Development of virtual CT cholangiopancreatoscopy

Endoluminal virtual computed tomographic (CT) cholangiopancreatoscopic views of the pancreatic and common bile ducts were generated in 16 patients by using helical CT data sets and endoscopic three-dimensional reconstruction images. In all patients with ductal dilatation, virtual images were obtained and findings correlated with those at helical CT and endoscopic retrograde cholangiopancreatography. Virtual CT cholangiopancreatoscopy is a feasible technique, and initial experience shows promising results.     

a Medical Food-Supplemented Detoxification Program in the Management of Chronic Health Problems

Objective * To evaluate the effectiveness of a medical food-supplemented detoxification program versus a hypoallergenic, calorie-controlled diet alone in the management of symptoms in chronically ill patients. Design * Outcome-focused study of patient response to dietary interventions. Setting * Clinical outpatient research facility. Patients * 106 chronically ill patients. Intervention * A medical food supplement designed to provide nutritional support for gastrointestinal healing and hepatic detoxification in addition to an oligoantigenic, calorie-controlled diet, versus an oligoantigenic, calorie-controlled diet alone. Results * The 84 patients in the experimental group, who consumed the medical food supplement, had a 52% reduction in symptoms over 10 weeks as measured by the Metabolic Screening Questionnaire. In comparison, the 22 patients on the control diet had only a 22% reduction of symptoms. Symptom reduction in the intervention group occurred concomitantly with the normalization of hepatic phase I cytochrome P450 activity in relation to phase II glycine conjugation detoxification function measured before and after intervention. The intervention group also had a statistically significant increase in urinary sulfate-to-creatinine ratio after treatment, suggesting improved reserves of sulfur-conjugating nutrients and glutathione status. Enhanced nutrient absorption after intervention was implied by the increased absorption and urinary excretion of mannitol after the 10 weeks of therapy, although the results were only marginally significant. Conclusions * These results suggest that this supplemental medical food program may provide an important adjunctive therapy for the management of many complex symptoms associated with the chroni     

Videodensitometry of osteons in females with femoral neck fractures

The medial femoral cortices of 10 females with femoral neck fractures and 10 age-matched female autopsy cases were studied using computer-assisted videodensitometry. Radiographic mineral density was determined using the calibration method described by Martin et al. [20]. Measurements were made of porosity, osteon and haversian canal dimensions, and of interstitial and osteon mineral density across the cortical wall of the orthopedic calcar region. There were no differences between the fracture and nonfracture groups in the overall mean mineral density of the bone averaged over the microstructure, excluding pore space, or in the interstitial bone mineral density. The porosity in the fracture group was greater than in the autopsy group, especially in the periosteal region, where the porosity was 2.4 times greater and where there were also 27% fewer osteons per unit area than in the autopsy group (P < 0.05). Mean osteon mineral density was 2.5% higher in the fracture group (P < 0.05) compared with the autopsy group in the endosteal region, and 4% higher in the periosteal region. Osteon and haversian canal areas were also larger in the fracture group, especially in the middle region of the cortical wall (17% and 23%, respectively, P < 0.05).     

Endothelial cell morphology in areas of in vivo Evans blue uptake in the aorta of young pigs. II. Ultrastructure of the intima in areas of differing permeability to proteins

The fine structure of the intima of the pig aortic arch is described for areas of spontaneously differing in vivo endothelial permeability, as demarcated by uptake of the protein-binding azo dye Evans blue. Areas of enhanced permeability (blue areas) consistently show a variety of features not observed in areas devoid of dye accumulation (white areas). The subendothelial space of blue areas is markedly thickened and edematous, containing collagen, elastic tissue elements, and undifferentiated cells dispersed in an amorphous floccular matrix of low electron density. Endothelial cells in blue areas are generally cuboidal, with relatively short, frequently vacuolated junctions. In contrast, endothelial cells from white areas are flat and elongate, with long intercellular junctions exhibiting many interdigitations. Cytoplasmic differences include a well-developed rough endoplasmic reticulum and more frequent lysosomal bodies in blue areas and a prominent Golgi apparatus in the endothelium of white areas. Additionally, endothelial cell injury or death with and without denudation occurs with a significantly greater frequency in blue relative to white areas. An endothelial glycocalyx is some threefold thicker over the surface of white relative to blue areas. It is concluded that neither endothelial structure nor function are homogeneous within the aortic arch of the young pig and that areas of spontaneously differing permeability to proteins are associated with a spectrum of alterations in endothelial and intimal morphology.