Percutaneous Transhepatic Radiologic Intervention of Biliary Complications following Liver Transplantation: A Single-center Experience

Background

Biliary complications are the leading cause of morbidity and mortality in patients undergo¬ing Liver Transplantation (LT). Post-biliary transplantation strictures (BSs) are a severe problem with a high risk of graft failure. However, management of these BSs has remained controversial, and consid¬erable variability has been reported in Percutaneous Transhepatic Radiological Interventions (PTRIs) related to broad differences in technical procedures.

Objective

This study aimed to evaluate the efficacy of percutaneous treatments in managing post-LT BSs in a center in Shiraz.

Methods

PTRIs including balloon dilatation, metallic stent, and internal or internal-external hand-made plastic stent insertion were done for 34 transplanted patients with BSs referring to the Interventional Radiology Unit of Shiraz Namazi Hospital. Technical success rate, patency rates, and complications were evaluated.

Results

The. In this study, 31 strictures were successfully treated without any significant difference between the anastomotic and non-anastomotic types of stricture (success rate: 91.2%). Based on the results, 12- , 24-, and 36-month primary patency rates were 90.1%, 84.5%, and 76.8%, respectively. The secondary patency rate was 100% at 12 and 24 months and 93.3% at 36 and 60 months. The rate of minor complica¬tions (mild cholangitis and hemobilia) was 6.4%, and no major complications were detected.

Conclusion

According to the findings, PTRI is an effective method for treating anastomotic and non-anas- tomotic strictures with a high success rate and low complications.

Flavanols are potential anti-obesity agents, a systematic review and meta-analysis of controlled clinical trials

BACKGROUND

The anti-obesity potential of flavonoids has been shown by animal and human studies. In this meta-analysis, we systematically reviewed controlled clinical trials and quantified the effects of flavonoids and flavonoid subclasses on obesity-related anthropometric measures.

METHODS AND RESULTS

PubMed, EMBASE, Scopus, Web of Science, and ProQuest databases were searched to identify trials examining the effect of flavonoids on body mass index (BMI), waist circumference, and body fat percentage. Fifty eight trials passed the eligibility process. Analysis endpoints were calculated as the mean difference between baseline and post-treatment. Flavonoids were in subclasses of flavanols, flavonols, isoflavones, flavanones, anthocyanins, and proanthocyanidins. They were mostly in the form of supplements and dosages varying from 40 to 1300 mg/day. Among flavonoid subclasses, flavanols showed potential for decreasing BMI, in the overall population (mean difference (MD) = -0.28 kg/m², P = 0.04; n = 21) and in the subgroups of Asians (MD = -0.42 kg/m²; P = 0.046; n = 13), ages < 50 years (MD = -0.50 kg/m²; P = 0.008; n = 14), BMI ≥ 25 kg/m² (MD = -0.30 kg/m²; P = 0.049; n = 15), and at doses ≥ 500 mg/day (MD = -0.36 kg/m²; P = 0.049; n = 12). Isoflavones also decreased BMI of non-Asian populations (MD = -0.26 kg/m²; P = 0.035; n = 13) and doses ≥ 75 mg/day (MD = -0.34 kg/m²; P = 0.027; n = 8). In the overall assessment, flavanols also decreased waist circumference (MD = -0.60 cm; P = 0.02; n = 18) but had no significant effect on body fat percentage. The available trials did not reveal significant effects from flavonols, flavanones, and anthocyanins on the specified anthropometric measures.

CONCLUSIONS

Overall results of this meta-analysis showed that flavanols have potential against obesity.

Genetic connectivity and phenotypic plasticity in the cyprinodont Aphanius farsicus from the Maharlu Basin, south-western Iran

Meristic and morphometric characteristics, including otolith data, of the Farsi tooth-carp Aphanius farsicus, which is endemic to the endorheic Maharlu Basin in south-western Iran, were analysed for a sample of 92 individuals from four spring-streams; DNA sequence data (cytochrome b gene) are presented for 29 specimens. Some phenotypic variation was detected but the genetic data clearly indicate connectivity between the populations. Possible links between phenotypic variation and environmental variables such as water temperature, habitat size and absence or presence of predators and competitors are discussed. Based on a literature survey and the new data, it is concluded that population connectivity is maintained during times of droughts via large aquifers that formed during the late Pliocene to early Pleistocene, when the extant endorheic Maharlu Basin was created. Based on new data presented here and previous work, it is apparent that plastic and constant characteristics are present in Aphanius species, and that, if a population becomes isolated, a given trend of evolution may give rise to a taxonomically useful characteristic.

Occurrence of Clinostomum complanatum in Aphanius dispar (Actinoptrygii: Cyprinodontidae) collected from Mehran River, Hormuzgan Province, South of Iran

OBJECTIVE

To investigate the possibility of Aphanius dispar (A.dispar) acting as intermediate host for Clinostomum complanatum (C. complanatum), from Mehran River, Hormuzgan Province of Iran.

METHODS

During a biological study of A. dispar in Mehran River, Hormuzgan Province, South of Iran, a total of 97 fish specimens were collected in 24 January 2006.

RESULTS

4 specimens (4.12%) including 1 male and 3 female were found infected with C. complanatum metacercaria. These metacercaria were coiled in the epiderm on the body surface of infected fishes. The infection is known as yellow spot disease. The parasite abundance, intensity and prevalence were 0.05%, 1.25% and 4.12%, respectively. The infection was higher in females than males.

CONCLUSIONS

To the best of our knowledge, this is the first report on occurrence of C. complanatum metacercaria in A. dispar in Iran.

Comparison of the positional cloning methods used to isolate the BRCA1 gene

A critical step in positional cloning is the identification of candidate genes from a large, genetically defined region. Candidate gene isolation by hybrid selection, genomic sequencing, and direct cDNA library screening identified 45 candidate gene fragments (CGFs) from a 600 kb genomic region that contains the BRCA1 gene. These CGFs define a minimum of 15 genes, six of which are newly localized to the BRCA1 region. We present an analysis of the efficiency and the sequences generated for each of these methods. We also compare our CGF set to those reported for the BRCA1 region by three other groups, revealing a surprising lack of overlap among the sets.