El componente racial influencia la resistencia a la infección con el virus de la leucosis bovina / The racial component influences resistance to infection with the bovine leukemia virus

RESUMEN El virus de la leucosis bovina (VLB) es un retrovirus que afecta principalmente el ganado lechero, reduciendo la producción de leche entre el 2,5 y 5%. La raza criolla colombiana Blanco Orejinegro (BON) es una raza rustica, bien adaptada, que ha mostrado resistencia in vitro a las infecciones ocasionadas por los virus de la fiebre aftosa y la estomatitis vesicular, así como las originadas por la bacteria Brucella abortus. El objetivo del presente estudio fue determinar si la raza BON y su cruce con Holstein son resistentes a la infección por el VLB. Se tomaron 124 muestras de sangre (59 Holstein, 40 BON y 25 BON x HOL) del mismo hato, se extrajo el DNA y se realizó una PCR-anidada correspondiente a una región del gen env de VLB. Se obtuvo un fragmento de 444 pb en los animales positivos. La prevalencia molecular del hato fue 33% para VLB. Se encontró diferencia significativa para infección por VLB entre los tres grupos raciales (p < 0,05). El porcentaje de infección fue del 55,9% para la raza Holstien, 5% para las vacas BON y 24% para el cruce BON x HOL; este último presentó una reducción en el porcentaje de infección del 32% respecto a la raza Holstein, lo cual puede ser atribuido a la presencia de genes de resistencia en la raza BON. Se comprobó que el nivel de infección es menor en vacas lecheras del cruce BON x HOL que en la raza lechera Holstein.

ABSTRACT The bovine leukemia virus (BLV) is a retrovirus that primarily affects dairy cattle, reducing milk production between 2.5 and 5%. The Colombian Blanco Orejinegro (BON) is a well-adapted, rustic, creole breed resistant to in vitro infections of Foot-and-mouth disease virus and vesicular stomatitis virus, as well as to Brucella abortus. This study aimed to determine if the crossing of BON and Holstein breeds is resistant to infection by BLV. Blood samples of 124 individuals (59 Holstein, 40 BON, and 25 BON x HOL) of the same herd were taken. The DNA was extracted, and a nested PCR was performed related to a region of the env gene of BLV. A fragment of 444 bp was obtained for positives animals. The molecular in-herd prevalence was 33% for BLV. A significant difference for BLV infection was found among the groups (p<0.05). The infection rate for the Holstein group was 55.9%, for BON cattle 5%, and for BON x HOL cattle 24%. The latter showed a reduction in the infection rate of 32% to the Holstein breed, which can be attributed to the presence of resistance genes in the BON breed. It was found that the level of infection is lower in BON x HOL cattle in contrast with Holstein dairy cows.

Cation exchange capacity of biochar: An urgent method modification.

Biochar, produced through pyrolysis of organic matter, is negatively charged, thus contributing to electrostatic adsorption of cations. However, due to its porous structure and contents of alkaline ashes, the determination of the cation exchange capacity (CEC) is challenging. Literature values for the CEC of biochar are surprisingly variable and are often poorly reproducible, suggesting methodological problems. Here, we modify and critically assess different steps in the existing ammonium acetate (NH4OAc) method (pH 7), where ammonium (NH4+) is displaced by potassium chloride (KCl), following removal of excess NH4OAc with isopropanol, in batch mode. We used pigeon pea biochar to develop the method and conducted a test on three additional biochars with different acid neutralizing capacity. A pretreatment step of biochar was introduced, using diluted hydrochloric acid, to decrease biochar pH to near neutral, so that 1 M NH4OAc effectively buffers the biochar suspension pH at 7. This allows the CEC of all biochars to be determined at pH 7, which is crucial for biochar comparison. The dissolution of ashes may cause relatively large weight losses (e.g. for cacao shell biochar), which need to be accounted for when computing the CEC of raw biochar. The sum of NH4OAC-extractable base cations provided a smaller and better estimate of the CEC than KCl-extractable NH4+. We hypothesize that the overestimation of the CEC based on KCl-extractable NH4+ is due to the ineffectiveness of the relatively large isopropanol molecules to remove excess NH4OAc in biochars rich in micro-pores, due to size exclusion. The amount of base cations removed in the pretreatment was about three (rice husk biochar) to ten times (pigeon pea biochar) greater than the amount of exchangeable cations. The CEC values of biochar increased from 10.8 cmol/Kg carbon to 119.6 cmol/Kg carbon. These values are smaller than reported CEC values of soil organic carbon.

Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis.

Growing evidence suggests chronic low-grade inflammation (LGI) as a possible mechanism underlying the aging process. Some biological and pharmaceutical compounds may reduce systemic inflammation and potentially avert functional decline occurring with aging. The aim of the present meta-analysis was to examine the association of pre-selected interventions on two established biomarkers of inflammation, interleukin-6 (IL-6), and C-reactive protein (CRP) in middle-age and older adults with chronic LGI. We reviewed the literature on potential anti-inflammatory compounds, selecting them based on safety, tolerability, acceptability, innovation, affordability, and evidence from randomized controlled trials. Six compounds met all five inclusion criteria for our systematic review and meta-analysis: angiotensin II receptor blockers (ARBs), metformin, omega-3, probiotics, resveratrol and vitamin D. We searched in MEDLINE, PubMed and EMBASE database until January 2017. A total of 49 articles fulfilled the selection criteria. Effect size of each study and pooled effect size for each compound were measured by the standardized mean difference. I2 was computed to measure heterogeneity of effects across studies. The following compounds showed a significant small to large effect in reducing IL-6 levels: probiotics (-0.68 pg/ml), ARBs (-0.37 pg/ml) and omega-3 (-0.19 pg/ml). For CRP, a significant small to medium effect was observed with probiotics (-0.43 mg/L), ARBs (-0.2 mg/L), omega-3 (-0.17 mg/L) and metformin (-0.16 mg/L). Resveratrol and vitamin D were not associated with any significant reductions in either biomarker. These results suggest that nutritional and pharmaceutical compounds can significantly reduce established biomarkers of systemic inflammation in middle-age and older adults. The findings should be interpreted with caution, however, due to the evidence of heterogeneity across the studies.

Resveratrol-cyclodextrin complex affects the expression of genes associated with lipid metabolism in bovine in vitro produced embryos.

Antioxidants have been widely used during in vitro production to decrease the negative effect of reactive oxygen species. It was reported that the complex resveratrol-methyl ß-cyclodextrin (RV-CD) improves resveratrol's stability and bioavailability and increases its antioxidant activity. This study evaluates the effect of RV-CD during in vitro oocyte maturation (IVM) or in vitro embryo culture (IVC) on developmental competence and quantitative changes in gene expression of developmental important genes. In experiment 1, RV-CD was added to IVM media and maturation level, embryo development and oocytes, cumulus cells, and blastocysts gene expression by RT-qPCR were examined. In experiment 2, presumptive zygotes were cultured in SOF supplemented with RV-CD and embryo development and blastocysts gene expression by RT-qPCR were studied. A group without RV-CD (control- ) and a group with cyclodextrin (control+ ) were included. No differences were found in cleavage rate or blastocyst yield between groups. However, the expression of LIPE was higher in blastocysts derived from oocytes treated with resveratrol compared with control groups (p < .05). Blastocysts produced by IVC with resveratrol showed that RV-CD could modify the expression of genes related to lipid metabolism (CYP51A1, PNPLA2 and MTORC1) compared with control groups (p < .05). RV-CD in the IVM and IVC media could reduce accumulated fat by increasing lipolysis and suppressing lipogenesis of blastocysts.

Normothermic Ex Vivo Kidney Perfusion Following Static Cold Storage-Brief, Intermediate, or Prolonged Perfusion for Optimal Renal Graft Reconditioning?

Normothermic ex vivo kidney perfusion (NEVKP) demonstrated superior results compared to hypothermic storage in donation after circulatory death (DCD) kidney transplantation. It is unknown whether an optimal perfusion time exists following hypothermic storage to allow for the recovery of renal grafts from cold ischemic injury. In a porcine model of DCD kidney autotransplantation, the impact of initial static cold storage (SCS) (8 h) followed by various periods of NEVKP recovery was investigated: group A, 8 hSCS only (control); group B, 8 hSCS + 1 hNEVKP (brief NEVKP); group C, 8 hSCS + 8 hNEVKP (intermediate NEVKP); and group D, 8 hSCS + 16 hNEVKP (prolonged NEVKP). All grafts were preserved and transplanted successfully. One animal in group D was sacrificed and excluded by postoperative day 3 due to hind limb paralysis, but demonstrated good renal function. Postoperative graft assessment during 8 days' follow-up demonstrated lowest levels of peak serum creatinine for intermediate (C) and prolonged (D) NEVKP (p = 0.027). Histological assessment on day 8 demonstrated a significant difference in tubular injury (p = 0.001), with highest values for group B. These results suggest that longer periods of NEVKP following SCS are feasible and safe for postponing surgical transplant procedure and superior to brief NEVKP, reducing the damage caused during cold ischemic storage of renal grafts.

Continuous Normothermic Ex Vivo Kidney Perfusion Is Superior to Brief Normothermic Perfusion Following Static Cold Storage in Donation After Circulatory Death Pig Kidney Transplantation.

Hypothermic preservation is known to cause renal graft injury, especially in donation after circulatory death (DCD) kidney transplantation. We investigated the impact of cold storage (SCS) versus short periods of normothermic ex vivo kidney perfusion (NEVKP) after SCS versus prolonged, continuous NEVKP with near avoidance of SCS on kidney function after transplantation. Following 30 min of warm ischemia, kidneys were removed from 30-kg Yorkshire pigs and preserved for 16 h with (A) 16 h SCS, (B) 15 h SCS + 1 h NEVKP, (C) 8 h SCS + 8 h NEVKP, and (D) 16 h NEVKP. After contralateral kidney resection, grafts were autotransplanted and pigs followed up for 8 days. Perfusate injury markers such as aspartate aminotransferase and lactate dehydrogenase remained low; lactate decreased significantly until end of perfusion in groups C and D (p < 0.001 and p = 0.002). Grafts in group D demonstrated significantly lower serum creatinine peak when compared to all other groups (p < 0.001) and 24-h creatinine clearance at day 3 after surgery was significantly higher (63.4 ± 19.0 mL/min) versus all other groups (p < 0.001). Histological assessment on day 8 demonstrated fewer apoptotic cells in group D (p = 0.008). In conclusion, prolonged, continuous NEVKP provides superior short-term outcomes following DCD kidney transplantation versus SCS or short additional NEVKP following SCS.

Inducing Hepatitis C Virus Resistance After Pig Liver Transplantation-A Proof of Concept of Liver Graft Modification Using Warm Ex Vivo Perfusion.

Normothermic ex vivo liver perfusion (NEVLP) offers the potential to optimize graft function prior to liver transplantation (LT). Hepatitis C virus (HCV) is dependent on the presence of miRNA(microRNA)-122. Miravirsen, a locked-nucleic acid oligonucleotide, sequesters miR-122 and inhibits HCV replication. The aim of this study was to assess the efficacy of delivering miravirsen during NEVLP to inhibit miR-122 function in a pig LT model. Pig livers were treated with miravirsen during NEVLP or cold storage (CS). Miravirsen absorption, miR-122 sequestration, and miR-122 target gene derepression were determined before and after LT. The effect of miravirsen treatment on HCV infection of hepatoma cells was also assessed. NEVLP improved miravirsen uptake versus CS. Significant miR-122 sequestration and miR-122 target gene derepression were seen with NEVLP but not with CS. In vitro data confirmed miravirsen suppression of HCV replication after established infection and prevented HCV infection with pretreatment of cells, analogous to the pretreatment of grafts in the transplant setting. In conclusion, miravirsen delivery during NEVLP is a potential strategy to prevent HCV reinfection after LT. This is the first large-animal study to provide "proof of concept" for using NEVLP to modify and optimize liver grafts for transplantation.

Trasplante combinado hígado-riñón en la fundación valle del Lili, Cali, Colombia - Experiencia de un centro / The experience of the Fundacion Valle Del Lili in Cali, Colombia with Combined Liver and Kidney Transplantation

Introducción: el trasplante combinado de hígado y riñón (CLK) ha mostrado ser una buena alternativa para pacientes con diagnóstico concomitante de enfermedad renal crónica (ERC) y enfermedad hepática terminal. Algunos estudios han mostrado además un beneficio inmunológico del trasplante combinado, con disminución de la tasa de rechazo del injerto renal. Objetivo: describir las indicaciones y los resultados clínicos en receptores de trasplante CLK en un hospital de alta complejidad. Materiales y métodos: se seleccionaron los pacientes con trasplante CLK del registro institucional de trasplante (TRENAL) entre 2000 y 2011. Se describieron las características demográficas y clínicas y se estimó la sobrevida de los pacientes y de los injertos con el método Kaplan Meier. Resultados: en un período de 11 años, se realizaron 16 trasplantes CLK. Esto corresponde al 1.51% de los trasplantes de riñón y al 3.48% de los trasplantes de hígado hechos en la institución durante el mismo periodo de tiempo. La mayoría de los receptores fueron de sexo masculino (10/16). La mediana de la edad fue 56.5 años. La mediana del MELD fue de 17 (RIQ: 12.5-20.5, Rango 8-24). El diagnóstico hepático más frecuente fue cirrosis por NASH (4/16). Todos los pacientes tenían diagnóstico de ERC, en 4 casos secundaria a diabetes mellitus. Las indicaciones más comunes del trasplante fueron ascitis de difícil manejo, encefalopatía recurrente y desnutrición. El tiempo promedio de isquemia en frío del hígado fue de 7,3 horas, y del riñón 9,6 horas. La sobrevida de los pacientes y de los injertos hepático y renal fue de 87,5% al año y 67,3% a los 5 años. Cuatro pacientes murieron, 2 casos como consecuencia de sepsis y otros 2 por malignidad. Conclusión: el trasplante CLK en la Fundación Valle del Lili tiene resultados clínicos satisfactorios y comparables a los reportados en otros centros.

Introduction: Combined liver and kidney transplantation (CLK) has been shown to be a good alternative for patients with concomitant diagnosis of chronic kidney disease (CKD) and end-stage liver disease. Some studies have also shown immunological benefits from combined transplantation with decreased rates of kidney graft rejection. Objective: The objective of this study was to describe the indications and clinical outcomes of CLK transplant recipients in a highly complex hospital. Materials and Methods: CLK transplant patients were selected from the institutional transplant registry (Trenal) from 2000 to 2011. Demographic and clinical characteristics were described and survival of patients and grafts were estimated with the Kaplan-Meier method. Results: Over a period of 11 years, 16 CLK transplants were performed. This was 1.51% of kidney transplants and 3.48% of liver transplants done in the institution during this period. Most recipients were male (10/16). The median age was 56.5 years. The median MELD was 17 (IQR: 12.5 to 20.5, range: 8 to 24). The most frequent diagnosis was liver cirrhosis due to NASH (4/16). All patients had been diagnosed with CKD: four cases were secondary to diabetes mellitus. The most common indications for transplants were difficult to manage ascites, recurrent encephalopathy and malnutrition. The average liver cold ischemia time was 7.3 hours, and the average kidney cold ischemia time 9.6 hours. The five-year liver graft survival rate was 87.5%, and the five-year kidney graft survival rate was 67.3%. Four patients died: two as the result of sepsis and two as the result of malignancy. Conclusion: CLK transplantation results at the Fundación Valle del Lili have been satisfactory and comparable to those reported by other transplant centers.

Sacha Inchi (plukenetia volubilis Hnneo): ¿una experiencia ancestral desaprovechada? Evidencias clínicas asociadas a su consumo / Sacha Inchi (plukenetia volubilis linneo): a wasted ancestral experience? Clinical evidence related to its consumption

Sacha Inchi (Plukenetia volubilis L.) es una planta oleaginosa trepadora que crece en países como Perú, Bolivia y Colombia. Es una excelente fuente de ácidos grasos insaturados, fundamentalmente alfa linolénico (C18:3) y linoleico (C18:2), que representan aproximadamente 82% del contenido total del aceite. Sacha Inchi ha sido parte de la dieta de indígenas desde la antigüedad y es visto en la actualidad como un cultivo prometedor. Por su composición en ácidos grasos esenciales y su alto contenido en tocoferoles y antioxidantes, la recomendación de su consumo en la dieta habitual puede ser una estrategia encaminada a la prevención de enfermedades cardiovasculares en poblaciones de América Latina, en las que el consumo de aceite de oliva, reconocido por sus propiedades cardioprotectoras, es bajo. Este artículo tiene por objetivo hacer una revisión de la literatura publicada en relación con la inocuidad, aceptabilidad e impacto sobre la salud, del aceite de Sacha Inchi.

Sacha Inchi (Plukenetia volubilis L.) is an oleaginous climbing plant thatgrows in countries like Peru, Bolivia and Colombia. It is an excellent source of unsaturated fatty acids, mainly alpha lino-lenic (C18:3) and linoleic (C18:2), which represent approximately 82% of total oil content. Sacha Inchi has been part of the diet of native people of the region since ancient times and is seen as a promising crop today Due to its composition of essential fatty acids and its high content of antioxidants and tocopherols, the re-commendation of its consumption in the diet can be a strategy for the prevention of cardiovascular disease in populations of Latin America, as olive oil consumption known for its cardioprotective properties, is typically low in these populations. The aim of this article is to review the published literature regarding the safety, acceptability and health impact of Sacha Inchi oil.

Classification and Use of Natural and Anthropogenic Soils by Indigenous Communities of the Upper Amazon Region of Colombia.

Outsiders often oversimplify Amazon soil use by assuming that abundantly available natural soils are poorly suited to agriculture and that sporadic anthropogenic soils are agriculturally productive. Local perceptions about the potentials and limitations of soils probably differ, but information on these perceptions is scarce. We therefore examined how four indigenous communities in the Middle Caquetá River region in the Colombian Amazon classify and use natural and anthropogenic soils. The study was framed in ethnopedology: local classifications, preferences, rankings, and soil uses were recorded through interviews and field observations. These communities recognized nine soils varying in suitability for agriculture. They identified anthropogenic soils as most suitable for agriculture, but only one group used them predominantly for their swiddens. As these communities did not perceive soil nutrient status as limiting, they did not base crop-site selection on soil fertility or on the interplay between soil quality and performance of manioc genetic resources.

Analysis of adult 20-year survivors after liver transplantation.

BACKGROUND: Liver transplantation (LT) is the treatment of choice for chronic and acute liver failure; however, the status of long-term survivors and allograft function is not well known. AIM: To evaluate the clinical outcome and allograft function of survivors 20 years post-LT, cause of death during the same period and risk factors of mortality. METHODS: A retrospective study was conducted from prospective, longitudinal data collected at a single center of adult LT recipients surviving 20 years. A comparative sub-analysis was made with patients who were not alive 20 years post-transplantation to identify the causes of death and risk factors of mortality. RESULTS: Between 1988 and 1994, 132 patients received 151 deceased-donors LT and 28 (21%) survived more than 20 years. Regarding liver function in this group, medians of AST, ALT and total bilirubin at 20 years post-LT were 33 IU/L (13-135 IU/L), 27 (11-152 IU/L) and 0.6 mg/dL (0.3-1.1 mg/dL). Renal dysfunction was observed in 40% of patients and median eGFR among 20-year survivors was 64 mL/min/1.73 m(2) (6-144 mL/min/1.73 m(2)). Sixty-one percent of 20-year survivors had arterial hypertension, 43% dyslipidemia, 25% de novo tumors and 21% diabetes mellitus. Infections were the main cause of death during the 1st year post-transplant (32%) and between the 1st and 5th year post-transplant (25%). After 5th year from transplant, hepatitis C recurrence (22%) became the first cause of death. Factors having an impact on long-term patient survival were HCC indication (p = 0.049), pre-transplant renal dysfunction (p = 0.043) and long warm ischemia time (p = 0.016); furthermore, post-transplant factors were diabetes mellitus (p = 0.001) and liver dysfunction (p = 0.05) at 1 year. CONCLUSION: Our results showed the effect of immunosuppression used during decades on long-term outcome in our LT patients in terms of morbidity (arterial hypertension, diabetes mellitus, dyslipidemia and renal dysfunction) and mortality (infections and hepatitis C recurrence).

Association between a polymorphism in intron 3 of the bovine growth hormone gene and growth traits in Holstein heifers in Antioquia.

The aim of this study was to determine the association between a polymorphism in intron 3 of the bovine growth hormone (BGH) gene and growth traits related to the start of the reproductive life of Holstein heifers. This research was conducted using 480 Holstein heifers belonging to eight herds in three municipalities in the Department of Antioquia (Colombia). The phenotypic information used corresponded to information that had been historically recorded for each of the herds and was supplemented with information obtained through bimonthly visits to the herds over a period of 24 months. Genotyping was performed using the PCR-RFLP technique with DNA extracted from peripheral blood using the salting out technique. To determine association, statistical analyses were performed using parametric methods. Allele frequencies for the alleles (+) and (-) were 0.91 and 0.09, respectively. The genotype frequencies were 0.77, 0.2 and 0.03 for the genotypes (+/+), (+/-) and (-/-), respectively. There was an association between genotype and weight at first estrus and first calving (P < 0.01). The regression coefficients for both characteristics were significant, indicating that for each (+) allele, weight at first estrus and first calving decreased by 9.24 and 16.07 kg, respectively. The results indicated the existence of an association between a polymorphism in intron 3 of the BGH gene and both weight at first estrus and first calving, which can be used to facilitate the selection of animals with these genotypes for use in breeding programs.

Effect of two single nucleotide polymorphisms on milk yield and composition.

The bovine prolactin (PRL) and bovine growth hormone (bGH) genes exhibit several polymorphisms. Some of them can be detected by molecular techniques using restriction endonucleases, such as RsaI for the PRL gene and MspI for the bGH gene. We examined the relationship between the PRL-RsaI and bGH-MspI polymorphisms and some economically important characteristics of Holstein cows. Research was conducted on 315 Holstein cows from 5 municipalities in the Department of Antioquia, Colombia. Individuals were genotyped using PCR/RFLP. The statistical analysis was carried out using generalized linear models and a regression analysis. Polymorphism of the bGH gene was found to have a significant association with the percentage of protein in milk and milk yield. Genotype (-/-) was favorable for dairy yield, while genotype (+/+) was favorable for protein percentage. The PRL gene showed no significant association with any of the evaluated characteristics. The bGH gene appears to be a candidate for the implementation of marker-assisted selection programs. To determine the effect of the prolactin gene, research should be conducted with a larger sample size and a group of animals with more balanced genotypes.

La menopausia en el curriculo de la Facultad de Medicina de la Universidad de Antioquia / The menopause as a part of the curriculum of the School de Medicine of the Antioquia University

El presente informe responde por la investigación realizada entre los años 1997-98, con 128 estudiantes de los niveles XII y XIII correspondientes al año de Internado, de la Facultad de Medicina de la Universidad de Antioquia, en la Ciudad de Medellín

Focal liver lesions: characterization with conventional spin-echo versus fast spin-echo T2-weighted MR imaging.

PURPOSE: To compare prospectively the diagnostic accuracy of T2-weighted conventional spin-echo (SE) and fast SE magnetic resonance (MR) imaging for differentiation of benign (hemangiomas or cysts) from malignant (metastases or hepatocellular carcinoma) liver lesions. MATERIALS AND METHODS: Fifty-three patients with 55 confirmed liver lesions (20 hemangiomas, eight cysts, 22 metastases, four hepatocellular carcinomas, one malignant fibrous histiocytoma) underwent T2-weighted conventional SE (repetition time msec/echo time [TE] msec = 3,100/ 80,160) and fast SE (5,000-5,000/99-104 [effective TE]) MR imaging at 1.5 T. The images were evaluated quantitatively (lesion-liver signal intensity ratio and lesion T2 index [SIlesion TE80/SIlesion TE160, where SI = signal intensity] and qualitatively (blinded reading) by using receiver operating characteristic analysis. RESULTS: Quantitatively, the T2 index (Az = .988) was more accurate than the signal intensity ratio at conventional SE (Az = .920) and fast SE (Az = .910) imaging (P < .05). Qualitatively, there was no statistically significant difference between the blinded reading of conventional SE (Az = .988) and fast SE (Az = .986) images in lesion characterization (benign vs malignant). There was a trend, however, toward superiority of conventional SE imaging for evaluation of "hypervascular" metastases (n = 9). CONCLUSION: With the specific parameters used, conventional SE and fast SE images provide equal accuracy for characterization of focal liver lesions. In patients with hypervascular metastases, double-echo conventional SE images may be preferable.

T2 relaxation times of hypervascular and non-hypervascular liver lesions: do hypervascular lesions mimic haemangiomas on heavily T2-weighted MR images?

AIM: To correlate the T2 relaxation times of liver lesions with their vascularity at angiography and to determine whether hypervascular lesions have similar signal intensity to haemangiomas on heavily T2-weighted MR images. PATIENTS AND METHODS: Thirty-four patients with histologically proven malignant liver lesions had both angiography and T2W (SE 3000/80,160) MR imaging (1.5 T) of the liver. Angiographically, the lesions were hypervascular in 15 and non-hypervascular in 19 patients. Fifteen additional patients with proven haemangioma also had MR imaging during the same time period. The T2 relaxation time of a representative lesion was calculated for each patient and the results compared. RESULTS: The mean T2 time for hypervascular lesions was 76 +/- 21 ms compared with 79 +/- 18 ms for non-hypervascular lesions (P = 0.61). The mean T2 relaxation time for haemangiomas was significantly longer than either group: 147 +/- 46 ms (P = 0.0001). CONCLUSION: The T2 relaxation times of hypervascular and non-hypervascular liver lesions are similar and are significantly shorter than those of haemangiomas. Therefore, hypervascular lesions should not mimic haemangiomas on heavily T2-weighted images.

Percutaneous drainage of subphrenic fluid collections that occur after splenectomy: efficacy and safety of transpleural versus extrapleural approach.

OBJECTIVE: The purpose of this study was to compare the safety and efficacy of transpleural and extrapleural approaches for draining left subphrenic abscesses in patients who have had splenectomy. MATERIALS AND METHODS: Twenty-five patients who had percutaneous catheter drainage (28 drainages) of postsplenectomy fluid collections were studied. Twenty drainages were transpleural and eight were extrapleural. In eight of the 20 transpleural drainages, it was elected to place the catheter transpleurally. In the remaining 12 patients, catheter drainage was judged to be transpleural on review, despite efforts to use an extrapleural approach. RESULTS: Sixteen of 18 patients who had transpleural percutaneous drainage and six of seven patients who had true extrapleural (subcostal) percutaneous drainage were cured by catheter drainage requiring no further intervention. The mean number of days of drainage was not significantly different (p > .05) for the group drained transpleurally (mean, 18 days; range, 1-90 days) versus the group drained extrapleurally (mean, 20 days; range, 6-43 days). Complications (pneumothorax) requiring treatment were seen in two patients in whom a transpleural approach was used and in none of the patients in whom an extrapleural approach was used. Complications that did not require treatment were seen in four further patients drained transpleurally. These were inadvertent placement of catheter into pleural space (two patients) and pneumothorax not requiring treatment (two patients). No patient had an empyema. CONCLUSION: Transpleural drainage of left subphrenic collections occurring after splenectomy is associated with a slightly increased complication rate but has a success rate similar to that of extrapleural drainage.

An acrylic resin core for processing silicone facial prostheses.

A technique is presented for making an acrylic resin core for processing silicone facial prostheses. This technique ensures a durable core that can be used to make multiple prostheses. The core resists fungal growth during storage and creates a smooth, easily cleanable internal surface for a facial prosthesis. The core also permits a controllable thickness and therefore a lighter prosthesis.

Impression making, sculpting, and coloring of orbital prostheses.

The replacement of any anatomic structure by artificial means remains a challenge. This is particularly true in the facial area. The replacement must be one which blends with the adjacent tissues as well as replaces the missing structures. Careful planning and meticulous attention to detail in fabrication of a prosthesis can enable the maxillofacial prosthodontist to make a major contribution in the rehabilitation of the patient with an orbital defect.