Herbal and Holistic Solutions for Neurodegenerative and Depressive Disorders: Leads from Ayurveda

Neuropsychiatric and neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, schizophrenia, epilepsy, depression and anxiety pose a sizable global health problem, accompanying substantial burden of disorders, suicides, physical comorbidities, high fiscal expenses, and poor quality of life. There is a recent upsurge in global interest toward the area of traditional therapies and phytomedicines are widely admired by researchers owing to their natural source and fewer side effects. On the contrary, conventional synthetic drugs have been reported with undesirable but inevitable ill effects having poor patient compliance. Thus, herbal medicines are being preferred over synthetic drug therapies as an effective remedy for many brain disorders. Ayurveda provides a holistic approach to treatment along with several nootropic herbs having multi-dimensional bioactivities in various disorders. Scattered information is available pertaining to traditional Ayurvedic remedial options for various mental disorders. Present review encompasses: (i) common brain disorders and the associated changes (ii) Ayurvedic holistic approach to manage neurodegenerative and depressive disorders, and (iii) important Ayurvedic single herbs and polyherbal formulations with description of their traditional usage and administration. Concomitantly, it opens up for future investigations and standardization on Ayurvedic nootropic herbs.

Traditional Ayurvedic and herbal remedies for Alzheimer's disease: from bench to bedside

INTRODUCTION

Alzheimer's disease (AD) is a progressive, neurodegenerative disorder prevalent worldwide among elderly populations. Owing to limited efficacy, side effects, and poor patient compliance for current rationally designed therapies, options are being searched from alternate therapies such as Indian (Ayurvedic), Chinese, or other traditional systems. Areas covered: Following a comprehensive literature search, the authors provide a review encompassing: (1) pathophysiological changes involved in AD, (2) Ayurvedic holistic approach and herbal medicines to manage dementia and AD, and (3) traditional plants and their phytoconstituents effective in AD with description of possible mechanism of action. Expert opinion: Traditional remedies could be adjunct therapeutic options to allay wide-ranging pathological cascades of AD. Ayurveda offers a holistic approach of treatment along with a list of nootropic herbs and formulations that are the rich sources of antioxidants, anti-amyloidogenic, neuroprotective, adaptogenic, anti-inflammatory, and immunomodulatory compounds that are found to modulate neuroendocrine-immune activities, enhance memory, intellect, rejuvenate brain functions, and improve quality of life. A strong knowledge base of traditional systems coupled with contemporary science may provide new functional leads for age-associated neurodegenerative disorders at preventive, promotive, and curative levels, and evolution of new drug therapies and development processes, though further research is needed.

Direct access colonoscopy in primary care: is it a safe and practical approach?

BACKGROUND

Implementation of colorectal cancer screening programme and provision of cancer service within certain timeframe has significantly increased the workload on endoscopy services. Direct access colonoscopy in primary care centers helps offload burden on conventional colonoscopy in secondary care, thereby reducing waiting times. The aim of this study was to assess the safety and efficacy of direct access colonoscopy service.

MATERIALS AND METHODS

Provision of colonoscopy service in our healthcare trust was analysed retrospectively during a two-year period. Safety and feasibility of direct access colonoscopy was analysed against conventional colonoscopy. The groups were compared for findings at colonoscopy, procedural outcomes, and complications.

RESULTS

A total of 3468 colonoscopies were analysed. Of those, 1189(34.3%) were performed as direct access colonoscopy and 2279(65.7%) as conventional colonoscopy. No abnormality was detected in 408/1189(34.3%) and 825/2279(36.2%) patients in the direct access colonoscopy and conventional colonoscopy groups, respectively (p = 0.52). Colorectal cancer detection rate was similar between the groups; conventional colonoscopy vs direct access colonoscopy, 3.1% (68/2279) vs 3.2% (39/1189) (p = 0.85). However, there was significantly higher detection rate of polyps greater than 1 cm in conventional colonoscopy group compared to direct access colonoscopy group, 22.6%(518/2289) vs 12.6% (150/1189) (p = 0.02). Complication rates were comparable between the groups.

CONCLUSION

Direct access colonoscopy in primary care centers is safe and feasible. Colorectal cancer detection remains comparable to that of conventional colonoscopy in secondary care despite relatively lower polyp detection rate.

Hirschsprungs disease with congenital hypothyroidism

We report a female newborn baby who presented with vomiting and abdominal distension on day 21 of life. Examination revealed facial puffiness, open posterior fontanelles, dry skin, cold peripheries and prominent abdominal veins with visible peristalsis. Barium enema revealed dilated proximal colon, empty rectum, funnel like transition zone between proximal dilated and distal constricted bowel. Serum TSH level was >;150 uIU/mL. Biopsy revealed aganglionic segment suggesting Hirschsprungs disease, an unusual association with congenital hypothyroidism.

Lower limb compartment syndrome following laparoscopic colorectal surgery: a review

AIM

  In spite of recent advances in technology and technique, laparoscopic colorectal surgery is associated with increased operating times when compared with open surgery. This increases the risk of acute lower limb compartment syndrome. The aim of this review was to gain a better understanding of postoperative lower limb compartment syndrome following laparoscopic colorectal surgery and to suggest strategies to avoid its occurrence.

METHOD

A MEDLINE search was performed using the keywords 'compartment syndrome', 'laparoscopic surgery' and 'Lloyd-Davies position' between 1970 and 2008. All relevant articles were retrieved and reviewed.

RESULTS

A total of 54 articles were retrieved. Of the 30 articles in English, five were reviews, six were original articles and 19 were case reports, of which only one was following laparoscopic colorectal surgery. The remaining 24 were non-English articles. Of these, two were reviews and 22 were case reports, of which only one was following laparoscopic colorectal surgery. The incidence of acute compartment syndrome following laparoscopic colorectal surgery is unknown. The following are believed to be risk factors for acute lower limb compartment syndrome: the Lloyd-Davies operating position with exaggerated Trendelenburg tilt, prolonged operative times and improper patient positioning. Simple strategies are suggested to reduce its occurrence.

CONCLUSION

Simple preventative measures have been identified which may help to reduce the incidence of acute lower limb compartment syndrome. However, if suspected, timely surgical intervention with four-compartment fasciotomy remains the standard of care.

Estimation of heavy metals in commonly used medicinal plants: a market basket survey

Popularity of herbal drugs is increasing all over the world because of lesser side effects as compared to synthetic drugs besides it cost effectiveness and easy availability to poor people particularly in developing countries. Keeping in view the increased market demand of herbal drugs, it is essential to ensure their chemical quality prior to use. Raw drugs and herbs are usually collected from different places, which might be contaminated with various contaminants. It is pertinent to estimate the levels of heavy metals and other micronutrients, which could be affected by their presence in the surrounding environments. Heavy metals are known to pose a potential threat to terrestrial and aquatic biota. Keeping this in view, samples of ten plants or plant parts used in drug making were collected from local markets of Punjab for heavy metal and micronutrient estimation. It was found that the samples were contaminated having cadmium, lead, chromium, iron, manganese, and zinc. The highest mean level of cadmium (23.1 μg/kg) was found in Haritaki sample. Chromium concentration of the plant samples ranged between 7.25 and 1.34 μg/kg with the highest values was in Daruharidra and lowest in Pippali. The levels of these heavy metals were within permissible limits.

A critical study of the manuscripts of Paryaya Muktavali available at Orissa

Though the Nidana book of Madhavakara has been very popular among Ayurvedic fraternity his other deeds on Dravyaguna, Cikitsa etc. could not come to lime light due to lack of sufficient number of manuscripts for comparison and editing. One such text is Paryaya Muktavali, manuscripts of which are plentily available in the State of Orissa. This modified text redacted by Hari Charana Sena, is a bright example of scribal error and missing of verses which occur during repeated scribe in palm leaf manuscript. This is a lexicon of drugs, which is prime necessity of Dravyaguna and Rasaśastra. Publication of such text will be an addition to the treasure of Ayurvedic texts.

Evolution of drug: a historical perspective

To trace out the first person who discovered the first medicine is extremely difficult. Perhaps the origin of medicine and drug and its early history has been lost in myths. The use of medicinal plants dates back not only to human civilization but to ancient people also. Plants have been crucial in sustaining human health and well being of mankind. The word Drug, taken from French word Drogue which means Dry Herb, strongly suggests that earliest drugs were taken out from plant sources. Earliest people used to treat diseases by some unconventional methods, using plants, animal products and minerals, of them plants were given priority. World's ancient systems of medicine e.g. Chinese Medicine, Ayurveda and Greek Medicine, despite, having wider differences in their principles of treatment agree upon the point, that disease is due to imbalance within the constituents of the body and that the aim of treatment is to restore the balance with the help of herbs. So, herbs played vital role in the development of Pharmacology and Pharmacy. The splendid architect of today's advanced Pharmacology was not built in a day, but its foundation stone has been laid on old base. Pharmacology from its very beginning to the age of Chemotherapy and on words, has traversed long voyage. In this article travelogue of the Pharmacology has been discussed briefly.

A review of Brahmavaivartapurana (BVP) with reference to Ayurveda

Brahmavaivartapurana is one of the important Mahapurana, which is considered as a Vaisnavapurana. The text is divided into four parts called khanda i.e., Brahma, Prakrti, Ganapati, and Srikrsnajanmakhanda. The total number of chapters are 276 and comprising about 20,500 verses. Brahmavaivartapurana comprises both ancient and medieval materials. It considers Ayurveda as Pancama Veda and devoted 16th chapter of Brahmakhanda which describes the origin of Ayurveda its propagaters headed by Bhaskara (sun god) and his 16 students and their corresponding books in detail. An account of the Jvara (Fever) and other diseases, Dinacarya (daily routine), Rtucarya (seasonal regimen), Tridosa (three humours), their Prakopa (Vitiation) and Praśamana (palliation) etc are described in this book. BVP deals with the do's and dont's of food intake, sleep and sexual indulgance in detail which are deemed to be Trayopastambha (three sub pillers of health). The book provides an account of Plant Tulsi's origin and its spiritual importance. Prakrti (nature's) origins, Pañcamahabhuta nature of the body are described in Prakrtikhanda. At the flag end of the book there is a legend describing the origin of Lord Dhanvantari and describes his scholarship in the field of Veda and śastra. On the whole purana provides glimpse of the life style of a Vaisnava devoutee and the people of the time when it was compiled. It serves the purpose of a practical manual to lead a healthy life and ensure spiritual growth in the life of any individual who believes in the precepts of this book.

Some explorative information regarding 'Jwaratimirabhăskara' and its author Kăyastha Camunda

Out of the treasure of Ayurvĕdic literature, a few texts have come in to lime light while some are in dark and available in incomplete form. But many names of the texts with unknown or known authors have been quoted by different subsequent authors in their texts or in the explications by their commentators, for which complete texts are not available at present. Among the texts on specific diseases, one notable work is 'Jwaratimirabhăskara' written by Kăyastha Camunda. Nowhere a detailed account of author's identity, time and place has been mentioned, while short references are available in some historical books. However, manuscripts of this text are available in many repositories of our country. In this article, an attempt has been made to establish the identity of the author, period of the text and also to highlight the salient features of this text.

Important Ayurvĕda literatures from the manuscripts available from Orissa (Cikitsărnava)

In the treasure of Ayurvĕdic literature, many texts are missing or partially available. Only references or few verses from many such texts are mentioned in later texts. Unfortunately, a large number of Ayurvĕdic texts are unexplored till today are likely to exist in palm-leaf manuscripts, which are decaying or undergoing permanent annihilation. As such many unique and valuable information contained in these texts are being lost. Though several Institutions have taken up work on literary Research, only few texts have been published during past decades. The present paper highlights the salient features of the text 'Cikitsărnava' authored by Viśvanăth Sena of 16th century of Orissa. Though his text on Pathyăpathya has already been published, which has got a place in the pages of history of Ayurvĕda, a very little is known about this important text on therapeutics. Various aspects of this text and its author have been discussed to bring it in to the knowledge of fraternity of Ayurvedic physicians and Sanskrit scholars.

Early peri-operative glycaemic control and allograft rejection in patients with diabetes mellitus: a pilot study

BACKGROUND

Hyperglycemia alters the inflammatory response to infection and ischemia. We hypothesize that perioperative glycemic control could also influence the risk for allograft rejection.

METHODS

Consecutive patients with established diabetes undergoing their first cadaveric renal transplantation and receiving steroid-sparing immunosuppression were identified (n=50). Records of capillary glucose observations over the first 100 hr following surgery and transplantation variables pertaining to graft function, acute rejection, and postoperative infection were identified and entered into multivariate analysis.

RESULTS

Perioperative glycemic control was associated with an increased incidence of infection and acute rejection. Only 3 of 27 patients (11%) with optimal glycemic control during the 100 hr following surgery (mean<11.2 mmol/L) had rejection episodes compared with 58% of patients with poor control (>11.2 mmol/L). All patients with poor glycemic control experienced postoperative infection.

CONCLUSIONS

This pilot study suggests that hyperglycemia may be associated with an increased risk of both allograft rejection and postoperative infection in patients with diabetes.

Intraoperative vascular localization to facilitate endopyelotomy after renal transplantation

BACKGROUND

Pelviureteric junction (PUJ) obstruction after renal transplantation is uncommon. Surgical correction can be technically challenging due to dense perinephric adhesions and variable hilar vascular anatomy. Endopyelotomy is well established in the treatment of PUJ obstruction in native kidneys.

METHODS

The present paper reports the first experience of antegrade visual cold-knife endopyelotmy performed in a renal allograft. In orientating the incision at the PUJ, preoperative imaging was supplemented by intrarenal Doppler ultrasound, using a probe designed for transoesophageal cardiac monitoring. To the authors' knowledge this approach has not previously been reported.

RESULTS

Renal vascular relationships were readily indentified by identifying arterial and venous waveforms.

CONCLUSIONS

For this uncommon procedure the use of intrarenal Doppler ultrasound provides greater security in avoiding inadvertent vascular injury.

A simple technique for closure of the last laparoscopic working port

Closure of the last laparoscopic working port can be frustrating, particularly in the very obese. A technique is described that simplifies this procedure, using a grasping forcep to transfer the abdominal wall suture.

Transperitoneal guide-wire or drainage catheter placement for guidance of laparoscopic marsupialization of lymphocoeles post renal transplantation

BACKGROUND

Lymphocoeles post renal transplantation can be difficult to see laparoscopically. The objective of this study was to report a new technique of catheter or guide-wire placement for the guidance of laparoscopic marsupialization of symptomatic post renal transplant lymphocoeles, refractory to conservative therapy.

METHODS

Conventional aseptic technique under local anaesthesia was used for guide-wire or catheter insertion, with the difference being the use of a transperitoneal approach. Computerized tomography (CT) or ultrasound (US) guidance was used. All lesions were confirmed to be sterile lymphocoeles beforehand by either needle aspiration or previous catheter drainage.

RESULTS

Four catheters and one guide-wire were placed pre-operatively without complication. All cases underwent satisfactory laparoscopic marsupialization. No immediate complications were noted in any patient. The drainage catheters were inserted between 5 and 19 days before laparoscopic marsupialization, and guide-wire inserted immediately before. All patients proceeded to laparoscopic marsupialization.

CONCLUSIONS

This technique offers precise guidance on laparoscopic surgery, is relatively simple to perform and no complications were experienced in this study. Its use is limited to sterile and benign lesions due to the risks of peritoneal seeding, making recurrent post-operative lymphocoeles ideally suited for this application.

The safety and efficacy of laparoscopic live donor nephrectomy: a systematic review

BACKGROUND

The aim of this systematic review was to compare the safety and efficacy of laparoscopic live donor nephrectomy with the "gold" standard of open live donor nephrectomy.

METHODS

SEARCH STRATEGY

Three search strategies were devised to enable literature retrieval from the Medline, Current Contents, Embase, and Cochrane Library databases up until, and including, February 2000.

STUDY SELECTION

Inclusion of a report was determined on the basis of a predetermined protocol, independent assessment by two reviewers, and a final consensus decision. English language reports were selected and acceptable study designs included randomized-controlled trials, controlled clinical trials, case series, or case reports. Each report was required to provide information on at least one of several safety and efficacy outcomes as detailed in the protocol.

DATA COLLECTION AND ANALYSIS

Twenty-five reports met the inclusion criteria. They were tabulated and critically appraised in terms of the methodology and design, sample size, outcomes, and the possible influence of bias, confounding, and chance.

RESULTS

High level evidence comparing the safety and efficacy of laparoscopic live donor nephrectomy with open donor nephrectomy was not available at the time of this review. Limited low level evidence suggested that the laparoscopic approach might be advantageous regarding the donor's hospital stay, convalescence, pain, and resumption of employment.

CONCLUSIONS

The ASERNIP-S Review Group concluded that the evidence-base for laparoscopic live donor nephrectomy was inadequate to make a safety and efficacy recommendation. Clinical and research recommendations were developed regarding the introduction and current practice of this procedure in Australia.

Uncommon complications of renal transplantation

As a result of advances in surgical technique and immunosuppressive therapy, the incidence and the consequences of post-transplant surgical complications has decreased. However, surgical complications still cause considerable morbidity and test the skills of the surgical team. Several reviews have been published analyzing the incidence of these complications and the management strategies employed to correct them. We report some uncommon or rare complications encountered in our unit after the introduction of low-dose steroids or steroid-free immunosuppressive protocols.

Bull-specific effect on fertilization rate and viable embryo recovery in the superovulated buffalo (Bubalus bubalis)

This study was conducted to compare fertilization rate and viable embryo recovery rate in superovulated buffalo (n = 64) following insemination with semen from buffalo bulls (n = 5) having different fertility rates as determined by AI. Frozen-thawed semen from fertile bulls with similar post-thaw progressive motility and sperm morphology was used to inseminate buffalo at superovulatory estrus. Fertilization and viable embryo recovery rates differed among bulls, but this bull-specific effect was not related to the overall herd fertility rate as determined by AI in normal cyclic animals. These results indicate that individual bulls differ in their contribution to fertilization of superovulated donors and also to embryonic development, as determined by viable embryo recovery. Moreover, the results also suggest that buffalo bulls can be screened for optimal fertility and embryo recovery rates in superovulated donors. Further studies are warranted to ascertain the factors which contribute to such bull-specific effects.

Factors affecting pregnancy rate following nonsurgical embryo transfer in buffalo (Bubalus bubalis): a retrospective study

The objectives of this study were to determine the pregnancy rate and factors affecting it following nonsurgical embryo transfer in buffalo. Donor buffalo were superovulated with FSH, and embryos collected nonsurgically were evaluated for stage of development and quality. They were transferred nonsurgically to 91 recipients on Days 5 to 7 of the natural (n = 52) or induced (n = 39) estrus (estrus = Day 0). The overall pregnancy rate of 24/91(26.4%) was higher than in earlier reports for buffalo but was much lower than in cattle. Pregnancy rates were not affected by season (autumn vs winter), side of transfer (right vs left uterine horn), or type of estrus (spontaneous vs induced). The pregnancy rate was high 11/27(40.7%) when donors and recipients were closely synchronized, while it was compromised when recipients were in estrus at +12 h (1/7, 14.3%) and at -12 h (5/27, 18.5%). Asynchrony beyond 12 h on either side resulted into conception failure. The pregnancy rate tended to increase with the increase in CL size of recipients, while stage of embryonic development had no effect. The transfer of an 8-cell embryo with a 16-cell embryo led to the birth of heterosexual twins, indicating that the uterine milieu of Day 5 to 6 recipients may be tolerated by the out-of-phase 8-cell embryo, at least in the presence of a more mature embryo. Embryo quality had the greatest effect on pregnancy rate as it was higher (P < 0.005) after the transfer of Grade I than Grade III embryos (6/10, 60.0% vs 3/36, 13.9%). Assessment of returns to estrus indicated that among nonpregnant recipients, 17/67 (25.4%) embryos never matured sufficiently to prevent luteolysis through maternal recognition of pregnancy (MRP), while 14/67 (20.8%) embryos probably died following MRP. These results indicate that efforts to increase pregnancy rate following embryo transfer in buffalo should include prevention of luteolysis during the first week of transfer and a reduction in the incidence of embryonic mortality.

Laparoscopic live donor nephrectomy: the preliminary experience

BACKGROUND

Recent improvements in video technology and surgical instrumentation have resulted in the application of minimally invasive techniques to many surgical procedures including splenectomy and adrenalectomy. Nephrectomy requires a long flank incision with division of abdominal musculature and possible subcostal nerve damage. Severe postoperative pain and a prolonged recuperative period may result, and the cosmetic outcome may not be satisfactory. A new surgical approach utilizing laparoscopic dissection and delivery of the kidney through a small incision was performed to circumvent these problems. The aim of this paper is to describe the technique of laparoscopic live donor nephrectomy (LLDN) and present the preliminary outcome.

METHODS

Over the 12-month period between May 1997 and April 1998, 16 donors underwent donor nephrectomy by a laparoscopic approach. The procedure was assessed with regard to its safety, feasibility and advantages over the open method.

RESULTS

All the nephrectomies were completed without conversion to an open procedure. The average postoperative pain score on a visual analogue scale of 1-10 was 2 in LLDN. The donors required 36 mg morphine on average over 36 h postoperatively. Postoperative stay averaged 3 days. One donor developed an infective complication along the wound drain tract which settled with adequate drainage and antibiotics. All the removed donor kidneys were transplanted with immediate good function. There were no surgical complications or graft losses. The recipients' serum creatinine was in the range of 96-181 mmol/L 3 months after transplantation.

CONCLUSIONS

Significant potential advantages of LLDN include less postoperative pain, shorter hospitalization and decreased recuperative time. This preliminary experience indicates LLDN to be effective in terms of safety and feasibility.

The use of spiral computed tomographic angiography for the assessment of living kidney donors

BACKGROUND

Recent reports suggest that spiral computed tomographic (CT) angiography can replace conventional angiography and intravenous urography for the assessment of potential kidney donors. The purpose of this study is to assess the accuracy of spiral CT in potential kidney donor workup.

METHODS

Over a period of 1 year, from December 1995 to December 1996, 16 consecutive potential renal donors had intravenous pyelography, percutaneous transfemoral angiography with selective renal angiography and spiral CT angiography. The spiral CT and renal angiograms were assessed independently by two radiologists. The number of renal arteries, presence or absence of renal artery stenoses and associated parenchymal abnormalities were assessed.

RESULTS

A total of 39 renal arteries were detected. Conventional transverse scans viewed in a cine loop format detected all 39 vessels, while the maximum intensity projection and shaded surface display demonstrated only 37. All 39 vessels were detected by the catheter angiography. With the exception of one potential donor with fibromuscular dysplasia, 15 donors were accepted. There was 100% accuracy between the two methods of visualization for the renal arteries. A simple renal cyst was noted in both spiral CT and conventional angiogram, while another had gallstones in spiral CT.

CONCLUSIONS

Spiral CT angiography performed as an outpatient procedure is less invasive, less expensive, and provides good images of the arterial and venous anatomy. It has the potential to replace conventional catheter angiography and intravenous pyelogram in the assessment of potential renal donors.

Combined anti-vascular cell adhesion molecule-1 and anti-leukocyte function-associated molecule-1 monoclonal antibody therapy does not prolong allograft survival in an ovine model of renal transplantation

This study investigates the therapeutic efficacy of an anti-vascular cell adhesion molecule (VCAM)-1 monoclonal antibody (mAb), alone or in combination with an anti-leukocyte function-associated-1 mAb, in prolonging allograft survival in an ovine model of renal transplantation. The kinetics of VCAM-1 induction and expression during renal allograft rejection have also been studied. Sheep receiving anti-ovine VCAM-1 antibody demonstrated graft failure at a mean of 8.4 (+/- SD; 0.7) days after transplantation compared with 9.3 (+/- 0.5) days after transplantation for the group given control antibody and 7.7 (+/- 0.3) days after transplantation in the animals given the combined anti-VCAM-1 and anti-leukocyte function-associated-1 mAb therapy. VCAM-1 expression was detected in the allografts at day 1 after transplantation, with peak expression detected by day 5. Tubular expression of VCAM-1 was minimal, with sparse focal staining at the basolateral surfaces. The degree of mononuclear cell infiltrate in the allografts paralleled the progressive increase in VCAM-1 expression after transplantation, and there was no difference in the level of mononuclear cell infiltrate compared with controls.

Rate of transport and development of preimplantation embryo in the superovulated buffalo (Bubalus bubalis)

This study was designed to ascertain the rate of transport and development of preimplantation embryo in the superovulated buffalo in order to determine the optimum time for their nonsurgical collection. Eighteen Murrah-type buffalo were superovulated with 600 mg NIH-FSH-P1. Luteolysis was induced by administration of PGF2 alpha at 72 (PG + 72) and 84 h (PG + 84) after initiating gonadotrophin treatment and fixed-time AI was done beginning at 36 h post PG + 72 administration and at 12-h intervals thereafter, upto 72 h. Six control buffalo received treatment similar to experimental group except that in place of FSH they received normal saline. For embryo collection, experimental animals were humanely killed at 6-h intervals corresponding to 156 (n = 2), 162 (n = 2), 168 (n = 2), 174 (n = 3), 180 (n = 3), 186 (n = 3) and 192 h(n = 3) after PG + 72 treatment, whereas the control animals were humanely killed at 156 (n = 2), 174 (n = 2) and 192 h (n = 2). Superovulated buffalo had higher number of ovulations than untreated controls (8.78 +/- 5.00 vs 0.67 +/- 0.51) and total ova/embryos recovered was 4.11 +/- 2.46 and 0.67 +/- 0.51, respectively. The high estradiol-17 beta (E2) levels with its prolonged rise may, by leading to reverse peristalsis in the oviduct with a consequent loss of some embryos in the peritoneal cavity, be one of the reasons for our inability to recover nearly 84/158 ova/embryos in the superovulated buffalo. In superovulated animals, nearly all the ova/embryos reached the uterus between 168 and 174 h post PG + 72 treatment or about 134 h (circa 5.5 d) after the onset of superovulatory estrus, suggesting that the ideal time for non-surgical embryo collection in the buffalo is between Days 7 to 8 after PG + 72 treatment or Days 5.5 to 6.0 of the superovulated cycle (estrus = Day 0). Embryo development of superovulated buffalo showed considerable variation as various stages of embryos (8 cell to expanded blastocyst) were recovered from the same donor buffalo, and the rate of development appeared to be 24 to 36 h faster than in cattle.

Quantification of phenylbutazone in equine sera by use of high-performance liquid chromatography with a nonevaporative extraction technique

OBJECTIVE

To develop a sensitive, rugged high-performance liquid chromatography (HPLC) method for the measurement of phenylbutazone (PBZ) in equine sera, using a rapid, nonevaporative extraction technique.

SAMPLE POPULATION

Sera from 5 nonexercising adult horses.

PROCEDURE

After addition of sodium chloride and acetonitrile to serum samples, reverse-phase HPLC analysis for PBZ and oxyphenbutazone (OXY) was performed directly on extracts, using diode array UV spectrophotometric detection. Probenecid was used as an internal standard. Data were evaluated by standard means of statistical analysis.

RESULTS

Recoveries of PBZ, OXY, and probenecid from spiked samples were acceptable (ie, > or = 80%) and within run retention times were reproducible. Chromatograms were free of interfering substances, and linearity of calibration curves was observed throughout operational ranges. Coefficients of variation at each fortified PBZ concentration were in the 5 to 10% range. The method was applicable to analysis of PBZ and OXY in serum extracts from horses dosed with PBZ (4.4 mg/kg of body weight, IV) in a controlled environment. Track samples analyzed by use of this method and a conventional liquid/liquid extraction method gave comparable results (mean deviation, 1.6%) for PBZ concentrations.

CONCLUSION

The HPLC protocol described is suitable for measuring PBZ and OXY in equine sera to regulate PBZ administration in horses involved in pari-mutuel racing.

Brazilian Baccharis toxins: livestock poisoning and the isolation of macrocyclic trichothecene glucosides

Samples of the toxic Brazilian plant, Baccharis coridifolia, which is responsible for numerous cases of livestock poisoning in southern Brazil and Argentina, were collected during the growing season, and the toxicities in calves of the plant materials were correlated with the levels of macrocyclic trichothecenes present. Female plants in flower were considerably more toxic than male plants or plants not in flower. Plants not in flower were of intermediate toxicity. The female plants in flower typically contained 5-10 times the levels of toxins as were found in the male plants. In addition, six new glucosides of the macrocyclic trichothecenes were isolated and characterized. The most prominent glucosides, those of roridins A and E, were found in high levels in the female plants.

Evaluation of ketorolac, ibuprofen-paracetamol, and dextropropoxyphene-paracetamol in postoperative pain

STUDY OBJECTIVE

To compare the analgesic efficacy of ketorolac, ibuprofen-paracetamol (acetaminophen), and dextropropoxyphene-paracetamol in postoperative pain.

DESIGN

Randomized, double-blind, parallel, single-dose study.

SETTING

Multicenter, with five centers participating.

PATIENTS

One hundred sixty patients with moderate to severe postoperative pain requiring oral analgesics were enrolled. Seventeen patients were excluded from final analysis due to deviation from protocol.

INTERVENTIONS

Ketorolac tromethamine 10 mg, a combination of ibuprofen 400 mg plus paracetamol 325 mg, or a combination of dextropropoxyphene 65 mg plus paracetamol 400 mg was given orally to patients with moderate to severe baseline pain.

MEASUREMENTS AND MAIN RESULTS

Pain intensity and pain relief scores were rated at baseline, at 30 minutes, and hourly to 6 hours. Until the end of first hour, analgesia was similar for all three regimens. Ketorolac had a significantly higher analgesic effect than the two combinations between hours 2 and 6. Analgesia was similar for the two combinations. For all three test drugs the frequency of adverse effects was similar.

CONCLUSIONS

Ketorolac 10 mg is a superior analgesic to ibuprofen-paracetamol or dextropropoxyphene-paracetamol in the treatment of postoperative pain.

Screening and confirmation of drugs in horse urine by using a simple column extraction procedure

A simple and reproducible column (Clean Screen-DAU, copolymeric bonded-phase silica column) extraction procedure has been described for the screening and confirmation of drugs in horse urine. The recovery of drugs by the column extraction was better than or comparable to the recovery by the liquid-liquid extraction, which is commonly used in the equine analytical laboratories. The column extraction provided broad coverage of drugs, separated extracts into three fractions (acidic/neutral, steroids, basic), produced a cleaner extract, and eliminated the need for special liquid-liquid extraction procedures for different drugs. The column extract was cleaner and did not contain impurities, whereas, the liquid-liquid extract was relatively impure and the extract required further thin-layer chromatographic cleanup. The column extraction procedure was used to confirm the presence of several potent drugs, such as fentanyl, etorphine, and mazindol.

Expression of the Kirsten ras viral and human proteins in Escherichia coli

The expression vectors pINIII-A and pINIII (lpp p5) were used to construct plasmids which direct the synthesis in Escherichia coli of the Kirsten ras viral (v-Ki-ras) and human cellular (c-Ki-ras) oncogene products as fusion proteins containing 9 and 10 extra amino acids, respectively, at their N termini. Authenticity of the bacterially produced proteins was determined by immunoprecipitation and immunoblot analyses with ras-specific monoclonal antibodies. After induction with isopropyl-beta-D-thiogalactopyranoside, the viral protein represented approximately 20% of the total cellular protein. The majority of the protein was found in the postsonication low-speed centrifugation pellet. The synthesized viral protein was active in GTP binding, as judged by autophosphorylation and photoaffinity labeling assays.

A sheep preparation for studying interactions between blood flow and drug disposition. I: Physiological profile

A sheep preparation has been developed which allows repeated measurements of regional blood flow, oxygen consumption and drug disposition in awake, unrestrained animals. This allows systematic studies of both acute changes, such as haemodynamic disturbances, and of chronic changes, such as enzyme induction, to be carried out. Good agreement was shown between the values for cardiac output and regional blood flow obtained by the Fick and indicator dilution methods, and those obtained by others using microspheres. Significant day-to-day fluctuations in haemodynamic indices were shown to occur; assumptions that hepatic or renal blood flows are constant fractions of cardiac output, or that renal or hepatic flow indicator extraction ratios remain unchanged from day-to-day, will lead to significant errors. Thus, control measurements for each experiment are necessary. It is proposed that physiological models for studying drug disposition based on data from awake, unrestrained animals may provide insight into some mechanisms of changes in drug disposition that cannot be obtained using the traditional compartmental method.

The spectral domain of multivariate harmonizable processes

The spectral or frequency domain of a multivariate weakly harmonizable process is a vector space of vector functions that are integrable relative to a positive definite matrix bimeasure. It has a norm derived from a Gramian inner product. The completeness property of this space, which is needed for many applications, has been open for some years. An affirmative solution and an application to optimal least-squares estimation of a weakly harmonizable signal are presented here.

The effect of purine and pyrimidine bases on splenic plaque-forming cells and cellular immunity

The effects of a variety of purine and pyrimidine bases on splenic plaque-forming cells and cellular immunity in mice are presented. The antibody-forming plaque cells were measured in spleens of female C57/B1 mice by the Jerne plaque method using sheep red blood cells as the antigen. Bases were given on days 0 and 1 at doses varying from 2 to 200 mumoles per mouse and the antigen was given on day 0; the antibody response was measured on day 4. Cell-mediated immunity was measured by the survival of 1 cm2 skin allografts transplanted across an H-2 histocompatibility barrier in female mice from C57/B1 donors to Balb/c recipients. For the plaque assay, adenine given at 25 and 50 mumoles/mouse and adenosine at 100 mumoles/mouse, resulted in significant 7 to 14-fold immunosuppression. Adenosine at 25 and 50 mumoles/mouse and guanosine and hypoxanthine at 100 mumoles/mouse resulted in an approximate 2-fold immunoenhancement. 2'-Deoxyadenosine, inosine, guanine, 2'-deoxyguanosine and the pyrimidines cytosine, cytidine, 2'-deoxycytidine, 2'-deoxythymidine and uridine all given at 100 mumoles/mouse and orotic acid given at 25 mumoles/mouse had no significant effects on the plaque response; orotic acid at a dose of 50 mumoles/mouse was lethally toxic to mice. In the primary immune response adenine was immunosuppressive at day 4, but significantly immunoenhancing at days 7 and 11. In the secondary response, adenine was immunosuppressive up to day 3 of the IgG and IgM responses; however, immunoenhancement occurred at day 4 (IgM) and day 5 (IgG). In the cell-mediated immune response, adenine at doses of 25 and 50 mumoles/mouse resulted in a significant 40% increase in the survival of skin allografts across an H-2 histocompatibility barrier.

Intrarenal abscess in a transplant organ

We report the first case of an intrarenal abscess in a transplant organ. Diagnosis was made by ultrasonography and excretory urography, and was confirmed by percutaneous aspiration under ultrasonographic guidance. Surgical drainage and systemic antibiotic therapy resulted in complete resolution of the lesion and no change in renal function.

Expanded polytetra fluoroethylene (PTFE) graft in hemodialysis

Currently, PTFE grafts are regarded to be the alternative method of choice for patients with failed conventional fistulae. Observation over a longer period is necessary to assess the long term patency rate. Our experience in the use of PTFE grafts in providing vascular access for selected patients is reviewed. Thirty grafts were implanted in twenty-six patients over a sixteen-month period. Complications noted were thrombosis (six patients) and infection (two). Twenty patients were successfully hemodialysed without complications. Two additional patients had access provided for long term parenteral therapy or transfusion.

Representation of weakly harmonizable processes

Weakly harmonizable processes are represented by a family of positive definite contractive linear operators in a Hilbert space. This generalizes the known result on weakly stationary processes involving a unitary family. A characterization of the vector Fourier integral of a measure on R → [unk], a reflexive space, is given, and this yields another characterization of weakly harmonizable processes when [unk] is a Hilbert space. Also these processes are shown to have associated spectra, yielding a positive solution to a problem of Rozanov.

Plant anticancer agents. IX. Constituents of Hyptis tomentosa

The twigs, leaves, and flowers of Hyptis tomentosa were found to owe their major cytotoxic activity to the presence of desoxypodophyllotoxin (4), but the two weakly cytotoxic flavones 5-hydroxy-4',6,7,8-tetramethoxy flavone (3) and 5-hydroxy-4',3,6,7,8-pentamethoxy flavone (2) also contributed to the total cytotoxicity of the crude extracts. The flavones eupatorin (6) and 5-hydroxy-3',4',6,7-tetramethoxy flavone (5) were isolated as inactive constituents, together with the lignan sesamin (1).

The effect of prostatectomy on urodynamic parameters

Sixty per cent of men subjected to prostatectomy had unstable bladders. It was found that this was related to the presence of either an indwelling catheter or obstruction, but had little influence on the result of prostatectomy. The functional urethral pressure profile length did not correlate with the size of the prostate gland. Shortening of the prostatic plateau was always found, but the extent to which the plateau was reduced did not correlate with urine flow rates.