Inhibition of endoplasmic reticulum stress and activation of autophagy-protect intestinal and renal tissues from western diet-induced dysbiosis and abrogate inflammatory response to LPS: role of vitamin E.

Diet pattern is an emerging risk factor for renal disease. The mechanism by which high-fat high fructose (western) diet mediates renal injury is not yet fully understood. The objective of the present study was to investigate the relationship between endoplasmic reticulum (ER) stress and autophagy in the development of renal impairment and aggravation of the inflammatory response. Eighty male rats were randomly divided into four groups as follows: a standard diet-fed (ConD), a high-fat high fructose diet fed (HFHF-V), ConD fed and orally supplemented with vitamin E (ConD-E), and HFHF fed and orally supplemented vitamin E (HFHF-E). After 12 weeks, either lipopolysaccharide (LPS) or saline was injected. We found that upregulation of endoplasmic reticulum stress-related proteins rendered the cells susceptible to injury induced by dysbiosis and microbiota-derived metabolites. A downregulation of autophagy and upregulation of caspase-12 resulted in the loss of intestinal integrity and renal tubular injury. Maintained ER stress also increased the inflammatory response to LPS. In contrast, vitamin E effectively ameliorated ER stress and promoted autophagy to protect intestinal and renal tissues. Our results provide insight into the influences of sustained ER stress activation and autophagy inhibition on the development of renal injury, which may contribute also to the enhanced inflammatory response.

Tumor potential in rat wounds after short- and long-term administration of platelet-rich plasma.

Platelet-rich plasma (PRP) has been recognized as an effective strategy for tissue regeneration, how-ever, the safety of PRP in wound healing in terms of tumorigenicity has not yet been addressed. Therefore, the aim of this study was to examine the impact of PRP administration on the expression of the inflammatory marker, tenascin-C (TnC) and the myofibroblast markers, α-smooth muscle actin (α-SMA) and vimentin. The immune suppressive response was examined by determining the level of forkhead box protein 3 (Foxp3). PRP was administered for both long-term (two times weekly for four weeks) and short-term (for the fourth week only) post-wounding. Collagen I (col1) and lysyl oxidase (LOX) were used to indicate complete healing, after which any increase in the myofibroblast or in the inflammatory markers would suggest tumor potential. Collagen III (col3), a marker for granulation tissue, was used to remark non-healing. Quantitative real-time reverse transcriptase polymerase chain reaction (QRT-PCR) and Western blot showed that after long-term administration of PRP, the expression of TnC, α-SMA and vimentin was barely detected, while being markedly expressed in the wounded non-treated group and in the short-term administration group. Moreover, the active expression of α-SMA in the two groups was associated positively with the expression of col3 and negatively with the expression of col1. The low expression of Foxp3 after short-term administration relative to the control group indicated active immunity against tumor development. In conclusion, these findings indicate that PRP can be safely used in short- and long-term administration without tumorigenesis concern.

Desflurane or sevoflurane for gynaecological day-case anaesthesia with spontaneous respiration?

Sixty gynaecological day-case patients were anaesthetised with either desflurane or sevoflurane in oxygen/nitrous oxide, following intravenous induction. Mean end-tidal desflurane was 4.5% at 5 and 10 min post induction, whereas mean end-tidal sevoflurane was 1.7%. There were five untoward airway events (coughing, hiccoughs) in the desflurane group and three in the sevoflurane group, including one laryngospasm. Time to eye opening and orientation following anaesthesia were significantly faster in the desflurane group (2.8 min/4.8 min) than in the sevoflurane group (7.0 min/9.8 min; p < 0.0001). Time to being ready for discharge home was also significantly earlier in the desflurane group (3 h compared with 3.5 h). Telephone interview on the first postoperative day showed that in the desflurane group 29 of 31 were fully returned to normal activity compared with only 15 out of 29 in the sevoflurane group (p < 0.01).

Myringoplasty: update on onlay pedicle skin flap and temporalis fascia sandwich graft.

The technique of onlay sandwich grafting of tympanic membrane perforations fashioned by the use of pedicle flap raised from the posterior deep meatal skin and autologous temporalis fascia is described. The results of a series of 124 ears operated between 1987 and 1999 are the basis of this report. Of these 106 patients had myringoplasty for the first time. The operation was successful in 102 (96.23 per cent) patients. Eighteen patients had revision myringoplasty, with a successful result in 14 (77.78 per cent). None of the patients developed complications usually associated with onlay grafting. A preliminary report of this work was presented at the XVI World Congress of Otolaryngology Head and Neck Surgery at Sydney in 1997.

Ethanol sclerotherapy for symptomatic simple renal cysts.

Twenty-eight patients with 30 symptomatic simple renal cysts were treated by percutaneous aspiration of the cyst and injection of 95% ethanol. All patients were available for follow-up during mean period of 19 (range 14-40) months. In all patients, successful resolution of the cyst with disappearance of the symptoms was observed within 1 month after treatment. During the whole period of follow-up, no patient experienced recurrence of symptoms or required repeat therapy. Of all renal cysts treated, resolution was complete in 25 (83%) and partial (recurrence of < 50% of original cyst volume with no symptoms) in 5 (17%). The degree of response to sclerotherapy (whether complete or partial) correlated significantly with cyst size (P > 0.0008). Major complications were not encountered, while microscopic hematuria was seen in two patients, and low-grade fever was observed in another two. Ethanol sclerotherapy is simple, noninvasive, and highly cost-effective and should be recommended for the treatment of symptomatic simple renal cysts.

Optimization of night and shiftwork plans among policemen in Kuwait: a field experiment.

A pilot survey was designed to define incidence, rotation period, rotation direction and cycle of shiftwork plans in the production and service units in Kuwait. Preliminary results from the Ministry of Interior showed that four different shift plans are widely used. Forty policemen, ten from each shift plan, volunteered to fill in a diary for a period of two or more cycles. The diary was comprised of a set of questions planned to reveal disturbances in sleep duration, sleep quality, food intake and appetite. The daily questionnaire also covered psychosomatic complaints and subjective judgement of recovery. A control group, on permanent day work, volunteered to fill in the diary for the same period. The results indicated that one of the four shift plans was quite satisfactory and least harmful to the policemen. Two plans were associated with excessive strain during working days, but the number of free days was sufficient to achieve complete recovery. The fourth plan was associated with excessive strain during working days and recovery was not achieved after 24 h of rest at the end of the shift cycle.

Von Willebrand factor has more than one binding site for platelets.

By the use of a series of monoclonal antibodies against platelet membrane glycoproteins (GP) and the von Willebrand factor (vWF), it is shown that thrombin-induced binding to GP IIb/IIIa involves a different site on vWF from ristocetin-induced binding to GP Ib.

Radiation-induced fibrosarcoma of the head and neck.

Primary fibrosarcoma of the neck is uncommon; radiation-induced similar lesions are rare. They might start as irradiation fibromatosis akin to extraabdominal desmoids, but they tend to kill by local invasion rather than by distant dissemination. The literature has been briefly reviewed with a short discussion of clinical and pathological features of both the primary (de novo) and the secondary (radiation-induced) types of fibrosarcoma. Two cases of post-irradiation fibrosarcoma of the neck are presented.

Malignant oncocytoma of the nasal cavity.

Malignant oncocytoma of the major salivary glands is uncommon. Those of the endocrine, minor salivary and mucous glands are certainly rare. A case of a slowly-growing, low-grade malignant oncocytoma of the nasal cavity in a 50-year-old male, with no lymph node or distant metastases or local invasion of vital adjacent structures, and treated with combined radiotherapy and radical surgery, has been presented. The literature has been briefly reviewed, and the histological types; the electro-microscopic, histochemical and clinical pictures; and the outlines of treatment of oncocytomas have been discussed.

Traumatic aneurysm of the internal carotid artery and epistaxis. (Review of literature and report of a case).

A review of 108 years of world literature revealed 69 cases fulfilling the picture of a clinical syndrome of head injury, a latent period followed by epistaxis and cranial nerve lesions. A similar case has been added which is the fourth case to be reported to be due to a bullet injury. The applied anatomy of the intracranial internal carotid artery (ICA) and the aetiology, clinical syndrome, pathology, diagnosis, prognosis and management of ICA aneurysms have been briefly discussed.

The effects of fasting in Ramadan. 1. Serum uric acid and lipid concentrations.

1. The changes in serum levels of uric acid and lipids during 1 month of starvation-refeeding were measured in sixteen male volunteers. 2. Uric acid levels increased linearly with the duration of the experiment. The increase was positively correlated with the increase in serum triglycerides but not with cholesterol or phospholipids. 3. Triglycerides increased at a faster rate than uric acid implying that the increase in uric acid was secondary to that of the lipid. 4. It was concluded that the purine and lipid synthetic pathways are linked through a common small-molecular-weight effector rather than through the sharing of a common enzyme.