Diagnosis of gallbladder dyskinesia by quantitative hepatobiliary scintigraphy

AIM: The aim of the present study was to develop a new pharmacologic method during hepatobiliary scintigraphy by which patients with functional and organic forms of gallbladder (GB) dysfunction can be differentiated. METHODS: Quantitative hepatobiliary scintigraphy (QHBS) was performed on 31 patients with impaired GB motility selected by cerulein-augmented ultrasonography. Nineteen patients had acalculous biliary pain (ABP) and suspected GB dyskinesia, 6 patients had celiac disease, and 6 patients had type II diabetes mellitus. Sixty minutes after the isotope administration, 1 ng/bwkg/min cerulein (CCK10) was infused for 10 minutes, and then from the 90th minute, an equivalent dose of CCK10 was infused in the presence of 0.5 mg sublingual glyceryl trinitrate (GTN) in 12 or placebo in 7 consecutive patients. The GB ejection fraction (GBEF) was calculated repeatedly in time periods from 60 to 90 and from 90 to 120 minutes. RESULTS: In the majority of patients with ABP and suspected GB dyskinesia, CCK10 and GTN coadministration normalized the previously impaired GB-emptying. When the cumulative results of all 12 patients were calculated, we demonstrated significant differences (P=0.003) in the GBEF between the first (CCK10) versus the second (CCK10 plus GTN) stimuli: 19+/-11% versus 40+/-17%, respectively. In contrast, in 12 patients with celiac sprue and diabetes mellitus, no differences in the GBEF were detected when the first (CCK10 alone) versus the second (CCK10 plus GTN) stimuli was compared: 21+/-10% versus 22+/-13%, respectively. Finally, placebo and CCK10 coadministration in 7 consecutive patients with ABP and suspected GB dyskinesia did not influence the GBEF as compared with CCK10 alone: 13+/-9% versus 15+/-10%, respectively. CONCLUSION: GTN and CCK10 coadministration induces a significant improvement of the GBEF in patients with GB dyskinesia. The application of this new pharmacologic test during QHBS permitted the noninvasive separation of those patients with secondary impaired GB-emptying as a result of GB dyskinesia from those with primary forms of GB hypokinesia.     

The protective effect of the ER22/23EK polymorphism against an excessive weight gain during pregnancy

It has been shown that women who gained an excessive weight during pregnancy had an increase in long-term BMI compared with those without an excessive weight gain. Several studies have demonstrated that some polymorphisms of the glucocorticoid receptor (GR) gene may influence body composition and metabolic parameters. In the present study, we wanted to explore whether any association could exist between the BclI, N363S and ER22/23EK polymorphisms of the GR gene and the weight gain during pregnancy. We found that the allelic frequencies of the BclI, N363S and ER22/23EK polymorphisms in 300 women with uncomplicated pregnancies were similar to those measured in healthy Hungarian population. None of the three polymorphisms associated with body weight or BMI at the 1st trimester of pregnancy or before delivery. However, a significantly lower weight gain (p = 0.044) and consequently lower increase of BMI during pregnancy (p = 0.044) was observed in heterozygous carriers of the ER22/23EK polymorphism. These results support a protective role of the ER22/23EK polymorphism against an excessive weight gain and excessive increase of BMI during uncomplicated pregnancy.     

Ultrastructural localization of acetylcholinesterase in autonomic postganglionic axons

Summary Acetylcholinesterase activity of autonomic nerve fibers in ther dilatator area of the rat iris was located light- and electronmicroscopically by means of am, dified thiocholin technique. Some axons exhibit acetylcholinesterase activity, other ones are devoid of this enzyme. The enzyme is located in the axolemmal membrane of cholinergic nerve fibers. On the basis of these studies, the idea is refuted that adrenergic postganglionic axons also exert acetylcholinesterase activity.

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Zusammenfassung Die Acethylcholinesterase-Aktivität der vegetative Nervenfasern in dem M. dilatator pupillae der Ratteniris wurde licht- und elektronenmikroskopisch mit einer modifizierten Thiocholinmethode lokalisiert. Einige Axone zeigen eine Acetylcholinesterase-Aktivität, während andere Enzym-negativ sind. Das Enzym ist in der axolemmalen Membran der cholinergischen Nervenfasern lokalisiert. Die Hypothese einiger Forscher, daß adrenergische Axone ebenfalls über eine Acethylcholinesterase-Aktivität verfügen, wird an Hand dieser Befunde widerlegt.

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With 2 Figures     

Lectin binding: a genuine marker for transganglionic regulation of human primary sensory neurons

Medium-sized human dorsal root ganglion cells and their central terminals in the upper dorsal horn exert preferential affinity for Ulex europaeus I lectin. Lectin binding of glycoconjugates outlines lamina III (+IIi) and disappears after peripheral neurotomy, which renders it a useful marker to study transganglionic regulation in man.     

Enzyme translocation in the course of regeneration of central primary afferent terminals in the substantia gelatinosa of the adult rodent spinal cord

Synaptic circuitry in the upper dorsal horn, disorganized due to transganglionic degenerative atrophy (evoked by blockade of retrograde axoplasmic transport in the related peripheral nerve), begins to be reestablished by a process of regenerative synaptoneogenesis as soon as retrograde transport is resumed. Central axons of type C primary sensory neurons, terminating in substantia gelatinosa Rolandi, as well as their cells of origin in dorsal root ganglia are specifically and selectively labeled by the enzyme thiamine monophosphatase (TMPase). Under normal conditions, TMPase is localized in axolemmal membranes at the electron histochemical level. In axonal growth cones of regenerating central terminals, only negligible TMPase reaction was found. In axonal filopodia and young nerve sprouts, there appears an increasing number of intraaxonal grains of the reaction product. Varicous swellings (beads) of regenerating axonal sprouts are transformed into scalloped (sinusoid) en passant terminals. TMPase reaction end product, present initially in the axoplasm of beads and scalloped terminals, is successively translocated to the axolemmal membrane in the course of cytochemical maturation. Structural regeneration and cytochemical maturation of central terminals of primary sensory neurons are completed 60 days after crush injury to the related peripheral axons, i.e., about 7 weeks after the peripheral nerve has regenerated.     

In vitro antispasmodic and anti-inflammatory effects of Drosera rotundifolia

In investigations of the anti-inflammatory and spasmolytic effects of Drosera rotundifolia two extracts were tested in different in vitro assays. An aqueous and an ethanolic extract inhibited human neutrophil elastase, achieving IC50 values of 5 and 1 microg/mL, respectively. The very low naphthoquinone concentrations in the extracts seem not to be responsible for the effect, as the pure compounds were not effective in the test system used. Thus, flavonoids like hyperoside, quercetin and isoquercitrin, which were detected in the extracts in considerable concentrations, may contribute to the activity. These substances showed activity in the assay. Ellagic acid, detected especially in the ethanolic extract in higher amounts, was substantially less active than the flavonoids. In guinea-pig ileum the extracts led to an antispasmodic effect possibly by affecting an allosteric binding site of the muscarinic M3 receptors.