Physiological and Functional Evaluation of the Transposed Human Pylorus as a Distal Sphincter

BACKGROUND/AIMS: Studies evaluating the human pylorus as a sphincter are scanty and contradictory. Recently, we have shown technical feasibility of transposing the human pylorus for end-stage fecal incontinence. This unique cohort of patients provided us an opportunity to study the sphincter properties of the pylorus in its ectopic position. METHODS: Antro-pylorus transposition on end sigmoid colostomies (n = 3) and in the perineum (n = 15) was performed for various indications. Antro-pylorus was assessed functionally (digital examination, high resolution spatiotemporal manometry, barium retention studies and colonoscopy) and by imaging (doppler ultrasound, MRI and CT angiography) in its ectopic position. RESULTS: The median resting pressure of pylorus on colostomy was 30 mmHg (range 28-38). In benign group, median resting pressure in perineum was 12.5 mmHg (range 6-44) that increased to 21.5 mmHg (range 12-29) (P = 0.481) and 31 mmHg (range 16-77) (P = 0.034) on first and second follow-up, respectively. In malignant group, median post-operative pressures were 20 mmHg (range 14-36) and 21 mmHg (range 18-44) on first and second follow-up, respectively. A definite tone and gripping sensation were felt in all the patients on digital examination. On distal loopogram, performed through the diverting colostomies, barium was retained proximal to the neo-pyloric valve. Both perineal ultrasound and MRI showed viable transposed graft. CT angiography and color doppler studies confirmed vascular flow in the transposed position. CONCLUSIONS: The human pyloric valve can function as a tonic sphincter when removed from the gastroduodenal continuity.

Growth of a mangrove (Rhizophora apiculata) seedlings as influenced by GA3, light and salinity

The growth performance of Rhizophora apiculata Blume (mangrove) seedlings in the presence and absence of exogenous gibberellic acid (GA3) under different combinations of salinity and light was analyzed. Root and shoot growth responses of 75-day old seedlings in liquid-culture, were measured. It was concluded that light exhibited a significant inhibitory effect on all the growth parameters-number of primary roots, primary root length, shoot elongation, number of leaves, total leaf area; and, the GA3 treatment singly or in combinations with light, showed a significant influence on the total leaf area and primary root length.

Modulation by insulin rather than blood glucose of the pain threshold in acute physiological and flavone induced antinociception in mice.

The present study investigated the cause effect relationship between glycemic and algesic states. The hypo- and hyperglycemic conditions were induced physiologically through exercise (3 min swim at room temperature 28 degrees - 30 degrees C) and external dextrose (2 g/kg, ip) administration respectively in mice. Besides, flavone (50 mg/kg, sc) a known antinociceptive drug was chosen to study such a cause effect relationship. The anti-nociception was assessed by acetic acid assay, blood glucose measured using glucometer (Ames) and serum insulin by radioimmunoassay. The findings revealed that irrespective of the glycemic state whether hypo-, hyper, or euglycemic induced by swim stress, dextrose or flavone per se respectively, significant antinociceptive response was recorded. Pretreatment with flavone (50 mg/kg, sc) always exhibited a tendency to reverse the hyperglycemia, if any, but enhanced the antinociceptive response either after swim stress or after dextrose. These data support the contention that changes in the glycemic state in acute condition is not responsible for antinociceptive response and thereby suggesting dissociation between these two parameters. Extended studies estimating serum insulin level after the above mentioned maneuvers showed a significant rise whenever antinociceptive response was recorded irrespective of the glycemic state. It is suggested that serum insulin level, a hormonal parameter rather than the blood glucose level, which is a metabolic parameter, appears more reliable. It appears that the changes in serum insulin level produced by various treatments may have a relationship with the antinociceptive response. However, this study has the limitation that the results can apply only for acute conditions and extrapolation to clinical conditions is debatable.

Carbamate pesticide induced toxic epidermal necrolysis.

A 36-year-old male alleged to have consumed carbamate pesticide liquid (Baygon@) developed toxic epidermal necrolysis (TEN) within twenty-four hours of intake. Though drugs have been commonly incriminated as offending agents for TEN, carbamate pesticide was found to be the causative agent in our case.

The effects of electric impulse on growth of Rhizophora mucronata seedlings (Rhizophorales: Rhizophoraceae)

Exposure of mangrove seedlings to electric current was studied at an intensity of 10, 20 and 30 mA to 0.5, 1, 3, 6, 12 and 24 h in different combinations, either to plumule or radicle or both parts of the propagules of Rhizophora mucronata Poir (sample size = 30). The electric current-treated propagules and untreated control were cultured hydroponically in sea water for 75 days, and root and shoot growth parameters measured. The root elongation was significantly influenced by duration of exposure, site of propagule treated and combined effects of current intensity x site of propagule treated. Leaf number and area were significantly influenced by intensity of electric current and duration of exposure; whereas shoot elongation was affected by the duration of exposure. The root number was significantly affected by duration of exposure. In general, the electric impulse improved the growth characteristics of shoot and root.

Antinociceptive pattern of flavone and its mechanism as tested by formalin assay.

Flavone, dextrose and long swim stress exhibited antinociception. Degree of antinociception was greater with long swim stress as compared to flavone or dextrose. Combination of these treatments resulted in potentiation of antinociception. Naloxone (opioid antagonist; 5 mg/kg i.p.) antagonised flavone or long stress induced antinociception showing opioid medicated mechanism, however, failed to reverse the potentiated antinociceptive component recorded in long stressed animals which received flavone and dextrose. Antinociceptive activity of flavone, dextrose and long swim stress which was documented by acetic acid assay has been confirmed in the present study. Role for opioid system in this action has been demonstrated. Therefore, formalin test can also be considered as an useful assay procedure for testing flavonoids. However, like acetic acid assay this assay procedure also has the limitation that it is unable to detect minor changes in the degree of antinociception produced by physiological interventions such as long swim and dextrose.

In vitro anti human immunodeficiency virus activity of mangrove plants.

Mangrove plant extracts were screened in vitro against human immunodeficiency virus (HIV) on MT-4 cells. HIV infected MT-4 cells were cultured for five days in the presence of the extract, at various concentrations. Anti-HIV activity was evaluated by tetrazolium-based colorimetric assay. Seven extracts were found effective. Five of the active extracts completely inhibited the virus adsorption to the cells. Most of the active plants are from the family Rhizophoraceae.

Palmo-plantar lesions in paucibacillary leprosy--unusual clinical expressions.

Paucibacillary leprosy of the palmo-plantar skin is regarded as unusual. Three cases of Paucibacillary leprosy with such lesions are discussed and the relevent literature reviewed.