We aimed to investigate the effects of different formaldehyde (FA) concentrations on some enzyme activities that take part in metabolic pathways in the liver. The enzymes studied were hexokinase (HK), glucose-6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), lactate dehydrogenase (LDH), and malate dehydrogenase (MDH) which are included in the three main metabolic pathways; glycolysis, citric acid cycle, and pentose phosphate pathway. Thirty male Wistar albino rats were raudemly divided into 3 separate groups (10 per group). The first ten rats were used as control (grup I). Rats were exposed to atmosphere containing 10 and 20 ppm FA continuously (8 hours per day, 5 days per week) in groups II and III. HK, G6PD, 6PGD, LDH, and MDH activities were measured in liver tissues. The results showed a remarkable reduction in G6PD and 6PGD activities, significant increase in MDH activity in liver tissues from rats exposed to 10 ppm FA for 13-weeks. There were no differences in the activities of HK and LDH between test and control groups. Conversely G6PD activity was decreased and MDH activity was increased in liver tissues from rats exposed to 20 ppm FA for 13-weeks. These results may suggest the possible changing effect of FA inhalation on metabolic enzymes in liver.

The present experiment was conducted to study the glycemic effect of stevioside (SVS) and clarify whether SVS participates in glycemic action of aqueous extract of Stevia rebaudiana (SR) in diabetic rats. Male Wistar rats weighing between 150-180 g were used. Six groups of rats were established. The first three groups were normal rats daily fed by intragastric intubation of water or SVS (0.25 g / kg body weight) or SR at the dose corresponding to the dose of SVS administration (4.66 g / kg body weight) for 8 weeks. The other three groups were diabetic rats treated with the same procedure as normal rats. The plasma glucose level (PG) was determined once a week after overnight fasted. At the end of experiment, serum insulin and plasma glucagon levels were determined. Insulin-induced glucose uptake by isolated diaphragm was also evaluated using 2-deoxy-D-[3H]-glucose and [14C]-manitol. The results show that SVS slightly but significantly raised PG since the third week in normal rats whereas no significant change was noted in diabetic rats throughout experimental period. The PG was not altered in normal rats fed with SR whereas it significantly reduced since the second week until the end of experiment in diabetic rats fed with SR. Serum insulin and plasma glucagon levels were not significantly changed in normal rats fed with either SVS or SR. Serum insulin was raised to the same extent in diabetic rats fed with either SVS or SR. The high plasma glucagon level was suppressed in diabetic rats fed with SR to the level that was not significantly different from that of the normal rats. Insulin-induced glucose uptake by isolated diaphragm muscle were suppressed in both normal and diabetic rats fed with SVS whereas no change was apparent in both normal and diabetic rats fed with SR. A suppression of insulin-induced glucose uptake by muscle plays a predominant role to produce hyperglycemia in normal rats fed with SVS. Despite an improvement of insulin level, anti-hyperglycemic effect of SVS can not be displayed in diabetic rats since a reduction of insulin-induced glucose uptake was noted as well. An elevation of insulin and suppression of glucagon are the primary cause of anti-hyperglycemic effect of SR in diabetic rats. SVS containing in SR may indirectly contribute to anti-hyperglycemic action of SR in diabetic rats via its effect to potentiate insulin release.

The ready availability of abdominal ultrasonography for the investigation of a wide range of abdominal symptoms has resulted in the increased diagnosis of asymptomatic gallstones. Management of such accidentally discovered gallstones poses a dilemma as conclusive evidence of the benefits of cholecystectomy is lacking. The aim of this study was to understand the natural history of asymptomatic gallstones discovered through a routine patient care process. We followed 109 persons with asymptomatic gallstones. All were then reviewed annually for 18 years for evidence of gallstone-related problems. Results were compared with previous literature studies. Of 109 patients, 73 were women and 36 men, with an average age of 48.2 years (21 - 70). Symptoms developed in 31 patients (28.4%) after an average latency period of 37 months (2 – 98 months). One woman had gallbladder adenocarcinoma, and ten patients underwent prophylactic cholecystectomy. Women were more likely to become symptomatic than men, but symptom development in the men was more serious because initial presentations were biliary complications. Death due to nonbiliary causes occurred in 16 (14.7%) persons. The average age at the time of death was 70 years, ranging from 62 to 83 years. 52 persons remained asymptomatic for 18 years. The yearly risk of biliary pain appears to decrease with the passage of time . Follow-up showed that only 28.4% developed symptomatic gallstones. Most patients with asymptomatic gallstones required no treatment.

We performed a pragmatic economic evaluation of a randomized controlled trial comparing two alternative surgical techniques for haemorrhoid treatment: Longo vs Ferguson. The primary economic evaluation framework employed was cost-utility analysis. 40 patients with 3rd and 4th degree haemorrhoids were randomly assigned to either technique (20 each). Cost data were measured within and out with the trial, then were combined with quality-adjusted life years (QALYs) to obtain cost-per-QALY ratios. Mean cost of Longo technique was €3,637.49 compared with €4,509.36 for Ferguson technique. The extra €871.87 in Ferguson group was mainly indirect costs. At 2 years post-intervention, Ferguson-treated patients gained a mean 1.8294 QALYs while Longo-treated patients gained a mean 1.5706 QALYs. This difference was not statistically significant (P>0.05) so we opted for analysis of cost minimization. We had three cases of anal fissures, twelve tenesmus, five recurrences and 80 % of the patients with fourth degree haemorrhoids were unsatisfied, complained of persistent skin tags and requested excision. The trade-offs between each procedure´s attributes providing monetary estimates of benefit for both techniques (trade-offs -willingness to pay €2,703; Longo and €2,395.5 Ferguson), showed that the costs were significantly higher than the benefit in both. At three months all favoured Longo procedure, but at 3 years only third degree patients did so, while fourth degree patients favoured Ferguson procedure. The low benefit perceived in both procedures may be attributed to Health Service funding.

The aim of this study was to determine clinical value of alone and combined use of serum cytokeratin (CK)-18, carcinoembryonic antigen (CEA) and CA 19-9 in esophageal squamous cell carcinoma and gastric adenocarcinoma. Serum tumor markers were measured in 60 patients who had esophageal squamous cell carcinoma or gastric adenocarcinoma. Thirty healthy subjects served as controls. In patients with gastric adecarcinoma serum CK-18 levels were significantly increased compared to both esophageal squamus cell carcinoma and control groups (p<0.01, p<0,05 respectively). But there was no significant difference in CK-18 levels between esophageal squamous cell carcinoma patients and healthy subjects (p>0.05). On the other hand, serum CEA and CA 19-9 levels did not differ between groups (p>0.05). The sensitivity of serum CK-18, CEA and CA19- 9 in esophageal squamous cell carcinoma were 53%, 70% and 66%, respectively. For gastric adenocarcinoma, the sensitivity of each tumor marker was similar 70%, 70% and 70%, respectively. CK-18/CA19-9 combination in the esophageal (83%) and gastric carcinomas (93%) were found to be more sensitive than other tumor markers when these markers were evaluated in combination. CEA exhibited the highest sensitivity for esophageal squamous cell carcinoma compared to CK-18, and CA19-9. However, the sensitivity of all tumor markers in gastric adenocarcinoma were similar. The combination of CK-18 and CA19-9 could increase the diagnostic sensitivity in esophageal and gastric carcinomas.