Endoscopic sistrunk using bilateral axillo-breast approach - A minimal access technique for thyroglossal duct cysts.

Sistrunk procedure for thyroglossal duct cyst (TGDC) includes removal of the thyroglossal cyst, middle portion of the hyoid bone and the tract towards the foramen caecum. Endoscopic approaches have surpassed the traditional open approaches for the treatment of benign thyroid swellings and TGDCs. Endoscopic Sistrunk procedure using bilateral axillo-breast approach is a safe and better alternative for the successful treatment of TGDC and provides excellent cosmetic results.

Laparoscopic lateral pancreaticojejunostomy: an evolution to endostapled technique.

BACKGROUND: Chronic pancreatitis (CP) is a debilitating condition resulting in severe pain with progressive deterioration of pancreatic function. "Tropical" pancreatitis represents a variant of the disease with widely dilated ducts, numerous calculi, and few strictures. Traditionally, modified Puestow's procedure has been the treatment of choice for a dilated pancreatic ductal system. However, it has only recently been adapted to laparoscopic approach which is a technically demanding procedure primarily due to need for extensive intra-corporeal suturing. METHODS: Symptomatic cases of CP presenting at our center with minimum 8 mm mean ductal diameter at body and head were selected for laparoscopic modified Puestow's procedure. Those with prior pancreatic surgery, pancreatic head masses, endoscopic pancreatic stenting, and portal hypertension were excluded. Twenty-eight cases meeting selection criteria underwent a laparoscopic procedure. RESULTS: Seven patients (25%) underwent a stapled pancreaticojejunal anastomosis, 17 (60.7%) received a sutured anastomosis. Four patients (14.3%) were converted to open surgery due to failure to localize the pancreatic duct with percutaneous needle aspiration. Of those patients who underwent a successful laparoscopic procedure, a single patient developed a pancreatic fistula which resolved spontaneously; another patient had a difficult post-operative course with prolonged intensive care. We suffered no mortality within the series and no patient had any long-term disability. Anastomotic patency rates of 100% were achieved by the third post-operative month. CONCLUSION: Lateral pancreaticojejunostomy is an effective surgical management for CP with a dilated ductal system. Its laparoscopic adoption is the rational next surgical step. It allows effective duct decompression with low mortality and morbidity. The procedure demands an advanced surgical skill set with an emphasis on intra-corporeal suturing. Those patients suffering from tropical CP with wide ductal dilatation greater than 12 mm are suited to an endostapled anastomosis which helps significantly reduce operative time without any corrosion of outcomes.

Optimization of Biotransformation of l-Tyrosine to l-DOPA by Yarrowia lipolytica-NCIM 3472 Using Response Surface Methodology.

l-DOPA (3,4-dihydroxyphenyl-l-alanine) is the most widely used drug for treatment of Parkinson's disease. In this study Yarrowia lipolytica-NCIM 3472 biomass was used for transformation of l-tyrosine to l-DOPA. The process parameters were optimized using response surface methodology (RSM). The optimum values of the tested variables for the production of l-DOPA were: pH 7.31, temperature 42.9 °C, 2.31 g l(-1) cell mass and 1.488 g l(-1)l-tyrosine. The highest yield obtained with these optimum parameters along with recycling of the cells was 4.091 g l(-1). This optimization of process parameters using RSM resulted in 4.609-fold increase in the l-DOPA production. The statistical analysis showed that the model was significant. Also coefficient of determination (R(2)) was 0.9758, indicating a good agreement between the experimental and predicted values of l-DOPA production. The highest tyrosinase activity observed was 7,028 U mg(-1) tyrosine. l-DOPA production was confirmed by HPTLC and HPLC analysis. Thus, RSM approach effectively enhanced the potential of Y. lipolytica-NCIM 3472 as an alternative source to produce l-DOPA.

Endoscopic Thyroidectomy: A 6-Year Experience from a Tertiary Care Teaching Hospital in Western India.

Background: Minimally invasive and endoscopic surgical techniques have surpassed the conventional open thyroidectomy for the treatment of thyroid nodules. Trans-axillary, Unilateral Axillo-Breast Approach (UABA), Bilateral Axillo-Breast Approach, and Trans-Oral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) are the most common endoscopic procedures performed currently. This article highlights our experiences with UABA and TOETVA over a period of 6 years. Materials and Methods: Between January 2015 and December 2020, we retrospectively analyzed our experience in Endoscopic thyroidectomy with 119 patients using UABA (n = 72) and TOETVA (n = 47) in our tertiary care teaching hospital. Both approaches used the standard three-port technique. Real time angiography was performed intraoperatively using Indocyanine Green dye to delineate the vessels in all patients. Results: The mean operative time for UABA and TOETVA was 90 and 110 minutes, respectively. Estimated blood loss was 18 mL in the former and 20 mL in the latter. Temporary Recurrent Laryngeal Nerve palsy and Hypoparathyroidism were minimal with TOETVA (5 patients versus 4 patients and 7 patients versus 2 patients). Shorter duration of hospital stay was observed with UABA (3 days versus 5 days). Cosmetic satisfaction was better with TOETVA. Conclusion: Based on our 6-year experience, we propose "JJ Hospital Criteria," which we currently follow to decide which surgical approach will yield best results. UABA and TOETVA are safe, feasible, and give exceptional cosmetic satisfaction. Both approaches should be seen as complementary rather than competitive.

Management of thymomatous myasthenia gravis - Case report of a rare Covid19 infection sequelae.

INTRODUCTION: SARS CoV19 infection can predispose to many autoimmune and neurological conditions, thymomatous myasthenia gravis being one of them. The rarity of these case poses therapeutic dilemmas about their further management. PRESENTATION OF CASE: A 61 year old gentleman who had covid19 infection 2 months back, presented with new onset myasthenia gravis and an anterior mediastinal mass. He was diagnosed as a case of anti acetyl choline receptor antibody positive thymomatous myasthenia gravis. The patient was posted for video assisted thoracoscopic excision of thymoma. The procedure was uneventful and patient was discharged with improvement in myasthenic symptoms. Histopathological examination confirmed the diagnosis of WHO Type A Spindle cell thymoma. DISCUSSION: SARS CoV19 infection is associated with an array of autoimmune disorders due to various proposed phenomenon including molecular mimicry and loss of immune tolerance. Post infectious thymomatous myasthenia gravis is extremely uncommon, and can be managed with open, minimally invasive or robotic approach. CONCLUSION: This is the first documented case of post covid19 infection thymomatous myasthenia gravis to the best of our knowledge, managed with minimally invasive thoracoscopic surgery. Further research is required for documentation of the natural history of the disease and therapeutic outcomes.

Rapid biodegradation and decolorization of Direct Orange 39 (Orange TGLL) by an isolated bacterium Pseudomonas aeruginosa strain BCH.

A newly isolated novel bacterium from sediments contaminated with dyestuff was identified as Pseudomonas aeruginosa strain BCH by 16S rRNA gene sequence analysis. The bacterium was extraordinarily active and operative over a wide rage of temperature (10-60 degrees C) and salinity (5-6%), for decolorization of Direct Orange 39 (Orange TGLL) at optimum pH 7. This strain was capable of decolorizing Direct Orange 39; 50 mg l(-1) within 45 +/- 5 min, with 93.06% decolorization, while maximally it could decolorize 1.5 g l(-1) of dye within 48 h with 60% decolorization. Analytical studies as, UV-Vis spectroscopy, FTIR, HPLC were employed to confirm the biodegradation of dye and formation of new metabolites. Induction in the activities of lignin peroxidases, DCIP reductase as well as tyrosinase was observed, indicating the significant role of these enzymes in biodegradation of Direct Orange 39. Toxicity studies with Phaseolus mungo and Triticum aestivum revealed the non-toxic nature of degraded metabolites.

Genetic suppression of defective profilin by attenuated Myosin II reveals a potential role for Myosin II in actin dynamics in vivo in fission yeast.

The actin cytoskeleton plays a variety of roles in eukaryotic cell physiology, ranging from cell polarity and migration to cytokinesis. Key to the function of the actin cytoskeleton is the mechanisms that control its assembly, stability, and turnover. Through genetic analyses in Schizosaccharomyces pombe, we found that myo2-S1 (myo2-G515D), a Myosin II mutant allele, was capable of rescuing lethality caused by partial defects in actin nucleation/stability caused, for example, through compromised function of the actin-binding protein Cdc3-profilin. The mutation in myo2-S1 affects the activation loop of Myosin II, which is involved in physical interaction with subdomain 1 of actin and in stimulating the ATPase activity of Myosin. Consistently, actomyosin rings in myo2-S1 cell ghosts were unstable and severely compromised in contraction on ATP addition. These studies strongly suggest a role for Myo2 in actin cytoskeletal disassembly and turnover in vivo, and that compromise of this activity leads to genetic suppression of mutants defective in actin filament assembly/stability at the division site.

Batch and continuous biodegradation of Amaranth in plain distilled water by P. aeruginosa BCH and toxicological scrutiny using oxidative stress studies.

Bacterium Pseudomonas aeruginosa BCH was able to degrade naphthylaminesulfonic azo dye Amaranth in plain distilled water within 6 h at 50 mg l(-1) dye concentration. Studies were carried out to find the optimum physical conditions and which came out to be pH 7 and temperature 30 °C. Amaranth could also be decolorized at concentration 500 mg l(-1). Presence of Zn and Hg ions could strongly slow down the decolorization process, whereas decolorization progressed rapidly in presence of Mn. Decolorization rate was increased with increasing cell mass. Induction in intracellular and extracellular activities of tyrosinase and NADH-DCIP reductase along with intracellular laccase and veratryl alcohol oxidase indicated their co-ordinate action during dye biodegradation. Up-flow bioreactor studies with alginate immobilized cells proved the capability of strain to degrade Amaranth in continuous process at 20 ml h(-1) flow rate. Various analytical studies viz.--HPLC, HPTLC, and FTIR gave the confirmation that decolorization was due to biodegradation. From GC-MS analysis, various metabolites were detected, and possible degradation pathway was predicted. Toxicity studies carried out with Allium cepa L. through the assessment of various antioxidant enzymes viz. sulphur oxide dismutase, guaiacol peroxidase, and catalase along with estimation of lipid peroxidation and protein oxidation levels conclusively demonstrated that oxidative stress was generated by Amaranth.

Statistically optimized biotransformation protocol for continuous production of L-DOPA using Mucuna monosperma callus culture.

L-DOPA (3,4-dihydroxyphenyl-L-alanine), a modified amino acid, is an expansively used drug for the Parkinson's disease treatment. In the present study, optimization of nutritional parameters influencing L-DOPA production was attempted using the response surface methodology (RSM) from Mucuna monosperma callus. Optimization of the four factors was carried out using the Box-Behnken design. The optimized levels of factors predicted by the model include tyrosine 0.894 g l(-1), pH 4.99, ascorbic acid 31.62 mg l(-1)and copper sulphate 23.92 mg l(-1), which resulted in highest L-DOPA yield of 0.309 g l(-1). The optimization of medium using RSM resulted in a 3.45-fold increase in the yield of L-DOPA. The ANOVA analysis showed a significant R (2) value (0.9912), model F-value (112.465) and probability (0.0001), with insignificant lack of fit. Optimized medium was used in the laboratory scale column reactor for continuous production of L-DOPA. Uninterrupted flow column exhibited maximum L-DOPA production rate of 200 mg L(-1) h(-1) which is one of the highest values ever reported using plant as a biotransformation source. L-DOPA production was confirmed by HPTLC and HPLC analysis. This study demonstrates the synthesis of L- DOPA using Mucuna monosperma callus using a laboratory scale column reactor.

Optimization of melanin production by Brevundimonas sp. SGJ using response surface methodology.

Melanins are predominantly indolic polymers which are extensively synthesized in animals, plants and microorganisms. It has wide applications in cosmetics, agriculture and medicine. In the present study, optimization of process parameters influencing melanin production was attempted using the response surface methodology (RSM) from Brevundimonas sp. SGJ. A Plackett-Burman design was used for screening of critical components, while further optimization was carried out using the Box-Behnken design. The optimum conditions observed were pH 5.31, tryptone 1.440 g l-1, L-tyrosine 1.872 g l-1 and CuSO4 0.0366 g l-1. Statistical analysis revealed that the model is significant with model F value 29.03 and R2 value 0.9667. The optimization of process parameters using RSM resulted in a 3.05-fold increase in the yield of melanin. The intermittent addition of L-tyrosine enhanced the melanin yield to 6.811 g l-1. The highest tyrosinase activity observed was 2,471 U mg-1 at the 18th hour of the incubation period with dry cell weight of 0.711 g l-1. The melanin production was confirmed by UV-Visible spectroscopy, FTIR and EPR analysis. Thus, Brevundimonas sp. SGJ has the potential to be a new source for the production of melanin.

Optimization of L-DOPA production by Brevundimonas sp. SGJ using response surface methodology.

L-DOPA (3,4-dihydroxyphenyl-L-alanine) is an extensively used drug for the treatment of Parkinson's disease. In the present study, optimization of nutritional parameters influencing L-DOPA production was attempted using the response surface methodology (RSM) from Brevundimonas sp. SGJ. A Plackett-Burman design was used for screening of critical components, while further optimization was carried out using the Box-Behnken design. The optimized levels of factors predicted by the model were pH 5.02, 1.549 g l(-1) tryptone, 4.207 g l(-1) L-tyrosine and 0.0369 g l(-1) CuSO(4) , which resulted in highest L-DOPA yield of 3.359 g l(-1). The optimization of medium using RSM resulted in a 8.355-fold increase in the yield of L-DOPA. The anova showed a significant R(2) value (0.9667), model F-value (29.068) and probability (0.001), with insignificant lack of fit. The highest tyrosinase activity observed was 2471 U mg(-1) at the 18th hour of the incubation period with dry cell weight of 0.711 g l(-1). L-DOPA production was confirmed by HPTLC, HPLC and GC-MS analysis. Thus, Brevundimonas sp. SGJ has the potential to be a new source for the production of L-DOPA.

Biodecolorization of azo dye Remazol orange by Pseudomonas aeruginosa BCH and toxicity (oxidative stress) reduction in Allium cepa root cells.

In this report a textile azo dye Remazol orange was degraded and detoxified by bacterium Pseudomonas aeruginosa BCH in plain distilled water. This bacterial decolorization performance was found to be pH and temperature dependent with maximum decolorization observed at pH 8 and temperature 30 °C. Bacterium tolerated higher dye concentrations up to 400 mg l(-1). Effect of initial cell mass showed that higher cell mass concentration can accelerate decolorization process with maximum of 92 % decolorization observed at 2.5 g l(-1) cell mass within 6.5 h. Effect of various metal ions showed Mn has inducing effect whereas Zn strongly inhibited the decolorization process at 5 mM concentration. Analysis of biodegradation products carried out with UV-vis spectroscopy, HPTLC and FTIR confirmed the decolorization and degradation of Remazol orange. Possible route for the degradation of dye was proposed based on GC-MS analysis. During toxicological scrutiny in Allium cepa root cells, induction in the activities of superoxide dismutase (SOD), guaiacol peroxidase (GPX) and inhibition of catalase (CAT) along with raised levels of lipid peroxidation and protein oxidation in dye treated samples were detected which conclusively indicated the generation of oxidative stress. Less toxic nature of the dye degraded products was observed after bacterial treatment.