine antibiotics, were used to group 26 Bradyrhizobium spp. (TGx) isolates and four other Bradyrhizobium strains. The clusters of isolates obtained from the four grouping methods were all different, although all methods revealed large genetic diversity among the isolates. CONCLUSIONS: Results indicate that the antibiotic resistance profile method is as good as the three molecular methods used in this study for phylogenetic grouping of the Bradyrhizobium spp. (TGx) isolates, which may serve as a basis for further characterization of selected isolates from each group. SIGNIFICANCE AND IMPACT OF THE STUDY: The antibiotic resistance profile method can be used as a simple means of assessing genetic variability and grouping of a large number of Bradyrhizobium spp. (TGx) isolates. Representative isolates from each group can then be selected for further characterization.

Selection of several classes of mimosine-degradation-defective Tn3Hogus-insertion mutants of Rhizobium sp. strain TAL1145 on the basis of mimosine-inducible GUS activity.

Rhizobium sp. strain TAL1145 that nodulates Leucaena leucocephala degrades mimosine, a toxin produced by this tree legume. A cosmid clone, pUHR263, containing approximately 25 kb cloned DNA was isolated by plating Escherichia coli cells containing the cosmid clone library of TAL1145 on a minimal medium in which 3-hydroxy-4-pyridone (HP), a degradation product of mimosine, was used as the source of nitrogen. Cosmid pUHR263 was mutagenized by random insertions of Tn3Hogus, a transposon that makes transcriptional gus fusions when it is inserted in a gene in the correct orientation. Various pUHR263::Tn3Hogus derivatives that showed mimosine-inducible or mimosine-repressible GUS activities when transferred to the Rhizobium sp. strain TAL1145 were selected. Mutants of TAL1145 were constructed by transferring these Tn3Hogus insertions into the TAL1145 chromosome through double-homologous recombination. These mutants were classified into five classes on the basis of defects in mimosine degradation. The growth of these mutants was inhibited to different extents by mimosine applied to the growth medium. Mimosine forms a red-colored Fe-mimosine complex when FeCI3 is added to the medium. The inhibitory effect of Fe-mimosine on growth of the mutants was much less than that of mimosine.

Bradyrhizobium spp. (TGx) isolates nodulating the new soybean cultivars in Africa are diverse and distinct from bradyrhizobia that nodulate North American soybeans.

The newly developed cultivars of soybean in Africa, known as Tropical Glycine cross (TGx), are nodulated by bradyrhizobia indigenous to African soils, here designated Bradyrhizobium spp. (TGx). Isolates of Bradyrhizobium spp. (TGx) obtained from nodules of TGx soybeans that were inoculated with soils from 65 locations in six African countries were characterized and grouped into 11 phylogenetic clusters on the basis of RFLP of the 16S rRNA gene. Five restriction enzymes (RsaI, HinfI, MspI, CfoI and HaeIII) established RFLP groups within these Bradyrhizobium spp. (TGx) isolates, which were used to construct a phylogenetic tree showing their genetic relationship with other Bradyrhizobium species. RFLP analysis indicated that Bradyrhizobium spp. (TGx) is a heterogeneous group with some isolates related to Bradyrhizobium japonicum and Bradyrhizobium elkanii strains and some to Bradyrhizobium spp. (misc.) reference strains isolated from a variety of tropical legumes. The heterogeneity within the large phylogenetic clusters was further examined through analysis of randomly amplified polymorphic DNA (RAPD) using GC-rich PCR primers. The RAPD analysis showed additional heterogeneity in the Bradyrhizobium spp. (TGx) phylogenetic clusters, which was not revealed by separations based on RFLP analysis. The Bradyrhizobium spp. (TGx) isolates were classified into effective and ineffective types based on their symbiotic performance on TGx soybean. The isolates were randomly distributed throughout the phylogenetic clusters regardless of their symbiotic effectiveness on TGx soybean.

A 150-megadalton plasmid in Rhizobium etli strain TAL182 contains genes for nodulation competitiveness on Phaseolus vulgaris L.

Rhizobium etli TAL182, a competitive strain for the nodulation of Phaseolus beans, occupied more than 99% of the nodules when co-inoculated in various proportions with Rhizobium TAL1145 or Rhizobium tropici CIAT899. Two overlapping cosmid clones, pUHR68 and pUHR69, containing genes for nodulation competitiveness from TAL182, were isolated by functional complementation of strain TAL1145. Using one of these cosmid clones, we constructed two Tn5-insertion mutants of TAL182 defective in nodulation competitiveness. The Tn5 insertions in both mutants were localized in identical positions within a 4.6-kb HindIII fragment. One mutant, RUH120, was complemented for nodulation competitiveness by this HindIII fragment. The cloned DNA in pUHR68 is a part of a plasmid, 150 MDa in size, in TAL182 and does not show homology with TAL1145 genomic DNA. The 4.6-kb HindIII fragment contains a gene(s) required for nodulation competitiveness on beans, which is present only in some R. etli strains and absent in other Rhizobium spp.

Cross-resistance of the diamondback moth indicates altered interactions with domain II of Bacillus thuringiensis toxins.

We compared responses to six insecticidal crystal proteins from Bacillus thuringiensis by a Cry1A-resistant strain (NO-QA) and a susceptible strain (LAB-P) of the diamondback moth, Plutella xylostella. The resistant strain showed > 100-fold cross-resistance to Cry1J and to H04, a hybrid with domains I and II of Cry1Ab and domain III or Cry1C. Cross-resistance was sixfold to Cry1Bb and threefold to Cry1D. The potency of Cry1I did not differ significantly between the resistant and susceptible strains. Cry2B did not kill resistant or susceptible larvae. By combining these new data with previously published results, we classified responses to 14 insecticidal crystal proteins by strains NO-QA and LAB-P. NO-QA showed high levels of resistance to Cry1Aa, Cry1Ab, and Cry1Ac and high levels of cross-resistance to Cry1F, Cry1J, and H04. Cross-resistance was low or nil to Cry1Ba, Cry1Bb, Cry1C, Cry1D, Cry1I, and Cry2A. Cry1E and Cry2B showed little or no toxicity to susceptible or resistant larvae. In dendrograms based on levels of amino acid sequence similarity among proteins, Cry1F and Cry1J clustered together with Cry1A proteins for domain II, but not for domain I or III. High levels of cross-resistance to Cry1Ab-Cry1C hybrid H04 show that although Cry1C is toxic to NO-QA, domain III or Cry1C is not sufficient to restore toxicity when it is combined with domains I and II of Cry1Ab. Thus, diamondback moth strain NO-QA cross-resistance extends beyond the Cry1A family of proteins to at least two other families that exhibit high levels of amino sequence similarity with Cry1A in domain II (Cry1F and Cry1J) and to a protein that is identical to Cry1Ab in domain II (H04). The results of this study imply that resistance to Cry1A alters interactions between the insect and domain II.

Discrete differences between strains of different Rhizobium spp. for competitive nodule occupancy on beans.

Rhizobium etli strain TAL182 and R. leguminosarum bv phaseoli strain 8002, both of which produce melanin pigment, were tested for their nodulation competitiveness on beans by paired inoculation with two strains which do not produce melanin: R. tropici strain CIAT899 and Rhizobium sp. strain TAL1145. An assay was developed to distinguish nodules formed by the melanin-producing and non-producing strains. Strain TAL182 had discrete competitive superiority over CIAT899 and TAL1145 for nodulation of beans. Nodulation competitiveness was not correlated with the ability to produce melanin pigment or the host range of the Rhizobium strains tested.

Mimosine, a Toxin Present in Leguminous Trees (Leucaena spp.), Induces a Mimosine-Degrading Enzyme Activity in Some Rhizobium Strains.

Thirty-seven Rhizobium isolates obtained from the nodules of leguminous trees (Leucaena spp.) were selected on the basis of their ability to catabolize mimosine, a toxin found in large quantities in the seeds, foliage, and roots of plants of the genera Leucaena and Mimosa. A new medium containing mimosine as the sole source of carbon and nitrogen was used for selection. The enzymes of the mimosine catabolic pathway were inducible and were present in the soluble fraction of the cell extract of induced cells. On the basis of a comparison of the growth rates of Rhizobium strains on general carbon and nitrogen sources versus mimosine, the toxin appears to be converted mostly to biomass and carbon dioxide. Most isolates able to grow on mimosine as a source of carbon and nitrogen are also able to utilize 3-hydroxy-4-pyridone, a toxic intermediate of mimosine degradation in other organisms.