Rapid resolution of small-bowel obstruction with the long tube, endoscopically advanced into the jejunum

BACKGROUND: Long-tube decompression has achieved a 75% to 80% success rate in 5 studies, and the short tube had a 40% success rate in 3 studies. METHODS: From 1984 to 1991, an endoscope-advanced long intestinal tube was placed into the jejunum in 17 patients, and from 1992 to 2004 an improved long tube was used in 23 patients. Costs were calculated for each type of procedure. RESULTS: In the first group, decompression was successful in 12 of 17 patients (70%). In the second group, decompression was successful in 21 of 23 patients (90%). The average charges were as follows: for the short tube the average charge was 21,687 dollars, and for the long tube the average charge was 11,316 dollars. CONCLUSIONS: First, by using the improved long tube, which was advanced endoscopically into the jejunum, the success rate was 90% with procedures that are standard in every hospital. Second, most patients who fail the short-tube procedure are candidates for the long tube. Third, the improved long tube, endoscopically advanced into the jejunum, is recommended strongly because it provides significant advantages, both clinically and economically, over the short-tube approach. A prospective randomized study comparing the short tube for 3 days versus the long tube for 3 days is recommended to prove the superiority of the long tube in patients with small-bowel obstruction.     

The influence of goals on movement kinematics during imitation

This study took a quantitative approach to investigate movement kinematics during the imitation of goal-directed and non-goal directed movements. Motion tracking equipment was used to record the hand movements of 15 healthy participants during an imitation task involving aiming movements that varied in speed. We predicted that movement kinematics would be most similar to the observed movements in the non-goal condition, as a result of direct visuomotor mapping of the action, and least similar in the goal-directed condition because more importance would be given to the end goal. We also predicted that precues (prior information about the movement) would increase imitation accuracy in the non-goal condition by reducing cognitive demand, and that precues would reduce accuracy in the goal-directed condition, as less attention would be paid to the movement. Results showed that imitation was modulated by the speed of the observed action in the non-goal condition only. Contrary to predictions, precues did not improve imitation in the non-goal condition or improve imitation accuracy in the goal-directed condition. These results demonstrate that visuomotor mapping is favoured in non-goal imitation, regardless of prior information, and that accurate imitation of movement detail is compromised by the presence of goals. Such differences in movement kinematics indicate that different processes mediate the imitation of non-goal and goal-directed actions.     

Sequential replication-coupled destruction at G1/S ensures genome stability

Timely ubiquitin-mediated protein degradation is fundamental to cell cycle control, but the precise degradation order at each cell cycle phase transition is still unclear. We investigated the degradation order among substrates of a single human E3 ubiquitin ligase, CRL4^Cdt2, which mediates the S-phase degradation of key cell cycle proteins, including Cdt1, PR-Set7, and p21. Our analysis of synchronized cells and asynchronously proliferating live single cells revealed a consistent order of replication-coupled destruction during both S-phase entry and DNA repair; Cdt1 is destroyed first, whereas p21 destruction is always substantially later than that of Cdt1. These differences are attributable to the CRL4^Cdt2 targeting motif known as the PIP degron, which binds DNA-loaded proliferating cell nuclear antigen (PCNA^DNA) and recruits CRL4^Cdt2. Fusing Cdt1''s PIP degron to p21 causes p21 to be destroyed nearly concurrently with Cdt1 rather than consecutively. This accelerated degradation conferred by the Cdt1 PIP degron is accompanied by more effective Cdt2 recruitment by Cdt1 even though p21 has higher affinity for PCNA^DNA. Importantly, cells with artificially accelerated p21 degradation display evidence of stalled replication in mid-S phase and sensitivity to replication arrest. We therefore propose that sequential degradation ensures orderly S-phase progression to avoid replication stress and genome instability.     

Maternal transmission,sex ratio distortion,and mitochondria

In virtually all multicellular eukaryotes, mitochondria are transmitted exclusively through one parent, usually the mother. In this short review, we discuss some of the major consequences of uniparental transmission of mitochondria, including deleterious effects in males and selection for increased transmission through females. Many of these consequences, particularly sex ratio distortion, have well-studied parallels in other maternally transmitted genetic elements, such as bacterial endosymbionts of arthropods. We also discuss the consequences of linkage between mitochondria and other maternally transmitted genetic elements, including the role of cytonuclear incompatibilities in maintaining polymorphism. Finally, as a case study, we discuss a recently discovered maternally transmitted sex ratio distortion in an insect that is associated with extraordinarily divergent mitochondria.     

Saccadic instabilities and voluntary saccadic behaviour

Primary gaze fixation is never perfectly stable but can be interrupted by involuntary, conjugate saccadic intrusions (SI). SI have a high prevalence in the normal population and are characterised by a horizontal fast eye movement away from the desired eye position, followed, after a variable duration, by a return saccade or drift. Amplitudes are usually below 1° and they often exhibit a directional bias. The aim of the present study was to investigate the aetiology of SI in relation to saccadic behaviour. It was hypothesised that if SI resulted from deficits in the saccadic system (i.e. reduced inhibitory mechanisms), changes in voluntary saccade behaviour may be apparent and related to SI frequency. To examine this, synchrony (no gap), gap, overlap and antisaccade tasks were conducted on ten normal subjects. No significant correlations were found between SI frequency and voluntary saccade latencies, the percentage of express saccades, or the percentage of antisaccade errors. In addition, no significant correlations were found between SI directional biases and saccade latency directional biases, express saccade biases or antisaccade error biases. These results suggest that an underlying alteration to saccadic behaviour is unlikely to be involved in SI production, and that the SI command signal may arise from the influence of attention on an intact saccadic system. Specifically, descending corticofugal signals relating to attention level and orientation may alter the balance between fixation and saccade generation, so determining SI characteristics.     

Complete regression of villous adenomas of the colon using piroxicam,a nonsteroidal anti-inflammatory drug

A 73-year-old patient with a past history of rectal carcinoma was found to have two sessile villous adenomas of the cecum. Because he refused surgical resection, a course of nonsteroidal anti-inflammatory drug therapy using piroxicam was given, and the villous adenomas regressed within three months. The cecum has remained clear at one year.