Choledocholithiasis after cholecystectomy

Concrements were found in the ducts of 172 patients subjected to secondary surgical interventions on bile ducts. The detailed analysis of the data failed to answer the question whether the stones could be formed immediately in the ducts without such conditions as a mechanical obstacle for the outflow of bile, the presence of foreign bodies and a big stump of the cystic duct. Such a formation of stones can take place in very few cases. The authors have shown that control cholangiography and especially choledochoscopy can reduce the danger to leave the stones in the ducts, but does not eliminate the danger completely. Nevertheless they think that now it is possible to lessen the indications for biliodigestive anastomoses in choledocholithiasis since the retained stones can be revealed within the first days after surgery and, as a rule, removed with instruments or by other methods using the drainage left in the ducts.     

The effects of alcohol on the heart: detrimental or beneficial?

Alcohol abuse is a substantial public health problem, resulting in staggering financial costs and other burdens. Prolonged alcohol abuse leads to cardiomyopathy in a minority of alcohol abusers, but because alcoholism is so widespread, alcohol is the major cause of nonischemic cardiomyopathy in Western society. In contrast, substantial evidence now suggests that moderate alcohol consumption has cardioprotective effects. It not only reduces the incidence of fatal ischemic heart disease, but it improves outcome in patients who have other risks for coronary events and go on to have myocardial infarctions. Therefore, physicians' recommendations about alcohol consumption should be as individualized as their patients.     

Diagnosis and treatment of suppurative complication of anaerobe etiology in trauma and orthopedic patients

An extensive study of road traffic accident cases occurring within eastern suburban Calcutta during April 1992 to March 1993 was done. Of which 276 fatal cases having minimum medical aids were taken into consideration to avoid erroneous interpretation. Male pedestrians of age group of 50 years and above were mostly involved during the time period of 5 A.M. to 12 Noon. Fatal Accidents mostly occurred during winter and on the broader roads (Highways) and in majority of cases victims were at fault.     

Suppression of anchorage-independent growth and matrigel invasion and delayed tumor formation by elevated expression of fibulin-1D in human fibrosarcoma-derived cell lines

Using differential display, we identified an mRNA that is markedly down-regulated in cell line 6A/SB1, derived from a fibrosarcoma formed in an athymic mouse following injection of carcinogen-transformed MSU-1.1 cells. The nontumorigenic parental cell strain, MSU-1.1, expresses high levels of this mRNA. Sequencing of the corresponding cDNA fragment revealed that it corresponded to an expressed sequence tag, which ultimately led to its identification as the fibulin-1D gene. Fibulin-1 is a cysteine-rich, calcium-binding extracellular matrix and plasma protein, which has four isoforms, A-D, derived from alternative splicing. Northern and Western blotting analysis of 16 cell lines established from tumors formed in athymic mice by MSU-1.1-derived cell strains independently transformed in culture showed that 44% exhibited low level or lack of expression of fibulin-1D mRNA and protein. In a similar analysis of 15 malignant cell lines derived from patients, 80% showed low level or no expression. To study the role of fibulin-1D in transformation, we transfected 6A/SB1 cells and a human fibrosarcoma-derived cell line (SHAC) with a fibulin-1D cDNA expression construct. Transfectants displaying high levels of fibulin-1D were isolated and characterized. Elevated expression of fibulin-1D led to reduced ability to form colonies in soft agar and reduced invasive potential as tested in a matrigel in vitro invasion assay. Furthermore, expression of fibulin-1D resulted in a markedly extended latency in tumor formation in athymic mice. These results indicate that low expression of fibulin-1D plays a role in tumor formation and invasion.