Unveiling mediastinal pathology: role of EUS guided fine needle aspiration in diagnosing mediastinal lesions

Background: Mediastinal lesion is the focus of investigation in diagnosis of infective, granulomatous or neoplastic pathology of respiratory system. Metastatic mediastinal node assessment is an integral part of oncological management. EUS provides access to sampling of mediastinal mass, sub-carinal and aorto-pulmonary nodes. This study aims to assess the clinical impact, diagnostic yield and safety of EUS guided FNA for mediastinal lesions.Methods: Retrospective analysis of prospectively collected data of 72 cases of mediastinal lesions between January 2014 and December 2017 was done. EUS-FNA was performed with a linear echoendoscope using a 22- or 25-gauge needle. Adequacy of cellularity was assessed by on site pathologist. Patient data (demographics, intervention and follow-up) were prospectively collected and introduced in a predefined computer database for later review.Results: EUS-FNA was performed from 57 lymph nodes and 15 mediastinal masses. Adequate samples were obtained in 67 of 72 patients (93.05%). All mediastinal masses were malignant and were identified in the 3rd, 5th and 6th decade of life. Of the 57 lymph nodes, 15 were malignant, 28 had granulomatous lymphadenitis of which 16 individuals became asymptomatic after anti tubercular therapy. Sample was inadequate in 5 circumstances. No major complications were encountered with the procedure in any of the individuals.Conclusions: EUS guided tissue diagnosis is a safe technique and our data supports the use of EUS-FNA in work-up of mediastinal lesions. It is minimally invasive, accurate and has easy access to mediastinum. It has significant impact on patient diagnosis, management and should be considered over other invasive techniques

Colorectal polyps and heterotrophic esophageal polyp of colon in a paediatric cohort in South India

Background: Clinical profile of polyps in paediatric cases are less in South India. Juvenile Polyps were the most common polyps in paediatric cases described in literature, presenting as LGI bleed. The aim of the study is to describe the clinical profile of colorectal polyps in paediatric population in a single tertiary care centre in South India.Methods: Paediatric cases between 0 and 16 years of age who underwent colonoscopy in our department from January 2002 to July 2018 were included from database. These cases were retrospectively analysed for presence of polyps, clinical presentation, indication for colonoscopy, histopathology of the resected polyps and other demographic details.  Incomplete procedures were excluded.Results: About 166 paediatric cases underwent colonoscopy in the study period. 21 cases (12.65%) had colorectal Polyps. 85.7% of the polyps were in recto sigmoid region. Most common histological type was Juvenile Polyp (51.6%). One infant had sessile polyp in descending colon which was reported as heterotrophic esophageal mucosa in histopathology. LGI bleed was the most common presentation in children with polyps (66.6%).Conclusions: The prevalence of polyps in our cohort was 12.65%. Solitary Juvenile Polyp was the most common polyp in children, with lower GI bleed as the most common presenting feature. Rare case of heterotrophic esophageal polyp was seen in descending colon

Subdural electrode recording of generalized photoepileptic responses

AbstractWe evaluated the spatiotemporal distribution of photic driving (PDR), photoparoxysmal (PPR), and photoconvulsive (PCR) responses recorded by intracranial electrodes (ic-EEG) in a patient with generalized photosensitivity and right frontal lobe cortical dysplasia. Intermittent light stimulation (ILS) was performed thirteen times in nine days. Cortical responses to ILS recorded by ic-EEG were reviewed and classified as PDRs, PPRs, and PCRs. Photic driving responses were restricted to the occipital lobe at ILS frequencies below 9Hz, spreading to the parietal and central regions at >9Hz. Photoparoxysmal responses commonly presented as focal, medial occipital, and parietal interictal epileptic discharges (IEDs), the latter propagating to the sensorimotor cortices. Generalized IEDs were also generated in the setting of PPRs. Photoconvulsive responses, characterized by repetitive bilateral upper extremity myoclonus sustained until the end of the stimulus, were associated with propagation of the medial parieto-occipital discharge to the primary sensorimotor and supplementary area cortices, while generalized myoclonic seizures were associated with a generalized spike-and-wave discharge with an interhemispheric posterior cingulate onset sparing the sensorimotor cortices. Both types of PCR could occur during the same stimulus. Regardless of the pathway, PCRs only occurred when PDRs involved the parietal cortices. While there may be more than one pathway underlying PCRs, parietal lobe association cortices appear to be critical to their generation

Membrane Insertion for the Detection of Lipopolysaccharides: Exploring the Dynamics of Amphiphile-in-Lipid Assays

Shiga toxin-producing Escherichia coli is an important cause of foodborne illness, with cases attributable to beef, fresh produce and other sources. Many serotypes of the pathogen cause disease, and differentiating one serotype from another requires specific identification of the O antigen located on the lipopolysaccharide (LPS) molecule. The amphiphilic structure of LPS poses a challenge when using classical detection methods, which do not take into account its lipoglycan biochemistry. Typically, detection of LPS requires heat or chemical treatment of samples and relies on bioactivity assays for the conserved lipid A portion of the molecule. Our goal was to develop assays to facilitate the direct and discriminative detection of the entire LPS molecule and its O antigen in complex matrices using minimal sample processing. To perform serogroup identification of LPS, we used a method called membrane insertion on a waveguide biosensor, and tested three serogroups of LPS. The membrane insertion technique allows for the hydrophobic association of LPS with a lipid bilayer, where the exposed O antigen can be targeted for specific detection. Samples of beef lysate were spiked with LPS to perform O antigen specific detection of LPS from E. coli O157. To validate assay performance, we evaluated the biophysical interactions of LPS with lipid bilayers both in- and outside of a flow cell using fluorescence microscopy and fluorescently doped lipids. Our results indicate that membrane insertion allows for the qualitative and reliable identification of amphiphilic LPS in complex samples like beef homogenates. We also demonstrated that LPS-induced hole formation does not occur under the conditions of the membrane insertion assays. Together, these findings describe for the first time the serogroup-specific detection of amphiphilic LPS in complex samples using a membrane insertion assay, and highlight the importance of LPS molecular conformations in detection architectures

The Evolution of High Temperature Gas Sensors.

Gas sensor technology based on high temperature solid electrolytes is maturing rapidly. Recent advances in metal oxide catalysis and thin film materials science has enabled the design of new electrochemical sensors. We have demonstrated prototype amperometric oxygen sensors, nernstian potentiometric oxygen sensors that operate in high sulfur environments, and hydrocarbon and carbon monoxide sensing mixed potentials sensors. Many of these devices exhibit part per million sensitivities, response times on the order of seconds and excellent long-term stability

Deletion of Panx3 Prevents the Development of Surgically Induced Osteoarthritis

© 2015, Springer-Verlag Berlin Heidelberg. Abstract: Osteoarthritis (OA) is a highly prevalent, disabling joint disease with no existing therapies to slow or halt its progression. Cartilage degeneration hallmarks OA pathogenesis, and pannexin 3 (Panx3), a member of a novel family of channel proteins, is upregulated during this process. The function of Panx3 remains poorly understood, but we consistently observed a strong increase in Panx3 immunostaining in OA lesions in both mice and humans. Here, we developed and characterized the first global and conditional Panx3 knockout mice to investigate the role of Panx3 in OA. Interestingly, global Panx3 deletion produced no overt phenotype and had no obvious effect on early skeletal development. Mice lacking Panx3 specifically in the cartilage and global Panx3 knockout mice were markedly resistant to the development of OA following destabilization of medial meniscus surgery. These data indicate a specific catabolic role of Panx3 in articular cartilage and identify Panx3 as a potential therapeutic target for OA. Lastly, while Panx1 has been linked to over a dozen human pathologies, this is the first in vivo evidence for a role of Panx3 in disease. Key message: Panx3 is localized to cartilage lesions in mice and humans.Global Panx3 deletion does not result in any developmental abnormalities.Mice lacking Panx3 are resistant to the development of osteoarthritis.Panx3 is a novel therapeutic target for the treatment of osteoarthritis

Catalyst-Inspired Charge Carriers for High Energy Density Redox Flow Batteries

We introduce a theoretical design approach aiming at improving energy density of redox flow batteries (RFBs) via the utilization of redox non-innocent ligands capable of stabilizing a metal center in a wide range of oxidation states. Our findings suggest that this promotes the possibility of multiple redox events as well as high open circuit voltages. Specifically, we have proposed two Fe-coordination complexes (I, Fe(Me2Pytacn)(C2N3H2), and II, Fe(H2pmen)(C2N3H2)) combining two different types of ligands, i.e., catalyst-inspired scaffolds and triazole ring, which were previously shown to promote high and low oxidation states in transition metals, respectively. These complexes exhibit as many as six theoretical redox events in the full range of charge states +4 → −2, several of which reside within the electrochemical window of acetonitrile. Electronic structure calculations show that the Fe center exhibits oxidation states ranging from the very rare Fe4+ to Fe1+. Values of the reduction potentials as well as nature of the redox events of both complexes is found to be similar in their high +4 → +1 charge states. In contrast, while exhibiting qualitatively similar redox behavior in the lower 0 → −2 range, some differences in the electronic ground states, delocalization patterns as well as reduction potential values are also observed. The calculated open circuit voltages can reach values of 5.09 and 6.14 V for complexes I and II, respectively, and hold promise to be experimentally accessible within the electrochemical window of acetonitrile expanded by addition of ionic liquids. The current results obtained for these two complexes are intended to illustrate a more general principle based on the simultaneous utilization of two types of ligands responsible for the stabilization of high and low oxidation states of the metal that can be used to design the next-generation charge carriers capable of supporting multi-electron redox and operating in a broad range of charge states, leading to RFBs with greater energy density

Assessment on the Use of High Capacity “Sn4_{4}P3_{3}”/NHC Composite Electrodes for Sodium-Ion Batteries with Ether and Carbonate Electrolytes

This work reports the facile synthesis of a Sn–P composite combined with nitrogen doped hard carbon (NHC) obtained by ball-milling and its use as electrode material for sodium ion batteries (SIBs). The “Sn$_{4}$P$_{3}$”/NHC electrode (with nominal composition “Sn$_{4}$P$_{3}$”:NHC = 75:25 wt%) when coupled with a diglyme-based electrolyte rather than the most commonly employed carbonate-based systems, exhibits a reversible capacity of 550 mAh g$_{electrode}$$^{−1}$ at 50 mA g$^{−1}$ and 440 mAh g$_{electrode}$$^{−1}$ over 500 cycles (83% capacity retention). Morphology and solid electrolyte interphase formation of cycled “Sn$_{4}$P$_{3}$”/NHC electrodes is studied via electron microscopy and X-ray photoelectron spectroscopy. The expansion of the electrode upon sodiation (300 mAh g$_{electrode}$$^{−1}$) is only about 12–14% as determined by in situ electrochemical dilatometry, giving a reasonable explanation for the excellent cycle life despite the conversion-type storage mechanism. In situ X-ray diffraction shows that the discharge product is Na$_{15}$Sn$_{4}$. The formation of mostly amorphous Na$_{3}$P is derived from the overall (electro)chemical reactions. Upon charge the formation of Sn is observed while amorphous P is derived, which are reversibly alloying with Na in the subsequent cycles. However, the formation of Sn$_{4}$P$_{3}$ can be certainly excluded

Relationship of cognitive function in patients with schizophrenia in remission to disability: a cross-sectional study in an Indian sample

Background: Cognitive deficits in various domains have been consistently replicated in patients with schizophrenia. Most studies looking at the relationship between cognitive dysfunction and functional disability are from developed countries. Studies from developing countries are few. The purpose of the present study was to compare the neurocognitive function in patients with schizophrenia who were in remission with that of normal controls and to determine if there is a relationship between measures of cognition and functional disability. <p/>Methods: This study was conducted in the Psychiatric Unit of a General Hospital in Mumbai, India. Cognitive function in 25 patients with schizophrenia in remission was compared to 25 normal controls. Remission was confirmed using the brief psychiatric rating scale (BPRS) and scale for the assessment of negative symptoms (SANS). Subjects were administered a battery of cognitive tests covering aspects of memory, executive function and attention. The results obtained were compared between the groups. Correlation analysis was used to look for relationship between illness factors, cognitive function and disability measured using the Indian disability evaluation and assessment scale. <p/>Results: Patients with schizophrenia showed significant deficits on tests of attention, concentration, verbal and visual memory and tests of frontal lobe/executive function. They fared worse on almost all the tests administered compared to normal controls. No relationship was found between age, duration of illness, number of years of education and cognitive function. In addition, we did not find a statistically significant relationship between cognitive function and scores on the disability scale. <p/>Conclusion: The data suggests that persistent cognitive deficits are seen in patients with schizophrenia under remission. The cognitive deficits were not associated with symptomatology and functional disability. It is possible that various factors such as employment and family support reduce disability due to schizophrenia in developing countries like India. Further studies from developing countries are required to explore the relationship between cognitive deficits, functional outcome and the role of socio-cultural variables as protective factors