SOLITARY BENIGN PAPILLOMA (PAPILLARY ADENOMA) OF THE CYSTIC DUCT: A RARE CAUSE OF BILIARY COLIC

SUMMARY Benign tumours of the extrahepatic bile ducts are rare, mostly occurring in the common bile duct and hepatic ducts. Solitary papillomas occur mainly in the gallbladder or at the ampulla of Vater.¹ Tumours of the cystic duct are extremely rare, and we are unaware of any reports of solitary papilloma of the cystic duct. Such a case in a 72-year-old woman is presented.     

Production of multiple cytokines by Hodgkin's disease derived cell lines.

The production of cytokines was analysed in Hodgkin's disease (HD) derived cell lines by enzyme linked immunosorbent tests (ELISA) and Northern blot experiments. Our results demonstrate that HD derived cell lines produce a variety of cytokines, such as IL1 alpha, IL4, IL5, IL6, IL8, TNF alpha, TNF beta and GM-CSF but not IL1 beta, IL2, IL3 and G-CSF. In cell lines with a high expression of CD25 (the light chain of the IL2 receptor), we found soluble IL2 receptors in the supernatants. In addition, receptors for IL6 could be detected in most of the HD derived cell lines. However the growth of HD derived cell lines, which produce IL6 and IL6 receptors could not be inhibited by anti-IL6 antibodies. From our data we conclude, that IL6 and additional cytokines may be involved in the biology of HD.     

Evaluation of the biliary tract: The value of performing magnetic resonance cholangiopancreatography in conjunction with a 3‐D spoiled gradient‐echo gadolinium enhanced dynamic sequence

The 3‐D gradient‐echo (GRE) sequence allows thinner sections and better resolution of biliary obstruction. When the presence of biliary obstruction is identified using magnetic resonance cholangiopancreatography, the addition of the 3‐D GRE sequence may be helpful for diagnosing biliary obstruction. By showing the changes in the bile duct wall, within the duct lumen and around the bile duct, this technique can be helpful for distinguishing benign from malignant stricture as well as a stone from an enhancing intraluminal mass.     

Heterogeneous and monoclonal helper T cells induce similar anti-(4-hydroxy-3-nitrophenyl)acetyl (NP) antibody populations in the primary adoptive response. I. Isotype distribution

In the response to NP-lipopolysaccharide or NP-Ficoll predominantly anti-NP antibodies of the IgM class are produced in mice with lower amounts of IgG3 and IgG2b but little or no IgG1 and IgG2a. In contrast, in the primary T-dependent response to NP-keyhole limpet hemocyanin (KLH) or NP-chicken gamma globulin high amounts of all IgG isotypes are induced. To investigate whether isotype-specific T cells are responsible for these differences we carried out cell transfer experiments using carrier-specific T cell lines. Two such lines were established and one of the two could be cloned. Upon activation by antigen the T cell lines induced unprimed syngeneic splenic B cells to proliferate and differentiate into antibody-secreting cells in vitro in an antigen-nonspecific way. Antigen-specific activation of unprimed B cells in a cell transfer system in vivo showed that high concentrations of hapten-specific antibodies of all IgG isotypes are induced through both carrier-specific T helper lines. The isotypic pattern of these antibodies is similar to that produced via heterogeneous splenic T cells in the cell transfer system, or in normal animals on immunization with the same antigen. These results suggest that isotype-specific T cells are not required for the production of IgG isotypes in a primary anti-NP response and thus not responsible for the differences seen in isotypic patterns between T-dependent and T-independent responses.     

Effects of detraining following short term resistance training on eccentric and concentric muscle strength.

Healthy males were examined before and after 12 weeks of accommodated resistance training (three week-1) and after 12 weeks of detraining. Training consisted of four to five sets of six coupled maximum voluntary bilateral concentric and eccentric (Grp ECCON; n = 10) or 12 concentric (Grp CON; n = 8) quadriceps muscle actions. Concentric and eccentric peak torque at various constant angular velocities and three repetition maximum half-squat and vertical jump height were measured. Grp ECCON showed greater (P less than 0.05) overall increase in peak torque after training and detraining than Grp CON. Thus, concentric peak torque (0.52 rad s-1) increased more (P less than 0.05) over the experimental period in Grp ECCON and increases in eccentric peak torque were preserved in Grp ECCON only. Increases in peak torque in response to training were greater (P less than 0.05) at 0.52 than at 2.62 rad s-1. Alterations in the torque-velocity patterns induced by training remained after detraining in Grp ECCON but not in Grp CON. The retained increases (P less than 0.05) in half-squat were 12 and 18% in Grps CON and ECCON, respectively. Neither group showed increased vertical jump height after detraining. This study showed greater preservation of concentric and eccentric peak torque after detraining following coupled concentric and eccentric than concentric resistance training. Only the former regime induced a change in the shape of torque-velocity curves that was manifest after detraining.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of 84-days of bedrest and resistance training on single muscle fibre myosin heavy chain distribution in human vastus lateralis and soleus muscles

AIM: This investigation determined the effects of 84 days of bedrest on the composition of myosin heavy chain (MHC) in single skeletal muscle fibres with and without a resistance-training countermeasure programme. METHODS: Muscle biopsies were obtained from the m. vastus lateralis (VL) and m. soleus (SOL) before and after 84 days of bedrest. While control (BR) subjects (VL n = 9; SOL n = 3) refrained from exercise, BRE subjects (VL n = 8; SOL n = 3) performed knee extensor and plantar flexor resistance exercise every third day. Approximately 110 fibres per sample were analysed for MHC composition using SDS-PAGE. RESULTS: BR-VL had 16 and 14% decreases (P < 0.05) in MHC I and IIa fibres, respectively. There were 10% increases (P < 0.05) in MHC I/IIa, IIa/IIx, I/IIa/IIx, and a approximately 30% increase (P < 0.05) in total hybrid fibres. BRE-VL showed a 15% reduction (P < 0.05) in MHC I fibres, no change in MHC IIa fibres, and a 13% increase (P < 0.05) in total hybrids. BR-SOL had a 19% decrease (P < 0.05) in MHC I fibres with a 22% increase in total hybrids. BRE-SOL showed no change in MHC composition across all fibre types. CONCLUSION: These data suggest that the exercise countermeasures programme prevented MHC shifts in the SOL and mitigated MHC shifts in the VL. Furthermore, in the VL it appears that the resistance training programme employed in this investigation during bedrest, emphasized the use of MHC IIa phenotype muscle fibres.     

Signal intensity of MR-images of thigh muscles following acute open- and closed chain kinetic knee extensor exercise – index of muscle use

Exercise-induced shifts in signal intensity (SI) of magnetic resonance (MR) images were examined to assess indirectly muscle use in closed- and open-chain knee extensor exercises. Eight men performed five sets of 8–12 repetitions in the leg press (LP) and the seated knee extension (KE) exercises at 50, 75 and 100%, respectively of the 5×10 repetition maximum (RM) load. Prior to exercise and after each load setting, images of the thigh were obtained. The increase in SI ( SI) of the quadriceps at 100% load was greater (P<0.05) after KE (32.1±9.0%) than after LP (21.9±9.2%). Regardless of load, the four individual muscles of the quadriceps showed similar changes in SI after LP. The three vastii muscles showed comparable increases in SI after KE. M. rectus femoris showed greater (P<0.05) SI than the vastii muscles at 100%. Neither exercise produced increase in SI of mm. semimembranosus, semitendinosus, gracilis or biceps femoris. Mm. adductor magnus and longus showed increased (13.3±6.5%; P<0.05) SI after LP, but not after KE, at 100% load. The present data also infer greater involvement of the quadriceps muscle in the open-chain knee extension than in the closed-chain leg press exercise. The results of the current investigation also indicate similar over-all use among the three vastii muscles in LP and KE, but differential m. rectus femoris use between the two exercises. This report extends the merits of the MR imaging technique as an aid to study individual muscle involvement in a particular exercise task.     

Efficacy of a gravity‐independent resistance exercise device as a countermeasure to muscle atrophy during 29‐day bed rest

Aim: This study determined changes in knee extensor and plantar flexor muscle volume during 29 days of bed rest with or without resistance exercise using a gravity‐independent flywheel ergometer. Methods: Seventeen men (26–41 years) were subjected to 29 days of bed rest with (n = 8) or without (n = 9) resistance exercise; Supine Squat (SS) and Calf Press (CP) performed every third day. Quadriceps and triceps surae muscle volume was determined before and after bed rest and force and power were measured during training. Prior to these interventions, reproducibility of this device for training and testing was assessed in 23 subjects who performed bilateral maximal concentric, eccentric and isometric (MVC) knee extensions and plantar flexions over repeated sessions with simultaneous measurements of force, power and electromyographic (EMG) activity. Results: Quadriceps and triceps surae muscle volume decreased (P < 0.05) 10 and 16%, respectively, after 29 days bed rest. Exercise maintained quadriceps volume and mitigated triceps surae atrophy. Thus, either muscle showed different response across subject groups (P < 0.05). Force and power output during training were either maintained (P > 0.05) or increased (P < 0.05). EMG amplitude in the training mode was similar (SS; P > 0.05) or greater (CP; P < 0.05) compared with that elicited during MVC. Peak force and power test‐retest coefficient of variation (CV) ranged 5–6% and 7–8% for SS and CP, respectively. Conclusion: The present data suggest that this resistance exercise paradigm counteracts quadriceps and abates the more substantial triceps surae muscle atrophy in bedridden subjects, and therefore should be an important asset to space travellers.     

Invasive fungal infections in neutropenic enterocolitis: A systematic analysis of pathogens, incidence, treatment and mortality in adult patients

Background  

Neutropenic enterocolitis is a life-threatening complication most frequently occurring after intensive chemotherapy in acute leukaemias. Gramnegative bacteria constitute the most important group of causative pathogens. Fungi have also been reported, but their practical relevance remains unclear. The guidelines do not address concrete treatment recommendations for fungal neutropenic enterocolitis.