Characterization of normal and infarcted rat myocardium using a combination of small-animal PET and clinical MRI.

The combination of small-animal PET and MRI data provides quantitative in vivo insights into cardiac pathophysiology, integrating information on biology and morphology. We sought to determine the feasibility of PET and MRI for the quantification of ischemic injury in the rat model. METHODS: Fourteen healthy male Wistar rats were studied with 18F-FDG PET and cine MRI. Myocardial viability was determined in a transmural myocardial infarction model in 12 additional rats, using 18F-FDG PET and delayed-enhancement MRI with gadolinium-diethylenetriaminepentaacetic acid. All PET was acquired with a dedicated small-animal PET system. MRI was performed on a 1.5-T clinical tomograph with a dedicated small-animal electrocardiographic triggering device and a small surface coil. RESULTS: In normal rats, 18F-FDG uptake was homogeneous throughout the left ventricle. The lowest mean uptake of the 18F-FDG was found in the apical regions (79% +/- 6.0% of maximum) and the highest uptake was in the anterior wall (93% +/- 4.3 % of maximum). Myocardial infarct size as determined by histology correlated well with defects of glucose metabolism obtained with 18F-FDG PET (r = 0.89) and also with delayed-enhancement MRI (r = 0.91). Left ventricular ejection fraction in normal rats measured by cine MRI was 57% +/- 5.4% and decreased to 38% +/- 12.9% (P < 0.001) in the myocardial infarction model. CONCLUSION: Integrating information from small-animal PET and clinical MRI instrumentation allows for the quantitative assessment of cardiac function and infarct size in the rat model. The MRI measurements of scar can be complemented by metabolic imaging, addressing the extent and severity of ischemic injury and providing endpoints for therapeutic interventions.     

Fast Track—Different Implications in Pancreatic Surgery

Concepts in “fast-track” surgery, which provide optimal perioperative care, have been proven to significantly reduce complication rates and decrease hospital stay. This study explores whether fast-track concepts can also be safely applied and improve the outcomes of major pancreatic resections. Perioperative data from 255 consecutive patients, who underwent pancreatic resection by means of fast-track surgery in a high-volume medical center, were analyzed using univariate and multivariate models. Of the 255 patients, 180 received a pancreatic head resection and 51 received distal, 15 received total, and 9 received segmental pancreatectomies. The patients were discharged on median day 10 with a 30-day readmission rate of 3.5%. The in-hospital mortality was 2%, whereas medical and surgical morbidities were 17 and 25%, respectively. Fast-track parameters, such as first stools, normal food, complete mobilization, and return to normal ward, correlated significantly with early discharge (p < 0.05). Patients’ age, operation time, and early extubation proved to be independent factors of early discharge, shown through multivariate analysis (odds ratio: 4.0, 2.0, and 2.8, respectively; p < 0.05). Low readmission, mortality, and morbidity rates demonstrate that fast-track surgery is in fact feasible and safe and promotes earlier discharge without compromising patient outcomes.     

An enzymatic cow immunity-targeted approach to reducing milk somatic cell count: 3. A comparative field trial

The effectiveness of lysosubtilin and lysozyme, a combination thereof and a combination of these enzyme preparations (each alone and in combination) with vitamins as possible coimmunostimulants, which reduced the milk somatic cell count (SCC), were compared in a field trial. Seventy second to third lactation Lithuanian Black and White cows with a similar milk SCC ([750±200]×10³?cells?ml^?1) and of a similar weight (550±50?kg) were involved in the trial and were randomly allocated into seven groups (n=10). Lysosubtilin and/or lysozyme at doses of 0.02?g?kg?wt^?1 and 0.2?g?kg?wt^?1, respectively, and vitamins A, C and E (if any) at doses twice as high as required for nutritional adequacy were given, except for control group cows, once daily with feed for ten successive days. After four-, seven-, and ten-day periods of giving enzymes (with or without vitamins) a significant reduction of SCC (p<0.001) was observed in the milk of cows that received a combination of lysozyme with vitamins. On the tenth day a significant reduction of SCC (p<0.001) was also observed in the milk of cows that received lysozyme and lysosubtilin (each alone; without vitamins) or lysosubtilin in combination with vitamins. At the end of the trial (on the 15th day) SCC in milk of cows of all of the study groups was significantly lower (p<0.001) when compared with that of the control group.     

Advances in laryngeal imaging

Imaging and image analysis became an important issue in laryngeal diagnostics. Various techniques, such as videostroboscopy, videokymography, digital kymograpgy, or ultrasonography are available and are used in research and clinical practice. This paper reviews recent advances in imaging for laryngeal diagnostics.     

Preoperative stratification of pancreas-related morbidity after the Whipple procedure

Morbidity and mortality after pancreatoduodenectomy are greatly related to dehiscence of pancreatojejunostomy. We have analyzed risk factors of significance for and prediction of pancreas-related morbidity. We have retrospectively analyzed 122 patients. The relationship of fibrosis of pancreas, exocrine function, and diameter of pancreatic duct to pancreas-related morbidity was evaluated. Computer-aided morphometric analysis and the pancreatic elastase-1 stool test were used. Univariate analysis showed that the diameter of the main pancreatic duct and postoperative amylasemia were different in patients with and without pancreatic complications (P = 0.001 and P = 0.002, respectively). Pancreatic exocrine function was reduced and fibrosis was higher in patients without pancreatic complications (P = 0.003 and P = 0.026, respectively). Logistic regression analysis revealed exocrine pancreatic function as an independent risk factor. Pancreas-related morbidity is influenced by pancreatic fibrosis, diameter of pancreatic duct, and exocrine function. Preoperative evaluation of exocrine function allows detection of patients with minimal risk for pancreas-related morbidity.     

Experimental acute pancreatitis induces mitochondrial dysfunction in rat pancreas,kidney and lungs but not in liver

Background/aimsExcessive systemic inflammatory response syndrome during severe acute pancreatitis (AP) leads to multiple organ dysfunction syndrome, which is the main cause of death and may be associated with primary mitochondrial disturbances. The aim of our study was to evaluate the role of mitochondria during experimental AP in pancreas and vital organs like kidney, lungs and liver within the first 48 h.MethodsAP was induced in 39 male Wistar rats by intraductal application of sodium taurocholate (5%, 1.75 ml/kg). Animals were divided into groups reflecting the time from induction of the AP till collection of tissues (control and 1, 3, 6, 12, 24, 48 h). Mitochondria were isolated by differential centrifugation and mitochondrial respiration rates were measured oxygraphically.Results(1) Mitochondria in pancreas are affected within the first 6 h after onset of AP, (2) kidney mitochondria are affected 24 h after onset of AP, (3) lungs mitochondria are affected within 48 h after onset of AP whereas (4) liver mitochondria remain well preserved within the first 48 h. Severe AP–induced decrease in the oxidative phosphorylation of pancreas, kidney and lungs mitochondria was more pronounced with Complex I-linked (glutamate/malate) than with Complex II-linked (succinate) substrates and was associated with inhibition of Complex I.ConclusionOur data show that the disturbances of mitochondrial energy metabolism in pancreas, kidney and lungs may play an important role in the development and progression of AP as a systemic disease.