Major abdominal cancer resections in cirrhotic patients: How frequent is postoperative hepatocellular decompensation?

Background

The reported incidence of postoperative liver failure in cirrhotic patients is highly varied with diverse risk factors identified to predict risk, mainly drawn from organ or disease-specific studies. We aimed to assess risk factors for the development of postoperative liver failure in a specific cohort of patients with cirrhosis undergoing abdominal cancer resection.

Methods

From November 2007 to October 2012, 30 cirrhotic patients who underwent curative resection for abdominal cancer were analyzed. The postoperative trends in liver function were followed and the incidence of postoperative liver failure was demonstrated.

Results

Among the 30 patients, the tumors were located in the stomach (n?=?5), pancreas (n?=?5), colon/rectum (6), liver (n?=?11), gallbladder (n?=?1), and retroperitoneum (n?=?2). Eighteen (60 %) patients experienced postoperative liver failure of which 7 (23 %) patients required deviation from the clinical course or management. There was one mortality due to grade C liver failure and hepatorenal syndrome. On multivariate analysis, only age (>55 years) was found to be statistically significant to predict postoperative liver failure (p?=?0.024).

Conclusion

Liver dysfunction remains a major problem during the postoperative phase of major gastrointestinal cancer resections. However, less than one fourth of well-selected patients will develop significant postoperative liver failure. This incidence may be further reduced if the selection is restricted to younger patients.     

Evaluation of fatty acid profile in seed and oil of Manjari Medika,a novel Indian grape cultivar and its comparison with Cabernet Sauvignon and Sauvignon Blanc

The study investigated the profile of fatty acids (FA) in grape seed (GS) and grape seed oil (GSO) of a newly developed teinturier grape variety, named Manjari Medika (MM). FAs were identified and quantified by gas chromatography with flame ionisation detection. The identification of FAs was further confirmed using a GC with mass selective detector (GC-MS). The profiles of MM-GS and MM-GSO were compared with the corresponding products of two established varieties, viz. Cabernet Sauvignon (CS) and Sauvignon Blanc (SB). The unique FA profile of MM was differentiated from CS and SB through multivariate statistical analysis and pattern recognition of selective FAs. MM-GSO was found to be superior to SB-GSO and equivalent to CS-GSO in terms of FA profile. The presence of unsaturated FAs at a higher level and a favourable ratio of essential FAs (omega-6: omega-3) indicated the potential health benefits of MM- GS and GSO. The FA levels in MM-GSO were within or above the Codex standards for edible oil. The typical FA profile uniquely differentiated these three varieties of seeds and corresponding oils. The results formed the basis of a future endeavor in establishing their varietal authenticity.     

The 5α-reductase inhibitor finasteride reduces opioid self-administration in animal models of opioid use disorder

Opioid use disorder (OUD) has become a leading cause of death in the United States, yet current therapeutic strategies remain highly inadequate. To identify potential treatments for OUD, we screened a targeted selection of over 100 drugs using a recently developed opioid self-administration assay in zebrafish. This paradigm showed that finasteride, a steroidogenesis inhibitor approved for the treatment of benign prostatic hyperplasia and androgenetic alopecia, reduced self-administration of multiple opioids without affecting locomotion or feeding behavior. These findings were confirmed in rats; furthermore, finasteride reduced the physical signs associated with opioid withdrawal. In rat models of neuropathic pain, finasteride did not alter the antinociceptive effect of opioids and reduced withdrawal-induced hyperalgesia. Steroidomic analyses of the brains of fish treated with finasteride revealed a significant increase in dehydroepiandrosterone sulfate (DHEAS). Treatment with precursors of DHEAS reduced opioid self-administration in zebrafish in a fashion akin to the effects of finasteride. These results highlight the importance of steroidogenic pathways as a rich source of therapeutic targets for OUD and point to the potential of finasteride as a new treatment option for this disorder.     

Primary adenocarcinoma of lung: A pictorial review of recent updates

Primary adenocarcinoma of lung has replaced squamous cell carcinoma as the commonest histological subtype of lung cancer and the incidence of primary lung adenocarcinoma appears to be rising. Although the main factors behind this ‘epidemic-like’ situation are largely undiscovered, filter cigarettes appear to significantly contribute to this shift in the histopathological spectrum. The new multidisciplinary classification of adenocarcinoma of lung was introduced to address advances in clinical, pathological, radiological and molecular sciences. The purpose of this essay is to discuss various classes of lung adenocarcinoma in the new classification with their classical imaging features on computed tomography and summarise the recent advances in the field of radiology and review radiology recommendations.     

Potpourri of retinopathies in rare eye disease – A case series

This case series describes the ocular and retinal manifestations of rare eye diseases in systemic syndromes. This observational case series consists of five patients with varied ophthalmic manifestations and documentation of imaging in rare pediatric and adult retinopathies. Two patients had Kearns Sayre syndrome (KSS) based on the classical triad of external ophthalmoplegia, pigmentary retinopathy, and onset before 20 years of age. In one patient of KSS, the mitochondrial retinopathy was seen in an asymmetric pattern, and the second patient presented with KSS after being mis-diagnosed as myasthenia gravis elsewhere. A case of Senior Loken syndrome in pediatric age is described in this series with varied ophthalmic manifestations ranging from retinitis pigmentosa to orbital abscess. This series also enlightens features of Hallervorden Spatz syndrome presenting with bull’s eye maculopathy and a case of spino-cerebellar ataxia type 7 presenting with pigmentary retinopathy.     

Incidence,mortality and bacteriological profile of septicemia in pediatric patients

A study of the blood cultures of 326 pediatric septicemia cases showed 189 (59.9%) to be positive for bacterial growth; of these 117 (61.9%) expired. Gram negative bacteremia (136) were more common than Gram positive (53). Commonly isolated organisms were Klebsiella, Coagulase Positive Staphylococci and Pseudomonas. Antibiotic susceptibility pattern revealed the isolates to be resistant to commonly used antimicrobial agents.     

Rosiglitazone attenuates the cognitive deficits induced by high fat diet feeding in rats

The present study was designed to test the hypothesis that insulin resistance plays a role in high fat diet feeding induced cognitive deficits. Rats consuming the high fat diet exhibited characteristic features of insulin resistance viz. mild hyperglycemia, hypertriglyceridemia, hypercholesterolemia, and hyperinsulinemia. Further, these rats showed a severe deficit in learning and memory. In contrast, rosiglitazone at the dose of 5 mg/kg, p.o. for 7 days prior to biochemical and behavioral testing significantly lowered the plasma glucose, triglycerides, cholesterol, and insulin levels. These animals also performed better on Morris water maze task, suggesting improved spatial memory. Our data demonstrate that the insulin sensitizers can overcome the cognitive deficits arising from high fat diet feeding, which may be in part mediated through the development of peripheral insulin resistance.     

Change in post-translational modifications of histone H3, heat-shock protein-27 and MAP kinase p38 expression by curcumin in streptozotocin-induced type I diabetic nephropathy

BACKGROUND AND PURPOSE: Curcumin has been used to treat cancer, diabetes and other pathologies. However, little is known regarding its role in altering post-translational modifications of histone H3. A recent report suggests that acute hyperglycaemia induces a global down-regulation of gene expression in human tissues and epigenetic regulation of gene expression could be a novel mechanism underlying the pathological processes of hyperglycaemia. The present study was undertaken to examine changes in histone modification by curcumin treatment which prevents development of type I diabetic nephropathy. EXPERIMENTAL APPROACH: Male Sprague-Dawley rats were rendered diabetic using a single dose of streptozotocin (55 mg kg(-1), i.p.). Diabetic nephropathy was assessed by measurements of blood urea nitrogen, albumin and creatinine levels. Post-translational modifications of histone H3, heat shock protein-27 (HSP-27) and mitogen-activated protein (MAP) kinase p38 expression were examined by western blotting. KEY RESULTS: Treatment of diabetic rats with curcumin significantly decreased blood urea nitrogen and creatinine and increased albumin; variables associated with the development of diabetic nephropathy. There were also increased levels of HSP-27 and MAP kinase (p38) in diabetic kidney. However, curcumin treatment prevented this increase in HSP-27 and p38 expression. Moreover, at nuclear level curcumin prevented the decrease in dephosphorylation and increases acetylation of histone H3. CONCLUSIONS AND IMPLICATIONS: Our results suggested that protection against development of diabetic nephropathy by curcumin treatment involved changes in post-translational modifications of histone H3, expression of HSP-27 and MAP kinase p38 in diabetic kidney.     

In Vitro Propagation of <Emphasis Type="Italic">Ceropegia anjanerica</Emphasis> Malpure et al.: A Rare Endemic Plant from Maharashtra

An in vitro micropropagation system has been developed for the Ceropegia anjanerica Malpure et al., a rare endemic plant species having ornamental as well as medicinal potential but a limited reproductive capacity. Axillary bud explants were cultured on Murashige and Skoog medium supplemented with 6-Benzylaminopurine, Thidiazuron and 6-Furfurylaminopurine along with combination of Indole-3-Butyric Acid. Although all concentrations showed multiple shoot formation, the best results (8.0 ± 0.5) were achieved with MS + 6-Benzylaminopurine (8.87 µM) + 6-Furfurylaminopurine (18.58 µM). Half strength Murashige and Skoog medium fortified with Indole-3-Acetic Acid (8.56 µM) showed good rooting response (4.0 ± 0.7). Well grown plantlets hardened, acclimatized and established in greenhouse exhibited 78 % survival.