Routine intraoperative laparoscopic cholangiography

BACKGROUND: Whether intraoperative laparoscopic cholangiography should be routine is debatable. METHODS: We reviewed the cholangiography experience in 669 consecutive laparoscopic cholecystectomies. RESULTS: Mean age of the patients was 39 years, 78% were female, and 29% had acute cholecystitis. Cholecystectomy was completed laparoscopically in 606 (91%). Laparoscopic cholangiography was completed in 562 (93%) and 348 (62%) were routine (no preoperative indication). The mean operating time in 1996 was 61 minutes. Out of the 348 routine cholangiograms, 17 demonstrated evidence of unsuspected choledocholithiasis. Five patients had choledocholithiasis documented by laparoscopic common bile duct exploration and/or endoscopic retrograde cholangiopancreatography. Two patients had normal postoperative cholangiopancreatography. One of 10 patients managed expectantly was readmitted postoperatively with obstructive jaundice. In 4 patients, routine cholangiography revealed unexpected anatomy, and in 2, this prevented misidentification and transection of the common bile duct. CONCLUSION: Laparoscopic cholangiography is safe, quick, detects unsuspected choledocholithiasis, and can prevent common bile duct transection. It should be routine.     

Automatic alerting does not speed late motoric processes in a reaction-time task

When an irrelevant 'accessory' stimulus is presented at about the same time as the imperative signal in a choice reaction time-task, the latency of the voluntary response is markedly reduced. The most prominent cognitive theories agree that this effect is attributable to a brief surge in arousal ('automatic alerting'), but they disagree over whether the facilitation is localized to a late, low-level motoric process or to an earlier stage, the process of orienting to and then perceptually categorizing the reaction stimulus. To test these alternative hypotheses, we used the onset of the lateralized readiness potential (a movement-related brain potential) as a temporal landmark to partition mean reaction time into two time segments. The first segment included the time required to perceive the visual stimulus and decide which hand to react with; the second included only motoric processes. Presentation of an irrelevant acoustic stimulus shortened the first interval but had no effect on the second. We therefore rejected the motoric hypothesis.     

Phytochromes and cryptochromes in the entrainment of the Arabidopsis circadian clock

Circadian clocks are synchronized by environmental cues such as light. Photoreceptor-deficient Arabidopsis thaliana mutants were used to measure the effect of light fluence rate on circadian period in plants. Phytochrome B is the primary high-intensity red light photoreceptor for circadian control, and phytochrome A acts under low-intensity red light. Cryptochrome 1 and phytochrome A both act to transmit low-fluence blue light to the clock. Cryptochrome 1 mediates high-intensity blue light signals for period length control. The presence of cryptochromes in both plants and animals suggests that circadian input pathways have been conserved throughout evolution.     

Tissue phenotype depends on reciprocal interactions between the extracellular matrix and the structural organization of the nucleus

What determines the nuclear organization within a cell and whether this organization itself can impose cellular function within a tissue remains unknown. To explore the relationship between nuclear organization and tissue architecture and function, we used a model of human mammary epithelial cell acinar morphogenesis. When cultured within a reconstituted basement membrane (rBM), HMT-3522 cells form polarized and growth-arrested tissue-like acini with a central lumen and deposit an endogenous BM. We show that rBM-induced morphogenesis is accompanied by relocalization of the nuclear matrix proteins NuMA, splicing factor SRm160, and cell cycle regulator Rb. These proteins had distinct distribution patterns specific for proliferation, growth arrest, and acini formation, whereas the distribution of the nuclear lamina protein, lamin B, remained unchanged. NuMA relocalized to foci, which coalesced into larger assemblies as morphogenesis progressed. Perturbation of histone acetylation in the acini by trichostatin A treatment altered chromatin structure, disrupted NuMA foci, and induced cell proliferation. Moreover, treatment of transiently permeabilized acini with a NuMA antibody led to the disruption of NuMA foci, alteration of histone acetylation, activation of metalloproteases, and breakdown of the endogenous BM. These results experimentally demonstrate a dynamic interaction between the extracellular matrix, nuclear organization, and tissue phenotype. They further show that rather than passively reflecting changes in gene expression, nuclear organization itself can modulate the cellular and tissue phenotype.     

Rice (Oryza sativa) centromeric regions consist of complex DNA

Rice bacterial artificial chromosome clones containing centromeric DNA were isolated by using a DNA sequence (pSau3A9) that is present in the centromeres of Gramineae species. Seven distinct repetitive DNA elements were isolated from a 75-kilobase rice bacterial artificial chromosome clone. All seven DNA elements are present in every rice centromere as demonstrated by fluorescence in situ hybridization. Six of the elements are middle repetitive, and their copy numbers range from approximately 50 to approximately 300 in the rice genome. Five of these six middle repetitive DNA elements are present in all of the Gramineae species, and the other element is detected only in species within the Bambusoideae subfamily of Gramineae. All six middle repetitive DNA elements are dispersed in the centromeric regions. The seventh element, the RCS2 family, is a tandem repeat of a 168-bp sequence that is represented approximately 6,000 times in the rice genome and is detected only in Oryza species. Fiber-fluorescence in situ hybridization analysis revealed that the RCS2 family is organized into long uninterrupted arrays and resembles previously reported tandem repeats located in the centromeres of human and Arabidopsis thaliana chromosomes. We characterized a large DNA fragment derived from a plant centromere and demonstrated that rice centromeres consist of complex DNA, including both highly and middle repetitive DNA sequences.     

Intrarenal nitric oxide activity and pressure natriuresis in anesthetized dogs

In the course of an ongoing cohort study on constitutional and occupational risk factors for the development of irritant hand dermatitis in hairdressing apprentices, an increased prevalence of irritant skin changes was noted in a subgroup examined during particularly cold winter months. Prompted by this observation, the importance of several meteorological factors (day means of temperature, relative and absolute humidity) was assessed in extensive statistical analyses based on data of 742 participants, supplemented by meteorological information obtained from the German Meteorological Service (DWD). There were significant associations of existing hand dermatitis with low temperature and low absolute humidity (Mann-Whitney U-test, P < 0.0001), but not with relative humidity (P = 0.38). Logistic regression analysis, including known determinants of irritant hand dermatitis in this setting, showed that low temperature and low relative humidity tended to be risk factors (OR = 1.66 and 1.57, respectively, for the lower quartiles, P = 0.07 in both cases), and confirmed that absolute humidity significantly influenced the occurrence of irritant hand dermatitis (OR = 2.06 for < 4.8 mg/L, P < 0.01). Thus, these environmental factors must be regarded as possible confounders in the analysis of future epidemiological studies on irritant hand dermatitis and should be considered in multifactorial analyses.     

Multiple virus genes involved in the nematode transmission of pea early browning virus

Gorlin syndrome is an autosomal dominant disorder characterized by multiple basal cell carcinomas, medulloblastomas, ovarian fibromas, and a variety of developmental defects. All affected individuals share certain key features, but there is significant phenotypic variability within and among kindreds with respect to malformations. The gene (NBCCS) maps to chromosome 9q22, and allelic loss at this location is common in tumors from Gorlin syndrome patients. Two recessive cancer-predisposition syndromes, xeroderma pigmentosum group A (XPAC) and Fanconi anemia group C (FACC), map to the NBCCS region; and unusual, dominant mutations in these genes have been proposed as the cause of Gorlin syndrome. This study presents cytogenetic and molecular characterization of germ-line deletions in one patient with a chromosome 9q22 deletion and in a second patient with a deletion of 9q22-q3l. Both have typical features of Gorlin syndrome plus additional findings, including mental retardation, conductive hearing loss, and failure to thrive. That Gorlin syndrome can be caused by null mutations (deletions) rather than by activating mutations has several implications. First, in conjunction with previous analyses of allelic loss in tumors, this study provides evidence that associated neoplasms arise with homozygous inactivation of the gene. In addition, dominant mutations of the XPAC and FACC1 genes can be ruled out as the cause of Gorlin syndrome, since the two patients described have null mutations. Finally, phenotypic features that show variable expression must be influenced by genetic background, epigenetic effects, somatic mutations, or environmental factors, since these two patients with identical alterations (deletions) of the Gorlin syndrome gene have somewhat different manifestations of Gorlin syndrome.     

Young children use motive information to make trait inferences

The present study investigates children's capacity to understand traits in a psychologically meaningful way. Participants included 18 individuals in each of 4 age groups: kindergarten (ages 5-6), 2nd grade (ages 7-8), 5th grade (ages 10-11), and adult. They heard a series of 6 short stories in which a main character performs an action based on a particular motive (positive, negative, or incidental) that results in either a positive or a negative emotional consequence for another character. Participants evaluated each main character and predicted the character's behavior and mental states in different social contexts. Participants in all age groups, even the 5- to 6-year-olds, made trait inferences that were influenced by motive information. These results provide evidence that young children are capable of more sophisticated reasoning about traits than has been suggested previously.