A modified method of hepaticocholedochojejunal anastomosis

"Declive" latero-terminal and latero-lateral hepaticocholedocho-jejunoanastomosis with a loop of the small intestine isolated by the Roux method was carried out in 6 patients (5 females and 1 male) according to absolute indications. In this type of anastomosis, the longitudinal incision in the hepaticocholedochus is made not on the midline but latero-dorsally on its right supraduodenal circumference. The anastomosis is formed by means of a modified suture or a suture commonly used for bilio-digestive anastomoses; the needle is inserted through the wall of the bile duct 2-2.5 mm from the border of its opening and the sutures are placed at a similar distance from one another, the seromusculo-submucous sutures are applied 6-7 mm from the edge of the opening and at a distance of 3-3.5 mm from one another. Comparison with patients in whom heapticocholedochojejunoanastomosis was established by the routine method showed the results to be better in the modified method.     

The influence of affective state on sensory and emotional perception: Application of the Sense’n Feel™ method

Emotions play a key role in our daily life through their control over our thoughts and behaviors. While it is commonly accepted that depressive patients have emotional perception disorders, it is important to know how these disorders affect patients’ sensory perception to develop products to provide them with better support. In this study, we first examined the existence of modifications in the emotional perception of subjects with minor depressive symptoms (MDS, n = 80) compared with healthy controls (HC, n = 80) using a nonverbal method based on pictures to measure projected emotions and personality traits: the Sense'n Feel? method. The investigated stimuli were two unpleasant and two pleasant odors and one pleasant food product: a madeleine. Second, we investigated the hedonic, familiarity and intensity olfactory perceptions of the subjects using the same stimuli. No significant difference was found in any olfactory qualities between the two groups. Concerning the pleasant olfactory stimuli, however, we did note that the MDS subjects had a significantly lower score for the positive emotion of joy/happiness than the controls. Additionally, the MDS group's attribution of some positive personality traits for the three pleasant stimuli was significantly weaker than that in the HC group. These results could be explained by the affective state of the MDS subjects; they were more anxious and more alexithymic compared with the controls. Further research is needed to validate our study in clinically depressed individuals and to determine whether the modifications of the emotional olfactory perception are due to the disease and/or to neuropsychological alterations.     

Small genome of the fungus Escovopsis weberi,a specialized disease agent of ant agriculture

Many microorganisms with specialized lifestyles have reduced genomes. This is best understood in beneficial bacterial symbioses, where partner fidelity facilitates loss of genes necessary for living independently. Specialized microbial pathogens may also exhibit gene loss relative to generalists. Here, we demonstrate that Escovopsis weberi, a fungal parasite of the crops of fungus-growing ants, has a reduced genome in terms of both size and gene content relative to closely related but less specialized fungi. Although primary metabolism genes have been retained, the E. weberi genome is depleted in carbohydrate active enzymes, which is consistent with reliance on a host with these functions. E. weberi has also lost genes considered necessary for sexual reproduction. Contrasting these losses, the genome encodes unique secondary metabolite biosynthesis clusters, some of which include genes that exhibit up-regulated expression during host attack. Thus, the specialized nature of the interaction between Escovopsis and ant agriculture is reflected in the parasite’s genome.The highly evolved agricultural lifestyle of leaf-cutting ants has attracted particular attention because these ants cultivate a symbiotic fungus that serves as their major food source. These ants cut leaves, preprocess them into small pieces, and feed them to the cultivated fungus (1). The capacity of the cultivated fungus to break down plant material gives ant agriculturalists access to the vast nutrient stores locked within neotropical plants (Fig. 1A) (2–5). The symbiosis between fungus-growing ants and their cultivated fungi has persisted for at least 50 million years (6).Open in a separate windowFig. 1.Escovopsis weberi, a specialized mycoparasite of the fungus-growing ant symbiosis, has a small genome compared with other Pezizomycotina fungi. (A) Both fungus-growing ants and the mycoparasite E. weberi use the ants’ cultivated fungi as their primary food source. The ability of the cultivated fungi to efficiently break down plant material gives both consumers access to the biomass of neotropical plants. (B) Size and protein-coding gene content of genomes of diverse fungi in the Pezizomycotina. Bayesian phylogeny estimated using partial amino acid alignments of three genes (Rpb1, Rpb2, ef1-α). All posterior probabilities are greater than 0.95. Phylogeny is rooted with Sacchormyces cervesiae (not shown). (C) Relationship between genome size and gene content. A list of genomes included in this panel is in SI Appendix, Table S1.Like human agriculture, ant agriculture is hampered by disease. The ants’ fungal crops are attacked and consumed by fungal parasites of the genus Escovopsis (Ascomycota, Pezizomycotina: anamorphic Hypocreales) (Fig. 1A) (7), which have evolved in association with the ants and their cultivated fungi (8). Escovopsis infection can have detrimental impacts on garden health and, consequently, on the survival of ant colonies (9, 10). Such mycoparasitism, the phenomenon whereby one fungus is parasitic on another fungus, is rare. It is most well-known for species from the genus Trichoderma, some of which are used as biocontrol agents for fungal diseases and others of which attack human-cultivated fungi (11–13). In contrast to Trichoderma species, however, Escovopsis species grow poorly in their hosts’ absence (SI Appendix, Figs. S1 and S2).Escovopsis species have never been isolated outside of fungus-growing ant colonies, and different strains of Escovopsis are capable of attacking the fungi grown by different fungus-growing ant species (8, 14, 15). The long-term, specialized evolutionary history of the association between Escovopsis and their hosts provides a unique venue to explore the consequences of host specialization on pathogen genome evolution. Here, we assemble and annotate the genome of a strain of Escovopsis weberi. Consistent with expectations under an evolutionary transition toward using a narrow host range, and similar to many other specialized, host-associated microbes (16, 17), E. weberi exhibits gene loss. Contrasting other fungal pathogens, the large genomes of which are expanded with genetic elements that influence host adaptation (18), the genome size of Escovopsis is small compared with those of its closest sequenced relatives.     

Is the Newly Described Interstitial Network the Anatomical Basis of Acupuncture Meridians? A Commentary

A network passing through interstitial tissues of the human body has been recently described. Despite its functional importance is yet unknown, we try to briefly summarize the known data and to interpret it from the viewpoint of Traditional Chinese medicine. We consider the peculiarities of the interstitium to be the morphological basis of at least some of the known phenomena along acupuncture meridians.     

Autoimmune thrombocytopenia during pregnancy (case report and review of literature)

A case of autoimmune thrombocytopenia [AIT], diagnosed in the first trimester of pregnancy is described. Despite the active treatment with steroids and IVIG the platelet count dropped to extremely low levels in the third trimester--8 x 10(9)/l. Labor was induced in 34 w.g. because of the ineffective treatment of AIT, clinical and sonographic evidence of IUGR and favorable pelvic score. Before and during labor induction platelets were transfused and recombinant factor VIIa (rFVIIa) was applied. After delivery antifibrinolytics as well as low molecular weight heparin [LMWH] were applied also. Laboratory tests demonstrated transient fibrinolysis activation after delivery. Mild transient thrombocytopenia of the newborn was found that was successfully treated with steroids. Review of contemporary literature is made with analysis of the therapeutic approaches in cases of AIT during pregnancy. The impact of thrombocytopenia on pregnancy, labor and delivery, the fetus and the newborn and the route of delivery are discussed. The clinical course and the therapeutic strategies in the particular case are analyzed. A nouvelle approach during labor and after delivery was the application of rFVIIa (because of the tendency for elevation of the titers of allogenic antibodies due to platelet transfusions) and of antifibrinolytics (preserving platelet functions).     

Hormonal treatment of recurrent spontaneous abortions

A retrospective study with 79 pregnant women was conducted. All of them were diagnosed as spontaneous abortion. The patients were separated in two group and the women have been treated in two schemes--51%--Utrogestan and 49%--Utrogestan and Profasi. The medication was applied only into the first trimester of the pregnancy. The duration of the therapy was 15.0 +/- 12.34 days. The mean gestational age in this study was 7.6 +/- 3.0 gestational weeks. Women with a first pregnancy and spontaneous abortion were excluded from the study. The number of this hormonal treated pregnancy was 2.84 +/- 1.13. 10.2% of the followed women had 3 and more than 3 miscarriages. The followed group of women was historically and clinically heterogenic. For that reason we think that many other factors could play a role in the optimum outcome of this pregnancy. The criteria for positive result we accepted the vital embryo/fetus on the time of dehospitalization. From these pregnancy only 3 terminated with miscarriage--3.79%. The rest of 96.2% went at home with intact pregnancy. The authors try to find a theoretical support for use of micronized progesterone Utrogestan--there could be some changes in the cellular and humoral immunity at repeated abortions, related to the change of the cytokine production. It could be find an ability to realize a readjustment of the endocrine system of the mother and to control the immune reaction in the fetoplacental unit.     

Paroxysmal tachicardia during pregnancy, electro-cardioversion, delivery

We present a rare case of high-stage paroxysmal atrial tachycardia, clinically exhibit during pregnancy. Refers to 29-years-old pregnant woman, without preceding heart disease. With advancement of pregnancy tachycardial bout getting up daily, its severity increased gradually. At 24 weeks gestation, close to serial ponderous crisis, heart frequency exceed 200 heart beat per minute, expressing clinical manifestation of MAS-syndrome. The bout was not influenced on applied drug therapy. Restore to normal heart rhythm is reached difficult after electro-cardioversion . Because of new extremely acceleration of heart rate and unstable hemodynamics during the supportive therapy, is undertaking second electro-cardioversion. We applied anti-recurrent drug therapy. At 36 weeks gestation, the patient manifested resistance to applied therapy, which imposed pre-term delivery by elective caesarean section in interest of the mother and fetus, by the presence of cardiologist.