Preparation, characterization, and in vitro antimicrobial assessment of nanocarrier based formulation of nadifloxacin for acne treatment.

The objective of the present study was to develop a nanocarrier based formulation of nadifloxacin and to investigate its in vitro antimicrobial effect against Propionibacterium acnes. Nanocarrier based microemulsion formulations were prepared by aqueous titration method, using oleic acid as oil phase, Tween-80 as surfactant and ethanol as co-surfactant in different ratios. This procedure yielded monodisperse microemulsions exhibiting a mean droplet size in the range of 95-560 nm. This range of particle size is good to treat follicle related disorders like acne vulgaris because the size of follicles is in the range of 50-100 microm. Furthermore the optimized formulations were characterized for surface morphology by transmission electron microscopy and refractive index. The permeation studies were carried out using rat skin mounted in Franz diffusion cells. Flux of the optimised formulation was 2.24 times that of control. The diameter of inhibition zone of the microemulsion was found good but smaller than that of a clindamycin disc because of the higher therapeutic efficacy of clindamycin against P. acnes. The results indicated that the developed microemulsion shows promising results against P. acnes bacteria and may be a good approach for acne treatment.

Upregulation of connexin 26 is a feature of keratinocyte differentiation in hyperproliferative epidermis, vaginal epithelium, and buccal epithelium.

In epidermis, it has been suggested, intercellular communication through gap junctions is important in coordinating cell behavior. The connexins, may facilitate selective assembly or permeability of gap junctions, influencing the distribution of metabolites between cells. Using immunohistochemistry, we have compared the distribution of connexins 26 and 43 with that of proliferating cells (Ki67 labeling) in normal epidermis, hyperplastic epidermis (tape-stripped epidermis, psoriatic lesions, and viral warts), and vaginal and buccal epithelia. Connexin 43 was abundant in spinous layers of all epidermal specimens and in vaginal and buccal epithelia. Connexin 26 was absent from the interfollicular and interductal epidermis of normal hair-bearing skin, and nonlesional psoriatic epidermis but present at very low levels in plantar epidermis. Connexin 26 was prominent in lesional psoriatic epidermis and viral warts and in vaginal and buccal epithelia. In three independent experiments connexin 26 appeared in a patchy intercellular distribution in the basal epidermis within 24 h of tape stripping, proceeding to more extensive distribution in basal and suprabasal layers by 48 h. The increase in connexin 26 preceded that in cell proliferation. In vaginal epithelium, buccal epithelium, and viral warts connexin 26 was restricted mainly to suprabasal, nonproliferating cells. In psoriatic lesional epidermis connexin 26 was also located mainly in suprabasal, nonproliferating cells. Connexin 26 was present in a patchy distribution in the basal layer of psoriatic lesional epidermis, but double labeling for connexin 26 and Ki67 showed that many connexin 26 positive basal cells were nonproliferative, suggesting that connexin 26 may be related to differentiation rather than to proliferation. These observations would be consistent with a role for connexin 26 containing gap junctions during both early and later stages of keratinocyte differentiation in hyperplastic epidermis and in vaginal and buccal epithelia.

Localization of androgen receptors in human skin by immunohistochemistry: implications for the hormonal regulation of hair growth, sebaceous glands and sweat glands.

A mouse monoclonal antibody against the N-terminal region of human androgen receptor (AR) was used to identify receptors by immunoperoxidase staining in frozen serial sections of skin from scalp, face, limb and genitalia of men and women aged 30-80 years. AR staining was restricted to cell nuclei. In sebaceous glands, AR were identified in basal and differentiating sebocytes. The percentage of receptor-positive basal sebocyte nuclei in the temple/forehead region was greater in males (65%) than in females (29%). AR staining was restricted to the cells of dermal papillae in anagen and telogen hair follicles. The percentage of dermal papillae containing AR was greater in males (58%) than in females (20%). The number of positively stained dermal papillae was lowest in female scalp skin. In 163 hair follicles sectioned, AR were absent from germinative matrix, outer root sheath (including the bulge region), inner root sheath, hair shaft and hair bulb, and from the capillaries present in some large dermal papillae. AR were present in pilosebaceous duct keratinocytes, suggesting that androgens may influence pilosebaceous duct keratinization. AR were also identified in interfollicular epidermal keratinocytes and dermal fibroblasts although, in both cell types, intensity and frequency of staining were greatest in genital skin. AR were identified in luminal epithelial cells of apocrine glands in genital skin and in certain cells of the secretory coils of eccrine sweat glands in all body sites. This study indicates that androgens regulate sebaceous gland and hair growth by acting upon two different types of target cells, the epithelial sebocytes of sebaceous glands and the mesenchymal cells of the hair follicle dermal papilla.(ABSTRACT TRUNCATED AT 250 WORDS)

Internal fixation or hemiarthroplasty for undisplaced fractures of the femoral neck in octogenarians.

We compared the reoperation rate after internal fixation for minimally displaced or impacted intracapsular fractures of the femoral neck in patients aged 80 years and above with that in similar patients aged 65 to 79 years. We also compared the results of internal fixation with those of hemiarthroplasty for displaced intracapsular fracture in an age- and sex-matched group of elderly patients. We found that a significantly greater proportion of the older patients treated by internal fixation required reoperation than either the younger group or the age-matched group treated by hemiarthroplasty. Our results indicate that internal fixation may not be the best treatment for extremely elderly patients with minimally displaced or impacted intracapsular fractures of the femoral neck.

Plasma viscosity and C-reactive protein after total hip and knee arthroplasty.

We studied the changes in plasma viscosity and C-reactive protein to establish normal values after total hip or knee arthroplasty. Viscosity decreased from 1.68 (+/- 0.017) to 1.57 (+/- 0.014) on the first postoperative day and thereafter rose to 1.60 (+/- 0.019), 1.75 (+/- 0.015), and 1.74 (+/- 0.011) on the third, seventh and fourteenth days respectively. Six to eight weeks after operation it had returned to pre-operative levels. A viscosity above the upper limit of the laboratory range, obtained more than two months after operation, may be considered as abnormal. The C-reactive protein level increased significantly on the first postoperative day and then decreased from a peak on the second day, attaining nearly normal levels at six to eight weeks after operation. It may be a more sensitive indicator of deep postoperative infection than plasma viscosity.

Prevalence and associations of hepatitis C viremia in hemodialysis patients at a tertiary care hospital.

Hepatitis C virus (HCV) infection in hemodialysis (HD) is a significant problem. We evaluated the prevalence and associations of HCV viremia in our HD patients. All patients undergoing maintenance HD at our center were tested for HCV RNA by PCR after written informed consent. Detailed history regarding age, sex, and duration of dialysis, frequency of dialysis, blood transfusions in one year, number of dialysis centers, dialyzer reuse/fresh use, and recent laboratory data was recorded. A total of 119 patients (77 males and 42 females) were tested for HCV RNA. Thirty three (27.7%) tested positive. Duration of dialysis was significantly longer in HCV RNA positive group (P = 0.001). 45.2% of patients with duration of dialysis more than 16 months were HCV RNA positive while only 7.4% of patients with dialysis duration

Sexing of human hip bones of Indian origin by discriminant function analysis.

The present study was carried out in terms of discriminant analysis and was conducted on 100 human hip bones (of unknown sex) of Indian origin. Based on morphological features, each of the hip bone was rated on a scale of 1-3 for sexing. Twelve measurements and five indices were recorded. The results of discriminant function analysis showed that the acetabular height (vertical diameter) and indices 1 (total pelvic height/acetabular height), 2 (midpubic width/acetabular height) and 3 (pubic length/acetabular height) were very good measures for discriminating sexes. Pelvic brim depth, minimum width of ischiopubic ramus and indices 4 (pelvic brim chord x pelvic brim depth) and 5 (pubic length x 100/ischial length) were also good discriminators of sex. The remaining parameters were not significant as they showed a lot of overlap between male and female categories. The results indicated that one exclusive criterion for sexing was index 3 (pubic length/acetabular height). In comparison with the morphological criteria, the abovementioned index caused 25% and 10.25% increase in the hip bones of female and male category, respectively.

A prospective comparison of four techniques for diagnosis of paroxysmal nocturnal hemoglobinuria.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal stem cell disorder with altered expression of glycosylphosphatidylinositol (GPI)-anchored proteins, resulting in the increased susceptibility of erythrocytes to complement-mediated lysis. This study compared the available laboratory methods for detection of PNH cells and evaluated their utility in routine clinical practice. Fifty patients were evaluated by flow cytometric immunophenotyping (FCMI) using CD55 and CD59 monoclonal antibodies, PNH gel card test (GCT), Ham test and sucrose lysis test (SLT). A PNH clone was detectable in erythrocytes in 14 (28%) patients by FCMI, 13 (26%) by GCT and 10 (20%) by Ham test and SLT. The GCT and lytic tests showed 100% specificity and sensitivity was 92.8% and 71.1%, respectively. The GCT results correlated with type III cells (positive for > or =3.21% type III cells) and lytic test results correlated with CD59(-) type III cells (positive for > or =5% CD59(-) type III cells). The GCT and lytic tests were comparable in their sensitivity to detect type II cells (positive for > or =18.5% type II cells). Among the available methods, FCMI is most sensitive, can quantify and delineate PNH cells with differential expression of GPI-anchored proteins. The GCT is a useful screening tool as it is fairly sensitive, easy to perform and interpret. Well-standardized lytic tests are fairly reliable as screening tests.

Unusual features associated with cranial openings of optic canal in dry adult human skulls.

One hundred and eighty six dry adult human skulls (372 sides) were studied in order to reveal the presence of unusual features--such as recess, fissure and notch--in the cranial opening of the optic canal. Recess, an extension of the lateral wall, was found in 229 (61.5%) sides. Fissure, an irregular discontinuity above the lateral recess, was observed in 158 (42.4%) sides. Notch, a gap in the posterior-most limit of the roof, was seen in 66 (17.7%) sides. These were commonly seen bilaterally. The etiology of these was attributed to the development of the optic canal. During intrauterine life the optic canal is in the form of a large keyhole shaped foramen, which slowly transforms into the adult canal. A developmental arrest at an early stage may lead to the formation of recesses and fissures.

Morphological description of combined variation of distal attachments of fibulares in a foot.

An interesting case of peculiarity of the distal attachment of the three fibular muscles is reported in the left foot of a male adult cadaver of Indian origin. The fibularis brevis, just inferior to the fibular malleolus, gave off an additional slender tendon anteromedial to its main tendon. This was attached to the dorsal digital expansion of the little toe while its main tendon was inserted to the customary bone. The tendon of fibularis longus on the plantar aspect just medial to the cuboid tunnel received a prominent slip of attachment of the tendon of tibialis posterior. The fibularis tertius had two parallel-running tendons attached to the bases of the fourth metatarsal and the fourth and fifth metatarsals respectively. The combined variation of the three fibulares in a single foot has not been reported previously. The more distal attachment of the fibularis brevis in this case is a regression in evolution. Weakness of both the fibularis brevis and fibularis longus is found in pes cavovarus. The former can be used as a rotational graft in soft tissue loss of the leg.

Precondylar tubercles on the basiocciput of adult human skulls.

The basiocciput of 265 Indian adult human skulls was examined for precondylar tubercles, which are single or paired osseous formations anterior to the occipital condyles and foramen magnum. Of the 14% of skulls displaying these tubercles unilaterally or bilaterally, 5.3% demonstrated ridges, 4.9% showed spines and 3.8% exhibited processes. Sexual dimorphism was evident with female skulls showing a higher incidence (8.7%) compared with male skulls (5.3%). The corresponding atlas vertebrae were normal. These craniovertebral anomalies may have clinical relevance for lesions at the foramen magnum.

Facial vein terminating in the external jugular vein. An embryologic interpretation.

The external jugular v. (EJV) is increasingly being used for therapeutic procedures and monitoring by clinicians. In view of this clinical relevance, dissection was done on the head and neck regions in 40 adult cadavers of Indian origin to detect variations of the EJV. Though several patterns of tributaries were found, a facial v. (FV) of considerable size was observed coursing obliquely to join the EJV in the neck in four cases (5%). The distance of the junction of the FV and the EJV from the angle of the mandible ranged between 55 and 104 mm. This may represent a persistent communication of the primitive linguofacial v. with the secondarily developing EJV. This anastomotic channel is present for some time in the fetus but later undergoes retrogression. Its persistence in some individuals results in this variation.

Duplication of optic canals in human skulls.

Three human skulls showing duplication of the optic canal are reported. Two had bilateral duplication while one had duplication on one side only. The measurements of the whole canal were within the range of normal. Septa of variable thickness separated the main and the accessory canals in these skulls and the skulls also showed a tendency to excessive bone formation.

Incidence and morphological study of zygomaticofacial and zygomatico-orbital foramina in dry adult human skulls: the non-metrical variants.

Morphological diversity in the form of multiple zygomaticofacial (ZF) foramina was studied in 165 dry, unsexed adult human skulls. Zygomatic bones revealed variation in the number of foramina on their orbital and facial aspects. These were absent in 72 (21.8%) sides. A single ZF foramen was seen in 148 (44.9%) sides. Two ZF foramina were found in 92 (27.9%) sides, out of which 29 (8.8%) sides had one zygomatico-orbital (ZO) foramen, while 63 (19.1%) sides had two ZO foramina. Three ZF foramina, a relatively uncommon occurrence, were found in 17 (5.1%) sides, which included eight (2.4%) sides with one less and nine (2.7%) sides with the same number of ZO foramina. Four ZF foramina were seen in one (0.3%) side with three on the orbital aspect, a feature not reported before. The zygomatic nerve may be disrupted on elevating periorbita from the lateral wall during orbital surgery, and care should be taken to prevent injury to the nerve during the lateral orbitotomy approach to access intraorbital soft tissue tumors.

Unusual facets on the acetabulum in dry adult human coxal bones: a morphological and radiological study.

A smooth facet was found antero-inferior to lunate surface of 48 acetabula, in a study conducted on 315 dry adult coxal bones, 26 of which (13 pairs) were of articulated pelves. Three different shapes of the facet were oval (56.3%), piriform (22.9%) and elongated (20.8%). The prevalence of the oval facet was higher in both sexes. In 37.5% bones it extended to superior ramus of pubis and in 62.5% it was limited within the acetabular margin. They were either discrete (58.3%) or continuous with the lunate surface (41.7%). The surface configuration was flat (29.2%), concave (43.7%) or grooved (27.1%). One male articulated pelvis showed a bilateral presentation. Measured along the long axis the size varied between 11 to 17 mm. The radiographs showed notching, antero-inferior to acetabular margin in grooved facets whereas concave and flat facets were seen as areas of rarefaction. It is postulated that this facet could be a consequence of a particular posture which results in traction of the ligaments attached to this area. This unusual feature has not been reported earlier.

Changing patterns of gap junctional intercellular communication and connexin distribution in mouse epidermis and hair follicles during embryonic development.

In the mouse embryo between embryonic days 12 (E12) and 16, regular arrays of epidermal placodes on the mystacial pad develop into whisker follicles. This system was chosen for analysis of gap junctional intercellular communication during differentiation. The patterns of communication were studied by microinjection of the tracers Lucifer yellow-CH (LY-CH) and neurobiotin (NB), while immunofluorescent staining was used to study distribution of connexins 26 and 43. Extensive communication was seen between keratinocytes in developing hair pegs or, in later-stage hair follicles, in the germinative matrix. Coupling between adjacent hair pegs via interfollicular epidermis was not observed. Coupling also became restricted as follicular cells differentiated to form outer root sheath, inner root sheath, and hair shaft. Extensive gap junctional coupling is characteristic of keratinocytes that are rapidly proliferating (as in hair pegs and germinative matrix). Follicular keratinocytes commence differentiation shortly before restriction of gap junctional coupling becomes evident. Dermal mesenchymal cells undergoing different modes of differentiation also exhibit differences in gap junctional coupling, as evidenced by poor transfer of LY-CH between cells in dermal condensations of hair follicles compared with extensive transfer elsewhere in the dermis. LY-CH and NB were not transferred between epidermal or follicular epithelium and mesenchyme, arguing against a direct role for gap junctions permeable to known second messenger molecules or nucleotides in epithelial-mesenchymal interactions in this system. The distribution of connexins 26 and 43 in epidermis and hair follicles changed during differentiation but there was no correlation with changing patterns of dye transfer, indicating an unexpected degree of complexity in the relationship between gap junctional intercellular communication and connexin protein distribution during development.