Effect on Gastric Emptying and Weight Reduction of Botulinum Toxin-A Injection into the Gastric Antral Layer: An Experimental Study in the Obese Rat Model

Background: We investigated the effects of Botox-A on weight loss and gastric emptying in an experimental obese rat model. Although there is evidence of weight loss in normal-weight rats after Botox-A injection, there are no studies indicating the effect of Botox-A injection on weight loss and gastric emptying time in obese rats. Methods: 37 female Wistar Albino rats were given high calorie diet for 90 days. They were separated into 3 groups. The first group (Botox group) consisted of 15 obese rats whose gastric antrum was injected with 20 U of Botulinum Toxin Type A. The second group (Saline group) consisted of 15 obese rats whose gastric antrum was injected with 20 U of saline. The third group (Control group) had no surgical intervention. Gastric scintigraphy was performed in the 3 groups pre- and postoperatively. Results: The saline group had a weight reduction in the early postoperative days but began to gain weight thereafter. The mean weight of the Botox group between the 16th and 28th days postoperatively was significantly lower than the mean weights of the control and the saline groups (P<0.05, P<0.001). The results of gastric emptying scintigraphy in all 3 groups at day 20 revealed significantly higher T1/2 values in the Botox-A group when compared to the results of the control and saline groups (P<0.001). Conclusion: Botox-A application to the gastric antrum in obese rats leads to weight loss by increasing the gastric emptying time.     

Pre-ablative diagnostic whole-body scan following total thyroidectomy for well-differentiated thyroid cancer: is it necessary?

OBJECTIVE: This study reviewed the incidence of positive pre-ablative diagnostic scan after total thyroidectomy and the efficacy of the current ablative dose. The predictive factors for outcome using a standard ablative dose and postoperative complications of total thyroidectomy were also examined. METHODS: This was a retrospective review of patients referred for radioiodine ablation after total thyroidectomy between September 1997 and September 2001. RESULTS: Forty patients were included in this study, of whom 95% had a positive scan after total thyroidectomy. Of the 30 patients who underwent standard 80-mCi radioiodine ablation, 21 (70%) had successful single ablation while the remaining nine patients needed a higher ablative dose. There were no significant differences between patients who had successful ablation with the standard dose and those who did not in terms of tumour size, patient age, lymph node status and extra-thyroidal extension. Fifteen percent suffered from permanent hypoparathyroidism requiring calcium supplementation. Three patients had documented recurrent laryngeal nerve paralysis. CONCLUSION: Bypassing the pre-ablative diagnostic scan is feasible. The present ablation dose of 80 mCi of radioiodine is effective. The relatively high postoperative morbidity after difficult total thyroidectomy suggests less aggressive excision and postoperative radioiodine ablation of the remnant tissue.     

LncRNA调控肝脏疾病中信号转导通路的研究进展

肝脏疾病的发病率逐年上升,由于肝脏疾病发病诱因复杂和发病机制尚未阐明,治愈率不够理想,迫切需要明确其作用机制以找到更有效的治疗靶点与药物。长链非编码RNA(long non-coding RNA,lncRNA)作为一种长度超过200 nt的非编码RNA,是近年来肝脏疾病的研究热点。本文以肝脏疾病中主要的信号转导通路为主线,对近年来lncRNA调控肝脏疾病相关信号通路的最新研究进展进行归纳总结,详细阐述lncRNA通过调节肝脏疾病中关键的信号通路,参与细胞增殖、凋亡、侵袭、迁移等多种生理过程,从而促进肝脏疾病的发生发展,为肝脏疾病的机制研究提供新的思路,为寻找治疗肝脏疾病的新靶点及生物标志物提供新的研究方向。     

A comparison of different hemorrhoidectomy procedures

OBJECTIVE: To evaluate the pain level, analgesic consumption, operation time, bleeding and early complications after open and closed hemorrhoidectomy using a harmonic scalpel (HS) and classical methods. METHODS: Between January 2005 and January 2006, 87 patients with grade III-IV hemorrhoids, admitted in General Surgery Clinic, Gulhane Military Medical Academy, Ankara, Turkey were enrolled in the study. They were randomized into open HS (n=22), closed HS (n=22), Miligan Morgan (n=22), and Ferguson (n=21) hemorrhoidectomy. Patients were evaluated for postoperative pain, painkiller consumption, bleeding and operation time. RESULTS: Bleeding volume was significantly lower in Groups I-II (p<0.001). Operation time was significantly shorter in Group I (p<0.001). Postoperative pain and pain at the time of first defecation, was significantly lower in Groups I-III (p<0.001) compared with the other 2 groups and lower during days 2-6 in Group I compared to the Group III (p<0.004). Visual Analogue Scale results were similar in Groups II and IV. Analgesic consumption in Groups I-III was significantly lower than Groups II-IV (p<0.001). Oral analgesic consumption during 2-5 postoperative days was lower in Group I than in Group III (p<0.007) and similar in closed hemorrhoidectomy group. CONCLUSION: The use of HS in hemorrhoidectomy reduces postoperative pain, analgesic consumption, operation time, and bleeding. Harmonic scalpel hemorrhoidectomy is an effective, comfortable, and safe procedure. Use of suture in hemorrhoidectomy is a major cause of postoperative pain.     

Bioequivalence evaluation of two different formulations of ciprofloxacin tablets in healthy volunteers

INTRODUCTION: A bioequivalence study of two oral formulations of 500 mg tablets of ciprofloxacin (RAZA Pharmaniaga, Malaysia) as test and Ciprobay (Bayer AG, Germany) as reference, was carried out in 24 healthy human volunteers. Each volunteer received a single dose of ciprofloxacin. METHODS: The study method used was a double-blind, two-period, two-treatment, two-sequence, and crossover randomised design. Blood samples were taken before, and within 24 hours after drug administration. Plasma concentrations of ciprofloxacin were determined by a high-performance liquid chromatographic method with ultraviolet detection. The pharmacokinetic parameters, C(max) and T(max), were obtained directly from plasma data, k(e) was estimated by log-linear regression, and the area under the curve (AUC) was calculated by the linear trapezoidal rule. The parameters, AUC(0-infinity) and C(max), were tested for bioequivalence after log-transformation of data, while the differences of T(max) were evaluated nonparametrically. RESULTS: When AUC(0-infinity) and C(max) were analysed using analysis of variance, no statistically significant difference was observed between the two different formulations. The 90 percent confidence intervals of the mean values for the test/reference ratios were 0.95-1.07 for AUC(0-infinity) and 0.90-1.07 for C(max), respectively. Both of these values were within the bioequivalence acceptance range of 0.80-1.25. CONCLUSION: We found that both formulations are bioequivalent and, therefore, interchangeable.     

Standardizing Postoperative Complications—Validating the Clavien-Dindo Complications Classification in Cardiac Surgery

1. Download : Download high-res image (184KB)
2. Download : Download full-size image

     

Routine diagnostics for neural antibodies,clinical correlates,treatment and functional outcome

Objective

To determine frequencies, interlaboratory reproducibility, clinical ratings, and prognostic implications of neural antibodies in a routine laboratory setting in patients with suspected neuropsychiatric autoimmune conditions.

Methods

Earliest available samples from 10,919 patients were tested for a broad panel of neural antibodies. Sera that reacted with leucine-rich glioma-inactivated protein 1 (LGI1), contactin-associated protein-2 (CASPR2), or the voltage-gated potassium channel (VGKC) complex were retested for LGI1 and CASPR2 antibodies by another laboratory. Physicians in charge of patients with positive antibody results retrospectively reported on clinical, treatment, and outcome parameters.

Results

Positive results were obtained for 576 patients (5.3%). Median disease duration was 6 months (interquartile range 0.6–46 months). In most patients, antibodies were detected both in CSF and serum. However, in 16 (28%) patients with N-methyl-d-aspartate receptor (NMDAR) antibodies, this diagnosis could be made only in cerebrospinal fluid (CSF). The two laboratories agreed largely on LGI1 and CASPR2 antibody diagnoses (κ = 0.95). The clinicians (413 responses, 71.7%) rated two-thirds of the antibody-positive patients as autoimmune. Antibodies against the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), NMDAR (CSF or high serum titer), γ-aminobutyric acid-B receptor (GABABR), and LGI1 had ≥ 90% positive ratings, whereas antibodies against the glycine receptor, VGKC complex, or otherwise unspecified neuropil had ≤ 40% positive ratings. Of the patients with surface antibodies, 64% improved after ≥ 3 months, mostly with ≥ 1 immunotherapy intervention.

Conclusions

This novel approach starting from routine diagnostics in a dedicated laboratory provides reliable and useful results with therapeutic implications. Counseling should consider clinical presentation, demographic features, and antibody titers of the individual patient.

     

Midterm Outcomes of the Dissected Aorta Repair Through Stent Implantation Trial

1. Download : Download high-res image (134KB)
2. Download : Download full-size image

     

Expression of anti-heterogenous nuclear ribonucleoprotein (anti-hnRNP) in limited systemic sclerosis patients: Relation to radiographic findings of the hand

Background

Systemic sclerosis (SSc) is an autoimmune connective tissue disease with vascular, fibrotic and immune changes of skin and some internal organs. Anti-heterogeneous nuclear ribonucleoproteins (anti-hnRNP) were found in SSc patients.