Functioning neorectum

Seventeen patients (15 males, 2 females) underwent restorative proctocolectomy during the 4 year period 1983-87. Twelve patients had familial adenomatous polyposis. Two of these had superimposed malignancy--one each in the cecum and transverse colon. Five patients had ulcerative colitis. Ten pouch procedures were of the J type, six of the S type and one of W configuration. There was one death (mortality 6%). Mean stool frequency was 4.2 per day at one year after surgery and all patients were totally continent at this time. The ileal pouch-anal anastomosis provided a functioning neorectum with low stool frequency and complete continence. The J pouch was found to be functionally superior though the numbers were too small to allow statistical comparison.     

Alteration of pregnancy related hormones and fetal survival in F-344 rats exposed by inhalation to benzo(a)pyrene

The objective of this study was to evaluate the effect of subacute exposure to inhaled benzo(a)pyrene (BaP) on fetal survival and luteal maintenance using timed-pregnant Fisher 344 rats. Prior to assignment of pregnant rats to treatment and control groups, numbers of implantation sites were determined on gestation day (GD) 8 via midventral laparotomy. Subsequently, animals were assigned randomly to three treatment groups and two control groups. Treatment consisted of subacute exposure of rats via inhalation to BaP 25, 75, and 100 μg/m³, 4 h daily for 10 days (GD-11–20). Control animals were either sham exposed to carbon black (CB) to control for inert BaP carrier or remained unexposed (UNC). Blood samples were collected on days 15 and 17 of gestation via sinus orbital veini-puncture for plasma. Number of pups per litter was determined postpartum and fetal survival rate was expressed as a percentage of the corresponding implantation sites. Radioimmunoassays were used to determine plasma progesterone, estrogen, and prolactin (indirect measurement of decidual luteotropin) concentrations. Fetal survival among BaP-treated rats declined in a dose-dependent manner (25 μg/m³, 78.3% per litter; 75 μg/m³, 38.0% per litter; 100 μg/m³, 33.8% per litter; P<0.05) compared with CB (96.7% per litter) and UNC (98.9% per litter). Plasma progesterone, estrogen, and prolactin concentrations also declined as a result of subacute exposure of rats to BaP compared to controls. These data suggest that inhaled BaP compromised fetal survival and consequently luteotropic activity in the exposed animals.     

Transoesophageal Doppler pulmonary venous flow pattern and left atrial spontaneous contrast in mitral stenosis.

The relationship between transoesophageal Doppler pulmonary venous flow pattern and spontaneous left atrial contrast was studied in 23 patients with isolated severe mitral stenosis (mitral valve area = 0.8 +/- 0.2 cm2). The patients with none or minimal (1+) spontaneous contrast (n = 15, group I) were compared with those with significant spontaneous contrast (grade 2+, n = 8, group II) with regard to peak systolic velocity (33 +/- 14 cm/s vs 28 +/- 12 cm/s, p = NS), peak diastolic velocity (36 +/- 14 cm/s vs 28 +/- 8 cm/s, p = NS) and peak atrial reversal velocity (19 +/- 4 cm/s vs 19 +/- 8 cm/s, p = NS), systolic forward flow velocity time integral (3.37 +/- 1.73 cm vs 2.78 +/- 0.9 cm, p = NS), diastolic forward flow velocity time integral (2.85 +/- 1.2 cm vs 2.65 +/- 1.87 cm, p = NS), ratios of peak systolic and diastolic velocity (0.91 +/- 0.21 vs 0.95 +/- 0.29, p = NS) and duration of diastolic deceleration (117 +/- 59 ms vs 132 +/- 106 ms, p = NS). The results show that the occurrence of spontaneous contrast in the left atrium in patients with mitral stenosis is not related to the Doppler-estimated pulmonary venous flow.     

Bone formation over partially exposed implants using guided tissue generation.

This pilot study tested whether a semipermeable expanded polytetrafluoroethylene (e-PTFE) membrane could be used to induce new bone to cover the partially exposed surface of titanium and hydroxylapatite (HA)-coated endosseous implants. Twenty threaded titanium and 10 HA-coated implants were placed in the tibia of five mongrel dogs. The implants were placed in a manner that left the cervical 2 to 3 mm exposed. Fifteen implants were used as controls and the rest were covered with an e-PTFE membrane. Animals were killed at 6, 8, and 12 weeks. Those implants covered by the membrane showed a progressive formation of bone on the exposed portion. The threaded titanium control implants showed reactive periosteal bone formation in the adjacent area, but no new bone formation on the exposed threads. The HA-coated controls, however, showed progressive bone formation on the exposed portion. Membrane position appeared to have an effect on the quantity of bone that formed, as those test sites in which there was a collapse of the membrane against the implant showed less new bone than those in which a protected space was created. This study showed that guided tissue generation may be used to induce new bone to form over the exposed portion of an implant, that the amount of new bone is influenced by the width of the space between membrane and implant, and that new bone forms on an exposed HA-coated implant even in the absence of a guiding membrane.     

Duane—minus (Duane sine retraction and Duane sine limitation): possible incomplete forms of Duane retraction syndrome

PurposeTo report ocular motility patterns that mimic, but do not fulfil the full clinical picture of Duane retraction syndrome (DRS) and to describe their clinical features and surgical management.MethodsThis is a retrospective case series study conducted on patients with DRS, mimicking non-comitant exotropia or esotropia and a face turn. Patients were included only if they lacked either globe retraction on adduction (sine retraction) or limitation of adduction or abduction on ductions (sine limitation not >0.5). Any overshoots or pattern strabismus was recorded. The ocular motility and alignment, details of surgery and their surgical outcomes were analysed.ResultsTwenty-one patients were identified; 13 in the sine retraction and 8 in the sine limitation group. All patients presented with a compensatory face turn. Overshoots were present in 10 (77%) and 7 patients (88%) in the sine retraction and sine limitation groups, respectively. Forced duction test showed tightness of the ipsilateral medial and the ipsilateral lateral rectus muscle in esotropic (n = 3) and exotropic patients (n = 18), respectively. Orthotropia was achieved in 82% of patients following ipsilateral medial or lateral rectus muscle recession.ConclusionsThere is a subset of patients who present with motility pattern similar to DRS but lack its complete diagnostic criteria. The presence of a face turn, overshoots on adduction or an ipsilateral tightness of the affected muscle should make one consider DRS sine retraction/sine limitation. The patients in our study responded well to lines of management similar to those of DRS.Subject terms: Ocular motility disorders, Eye abnormalities     

Role of Glycoproteins Isolated from Epicoccum purpurascens in Host-Pathogen Interaction.

OBJECTIVE: Attachment to host matrix is an important provisory step for the institution of any fungal infection. The present study investigates the role of glycoproteins of Epicoccum purpurascens in host-fungal adherence. METHODS:Epicoccum spore-mycelial extract was fractionated on a concanavalin A-Sepharose column. Three glycoproteins of 12, 17 and 33 kDa (Epi p 1) were electroeluted and checked for hemagglutination and hemagglutination inhibition. The monosaccharide content of the highly potent protein Epi p 1 was determined by high-performance anion exchange chromatography and pulsed amperometric detection. The interaction of Epi p 1 with mannose-binding lectin (MBL) leading to the activation of the complement system was studied by immunoblot, ELISA and ELISA inhibition techniques. Immunoblot and immunoblot inhibition were carried out with culture filtrate to determine the nature of Epi p 1. RESULTS: 33 (Epi p 1)-, 17- and 12-kDa proteins were 58, 46 and 38 times more potent than crude extract in hemagglutination activity (HA). The HA of Epi p 1 was inhibited by N-acetyl glucosamine, glucose and laminin. Epi p 1 had a high mannose content, showed MBL binding in ion-dependent manner and caused complement activation. The protein was detected in culture filtrate and thus seems to play a significant role in fungal invasion. CONCLUSION: Epi p 1, an allergenic glycoprotein of E. purpurascens, is involved in host-fungal interactions through MBL.     

Strain-dependent association between immune function and paw preference in mice

The relationship between immune function and the preferred direction of behavioral asymmetry was examined in several mouse strains. Mixed leukocyte reaction, natural killer cell activity, cytotoxic T lymphocyte response and lymphoproliferation in response to mitogens were investigated in animals with left or right paw preference. From the 7 strains and substrains examined, it appeared that differences in immune function between left and right pawed mice, when present, vary in directionality. Thus, in C3H/HeJ and 129/J, left pawed mice had higher immune responses than right pawed mice, whereas in C3H/HeNCr MTV- and BALB/cJ animals, the reverse was found. In C3H/HeNCr MTV+, C57BL/6J and Collin's heterogenous control population for the high/low asymmetry lines, no differences between animals with left or right paw preference were found. The statistical significance of these differences were not uniform for all the immune parameters studied. These data indicate that the association between immune function and preference for using the left versus right paw is a strain-dependent phenomenon and may suggest that the inconsistent evidence for an association between immune deficiency and left-handedness could be due to genetic heterogeneity among subpopulations.     

Growth factors in the aqueous humor and their therapeutic implications in glaucoma and anterior segment disorders of the human eye

The presence of growth-promoting substances in the aqueous humor has been suspected for the past decade, but it has been only during the last 2 years that the existence of growth factors such as basic fibroblast growth factor, epidermal growth factor, transforming growth factorp, transferrin, and insulin-like growth factors in the aqueous humor has been demonstrated. The structures that border the anterior and posterior chambers of the eye syn- thesize some of these growth factors and release them into the aqueous humor. A breakdown of the blood-aqueous-barrier increases the amounts of growth factors and may also bring platelet-derived growth factor, nerve growth factor, and interleukin-6 into the aqueous humor. Growth factors maintain the normal function of ocular tissues in health and have a significant role in the pathogenesis and possible management of several disorders of the eye. The outcome of the pathogenetic process and its modulation are determined by a complex coordination and interactions of the growth factors in the aqueous humor and their eventual effect on the target tissues. We discuss the therapeutic implications of growth factors and their antagonists in the treatment of certain disorders of the anterior segment of the eye, including rubeosis iridis, neovascular glaucoma, primary open-angle glaucoma, sand wound after filtration Surgery.     

Impact of kidney transplantation on sleep apnoea in patients with end-stage renal disease.

BACKGROUND: Sleep apnoea is common in patients with end-stage renal disease. Although individual case reports have described an improvement in sleep apnoea following kidney transplantation, there have been no longitudinal studies of a case series to determine what proportion of patients with sleep apnoea improve. METHODS: Dialysis-dependent patients awaiting kidney transplantation and pre-dialysis patients with an identified living donor kidney had overnight polysomnography, which was repeated several months after successful kidney transplantation. Patients were divided into apnoeic and non-apnoeic groups based on an apneoa-hypopnoea index (AHI) > 10/h during pre-transplant polysomnography and, following transplantation, apnoeic patients were further divided into responders and non-responders based on >50% reduction in AHI and/or AHI < 10/h. RESULTS: Eighteen patients (11 men, 7 women), aged 27-65, were studied. Pre-transplant sleep apnoea was present in 11 of 18 (61%) patients. Although transplantation was associated with a significant reduction in blood urea nitrogen and serum creatinine, there were no significant changes in AHI (pre vs post: 20.2 +/- 15.1 vs 23.5 +/- 21.3). Among the 11 apnoeic patients, only three met the criteria for a significant improvement ('responder'). There were no patient characteristics, sleep apnoea indices or renal function changes that distinguished responders from non-responders. CONCLUSIONS: Sleep apnoea improves in a minority of patients with end-stage renal disease following successful kidney transplantation. Specific determinants of improvement were not identified.