The Mitchell and Scarf Osteotomies for Hallux Valgus Correction: A Retrospective, Comparative Analysis Using Plantar Pressures

A retrospective analysis was performed to describe the effects of Mitchell and Scarf osteotomies on plantar pressure distribution and their relevance to the clinical outcome. This study evaluated 28 patients who underwent operations for moderate to severe hallux valgus deformities over a period of 3 years at 2 different centers. Twenty-two Mitchell and 22 Scarf osteotomies were performed on 28 patients with a mean follow-up of 23 months (13-62 months). The average postoperative American Orthopaedic Foot and Ankle Society scores after Mitchell and Scarf osteotomies were 74 and 84, respectively. A control group of 15 individuals with 20 healthy feet were included for comparison. The plantar pressures were documented with the Musgrave footplate. The pressure distributions under the first metatarsal head were within normal limits in both study groups compared with the control group (P = .77). After Mitchell osteotomies, deficient load bearing was noted under the hallux (P = .007), coupled with overloading of the second and third metatarsal heads (P = .01). But after the Scarf procedures, increased weight bearing was noted at the heel (P = .04) and midfoot (P = .09), with better load distribution under the hallux. However, it was not comparable with the control group. Correlation of American Orthopaedic Foot and Ankle Society scores and pressure variables demonstrated a significant positive correlation with hallux loading (P = .001). This study demonstrates that adequate hallux loading is imperative for a better outcome of the procedure. Mitchell and Scarf osteotomies do not restore the load-bearing function of the foot to normal, whereas hallux loading plays an important role for a better outcome of the procedure.     

Application of the indicator amino acid oxidation technique for the determination of metabolic availability of sulfur amino acids from casein versus soy protein isolate in adult men

Our objective was to determine the metabolic availability (MA) of sulfur amino acids in dietary proteins using the indicator amino acid oxidation (IAAO) technique. Five to seven men received graded levels (20, 40, 60, and 70%) of the mean total sulfur amino acid (TSAA) requirement of 13 mg x kg(-1) x d(-1) as a crystalline AA mixture, casein, and soy protein isolate (SPI) (40, 50, 60, and 70%), respectively. Five of these subjects received 40% of TSAA requirement from SPI supplemented with methionine to the level of 40% of requirement. These 5 subjects also repeated the level of 60% TSAA requirements from both casein and SPI to assess repeatability. The mean MA of TSAA from SPI (71.8 +/- 3.6%) was lower than from casein (87.4 +/- 3.8%, P < 0.05). Supplementation of SPI with methionine decreased the IAAO (11.5 +/- 0.3% administered dose) compared with unsupplemented SPI (12.8 +/- 0.5% administered dose, P < 0.05). IAAO was similar for repeated measurements of casein and SPI, respectively, at the 60% TSAA intake level (10.8 +/- 1.0 vs. 10.7 +/- 1.2% for casein; 12.7 +/- 1.3 vs. 12.9 +/- 2.6% for SPI). In conclusion, the IAAO technique can be used to determine the MA of AA for protein synthesis in test proteins for humans.     

An effort to improve the accuracy of documented surgical wound classifications

Background

Discordance between circulating nurse- and surgeon diagnosis-based wound classifications may lead to erroneous risk-adjusted rates of surgical site infections with effects on inter-hospital rating, reimbursement, and public perceptions regarding quality of care.

Ex vivo generation of genetically modified dendritic cells for immunotherapy: implications of lymphocyte contamination

Genetically modified dendritic cell (DC) vaccines expressing tumor-associated antigens are currently used for cancer immunotherapy. Peripheral blood (PB) monocyte precursors are a relatively convenient source of DCs for use in clinical studies, but are often contaminated by lymphocytes. The current study was conducted to examine the impact of T-lymphocyte contamination on genetically modified DC product. PB monocyte-derived DCs were efficiently transduced (75-95%) with an HIV-1-based self-inactivating lentiviral vector encoding a model antigen, the enhanced green fluorescent protein (eGFP). The lymphocyte-free DC culture transduced with Lenti-eGFP showed stable expression of eGFP without measurable decline in viability. In contrast, the eGFP-positive DCs disappeared rapidly in transduced DC cultures containing lymphocyte contaminants, concurrent with detectable activation and expansion of T-lymphocytes. Upon antigen recall, these T cells elicited major histocompatability complex-restricted antigen-specific cytotoxicity against eGFP-positive autologous DCs and mitogen-stimulated T lymphoblasts, mainly through the perforin-mediated pathway. In summary, this study demonstrate that the relative purity of DC cultures could determine the persistence of gene-modified DC, which may affect the induction of effective immune responses by DC vaccination strategies.     

Galangin,a dietary flavonol inhibits tumor initiation during experimental pulmonary tumorigenesis by modulating xenobiotic enzymes and antioxidant status

The aim of present study was to elucidate anti-initiating efficacy of galangin against benzo(a)pyrene (B(a)P)-induced lung carcinogenesis in male Swiss albino mice. Therefore, the activities of xenobiotic metabolic enzymes such as phase I and II were examined in lung as well as liver tissues (to compare the effects between target and non-target organs). Besides, the activities/levels of tissue marker enzymes, antioxidants, lipid peroxidation (LPO), cytochrome P450 1A1 (CYP1A1) expressions and histological observation of lungs were also analyzed. B(a)P (50 mg/kg body weight) was administered to male Swiss albino mice (20–25 g) to experimentally induce lung cancer. B(a)P-induced animals showed increased activity of phase I (Cytochrome P450, Cytochrome b5, NADPH Cytochrome P450 redcutase and NADH Cytochrome b5 reductase) drug metabolic enzymes, LPO levels, tissue marker enzymes and decreased activity of phase II metabolic enzymes (glutathione-S-transferase, DT-diaphorase and UDP-glucuronyl transferase) as well as antioxidant levels. Histological examination of lungs revealed severe alveolar and bronchiolar damages in B(a)P-induced mice. Immunohistochemical and western blot analysis of CYP1A1 increased significantly in lung tissues of B(a)P-induced animals. Treatment with galangin (20 mg/kg body weight) efficiently counteracted all the above anomalies and restored cellular homeostasis. Our results demonstrate that galangin can modify xenobiotic enzymes in murine model of pulmonary tumorigenesis.     

Acaricidal activity of synthesized titanium dioxide nanoparticles using Calotropis gigantea against Rhipicephalus microplus and Haemaphysalis bispinosa

ObjectiveTo assess the acaricidal activity of titanium dioxide nanoparticles (TiO₂ NPs) synthesized from flower aqueous extract of Calotropis gigantea(C. gigantea) against the larvae of Rhipicephalus (Boophilus) microplus [R. (B.) microplus] and the adult of Haemaphysalis bispinosa (H. bispinosa).MethodsThe lyophilized C. gigantea flower aqueous extract of 50 mg was added with 100 mL of TiO(OH)₂ (10 mM) and magnetically stirred for 6 h. Synthesized TiO₂ NPs were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM), and Energy dispersive X-ray spectroscopy (EDX). The synthesised TiO₂ NPs were tested against the larvae of R. (B.) microplus and adult of H. bispinosa were exposed to filter paper impregnated method.ResultsXRD confirmed the crystalline nature of the nanoparticles with the mean size of 10.52 nm. The functional groups for synthesized TiO₂ NPs were 1 405.19, and 1 053.45 cm^?1 for -NH₂ bending, primary amines and amides and 1 053.84 and 1 078.45 cm^?1 for C-O. SEM micrographs of the synthesized TiO₂ NPs showed the aggregated and spherical in shape. The maximum efficacy was observed in the aqueous flower extract of C. gigantea and synthesized TiO₂ NPs against R. (B.) microplus (LC₅₀=24.63 and 5.43 mg/L and r²=0.960 and 0.988) and against H. bispinosa (LC₅₀= 35.22 and 9.15 mg/L and r² = 0.969 and 0.969), respectively.ConclusionsThe synthesized TiO₂ NPs were highly stable and had significant acaricidal activity against the larvae of R. (B.) microplus and adult of H. bispinosa. This study provides the first report of synthesized TiO₂ NPs and possessed excellent anti-parasitic activity.     

Comparative leprosy vaccine trial in south India

This report provides results from a controlled, double blind, randomized, prophylactic leprosy vaccine trial conducted in South India. Four vaccines, viz BCG, BCG+ killed M. leprae, M.w and ICRC were studied in this trial in comparison with normal saline placebo. From about 3,00,000 people, 2,16,000 were found eligible for vaccination and among them, 1,71,400 volunteered to participate in the study. Intake for the study was completed in two and a half years from January 1991. There was no instance of serious toxicity or side effects subsequent to vaccination for which premature decoding was required. All the vaccine candidates were safe for human use. Decoding was done after the completion of the second resurvey in December 1998. Results for vaccine efficacy are based on examination of more than 70% of the original "vaccinated" cohort population, in both the first and the second resurveys. It was possible to assess the overall protective efficacy of the candidate vaccines against leprosy as such. Observed incidence rates were not sufficiently high to ascertain the protective efficacy of the candidate vaccines against progressive and serious forms of leprosy. BCG+ killed M. leprae provided 64% protection (CI 50.4-73.9), ICRC provided 65.5% protection (CI 48.0-77.0), M.w gave 25.7% protection (CI 1.9-43.8) and BCG gave 34.1% protection (CI 13.5-49.8). Protection observed with the ICRC vaccine and the combination vaccine (BCG+ killed M. leprae) meets the requirement of public health utility and these vaccines deserve further consideration for their ultimate applicability in leprosy prevention.     

Larvicidal and repellent activity of medicinal plant extracts from Eastern Ghats of South India against malaria and filariasis vectors

ObjectiveTo evaluate the larvicidal and repellent activities of ethyl acetate and methanol extracts of Acacia concinna (A. concinna), Cassia siamea (C. siamea), Coriandrum sativum (C. sativum),Cuminum cyminum (C. cyminum), Lantana camara (L. camara), Nelumbo nucifera (N. nucifera) Phyllanthus amarus (P. amarus), Piper nigrum (P. nigrum) and Trachyspermum ammi (T. ammi) against Anopheles stephensi (An. stephensi) and Culex quinquefasciatus (Cx. quinquefasciatus).MethodsThe larvicidal activity of medicinal plant extracts were tested against early fourth-instar larvae of malaria and filariasis vectors. The mortality was observed 24 h and 48 h after treatment, data were subjected to probit analysis to determine the lethal concentrations (LC₅₀ and LC₉₀) to kill 50 and 90 per cent of the treated larvae of the tested species. The repellent efficacy was determined against two mosquito species at five concentrations (31.25, 62.50, 125.00, 250.00, and 500.00 ppm) under the laboratory conditions.ResultsAll plant extracts showed moderate effects after 24 h and 48 h of exposure; however, the highest activity was observed after 24 h in the leaf methanol extract of N. nucifera, seed ethyl acetate and methanol extract of P. nigrum against the larvae of An. stephensi (LC₅₀ = 34.76, 24.54 and 30.20 ppm) and against Cx. quinquefasciatus (LC₅₀ = 37.49, 43.94 and 57.39 ppm), respectively. The toxic effect of leaf methanol extract of C. siamea, seed methanol extract of C. cyminum, leaf ethyl acetate extract of N. nucifera, leaf ethyl acetate and methanol extract of P. amarus and seed methanol extract of T. ammi were showed 100% mortality against An. stephensi and Cx. quinquefasciatus after 48 h exposer. The maximum repellent activity was observed at 500 ppm in methanol extracts of N. nucifera, ethyl acetate and methanol extract of P. nigrum and methanol extract of T. ammi and the mean complete protection time ranged from 30 to 150 min with the different extracts tested.ConclusionsThese results suggest that the leaf and seed extracts of C. siamea, N. nucifera, P. amarus, P. nigrum and T. ammi have the potential to be used as an ideal ecofriendly approach for the control of the An. stephensi and Cx. quinquefasciatus.     

Screening for feeding deterrent activity of herbal extracts against the larvae of malaria vector Anopheles subpictus Grassi

This no-choice, laboratory study focuses on the feeding of homogeneous powdered, dried, yeast with different plant extracts on mosquito fourth-instar larvae to determine the effects on their mortality. Screening for antifeedant activity of plant extracts with some known medicinal attributes could lead to the discovery of new agents for vector control. The aim of this study was to investigate the antifeedant activity of crude leaf hexane, ethyl acetate, acetone, and methanol extracts of Andrographis lineata Wallich ex Nees. (Acanthaceae), Anisomeles malabarica (L.) Sims. (Lamiaceae), Argemone mexicana L. (Papaveraceae), Aristolochia bracteolata Lam. (Aristolochiaceae), Chrysanthemum indium L. (Asteraceae), Datura metal L. (Solanaceae), Eclipta prostrata L. (Asteraceae), and Sesbania grandiflora (L.) Pers. (Fibaceae) against the fourth-instar larvae of Anopheles subpictus Grassi (Diptera:Culicidae). All the crude extracts showed antifeedant activity in a dose-dependent manner. The plant extracts exhibited a significant antifeedant activity after 24 and 48 h of exposure; however, the highest larval mortality was found in leaf ethyl acetate extract of A. malabarica, acetone extract E. prostrata, methanol extract of A. lineata, C. indium, and S. grandiflora after 24 h (LC₅₀ = 2.53, 2.82, 2.31, 2.56, and 2.08 mg/mL; LC₉₀ = 6.40, 8.06, 7.45, 6.98, and 6.20 mg/mL), respectively. The hexane extract of A. lineata, D. metal, methanol extract of A. bracteolata and E. prostrata showed larval mortality after 48 h (LC₅₀ = 3.05, 2.11, 3.00, and 2.18 mg/mL; LC₉₀ = 9.06, 6.22, 8.23, and 5.77 mg/mL), respectively. One hundred percent larval mortality was observed in methanol extract of A. lineata, and C. indium after 24 h and the hexane extract of A. lineata and D. metal after 48 h at 10 mg/100 mL. The methanol extracts of A. lineata and C. indium significantly increased larval mortality in comparison to larvae fed with untreated diet. Bacillus thuringiensis subsp. israelensis is widely accepted as a biological pesticide because of its highly specific activity against dipteran insects without adverse effects on other organisms. The feeding deterrent activity of different herbal extracts against the larvae of malaria vector A. subpictus exhibited significantly lower toxicity compare with the bio larvicides, B. thuringiensis. These results suggest that the methanol extract of A. lineata, C. indium, the hexane extract of A. lineata and D. metal have the potential to be used as an ideal eco-friendly approach for the control of the medically important vector A. subpictus. These findings corroborate traditional insecticidal application of selected plants and the results can be extended for the control of mosquitoes.