Exacerbation of acute pancreatitis by combined cholinergic stimulation and duct obstruction

BACKGROUND: The role of cholinergic pathways in the pathogenesis of bile-pancreatic duct ligation (BPDL)-induced acute pancreatitis in rats remains controversial. We hypothesized that cholinergic stimulation exacerbates acute pancreatic inflammation in the presence of duct obstruction. METHODS: We studied 34 rats divided into 5 groups as follows: (1) sham operation; (2) BPDL; (3) BPDL with duodenal bile-pancreatic juice (BPJ) replacement fresh from a donor rat; (4) BPDL with BPJ replacement as in 3 above, and carbachol (CCh) 5 ug/h subcutaneously; or (5) CCh 5 ug/h subcutaneously only. Rats were killed after 6 hours. RESULTS: The P value was less than .05 by analysis of variance. Pancreatic morphologic changes and zymogen fraction hyperamylasemia seen with duct ligation (2 vs. 1) were ameliorated significantly by duodenal BPJ replacement (3 vs. 2), but not when exogenous CCh was administered (4 vs. 3), whereas CCh alone showed no significant changes compared with sham (5 vs. 1). CONCLUSIONS: Cholinergic stimulation and duct obstruction synergistically amplify acinar hyperstimulation and exacerbate acute pancreatitis.     

Arthroscopic reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone autograft: experience of the first 100 cases

PURPOSE: To review the results of patients who underwent arthroscopic reconstruction of the anterior cruciate ligament (ACL) via a single incision technique using a bone-patellar tendon-bone autograft. METHODS: Patients with ACL-deficient knees who were symptomatic and wanted to maintain an active lifestyle or continue sporting activities were included. ACL reconstruction using the bone-patellar tendon-bone graft was performed on 100 patients. One-year follow-up was completed in 78 patients who were then reviewed. The mean age of patients reviewed was 26.8 years (range, 21-39 years), of whom 35 (44.9%) were aged between 26 and 30 years. There were 73 men and 5 women (ratio, 14.6:1). Injuries on the right side outnumbered those on the left (44 versus 34). Sports injuries accounted for 66.7% (n = 52) of patients, motor vehicle accidents and household injuries accounted for 30.8% (n = 24) and 2.6% (n = 2), respectively. RESULTS: Excellent and good-to-excellent results were achieved in 7 (9%) and 61 (78.2%) of patients. Residual anterior knee pain (n = 18) was the most common complication, followed by difficulty in regaining full range of motion (n = 10) and divergence of femoral screw (n = 9). CONCLUSION: This procedure provides consistent and reproducible results in carefully selected patients and allows them an early return to sporting activities with minimal residual morbidity.     

Squamous cell carcinoma lower lip - an experience with Karapandzic technique

Carcinoma of the lip is a common cancer of head and neck area. It occurs frequently on the lower lip of middle-aged and elderly males who have a history of chronic sun exposure. Surgical excision and radiotherapy are regarded as equally effective treatment options, but preferred method is surgical excision. Karapandzic technique provides myoneurovascular pedicled advancement flap for reconstruction of the defect after surgical excision. It is a simple and safe technique, functionally and esthetically, sacrifices little tissue, heals rapidly and is effective for repair of defects covering 1/3 to 4/5 of the lower lip. We report a 62 years male who presented with a large, fungating, pus-discharging and tender mass of lower lip. Biopsy confirmed squamous cell carcinoma. Tumor was excised and defect was reconstructed using Karapandzic technique. Patient remained asymptomatic during follow-up visits.     

Kidney-bone, bone-kidney, and cell-cell communications in renal osteodystrophy

The relationship between bone and the kidney in renal osteodystrophy is a complex interplay of kidney to bone connections, bone to kidney connections, and cell to cell connections. In addition, such interactions have a profound effect on the vasculature. In this review, we discuss the role of the bone morphogenetic proteins (BMPs) in the skeleton, kidney, and vasculature. In addition, we propose that deficiencies of these BMPs seen in chronic kidney disease (CKD) result in decreased bone remodeling and a compensatory secondary hyperparathyroidism (high turnover state). Treatment of the hyperparathyroidism blocks this compensatory arm and thus decreased bone remodeling occurs (low turnover). We review animal models of CKD in which treatment with BMP-7 resulted in normalization of both high and low turnover states. Finally, we discuss vascular calcification as it relates to bone metabolism. We discuss the roles of BMP-7 and 2 other bone regulatory proteins, osteoprotegerin (OPG) and alpha2-HS glycoprotein (AHSG, human fetuin), in the human vasculature and their implications for vascular calcification.     

Surgical Management of Breast Cancer in Saudi Arabia before and after Outreach Activities

We collected management information from the 1996 referral documents of 100 consecutive patients who came to us for continued treatment of breast cancer. Major deficiencies were noted with regard to clinical assessment, surgery, and pathology. Since 1997 we have intensified our personnel contacts with referring surgeons, and we have performed outreach visits. To measure the effect of our efforts, we repeated the same collection of information between March 2001 and March 2002. Correct performance of TNM (tumor, node metastasis) classification decreased from 36%–16%. The use of mammography increased from 29%–56%, application of fine needle aspiration (FNA) increased from 46%–70%, and use of core needle biopsy (CNB) increased from 0%–6%. The rate of performance of triple assessment (including correct performance of TNM) was 9% and is now 10%. The number of patients who had surgery before referral decreased from 84%–46%. A proper metastatic work-up in the present study was performed in 10% of patients, and mammography was performed in 33% of the patients who had either modified radical mastectomy (MRM) or breast conserving therapy (BCT). Previously, 78 patients had 98 operations before referral and 75% of those needed additional surgery; now only 9 patients out of 39 who had incisional biopsy or lumpectomy needed further surgery. The median number of lymph nodes now is 10, whereas previously 42% of the axillary dissections yielded < 8 lymph nodes. Pathology reports mentioning both tumor size and surgical margins have increased from 29%–53%. These new data indicate that there is a need to join all hospitals in a national guidelines plan for the management of breast cancer.     

Antifertility effects of methanolic pod extract of Albizzia lebbeck （L.） Benth in male rats

Aim: To evaluate the antifertility activity of the methanolic pod extract of Albizzia lebbeck (L.) Benth in male albino rats. Methods: The methanolic pod extract of Albizzia lebbeck was administrated orally for 60 days at 50, 100 and 200 mg·kg-1·day-1 to male albino rats. Sperm motility and density in cauda epididymides were assessed. Biochemical and histological analysis were performed in blood samples and reproductive organs. Results: A. lebbeck pod extract brought about a significant decrease in the weights of testis, seminal vesicles, epdidymis and ventral prostate. The sperm motility and density were significantly reduced. There was a marked reduction in the numbers of primary spermatocytes, secondary spermatocytes and spermatids. The Sertoli cell count as well as its cross sectional surface area were significantly decreased. The Leydig cell nuclear area and the number of mature Leydig celis were also significantly decreased. The protein, glycogen and cholesterol content of the testis, the fructos     

Potent inhibition of respiratory syncytial virus by combination treatment with 2-5A antisense and ribavirin

Respiratory syncytial virus (RSV) is a major cause of lower respiratory diseases in infants, young children, and the elderly. Ribavirin, the only currently approved drug for the treatment of RSV infections in the U.S., requires high doses to be effective. Therefore, it has only a limited clinical efficacy in the treatment of RSV infections. It has been shown that a cellular ribonuclease, RNase L, can be recruited by 2'-5' linked tetra-adenylates (2-5A) attached to an antisense sequence complementary to the RSV genome to specifically cleave RSV genomic RNA. Here we confirm the antiviral activity of the lead 2-5A antisense compound, RBI034, by using several different viral assays. We demonstrate that RBI034 is more efficient than antisense lacking 2-5A or small interfering dsRNA (siRNA) in inhibiting RSV replication. Although the best antiviral activity of RBI034 was observed with co-treatment of RSV infection, it remained effective even when administered 24 h after the initiation of infection. Interestingly, the activity of RBI034 can be further enhanced by a combination treatment with ribavirin. At suboptimal concentrations, neither ribavirin nor RBI034 was effective in suppressing RSV replication. However, a combination of these two drugs at the same suboptimal concentrations showed a potent inhibitory activity. The potent reduction of RSV replication by combination treatment was also confirmed in primary human airway epithelial cells. Therefore, a combination therapy of the 2-5A antisense compound RBI034 and ribavirin might be a more effective therapeutic approach for treating RSV infections than ribavirin alone.     

An unusual case of primary nasal tuberculosis with epistaxis and epilepsy

Primary nasal tuberculosis is rare. We report a case that was all the more extraordinary because of the age and sex of the patient (an 11-year-old boy), the unusual associated symptoms (epistaxis and grand and seizures), and the presence of intracranial extension. Clinical and radiologic findings on our initial evaluation suggested that the patient had a large sinonasal malignancy. The patient manifested no evidence of pulmonary tuberculosis. The diagnosis of primary nasal tuberculosis was established only after we obtained the results of histopathology of the excised mass and a subsequent tuberculin skin test; the diagnosis was confirmed by the patient's rapid response to antituberculosis drug therapy. We also review the relevant literature on this rare condition.     

Effect of textile waste water on the spermatogenesis of male albino rats

Textile waste water released from dyeing and printing industries situated in Sanganer, Jaipur (India), brought about inhibition of spermatogenesis in male rats. Water analysis showed the presence of heavy metals at more than permissible limits. Oral administration of waste water to the rats at the dose level of 26.6 ml kg(-1) body wt. significantly reduced the weights of testes, epididymides and seminal vesicle. Treated animals showed a notable depression of various stages of spermatogenesis. The production of spermatids was inhibited by 70.8% in waste-water-treated rats. The populations of spermatogonia, preleptotene spermatocytes and secondary spermatocytes were decreased by 67.2, 71.1 and 73.2%, respectively. The total number of Sertoli cells was affected after waste water treatment. Reduced sperm count and motility resulted in treated groups. A significant fall in the content of various biochemical parameters of reproductive tissues was observed after water treatment.