bluuebunny/crossref_metadata_2025 huggingface dataset:
Cystic lymphangioma of the gall‐bladder: A case report
Authors: OHBA K. , SUGAUCHI F. , ORITO E. , SUZUKI K. , OHNO T. , MIZOGUCHI N. , KOIDE T. , TERASHIMA H. , NAKANO T. , MIZOKAMI M.
Published: March 2008

Intra‐abdominal cystic lymphangiomas are rare lesions that can be difficult to diagnose. We present a report of a patient with a giant multilocular cystic lesion in the abdomen. Ultrasonography and computed tomography scans of the abdomen revealed that the cyst had originated in the gallbladder fossa. There was some calcification and thickening of the cyst wall. Endoscopic retrograde cholangiopancreatography demonstrated a medially deviated common bile duct, an elongated cystic duct and an inferior compressed gallbladder. There was no apparent communication between the cyst and the biliary tract; however, an abdominal angiogram revealed that the lesion was supplied by a branch of the cystic artery. Histological findings obtained intra‐operatively were consistent with a cystic lymphangioma. Its characteristic histology was observed in the subserous layer of the gall‐bladder. This case is a rare instance of a cystic lymphangioma originating in the gall‐bladder.
Direct evidence of monocyte recruitment to inflammatory bowel disease mucosa
Authors: GRIMM MC , PULLMAN WE , BENNETT GM , SULLIVAN PJ , PAVLI P. , DOE WF
Published: March 2008

Alterations in phenotype and function of intestinal macrophages occur in inflammatory bowel disease (IBD) but it is unclear whether these changes result from the recruitment of circulating monocytes to the intestine or from proliferation of resident intestinal macrophages. We sought to demonstrate the arrival of blood monocytes, the precursors of macrophages, in IBD mucosa. Peripheral blood mononuclear cells were isolated from 23 patients with clinically active intestinal inflammation (13 Crohn's disease, eight ulcerative colitis, two infective colitis), then radiolabelled with 99mtechnetium (Tc)‐stannous colloid (n=13) or 111indium (In)‐oxine (n=10) before re‐injection and abdominal scanning. Four patients had demonstrable intestinal monocyte uptake using [99mTc]‐stannous colloid, while six [111In]‐oxine‐labelled monocyte scans were positive. Uptake sites correlated with actively inflamed regions. Patients demonstrating monocyte uptake had been treated with corticosteroids for a significantly (P < 0.02) shorter duration (median 3 vs 20 days) than those with negative scans. There was no significant difference between positive and negative scans for disease category, clinical or histological disease activity, or radioisotope used. Biopsies of inflamed mucosa from two patients suffering ulcerative colitis who had positive scans showed a high proportion of CD14‐positive macrophages, 4–9% of which contained autoradiographic grains. These results demonstrate that blood monocytes are recruited to the mucosa of actively inflamed bowel, and suggest that this process may be inhibited by corticosteroids. Moreover, the phenotype of the recently‐arrived monocytes indicates their susceptibility to stimulation by lipopolysaccharide, and suggests a mechanism for the continuing inflammation in the bacterial product‐rich milieu of IBD.
Interaction of Kupffer cells to splenic macrophages and hepatocytes in endotoxin clearance: Effect of alcohol
Authors: FUKUI HIROSHI , KITANO HIROYUKI , OKAMOTO YASUYUKI , KIKUCHI EIRYOU , MATSUMOTO MASAMI , KIKUKAWA MASAJI , MORIMURA MASAFUMI , TSUJITA SIGENOBU , NAGAMOTO ISSEI , NAKATANI TOSHIYA , TSUJII TADASU
Published: March 2008

An additional administration of high dose ethanol to chronic alcohol‐fed rats led to a decrease in endotoxin clearance and an increase in endotoxin accumulation in the spleen accompanied by an elevation of tumour necrosis factor (TNF) levels in the portal vein. Endotoxin uptake and TNF production by Kupffer cells (KC) and splenic macrophages in the chronic ethanol load rats were significantly greater than those in the control rats. When these cells were precultured in the medium containing 10 to 100mmol/L ethanol, the endotoxin uptake and TNF production of KC were decreased. However, this did not affect the endotoxin uptake and TNF production of splenic macrophages.

The hepatic production of endotoxin binding protein was increased when KC were preincubated in the medium containing ethanol and the resultant culture supernatant was added to the hepatocyte culture system. This endotoxin binding protein was proved to enhance the uptake of endotoxin and suppressed the production of TNF in the KC. When KC and hepatocytes were isolated from chronically alcohol‐fed rats, further addition of ethanol to the culture medium of KC did not affect the hepatic production of endotoxin binding protein. The increase in hepatic production of endotoxin binding protein may serve as a defence mechanism against endotoxicity. There is a possibility that an impairment of this defence mechanism has a pivotal role in the development of endotoxaemia and endotoxicity in chronic alcoholics.
Role of vitamin A in liver fibrosis
Authors: KNOOK DL , BOSMA A , SEIFERT WF
Published: March 2008

The relationship between vitamin A and liver fibrosis was studied with a CCl4‐induced fibrosis model in rats. Depending on the time of administration, vitamin A can potentiate or reduce fibrosis: when present during CCl4‐treatment parenchymal cell damage and fibrosis were enhanced, whereas vitamin A post‐treatment strongly reduced fibrosis. Enhanced fibrosis was also found in rats with low hepatic retinoid levels. Administration of ß‐carotene during CCl4‐treatment reduced several signs of fibrosis. The notion that liver retinoids play an important role in hepatic fibrogenesis is discussed.
New prolyl 4‐hydroxylase inhibitor reduces procollagen gene expression and enzyme‐altered lesions in rat liver cirrhosis
Authors: SAKAIDA ISAO , OKITA KIWAMU
Published: March 2008

A choline deficient l‐amino acid defined (CDAA) diet led to the development of liver cirrhosis in male Wistar rats after 16 weeks. A new prolyl 4‐hydroxylase inhibitor, 2,4‐pyridine dicarboxylic acid bis [(2‐methoxyethyl amide)] (HOE 077), prevented liver fibrosis in a dose‐dependent manner without a reduction in increased serum alanine aminotransferase and aspartate aminotransferase in parallel with a reduction in preneoplastic enzyme‐altered lesions stained with anti‐glutathione S‐transferase placental form antibody. HOE 077 reduced the increase in serum procollagen III peptide (PIIIP) in a dose‐dependent manner and in proportion to the reduction in mRNA expression of type III procollagen in the liver of rats fed a CDAA diet.
Apoptosis: A new mechanism of endothelial and Kupffer cell killing
Authors: TAKEI YOSHIYUKI , KAWANO SUNAO , NISHIMURA YOSHIYA , GOTO MORITAKA , NAGAI HIROTAKA , CHEN SHENG‐SONG , OMAE ATSUSHI , FUSAMOTO HIDEYUKI , KAMADA TAKENOBU , IKEDA KAZUO , KAWADA NORIFUMI , KANEDA KENJI
Published: March 2008

Kupffer cells (KC) become activated in response to lipopolysaccharide (LPS) and produce a variety of mediators. Among them, TNFα is known to injure the liver. Here we report that TNFα mediates apoptosis in KC and sinusoidal endothelial cells. After stimulation for 24 h with LPS (0‐10 μg/mL), apoptosis in KC detected by TUNEL TdT‐mediated dUTP‐biotin nick end labelling (TUNEL) increased in a concentration‐dependent manner (0 μg/mL, 12 ± 4%; 0.1 μg/mL, 36 ± 11%; 1.0 μg/mL, 65 ± 9%; 10 μg/mL, 78 ± 15%). In contrast, co‐incubation of endothelial cells with LPS‐stimulated KC resulted in a marked increase in TUNEL‐positive endothelial cells. TNFα antibody blocked apoptosis in both KC and endothelial cells. Apoptosis was observed in cells adjacent to or in contact with KC. Reducing transmembrane TNFα expressed on KC also led to a decrease in endothelial cell apoptosis, suggesting that transmembrane TNFα is implicated in the cell‐to‐cell contact mechanism of induction of apoptosis. Thus, TNFα mediates apoptosis in KC and endothelial cells.
Nitric oxide mediates mitochondrial dysfunction in hepatoma cells induced by non‐activated Kupffer cells: Evidence implicating ICAM‐1‐dependent process
Authors: KUROSE IWAO , EBINUMA HIROTOSHI , HIGUCHI HAJIME , YONEI YOSHIKAZU , SAITO HIDETSUGU , KATO SHINZO , MIURA SOICHIRO , ISHII HIROMASA
Published: March 2008

The metabolic changes in a rat hepatoma cell line, AH70 cells, after co‐culture with rat Kupffer cells (KC) were visualized and analysed using a fluorescence microscope equipped with a silicon intensified target camera and a laser scanning confocal microscopic system. Kupffer cells were isolated from male Wistar rats, and cultured without any stimuli. The non‐activated KC reduced the mitochondrial energization in the cocultured AH70 cells within 2 h, which was indicated by decreased rhodamine 123 (Rh123) fluorescence. Either Ng‐monomethyl‐l‐arginine or dexamethasone significantly attenuated the KC‐induced mitochondrial dysfunction in AH70 cells, suggesting the involvement of nitric oxide (NO) derived from inducible‐type nitric oxide synthase (iNOS). Administration of monoclonal antibody (mAb) directed against rat ICAM‐1 also prevented the decrease in Rh123 fluorescence. Electron microscopy revealed that the membrane‐to‐membrane attachment between KC and AH70 cells occurred within 2 h. A laser scanning confocal microscopic observation using mAb against ICAM‐1 presented that the ICAM‐1 expression on AH70 cells and KC increased after the co‐culture. It is therefore concluded that the KC‐mediated mitochondrial dysfunction of hepatoma cells largely depends on NO production by iNOS. Furthermore, the present study supports a scenario that the NO production and release from KC is triggered by the close contact with hepatoma cells through adhesion molecules such as ICAM‐1.
Activated liver macrophages in human liver diseases
Authors: YAMAMOTO KAZUHIDE , OHMOTO MASAKI , MATSUMOTO SEIJI , NAGANO TAKUYA , KOBASHI HARUHIKO , OKAMOTO RYOICHI , TSUJI TAKAO
Published: March 2008

Immunohistochemical analysis using monoclonal antibodies specific for cells of monocyte/macrophage lineage reveals that resident liver macrophages have a phenotype distinct from that of monocytes or activated liver macrophages. Liver macrophages consist of heterogeneous cell populations in maturation (matured 25F9‐positive and immature 25F9‐negative) but the ratio of two populations is constant in normal and diseased livers. The expression of CD 14 is down‐regulated in resident liver macrophages as compared to that in monocytes, while the expression of 25F9 is up‐regulated. On the other hand, the expressions of CD 14 and Fc γ RI are up‐regulated in activated liver macrophages in viral and autoimmune hepatitis. In vitro culture of monocytes in medium without cytokines induces the phenotype similar to that of resident liver macrophages. Addition of macrophage‐colony stimulating factor or interferon‐γ into the culture medium induces the expression of Fc γ RI, the phenotype of which resembles that of activated liver macrophages. These results suggest that liver macrophages consist of heterogeneous cell populations and that both phenotype and function are affected by the local milieu of cytokines.
Dual role of Kupffer cell activation and endothelial cell damage in reperfusion injury to livers stored for transplantation surgery
Authors: LEMASTERS JOHN J , PENG XING‐XI , BACHMANN SIGRID , CURRIN ROBERT T , GAO WENSHI , THURMAN RONALD G
Published: March 2008

In rat models of liver preservation, the primary event leading to liver graft failure after cold storage is a reperfusion injury causing damage to sinusoidal endothelial cells and activation of Kupffer cells (KC). After storage for longer than 16 h in University of Wisconsin solution, reperfusion induces rapid endothelial cell killing. Kupffer cell activation also occurs as indicated by cell surface ruffling, degranulation, release of hydrolytic enzymes, generation of oxygen radicals, and increased phagocytosis. Down‐regulation of KC activity with nisoldipine or pentoxifylline improves graft survival. Moreover, pretreatment of donors with small amounts of endotoxin to activate KC causes a drastic reduction of graft survival. Together, KC activation and endothelial damage cause marked microcirculatory disturbances after transplantation characterized by reduced and uneven blood flow and increased leucocyte and platelet adhesion. Such events culminate in inflammation, necrosis and fulminant graft failure. Modification of reperfusion conditions can reduce the extent of injury. In particular, flushing livers with Carolina rinse solution (CRS) at the end of storage reduces endothelial cell killing, suppresses KC activation, improves the microcirculation, and increases graft survival. Active ingredients in CRS include antioxidants (allopurinol, desferrioxamine and glutathione), adenosine and slightly acidic pH (6.5). Other potentially important ingredients are nicardipine, a calcium channel blocker, and fructose, glucose and insulin to promote glycolysis. The cytoprotective amino acid, glycine, further improves the performance of Carolina rinse solution. Reperfusion‐induced changes to nonparenchymal cells play an essential role in damage to livers preserved for transplantation surgery. Understanding the role of sinusoidal endothelial cells and KC in this injury has led to promising new strategies to prolong organ storage and reduce graft failure.
Serum ferritin: Does it differ from tissue ferritin?
Authors: LINDER MARIA C. , SCHAFFER KENNETH J. , HAZEGH‐AZAM MARYAM , ZHOU CECILIA YJ , TRAN TUE N. , NAGEL GLENN M.
Published: March 2008

Serum ferritin isolated from the horse was structurally compared with horse spleen ferritin and was found to differ markedly in molecular weight, iron content, carbohydrate, subunit size and amino acid sequence. The results are summarized and initial results obtained with candidate clones of pieces of two serum ferritin subunits are described
Alcohol and iron: One glass of red or more?
Authors: FLETCHER LINDA M.
Published: March 2008

The consumption of excessive amounts of alcohol affects human iron homeostasis and an association of iron overload and heavy alcohol consumption has been recognized for many years. Both major proteins of iron metabolism, ferritin and transferrin, are affected by alcohol. Increased hepatic iron levels are seen in a high proportion of alcoholic subjects, sometimes causing confusion in diagnosis between alcoholic liver disease and iron‐overload disease. The pattern of deposition of this iron in alcoholics, however, differs from that seen in the iron‐overload disease haemochromatosis. Excessive alcohol consumption causes transferrin to become carbohydrate deficient, which allows it to be used as an efficient biochemical marker of alcohol abuse. It is concluded that alcohol consumption in moderation is unlikely to have deleterious health consequences.
Complications and outcome of percutaneous endoscopic gastrostomy in different patient groups
Authors: CHOWDHURY MOSIUDDIN A. , BATEY ROBERT
Published: March 2008

A retrospective study of percutaneous endoscopic gastrostomy (PEG) was performed to evaluate the complications of PEG and determine the role of prophylactic antibiotics in preventing early wound infection and to evaluate the outcome of patients in different groups (neurological disease, head injury, AIDS). Percutaneous endoscopic gastrostomy was performed on 50 patients between March 1991 and November 1993 and the survey was completed in July 1994. The average time to PEG placement post‐cerebrovascular accident or head injury was 5 weeks. No deaths were attributable to the procedure. Four of 50 (8%) patients died in the first 30 days (early mortality). Wound infection (early eight, late five) was the most common complication: two of 13 patients receiving prophylactic antibiotics and six of 37 not receiving antibiotics had early wound infection. At completion of follow‐up 19 of 26 patients with neurological disease had died (median survival = 370 days), three resumed oral feeding and four continued PEG feeding. All head injury patients (n= 6) were alive and had resumed oral feeding; five returned home. All AIDS patients (n= 7) died within 12 months (median survival = 138 days), although improved nutritional state was found after gastrostomy feeding. In conclusion, PEG placement is a useful procedure to assist feeding in multiple patient groups. Wound infection is a common but not life threatening complication. The need for prophylactic antibiotics to prevent early wound infection has not been proven. The 5 week delay in PEG insertion may contribute to lower early mortality. The 100% survival rate in head injury patients may reflect their young age and absence of underlying medical illness. In AIDS patients, improved nutritional state is not known to translate into better quality of life or prolonged survival.
Method for quantitative assessment of transformation of non‐micellar cholesterol carriers in model bile systems*
Authors: YAMASHITA YOSHIFUMI , TAZUMA SUSUMU , KAJIYAMA GORO
Published: March 2008

Aggregation and fusion of non‐micellar particulate species, such as unilamellar vesicle and phospholipid lamellae, are believed to precede the nucleation of cholesterol crystals in bile. However, little is known about the time sequence relationship between transformation of non‐micellar particles and the initial appearance of cholesterol crystals, as no adequate technique is available for assessing such transformations quantitatively. We have developed a novel method for quantitatively estimating vesicle transformation in supersaturated model bile systems, using a spectrophotometric technique to determine the time sequence relationship between such transformations and cholesterol crystal nucleation. We also investigated the potency of a given effector substance on this transformation. This method permits simultaneous quantitative determination of vesicle aggregation and of cholesterol crystal growth. Maximal vesicular aggregation as determined from turbidity, coincided with initiation of cholesterol crystal nucleation. The addition of divalent cations, Ca2+ and Mg2+, to the model bile solutions promoted vesicle aggregation and cholesterol crystal nucleation and growth. In contrast, apolipoproteins A‐1 and A‐2 retarded such processes. These data were highly reproducible and reliable. The method described is easy to perform, provides reproducible results and permits the determination of the potency of effector substances on vesicle transformation and on the nucleation of cholesterol crystals.
GASTROINTESTINAL HAEMORRHAGE
Authors: YACHHA SK , KHANDURI A. , SHARMA BC , KUMAR M.
Published: March 2008

Abstract  We prospectively evaluated 139 consecutive children presenting to the Sanjay Gandhi Postgraduate Institute of Medical Sciences (Lucknow, India) with gastrointestinal (GI) bleeding from January 1991 to November 1994. Our aims were to find out whether the causes of GI bleeding in a developing country differed from developed countries and how the application of newer diagnostic techniques would help in the diagnosis of GI bleeding. Barium studies, endoscopy, technetium‐99m‐labelled (erythrocytes and pertechnetate) scans, selective abdominal angiography using a digital subtraction technique and rectal endoscopic ultrasonography were performed. Upper GI bleeding (n = 75) was variceal in 71 (95%) children (extrahepatic portal venous obstruction in 65, cirrhosis in six) and non‐variceal in four (5%) cases (Henoch‐Schonlein purpura, idiopathic thrombocytopenic purpura, drug‐induced gastric erosions and pseudoaneurysm of the gastroduodenal artery due to idiopathic chronic calcific pancreatitis). Causes of lower GI bleeding (n= 64) were colitis (27 cases; 42%), colorectal polyps (26 cases; 41%), enteric fever (n = 3), solitary rectal ulcer (n = 3), portal hypertensive colopathy (n = 2), colonic arteriovenous malformation (n= 1) and internal haemorrhoids (n = 1). One patient remained undiagnosed. Angiography performed in four children was diagnostic in two. In one child with massive lower GI bleeding from portal colopathy, the bleeding site (caecum) was localized by intra‐operative colonoscopy, while in the other child with portal colopathy, rectal endoscopic ultrasonography was performed to substantiate the diagnosis. We conclude that the causes of upper GI bleeding in children in developing countries are different from those in developed countries (variceal bleeding due to extrahepatic portal venous obstruction is the most common cause, while peptic ulcer is rare). However, the spectrum of lower GI bleeding is similar to that of developed countries. Application of newer diagnostic techniques is helpful and safe in the identification of the cause of GI bleeding in children.
Case Report: Pneumomediastinum and pneumothorax complicating colonoscopy
Authors: TAM WILLIAM CE , POLLARD IAN , JOHNSON RICHARD D
Published: March 2008

Colonic perforation is potentially the most serious complication of colonoscopy. Both the clinical manifestation and rapidity of onset of symptoms can vary depending on whether the perforation occurs directly into the peritoneal cavity or into the retroperitoneal space. Colonic perforation is often associated with abdominal pain, although more uncommon presentations have been documented. A case report of a unilateral pneumothorax and pneumomediastinum complicating colonoscopy is described, which responded well to conservative measures without recourse to surgical intervention, antibiotic therapy or parenteral alimentation.
Do non‐steroidal anti‐inflammatory drugs cause duodenal ulcer? Evaluation of basal acid output and ulcer complications
Authors: COLLEN MARTIN J. , ABDULIAN JOHN D.
Published: March 2008

Non‐steroidal anti‐inflammatory drug (NSAID) use and basal acid outputs determined by nasogastric suction were evaluated prospectively in 184 patients with endoscopically documented duodenal ulcer. The mean basal acid output and percentage of gastric acid hypersecretion for duodenal ulcer patients who used NSAID were compared with duodenal ulcer patients who did not use NSAID to determine whether patients using NSAID who develop duodenal ulcer have basal acid outputs in the normal range or in the duodenal ulcer range. Results were compared with 65 normal subjects and 105 patients with nonulcer dyspepsia. There were no significant differences with regard to the percentage of male gender, mean age, mean basal acid output, percentage of gastric acid hypersecretion and percentage of cigarette smoking history between duodenal ulcer patients who used NSAID and duodenal ulcer patients who did not. However, significant differences were observed between duodenal ulcer patients who used NSAID and duodenal ulcer patients who did not use NSAID with regard to the percentage of bleeding duodenal ulcer (59 compared with 23%;p= 0.0008) and the percentage of patients with giant duodenal ulcer (41 compared with 5%;P= 0.00001). These results suggest that NSAID use does not cause duodenal ulcer but does make pre‐existing duodenal ulcer worse by causing duodenal ulcer complications.
Case Report: Gastrointestinal tuberculosis simulating Crohn's disease
Authors: KAUSHIK SP , BASSETT ML , McDONALD C. , LIN BPC , BOKEY EL
Published: March 2008

A male Caucasian presented with abdominal pain and a right iliac fossa mass. There were no risk factors for Mycobacterium tuberculosis infection. He was investigated by upper and lower gastrointestinal endoscopy, chest and small bowel radiology. The latter showed stricturing of the third and fourth parts of the duodenum, mid‐jejunum and terminal ileum. Biopsies were non‐specific and he was thought to have Crohn's disease. Subsequent treatment with corticosteroids resulted in improved well being and weight gain; however, the patient demonstrated disease progression with the development of complex fistulae and Escherichia coli septicaemia. At surgery the patient was found to have an ileal inflammatory mass with fistulae to the sigmoid colon. The terminal ileum, fistulae and a segment of colon were resected. Treatment with anti‐tuberculous drugs ensued and the patient is now asymptomatic after 15 months of follow‐up. This case serves to highlight the difficulty in making the diagnosis of gastrointestinal tuberculosis, a disease that may mimic Crohn's disease, and the need for caution in the use of corticosteroids in any disease in which tuberculosis enters into the differential diagnosis. The role of surgery in making the diagnosis and managing the complications, in conjunction with anti‐tuberculous drugs, and the prospect of cure are exemplified by this case.
Liver and Bone
Authors: NAKANO ATSUSHI , KANDA TSUTOMU , ABE HIROKO
Published: March 2008

Abstract  To investigate the pathogenesis of hepatic osteodystrophy (HOD) in parenchymal liver disease, we developed a laboratory model in animals using carbon tetrachloride (CCl4) and thioacetamide. Biochemical and histological parameters in the model were measured. In rats with both chronic non‐cirrhotic liver injury and CCl4‐induced cirrhosis, tibial bone volume was significantly lower than in controls. In CCl4‐treated cirrhotic rats, the osteoid volume decreased while the urinary calcium/creatinine ratio increased. In all CCl4‐treated rats, bone volume was significantly correlated with both the serum albumin concentration and the number of goblet cells reflecting intestinal villous atrophy. The serum concentration of vitamin D metabolites was not correlated with bone volume. Whole body retention of 47Ca was significantly lower in CCl4‐treated cirrhotic rats than in controls. Furthermore, the bone volume in thioacetamide‐treated cirrhotic rats was significantly lower than in controls. These data demonstrate that chronic parenchymal liver injury itself causes osteoporosis (i.e. HOD) due to a combination of low bone formation rates and high resorption rates, that HOD begins at the stage of chronic non‐cirrhotic liver injury, that bone volume in HOD parallels liver damage and that the principal pathogenesis of HOD seems to be intestinal Ca malabsorption due to lower serum albumin and villous atrophy, while serum levels of vitamin D metabolites have little influence on the pathogenesis of HOD.
Sedation for Endoscopy
Authors: BALSON KR , MORGAN DJ , RICHMOND BH , McALINDON ME , ELLIOTT SL , YEOMANS ND
Published: March 2008

Abstract  In order to examine the investigators' clinical suspicion that Vietnamese patients were more sensitive to the sedative effects of midazolam than were Caucasians, the pharmacokinetics of a single, weight‐adjusted intravenous dose of midazolam (0.05 mg/kg) were compared in a group of healthy Caucasian and Vietnamese male volunteers. The Vietnamese group (n=8) had a significantly lower height, lean body mass and mean weight (59.8±5.5 vs 72.1±8.1 kg, respectively) compared with the Caucasian group (n=8). No significant differences were found between the Vietnamese and Caucasian groups with regard to distribution half‐life of midazolam (8.38±13.1 vs 1.49±0.63 min, respectively), elimination half‐life (2.49±1.80 vs 1.48±0.66 h, respectively), clearance (4.93±1.31 vs 5.90±2.12 mL/min per kg, respectively), steady state volume of distribution (0.863±0.497 vs 0.530±0.132 L/kg, respectively) or percentage of unbound drug in plasma (4.89±0.74 vs 4.11±1.08, respectively). This suggests that dosage of midazolam in Vietnamese should be based on total body‐weight. Two Vietnamese subjects who were brothers had marked elevation of distribution half‐life and initial volume of distribution and lesser elevations in elimination half‐life and volume of distribution at steady state. This suggests that the known subgroup of subjects who demonstrate dyshomogeneity in midazolam volume of distribution may be genetically determined.
CASE REPORT: Fibrosing cholestatic hepatitis after living related‐donor renal transplantation
Authors: WAGURI NOBUO , ICHIDA TAKAFUMI , FUJIMAKI RYOUKO , ISHIKAWA TORU , NOMOTO MINORU , ASAKURA HITOSHI , NAKAMARU TSUKASA , SAITOH AKIHIKO , ARAKAWA MASAAKI , SAITOH KAZUHIDE , TAKAHASHI KOUTA
Published: March 2008

A 43‐year‐old man underwent living related‐donor renal transplantation because of chronic renal failure in 1991. During the transplant period, both donor and recipient were seronegative for hepatitis B surface antigen (HBsAg). The donor was seropositive for antibody to hepatitis B surface antigen (anti‐HBs) due to hepatitis B virus (HBV) vaccination. After transplantation, FK506 and methylprednisolone had been administered to the patient as immunosuppressants. In 1993, HBsAg appeared in his serum. His alanine aminotransferase level elevated gradually during 1995 and then in 1996, general fatigue, ascites and jaundice developed. At this time his serum was positive for hepatitis B e antibody, contained more than 100000 Meq/mL HBV‐DNA and 100% precore mutant. Despite subsequent intensive therapy, liver dysfunction progressed and this patient died of hepatic failure 2 months following admission. At autopsy, the liver exhibited cholestasis, fibrosis extending from the portal tracts, mild inflammation and hepatocytes with a ground‐glass appearance. In addition, HBsAg and hepatitis B core antigens had accumulated in the hepatocytes. Consequently, the final diagnosis was fibrosing cholestatic hepatitis (FCH) due to precore mutant HBV infection contracted after renal transplantation. It is unclear when and where the recipient liver became HBV infected. Nevertheless, after renal transplantation, while receiving immunosuppressive drugs, HBV appeared to have the potential to cause hepatic failure and FCH may have been a fatal complication for the recipient.
Imaging of follicular dendritic cell tumours of the liver
Authors: PEH WILFRED CG , SHEK TONY WH , NG IRENE OL , LO CHUNG‐MAU , FAN ST , NGAN HENRY
Published: March 2008

Follicular dendritic cell tumour of the liver is a recently recognized entity. To date, only two cases have been described, both in the pathology literature. Histologically, it resembles an inflammatory pseudotumour and immunohistochemical and ultrastructural studies are required for its diagnosis. The ultrasound, computed tomography and angiographic features of two cases of follicular dendritic cell tumour of the liver are described in detail. One of the patients had multiple recurrences of this tumour. The imaging features are very similar to those of hepatocellular carcinoma. As follicular dendritic cell tumour is considered to be of low‐grade malignant potential, in contrast to the dismal prognosis for hepatocellular carcinoma, it is important to be able to accurately distinguish between the two types of tumour prior to initiating definitive therapy.
Treatment of severe forms of alcoholic hepatitis: Where are we going?
Authors: Mathurin Philippe , Louvet Alexandre , Dharancy Sébastien
Published: March 2008

Alcoholic hepatitis (AH) is observed in approximately 20% of heavy drinkers. The treatment of AH remains one of the main challenges to clinicians involved in the management of severe alcoholic liver disease. Corticosteroids improved the short‐term survival of patients with severe AH. Nevertheless, the efficacy of corticosteroids is still considered controversial for some authors. Pentoxifylline may be considered an alternative to corticosteroids. Early identification of subjects with substantial risk of death according to the Lille model will improve management of patients suffering from severe AH and will aid in the design of future studies for alternative therapies. Alternative therapies are required to improve the prognosis of patients with a severe form of AH. Progress in understanding the pathogenesis of AH is opening up an exciting new era and is lending impetus to future evaluation of new drugs targeting the tumor necrosis factor pathways.
TALL GIRLS ASSESSMENT AND MANAGEMENT
Authors: WETTENHALL H. N. B. , ROCHE A. F.
Published: March 2008

SYNOPSIS

Many girls above the mean in stature become concerned about this when they are pubescent. A selected group of these girls has been treated successfully with stilboestrol to accelerate their skeletal maturation and thus reduce their adult stature. The selection of girls for treatment, and the sources of inaccuracy in estimating the effectiveness of treatment in individual girls are discussed.
Changing Land Tenure Arrangements and Access to Primary Assets under Globalization: A Case Study of Two Villages in Anglophone Cameroon
Authors: Menjo Baye Francis
Published: March 2008

Abstract:  This paper illustrates how, in relation to globalization, formal and informal land institutions are prone to generate conflict over land rights and examines the implications of such conflicts on security levels of access to primary assets for the poor in two villages in Cameroon — Vekovi and Ekona. The land laws in Cameroon are an outcome of its colonial heritage and exist alongside the communal tenure system. As the issue of land awareness comes to the fore, engendered partly by population pressure, relative price changes and the commoditization of land, conflicts develop: farmer–grazer conflicts in Vekovi, and farmer–farmer and indigenous people–state conflicts in Ekona. The rent‐seeking attitude of administrative and judicial authorities, who use inconsistencies in the dual tenure system, reduces the possibility of negotiating lasting solutions to land‐related conflicts in these villages. The social cost of this behaviour is not limited only to mutual distrust but also includes the opportunity costs of both time and financial resources mobilized by the parties in conflict to follow‐up legal procedures. The informal land tenure system generally operates in opposition to the national land laws in our case study villages, an atmosphere that generates or exacerbates conflict situations that create insecurity and restrict productivity‐enhancing investments. Land markets are more buoyant in Ekona, which is relatively more cosmopolitan and with farm‐to‐market roads that are fairly developed, than in Vekovi, which experiences net out‐migration and is poorly accessible. As a more homogenous society with strong traditional conventions, land transfer in Vekovi remains biased in favour of males, while Ekona enjoys gender neutrality in access to land. Conflict adjudication in the case study villages would be more legitimate if both formal and informal interpretations inform the land dispute settlement mechanisms.
REVIEWS
Authors: Comer David
Published: March 2008

Reported Miracles, by J. Houston, Cambridge University Press.
Intentions, Gestures, and Salience in Ordinary and Deferred Demonstrative Reference
Authors: MOUNT ALLYSON
Published: March 2008

Abstract:  In debates about the proper analysis of demonstrative expressions, ostensive gestures and speaker intentions are often seen as competing for primary importance in securing reference. Underlying some of these debates is the mistaken assumption that ostensive gestures always make the demonstrated object maximally salient to interlocutors. When we abandon this assumption and focus on an object’s mutually‐recognized salience itself, rather than on how the object came to be salient, we can work towards a more promising analysis with a uniform treatment of demonstrative reference whether or not there is an ostensive gesture, and whether reference is ordinary or deferred.
Cytoplasmic Dynein is Involved in the Retention of Microtubules at the Centrosome in Interphase Cells
Authors: Burakov Anton , Kovalenko Olga , Semenova Irina , Zhapparova Olga , Nadezhdina Elena , Rodionov Vladimir
Published: March 2008

Cytoplasmic dynein is known to be involved in the establishment of radial microtubule (MT) arrays. During mitosis, dynein activity is required for tethering of the MTs at the spindle poles. In interphase cells, dynein inhibitors induce loss of radial MT organization; however, the exact role of dynein in the maintenance of MT arrays is unclear. Here, we examined the effect of dynein inhibitors on MT distribution and the centrosome protein composition in cultured fibroblasts. We found that while these inhibitors induced rapid (t1/2 ∼ 20 min) loss of radial MT organization, the levels of key centrosomal proteins or the rates of MT nucleation did not change significantly in dynein‐inhibited cells, suggesting that the loss of dynein activity does not affect the structural integrity of the centrosome or its capacity to nucleate MTs. Live observations of the centrosomal activity showed that dynein inhibition enhanced the detachment of MTs from the centrosome. We conclude that the primary role of dynein in the maintenance of a radial MT array in interphase cells consists of retention of MTs at the centrosome and hypothesize that dynein has a role in the MT retention, separate from the delivery to the centrosome of MT‐anchoring proteins.
Clinical and neurological characteristics of aortic thromboembolism in dogs
Authors: Gonçalves R. , Penderis J. , Chang Y. P. , Zoia A. , Mosley J. , Anderson T. J.
Published: March 2008

Objectives:To characterise the clinical presentation and neurological abnormalities in dogs affected by aortic thromboembolism.

Methods:The medical records of 13 dogs diagnosed with aortic thromboembolism as the cause of the clinical signs, and where a complete neurological examination was performed, were reviewed retrospectively.

Results:The onset was acute in only four dogs, chronic in five dogs (with all of these presenting as exercise intolerance) or chronic with acute deterioration in four dogs. Dogs with an acute onset of clinical signs were more severely affected exhibiting neurological deficits, while dogs with a chronic onset of disease predominantly presented with the exercise intolerance and minimal deficits. The locomotor deficits included exercise intolerance with pelvic limb weakness (five of 13), pelvic limb ataxia (one of 13), monoparesis (two of 13), paraparesis (two of 13), non‐ambulatory paraparesis (two of 13) and paraplegia (one of 13). There was an apparent male predisposition and the cavalier King charles spaniel was overrepresented.

ClinicalSignificance:The rate of onset of clinical signs appears to segregate dogs affected by aortic thromboembolism into two groups, with different clinical characteristics and outcomes. Dogs with an acute onset of the clinical signs tend to be more severely affected, while dogs with a chronic onset predominantly present with exercise intolerance. It is therefore important to consider aortic thromboembolism as a differential diagnosis in dogs with an acute onset of pelvic limb neurological deficits and in dogs with longer standing exercise intolerance.
OVINE PREGNANCY TOXAEMIA. III. Further Evidence of the Correlation of Depth of Hypoglycaemia and Induction of Symptoms
Authors: McClymont G. L. , Setchell B. P.
Published: March 2008

Two further instances are presented of significantly lower blood glucose levels in underfed and fasted pregnant ewes which developed pregnancy toxaemia, in comparison with those that remained normal. There was no significant difference in blood ketone levels.

A high rate of spontaneous recovery, despite continued fasting, but associated with an increased blood glucose level, provides further evidence of the reversability of the encephalopathy of pregnancy toxaemia in early cases.

It is considered that the data provide additional support for the tentative identification of pregnancy toxaemia as a hypoglycaemic encephalopathy.
EXPERIENCES DURING THE FIRST EIGHT WEEKS OF LIFE OF HYPAR PIGLETS
Authors: Henry D. P.
Published: March 2008

An account is given of the rearing of 74 out of 104 (71%) HYPAR (hysterectomy procured artificially reared) piglets to the age of eight weeks. The classical hysterectomy hood (Young and Underdahl 1953) was used; and the piglets spent approximately two weeks in a newly designed constant temperature air‐conditioned rearing chamber where 82.6% survived. Descriptions follow of the piglets' diet, the methods ensuring initial sterility, and the growth performance and feed conversion of the piglets from two to eight weeks. The heaviest losses occurred after removal from the rearing chamber. It is suggested that factors related to this are low body weight and evaporative cooling. If piglets weigh at least 5 lb before entering a free environment, and remain warm and dry, they are likely to survive.
CLINICAL AND PATHOLOGICAL STUDIES OF BORDER LEICESTER RAMS NATURALLY INFECTED WITH ACTINOBACILLVS SEMINIS
Authors: Baynes I. D. , Simmons G. C.
Published: March 2008

Clinical examination of 31 rams with evidence of Actinobacillus seminis infection revealed 15 cases with marked lesions of the scrotal contents, two cases with very mild lesions, one with testicular atrophy but no abnormality of the epididymides, and another 13 without any palpable abnormalities of the genitalia. The rams were from a Border Leicester flock and included 27 un‐mated rams from 6 to 12 months old.

Histological examinations of affected epididymides showed a mixed purulent and non‐purulent inflammation, with cystic hyperplasia of the ductus epididymis. Interstitial fibrosis and spermatic granulomas were seen in chronic lesions. Bilateral testicular atrophy and seminal degeneration were found in the nine rams that were autopsied. The clinical and pathological features of the disease are similar to those of ovine brucellosis. A pyelonephritis of unknown significance was found in four of the nine rams examined.
RANULA IN THE DOG–A SURGICAL TREATMENT
Authors: Prescott C. W.
Published: March 2008

A surgical treatment of ranula in the dog is described. The main features is the insertion of a stainless steel wire loop in a drainage incision. A permanent sinus or artificial puncta is hereby produced. The adaptability of this technique is illustrated in the two unusual cases presented.
SCROTAL ABNORMALITIES IN RAMS IN TROPICAL QUEENSLAND WITH PARTICULAR REFERENCE TO OVINE BRUCELLOSIS AND ITS CONTROL
Authors: Murray R. M.
Published: March 2008

Clinical conditions affecting the reproductive organs were found affecting 17.2% of 2,332 rams. The following conditions were found: epididytimis 69.4%, atrophy 15.4%, varicocoele 9.5%, hernia 2.9%, cryptorchidism 1.2%, and hydrocoele 1.5%. The incidence of Brucella ovis antibodies as determined by the CF test in 2,332 rams from 12 flocks in north western Queensland was found to be 18.3%.

The age distribution of ovine brucellosis among 1,772 rams whose ages were known was as follows: 1 year 2.1%, 2 years 10.4%, 3 years 15.9%, 4–7 years 21.8%, and over 7 years 24.4%. The age incidence of all the various clinical conditions as they affected the 1,772 rams was: 1 year 3.6%, 2 years 8.4%, 3 years 13.1%, 4–7 years 28.4%, and over 7 years 27.9%.

Control of brucellosis in two flocks is reported and a possible means of control of this disease in Queensland is discussed.
THE BACTERIOLOGY OF CERVICAL MUCUS OF EWES AT OESTRUS FOLLOWING TREATMENT WITH FLUORO‐PROGESTAGEN IMPREGNATED INTRAVAGINAL SPONGES
Authors: Quinlivan T. D.
Published: March 2008

The presence of an intravaginal sponge impregnated with the fluoro‐progestagen is responsible for an alteration in the bacterial flora of cervical mucus of the ewe at the first oestrus following withdrawal. There is an increase in the number of coliform organisms, specifically E. coli, Alcaligenes spp and other Gram negative bacteria, and C. pyogenes, probably through contamination of the string by facees and urine and the actual presence of an intravaginal foreign body.
COBALT PELLETS AND HELZOTROPIUM EUROPAEUM POISONING IN PENNED SHEEP
Authors: LANIGAN G. W. , WHITTEM J. H.
Published: March 2008

Twenty‐five sheep in single pens were fed for up to 16 months a ration containing up to 40% (air dry weight basis) of Heliotropium europaeum.

Thirteen of these sheep had two cobalt pellets administered into their rumen before commencement of feeding. The other twelve sheep constituted the control group and were not treated in any way.

The sheep in both groups developed the characteristic live pathology of chronic pyrrolizidine alkaloidosis to varying degrees.

The median chronic lethal oral dose of Heliotropium europaeum alkaloids for sheep was found to be 23–33 g/kg body weight, expressed as heliotrine equivalent. This is 15–20 times the established mean total lethal parenteral dose of heliotrine when chronically administered to rats.

Prior administration of cobalt pellets did not reduce morbidity or mortality rate. Thus it is concluded that cobalt pellets are unlikely to be an effective prophylactic agent for sheep exposed to H. europaeum grazing.

This finding is discussed in relation to present knowledge of pyrrolizidine alkaloid metabolism in the rumen.
HYDATIDOSIS AND CYSTICERCOSIS — 3. INDUCED RESISTANCE TO THE LARVAL PHASE
Authors: Gemmell M. A.
Published: March 2008

Lambs from birth were reared in a tapeworm‐free environment or on pasture contaminated with eggs of Taenia hydatigena. An examination for cysts at autopsy of some of the latter at 3 months of age revealed that they had ingested eggs.

Eggs of T. hydatigena and T. ovis were fed at 6 months of age to lambs reared in the tapeworm‐free environment and to some of those reared on the pasture. By comparing the number of cysts established at 9 months of age in the animals of each group, it was determined that those reared on the pasture had acquired some resistance to superinfection with T. hydatigena and infection with T. ovis.

The remaining animals reared on the pasture were immunised (hyperimmunised) at 3 months of age by a parenteral injection of the eggs or embryos of T. hydatigena or T. ovis or both species. These animals were subsequently fed with the eggs of both species at 6 months of age. An examination of them for cysts at 9 months of age suggested that those immunisation procedures using the homologous organisms increased the resistance already acquired to superinfection with T. hydatigena and possibly also to that acquired to T. ovis. In addition, three of the procedures using homologous organisms appeared to induce regression of any cysts established from eggs of T. hydatigena ingested from the pasture prior to hyperimmunisation.
THE ACTION OF PHENANTHROLINE METAL CHELATES AND RELATED SUBSTANCES ON ERYSIPELOTHRIX RHUSIOPATHIAE AND FUSIFORMIS NODOSUS
Authors: Cade Gina , Cohen Margaret , Shulman A.
Published: March 2008

Metal chelates, quaternary salts and hydrochlorides of 3,4,5,‐tetramethyl‐1,10‐phenanthroline are bactericidal to E. rhusiopathiae and F. nodosus; for the metal chelates, the rank order of speed of bactericidal action against E. rhusiopathiae is Cu(II) > Fe(Ii) = Ni(II) ≥ Ru(II) > Zn(II) > Mn(II) = Co(II). E. rhusiopathiae does not develop significant resistance to the Cu(II) chelate. The unusual susceptibility of F. nodosus to the Co(II) chelate and the possible uses of such metal chelates in veterinary practice are discussed.
PRENATAL LOSSES IN BORDER LEICESTER‐MERINO CROSS EWES IN VICTORIA
Authors: Cannon D. J. , Bath J. G.
Published: March 2008

Systematic observations of the incidence of failure to mate, return to service, failure to lamb, and twin births in Border Leicester X Merino ewes were made in north eastern Victoria on 1,276 maiden ewes of five flocks and on 193–138 ewes of one of these flocks in a further six consecutive years.

Almost all ewes mated when joined with rams in summer, and of these 80–97% lambed and 3–17% bore twins. Mean minimum wastage of ova varied from 9 to 35% in the different flocks. More twins were born to older ewes, but in other aspects of reproductive performance there was little difference between maiden and older ewes.
RUPTURED BILE DUCT IN A DOG
Authors: Watson A. D. J. , Porges W. L.
Published: March 2008

Traumatic rupture of the bile duct was diagnosed in a dog which showed depression, anorexia, loss of weight and abdominal distension two weeks after a road accident. The diagnosis was indicated by the finding of a bilestained inflammatory exudate in the abdomen.