Total neopharyngeal stenosis following pharyngolaryngo-oesophagectomy with gastric interposition: Successful recanalisation using a transcervical radiologically guided technique.

Introduction: Pharyngo-oesophageal stricturing is common following treatment of head and neck cancers. Absolute dysphagia secondary to total stenosis, although rare, is particularly debilitating and presents a significant therapeutic challenge. We present a strategy for managing total neopharyngeal stenosis following pharyngolaryngo-oesophagectomy (PLOG).

Autoimmune limbic encephalitis.

Autoimmune limbic encephalitis is an increasingly recognised cause of cognitive decline and confusion. The typical presentation is with subacute cognitive decline, behavioural disturbance and seizures. Magnetic resonance imaging may show characteristic changes in the medial temporal regions.

The Stoke contribution to peritoneal dialysis research.

The Stoke Renal Unit has been at the forefront of peritoneal dialysis (PD) research for much of the past two decades. Central to this work is the PD cohort study, which was started in 1990 and is based on regular outpatient measurements of peritoneal and clinical function, correlating these with long-term outcomes. It has provided a wealth of information on risk factors for morbidity and mortality in patients on PD, the most significant being demonstration of the effects of time and dialysate glucose exposure on changes to the peritoneal membrane, as evidenced by increases in small solute transport.

Post-parathyroidectomy parathyroid hormone levels: the impact on patient survival - a single-centre study in a stage 5 chronic kidney disease population.

Background/aims: Both severe, uncontrolled and low parathyroid hormone (iPTH) levels are associated with adverse outcomes in stage 5 chronic kidney disease (CKD) patients; however, the impact of iPTH levels following parathyroidectomy (PTX) is unexplored.

Methods: A total of 235 stage 5 CKD patients who underwent PTX between 1990 and 2007 were identified, and iPTH levels following surgery were used to divide patients according to the quartile of maximum iPTH recovery during the 5 years following PTX. Survival, biochemistry and pharmacotherapy were analysed.

Dietary phosphate modulates atherogenesis and insulin resistance in apolipoprotein E knockout mice--brief report.

Objective: Epidemiological studies link higher serum phosphate and the phosphatonin fibroblast growth factor 23 with cardiovascular events and atheroma, and they link lower serum phosphate with insulin resistance and the metabolic syndrome. We investigated whether manipulating dietary phosphate influences atherogenesis or insulin sensitivity in mice.

Methods And Results: Apolipoprotein E knockout mice were fed an atherogenic diet with low (0.

Initial observations using a novel "cine" magnetic resonance imaging technique to detect changes in abdominal motion caused by encapsulating peritoneal sclerosis.

Encapsulating peritoneal sclerosis (EPS) is an uncommon complication of peritoneal dialysis (PD), with high mortality and morbidity. The peritoneum thickens, dysfunctions, and forms a cocoon that progressively "strangulates" the small intestine, causing malnutrition, ischemia, and infarction. There is as yet no reliable noninvasive means of diagnosis, but recent developments in image analysis of cine magnetic resonance imaging for the recognition of adhesions offers a way forward.

Controversies in the management of infective complications of peritoneal dialysis.

Peritoneal dialysis is an effective form of renal replacement therapy. Despite improvements in connection technology, peritoneal infection is still the most important preventable cause of patient morbidity and mortality. There has been a shift in focus from treatment to prevention of infection, but wide variation in peritonitis incidence across and within peritoneal dialysis populations remains.

The lampricide 3-trifluoromethyl-4-nitrophenol (TFM) uncouples mitochondrial oxidative phosphorylation in both sea lamprey (Petromyzon marinus) and TFM-tolerant rainbow trout (Oncorhynchus mykiss).

The toxicity of 3-trifluoromethyl-4-nitrophenol (TFM) appears to be due to a mismatch between ATP supply and demand in lamprey, depleting glycogen stores and starving the nervous system of ATP. The cause of this TFM-induced ATP deficit is unclear. One possibility is that TFM uncouples mitochondrial oxidative phosphorylation, thus impairing ATP production.

The effect of natural dissolved organic carbon on the acute toxicity of copper to larval freshwater mussels (glochidia).

The present study examined the effect of dissolved organic carbon (DOC), both added and inherent, on Cu toxicity in glochidia, the larvae of freshwater mussels. Using incremental additions of natural DOC concentrate and reconstituted water, a series of acute copper toxicity tests were conducted. An increase in DOC from 0.

The anatomy and pathology of the lesser sac: implications for peritoneal dialysis.

Pathological conditions involving the lesser sac of the peritoneal cavity in patients on peritoneal dialysis (PD) can pose significant diagnostic and therapeutic challenges. Lack of appreciation of these challenges may delay diagnosis and compromise outcome. A case series by Li and colleagues in this issue of Peritoneal Dialysis International highlights the diagnostic challenges presented by lesser sac infection in PD patients, and in this accompanying commentary we discuss the development and anatomy of the lesser sac, as well as the pathological conditions and investigations relevant to the management of patients on PD.

Polymorphisms in xenobiotic metabolizing enzymes and diet influence colorectal adenoma risk.

Objectives: We have earlier shown that diet and xenobiotic metabolizing enzyme genotypes influence colorectal cancer risk, and now investigate whether similar associations are seen in patients with premalignant colorectal adenomas (CRA), recruited during the pilot phase of the Scottish Bowel Screening Programme.

Methods: Nineteen polymorphisms in 13 genes [cytochrome P450 (P450), glutathione S-transferase (GST), N-acetyl transferase, quinone reductase (NQ01) and microsomal epoxide hydrolase (EPHX1) genes] were genotyped using multiplex PCR or Taqman-based allelic discrimination assays and analyzed in conjunction with diet, assessed by food frequency questionnaire, in a case-control study [317 CRA cases (308 cases genotyped), 296 controls]. Findings significant at a nominal 5% level are reported.

Influence of natural organic matter (NOM) quality on Cu-gill binding in the rainbow trout (Oncorhynchus mykiss).

Natural organic matter (NOM) in aquatic environments reduces metal toxicity to fish by forming metal-NOM complexes, which reduce metal bioavailability, metal-gill binding and toxicity. However, differences in the chemical composition of different types of NOM (quality) could also affect metal-NOM binding and toxicity. We predicted that Cu-gill binding would vary in trout exposed to Cu in the presence of NOM of different qualities.

Failure of ATP supply to match ATP demand: the mechanism of toxicity of the lampricide, 3-trifluoromethyl-4-nitrophenol (TFM), used to control sea lamprey (Petromyzon marinus) populations in the Great Lakes.

Although the pesticide, 3-trifluoromethyl-4-nitrophenol (TFM), has been extensively used to control invasive sea lamprey (Petromyzon marinus) populations in the Great Lakes, it is surprising that its mechanism(s) of toxicity is unresolved. A better knowledge of the mode of toxicity of this pesticide is needed for predicting and improving the effectiveness of TFM treatments on lamprey, and for risk assessments regarding potential adverse effects on invertebrate and vertebrate non-target organisms. We investigated two hypotheses of TFM toxicity in larval sea lamprey.

Inhibition of IGF-I receptor signaling in combination with rapamycin or temsirolimus increases MYC-N phosphorylation.

Background: It has been previously shown that blockade of the type 1 insulin-like growth factor receptor (IGF1R) signaling combined with mTOR inhibition decreased neuroblastoma proliferation in vitro. MYC-N inactivation occurs through phosphorylation by downstream elements of the IGF1R signaling pathway. It was hypothesized that inhibition of IGF1R signaling would increase the inactivation of MYC-N.

Peritoneal Dialysis Access -- Results from a UK Survey.

Objective: To obtain information about peritoneal dialysis (PD) access practices in the United Kingdom.

Methods: During July of 2007, a PD access survey was circulated to 80 clinical directors of renal units in the UK.

Results: Returns were received from 43 units; annual catheter insertion numbers ranging from 5 to 100 (median 34, mean 38) were reported.

Ammonia and urea transporters in gills of fish and aquatic crustaceans.

The diversity of mechanisms of ammonia and urea excretion by the gills and other epithelia of aquatic organisms, especially fish and crustaceans, has been studied for decades. Although the decades-old dogma of ;aquatic species excrete ammonia' still explains nitrogenous waste excretion for many species, it is clear that there are many mechanistic variations on this theme. Even within species that are ammonoteles, the process is not purely ;passive', often relying on the energizing effects of proton and sodium-potassium ATPases.

Impact of vitamin D dose on biochemical parameters in patients with secondary hyperparathyroidism receiving cinacalcet.

Background/aims: The calcimimetic cinacalcet (Mimpara/Sensipar) simultaneously lowers parathyroid hormone (PTH), phosphorus (P) and calcium (Ca) levels in patients with secondary hyperparathyroidism. The OPTIMA study demonstrated that cinacalcet and adjusted doses of vitamin D maximized control of these parameters. This post-hoc analysis of OPTIMA data assessed the impact of reducing or increasing the dose of concomitant vitamin D on PTH, P and Ca in patients receiving cinacalcet.

Iron-magnesium hydroxycarbonate (fermagate): a novel non-calcium-containing phosphate binder for the treatment of hyperphosphatemia in chronic hemodialysis patients.

Background And Objectives: This phase II study tested the safety and efficacy of fermagate, a calcium-free iron and magnesium hydroxycarbonate binder, for treating hyperphosphatemia in hemodialysis patients.

Design, Setting, Participants, & Measurements: A randomized, double-blind, three-arm, parallel-group study compared two doses of fermagate (1 g three times daily or 2 g three times daily with placebo). Sixty-three patients who had been on a stable hemodialysis regimen for > or =3 mo were randomized to the treatment phase.