Silver oxide nanoparticles alleviate indomethacin-induced gastric injury: a novel antiulcer agent.

Silver and silver oxides are gaining interest in medical applications for their prominent antibacterial and antimicrobial potentials. Recent studies suggest that nanosilver oxide has remarkable anti-inflammatory effects and enhances wound healing. Nevertheless, its effect on gastric ulcer has not yet been illustrated. Thus the current study aimed to explore the prospect protective effect of nanosilver oxide against indomethacin-induced gastric ulcer. A new approach has been followed to synthesize nanosilver oxide. X-ray diffraction, UV-Vis spectroscopy and transition electron microscope techniques have been successfully used to characterize the synthesized nanoparticles. Treatment of ulcerated rats with different doses of nanosilver oxide especially (175 and 350 ppm/p.o.) alleviated adverse effects of indomethacin-induced gastric injury as demonstrated by decreasing ulcer index and elevating % of ulcer inhibition. These positive effects excelled those exerted by the reference antiulcer drug omeprazole. Nanosilver oxide suppressed gastric inflammation by reducing myeloperoxidase, tumor necrosis alpha, interleukin 1beta and interferon gamma. Moreover, nanosilver oxide halted gastric oxidative stress via inhibiting lipid  peroxidation and enhancing glutathione and paraoxonase-1. Regarding gastric apoptosis, nanosilver oxide down regulated the expression of caspase 9, tumor protein 53, and nuclear factor kappa B and allograft inflammatory factor-1 genes. These findings emphasize the antiulcerogenic potential of nanosilver oxide against indomethacin-induced gastric ulcers which are multi-factorial including anti-inflammatory, antioxidant and antiapoptotic effects.

Synthesis, Characterization, and Anticancer Activity of New Metal Complexes Derived from 2-Hydroxy-3-(hydroxyimino)-4-oxopentan-2-ylidene)benzohydrazide.

Novel metal(II) complexes derived from 2-hydroxy-N'-((Z)-3-(hydroxyimino)-4-oxopentan-2-ylidene)benzohydrazide ligand (H2L) were synthesized and characterized by elemental and thermal analyses (DTA and TGA), IR, UV-VIS, (1)H-NMR, ESR and mass spectroscopy, magnetic susceptibilities, and conductivities measurements. The complexes adopt distorted octahedral geometry. The ESR spectra of the solid copper(II) complexes are characteristic to d(9) configuration and have an axial symmetry type of a d(x (2)-y (2)) ground state. The g values confirmed the tetragonal octahedral geometry with a considerably ionic or covalent environment. The cytotoxic activity of the ligand and its metal complexes showed potent cytotoxicity effect against growth of human liver cancer HepG2 cell lines compared to the clinically used Sorafenib (Nexavar).

Vascular dysfunction in patients with young ß-thalassemia: relation to cardiovascular complications and subclinical atherosclerosis.

We aimed to study the endothelial dysfunction among children and adolescents with transfusion-dependent ß-thalassemia using von Willebrand factor antigen (VWF:Ag) and flow cytometric analysis of circulating CD144(+) endothelial microparticles (EMPs) and endothelial progenitor cells (CD34(+)VEGFR2(+)) and assess their relation to iron overload, erythropoietin and chelation therapy as well as echocardiographic parameters and carotid intima-media thickness. The VWF:Ag, EMPs, and CD34(+)VEGFR2(+) cells were significantly higher among patients with ß-thalassemia than controls (P < .001). The type of chelation and patients' compliance did not influence the results. No significant correlations were found between the studied vascular markers. Patients with evident heart disease had higher VWF: Ag, EMPs, and CD34(+)VEGFR2(+) cells than those without. Carotid intima-media thickness was increased among patients but not correlated with vascular markers. We suggest that procoagulant EMPs and VWF: Ag are involved in cardiovascular complications in patients with young ß-thalassemia. CD34(+)VEGFR2(+) cells were further increased in response to tissue injury contributing to reendothelialization and neovascularization.

Awake anaesthesia for major thoracic surgical procedures: an observational study.

OBJECTIVE: Major thoracic surgical procedures are rarely performed under awake anaesthesia. The purpose of this study is to review the experience of a tertiary center in major thoracic surgical procedures done under awake anaesthesia. METHODS: This single center, single operator, retrospective review of cases of thoracic surgery were done under awake anaesthesia, which included all patients operated on from September 2002 to September 2006. Patients were pre-medicated with intravenous fentanyl 50 microg and midazolam 3mg. Thoracic epidural anaesthesia was done either between T1-T3 and T4-T6 depending on the type of procedure. The block level was verified using warm-cold discrimination. In addition, stellate ganglion block was performed in some patients to achieve cough control. The following data were documented: patients' demographics, the type and approach of procedure, operative time, intraoperative complications, conversion to general anaesthesia, mortality, the need for intensive care unit (ICU) admission and postoperative hospital length of stay. RESULTS: A total of 79 cases were performed over the study period. The mean age was 37+/-18 years (59% male). Twenty-five patients (32%) underwent thymectomy, 11 patients (13%) lung resection and 8 patients (11%) sympathectomy. The most common approach was thoracoscopy in 61 patients (77%), followed by thoracotomy in 11 patients (14%) and median sternotomy in 3 patients (4%). The median postoperative hospital stay was 1.5 days, with 33% of cases discharged on the same day of operation (day surgery). Only five patients (6%) required ICU admission; three of these patients in 2002 did not need ICU, but epidural policy at that time mandated ICU admission - only 2/79 (2.5% required ICU). One patient died as a result of his underlying metastatic hepatocellular carcinoma 9 days postoperatively. Another patient was converted early to general anaesthesia prior to pneumonectomy after discovery of left upper lobe involvement and he died 3 months later. There was no anaesthesia related mortality. CONCLUSIONS: We conclude that major thoracic procedure can be safely performed under awake anaesthesia. The technique avoids general anaesthesia and endotracheal intubation, reduces postoperative hospital stay and minimizes intensive care unit admission. This study strongly suggests awake anaesthesia can improve outcomes and reduce cost. A proper multi-center trial to further evaluate this technique is needed.