Hepatic blood flow in rats with portal branch ligation

Hepatic arterial blood flow (HABF) in the liver lobes and splanchnic nonhepatic arterial blood flow were measured in rats with and without right portal branch ligation for 1 month using 57Co microspheres. Portal branch ligation led to 60% atrophy of the ligated lobe and to hypertrophy of the nonligated lobe. In nonligated lobes of the portal branch ligation model and in the lobes of controls, HABF expressed per gram liver was comparable. In both models splanchnic non-HABF was also comparable. In the atrophic lobe, HABF remained constant; expressed per gram liver, it increased. In this lobe the net result was a significant decrease in total hepatic blood flow (ml/min/g liver).     

Pyloric duplication in a neonate: a rare entity

Duplications of the alimentary tract are rare anomalies that have been reported to occur all along the gastrointestinal tract. Of the various alimentary tract duplications, pyloric duplications are extremely rare. We report the case of a 3-day-old neonate who was antenatally diagnosed as having a cystic mass in the abdomen and who presented with vomiting on the 2nd day of life. At operation, a duplication cyst of the pylorus was removed successfully and a pyloroantrectomy performed.     

Bilateral congenital lobar emphysema: how should we proceed?

We report a case of a 4-week-old male infant who presented with increasing respiratory distress and was diagnosed to have bilateral congenital lobar emphysema on chest x-ray. Our approach to the surgical management in two sequential operations of left upper lobectomy followed by right middle lobectomy is discussed.     

A traumatic intra-renal pseudo-aneurysm in a child

Intra-renal pseudo-aneurysms after penetrating renal trauma have not been reported in children. We report a case of a 9-year-old girl who presented with gross haematuria 2 weeks following renal exploration for a penetrating injury. The diagnosis of intra-renal pseudoaneurysm was made by Doppler ultrasound and was successfully treated by selective arterial embolisation.     

Heart transplantation in diabetic recipients: a decade review of 161 patients at Columbia Presbyterian

OBJECTIVE: Diabetes is considered by some transplant centers to be a relative contraindication for cardiac transplantation because of concerns regarding decreased survival, as well as increased incidence of infection and transplant coronary artery disease. We evaluated our experience with diabetic recipients over the last 10 years. METHODS: From January 1992 through June 2002, 881 patients underwent cardiac transplantation at New York Presbyterian Hospital. Of these, 161 (18.3%) were diabetic patients. Diabetic recipients were compared with a control group of 161 nondiabetic recipients matched for age, sex, cause of heart failure, United Network for Organ Sharing status, and immunosuppression era. Outcome measures included posttransplantation survival, incidence of infection, rejection, and transplant coronary artery disease. RESULTS: There was no statistically significant difference in survival between diabetic and nondiabetic recipients, with actuarial survival at 1, 5, and 10 years of 89.3%, 66.9%, and 45.6%, respectively, for diabetic patients and 87.4%, 78.8%, and 59.1%, respectively, for nondiabetic patients (P =.168). There was no significant difference in freedom from infection, rejection, or transplant coronary artery disease between the groups. By using Cox proportional hazard models, development of infection, rejection, and transplant coronary artery disease were independent predictors of decreased survival (P <.001, P =.004, and P =.004, respectively). CONCLUSIONS: These results demonstrate similar short-term and long-term survivals, as well as similar risks for infection and transplant coronary artery disease, in diabetic and nondiabetic patients undergoing cardiac transplantation. The trend toward worse survival in the diabetic cohort, however, raises the possibility that if a greater number of diabetic patients were evaluated, a significant difference in survival might be observed, suggesting the need for a multicenter analysis to validate these outcomes.     

Acute and subchronic (28-day) oral toxicity study in rats fed with novel surfactants

The toxicity of 2 new synthetic lipids, 1,2-dioleoyl-rac-glycerol-3-dodecaethylene glycol, GDO-12 (lipid 1) and 1,2-distearoyl-rac-glycerol-3-dodecaethylene glycol, GDS-12 (lipid 2) has been evaluated in acute and subchronic toxicity studies. Acute oral toxicity studies in male and female rats documented no deaths or treatment-related signs at high doses. The lipids were individually administered (by gavage) to male and female Sprague-Dawley rats at concentrations of 250, 500, and 1000 mg/Kg bodyweight for 28 days. All animals survived the duration of the study, with no significant changes in clinical signs, hematological parameters, organ weights, ophthalmology evaluations, or histopathological findings. These studies establish that both GDO-12 (lipid 1) and GDS-12 (lipid 2) are nontoxic in rats following oral administration. The no-observed-adverse-effect level ranged between 250 mg/Kg and 1000 mg/Kg following oral administration.     

Arrhythmogenic right ventricular dysplasia in the elderly

Arrhythmogenic right ventricular dysplasia (ARVD) is a syndrome characterized by recurrent ventricular tachycardia. However, cases of ARVD have also presented as dilated cardiomyopathy later associated with ventricular arrhythmias. Histologically, this syndrome manifests as a fibrofatty replacement of the RV myocardium, predisposing the heart to ventricular arrhythmias. ARVD was once considered a disease of the young, but may be underrecognized in the older population. This report presents two cases of elderly men with newly symptomatic ARVD, believed to represent the oldest patients with ARVD described in the literature to date. The diagnosis of ARVD should be considered in individuals of all ages who present with a clinical syndrome consistent with ARVD and supportive evidence on ECG.     

RAGE-mediated neutrophil dysfunction is evoked by advanced glycation end products (AGEs)

The accumulation of advanced glycation end products (AGEs) in the tissue and serum of subjects with diabetes has been linked to the pathogenesis of vascular complications. Because diabetes may be also complicated by increased susceptibility to recurrent infection, we investigated the effects of AGEs on human neutrophils, because their burst of activity immediately upon engagement of pathogens or other inflammatory triggers is critical to host response. We demonstrate the presence of receptor for advanced glycation end products (RAGE) at the message and protein levels. We also demonstrate that AGE albumin (but not control albumin) binds with high affinity to human neutrophils (K(d) of 3.7 +/- 0.4 nM). The binding was blocked almost completely by excess soluble RAGE, anti-RAGE antibodies, or antibodies to CML-modified albumin. AGE albumin induced a dose-dependent increase in intracellular-free calcium as well as actin polymerization. Further, AGE albumin inhibited transendothelial migration and Staphylococcus aureus-induced but not fMLP-induced production of reactive oxygen metabolite. Moreover, although AGE albumin enhanced neutrophil phagocytosis of S. aureus, it inhibited bacterial killing. We conclude that functional RAGE is present on the plasma membrane of human neutrophils and is linked to Ca(2)(+) and actin polymerization, and engagement of RAGE impairs neutrophil functions.