Percutaneous cholecystography in children

Percutaneous cholecystography was performed on 13 children who had biliary system abnormalities: two had biliary hypoplasia, five had sclerosing cholangitis, three had cirrhosis, two had distal choledochal obstruction, and one had an obstructed portoenterostomy. In 12 patients transcholecystic cholangiography showed, without significant complications, the intra-and extrahepatic bile ducts. In one patient with primary sclerosing cholangitis, the intrahepatic bile ducts were not opacified satisfactorily; dilatation of the gallbladder required surgical drainage. The transcholecystic technique is indicated when the intrahepatic bile ducts are either mildly dilated or not dilated.     

Rotator cuff lesions of the shoulder: evaluation by direct sagittal CT arthrography

Direct sagittal computed tomographic scanning (DSCT) of the shoulder was performed in 42 symptomatic patients, six healthy volunteers, and two cadaver shoulders. Axial CT scanning and double-contrast arthrography with plain radiographs were performed in 41 patients for comparison. DSCT enabled correct identification of 27 of 29 lesions in 24 patients. Seventeen patients had normal shoulders. Axial CT scanning and DSCT together enabled correct identification of all lesions and were markedly superior to plain-film arthrography. DSCT enabled diagnosis of all cases of complete rotator cuff tear plus three cases of incomplete tear and three of rotator cuff atrophy not identified by the other techniques. Axial CT scanning was better than DSCT for diagnosis of Bankart lesions.     

The Quality of Life of Family Caregivers of Eating Disorder Patients

Having a relative with an eating disorder (ED) affects the life of family caregivers and may thus affect their quality of life. To study this aspect, 40 caregivers of ED patients filled out a health-related quality of life questionnaire (Short Form-36) and a questionnaire on the impact of the ED on various areas of life domains, and on the relationship with the ED patient and the need for professional support. Quality of life of caregivers was worse than in a normal reference group. Specifically, mental health, vitality and emotional role functioning were reported to be most impaired. ED appeared to affect families’ lives substantially. In response to the ED, caregivers felt anxious, powerless, sad, or desperate. The relationship of the caregiver with the ED patient had also changed. Caregivers were more worried, lost their trust, and reported more conflicts. Seventy five percent welcomed professional support. Caregivers need practical advice, information on ED, and emotional support. Quality of life of caregivers should be addressed in the treatment of ED.     

Anulus fibrosus in bulging intervertebral disks

In this investigation the association of radial tears of the anulus fibrosus and bulging of the intervertebral disk was studied. An index of disk bulging was measured in sagittal anatomic sections in 149 lumbar disks from 31 cadavers. The indexes of disk bulging were correlated with stages of disk development and the presence of an annular tear. The largest disk-bulging indexes were always associated with radial tears of the anulus. Eighty-four percent of the disks with radial tears had disk-bulging indexes greater than 2.5 mm. Most normal adult disks had an index of less than 2.5 mm. The results challenge the concept that the anulus fibrosus is intact in bulging disks, although ruptured in herniated disks.     

肛门镜压迫下内痔注射法治疗Ⅱ、Ⅲ期内痔的临床疗效

为探讨新型肛门镜压迫下内痔注射法治疗Ⅱ、Ⅲ期内痔的临床疗效,本研究采用多中心随机对照方法,选取200例Ⅱ、Ⅲ期内痔患者分为试验组及对照组,各i00例,试验组采用新型肛门镜压迫下内痔注射法治疗,对照组采用传统消痔灵注射法治疗,观察两组疗效及不良反应。结果显示,试验组治愈84例,好转12例,无效4例,治愈率为84．0％;对照组治愈30例,好转58例,无效12例,治愈率为30．0％。试验组治愈率明显高于对照组,P〈0．01。两组术后第3天出血治愈率差异无统计学意义,P〉0．05;但试验组术后痔核脱出、肛门坠胀治愈率明显高于对照组,P〈0．01。结果表明,肛门镜压迫下内痔注射法治疗Ⅱ、Ⅲ期内痔疗效确切,与传统消痔灵注射法比较,在治疗内痔脱出方面具有更高的临床实用价值。？     

Discovery of a Novel Chemical Class of mGlu(5) Allosteric Ligands with Distinct Modes of Pharmacology

We previously discovered a positive allosteric modulator (PAM) of the metabotropic glutamate receptor subtype 5 (mGlu(5)) termed 4 N-{4-chloro-2-[(1,3-dioxo-1,3-dihydro-2H-isoindol-2-yl)methyl]phenyl}-2-hydroxybenzamide (CPPHA) that elicits receptor activation through a novel allosteric site on mGlu(5), distinct from the classical mGlu(5) negative allosteric modulator (NAM) MPEP allosteric site. However, a shallow structure-activity relationship (SAR), poor physiochemical properties, and weak PAM activity at rat mGlu(5) limited the utility of CPPHA to explore allosteric activation of mGlu(5) at a non-MPEP site. Thus, we performed a functional high-throughput screen (HTS) and identified a novel mGlu(5) PAM benzamide scaffold, exemplified by VU0001850 (EC(50) = 1.3 μM, 106% Glu(max)) and VU0040237 (EC(50) = 350 nM, 84% Glu Max). An iterative parallel synthesis approach delivered 22 analogues, optimized mGlu(5) PAM activity to afford VU0357121 (EC(50) = 33 nM, 92% Glu(max)), and also revealed the first non-MPEP site neutral allosteric ligand (VU0365396). Like CPPHA, PAMs within this class do not appear to bind at the MPEP allosteric site based on radioligand binding studies. Moreover, mutagenesis studies indicate that VU0357121 and related analogues bind to a yet uncharacterized allosteric site on mGlu(5), distinct from CPPHA, yet share a functional interaction with the MPEP site.     

Evaluation of metastatic and angiogenic potentials of human colon carcinoma cells in chick embryo model systems

Increased metastatic and angiogenic potentials of aggressive human colon carcinoma cells were verified in independent chick embryo models by comparing in vivo highly metastatic SW620 colon carcinoma cell line with its isogenic, non-metastatic SW480 cell variant. In the experimental metastasis model, both cell types rapidly arrested in the chorioallantoic membrane (CAM) vasculature as demonstrated by quantitative PCR and immunohistochemistry. Live cell imaging also indicated that both SW620 and SW480 cells efficiently extravasated from the CAM capillary system. However, only few SW480 cells were present in the CAM tissue after 24–48 h. In contrast, the numbers of SW620 cells increased exponentially, indicating proliferative and survival advantages of metastatic colon carcinoma cells in vivo. Multicellular SW620 foci were identified in close proximity to CAM blood vessels. A positive correlation between increased metastatic ability and VEGF-expression of colon carcinoma SW620 cells was demonstrated by the substantial inhibitory effects of anti-VEGF treatment on the levels of metastatic colonization and density of blood vessels adjacent to tumor cell foci. Furthermore, the chick embryo angiogenesis model confirmed high levels of VEGF-dependent angiogenesis induced by SW620 cells, but not SW480 cells. Thus, chick embryo experimental metastasis and CAM angiogenesis models appear to coordinately reflect critical features of advanced colon carcinomas, i.e., the acquisition of enhanced survival and increased angiogenic potentials, both constituting critical determinants of colon cancer progression. The use of rapid and quantitative chick embryo models might provide alternative approaches to conventional mammalian model systems for screening anti-cancer agents.     

Ultrastructure of the early gravid uterus of <Emphasis Type="Italic">Corallobothrium fimbriatum</Emphasis> (Cestoda: Proteocephalidea)

The ultrastructure of the uterine epithelium and underlying extracellular matrices has been studied in several cyclophyllideans, but relatively little has been published on uterine fine structure in other cestode orders. To develop comparative data, we initiated a study focusing on a common and widespread genus of the order Proteocephalidea. Adult specimens of Corallobothrium fimbriatum were removed from the small intestine of brown bullhead catfish, Ameiurus nebulosus, from the St. Lawrence River in North America. Early gravid proglottids were examined by light microscopy as whole mounts or diced in buffered glutaraldehyde, processed by standard techniques and examined by as stained sections by light microscopy and by transmission electron microscopy. Voucher specimens were deposited in the Museum of Comparative Zoology at Harvard University. The uterus consisted of an epithelial wall supported basally by an extracellular matrix and parenchyma cells, which together formed epitheliomesenchymal villi at many points. The uterine epithelium consisted of a single thin syncytial layer, folded distally into long epithelial villi that protruded into the lumen at some points. The epithelium’s numerous nuclei were very close to the lumen, but bulged along with the perinuclear cytoplasm proximally into the surrounding medullary parenchyma. Each nucleus contained small amounts of evenly dispersed heterochromatin and euchromatin, with a central nucleolus. Numerous mitochondria occurred in the cytoplasm, which was densely filled with free ribosomes but contained scant endomembrane components and showed little evidence of secretory activity. The uterine cells possessed few of the apical microvilli that are typical of some cyclophyllidean species, but the apical plasma membrane and cortical cytoplasm were extensively developed into long microlamellae similar to other species. The basic syncytial nature of the epithelium is similar to that of other cestodes studied previously, but the specific combination of features is unlike any previously described. Based on this one proteocephalidean species, we discerned no pattern that would distinguish between Proteocephalidea and Cyclophyllidea based on uterine structure.