Incidental Coronary Artery Calcification Seen on Low-Dose Computed Tomography Is a Risk Factor for Obstructive Coronary Artery Disease in Patients Undergoing Liver Transplant

Incidental arterial calcification (Ca) on low-dose computed tomography (CT) prior to liver transplant (LT) may help identify those at risk for obstructive coronary artery disease (CAD). A single-center retrospective study of 358 consecutive patients who had undergone LT was performed. Of the 296 patients who met inclusion criteria, 193 patients (65.2%) had CT Ca. Aortic Ca was seen in 116 (39.2%), coronary Ca in 141 (47.6%), and peripheral Ca in 8 patients (2.7%). Patients with coronary Ca were assigned ordinal coronary artery Ca scores and classified as mild, moderate, and severe. All-cause mortality was higher in patients with Ca in any location (14.5% vs 6.8%, P = .05). Of the patients who underwent coronary angiography, those with obstructive CAD were more likely to have aortic and coronary Ca than patients with nonobstructive or no CAD (85.7% vs 50.0%, P = .02 and 92.9% vs 37.9%, P = < .001, respectively). Severe coronary artery Ca scores were more frequent in patients with obstructive CAD (35.7% vs 0%, P < .001). Any severity coronary Ca had an odds ratio of 11.57 (95% CI, 1.61-244.92; P = .04) for obstructive CAD. In conclusion, incidental coronary Ca seen on low-dose CT is a risk factor for obstructive CAD in patients undergoing LT.

Calculation of gyrotropy coefficients in media with low-pitch helical structures

Chiral smectic liquid crystals are known for their huge optical activity due to the precession of the anisotropic dielectric tensor around the helicoidal axis. For an oblique direction of the propagating wave, the helix acts as a grating which splits an incident beam in different directions as long as the pitch is not too small with respect to the light wavelength. When the pitch of the helix is smaller than the wavelength, the effect of the helix is a renormalization of the gyrotropic coefficients (g_{⊥} and g_{∥}) of the resulting uniaxial medium. We report here on a method to compute these coefficients in that limit. Resolution of the Maxwell equations, using a perturbative approach, gives expressions for g_{⊥} and g_{∥} as a power development of the ratio (p/λ). The various terms of these developments coincide with the approximate expressions of these coefficients known in the literature.

Denaturation process of laccase in various media by refractive index measurements

In this work, we are interested in the denaturation process of a laccase from Tramates versicolor via the determination of the refractive index, the refractive index increment and the specific volume in various media. The measurements were carried out using an Abbe refractometer. We have shown that the refractive index increment values obtained from the slope of the variation of the refractive index vs. Concentration are outside the range refractive index increments of proteins. To correct the results, we have followed the theoretical predictions based on the knowledge of the protein refractive index from its amino acids composition. The denaturation process was studied by calculating the specific volume variation where its determination was related to the Gladstone-Dale and the Lorentz-Lorentz models.

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Refractive index measurements to follow the denaturation process in various medium.

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The denaturation process was studied by using the Gladstone-Dale and the Lorentz-Lorentz models.

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[Morph][F] denatures laccase faster than [pyrr][F].

Structures in the meniscus of smectic membranes: the role of dislocations?

We report an experimental investigation of the structure of periodic patterns observed in the meniscus of free-standing smectic films. Combination of polarizing optical microscopy and phase shifting interferometry enabled us to obtain new information on the structure of the meniscus, and in particular, on the topography of the smectic-air interface. We investigate the profile of the undulations in the striped structure in the thin part of the meniscus, change of the stripe period with the meniscus thickness and subsequent transition into a two-dimensional structure. It is shown that the two-dimensional structure has an unusual complex profile of "egg-box" type. The striped texture occurs upon cooling from the nontilted smectic-A to the smectic-C* phase, whereas the two-dimensional pattern is present in both phases. We discuss the possible origin of the modulated structures, the role of the dislocations in the meniscus, the elasticity of smectic layers, and the mechanical stress induced by dislocations.

145 THE INFLUENCE OF PROPYLENE GLYCOL DRENCHING ON THE SUPEROVULATORY RESPONSE AND EMBRYO QUALITY IN HIGH-YIELDING DAIRY COWS

Genetic improvement of dairy cows increased markedly over the last decades; this has marked increased milk yield, which has been associated with reduced fertility parameters. The objective of this study was to determine the effects of feeding propylene glycol (PG) on superovulatory responses of 50 dairy cows and on their embryo quality and quantity. Starting at 1 week before the application of superovulatory regimen, each cow received once daily an oral dose of 150 g of PG (PG group) or water (control group). All cows were superovulated with a total dose of 400 mg of FSH administrated twice daily in decreasing doses over 4 consecutive days. Embryos were recovered nonsurgically 7.5 days after the onset of oestrus using a 2-way catheter. Evaluation of embryo quality was done according to the IETS manual based on 1 to 4 grades. Grade 1 embryos were transferred after freezing; grade 2 and 3 embryos were freshly transferred. The results showed that the number of total ova/embryos recovered, grade 1 embryos, and the number of transferable embryos were significantly higher (P = 0.048, 0.015, and 0.014, respectively) in the PG group (10.33 ± 1.9, 7.08 ± 1.7, and 7.92 ± 1.6, respectively) when compared with control group (6.09 ± 0.9, 2.11 ± 0.45, and 3.92 ± 1.25, respectively). Insignificant increase in grade 2 and grade 3 embryos was indicated in the control group (1.37 ± 0.3 and 0.51 ± 0.18, respectively) when compared with PG group (0.75 ± 0.28 and 0.25 ± 0.13, respectively). On the other hand, the results indicated that there was an increase in the number of degenerated embryos and unfertilized ovum in the PG group (2.33 ± 0.85) compared with control group (2.09 ± 0.6). In conclusion, these results suggested that administration of PG has the ability to positively improve the superovulatory response and embryo quality in high-yielding dairy cows.

Effect of an external electric field on the smectic-Ctilted* phases

We are interested in the chiral tilted smectic subphases, smectic-C(tilted)(*), including commensurate structures as well as the incommensurate smectic-C(α)(*) one. The continuum theory defines two scalar order parameters I and J, which can be coupled with an external electric field through a linear term I × E and a dielectric term J × E(2). We have calculated the changes due to these terms in the phase diagrams in the (α,η) plane, where α comes from the spontaneous twist and η measures the strength of the biaxial order. The coupling with an external electric field induces the expansion of the areas with spontaneous polarization and the appearance of an electroazimuthal effect.

Relationships Between IgG, IgM, IgE and Resistance to Reinfection During the Early Phase of Infection withClonorchis sinensisin Rats

An enzyme linked immunosorbent assay (ELISA) was used to study the correlation between the levels of IgG, IgM and IgE immunoglobulin isotypes and resistance to reinfection in rats during the first month of infection with Clonorchis sinensis. Rats were infected with Clonorchis sinensis (primary infection), and then treated with praziquantel on the 1st, 3rd, 7th, 14th and 28th day post infection (p.i.). To measure resistance, rats were re-infected with C. sinensis (secondary infection), 2 weeks after the treatment and worms were recovered 4 weeks later. During the primary infection, significantly increased levels of IgG isotype were observed on days 14 and 28 p.i. (P < 0.001) and IgM levels were significantly increased on 3rd and 28th day (P < 0.001). During the secondary infection, significantly increased levels of IgG isotype were found from 3rd to 28th day and IgE isotype on 7th and 14th day (P < 0.01) while significant levels of IgM were found on the 3rd and 28th day (P < 0.05). Furthermore, significant differences of worm numbers between infected and control group was found on the 14th and 28th day (P < 0.001). An inverse correlation betwee the IgG levels and the resistance to re-infection was also observed (r = -0.948, P = 0.004), indicating that the resistance to reinfection is highly associated with the levels of IgG during the early phase of infection, and then with the IgM and IgE.

Beneficial effects of cardiac rehabilitation and exercise after percutaneous coronary intervention on hsCRP and inflammatory cytokines in CAD patients

Recent studies showed that tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), as well as high-sensitive C-reactive protein (hsCRP) levels are predictive factors of cardiovascular risk. However, the effect of cardiac rehabilitation (CR) intervention in coronary artery disease (CAD) patients on these factors is not known. The aim of this study was to evaluate the effects of CR and exercise on hsCRP and inflammatory cytokine levels in patients with CAD after percutaneous coronary intervention (PCI). CAD patients who underwent PCI were divided into a CR and exercise group (CRE, n = 29) or a control group (CON, n = 10). CR and exercise consisted of 6 weeks supervised exercise training and 8 weeks home-based, self-managed exercise. Compared to pre-experimental levels, TNF-alpha (by 20.4%; p = 0.006) and IL-6 (by 49.0%; p < 0.0001), as well as hsCRP (by 59.4%; p < 0.0001), were markedly decreased after CR and exercise in CAD patients but not in control group, except for IL-6 (by 41.6%; p = 0.001). However, there was no significant alteration of adiposity-related variables such as BMI, percent body fat, and waist circumferences, in both groups. We suggest that CR and exercise in CAD patients after PCI induce significant reduction in hsCRP and inflammatory cytokines (TNF-alpha and IL-6), and marked increase in exercise tolerance and capacity.

Prolonged residence of temperate natives in the tropics produces a suppression of sweating

Tropical natives possess heat tolerance due to the ability to off-load endogenous and exogenous heat efficiently using a minimum amount of sweat. On the other hand, exposure of temperate natives to heat results in exaggerated production of sweat, of which part is lost by dripping and, thus, not available for evaporation. How sweating is modified in natives of temperate climate zones by prolonged residence in the tropics is not well-understood. The aim of this study was to investigate possible changes in the peripheral sweating mechanisms. Sweating responses to iontophoretically applied acetylcholine (ACh) were compared between Japanese subjects having either permanently resided in Japan (Japan resident Japanese, JRJ) or having stayed in the tropics for 2 years or longer (Tropics resident Japanese, TRJ). Quantitative sudomotor axon reflex tests by iontophoresis of ACh (10%, 2 mA for 5 min) were applied to determine directly activated (DIR) and axon reflex-mediated sweating during [AXR(1)] and after [AXR(2)] ACh iontophoresis. The sweat onset time of AXR(1) was 0.6 min shorter in JRJ than in TRJ (P<0.0001), and AXR(1) (P<0.0004), AXR(2) (P<0.0001), and DIR (P<0.0001) sweating responses were larger in JRJ than in TRJ. AXR and DIR sweating volumes (P<0.0001) were negatively correlated, and sweat onset times (P<0.0001) were positively correlated with the duration of residence in the tropics (2 to 13 years). The observed attenuation of sweating in TRJ suggests that temperate natives may acquire heat tolerance with improved sweating economy similar to tropical natives after prolonged residence in the tropics.

Effect of Cardiac Rehabilitation and Statin Treatment on Anti-HSP Antibody Titers in Patients With Coronary Artery Disease After Percutaneous Coronary Intervention

Accumulating evidence suggests that higher antibody titers to heat shock proteins (HSPs) are associated with the development and severity of atherosclerosis. The aim of this study was to evaluate the impact of cardiac rehabilitation therapy (CRT) or stain treatment (STT) or a combination of both (COM) on anti-HSP antibodies in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Clinical evaluation of subjects was performed both at the commencement and completion of the 14 weeks of treatment. CRT consisted of a supervised 6 weeks of exercise following hospital discharge and 8 weeks of home stay exercise. Patients assigned to statin therapy were treated with 80 mg per day of fluvastatin. Blood samples from 39 patients were analyzed for antibodies to HSP60 and HSP70 by ELISA. Biochemical parameters, including lipids, high-sensitivity C reactive protein (hsCRP), and interleukin-6 (IL-6), were also analyzed. We found that CRT and COM reduced antibody titers to HSP60 and HSP70 in CAD patients (by 3.79 and 10.00% of anti-HSP60, and by 5.74 and 3.45% of anti-HSP70, respectively) but statin treatment reduced only antibody titers to HSP70 (by 3.83%). There was a significant correlation between antibody titers to HSP60 versus HSP70. Considering the fact that antibody titers to HSPs are associated with the autoimmune process in CAD, CRT and COM have greater effects on reduction in autoimmune reaction after PCI than statin treatment. This reduction was accompanied by greater improvements in blood biochemical variables, such as lipids, hsCRP, and IL-6 after CRT and COM.

Cytoskeletal protein 4.1G is a binding partner of the metabotropic glutamate receptor subtype 1 alpha

Recent evidence suggests that cytoskeletal proteins play important roles in the clustering and anchoring of glutamate receptors to the cell surface membrane. To examine further this issue, we tested for direct interactions between the metabotropic glutamate receptor subtype 1alpha (mGlu1alpha) and 4.1G, which is a member of the erythrocyte membrane, cytoskeletal protein 4.1 family. First, co-localization of 4.1G and mGlu1alpha was observed in cultured hippocampal neurons. Second, in transiently transfected HEK 293 cells and in whole rat brain tissue, direct interactions between mGlu1alpha and 4.1G were observed. Third, we were able to identify the C-terminal tail of mGlu1alpha as an essential region for mGlu1alpha-4.1G interactions. Fourth, 4.1 G influences mGlu1alpha-mediated cAMP accumulation. Finally, we found that 4.1G increases the ligand-binding ability of mGlu1alpha and alters its cellular distribution. These observations identify 4.1G as a novel binding partner of mGlu1alpha that can regulate the action of mGlu1alpha.

Cytoskeletal protein 4.1G binds to the third intracellular loop of the A1 adenosine receptor and inhibits receptor action

To identify binding partners of the A1AR (A1 adenosine receptor), yeast two-hybrid screening of a rat embryonic cDNA library was performed. This procedure led to the identification of erythrocyte membrane cytoskeletal protein (represented as 4.1G) as an A1AR-binding partner. Truncation studies revealed that the C-terminal domain of 4.1G was essential for binding to A1ARs and that the C-terminal domain of 4.1G and the third intracellular loop of A1ARs interacted. A1AR-4.1G interaction was also confirmed in studies using brain tissue. Studies in HEK-293 (human embryonic kidney 293) cells and Chinese-hamster ovary cells showed that 4.1G interfered with A1AR signal transduction, as 4.1G reduced A1AR-mediated inhibition of cAMP accumulation and intracellular calcium release. 4.1G also altered cell-surface A1AR expression. These observations identify 4.1G as a novel A1AR-binding partner that can regulate adenosine action.

Oligodendrocytes express functional A1 adenosine receptors that stimulate cellular migration

A1 adenosine receptors (A1ARs) exert important effects in the central nervous system. However, the expression and function of A1ARs in oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLGs) is unclear. To address this issue, we examined A1AR expression during different stages of oligodendrocyte development. Radioreceptor studies showed that membranes prepared from OPCs and OLGs expressed high-affinity A1ARs with Kd values of 1.35 +/- 0.33 and 1.2 +/- 0.27 nM for [3H]CCPA, 1.17 +/- 0.24 and 1.4 +/- 0.34 nM for [3H]DPCPX, respectively. Bmax values were 64.31 +/- 6.14 and 75 +/- 6 fmol/mg protein for [3H]CCPA, and 153 +/- 12 and 205 +/- 17.8 fmol/mg protein for [3H]DPCPX, respectively. Activation of A1ARs using N6-cyclopentyladenosine (CPA) reduced both forskolin- and N-ethylcarboxyamidoadenosine (NECA)-stimulated cAMP accumulation, but did not affect basal cAMP levels. Activation of A1ARs by CPA stimulated OPC migration, but did not affect cell viability, proliferation, or differentiation. These results show that OPCs and OLGs express functional A1ARs that can stimulate the migration of OPCs.

Differences between rat primary cortical neurons and astrocytes in purine release evoked by ischemic conditions

In the brain, the levels of adenosine increase up to 100-fold during cerebral ischernia; however, the roles of specific cell types, enzymatic pathways and membrane transport processes in regulating intra- and extracellular concentrations of adenosine are poorly characterized. Rat primary cortical neurons and astrocytes were incubated with [(3)H]adenine for 30 min to radiolabel intracellular ATP. Cells were then treated with buffer, glucose deprivation (GD), oxygen-glucose deprivation (OGD), 100 micro M sodium cyanide (NaCN) or 500 micro M iodoacetate (IAA) for 1 h to stimulate the metabolism of ATP and cellular release of [(3)H]purines. The nucleoside transport inhibitor dipyridamole (DPR) (10 micro M), the adenosine kinase inhibitor iodotubercidin (ITU) (1 micro M), the adenosine deaminase inhibitor EHNA (1 micro M) and the purine nucleoside phosphorylase inhibitor BCX-34 (10 micro M) were tested to investigate the contribution of specific enzymes and transporters in the metabolism and release of purines from each cell type. Our results indicate that (a). under basal conditions astrocytes released significantly more [(3)H]adenine nucleotides and [(3)H]adenosine than neurons, (b). OGD, NaCN and IAA conditions produced significant increases in [(3)H]adenosine release from neurons but not astrocytes, and (c) DPR blocked [(3)H]inosine release from both astrocytes and neurons but only blocked [(3)H]adenosine release from neurons. These data suggest that, in these experimental conditions, adenosine was formed by an intracellular pathway in neurons and then released via a nucleoside transporter. In contrast, adenine nucleotide release and extracellular metabolism to adenosine appeared to predominate in astrocytes.

A1 adenosine receptor activation induces ventriculomegaly and white matter loss

A1 adenosine receptors (A1ARs) are widely expressed in the brain during development. To examine whether A1AR activation can alter postnatal brain formation, neonatal rats from postnatal days 3 to 14 were treated with the A1AR agonist N6-cyclopentyladenosine (CPA) in the presence or absence of the peripheral A1AR antagonist 8-(p-sulfophenyl)-theophylline (8SPT). CPA or CPA + 8SPT treatment resulted in reductions in white matter volume, ventriculomegaly, and neuronal loss. Quantitative electron microscopy revealed reductions in total axon volume following A1AR agonist treatment. We also observed reduced expression of myelin basic protein in treated animals. Showing that functional A1ARs were present over the ranges of ages studies, high levels of specific [3H]CCPA binding were observed at PD 4, 7 and 14, and receptor-G protein coupling was present at each age. These observations show that activation of A1ARs with doses of CPA that mimic the effects of high adenosine levels results in damage to the developing brain.

Ethanol alters glutamate but not adenosine uptake in rat astrocytes: evidence for protein kinase C involvement

Glutamate is the primary excitatory neurotransmitter in brain. By stimulating neuronal activity, glutamate increases cellular energy utilization, enhances ATP hydrolysis and promotes the formation of adenosine. Adenosine has receptor-mediated effects that reduce or oppose the excitatory effects of glutamate. As a possible mechanism for ethanol's ability to inhibit excitatory effects of glutamate and enhance inhibitory effects of adenosine, we tested the hypothesis that ethanol promotes [3H]glutamate uptake and inhibits [3H]adenosine uptake. Using primary cultures of rat astrocytes, we found that acute treatment with ethanol (50 mM, 30 min) inhibited [3H]glutamate uptake and reduced protein kinase C (PKC)-induced stimulation of [3H]glutamate uptake. Prolonged treatment (50 mM, 3 day) with ethanol, however, increased both [3H]glutamate uptake and PKC activity. Contrary to other cell types, neither acute or chronic ethanol exposure affected [3H]adenosine uptake in astrocytes. These data indicate that in rat cortical astrocytes ethanol affects [3H]glutamate uptake but not [3H]adenosine uptake by affecting PKC modulation of transporter activity.

A preliminary investigation of the effects of maternal ethanol intake during gestation and lactation on brain adenosine A(1) receptor expression in rat offspring

Ethanol exposure during fetal development can result in behavioral and neurological deficits, including reduced cognitive functions, retarded growth, and craniofacial abnormalities. Adenosine is an endogenous neuromodulator that fine-tunes the release and/or synaptic activities of several neurotransmitters, including glutamate, dopamine, and serotonin. Our aim was to determine whether ethanol exposure during early development affects adenosine receptors, particularly the A1 receptor subtype, in adult rats. Female rats were given water or 15% (vol/vol) ethanol in water prior to mating and throughout gestation and lactation. Sixty-day-old male rat offspring from these dams were randomly selected and assayed for adenosine A1 receptor expression in four brain areas: cortex, cerebellum, hippocampus, and striatum. Our results indicate that ethanol intake by dams decreased body and brain weights of offspring and reduced both A1 receptor mRNA and protein density in cortex and cerebellum. These preliminary findings indicate that ethanol intake by dams during pregnancy and lactation can affect adenosine A1 receptor signalling in the offspring. A pair-fed controlled study is warranted to explore these findings further.

Hyperthermic Enhancement of the Apoptotic and Antiproliferative Activities of Paclitaxel

The antineoplastic agent paclitaxel (PTX), a microtubule-stabilizing agent, is known to arrest cell cycle progression and induce apoptosis. Mild hyperthermia (HT) also disrupts the microtubule system and triggers apoptosis. We therefore investigated whether concurrent exposure of murine breast cancer cells to 10 micromol/l PTX and 43 degrees C HT will promote improved anticancer effects. To do this, we exposed FM3A murine cancer cells to: (1) 10 micromol/l PTX for 1 h at 37 degrees C followed by exposure at 43 degrees C HT for 1 h; (2) 10 micromol/l PTX at 37 degrees C for 2 h; (3) 37 degrees C for 1 h followed by 43 degrees C HT for 1 h, and (4) untreated cells at 37 degrees C for 2 h which served as the control. Treatment No. 1 resulted in an enhanced cell cycle arrest, apoptosis and cytotoxicity. Exposure to 43 degrees C HT alone or 10 micromol/l PTX alone induced lesser apoptosis and cytotoxicity than the two treatments concurrently applied. The apoptotic cell death occurred in a time-dependent manner as follows: (1) concurrently applied 43 degrees C HT and 10 micromol/l PTX (5.6 +/- 0.5, 16.5 +/- 2 and 27.6 +/- 1%); (2) 43 degrees C HT alone (4.3 +/- 1, 6.6 +/- 0.3 and 12.7 +/- 1%) and (3) 10 micromol/l PTX alone (4.4 +/- 0.3, 8.6 +/- 1 and 12.8 +/- 1%) at 1, 6 and 24 h postexposure respectively compared to control of 2.0%. These data indicate that while both HT and PTX can individually induce apoptosis and antiproliferation in FM3A cancer cells, they may offer synergistic benefits when used concurrently.

Long-term follow-up of percutaneous transhepatic therapy (PTT) in patients with definite benign anastomotic strictures after hepaticojejunostomy

BACKGROUND AND STUDY AIMS

Percutaneous transhepatic therapy (PTT) is a promising minimally invasive procedure for benign stenosis of the anastomosis after hepaticojejunostomy. In this prospective study, the effectiveness and safety of this technique were investigated.

PATIENTS AND METHODS

Between October 1995 and May 2000 34 consecutive patients were referred for treatment of symptomatic cholestasis due to anastomotic strictures after hepaticojejunostomy. In all patients percutaneous transhepatic cholangioscopic (PTCS) drainage and bougienage of the stenosis up to 16 Fr were performed. Associated bile duct stones were fractured using PTCS laser lithotripsy and removed into the jejunum. Afterwards, patients received transhepatic drainage for 3 months initially. The tubes were replaced in case of persistent strictures every 3 months up to 1 year. Patients in whom treatment failed underwent surgery or received biliary metal stents, depending on risk factors and individual anatomy.

RESULTS

The procedure was performed in 34 patients (mean age 57 +/- 15) with cholestasis (alkaline phosphatase 691 +/- 485 U/l, bilirubin level mean 3.2 +/- 3.1 mg/dl). The transhepatic tube was successfully positioned into the right hepatic bile duct (n = 25), into the left (n = 3), or into both (n = 3) after 4 +/- 1 sessions, except in two patients in whom an external drainage was used and another patient in whom the procedure had to be stopped due to a bleeding complication. In 14 patients bile duct stones were successfully treated by PTCS laser lithotripsy before the placement of a transhepatic tube. The 30-day morbidity and mortality rates were 23.5% and 0% respectively. In 23 patients, the transhepatic tube could be removed after 212 +/- 122 days, with no evidence of cholestasis during a further follow-up of 736 +/- 479 days. Four patients received metal stents because of persistent strictures after transhepatic intubation. Surgery had to be performed in a total of five patients, because of recurrent bile duct stones or recurrent strictures, in one patient with previous implantation of a metal stent, and in two patients with bile duct disconnection. Two patients died, one 1.5 years after surgery and one 427 days after metal stent implantation. None of these cases was related to the procedure. In two patients, the transhepatic tube is still in situ.

CONCLUSIONS

Percutaneous transhepatic treatment of anastomotic strictures after hepaticojejunostomy is safe and highly effective in achieving internal biliary drainage. Temporary transhepatic intubation seems to be a promising minimally invasive alternative to surgery.

Anatomical and neurochemical peculiarities of the pika retina: basis for lack of circadian rhythm of core temperature

We have previously reported a complete lack of circadian rhythm in the body temperature of pikas in contrast to other lagomorphs. In this present study, the anatomical and neurochemical findings by immunohistochemical, photo and electron microscopic methods reveal that the photoreceptor system of this animal is poorly developed. This probably explains their stable core body temperature which help them survive in cold temperatures.

Coactivation of the flexor muscles as a synergist with the extensors during ballistic finger extension movement in trained kendo and karate athletes

To analyse the effects of ballistic property training on ballistic finger extension movement, surface electromyographic pattern (EMGs) of the finger extensor and flexor muscles and the acceleration signal of the middle finger were recorded in trained kendo and karate athletes, and sedentary non-athletic men. Ballistic finger extension did not show the characteristic triphasic EMG pattern reported in single joint, but a coactivation of flexor and extensor muscles. Reaction time (RT) in kendo (143 +/- 12 msec) and karate (146 +/- 11 msec) athletes were significantly shorter than that in the control (176 +/- 12 msec). The shortenings of the RT were attributed to both the shortenings of premotor time and motor time. The delay of the flexor muscles discharge after those of the extensors in kendo (0.8 +/- 7.0 msec) and karate (-0.2 +/- 5.0 msec) athletes was significantly shorter than in control (12.7 +/-5.6 msec). These results suggest that the RT is shortened through motor learning in the kendo and karate athletes who trained for momentary movements; and that the flexor muscles may play an important role as a synergist in heightening the efficiency of ballistic finger extension in coordination with the extensor muscles.

[Intensive medical monitoring with transesophageal echocardiography in fulminant pulmonary embolism]

HISTORY AND FINDINGS

A 60-year-old man underwent a continence-preserving anterior rectal resection for a high rectal carcinoma. After mobilisation on the 5th postoperative day dyspnoea and cyanosis suddenly developed requiring emergency intubation and mechanical ventilation.

INVESTIGATIONS

His heart rate was 160/min, blood pressure 80/50 mmHg, mean pulmonary artery pressure by indwelling catheter was 70 mmHg. The electrocardiogram had the classical signs of acute right-heart overload. Transoesophageal echocardiography (TOE) demonstrated marked right-heart and pulmonary artery dilatation.

TREATMENT AND COURSE

Despite thrombolytic treatment (bolus of 50 mg r-TPA; one day later bolus of 1 million IU urokinase followed by 100,000 IU/h) a new thromboembolus was seen by TOE to straddle the pulmonary artery bifurcation. After the urokinase dosage had been raised to 200,000 IU/h TOE on the 6th day no longer showed the embolus and documented a reduction in right-heart dilatation associated with improved haemodynamics.

CONCLUSION

TOE is an ideal method for the rapid diagnosis and for monitoring the response to treatment of fulminant pulmonary arterial embolism. As it can also diagnose thromboembolism without significant haemodynamic consequences it is possible to adjust fibrinolytic treatment accordingly.

[Tinea of the scalp in Egypt]

This survey of 230 samples collected from an agricultural village. We have found that 18 positives cultures from which II are healthy carriers, the fungus isolated was T. violaceum. A comparison with others studies in Egypt was reported.