105Changes in Nitric Oxide Levels After Deep Dermal injury in the Female,Red Duroc Pig (FRDP)

Introduction : Hypertrophic scar is a devastating sequel to burns and other tangential skin injuries. It follows deep dermal injuries and does not occur after superficial injuries. Nitric oxide (NO) plays many important roles in wound healing from inflammation to scar remodeling. Studies have shown that expression of nitric oxide synthase and nitric oxide production are decreased in human hypertrophic scar. However little is known about NO involvement in the early stages of hypertrophic scarring, because of the lack of an animal model. It was recently reported that the female red Duroc pig (FRDP) makes thick scar, which is similar to human hypertrophic scar. We hypothesized that NO production in wounds on the female, red Duroc pig is similar to that of human hypertrophic scar and that NO involvement in deep wounds is different from that in superficial wounds. Methods : Superficial (0.015” to 0.030”) and deep (0.045” to 0.060”) wounds were created on the backs of four FRDPs. Biopsies were collected at weeks 1.5, 4, 8 and 21 post wounding including samples of uninjured skin. Nitric oxide levels were measured with the Griess reaction assay and normalized with tissue protein level. Results : Superficial wounds healed with an invisible scar whereas the deep wounds healed with scar resembling mild hypertrophic scar. The thickness of the scars from the deep wounds was significantly greater than uninjured skin and healed superficial wounds (p < 0.01). NO levels were increased at 1.5 weeks in deep wounds compared to superficial wounds and uninjured skin (p < 0.05). At 8 weeks, NO levels in deep wounds had returned to the level of uninjured tissue and superficial wounds. By 21 weeks, NO levels had decreased significantly when compared to superficial wounds (p < 0.01). There were no differences in NO levels between uninjured skin and superficial wounds at any time point (p > 0.05). Conclusions : NO production is similar in late, deep wounds on the female, red Duroc pig to that reported in the literature for human hypertrophic scar further validating this animal model. NO production is quite different after deep wounds as compared to superficial wounds in the FRDP. Early elevation in nitric oxide production might account for excessive inflammation in deep wounds that become thick scars in the FRDP. Nitric oxide regulators and effects at early stages of scar formation should be elucidated further and the FRDP appears to be a useful model.     

Spontaneous perforation of the rectosigmoid colon: a report of 2 cases

Spontaneous perforation of rectosigmoid colon is rare but usually results in severe peritonitis, with very high mortality. Two cases of spontaneous rectosigmoid perforations are reported here along with a brief literatures review.     

阿卡波糖和二甲双胍治疗糖耐量异常合并代谢综合征的比较

目的:观察阿卡波糖和二甲双胍治疗对糖耐量异常合并代谢综合征的影响.方法:糖耐量异常并代谢综合征患者48例,分为2组,分别给予阿卡波糖50～100 mg,3次/d,即阿卡波糖组;或给予盐酸二甲双胍片250～500mg,3次/d,即二甲双胍组;疗程均为3 mo.结果:阿卡波糖组能显著控制餐后血糖,疗效优于二甲双胍,且具有调节血脂的作用,故可治疗2型糖尿病,改善代谢综合征,预防心血管疾病的发生.     

Laparoscopic hand-assisted versus open transhiatal esophagectomy: a case-control study

Background This case-control study evaluated and compared the outcomes of laparoscopically assisted (LTE) and open transhiatal esophagectomy (OTE).Methods In this study, 17 patients who underwent LTE during this period August 1999 through June 2003 were compared with 14 matched control patients who underwent OTE during this period December 1989 through September 2001. The groups had stage I esophageal cancer or lesser disease at the preoperative evaluation. Patients with prior upper abdominal or thoracic surgery were excluded.Results There was no significant difference between the groups with respect to age, body mass index, American Society of Anesthesiology (ASA) classification, or operating time. The estimated blood loss was 331 (± 220) ml for LTE and 542 (± 212) ml for OTE (p = 0.01). The hospital stay was 9.1 (± 3.2) days for LTE and 11.6 (± 2.9) days for OTE (p = 0.04). Comparing only the last six LTE with the OTE, the operating time was 311 (± 31) min for LTE and 388 (± 14) min for OTE (p = 0.02).Conclusions The findings showed shorter operative time, less blood loss, and a shorter hospital stay with LTE than with OTE.Presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2004 Scientific Session and Postgraduate Courses, Denver, Colorado, 31 March-3 april 2004     

A comparison of the effects of tamsulosin and alfuzosin on neurally evoked increases in bladder neck and seminal vesicle pressure in rats

OBJECTIVE: To assess the effects of the alpha 1-adrenoceptor antagonists alfuzosin and tamsulosin on the physiological events associated with ejaculation in the rat, because when these drugs are used for treating symptomatic benign prostatic hyperplasia in men they may affect ejaculation by impairing bladder neck closure and seminal vesicle contraction. MATERIALS AND METHODS: In clinical trials the incidence of ejaculatory disorders in men is typically < 1% with alfuzosin and 4-18% with tamsulosin. The effects of tamsulosin and alfuzosin on bladder neck and seminal vesicle pressures (BNP and SVP) in the rat were analysed. Increases in BNP and SVP were induced in urethane-anaesthetized. Wistar rats by electrical stimulation (ES) of the hypogastric nerve (HN) before and after an intravenous injection with vehicle, 3 or 10 micrograms/kg of tamsulosin or alfuzosin (10 rats/group). The mean amplitude and area under the curve (AUC) of the BNP and SVP were expressed as the percentage of the response to ES of HN before the treatment. RESULTS: The amplitude and AUC of the SVP were significantly decreased by both doses of tamsulosin, and marginally decreased by the same doses of alfuzosin. The amplitude of the BNP was significantly decreased by 3 and 10 micrograms/kg of tamsulosin and 10 micrograms/kg alfuzosin, and marginally decreased by 3 micrograms/kg alfuzosin. The AUC of the BNP was significantly decreased by both doses of tamsulosin, but barely affected by alfuzosin at the same doses. CONCLUSION: Over the doses assessed, alfuzosin had significantly less deleterious effect on increases in BNP and SVP induced by ES of the HN than had tamsulosin.     

In vitro antiplasmodial activity and cytotoxicity of crude extracts and compounds from the stem bark of <Emphasis Type="Italic">Kigelia africana</Emphasis> (Lam.) Benth (Bignoniaceae)

In order to assess the potential of the stem bark of Kigelia africana (Lam.) Benth as source of new anti-malarial leads, n-hexane and ethyl acetate (EtOAc) extracts and four compounds isolated from the stem bark were screened in vitro against the chloroquine-resistant W-2 and two field isolates of Plasmodium falciparum using lactate dehydrogenase assay. The products were also tested for their cytotoxicity on LLC/MK2 monkey kidney cells. The EtOAc extract exhibited a significant antiplasmodial activity (IC₅₀ = 11.15 μg/mL on W-2; 3.91 and 4.74 μg/mL on field CAM10 and SHF4 isolates, respectively), whereas the n-hexane fraction showed a weak activity (IC₅₀ = 73.78 μg/mL on W-2 and 21.85 μg/mL on SHF4). Three out of the four compounds showed good activity against all the three different parasite strains (IC₅₀ < 5 μM). Specicoside exhibited the highest activity on W-2 (IC₅₀ = 1.54 μM) followed by 2β, 3β, 19α-trihydroxy-urs-12-en-28-oic acid (IC₅₀ = 1.60 μM) and atranorin (IC₅₀ = 4.41 μM), while p-hydroxycinnamic acid was the least active (IC₅₀ = 53.84 μM). The EtOAc extract and its isolated compounds (specicoside and p-hydroxycinnamic acid) were non-cytotoxic (CC₅₀ > 30 μg/mL), whereas the n-hexane extract and two of its products, atranorin and 2β, 3β, 19α-trihydroxy-urs-12-en-28-oic acid showed cytotoxicity at high concentrations, with the last one being the most toxic (CC₅₀ = 9.37 μg/mL). These findings justify the use of K. africana stem bark as antimalaria by traditional healers of Western Cameroon, and could constitute a good basis for further studies towards development of new leads or natural drugs for malaria.