By preventing tumor ingrowth and migration, covered SEMSs with an anti-migration system had a longer duration of patency than uncovered SEMSs, which recommends their use in the palliative treatment of patients with biliary obstruction due to pancreatic carcinomas.

To investigate the cause of disagreement within the large body of literature concerning the effect of exercise on the capacity of circulating neutrophils to produce reactive oxygen species (ROS), 10 male endurance-trained athletes underwent maximal exercise. The generation of superoxide radical (O2-.) by neutrophils was first detected on a cell-by-cell basis by using histochemical nitro blue tetrazolium tests performed directly on fresh unseparated blood, which showed that responsive neutrophils under several stimulatory conditions relatively decreased after exercise. Similarly, O2-. detected with bis-N-methylacridinium nitrate (lucigenin)-dependent chemiluminescence (CL) of a fixed number of purified neutrophils on stimulation with opsonized zymosan was decreased slightly after exercise. In contrast, the 5-amino-2,3-dihydro-1,4-phthalazinedione (luminol)-dependent CL response of the neutrophils indicative of the myeloperoxidase (MPO)-mediated formation of highly reactive oxidants was significantly enhanced after exercise. It therefore suggests that the pathway of neutrophil ROS metabolism might be forwarded from the precursor O2-. production to the stages of more reactive oxidant formation due to the facilitation of MPO degranulation. In addition, these phenomena were closely associated with the exercise-induced mobilization of neutrophils from the marginated pool into the circulation, which was mediated by the overshooting of catecholamines during exercise. These findings indicate that the use of different techniques for detecting ROS or the different stages of neutrophil ROS metabolism could explain some of the disparate findings of the previous studies.

Osteochondral autograft transplantation is a useful treatment for reattachment of the lesion as well as osteochondral resurfacing of elbow osteochondritis dissecans.

Background-Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and eVective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its eVect on papillary function has yet to be elucidated. Aim-To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its eVect on SO function. Patients and methods-The papillary function of 10 patients with CBD stones was studied using endoscopic manometry before and one week after EPBD. The manometric studies were repeated one month after EPBD in seven patients. Results-One week after EPBD, CBD pressure, SO peak pressure, SO basal pressure, and SO frequency decreased significantly. One month after EPBD, however, all parameters increased although the increases in SO basal pressure and CBD pressure were not significant. There was no significant diVerence in values of any parameter before and one month after EPBD. No serious complications occurred. Conclusion-These data suggest at least partial recovery of papillary function one month after the procedure. EPBD seems to preserve papillary function in treatment of CBD stones; a longer term follow up study with SO manometry should be performed to clarify the eVect of EPBD on SO function. (Gut 1997; 41: 541-544) Keywords: endoscopic papillary balloon dilatation; sphincter of Oddi Endoscopic sphincterotomy (EST) is widely accepted as an eVective procedure for removing common bile duct (CBD) stones. There is however concern that EST may alter the structure and motor function of the sphincter of Oddi (SO) for a long period of time in young patients having laparoscopic cholecystectomy.1 2 Endoscopic papillary balloon dilatation (EPBD) has been proposed as a less invasive alternative for CBD stone management.1-4 Based on animal studies, EPBD is expected to preserve papillary smooth muscle integrity in humans. 5 In this study, we investigated SO motility before and after EPBD to determine its eVect on SO function up to one month after the procedure. Patients and MethodsTen patients (five women and five men; mean age 70 years, range 52-92 years) undergoing EPBD for removal of CBD stones were studied. No patient had had any upper abdominal operation before EPBD. Although five patients had simultaneous gall bladder stones, all refused cholecystectomy mainly because of their age. Before EPBD, patients underwent SO manometry studies and endoscopic retrograde cholangiography (ERC) at the same session. The same sequence was used for the study one week after EPBD in all patients. One month later, only the manometric study was repeated, with measurement of CBD diameter by ultrasound image, in seven patients. Manometry was performed before ERC, and pharyngeal topical anaesthesia (lidocaine spray) was given prior to SO manometry.6-8 A 4-French microtransducer catheter (Gaeltec Ltd, Dunvegam, Isle of Skye, Scotland, UK) was inserted into the CBD through a biopsy channel of the duodenofibrescope (Olympus JF200 or TJF20, Olympus, Tokyo, Japan), and fluoroscopy w...

Background and Purpose-A growing amount of evidence suggests that infectious and inflammatory processes may be involved in the initiation of arteriosclerosis, but the mechanisms are conceivably multifactorial and complex. Two European groups have recently demonstrated that a C(Ϫ260)3 T polymorphism in the promoter of the CD14 lipopolysaccharide receptor may be a risk factor for coronary artery disease (CAD). The T allele of this polymorphism reportedly increases the expression of CD14 and may be involved in atherogenesis. In the present study we investigated a possible association between the C(Ϫ260)3 T polymorphism in the CD14 promoter and the occurrence of symptomatic ischemic cerebrovascular disease (CVD). Methods-Genotype frequencies of the C(Ϫ260)3 T polymorphism in the CD14 promoter were determined in 235 patients with CVD, as confirmed by brain CT and/or MRI, and 309 age-and sex-matched control subjects. Results-The distribution of genotypes was as follows: CVD patients, T/T 24.3%, C/T 53.2%, and C/C 22.6%; controls, T/T 26.9%, C/T 50.2%, and C/C 23.0%. There was no significant difference between the CD14 promoter genotypes of the CVD patients and the controls ( 2 ϭ0.601, Pϭ0.741). We also measured the concentration of serum soluble CD14 and the density of membranous CD14 on monocytes in the CVD patients, but the polymorphism was not associated with either the concentration of soluble CD14 or the density of membranous CD14 (Pϭ0.358, Pϭ0.238, respectively). Conclusions-Our results indicate that the C(Ϫ260)3 T polymorphism in the CD14 promoter is not associated with an increased risk for CVD. here are accumulating data indicating that infection may be linked to atherosclerotic disease. [1][2][3] Although the true role of infection as a risk factor for atherosclerosis is unclear, several known mechanisms may play at least a partial role in this process. One of the most likely mechanisms involves lipopolysaccharide (LPS) and its receptor, CD14, both of which have been implicated in atherogenesis. 3 LPS, a structural component of gram-negative bacteria, is bound in plasma by LPS binding protein. 4 The LPS-LPS binding protein complex then binds to a glycosylphosphatidylinositolanchored membrane protein, membranous CD14 (mCD14), on monocytes and macrophages and activates these cells. The activated phagocytes in turn secrete inflammatory cytokines through which LPS indirectly activates endothelial cells. Soluble CD14 (sCD14), which lacks a glycosylphosphatidylinositol anchor, can also be found in plasma. Endothelial cells and smooth muscle cells, lacking their own mCD14, are directly activated by LPS-sCD14 complex. 5,6 Directly and indirectly activated endothelial cells express cell adhesion molecules and increased procoagulant activity, and they release free radicals, thereby mediating the initiation and development of atherosclerosis.Two European groups have recently reported that genetic variation in the CD14 promoter may be a risk factor for coronary artery disease (CAD). 7,8 Both groups, one in Germany and t...

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Infection by a baculovirus (Bombyx mori nuclear polyhedrosis virus, BmNPV) in silkworm (Bombyx mori) larvae is highly efficient as an expression system for the production of useful proteins. However, the amount of the protein of interest expressed tends to decrease in the later stages of infection presumably due, in part, to a proteinase produced in the larval haemolymph. The N-terminal amino acid sequence of a proteinase purified from the haemolymph of BmNPV-infected larvae was identical to the internal amino acid sequence of the viral cysteine proteinase gene of BmNPV, suggesting that the cysteine proteinase in the haemolymph originated from the BmNPV gene. We constructed a

Camptocormia is uncommon in PD and is associated with disease severity, higher L-dopa dose and higher frequencies of autonomic symptoms.