Duodenogastric reflux after choledochoduodenostomy

Duodenogastric reflux (DGR) has been implicated in several disease processes. The present study was carried out to document the incidence and evaluate the clinical significance of DGR after choledochoduodenostomy (CDD). A total of 13 patients who had undergone cholecystectomy with a standard side-to-side CDD for choledocholithiasis or chronic pancreatitis were studied by symptom evaluation, scintigraphy, endoscopy, and gastric mucosal histology at least 6 months after surgery. The scintigraphic findings were then compared with those of 10 patients who had undergone cholecystectomy alone. Only two patients (15%) had mild dyspeptic symptoms. The incidence of DGR after CDD was 69% compared to 20% in the cholecystectomy alone group (P < 0.05). In the majority of patients the DGR was only mild to moderate and the severity correlated well with the degree of endoscopic gastritis, but not with the clinical symptoms or histological findings. These results indicate that while CDD is associated with a high incidence of DGR, its occurrence does not produce significant clinical symptoms.     

The influence of pentoxifylline on motility and viability of spermatozoa from normozoospermic semen samples

In order to evaluate the effects of pentoxifylline on sperm motility and longevity, a controlled in-vitro study was conducted on normozoospermic donor semen samples using the Cellsoft automated system for sperm motility analysis. After incubation and selection, pentoxifylline was found to improve the recovery of spermatozoa and to increase their velocity. In the subgroup of progressively motile spermatozoa, curvilinear velocity was also enhanced. It is concluded that pentoxifylline has an effect on the vigour, but not on the pattern, of sperm motion. Pentoxifylline did not improve the motility characteristics of senescent spermatozoa in normozoospermic sperm samples. Sperm survival, as shown by supra-vital staining, and motility longevity both decreased with time after pentoxifylline treatment.     

Human immunodeficiency virus isolates from asymptomatic homosexual men and from AIDS patients have distinct biologic and genetic properties.

Human immunodeficiency virus type 1 (HIV-1) isolates from asymptomatic homosexual men and AIDS patients were compared for their in vitro biologic and genetic properties. Most of the HIV-1 isolates from asymptomatic men, but not from AIDS patients, failed to infect CD4+ H9 cells and phytohemagglutinin-stimulated peripheral blood lymphocytes. In a longitudinal study, serial HIV-1 isolates obtained from men who seroconverted to HIV-1 and later developed AIDS were able to infect H9 cells. In contrast, longitudinal isolates from men who remained asymptomatic did not infect H9 cells. HIV-1 isolates from AIDS patients in general exhibited increased production of intracellular viral DNA, RNA, and protein as compared to isolates from asymptomatic men. Cells infected with HIV-1 isolates from asymptomatic men produced very little gp120, p24, and p55 proteins as compared to those from AIDS patients. The overall restriction patterns of HindIII, Sac-1, Pst-1, EcoR1, and BamH1 were very similar between HIV-1 isolates from asymptomatic men and those from AIDS patients. However, the restriction endonuclease pattern of BglII was quite distinct for isolates from asymptomatic men as compared to AIDS patients. Preliminary studies mapped a unique BglII site in the gag region of most of the isolates from asymptomatic men, approximately 2.0 kb from the 5' end. Thus, HIV-1 isolates from asymptomatic subjects and from AIDS patients have distinct biologic and genetic properties which may be related to the various clinical outcomes of HIV-1 infection.     

Is ribosomal cistron activity increased in human lymphoblastoid cell lines?

The genomic activity of nucleolar organizer regions (NORs) in eight human B-cell lymphoblastoid cell lines was studied following the routinely used Ag-NOR technique. The results demonstrate that (a) Ag-NORs are located in the short arms of D- and G-group chromosomes, (b) two out of eight cell lines have 66.7% and 49.0% of metaphases, respectively, with 9 to 10 active Ag-NORs, and (c) as a whole, Ag-NOR activity is much higher in B-cell lines as compared with conventional 72-hr peripheral blood lymphocyte (T-cell) harvests.     

Influence of family history of morbid cardiovascular events on blood pressure levels of school children

The influence of family history of hypertension, myocardial-infarction and/or stroke on the blood pressure levels of 3,194 children in the age group 5-15 years was studied. Compared to children of normotensive parents, subjects coming from families with history of uncomplicated hypertension, complicated hypertension (hypertension plus myocardial infarction or stroke) and myocardial infarction or stroke without history of hypertension tended to have significantly higher levels of both systolic and diastolic pressures (p less than 0.001) in both the sexes in all age groups studied. Further, 15 (4.83%) of the children coming from families with positive history of one of the aforesaid morbid cardiovascular events had persistent hypertension (BP greater than mean +2 SD for age and sex). On the contrary only one (0.03%) of the 2,884 children belonging to normal parents had persistent hypertension. All the 16 children with sustained hypertension had only mild hypertension and were asymptomatic. Ten (62.5%) of them were obese (weight/height2 greater than 2.26). Baseline investigations failed to detect underlying cause to account for raised blood pressures in 9 of the 16 cases that could be investigated. These findings suggest that children of people with hypertension or other morbid cardiovascular events are more likely to have persistently elevated blood pressures than children from families without such a history.     

Single-stage repair of severe hypospadias using bladder mucosa graft

Our experience of single-stage repair of severe hypospadias (penoscrotal, scrotal, and perineal) in 30 children using urinary bladder mucosa for urethroplasty is reported. These children had severe chordee, small prepuce, and often ventral transposition of the penis with bifid scrotum where Devine and Horton, Asopa, or Duckett techniques are not so suitable. The graft uptake was uniformly satisfactory. Ten patients had complications; most of the fistulae healed spontaneously. Surgical intervention was required in 2 cases only: 1 for a fistula and another for a stricture with fistula. Meatal stenosis, seen in 4 cases, led to delayed distal fistulae in 2, which healed spontaneously with meatal dilatation. Regular dilatation of the external meatus is recommended to prevent this problem.     

Biological standardization of pollen allergens from India.

Standardization of allergens are achieved by in vitro and in vivo methods. Some of the allergens from Western countries are standardized using biological potency of the extracts but no attempt has been made till now to standardize any of the pollen extracts from India based on biological units. Therefore, we have attempted to standardize two important pollen allergens Ricinus communis and Holoptelea integrifolia by biological methods. Broadly the methods adopted by Dreborg and Grimmer (1983) was followed. Skin prick tests were carried out with the extracts of R. communis and H. integrifolia on 15 allergic patients in five three fold log dilutions starting with 1:10, in 50% glycerinated buffer. Glycerinated buffer (50%) and histamine dihydrochloride (1 mg/ml) were used as negative and positive controls, respectively. The mean wheal diameter obtained with different concentrations showed a gradual systematic fall with increase in dilution. The mean relative diameter (% of histamine reaction) varied from 124.1 +/- 8.9 to 33.7 +/- 6.1 and 78.9 +/- 5.5 to 21.4 +/- 3.8 with the highest and lowest concentrations of R. communis and H. integrifolia pollen antigens, respectively. The histamine equivalent concentration of antigen 1,000 Biological Units (BU) obtained for crude pollen extracts of R. communis and H. integrifolia was 1:17 and 1:22 respectively.     

Age and gender related changes in stereoselective pharmacokinetics and pharmacodynamics of verapamil and norverapamil.

1. Pharmacokinetics and pharmacodynamics of R- and S-verapamil and R- and S-norverapamil were studied at steady state following administration of 180 mg verapamil delivered by a controlled-release gastrointestinal therapeutic system (COER-verapamil). 2. Of the 30 young (19 to 43 years) and 30 elderly subjects (65 to 80 years) enrolled, approximately half of each age group were women; all subjects were healthy and none were smokers. 3. Mean R- and S-verapamil and R- and S-norverapamil Cmax, Cmin, and AUC values for elderly subjects were 1.2 to 2.2 times greater than those for young subjects; these differences were statistically significant at P < 0.05. Median tmax values for young and elderly subjects were not significantly different for any enantiomer. The mean half-life values of R- and S-verapamil for elderly subjects were approximately 20 h compared with approximately 13 h for young subjects, respectively. The mean half-life values of R- and S-norverapamil for elderly subjects were approximately 31 h and 20 h, respectively, compared with approximately 19 h and 21 h for young subjects, respectively. 4. In both age groups, the mean plasma verapamil concentrations of each enantiomer were higher for women than for men at all time points. 5. Mean arterial pressure (MAP) had a significant correlation to R- (r2 = 0.86) and S-verapamil (r2 = 0.87) concentration values that was not influenced by either gender or age of the patient. Change in PR-interval also had a significant correlation to R- and S-verapamil concentration values. However, the sensitivity of the response to changes in R- and S-verapamil concentration values in elderly subjects was about 1/5 of that in younger subjects.