Gastric motility disorders and their endoscopic and surgical treatments other than bariatric surgery.

Gastroparesis is the most common gastric motility disorder. The cardinal symptoms are nausea, vomiting, gastric fullness, early satiety, or bloating, associated with slow gastric emptying in the absence of mechanical obstruction. Delayed gastric emptying is demonstrated by a gastric emptying scintigraphy or by a breath test. Gastroparesis can be idiopathic, post-operative, secondary to diabetes, iatrogenic, or post-infectious. Therapeutic care must be multidisciplinary including nutritional, medical, endoscopic and surgical modes. The complications of delayed gastric emptying must be sought and addressed, particularly malnutrition, in order to identify and correct vitamin deficiencies and fluid and electrolyte disturbances. An etiology should be identified and treated whenever possible. Improvement in symptoms can be treated by dietary regimes and pharmaceutical treatments, including prokinetics. If these are not effective, specialized endoscopic approaches such as endoscopic or surgical pyloromyotomy aim at relaxing the pyloric sphincter, while the implantation of an electrical stimulator of gastric muscle should be discussed in specialized centers.

Two New Flavonoids and Biological Activity of Astragalus abyssinicus (Hochst.) Steud. ex A. Rich. Aerial Parts.

2 new flavonoid glycosides, kaempferol 3-O-(4",6"-di-O-α-L-rhamnopyranosyl)-ß-D-glucopyranoside (1) and quercetin 3-O-(4",6"-di-O-α-L-rhamnopyranosyl)-ß-D-glucopyranoside (2), were isolated from the n-butanol soluble fraction of the methanol extract (BF) of Astragalus abyssinicus aerial parts, together with 3 known compounds, rutin (3), kaempferol 3-O-ß-D-rutinoside (4) and 5,7,4'-trihydroxy-3'-methoxyisoflavone (5). The structures of the isolated compounds were characterized on the basis of UV, NMR and negative ESI-MS analyses. The BF fraction showed in vitro weak antibacterial activity against Staphylococcus aureus, while 2 and 3 exhibited in vitro antioxidant activity higher than ascorbic acid using DPPH free radical scavenging activity method.

Radiological hazards of TENORM in the wasted petroleum pipes.

Disposal petroleum pipes containing sludge and scale as a technically enhanced natural occurring radioactive material (TENORM) leads to internal and external radiation hazards and then a significant radiation dose to the workers. In order to contribute to a future waste management policy related to the presence of TENORM in the disposal sites of wasted petroleum pipes, scale and sludge as TENORM wastes are collected form these disposal pipes for radiometric analysis. These pipes are imported from onshore oilfields at south Sinai governorate, Egypt. The highest mean (226)Ra and (228)Ra concentrations of 519 and 50 kBq/kg respectively, were measured in scale samples. Sludge lies within the normal range of radium concentration. The average absorbed dose caused by the exposure to the wasted pipes equal to 4.09 microGy h(-1) from sludge and 262 microGy h(-1) from scale. This is much higher than the acceptable level of 0.059 microGy h(-1). Due to radon inhalation, important radon related parameters are calculated which advantage in internal dose calculation. Fairly good correlation between real radium content and radon exhalation rate for sludge samples is obtained. The hazards from sludge come from its high emanation power for radon which equal to 3.83%. The obtained results demonstrate the need of screening oil residues for their radionuclide content in order to decide about their final disposal.

Radon effective dose from TENORM waste associated with petroleum industries.

Technically enhanced naturally occurring radioactive material (TENORM) associated with petroleum industries can be accumulated with elevated quantities and therefore can threat the workers through external and internal exposure. Measurements of radon-related parameters give information about the radioactivity levels in the TENORM waste using the well-established correlation. Also, it is useful to calculate the internal exposure due to radon inhalation in terms of effective radon dose. Among radon-related parameters, areal exhalation rate is the most suitable for characterising land and objects with only upper surface contamination in the case of petroleum waste. The TENORM in this study is collected from waste storage areas located near oilfields at south Sinai governorate, Egypt. The average values of exhalation rates as measured by Lucas cell based on delay count method are 273 +/- 144 and 38 +/- 8 Bq m(-2) h(-1) for scale and sludge, respectively. Whereas, two count method gives results with 18 and 20 % lower values for scale and sludge, respectively with good correlation coefficient of 0.999 and 0.852, respectively. Sealed cup fitted with CR-39 gives results compatible with Lucas cell with minor deviation in case of scale due to its thoron content. The results of CR-39 are qualified by taking into consideration the correction for back diffusion effect. The effective radon dose was calculated for different simulated radioactive waste storage areas with different contaminated areas and air ventilation rate. Minimising the contaminated areas and building up efficient ventilation systems can reduce the internal exposure even in the case of RWSA-containing TENORM with elevated radioactivity.

Two new flavonol glycosides from leaves of Koelreuteria paniculata.

Two new flavonol glycosides were isolated from dried leaves of Koelreuteria paniculata Laxm. (Sapindaceae) and characterized as 6,8-dihydroxy-afzelin and afzelin 3"-O-gallate, based on chemical and spectral evidences, in addition to nine known polyphenolic metabolites, including eight isolated for the first time from this species.

Idiopathic intussusception: the role of laparoscopy.

BACKGROUND: The use of a barium enema affords both diagnostic confirmation and a chance for nonsurgical complete reduction of the intussusception, which must be proven by adequate reflux of barium into the distal ileum. If this does not occur, it is assumed that the intussusception has not been reduced, and the infant is taken straight to the operating room for laparotomy and surgical treatment. The aim of this study is to limit unnecessary surgical explorations by the diagnostic and the therapeutic policy of laparoscopy with assisted hydrostatic saline reduction under general anesthesia. METHODS: Over a period of 3 years, 90 patients with intussusception were treated. Twenty patients in whom hydrostatic reduction was contraindicated were treated initially by surgery. In the remaining 70 patients, hydrostatic reduction was successful in 50 (71%), and laparoscopy was performed in 20 patients before laparotomy. Hydrostatic saline reduction was used when there was failure of reduction seen by laparoscopy. RESULTS: In 20 patients, laparoscopy showed reduction of intussusception in eight patients (40%), and saline hydrostatic reduction was successful in six patients (30%), with failure of reduction in six patients (30%) necessitating laparotomy. CONCLUSION: The use of laparoscopy for diagnosis of failure of reduction of intussusception and the hydrostatic reduction by saline enema during laparoscopy saved 14 patients from unnecessary laparotomy.

Leprosy affects facial nerves at the main trunk: neurolysis can possibly avoid transfer procedures.

The predilective sites of lesions in leprous peripheral nerves are well established, and their surgical decompression is common practice when sensorimotor disorders persist after medication. By contrast, the precise localization of leprous facial neuropathy still remains unclear, and musculofascial transfers have been the only type of surgical treatment. The goal of this study was to clarify where leprosy affects facial nerves and to determine whether neurolysis might suffice to restore facial function. In five Indian and two Egyptian patients suffering from leprous facial neuritis, the nerves were stimulated transcranially at the brainstem to evoke efferent motor nerve action potentials, which were recorded from the exposed nerves. Lesions were detected at the main trunk proximally from the first bifurcation in all cases. Epineuriotomy revealed fibrosis of the interfascicular epineurium in all instances, as an indication for interfascicular neurolysis. One patient was able to close his eye and showed a better smile soon after surgery. After 16 and 21 months, respectively, one patient had improved distinctly, two patients slightly, two patients showing no progress, and two patients were lost to follow-up. It is concluded that (1) leprous facial neuropathy is located at the main trunk close to the first bifurcation and not exclusively at the peripheral zygomatic branches, (2) microsurgical neurolysis can be considered in leprous facial neuropathy before transfer procedures as long as voluntary or spontaneous activity is present in the affected muscles, and (3) intraoperative transcranial electrical stimulation is an effective means of localizing the site and proximal extent of leprous facial neuropathy.

Isolation of triterpene saponins from Gypsophila capillaris.

Four novel triterpenoid saponins have been isolated from Gypsophila capillaris. Three were monodesmosidic: 3 beta-hydroxyolean-12-en-23,28-dioic acid 28-O-[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl-(1-->2)] [beta-D-galactopyranosyl(1-->6)]beta-D-glucopyranoside, 3 beta-hydroxyolean-12-en-23-oxo-28-oic acid 28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->3)] [beta-D-glucopyranosyl(1-->6)]beta-D-galactopyranoside, 3 beta-hydroxyolean-12-en-23,28-dioic acid 28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->3)] [beta-D-glucopyranosyl(1-->6)]beta-D-galactopyranoside. The fourth was bisdesmosidic: 3 beta-hydroxyolean-12-en-23,28-dioic acid 23-O-beta-D-glucopyranosyl-28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D- galactopyranosyl-(1-->3)][beta-D-glucopyranosyl-(1-->6)]beta-D- galactopyranoside. The structures of the compounds were elucidated by 1D and 2D NMR techniques and from other spectroscopic evidence.

Improvement of the nutritional quality of Egyptian and Sudanese sorghum grains by the addition of phosphates.

1. Male broilers (0 to 35 d) were given foods with two types of yellow sorghum substituted for maize in isonutrient diets. Sorghum-based foods were also supplemented with extra phosphorus, to provide a total P of about 8 g/kg; the P being from either orthophosphoric acid or food grade dicalcium phosphate. 2. Both sorghums depressed growth and food:gain ratio and increased the incidence of locomotor disorder to about 0.50 (maize control = 0). Sorghum from Sudan, with higher concentrations of both tannin and phytate, caused more severe anti-nutritive effects than sorghum from Egypt. 3. Within the limits of statistical significance the growth depressing effect of sorghum was completely reversed by extra P. With the more toxic Sudanese sorghum this amelioration was numerically less than complete (growth = 0.94, maize control = 1). Locomotor disorders were also virtually, but not completely, eliminated by phosphorus treatment. 4. Treatment of sorghum by dry-mixing with dicalcium phosphate could form the basis of a simple and economic method for extending the use of high-tannin sorghum in poultry foods. The mode of action of the treatment remains to be determined.

The susceptibility of suckling lambs to zinc toxicity.

1. Suckling lambs maintained for 4 weeks on a milk-substitute diet containing 407 g Toprina yeast/kg dry matter of diet exhibited poor growth, low appetite and extensive renal damage. 2. The batch of yeast used contained 2065 mg zinc/kg. 3. The kidneys of lambs offered a milk diet supplemented with the same Zn content as the yeast-fed diet (32-1 mg Zn/1000 kJ) were similarly affected.