Ultrasonography of the pancreas. 6. Endoscopic imaging

EUS is a high-resolution technique for pancreatic imaging. EUS has applictions in detecting and staging pancreatic tumors, EUS guided FNA of the pancreas for tissue diagnosis, and evaluation of chronic pancreatitis as well as EUS guided therapy such as celiac plexus block. This is a review of EUS imaging (EUS) of the pancreas covering technical aspects, clinical indications, advantages, and pitfalls as well as emerging trends in the field.     

Aldose reductase inhibition ameliorates pupillary light reflex and F-wave latency in patients with mild diabetic neuropathy

OBJECTIVE--The present study was conducted to investigate the effect of an aldose reductase inhibitor, epalrestat, on autonomic and somatic neuropathy at an early stage in type 2 diabetic patients by assessing the pupillary light reflex and minimum latency of the F-wave. RESEARCH DESIGN AND METHODS--A total of 30 diabetic patients with subclinical or mild diabetic neuropathy were randomly allocated to a control group (n = 15) and epalrestat (150 mg/day) group (n = 15). After 24 weeks, the pupillary light reflex test, cardiovascular autonomic function tests, and nerve conduction study were performed. RESULTS--The beneficial effect of epalrestat on the pupillary light reflex was observed in the minimum diameter after light stimuli (P = 0.044), constriction ratio (P = 0.014), and maximum velocity of constriction (P = 0.008). Among cardiovascular autonomic nerve functions, the ratio of the longest expiratory R-R interval to the shortest inspiratory R-R interval during deep breathing was significantly improved by epalrestat (P = 0.037). Minimum latencies of F-wave of median and tibial motor nerves were significantly shortened by epalrestat (P = 0.002 and P = 0.001, respectively); however, no significant effects were observed in motor or sensory nerve conduction velocity. CONCLUSIONS--These observations suggest that epalrestat may have therapeutic value at the early stage of diabetic neuropathy and that the pupillary light reflex and minimum latency of F-wave may be useful indicators of diabetic neuropathy.     

Muscle-derived factors enhance cholinergic neuronal expression in the chick embryo—II. In culture studies

The effects of muscle-derived factors on the cholinergic and GABAergic neuronal phenotypes were studied in cultures derived from 3-day-old whole chick embryo (E3WE) consisting of proliferating neuroblasts and 8-day-old chick embryo cerebral hemispheres (E8CH) consisting of differentiated neurons. The effects of limb muscle extract (LME) were examined either when added to the culture medium or to the polylysine coating substratum cultures. We also compared the effects of LME derived from 8- to 15-day-old chick embryos. We found that LME added to the medium not only increased choline acetyltransferase activity, a marker for cholinergic neurons throughout the development of neurons in E3WE or E8CH culture, but also delayed the decline in the activity observed in untreated cultures. The marked increase in choline acetyltransferase activity in E8CH cultures grown on substratum-bound LME as compared to those grown in medium-containing LME, suggests that LME factors may be adhesion-promoting substances stimulating neuronal growth. These findings provide evidence that muscle-derived factors may be important in early cholinergic phenotypic expression and support our previous in ovo studies indicating that target-derived factors in limb muscle extract have general cholinotrophic effect.