Arterial variants in pancreatic adenocarcinoma

Surgery remains the only curative option for the treatment of pancreatic adenocarcinoma. Local tumor resectability depends on a number of factors, but most importantly, the relationship of the tumor to adjacent arterial structures. For example, surgery is rarely performed when the tumor involves the celiac axis or the superior mesenteric artery. Unexpected variant arterial anatomy or tumor involvement of aberrant arteries may complicate pancreatic surgery. The classic visceral arterial anatomy occurs in only 55%–60% of the population, with one or more variant vessels occurring in the remaining population. Knowledge of both variant and normal anatomy is essential for accurate preoperative planning. We describe here the arterial variant anatomy of the pancreas and its identification by multidetector CT imaging, with and without the aid of post-processed volume-rendered images.     

Coronary flow reserve in hypertensive patients with hypercholesterolemia and without coronary heart disease

BACKGROUND: Coronary flow reserve (CFR) may be reduced both in arterial hypertension and in hypercholesterolemia. The aim of the study was to assess an association between CFR and levels of plasma total cholesterol (TC) in untreated arterial hypertension. METHODS: We studied 54 consecutive, untreated hypertensive outpatients free of coronary heart disease. Twenty of them had normal TC and 34 high TC (>/=200 mg/dL). Standard echocardiograms and transthoracic Doppler interrogation of the distal left anterior descending artery were obtained. Coronary diastolic peak velocities were measured both at rest and after low-dose dipyridamole. The CFR was calculated as dipyridamole/resting velocities ratio. RESULTS: The two groups had similar age, body mass index, heart rate, and diastolic blood pressure (BP). Patients with high TC had higher systolic BP (P < .05), triglycerides (P < .02), LDL-cholesterol, and TC/HDL-cholesterol ratio (both P < .0001) than controls. Left ventricular (LV) mass index, relative wall thickness, and fractional shortening did not differ between the two groups. Coronary diastolic peak velocities were similar at rest but lower after dipyridamole in patients with high TC (P < .02). As a consequence, CFR was reduced (P < .002). In multiple linear regression analyses, adjusting for age, heart rate, systolic BP, smoking, and relative wall thickness, TC (beta = -0.338) or high LDL-cholesterol (beta = -0.301) (both P < .001) were predictors of lower CFR independently of the concomitant effect of potential confounders. CONCLUSIONS: In hypertensive patients free of coronary artery disease, the degree of impairment in coronary vasodilator capacity is independently associated with plasma cholesterol and LDL-cholesterol.     

Vertebrate species profiling in one step using a single primer

Current species profiling techniques usually require several steps to identify an unknown species in quarantine cases and other forensic applications. Here we have developed a species profiling test that produces unique profiles for all vertebrate species tested using a single primer in a polymerase chain reaction. Samples tested included a range of mammals and other vertebrates such as fish and marsupials; a group of animals yet to be characterized with molecular speciation techniques. Species-specific profiles were shown to be reproducible and able to be generated from less than 10 ng of total DNA, comparable to DNA quantities used in conventional species profiling techniques. A case study demonstrates the utility of the technique by distinguishing between commercial and protected species of the Macropodidae (kangaroo) superfamily.     

Intensive therapy for severe paediatric morbid obesity

Morbid obesity in children and adolescents can cause life‐threatening medical complications such as obstructive sleep apnoea, intracranial pressure and debilitating joint disease that require an aggressive, invasive approach. Studies have shown that a weight reduction of 5–10% can reduce or eliminate the need for invasive procedures in comparable adult populations. The aim of this paper is to describe an inpatient, multidisciplinary programme designed to reduce or eliminate the need for invasive medical procedures in a morbidly obese paediatric population. The programme incorporates the six elements recommended by the Expert Committee on Obesity Evaluation (Barlow & Dietz, 1998 ): (1) Close monitoring of the medical condition. (2) Moderate caloric restriction to induce a modest (5–10%) weight reduction. (3) Intensive family intervention. (4) Individual behavioural and cognitive therapy. (5) Physical activity education. (6) Gradual community involvement and long‐term maintenance. Three patients with different life‐threatening medical complications of morbid obesity are described, and the rationale of the programme and its potential role as an alternative or adjunct to invasive medical intervention in severe paediatric morbid obesity are discussed. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.     

Differential effect of serum from bipolar versus schizophrenic patients on spontaneous acetylcholine release at mammalian neuromuscular junction

OBJECTIVE: The diagnosis of bipolar disease frequently requires a long time since the age of onset, especially because the disease is misdiagnosed with schizophrenia. The aim of the present work was to investigate whether sera from bipolar patients have an active substance that allows making a fast identification of the disease. METHODS: Sera from healthy volunteers, euthymic and non-stabilized bipolar patients, and schizophrenic patients were passively transferred into CF1 mice and after 2 day injections, MEPP frequency from diaphragm muscles was recorded. The same procedure was performed with sera fraction of high and low MW (cut-off 3000). RESULTS: Sera from non-stabilized bipolar patients induced a decreased MEPP frequency and occluded the presynaptic inhibitory effect of the specific adenosine A(1) receptor agonist 2-chloro-N(6)-cyclopentyl-adenosine (CCPA) in the recipient mice, while in the euthymic bipolar group spontaneous secretion reached control values although the action of CCPA was still prevented. Similar results were obtained with low MW sera fraction from euthymic and non-stabilized bipolar patients. The addition of adenosine deaminase to the sera fraction prevented the modification of spontaneous ACh release. In mice injected with sera from schizophrenic patients, MEPP frequency was within control values and CCPA induced its typical inhibitory action. CONCLUSIONS: These results indicate that bipolar patients contain in their blood an active substance compatible with adenosine, which was able to modify spontaneous ACh release in the recipient mice. This effect was not observed with sera from healthy volunteers and schizophrenic patients. The increase of adenosine concentration may result from synaptic hyperactivity that presumably plays a role in the symptoms of bipolar disorder and/or may derive from peripheral cells through a more general mechanism. SIGNIFICANCE: The different results obtained with bipolar and schizophrenic sera raise the possibility that the passive transfer model could be used as a diagnostic test in the future.     

Psychological reactions to thermography and mammography

Psychological distress and illness attitudes were investigated in women undergoing thermography and mammography by means of two self-rating scales: the Symptom Questionnaire (SQ) and the Illness Attitude Scales (IAS). After receiving normal results from thermography, a significant decrease in anxiety, depression, somatic symptoms, hostility, worry about illness, concern about pain, and fear of dying took place. Women who, because of the thermography results, required mammography, displayed significantly less distress and fewer fears before mammography than before thermography.