Early activation and recruitment of invariant natural killer T cells during liver ischemia-reperfusion: the major role of the alarmin interleukin-33.

Over the past thirty years, the complexity of the αβ-T cell compartment has been enriched by the identification of innate-like T cells (ITCs), which are composed mainly of invariant natural killer T (iNKT) cells and mucosal-associated invariant T (MAIT) cells. Based on animal studies using ischemia-reperfusion (IR) models, a key role has been attributed to iNKT cells in close connection with the alarmin/cytokine interleukin (IL)-33, as early sensors of cell-stress in the initiation of acute sterile inflammation. Here we have investigated whether the new concept of a biological axis of circulating iNKT cells and IL-33 applies to humans, and may be extended to other ITC subsets, namely MAIT and γδ-T cells, in the acute sterile inflammation sequence occurring during liver transplant (LT).

Representativeness of laboratory sampling procedures for the analysis of trace metals in soil.

This study was conducted to assess the representativeness of laboratory sampling protocols for purposes of trace metal analysis in soil. Five laboratory protocols were compared, including conventional grab sampling, to assess the influence of sectorial splitting, sieving, and grinding on measured trace metal concentrations and their variability. It was concluded that grinding was the most important factor in controlling the variability of trace metal concentrations.

Timing of (supplemental) parenteral nutrition in critically ill patients: a systematic review.

Supplemental parenteral nutrition (SPN) is used in a step-up approach when full enteral support is contraindicated or fails to reach caloric targets. Recent nutrition guidelines present divergent advices regarding timing of SPN in critically ill patients ranging from early SPN (<48 h after admission; EPN) to postponing initiation of SPN until day 8 after Intensive Care Unit (ICU) admission (LPN). This systematic review summarizes results of prospective studies among adult ICU patients addressing the best timing of (supplemental) parenteral nutrition (S)PN.

The blood pressure-lowering effect of renal denervation is inversely related to kidney function.

Objectives: In renal denervation (RDN), a wide range in the blood pressure (BP)-lowering effect has been reported. On the basis of the current knowledge of pathophysiology, we hypothesized that the BP-lowering effect of RDN would be inversely related to kidney function. Second, we investigated whether direct and indirect variables of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system (SNS) would be related as well.

Effects of carotid endarterectomy or stenting on arterial diameters in the circle of Willis.

Background: In patients with internal carotid artery (ICA) stenosis, the circle of Willis (CoW) is the primary collateral pathway. We compared luminal diameters in the CoW before and after carotid revascularization and compared the effects of carotid endarterectomy (CEA) and stenting on these diameters.

Methods: At a single center in the International Carotid Stenting Study, 139 patients with symptomatic ICA stenosis of 50% or more were randomized to stenting (n = 81) or CEA (n = 58).

Sacral neuromodulation in the treatment of severe anal incontinence. Forty consecutive cases treated in one institution.

Introduction: Sacral neuromodulation is a recognized therapeutic option in severe anal incontinence from neurogenic origins, when medical treatment has failed.

Methods: We report the results of this procedure applied in 40 consecutive patients operated on by a single surgeon from August 2001 to June 2004. Mean duration of incontinence was 5 years.

Technical and functional results after laparoscopic rectopexy to the promontory for complete rectal prolapse. Prospective study in 54 consecutive patients.

Introduction: Laparoscopic rectopexy for complete rectal prolapse offers short-term advantages compared with operations performed by laparotomy. The aim of this prospective study was to report technical and functional outcome after laparoscopic rectopexy to the promontory in consecutive patients operated on by a single surgeon.

Patients And Methods: From May 1996 to July 2004, 54 consecutive patients (47 women), median age 53 years (range: 16-84 years), underwent laparoscopic rectopexy to the promontory for complete rectal prolapse.

Effect of low-dose rabeprazole and omeprazole on gastric acidity: results of a double blind, randomized, placebo-controlled, three-way crossover study in healthy subjects.

Background: The treatment of acid-related symptoms requires rapid and consistent acid suppression, especially with on-demand regimens.

Aim: To compare the antisecretory activity of low-dose rabeprazole and omeprazole in healthy, Helicobacter pylori-negative subjects.

Methods: In this randomized, double-blind, placebo-controlled, three-way crossover study, 27 volunteers were given rabeprazole 10 mg, omeprazole 10 mg, or placebo once daily for 7 days with a 10-14-day washout between treatments.

Oesophageal motor and sensitivity abnormalities in non-obstructive dysphagia.

Objectives: To evaluate oesophageal sensitivity to balloon distension in patients with non-obstructive dysphagia (NOD), and to determine its relationship with the motility pattern in response to food ingestion.

Patients And Methods: Twenty-one healthy volunteers and 19 consecutive patients complaining of NOD with normal standard manometry were included. An oesophageal sensitivity test was carried out before the manometry study with liquid and solid swallows.

Central processing of rectal pain in patients with irritable bowel syndrome: an fMRI study.

Objectives: In healthy subjects, the neural correlates of visceral pain bear much similarity with the correlates of somatic pain. In patients with irritable bowel syndrome, the central nervous system is believed to play a strong modulatory or etiological role in the pathophysiology of the disease. We hypothesize that this role must be reflected in aberrations of central functional responses to noxious visceral stimulation in these patients.

Relationship between acid reflux episodes and gastroesophageal reflux symptoms is very inconstant.

In this prospective study 244 consecutive patients presenting with typical and chronic signs of gastroesophageal reflux were included. Conventional 24-hr esophageal pH monitoring was carried out to establish the symptom association probability, the concordance index, and the symptom sensitivity index. The symptom association probability could be calculated in 110 patients (45%).

Abnormal allometric size of vital body organs among sudden infant death syndrome victims.

Sudden infant death syndrome (SIDS) victims are difficult to describe physically because they seem outwardly indistinguishable in nearly all characteristics from infants (alive or dead) of comparable chronological age. Relative (allometric) size of vital organ and body weights has not been examined among SIDS victims. In the present study, autopsy organ and body weights for 152 SIDS deaths (1-12 months) were compared with the results of 115 controls that were trauma or illness-related death (0.

Central processing of rectal pain: a functional MR imaging study.

Background And Purpose: Although the central processing of somatic pain has been dealt with in numerous brain imaging studies, the neural correlates of visceral pain have received much more limited attention. Our goal was to assess the feasibility of detecting brain activation patterns induced by rectal pain by means of functional MR imaging. We hypothesized that the cerebral processing of rectal pain would exhibit strong similarities with the central processing of somatic pain.

[Evaluation of esophageal motility disorders triggered by ingestion of solids in the case of non-obstructive dysphagia].

Unlabelled: The aim of this study was to define the normal manometric pattern of esophageal motility in response to food ingestion and to evaluate the contribution of esophageal manometry in the management of patients complaining of functional dysphagia.

Patients And Methods: Twenty-one healthy volunteers and 25 consecutive patients complaining of functional dysphagia with normal conventional esophageal manometry were included in this prospective study. An event marker was used to study the relationship between dysphagia and motility events.

Achalasia: outcome of patients treated with intrasphincteric injection of botulinum toxin.

Background: To evaluate the safety and clinical efficacy of botulinum toxin (BT) in patients with achalasia followed up for six months.

Methods: Fifty five symptomatic patients with manometrically proven achalasia were included in a multicentre prospective trial. Before and two weeks and two months after intrasphincteric injection of BT, symptoms of dysphagia, regurgitation, and chest pain were scored on a 0-3 scale, and lower oesophageal sphincter pressure (LOSP) was assessed.

'Bridge' between knowledge and practice in diagnosing depression.

Depression is one of the most common disorders in primary care patients. Yet, physicians fail to recognize it in most patients. One of the likely reasons for this problem may be that medical students and physicians have difficulty recalling pertinent psychiatric didactic information in a clinically usable form.

Whole blood levels of dodecanoic acid, a routinely detectable forensic marker for a genetic disease often misdiagnosed as sudden infant death syndrome (SIDS): MCAD deficiency.

We investigated whether or not elevated whole blood dodecanoic acid concentration was due to a beta-oxidation defect in fatty acid metabolism previously reported. We prospectively analyzed blood from 55 consecutive sudden infant death syndrome (SIDS) cases for fatty acid concentrations by gas chromatograph. Three of 55 cases had elevated dodecanoic acid concentrations (> or = 18.

Fatal iatrogenic iodine toxicity in a nine-week old infant.

Background: Povidone-iodine has been used since the 1950s for various labelled uses as a topical antiseptic. The toxicity of an excessive dose in internal use is described in this case report.

Case Report: A 9-week old infant was treated for colic by a pediatric gastroenterologist with loperamide and the elimination of nonhuman milk.

Hair analysis--perspectives and limits of a proposed forensic method of proof: a review.

In the last few decades, a significant trend has been the self-administration of drugs to 'get high' or to achieve other desired pleasurable effects. This trend has produced major efforts to combat drug misuse or abuse. One such effort has been to utilize analytical toxicology to identify individuals who abuse drugs.

Alcohol in decomposed bodies: postmortem synthesis and distribution.

Blood alcohol (ethanol) concentrations in decomposed bodies can mean drinking during life and/or endogenous production after death. The correct interpretation is important in medicolegal cases. This retrospective study of 286 autopsied medical examiner cases was undertaken to evaluate alcohol concentrations and distribution in various fluids and tissues in decomposed bodies.

Role of upper esophageal reflex and belch reflex dysfunctions in noncardiac chest pain.

Fifty-four patients examined for noncardiac chest pain (NCCP), showing no esophageal motor disorder or gastroesophageal reflux disease compatible with NCCP, were subjected to an intraesophageal balloon distension test and a study of the belching reflex provoked by intraesophageal air injection. Thirty-three control subjects were also studied, allowing us to define high-threshold belchers (group I) as those who belched during two of three 40-ml distensions and low-threshold belchers (group II) as those who did not. The balloon distension test induced NCCP in 64% of the patients in group I, and in 14% of the patients in group II (P < 0.

Alleviating stress in residency training through enhanced communication: a practical guide.

Stress is an inherent component of residency training and its effect on healthcare provided is well documented. Although stress-related signs and symptoms are easily recognized, residents and trainers are likely to ignore them--until a crisis occurs. Based on the theory that good communication alleviates stress, the "I" Language Model, discussed in this article, is designed to enhance communication between residents and their superiors, colleagues, and families.