Richter's hernia

Richter's hernia is associated with rapid onset of gangrene and a high mortality. We report a case of a strangulated inguinal Richter's hernia of the cecum requiring a laparotomy and bowel resection. Due to the misleading clinical presentation, a high index of suspicion, particularly in patients with a history of laparoscopic surgery, will minimize delay in diagnosis.     

Recurrence of progressive multifocal leukoencephalopathy despite immune recovery in two HIV seropositive individuals

We present two cases of recurrent progressive multifocal leukoencephalopathy (PML) in patients with long standing virally suppressed human immunodeficiency virus (HIV) and normal CD4+ T cell count who were taking stable regimens of highly active antiretroviral therapy (HAART). This has significant implications for other patients with a past history of PML, not just those with HIV but also those on medications such as natalizumab or fumarates.     

Impact of Tropospheric Ozone on Crop Plants

Tropospheric ozone (O₃) is the most important regional atmospheric pollutant causing risk to food production across the globe due to its phytotoxicity and prevalence over agricultural areas. Peak O₃ concentrations have declined in Europe and North America due to reductions in precursors during the last decades, however, emissions of O₃ precursors have increased in Asia. The current critical level of ozone is determined by the threshold for yield loss which is based on the seasonal sum of the external concentration above 40?ppb. In the present article, the impact of tropospheric O₃ on crop photosynthesis, defense mechanism, growth, reproductive processes and yield of crop plants have been documented. O₃ upon its entry into the leaf intercellular spaces rapidly forms reactive oxygen species and reacts with components of the leaf apoplast to initiate a complex set of responses that constitute variable countermeasures by antioxidative enzymes. Ozone affects photosynthetic process by influencing photosynthetic pigments, chlorophyll fluorescence kinetics and electron transport as well as carbon fixation in terms of decreased Rubisco activity and quantity. Translocation and allocation pattern of photosynthate also get influenced under O₃, which affect reproductive processes and yield of crops. Plant species and cultivars exhibit a range of sensitivity to O₃, which is identifiable in terms of biochemical, physiological, molecular and yield responses. Hence, understanding of cultivar sensitivity in context to O₃ would be helpful in development of potential O₃ biomarkers and O₃ tolerant variables.     

Brain injury and neural stem cells

Many therapies with potential for treatment of brain injury have been investigated. Few types of cells have spurred as much interest and excitement as stem cells over the past few decades. The multipotentiality and self-renewing characteristics of stem cells confer upon them the capability to regenerate lost tissue in ischemic or degenerative conditions as well as trauma. While stem cells have not yet proven to be clinically effective in many such conditions as was once hoped, they have demonstrated some effects that could be manipulated for clinical benefit. The various types of stem cells have similar characteristics, and largely differ in terms of origin; those that have differentiated to some extent may exhibit limited capability in differentiation potential. Stem cells can aid in decreasing lesion size and improving function following brain injury.     

Engineering calcium deposits on polycaprolactone scaffolds for intravascular applications using primary human osteoblasts

Total atherosclerotic occlusions often include significant calcium deposits. Current animal models do not mimic the pathology of gradual occlusion of arteries and lack cell‐mediated calcium. The primary goal of this project was to establish an animal model incorporating these features into chronic total occlusions, using biodegradable scaffolds. As the first step, this study sought to determine the optimal dosage of TGF‐β1 on polycaprolactone (PCL) scaffolds cultured with primary human osteoblasts (HOBs) to effectively induce in vitro calcification. HOBs were cultured in TGF‐β1 and dexamethsaone (Dex)‐supplemented medium in well plates. Calcium in the cultures was visualized using alizarin red. The highest calcification was observed in groups with both TGF‐β1 (0.02 ng/ml) and Dex (10^?10 M ) in the medium. Next, HOBs were cultured on PCL scaffolds with different loadings of TGF‐β1: 0 (control), 5, 10, 50 and 100 ng. These cultures were performed with or without Dex (10^?10 M ) in the medium. DNA content, ALP activity and the amount and distribution of calcium were examined at 7, 14, 21 and 28 days. TGF‐β1 appeared to have an inhibitory effect on scaffold calcification when grown in Dex‐supplemented medium. When cultured without Dex, the lower amount of TGF‐β1 loading (5 ng) showed the most calcification, high DNA synthesis and high ALP activity on scaffolds. This study demonstrates the potential of implanting a PCL–HOB construct in an animal artery to establish a model of atherosclerotic occlusion with calcification. Copyright © 2010 John Wiley & Sons, Ltd.     

Stitch retractor—simple and easy technique to retract brain

BackgroundSelf-retaining brain retractors are commonly used during intracranial surgery, and they are indispensable during microneurosurgery. There is a common severe complication due to the use of self-held retractors, that is, formation of a hemorrhagic infarct area in the brain region exposed to traction. All the more, present retractor systems are fixed and rigid and obstruct surgeons during surgery. Sometimes these retractors create glare in the microscope that distracts the surgeon. We hereby propose a simple and easy method of retraction of brain especially the temporal lobe using the transsylvian approach and vermis using the transvermian approach.MethodsThis is retrospective analysis of 47 patients in 4 years in which we have used our stitch retractor. We have analyzed their outcome, postoperative scan, and ease of performing surgery.ResultsIn 47 patients, there was only 1 postoperative contusion, and the longest period it was kept for is 6 hours. The other advantage was that it does not obstruct in any way while doing dissections and surgery. There was no glare while operating under a microscope.ConclusionWe hereby propose a simple and easy method of retraction of brain especially the temporal lobe using the transsylvian approach and vermis using the transvermian approach. It is minimally traumatic, reducing insult to the brain. It allows the surgeon to dissect without any obstruction and glare in the way. The biggest advantage of the present stitch retractor is that it is very cheap and simple to use.