A modified method of hepaticocholedochojejunal anastomosis

"Declive" latero-terminal and latero-lateral hepaticocholedocho-jejunoanastomosis with a loop of the small intestine isolated by the Roux method was carried out in 6 patients (5 females and 1 male) according to absolute indications. In this type of anastomosis, the longitudinal incision in the hepaticocholedochus is made not on the midline but latero-dorsally on its right supraduodenal circumference. The anastomosis is formed by means of a modified suture or a suture commonly used for bilio-digestive anastomoses; the needle is inserted through the wall of the bile duct 2-2.5 mm from the border of its opening and the sutures are placed at a similar distance from one another, the seromusculo-submucous sutures are applied 6-7 mm from the edge of the opening and at a distance of 3-3.5 mm from one another. Comparison with patients in whom heapticocholedochojejunoanastomosis was established by the routine method showed the results to be better in the modified method.     

Studies on the plasma cholesterol and triacylglycerols in chronic methemoglobinemia in rats.

Plasma cholesterol and triacylglycerols were measured in rats with modelled chronic two-stage (mild and moderate) intermittent nitrite methemoglobinemia for 15 and 30 days. It was found that at the moment of methemoglobinemic peak (60 +/- 10 min) the experimental animals had mixed (hemtoxic, anemic and hypoxic) hypoxemia. The every day "pulse" decrease of the total oxygen concentration during the 30-day methemoglobinemia was accompanied with a significant rise (p < 0.05) of cholesterol concentrations in the high-density lipoproteins and the total cholesterol, as well as a decrease in the amount of triacylglycerols. These changes are considered to represent the side effects of adaptation for whose elucidation further research is needed.     

Pulp revascularization for immature replanted teeth: a case report

Immature avulsed teeth are not usually treated with pulp revascularization because of the possibility of complications. However, this therapy has shown success in the treatment of immature teeth with periapical lesions. This report describes the case of an immature replanted tooth that was successfully treated by pulp revascularization. An 8‐year‐old boy suffered avulsion on his maxillary left lateral incisor. The tooth showed incomplete root development and was replanted after 30 minutes. After diagnosis, revascularization therapy was performed by irrigating the root canal and applying a calcium hydroxide paste and 2% chlorhexidine gel for 21 days. In the second session, the intracanal dressing was removed and a blood clot was stimulated up to the cervical third of the root canal. Mineral trioxide aggregate was placed as a cervical barrier at the entrance of the root canal and the crown was restored. During the follow‐up period, periapical repair, apical closure and calcification in the apical 4 mm of the root canal was observed. An avulsed immature tooth replanted after a brief extra‐alveolar period and maintained in a viable storage medium may be treated with revascularization.     

Dissecting human cytomegalovirus gene function and capsid maturation by ribozyme targeting and electron cryomicroscopy

Human CMV (HCMV) is the leading viral cause of birth defects and causes one of the most common opportunistic infections among transplant recipients and AIDS patients. Cleavage of internal scaffolding proteins by the viral protease (Pr) occurs during HCMV capsid assembly. To gain insight into the mechanism of HCMV capsid maturation and the roles of the Pr in viral replication, an RNase P ribozyme was engineered to target the Pr mRNA and down-regulate its expression by >99%, generating premature Pr-minus capsids. Furthermore, scaffolding protein processing and DNA encapsidation were inhibited by 99%, and viral growth was reduced by 10,000-fold. 3D structural comparison of the Pr-minus and wild-type B capsids by electron cryomicroscopy, at an unprecedented 12.5-angstroms resolution, unexpectedly revealed that the structures are identical in their overall shape and organization. However, the Pr-minus capsid contains tenuous connections between the scaffold and the capsid shell, whereas the wild-type B capsid has extra densities in its core that may represent the viral Pr. Our findings indicate that cleavage of the scaffolding protein is not associated with the morphological changes that occur during capsid maturation. Instead, the protease appears to be required for DNA encapsidation and the subsequent maturation steps leading to infectious progeny. These results therefore provide key insights into an essential step of HCMV infection using an RNase P ribozyme-based inhibition strategy.