Activation of Peripheral Opioid Kappa1 Receptor Prevents Cardiac Reperfusion Injury.

The role of opioid kappa1 and kappa2 receptors in reperfusion cardiac injury was studied. Male Wistar rats were subjected to a 45-min coronary artery occlusion followed by a 120-min reperfusion. Opioid kappa receptor agonists were administered intravenously 5 min before the onset of reperfusion, while opioid receptor antagonists were given 10 min before reperfusion. The average value of the infarct size/area at risk (IS/AAR) ratio was 43 - 48% in untreated rats. Administration of the opioid kappa1 receptor agonist (-)-U-50,488 (1 mg/kg) limited the IS/AAR ratio by 42%. Administration of the opioid kappa receptor agonist ICI 199,441 (0.1 mg/kg) limited the IS/AAR ratio by 41%. The non-selective opioid kappa receptor agonist (+)-U-50,488 (1 mg/kg) with low affinity for opioid kappa receptor, the peripherally acting opioid kappa2 receptor agonist ICI 204,448 (4 mg/kg) and the selective opioid ?2 receptor agonist GR89696 (0.1 mg/kg) had no effect on the IS/AAR ratio. Pretreatment with naltrexone, the peripherally acting opioid receptor antagonist naloxone methiodide, or the selective opioid kappa2 receptor antagonist nor-binaltorphimine completely abolished the infarct-reducing effect of (-)-U-50,488 and ICI 199,441. Pretreatment with the selective opioid ? receptor antagonist TIPP[psi] and the selective opioid µ receptor antagonist CTAP did not alter the infarct reducing effect of (-)-U-50,488 and ICI 199,441. Our study is the first to demonstrate the following: (a) the activation of opioid kappa2 receptor has no effect on cardiac tolerance to reperfusion; (b) peripheral opioid kappa1 receptor stimulation prevents reperfusion cardiac injury; (c) ICI 199,441 administration resulted in an infarct-reducing effect at reperfusion; (e) bradycardia induced by opioid kappa receptor antagonists is not dependent on the occupancy of opioid kappa receptor.

A Masquerading and Unconventional Cause of Dynamic Intestinal Obstruction: Strangulated Obturator Hernia.

Obturator hernia is an extremely rare type of abdominal wall hernia occurring mostly in elderly, thin females. It is characterized by the herniation of intra-abdominal contents through the obturator foramen. Symptoms are often nonspecific, and the patient usually presents with an acute or subacute intestinal obstruction. A high index of suspicion is needed in such females presenting with abdominal distention and positive Howship-Romberg signs. Computed tomography of the abdomen and pelvis are often necessary to arrive at a diagnosis, and immediate surgical intervention is recommended. The high postoperative morbidity and mortality are often attributed to a delay in the diagnosis and in initiating treatment. We present a case of a 65-year-old lady with strangulated obturator hernia who underwent emergent, lower midline laparotomy with resection and anastomosis of the small bowel and purse-string repair of the hernial defect.

Palliative radiotherapy in esophageal cancer.

The present study was undertaken to evaluate the efficacy of radiotherapy in palliation of dysphagia in patients with squamous cell carcinoma (SCC) of esophagus and to see the quality of life (QoL) following radiotherapy. This was a prospective clinical study done between September 2006 and May 2008. All consecutive patients with SCC of the esophagus, who are not candidates for definitive treatment, were included in the study. Dysphagia and QoL were assessed using modified Takita's grading and modified questionnaire based on EORTC QLQ 30 respectively. External beam radiotherapy (EBRT) was delivered to all patients using linear accelerator 6 Mv photons. Patients who had good response with EBRT were further subjected to intraluminal brachytherapy (ILBT) at 700 cGy using Iridium-192. The cumulative dose each patient received was 65 Gy. Patients were followed up at 6 weeks from completion of treatment to look for any difference in dysphagia grade and QoL following therapy. Thirty-three patients were included in the study. The mean age among males and females was 60.9 and 49.8 years, respectively. Nineteen patients (57.6 %) received EBRT followed by ILBT; the remaining patients received only EBRT. Seven were lost during follow-up, and seven (21.2 %) died during the study period of 6 weeks. Nineteen (57.6 %) were followed up. On follow-up endoscopy, evidence of residual stricture was observed in 57.9 %, and growth in 36.8 %. Of the patients, 27.8 % had biopsy-confirmed residual disease. The median dysphagia score decreased from 4 to 3 after treatment (p = 0.002) in 17 (89.5 %) patients. The mean QoL score improved from 107.5 to 114.1 at 6-week follow-up. Following radiotherapy, 26.3 % had persistent chest pain, increased cough with expectoration in 15.8 %, and hyperpigmentation of skin in 10.5 %. Radiotherapy gives significant relief of dysphagia and improves QoL in 90 % of patients with SCC of esophagus. However, following radiotherapy, a number of patients will have persistent stricture, ulceration, and residual disease.

Comparative investigations into the content of available molybdenum in important soils of the arid and humid tropics.

The determination of the content of available molybdenum in 196 soil samples from different geographical (Yemen, Sudan, Tanzania, Ghana, Cuba, and Sri Lanka) and climatic (annual precipitation 30-3000 mm) regions gave these results: 1. Arid and subarid soils of dry regions as well as rendzina-type soils contained the highest amount of available molybdenum (0.216 ppm respectively). The lowest content was determined in the ferrallitic soils of the humid tropics (0.045 ppm). These differences are mainly attributed to high pH values and CaCO3 content in aridisols and rendzina-type soils and to a strongly acid soil reaction in ferrallitic soils. 2. The content of available molybdenum was significantly positively correlated with the pH, percentage base saturation, CEC and exchangeable Ca; it was negatively correlated with the clay content. 3. Deficiency of molybdenum is hardly to be expected in arid and subarid soils (24 per cent of all samples deficient). The proportion of samples with a low Mo content and the probability of Mo deficiency increases in this order: vertisols (40%) leads to fersiallitic soils (64%) leads to ferallitic soils (89%).