Successful closure of spontaneous esophageal perforation (Boerhaave's syndrome) by endoscopic clipping.

Endoscopic clips have been used mainly for control of gastrointestinal (GI) bleeding and occasionally for closure of GI perforations. However, closure of spontaneous esophageal perforation (Boerhaave's syndrome) by clipping has not been reported. We described successful non-surgical closure of spontaneous esophageal perforation by endoscopic clipping in a patient with bilateral pyopneumothorax and septicemia.     

Absence of a relationship between umbilical cord thickness and coiling patterns.

OBJECTIVE: The purpose of this study was to evaluate a relationship between the umbilical cord thickness and cord coiling patterns during the fetal sonographic anatomic survey in the second trimester of pregnancy. METHODS: This was a prospective study of 470 patients with singleton pregnancies who had a fetal anatomic survey with recorded umbilical coiling patterns between 18 and 23 weeks' gestation. The umbilical cord thickness was assessed as an umbilical diameter at the level of the fetal abdominal cord insertion and compared with the antenatal umbilical coiling index (aUCI), calculated as a reciprocal value of the distance between a pair of umbilical cord coils. RESULTS: Three hundred twenty-one patients had adequate sonographic umbilical cord images and maternal demographic, antenatal, and labor data to meet inclusion criteria. The mean aUCI was 0.41 with 10th and 90th percentiles of 0.21 and 0.60, respectively. A total of 10.6% (34/321) and 9.3% (30/321) of patients were categorized as having hypocoiled and hypercoiled umbilical cords, respectively. The mean cord diameter +/- SD was 9.48 +/- 0.97 mm (range 7.0-12.5 mm). There was no statistically significant correlation between aUCI and umbilical cord thickness (P = .1164). CONCLUSIONS: An aUCI, or umbilical coiling pattern, does not correlate with umbilical cord thickness. It appears that a lesser amount of the umbilical supportive tissue, mainly Wharton jelly, is not related to an increased umbilical cord coiling pattern.     

Nevirapine derivatives with broad-spectrum chemotherapeutic properties for the effective treatment of HIV/AIDS.

A series of nevirapine derivatives has been synthesized in an effort to enhance the spectrum of chemotherapeutic properties for the effective treatment of AIDS and AIDS-related opportunistic infections. The nevirapine derivative bearing isoniazid moiety (3a) was found to be the most potent compound with EC50 of<0.0636 microM, CC50 of>1000 microM and selectivity index of>15,723 which also exhibited 90% inhibition against Mycobacterium tuberculosis at 6.25 microg/ml. Compound 3c showed 100% inhibition against M. tuberculosis and also exhibited potent antibacterial activity against 24 pathogenic bacteria with MIC less than 1 microg/ml.     

Acute suppurative parotitis in a patient on total parenteral nutrition

A report of a patient who developed acute suppurative parotitis while on total parenteral nutrition for small bowel fistula is presented. The importance of early detection of parotitis as a cause of fever is emphasized. Attention to oral hygiene and early resumption of oral intake, whenever possible, are to be encouraged.     

Longitudinal analysis of B cell repertoire and antibody gene rearrangements during early HIV infection

In chronically HIV infected individuals, a number of functional B cell abnormalities have been described. However, the immediate changes that occur in the B cell compartment following viral exposure and how they affect the long-term course of infection are not well understood. We report the longitudinal analysis of B cell repertoires during early infection in untreated and treated individuals receiving highly active antiretroviral therapy (HAART). Analysis was based on IgG heavy chain gene utilization and CDR3 length measurement and relationship with CD4/CD8 counts, viral load, and total serum IgG, and anti-HIV antibodies levels. Repertoires were assessed at baseline and at weeks 2, 4, 12, 24, and 72 after initiation of therapy. The findings indicate a stable peripheral B cell repertoire during the first 72 weeks following infection, particularly in the HAART treated patients. A modest association between B cell repertoire integrity and viremia levels as well as treatment was detected.     

Synthesis and antimicrobial activity of Schiff and Mannich bases of isatin and its derivatives with pyrimidine.

Isatin and its derivatives have been reacted with 4-(4'-chlorophenyl)-6-(4"-methyl phenyl)-2-aminopyrimidine to form Schiff bases and the N-Mannich bases of these compounds were synthesized by reacting them with formaldehyde and several secondary amines. Investigation of antimicrobial activity of the compounds was made by the agar dilution method against 28 pathogenic bacteria, eight pathogenic fungi and anti-HIV activity against replication of HIV-1 (III B) in MT-4 cells. The compounds are significantly active against bacteria and fungi.     

Corneal absorption and anterior chamber pharmacokinetics of dipeptide monoester prodrugs of ganciclovir (GCV): in vivo comparative evaluation of these prodrugs with Val-GCV and GCV in rabbits.

AIM: The overall aim of this study was to evaluate the corneal absorption of dipeptide monoester prodrugs of ganciclovir (GCV) and compare these results with L-valine-GCV and GCV. Another aim was to evaluate the pharmacokinetics of these prodrugs in aqueous humor. METHODS: A well was placed on the cornea of anesthetized New Zealand albino rabbits with linear probes implanted in the aqueous humor. Two hundred microlitres (200 microL) of a 0.43% w/v (saturation concentration) solution of GCV and equimolar concentrations of its prodrugs, VGCV, glycine-valine-GCV (GVGCV), valine-valine-GCV (VVGCV), and tyrosine-valine- GCV (YVGCV), were placed in the corneal well and were allowed to diffuse for a period of 2 h. Subsequently, the drug solution was aspirated and the well removed. Samples were collected every 20 min throughout the infusion and postinfusion phases and were analyzed by high-performance liquid chromatography to determine the aqueous humor concentrations. RESULTS: Area under the concentration time profile (AUC)infinity and maximum concentration (Cmax) of YVGCV were found to be higher than other prodrugs. AUC of total GCV obtained from YVGCV administration was found to be twelvefold more than AUC of GCV and 6.2-fold more than AUC obtained with total GCV from VGCV administration. VVGCV also exhibited 3.2 times higher AUC relative to VGCV. Also, AUC and Cmax of regenerated GCV from YVGCV was 8.6 and 4.9 times more than GCV, respectively. VVGCV did not produce higher concentrations of GCV. Elimination half-life of regenerated GCV from YVGCV administration was observed to be 157 min. CONCLUSIONS: YVGCV and VVGCV exhibited superior corneal absorption and bioavailability, in comparison with GVGCV, VGCV, and GCV. Such facilitated absorption of prodrugs may be a result of a combination of transcellular passive diffusion and peptide transporter (PEPT1)-mediated transport across the corneal epithelium.     

Evaluation of Hydro-Alcoholic Extract of Eclipta alba for its Multidrug Resistance Reversal Potential: An In Vitro Study

The development of multidrug resistance (MDR) causes problems in the chemotherapy of human cancer. The present study was designed to evaluate and establish the role of Eclipta alba as MDR reversal agent using multidrug resistant hepatocellular carcinoma cell line (DR-HepG2). To develop DR-HepG2, hepatocellular carcinoma cell line (HepG2) was transfected with 2-Acetylaminofluorene (AAF) and Aflatoxin B1 (AFB). Cytotoxic effects of the Eclipta alba hydroalcoholic extract (EAE) and standard anti-ancer drug Doxorubicin (DOX) were determined in DR-HepG2 and the parental cells HepG2 using MTT assay. The expression level of MDR1 gene and P-glycoprotein (P-gp) level was analyzed by RT-PCR and western blotting. From the present investigation, it was found that EAE (10 and 20 μg/ml) could significantly inhibit cell proliferation in DR-HepG2 whereas DOX (0.5 μg/ml) could not because of enhancement effect of MDR1/P-gp. This study demonstrated for the first time the antiproliferative activities of EAE in multidrug resistant DR-HepG2 cells. The findings revealed that Eclipta alba components are effective inhibitors of MDR1/P-gp.