Cerebrovascular Manifestations of Neurosarcoidosis: An Underrecognized Aspect of the Imaging Spectrum.

Involvement of the central nervous system by sarcoidosis, also referred to as neurosarcoidosis, is seen clinically in about 5% of patients with systemic disease. CNS involvement most frequently affects the leptomeninges and cranial nerves, though the ventricular system, brain parenchyma, and pachymeninges may also be involved. Even though the involvement of the intracranial vascular structures is well-known on postmortem studies, there is scant literature on imaging manifestations secondary to the vessel wall involvement, being confined mostly to isolated case reports and small series. The authors present a review of various cerebrovascular manifestations of neurosarcoidosis, along with a brief synopsis of the existing literature.

Blunt Cerebrovascular Injuries: Advances in Screening, Imaging, and Management Trends.

Blunt cerebrovascular injury is a relatively uncommon but sometimes life-threatening injury, particularly in patients presenting with ischemic symptoms in that vascular territory. The decision to pursue vascular imaging (generally CT angiography) is based on clinical and imaging findings. Several grading scales or screening criteria have been developed to guide the decision to pursue vascular imaging, as well as to recommend different treatment options for various injuries. The data supporting many of these guidelines and options are limited however. The purpose of this article is to review and compare these scales and criteria and the data supporting clinical efficacy and to make recommendations for future research in this area.

Functional and cosmetic outcome of single-digit ray amputation in hand.

PURPOSE: To assess patient satisfaction, functional and cosmetic outcomes of single-digit ray amputation in hand and identify factors that might affect the outcome. METHODS: Forty-five patients who underwent ray amputation were evaluated, 37 males and eight females whose mean age was 36.6 years ranging between 15 and 67 years. Twenty-eight patients had dominant hand involvement. Twenty-one patients underwent primary ray amputation, and 24 patients had secondary ray amputation. Eight out of the 23 patients with central digit injuries underwent transposition. Grip strength, pinch strength, tactile sensibility and functional evaluation using Result Assessment Scale (RAS) and DASH score were analysed. Cosmetic assessment was performed using visual analogue scale (VAS) for cosmesis. RESULTS: Median time of assessment after surgery was 20 months. Average loss of grip strength and pinch strength was found to be 43.3 and 33.6%, respectively. Average RAS score was 3.75. Median DASH score was 23.4. Eighty-three percentage of patients had excellent or good cosmesis on the VAS. Transposition causes significant increase in DASH scores for central digit ray amputations but was cosmetically superior. Middle finger ray amputation had the maximum loss of grip strength, and index finger ray amputation had greater loss of pinch strength. Affection of neighbouring digits caused greater grip and pinch loss, and a higher DASH score. Primary ray resection decreased the total disability and eliminated the costs of a second procedure. CONCLUSION: Following ray amputation, one can predict an approximate 43.3% loss of grip strength and 33.6% loss of pinch strength. The patients can be counselled regarding the expected time off from work, amount of disability and complications after a single-digit ray amputation. Majority of the patients can return to the same occupation after a period of dedicated hand therapy. LEVEL OF EVIDENCE: Therapeutic, Level III.

Short EpiData course: do participants use the data entry tool two years post-training?

SETTING: Training courses on data entry are few and far between compared to analysis. To address this gap, we conducted a short 2-day course on quality-assured data capture using EpiData for public health professionals in Bangalore and Puducherry, India, in 2013. OBJECTIVE: To determine the proportion of participants who used EpiData and taught the software to others during the 2-years after training and explore the reasons for doing/not doing so. DESIGN: Cross-sectional study with self-administered, semi-structured questionnaire developed using web-based Google Forms. We performed a manual thematic analysis to identify the major reasons for using/not using EpiData. RESULTS: Of 46 participants, 38 (83%) responded. Of 31 participants involved in research, 17 (55%) had used EpiData, of whom 6 (35%) had performed double entry and validation. Of the 14 who did not use EpiData, 11 had used MS Excel or SPSS/Epi Info for data entry. Of the 38 respondents, 29 (76%) had taught EpiData to other colleagues and students. Reasons for using EpiData included its user-friendliness, its being open access and the ease in preventing data entry errors. Reasons for not performing double entry included lack of time and manpower. CONCLUSION: The short course on EpiData was effective in knowledge transfer and provides a scalable model for incorporation into the teaching curricula of medical schools and research institutions.

Contexte : Les formations à la saisie de données sont très rares comparées à la formation à l'analyse des données. Nous avons donc voulu combler ce manque en réalisant une formation brève de 2 jours sur le thème « saisie de données de qualité garantie avec EpiData ¼ destinée à des professionnels de santé publique à Bangalore et Pondichéry, en Inde, en 2013.Objectif : Déterminer la proportion de participants qui ont utilisé EpiData et ont enseigné le logiciel à d'autres pendant les 2 années qui ont suivi la formation et explorer les raisons pour lesquelles ils l'ont fait ou pas fait.Schéma : Etude transversale grâce à un questionnaire auto-administré, semi-structuré élaboré avec les formulaires Google trouvés sur le web. Nous avons réalisé une analyse manuelle thématique afin d'identifier les raisons majeures d'utiliser ou non EpiData.Résultats : Sur 46 participants, 38 (83%) ont répondu. Sur 31 participants impliqués dans la recherche, 17 (55%) ont utilisé EpiData, dont 6 (35%) ont réalisé la double entrée et la validation. Sur les 14 participants qui n'ont pas utilisé EpiData, 11 ont utilisé MS Excel ou SPSS/Epi Info pour la saisie des données. Sur 38 participants, 29 (76%) ont enseigné EpiData à leurs collègues et étudiants. Les raisons du choix d'EpiData incluent la convivialité du logiciel, la liberté d'accès et la facilité à éviter les erreurs de saisie de données. A l'inverse, ceux qui ne l'ont pas fait ont invoqué le manque de temps et de main d'œuvre.Conclusion : Cette formation brève a été utile en termes de transfert de connaissances et fournit un model extensible à incorporer dans les programmes d'enseignement des facultés de médecine et des institutions de recherche.

Marco de referencia: Los proyectos de adiestramiento en materia de introducción de datos son infrecuentes en comparación con la capacitación en el análisis de datos. Con el propósito de corregir esta deficiencia se impartió un curso de dos días sobre 'captación de datos con garantía de la calidad con el programa EpiData' dirigido a los profesionales de salud pública en Bangalore y Puducherry, en la India, en el 2013.Objetivo: Determinar la proporción de participantes que utilizaba el programa EpiData y lo enseñaba a otras personas durante los 2 años que siguieron a la capacitación y analizar las razones de las actitudes observadas.Método: Fue este un estudio transversal realizado tras la autoadministración de un cuestionario semiestructurado mediante Formularios con Google en línea. Se realizó un análisis temático manual con el fin de reconocer las principales razones para la utilización del programa EpiData o su falta de aplicación.Resultados: De los 46 participantes, respondieron 38 (83%). De los 31 participantes vinculados con la investigación, 17 usaban EpiData (55%) y de ellos seis practicaban la doble introducción de datos y la validación (35%). De las 14 personas que no utilizaban EpiData, 11 aplicaban MS Excel o módulos SPSS y Epi Info en la introducción de datos. De los 38 participantes, 29 enseñaban el programa EpiData a otros colegas y estudiantes (76%). Entre las razones aducidas para el uso del programa EpiData estaban su sencillez de utilización, el hecho de tratarse de un programa en acceso libre y la facilidad con que se evitan los errores de introducción. Las razones para no aplicar la doble entrada de datos fueron el tiempo y la escasez de personal.Conclusión: El curso corto fue eficaz en materia de transmisión de los conocimientos y ofrece un modelo escalonable que se puede incorporar en los programas educativos de las facultades de medicina y los establecimientos de investigación.

Effect of plasmon-enhancement on photophysics in upconverting nanoparticles.

Surface plasmon polaritons (SPP) waves have been shown to significantly affect the near-field photophysical phenomenon. In particular, strong Coulombic interactions can enhance nearby non-linear optics and energy transfer process, while SPP waves also affect other photophysical processes like quenching observed in fluorescent and excitonic systems. Here, using different plasmonic substrates, we show the effect of plasmon-enhancement on quenching, phonon-assisted non-radiative decay, weak Purcell effect or electromagnetic field enhancement, and energy transfer rates of upconverting doped-lanthanide nanoparticles. While the resonant plasmons enhance the local electromagnetic field and the rate of energy transfer leading to enhanced upconversion photoluminescence of infrared radiation to visible light, it can also increase the quenching and non-radiative decay rates of photoexcited electron-hole pairs leading to losses and lower efficiency. These results can guide the design of optimized substrate geometry for using surface plasmons to modulate the photophysics in other applications too.

Eosinophilic ascites. A rare presentation of eosinophilic gastroenteritis.

EGED is a rare entity; it should be kept in mind in patient of unexplained abdominal symptoms. Any age group and any part of GI tract can be involved. Eosinophillia may be absent in the peripheral smear and biopsy may be negative in up to 10% of the cases. Here we are reporting a 40 years old male who presented to us with eosinophilic ascites, a rare presentation of serosal variant of eosinophilic gastroenteritis (EGED).

A comparative debate on the various anti-vascular endothelial growth factor drugs: pegaptanib sodium (Macugen), ranibizumab (Lucentis) and bevacizumab (Avastin).

Wet age-related macular degeneration and diabetic retinopathy are pathological consequences of vascular endothelial growth factor (VEGF) release as a reaction to deficiency of oxygen and nutrients in the macular cells. Conventional treatment modalities have been constrained by limited success. Convincing evidence exists that targeting VEGF signaling is a significant approach for the therapy of these ocular angiogenesis-dependent disorders. We have come a long way since the approval of the first angiogenesis inhibitors in medicine. The clinical use of these drugs has provided enormous tempo to clinical and pharmacological research. It has also significantly altered patient outcome and expectations. In the following brief, we will discuss the development and emergence of these drugs as well as the anticipated future course based on evidence.

Postcataract cystoid macular edema.

Ocular tissues, like those of other organs, exhibit well-defined morphologic reactions to local trauma and insult in the form of hyperemia, vasodilation, increased permeability of blood vessels, and edema. Cystoid macular edema (CME) following cataract surgery is one such manifestation, and it can result in either temporary, or rarely, a permanent reduction of visual acuity. Although its cause remains obscure, the relationship of CME to the details of the surgical procedures and their complications are becoming clearer. Likewise more insight into the phenomenon is being imparted by the agents being used in the preventative or curative line of management in CME.

Endophthalmitis following cataract surgery.

This article is an attempt to review the latest advances in recognition, treatment, and prevention of postcataract extraction endophthalmitis.

Antiandrogen and Antimicrobial Aspects of Coordination Compounds of Palladium(II), Platinum(II) and Lead(II).

Synthesis, characterization and antimicrobial activities of an interesting class of biologically potent macrocyclic complexes have been carried out. All the complexes have been evaluated for their antimicrobial effects on different species of pathogenic fungi and bacteria. The testicular sperm density, testicular sperm morphology, sperm motility, density of cauda epididymal spermatozoa and fertility in mating trails and biochemical parameters of reproductive organs have been examined and discussed. The resulting biologically active [M(MaL(n))(R(2))]Cl(2) and [Pb(MaL(n))(R(2))X(2)] (where, M = Pd(II) or Pt(II) and X = Cl or NO(3)) type of complexes have been synthesized by the reactions of macrocyclic ligands (MaL(n)) with metal salts and different diamines in 1:1:1 molar ratio in methanol. Initially the complexes were characterized by elemental analyses, molecular weight determinations and conductivity measurements. The mode of bonding was established on the basis of IR, (1)H NMR, (13)C NMR, (195)Pt NMR, (207)Pb NMR, XRD and electronic spectral studies. The macrocyclic ligand coordinates through the four azomethine nitrogen atoms which are bridged by benzil moieties. IR spectra suggest that the pyridine nitrogen is not coordinating. The palladium and platinum complexes exhibit tetracoordinated square-planar geometry, whereas a hexacoordinated octahedral geometry is suggested for lead complexes.

AXR2 encodes a member of the Aux/IAA protein family.

The dominant gain-of-function axr2-1 mutation of Arabidopsis causes agravitropic root and shoot growth, a short hypocotyl and stem, and auxin-resistant root growth. We have cloned the AXR2 gene using a map-based approach, and find that it is the same as IAA7, a member of the IAA (indole-3-acetic acid) family of auxin-inducible genes. The axr2-1 mutation changes a single amino acid in conserved domain II of AXR2/IAA7. We isolated loss-of-function mutations in AXR2/IAA7 as intragenic suppressors of axr2-1 or in a screen for insertion mutations in IAA genes. A null mutant has a slightly longer hypocotyl than wild-type plants, indicating that AXR2/IAA7 controls development in light-grown seedlings, perhaps in concert with other gene products. Dark-grown axr2-1 mutant plants have short hypocotyls and make leaves, suggesting that activation of AXR2/IAA7 is sufficient to induce morphological responses normally elicited by light. Previously described semidominant mutations in two other Arabidopsis IAA genes cause some of the same phenotypes as axr2-1, but also cause distinct phenotypes. These results illustrate functional differences among members of the Arabidopsis IAA gene family.

Independent action of ELF3 and phyB to control hypocotyl elongation and flowering time.

Light regulates various aspects of plant growth, and the photoreceptor phytochrome B (phyB) mediates many responses to red light. In a screen for Arabidopsis mutants with phenotypes similar to those of phyB mutants, we isolated two new elf3 mutants. One has weaker morphological phenotypes than previously identified elf3 alleles, but still abolishes circadian rhythms under continuous light. Like phyB mutants, elf3 mutants have elongated hypocotyls and petioles, flower early, and have defects in the red light response. However, we found that elf3 mutations have an additive interaction with a phyB null mutation, with phyA or hy4 null mutations, or with a PHYB overexpression construct, and that an elf3 mutation does not prevent nuclear localization of phyB. These results suggest that either there is substantial redundancy in phyB and elf3 function, or the two genes regulate distinct signaling pathways.

The impact of information technology on the practice of ophthalmology.

Information technology has had a tremendous impact on the outlook of our professional lives. The Internet has revolutionised the speed of access to information with touch of a button. This article discusses the various aspects of information technology which are changing and enhancing our professional lives. It provides tips to enable the busy practising clinician to use the available resources effectively. Problems such as reliability of information on the web and how to assess the quality of such matter are also discussed.

Isolation and characterization of a cDNA clone from Arabidopsis thaliana with partial sequence similarity to integrins.

An Arabidopsis thaliana cDNA, called At14a, was isolated by immunoscreening an expression library with an anti-integrin antibody. The At14a cDNA is 1459 nucleotides and has an open reading frame encoding a protein of 385 amino acids and a predicted molecular weight of 43kDa. At14a has a small domain that has sequence similarities to integrins from fungi, insects and humans. Transcripts of At14a are found in all Arabidopsis tissues examined, and when expressed as an epitope tagged fusion protein in transgenic plants, At14a localizes partly to the plasma membrane.

Ophthalmology on the information superhighway: an introduction to the Internet.

Internet, e-mail, world wide web and the information superhighway have fast become part of the modern human vocabulary. How are we as ophthalmologists affected by this revolution and how can we utilise the enormous potential of this revolution? This article provides an overview of the practicalities and possibilities of this new medium.