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.     

The specificity of nonspecific concanavalin A-induced helper factors.

Addition of supernatants from concanavalin A (Con A)-stimulated spleen cells enable nude spleen cells to respond in vitro to a variety of antigens (in our experiments, sheep (SRBC) and horse erythrocytes (HRBC)). Experiments presented here, indicate that such nonspecific helper supernatants are in fact a polyclonal mixture of diverse, specif- ic activities. Con A stimulation of thoracic duct lymphocytes, specifically depleted of SRBC or HRBC-reactive cells by the Sprent technique, results in a specific decrease in the activity to the relevant antigen. On the one hand, Con A stimulation of in vivo activated thymocytes results in the production of helper supernatants which are almost totally specific for the antigen used in priming. In spite of these indications of specificity, it has been impossible to absorb out helper activity from normal Con A supernatants on the corresponding antigen. Specific removal of helper activity, however, can readily be achieved by absorbing helper supernatants on complexes of antigen and early immune sera. Various control ex- periments demonstrate that the loss of activity in the absorbed supernatants is not due to carry-over of antibody into the test cultures. Furthermore, the fraction of helper activity that can be specifically removed on antigen-antibody complexes depends on the conditions used in the preparation of the supernatants; this fraction is highest when Con A activation of T cells is performed in the presence of B cells without antigen. These results suggest that “nonspecific helper factors” are a mixture of diverse molecules, some of which show specificity for variable regions of antibodies.     

Apical hard-tissue deposition in adult teeth of monkeys with use of calcium hydroxide

A bstract — The periapical tissues of adult teeth of monkeys were examined histologically after root canal treatment with calcium hydroxide. Healing, as evidenced by complete apical closure with a hard tissue bridge and an inflammation-free periodontal ligament, occurred more frequently where canals were instrumented 1 mm short of the apex. Overinstrumented canals exhibited a significantly decreased incidence of apical closure.     

Serum proteomic changes in adults with obstructive sleep apnoea

To examine whether differentially expressed proteins are present in the serum of patients with obstructive sleep apnoea (OSA), iTRAQ techniques (isobaric tags for relative and absolute quantification) were employed in a prospective study. Individuals were assigned to either a non‐OSA control group (apnoea–hypopnoea index, AHI <5) or an OSA group (AHI ≥5). Blood samples were collected, aliquoted and frozen at ?80 °C. Protein digestion and tagging with iTRAQ4plex^® and mass spectrometry analysis was then performed (MALDI TOF/TOF). Ten male subjects were included in the control group (age = 45 ± 9.7 years) and 30 male patients in the OSA group (age = 45 ± 10.7 years), the latter being then subdivided into three severity groups. A total of 103 proteins were identified with differential levels between patients with OSA and controls. Of these, 11 proteins were underexpressed and 19 were overexpressed in patients with OSA. C4BPA and thrombospondin were underexpressed in all three OSA severity groups. Among the overexpressed proteins, 13 were overexpressed in the mild OSA group, seven in the moderate group and five in the severe group. Analysis of interactions between the identified proteins revealed that protein alterations in OSA are primarily associated with derangements in lipid and vascular metabolic pathways. This study provides initial evidence that differential protein expression occurs in adults with OSA, and that such proteins change according to disease severity, and appear to primarily involve lipid and vascular metabolic pathways.