Magnesium Supplementation Is Associated with a Lower Cardio-Metabolic Risk in Patients Submitted to Bariatric Surgery.

PURPOSE: Literature has demonstrated an inverse relation between magnesium (Mg) consumption and development of type 2 diabetes mellitus (T2DM), hypertension (HT), and dyslipidemia. After bariatric surgery (BS), micronutrients deficiencies are common, it being important to ensure appropriate supplementation. There is no recommendation about Mg supplementation and to our knowledge, its effect has not been studied to date. Our aim was to evaluate the effect of Mg supplementation in cardio-metabolic risk factors on post-bariatric patients. MATERIALS AND METHODS: A retrospective observational study of patients with obesity who underwent BS was performed. Data was assessed preoperatively and yearly (4-year follow-up). RESULTS: A total of 3363 patients were included. In the first year of follow-up, 79.8% (n = 2123) of the patients were supplemented with Mg, with evidence of slightly decreased percentages in the following years. Mg deficiency (serum Mg < 1.52 mEq/L) was more common among patients who were not supplemented during each year of follow-up (p < 0.05). Among those who underwent Mg supplementation, the percentage of T2DM, HT, or low-density lipoprotein cholesterol (LDL-C) > 130 mg/dL was significantly lower. In the first year post-surgery, the supplementation group had a lower risk of T2DM (OR = 0.545, p < 0.0001), LDL-C > 130 mg/dL (OR = 0.612, p < 0.0001), and HT (OR = 0.584, p < 0.0001). The OR for having these metabolic comorbidities persisted lower during the 4 years' follow-up. Patients who had Mg deficiency had higher prevalence of T2DM and HT. CONCLUSION: Mg supplementation seems to have a protective effect on the development of T2DM, HT, and LDL-C > 130 mg/dL in post-bariatric patients.

A 10-min Targeted Geriatric Assessment Predicts Mortality in Fast-Paced Acute Care Settings: A Prospective Cohort Study.

OBJECTIVES: To estimate whether a 10-minute Targeted Geriatric Assessment (10-TaGA) adds utility to sociodemographic characteristics and comorbidities in predicting one-year mortality in busy acute care settings. We have also compared the performance of 10-TaGA with the Identification of Seniors at Risk (ISAR) scale. DESIGN: Prospective cohort study. SETTING: Geriatric day hospital specializing in acute care in Brazil. PARTICIPANTS: 751 older adults aged 79.4 ± 8.4 years (64% female), presenting non-surgical, medical illness requiring hospital-level care (e.g., intravenous therapy, laboratory test, radiology) for ≤ 12 hours. MEASUREMENTS: The 10-TaGA, an easy-to-administer screening tool based on the comprehensive geriatric assessment (CGA), provided a measure of cumulative deficits ranging from 0 (no deficits) to 1 (highest deficit) on admission. Standard risk factors, including sociodemographics (age, gender, ethnicity, income) and the Charlson comorbidity index, were evaluated. The ISAR, a well-validated screening tool, was used for comparison. RESULTS: During one year of follow-up, 130 (17%) participants died. Compared to the ISAR, 10-TaGA offered better accuracy in identifying older patients at risk of death (area under the receiver operating characteristic curve: [AUC] 0.70 vs 0.65; P = 0.03). In a Cox regression model adjusted for sociodemographics and comorbidities, each 0.1 increment in the 10-TaGA score (range 0-1) was associated with increased mortality (hazard ratio = 1.42, 95% confidence interval 1.27-1.59). The addition of 10-TaGA markedly improved the discrimination of the model, which already incorporated standard risk factors (AUC 0.76 vs 0.71; P = 0.005); adding ISAR (AUC 0.73 vs 0.71; P = 0.09) did not have this marked effect. CONCLUSION: The 10-TaGA is an independent predictor of one-year mortality in acute care patients. This multidimensional screening tool offers better accuracy than ISAR when differentiating between older people at low and high risk of death in healthcare settings where providers have limited time and resources.

Differential expression of LHCGR and its isoforms is associated to the variability in superovulation responses of Gir cattle.

The aim of this study was to evaluate the pattern of expression of LHCGR isoforms in Gir heifers characterized as good (10.3 ±â€¯1.2 ova/embryos per flush, n = 5) or poor responders (1.1 ±â€¯0.3 ova/embryos per flush, n = 5) to superovulation protocols. In both groups, an adapted ultrasound-guided follicular aspiration system was used to collect granulosa cells from 8 mm follicles formed either during a synchronized, non-stimulated follicular wave (no stimulation control, NS) or on the fourth day of a superovulation protocol (SOV) induced with 200 IU of pFSH. The recovered follicular fluid was centrifuged and granulosa cells were washed with NaCl 0.9% and kept in RNAlater®. RNA extraction was performed using a commercial RNeasy Micro Kit and eluted samples were quantified and reverse transcribed using the commercial Superscript III kit. cDNA samples were amplified by real-time PCR using a primer to target LH/hCG receptor gene - not selective for LHCGR isoforms (total LHCGR) - and four sets of isoforms selective primers (S1, S10, S10 + 11, and S11). Analyses were performed using the REST software and expression levels are shown as mean ± SEM. Under physiological conditions (NS), poor responders had a higher expression of total LHCGR (4.9 ± 1.7 fold-change, P < 0.01) as well as isoforms S10, S11 and S10 + 11, compared to good responders. In both phenotypes, superovulation down-regulated total LHCGR expression (-0.5 ± 0.2 and -0.9 ± 0.0 for good and poor responders, respectively; P < 0.05). However, in poor responders the exogenous FSH treatment up-regulated the S10 (2.4 ± 2.0; P < 0.05), S10 + 11 (3.8 ± 3.2; P < 0.01), and S1 isoforms (1.8 ± 1.3; P < 0.05), compared to good responders We conclude that down-regulation of total LHCGR, associated to up-regulation of their inactive isoforms, may have compromised follicle development and thus contributed to the low efficiency of superovulation in heifers with a poor responder phenotype.

Squalus bassi sp. nov., a new long-snouted spurdog (Chondrichthyes: Squaliformes: Squalidae) from the Agulhas Bank.

The long-snouted African spurdog Squalus bassi sp. nov. is described based on material collected from the outer shelf and upper continental slope off South Africa and Mozambique. Squalus bassi shares with S. mitsukurii, S. montalbani, S. chloroculus, S. grahami, S. griffini, S. edmundsi, S. quasimodo and S. lobularis a large snout with prenarial length greater than distance between nostrils and upper labial furrows, dermal denticles tricuspidate and rhomboid and elevated number of vertebrae. Squalus bassi can be distinguished from all its congeners by a combination of body and fin colouration, external morphometrics, vertebral counts and shape of dermal denticles. Similar long-snouted congeners from the Indo-Pacific region, including S. montalbani, S. edmundsi and S. lalannei are compared in detail with the new species. This new species has been misidentified as the Japanese S. mitsukurii and the Mediterranean S. blainvillei due to the lack of comparative morphological analyses. The validity of the nominal species S. mitsukurii in the south-eastern Atlantic Ocean and western Indian Ocean is also clarified herein, indicating it has a more restricted geographical distribution in the North Pacific Ocean.

Cloprostenol administration in the first week postpartum reduces expression of oxytocin receptors in the endometrium in Holstein-Zebu cows / Administração de cloprostenol na primeira semana pós-parto pode reduzir a expressão de receptores de ocitocina no endométrio de vacas mestiças Holandês-Zebu

The present study investigated the hormonal profile and expression of prostaglandin F2α (PGF2α), oxytocin and estrogen receptors in uterine tissues of postpartum cows treated with cloprostenol. Twenty Holstein-Zebu crossbred cows were treated with saline solution (treatment CONT) or cloprostenol (treatment CLO), both administered two and five days postpartum. Blood samples were collected on days two, seven, 14, 21 and 28 postpartum for progesterone, PGF2α metabolite (PGFM) and estradiol determination, and endometrial biopsy was performed in order to quantify the expression of oxytocin receptor (OXTR), prostaglandin F receptor (PTGFR) and estrogen receptor 1 (ERS1) genes. In the CLO treatment, expression of OXTR was reduced (P<0.05) but no difference (P>0.05) between treatments was found for PTGFR and ERS1 expression. Estrogen concentrations increased progressively until day 14 (P<0.05) and the highest OXTR expression and lowest PTGFR expression were observed on day 14 (P<0.05) in both treatments. Serum PGFM concentrations were high throughout the experiment. In conclusion, cloprostenol administration at days two and five of postpartum seems to reduce OXTR expression in the endometrium in crossbred cows.(AU)

O presente estudo avaliou o perfil hormonal e a expressão gênica de receptores de prostaglandina F2α (PGF2α), ocitocina e estrógeno no endométrio de vacas pós-parto tratadas com cloprostenol. Vinte vacas mestiças Holandês-Zebu foram tratadas com solução salina (tratamento CONT, n = 10) ou cloprostenol (tratamento CLO, n = 10), ambos administrados dois e cinco dias após o parto. Amostras de sangue foram coletadas nos dias dois, sete, 14, 21 e 28 pós-parto para mensuração de progesterona, de metabólito de PGF2α (PGFM) e de estradiol, e foram obtidas biópsias endometriais para quantificar a expressão de PTGFR, OXTR e ESR1. No tratamento CLO, a expressão gênica de receptores de ocitocina foi menor (P<0,05). As concentrações de estrógeno aumentaram progressivamente até o dia 14 (P<0,05). A maior expressão de OXTR foi observada no dia 14 (P<0,05). A expressão de ESR1 foi semelhante entre os tratamentos (P>0,05). Os níveis de PGFM foram altos durante todo o estudo. Conclui-se que a administração de cloprostenol nos dias dois e cinco pós-parto parece diminuir a expressão de OXTR no endométrio em vacas mestiças.(AU)

Intrafollicular oestradiol production, expression of the LH receptor (LHR) gene and its isoforms, and early follicular deviation in Bos indicus.

The aim of the present study was to characterise the roles of intrafollicular oestradiol production and granulosa cell (GC) expression of the LH receptor (LHR) gene and its isoforms during follicular deviation in Bos indicus. Follicular wave emergence was synchronised in heifers from a Bos taurus dairy (Holstein; n=10) and a B. indicus dairy breed (Gir; n=10). Follicles were aspirated individually at sizes corresponding to the periods of predeviation, deviation and postdeviation. Intrafollicular oestradiol (IF-E2) and progesterone (IF-P4) concentrations were determined in the follicular fluid (FF) by radioimmunoassay, and relative expression of P450 aromatase (CYP19A1) and LHR forms was evaluated in GC using real-time quantitative-polymerase chain reaction. Despite differences in the size of the dominant follicle at deviation, changes in CYP19A1 expression and IF-E2 concentrations were similar in follicles of the same diameter in both breeds. A peak in total LHR expression occurred after follicular deviation in association with low expression of LHR isoforms. The results suggest that regulation of LHR function by sequential changes in the expression pattern of LHR isoforms may play a role in the early deviation of the dominant follicle, as observed in B. indicus breeds.

Polymorphisms and alternative splicing of the luteinizing hormone receptor of dairy cattle.

The aim of this study was to screen for variability in the luteinizing hormone/choriogonadotropin receptor (LHCGR) and to determine the occurrence of LHCGR mRNA isoforms in two dairy breeds of cattle. Granulosa cells from dominant ovarian follicles were recovered from 16 Gir and 16 Holstein cows, and total RNA was extracted. Complementary DNA was synthesized and PCR was used to generate amplicons for sequencing. Chromatograms were evaluated, and multiple sequences were aligned and analyzed for the presence of polymorphisms, allele frequency, polymorphic information content (PIC), and Hardy-Weinberg equilibrium (HWE). Twenty-one single nucleotide polymorphisms (SNPs) were identified in LH receptor mRNA. Seventeen SNPs were identified in Gir cattle (seven exclusively), and 14 were found in Holstein cattle (four exclusively). Seven of the 21 polymorphisms found did not alter which amino acid was translated. Eight SNPs caused a change to an amino acid in a different chemical group. Classification of SNPs according to PIC values identified 12 as being highly informative in Gir cattle and five in Holstein. Eight SNPs deviated from HWE in Gir compared with 11 in Holstein, and eight in both breeds. Two isoforms were also identified, one in exon 1, which lacks 30 nucleotides beginning at position 118, and the other in exon 10. Taken together, these data show that LHCGR in dairy cattle breeds has a high frequency of polymorphism and exists in multiple isoforms resulting from alternative splicing.

Absence of Sperm Factors as in the Parthenogenesis Does Not Interfere on Bovine Embryo Sensitiveness to Heat Shock at Pre-Implantation Stage.

Oocyte has been considered the major contributor for embryo thermo-tolerance. However, it was shown that sperm factors can be transferred to the oocyte during fertilization, raising the question of whether the absence of such factors could interfere on embryo thermo-tolerance. In this study, we used parthenogenesis to generate bovine embryos without spermatozoa in order to test whether the absence of sperm factors could influence their thermo-sensitiveness at early stages. In vitro fertilized (IVF) and parthenogenetic (PA) embryos at 44 h post-insemination/chemical activation were exposed to 38.5°C (control) or 41°C (heat shock) for 12 h and then developed for 48 h and up to blastocyst stage. Apoptosis index and expression of PRDX1, GLUT1, GLUT5 and IGF1r genes in blastocysts derived from heat-shocked embryos were also evaluated. The heat shock decreased the blastocyst rate at day seven (p < 0.05) for IVF embryos and at day eight (p < 0.01) for both IVF and PA embryos. Total cell number was not affected by heat shock in IVF and PA blastocysts, but there was an increased proportion (p < 0.05) of apoptotic cells in heat-shocked embryos when compared to controls. There was no interaction (p > 0.05) between method of activation (IVF and PA) and temperature (38.5°C or 41.5°C) for all developmental parameters evaluated. Expression of GLUT1 gene was downregulated (p < 0.05) by heat shock in both IVF and PA blastocyst whereas expression of GLUT5 and IGF1r genes was downregulated (p < 0.05) by heat shock in PA blastocysts. Those data show that the heat shock affects negatively the embryo development towards blastocysts stage, increases the apoptotic index and disturbed the expression of some genes in both IVF and PA embryos, indicating that the presence or absence of sperm factors does not influence the sensitivity of the bovine embryo to heat shock.

Activity of cycloartane-type triterpenes and sterols isolated from Musa paradisiaca fruit peel against Leishmania infantum chagasi.

UNLABELLED: The aim of the study was to evaluate in vitro the antileishmanial activity of triterpenes and sterols isolated from Musa paradisiaca (banana) fruit peel used traditionally to treat leishmaniasis. The compounds were isolated from the ethanolic extract of the peel of the banana fruit by column chromatography. The chemical structure of compounds was determined by (1)H and (13)C - nuclear magnetic resonance spectroscopy. The cytotoxicity was measured in RAW 264.7 cells and LLC-MK2. Leishmanicidal activity against L. infantum chagasi promastigotes was performed by the MTT colorimetric method and activity against amastigotes was assayed in mammalian cells using in situ ELISA method. Five compounds were identified, consisting of three triterpenes: cycloeucalenone, 31-norcyclolaudenone and 24-methylene-cicloartanol and a mixture of two sterols: beta-sitosterol and stigmasterol. With the exception of cycloeucalenone, all compounds showed statistically similar activity against promastigote to pentamidine. While, acting against amastigotes, excluding 31-norcyclolaudenone, other compounds showed activity similar to amphotericin B. All compounds showed low cytotoxicity in mammalian cells. CONCLUSION: This study partially confirms the use of Musa paradisiaca in folk medicine against leishmaniasis. Further in vivo studies are necessary to evaluate the efficacy.

Expression of immune response genes in peripheral blood of cattle infested with Rhipicephalus microplus.

The bovine tick Rhipicephalus microplus is responsible for severe economic losses in tropical cattle production. Bos indicus breeds are more resistant to tick infestations than are Bos taurus breeds, and the understanding of the physiological mechanisms involved in this difference is important for the development of new methods of parasite control. We evaluated differences in the transcript expression of genes related to the immune response in the peripheral blood of cattle previously characterized as resistant or susceptible to tick infestation. Crossbreed F2 Gir x Holstein animals (resistant, N = 6; susceptible, N = 6) were artificially submitted to tick infestation. Blood samples were collected at 0, 24, and 48 h after tick infestation and evaluated for transcript expression of the CD25, CXCL8, CXCL10, FoxP3, interleukin (IL)-10, and tumor necrosis factor alpha (TNFα) genes. Gene expression of CD25 (6.00, P < 0.01), IL-10 (31.62, P < 0.01), FoxP3 (35.48, P < 0.01), and CXCL10 (3.38, P < 0.05) was altered in the resistant group at 48 h compared with samples collected before infestation. In the susceptible group, CXCL8 (-2.02, P < 0.05) and CXCL10 (2.20, P < 0.05) showed altered expression 24 h after infestation. CXCL8 (-5.78, P < 0.05) also showed altered expression at 48 h after infestation when compared with samples collected before infestation. We detected a correlation between T γδ cell activity and the immunological mechanisms that result in a higher resistance to R. microplus in cattle.

Spatial memory impairments in a prediabetic rat model.

Diabetes is associated with an increased risk for brain disorders, namely cognitive impairments associated with hippocampal dysfunction underlying diabetic encephalopathy. However, the impact of a prediabetic state on cognitive function is unknown. Therefore, we now investigated whether spatial learning and memory deficits and the underlying hippocampal dysfunction were already present in a prediabetic animal model. Adult Wistar rats drinking high-sucrose (HSu) diet (35% sucrose solution during 9 weeks) were compared to controls' drinking water. HSu rats exhibited fasting normoglycemia accompanied by hyperinsulinemia and hypertriglyceridemia in the fed state, and insulin resistance with impaired glucose tolerance confirming them as a prediabetic rodent model. HSu rats displayed a poorer performance in hippocampal-dependent short- and long-term spatial memory performance, assessed with the modified Y-maze and Morris water maze tasks, respectively; this was accompanied by a reduction of insulin receptor-ß density with normal levels of insulin receptor substrate-1 pSer636/639, and decreased hippocampal glucocorticoid receptor levels without changes of the plasma corticosterone levels. Importantly, HSu animals exhibited increased hippocampal levels of AMPA and NMDA receptor subunits GluA1 and GLUN1, respectively, whereas the levels of protein markers related to nerve terminals (synaptophysin) and oxidative stress/inflammation (HNE, RAGE, TNF-α) remained unaltered. These findings indicate that 9 weeks of sucrose consumption resulted in a metabolic condition suggestive of a prediabetic state, which translated into short- and long-term spatial memory deficits accompanied by alterations in hippocampal glutamatergic neurotransmission and abnormal glucocorticoid signaling.

Genetic variability of an endangered Bromeliaceae species (Pitcairnia albiflos) from the Brazilian Atlantic rainforest.

Pitcairnia albiflos is a Bromeliaceae species endemic to Brazil that has been included as data-deficient in the extinction risk list of Brazilian flora. We analyzed genetic variability in P. albiflos populations using RAPD markers to investigate population structure and reproductive mechanisms and also to evaluate the actual extinction risk level of this species. Leaves of 56 individuals of P. albiflos from three populations were collected: Urca Hill (UH, 20 individuals), Chacrinha State Park (CSP, 24 individuals) and Tijuca National Park (TNP, 12 individuals). The RAPD technique was effective in characterizing the genetic diversity in the P. albiflos populations since it was possible to differentiate the populations and to identify exclusive bands for at least two of them. Even if there is low genetic diversity among them (CSP-UH = 0.463; CSP-TNP = 0.440; UH-TNP = 0.524), the populations seem to be isolated according to the low genetic diversity observed within them (H(pop) CSP = 0.060; H(pop) UH = 0.042; H(pop) TNP = 0.130). This fact might be the result of clonal and self-reproduction predominance and also from environmental degradation around the collection areas. Consequently, it would be important to protect all populations both in situ and ex situ to prevent the decrease of genetic variability. The low genetic variability among individuals of the same population confirms the inclusion of this species as critically endangered in the risk list for Brazilian flora.

Somatic development and embryo yield in crossbred F1 mice generated by different mating strategies.

The aim of this study was to evaluate different mating strategies among endogamic strains to create F1 populations of mice, minimising the effect of inbreeding depression on somatic development and embryo yield. Females from the strains Swiss, CBA and C57Bl/6 were divided in nine experimental mate arrangements. The total numbers of pups born alive per dam and somatic development, estimated by weighing and measuring the crown-rump length, were recorded. Superovulation response was evaluated in outbreed females. Litter size differed among endogamic dams, irrespective of the sire. Somatic development results suggest heterosis and imprinting phenomena, once a differential parental effect was demonstrated. There was no difference in corpora lutea, ova or embryos recovered (P > 0.05), but recovery and viability rates differ among F1 groups (P < 0.05). The association of dam prolificity with somatic development and superovulation response of the pups should be considered for experimental F1 populations establishment. The use of outbreed animals, however, did not reduce response variability to hormone treatment.

Somatic development and embryo yield in crossbred F1 mice generated by different mating strategies / Desenvolvimento somático e produção de embriões em camundongos cruzados F1 gerados com diferentes estratégias de cruzamento

The aim of this study was to evaluate different mating strategies among endogamic strains to create F1 populations of mice, minimising the effect of inbreeding depression on somatic development and embryo yield. Females from the strains Swiss, CBA and C57Bl/6 were divided in nine experimental mate arrangements. The total numbers of pups born alive per dam and somatic development, estimated by weighing and measuring the crown-rump length, were recorded. Superovulation response was evaluated in outbreed females. Litter size differed among endogamic dams, irrespective of the sire. Somatic development results suggest heterosis and imprinting phenomena, once a differential parental effect was demonstrated. There was no difference in corpora lutea, ova or embryos recovered (P > 0.05), but recovery and viability rates differ among F1 groups (P < 0.05). The association of dam prolificity with somatic development and superovulation response of the pups should be considered for experimental F1 populations establishment. The use of outbreed animals, however, did not reduce response variability to hormone treatment.

Objetivou-se neste estudo avaliar diferentes estratégias de cruzamento entre linhagens endogâmicas para a formação de populações de camundongos F1, minimizando o efeito da depressão por endogamia nos resultados de desenvolvimento somático e produção de embriões. Fêmeas das linhagens Swiss, CBA e C57Bl/6, foram distribuídas em nove possíveis cruzamentos. Foram registrados o número de filhotes nascidos vivos por matriz e o desenvolvimento somático dos mesmos, mensurado pelo peso e comprimento. A resposta superovulatória foi avaliada nas fêmeas cruzadas. O tamanho das ninhadas diferiu entre as linhagens das matrizes, de forma independente da linhagem dos reprodutores. Os resultados do desenvolvimento somático sugerem a ocorrência de heterose e imprinting, uma vez que foi demonstrado um efeito parental diferenciado. Não foram observadas diferenças no número de corpos lúteos, estruturas ou embriões recuperados (P > 0,05), mas as taxas de recuperação e o percentual de embriões viáveis diferiram entre os grupos (P < 0,05). A associação da prolificidade da linhagem das matrizes com as características do desenvolvimento somático e resposta superovulatória dos filhotes deve ser considerada no estabelecimento de populações experimentais F1. O uso de animais cruzados, contudo, não reduziu a variabilidade da resposta aos tratamentos hormonais.

Results of R0 surgery with D2 lymphadenectomy for the treatment of localised gastric cancer.

INTRODUCTION: Surgical excision is the best therapeutic option for gastric cancer, provided it is performed with curative intent as R0 surgery. And, according to many authors, D2 lymphadenectomy may be performed with acceptable morbidity and mortality rates. MATERIALS AND METHODS: A prospective study was conducted on a series of 126 consecutive cases of gastric cancer treated with gastrectomy and D2 lymphadenectomy. A R0 resection was done in 99 cases (78.6%). RESULTS: Total gastrectomy was performed in 70 patients and subtotal gastrectomy in 29. The mean number of lymph nodes removed was 32.5 per patient. Suture dehiscence occurred in 3 patients (in one of them in the esophago-jejunal anastomosis). Hospital mortality was 2%. Twenty-six recurrences were detected after a median follow-up of 73.6 months. Five-year actuarial survival was 65%. Five-year survival of patients with positive lymph nodes at the N2 level was 26.5%. CONCLUSIONS: Gastrectomy with D2 lymphadenectomy may be performed with low morbidity and mortality. R0 resection allows acceptable survival rates to be achieved. There is even a group of patients with invaded lymph nodes at the N2 level surviving at 5 years. It appears to be very important that this surgery is performed by specialised surgeons.

Results of R0 surgery with D2 lymphadenectomy for the treatment of localised gastric cancer

INTRODUCTION: Surgical excision is the best therapeutic option for gastric cancer, provided it is performed with curative intent as R0 surgery. And, according to many authors, D2 lymphadenectomy may be performed with acceptable morbidity and mortality rates. MATERIALS AND METHODS: A prospective study was conducted on a series of 126 consecutive cases of gastric cancer treated with gastrectomy and D2 lymphadenectomy. A R0 resection was done in 99 cases (78.6%). RESULTS: Total gastrectomy was performed in 70 patients and subtotal gastrectomy in 29. The mean number of lymph nodes removed was 32.5 per patient. Suture dehiscence occurred in 3 patients (in one of them in the esophago-jejunal anastomosis). Hospital mortality was 2%. Twenty-six recurrences were detected after a median follow-up of 73.6 months. Five-year actuarial survival was 65%. Five-year survival of patients with positive lymph nodes at the N2 level was 26.5%. CONCLUSIONS: Gastrectomy with D2 lymphadenectomy may be performed with low morbidity and mortality. R0 resection allows acceptable survival rates to be achieved. There is even a group of patients with invaded lymph nodes at the N2 level surviving at 5 years. It appears to be very important that this surgery is performed by specialised surgeons (AU)

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Mucoid degeneration of the anterior cruciate ligament: magnetic resonance imaging findings of an underdiagnosed entity.

Although imaging and clinical criteria are already established for the diagnosis of mucoid degeneration of the anterior cruciate ligament (ACL), many radiologists remain unaware of their existence. Once regarded as a rare occurrence, it has been recently suggested that its incidence is in fact very much higher than previously thought, and that it is probably underdiagnosed or misdiagnosed as partial ruptures of the ACL or as cystic ganglia. In this review, the authors revisit the literature concerning this subject and present their personal experience with it, stressing the paramount importance of magnetic resonance imaging and correlation with clinical data for a correct diagnosis.

Hemicerebelitis frente a tumor cerebeloso / Hemicerebellitis in contrast to cerebellar tumour

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Diffuse intrasubstance signal abnormalities of the posterior cruciate ligament: the counterpart of the mucoid degeneration of the anterior cruciate ligament? A case series.

In this report seven cases of diffusely altered signal intensity of the posterior cruciate ligament (PCL) at magnetic resonance imaging (MRI) are described. The abnormalities resemble those of mucoid degeneration of the anterior cruciate ligament (ACL) and are associated with it in six cases. Although mucoid degeneration of the ACL is an increasingly reported entity, with well-established imaging criteria at MRI, to the authors' knowledge similar findings were never described before for the PCL. It is hypothesized that these abnormalities of the cruciate ligaments are similar in nature, probably related to degenerative changes of the connective tissue.