Study of renal and ophthalmic manifestations in hypertensive disorders of pregnancy and its outcome

Background:Hypertensive diseases of pregnancy are commonly manifested in renal and ocular changes. Proper evaluation of findings provided by urine analysis, renal function test, urine output and examination of the optic fundi and visual fields may help in assessing the severity and the need for intervention. The primary objective was to determine the prevalence of retinal and renal manifestations in hypertensive disorders in pregnancy and feto-maternal outcome.Methods: This prospective study was conducted in VIMS, Ballary, Karnataka, India between 1st March 2014 to 28th February 2015. Detailed history and ocular examination with direct fundoscopy and renal parameters were noted on the mothers admitted and their correlation with feto maternal outcome studied.Results: 432 patients were included in the study, 41.7% had retinopathy changes on fundoscopy, 31.3% patients had Grade I hypertensive changes. Grade II, III and IV changes were seen in 4.2%, 2.1% and 4.2% respectively. There was an increase in blood uric acid levels with increase in severity of preeclampsia. The incidence of IUFD (8.3%), still born (8.3%) and need for NICU admission were significantly more with the severity of preeclampsia.Conclusions: Cases of hypertensive disorders in pregnancy with visual disturbances and headache are commonly associated with retinal changes. It is essential to examine every pre-eclampsia patient for ocular manifestations, which is helpful in the management of patient. Maternal urine protein test helps to detect the glomerular insult in the kidney and is a strong predictor of maternal and fetal complications

A RARE CASE OF PULMONARY ASPERGILLOMA

Pulmonary aspergilloma is unprecedented disorder affecting lung parenchyma in already existing cavity in healed pulmonary tuberculosis patients. Typically, it is resulting from Aspergillus fumigates leading to development of fungal ball. Common presenting complaints are Haemoptysis, Dyspnoea, Cough, Chest pain and Fever. We are reporting a case of Pulmonary aspergilloma a sequel of Pulmonary tuberculosis, has been recognized on basis of clinical findings, chest X-ray, CT thorax in which Fungal ball is seen in pre-existing cavity. It has been managed with antifungal drug Amphotericin B and Itraconazole. It must be differentiated from different clinical entity specifically Lung carcinoma on basis of relevant examination and research to treat successfully

A RARE CASE OF PULMONARY ASPERGILLOMA

Pulmonary aspergilloma is unprecedented disorder affecting lung parenchyma in already existing cavity in healed pulmonary tuberculosis patients. Typically, it is resulting from Aspergillus fumigates leading to development of fungal ball. Common presenting complaints are Haemoptysis, Dyspnoea, Cough, Chest pain and Fever. We are reporting a case of Pulmonary aspergilloma a sequel of Pulmonary tuberculosis, has been recognized on basis of clinical findings, chest X-ray, CT thorax in which Fungal ball is seen in pre-existing cavity. It has been managed with antifungal drug Amphotericin B and Itraconazole. It must be differentiated from different clinical entity specifically Lung carcinoma on basis of relevant examination and research to treat successfully

FUNCTIONAL OUTCOME AND ASSOCIATED COMPLICATIONS OF INTERTROCHANTERIC FRACTURE TREATED WITH TROCHANTERIC FEMORAL NAIL: A PROSPECTIVE OBSERVATIONAL STUDY

Introduction: As age increases, fall becomes more often so as intertrochanteric fracture of femur. Because of early mobilization, The Trochanteric Femoral Nail (TFN) is  found effective and suitable in Indian population as it is smaller in size than Proximal Femoral Nail (PFN). AIM: To clinically evaluate the functional outcome and associated complications of intertrochanteric fracture treated with trochanteric femoral nail. Methodology: Study was done in 30 patients with intertrochanteric fractures treated with trochanteric femoral nail. Patients were followed up at 6 wks, 3months, and 6 months. The intraoperative blood loss, duration of surgery, intra operative complications, post-operative complication, duration of hospital stay were studied. Functional outcome was assessed based on Kyle criteria. Results: In our series of 30 cases there were 22 male and 8 female, maximum age of 90 yrs and minimum age of 20 yrs, most of the patients were between 60 to 70 yrs. Mean age of 58 yrs. 63.3% of cases were admitted due to Domestic fall and 36.7% due to road traffic accidents with common predominance of both sides.AO Type 31A2 fracture accounted for 40 % of cases. Mean duration of hospital stay is 14 days and mean time of full weight bearing is 6 wks. Good to excellent results are seen in 81% cases, Fair in 16%, 3% case with poor results according to kyle's criteria. Conclusion: Trochanteric femoral nail can be considered the most judicious and rational method of treating intertrochanteric fractures, especially the unstable and reverse oblique type

FUNCTIONAL OUTCOME AND ASSOCIATED COMPLICATIONS OF INTERTROCHANTERIC FRACTURE TREATED WITH TROCHANTERIC FEMORAL NAIL: A PROSPECTIVE OBSERVATIONAL STUDY

Introduction: As age increases, fall becomes more often so as intertrochanteric fracture of femur. Because of early mobilization, The Trochanteric Femoral Nail (TFN) is  found effective and suitable in Indian population as it is smaller in size than Proximal Femoral Nail (PFN). AIM: To clinically evaluate the functional outcome and associated complications of intertrochanteric fracture treated with trochanteric femoral nail. Methodology: Study was done in 30 patients with intertrochanteric fractures treated with trochanteric femoral nail. Patients were followed up at 6 wks, 3months, and 6 months. The intraoperative blood loss, duration of surgery, intra operative complications, post-operative complication, duration of hospital stay were studied. Functional outcome was assessed based on Kyle criteria. Results: In our series of 30 cases there were 22 male and 8 female, maximum age of 90 yrs and minimum age of 20 yrs, most of the patients were between 60 to 70 yrs. Mean age of 58 yrs. 63.3% of cases were admitted due to Domestic fall and 36.7% due to road traffic accidents with common predominance of both sides.AO Type 31A2 fracture accounted for 40 % of cases. Mean duration of hospital stay is 14 days and mean time of full weight bearing is 6 wks. Good to excellent results are seen in 81% cases, Fair in 16%, 3% case with poor results according to kyle\u27s criteria. Conclusion: Trochanteric femoral nail can be considered the most judicious and rational method of treating intertrochanteric fractures, especially the unstable and reverse oblique type

Stem and progenitor cell division kinetics during postnatal mouse mammary gland development.

The cycling properties of mammary stem and progenitor cells is not well understood. To determine the division properties of these cells, we administered synthetic nucleosides for varying periods of time to mice at different stages of postnatal development and monitored the rate of uptake of these nucleosides in the different mammary cell compartments. Here we show that most cell division in the adult virgin gland is restricted to the oestrogen receptor-expressing luminal cell lineage. Our data also demonstrate that the oestrogen receptor-expressing, milk and basal cell subpopulations have telomere lengths and cell division kinetics that are not compatible with these cells being hierarchically organized; instead, our data indicate that in the adult homeostatic gland, each cell type is largely maintained by its own restricted progenitors. We also observe that transplantable stem cells are largely quiescent during oestrus, but are cycling during dioestrus when progesterone levels are high.We thank the members of Stingl lab, Doug Winton, Jason Carroll, Robert Clarke, Phil Jones and Hamid Raza Ali for scientific discussions. We thank the core facilities at the Cancer Research UK-CI for enabling experiments. In particular, Loic Tauzin, Nina Lane and Mateuz Strzelecki for assistance with cell sorting; the Biological Resources Unit for animal husbandry; and Histopathology staff, in particular Leigh-Anne McDuffus and Cara Walters. J. Stingl’s laboratory acknowledges the support of The University of Cambridge, Cancer Research UK (core grant number C14303/A17197) and Hutchison Whampoa Limited. M.A. Blasco’s laboratory is funded by the Spanish Ministry of Economy and Competitiveness Project SAF2013-45111RETOS, the European Union FP7 Project EUROBATS, the European Research Council (ERC) Project TEL STEM CELL (GA#232854), the Regional Government of Madrid project 2+2 ReCaRe, the AXA Research Fund and the Fundación Botín.This is the final version of the article. It was first available from Nature via http://dx.doi.org/10.1038/ncomms948

A VERY INFREQUENT ASSOCIATION OF WILLIAM-BEURAN SYNDROME AND TETRALOGY OF FALLOT

WB-S Autosomal Dominant Disorder is the most common genetic disorder. We report a case of 20 year old with infrequent association of WBS and TOF. Clinical examination and ECHO confirmed TOF, WB-S was suspected based on the clinical signs used in the scoring system of WB-S which were described by AAP(2001), FISH study was performed in this patient because of having more than 3 clinical signs of WB-S and FISH study showed 7q11.23 deletion and remains the gold standard laboratory investigation for WB-S. KEYWORDS: Tetralogy of Fallot; William Beuren Syndrome; Clinical Diagnosis; Fluroscence In Situ Hybridisation

A VERY INFREQUENT ASSOCIATION OF WILLIAM-BEURAN SYNDROME AND TETRALOGY OF FALLOT

WB-S Autosomal Dominant Disorder is the most common genetic disorder. We report a case of 20 year old with infrequent association of WBS and TOF. Clinical examination and ECHO confirmed TOF, WB-S was suspected based on the clinical signs used in the scoring system of WB-S which were described by AAP(2001), FISH study was performed in this patient because of having more than 3 clinical signs of WB-S and FISH study showed 7q11.23 deletion and remains the gold standard laboratory investigation for WB-S. KEYWORDS: Tetralogy of Fallot; William Beuren Syndrome; Clinical Diagnosis; Fluroscence In Situ Hybridisation

Mammary stem cells have myoepithelial cell properties.

Contractile myoepithelial cells dominate the basal layer of the mammary epithelium and are considered to be differentiated cells. However, we observe that up to 54% of single basal cells can form colonies when seeded into adherent culture in the presence of agents that disrupt actin-myosin interactions, and on average, 65% of the single-cell-derived basal colonies can repopulate a mammary gland when transplanted in vivo. This indicates that a high proportion of basal myoepithelial cells can give rise to a mammary repopulating unit (MRU). We demonstrate that myoepithelial cells, flow-sorted using two independent myoepithelial-specific reporter strategies, have MRU capacity. Using an inducible lineage-tracing approach we follow the progeny of myoepithelial cells that express α-smooth muscle actin and show that they function as long-lived lineage-restricted stem cells in the virgin state and during pregnancy.This work was funded by Cancer Research UK, Breast Cancer Campaign, the University of Cambridge, Hutchison Whampoa Limited, La Ligue Nationale Contre le Cancer (Equipe Labelisée 2013) and a grant from Agence Nationale de la Recherche ANR- 08-BLAN-0078-01 to M.A.G.This is the author accepted manuscript. The final version is available from Nature at http://www.nature.com/ncb/journal/vaop/ncurrent/full/ncb3025.html

Phenotypic and Functional Characterization of Human Mammary Stem/Progenitor Cells in Long Term Culture

Background: Cancer stem cells exhibit close resemblance to normal stem cells in phenotype as well as function. Hence, studying normal stem cell behavior is important in understanding cancer pathogenesis. It has recently been shown that human breast stem cells can be enriched in suspension cultures as mammospheres. However, little is known about the behavior of these cells in long-term cultures. Since extensive self-renewal potential is the hallmark of stem cells, we undertook a detailed phenotypic and functional characterization of human mammospheres over long-term passages. Methodology: Single cell suspensions derived from human breast `organoids' were seeded in ultra low attachment plates in serum free media. Resulting primary mammospheres after a week (termed T1 mammospheres) were subjected to passaging every 7th day leading to the generation of T2, T3, and T4 mammospheres. Principal Findings: We show that primary mammospheres contain a distinct side-population (SP) that displays a CD24(low)/CD44(low) phenotype, but fails to generate mammospheres. Instead, the mammosphere-initiating potential rests within the CD44(high)/CD24(low) cells, in keeping with the phenotype of breast cancer-initiating cells. In serial sphere formation assays we find that even though primary (T1) mammospheres show telomerase activity and fourth passage T4 spheres contain label-retaining cells, they fail to initiate new mammospheres beyond T5. With increasing passages, mammospheres showed an increase in smaller sized spheres, reduction in proliferation potential and sphere forming efficiency, and increased differentiation towards the myoepithelial lineage. Significantly, staining for senescence-associated beta-galactosidase activity revealed a dramatic increase in the number of senescent cells with passage, which might in part explain the inability to continuously generate mammospheres in culture. Conclusions: Thus, the self-renewal potential of human breast stem cells is exhausted within five in vitro passages of mammospheres, suggesting the need for further improvisation in culture conditions for their long-term maintenance