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Gastrointestinal myoelectric activity during endotoxemia.

BACKGROUND: Gastrointestinal myoelectric activity during postoperative ileus has been well characterized. However, the common clinical scenario of ileus occurring during and after episodes of sepsis is not well understood. The aim of our study was to determine the effects of a single, sublethal dose of endotoxin on canine gastrointestinal myoelectric activity. METHODS: Eight dogs underwent placement of serosal electrodes on the stomach and small intestine and insertion of a jejunal cannula. After the animals recovered, electrical activity and jejunal mucosal blood flow were determined during fasting and with feeding. Following completion of these baseline studies dogs were given a single, sublethal dose of Escherichia coli lipopolysaccharide (200 g/kg) intravenously, and the studies were repeated daily for 3 consecutive days. RESULTS: Endotoxin resulted in an absence of the interdigestive migrating myoelectric complex for 2 days, a decrease in duodenal and jejunal action potentials during fasting and with feeding, but no decreases in jejunal mucosal blood flow. The gastrointestinal myoelectrical patterns returned to those found in health on postendotoxin day 3. CONCLUSIONS: A single, sublethal dose of endotoxin results in a temporary disruption of gastrointestinal myoelectric activity similar to that seen during postoperative ileus. The etiology of this "adynamic" ileus is unknown but does not appear to be secondary to intestinal ischemia.

Action Potentials↗

Retrievable vena cava filters: a review.

PURPOSE OF REVIEW: To examine the current literature regarding retrievable inferior vena cava filters and to discuss the appropriate indications for their clinical use. RECENT FINDINGS: Permanent filters have been shown to be effective, but have a number of long-term complications such as filter thrombosis or migration. Indications for their placement should be accurately evaluated, especially in patients with a long life expectancy, or in whom the period of contraindication to anticoagulation is short. On the other hand, temporary filters are difficult to manage and their maximum implantation time is often insufficient to solve the clinical problem leading to their placement. Four different retrievable filters recently received approval for temporary insertion. Recent data suggest that the use of these filters may be related to a low rate of pulmonary embolism and insertion complications. Nevertheless, no randomized clinical trials have been performed, and the only available data refer to retrospective or prospective studies. SUMMARY: Retrievable filters are a new generation of filter that offers the attractive possibility of being left in place permanently or being removed after quite a long period when they become unnecessary.

Device Removal↗

Bio-psycho-social consequences of migration stress: a multidimensional approach.

This paper emphasizes the complexity of contemporary migration research. It presents the different choices for investigation, namely the biological, psychological and social aspects. Different clinical findings are presented that are found in migrant groups, individuals and families ranging from temporary crisis situations to adjustment difficulties, leading eventually to maladjustment.

Acculturation↗

The Filcard temporary, removable vena cava filter: use in local thrombolytic therapy.

Femoral and iliac vein thrombosis with impending pulmonary embolism is a potentially life-threatening condition. The decision whether or not to implant a permanent caval filter always requires critical consideration of a number of factors. Improper positioning of the filter with resultant filtering inefficiency, thrombosis of the filter and of the cava, propagation of the thrombus through the filter, perforation by the filter of the vena cava with penetration of the aorta, the duodenum, the psoas muscle or the vertebral body, fragmentation of the filter and migration of the filter are well-documented complications of the currently available permanent filters. The danger of fatal pulmonary embolism has to be weighed against that of one or a combination of any of the above-mentioned possible complications associated with permanent caval filters which may affect the quality of later life. We present our initial observations with a temporary, removable inferior vena cava (IVC) filter in a young female patient with a floating thrombus in the left femoral and iliac vein who underwent successful local thrombolytic therapy.

Adolescent↗

Costimulatory molecule-deficient dendritic cell progenitors (MHC class II+, CD80dim, CD86-) prolong cardiac allograft survival in nonimmunosuppressed recipients.

We have shown previously that granulocyte-macrophage colony-stimulating factor-stimulated mouse bone marrow-derived MHC class II+ dendritic cell (DC) progenitors that are deficient in cell surface expression of the costimulatory molecules B7-1 (CD80) and B7-2 (CD86) can induce alloantigen-specific T-cell anergy in vitro. To test the in vivo relevance of these findings, 2 x 10(6) B10 (H2b) mouse bone marrow-derived DC progenitors (NLDC 145+, MHC class II+, B7-1dim, B7-2-/dim) that induced T-cell hyporesponsiveness in vitro were injected systemically into normal C3H (H2k) recipients. Seven days later, the mice received heterotopic heart transplants from B10 donors. No immunosuppressive treatment was given. Median graft survival time was prolonged significantly from 9.5 to 22 days. Median graft survival time was also increased, although to a lesser extent (16.5 days), in mice that received third-party (BALB/c; H2d) DC progenitors. Ex vivo analysis of host T-cell responses to donor and third-party alloantigens 7 days after the injection of DC progenitors (the time of heart transplant) revealed minimal anti-donor mixed leukocyte reaction and cytotoxic T lymphocyte reactivity. These responses were reduced substantially compared with those of spleen cells from animals pretreated with "mature" granulocyte-macrophage colony-stimulating factor + interleukin-4-stimulated DC (MHC class IIbright, B7-1+, B7-2bright), many of which rejected their heart grafts in an accelerated fashion. Among the injected donor MHC class II+ DC progenitors that migrated to recipient secondary lymphoid tissue were cells that appeared to have up-regulated cell surface B7-1 and B7-2 molecule expression. This observation may explain, at least in part, the temporary or unstable nature of the hyporesponsiveness induced by the DC progenitors in nonimmunosuppressed recipients.

Animals↗

The immune response of sheep to subclinical chronic exposure to the herbicide Bentazon TP.

A study of the effect of the Czechoslovakian herbicide BENTAZON TP on cells of the sheep immune system was carried out over a 3-mo period. A temporary decline in the number of T-lymphocytes in the peripheral blood was seen after 6 w of daily feeding of the herbicide. Dose-dependent statistically significant changes in the leucocyte migration index (p < 0.05) were seen at daily doses of 1/10 the LD50 (195 mg/kg body weight) and 1/20 the LD50 (97.5 mg/kg body weight) the 8th and 10th w of feeding, respectively. Significant changes of phagocytic activity and in the phagocytic index were not observed.

Animals↗

Relevance of the pharyngotympanic tube.

The auditory (Eustachian) tube connects the middle ear with the nasopharynx. This conduit permits equalisation of pressure between the middle ear and the throat. Balanced pressure allows the eardrum to vibrate freely as sound waves strike it. The auditory tube is also a potential anatomical route whereby opportunistic pathogens may migrate from the nose and throat to the middle ear. Eustachian tube (ET) function is disturbed in children with cleft palate, thereby rendering them susceptible to chronic otitis media with effusion (OME) and temporary conductive deafness. ET obstruction follows in these patients, and is thought to be related to the inability of the tensor veli palatini (TVP) to function properly. This anatomical overview reviews the clinical importance of the ET in the normal population and children with cleft palate.

Cleft Palate↗

Subcutaneous emphysema from an axillary wound that resulted in pneumomediastinum and bilateral pneumothorax in a horse.

A 5-year-old Thoroughbred gelding was examined because of a small axillary wound sustained 5 days earlier and had resulted in extensive subcutaneous emphysema. Three days after admission, the horse's respiratory rate had increased to 72 breaths/min, and the horse appeared anxious and distressed. Thoracic radiography revealed pneumomediastinum and severe bilateral pneumothorax. Tube thoracostomy was performed on both hemithoraxes. The drains were connected to one-way suction valves and suction devices to decompress the thorax. A nasopharyngeal catheter was inserted, and oxygen insufflation was started. Cross ties were placed on the horse to limit movement, and the wound was packed. The horse improved within 30 minutes after initiating treatment. The horse was released 15 days after the development of pneumothorax, at which time the pneumothorax had resolved, the wound was no longer open, and the subcutaneous emphysema had greatly decreased. Although subcutaneous emphysema is usually regarded as a temporary cosmetic disfigurement, it can lead to serious complications such as pneumothorax. This case demonstrates that subcutaneous emphysema can lead to a life-threatening pneumothorax if the pressure is great enough to migrate through the mediastinum and into the pleural cavity. Horses with subcutaneous emphysema should be kept in confinement and monitored for the development of pneumothorax.

Animals↗

Impact of migration on fertility in sub-Saharan Africa.

Much lower levels of fertility in urban than rural areas throughout sub-Saharan Africa imply that fertility decline in the region may be facilitated by rapid urbanization and rural-to-urban migration. The present study uses data from Demographic and Health Surveys in six countries--Ghana, Kenya, Mali, Senegal, Togo and Uganda--to assess the impact of long-term rural-urban female migration on fertility. Results of logit analyses indicate that in most countries women who leave the countryside represent the higher fertility segment of the rural population in the years before migration. Migrants' risk of conception declines dramatically in all countries around the time of migration and remains lower in the long run among most migrant groups than among rural and urban nonmigrants. Descriptive analyses suggest that the decline in migrant fertility is related to the rapid and pronounced improvement in standard of living experienced by migrants after settling in the urban area and may be due in part to temporary spousal separation.

Africa South of the Sahara↗

Histopathologic retinal changes with intravitreous fluorosilicone oil in rabbit eyes.

BACKGROUND: Fluorosilicone oil (FSiO, 1,000-10,000 centistokes), which has a higher density (1.29 g/cm3) than vitreous gel, is useful as an operative tool and a tamponade for the inferior retina during difficult retinal detachment surgery. The occurrence of histopathologic retinal changes after injection of FSiO into the vitreous cavity is controversial. METHODS: Retinas obtained from 18 rabbits were evaluated histopathologically within 8 weeks of injection into the vitreous cavity of purified FSiO or balanced salt solution as control in phakic eyes. The histopathologic retinal changes caused by FSiO were compared with those of previously reported high-density hydrophobic vitreous substitutes, such as silicone-fluorosilicone copolymer oil (SiFO) and perfluorocarbon liquids. RESULTS: By light and electron microscopy, all retinas injected with FSiO were the same as control retinas within 2 weeks of the injection, but the outer plexiform layer disappeared from the inferior retina 4 weeks after injection. The receptor cell nuclei migrated to the photoreceptor layer in the inferior retina 8 weeks after injection. However, no preretinal membrane, including foam cells, was found in any eye injected with FSiO. CONCLUSION: FSiO may be useful as a temporary vitreous substitute in difficult inferior retinal detachments.

Animals↗

Utility quick test for analyzing materials for drinking water distribution systems for effect on taste-and-odor.

A workshop of international drinking water experts was convened in Sedona, Arizona, March 26-27, 2001 for the purpose of developing a method for testing drinking water system components for their potential to contribute to taste-and-odor problems in drinking water. The workshop participants derived a method using provisions from European Standards as well as newly developed approaches. It is intended that this method can serve as a temporary procedure for water utilities, as well as a recommended template to derive an official standard. Materials to be tested may include pipes, fittings, ancillaries, joints, lubricants, tanks, and reservoirs. The recommended method includes a migration (leaching) test with chlorinated water, followed by sensory analysis of the samples from the migration test after dechlorination. Sensory analyses use both statistical (e.g., triangle test) and descriptive (e.g. Flavor Profile Analysis) techniques. A decision tree for the results is provided.

Chlorine Compounds↗

Human gingival attachment responses to subgingival crown placement. Marginal remodelling.

13 teeth in block were extracted from 2 patients. Their facial periodontal condition was essentially within normal clinical limits. Temporary crowns covering the bevel were placed below the base of the crevice 1 to 8 weeks prior to extraction. At time of extraction, all blocks were decalcified, the temporary crown dissolved, and the blocks prepared for histologic examinations using buccolingual cut, step serial sections. Histologic data revealed reformation of a new supracrestal attachment unit within 1 week following crown placement. The reformation of the gingival unit consisted of marginal recession with apical and lateral migration of the junctional epithelium to the level of remaining cementum inserted fibers. With gingival recession and migration of junctional epithelium, resorption of crestal portions of the facial plate occurred. However, periodontal fibers anchored into cementum opposite the resorbed bone were not lysed. Rather, the attached fibrillar ends appeared to interdigitate with fibers from the corium of the facial gingiva at this site, thereby forming a more apically located crestal attachment. This response may be one mechanism of reformation of the gingival attachment unit taking place following mechanical and/or surgical injury to this site and is completed often, within 2 weeks after injury.

Connective Tissue↗

Cell-mediated immunity in chickens vaccinated with the V4 strain of Newcastle disease virus.

A leukocyte migration inhibition assay was used to demonstrate antigen-specific cell-mediated immunity (CMI) in chickens vaccinated with the V4 strain of Newcastle disease virus. Chickens were vaccinated when 5 weeks old, and again 3 and 7 weeks later. CMI was detected 9 days after initial vaccination by eyedrop, but only after the second dose of vaccine delivered into the crop. In some chickens there was a temporary suppression of CMI to Newcastle disease virus, especially after the initial application of vaccine to the crop. Haemagglutination inhibition antibodies developed to similar levels in chickens after vaccination by either route. There was no obvious correlation between antibody and CMI responsiveness.

Animals↗

Results of a multicenter study of the retrievable Tulip Vena Cava Filter: early clinical experience.

PURPOSE: To evaluate clinically a new, retrievable vena caval filter in a multicenter study. METHODS: The Tulip filter is a stainless steel half-basket that is suitable for antegrade or retrograde insertion via an 8.5 Fr introducer sheath. The filter can be retrieved via the jugular approach using an 11 Fr coaxial retrieval system. Forty-eight filters were implanted via the femoral approach and 38 via the jugular approach in 83 patients. Follow-up examinations (plain films, colorcoded duplex sonography) were performed up to 3 years after filter insertion (mean 136 days) in 75 patients. Twenty-seven patients were screened by colorcoded duplex sonography for insertion site thrombosis. RESULTS: An appropriate filter position was achieved in all cases. Insertion problems occurred in 3 cases; these were not due to the filter design but to an imperfect prototype insertion mechanism that has now been modified (n = 2) or a manipulation error (n = 1). In 2 of these cases the filters were replaced percutaneously; 1 patient required venotomy for filter removal. No further complications due to filter insertion occurred. Two filters were used as temporary devices and were successfully removed after 6 and 11 days, respectively. There was 1 fatal recurrent pulmonary embolism (PE) and 2 non-fatal PE, 5 complete and 3 partial caval occlusions, and 3 caudal migrations of the filter. Insertion site venous thrombosis was not seen in the 27 patients monitored for this complication. CONCLUSION: Precise placement of the Tulip filter is feasible by either access route and the device appears mechanically stable. Further observations are needed to confirm that safe filter removal is practical up to 10 days after its insertion.

Adult↗

Human glioblastoma biopsy spheroids xenografted into the nude rat brain show growth inhibition after stereotactic radiosurgery.

BACKGROUND: The Gamma Knife is currently used to boost treatment of malignant gliomas. However, few experimental studies have focused on its radiobiological effects. In this work, the growth and invasiveness of human glioblastoma spheroids xenografted into nude rat brains were assessed after radiosurgery. Temporary in vitro as well as long-term in vivo radiation effects were studied. METHODS: Glioblastoma biopsy spheroids were irradiated with 12 or 24 Gy. Short-term in vitro spheroid viability and tumour cell migration was determined by microscopic techniques. Pre-irradiated glioblastoma spheroids were implanted into brains of immunosuppressed rats. Long-term tumour development was assessed by magnetic resonance (MR) imaging, and animal survival was recorded. An immunohistochemical analysis was performed on the sectioned rat brains. RESULTS: Both un-irradiated and irradiated spheroids remained viable during 2 months in culture, but a dose-dependent inhibition of tumour growth and migration was seen. MR imaging 4 weeks after implantation also showed a dose-dependent inhibition in tumour development. Median animal survival times were 25.5 days (control group), 43 days (12 Gy group) and 96 days (24 Gy group). The study of in vivo long-term radiation effects on the remaining viable tumour population showed no difference in Ki-67 labelling index and microvascular density before and after radiosurgery. CONCLUSIONS: A dose-dependent inhibition of tumour growth and invasion, as well as a dose-dependent increase in animal survival was observed. The model system described is well suited for assessing the radiobiological effects of Gamma Knife radiosurgery. The results indicate that radiosurgery of malignant gliomas might be effective in controlling tumour progression in selected glioblastoma patients.

Analysis of Variance↗

Two-stage combined vestibuloplasty and partial mandibular ridge augmentation with hydroxyapatite.

The preliminary results of a new two-stage technique for partial augmentation of the edentulous mandibular ridge with hydroxyapatite are reported. The technique, which has been applied to five patients, can be performed under local analgesia, and involves initial placement of temporary silicone spacers, together with submucous vestibuloplasty to preserve sulcus depth. The spacers are later replaced by dense particulate hydroxyapatite, and the connective tissue capsules that remain after removal of the spacers allow control of particle migration and minimize the amount of hydroxyapatite required.

Alveolar Ridge Augmentation↗

The peritoneal complications of ventriculo-peritoneal shunts.

One hundred and two patients with ventriculo-peritoneal shunts were studied. The aim of the study was to record the complications caused by the peritoneal end of the catheter and the frequency with which they occurred. Some of the complications involving tube migration are illustrated by case reports emphasizing the possible morbidity adn mortality that may be associated with this problem. Fity-one patients in the series had a complication; of these, 23 had only a mild temporary intestinal ileus following initial insertion of the shunt system. In the remaining 28 patients, the complications could have been significantly reduced by careful attention to operative detail and a closer follow-up of the patients following the shunt insertion.

Abdominal Muscles↗

[Infectious diseases and medical institutions in the late Chosen dynasty].

There were severe outbreaks of cholera and syphilis in the late Chosen Dynasty. In this article, I examine how these diseases spreaded and which preventive and curative measures were used against them. There were five times of cholera epidemic in Chosen Dynasty. Oriental medicine was initially adopted for the prevention and cure of the disease, but it did not produce remarkable results. Disinfection center and Cholera Clinic, the first special institution for the patients suffering from epidemic diseases, were established in Jeol-yung island, but could not be run properly at first. As preventive measures came to be more westernized, the popular awareness of understanding of the disese was improved. Temporary quarantine stations were established, and Korean government announced several rules against cholera. Contemporary Korean physicians had not known well about syphilis. Syphilis began to spread after the 1905 Protectorate Treaty was contracted and the Japanese migrated to Korea in large numbers. Syphilis had already spreaded widely among the Japanese prostitutes, and special clinic was established from relatively early times. ...

Cholera↗