A morphologic study of gastric carcinoma in southern India

A detailed histologic and histochemical analysis of resected specimens of stomach showed that in southern India the intestinal type of gastric carcinoma was the most prevalent. This suggests that this region is a high risk area for gastric carcinoma. A minority of patients (16%) were below 40 years of age but the prevalence of chronic gastritis or intestinal metaplasia was not higher in this age group. Possible factors contributing to the aetiology are discussed.     

CUTANEOUS LUPUS ERYTHEMATOSUS IN INDIA: IMMUNOFLUORESCENCE PROFILE

The clinical profile and cutaneous lesions of 65 patients with lupus erythematosus (LE) are described. This included 28 discoid LE (13 disseminated, 15 localized), five subacute cutaneous LE, and 32 systemic LE. The need to recognize a pigmented macular form constituting 25% of discoid LE is emphasized. Increased incidence of involvement of the lower lip in discoid LE and pigmentation in systemic LE is noted. Lupus band test was found to be highly sensitive; it was positive for lesional skin of all untreated patients with subacute cutaneous LE and systemic LE, it was, however, not useful on nonlesional skin.     

Ispaghula therapy in irritable bowel syndrome: Improvement in overall well-being is related to reduction in bowel dissatisfaction

This placebo controlled, double-blind, cross-over trial involving 20 patients was conducted to assess the effect of ispaghula husk on the major bowel symptoms and the whole gut transit time in irritable bowel syndrome (IBS) and to determine if changes in these parameters were related to global improvement. All 20 patients were interviewed at the end of the treatment periods and 14 patients kept concurrent daily records. Ispaghula therapy resulted in improvement in global symptoms and satisfying bowel movements (P less than 0.001) but produced no change in abdominal pain or flatulence. There was a correlation between the improvement of well-being and the number of days of satisfying bowel movements (P less than 0.001) but not with the indexes of pain, stool frequency or changes in the transit time. The easing of bowel dissatisfaction appears to be a major reason for the therapeutic success of ispaghula in IBS.     

Symptom relief with amitriptyline in the Irritable Bowel syndrome

Anti-depressants have been reported to be useful in the management of the Irritable Bowel syndrome. We studied the efficacy of amitriptyline for 12 weeks in a randomized double-blind placebocontrolled trial. Forty patients who met predefined criteria entered the trial. They received 25 mg amitriptyline for the first week, 50 mg for the second week and 75 mg nightly thereafter until the end of the 12th week. The drug and placebo groups were comparable in all major pretreatment variables. Amitriptyline was found to be significantly more effective than placebo in producing global improvement, increasing feelings of well-being, reducing abdominal pain and increasing satisfaction with bowel movements. Younger age and increasing extroversion predicted a better response to amitriptyline. Severity of depressive and anxiety symptoms and other personality variables did not influence outcome.     

DIAGNOSTIC EVALUATION OF THE LUPUS BAND TEST IN DISCOID AND SYSTEMIC LUPUS ERYTHEMATOSUS

Background. The usefulness of the lupus band test (lbt ) in the diagnosis of cutaneous lupus erythematosus remains controversial. The study was done to determine the sensitivity, specificity, and predictive value of the lbt in discoid lupus erythematosus (dle ) and systemic lupus erythematosus (sle ). Methods. During the study period, 32 patients with SLE and 28 patients with DLE were included. The final classification of cases was based on the American Rheumatism Association Criteria (ara ) for sle , histopathology, and consensus of the clinical staff. Thirty controls, 15 each for DLE and sle , were chosen from a group of patients, who had lesions clinically simulating dle and sle , but could be excluded by histopathology, laboratory tests, and follow-up. Histopathologic examinations and direct immunofluorescence (DIF) tests were done on lesional skin. Results. In dle , the sensitivity of the LE band test was 58% and the specificity 87%. The positive predictive value was 95% and negative predictive value was 32%. In sle the sensitivity was 93% and specificity 87%. The positive predictive value was 64% and negative predictive value 98%. Conclusions. The high negative predictive value of lbt in sle suggests that it is valuable in excluding diseases clinically similar to sle .     

Anatomy and Electrophysiology of the Human AV Node

The atrioventricular node (AVN) has mystified generations of investigators over the last century and continues today to be at the epicenter of debates among anatomists, experimentalists, and electrophysiologists. Over the years, discrepancies have remained in regard to correlating components of AVN structure to function, as evidenced by studies from microelectrodes, optical mapping, and the electrophysiology laboratory. Historically, the AVN has been defined by classical histological methods; however, with recent advances in molecular biology techniques, a more precise characterization of structure is becoming attainable. Distinct molecular compartments are becoming apparent based on connexin staining and genotyping, providing new insight into previously characterized functional aspects of the AVN and its surrounding structures. Advances in optical mapping have provided a unique opportunity for correlating structure and function—unmasking properties of the native AVN pacemaker and providing further insight into basic mechanisms involved in AV conduction. Additionally, procurement of explanted human hearts have provided a unique opportunity to further characterize the human AVN structurally and functionally with both molecular biology techniques and optical mapping. With the elucidation of basic elements of both structure and function via molecular investigation and optical mapping, new opportunities are becoming apparent in utilizing the unique properties of the AVN for pursuing novel clinical applications relevant to clinical electrophysiology. (PACE 2010; 33:754–762)