Clinical significance and characteristics of left-sided gallbladder: case series study of 10 patients

PURPOSE: The aims of this case series study were to review the 10 patients who were diagnosed with left-sided gallbladder and analyze their anatomic variations in the bile duct, portal vein, and hepatic vessels. METHODS: In this case series study, 10 patients with left-sided gallbladder were retrospectively analyzed at 2 tertiary referral centers between April 2004 and May 2019. RESULTS: Mean age was 61.1 years; there were 7 women and 3 men. Ten patients underwent laparoscopic cholecystectomy for acute cholecystitis or symptomatic gallbladder stone. The mean operation time was 77.2 minutes. Three ports were used in laparoscopic cholecystectomy procedures. The mean postoperative hospital stay was 3.5 days, and there were no cases of surgery-related morbidity. Two patients had type 1 bile duct and 3 had type 3 bile duct (2 type 3B and 1 type 3A). The right posterior portal vein as the first branch of the main portal vein was observed in all patients. Segment IV branches of the left portal vein crossing over to the segment VIII territory were observed in 7 of the 10 patients. CONCLUSION: Although left-sided gallbladder is a very rare disease, it is possible to diagnose it preoperatively and perform laparoscopic cholecystectomy safely by adjusting port position. The common important features of left-sided gallbladder include distribution of the left portal vein crossing over to the right side of the liver and increased size of the left portal vein. These variations may have important clinical implications in the management of hepatic resection including donor hepatectomy.

PKD2 mutation in an Iranian autosomal dominant polycystic kidney disease family with misleading linkage analysis data

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic renal disorder caused by mutation in 2 genes PKD1 and PKD2. Thus far, no mutation is identified in approximately 10% of ADPKD families, which can suggest further locus heterogeneity. Owing to the complexity of direct mutation detection, linkage analysis can initially identify the responsible gene in appropriate affected families. Here, we evaluated an Iranian ADPKD family apparently unlinked to both PKD1 and PKD2 genes. This is one of the pioneer studies in genetic analysis of ADPKD in Iranian population. METHODS: Linkage reanalysis was performed by regenotyping of flanking microsatellite markers in 8 individuals of the ADPKD family. Direct mutation analysis was performed by Sanger sequencing. RESULTS: Mutation analysis revealed a pathogenic mutation (c.1094+1G>A) in the PKD2 gene in the proband. Analyzing 2 healthy and 4 clinically affected members confirmed the correct segregation of the mutation within the family and also ruled out the disease in 1 suspected individual. Misinterpretation of the linkage data was due to the occurrence of 1 crossing over between the PKD2 intragenic and the nearest downstream marker (D4S2929). Homozygosity of upstream markers caused the recombination indistinguishable. CONCLUSION: Although analysis of additive informative polymorphic markers can overcome the misleading haplotype data, it is limited because of the lack of other highly polymorphic microsatellite markers closer to the gene. Direct mutation screening can identify the causative mutation in the apparently unlinked pedigree; moreover, it is the only approach to achieve the confirmed diagnosis in individuals with equivocal imaging results.

A Novel Surgical Method Using Two Triangular Flaps for Accessory Tragus

BACKGROUND: Accessory tragus is an abnormal ear structure that has the shape of a nodule or a papule. The existing surgical method is very simple, wherein an elliptical incision is made around the lesion and the underlying cartilage is removed. However, this method may leave a depressed or dimpled scar and may cause chondrodermatitis. METHODS: We corrected the accessory tragus by a new method using triangular flaps, and the procedure was performed in eight patients. Out of the four triangular flaps, which were created by drawing lines that connected the left and the right sides and the superior and inferior surfaces of the accessory tragus and quartering them, two flaps that faced each other were excised. Once the cartilaginous tissue inside was verified and removed up to the base to the greatest extent possible, the remaining two triangular flaps were sutured and the remaining skin margin of the flap was trimmed. RESULTS: None of the patients had any wound problems related to the surgery, and none of them complained of chondrodermatitis up to 6 months postoperatively. No depression or dimple was observed externally up to 6 months after the operation, and the z-shaped scar, which was created by the crossing over of the triangular flaps, was not as visible as a linear scar. CONCLUSIONS: Correction of an accessory tragus by using the triangular flaps introduced in this study provides a wider operative view through a smaller incision, while preventing the formation of dimples or a depression after the operation.

Right-sided aortic arch with the retroesophageal left subclavian artery as the fourth branch / 대한해부학회지

We present a rare variation of the right-sided aortic arch with the retroesophageal left subclavian artery as the forth branch found in a cadaver of an 89-year-old Korean woman during a routine dissection. In this case, the first branch that arose from the ascending aorta was the left common carotid artery, which crossed ventral to the trachea in a left cephalic direction, followed by the right common carotid artery and then the right subclavian artery. Distal to these branches the aortic arch ran dorsally, passing between the esophagus and the vertebra. The left subclavian artery arose from the descending portion of the aortic arch, crossing over to the left upper extremity behind the esophagus. This anomaly was not accompanied by congenital heart disease. Accurate information regarding this variation is of great importance to surgeons for its early identification and preservation during interventions and to radiologists for precise interpretation of angiograms.

The Unusual Origin of the Sternocleidomastoid Artery from the Lingual Artery

The sternocleidomastoid (SCM) artery supplying blood to the SCM muscle has different origins according to its anatomical segment. The authors performed cadaveric neck dissection to review the surgical anatomy of neurovascular structures surrounding the carotid artery in the neck. During the dissection, an unusual finding was cited in which the SCM artery supplying the middle part of the SCM muscle originated from the lingual artery (LA); it was also noted that it crossed over the hypoglossal nerve (HN). There have been extremely rare reports citing the SCM artery originated from the LA. Though the elevation of the HN over the internal carotid artery was relatively high, the vascular loop crossing over the HN was very close to the carotid bifurcation. Special anatomical consideration is required to avoid the injury of the HN during carotid artery surgery.

A recombination event occurring between HLA-B and DRB1 loci within a Chinese Han family / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate a recombination event occurring between the HLA-B and DRB1 loci in a Chinese family with a leukemia patient.</p><p><b>METHODS</b>HLA class I (-A and -B) low resolution typing was carried out by polymerase chain reaction-sequence specific oligonucleotide, PCR-SSO). HLA class II low resolution typing was performed by PCR-sequence specific primer (PCR-SSP). And HLA class I and II high resolution typing was done by sequencing-based typing (SBT). Then the recombination event was analyzed by family study.</p><p><b>RESULTS</b>The 2 haplotypes of the patient were A*3101-B*1301-DRB1*0701 and A*3303-B*4403-DRB1*1302. His father's 2 haplotypes were A*3001-B*1302-DRB1*0701 and A*3101-B*1301-DRB1*1501. Family study demonstrated that the HLA-A*3101-B*1301 was from one of his father's chromosome and the DRB1*0701 was from the other chromosome of his father. So the result indicated that the recombination event occurred between the HLA-B and -DRB1 loci during meiosis of his father and resulted in a new HLA haplotype that was transferred to the son.</p><p><b>CONCLUSION</b>A HLA-B/DR recombination event occurring between the HLA-B and -DRB1 loci has been found in a Chinese family, which may help further study of the mechanism of HLA recombination.</p>

Transcription of meiotic-like-pathway genes in Giardia intestinalis

The reproductive mechanism of Giardia intestinalis, considered one of the earliest divergent eukaryotes, has not been fully defined yet. Some evidence supports the hypothesis that Giardia is an exclusively asexual organism with a clonal population structure. However, the high genetic variability, the variation in ploidy during its life cycle, the low heterozygosity and the existence of genes involved in the meiotic-like recombination pathway in the parasite's genome cast doubt on exclusively asexual nature of Giardia. In this work, semiquantitative RT-PCR analysis was used to assess the transcription pattern of three meiosis-like-specific genes involved in homologues recombination: dmc1, hop1 and spo11. The mRNAs were amplified during the parasite's differentiation processes, encystation and excystation, and expression was found at each stage of its life cycle. A semiquantitative assessment also suggests that expression of some of the genes is regulated during encystation process.

Induction of mitotic crossing-over in diploid strains of Aspergillus nidulansusing low-dose X-rays

As a contribution towards detecting the genetic effects of low doses of genotoxic physical agents, this paper deals with the consequences of low-dose X-rays in the Aspergillus nidulans genome. The irradiation doses studied were those commonly used in dental clinics (1-5 cGy). Even very low doses promoted increased mitotic crossing-over frequencies in diploid strains heterozygous for several genetic markers including the ones involved in DNA repair and recombination mechanisms. Genetic markers of several heterozygous strains were individually analyzed disclosing that some markers were especially sensitive to the treatments. These markers should be chosen as bio-indicators in the homozygotization index assay to better detect the recombinogenic/carcinogenic genomic effects of low-dose X-rays.

Asexual Recombination in a uvsH Mutant of Aspergillus nidulans

Mutations in the gene uvsH of Aspergillus nidulans result in increased spontaneous chromosome instability and increased intragenic and intergenic mitotic recombination in homozygous diploids. The aim of the present work was to obtain a uvs mutant of A. nidulans and to use it for the isolation of asexual recombinants (parameiotic segregants). The mutant uvsH, named B511, showed normal frequency of meiotic recombination in sexual crosses and high frequency of parameiotic segregants in the parasexual crossings with master strains (B511//A757 and B511//A288). Asexual haploid recombinants (parameiotic segregants), diploid and aneuploid segregants were recovered directly from the uvs//uvs+ heterokaryons (B511//A757 and B511// A288). Parameiotic segregants originated through mitotic crossing-over and independent assortment of chromosomes.

B chromosomes in popcorn (Zea mays L. )

Cytological analysis of microsporogenesis in 72 popcorn plants, comprising nine from the original population (CMS-43, S0) and 63 from seven cycles of self-fertilization (S1 to S7), one plant of S0 generation (plant 2) was identified with B chromosomes. The number of B chromosomes varied from two to three in the same anther. The pattern of chromosome pairing and meiotic behavior of Bs were similar to those found in other plant species. The presence of B chromosomes did not affect chiasma frequency and chiasma distribution in A chromosomes. This is the first report of B chromosomes in popcorn

[Creation of a null mutation in the STX[2] gene of Escherichia coli o[157]: H[7]]

To construct a specific mutation in E.coli O157:H7. Allelic exchange approach for producing stx[2]-negative mutant. 1-Obtaining PCR product from stx[2] gene.2-Cloning this product to T-vector.3-Inseting a gentamicin resistance cassette.4-Transfering the stx[2] gene with GMR cassette to suicide vector.5-Mating donor [SM10 [+pRE107 - stx[2]: GM] and recipient [Str[R]EC960904].6-Selection of single-cross-overs.7-Counter-selection of double cross-overs. Selecting Gm[R]/Str[R] and Amps colonies.8-Confirmation of mutant by PCR and cytotoxigenicity assay on vero cells. In this study, after mating between the donor [SM10[+pRE107 -Stx[2]: GM] and the recipient cells [Str R-EC960904 wild type], colonies were resistant to gentamycin and streptomycin but sensitive to ampicillin. The result of PCR showed that the mutant was the stx[2] negative strain. However, the mutant strain was unable to lyse the vero cells compare to wild type strain. Hutant strain was produced by a suitable suicide vector

Photographical Analysis of Crow's Feet Pattern According to Sex and Age in Korean

It is well known that crow's feet are caused by hyperkinetic facial muscles. Recently, rejuvenation in this area has been improved enormously by radical approach and various combined adjuvant surgery. And many articles regarding with the various applicable treatment modalities are published every year. Actually, there are various types of crow's feet, but treatment method of crow's feet doesn't have to be different according to their types. Therefore, we tried to analyze the pattern of crow's feet among Korean people and classified them by age and sex. Total of 256 volunteer people were inspected and photographed. We took pictures of oblique view of periorbital area showing primary gaze and smiling feature. Pictures which show poor quality or any disagreement of opinions from three plastic surgeons were excluded. Finally, 160 pictures were collected and classified. The crow's feet lines were classified as four patterns; i.e., central upper, central, central lower and combined pattern. The "central upper pattern" is shown among those with wrinkle lines only in the upper eyelid skin down to the lateral canthus. The "central pattern" is categorized in those who exibit wrinkles only in the lateral canthal area, and the "central-lower pattern" is recognized to have wrinkling on the lower lid and upper cheek area. The "combined pattern" is defined as patients exhibiting crinkling of their lateral canthal skin from the lower lateral brow across the upper eyelid, through the lateral canthus, and across the lower eyelid, upper cheek junction with horizontal and perpendicular wrinkles crossing over. In this study, the most common pattern of the wrinkle pattern was the combined type. In thirties and fourties, central- lower pattern was more common in men. In women, the type of central and central-upper pattern showed nearly equal frequency. However, over the age of 50-year's, combined pattern was common in both sex. For maintenance of a long-lasting and natural outcome we should recognize the diversity of facial expression among indivisuals and render the treatment accordingly. This observations could also be applied to the injection technique of botulinum toxin for the facial rejuvenation.

Cremophor EL stimulates mitotic recombination in uvsH//uvsH diploid strain of Aspergillus nidulans

Cremophor EL is a solubilizer and emulsifier agent used in the pharmaceutical and foodstuff industries. The solvent is the principal constituent of paclitaxel's clinical formulation vehicle. Since mitotic recombination plays a crucial role in multistep carcinogenesis, the study of the recombinagenic potential of chemical compounds is of the utmost importance. In our research genotoxicity of cremophor EL has been studied by using an uvsH//uvsH diploid strain of Aspergillus nidulans. Since it spends a great part of its cell cycle in the G2period, this fungus is a special screening system for the study of mitotic recombination induced by chemical substances. Homozygotization Indexes (HI) for paba and bi markers from heterozygous B211//A837 diploid strain were determined for the evaluation of the recombinagenic effect of cremophor EL. It has been shown that cremophor EL induces increase in mitotic crossing-over events at nontoxic concentrations (0.05 and 0.075 percent v/v).

Vincristine induces somatic segregation, via mitotic crossing-over, in diploid cells of Aspergillus nidulans

Vincristine is an alkaloid widely used as an antineoplastic agent. In eukaryotic cells the drug causes blockage in the G2 phase of the cell cycle and an increase in the frequency of sister chromatid exchanges. Due to the fact that germinating Aspergillus nidulans cells spend most of their cycle in G2 phase, they provide an excellent system for the study of mitotic crossing-over. Taking into account that mitotic crossing-over occurs during G2 period, the evaluation of recombinagenic and aneugenic potential of vincristine is provided with regard to two diploid strains of A. nidulans: a wild strain (uvsH+//uvsH+) and a defective one in DNA repair (uvsH//uvsH). Drug toxicity and its effect on the asexual cycle of A. nidulans has been evaluated as well. Treatment of both strains with vincristine did not change colony growth in the culture, however cytological analyses showed aberrant conidiophores. Recombinagenic potential of vincristine was evaluated by induction of gene homozygosis originally present in heterozygosity diploid strains (Homozygotization Index). Results show that vincristine induces mitotic crossing-over and higher frequency of aneuploid mitotic segregants. The results also show the recombinagenic and aneuploidogenic potential of vincristine and suggest its participation in the induction of secondary malignancies.

Giant Hydronephrosis with Contralateral Congenital Renal Agenesis: A Case Report / 대한비뇨기과학회지

We report a case of giant hydronephrosis due to congenital ureteropelvic junction obstruction in a 7-month-old female infant with contralateral renal agenesis. Congenital renal agenesis is an uncommon congenital condition that results from a failure of induction of the metanephric blastema by the ureteral bud and fifteen per cent of cases show anomalies of the contralateral kidney. An excretory urogram and abdominal CT scan of the patient revealed nonvisualization of left kidney, and a retrograde pyelogram showed markedly dilated extrarenal pelvis crossing over the mid-line because of narrowing of ureteropelvic junction. However, the other combined anomalies were not identified. A successful dismembered pyeloplasty was performed after temporary urinary diversion with percutaneous nephrostomy for 4 weeks.

A new method to detect potential genotoxic agents using mitotic crossing-over in diploid strains of Aspergillus nidulans

This paper presents a new method for detecting mitotic crossing-over in Aspergillus nidulans, based on the "homozygosity index" (HI) of recessive genes originally present in hetrozygosis in diploid strains, which occurs after mitotic crossing-over between the marker in question and the centromere. Since homozygous diploids (-/-) for auxotrophic markers can not grow in MM, homozygotization can be demonstrated by distorted mitotic segregation of the alleles involved. Two similar diploid strains (UT 448/UT 184 and Z1//UT 184), which differ by a chromosomic duplicate segment transposed from chromosome II to I in the Z1 haploid strain, were used. This excess of genetic material confers to the Z1 mutant the uvs character and makes Z1//UT 184 more unstable and sensitive to genotoxic agents, as evidenced by its high spontaneous recombinational index.

Genes oncosupresores: nuevas perspectivas para la investigación clínica en cáncer / Tumor suppressor genes: new perspectives for clinical investigations in cancer

La tumorigénesis comprende una serie de eventos genéticos específicos que ocurren en una célula y en sus descendientes clonales. El desarrollo de la biologia molecular durante la última década, permitió distribuir estos eventos dentro de dos categorías: la activación de protooncogenes y la inactivación de genes oncosupresores. Los genes oncosupresores son genes cuya inactivación es requerida para la transformación maligna de una célula. La pérdida de los genes oncosupresores juega un importante papel en el desarrollo de los tumores humanos. Estudios en hibridos celulares somáticos han demonstrado que la supresión tumorigénica ocurre en las células neoplásicas que reciben cromosomas humanos normales mediante fusión celular. Estos experimentos han demostrado que la tumorigénesis es un carácter fenotipicamente recessivo, controlado por cromosomas específicos. Ciertos tipos de genes oncosupresores, p. ej. p53 y RB1, están implicados en una gran variedad de neoplasias, mientras otros, p. ej., el gen DCC, están restingidos a un solo tipo de tumores. La detección de mutaciones germinales en los genes oncosupresores permitirá la identificación de los individuos con alto riesgo de desarrollar neoplasias