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Types and frequencies of biliary tract variations associated with a major portal venous anomaly: analysis with multi-detector row CT cholangiography.

PURPOSE: To retrospectively determine whether major portal venous variation was more frequently associated with biliary variants, with consideration of the types and frequencies of biliary tract variations in the right and left liver lobes. MATERIALS AND METHODS: Before undergoing computed tomographic (CT) cholangiography, patients gave informed consent. The retrospective research protocol was approved, and informed consent was waived by the ethics committee. Forty-four patients aged 29-80 years who underwent multi-detector row CT cholangiography had a major portal vein variation in which the main portal vein diverged into the common trunk of the left portal vein and right anterior sectorial portal vein. One hundred fifty-eight consecutive patients aged 26-89 years who did not have this variation served as the control group. Three radiologists retrospectively evaluated the confluence pattern of the bile duct, the relationship between this pattern and the portal vein, and the major branching pattern of the portal vein. Pearson chi2 and Fisher exact tests were performed to identify significant differences between the two patient groups. RESULTS: The classic hilar confluence pattern, where the right posterior sectorial duct connects supraportally with the right anterior sectorial duct, was less frequent in the patients with the portal vein variation than in the control subjects (32% vs 73%, P < .05). The following biliary tract variations were identified more frequently in the variation group than in the control group (P < .05): right posterior sectorial duct joining left hepatic duct with a supraportal course (34% vs 12%), right posterior sectorial duct joining right anterior sectorial duct with an infraportal course (13% vs 4%), right posterior sectorial duct following an infraportal course (23% vs 8%), and left lateral segmental ducts caudal to the umbilical portion of the portal vein (14% vs 3%). The right hepatic duct, which receives all biliary ducts from the right lobe, was significantly less frequently developed in the variation group (46% vs 79%, P < .05). In addition, retroportal bile ducts were seen in four patients with the portal vein variation (P < .05). CONCLUSION: Bile duct configurations in patients with portal vein variation were significantly different from those in control subjects.

Adult↗

Decrease in the seasonality of sexual behavior and sperm production in bucks by exposure to short photoperiodic cycles.

Bucks show seasonal variation in their body weight and sexual activity. Three groups of six Alpine and Saanen bucks were used over two consecutive years to investigate if rapid alternations between long and short days could abolish this seasonal variation. The control group was kept under natural annual daylength, while the experimental groups were exposed to alternations of either 1 month of 16L:8D and 1 month of 8L:16D (2-month treatment) or to 2 months of 16L:8D and 2 months of 8L:16D (4-month treatment). In the control group, body weight, sexual behavior, testicular weight and sperm production showed important seasonal variations: body weight decreased between September and January by about 7 kg; refusal to ejaculate went up to 25% in August; testicular weight varied from 103 +/- 2 g (March) to 149 +/- 7 g (October). In contrast, seasonal variations of these parameters decreased in the two experimental groups. In the 2-month treatment group, testicular weight increased from 134 +/- 7 (March) to 148 +/- 8 g (October); while in the 4-month treatment group it increased from 123 +/- 10 to 138 +/- 12 g, respectively; in the same period, the two experimental groups of bucks produced a larger total number of spermatozoa per ejaculate (6.3 +/- 0.3 x 10(9); 2-month treatment and 7.2 +/- 0.3; 4-month treatment) than in the control group (4.2 +/- 0.4). We conclude that rapid alternations between long and short days decreased seasonality in the sexual activity of bucks.

Journal Article↗

Regional GABA/benzodiazepine receptor/chloride channel coupling after acute and chronic benzodiazepine treatment.

GABA/benzodiazepine coupling was evaluated in 8 regions of rat brain by the ability of GABA to stimulate 0.5 nM [3H]flunitrazepam binding. Rats were treated acutely with diazepam (p.o) or chronically with flurazepam, offered in the drinking water for 4 weeks, and compared to a pair-handled vehicle-treated control group. Regional variations in GABA/benzodiazepine coupling were found in control membranes. GABA increased benzodiazepine binding maximally (40%) in cerebellum and medulla, and least (25%) in olfactory bulb. A significant decrease in the effect of GABA was found in cortex of chronically treated rats immediately after, but not 2 days following treatment. The Emax for GABA stimulation of [3H]flunitrazepam binding was significantly increased in medulla after acute treatment but was not altered after acute or chronic treatment in other brain areas evaluated. Treatment had no effect on the ability of bicuculline to inhibit [3H]flunitrazepam binding in cortex. Benzodiazepine/Cl- coupling in cortex or hippocampus of acutely and chronically treated rats, evaluated by the ability of Cl- to stimulate specific [3H]flunitrazepam binding, was not changed. The results support the hypothesis that a functional uncoupling of the benzodiazepine recognition site from the GABA receptor in cortex, but not from the anion recognition site, may play a role in tolerance development.

Analysis of Variance↗

[Variability of bone response to hormone replacement therapy].

Bone response to hormone replacement therapy (HRT) was assessed in a retrospective longitudinal study. 115 women started on HRT for the first time and 252 controls underwent initial densitometric evaluation (spine and femur) and a second evaluation on average 29 months later. Patients were classified as post-menopausal or perimenopausal according to whether they had had more or less than 6 months amenorrhea. Oral or non-oral 17-beta estradiol was used at the dose generally accepted to be skeletally protective. In the post-menopausal group, prescription of HRT was followed by spinal and femoral bone gain (+ 2.85% and + 1.06% per year respectively). There was no bone gain with HRT in the peri-menopausal women, but the stability seen contrasted greatly with the very marked bone loss found in controls (spine - 3.09% per year and femur - 1.78% per year). Lumbar densitometric variations were correlated, at least in the post-menopausal group, with those in the femur, but the amplitude of femoral variations was half that of the spine. Body mass index (BMI) was not found to be a predictive factor of bone response to HRT in this group, but the time since the menopause and initial densitometric results were. For the spine, the % of subjects losing their bone mass in response to the start of HRT, nil in the post-menopausal group, was 16% in peri-menopausal women. The % of good responders increased from 8% peri-menopausally to more than 59% 2 years after the menopause. The response in the femur appeared to be very different, with 20% good responders and a % of stable subjects similar to that of the control group. Femoral variations and the existence regarding the spine of a group showing no or only a poor response to HRT would be in favor of densitometric monitoring when initial bone mass is low.

Absorptiometry, Photon↗

Simple method for quantifying disorientation of myofiber in endomyocardial biopsy specimens using an image analyzer.

The disarray of cardiac myofibers was morphometrically evaluated in biopsy specimens, obtained from patients with hypertrophic cardiomyopathy (HCM), hypertensive heart disease (HHD), chronic phase myocarditis and controls. Microphotographs of myocardium were taken at a final magnification of x 250. For each segment of myofibers, the longitudinal direction was traced on a transparent sheet, and the angle of the traced direction to the baseline was measured by an image analyzer. The standard deviation of the angles was used as an indicator of myofiber disarray. The histograms showed a narrow variation in the control group, but a wide variation in the patients with HCM, HHD and chronic phase myocarditis. The mean value of standard deviations of myofiber angles in HCM was significantly larger than that in the other groups. In HCM, the standard deviation of the myofiber angle proved to correlate positively with IVST/LVPWT (the thickness ratio of interventricular septum to the left ventricular posterior wall) (r = 0.70, p < 0.05), and also with LVEDP (left ventricular end-diastolic pressure) (r = 0.66, p < 0.05). In conclusion, the image analyzer serves as a simple and useful tool in quantifying the disorientation of myofibers and estimating the correlation between the histological and clinical findings.

Adult↗

Association study of four activity SNPs of CYP3A4 with the precocious puberty in Chinese girls.

CYP3A4 plays an important role in the metabolism of a variety of endogenous and exogenous compounds. Earlier studies revealed that a high-activity variation of the CYP3A4 gene, CYP3A4*1B is significantly associated with the precocious puberty in girls. Other three variations, CYP3A4*4, CYP3A4*5 and CYP3A4*6, which were found in a study carried out in a Chinese population in Taiwan, were reported to down-regulate the enzymatic activity of CYP3A4. The four activity SNPs were typed in our study in two groups of Chinese girls: 176 girls with precocious puberty as the case group, and 192 normal girls as the control group. No variations of CYP3A4*1B and CYP3A4*4 were found in all the cases and controls. Heterozygous of CYP3A4*5 was found in five subjects of the 192 controls but none in the cases, heterozygous of CYP3A4*6 was found in two subjects of the controls but none in the cases. Fisher's exact test showed that the variation of CYP3A4*5 was associated with the onset of puberty in Chinese girls (P-trend=0.038), while the variation of CYP3A4*6 was not associated with the onset of puberty in Chinese girls (P-trend=0.272). The result suggests that these mutations in the CYP3A4 gene have no contribution to the early onset of puberty in Chinese girls, but are related in some way with the puberty development in Chinese girls.

Alleles↗

Preservative-free lidocaine 1% anterior chamber irrigation as an adjunct to topical anesthesia.

PURPOSE: To evaluate the effect on the central corneal endothelium of anterior chamber irrigation with preservative-free lidocaine 1% as an adjunct to topical anesthesia during phacoemulsification. SETTING: Department of Ophthalmology, Hospital Capuchos, Lisbon, Portugal. METHODS: This prospective, randomized controlled study comprised 59 eyes. Thirty-one eyes had phacoemulsification (in-the-bag cracking technique) under topical anesthesia with anterior chamber irrigation by preservative-free lidocaine 1%. Twenty-eight eyes having the same procedure but with local-regional anesthesia served as the control group. All eyes had preoperative and postoperative specular microscopy and computer-assisted morphometry. A Student's t-test was used for between-group comparison of the following parameters: patient age, central corneal endothelial cell loss, mean endothelial cell size variation, and phacoemulsification ultrasound time Follow-up was 4 weeks. RESULTS: The between-group differences in mean patient age and ultrasound time were not significant. The differences between groups in the endothelial cell parameters were also not significant. Mean postoperative endothelial cell loss was 3.59% +/- 2.79 (SD) in the topical anesthesia group and 4.37 +/- 2.00% in the control group. Mean variation in cell size was 3.71 +/- 1.57% and 3.79 +/- 1.07%, respectively. CONCLUSION: Intracameral infusion of preservative-free lidocaine 1% had no effect on the corneal endothelial cell loss rate or mean cell size variation in this short-term assessment.

Adjuvants, Anesthesia↗

[The effect of repeated administration of carbetocin (Depotocin, Spofa) in the first days postpartum on levels of thyroxine, triiodothyronine, 17 beta-estradiol, progesterone and on fertilization].

Application of new procedures in the sphere of the control of sexual functions requires an extension of present knowledge of postparturient endocrinium or endogenic factors comprised in postparturient physiology of sexual activity. According to recent data, oxytocin, besides its uterotonic and luteolytic activity, acts as an ovarian factor in the local intrafollicular regulation of stereidogenesis and as a modulator of uterine secretion of prostaglandines. Based on present knowledge of oxytocin effects, this study was aimed at investigation of the influence of repeated carbetocin (Depotocin inj. Spofa) administration on the dynamics of changes in thyroxine (T4), triiodothyronine (T3), 17 beta-estradiol (E2), progesterone (P4) concentrations and their mutual correlations from the 36th hour till the 51st day after parturition. Simultaneous study of a possible delayed influence of applied carbetocin on conception of ewes after oestrus evocation on day 51 after lambing was carried out. Nineteen ewes of the Slovak Merino breed, lambed in the first decade of February, were assigned to the experimental (n = 9) and to the control group (n = 10). Experimental ewes were subjected to repeated postparturient carbetocin treatment at the dose 0.07 mg per animal. The first dose was applied i. m. in 24 hours, and the second in 72 hours after parturition. On day 51 oestrus was induced in nine ewes of each group by combined treatment with chlorsuperlutin (Agelin, vaginal pessaries, Spofa) and PMSG (500 I.U./animal). On the day of PMSG application ewes were housed together with rams for the period of the next six days. Samples of blood were taken 24 hours before parturition (-1st day), up to 36 h after parturition and on days 4, 7, 14, 17, 21, 25, 34, 42 and 51 after parturition. Concentrations of T4, T3, E2 and P4 were determined by commercial kits RIA-test-T4; RIA-test-T3; RIA-test-ESTRA and RIA-test-PROG (URVJT Kosice). Animal of the control group showed variations of T4 concentrations (Tab. I, Fig. 1) at the level of original values (59.4 +/- 9.69 nmol.l-1) up to the 21st day with the exception of temporary drop on day 4 and rise on day 7, insignificant compared to the -1st day. T4 concentrations of the control group displayed an intermittent increasing trend with the statistically insignificant peak after 36 h and on day 17, compared to the -1st day. After the 21st day controls revealed a sustained moderate increase while the experimental ewes displayed a decline of its concentrations until the 51st day.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Synthesis of rat brain DNA during acquisition of an appetitive task.

We have examined the incorporation of [3H-methyl]thymidine into DNA extracted from several brain regions of rats learning a reverse handedness task, of control rats allowed to use their preferred paw, and of control rats left in their home cages. In learning animals, decrements in percent incorporation were observed in the visual cortex, remaining brain, hippocampus and entorhinal cortex. In the latter two regions less marked decreases were present in the active control group. No variation occurred in the sensory-motor cortex. In learning rats the specific radioactivity of neuronal DNA was markedly decreased in the hippocampus and remaining brain. In the former region, a less marked decrease was present in active control rats. In subcellular fractionation studies it was observed that decreases in DNA specific radioactivity prevailed in the mitochondrial fraction isolated from the hippocampus and visual cortex of learning rats. Brain radioactive DNA was widely distributed among fractions differing in their degree of repetitiveness. Its pattern of distribution did not coincide with that of bulk DNA and differed significantly among behavioural groups. The results suggest a non random origin of newly-synthesized brain DNA and its involvement in learning.

Animals↗

Diagnostic value of integrated ultrasonic backscatter in congestive cardiomyopathy.

Congestive cardiomyopathy is a fatal myocardial disease which can be diagnosed by clinical findings, electrocardiography, roentgenography and echocardiography. Tissue characterization and pathology have been determined recently using histogram methods to analyze ultrasonographs. In this study ultrasonic backscatter analysis for differentiation of normal and diseased myocardium was tested. Two-dimensional echo data and radio frequency signals of long-axis views of the left ventricular posterior wall of 10 healthy children and 14 patients with congestive cardiomyopathy in systolic and diastolic phase were digitized online into the computer memory. Cyclic variation was obtained in the control group but no variation was detectable in myopathic hearts.

Cardiomyopathy, Dilated↗

[The investigation of the influence of cryopreservation and inbreeding on the variability of morphological characteristics of the evening-primrose biennial (Oenothera biennis L.)].

The effect of deep freezing of seeds at -196 degrees C (-320.8 degrees Fahrenheit) and inbreeding on the morphological characteristics of the evening-primrose biennal (Oenothera biennis L.), such as the size of plant parts and the amount of fruits, cauline nodes, and generative and vegetative shoots was investigated. The variation coefficients for these characteristics after treatment with low temperatures and inbreeding were calculated. It was shown that the characteristics of plant size show a low and a middle level of variability in the control group. The variation curves for these characteristics are similar to normal distribution curves. After stresses they slightly change or remain invariant. Large adventive shoots show a high level of variability. The distribution of the results in this case significantly differs from the normal. The branching of plants changes after both stress factors: the amount of all kinds of shoots decreases by half or even more.

Cryopreservation↗

[Effects of the infusion of glucagon on the blood levels of thyroid hormones].

We have attempted to determine if mild hyperglucagonemia induced by exogenous glucagon infusion induces changes of serum thyroid hormone levels. Eleven healthy subjects, overnight fasting, received glucagon infusion (2 mg/90 min i.v.), whereas 5 healthy subjects (control group) received normal saline infusion. In the subjects infused with exogenous glucagon plasma glucagon concentrations increased from 130 +/- 24 pg/ml to 550 +/- 68 pg/ml at the end of infusion. At the same time no significant changes in serum T3, rT3 and T4 levels were found. A significant increase in serum rT3 levels was found 270 min after glucagon infusion withdrawal, whereas serum T4 levels remained unaltered during the whole period. Normal saline infusion failed to induce any variation in control group, however a late (at 6th hour) mild increase of serum rT3 in these subjects resulted comparable to the same increase of glucagon infused subjects. The results from this study suggest that mild increase in plasma glucagonemia, as found in patients with severe illness, does not induce a short-time significant lowering of serum T3 and a simultaneous rise of serum rT3 in normal subjects.

Adult↗

Rat liver cytosolic protein changes after ethanol exposure studied by two-dimensional electrophoresis.

Rats were fed liquid food containing ethanol in concentrations ranging from 1-5% for 13 weeks. Livers were removed for histopathology and the liver cytosolic protein fraction was prepared and used for two-dimensional gel electrophoresis (2D-PAGE). Polypeptides were visualized by silver staining. Scanning was made for estimation of the relative abundance of protein in each polypeptide spot in the gels and for comparison between rats. Visual inspection and scanning of gels with the stained polypeptide spots obtained after equilibrium isoelectric focusing and non-equilibrium pH gradient electrophoresis revealed that: 1) within the control rat and ethanol-treated rat livers the numbers of polypeptide spots detected using isoelectric focusing in the first dimension were approximately 500 and for non-equilibrium pH gradient electrophoresis 400; 2) in the control group the variation in the estimated amount of protein in each spot was remarkably small; 3) pronounced differences in the relative abundance of protein in several of the spots was observed in the ethanol-exposed rats as compared to controls. Dose-response relations and possible causes for the effects of ethanol are discussed.

Animals↗

[Study on the variation of relaxation time in diabetic cataractous lenses of rats by using NMRA].

Nuclear magnetic resonance analysis (NMRA) was used to measure the relaxation time T1 and T2 of the protons in the different-stage-diseased lenses of rats with diabetic cataract caused by the streptozotocin, and the results were put in comparison with those obtained from the control group, showing that after one month of medication the values of T1 and T2 in the cataractous lenses are greater than those gained from the control group. The variation, as time goes on, becomes greater and greater. T1 and T2 indicate the speed of the free induction decay (FID) signals, and the variation of the FID signals are in direct proportion to that of the proton content of the samples. This shows that an increase in T1 and T2 indicates an increase in the water content in the diseased lenses, and the changes in ratio of "bound" water to free water. Such changes may be explained that the space for "bound" water is occupied by some other macromolecules, causing the alteration of the macromolecular structure, and consequently the aggregation of protein and the degeneration or dehydration or dehydration of the membrane occur, which may give rise to another scattering centre. So the scattering of the lens increases and its transparency decreases. This result is in agreement with some reports in the medical literature. As T1 and T2 are quite different in the normal and pathological tissues, and the protons are the most extensive nucleus in all biological tissues, NMR is a very important method to determine the proton relaxation time in the biological tissue and to judge if it is normal or not.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Instrumentation of the patellar osteotomy in total knee arthroplasty. The relationship of patellar thickness and lateral retinacular release.

This study investigates the influence of patellar thickness in total knee arthroplasty (TKA) with routine patellar resurfacing on the rate of lateral retinacular release. A study group comprised of 121 TKAs using surgical instrumentation allowing a measured resection of the patella was compared with a control group comprised of 100 TKAs using an "eye-ball" technique for patellar resurfacing without particular attention to patellar thickness. A composite without patellar thickness equal to or slightly less than the original patella was attempted in the study group. The average thickness difference of the patella in the study group was -1.58 mm. Lateral retinacular release for patellar maltracking was performed in 12.4% of knees in the study group compared with 55% of knees in the control group. The variation in patellar thickness in this series often led to a residual bone thickness < 15 mm. No clinical problems have been observed to date.

Aged↗

Tear analysis in contact lens wearers.

Tear analysis in contact lens wearers was compared with tear analysis in aphakics without contact lens wear and normal phakic patients. Subjects were divided into five groups: group 1, aphakic without contact lens; group 2, phakic with daily-wear hard contact lens; group 3, phakic with daily-wear soft contact lens; group 4, phakic with extended-wear soft contact lens; and group 5, aphakic with extended-wear soft contact lens. The experimental groups were compared with age- and sex-matched control groups for statistical analysis of tear variables by means of the Student's t-test. The variables measured were tear osmolarity, tear albumin, and lysozyme and lactoferrin concentrations in basal and reflex tears. Highly significant elevations of tear osmolarity were found in aphakic subjects without contact lenses. Less significant differences in tear osmolarity were found in phakic subjects with hard daily-wear lenses or with extended-wear soft lenses. Tear albumin, lysozyme, and lactoferrin in basal and reflex tears were not significantly different in the different groups of contact lens wearers or in the group of aphakic subjects without contact lenses compared with their control groups. Individual variations in tear albumin, lysozyme, and lactoferrin appeared to be responsible for the inability to demonstrate significant differences in tear composition in association with the wearing of different types of contact lenses. Older and aphakic patients demonstrated a tendency to have increased concentrations of proteins in the tears compared with younger, phakic contact lens wearers and normal controls without contact lenses.

Adolescent↗

Psychiatric consultation in somatization disorder. A randomized controlled study.

The per capita expenditure for health care of patients with multiple physical symptoms but no apparent physical disease (somatization disorder) is up to nine times the average per capita amount. We conducted a randomized controlled trial to determine whether psychiatric consultation would reduce the medical costs of these patients, without effecting a substantial change in patient outcome. Thirty-eight patients were randomly assigned to treatment or control groups and studied prospectively for 18 months. Treatment consisted of a psychiatric consultation and suggestions on management given to primary physicians. After nine months, the control group was crossed over to receive treatment with the same intervention. After the psychiatric consultation, the quarterly health care charges in the treatment group declined by 53 percent (P less than 0.05). In contrast, the charges in the control group showed wide variations but no overall change. The quarterly charges in the control group were significantly higher than those in the treatment group (P less than 0.05). After the control group was crossed over to receive treatment, their quarterly charges declined by 49 percent (P less than 0.05). The reductions in expenditures in both groups were due largely to decreases in hospitalization. We conclude that psychiatric consultation in the care of patients with somatization disorder reduced subsequent health care expenditures without inducing changes in health status or patients' satisfaction with their health care.

Adult↗

MR imaging of intrarenal macrophage infiltration in an experimental model of nephrotic syndrome.

The objective of this study was to use MR imaging to detect macrophage infiltration of the kidney after injection of ultrasmall superparamagnetic iron oxide (USPIO) particles in a rat model of experimental nephropathy. Ninety micromol of USPIO were injected intravenously in 10 rats with nephropathy secondary to intravenous injection of 5 mg of puromycin aminonucleoside (PAN), and in 10 control rats. The signal intensity was measured in each kidney compartment before and 24 h after injection of the contrast agent. FLASH sequences were performed on a spectrometer operating at 4.7 T. MR findings were compared with histological data. Twenty-four hours after injection of USPIO, a significant decrease (P < 0.0001) was observed in signal intensity in each kidney compartment in the PAN group. There was no variation in the control group. In the diseased kidneys, histological data revealed the presence of macrophages with iron oxide particles within their cytoplasm and lysosomes. Using USPIO, MR imaging can evidence infiltration of the rat kidney by macrophages.

Animals↗