Supernumerary heads of biceps brachii muscle in South Indian Cadavers

Biceps brachii is a muscle of the anterior compartment of the arm having a long head and a short head. Distally both heads unite to form a common tendon inserting into the radial tuberosity and the bicipital aponeurosis. Most commonly it may have an additional head but presence of four heads and more is relatively very rare. The present study documents the incidence and morphological characteristics of supernumerary head of biceps brachii in adult South Indian cadavers. We studied 40 arms of 20 adult formalin fixed cadavers in the Department of Anatomy, Kasturba Medical College, Manipal, India. The presence of number of additional heads and their details of attachments were studied. We observed presence of supernumerary heads of biceps brachii in 6 (15%) cases, in which having three heads observed in five cases (12.5%) and four heads in one case (2.5%). In one case, we noticed bilateral incidence with three heads on left side and four heads on right side. Knowledge of incidences of such variable numbers of additional heads and pattern of their attachment may facilitate the preoperative diagnosis in addition to the surgical procedures of the upper limbs.Keywords: Biceps brachii, supernumerary heads, additional head

Temperature and blood flow distribution in the human leg during passive heat stress

The influence of temperature on the hemodynamic adjustments to direct passive heat stress within the leg’s major arterial and venous vessels and compartments remains unclear. Fifteen healthy young males were tested during exposure to either passive whole-body heat stress to levels approaching thermal tolerance (core temperature, Tc + 2 °C; Study 1; n=8) or single leg heat stress (Tc + 0 °C; Study 2; n=7). Whole-body heat stress increased perfusion and decreased oscillatory shear index in relation to the rise in Tleg in all three major arteries supplying the leg - plateauing in the common and superficial femoral arteries prior to reaching severe heat stress levels. Isolated leg heat stress increased arterial blood flows and shear patterns to a level similar to that obtained during moderate core hyperthermia (Tc + 1°C). Despite modest increases in great saphenous venous blood flow (0.2 l/min), the deep venous system accounted for the majority of returning flow (common femoral vein 0.7l/min) during intense to severe levels of heat stress. Rapid cooling of a single leg during severe whole-body heat stress resulted in an equivalent blood flow reduction in the major artery supplying the thigh deep tissues only - suggesting central temperature-sensitive mechanisms contribute to skin blood flow alone. These findings further our knowledge of leg hemodynamic responses during direct heat stress and provide evidence of potentially beneficial vascular alterations during isolated limb heat stress that are equivalent to those experienced during exposure to moderate levels of whole-body hyperthermia

Role of yoga intervention on quality of life and prehypertension

351-355   In developing countries like India, hypertension poses a major problem. Rise in blood pressure for a prolonged period above the normal range is labeled as hypertension and this is usually preceded by prehypertension. Yogic exercises done on regular basis can have beneficial effects on hypertension. The aim of present study was to evaluate the effects of yogic exercises in controlling blood pressure in pre-hypertensive.    Security personnel were screened for hypertension and the subjects with pre-hypertension were selected for study. subjects with pre-hypertension were divided into control and intervention group by using simple random sampling method. Intervention group were trained for yoga and both the groups were followed up to check blood pressure every 3 months.    The study observed a decrease in weight and blood pressure of intervention group as compared to the control group but it was not statistically significant. The intervention group showed significant improvement in self rated quality of life compared to the control group.    Yogasanas and meditation seems to have an antihypertensive effect and a positive effect on self rated quality of lifeby intervention group as compared to the control group. This proves that simple yogasanas and meditation could be useful to improve the quality of life and control blood pressure in subjects with pre-hypertension

Determination of sex from tooth pulp tissue

Objective: This study was carried out to determine the reliability of sex determination from teeth pulp tissue. Patients and methods: This study was carried on 60 maxillary and mandibular premolars and permanent molars (30 male teeth and 30 female teeth) which were indicated for extraction. The teeth were categorized into three groups of 20 each (10 from males and 10 from females).Group 1-pulp tissue from teeth examined immediately after extraction. Group 2- and Group 3-pulp tissue examined from teeth one and five month after extraction, respectively. Teeth was sectioned and pulpal cells were stained with quinacrine dihydrochloride. The cells were observed with fluorescent microscope for fluorescent body. Gender was determined by identification of Y chromosome fluorescence in dental pulp. Results: Freshly extracted teeth and for those examined one month later, sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were all 100%. Conclusion: The fluorescent Y body test is shown to be a reliable, simple, and cost-effective technique for gender identification in the immediate postmortem period up to one month

RDH12 retinopathy: novel mutations and phenotypic description

PurposeTo identify patients with autosomal recessive retinal dystrophy caused by mutations in the gene, retinal dehydrogenase 12 (RDH12), and to report the associated phenotype.MethodsAfter giving informed consent, all patients underwent full clinical evaluation. Patients were selected for mutation analysis based upon positive results from the Asper Ophthalmics Leber congenital amaurosis arrayed primer extansion (APEX) microarray screening, linkage analysis, or their clinical phenotype. All coding exons of RDH12 were screened by direct Sanger sequencing. Potential variants were checked for segregation in the respective families and screened in controls, and their pathogenicity analyzed using in silico prediction programs.ResultsScreening of 389 probands by the APEX microarray and/or direct sequencing identified bi-allelic mutations in 29 families. Seventeen novel mutations were identified. The phenotype in these patients presented with a severe early-onset rod-cone dystrophy. Funduscopy showed severe generalized retinal pigment epithelial and retinal atrophy, which progressed to dense, widespread intraretinal pigment migration by adulthood. The macula showed severe atrophy, with pigmentation and yellowing, and corresponding loss of fundus autofluorescence. Optical coherence tomography revealed marked retinal thinning and excavation at the macula.ConclusionsRDH12 mutations account for approximately 7% of disease in our cohort of patients diagnosed with Leber congenital amaurosis and early-onset retinal dystrophy. The clinical features of this disorder are highly characteristic and facilitate candidate gene screening. The term RDH12 retinopathy is proposed as a more accurate description

Comparative assessment of antioxidant potential of different body parts of the yellow seahorse, Hippocampus kuda (Bleeker, 1852): source of traditional medicine

804-811Antioxidant potential of different body parts such as seahorse internal organs (SIO), skin with bones (SSB), bones (SB) and muscle tissues (SM) of cultured yellow seahorse, Hippocampus kuda was assessed in terms of total phenolic content (TPC), reducing power (RP), metal chelating activity (MCA), 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity, hydroxyl radical scavenging (HRS) and lipid peroxidation assay (LPX). In general, relatively elevated levels of TPC and other measured antioxidant activities were recorded in extracts from SIO and SM. Extract prepared from SIO exhibited significantly higher levels of TPC, RP, DPPH scavenging activity and LPX inhibition, while MCA and HRS activities were significantly higher in SM and SSB, respectively (P < 0.05). A significant difference in TPC and antioxidant activities between different body parts of seahorse was discernible. The results of the study revealed that internal organs and muscle tissues contribute significantly to the antioxidant potential in the H. kuda. Results obtained in the present investigation suggest that TPC and other antioxidant activities are dependent upon biochemical composition of individual body parts

A randomized controlled trial of methotrexate for patients with generalized myasthenia gravis

OBJECTIVE: To determine the steroid-sparing effect of methotrexate (MTX) in patients with symptomatic generalized myasthenia gravis (MG). METHODS: We performed a 12-month multicenter, randomized, double-blind, placebo-controlled trial of MTX 20 mg orally every week vs placebo in 50 acetylcholine receptor antibody-positive patients with MG between April 2009 and August 2014. The primary outcome measure was the prednisone area under the dose-time curve (AUDTC) from months 4 to 12. Secondary outcome measures included 12-month changes of the Quantitative Myasthenia Gravis Score, the Myasthenia Gravis Composite Score, Manual Muscle Testing, the Myasthenia Gravis Quality of Life, and the Myasthenia Gravis Activities of Daily Living. RESULTS: Fifty-eight patients were screened and 50 enrolled. MTX did not reduce the month 4-12 prednisone AUDTC when compared to placebo (difference MTX - placebo: -488.0 mg, 95% confidence interval -2,443.4 to 1,467.3, p = 0.26); however, the average daily prednisone dose decreased in both groups. MTX did not improve secondary measures of MG compared to placebo over 12 months. Eight participants withdrew during the course of the study (1 MTX, 7 placebo). There were no serious MTX-related adverse events. The most common adverse event was nonspecific pain (19%). CONCLUSIONS: We found no steroid-sparing benefit of MTX in MG over 12 months of treatment, despite being well-tolerated. This study demonstrates the challenges of conducting clinical trials in MG, including difficulties with recruitment, participants improving on prednisone alone, and the need for a better understanding of outcome measure variability for future clinical trials. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with generalized MG MTX does not significantly reduce the prednisone AUDTC over 12 months of therapy

Activation of Wnt Signaling by Chemically Induced Dimerization of LRP5 Disrupts Cellular Homeostasis

Wnt signaling is crucial for a variety of biological processes, including body axis formation, planar polarity, stem cell maintenance and cellular differentiation. Therefore, targeted manipulation of Wnt signaling in vivo would be extremely useful. By applying chemical inducer of dimerization (CID) technology, we were able to modify the Wnt co-receptor, low-density lipoprotein (LDL)-receptor-related protein 5 (LRP5), to generate the synthetic ligand inducible Wnt switch, iLRP5. We show that iLRP5 oligomerization results in its localization to disheveled-containing punctate structures and sequestration of scaffold protein Axin, leading to robust β-catenin-mediated signaling. Moreover, we identify a novel LRP5 cytoplasmic domain critical for its intracellular localization and casein kinase 1-dependent β-catenin signaling. Finally, by utilizing iLRP5 as a Wnt signaling switch, we generated the Ubiquitous Activator of β-catenin (Ubi-Cat) transgenic mouse line. The Ubi-Cat line allows for nearly ubiquitous expression of iLRP5 under control of the H-2Kb promoter. Activation of iLRP5 in isolated prostate basal epithelial stem cells resulted in expansion of p63+ cells and development of hyperplasia in reconstituted murine prostate grafts. Independently, iLRP5 induction in adult prostate stroma enhanced prostate tissue regeneration. Moreover, induction of iLRP5 in male Ubi-Cat mice resulted in prostate tumor progression over several months from prostate hyperplasia to adenocarcinoma. We also investigated iLRP5 activation in Ubi-Cat-derived mammary cells, observing that prolonged activation results in mammary tumor formation. Thus, in two distinct experimental mouse models, activation of iLRP5 results in disruption of tissue homeostasis, demonstrating the utility of iLRP5 as a novel research tool for determining the outcome of Wnt activation in a precise spatially and temporally determined fashion

Are textbook lungs really normal? A cadaveric study on the anatomical and clinical importance of variations in the major lung fissures, and the incomplete right horizontal fissure.

INTRODUCTION: The lungs have three main fissures: the right oblique fissure (ROF), right horizontal fissure (RHF), and left oblique fissure (LOF). These can be complete, incomplete or absent; quantifying the degree of completeness of these fissures is novel. Standard textbooks often refer to the fissures as complete, but awareness of variation is essential in thoracic surgery. MATERIALS AND METHODS: Fissures in 81 pairs of cadaveric lungs were classified. Oblique fissures were measured from lung hila posteriorly to the lung hila anteriorly; and the RHF measured from the ROF to the anteromedial lung edge. The degree of completeness of fissures was expressed as a percentage of the total projected length were they to be complete. The frequency and location of accessory fissures was noted. RESULTS: LOF were complete in 66/81 (81.5%), incomplete in 13/81 (16.0%) and absent in 2/81 (2.47%); ROF were complete in 52/81 (64.2%), incomplete in 29/81 (35.8%) and never absent; RHF were more variable, complete in 18/81 (22.2%), incomplete in 54/81 (66.7%) and absent in 9/81 (11.1%). LOF and ROF were on average 97.1% and 91.6% complete, respectively, being deficient posteriorly at the lung hila. The RHF on average 69.4% complete, being deficient anteromedially. There were accessory fissures in 10 left and 19 right lungs. CONCLUSIONS: This study provides a projection of the anatomy thoracic surgeons may encounter at operation, in particular the variable RHF. This knowledge is essential for optimal outcomes in both benign and oncological procedures influenced by the fissures