Morphologic study of the intestine in an experimental model of amnioinfusion in fetal rabbits with gastroschisis

An experimental model of serial amnioinfusion has been developed in fetal rabbits with gastroschisis, using an intraamniotic catheter connected to a subcutaneous port. Fetuses of 4 groups were compared 7 days after surgery: group A: gastroschisis and daily amnioinfusion through an implanted catheter; group C: gastroschisis and blind amniotic catheter; group G: gastroschisis without catheter; group O: nonoperated fetuses. Survival rate, fetal body weight, lung weight, intestinal weight and length were determined. Computer aided morphometric analysis was performed, in which intestinal diameter, thickness and villi length were measured. Amniotic fluid samples were recovered along the experimental period. Intestinal length was significantly shorter and had a significantly thicker wall than nonoperated fetuses; we found no other morphometric differences between gastroschisis treated with amnioinfusion (group A) and the other gastroschisis groups (C and G). Amnioinfusion did not affect fetal survival rate; the amniotic catheter alone did not cause pulmonary hypoplasia due to significant amniotic leak. The physiological decrease in amniotic volume towards the end of gestation has not been modified by this regime of amnioinfusion.     

Magnetic resonance imaging measurement of brain edema in patients with liver disease: resolution after transplantation

PURPOSE OF REVIEW: Results from experimental studies indicate that widespread osmotic disturbance induced by astrocytic accumulation of glutamine as a result of ammonia detoxification may lead to brain edema, not only in cases of fulminant hepatic failure, but in the entire spectrum of liver disease. This review summarizes recent magnetic resonance imaging data obtained in patients with chronic liver failure before and after liver transplantation that support the hypothesis that mild brain edema exists in these patients in the absence of clinical hepatic encephalopathy. RECENT FINDINGS: Diffuse white matter abnormalities have been detected with several magnetic resonance imaging techniques such as magnetization transfer ratio measurements, which show significantly low values in otherwise normal appearing brain white matter, and fast-Flair sequences, which show abnormal high-signal intensity of the hemispheric white matter tracts. Both these abnormalities return to normal with restoration of liver function, indicating their reversibility and supporting the hypothesis that they reflect mild diffuse brain edema. SUMMARY: It is likely that magnetic resonance imaging will be increasingly used to evaluate the mechanisms involved in the pathogenesis of hepatic encephalopathy and to assess the effects of therapeutic measures focused on correcting astrocyte swelling in these patients.     

慢性肾炎肾虚证患者红细胞变形能力改变的临床研究

目的为了探索肾虚证红细胞变形能力的相关性,我们采用激光衍射的方法。方法选择临床上慢性肾为肾阴虚证与肾阳虚证患者为研究对象,设正常人为对照组,对其血红细胞变形能力(用红细胞变形指数表示)进行了临床观察。结果在所观察的慢性肾炎96例病人中肾阴虚与肾阳虚两组血红细胞变形指数均低于正常人(均P <0 .0 1) ;肾阴虚证与肾阳虚证两组间比较肾阴虚证偏低(P <0 .0 1)。结论肾阴虚证与肾阳虚证患者均有红细胞变形能力损伤。     

Diagnostic efficiency of Sestamibi gammagraphy and Doppler sonography in the preoperative assessment of breast lesions

Introduction It would be desirable to have preoperative methods that allow an adequate selection of patients with breast lesions to rule out breast cancer: The aim of the present study is to evaluate the efficiency of preoperative Sestamibi gammagraphy and Doppler sonography regarding the differential diagnosis of malignancy in breast lesions. Material and methods A prospective observational study was conducted on 88 consecutive patients with breast lesions. All the patients underwent preoperative Doppler sonogrpahy with an echo-enhancing agent and Sestamibi gammagraphy. All the patients had histopathological study of the surgical specimen to compare with the result of the preoperative techniques. These comparations were done both for the overall series and separately for palpable and non-palpable lesions. Results In the overall series results, both tests separately and the two combined, are related significantly to the malignant histological diagnosis (p<0.001). In palpable lesions, there is a considerable increase in sensitivity, and especially in specificity, attaining 100%, with the combination of both tests. In non-palpable lesions, a relationship was only found between the results of the Sestamibi gammagraphy and the malignant histological diagnosis (93.3%; p<0.05). Conclusions Sestamibi gammagraphy and Doppler sonography are two efficient exploratory techniques in the preoperative assessment of malignancy in breast lesions, especially for palpable lesions, and this efficiency is greater when they are combined.     

La obesidad parental se asocia con la gravedad de la obesidad infantil y de sus comorbilidades

Introduction

The influence of parental obesity on their obese offsprings is acknowledged but insufficiently characterised.

Gastrin-releasing peptide (GRP) induces angiogenesis and the specific GRP blocker 77427 inhibits tumor growth in vitro and in vivo

Angiogenesis is becoming a major target for antitumor therapies, and identifying new angiogenic factors and their specific inhibitors may provide new avenues for tumor management. Here we identify gastrin-releasing peptide (GRP) as a new angiogenic molecule that is secreted by tumors and acts directly upon GRP receptors in the endothelial cells. Addition of GRP increases endothelial cell migration and cord formation in vitro, and induces angiogenesis in an in vivo assay. We have recently identified a small molecule GRP blocker, compound 77427. This inhibitor significantly reduced endothelial cell cord formation in vitro and angiogenesis in vivo. Conversely, when applied to VEGF-induced angiogenesis, the small molecule did not have any effect, demonstrating its specificity. Furthermore, this GRP blocker was able to reduce lung tumor cell growth in vitro as demonstrated by MTT and clonogenic assays. When applied to a xenograft model with lung cancer cells, compound 77427 reduced tumor volume to undetectable sizes, although when the treatment was suspended, tumors began to grow again at normal rates. Our collective observations indicate that GRP is a new angiogenic peptide and that its inhibition offers an attractive tool to reduce tumor burden.     

Engraftment syndrome emerges as the main cause of transplant-related mortality in pediatric patients receiving autologous peripheral blood progenitor cell transplantation

The authors examined data from 166 children who received autologous peripheral blood progenitor cell (PBPC) transplantation to ascertain the incidence of early transplant-related mortality (TRM) and the contributing risk factors. Eleven patients (6.6%) (6 boys, 5 girls) died within 180 days following PBPC infusion. The median age was 4 years (range 2-17). The overall probability of TRM was 6.9 +/- 2% at day +180. On univariate analysis, the status of disease at transplantation (complete remission vs. not in complete remission) was identified as the only pretransplant significant predicting factor for TRM (14% of patients who were not in complete remission died within 180 days after PBPC infusion, whereas only 2% of patients in complete remission died) (relative risk [RR] 1.13, 95% confidence interval [CI] 1.01-1.26, P = 0.01). Age, gender, conditioning, and number of CD34+ cells infused were not significantly associated with TRM. In the postinfusion phase, patients who developed multiorgan dysfunction during the neutropenic period, especially when the lung was the first failing organ (RR 16.1, 95% CI 7.16-36.18, P = 0.0001), and those with engraftment syndrome (RR 2.81, 95% CI 1.49-5.24, P = 0.001) had an increased risk for TRM. On multivariate analysis, development of engraftment syndrome was the only significant variable that influenced TRM. In conclusion, the authors found for the first time that engraftment syndrome emerges as the main cause of TRM after autologous PBPC transplantation in children with malignancies.