Primary cystic duct carcinoma case report and literature review

Primary cystic duct carcinoma is rare. To date only 27 cases have been reported in the English literature, and 17 cases in the Japanese literature. This paper reports another case of primary cystic duct carcinoma. A 70-year-old male presented with signs and symptoms of acute calcular cholecystitis and dilated extrahepatic bile ducts. An ERCP failed technically. An ultrasound-guided aspiration was performed to drain an obstructed gall bladder and an adjacent pyogenic liver abscess. A cholecystogram showed an obstructed cystic duct. On table a tumour was suspected at the junction of the cystic duct and common hepatic duct [CHD]. En masse excision of the gall bladder, cystic duct, tumour, part of the CHD and the supraduodenal part of the common bile duct was performed with a Roux-en-Y hepatico-jejunostomy. Histopathologically the tumour fulfills all of Farrar's criteria for primary cystic duct carcinoma. Our case is of interest since it is the 2nd case to present with Mirrizzi-like syndrome

Etiologic infective agents in chronic prostatis

Chronic prostatitis is a very common entity but many uncertainties exist about its etiology. In this study, 102 patients with more than 20 WBC's/HPF in EPS, and 100 controls, had their samples tested for aerobic and anaerobic organisms. 30 patients with non bacterial prostatitis and 62 controls were tested for chlamydia trachomatic antigen using ELISA. 50 patients with prostatitis and 20 controls were tested for urea plasma urealyticum. Chlamydia trachomatis was identified in the specimens of 4 [13.3%] out of 30 patients but in none of 62 controls. Additional epidemiologic data suggesting a role of chlamydia in prostatitis, as its age distribution in this study [mean of 30.2] coincided with the known age distribution of chlamydia in epididymitis where it is a well established pathogen. Mean number of WBC's/HPF in EPS was lower with chlamydia [30] than the rest of the patients [46]. This conforms with its propensity for low inflammatory response. A statistically significant difference between the patients and control groups was also found for gram negative organisms. Proteus was more frequently identified [6.8%] than E. Coli [3.9%]. Staph. albus was the most common gram positive organism [39.2%] followed by Staph. aureus [5.8%]. Anaerobic organisms and ureaplasma urealyticum were more isolated from patients than control. However, the difference is not statistically significant

Protein and energy requirements of [tilapia zillii] fingerlings

Two experiments were conducted to determine the optimum dietary protein and energy requirement of Tilapia zillii fingerlings. In the first experiment, four semipurified, isocaloric [360 kCal ME/100 g diet] diets with protein levels ranging from 25 to 40% were fed to the fish for nine weeks. Maximum growth rates were achieved at 35% protein with P/E ratio of 100 mg crude protein/kCal ME, while protein and energy retention were negatively correlated with P/E ratio in the diets. In the second experiment, T. zillii were fed semipurified diets with a constant P/E ratio of 100 at variable protein [25-40%] and energy [250-400 kCal ME/100 g] levels at 30% protein and 300 kCal ME/100 g. This indicated that as adequate protein and energy levels with the proper P/E ratio, the proportion of dietary protein oxidized for energy can be saved for growth