Effect of palm oil (Elaeis guineensis) tocotrienols on mesenteric adipose tissue deposition and the expression of 11ß-hydroxysteroid dehydrogenase type 1 enzyme (11ß-HSD1) in adrenalectomized rats treated with dexamethasone.

OBJECTIVES: A study was done to investigate the effect of palm oil (Elaeis guineensis) tocotrienols on (1) rats mesenteric adipose tissue deposition (2) and 11ß-HSD1 enzyme expression in mesenteric adipocyte. There is a necessity to find an inhibitor for the 11ß-HSD1 enzyme which enhances the proliferation of mesenteric adipocyte tissue therefore curbing the onset of metabolic syndrome. MATERIAL AND METHODS: A total of 35 male Spraque Dawley rats were divided into 5 different groups, i.e., a baseline control group (n=7), a sham operated group (n=7) and three experimental adrenalectomised groups (ADR) (n=21). Each of the experimental ADR group was given intramuscular dexamethasone (Dexa) with a dose of 120 µg/kg after 2 weeks post adrenalectomy and were divided into adrenalectomised control (n=7), Glycyrrhizic acid (GCA) treated (dose=120 mg/kg/day; n=7) and Palm Tocotrienol treated (dose=60 mg/kg/day; n=7) groups. These various treatments were given 6 days a week for 8 weeks via gastric gavage (following 2 weeks of adrenalectomy). Data is expressed as mean ± standard error mean (SEM), compared to each other using one-way analysis-of-variance (ANOVA) followed by Tukey's post hoc test and then a t-test. RESULTS: The results show that palm tocotrienol tend to slightly increase mesenteric adipose tissue deposition in rats. However, palm tocotrienol was also found to have potential in inhibiting the expression of 11ß-HSD1 enzyme in mesenteric adipocytes. CONCLUSIONS: This study suggests palm tocotrienol inhibits 11ß-HSD1 enzyme expression and activity.

Anomalous structures of the liver: an anatomical insight.

BACKGROUND AND AIMS: Anomalous structures of the liver are incidentally detected during autopsies or during routine cadaveric dissection. The present study aimed to observe the abnormal shapes of quadrate lobe, accessory sulci and ligamentum teres of the liver. MATERIALS AND METHODS: A total of 20 formalin fixed cadaveric livers (n=20), irrespective of the sex, were taken for this study. These specimens belonged to cadavers of unknown origins. The presence of accessory sulci and abnormalities related to the quadrate lobe and ligamentum teres were studied in detail. Morphometric measurements were taken for the abnormal accessory sulci and abnormal quadrate lobes. RESULTS: Variable shapes of the quadrate lobes were observed with 8 (40%) being rectangular, 6 (30%) being pear-shaped, 4 (20%) being triangular and another 2 specimens (10%) which were square in shape. The presences of accessory sulci on the diaphragmatic surface of the liver were observed in 2 specimens (10%). Ligamentum teres traversed the groove in 18 (90%) while in 2 (10%) specimens, the ligamentum teres was embedded in the groove and it was covered by parenchymatous tissue of the liver it from the side of the quadrate lobe. CONCLUSION: Prior anatomical knowledge of the presence of the anomalous structures in the liver with may be helpful for the radiologist and surgeons for correct interpretation of radiographs and planning appropriate hepatobiliary surgeries.

Higher division of the tibial nerve in the leg: gross anatomical study with clinical implications.

BACKGROUND AND OBJECTIVES: Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications. MATERIALS AND METHODS: A total of 20 cadaveric limbs (irrespective of left or right side) were taken randomly. The posterior compartment of the thigh and leg was dissected to trace the tibial nerve and its branches. The specimens were subjected to measurements with respect to an arbitrary horizontal line passing through tip of medial malleolus and the calcaneum. All the specimens were photographed. RESULTS: In 5 cases (25%), the tibial nerve divided deep to the flexor retinaculum. In 15 cases (75%) cases, the tibial nerve divided at a distance of 3.5 cm - 6.5 cm (average 5 cm) above the medial malleolus. CONCLUSION: The tibial nerve and its divisions are important for performing successful nerve blocks and insertion of plates while treating fractures. Variations may account for the various discrepancies between the electromyographic tests and clinical tests.

Piper sarmentosum is comparable to glycyrrhizic acid in reducing visceral fat deposition in adrenalectomised rats given dexamethasone.

OBJECTIVES: Visceral obesity may be due to the dysregulation of cortisol production or metabolism that lead to metabolic disease. In adipose tissue, the enzyme 11beta-hydroxysteroid dehydrogenase type 1 regulates cortisol metabolism (11beta-HSD1). A previous study showed an increase in the visceral fat deposition in adrenalectomised rats given intramuscular dexamethasone. Glycyrrhizic acid (GCA) has been shown to reduce fat deposition because it is a known potent inhibitor of the 11beta-HSD1 enzyme. Piper sarmentosum (PS) is an edible medicinal plant commonly used in Asia as traditional medicine for treating diabetes, hypertension and joint pains. In this study, we determined the effects of PS extract on the disposition and morphology of perirenal adipocytes of adrenalectomised rats given intramuscular dexamethasone. MATERIALS AND METHODS: A total of 21 male Spraque Dawley rats were adrenalectomised and given intramuscular dexamethasone, 120 µg/kg/day. These rats were further divided into three groups: adrenalectomised control (ADR+Dexa; n=7), GCA-treated (ADR+Dexa+GCA; dose=240 mg/kg/day; n=7) and PS-treated (ADR+Dexa+PS; dose=125 mg/kg/day; n=7) groups. The various treatments were given via gastric gavage following 2 weeks of adrenalectomy. RESULTS: Treatment with PS extract for 8 weeks showed decreased deposition of perirenal adipocytes which was similar to the GCA-treated group. However, PS-treated rats had thinner adipocyte membrane compared with that of the GCA-treated group. CONCLUSION: In conclusion, PS extract decreased perirenal fat deposition and reduced the diameter of the adipocyte membrane. However, the mechanisms of action needed further study.

Topographical anatomy of the profunda femoris artery and the femoral nerve: normal and abnormal relationships.

BACKGROUND AND OBJECTIVE: Femoral nerve (FN) is the largest branch of lumbar plexus. It lies lateral to femoral artery (FA) and it is located outside the femoral sheath. Profunda femoris artery (PFA) is a branch of the FA. The present study aimed to observe the topographical anatomy and relationship of the PFA and the FN. MATERIALS AND METHODS: A total of 12 embalmed cadaveric lower limbs (7 lefts and 5 rights) were taken and the thighs were dissected in detail. The relationship of PFA and FN were observed. Appropriate measurements were taken and the specimens were photographed. RESULTS: The PFA originated from the FA in all the 12 specimens (100%). In 10 specimens (83.3%), the PFA was found to originate lateral to the FA while in 2 specimens, the origin of PFA was posterior to the FA (16.7%). The PFA originated from the FA at a distance of 6.5 + 1.5 cm with regard to the midinguinal point. All FN were found to lie outside the femoral sheaths. Out of the 12 specimens, only 2 specimens (16.7%) exhibited the FN to lie posterior to the PFA, while in 10 specimens (83.3%), the FN was found to lie anterior to the PFA. CONCLUSION: Prior anatomical knowledge of structures in the anterior compartment of thigh may be helpful for surgeons performing nerve block, cannulation and catheterization. Knowledge of abnormal anatomy of the FN and PFA is important in order to prevent any inadvertent injury to the PFA or FN.

Absence of the isthmus of the thyroid gland: anatomical and clinical considerations.

The right and left lobes of the thyroid gland are connected by an isthmus. The isthmus lies at the level of the second and third tracheal rings. Occasionaly, the isthmus may be absent. We hereby, report the absence of isthmus in a 52-year-old male cadaver of unknown origin. Both the right and left lobes were normal but they were separated. Both the right and left lobes of the thyroid gland measured 4.3 cm vertically. The separation distance between right and left glands was noted at the upper, middle and lower parts. The upper end of medial border of both lobes were separated by a distance of 1 cm while the separation distance was 0.7 cm and 1.5 cm at the middle and lower parts, respectively. The anatomical and clinical significance of absence of isthmus is important for medical personnel and the surgeons operating on the thyroid gland. The present case report is a an attempt to highlight such.

Use Piper sarmentosum as an effective antidiabetic supplement in South East Asia: a review.

Herbs with antidiabetic activity have a potential role to play. Herbal medicines have been widely used in South East Asia because of lesser side effects and cost effectiveness. The main aim of this review article was to disseminate important information regarding the use of herbal products in oxidative stress involved in diseases like diabetes mellitus. The article highlights some of the traditional medicinal plants which have been widely used in South East Asia with special emphasis on Piper sarmentosum. Piper sarmentosum have been reported to possess varying degree of hypoglycemic, antidiabetic and other additional properties. The antioxidant properties of the herbs may be effective in controlling the oxidative damage produced during diabetes mellitus. The review article highlights the positive role of traditional herbs towards diabetes mellitus and also describes its complications.

Effect of 11ß-HSD1 dehydrogenase activity on bone histomorphometry of glucocorticoid-induced osteoporotic male Sprague-Dawley rats.

INTRODUCTION: Glucocorticoids cause osteoporosis by decreasing bone formation and increasing bone resorption activity. Glucocorticoid action in bones depends on the activity of 11-beta-hydroxysteroid dehydrogenase type 1 (11ß-HSD1) enzyme, which plays an important role in regulating corticosteroids. 11ß-HSD1 is expressed by human and rat osteoblasts. We aimed to investigate the relationship between 11ß-HSD1 dehydrogenase activity and bone histomorphometric changes in glucocorticoid-induced osteoporotic bone in rats. METHODS: A total of 30 male Sprague-Dawley rats (aged three months, weighing 200-250 g) were divided into three groups of ten each. Group 1 rats were the baseline control, which were sacrificed untreated at the beginning of the study. Group 2 rats underwent sham operation and were administered with vehicle olive oil intramuscularly at 0.05 ml/kg. Group 3 rats were adrenalectomised and administered with an intramuscular injection of dexamethasone 120 µg/kg body weight/day. The treatment was started two weeks after the operation, for a duration of two months. Plasma osteocalcin, plasma pyrodinoline, plasma corticosterone and 11ß-HSD1 were measured, and bone histomorphometry analysis was performed. RESULTS: Dexamethasone treatment caused an increase in plasma corticosterone level, together with a significant reduction in 11ß-HSD1 dehydrogenase activity of the bone, along with a higher plasma level of the bone resorption marker, pyridinoline. Dexamethasone treatment also caused a reduction in trabecular volume, number and thickness, and an increase in trabecular separation. CONCLUSION: Long-term glucocorticoid treatment reduces the 11ß-HSD1 dehydrogenase activity in the bone, which can otherwise lead to bone loss due to the increased level of active glucocorticoids.

Piper sarmentosum prevents glucocorticoid-induced osteoporotic bone resorption by increasing 11ß-hydroxysteroid dehydrogenase type 1 activity.

AIMS: Osteoporosis is a proven complication of long-term glucocorticoid therapy. Concern on glucocorticoid induced osteoporosis has increased dramatically in recent years with the widespread use of synthetic glucocorticoids. Glucocorticoid action in bone depends upon the activity of 11ßhydroxysteroid dehydrogenase type 1 enzyme (11ßHSD1). This enzyme plays an important role in regulating corticosteroids by locally interconverting cortisone into active cortisol. This has been demonstrated in primary cultures of human, mouse or rat osteoblasts. Therefore, inhibition of this enzyme may reduce bone resorption markers. Piper sarmentosum (Ps) is a potent inhibitor of 11ßHSD1 in liver and adipose tissue. In this study we determined the effect of Ps on 11ßHSD1 activity in bones of glucocorticoid-induced osteoporotic rats. MATERIALS AND METHODS: Three-month old male Sprague-Dawley rats were adrenalectomised to remove the main source of circulating glucocorticoids. The animals were administered with dexamethasone 120 µg/kg body weight/day. Treatment with Ps 125 mg/kg body weight and glycirrhizic acid (GCA) 120 mg/kg body weight were given simultaneously. RESULTS: The results showed that Ps extract reduced plasma corticosterone concentration (1.05+0.02 µg/ml) and induced 11ßHSD1 dehydrogenase activity in bone (87.69+1.41%). Consequently, it also reduced the bone resorption marker, pyridinoline, in dexamethasone-treated adrenalectomised rats (2.07+0.62/L). Despite that, our data showed an inverse relationship between the plasma corticosterone level and the dehydrogenase activity of 11ßHSD1 in the bone. CONCLUSIONS: This suggests that 11ßHSD1 acts as the local regulator of glucocorticoid and its activity in bone was not correlated to systemic corticosterone level.

An atavastic belly of the flexor digitorum profundus with absence of tendon of flexor digitorum superficialis to the little finger: morphological and histological considerations.

In this case report, we report the absence of the fourth tendon of flexor digitorium superficialis (FDS) to the little finger with a concurrent anomalous muscular belly of flexor digitorum profundus (FDP) in the palm. The FDS originated from the medial epicondyle, divided into three tendons for the index, middle and ring fingers with the little finger devoid of any attachment. The FDP exhibited a muscular belly which passed deep to the flexor retinaculum (FR) and continued for another 4 cm thereby dividing into four slips for the index, middle, ring and little fingers. The presence of the muscular belly of the FDP lead us to think whether it was an adhesion between the tendons of the FDP, so we proceeded to histological analysis. The tissue was processed and stained with Hematoxylin and Eosin. Abundant longitudinal muscle fibers with peripherally situated nuclei confirmed it to be a skeletal muscle. Absence of the tendon of FDS to little finger may influence the flexion movement in the middle and proximal interphalangeal joints. Presence of anomalous muscle belly of FDP in the palm may mimic any soft tissue tumour, compress neurovascular structures or even pose difficulty while performing tendon transplant surgeries.