Aflibercept monotherapy versus aflibercept with targeted retinal laser to peripheral retinal ischemia for diabetic macular oedema (LADAMO).

OBJECTIVE: We tested the hypothesis that targeted retinal laser photocoagulation (TPRP) to peripheral retinal ischaemia reduces the overall burden of aflibercept injections when treating diabetic macular oedema (DMO) over a 24-month period. METHODS: Prospective, double-masked, multicentre, randomised controlled trial in Australia comparing aflibercept monotherapy, following a treat-and-extend protocol, or combination therapy of aflibercept and TPRP for DMO. The aflibercept monotherapy group received placebo laser. The primary outcome measure was the mean number of intravitreal aflibercept injections for each group at 24 months. Secondary outcome included: mean change in central macular thickness (CMT) and vision at trial completion, the proportion of eyes whose DMO resolved and the mean injection treatment interval. Ocular and systemic adverse events were recorded. RESULTS: We enrolled 48 eyes of 47 patients; 27 eyes were randomised to combination therapy (aflibercept and TPRP) and 21 to aflibercept monotherapy. Thirty-two eyes (67%) completed the 2-year study. The number of intravitreal treatments given were similar for combination therapy (10.5 (SD 5.8) and monotherapy (11.8 (SD5.6)) (P = 0.44). The mean visual improvement (+4.0 (-1.8, 9.8) and +7.8 (2.6, 12.9) letters, P = 0.32), mean decrease in CMT (-154 (-222,-87) µm and -152 (-218,-86) µm, P = 0.96), proportion of eyes with CMT < 300 µm (48% and 67%; P = 0.50) and safety outcomes were similar in both the combination and monotherapy treatment groups (respectively). CONCLUSIONS: Laser to areas of ischaemic peripheral retina does not reduce the burden of intravitreal aflibercept injections when treating diabetic macular oedema.

Patents on Endophytic Fungi.

BACKGROUND: Endophytic fungi are taxonomically and ecologically heterogeneous group of organisms, mainly belonging to the Ascomycotina and Deuteromycotina. Endophytes usually produce the enzymes necessary for the colonization of plant tissues. Endophytes are able to utilize components of plant cells without disturbing host metabolism, which is confirmed by isozyme analysis and studies on substrate utilization. The patents related to enzymes and metabolites produced by endophytic fungi are associated with their ecological significance. Application of metabolites and growth promoting factors produced from endophytic fungi, in the pharmaceutical and agricultural industries, is now well established. The patents on secretion of extracellular enzymes in vitro by endophytic fungi needed for cell wall degradation, support the hypothesis that fungal endophytes represent a group of organisms specialized to live within plant tissue. OBJECTIVE: This review presents the patents granted on different aspects of endophytic fungi for the last 11 years. This expresses the scenario and impact of these patents regarding significance in human society. CONCLUSION: In the last few years, research and inventions regarding the different aspects of endophytic fungi beneficial for host plant as well as for human beings have been carried out, which is supported by the increasing number of patents granted on endophytic fungi.

Allergy genuflection? It's surmount with special focus on ear, nose and throat.

The system that protects body from infectious agents is immune system. On occasions, the system seldom reacts with some foreign particles and causes allergy. Allergies of the ear, nose and throat (ENT) often have serious consequences, including impairment and emotional strain that lowers the quality of life of patients. This is further responsible for the common cold, cough, tonsillitis, dermal infection, chest pain and asthma-like conditions which disturb one's day to day life. The present review enlightens some common ENT allergies which one can suffer more frequently in one's lifetime, and ignorance leads to making the condition chronic. Information regarding pathophysiology and the management of ENT allergy by this review could help clinicians and common people to better understand the circumstances and treatment of ENT allergy.

Assessment of Bt trait purity in different generations of transgenic cottons.

Adequate expression of Bt (Bacillus thuringiensis) toxins and purity of seeds of Bt-transgenic cottons are important for controlling bollworms, and thereby increasing the cotton productivity. Therefore, we examined the variability in expression of Bt toxin proteins in the seeds and in leaves of different cotton (Gossypium hirsutum (L.) hybrids (JKCH 226, JKCH 1947, JKCH Durga, JKCH Ishwar, JKCH Varun KDCHH 441 and KDCHH 621) expressing Bt toxins in F1 and F2 generations, using bioassays against the cotton bollworm, Helicoverpa armigera (Hübner), and the lateral flow strip (LFS) test. Toxicity of Bt toxin proteins in the seeds of Bt-transgenic cottons to H. armigera correlated with their toxicity in the leaves in one- toxin Bt cotton hybrids. The Bt-F1 and Bt-F2 seeds of JKCH 1947 were more toxic to H. armigera than those of JKCH Varun seeds. The seeds and leaves of F1s showed greater toxicity than the F2 seeds or leaves of one-toxin (cry1Ac) Bt cotton hybrids. However, no significant differences were observed for the two-toxin (cry1Ac and cry2Ab) hybrid, KDCHH 621. Toxicity of leaves to H. armigera increased with crop age, until 112 days after seedling emergence. The Bt trait purity in F1 seeds of four two-toxin Bt cotton hybrids ranged from 86.7 to 100%. The present study emphasizes the necessity of 95% Bt trait purity in seeds of transgenic cotton for sustainable crop production.

Change in the collateral and accessory collateral ligament lengths of the proximal interphalangeal joint using cadaveric model three-dimensional laser scanning.

UNLABELLED: The purpose of this study was to assess the lengths of the index and middle finger proximal interphalangeal joint ligaments and determine the relative changes in the collateral and accessory collateral ligament lengths at 0°, 45° and 90° flexion. We generated three-dimensional scans of 16 finger (eight index and eight middle) proximal interphalangeal joints to assess relative changes in ligament length. Significant changes were found between 45°-90° and 0°-90° for the ulnar collateral ligament of the index finger and both collateral ligaments of the middle finger between 45°-90° and 0°-90°. No significant changes in length were found for the radial collateral ligament of the index finger or the accessory collateral ligaments of the index and middle fingers. Overall, it was found that the collateral ligament length changed significantly, but there was no significant change in the accessory collateral ligaments. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Recent patents on flavonoids.

Flavonoids are substances which are widely distributed in the plant kingdom. They occur in considerable quantities in common food products, spices and beverages. Interest of researchers has been greatly enhanced towards therapeutic potential of flavonoids in last some years. This review summarizes important patents pertaining to recent biotechnological techniques applied for the production, analysis of biosynthetic pathways, effects and applications of different flavonoids. For systematic studies investigations which have been published in the form of patents, are classified in different sectors like biosynthesis, medical application, antimicrobial activity, alteration of flower color, industrial application, cosmetics, food and plant tissue culture. A number of activities have been observed in each sector with vast area of research on flavonoids.

Do topical ophthalmic corticosteroids suppress the hypothalmic-pituitary-adrenal axis in post-penetrating keratoplasty patients?

PURPOSE: To establish whether hypothalmic-pituitary-adrenal axis suppression is possible secondary to long-term topical ophthalmic corticosteroid use in patients who have undergone penetrating keratoplasty (PKP). METHODS: Patients who had undergone a PKP and had been using corticosteroid-based eye drops continuously for more than 6 months, with no history of concomitant steroid (oral, inhaled, or cutaneous) use, were included within the study. A low-dose short Synacthen (LDSST) test was performed in each patient followed later by a short Synacthen test (SST). The mean SST and LDSST after 30 min were calculated along with their corresponding 95% confidence intervals (CIs). Correlation between both baseline SST and baseline LDSST with duration of treatment was determined using Spearman's correlation. RESULTS: In all, 20 patients were included within the study. The mean duration treatment was 28.2 months (range 11-96 months). All patients had normal baseline cortisol levels in both SST and LDSST tests. The mean 30 min SST was 753.8 nmol/l (95%CI: 696.6 nmol/l, 811.0 nmol/l) and no patients displayed inadequate adrenal response. The mean 30 min LDSST was 709.8 nmol/l (95%CI: 665.1 nmol/l, 754.5 nmol/l) and only one patient had an inadequate adrenal response. There was no correlation between baseline SST or LDSST and duration of treatment. CONCLUSIONS: This study found no evidence that patients using continuous long-term corticosteroid eye drops after PKP experienced inadequate adrenal response. We did not find any evidence of a negative correlation between length of treatment and SST or LDSST measurements at baseline.

Iron regulation in tuberculosis research: promise and challenges.

Tuberculosis is a major global health challenge and is far from being controlled. Development of resistance to currently available drugs due to the successful adaptation of the pathogen has been a major contributing factor for its control failure. Presently, there is an immense interest in identification of pathways, unique to the intracellular environment that could be utilized for the development of new and better drugs. In this sequence, targeting essential functions of Mycobacterium tuberculosis has emerged as a reliable strategy for containing the spread of the disease by this organism. The fact that iron has been known to be the key player required for its survival and ability to spread infection, the organism must carefully balance iron acquisition with iron uptake for its infectivity. Conversely, this iron homeostatic process could be disrupted to interfere with the survival and replication of this bacterium in host. Urgency to develop such an approach has been further strengthened with the worldwide recrudescence of tuberculosis especially in the developing nations of the world. In the current review, we have focused on the recent developments in targeting the essential functions of mycobacterium especially interfering in its iron homeostatic process. The relevance of iron for mycobacterial virulence, the intracellular survival and the immense potential of targeting iron-sulfur (Fe-S) cluster containing proteins in tuberculosis drug discovery has been discussed.

Morphological and genetic differentiation among four pigment producing Indian species of Phoma (Saccardo, 1899).

A PCR-based technique, involving the random amplification of polymorphic DNA (RAPD), was used for assessing genetic relatedness among isolates of the genus Phoma. Randomly Amplified Polymorphic DNA (RAPD) revealed the presence of interspecific genetic variation among the pigment producing isolates of Phoma and has shown distinct phylogenetic cluster. The major objective of the study was to study the genetic variation, if any. Study was aimed to differentiate four pigment producing species of Phoma based on morphological studies and molecular markers in general and RAPD in particular. We found that the test species of Phoma can be very well differentiated using molecular markers. Phoma sorghina was differentiated from P. exigua, P. fimeti and P. herbarum. RAPD profiles of P. herbarum and P. fimeti has shown the maximum similarity, which indicates the genetic relatedness among these two species which were considered earlier as distinct species based on morphological observation.

Correlation of optical coherence tomography and fundus fluorescein angiography following photodynamic therapy for choroidal neovascular membranes.

AIMS: To assess the correlation between optical coherence tomography (OCT) and leakage on fundus fluorescein angiography (FFA) following photodynamic therapy (PDT) with verteporfin for choroidal neovascularisation (CNV). METHODS: Retrospective comparative observational case series of patients who were treated with PDT for CNV from one centre. All patients had 3 monthly FFA and OCT following initial PDT to assess if further treatment was required. A pair of FFA and OCT images from the same visit at a random follow up date were taken from each patient's series and assessed separately by different observers. The presence of pigment epithelial detachment, subretinal fluid, vitreomacular traction, intraretinal fluid, absence of foveal depression, and the retinal thickness on OCT were correlated with presence of leaks on FFA. RESULTS: A total of 121 eyes of 121 patients were included. The presence of subretinal fluid, gross cystoid macular oedema, sponge-like retinal thickening and retinal thickness of more than 350 mum on OCT correlated well with leak on FFA (p value <0.01). The likelihood ratios were 3.0, 5.7, 2.7, and 3.6, respectively. The presence of a solitary foveal cyst did not correlate well with leaks on FFA. CONCLUSIONS: The presence of subretinal fluid, intraretinal fluid in the form of gross cystoid macular oedema, or sponge-like retinal thickening, or a retinal thickness more than 350 mum correlates with leaks on FFA and so suggests the need for repeat PDT.

Correlation of optical coherence tomography, with or without additional colour fundus photography, with stereo fundus fluorescein angiography in diagnosing choroidal neovascular membranes.

AIMS: To assess the diagnostic accuracy of optical coherence tomography (OCT), with/without colour fundus photographs, in predicting fundus fluorescein angiography (FFA) findings in patients suspected of having choroidal neovascularisation (CNV). METHODS: A consecutive series of patients suspected of having CNV underwent OCT and stereo FFA images, which were assigned a diagnosis by two masked observers, one examining OCT alone and then OCT plus stereo colour photographs, and one examining FFA alone. The main outcome measures were the diagnostic accuracy of OCT (with/without colour photos) in predicting the presence of CNV and secondly the characteristics of the CNV compared to the FFA findings. RESULTS: 131 eyes of 118 patients were analysed. The sensitivity and specificity of OCT for detecting new potentially treatable CNV lesions compared to FFA was 96.4%, and 66.0%, respectively. For OCT with stereo images the sensitivity was 94.0% and specificity 89.4%. For detecting CNV with a classic component the sensitivity and specificity of OCT alone was 78.6% and 82.7%. With stereo colour images the sensitivity was 82.1% and specificity 89.3%. CONCLUSION: OCT is good at detecting the presence of CNV in patients suspected of having new CNV. However, it is less accurate at identifying the exact components of CNV. OCT cannot at present replace FFA in accurately diagnosing CNV components. However, this imaging method may have a role as a screening tool to help prioritise FFA requests.

DNA tagging of blast resistant gene(s) in three Brazilian rice cultivars

Rice blast is the most important fungal disease of rice and is caused by Pyricularia oryzae Sacc. (Telomorph Magnoporthe grisea Barr.). Seven randomly amplified polymorphic DNA (RAPD) markers OPA5, OPG17, OPG18, OPG19, OPF9, OPF17 and OPF19 showed very clear polymorphism in resistant cultivar lines which differed from susceptible lines. By comparing different susceptible lines, nine DNA amplifications of seven primers (OPA5(1000), OPA5(1200,) OPG17(700), OPG18(850), OPG19(500), OPG19(600), OPF9(600), OPF17(1200) and OPF19(600)) were identified as dominant markers for the blast resistant gene in resistant cultivar lines. These loci facilitate the indirect scoring of blast resistant and blast susceptible genotypes. The codomine RAPDs markers will facilitate marker-assisted selection of the blast resistant gene in two blast resistant genotypes of rice (Labelle and Line 11) and will be useful in rice breeding programs.

RAPD analysis of herbicide-resistant Brasilian rice lines produced via mutagenesis

Over the last two decades, mutational techniques have become one of the most important tools available to progressive rice- breeding programs. In a mutation-breeding program initiated in 1999 at the Instituto Agronômico of Campinas, SP, Brazil, a rice line, IAC103, was selected for mutational studies with gamma radiation and ethyl methyl sulfonate mutagenesis, with the aim of developing a herbicide-resistant crop. After mutagenesis, surviving plants were exposed to glufosinate to check for herbicide resistance, which was examined up to the second generation. A detailed RAPD analysis was made of the resistant plants. Eighty Operon technology primers were tested and 10 were selected for a detailed study of RAPD markers that could tag herbicide resistance genes. Resistant and susceptible lines produced variation in the RAPD patterns and certain bands were found only in certain lines. These results suggest genetic ligation that will be confirmed through a genetic segregation study

RAPD analysis of herbicide-resistant Brasilian rice lines produced via mutagenesis.

Over the last two decades, mutational techniques have become one of the most important tools available to progressive rice- breeding programs. In a mutation-breeding program initiated in 1999 at the Instituto Agronômico of Campinas, SP, Brazil, a rice line, IAC103, was selected for mutational studies with gamma radiation and ethyl methyl sulfonate mutagenesis, with the aim of developing a herbicide-resistant crop. After mutagenesis, surviving plants were exposed to glufosinate to check for herbicide resistance, which was examined up to the second generation. A detailed RAPD analysis was made of the resistant plants. Eighty Operon technology primers were tested and 10 were selected for a detailed study of RAPD markers that could tag herbicide resistance genes. Resistant and susceptible lines produced variation in the RAPD patterns and certain bands were found only in certain lines. These results suggest genetic ligation that will be confirmed through a genetic segregation study.

Transformation system of Beauveria bassiana and Metarhizium anisopliae using nitrate reductase gene of Aspergillus nidulans.

An heterologous transformation system for entomopathogenic fungi B. bassiana and M. anisopliae was developed based on the use of A. nidulans nitrate reductase gene (niaD). B. bassiana and M. anisopliae niaD stable mutants were selected by treatment of protoplast with ethane methane sulphonate (EMS) and regenerated on chlorate medium. The cloned gene was capable of transforming B. bassiana and M. anisopliae at a frequency of 5.8 to 20 transformants per microg of DNA. Most of them were mitotically stable.

An improved cementing technique for revision hip surgery after peri-prosthetic fractures.

Replacement of the femoral component by a long-stemmed implant is one possible solution to the management of periprosthetic femoral shaft fractures. A problem often encountered, due to the extensive disruption of the femoral canal, is difficulty in achieving adequate cement pressurisation. We have overcome this by applying a split 60 ml syringe sleeve around the femoral shaft and holding it in position with clamps. This method has been used on five patients of mean age 87.7 (range 82-94) years with fractures that occurred at an average of 7.2 (range 4-17) years after the primary hip surgery. Two of the five patients achieved independent mobility and all of the patients were sufficiently independent to be discharged from the acute orthopaedic unit. We hope this cheap, effective method of supporting the bone fragments, maintaining alignment and achieving an acceptable level of pressurisation will lead to a decrease in the inevitable morbidity and mortality associated with a problem which as a result of an ageing population is likely to become increasingly common.

Subpectoral breast reconstruction using the biodimensional system.

Increasing awareness among the general public has fuelled a demand for post-mastectomy breast reconstruction. However, owing to the limited number of plastic surgical centres this need is unlikely to be fulfilled in the near future. We report our early experience with a modified technique using a new subpectoral implant--the Biodimensional System. Seventeen consecutive patients underwent reconstruction (16 immediately) after mastectomy. In the group of patients having immediate reconstruction, the surgery was undertaken by the breast surgeon performing the primary procedure. This study demonstrates that an acceptable result can be obtained in the majority of patients and that it is possible for a breast surgeon to undertake primary reconstruction on selected patients using the Biodimensional System. It is hoped that this may aid patients in their physical and mental rehabilitation.