Effects of chronic manipulations of dietary choline on dynamic behavioural situations

1. The modifications in rat behaviour caused by chronic manipulations of dietary choline were studied in two schedules of operant conditioning. Adult rats were maintained on choline-deficient, low-choline and high-choline enriched diets. 2. In the "periodic conditioning" test, the schedule of reinforcement was changed from a fixed ratio to a fixed interval schedule. In the "reversal" test the contingency for food delivery was switched four times from one lever to the other in a two lever Skinner box. 3. In the "periodic conditioning" test, control and treated groups showed the same reduction of responses/reinforcement from the beginning to the end of trial. The time-course reduction of responses/reinforcement became significant in the high-choline (331 mg/kg/day) and deficient-choline groups earlier than in the low-choline (75 mg/kg/day) enriched and control groups. 4. In the "reversal" test, the low-choline (110 mg/kg/day) enriched diet improved the reinforced responses in the IV reversal; the high-choline (330 mg/kg/day) diet gave a significant impairment of the reinforced responses in the III and IV reversals. The deficient-choline diet caused a reduced number of the total responses and a worsening of the reinforced responses in the II, III and IV reversals.     

Liver-First Approach for Synchronous Colorectal Metastases: Analysis of 7360 Patients from the LiverMetSurvey Registry

Annals of Surgical Oncology - The liver-first approach in patients with synchronous colorectal liver metastases (CRLM) has gained wide consensus but its role is still to be clarified. We aimed to...     

Mental health services and the city: a neighbourhood-level epidemiological study

Journal of Public Health - Neighbourhood composition is considered a social determinant of mental health that can be addressed by policymakers to improve outcomes. Deprived neighbourhoods typically...     

Experimentelle und Finite-Elemente-Analyse der Biomechanik des Unterkiefers unter Belastung

Biomechanical investigations of the mandible are difficult to perform due to a variety of conditions involved. For the appropriate reconstruction of biomechanical properties, a geometrically correct body model has to be established which fits to complex in vivo conditions. The aim of our study was to evaluate the use of finite-element models (FEM) for the assessment of mandibular deformation under mechanical loading. Explanted human mandibles (n = 5) were investigated by strain gauges to determine the individual strain distribution under mechanical loading. FEM analysis based on a computed tomograph (CT) was performed and the results were matched with the test data. Our study demonstrates only minor interindividual differences in the strain distribution for each load studied. The mechanical response in terms of deformation was found to depend mainly on gross geometrical properties and to a minor extent on the various other variables. At all positions the maximum principal strain was tensile, the minimum principal strain was compressive, and the absolute strain values were correlated with the magnitude of the applied force. CT-based FEM analysis revealed the utility of mathematical models to approximate simulated data our experimental results. Hence, FEM analysis is a non-invasive tool in the prediction of biomechanical behaviour of individual mandibles and therefore may help in trauma reconstruction and treatment planning.     

Mechanism underlying superantigen-induced clonal deletion of mature T lymphocytes

We observed that peripheral T cells activated in vivo or invitro by superantigens are susceptible to cell death when theirantigen receptor is cross-linked with the appropriate anti-ßTCR mAb. TCR ligation by mAbs specifically drove the T cellclonal deletion in both CD4⁺ and CD8⁺ cell subsets. An IL-2/1L-2Rinteraction seems to be a critical step In predisposing superantigenactivated cells to death; In fact, in vivo IL-2R bockade reversedT cell deletion In superantlgen plus anti-ß TCR mAbtreated mice. TCR ligatlon by mAbs also produced cell deathof the relevant targets in in vitro IL-2 activated T cells.Surprisingly, no T cell deletion was demonstrable in IL-2 activatedcells following staphylococcal enterotoxin B - TCR Interaction,ruling out the possibility that superantigen in Itself can inducecell death. Thus, while superantigen activation opens the celldeath program, a subsequent TCR-antigen (self) Interaction appearsnecessary to produce clonal deletion in mature T lymphocytes.     

Recurrent posttraumatic urethro-vaginal fistula: a new application for ASTRA

The authors describe the results of an application of the surgical technique called ASTRA (anterior sagittal transrectal approach) in a 16-year-old girl with recurrent urethro-vaginal fistula. The young girl had a posttraumatic urethro-vaginal fistula. It recurred after 4 operations by a direct vaginal approach before definitive correction with the ASTRA. Three years after the operation the patient has remained well with complete healing and no fistula recurrence confirmed by a voiding cystourethrogram and urodynamic and rectal manometric tests. This report suggests that ASTRA is a useful method of treating acquired or developmental anomalies of the perineal region.     

Activity of standard and investigational cytotoxic drugs in primary cultures of tumor cells from patients with kidney and urinary bladder carcinomas

PURPOSE: In vitro tumor models could support the process of development of new cytotoxic drugs and selection of suitable drugs for the individual patient. We investigated whether the testing of tumor cells from patients with kidney or urinary bladder carcinoma by fluorometric microculture cytotoxicity assay (FMCA) could provide clinically relevant data for these tumor types. MATERIALS AND METHODS: A total of 45 tumor samples from patients with kidney or urinary bladder carcinoma were compared with 247 samples of other tumor types with respect to sensitivity to 8 standard and 6 investigational cytotoxic drugs in the FMCA, a 72 hour assay based on the concept of total cell kill. In bladder carcinomas, sensitivity to standard drugs was correlated to various tumor characteristics. RESULTS: The technical success rate for kidney and bladder carcinomas was high; approximately 90% of the samples could be analyzed successfully. Kidney carcinomas were highly resistant to standard drugs and bladder carcinomas essentially as sensitive as carcinomas of the breast and ovary but with a steeper dose-response relationship. In bladder carcinoma there was no clear relationship between tumor stage, grade, ploidy, mitoses or p53 expression and drug sensitivity. Except for suramin, kidney carcinomas were poorly sensitive to the investigational drugs CdA, gemcitabine, paclitaxel, vinorelbine and topotecan. In bladder carcinomas paclitaxel, gemcitabine and suramin showed promising activity. CONCLUSIONS: The FMCA seems suitable for cytotoxic drug sensitivity testing of urinary tract carcinomas. This technique may have a role in new drug development in these tumor types.     

Physicians and death: Comments and behaviour of 605 doctors in the north-east of Italy

The aim of this study was to determine the influence of socio-demographic and professional factors on physicians' attitudes to the terminally ill. Between May 1992 and May 1993, a survey was conducted in the province of Pordenone (north-east, Italy) in order to analyse a number of specific issues, such as emotional involvement, the need for aggressive treatments and the communication of diagnosis and prognosis. After obtaining a list of board-certified physicians from the Medical Association office in Pordenone, a modification of the cancer questionnaire of Haley and Blanchard (QSPT) was mailed to 916 doctors. Of these, 605 (60%; 487 male, 118 female; mean age 41 ± 11 SD) returned the completed questionnaire. Within the group of responders, we identified three main subgroups, according to their type of activity: general practitioners (175, 29%), hospital doctors (235, 39%) and other doctors (195, 32%). In age, sex and activity, the only significant difference between responders and non-responders was age (mean age 41 and 43 years respeetively). Most of the responders (77%) stated that they were able to deal with the terminally ill patient and his/her needs; 44%, however, admitted that patients' anxiety is sometimes unbearable. For the vast majority of the doctors polled (91%), providing a comfortable environment for an incurable patient was more important than pursuing aggressive treatment, but only 44% were convinced of the uselessness of aggressive care. To the question on whether to disclose information about imminent death to allow patients to prepare spiritually, 37% answered No, 38% Yes, and 25% were uncertain. Almost all responders (95%), however, believed in the beneficial effect of hope on the terminally ill. Ourresults suggest that doctors' professional and, most of all, sociodemographic and cultural factors determine the relationship with the patient on both the emotional and the clinical decision-making levels.