THE MANAGEMENT OF CHYLOTHORAX

Chylothorax is readily diagnosed from the characteristic qualities of the effusion. Treatment should initially be conservative, consisting of multiple aspirations followed, if necessary, by suction drainage.Approximately half of the patients will not respond to these measures, and direct ligation and division of the duct is necessary for cure. This operation is most readily carried out through the right chest, the thoracic duct being ligated just above the diaphragm. In cases in which the duct is surrounded by tumor, radiotherapy to the mediastinum is often successful in controlling the reaccumulation of chyle, but irradiation is generally not recommended until after a tissue diagnosis has been made by thoracotomy.Nutritional problems are often concomitants of chylothorax.     

IMPORTANCE OF CALORIC INTAKE DURING RENAL FAILURE

Loss of excretory function in acute renal failure results in the retention of catabolites and fluid. In the absence of available carbohydrate, endogenous fat and protein become the main caloric sources. This results in the rapid accumulation of keto acids and nitrogenous wastes. By providing readily available non-nitrogenous calories, protein catabolism is reduced, complete oxidation of fat is obtained and energy is provided to drive potassium into the intracellular compartment.The patient should be encouraged to eat despite his apathy, fear of vomiting and characteristically paranoid mood. Tube or parenteral feeding is complicated by the need to restrict fluid. Numerous small feedings are more successful than large meals. Hard candy and alcohol are often acceptable sources of calories, fat emulsions seldom. Oral hygiene aids feeding, and tranquilizers and anticholinergics are useful.If the patient does not take food by mouth, tube feeding may be carried out. Because of the bleeding tendency so often occurring in uremia, tube feeding may be contraindicated if it causes erosion of the pharynx or esophagus. Intravenous infusion of invert sugar, glucose and alcohol may be necessary if nutrition cannot be accomplished by other means.     

A new method for cannulation of the common bile duct in an experiment]

The proposed method of common biliary duct cannulation is simple, easily performed and permits studying bile hydrodynamics biligenesis for a necessary time. Tightness of the system is completely preserved after removal a choledochostomical tube. Walls of the invaginated stump of the cystic duct are swiftly abated as a result of hydrostatic pressure and cover its gap. The presence of purse string kapron suture in a stump orifice creates an obstacle to deinvagination. Good reparation properties of serous and subserous membranes, covering the biliary duct, promote rapid closing of stoma. Effectiveness of the proposed method of common biliary duct cannulation by means of the invaginated stump of the cystic duct is confirmed by the smooth postoperative course and absence of a biliary fistula after the tube removal.     

An improved, simple nest-box trap

ABSTRACT.   The success of ornithological studies often hinges on a researcher's ability to capture individuals quickly and efficiently. Sometimes it is necessary to capture the same individual multiple times, as is the case in many metabolic, ecotoxicological, and immunocompetence studies. Several methods of capturing cavity-nesting birds at their nest boxes have been described. However, these methods proved inefficient when attempting to catch wary individuals that had already been captured previously. Here we describe a simple and inexpensive method for capturing cavity-nesting birds using a square plate of sheet metal (5.8 × 5.8 × 0.2 cm), a drinking straw, a piece of duct tape, and a monofilament line. This method has the advantages of allowing selective capture of one, but not both members of a pair and being nearly invisible to trap-shy birds.     

Evaluating the potential efficacy of three antifungal sealants of duct liner and galvanized steel as used in HVAC systems

Current recommendations for remediation of fiberglass duct materials contaminated with fungi specify complete removal, which can be extremely expensive, but in-place duct cleaning may not provide adequate protection from regrowth of fungal contamination. Therefore, a common practice in the duct-cleaning industry is the postcleaning use of antifungal surface coatings with the implication that they may contain or limit regrowth. However, even the proper use of these products has generally been discouraged because little research has been conducted on the effectiveness of most products as used in heating, ventilating, and air-conditioning (HVAC) systems. Three different coatings were evaluated on fiberglass duct liner (FGDL). Two of the three coatings were able to limit growth in the 3-month study; the third did not. One of the coatings that was able to limit growth was further evaluated in a comparison of FGDL or galvanized steel (GS) under conditions that mimicked their use in HVAC systems. The results showed that both moderately soiled and heavily soiled uncoated FGDL and GS duct material can support fungal growth, but that GS duct material was more readily cleaned. The use of an antifungal coating helped limit, but did not fully contain, regrowth on FGDL. No regrowth was detected on the coated GS. Journal of Industrial Microbiology & Biotechnology (2002) 29, 38–43 doi:10.1038/sj.jim.7000261 Received 19 November 2001/ Accepted in revised form 29 March 2002     

A study of gonadal organogenesis,and the factors influencing regeneration following surgical castration in Deroceras reticulatum (Pulmonata:Limacidae)

Summary At hatching, the hermaphrodite duct of Deroceras reticulatum consists of a single cell type designated the Gonadal Stem Cell (GSC). Proliferation of the GSC leads to the formation of numerous ductules each of which forms one of the acini of the gonad. The germinal and supporting cells are derived entirely from the GSC. The germ cells differentiate first, followed by the Sertoli and follicle cells. At the early sperm stage of gonadal development the hermaphrodite duct differentiates to function as a seminal vesicle. Once the GSC are committed to this change they lose their regenerative ability. The only remaining GSC are the cells of the acinar epithelium, and these retain their germinal potential until the death of the animal.Regeneration will occur from the hermaphrodite duct provided it is in the immature state, i.e., composed of GSC, and is exposed to the hormonal conditions of a young animal. Nervous connections and the presence of an artery are not necessary for this regeneration. The presence of a functional gonad does not inhibit regeneration.     

ROUTINE CHOLANGIOGRAPHY DURING OPERATION FOR GALLSTONES

Cholangiography done routinely during operation was found valuable for detection of stones in the bile ducts. Operation for stone not seen in the operative cholangiogram was seldom necessary.When no stone is demonstrated, it seems proper to spare the patient the additional trauma of common duct exploration.     

Image analysis in fluorescence microscopy: bacterial dynamics as a case study

Fluorescence microscopy is the primary tool for studying complex processes inside individual living cells. Technical advances in both molecular biology and microscopy have made it possible to image cells from many genetic and environmental backgrounds. These images contain a vast amount of information, which is often hidden behind various sources of noise, convoluted with other information and stochastic in nature. Accessing the desired biological information therefore requires new tools of computational image analysis and modeling. Here, we review some of the recent advances in computational analysis of images obtained from fluorescence microscopy, focusing on bacterial systems. We emphasize techniques that are readily available to molecular and cell biologists but also point out examples where problem-specific image analyses are necessary. Thus, image analysis is not only a toolkit to be applied to new images but also an integral part of the design and implementation of a microscopy experiment.     

Mass spectrometry and tandem mass spectrometry,alone or after liquid chromatography,for analysis of polymerase chain reaction products in the detection of genomic variation

The availability of the sequences of entire bacterial and human genomes has opened up tremendous opportunities in biomedical research. The next stage in genomics will include utilizing this information to obtain a clearer understanding of molecular diversity among pathogens (helping improved identification and detection) and among normal and diseased people (e.g. aiding cancer diagnosis). To delineate such differences it may sometimes be necessary to sequence multiple representative genomes. However, often it may be adequate to delineate structural differences between genes among individuals. This may be readily achieved by high-throughput mass spectrometry analysis of polymerase chain reaction products.     

Elevated plasma IL-6 associates with increased risk of advanced fibrosis and cholangiocarcinoma in individuals infected by Opisthorchis viverrini

Opisthorchis viverrini is considered among the most important of the food-borne trematodes due to its strong association with advanced periductal fibrosis and bile duct cancer (cholangiocarcinoma). We investigated the relationship between plasma levels of Interleukin (IL)-6 and the risk of developing advanced fibrosis and bile duct cancer from chronic Opisthorchis infection. We show that IL-6 circulates in plasma at concentrations 58 times higher in individuals with advanced fibrosis than age, sex, and nearest-neighbor matched controls and 221 times higher in individuals with bile duct cancer than controls. We also observed a dose-response relationship between increasing levels of plasma IL-6 and increasing risk of advanced fibrosis and bile duct cancer; for example, in age and sex adjusted analyses, individuals with the highest quartiles of plasma IL-6 had a 19 times greater risk of developing advanced periductal fibrosis and a 150 times greater risk of developing of bile duct cancer than individuals with no detectable level of plasma IL-6. Finally, we show that a single plasma IL-6 measurement has excellent positive predictive value for the detection of both advanced bile duct fibrosis and bile duct cancer in regions with high O. viverrini transmission. These data support our hypothesis that common mechanisms drive bile duct fibrosis and bile duct tumorogenesis from chronic O. viverrini infection. Our study also adds a unique aspect to the literature on circulating levels of IL-6 as an immune marker of hepatobiliary pathology by showing that high levels of circulating IL-6 in plasma are not related to infection with O. viverrini, but to the development of the advanced and often lethal pathologies resulting from chronic O. viverrini infection.     

Salivary duct carcinoma of the parotid gland: report of a rare case with a comparative study of aspiration cytology and histomorphology

BACKGROUND: Salivary duct carcinomas affecting primarily the parotid gland are extremely rare (0.2-2% of all salivary gland tumors). These carcinomas are considered to be of high grade malignancy, with mortality in up to 70% of cases. They usually affect elderly males and less often young adults. Despite the fact that the histomorphologic characteristics of this tumor are always necessary for its classification, several authors have reported that the cytopathologic approach, using fine needle aspiration (FNA) cytology, can establish the final diagnosis. The aim of this paper is to present a rare case of salivary duct carcinoma of the parotid gland with no typical microscopic findings that was diagnosed by FNA cytology through a combination of techniques on biopsy material. CASE: A 56-year-old male presented with a right parotid mass measuring 6 cm in diameter. The mass appeared to expand subcutaneously and infiltrate the skin of the neck region. Biopsy material from both the mass and skin was obtained using FNA and processed with conventional, cell block and liquid-based cytology techniques. A core biopsy was also performed on the mass for histologic evaluation. CONCLUSION: The findings were consistent with a salivary duct carcinoma of the parotid gland and were confirmed by the histologic report. FNA cytology combined with such techniques as liquid-based cytology provides the potential for the final diagnosis. Liquid-based cytology can improve the cellular morphology of the material and allows immunocytochemistry and other diagnostic techniques. The application of such techniques is significantly restricted by conventional processing; thus, combining liquid-based cytology with other techniques expands the boundaries of cytology as a diagnostic test.     

Migration of gall stones.

The factors influencing the migration of gall stones are ill understood. Altogether 331 patients undergoing cholecystectomy were studied prospectively. The diameters of the cystic and common bile ducts and of stones in the gall bladder and bile ducts were measured. Increasing pressure was applied to the freshly excised gall bladder in an attempt to evacuate stones through the cystic duct. Stones passed in 33 (60.0%) of patients with choledocholithiasis, 45 (67.2%) of patients with pancreatitis, and 7 (3.2%) of patients without either pancreatitis or choledocholithiasis. Stones migrated in 6 (3.0%) who had a normal cystic duct diameter (less than or equal to 4 mm) and in 46 (32.5%) with a duct over 4 mm diameter. Common bile duct stones were often larger than the diameter of the cystic duct and when reintroduced into the gall bladder would not migrate. The passage of debris (less than or equal to 1 mm) through the cystic duct bore no relation to the presence or absence of choledocholithiasis or a dilated cystic duct. Small stones (1-4 mm diameter) must migrate to initiate and facilitate further migration; some must increase in size in the common bile duct. Increased biliary pressure consequently dilates the duct system retrogradely, allowing larger stones to follow. Patients at risk of stone migration and thereby pancreatitis and jaundice have large ducts that can be detected by ultrasound assessment.     

A new approach in the kinetics of biological transport the potential of reversible inhibition studies

Kinetic equations are derived for reversible inhibition of both active and facilitated transport systems for seven common experimental arrangements. It is shown that the unique features of transport kinetics may be exploited to give new kinds of information. It is also shown that the familiar rules of enzyme kinetics, though often applied to transport, can be seriously misleading. The analysis leads to the following general conclusions: (1) A competitive mechanism frequently gives rise to non-competitive kinetics, depending on the experimental design, but a non-competitive mechanism never produces competitive kinetics. (2) Inhibition studies on exchange diffusion at equilibrium in non-active systems or in the final steady state in active systems are the only unambiguous kinetic tests to distinguish competitive from non-competitive mechanisms. (3) Substrate analogs that are bound to the carrier and transported are readily distinguished by inhibition kinetics from those not transported, even though both may rapidly enter the cell by another route. (4) Even in non-active systems competitive inhibitors commonly have far different affinities for the substrate sites on the two membranes faces: where sufficient non-polarity allows their penetration into the cell, inhibition kinetics readily establish such sidedness in their action. (5) Inhibition kinetics of the mixed competitive and non-competitive type result from moderately asymmetrical binding of inhibitor at the substrate site. (6) Asymmetry is a necessary feature of active transport; hence studies of inhibition kinetics should provide important insights into its mechanism.     

Growth hormone and epidermal growth factor in salivary glands of giant and dwarf transgenic mice.

Epidermal growth factor (EGF) in rat salivary glands is regulated by testosterone, thyroxin, and growth hormone (GH). Salivary glands of 45-day-old giant and dwarf male and female transgenic mice were examined histologically and by immunohistochemistry (IHC) for EGF. Male giants showed no significant differences from wild-type (WT) parotid and submandibular glands. However, their sublingual glands expressed EGF diffusely and strongly in granular cells within the striated ducts, where they were not found in WT mice. Submandibular gland ducts of female WT were different, having individual granular cells strongly positive for EGF and distributed sporadically along the striated duct walls. Neither female GH-antagonist dwarf mice nor GH-receptor knockout mice had any granular cells expressing EGF in any gland. Obvious presence of granular duct cells in the sublingual glands of giant male mice suggests GH-upregulated granular cell EGF expression. Furthermore, absence of granular duct cells from all glands in female GH-antagonist and GH-receptor knockout transgenic mice suggests that GH is necessary for the differentiation of the granular cell phenotype in female salivary glands.     

The density of graptoloid skeletal tissue, and its implication for the volume and density of the soft tissue

It has been proposed by many authors that a mechanism is necessary to achieve neutral buoyancy in graptoloids. Calculations are given to show the range of densities needed for both soft and skeletal tissues to achieve this, and it is concluded that a large volume of soft tissue, containing low density fats, is the most likely mechanism. This is not readily compatible with the rhabdopleuran model of the graptolite mid.     

Use of PCR primers containing a 3'-terminal ribose residue to prevent cross-contamination of amplified sequences.

Cross-contamination with previously amplified products poses a serious limitation in the use of PCR for clinical testing and in certain research applications as well. In the present study we report the use of novel primers containing a 3'-terminal ribose residue to circumvent this problem. Extension of the primer by Taq DNA polymerase generates a cleavable ribonucleotide linkage within the amplified product. Cleavage of the primer by base or with a ribonuclease interferes with further replication of the product should carry over to another sample occur. Primers terminating in any of the 4 ribose residues function equally well as all DNA primers. Taq DNA polymerase is thus able to both efficiently extend and copy the single ribose residue. In translating from all DNA primers to ones containing a 3'-ribose residue no modification of the PCR protocol is required. The products formed can be used in all applications of the PCR. Since neither the original sample DNA, the primers or the extension products are modified by base or ribonuclease treatment both pre- and post-amplification sterilization can be carried out. Pre-amplification treatment with RNase A can yield as high as 10(4)-fold sterilization. Under these conditions the addition of beta-mercaptoethanol or other sulfhydryl reducing agent is necessary to inactivate the enzyme during thermocycling. Post-amplification treatment with NaOH readily yields at least 10(6)-fold sterilization. This alone is sufficient for most, if not all, applications of PCR. It is especially useful for quantitative RT-PCR, since the original target RNA sequence, which may be present in high copy numbers, is also destroyed.     

The importance of the spermathecal duct in bumblebees

The elongated spermathecal duct of bumblebees has been studied in hibernating queens, queens shortly after hibernation, mature egg-laying queens and uninseminated queens captured during summer, and workers. Only rather small size differences are found when comparing spermathecae of queens and workers. Clear differences between bumblebee queens and workers are found when comparing the histochemistry of the spermathecal ducts. Adult queens, regardless of age and reproductive status have spermathecal ducts that contain PAS positive material, whereas workers do not. It is suggested that the polysaccharides in the spermathecal ducts of queens are necessary as a source of energy for the rapid activation of spermatozoa passing through the duct prior to oocyte fertilization. An ultrastructural investigation revealed the presence of high glycogen content in the cells lining the duct of queens. Assuming that sperm cells are kept in a rather inactive state in the reservoir, the carbohydrate (glycogen) probably serves as an energy source for the sperm. The comparatively increased spermathecal duct length of bumblebees may increase the retention time of sperm inside the lumen.     

Evaluation of a reservoir in the main excretory duct of rat submaxillary gland.

Cannulation of salivary gland main excretory duct at its oral opening is routinely used for collecting fluid, in situ, from the luminally perfused duct, or saliva from the stimulated gland. For perfusion of the main excretory duct, in situ, or for saliva collection, rat submaxillary gland is often the organ of choice, since electrolyte transport occurs at high rates both in the whole gland and in the main excretory duct. Recently, it has been reported that there is a pouchlike dilatation of the main excretory duct at its oral end, and that this dilatation may serve as a fluid reservoir. Because of possible effects of such a reservoir on measurements of electrolyte transport by the whole gland or the main duct segment, the size and form of the reservoir have now been examined. For this, techniques of histology, radiography, and microcatherization were employed. It was found that, while the functional volume of the reservoir exceeds that of the main duct proper, the time needed for displacement of reservoir fluid by perfusate or saliva would probably be only on the order of 1-3 min at higher rates of saliva or perfusate flow. Therefore, if adequate allowance is made for equilibration time, collection of saliva or luminal perfusate by oral cannula seems justified.     

On detecting interactions between species in population dynamics

If we are to progress out of our current state of uncertainty about the role of interspecific competition in community structure, it is essential that we can distinguish competition from other types of population interaction, and from lack of interaction, in particular case studies. To make such distinctions, it is necessary to quantify the effect of species on each other. One way to do this is to calculate interaction coefficients, and another (only readily applicable in experimental systems) is to plot graphs of N against time and to contrast monocultures with mixed cultures. We show (1) that these methods often appear to give contradictory results, and (2) that the problems are most pronounced when one species has a low equilibrium population size in mixed culture. To resolve the question of whether an interspecific interaction is taking place (and if so, what kind of interaction), it is necessary to apply tests of significance which overcome the problems of serial correlation inherent in all long-term population experiments. We illustrate the use of such tests in the analysis of the results from an experimental Drosophiia system. In the past, this kind of test has generally not been applied, and this raises the question of whether some of the 'classic cases of competition' in the experimental literature were really competition at all.     

Ultrastructure of the kidney of a South American caecilian,Typhlonectes compressicaudus (Amphibia,Gymnophiona)

Summary The ultrastructure of the distal nephron, the collecting duct and the Wolffian duct was studied in a South American caecilian, Typhlonectes compressicaudus (Amphibia, Gymnophiona) by transmission and scanning electron microscopy (TEM, SEM). The distal tubule (DT) is made up of one type of cell that has a well-developed membrane labyrinth established both by interdigitating processes and by interlocking ramifications. The processes contain large mitochondria, the ramifications do not. The tight junction is shallow and elongated by a meandering course. The connecting tubule (CNT) is composed of CNT cells proper and intercalated cells, both of which are cuboidal in shape. The CNT cells are characterized by many lateral interlocking folds. The intercalated cells have a dark cytoplasm densely filled with mitochondria. Their apical cell membrane is typically amplified by microplicae beneath which a layer of globular particles (studs) is found. The collecting duct (CD) is composed of principal cells and intercalated cells, again both cuboidal in shape. The CD epithelium is characterized by dilated intercellular spaces, which are often filled with lateral microfolds projecting from adjacent principal cells. The apical membrane is covered by a prominent glycocalyx. The intercalated cells in the CD are similar to those in the CNT. The Wolffian duct (WD) has a tall pseudostratified epithelium established by WD cells proper, intercalated cells and basal cells. The WD cells contain irregular-shaped dense granules located beneath the apical cell membrane. The intercalated cells of the WD have a dark cytoplasm with many mitochondria; their nuclei display a dense chromatin pattern.Research fellow of the Alexander von Humboldt Foundation