Acute intestinal obstruction: an unusual complication of mucocele of appendix

A rare case of intestinal obstruction due to compression of ileocecal junction by mucocele of appendix is presented. Imaging with ultrasound or computed tomography (CT) is useful in establishing preoperative diagnosis. Avoidance of rupture of during appendicectomy is critical in preventing potential complication of pseudomyxoma peritonei.

Progressive resistance exercise for people with multiple sclerosis

PURPOSE

This study aimed to determine if participation in a progressive resistance exercise (PRE) programme can: (1) increase the ability to generate maximal muscle force, (2) increase muscle endurance, (3) increase functional activity, and (4) improve overall psychological function of people with multiple sclerosis (MS).

METHODS

A pre-post single group research design with a 4-week baseline familiarisation phase was used. Nine people (mean age 45.6 years, SD 10.7) with MS attended a gymnasium three times over 4 weeks for familiarization. Participants then completed a twice-weekly 10-week PRE programme, with two sets of 10 - 12 repetitions of each exercise. Outcome measures of muscle strength (1RM for arms and legs), muscle endurance (repetitions at half 1RM), walking speed, the 2-min walk test (2MWT), a timed stairs test, and the impact of MS on physical and psychological function were taken at weeks 2, 4, and 14.

RESULTS

Participants attended 94.3% (SD 8.2%) of the training sessions, with no adverse events. After accounting for baseline stability, significant improvements (P < 0.05) were found in arm strength (14.4%), leg endurance (170.9%), fast walking speed (6.1%), and there was a trend for increased distance in the 2MWT (P = 0.06). The perceived impact of MS on physical function was reduced (P = 0.02).

CONCLUSIONS

Adults with MS benefited from a PRE programme by improving muscle performance and physical activities, without adverse events. These findings suggest that PRE may be a feasible and useful fitness alternative for people with mild to moderate disability due to MS.

A qualitative analysis of a progressive resistance exercise programme for people with multiple sclerosis

PURPOSE

This qualitative study explored the perceptions of adults with multiple sclerosis about the positive and negative effects of a progressive resistance strengthening programme; and identified factors that might facilitate or create barriers to participation.

METHODS

Seven women and two men (mean age 45.6 years, SD 10.7) with multiple sclerosis participated in a 10-week gymnasium based progressive resistance strengthening programme held twice a week. Participants were interviewed at the end of the programme. The recorded interviews were transcribed and then independently coded by three researchers. From these codes, the main themes emerged.

RESULTS

Reports about the programme were very positive with physical, psychological and social benefits noted. Most participants said that they had less fatigue as a result of the programme. Few negative outcomes were reported and these were minor such as aches and pains. Key extrinsic factors for programme completion were the leaders' encouragement and knowledge of exercise; and the group aspect of the programme. Key intrinsic factors were enjoyment, determination, seeing the signs of progress, and a previously held positive attitude about the benefits of exercise.

CONCLUSIONS

The results of this study suggest that progressive resistance strength training is a feasible fitness option for some people with multiple sclerosis. Factors perceived to be important for programme completion suggest that choosing encouraging leaders with knowledge of exercise, and exercising in a group may contribute to programme success.

Acetyl-l-carnitine (ALCAR) prevents hypobaric hypoxia-induced spatial memory impairment through extracellular related kinase-mediated nuclear factor erythroid 2-related factor 2 phosphorylation

Exposure to hypobaric hypoxia, a condition involving decreased availability of oxygen is known to be associated with oxidative stress, neurodegeneration and memory impairment. The multifactorial response of the brain and the complex signaling pathways involved therewith limits the therapeutic efficacy of several antioxidants in ameliorating hypobaric hypoxia-induced memory impairment. The present study was therefore aimed at investigating the potential of acetyl-l-carnitine (ALCAR), a known antioxidant that has been reported to augment neurotrophin-mediated survival mechanisms, in ameliorating hypoxia-induced neurodegeneration and memory impairment. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a key transcription factor involved in the cellular defense mechanism against oxidative stress related to brain injury and neurological disorders. The study was designed to understand the mechanisms involving Nrf2 stabilization following exposure to hypobaric hypoxia. The results displayed reference memory impairment in Sprague-Dawley rats exposed to hypobaric hypoxia (7620 m) for 14 consecutive days which however improved on administration of ALCAR during hypoxic exposure. The study also revealed Nrf2 regulated augmented antioxidant response on administration of ALCAR which was through a novel tyrosine kinase A (TrkA) receptor-mediated mechanism. A decrease in free radical generation, lipid peroxidation and protein oxidation was also observed along with a concomitant increase in thioredoxin and reduced glutathione levels on administration of ALCAR during exposure to hypobaric hypoxia. The present study therefore reveals the therapeutic potential of ALCAR under conditions of hypobaric hypoxia and elucidates a novel mechanism of action of the drug.

Removal of sulphates acidity and iron from acid mine drainage in a bench scale biochemical treatment system

The focus of this study was to develop a simple biochemical system to treat acid mine drainage for its safe disposal. Recovery and reuse of the metals removed were not considered. A three-step process for the treatment of acid mine drainage (AMD), proposed earlier, separates sulphate reducing activity from metal precipitation units and from a pH control system. Following our earlier work on the first step (biological reactor), this paper examines the second step (i.e. chemical reactor). The objectives of this study were: (1) to determine the increase in pH and the reduction of iron in the chemical reactor for different proportions of simulated AMD, and (2) to assess the capability of the chemical reactor. A series of experiments was conducted to study the effects of addition of alkaline sulphidogenic liquor (ASL) derived from a batch sulphidogenic biological reactor (operating with activated sludge and a COD/SO4 ratio of 1.6) on the simulated AMD characteristics. At 60-minute contact time, addition of 30% ASL (pH of 7.60-7.76) to the chemical reactor with 70% AMD (pH of 1.65-2.02), increased the pH of the AMD to 6.57 and alkalinity from 0 to 485 mg l(-1) as CaCO3, respectively and precipitated about 97% of the iron present in the simulated AMD. Others have demonstrated that metals in mine drainage can be precipitated by bacterial sulphate reduction. In this study, iron, a common and major component of mine drainage was used as a surrogate for metals in general. The results indicate the feasibility of treating AMD by an engineered sulphidogenic anaerobic reactor followed by a chemical reactor and that our three-step biochemical process has important advantages over other conventional AMD treatment systems.

Mechanism of tert-butylhydroperoxide induced cytotoxicity in U-937 macrophages by alteration of mitochondrial function and generation of ROS

tert-Butylhydroperoxide has been reported to inhibit growth and induce apoptosis in number of cell types, but little is known about the molecular mechanism mediating these effects. In the present study, we determined the molecular pathways that lead to apoptosis after treatment of cells with t-BOOH. The cells were exposed to different concentrations of t-BOOH (100-750 microM) for 1-4 h and various parameters such as cytotoxicity, ROS (reactive oxygen species) generation, MMP (mitochondrial membrane potential), intracellular Ca++ levels and expression of various proteins involved in apoptosis were determined. Exposure of U-937 cells to t-BOOH induced cytotoxicity in a time dependent manner with about 50% toxicity at 400 microM t-BOOH in 4h. t-BOOH treatment resulted in a time dependent increase in reactive oxygen species levels, Ca++ influx and annexin V positive cells. There was a significant fall in MMP following exposure to t-BOOH with time. t-BOOH treatment of U-937 cells leads to apoptosis, which is accompanied by activation of caspase-3. The caspase-3 inhibitor (Ac-DEVD-CHO) inhibits the cytotoxicity induced by t-BOOH, indicating a direct link between caspase-3 activation and cell death. This activation of apoptosis is accompanied by release of cytochrome c, down regulation of anti-apoptotic protein Bcl-2 levels with concurrent increase in pro-apoptotic proteins Bax and Bad levels. These observations indicate that t-BOOH induces cell death in U-937 macrophages by apoptosis, which is mediated through mitochondrial pathway.

Direct electron transfer with yeast cells and construction of a mediatorless microbial fuel cell

The direct electron transfer exhibited by the yeast cells, Hansenula anomala has been demonstrated using the electrochemical technique cyclic voltammetry by immobilizing the microorganisms by two different methods viz., physical adsorption and covalent linkage. The analysis of redox enzymes present in the outer membrane of the microorganisms has been carried out in this work. This paper demonstrates that yeast cells with redox enzymes present in their outer membrane are capable of communicating directly with the electrode surface and contribute to current generation in a mediatorless biofuel cells. The efficiency of current generation has been evaluated using three anode materials.

Management of Vascular Injuries in a Forward Hospital

BACKGROUND

Management of vascular injuries poses a challenging problem under warlike conditions. Several authorities recommend limb revascularisation only within first 6-8 hours, as the outcome after delayed revascularisation is poor.

METHODS

A retrospective analysis of 61 consecutive patients with vascular injury in a forward hospital over a 25- month period was carried out.

RESULTS

Vascular injuries constituted 3.1% of all injuries. The mean injury to treatment delay (lag time) was 11 hours, and 10 patients received treatment after 12 hours. The overall amputation rate was 15%, but only 6.5% for those revascularised within 12 hours and 44% for those undergoing surgery after 12 hours (Chi-square 4.59, p < 0.05). Presence of associated fractures was associated with an adverse outcome (Chi-square 4.24, p < 0.05), as was ligation in comparison to revascularisation (Chi-square 7.86, p < 0.005). Popliteal injuries were associated with a high amputation rate.

CONCLUSIONS

Failure to revascularise (ligation of artery), presence of associated fracture, and restoration of circulation beyond 12 hours are associated with a high amputation rate.

Biosolids from two-stage bioleaching could produce compost for unrestricted use

A biological process, called BIOSOL, developed in our laboratory, efficiently reduces metals and reduces pathogenic indicator bacteria in sewage sludges in a single-stage system to levels meeting Ontario Ministry of the Environment (OME) requirements for land application of biosolids. Since the requirements for unrestricted use of compost are 10 to 50 times (depending on the metal involved) more restrictive than those for land application, this study was carried out to determine whether the efficiency of the BIOSOL system could be increased to meet the more stringent limitations required for compost. A two-stage modified BIOSOL system was successfully operated for a period of 4% months, at 30 degrees C, treating anaerobically digested sludge from the Guelph Wastewater Treatment Plant. Elemental sulphur (4g l(-1)) was the energy source for the autotrophic bacteria (thiobacilli). The pH, metals (Cd, Cr, Cu, Pb and Zn), and sulphate were used to evaluate system effectiveness. At an HRT of 8 days in each solubilization tank, and a S*-concentration of 4g l(-1), sulphur oxidation efficiency was about 70%, while the metal removals were: Cd 90%, Cr 93%, Cu 96%, Pb 67% and Zn 98%. The finished product (biosolids) met the OME requirements for metal concentrations for producing compost or fertilizer for unrestricted use. The reduction of pathogenic indicator organisms was demonstrated in earlier studies.

A biological process that reduces metals in municipal sludge to yield sulphur enhanced biosolids

Heavy metal contamination can often restrict or prohibit land application of municipal sludge. In the present investigation a continuous biological process with powdered elemental sulphur as energy source was examined for solubilization of metals from anaerobically digested municipal sludge. The results showed that the continuous process can be designed to achieve both metal solubilization and efficient sulphur utilization. With a sulphur addition of 1.5 g l(-1) and an HRT of 14 days, solubilization efficiencies of 50, 33, 48, and 74% were obtained for cadmium, copper, nickel, and zinc, and about 80% of the added sulphur was oxidized. Addition of ferrous sulphate as an additional energy source did not improve the performance of the process. The residual sulphur in the metal decontaminated biosolids was in balance with the phosphorus content, potentially making it an effective sulphur fertilizer for soils deficient in the nutrient.

Cytoprotective and antioxidant activity of Rhodiola imbricata against tert-butyl hydroperoxide induced oxidative injury in U-937 human macrophages

The present study reports cytoprotective and antioxidant activity of aqueous and alcoholic extracts of Rhodiola imbricata rhizome on tert-butyl hydroperoxide (tert-BHP) induced cytotoxicity in U-937 human macrophages. There was an increase in cytotoxicity and apoptosis significantly in the presence of tert-BHP over control cells. The tert-BHP induced cytotoxicity can be attributed to enhanced reactive oxygen species (ROS) production which in turn is responsible for fall in reduced glutathione (GSH) levels; further there was a significant decrease in mitochondrial potential and increase in apoptosis and DNA fragmentation. Both aqueous and alcoholic extracts of Rhodiola rhizome at a concentration of 250 microg/ml were found to inhibit tert-BHP induced free radical production, apoptosis and to restore the anti-oxidant levels to that of the control cells. The alcoholic extract of Rhodiola showed higher cytoprotective activities than aqueous extract. These observations suggest that the alcoholic and aqueous extracts of Rhodiola have marked cytoprotective and antioxidant activities.

Intracranial subfrontal schwannoma treated with surgery and 3D conformal radiotherapy

Subfrontal schwannoma not arising from the cranial nerves are rare tumors. A 19-year-old man presented with a large subfrontal extra-axial enhancing mass with a preoperative diagnosis of skull base meningioma. A subtotal resection of the tumor mass was carried out. Microscopic examination revealed it to be a schwannoma. The residual tumor was treated with fractionated three-dimensional conformal radiotherapy (3D CRT). The rationale of treating with radiotherapy in such cases is analyzed.

Targeted cybridization in citrus: transfer of Satsuma cytoplasm to seedy cultivars for potential seedlessness

CMS (cytoplasmic male sterility) can be controlled by the mitochondrion genome in higher plants, including Satsuma mandarin. Somatic fusion experiments in citrus combining embryogenic callus protoplasts of one parent with leaf protoplasts of a second parent often produce cybrid plants of the leaf parent, a phenomenon occurring most often with interspecific fusion combinations. In an attempt to practically exploit this cybridization phenomenon, we conducted somatic fusion experiments combining embryogenic suspension-derived protoplasts of Satsuma mandarin, Citrus unshiu Marc. cv. Guoqing No. 1 (G1), a male-sterile cultivar, with leaf protoplasts of other seedy types--Hirado Buntan Pink pummelo (HBP) [Citrus grandis (L.) Osbeck], Sunburst mandarin (C. reticulata Blanco), Orie Lee hybrid (C. reticulata cv. Clementine x Murcott tangor), and Murcott tangor [C. reticulata x C. sinensis (L.) Osbeck], respectively--in an attempt to generate seedless cybrids by the targeted transfer of CMS. The genetic identities of regenerated plants from all four parental combinations were determined by flow cytometry, SSR, CAPS (or PCR-RFLP), RFLP, and chloroplast-SSR analyses. Regenerated plants from the first three parental combinations were diploids, and the cybrid nature of G1 + HBP with the mitochondrion genome from G1 and the chloroplast genome from HBP was confirmed, whereas the cybrid nature of the remaining two combinations was difficult to confirm because of the close phylogenetic relatedness of both fusion parents, as expected. Plants from G1 + Murcott were confirmed as tetraploid somatic hybrids. This is the first report of targeted citrus cybrid production by symmetric fusion with male-sterile Satsuma as the callus parent and other seedy cultivars as the leaf parents.

Cytoprotective and immunomodulatory properties of Geriforte, a herbomineral preparation, in lymphocytes

The study was designed to determine the cytoprotective and immunomodulatory properties of Geriforte, an indigenous herbomineral compound, using lymphocytes as a model system. The possible involvement of free radicals and the ability of Geriforte to inhibit the oxidative process induced by tert-butylhydroperoxide (tert-BHP) was also investigated. The production of free radicals (evaluated by fluorescent probe fluorescein-diacetate), level of malondialdehyde (MDA, as index of lipid peroxidation), and levels of anti-oxidants--reduced glutathione (GSH) and glutathione peroxidase (GPx) were determined. There was an increase in cytotoxicity and apoptosis significantly in the presence of tert-BHP (100 microM) over control. Addition of tert-BHP resulted in a marked increase in free radical production and MDA level with a concomitant decrease in GSH level in lymphocytes. Geriforte supplementation reduced cytotoxicity and apoptosis induced by tert-BHP. Further, Geriforte inhibited tert-BHP induced lipid peroxidation and maintained higher anti-oxidant levels. tert-BHP significantly inhibited the lymphocyte proliferation stimulated by mitogens (Lipopolysaccharide/Concanavalin A) and enhanced DNA fragmentation. Geriforte relieved the inhibitory effect of tert-BHP on lymphocyte proliferation and decreased DNA fragmentation appreciably. The results indicate that Geriforte possesses cytoprotective and immunomodulatory properties which could be due to its anti-oxidant activity.

Effect of vitamin E supplementation on hypoxia-induced oxidative damage in male albino rats

BACKGROUND

There is growing evidence that free radicals mediated oxidative injury due to inadequate oxygen availability is an important factor in various pathologies at high altitude. Since vitamin E is known to protect the cells from oxidative damage due to its potent antioxidant properties, the present study was carried out to explore the effect of vitamin E supplementation on various hematological and biochemical parameters in hypoxia-induced oxidative stress in albino rats.

METHODS

The experiments were conducted on male albino rats by intermittently exposing them to a simulated altitude of 7,576 m (25,000 ft), daily for 6 h for 15 d at 32 +/- 2 degrees C. The control group was fed vehicle only (1% Tween 80) and the experimental group was given vitamin E (40 mg per rat x d(-1)) orally, 5 d prior to and during the period of hypoxic exposure. The variables studied include: hemoglobin, hematocrit, RBC deformability index, alpha-tocopherol level, malondialdehyde (MDA), reduced glutathione (GSH), oxidized glutathione (GSSG), lactate dehydrogenase (LDH) and protein level in blood/plasma and various tissues.

RESULTS

Significant increase in hematocrit and hemoglobin and decrease in RBC deformability index was observed on exposure to hypoxia while vitamin E supplementation maintained them at the normal level. Hypoxia led to the decrease in plasma vitamin E and blood glutathione (GSH) level and two-fold increase in the plasma malondialdehyde (MDA) level. Vitamin E supplementation, on the other hand, resulted in less of an increase in MDA and increased the GSH concentration significantly. LDH activity, which was elevated on exposure to hypoxia, was arrested on vitamin E supplementation.

CONCLUSION

The results indicate that vitamin E supplementation results in preventing oxidative damage due to high altitude stress.

Reduction of indicator organisms during biological solubilization of metals: a pilot study

Laboratory and pilot scale studies on the biological solubilization of metals from undigested raw sludge were carried out using elemental sulphur as the energy source. Metals (Cu, Zn, Ni and Cd), pH, sulfate and indicator bacteria [total coliforms (TC) faecal coliforms (FC) and faecal streptococci (FS)] were used to evaluate the system effectiveness. This paper does not report the detailed design and operational data of the pilot plant (available elsewhere [1]) but focuses on the biological tests carried out at the Main Wastewater Treatment Plant in Toronto from July to December, 1997. Since the indicator bacteria are injured from exposure to low pH and potentially toxic metal concentrations, improved alternative methods for their enumeration and their ability to repair acid-metal induced injury in a resuscitation medium (CASO tryptone soya broth) were also investigated. Resuscitation was not effective in repairing cells injured during bacterial leaching. The MPN technique (using lauryl tryptose broth) for enumerating indicator bacteria (total coliforms) gave higher counts and was therefore superior to the spread plate technique (using m-Endo agar) in recovering bacteria from acidic leached sludge (biosolids). However, the coliform bacterial counts from raw sludge were similar by the two methods. This study indicated that the biological solubilization process could significantly reduce the pathogenic indicators. Concentrations of TC, FC and FS in the leached biosolids from the solubilization tank were lower than concentrations in the raw sludge by 4 to 6 orders of magnitude and the finished product (biosolids) met US. EPA requirements for pathogen and metal concentrations for Class A biosolids to be used on agricultural land.