Intraoperative monitoring of the biliary tracts as a means of preventing choledocholithiasis oversight

The aim of the work is to assess the performance and effectiveness of intraoperative cholangiography or choledochoscopy in the prevention of choledocholithiasis oversight. The effectiveness of choledochoscopy was assessed in 50 patients during the years 2001–2002. Since 2000 intraoperative cholangiography has been performed on all patients after classic cholecystostomy in the absence of indications to choledochotomy. The effectiveness of intraoperative cholangiography was assessed in 50 patients in 2001. Both groups underwent ultrasonographic control and tests of biochemical parameters a year after surgery. The advisability of performing intraoperative cholangiography or choledochoscopy and their high degree of effectiveness in the prevention of choledocholithiasis oversight was confirmed

The use of modern techniques of biliary tract monitoring in percutaneous drainage

The aim of this work is to assess the usefulness of current imaging techniques of biliary tracts in percutaneous transhepatic biliary drainage (PTBD). In the period from January 1996 to March 2003 44 cases of PTBD were carried out under ultrasonographic and X-ray control in 34 patients who could not have a bypass or endoscopic prothesis of the bile duct. The effectiveness of the method was evaluated in relation to the extent of the intra-hepatic bile ducts, the usefulness of simultaneous monitoring (ultrasonography and X-ray) and the possibility of preoperative contrasting of the bile ducts. Correct drainage of bile ducts was achieved in 43 PTBD. In 6 cases branches of the portal vein were pierced during drainage, but thanks to X-ray visualisation this was detected and the bile ducts were then drained correctly. During 4 PTBD the grooved probe slipped from bile ducts while the catheter was being introduced and a repeated prick was necessary. Total cholestasis caused by a tumour does not always bring about extension of bile ducts. However, simultaneous ultrasonographic and X-ray imaging of the bile ducts enables PTBD to be performed even in patients with a slight extension of the duct

Brain-derived proteins in the CSF, do they correlate with brain pathology in CJD?

BACKGROUND: Brain derived proteins such as 14-3-3, neuron-specific enolase (NSE), S 100b, tau, phosphorylated tau and Aβ(1–42 )were found to be altered in the cerebrospinal fluid (CSF) in Creutzfeldt-Jakob disease (CJD) patients. The pathogenic mechanisms leading to these abnormalities are not known, but a relation to rapid neuronal damage is assumed. No systematic analysis on brain-derived proteins in the CSF and neuropathological lesion profiles has been performed. METHODS: CSF protein levels of brain-derived proteins and the degree of spongiform changes, neuronal loss and gliosis in various brain areas were analyzed in 57 CJD patients. RESULTS: We observed three different patterns of CSF alteration associated with the degree of cortical and subcortical changes. NSE levels increased with lesion severity of subcortical areas. Tau and 14-3-3 levels increased with minor pathological changes, a negative correlation was observed with severity of cortical lesions. Levels of the physiological form of the prion protein (PrP(c)) and Aβ(1–42 )levels correlated negatively with cortical pathology, most clearly with temporal and occipital lesions. CONCLUSION: Our results indicate that the alteration of levels of brain-derived proteins in the CSF does not only reflect the degree of neuronal damage, but it is also modified by the localization on the brain pathology. Brain specific lesion patterns have to be considered when analyzing CSF neuronal proteins

Determination of composition and structure of spongy bone tissue in human head of femur by Raman spectral mapping

Biomechanical properties of bone depend on the composition and organization of collagen fibers. In this study, Raman microspectroscopy was employed to determine the content of mineral and organic constituents and orientation of collagen fibers in spongy bone in the human head of femur at the microstructural level. Changes in composition and structure of trabecula were illustrated using Raman spectral mapping. The polarized Raman spectra permit separate analysis of local variations in orientation and composition. The ratios of ν2PO43−/Amide III, ν4PO43−/Amide III and ν1CO32−/ν2PO43− are used to describe relative amounts of spongy bone components. The ν1PO43−/Amide I ratio is quite susceptible to orientation effect and brings information on collagen fibers orientation. The results presented illustrate the versatility of the Raman method in the study of bone tissue. The study permits better understanding of bone physiology and evaluation of the biomechanical properties of bone

Total prion protein levels in the cerebrospinal fluid are reduced in patients with various neurological disorders

We performed a study on levels of the total prion protein (PrP) in humans affected by different neurological diseases and assessed the influence of several factors such as age, gender, and disease severity on the cerebrospinal fluid PrP levels. PrP-ELISA technique was used to analyze cerebrospinal fluid (CSF) samples. 293 CSF samples of patients with Creutzfeldt-Jakob-disease (CJD), Alzheimer's disease, dementia with Lewy-bodies, Parkinson's disease, multiple sclerosis, cerebral ischemia, generalized epileptic seizures, and meningitis and encephalitis in comparison to controls were analyzed. We found a significant reduction of CSF PrP levels in patients suffering from all neurodegenerative disorders analyzed. This group exhibited mean PrP values of 164 ng/ml while non-neurodegenerative disorder patients and healthy controls showed PrP levels of 208 ng/ml and 226 ng/ml, respectively. CSF levels correlated with disease severity in CJD, Alzheimer's disease, and dementia with Lewy-bodies. The finding of decreased PrP levels in the CSF of patients not only with CJD but also in other neurodegenerative disorders is intriguing. Age-, gender-, and genetic-specific factors might be involved in the PrP;{c} regulation