Decreased oxidation susceptibility of plasma low density lipoproteins in patients with Gilbert's syndrome.

BACKGROUND AND AIM: The association of hyperbilirubinemia in Gilbert's syndrome (GS) with a decrease in prevalence of coronary artery disease is a well-known phenomenon. In this study, the state of low-density lipoprotein (LDL) oxidation which has been postulated to be a significant determinant at the etiopathogenesis of atherosclerotic disorders was investigated among individuals with GS. METHODS: For this purpose, serum cholesterol, LDL cholesterol, high-density lipoprotein cholesterol, triglycerides, uric acid, apolipoprotein A and B, bilirubins, thiobarbituric acid-reactive substances, and the sensitivity of LDL oxidation levels, as well as serum alanine aminotransferase, aspartate aminotranserfase, gamma glutamyl transferase, and alkaline phosphatase activities, were determined in 17 patients with Gilbert's syndrome and 15 healthy adults. RESULTS: There was no significant difference between the groups except the indirect bilirubin parameter (P < 0.001). In comparison with the healthy individuals, LDL oxidation levels between 75 and 120 min were significantly lower (P < 0.005) along with prolonged lag-phase in GS patients, indicating a delay in oxidation susceptibility. CONCLUSION: It is suggested that the chronic hyperbilirubinemia leading to a lag-phase prolongation in LDL oxidation and a decrease in LDL oxidation may be reason for the low percentage of coronary artery disease.

The effect of hyperbaric oxygen therapy on the adverse effects of octreotide on wound healing.

OBJECTIVE: Octreotide, a long-acting somatostatin analogue, has been used in the treatment of various disorders. Octreotide has significant detrimental impacts upon wound healing. We tested the hypothesis that hyperbaric oxygen therapy may overcome octreotide-mediated suppression of wound healing. DESIGN: Prospective, randomised, parallel-group animal study. METHODS: Operated rats were divided into four groups: (1) controls, (2) octreotide therapy, (3) hyperbaric oxygen therapy and (4) combination of octreotide and hyperbaric oxygen therapy. Wound healing was assessed by breaking-strength measurements, hydroxyproline levels and fibrosis scores. RESULTS: Octreotide decreased the breaking-strength measurements, hydroxyproline levels and fibrosis scores to 72%, 88% and 55%, respectively, of the control group. In the combination group, hyperbaric oxygen therapy increased breaking-strength measurements and hydroxyproline levels to 137% and 126%, respectively, of the control group. In the combination group, hyperbaric oxygen therapy tended to increase the fibrosis scores to 111% of the control group, but without statistical significance. CONCLUSION: Hyperbaric oxygen therapy tends to reverse the octreotide-induced impairment of wound healing.

Submarine escape from depths of 30 and 60 feet: 41,183 training ascents without serious injury.

INTRODUCTION: In the case of a submerged, disabled submarine, survivors may be forced to escape by entering the water and ascending rapidly to the surface. The large pressure changes involved may produce pulmonary barotrauma, arterial gas embolism, or barotrauma. To assess the likelihood of such injuries, we retrospectively evaluated medical problems due to submarine escape training among military personnel. METHODS: We evaluated 41,183 controlled ascents performed over the past 21 yr in the escape training tank at Gölcük-Kocaeli, Turkey. Each trainee performed two free ascents from 30 ft and two hooded ascents from 60 ft. Before participating, candidates were screened by physical examination, spirometry, and chest X-rays; ear examinations for barotrauma were made after ascents. If a trainee failed to exhale properly during ascent, an instructor aborted the ascent and took him to a bell or side recess of the tank. RESULTS: No record of pulmonary barotrauma or other major complications were found. Middle-ear barotrauma was observed following 1,643 of the ascents (4.1%), with rupture of the tympanic membrane in 35 cases. DISCUSSION: Submarine escape ascents can be safely performed provided that subjects are medically screened and well trained.

Gallbladder and gastric motility in patients with idiopathic slow-transit constipation.

OBJECTIVE: Idiopathic slow-transit constipation (STC) has been suggested to be a pangastrointestinal motility disorder. We investigated scintigraphically whether motility in the gallbladder and stomach was impaired in slow-transit constipation. METHODS: Twenty-four patients with STC were studied. Colon transit time, gallbladder motility, and solid-phase gastric emptying were measured by scintigraphy. RESULTS: Gallbladder dysmotility was observed in 8 of 18 (44.4%) patients. Mean gallbladder ejection fraction was 41.6 +/- 13.6% (range, 16.3-67.0%). Gastric emptying was delayed in 9 of 18 (50%) patients. Mean solid-phase gastric half-emptying time was 75 minutes. STC may be associated with impaired function of other gastrointestinal organs. Approximately half of patients with STC presented gallbladder or gastric dysmotility. CONCLUSION: STC may not be a pure colonic abnormality; it may be a component of a pangastrointestinal tract motility disorder involving several organs.