A retrospective review of the histopathology and clinicopathologic correlates of appendices removed from patients of acute appendicitis.

AIM: Appendicitis is the most common intra-abdominal condition requiring emergency surgery, with a life time risk of about 6%. Although considerable data are available in the literature regarding the histopathology of appendicectomy specimens, such information from the Indian subcontinent remains unreported. METHODS: A total of 348 consecutive appendices removed because of clinical suspicion of acute appendicitis were selected. Three sections from each specimen were submitted for histopathology. Histopathologic acute appendicitis if present was further classified into 3 subcategories. A retrospective analysis was performed on all these specimens. RESULTS: The male female ratio was 2.6:1 with highest number of cases in the age group 21-30 years; 282 specimens out of 348 showed features consistent with acute appendicitis with an overall higher occurrence in males. Statistically significant association was obtained between perforation and male sex, older age and acute suppurative appendicitis. CONCLUSIONS: Present study shows that acute appendicitis in India is a disease of young males. The negative appendicectomy rate is about 10.9%. On further subclassification of acute appendicitis, uncomplicated acute appendicitis seems to be the most common followed by acute suppurative appendicitis.

Theoretical permutation gel electrophoretic analysis of a curved DNA fragment located in circular permutation.

Using the theoretical model for DNA curvature, we analyzed a set of fragments with a curved insert located in circular permutation. The theoretical permutation analysis of each of the cyclically located fragments reveals the presence of a shifting molecular bend locus. The delineation of the molecular bend locus associated with the fragments obtained by a second permutation helps in providing an explanation for the differential mobility behavior of the fragments.

On the mobility behavior of a curved DNA fragment located in circular permutation.

Experimental and theoretical investigations on the mobility behavior of a set of permuted fragments with a K-DNA insert is reported. The fragments with the permuted flanking sequences have the K-DNA insert located differentially with respect to the fragment ends. The fragment wherein the insert is located in the center showed maximum retardation as compared to fragments where the insert was at the end. The experimental analysis is also in accord with the theoretical investigation.

The pacemaker-twiddler's syndrome: another disadvantage of abdominal implantation of pulse generators.

Breakage of a pacer lead due to the pacemaker-twiddler's syndrome (PTS) occurred in 4 of 62 survivors following epicardial-intramural pacer lead implantation with the pulse generator placed in each case in a subcostal left upper quadrant subcutaneous pocket. The abdominal pulse generator pocket appears to invite spontaneously occurring PTS, more so in a pregnant woman. The important predisposing factor to the development of PTS is an excessively spacious pulse generator pocket containing a pool of fluid. Addition of a few simple modifications to the technique of cardiac pacing would prevent the complication; these include implantation of the pulse generator in a plane deeper to the pectoral muscles, suspending the pulse generator from the clavicle and application of vacuum-suction drainage to the generator pocket in the initial phase of wound healing. In the presence of an optimally fitting pulse generator pocket, PTS should be rare with subclavicular subpectoral pulse generator implantation without active patient participation. The syndrome may not be as rare a cause of pacer lead malfunction as may appear from the relative paucity of reports in the literature.