Excessive portal flow causes graft failure in extremely small-for-size liver transplantation in pigs

AIM: To evaluate the effects of a portocaval shunt on the decrease of excessive portal flow for the prevention of sinusoidal microcirculatory injury in extremely small-for-size liver transplantation in pigs. METHODS: The right lateral lobe of pigs, i.e. the 25% of the liver, was transplanted orthotopically. The pigs were divided into two groups: graft without portocaval shunt (n = 11) and graft with portocaval shunt (n = 11). Survival rate, portal flow, hepatic arterial flow, and histological findings were investigated. RESULTS: In the group without portocaval shunt, all pigs except one died of liver dysfunction within 24 h after transplantation. In the group with portocaval shunt, eight pigs survived for more than 4 d. The portal flow volumes before and after transplantation in the group without portocaval shunt were 118.2±26.9 mL/min/100 g liver tissue and 270.5±72.9 mL/min/100 g liver tissue, respectively. On the other hand, in the group with portocaval shunt, those volumes were 124.2±27.8 mL/ min/100 g liver tissue and 42.7±32.3 mL/min/100 g liver tissue, respectively (P<0.01). As for histological findings in the group without portocaval shunt, destruction of the sinusoidal lining and bleeding in the peri-portal areas were observed after reperfusion, but these findings were not recognized in the group with portocaval shunt. CONCLUSION: These results suggest that excessive portal flow is attributed to post transplant liver dysfunction after extreme small-for-size liver transplantation caused by sinusoidal microcirculatory injury.     

Histological analysis of the periapical tissues of dog deciduous teeth after root canal filling with diferent materials

The problem of finding an ideal material for filling root canals of deciduous teeth has not been solved yet. This fact led to the development of an experiment to histologically analyze the periapical tissue reaction to 3 root canal filling materials. Eighty root canals of dog deciduous anterior teeth from 6 animals, 60 days old, were used in this study. After biomechanical preparation, the root canals were filled with the following materials: slowly resorbable Maisto paste, Sealer 26 with iodoform, L&C paste (calcium hydroxide with olive oil) and as a control group, canals that were prepared but not filled. At thirty days after the treatment the animals were killed and the teeth prepared for histological analysis. The materials were ranked statistically from the best to the worst as follows: a - Maisto paste, b - Sealer 26 with iodoform, c - control group, d - L&C paste. There was significant difference (p = 0.01) only when the results of the other groups were compared with the L&C paste group. It was also observed that L&C paste was not biologically compatible and that the other materials were biocompatible but their resorption was not at the same rate as that of the deciduous teeth roots.     

DNA cleavage in immunoglobulin somatic hypermutation depends on de novo protein synthesis but not on uracil DNA glycosylase

Activation-induced cytidine deaminase (AID) is required for the DNA cleavage step of Ig somatic hypermutation (SHM). However, its molecular mechanism is controversial. The RNA editing hypothesis postulates that AID deaminates cytosine in an unknown mRNA to generate a new mRNA encoding SHM endonuclease. On the other hand, the DNA deamination hypothesis explains DNA cleavage by cytosine deamination in DNA, followed by uracil removal by uracil DNA glycosylase (UNG). By using the protein synthesis inhibitor cycloheximide, we showed that SHM requires de novo protein synthesis in accord with predictions by the RNA editing hypothesis. In addition, we found that cycloheximide but not Ugi (the specific inhibitor of UNG) inhibited AID-dependent DNA cleavage in the Ig gene during SHM, by using histone H2AX focus formation as a marker of DNA cleavage. The results indicate the following order of events: AID expression, protein synthesis, DNA cleavage, and SHM. The requirement of protein synthesis but not of UNG for the DNA cleavage step of SHM forces us to reconsider the DNA deamination hypothesis and strengthens the RNA editing hypothesis.     

Primary hyperparathyroidism simulating motor neuron disease: case report

We report a case of a 26-year-old man who presented a lower motor neuron syndrome due to hyperparathyroidism. Electromyography showed neurogenic features with normal nerve conduction studies. Hypercalcemia led to the discovery of a primary hyperparathyroidism with gland hyperplasia. Following parathyroid surgery there was recovery of the neurological symptoms.     

Capsaicin- and anandamide-induced gastric acid secretion via vanilloid receptor type 1 (TRPV1) in rat brain

The activation of transient receptor potential vanilloid receptor 1 (TRPV1) by capsaicin in rat brain stimulates gastric acid secretion via tachykinin NK2 receptors and the vagus cholinergic nerve, but the involvement of other receptor systems has not been elucidated. We investigated the role of the glutamate and gamma-amino-butyric acid (GABA) receptor systems on the capsaicin response. Gastric acid secretion stimulated by the injection of capsaicin (30 nmol) into the lateral cerebroventricle (i.c.v.) was inhibited by 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, an antagonist of non-N-methyl-D-aspartate (non-NMDA) receptors, 10.9 nmol, i.c.v.) and bicuculline (a GABA(A) receptor antagonist, 222 microg kg(-1) 10 min(-1), i.v. infusion). Secretion stimulated by the injection of capsaicin (50 nmol) into the fourth cerebroventricle was inhibited by CNQX and bicuculline. I.c.v. injection of anandamide (an endogenous ligand of TRPV1 and cannabinoid receptors, 30 and 100 nmol) stimulated gastric acid secretion, and the response was inhibited by an antagonist of TRPV1 and in the capsaicin-treated rats, but not by an antagonist of cannabinoid receptors. In conclusion, the TRPV1 system, which is activated by capsaicin and anandamide, is preferentially coupled with non-NMDA and GABA(A) receptor systems in the brain and stimulates gastric acid secretion in rats.     

Distinction of long bone stress fractures from pathologic fractures on cross-sectional imaging: how successful are we?

OBJECTIVE: The objectives of our study were to define CT and MRI features that distinguish pathologic fractures from stress fractures and to compare the performance of CT and MRI with radiography. MATERIALS AND METHODS: Two reviewers retrospectively reviewed 45 MR images, 37 CT scans, and 43 radiographs in 59 patients (30 biopsy-proven pathologic fractures and 29 stress fractures followed to resolution). The features observed on MRI were abnormal bone marrow (well-defined, ill-defined); intracortical, periosteal, or muscle T1 or T2 signal; endosteal scalloping; and a soft-tissue mass. The features seen on CT were marrow abnormality and character (well-defined, ill-defined, permeative, moth-eaten), endosteal scalloping, periosteal reaction (benign, aggressive), and a soft-tissue mass. Reviewers rated their confidence for diagnosing a pathologic fracture on a 1-3 scale (< 50%, 50-95%, > 95% sure, respectively) with each technique. Performance of each technique was defined by reviewer accuracy and area under the receiver operating characteristic curve (Az); the frequency with which the MRI and CT features were associated with pathologic and stress fractures was calculated. RESULTS: For both reviewers, accuracy for differentiating pathologic from stress fractures was highest on MRI (accuracy/Az: reviewer 1, 98%/0.97; reviewer 2, 93%/0.99); CT (reviewer 1, 88%/0.83; reviewer 2, 82%/0.90) was less accurate than radiography (reviewer 1, 94%/0.98; reviewer 2, 88%/0.96). On MRI, pathologic fractures compared with stress fractures exhibited well-defined T1 marrow signal (83% vs 7%, respectively; p < 0.001), endosteal scalloping (58% vs 0%, p < 0.001), muscle signal (83% vs 48%, p = 0.026), and a soft-tissue mass (67% vs 0%, p < 0.001). On CT, pathologic fractures compared with stress fractures exhibited marrow abnormality (84% vs 17%, respectively; p = 0.001), endosteal scalloping (44% vs 0%, p = 0.006), and aggressive periosteal reaction (36% vs 0%, p = 0.04). CONCLUSION: MRI is useful for distinguishing pathologic from stress fractures, especially after inconclusive radiographic findings. Specifically, pathologic fractures exhibit well-defined T1 marrow alterations, endosteal scalloping, and adjacent soft-tissue abnormalities.     

Influence of the sealer and a plug in coronal leakage after post space preparation

The subject of this paper was to conduct an in vitro study of the coronal leakage after root canal filling and post space preparation. One hundred single-rooted human teeth had their crowns removed and the canals prepared and filled by the lateral condensation technique with gutta-percha points and the sealers CRCS and Endofill (a Grossman cement). After post space preparation, the remainder of the filling was protected or not with 1mm of a plug of the following materials: Coltosol, Super Bonder (cyanoacrylate-ester), CRCS and Endofill. After 24 hours in saline, the specimens were immersed in a 2% methylene blue solution in a vacuum environment for 24 hours. The teeth were then sectioned longitudinally, leakage was evaluated linearly and the obtained data were submitted to the Kruskal-Wallis test. The results with the two sealers studied were similar between themselves and worse (p<0.01) than the groups with a protector plug. The statistical analysis ordered the experimental groups from the best to the worst in the following way: a - Endofill-Super Bonder, CRCS-Super Bonder, CRCS-CRCS; b - Endofill-Endofill; c - Endofill-Coltosol, CRCS-Coltosol; d - Endofill, CRCS.