The ileum as a determinant organ of the functional liver cell mass in rats

PURPOSE: To evaluate if the ileum resection changes the functioning liver cell mass, the hepatic metabolism and the biodistribution of radiopharmaceutical in rats. METHODS: Twelve Wistar rats weighing 285g±34g were randomly divided into the ileum resection group (n = 6) and sham group rats (n = 6). After 30 days, they were anesthetized and 0.1mL of 99m-Tc-phytate(0.66MBq) was injected via femoral vein. After 30 minutes, blood samples were collected for red blood cells radioactive labeling and serum ALT, AST and gammaGT. Liver samples were used for 99m-Tc-phytatepercentage of radioactivity/gram of tissue and histopathology. Student’s t test was used with significance 0.05. RESULTS: There was a higher uptake of 99m-Tc-phytate in the liver of sham rats, compared to the ileum resection group (p<0.05). GammaGT, ALT and AST were increased in ileum resection rats compared to sham (p<0.05). The he patocytes count was significantly lower in ileum resection group than in sham (p<0.05). Liver: body mass ratio was lower in experimental animals than in sham group (p<0.05). CONCLUSION: These data support that the ileum has important role in liver function and liver mass regulation, and they have potential clinical implications regarding the pathogenesis of liver injury following lower bowel resection.

The complete organ sonatas of August Ritter.

CD recording - Priory CD PRCD1162 - of the complete organ sonatas of August Gottfried Ritter (1811-1885) recorded on the Ladegast organ of the Kirche Altleisnig, Polditz, Germany

The Auld Alliance: Organ music from Scotland and France.

CD recording of the Rieger organ of St Giles' Cathedral Edinburgh, performed by Michael Harris, with music from Scottish composers, and composers based in Scotland, as well as French organ music from the seventeenth to twentieth centuries. Works by James MacMillan, Thomas Wilson, Kenneth Leighton, Alfred Hollins, de Grigny, Guilmant, Fleury and Franck.

The organ works of Kaikhosru Shapurji Sorabji (1892-1988)

This is the first complete critical edition of the organ works of Kaikhosru Shapurji Sorabji (1892--‐1988). Of the three solo symphonies presented here only the first has previously appeared in print (Curwen, 1925). The other two works, both of hugely greater dimensions than the first, have not been published before although, in the late 1980s/early 90s, the present writer produced a hand‐copied edition of the second symphony that has been available in print form and in PDF through the Sorabji Archive since 1991.

Directive cadre sur l’eau - Bassin Loire-Bretagne. Contrôle de surveillance dans les masses d’eau côtières et de transition. Actions menées par Ifremer en 2014

Le contrôle de surveillance 2014 pour la DCE appliquée dans les eaux littorales de Loire Bretagne a porté sur les 25 masses d’eau côtières (sur 39 au total) et les 16 masses d’eau de transition (sur 30 au total) retenues au titre du contrôle de surveillance. L’ensemble des résultats acquis, aussi bien sur les paramètres biologiques que chimiques, a permis de mettre à jour l’évaluation de l’état des masses d’eau affiché sur l’atlas DCE accessible sur la page web d’Envlit correspondante.

Acute Q Fever Presenting with Multi-Organ Failure: Re-Evaluation of the Initial Diagnosis

We present the case of a 48-year-old man admitted to the critical care unit with atrial fibrillation, and acute heart and kidney failure accompanied by coagulopathy and an abnormal liver test. Initially diagnosed as a non-ST elevation myocardial infarction, re-evaluation of the case led to the consideration of severe sepsis. Q fever and leptospirosis were the most probable causes and empiric treatment was initiated. A complete recovery was achieved following treatment.

A Case Against Fancy Decorated Drinks: Multi-Organ Failure After Drinking a Mojito Cocktail

We present the first case of gastro-intestinal perforation caused by a mint twig decorating a cocktail drink. A 76-year-old man was enjoying his Mojito cocktail on a cruise ship near Mexico when he accidently swallowed a mint twig, resulting in ileum perforation. This led to a cascade of events, eventually resulting in life-threatening multi-organ failure. Given this rare but potentially severe complication and the increasing popularity of decorated drinks, a less ‘fancy’ presentation for cocktails and similar drinks may be warranted.

Expertise sur 3 masses d’eau de la Réunion (étangs de Saint-Paul et du Gol) et de Martinique (étang des Salines) : typologie et surveillance DCE

Trois masses d’eau situées sur le littoral de l’île de la Réunion et de la Martinique présentent des fonctionnements et des caractéristiques atypiques, ce qui pose actuellement des difficultés dans le cadre de l’application de la DCE. Les deux masses d’eau réunionnaises, l’étang du Gol et l’étang de Saint-Paul, sont actuellement identifiées en tant que plans d’eau au titre de la DCE. La masse d’eau martiniquaise, l’étang des Salines, est quant à elle identifiée en tant que masse d’eau de transition. L’objectif de cette étude est d’apporter une expertise, sur la base des données disponibles et des échanges avec les experts locaux et nationaux, concernant : · la typologie des masses d’eau, · les paramètres chimiques, physico-chimiques et biologiques pertinents à suivre dans le cadre de la surveillance DCE, · des pistes de travail pour consolider des grilles de diagnostic sur les masses d’eau. Cette expertise s’appuie également sur les retours d’expériences et les études réalisées dans le cadre de la mise en oeuvre de la DCE sur les lagunes des bassins Rhône Méditerranée et Corse, dont la morphologie et le fonctionnement se rapprochent des trois masses d’eau étudiées. L’analyse des données et études fournies sur les étangs réunionnais du Gol et de Saint-Paul conduit à poser la question de la pertinence de leur maintien dans le référentiel des masses d’eau au titre de la DCE. Si le choix est cependant fait de conserver ces étangs en tant que masses d’eau DCE, leurs caractéristiques correspondraient à la typologie des eaux de transition et à la gamme de salinité oligohaline. Des recommandations sont formulées en termes d’études complémentaires visant à préciser le fonctionnement hydrologique de ces étangs et de priorisation des suivis de leur qualité physico-chimique et biologique, pour aboutir à une surveillance DCE pérenne. Les recommandations formulées à partir des données fournies sur l’étang martiniquais des Salines concernent l’évaluation des pressions anthropiques pesant sur cette masse d’eau, la priorisation des suivis de sa qualité chimique, physico-chimique et biologique dans le cadre de la surveillance DCE. Des pistes sont également données pour l’élaboration et la consolidation de grilles de diagnostic adaptées à cet étang.

Hope for a peaceful death and organ donation

The therapeutic, social and economic benefits of organ transplantation are irrefutable; however, organ shortages contribute to avoidable patient deaths and burgeoning health care costs. This problem can be addressed by increasing family consent to deceased organ donation. There are high levels of community support for deceased organ donation in Australia and yet, almost fifty percent of families decline the request to donate. Increasing the number of families who agree to deceased organ donation is key to increasing national and international transplantation rates. The purpose of this study was to identify the major factors that influence a family to agree or decline deceased organ donation during the process of decision-making. The aims of the study were three-fold: to identify the key stages and the major influencers’ in the decisionmaking process; to determine if hope, deep hope and trust played a role in the decision, and to explore families’ perceptions of their decision-making experience. The study utilised an exploratory case study approach to examine the family decisionmaking process of deceased organ donation. Following ethics approval, recruitment was conducted utilising a qualitative purposive snowball strategy across Australia. A pilot study was conducted to test the study procedures prior to the main data collection, and 22 participants who had been involved in a deceased organ donation decision from nine families were interviewed. In five deaths family members had agreed to organ donation, and in four deaths the family declined. A theoretical framework based on the Precaution Adoption Process Model of decision-making was applied to propose trust, hope and deep hope underpin family organ donation decisions. Thematic analysis was conducted and three key themes comprising ‘In the fog drowning’, ‘Harvesting humanity’, and ‘It’s all up to Mum’ were revealed. The study found women, and in particular mothers, played a significant role in organ donation decision-making, and that the decision-making is bounded by family needs of trust, hope and deep hope across the continuum of time. It also found families who had their trust, hope and deep hope needs met expressed satisfaction about their decision-making experience and agreed to organ donation. Some families perceived that organ donation was a sacrifice that was too great to endure, even if the deceased had previously indicated intent to donate, and therefore declined donation. This study found that families’ ideas of a peaceful death and organ donation are not mutually exclusive. It concludes that when decision-makers’ trust and deep hope needs are met they are more willing to agree to donation. This study recommends that the idea of a ‘right’ to a peaceful death should be aligned with deceased organ donation practices and normalised.

Effect of remote ischaemic preconditioning in cardiac dysfunction and end-organ injury following cardiac surgery with cardiopulmonary bypass in children: A translational approach investigating clinical outcome and myocardial molecular biology

Congenital heart disease (CHD) is the most common birth defect, causing an important rate of morbidity and mortality. Treatment of CHD requires surgical correction in a significant percentage of cases which exposes patients to cardiac and end organ injury. Cardiac surgical procedures often require the utilisation of cardiopulmonary bypass (CPB), a system that replaces heart and lungs function by diverting circulation into an external circuit. The use of CPB can initiate potent inflammatory responses, in addition a proportion of procedures require a period of aortic cross clamp during which the heart is rendered ischaemic and is exposed to injury. High O2 concentrations are used during cardiac procedures and when circulation is re-established to the heart which had adjusted metabolically to ischaemia, further injury is caused in a process known as ischaemic reperfusion injury (IRI). Several strategies are in place in order to protect the heart during surgery, however injury is still caused, having detrimental effects in patients at short and long term. Remote ischaemic preconditioning (RIPC) is a technique proposed as a potential cardioprotective measure. It consists of exposing a remote tissue bed to brief episodes of ischaemia prior to surgery in order to activate protective pathways that would act during CPB, ischaemia and reperfusion. This study aimed to assess RIPC in paediatric patients requiring CHD surgical correction with a translational approach, integrating clinical outcome, marker analysis, cardiac function parameters and molecular mechanisms within the cardiac tissue. A prospective, single blinded, randomized, controlled trial was conducted applying a RIPC protocol to randomised patients through episodes of limb ischaemia on the day before surgery which was repeated right before the surgery started, after anaesthesia induction. Blood samples were obtained before surgery and at three post-operative time points from venous lines, additional pre and post-bypass blood samples were obtained from the right atrium. Myocardial tissue was resected during the ischaemic period of surgery. Echocardiographic images were obtained before the surgery started after anaesthetic induction and the day after surgery, images were stored for later off line analysis. PICU surveillance data was collected including ventilation parameters, inotrope use, standard laboratory analysis and six hourly blood gas analysis. Pre and post-operative quantitation of markers in blood specimens included cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP), inflammatory mediators including interleukins IL-6, IL-8, IL-10, tumour necrosis factor (TNF-α), and the adhesion molecules ICAM-1 and VCAM-1; the renal marker Cystatin C and the cardiovascular markers asymmetric dymethylarginine (ADMA) and symmetric dymethylarginine (SDMA). Nitric oxide (NO) metabolites and cyclic guanosine monophosphate (cGMP) were measured before and after bypass. Myocardial tissue was processed at baseline and after incubation at hyperoxic concentration during four hours in order to mimic surgical conditions. Expression of genes involved in IRI and RIPC pathways was analysed including heat shock proteins (HSPs), toll like receptors (TLRs), transcription factors nuclear factor κ-B (NF- κ-B) and hypoxia inducible factor 1 (HIF-1). The participation of hydrogen sulfide enzymatic genes, apelin and its receptor were explored. There was no significant difference according to group allocation in any of the echocardiographic parameters. There was a tendency for higher cTnI values and inotropic score in control patients post-operatively, however this was not statistically significant. BNP presented no significant difference according to group allocation. Inflammatory parameters tended to be higher in the control group, however only TNF- α was significantly higher. There was no difference in levels of Cystatin C, NO metabolites, cGMP, ADMA or SDMA. RIPC patients required shorter PICU stay, all other clinical and laboratory analysis presented no difference related to the intervention. Gene expression analysis revealed interesting patterns before and after incubation. HSP-60 presented a lower expression at baseline in tissue corresponding to RIPC patients, no other differences were found. This study provided with valuable descriptive information on previously known and newly explored parameters in the study population. Demographic characteristics and the presence of cyanosis before surgery influenced patterns of activity in several parameters, numerous indicators were linked to the degree of injury suffered by the myocardium. RIPC did not reduce markers of cardiac injury or improved echocardiographic parameters and it did not have an effect on end organ function; some effects were seen in inflammatory responses and gene expression analysis. Nevertheless, an important clinical outcome indicator, PICU length of stay was reduced suggesting benefit from the intervention. Larger studies with more statistical power could determine if the tendency of lower injury and inflammatory markers linked to RIPC is real. The present results mostly support findings of larger multicentre trials which have reported no cardiac benefit from RIPC in paediatric cardiac surgery.

Calculable lepton masses, seesaw relations, and four neutrino mixings in a 3-3-1 model with an extra U(1) symmetry

We propose a scheme in which the masses of the heavier leptons obey seesaw type relations. The light lepton masses, except the electron and the electron neutrino ones, are generated by one loop level radiative corrections. We work in a version of the 3-3-1 electroweak model that predicts singlets (charged and neutral) of heavy leptons beyond the known ones. An extra U(1)(Omega) symmetry is introduced in order to avoid the light leptons getting masses at the tree level. The electron mass induces an explicit symmetry breaking at U(1)(Omega). We discuss also the mixing matrix among four neutrinos. The new energy scale required is not higher than a few TeV.

Primary lymphomas of the female genital tract: imaging findings

Primary lymphomas of the female genital tract are extremely rare, and a definitive diagnosis requires correlation of the clinical, radiological, and pathological findings. Unlike nonlymphomatous malignant tumors, the treatment of lymphoma is typically nonsurgical, thus raising the possibility of lymphoma in the differential diagnosis of a pelvic mass, a radiologist can significantly change the approach to the disease. Although some imaging findings may appear nonspecific, others may suggest the possibility of lymphoma, such as the presence of one or more solid, well-defined, homogeneous masses without necrosis despite a large size or the presence of diffuse infiltration leading to organomegaly with architectural preservation. Additionally, pelvic lymphadenopathy may be evident. In this pictorial essay, we discuss the radiological appearances of gynecological primary lymphomas, grouped by organ, in ultrasonography, computed tomography, and magnetic resonance imaging.

Algoritmo de abordagem das lesões anexiais indeterminadas na ecografia

O esclarecimento do órgão de origem, ou principalmente da natureza benigna ou maligna de um tumor anexial ecograficamente indeterminado surge com frequência na prática clínica e obriga a uma investigação complementar da sua natureza de modo a evitar cirurgias inúteis, sem deixar de diagnosticar precocemente a patologia maligna. Neste trabalho apresentamos um algoritmo de diagnóstico por Ressonância Magnética (RM), que recentemente foi proposto pela European Society of Urogenital Radiology (ESUR), o qual permite um diagnóstico preciso dos casos indeterminados à ecografia e uma intervenção responsável na abordagem clínica destas doentes.

A new stable GIP-Oxyntomodulin hybrid peptide improved bone strength both at the organ and tissue levels in genetically-inherited type 2 diabetes mellitus

International audience

Els impactes del turisme de masses: economia, societat, cultura, mediambient [PPT]

Els impactes ambientals del turisme: tipus d'impactes i les implicacions territorials