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The neural crest cell-derived enteric nervous system (ENS) is the intrinsic innervation of the gastrointestinal tract (GIT) which consists of neurons and enteric glia cells in the myenteric ganglia and forming plexus. The ENS consists mainly of submucosal and myenteric plexuses. It has various functions on the GIT, which include control of local blood flow, motility, mucosal transport, secretions, immune modulation as well as endocrine functions and coordinated contractile activity of smooth muscle. The knowledge on the development of the innervations at different segments of the gut in humans from 11 to 26 weeks of gestation (WG) may help in understanding the pathophysiology of various congenital diseases affecting the ENS. The aim of this study is to determine the morphology of the myenteric plexus in the esophagus, ascending colon and sigmoid colon at various weeks of gestation. Tissue samples from 10 naturally terminated fetuses aged 11-26 WG were processed for hematoxylin and eosin staining and immunohistochemistry assay. The neurons, enteric glia, the smooth muscle were visualized using PGP9.5, Vimentin and S-100 antibodies. The number of neurons and enteric glial cells appeared lowest in the esophagus than the ascending and sigmoid colon. The myenteric ganglion was closely apposed to each other, forming a continuous arch along the entire circumference of gut sections of ascending and sigmoid colon but the myenteric ganglia in the esophagus was thinly populated and widely spread in the fetus at 13 WG. As the fetal gastrointestinal tract grew in diameter and length, the myenteric ganglia became discernible.

To study the distribution and morphometry of vascular foramina of adult human talus in Indian population. The study was carried out by using 56 adult human tali. The location, size, number and foraminal index of vascular foramina on head, neck and body of each bone were examined macroscopically. The difference in location of vascular foramina was further studied in relation to the pattern of calcaneal articular facets on talus. The vascular foramina were present on the superior neck, inferior neck and medial surface of talar body in all (100%) the bones. The Kruskal–Wallis test followed by series of Mann–Whitney test for post hoc analysis showed the number of vascular foramina was significantly greater on inferior surface of neck and medial surface of body. The number of vascular foramina ranged from 0 to 25. About 77.05% of foramina were ≥ 0.5 mm in size. The mean foraminal index of the closest foramina on inferior surface of neck and medial surface of body was 47.90% and 37.23%, respectively. The mean foraminal index of the farthest foramina on inferior surface of neck and medial surface of body was 75.08% and 71.35%, respectively. The present study has provided additional information on the vascular foramina of tali. This knowledge is important to the orthopedic, vascular and podiatric surgeons while performing the surgeries of hind foot. We opine that the lateral approach would be more beneficial in the surgical procedures to talus.

Summary Objective Colorectal carcinoma (CRC) is the third most common cancer in the world and fifth most common cancer in India. To understand the extent of perineural invasion (PNI) in CRC it is essential to study the morphology of enteric glial cells (EGCs). The aim of the study was to analyze the numerical density of EGCs and area of myenteric ganglia (MG) in the colonic tissue samples collected from CRC patients. Material and methods Fifteen intraoperative tissue specimens were collected from the tumor site and 2 cm proximal to the upper extent of tumor. The samples were divided into four groups: group 1 (n = 15): proximal tumor free colonic tissue; group 2 (n = 3): well-differentiated; group 3 (n = 8): moderately differentiated; group 4 (n = 4): poorly differentiated adenocarcinoma. After processing the tissues were subjected to hematoxylin and eosin staining. The anti-S100β and anti-GFAP antibodies were used to observe the EGCs. Results In the H&E stained sections the number of myenteric ganglia appeared to be decreasing with increasing grade of adenocarcinoma. Immunostaining showed significant decreasing pattern in the numerical density of EGCs per myenteric ganglion and mean area of myenteric ganglia in relation to the thickness of circular muscle, corresponding to the increasing grades of adenocarcinoma. The morphology of the EGCs remained unaltered in the colonic tissue adjacent to the tumor site. Conclusion Significant loss of EGCs and neurodegeneration corresponded with the grade of tumor emphasizing on its prognostic value. The PNI was not seen in the clear margin proximal to the tumor site.

Objective: To explore the role of VEGF in attenuating endoplasmic reticulum stress in placental trophoblast cells. Study design: Study was divided into following parts: 1. Serum Analysis of GRP78 and VEGF using sandwich ELISA. 2. Expression of VEGF and GRP78 in placentae by immunohistochemistry (IHC). 3. In Vitro experiments. Status of ER stress markers (GRP78, eIF2α, XBP1, ATF6 and CHOP) was assessed at various time points (8 h, 14 h, 24 h) when trophoblast cells were treated with varying concentration(s) of VEGF and also by adding recombinant VEGF at protein (Immunofluorescence, Western blot) and transcript levels (qRT-PCR). Results: Increased GRP78 and decreased VEGF protein levels in sera and placentae of preeclamptic pregnant women and reduced expression of various ER stress markers at both transcript and protein levels was observed in trophoblast cells when they were exposed to recombinant VEGF thereby indicating positive role of VEGF in alleviating ER stress. Conclusions: Reduced expression of ER stress markers in trophoblast cells against increased VEGF highlighted a new window to explore prospective drugs that can be designed to modulate the activities of various ER stress sensors in order to alleviate ER stress in pregnant women with preeclampsia. Keywords: Preeclampsia, UPR, ER stress, VEGF

The brachial plexus innervates the upper extremities. While variations in the formation of the brachial plexus and its terminal branches are quite common, it is uncommon for the median nerve to innervate the muscles of the arm. During the dissection of an elderly male cadaver at the Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India, in 2016, the coracobrachialis muscle was found to be supplied by a direct branch from the lateral root of the median nerve and the musculocutaneous nerve was absent. The branches of the median nerve supplied the biceps brachii and brachialis muscles and the last branch continued as the lateral cutaneous nerve of the forearm. These variations may present atypically in cases of arm flexor paralysis or sensory loss on the lateral forearm. Knowledge of these variations is important in surgeries and during the administration of regional anaesthesia near the shoulder joint and upper arm. Keywords: Anatomic Variation; Dissection; Median Nerve; Musculocutaneous Nerve; Case Report; India.

Preeclampsia (PE) and its subtypes (early and late onset) are serious concerns all across the globe affecting about 8% of total pregnancies and accounts for approximately 60,000 deaths annually with a predominance in developing under-developed and countries. The two-stage model in the progression of this disease, deficient spiral artery remodelling and an imbalance between angiogenic (VEGF) and anti-antigenic factor(s) (sFlt-1) are well established facts pertaining to this disease. The presence of increased sFlt-1, high oxidative stress and Endoplasmic reticulum stress (ER stress) have been proposed in preeclamptic pregnancies. Recently, the role of endoplasmic reticulum stress in the onset of the variant forms of PE highlighted a new window to explore further. In our previous studies, we demonstrated that sFlt-1 can induce apoptosis and oxidative stress in trophoblast cells. However the role of sFlt-1, in inducing ER stress is not known so far. In the present study, we for the first time demonstrated significant ER stress in the placental cells (BeWo Cells) (in vitro) when exposed to sera from preeclamptic pregnancies having increased concentration of sFlt-1. The expression of ER stress markers (GRP78, eIF2α, XBP1, ATF6 and CHOP) at both transcript and protein levels were compared (between preeclamptic and normotensive non-proteinuric women) at three different time points (8h, 14h and 24hrs), analyzed and found to be significant (pConclusionOur results suggested that sFlt-1, released from placental cells in preeclampsia may be one of the various factors having potential to induce endoplasmic reticulum stress in BeWo cells.

BackgroundThe concentration of sFlt-1, a major anti-angiogenic protein in maternal circulation has been seen to be raised in preeclamptic pregnancies. Endoplasmic reticulum (ER) stress represents one of the three (immunological, oxidative and ER stress) major stresses which placenta undergoes during pregnancies. The present study is designed to investigate the role of sFlt-1 in induction of ER stress in trophoblast cells.Materials and MethodsMaternal serum levels of anti-angiogenic protein sFlt-1 and central regulator of unfolded protein response GRP78 was measured using sandwich ELISA. The expression of various ER stress markers (GRP78, eIF2α, XBP1, ATF6 and apoptotic protein CHOP) were analyzed depending on various treatments given to the trophoblast cells using Immunofluorescence, western blot and q-RT PCR.ResultsIncreased expression of ER stress markers (GRP78, eIF2α, XBP1 ATF6 and apoptotic protein CHOP) was detected in the placental trophoblast cells treated with raised concentration of sFlt-1.ConclusionSignificant upregulated expression of ER stress markers in trophoblast cells exposed with increased concentration of sFlt-1 suggested that it may be one of the anti-angiogenic factors present in maternal sera which not only contributes to oxidative stress but also may cause endoplasmic reticulum stress.

Introduction: In developing countries, preeclampsia is still a leading cause of maternal mortality and morbidity, affecting nearly 8%–10% of pregnancies and overall death. Apart from various stresses that placenta undergoes while pregnancy, endoplasmic reticulum (ER) stress has been the center of attraction for several researchers all across the globe. Imbalance in circulating pro- and anti-angiogenic agents in maternal serum has also been linked with the upregulation of stress at subcellular level. The present study is an attempt to demonstrate the role of pro-angiogenic factor in mitigating ER stress in trophoblast cells. Material and Methods: Evaluation of expression of ER stress markers (eIF2α, X-box binding protein-1, and ATF6) at various time points was done after exposure of varying concentration (s) of pro-angiogenic factor (from preeclamptic mothers) to trophoblast cells (BeWo cells). Expression was also analyzed when BeWo cells were exposed to recombinant vascular endothelial growth factor (VEGF) along with serum from preeclamptic mothers. Molecular techniques used were immunofluorescence staining and Western blot analysis. Results: Immunofluorescence staining and Western blot analysis demonstrated upregulated expression of studied ER stress markers in BeWo cells when they were exposed to Preeclampsia (PE) sera. Exogenous addition of recombinant VEGF along with preeclamptic sera significantly reduced the expression of ER stress markers. Discussion and Conclusion: In the present study, significantly reduced expression of ER stress markers in BeWo cells indicates an interrelationship of angiogenic factor and molecular transmembrane sensors. Further experimentations thus may provide a strong base for the modulation of ER stress sensors, which could be effective in minimizing ER stress in preeclamptic pregnancies and thus would bring a new hope to numerous women worldwide.

Introduction: Normal development of placental vascular tree requiring angiogenesis and vasculogenesis is structurally and functionally indispensable for both adequate placental growth and delivery of nutrients from mother to the fetus. Impaired placental angiogenesis has been implicated in the pathophysiology of pregnancy complications which have immediate and long-lasting effects on the mother and her child, such as preeclampsia (PE) and fetal growth restriction. The mechanisms underlying the deregulation of placental angiogenesis in PE include a misbalance between the secretion and activity of pro-angiogenic (vascular endothelial growth factor [VEGF]) and anti-angiogenic (soluble fms-like tyrosine kinase-1 [sFlt-1]) factors. Considering the important roles of VEGF and sflt1 in pregnancy, functional polymorphisms in these genes may be potentially important as genetic markers for susceptibility to PE. Thus, the aim of the study was to screen for the presence of VEGF and sFlt-1 gene polymorphisms and to measure their levels in PE patients and controls of Indian origin. Material and Methods: Fifty each of clinically diagnosed patients and gestational and maternal age-matched normotensive, nonproteinuric controls were recruited after taking informed consent. DNA isolated from blood samples was processed for polymerase chain reaction amplification followed by restriction fragment length polymorphism to screen for the presence of VEGF + 936C/T, sFlt-1 (+4244G/A, −4771G/T, −523C/G) polymorphisms. Serum levels of VEGF-A and sFlt-1 were measured by Sandwich enzyme-linked immunosorbent assay (ELISA). Results: Decreased frequency of wild type genotype with respect to VEGF + 936C/T and sFlt-1 (+4244G/A, −4771G/T, and −523C/G) polymorphisms was seen in patients. ELISA results showed lower VEGF-A (198.43 ± 14.63 pg/ml vs. 235.08 ± 16.72 pg/ml [mean ± standard error of mean]) and higher sFlt-1 levels (2932.81 [1802.33–5760.46] pg/ml vs. 1114.94 [655.03–2694.35] Median [Range]; P

PET and PET/CT has been used for the management of breast cancer for initial staging, monitor the treatment response, detect recurrences, and predict tumor behavior. It has found to be useful in detecting primary breast cancer in patients with large primary tumors. However, it has not been used routinely for early diagnosis of primary breast cancer due to certain limitations. In this article, the authors discuss various important factors that can lead to false-negative and false-positive results in PET and PET/computed tomography imaging used for the diagnosis of primary breast cancer.

Aim: The present study aimed to evaluate and compare the placental variables of oxidative stress markers in preeclamptic women. Methods: A total of 60 placentas were collected. Of these, 30 were obtained from normotensive pregnancies, and 30 from pregnancies with preeclampsia as per International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Each placental tissue was analyzed for levels of pro-oxidant (malondialdehyde) and antioxidants (glutathione and superoxide dismutase) using the standard enzymatic assays. Results: Malondialdehyde levels were significantly higher (12.21 ± 4.1 versus 4.7 ± 2.1 nmol/g tissue, P

Objective: Variations in the arterial supply of human kidney have been observed frequently, either in routine dissections or surgical practice. The main objective of the present study was to describe the arterial segmental pattern of human kidneys and its variation by angiography and corrosion cast techniques. Materials and Methods: Forty kidneys were washed and a plastic cannula was inserted into renal artery and the omnipaque dye was injected into it and X-ray was taken. The corrosion casts were prepared by injecting coloured acetate butyrate (CAB) granules solution. Results: Five vascular segments of kidney were seen based on the branching pattern of the renal artery by angiography and corrosion cast techniques. The renal artery was divided into anterior and posterior branches. The anterior branch further divided into four branches viz. apical segmental artery (ASA), Upper segmental artery (USA), middle segmental artery (MSA), lower segmental artery (LSA) while the posterior branch continue as posterior segmental artery. The origins of segmental arteries were variable. In 60% cases apical segmental artery (ASA) had common origin with upper segmental artery (USA) while in 40% cases it took origin directly from the main renal artery. Similarly the variations in the origin of the other branches of anterior division of renal artery were observed. The posterior segmental artery (PSA) however was single and comparatively small and supplied the posterior surface of the kidney. Conclusion: The knowledge of the vascular pattern of the kidney is thus important for the purpose of angiography and surgical procedures especially for nephrectomy and kidney transplantation.

Background Obesity is recognized as a social problem, associated with serious health risks and increased mortality. Numerous trials have been conducted to find and develop new anti-obesity drugs through herbal sources to minimize side effects associated with the present anti-obesity drugs. The present study was designed to evaluate the quality control parameters, quantitative phytochemical analysis (total phenolic, total flavonoids and total saponin content), and the anti-obesity effect of lyophilized juice (LJ) of Stellaria media (Linn.) Vill. by employing in vitro and in vivo models. Methods In vitro studies were performed to evaluate the inhibitory activity of LJ on pancreatic amylase and lipase. The in vivo pancreatic lipase activity was evaluated by measurement of plasma triacylglycerol levels after oral administration of lipid emulsion to swiss albino mice. Furthermore, the anti-obesity effect of LJ was assessed at two doses, 400 mg/kg and 900 mg/kg body weight in mice fed a high-fat-diet with or without LJ for 6 weeks. Results The LJ inhibited pancreatic amylase and lipase activity in vitro and elevated plasma triacylglycerol level in mice. LJ suppressed the increase in body weight, retroperitoneal adipose tissue, liver weights and serum parameters viz., total cholesterol, total triglyceride, LDL-cholesterol level at the dose of 900 mg/kg body weight of the mice fed with high fat diet. The total phenolic, flavonoid and saponin contents were found to be 0.26 mg/g, 1.4 mg/g and 1.19 μg/g respectively of LJ. Conclusion The anti-obesity effects of LJ in high-fat-diet fed mice may be partly mediated through delaying the intestinal absorption of dietary fat and carbohydrate by inhibiting digestive enzymes.

Maturation of neurons of the myenteric plexus (MP) of human fetal sigmoid colon was studied at various weeks of gestation (WG). There is abundant literature on the development of MP in various segments of the gut but there are fewer reports on the development of MP in human sigmoid colon which is a site of various disorders. Sigmoid colonic segments from 12 aborted foetuses aged 14-23WG were processed for NADPH histochemistry. Stereologic evaluation of the neuronal cell profiles, numerical density, number of neurons per ganglion and myenteric fraction was conducted using using imageJ software. According to gestational age, foetuses were assigned into two groups (group 1 [n=7], less than 17WG). The overall size of neuronal cell profiles in the MP was significantly increased (P

The objective of the study was to observe and document the variation on the subject of branches of the median nerve. This report will assist clinicians and surgeons by considering anatomical variation associated with the median nerve in interpreting atypical clinical presentations. The arm and forearm region of a 55 year embalmed male cadaver during educational gross anatomy dissection. We found that an anomalous cutaneous branch arising from the median nerve in the right arm which was passing deep to the tendon of the biceps brachii. Later it enters the cubital fossa and then it is accompanied by the superficial vein of the forearm. The other limb of the cadaver did not show any such variation. No other neural, arterial or muscular variation was observed in either of the limbs. A rare anatomical variation in which the anomalous cutaneous branch arising from the median nerve in the right arm which is later accompanied by a superficial vein in the forearm. Such knowledge is advantageous in nerve grafting and neurophysiological evaluation for diagnosing peripheral neuropathies.