Application of leaching tests on phosphogypsum by infiltration-percolation

The phosphoric acid production obtained by attacking phosphate rock by sulphuric acid cogenerates considerable quantities of phosphogypsum. The world cogeneration is estimated about 100-280 Mt per year. In another context of sustainable development, the phosphate chemical industry develops different ways of phosphogypsum valorization, which makes its storage stack in a suitable way for its potential use as an industrial by-product. Although, this storage can cause an environmental impact largely due to the transfer of trace elements (TEs) to groundwater by leaching. It is therefore important to evaluate the impact linked to the storage in order to limit this transfer. The evaluation is usually performed through leaching tests in columns or reactor. In this work, leaching tests were performed in columns by infiltration-percolation on two filter mediums: phosphogypsum and synthetic sandy soils. The results showed that the phosphogypsum is acting as a filter, which retains and releases the TEs. Most of these TEs (Pb, Se, Ag, Zn and Cu) were highly retained in the synthetic soils surfaces and their contents in waters were considerably lower than the maximum contaminant levels (MCLs). Although As, Cd, Cr and Ni were strongly transferred to groundwater, their respective contents were higher than the MCLs.

Early Pregnancy Ultrasound and Management: Effect of a Multifaceted Training on Physician Knowledge

Vaginal bleeding is a common event in early pregnancy, with 20-40% of pregnancies affected. Prompt diagnosis and management of bleeding is important, both to reduce morbidity and to avoid excessive emotional distress. This was a prospective study of an educational programme aimed at Obstetrics and Gynaecology BST trainees in the National Maternity Hospital, Dublin. The educational programme consisted of didactic lectures, and simulation and practical sessions. A questionnaire reviewing early pregnancy complications was used to assess participant knowledge. Six trainees participated in the programme, with five (83%) answering the questionnaire. The pre-education questionnaire showed a generally poor level of knowledge of early pregnancy complications with 8/50 (16%) questions answered correctly. Following the educational intervention there was a statistically significant increase in participant knowledge with 45/50 (90%) questions answered correctly. A significant increase in participant knowledge of early pregnancy complications followed our multifaceted educational programme. Study limitations exist, however we have shown the potential value of our educational programme.

Intrinsic fluorescence of selenium nanoparticles for cellular imaging applications

Nanoparticles hold great potential in contributing to high-resolution bioimaging as well as for biomedical applications. Although, selenium (Se) nanoparticles (NPs) have been investigated owing to their potential roles in therapeutics, the imaging capability of these NPs has never been explored. This manuscript identifies the intrinsic fluorescence of Se NPs, which is highly beneficial for nanoscale imaging of biological structures. The emission of individual NPs and its evolution with time is explored. The photoluminescence spectra has revealed visible to near infrared emission for Se NPs. The work finally reflects on the role of this intrinsic fluorescence for in vitro imaging and tracking in fibroblast cells, without the need of any additional tags. This technique would overcome the limitations of the conventionally used methods of imaging with tagged fluorescent proteins and dyes, preventing possible adverse cellular effects or phototoxicity caused by the added fluorescent moieties.

In-silico identification of the binding mode of synthesized adamantyl derivatives inside cholinesterase enzymes

AIM

To investigate the binding mode of synthesized adamantly derivatives inside of cholinesterase enzymes using molecular docking simulations.

METHODS

A series of hybrid compounds containing adamantane and hydrazide moieties was designed and synthesized. Their inhibitory activities against acetylcholinesterase (AChE) and (butyrylcholinesterase) BChE were assessed in vitro. The binding mode of the compounds inside cholinesterase enzymes was investigated using Surflex-Dock package of Sybyl7.3 software.

RESULTS

A total of 26 adamantyl derivatives were synthesized. Among them, adamantane-1-carboxylic acid hydrazide had an almost equal inhibitory activity towards both enzymes, whereas 10 other compounds exhibited moderate inhibitory activity against BChE. The molecular docking studies demonstrated that hydrophobic interactions between the compounds and their surrounding residues in the active site played predominant roles, while hydrophilic interactions were also found. When the compounds were docked inside each enzyme, they exhibited stronger interactions with BChE over AChE, possibly due to the larger active site of BChE. The binding affinities of the compounds for BChE and AChE estimated were in agreement with the experimental data.

CONCLUSION

The new adamantly derivatives selectively inhibit BChE with respect to AChE, thus making them good candidates for testing the hypothesis that BChE inhibitors would be more efficient and better tolerated than AChE inhibitors in the treatment of Alzheimer's disease.

Antimycobacterial activity of selected medicinal plants traditionally used in Sudan to treat infectious diseases

ETHNOPHARMACOLOGICAL RELEVANCE

The emergence of multidrug-resistant strains of Mycobacterium tuberculosis underscores the need for continuous development of new and efficient methods to determine the susceptibility of isolates of Mycobacterium tuberculosis in the search for novel antimycobacterial agents. Natural products constitute an important source of new drugs, and design and implementation of antimycobacterial susceptibility testing methods are necessary to evaluate the different extracts and compounds. In this study we have explored the antimycobacterial properties of 50 ethanolic extracts from different parts of 46 selected medicinal plants traditionally used in Sudan to treat infectious diseases.

MATERIALS AND METHODS

Plants were harvested and ethanolic extracts were prepared. For selected extracts, fractionation with hydrophilic and hydrophobic solvents was undertaken. A luminometry-based assay was used for determination of mycobacterial growth in broth cultures and inside primary human macrophages in the presence or absence of plant extracts and fractions of extracts. Cytotoxicity was also assessed for active fractions of plant extracts.

RESULTS

Of the tested extracts, three exhibited a significant inhibitory effect on an avirulent strain of Mycobacterium tubercluosis (H37Ra) at the initial screening doses (125 and 6.25µg/ml). These were bark and leaf extracts of Khaya senegalensis and the leaf extract of Rosmarinus officinalis L. Further fractions of these plant extracts were prepared with n-hexane, chloroform, ethyl acetate, n-butanol, ethanol and water, and the activity of these extracts was retained in hydrophobic fractions. Cytotoxicity assays revealed that the chloroform fraction of Khaya senegalensis bark was non-toxic to human monocyte-derived macrophages and other cell types at the concentrations used and hence, further analysis, including assessment of IC50 and intracellular activity was done with this fraction.

CONCLUSION

These results encourage further investigations to identify the active compound(s) within the chloroform fraction of Khaya senegalensis bark.

A study of antioxidant activity, enzymatic inhibition and in vitro toxicity of selected traditional Sudanese plants with anti-diabetic potential

Background

Diabetes mellitus is a chronic metabolic disease with life-threatening complications. Despite the enormous progress in conventional medicine and pharmaceutical industry, herbal-based medicines are still a common practice for the treatment of diabetes. This study evaluated ethanolic and aqueous extracts of selected Sudanese plants that are traditionally used to treat diabetes.

Methods

Extraction was carried out according to method described by Sukhdev et. al. and the extracts were tested for their glycogen phosphorylase inhibition, Brine shrimp lethality and antioxidant activity using (DPPH) radical scavenging activity and iron chelating activity. Extracts prepared from the leaves of Ambrosia maritima, fruits of Foeniculum vulgare and Ammi visnaga, exudates of Acacia Senegal, and seeds of Sesamum indicum and Nigella sativa.

Results

Nigella sativa ethanolic extract showed no toxicity on Brine shrimp Lethality Test, while its aqueous extract was toxic. All other extracts were highly toxic and ethanolic extracts of Foeniculum vulgare exhibited the highest toxicity. All plant extracts with exception of Acacia senegal revealed significant antioxidant activity in DPPH free radical scavenging assay.

Conclusions

These results highly agree with the ethnobotanical uses of these plants as antidiabetic. This study endorses further studies on plants investigated, to determine their potential for type 2 diabetes management. Moreover isolation and identification of active compounds are highly recommended.

Crystal phase engineered quantum wells in ZnO nanowires

We report the fabrication of quantum wells in ZnO nanowires (NWs) by a crystal phase engineering approach. Basal plane stacking faults (BSFs) in the wurtzite structure can be considered as a minimal segment of zinc blende. Due to the existing band offsets at the wurtzite (WZ)/zinc blende (ZB) material interface, incorporation of a high density of BSFs into ZnO NWs results in type II band alignment. Thus, the BSF structure acts as a quantum well for electrons and a potential barrier for holes in the valence band. We have studied the photoluminescence properties of ZnO NWs containing high concentrations of BSFs in comparison to high-quality ZnO NWs of pure wurtzite structure. It is revealed that BSFs form quantum wells in WZ ZnO nanowires, providing an additional luminescence peak at 3.329 eV at 4 K. The luminescence mechanism is explained as an indirect exciton transition due to the recombination of electrons in the QW conduction band with holes localized near the BSF. The binding energy of electrons is found to be around 100 meV, while the excitons are localized with the binding energy of holes of ∼5 meV, due to the coupling of BSFs, which form QW-like structures.

Identification of antiplatelet and acetylcholinesterase inhibitory constituents in betel nut

OBJECTIVE

To investigate the possible mechanism and the compound(s) responsible for the antiplatelet and acetylcholinesterase (AChE) inhibitory effects of Areca catechu crude extract (Ac.Cr).

METHODS

Aqueous-methanol (70%) was used for extraction of plant material (betel nut). Antiplatelet activity was measured in human platelet-rich plasma by using a Lumi-aggregometer while anti-AChE activity was measured spectrophotometrically in vitro. In an attempt to find the responsible compound(s) in betel nut for antiplatelet and anti-AChE activities, different commercially available betel nut compounds were tested.

RESULTS

Ac.Cr inhibited platelet aggregation induced by arachidonic acid (AA), adenosine diphosphate (ADP), platelet-activating factor (PAF), epinephrine and Ca(2+)-ionophore. Ac.Cr was the most potent in inhibiting ADP- and Ca(2+)-ionophore-induced aggregation. In the AChE assay, Ac.Cr showed significant AChE inhibitory activity with almost complete inhibition of the enzyme. Out of the tested compounds, none of the compounds in betel nut showed any antiplatelet effect except for catechin that was the most potent against epinephrine-induced aggregation. Catechin was significantly less potent than Ac.Cr, indicating a presence of additional compound(s) with antiplatelet activity. For the AChE inhibitory effect, only tannic acid, gallic acid, diosgenin and isoguvacine were found to be active, whereby tannic acid was more potent than Ac.Cr.

CONCLUSION

This study shows the possible antiplatelet and AChE inhibitory potential of betel nut while further studies are needed to confirm and identify more compounds in betel nut for these actions.

Method for vector characterization of polar liquids using frequency-domain spectroscopy

A device for performing vector transmission spectroscopy on aqueous and polar solvent specimens at terahertz frequencies is presented. The device enables the direct measurement of the complex dielectric function across the terahertz band using a Fourier transform IR spectrometer for lossy solutions. Using microfluidic sampling, specimen handling is straightforward and direct measurements on polar specimens are made possible. The method is scalable to longer or shorter wavelengths.

Polarization insensitive terahertz metamaterial absorber

We present the simulation, implementation, and measurement of a polarization insensitive resonant metamaterial absorber in the terahertz region. The device consists of a metal/dielectric-spacer/metal structure allowing us to maximize absorption by varying the dielectric material and thickness and, hence, the effective electrical permittivity and magnetic permeability. Experimental absorption of 77% and 65% at 2.12 THz (in the operating frequency range of terahertz quantum cascade lasers) is observed for a spacer of polyimide or silicon dioxide respectively. These metamaterials are promising candidates as absorbing elements for thermally based terahertz imaging.

A terahertz polarization insensitive dual band metamaterial absorber

Metamaterial absorbers have attracted considerable attention for applications in the terahertz range. In this Letter, we report the design, fabrication, and characterization of a terahertz dual band metamaterial absorber that shows two distinct absorption peaks with high absorption. By manipulating the periodic patterned structures as well as the dielectric layer thickness of the metal-dielectric-metal structure, significantly high absorption can be obtained at specific resonance frequencies. Finite-difference time-domain modeling is used to design the structure of the absorber. The fabricated devices have been characterized using a Fourier transform IR spectrometer. The experimental results show two distinct absorption peaks at 2.7 and 5.2 THz, which are in good agreement with the simulation. The absorption magnitudes at 2.7 and 5.2 THz are 0.68 and 0.74, respectively.

Sensitivity pattern of methicillin resistant Staphylococcus aureus isolated from patients admitted in a tertiary care hospital of Pakistan

BACKGROUND AND OBJECTIVES

Methicillin resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen causing significant morbidity and mortality. The aim of this study was to evaluate in vitro activities of different antibiotics against methicillin resistant Staphylococcus aureus.

MATERIALS AND METHOD

The study was conducted over a period of one year (January 2009 - December 2009) in the Department of Microbiology, Army Medical College, the National University of Sciences and Technology, Pakistan. One hundred and thirty-nine Methicillin resistant Staphylococcus aureus isolated from the clinical specimens at Rawalpindi Military Hospital were subjected to in vitro susceptibility against various antimicrobials using Kirby Bauer disc diffusion technique.

RESULTS

All the isolated MRSA organisms were uniformly susceptible to vancomycin, linezolid and tigecycline. Other drugs which were found to be effective were chloramphenicol, and rifampacin. Most of the MRSA were isolated from pus samples.

CONCLUSION

Vancomycin, tigecycline and linezolid were effective against methicillin resistant strains of S.aureus. This study suggests that chloramphenicol and rifampacin also have good in vitro efficacy for methicillin resistant S. aureus infections. Oral dosing option for linezolid, chloramphenicol and rifampacin can allow earlier discharge of hospitalized patients and thus reduce health care expenses as well as help reduce the chances of vancomycin resistant strains emergence.

Phytochemical and enzyme inhibitory studies on indigenous medicinal plant Rhazya stricta

A new triterpenoid 3alpha-hydroxy-ursane-5-ene (1) and a known steroid stigma sterol (2) have been isolated for the first time from the fruit of Rhazya stricta. The structures of these compounds were elucidated and identified by spectral studies. The crude ethanolic extract of R. stricta fruit has led to the determination of good results of antibacterial, lipoxygenase and acetylcholinesterase activities. In addition, we also reported the acetylcholinesterase activity of stigma sterol (2) isolated from this plant. Stigma sterol (2) was found to be an acetyl-cholinesterase inhibitor with IC(50) at a concentration of 644.0 +/- 11.75 microM. Eserine [(-)-physostigmine, IC(50) = 61 nM)] was used as a positive control.

Imprinted terahertz artificial dielectric quarter wave plates

We have developed low-loss polymer artificial dielectric quarter wave plates (QWP) operating at 2.6, 3.2 and 3.8 THz. The QWPs are imprinted on high density polyethylene (HDPE) using silicon masters. The grating period for the quarter wave plates is 60 microm. 330 microm, 280 microm and 230 microm deep gratings are used to obtain a pi/2 phase retardance between TE and TM polarization propagating through the QWPs. High frequency structure simulator (HFSS) was used to optimize the grating depth. Since the required grating depth is high, two plates, fixed in a back-to-back configuration were used for each QWP. A maximum aspect ratio (grating height/grating width) of 6.6 was used.

Muscarinic, Ca++ antagonist and specific butyrylcholinesterase inhibitory activity of dried ginger extract might explain its use in dementia

Ginger rhizome (Zingiber officinale) has been used for centuries to treat dementia in South Asia. This study was undertaken to possibly justify its use. A 70% aqueous/methanolic extract of dried ginger (Zo.Cr) was used. Zo.Cr tested positive for the presence of terpenoids, flavonoids, secondary amines, phenols, alkaloids and saponins. When tested on isolated rat stomach fundus, Zo.Cr showed a spasmogenic effect (0.03–5.00 mg mL−1); it relaxed the tissue at concentrations ≥5 mg mL−1. The stimulant effect was resistant to blockade by hexamethonium and methysergide, but sensitive to atropine, indicating activity via muscarinic receptors. In atropinized (0.1 μM) preparations, Zo.Cr (0.3–3.0 mg mL−1) relaxed high K+ (80 mm)-induced contractions, indicating Ca++ antagonism in addition to the muscarinic effect. This possible Ca++ antagonist activity was investigated in Ca++-free conditions, with the inhibitory effect of the extract tested against contractions induced by externally administered Ca++. Zo.Cr (0.1–0.3 mg mL−1), similar to verapamil (0.03–0.10 μm), shifted the contractions induced by externally administered Ca++ to the right, thus suggesting an inhibitory interaction between Zo.Cr and voltage-operated Ca++ channels. Zo.Cr (0.1–3.0 μg mL−1) also potentiated acetylcholine peak responses in stomach fundus, similar to physostigmine, a cholinesterase inhibitor. Zo.Cr, in an in-vitro assay, showed specific inhibition of butyrylcholinesterase (BuChE) rather than acetylcholinesterase enzyme. Different pure compounds of ginger also showed spasmolytic activity in stomach fundus, with 6-gingerol being the most potent. 6-Gingerol also showed a specific anti-BuChE effect. This study shows a unique combination of muscarinic, possible Ca++ antagonist and BuChE inhibitory activities of dried ginger, indicating its benefit in dementia, including Alzheimer's disease.

Terahertz dual-band resonator on silicon

We have designed and fabricated a dual-band resonator in the terahertz frequency range on high-resistivity silicon. The device is designed to show resonances at 2.6 and 4.3 THz using the finite-difference time-domain modeling method. The characteristics of the fabricated device have been examined by using a Fourier-transform IR spectrometer. Measured results are in excellent agreement with the simulated data, showing two polarization-independent resonant peaks observed at 2.60 and 4.37 THz, respectively. The first resonance has a bandwidth of 0.56 THz, while the second one has a bandwidth of 0.70 THz. These dual-band resonant devices can be used for various applications such as dual-band spectral imaging and multiband biosensors.

Current trends in management of ectopic pregnancy in the United Kingdom

The potential advantages of laparoscopic management of ectopic pregnancy include lower morbidity, faster return to work, and less impact on reproductive health. This study aimed to investigate the current management of ectopic pregnancy in the United Kingdom. Thirty-five per cent of ectopic pregnancies are currently managed laparoscopically. Units that tended to operate laparoscopically were more likely to attempt to preserve the fallopian tube at surgery. Ninety per cent of units in the UK feel that they potentially could manage ectopic pregnancies laparoscopically but in practice only 60% managed any of the last three ectopic pregnancies by this technique.

Intraductal papillary mucinous tumor of the pancreas (IPMT): follow-up of twelve cases

INTRODUCTION

Intraductal papillary mucinous tumours (IPMT) were described as a distinct entity in I982. The extent of surgical resection for this disease remains controversial.

METHODS

Twelve patients with a diagnosis of IPMT were included in the present retrospective study.

RESULTS

Ten out of twelve patients had symptoms suggesting chronic pancreatitis. Two patients were not operated on due to biopsy-verified metastases in the liver. Nine patients were treated with a total pancreatectomy and one with a pancreaticoduodenectomy. In the ten patients operated on for IPMT, histological examination showed eight non-invasive- and two invasive carcinomas. In six cases, multifocal extensive intraductal changes were found, affecting either most of or the whole pancreas. There was no perioperative mortality. Six patients were alive at follow-up without recurrence and four patients were dead, two of them with recurrence.

CONCLUSION

IPMTs represent a subgroup of pancreatic neoplasms with a favourable prognosis, and the resection should aim at removing all dysplastic foci. In cases with diffuse dilatation of the main pancreatic duct, widespread tumour involvement of the duct system can be expected and total pancreatectomy should be the operation of choice.

Direct fabrication of terahertz optical devices on low-absorption polymer substrates

We have fabricated terahertz wire grid polarizer and terahertz bandpass filter devices on high-density polyethylene substrates using simple photolithographic fabrication techniques. The performance of the fabricated devices was measured using a Fourier transform IR spectrometer. Both devices showed good performance in the terahertz frequency range up to 5 THz, in agreement with rigorous coupled-wave analysis (polarizer) and finite-difference time-domain (filter) simulations. Our results successfully demonstrate the use of standard fabrication techniques to produce large-aperture free-standing terahertz optical devices on low-absorption polymer materials with the advantage of low cost using a simple fabrication process. The fabricated polarizer had better than 30 dB extinction ratio at 3 THz. Bandpass filters were demonstrated at three different center frequencies (1.5, 1.8, 2.9 THz) with a 3 dB insertion loss and 2<or=Q<or=7.

A simple method to screen for azo-dye-degrading bacteria

A stab-culture method was adapted to screen for azo dyes-decolorizing bacteria from soil and water samples. Decolorized azo dye in the lower portion of the solid media indicates the presence of anaerobic azo dyes-decolorizing bacteria, while aerobic decolorizing bacteria decolorizes the surface portion of the solid media. Of twenty soil samples tested, one soil sample shows positive results for the decolourisation of two azo dyes; Biebrich scarlet (BS) and Direct blue 71 (DB) under anaerobic conditions. A gram negative and oxidase negative bacterial isolate was found to be the principal azo dyes degrader The isolate was identified by using the Biolog identification system as Serratia marcescens.

Muscarinic, Ca(++) antagonist and specific butyrylcholinesterase inhibitory activity of dried ginger extract might explain its use in dementia

Ginger rhizome (Zingiber officinale) has been used for centuries to treat dementia in South Asia. This study was undertaken to possibly justify its use. A 70% aqueous/methanolic extract of dried ginger (Zo.Cr) was used. Zo.Cr tested positive for the presence of terpenoids, flavonoids, secondary amines, phenols, alkaloids and saponins. When tested on isolated rat stomach fundus, Zo.Cr showed a spasmogenic effect (0.03-5.00 mg mL(-1)); it relaxed the tissue at concentrations > or =5 mg mL(-1). The stimulant effect was resistant to blockade by hexamethonium and methysergide, but sensitive to atropine, indicating activity via muscarinic receptors. In atropinized (0.1 microM) preparations, Zo.Cr (0.3-3.0 mg mL(-1)) relaxed high K(+) (80 mM)-induced contractions, indicating Ca(++) antagonism in addition to the muscarinic effect. This possible Ca(++) antagonist activity was investigated in Ca(++)-free conditions, with the inhibitory effect of the extract tested against contractions induced by externally administered Ca(++). Zo.Cr (0.1-0.3 mg mL(-1)), similar to verapamil (0.03-0.10 microM), shifted the contractions induced by externally administered Ca(++) to the right, thus suggesting an inhibitory interaction between Zo.Cr and voltage-operated Ca(++) channels. Zo.Cr (0.1-3.0 microg mL(-1)) also potentiated acetylcholine peak responses in stomach fundus, similar to physostigmine, a cholinesterase inhibitor. Zo.Cr, in an in-vitro assay, showed specific inhibition of butyrylcholinesterase (BuChE) rather than acetylcholinesterase enzyme. Different pure compounds of ginger also showed spasmolytic activity in stomach fundus, with 6-gingerol being the most potent. 6-Gingerol also showed a specific anti-BuChE effect. This study shows a unique combination of muscarinic, possible Ca(++) antagonist and BuChE inhibitory activities of dried ginger, indicating its benefit in dementia, including Alzheimer's disease.

Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: a multicenter experience

BACKGROUND AND STUDY AIMS

Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other pancreatic tumors, especially pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultrasound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors.

PATIENTS AND METHODS

Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed.

RESULTS

A total of 28 patients were identified (four men [14 %], 24 women [86 %], mean age +/- standard deviation [SD] 35 +/- 10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50 % of cases. The mean tumor size +/- SD was 42 +/- 19.5 mm and the majority were located in the pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86 %; the tumors were solid in 14 patients (50 %), mixed solid and cystic in 11 patients (39 %), and cystic in three patients (11 %). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 %) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 %).

CONCLUSIONS

A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/cystic pancreatic lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75 % in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.

Rosiglitazone treatment improves cardiac efficiency in hearts from diabetic mice

Isolated perfused hearts from type 2 diabetic (db/db) mice show impaired ventricular function, as well as altered cardiac metabolism. Assessment of the relationship between myocardial oxygen consumption (MVO(2)) and ventricular pressure-volume area (PVA) has also demonstrated reduced cardiac efficiency in db/db hearts. We hypothesized that lowering the plasma fatty acid supply and subsequent normalization of altered cardiac metabolism by chronic treatment with a peroxisome proliferator-activated receptor-gamma (PPARgamma) agonist will improve cardiac efficiency in db/db hearts. Rosiglitazone (23 mg/kg body weight/day) was administered as a food admixture to db/db mice for five weeks. Ventricular function and PVA were assessed using a miniaturized (1.4 Fr) pressure-volume catheter; MVO(2) was measured using a fibre-optic oxygen sensor. Chronic rosiglitazone treatment of db/db mice normalized plasma glucose and lipid concentrations, restored rates of cardiac glucose and fatty acid oxidation, and improved cardiac efficiency. The improved cardiac efficiency was due to a significant decrease in unloaded MVO(2), while contractile efficiency was unchanged. Rosiglitazone treatment also improved functional recovery after low-flow ischemia. In conclusion, the present study demonstrates that in vivo PPARgamma-treatment restores cardiac efficiency and improves ventricular function in perfused hearts from type 2 diabetic mice.

New natural cholinesterase inhibiting and calcium channel blocking quinoline alkaloids

During this study, one new coumarin; 7-O-beta-D-glucopyranoside-2H-1-benzopyran-2-one (1) and three quinoline alkaloids; 3-hydroxy, 2, 2, 6-trimethyl-3, 4, 5, 6-tetrahydro-2H-pyrano[3,2-c] quinoline 5-one (2), ribalinine (3) and methyl isoplatydesmine (4) were isolated from the aerial parts of Skimmia laureola and their structures established by spectroscopic studies. Compounds 2-4 were found to be linear mixed type inhibitors of acetylcholinesterase (K(i) = 110.0, 30.0 and 30.0 microM, respectively). Compounds 2 and 3 were also found to be linear mixed type inhibitors of butyrylcholinesterase, while compound 4 was a noncompetitive inhibitor of the enzyme (K(i) = 90.0, 70.0 and 19.0 microM, respectively). The inhibition of acetyl- and butyryl-cholinesterase enzymes persists as the most promising therapeutic strategy for activating the impaired cholinergic functions in Alzheimer's disease and related dementias. Compound 4 also showed dose-dependent spasmolytic activity in the isolated rabbit jejunum intestinal preparation by relaxing the spontaneous (EC50 = 0.1 mg/mL) and K(+)-induced contractions (EC50 = 0.4 mg/mL), suggesting that the spasmolytic effect of compound 4 is mediated through the blockade of voltage-dependent Ca2+ channels.

New cholinesterase-inhibiting triterpenoid alkaloids from Buxus hyrcana

The current phytochemical investigation on Buxus hyrcana Pojark. has resulted in the isolation of the triterpenoid alkaloids 1-10. The structures of five new alkaloids, hyrcanone (1), hyrcanol (2), hyrcatrienine (3), N(b)-dimethylcycloxobuxoviricine (4), and hyrcamine (5), were elucidated by means of modern spectroscopic techniques, while the known alkaloids, buxidin (6), buxandrine (7), buxabenzacinine (8), buxippine-K (9) and E-buxenone (10), were identified by comparing their spectral data with those reported earlier. Compounds 1 and 3-9 were found to be acetyl- and butyrylcholinesterase inhibitors. The IC50 values were estimated to be in the range of 83.0-468.0 microM against AChE and 1.12-350.0 microM against BChE. The structure-activity relationship studies suggested that the presence of dimethylamino moieties at C(3) and C(20) is the most important factor influencing the activity of these compounds against the cholinesterase enzymes. All compounds were also evaluated for cytotoxicity on a fibroblast cell line with incubation of 24 h. No cytotoxic effects were exerted by any compound.

Impact of the availability of sonography in the acute gynecology unit

OBJECTIVE

The initial assessment of acute gynecology patients is usually based on history and clinical examination and does not involve ultrasound. The aim of this study was to investigate the impact of the availability of transvaginal sonography at the time of initial assessment of the emergency gynecology patient.

METHODS

This was a prospective observational study carried out over a 5-month period in the acute gynecology unit of an inner London teaching hospital. Women were assessed in the routine manner by history-taking and clinical examination and questionnaires were completed by the doctors, including details of the intention to treat. Transvaginal ultrasound examinations were then performed and a second diagnosis and management plan were made utilizing the extra information from the scan. The plans for clinical management before and after the ultrasound examination were compared.

RESULTS

We originally recruited 1000 consecutive women to the study. The mean age was 31.1 (SD, 9.81) years. Complete data were available for 920 (92%). 84 (9.1%) women did not require a scan. Of the 521 women with a positive pregnancy test, 75.6% were reassured immediately that their pregnancy was intrauterine. 143 women (27.4%) were given the diagnosis of a suspected ectopic pregnancy before sonography, compared with 29 (5.6%) after. Following the ultrasound examination there was a change in clinical management in 54.1% of the women with a positive pregnancy test and a reduction in admissions (including inpatient theater admissions) (from 40.3% to 17.1%) and outpatient follow-up examinations (from 41.1% to 35.5%). In 90 (23.8%) non-pregnant women a significant ovarian cyst (> 5 cm) was suspected clinically; 28/90 (31.1%) were confirmed on sonography. Following the ultrasound examination there was a change in clinical management for 38.1% of non-pregnant women and a reduction in admissions (from 37.1% to 19.4%) and outpatient follow-up examinations (from 25.7% to 18.1%).

CONCLUSION

It appears that the availability of transvaginal sonography at the time of initial assessment of emergency gynecology patients improves diagnostic accuracy and reduces unnecessary admissions and follow-up examinations.

A 93 year old man with the PRSS1 R122H mutation, low SPINK1 expression, and no pancreatitis: insights into phenotypic non-penetrance

BACKGROUND

The cationic trypsinogen (PRSS1) R122H mutation causes autosomal dominant hereditary pancreatitis (HP) with multiple attacks of acute pancreatitis, but the penetrance, frequency, and severity of attacks are highly variable. HP twins study suggests that modifier genes influence severity but not penetrance.

AIM

To investigate potential trypsin associated factors in subjects with the PRSS1 R122H mutation and phenotypic non-penetrance.

METHODS

Two subjects from HP families (including a 93 year old subject with PRSS1 R122H without pancreatitis), one with chronic pancreatitis and one with a normal pancreas, were studied. Relative expression of: (a) the PRSS1 R122 and H122 alleles; and (b) the PRSS1 and SPINK1 genes in pancreatitis were determined using complementary methods.

RESULTS

PRSS1 wild-type (R122) and mutant (H122) allele expression was equivalent in multiple (> 3) samples from the phenotypically affected and non-penetrant subjects with R122H genotypes using allele specific quantitative reverse transcription-polymerase chain reaction (RT-PCR) and intron spanning nested RT-PCR followed by cDNA sequencing. Compared with PRSS1 mRNA levels, SPINK1 mRNA levels were low in normal appearing tissue but markedly increased in samples with chronic inflammation, independent of PRSS1 genotype.

CONCLUSION

Attacks of acute pancreatitis in HP subjects appear to be independent of the relative expression of the mutant PRSS1 H122 allele or SPINK1 gene expression. The marked increase in SPINK1 gene expression with inflammation is consistent with its regulation as an acute phase protein.

The use of ultrasound-based 'soft markers' for the prediction of pelvic pathology in women with chronic pelvic pain-can we reduce the need for laparoscopy?

OBJECTIVE

To assess the accuracy of new transvaginal ultrasound-scan-based markers and to compare them to conventional ultrasound methods used in the detection of common pelvic pathology in women with chronic pelvic pain (CPP).

DESIGN

A prospective observational study.

SETTING

Teaching hospital.

POPULATION

A total of 120 consecutive women with CPP undergoing transvaginal ultrasonography before either diagnostic or operative laparoscopy.

METHODS

Anatomical abnormalities, e.g. endometrioma or hydrosalpinx (hard markers), were documented. The woman was then assessed for the presence or absence of 'soft markers' (reduced ovarian mobility and site-specific pelvic tenderness).

MAIN OUTCOME MEASURE

Presence or absence of pelvic pathology noted during laparoscopy.

RESULTS

Seventy women had pelvic pathology, of whom 51 had endometriosis alone, 7 both endometriosis and pelvic adhesions, 6 pelvic adhesions, 1 hydrosalpinx with endometriosis and 5 hydrosalpinx and pelvic adhesions. The likelihood ratio for the hard markers was infinity (specificity was 100%), for the soft makers 1.9 (95% CI 1.2-3.1) and for a 'normal' ultrasound 0.18 (0.09-0.34). The pre-test probability of pelvic disease in our population of women with CPP was 58%, and this probability of disease was raised to 100% with the presence of hard markers and to 73% with the presence of soft markers. The pre-test probability of 58% fell to 20% when ultrasound finding was found to be normal.

CONCLUSION

This new approach improves the detection and exclusion of significant pathology in women with CPP and may lead to a reduction in the number of unnecessary laparoscopies carried out on women with CPP.