Study of duodenal ulcer disease in 100 families using total serum pepsinogen as a genetic marker

Although various markers have been used in attempts to elucidate the mode of inheritance of duodenal ulcer, they have not significantly contributed to a clear understanding of the problem. In the present study total serum pepsinogen was used as a genetic marker and its concentrations were estimated in 100 ulcer patients and their family members up to three generations. Eighty three per cent of the ulcer patients had hyperpepsinogenaemia on a familial basis, and it followed an autosomal dominant mode of inheritance. Thus a large majority of ulcer patients have associated hyperpepsinogenaemia which forms a genetic basis of their disease. The remaining 17% ulcer patients did not have associated hyperpepsinogenaemia nor was the ulcer inherited by the family. Based on these observations we wish to suggest that duodenal ulcer associated with hyperpepsinogenaemia may be considered a genetic disease. This type may be termed 'primary duodenal ulcer'. In the remaining patients without hyperpepsinogenaemia or affected relatives the ulcer may be called 'secondary duodenal ulcer'. Thus total serum pepsinogen may be considered a reliable genetic marker in helping to delineate the genetic disorder from the non-genetic, thereby improving the predictive ability in duodenal ulcer.     

Therapies to increase high-density lipoprotein cholesterol and their effect on cardiovascular outcomes and regression of atherosclerosis

Epidemiological studies have shown that decreased level of high-density lipoprotein (HDL) cholesterol (C) is an independent inverse predictor of coronary artery disease (CAD) even in patients with normal levels of low-density lipoprotein (LDL)-C. There is an abundance of evidence in favor of statins and aggressive LDL-C lowering therapy for both primary and secondary prevention of CAD. In contrast, the evidence for reduction of CAD risk with HDL-C raising therapy is relatively thin, partly due to the paucity of effective and safe drugs for increasing HDL-C level. However, there are emerging new therapies for raising HDL-C level and growing evidence in favor of pharmacologic therapies to raise HDL-C level. We present in this article a review of pharmacologic therapies that are currently available to increase HDL-C level, their safety and efficacy in relation to cardiovascular endpoints.     

Induction of Mitochondrial Dysfunction and Oxidative Stress in Leishmania donovani by Orally Active Clerodane Diterpene

This study was performed to investigate the mechanistic aspects of cell death induced by a clerodane diterpene (K-09) in Leishmania donovani promastigotes that was previously demonstrated to be safe and orally active against visceral leishmaniasis (VL). K-09 caused depolarization of the mitochondrion and the generation of reactive oxygen species, triggering an apoptotic response in L. donovani promastigotes. Mitochondrial dysfunction subsequently resulted in the release of cytochrome c into the cytosol, impairing ATP production. Oxidative stress caused the depletion of reduced glutathione, while pretreatment with antioxidant N-acetyl cysteine (NAC) was able to abrogate oxidative stress. However, NAC failed to restore the mitochondrial membrane potential or intracellular calcium homeostasis after K-09 treatment, suggesting that the generation of oxidative stress is a downstream event relative to the other events. Caspase-3/-7-like protease activity and genomic DNA fragmentation were observed. Electron microscopy studies revealed gross morphological alterations typical of apoptosis, including severe mitochondrial damage, pyknosis of the nucleus, structural disruption of the mitochondrion-kinetoplast complex, flagellar pocket alterations, and the displacement of organelles. Moreover, an increased number of lipid droplets was detected after K-09 treatment, which is suggestive of altered lipid metabolism. Our results indicate that K-09 induces mitochondrial dysfunction and oxidative stress-mediated apoptotic cell death in L. donovani promastigotes, sharing many features with metazoan apoptosis. These mechanistic insights provide a basis for further investigation toward the development of K-09 as a potential drug candidate for VL.     

Detubularized sigmoid reservoir for bladder replacement after cystoprostatectomy: Preliminary report of new configuration

A technique for total bladder replacement using a detubularized sigmoid segment is described. The procedure is technically straightforward and results in a highly compliant, low-pressure reservoir that allows both day and night-time continence.     

Amniotic membrane is an effective burn dressing material

Human amniotic membrane is a readily available biological dressing material used to treat burns. It not only prevents oozing of plasma from burn wounds but also relieves pain and controls sepsis. We used human amniotic membrane to treat fifteen burn patients, and this material was effective. The application of this cost-free dressing material warrants further study as it can be made use of in areas where expensive and specialized equipment is not available.