Routine versus selective histological examination after cholecystectomy to exclude incidental gallbladder carcinoma.

Introduction Gallstone disease is treated commonly with cholecystectomy. Malignant disease of the gallbladder may present similarly and has a poor prognosis. It is common for cholecystectomy specimens to be sent for histological examination to exclude malignancy. However, the incidence of incidental gallbladder carcinoma (IGBC) is low and it has therefore been suggested that macroscopic inspection of the gallbladder by the surgeon, followed by selective histological examination of abnormal specimens, may be safe and cost saving. Methods All cholecystectomies performed between 1 May 2003 and 1 September 2009 were identified from clinical coding. Pathology records were used to identify gallbladder malignancies; these were searched manually to identify IGBC. Pathology reports and case notes were cross-referenced to determine whether there were macroscopic abnormalities present. Annual cost savings were estimated by comparing the number of gallbladder specimens over one year (May 2013 - April 2014) with the total number of cholecystectomies performed in that time. Results Of 4,776 cholecystectomies identified, 12 (0.25%) were cases of IGBC. These cases had a higher median age (68 vs 54 years, p<0.001) and a higher proportion were emergency operations (50% vs 12%, p<0.001). All cases had some form of macroscopic abnormality, most commonly wall thickening (n=6, 50%). Only two cases (17%) had a visible tumour present. Conclusions All cases of IGBC in this study had a macroscopically abnormal gallbladder. Our findings suggest it is safe to adopt a selective approach to histological examination. Savings of almost £20,500 per annum have been achieved.

Protein-nitrogen flux and protein growth efficiency of individual Atlantic salmon (Salmo salar L.).

Protein-nitrogen flux (the proportions of consumed and absorbed protein-nitrogen partitioned into protein synthesis and growth) was examined in Atlantic salmon, Salmo salar L. Salmon were held in groups and fed high or low rations or starved. Individual food consumption rates were measured using radiography. Fish varied widely in protein growth efficiency (protein growth divided by protein consumption), but this did not correlate with consumption rate, digestive capacity (as measured by absorption efficiency, trypsin levels and pyloric caecal size) or feeding hierarchy rank. Protein synthesis rates, measured in whole-animals, were linearly correlated with protein consumption and assimilation. There was a significant correlation between protein growth efficiency and the efficiency of retention of synthesised proteins. The capacity for protein synthesis and RNA activity were positively correlated with rates of food consumption and growth but were not correlated with protein growth efficiency. It was concluded that individual differences in protein growth efficiency related to differences in synthesis retention efficiency, but not to differences in the capacity for protein synthesis, RNA activity, digestive capacity or feeding hierarchy rank.

Digestive enzyme levels and histopathology of pancreas disease in farmed Atlantic salmon (Salmo salar).

1. The pancreatic digestive enzyme activities of trypsin and chymotrypsin were assessed in vitro and were found to correlate well with the histological changes characteristic of pancreas disease (PD) in farmed Atlantic salmon (Salmo salar). 2. Pancreatic enzyme activity was assessed in vivo using the chymotrypsin specific substrate N-benzoyl-L-tyrosyl-p-aminobenzoic acid. In all cases, significantly less p-aminobenzoic acid was excreted by fish later found to be suffering from PD. 3. It is concluded that the in vitro digestive enzyme assay was effective in diagnosing PD with the in vivo method, indicating further promise for assessing exocrine pancreatic function.

Binding of [14C]inosine to gustatory tissues of the turbot, Scophthalmus maximus.

Reversible specific binding of [14C]inosine has been demonstrated in turbot (Scophthalmus maximus) buccal tissues rich in taste buds. A highly significant correlation was found for a series of nucleosides and nucleotides between their feeding stimulant activity and their ability to displace bound [14C]inosine. It is concluded that the binding of inosine is the first step in the gustatory process.

Gadusol, an enolic derivative of cyclohexane-1,3-dione present in the roes of cod and other marine fish. Isolation, properties and occurrence compared with ascorbic acid.

Gadusol, C8H12O6, has been isolated from roes of the cod (Gadus morhua L.), i.e., ovaries that contain ripe eggs just before spawning. The concentration is about 4 g/kg dry wt. It has been identified as 1,4,5-trihydroxy-5-hydroxymethyl-2-methoxycyclo-hex-1-en-3-one and this structure was confirmed by synthesis of the anhydro tetra-acetate derivative from methyl 3,5-diacetoxy-4-methoxybenzoate. Concentrations of gadusol in the roes of other marine teleost fish examined are of the same order as in cod roes. Gadusol has some properties similar to ascorbic acid and both compounds, after oxidation, react with 2,4-dinitrophenylhydrazine in the commonly-used assay procedure for ascorbic acid. Specific assays showed that the concentrations of gadusol in the roes of marine fish are severalfold greater than those of ascorbic acid. Gadusol is structurally related to the mycosporines previously reported from a number of different organisms.