Reduction of inflammation and chronic tissue damage by omega-3 fatty acids in fat-1 transgenic mice with pancreatitis

Pancreatitis is a severe debilitating disease with high morbidity and mortality. Treatment is mostly supportive, and until now there are no clinically useful strategies for anti-inflammatory therapy. Although omega-3 polyunsaturated fatty acids (n-3 PUFA) are known to have anti-inflammatory effects, the utility of these fatty acids in the alleviation of pancreatitis remained to be investigated. The aim of this study was to examine the effect of n-3 PUFA on both acute and chronic pancreatitis in a well-controlled experimental system. We used the fat-1 transgenic mouse model, characterized by endogenously increased tissue levels of n-3 PUFA, and their wild-type littermates to examine the effect of n-3 PUFA on both acute and chronic cerulein-induced pancreatitis. Disease activity and inflammatory status were assessed by both histology and molecular methods. In acute pancreatitis, fat-1 mice showed a trend towards decreased necrosis and significantly reduced levels of plasma IL-6 levels as well as reduced neutrophil infiltration in the lung. In chronic pancreatitis there was less pancreatic fibrosis and collagen content accompanied by decreased pancreatic stellate cell activation in the fat-1 animals with increased n-3 PUFA tissue levels as compared to wild-type littermates with high levels of omega-6 (n-6) PUFA in their tissues. Our data provide evidence for a reduction of systemic inflammation in acute pancreatitis and of tissue fibrosis in chronic pancreatitis by increasing the tissue content of omega-3 polyunsaturated fatty acids. These results suggest a beneficial potential for n-3 PUFA supplementation in acute and particularly chronic pancreatitis.     

Investigation of the significance of Oil Red O‐positive macrophage excess in bronchoalveolar lavage fluid during HIV infection

L. Lacoste‐Collin, G. Martin‐Blondel, C. Basset‐Léobon, V. Lauwers‐Cancès, D. d’Aure, J. Aziza, A. Berry, B Marchou, M.B. Delisle and M. Courtade‐Saïdi Investigation of the significance of Oil Red O‐positive macrophage excess in bronchoalveolar lavage fluid during HIV infection Objective: To assess the significance of increased levels of Oil Red O‐positive macrophages (ORO‐PM) in bronchoalveolar lavage fluids (BALFs) from HIV‐positive patients. Methods: Cytological data for seventy BALF samples from 66 consecutive HIV‐infected patients were analysed according to antiretroviral therapy regimen, presence of Pneumocystis jiroveci infection, blood CD4⁺T cell count, HIV‐1 viral load and plasma lipid levels. Non‐parametric tests were used to compare the values between groups. Results: The percentages of ORO‐PM were high in this group: 40% [6–80] (median [interquartile range]). They were positively correlated with the BALF total cell count, 21% [5–48.5] for <300 cells/mm³ and 60% [26.5–80] for >300 cells/mm³ (P < 0.01) but inversely correlated with the percentage of BALF lymphocytes, 50% [20–80] for <15% lymphocytes and 11.5% [2–47] for ≥15% lymphocytes (P < 0.01). Antiretroviral therapy with or without protease inhibitors, plasma lipid levels, HIV‐1 viral load, blood CD4⁺T cell count or presence of a Pneumocystis jiroveci infection were not correlated with the ORO‐PM status. Conclusion: Significantly increased numbers of ORO‐PM were correlated with high total cell counts and low lymphocyte counts in BALF, irrespective of disease activity or treatment. Extended work on a larger series of patients needs to be conducted.     

Alterations of alkaline phosphatase activity during adaptation of Escherichia coli to phosphite and hypophosphite

When Escherichia coli cells were grown in media containing either phosphite or hypophosphite as the sole source of phosphorus, they responded to this situation primarily in the same way as phosphatelimited cultures: The activity of alkaline phosphatase increased drastically, which under natural conditions would enable the cells to compklensatae for the shortage increased drastically, which under natural conditions would enable the cells to compensate for the shortage of phosphate. Subsequent transfers, however, resulted in a quite different response: While the phosphatase activity of phosphate-limited cells stays at a high derepressed level, its increase was followed by a gradual decline in organisms grown on phosphite or hypophosphite. After eight to ten transfers on these P-compounds, phosphatase activity was back to its initial, repressed, low level, indicating that the cells were fully adapted to these substrates. Adaptation to either PO ₃ ^3- or PO ₂ ^3- was completely abolished if the cells were again grown with PO ₄ ^3- as P-source, whereafter the entire process of adaptation had to be repeated. The observed adaptation pattern, reflected by the alterations of phosphatase activity, was qualitatively equal with PO ₃ ^3- and PO ₂ ^3- , but quantitatively different, because the response to hypophosphite gave much higher values than the increase obtained with phosphite.Phosphite-adapted cells are not simultaneously adapted to hypophosphite, but their response to the latter was less intense than observed after direct transfers from PO ₄ ^3- to PO ₂ ^3- . Adaptation to hypophosphite, however, led simultaneously to phosphite adaptation, so that these cells can utilize both P-compounds as a substitute for phosphate.     

Evaluation of an enzyme-linked immunosorbent assay (ELISA) for the detection ofCampylobacter jejuni antibodies,and comparison with a complement fixation test (CFT)

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection of total anti-Campylobacter immunoglobulins in human sera. In this assay disintegratedCampylobacter bacteria were used as the antigen. Absorption tests including other possibly enteropathogenic bacterial species showed that the ELISA system displayed a high immunological specificity forCampylobacter. Using this ELISA it was found that in about 80% ofCampylobacter patients theseCampylobacter antibodies are produced to almost maximal levels within 8 days after onset of disease, and that they may persist for at least 4 months. Indeed,Campylobacter antibodies were demonstrated at low levels in a large number of control sera. However, accepting an antibody titre of 1: 640 as indicative ofCampylobacter infection, the statistical sensitivity of the ELISA system was 77% and the specificity 95%. In an epidemiological survey a high association was demonstrated between the severity ofCampylobacter-related symptoms and antibody titre values. Assessment ofCampylobacter antibody titres by means of this ELISA and by a complement fixation test in 92 sera from index patients and contacts with and without symptoms showed a high association of results.     

Topography and identification of the parathyroid glands in the calf

There is considerable controversy in the literature concerning the topography of the parathyroid glands in the calf. In the present study, the position of the parathyroids III (external parathyroids) and of the parathyroids IV (internal parathyroids) was examined in 25 young calves, 10 veal calves and 5 adult oxen. Detailed data for the recognition and the collection of these glands are provided. The parathyroids III are well suited for removal in a fresh state, since they can readily be located. They are situated medial to the carotid bifurcation and ventrolateral to the vagus nerve, where the latter gives off the cranial laryngeal nerve. In all young calves and in most veal calves, they lie embedded in the sub-basilar portion of the thymus, from which they can usually be differentiated easily by their color. However, they should not be confused with lymph nodes and hemal nodes, which are located in the neighborhood. Light-microscopical substantiation is therefore advisable. The parathyroids IV are not suited for collection, since they cannot be distinguished macroscopically from the adjacent thyroid gland.     

Mediastinal parathyroidectomy with the da Vinci robot

Mediastinal parathyroid glands are often located in a position which is inaccessible through a cervical approach. Because of the significant morbidity of open surgery, the need for minimal invasive approaches is high. More recently, robotic systems have been introduced to refine the dissection and optimize the view in the mediastinal region. We present two cases. The first case is a 34-year-old woman who was diagnosed with primary hyperparathyroidism. Because a bilateral neck dissection disclosed no parathyroid adenoma, we performed a parathyroid sestamibi scan and computed tomographic scan of neck and mediastinum to look for aberrant parathyroid glands. Both showed a parathyroid adenoma in the mediastinum on the left side. The second case is a 66-year-old man. A sestamibi scan showed a parathyroid adenoma of 3 cm in the superior mediastinum which was confirmed by and computed tomographic scan. In both cases, we performed a parathyroidectomy with the da Vinci robotic system through a left-sided approach. Three thoracoports were inserted around the mammary gland for the robot and a fourth auxiliary port was positioned in between. Single-lung ventilation was installed, and the mediastinum was entered by opening the parietal pleura along the left phrenic nerve. The upper margin for dissection was the left brachiocephalic vein that was followed until the right pleura. All the tissue in front of the pericardium was dissected en bloc. The sinking test of the nodule and a preoperative frozen section analysis confirmed the diagnosis of parathyroid adenoma, which was also proven by rapid parathyroid hormone analysis. The resection of a parathyroid adenoma from the aortopulmonary window represents an ideal case for robotic surgery.