Root morphology of mandibular molars: a cone-beam computed tomography study.

BACKGROUND: The aim of the study was to assess the number and anatomical classification of roots and root canals of first and second mandibular molars using cone-beam computed tomography (CBCT) in a Chilean population. MATERIALS AND METHODS: This study evaluated the CBCT scans of 289 patients aged between 14 and 86 years, obtaining a sample of 1022 mandibular first and second molars. The number of roots and root canals was evaluated according to the anatomical classification proposed by Ahmed in 2016. Data were analysed using Pearson's chi-squared test and ANOVA. RESULTS: Nine hundred fifty-one (93.05%) molars had two roots, while the remaining 71 (6.95%) molars had one root. The most frequent root and root canal morphologies found were: ²MM M² D¹ (29.65%), ²MM M²â»¹ D¹ (22.3%) and ²MM M¹ D¹ (13.4%) (M - mesial, D - distal), with a total of 32 different anatomical distributions. C-shaped canals were present in 56 molars and were more frequently found in women than in men (7.1% vs. 3.88%; p = 0.024). CONCLUSIONS: The analysis of internal anatomy using CBCT revealed a highly variable distribution of root canals. The most frequent morphology found in mandibular molars in a Chilean population was two roots and three canals.

In-hospital mortality risk score for very old patients hospitalized with decompensated chronic heart failure.

OBJECTIVE: To derive a risk score to predict in-hospital mortality for very old patients with decompensated chronic heart failure (DCHF). METHODOLOGY: Retrospective cohort study that included patients ≥ 80 years admitted to a Geriatric Acute Care Unit with DCHF between January 2012 and December 2014. We analyzed 70 candidate risk factors and in-hospital mortality. We derived a risk model using multivariate logistic regression model and constructed a scale for scoring risk. We used bootstrapping techniques for the internal validation. RESULTS: We included 629 patients with mean age of 90 (SD5) years, 470 (73.1%) being women. Eighty-six (13.7%) patients died during the hospitalization. Factors included in the final risk model were NYHA class III-IV, severe functional dependence (Katz activities of daily living index < 2), infection as cause of exacerbation of heart failure, number of medications ≥ 8, albumin < 3 mg/dL, glomerular filtration rate < 60 mL/min, level of potassium in blood > 5.5 mEq/L and red blood cell distribution width (RDW) > 17%. In-hospital mortality in risk groups was 3.0, 4.6, 9.5, 15.1 and 36.3%, respectively. The area under ROC curve risk for score after bootstrapping was 0.77 (95%: CI 0.70-0.83). CONCLUSION: This risk score could be useful for stratifying risk for in-hospital mortality among very old patients admitted to hospital for DCHF.

Binding and endocytosis of a monoclonal antibody to a high molecular weight human milk fat globule membrane-associated antigen by cultured MCF-7 breast carcinoma cells.

The aim of this study was to analyze whether a monoclonal antibody to human milk fat globule membrane-associated antigens, recognized specifically and homogeneously by human breast carcinoma cells but also by normal epithelial cells active in secretion, could be used to restrict the access of antitumoral drugs to cells exposing the epitope. The drug-antibody conjugate to be used is constructed by means of a covalent peptidic linkage stable in extracellular medium but hydrolyzed by lysomal enzymes after endocytosis of the drug-carrier conjugate. This monoclonal antibody specifically immunoprecipitates radioactive material from MCF-7 cells biosynthetically radiolabeled with galactose, glucosamine, palmitic acid, or acetic acid but not with mannose, leucine, or methionine. Upon polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate and dithiothreitol, the label migrates as two bands with apparent molecular weights of about 350,000 and 400,000. These bands disappear, or their molecular weight is affected, after treatment of the cells with cycloheximide or of cell lysates with trypsin, Pronase, or neuraminidase but not treatment of the immunoprecipitate with endoglycosidase F. This suggests that these antigens are glycoproteins with O-linked oligosaccharides containing sialic acid in the epitope. By analogy, they should be similar, if not identical, to those recognized by the monoclonal antibodies designated HMFG1 (H. Burchell, H. Durbin, and J. Taylor-Papadimitriou, J. Immunol., 131:508-513, 1983) and DF3 (H. Sekine, T. Ohno, and D.W. Kufe, J. Immunol., 135:3610-3615, 1985). Binding at 4 degrees C of the 3H-labeled antibody by MCF-7 cells indicates the specific attachment of about 1.2 X 10(6) IgG molecules per cells with a Kd of about 14 nM. At 37 degrees C, cells take up the 3H-labeled antibody in amounts much higher than the binding capacity. In addition to cell-associated material, labeled digestion products are released into the culture medium. Cell fractionation by differential centrifugation and isopycnic equilibration on sucrose gradient indicates that the bulk of cell-associated antibody is distributed like the marker enzyme of lysosomes. Although the total uptake of the antibody by the cells is unaffected by either 50 microM chloroquine or 3 micrograms/ml cycloheximide, the release of digestion products is completely inhibited by chloroquine. Antigen-antibody dissociation is pH dependent, since, respectively, 50 and 84% of membrane-bound antibody are released during washing at pH 4.6 and 4.1.(ABSTRACT TRUNCATED AT 400 WORDS)

Root anatomy and canal configuration of maxillary premolars: a cone-beam computed tomography study / Anatomía de la raíz y configuración del conducto de los premolares maxilares: estudio de tomografía computarizada de haz cónico

SUMMARY: The aim of the study was to determine the number and anatomical configuration of roots and root canals of maxillary first and second premolars using cone-beam computed tomography scans. n273 CBCT scans were evaluated, obtaining a sample of 592 maxillary premolars. Root number and root canal anatomy were categorized using Ahmed´s classification. Data was analyzed using Pearson's Chi-squared test. Two roots were present on 157 first premolars, one root in 132 premolars and three roots in 17. Second premolars presented one root in 266 samples and two roots in 20; no second premolars presented three roots. Eight different configurations were found; the most frequent was 2MP B1 P1 in first premolars (51,3 %) and 1MP1 (63.6 %) in second premolars. The most frequent morphology found in maxillary premolars in Chilean population was two and three roots. The analysis of internal anatomy using CBCT revealed a highly variable distribution of root canals, generally of low to medium complexity, similar to what is found in other ethnic groups.

RESUMEN: El objetivo de este estudio fue determinar el número y la configuración de raíces y canales radiculares de primeros y segundos premolares maxilares utilizado tomografía computacional de haz cónico. 273 TCHC fueron evaluados, obtenido una muestra de 592 premolares maxilares. El número de raíces y la anatomía de los canales radiculares fueron categorizados utilizando la clasificación de Ahmed. Los datos fueron analizados con la prueba Chi- Cuadrado de Pearson. Dos raíces fueron observadas en 157 primeros presentaron una raíz en 266 muestras y dos raíces en 20; no se encontraron tres raíces en segundos premolares. Ocho diferentes configuraciones fueron encontradas; siendo la más frecuente 2MP B1 P1 en primeros premolares (51,3 %) y 1MP1 (63,6 %) en segundos premolares. La morfología radicular más frecuentemente encontrada en premolares de población Chilena fue de dos y tres raíces. El análisis de la anatomía interna usando TCHC mostró una gran variabilidad de en la distribución de los canales radiculares. Generalmente de mediana y baja complejidad como los encontrados en otros grupos etnicos.

Release of D-[3H]aspartic acid from the rat striatum. Effect of veratridine-evoked depolarization, fronto-parietal cortex ablation, and striatal lesions with kainic acid.

The spontaneous and depolarization-evoked release of radiolabeled D-aspartic acid, previously taken up by rat striatal slices, was studied by using a superfusion system. Veratridine (10-50 microM), electrical field stimulation (20 Hz, 1.0 V, 60 sec), and potassium (53 mM) markedly potentiated the release of D-[3H]aspartate from striatal slices. The release of L-[3H]glutamate was also increased by veratridine, according to a pattern and time course of release similar to that of D-[3H]aspartate. However, the ratio of D-[3H]aspartic acid release evoked by veratridine over spontaneous levels of release was much higher when compared to that of radiolabeled L-glutamate. Omission of calcium from the superfusion medium almost completely suppressed D-[3H]aspartate release evoked by veratridine or by electrical stimulation whereas high K+-evoked release of the [3H]amino acid was only slightly reduced. However, increasing Mg2+ concentration to 12 mM in the superfusion medium did substantially block D-[3H]aspartate release induced by K+-depolarization. Additional experiments showed that tetrodotoxin (1 microM), a blocker of voltage-dependent Na+ channels, totally abolished veratridine-evoked release of D-[3H]aspartate from striatal slices. Finally, lesion studies showed that unilateral ablation of the frontoparietal cortex was accompanied by a significant decrease in the high-affinity uptake of striatal D-[3H]aspartate and by a large and parallel loss from striatal slices in D-[3H]aspartate release evoked by either veratridine or high K+. In contrast, unilateral injection of kainic acid into the striatum did not influence depolarization-evoked release of D-[3H]aspartate from striatal slices. The findings reported suggest that D-[3H]aspartic acid may be taken up preferentially and then released, in a Ca2+-dependent manner, by veratridine and electrical stimulation from nerve terminals belonging to the cortico-striatal pathway. In addition, the results provide further support for the view that excitatory amino acids may act as neurotransmitters at the cortico-striatal nerve fibers.

Transient increase of brain derived neurotrophic factor mRNA expression in substantia nigra reticulata after partial lesion of the nigrostriatal dopaminergic pathway.

By using non-isostopic in situ hybridization we have demonstrated a transient increase of BDNF mRNA in the lateral subregion of the substantia nigra pars reticulata 1 week after intrastriatal application of 6-OH-DA. These changes correlate with a partial reduction of dopamine (DA) content in the striatum but with a normal tyrosine hydroxylase immunoreactivity in substantia nigra pars compacta. Our data suggest that non-DA, BDNF expressing cells in substantia nigra pars reticulata may play a role in neuronal protection after partial lesions of the DA nigrostriatal pathway.

Differential regulation of glutamate, aspartate and gamma-amino-butyrate release by N-methyl-D-aspartate receptors in rat striatum after partial and extensive lesions to the nigro-striatal dopamine pathway.

The in vivo microdialysis methodology was used to assess the effect of N-methyl-D-aspartate (NMDA) receptor ligands on glutamate (GLU), aspartate (ASP) and gamma-aminobutyrate (GABA) extracellular levels in the striatum of anaesthetized rats, after damage to the dopamine (DA) nigrostriatal pathway by injections of different doses of 6-hydroxydopamine (6-OH-DA) seven days earlier. The 6-OH-DA treated rats were divided into two groups, corresponding to animals with 20-80% (partial) and 85-99% (extensive) striatal DA tissue depletion, respectively. In rats with partial DA depletion, the striatal extracellular ASP levels significantly increased after intrastriatal dialysis perfusion with MK-801 (100 microM), an antagonist of NMDA receptors. In addition, a change in the pattern of local NMDA (500 microM)- induced efflux of ASP was observed in the striatum of these rats. However, in these partially DA-depleted striata no changes were found in basal extracellular levels of GLU, ASP and GABA or in NMDA- and MK-801-mediated effluxes of GLU and GABA relative to striata from sham rats. In contrast, rats with extensive striatal DA depletion exhibited a significant increase in ASP and GABA extracellular striatal levels, after intrastriatal dialysis perfusion with NMDA. In addition, the MK-801-mediated stimulation of extracellular ASP levels was accentuated along with the appearance of a MK-801 mediated increase in extracellular striatal GLU. Finally, basal extracellular levels of ASP, but not of GLU and GABA, were found to increase in extensive DA-depleted striata when compared to sham and partially DA-depleted striata. Thus, a differential regulation of basal and NMDA receptor-mediated release of transmitter amino acids occur seven days after partial and extensive DA-depleted striatum by 6-OH-DA-induced lesions of the nigrostriatal DA pathway. These findings may have implications as regards the participation of NMDA receptors in the compensatory mechanisms associated with the progress of Parkinson's disease, as well as in the treatment of this neurological disorder.

Depolarization evoked release of d-[(3)H]aspartate from slices of substantia nigra: Effects of dopamine receptor ligands.

A superfusion system was used to study the effects of dopamine receptor agonists and antagonists on spontaneous and stimulus-evoked release of d-[(3)H]aspartic acid preaccumulated by slices of rat substantia nigra. Electrical field stimulation (20 Hz, 1.0 V, 2 min) produced a 2.4-fold increase in d[(3)H]aspartate release from nigral slices. Omission of Ca(2+) and increasing Mg(2+) to 12 mM, or addition of tetrodotoxin (0.1 ?M) to the superfusion medium, substantially blocked d-[(3)H]aspartate release induced by electrical stimulation. Apomorphine (50-100 ?M), a dopamine receptor agonist, significantly enhanced the Ca(2+)-dependent, electrically-evoked release of d-[(3)H]aspartate from nigral slices. Other dopamine receptor ligands, such as 2-amino-6,7-dihydroxy-1,2,3,4-tetrahydronaphthalene (100 ?M), also enhanced the stimulus-evoked release of the [(3)H]amino acid regardless of whether the stimuli applied were electrical or chemical. None of the dopamine receptor agonists tested were able to modify the spontaneous release of d-[(3)H]aspartate. Haloperidol (25 ?M) and (+) butaclamol (10 ?M), two well known dopamine receptor antagonist, had no effect on stimulus-evoked release of d-[(3)H]aspartate from nigral slices but they completely prevented the apomorphine (50 ?M)-mediated enhancement of stimulus-evoked release of [(3)H]amino acid. In contrast, (?) butaclamol, which is devoid of dopamine receptor blocking properties, had no effect on stimulus-evoked or on apomorphine-mediated facilitation of evoked-release of d-[(3)H]aspartate. The results shown support the idea that activation of nigral dopamine receptors may facilitate the Ca(2+)-dependent, depolarization induced-release of excitatory amino acid transmitters from neuronal structures in substantia nigra. The proposition is made that some of these dopamine receptors might be located in cortico-nigral nerve terminals.

Release of d-[(3)H]aspartic acid from the rat substantia nigra: effect of veratridine-evoked depolarization and cortical ablation.

The spontaneous and veratridine-evoked release of radioactive d-aspartic acid, previously taken up by rat substantia nigra slices, was studied by using a superfusion system. Veratridine (25 ?M, 1 min) markedly produced a 14-fold increase in d-[(3)H]aspartic acid release from nigral slices. Omission of Ca(2+) and increasing Mg(2+) concentration to 12 mM in the superfusion medium did substantially block d-[(3)H]aspartate release induced by veratridine depolarization. Nevertheless, veratridine was able to evoke [(3)H]amino acid release which seemed to be, at least, 30% Ca(2+)-independent. Additional experiments showed that tetrodotoxin (0.01-0.1 ?M), a blocker of voltage-dependent Na(+) channels, totally abolished veratridine-evoked release of d-[(3)H]aspartate from nigral slices. Lesion studies were performed in order to learn about the nature of the neuronal compartment in the substantia nigra upon which veratridine-depolarization acted to induce d-[(3)H]aspartate release. Unilateral ablation of the fronto-parietal cortex was accompanied by a significant decrease in the accumulation of nigral d-[(3)H]aspartate and by a large loss from ipsilateral nigral slices in d-[(3)H]aspartate release evoked by veratridine. In contrast, both the accumulation and veratridine-evoked release of [(3)H]dopamine, remained unchanged in the ipsilateral substantia nigra slices to the lesion. The findings reported suggest that d-[(3)H]aspartic acid may be taken up and then released, in a Ca(2+)-dependent manner, by nerve terminals located in the substantia nigra. In addition, the results shown provide support to the view that l-glutamate and/or l-aspartate may act as neurotransmitters at the cortico-nigral neuronal pathway.

Regulation of excitatory amino acid release by N-methyl-D-aspartate receptors in rat striatum: in vivo microdialysis studies.

The microdialysis technique was utilized to study the effects of N-methyl-D-aspartate (NMDA) receptor ligands on the in vivo release of endogenous glutamate (Glu) and aspartate (Asp) from the rat striatum. Addition of NMDA (250 and 500 microM) to the dialysis perfusion solution resulted in a striking dose-dependent increase in extracellular concentrations of Glu and Asp in the striatum. The NMDA-induced effects were reduced in a dose-related way by prior perfusion with 75 microM dizocilpine (MK-801), a non-competitive NMDA receptor antagonist. MK-801, at 75 microM, produced no changes on basal levels of Glu and Asp. However, 100 microM MK-801 did increase Glu and Asp extracellular concentrations. Local infusion with 500 microM D-serine, an agonist at the glycine site associated to the NMDA receptor, significantly increased basal level of Glu, but not Asp. Such D-serine-induced effects were reduced by 7-Cl-kynurenic acid (200 microM), a selective blocker of the glycine site present in the NMDA receptor. It is proposed that activation of NMDA receptors by endogenous Glu and Asp enhances the subsequent release of these excitatory amino acids in the striatum. Part of these NMDA receptors might be located presynaptically on cortico-striatal nerve endings. In addition, postsynaptic NMDA receptors present in the striatum may also indirectly modulate the release of Glu and Asp, through trans-synaptic mechanism.

N-methyl-D-aspartate receptor involvement in dexamethasone and stress-induced hypothalamic somatostatin release in rats.

The median eminence (ME) push-pull perfusion technique was used in this work and the results clearly showed that i.p. administration of MK-801 (4 mg/kg), a specific N-methyl-D-aspartate (NMDA) receptor antagonist, totally abolished dexamethasone (Dex) (300 micrograms/ 100 g i.p. injected) and immobilization stress-induced hypothalamic somatostatin release in adult male rats. We also observed that glutamate from median eminence-hypothalamic medio basal (ME-MBH) complex, measured by high performance liquid chromatography (HPLC), exhibited a conspicuous secretory pattern, with the total amount released not modified by Dex administration. This indicates that Dex and stress-induced somatostatin (SS) secretion is not mediated by endogenous glutamate variations but likely by activation of NMDA receptors.

Cultivation of rat cerebellar cells under conditions of optimal oxygen supply.

A method is described for the cultivation of essentially small cerebellar neurones under optimal oxygen supply. Cerebellar cells were seeded onto polylysine-coated dishes equipped with a gas-permeable bottom (Petriperm). Under these conditions, cells migrated to form small groups and developed dense networks of fibres covering the entire bottom of the dish. Contamination with non-neuronal cells was restricted to fibroblasts (less than 0.1%), oligodendrocytes (less than 1%) and astrocytes (approximately 6%), even after prolonged cultivation (15 days).

Rat striatal dopamine and tetrahydrobiopterin content following an intrastriatal injection of manganese chloride.

Injection of manganese into the rat corpus striatum causes a rapid fall in the biopterin and dopamine (DA) content ipsilateral to the lesion. Two weeks after the lesion both biopterin and DA are partially recovered. Controls, injected with saline or magnesium, do not show alterations in their DA or cofactor levels. It is proposed that the fall in DA levels results from a rapid displacement of the amine from its storage sites by manganese followed by a decrease in the rate of DA synthesis causes by the drop in cofactor levels.

Effect of superoxide dismutase from bovine erythrocytes on different activity parameters in adjuvant-induced arthritis.

BACKGROUND: The purpose of this work was to evaluate the effect of superoxide dismutase (SOD) on primary swelling, lipoperoxidation, body thymus, and spleen weight in the adjuvant-induced arthritis (AIA) model in rats. METHODS: Orally and intraperitoneally administered SOD (100 U/kg) from bovine erythrocytes, as well as naproxen (40 mg/kg) and dexamethasone (25 mg/kg), were evaluated against placebo. RESULTS: Primary edema was not decreased by SOD; in contrast, naproxen and dexamethasone showed good anti-inflammatory activity. Lipoperoxidation increased 1.8, 2.5, and 2.8 times with intraperitoneal SOD, naproxen, and dexamethasone administration, respectively, while oral SOD decreased lipoperoxidation levels to approximately one-half of that found in the control group. Body weight increased with SOD but decreased with dexamethasone. Naproxen did not change the animal weight. Thymus weight remained unchanged with SOD and naproxen, while it decreased with dexamethasone. Spleen weight remained the same with SOD, but increased with naproxen and decreased with dexamethasone. No side effects were observed in the SOD group, whereas 20% of the rats in the naproxen group died of gastrointestinal hemorrhage, and 50% of the rats in the dexamethasone group, of pulmonary infection. CONCLUSIONS: In conclusion, SOD showed no anti-inflammatory activity but decreased lipoperoxidation when administered orally. No deleterious effects in primary and secondary immunologic organs were observed with this agent.

Effects of avocado as a source of monounsaturated fatty acids on plasma lipid levels.

To examine the effects of avocado on plasma lipid concentrations, a three-diet trial involving 16 healthy volunteers was carried out. A diet rich in monounsaturated fatty acids using avocado as their major source (30% of the total energy was consumed as fat: 75% of the total fat from the avocado), with restriction of saturated fats and less than 300 mg of cholesterol per day was evaluated. Subjects also were in a free-diet period with the addition of the same amount of avocado. Finally, volunteers received a low-saturated fat diet without avocado. The first and third diets were designed to simulate a usual diet and volunteers carried on their normal activities during the trial, only the three daily meals were eaten in our clinical unit. Diets lasted 2 weeks and they were assigned in a randomized order. In both rich-monounsaturated fat (RMF) and low-saturated fat (LSF) diets, there were similar reductions in the plasma total cholesterol and low-density lipoprotein cholesterol levels. The levels of high-density lipoprotein cholesterol significantly decreased (p < 0.05) after 2 weeks of the LSF and free monounsaturated-enriched (FME) diets. The plasma triacyglycerol levels lessened after RMF and FME diets, while LSF diet increased them. In total cholesterol and in low-lipoprotein cholesterol levels, there were statistically significant differences between the FME and the LSF diet periods. Avocado is an excellent source of monounsaturated fatty acid in diets designed to avoid hyperlipidemia without the undesirable effects of low-saturated fat diets on HDL-cholesterol and triacylglycerol concentrations.

Effects of a vegetarian diet vs. a vegetarian diet enriched with avocado in hypercholesterolemic patients.

To determine the effects of a vegetarian diet with avocado as a source of monounsaturated fat on serum lipids, thirteen patients with phenotype II (twelve with IIa and one with IIb) dyslipidemia were included in a prospective, transversal and comparative study in which three four-week diets randomly assigned were assessed. One vegetarian diet (ALVD) was composed of 70% carbohydrates, 10% proteins and 20% lipids. Another was composed of 60% carbohydrates, 10% proteins and 30% lipids, 75% of which was supplied by avocado (AVD). A third diet was an avocado-added free diet (FDWA). Body weight, body mass index (BMI), and serum lipids (total cholesterol (TC), high (HDL) and low density lipoprotein (LDL) cholesterol and triglycerides (TG)) were evaluated. AVD produced a significant decrease in LDL. ALVD did not change TC and LDL, while FDWA increased them slightly. The three diets reduced TG levels, but only ALVD did so significantly. All three diets reduced HDL levels, particularly ALVD, which produced the greatest reduction. Low-fat, carbohydrate-rich vegetarian diets may be harmful to hypercholesterolemic patients. The avocado addition to a vegetarian diet does not correct these undesirable effects. To obtain beneficial effects on lipid profile with avocado, lower amounts of carbohydrates and polyunsaturated fatty acids are probably needed.

Effect of intranigral Mn2+ on striatal and nigral synthesis and levels of dopamine and cofactor.

A single injection of manganese chloride into the rat substantia nigra caused a significant and reversible drop in nigral and striatal dopamine and cofactor content ipsilateral to the lesion. Maximal decrease, in both tissues, was observed 60 days after the lesion, and showed complete recovery at 90 days. In vivo striatal tyrosine hydroxylation and GTP cyclohydrolase activities were also decreased maximally at 60 days and were recovered by 90 days after the lesion. No effects were observed on the side contralateral to the injection.

Trends in mechanical ventilation and immediate extubation after liver transplantation in a single center in Chile.

INTRODUCTION: Some groups have reported early extubation post-liver transplantation in patients with previously defined criteria, in an attempt to shorten the ICU stay and decrease costs. We review our experience with trends in mechanical ventilation and resource utilization. METHODS: We retrospectively reviewed the length of mechanical ventilation, ICU stay, hospital stay, transfusions, and costs of liver transplants performed since the program's inception in 1993 and 2002 including 82 OLT in 71 patients. We also report our experience with immediate postoperative extubation, which we have done from October to December of 2002. We compare different periods: the early days (1993 to 1997), namely, fewer than 10 OLT per year, with the subsequent years assessed individually. RESULTS: There has been a progressive decrease over time in the length of mechanical ventilation, ICU stay, hospital stay, and costs. Since the program's inception actuarial adult patient 1- and 5-year survival rates were 88.7% and 78%, respectively. The 1-year survival rate increased to 97% during the period of 2000 to 2002 (n = 30). From October to the present, we extubated four of seven adult patients who met criteria with none of them requiring reintubation. CONCLUSIONS: We demonstrate improved results, decreased length of mechanical ventilation, ICU, and hospital stay, and costs. The immediate postoperative extubation may be feasible for patients who meet previously defined criteria.

A decade of adult liver transplantation in a single center in Chile.

INTRODUCTION: Since the early days, liver transplantation (OLT) has conquered several barriers worldwide to become a proven therapy. We assessed the evolution of our adult liver transplant program. METHODS: We studied all adult patients who underwent OLT since the inception from November 1993 through May 2003. Donor data, recipient pretransplantation evaluation, surgical technique, results, and costs were examined over our evolution, stratifying 3 groups over time, based on the number of adult OLT per year. RESULTS: Between November 1993 and May 2003, 70 OLT were performed in 64 patients older than 15 years of age. Preoperative Child score, preoperative creatinine level, donor and recipient age, and proportion of emergencies were similar in the 3 groups. Over time, the predominant surgical technique was the piggyback technique (97% of OLT) with a decrease in the use of bypass from 63% to 5% during the last time period. Over the 10 years of our program's existence, warm ischemia time has been reduced to less than 1 hour, whereas cold ischemia time has remained constant at around 5 hours. Biliary and vascular complications decreased over time to around 10%. The mean length of hospital stay (LOS) decreased to 12 days (excluding emergencies). Since inception, our 1-year patient survival rate average is 91%; however, in just the last 3 years of our program (2000 through 2003), the 1-year patient survival rate is 97%. CONCLUSIONS: In summary, our surgical technique has evolved toward piggyback use without veno-venous bypass with a significant decrease in warm ischemia times. As expected, our results have improved over time and our LOS and costs have decreased. Finally, our current results are similar to the best ones reported in the medical literature today.

Granulocytic-like cells in the human fallopian tube.

In the fallopian tube there are three main epithelial cell types, i.e., ciliated and nonciliated (or secretory) cells and intercalary, or peg, cells. An additional cell type has been considered either a wandering or a progenitor cell. Our morphologic and histochemical study shows a close similarity between a fourth cell type in the fallopian epithelium and the endometrial granulocytes (K cells). It is suggested that the two cells might be of an identical nature and that granulocytes could be ubiquitous in the entire Müllerian tract.