Traumatic carotid-cavernous fistula: Clinical presentation and outcome

Objective:To evaluate the presentation, clinical course and outcome of traumatic carotid-cavernous fistula (CCF) withendovascular treatment at our institution during the last five years. Design: Retrospective descriptive study. Setting: The study included patients seen at Aga Khan University Hospital from January 2000 to December 2005. Methods: Retrospective analysis based on data retrieval from medical records using ICD coding system. Only those cases who had traumatic CCF and underwent endovascular treatment were included in the study. Results: A total of 8 patients were diagnosed with post-traumatic CCF and 11 procedures were done. Mean age at presentation was 35.6 years; mean duration of symptoms was 23 weeks after trauma; 6 patients were male and 2 female. Patients presented from 1 week to 2 years after the trauma; 7 had high-flow fistulas and 1 had low-flow fistula. Proptosis was the most common symptom (6 patients); decreased vision was present in 3 patients; 4 patients had an accompanying skull base fracture; and 1 patient had bilateral CCF. All patients were treated by endovascular procedures; 2 patients had recurrences, seen within 1 month of initial treatment and subsequently successfully treated. In 1 patient, the procedure failed due to the small size of the fistula. Conclusion: High success rate with minimal complications as seen in our series supports endovascular treatment as the leading option for CCF managemen

Molecular and biochemical characterization of Xanthomonas axonopodis pv. citri pathotypes

Prevalence of citrus bacterial canker caused by Xanthomonas axonopodis pv. citri in citrus groves is the major impediment and limiting factor in successful citrus production. Severity varies among different species, varieties and prevailing climatic conditions. Despite extensive studies on the biology, epidemiology and management of this disease, there is still little known about the role of different biocontrol agents for management of this disease. Traditional management of X. axonopodis pv citri is brought about by chemicals which have become complicated through the development of chemical resistance, and as such, it is hazardous for health. It is necessary to identify the pathotypes of X. axonopodis pv. citri through biochemical and molecular characterization and to determine the role of different biocontrol agents (antibiotics and plant extracts), in order to find out a safer way for controlling citrus canker as disease severity results in defoliation, dieback, premature fruit drop and blemished fruit that consequently decrease fruit production and market value.Keywords: Citrus, bacterial canker, Xanthomona

Diagnostic value of bronchoalveolar lavage in the subset of patients with negative sputum/smear and mycobacterial culture and a suspicion of pulmonary tuberculosis

Background: The diagnostic value of bronchoalveolar lavage in patients with negative sputum/smear for tuberculous bacilli has been well studied. However, its value in the subset of patients with both negative sputum/smear and culture is seldom reported. Methods: A retrospective study of patients referred for diagnostic bronchoscopy for the suspicion of pulmonary tuberculosis during the period from April 1st, 2015 to March 30th, 2016, and who had negative sputum/smear and culture for tuberculous bacilli. Results: One hundred and ninety patients fulfilled the inclusion criteria. Bronchoalveolar lavage detected further 61/190 (32.1%) pulmonary tuberculosis cases. Bronchoalveolar lavage mycobacterial culture and polymerase chain reaction (positive in 60/190 (31.6%) and 58/190 (30.5%) of patients respectively) provided the highest diagnostic yield, whereas direct smear provided the lowest yield. Bronchoalveolar lavage had a sensitivity of 89.7%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 94.6%, and a test accuracy of 96.3% in suspected pulmonary tuberculosis cases with negative sputum/smear and culture. Positive bronchoalveolar lavage yield for tuberculosis was significantly associated with a positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, radiological evidence of upper zone abnormality and patient's origin being from the Indian subcontinent. Conclusion: Bronchoalveolar lavage should be pursued as a useful diagnostic tool for suspected pulmonary tuberculosis cases when sputum/smear and culture are negative. Its value is higher in the subset of patients with positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, upper zone abnormality on radiograph or being from the Indian subcontinent.Scopu

Adomian decomposition method simulation of Von Kármán swirling bioconvection nanofluid flow

The study reveals analytically on the 3-dimensional viscous time-dependent gyrotactic bioconvection in swirling nanofluid flow past from a rotating disk. It is known that the deformation of the disk is along the radial direction. In addition to that Stefan blowing is considered. The Buongiorno nanofluid model is taken care of assuming the fluid to be dilute and we find Brownian motion and thermophoresis have dominant role on nanoscale unit. The primitive mass conservation equation, radial, tangential and axial momentum, heat, nano-particle concentration and micro-organism density function are developed in a cylindrical polar coordinate system with appropriate wall (disk surface) and free stream boundary conditions. This highly nonlinear, strongly coupled system of unsteady partial differential equations is normalized with the classical Von Kármán and other transformations to render the boundary value problem into an ordinary differential system. The emerging 11th order system features an extensive range of dimensionless flow parameters i.e. disk stretching rate, Brownian motion, thermophoresis, bioconvection Lewis number, unsteadiness parameter, ordinary Lewis number, Prandtl number, mass convective Biot number, Péclet number and Stefan blowing parameter. Solutions of the system are obtained with developed semi-analytical technique i.e. Adomian decomposition method. Validation of the said problem is also conducted with earlier literature computed by Runge-Kutta shooting technique

Evolving knowledge based product lifecycle management from a digital ecosystem to support automated manufacturing

This paper presents an approach at improving Product Lifecycle Management (PLM) in large scale multinational manufacturing companies using Ford Motor Company as a case study. The solution builds a software layer around an existing PLM infrastructure that uses Semantic Web Services (SWSs) to enable a new generation of PLM. This new PLM is then integrated into a digital ecosystem for factory automation using Ford Powertrain as a case study. The work illustrates how a Digital Business Ecosystem (DBE) can spur innovation and evolution in applications around this new type of PLM

Single molecule unfolding and stretching of protein domains inside a solid-state nanopore by electric field

Single molecule methods have provided a significantly new look at the behavior of biomolecules in both equilibrium and non-equilibrium conditions. Most notable are the stretching experiments performed by atomic force microscopes and laser tweezers. Here we present an alternative single molecule method that can unfold a protein domain, observed at electric fields greater than 106 V/m, and is fully controllable by the application of increasing voltages across the membrane of the pore. Furthermore this unfolding mechanism is characterized by measuring both the residence time of the protein within the nanopore and the current blockade. The unfolding data supports a gradual unfolding mechanism rather than the cooperative transition observed by classical urea denaturation experiments. Lastly it is shown that the voltage-mediated unfolding is a function of the stability of the protein by comparing two mutationally destabilized variants of the protein

Interactions outside the boundaries of the canonical binding groove of a pdz domain influence ligand binding

The postsynaptic density protein-95/discs large/zonula occludens-1 (PDZ) domain is a protein-protein interaction module with a shallow binding groove where protein ligands bind. However, interactions that are not part of this canonical binding groove are likely to modulate peptide binding. We have investigated such interactions beyond the binding groove for PDZ3 from PSD-95 and a peptide derived from the C-terminus of the natural ligand CRIPT. We found via nuclear magnetic resonance experiments that up to eight residues of the peptide ligand interact with the PDZ domain, showing that the interaction surface extends far outside of the binding groove as defined by the crystal structure. PDZ3 contains an extra structural element, a C-terminal helix (α3), which is known to affect affinity. Deletion of this helix resulted in the loss of several intermolecular nuclear Overhauser enhancements from peptide residues outside of the binding pocket, suggesting that α3 forms part of the extra binding surface in wild-type PDZ3. Site-directed mutagenesis, isothermal titration calorimetry, and fluorescence intensity experiments confirmed the importance of both α3 and the N-terminal part of the peptide for the affinity. Our data suggest a general mechanism in which different binding surfaces outside of the PDZ binding groove could provide sites for specific interactions

Interactions outside the boundaries of the canonical binding groove of a pdz domain influence ligand binding

The postsynaptic density protein-95/discs large/zonula occludens-1 (PDZ) domain is a protein-protein interaction module with a shallow binding groove where protein ligands bind. However, interactions that are not part of this canonical binding groove are likely to modulate peptide binding. We have investigated such interactions beyond the binding groove for PDZ3 from PSD-95 and a peptide derived from the C-terminus of the natural ligand CRIPT. We found via nuclear magnetic resonance experiments that up to eight residues of the peptide ligand interact with the PDZ domain, showing that the interaction surface extends far outside of the binding groove as defined by the crystal structure. PDZ3 contains an extra structural element, a C-terminal helix (α3), which is known to affect affinity. Deletion of this helix resulted in the loss of several intermolecular nuclear Overhauser enhancements from peptide residues outside of the binding pocket, suggesting that α3 forms part of the extra binding surface in wild-type PDZ3. Site-directed mutagenesis, isothermal titration calorimetry, and fluorescence intensity experiments confirmed the importance of both α3 and the N-terminal part of the peptide for the affinity. Our data suggest a general mechanism in which different binding surfaces outside of the PDZ binding groove could provide sites for specific interactions