Clinical utility of transient elastography as an imaging tool to assess the short-term impact of laparoscopic sleeve gastrectomy, together with clinical and biochemical parameters and clinico-biochemical indices, on obese patients with nonalcoholic fatty liver disease: An Egyptian pilot study. / La utilidad clínica de la elastografía transitoria como una herramienta de imagenología para evaluar el impacto a corto plazo de la gastrectomía laparoscópica en manga, en conjunto con parámetros clínicos y bioquímicos e índices clínico-bioquímicos en pacientes con enfermedad de hígado graso no alcohólico: un estudio piloto egipcio.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is a metabolic liver disorder commonly attributed to fatty acid deposition that can induce hepatic necroinflammation, defined as nonalcoholic steatohepatitis (NASH). It is strongly associated with obesity. Laparoscopic sleeve gastrectomy (LSG) is a favorable surgical modality for the treatment of morbid obesity. AIM: Our study evaluated the impact of LSG on patients with NAFLD and morbid obesity, 3 months after the operation, through clinical and biochemical characteristics, clinico-biochemical indices, and imaging parameters. PATIENTS AND METHODS: Morbidly obese patients with NAFLD±NASH underwent LSG. They were thoroughly evaluated clinically (body weight, body mass index, waist circumference) and biochemically (transaminases and triglycerides), as well as through the fatty liver index (FLI), the hepatic steatosis index (HSI), and ultrasound elastography imaging studies (liver stiffness measurement [LSM] and the controlled attenuation parameter [CAP]), before and 3 months after the LSG. RESULTS: Twenty-six obese patients with NAFLD underwent LSG that resulted in a significantly high reduction in all the parameters analyzed, except for liver transaminases. CONCLUSION: LSG is considered an efficient surgical modality for the treatment of morbidly obese patients with NAFLD.

Sexual maturational changes circulatory inhibin concentration in relation to FSH concentration and testicular size in Suffolk and DLS rams.

Developmental patterns in immunoactive inhibin and FSH concentrations in peripheral blood were determined for Suffolk and DLS (Dorset x Leicester x Suffolk) rams born in January Blood samples were taken every 3 to 4 wk when testes were developing during puberty (5 to 44 wk of age) and redeveloping in early adulthood (17 to 23 months of age). Suffolk lambs had a greater average daily gain (195 vs. 143 g/day, P<0.01), and they developed larger testes (P<0.01) than DLS lambs. Inhibin and FSH concentrations peaked at about the same pubertal (8 wk) and early adult (19 or 20 months) ages in both breeds. Elevations in FSH were greater (P< 0.05) in Suffolk than DLS rams at each stage of development. The pubertal inhibin peak was nearly 70% larger (P<0.01) in DLS than Suffolk rams, and the early adult peak was comparable in rams of both breeds, but much smaller (P<0.01) than the pubertal peak. Nonetheless, inhibin was positively correlated (r=0.48 to 0.57) with FSH in both breeds during each developmental stage. Inhibin and testicular size were negatively correlated in Suffolk (r=-0.74) and DLS (r=-0.86) rams during puberty, and positively correlated in DLS rams (r=0.46) in early adulthood. We conclude that 1) inhibin concentrations are higher in juvenile rams at the time Sertoli cell numbers are being established than in adult rams during testicular recrudescence and 2) rises in FSH concentration participate in regulating corresponding rises in inhibin concentration in both stages of testicular development.

Ontogeny of FSH receptor messenger ribonucleic acid transcripts in relation to FSH secretion and testicular function in sheep.

The role of alternative splicing of the FSH receptor gene in the generation of FSH receptor proteins and testicular function remains an enigma. To address this issue, this investigation was conducted to determine variations in the expression of alternate FSH receptor mRNA transcripts in relation to changes in FSH release, hormone binding activity and testicular function during pubertal development of ram lambs from two genotypes of sheep (Romanov and a cross between Booroola x DLS) with different sexual precocity. Serum 17 beta-estradiol and testosterone concentrations were used as indices of Sertoli cell and testicular function. The results indicated that increases in Sertoli cell and testicular function normally seen during pubertal development are accompanied by age-dependent reductions in concentration of functional FSH receptors, as determined by binding of iodinated FSH to testicular membrane preparations. During the course of these changes, FSH release was either maintained at a steady level in Romanov lambs or it was gradually reduced in the Booroola x DLS cross, thus indicating that the testis had become more responsive to hormonal signal. This acquisition of heightened sensitivity was also associated with contrasting changes in the level of expression of FSH receptor mRNA transcripts. For both geno-types of sheep, 5 distinct species of mRNA transcripts of approximately 1.1, 1.5, 2.0, 2.5 and 6.5 kb were highly expressed from 11 to 22 weeks of age. Amongst these transcripts, the 1.1 kb molecular species was the most abundant. Specific probing for a previously cloned transcript called 151A1 representing the first 4 exons of the FSH receptor gene revealed a paradoxical increase in the level of expression from 11 weeks up to a maximum at 18-22 weeks of age for both genotypes. Collectively, the results indicated that contrasting changes in the production of specific alternatively spliced mRNA transcripts may mediate changes in FSH receptor expression which apparently accounts for the augmentation in sensitivity and function of the testis during pubertal development. Furthermore, the data provide the first important indication that the novel truncated transcript (151A1), which predictably encodes a soluble protein of either intra- or extracellular fate, could be physiologically relevant.

Serum and milk folates during the first two gestations and lactations in Romanov, Finnsheep, and Suffolk ewes.

Concentrations of folates in serum and milk were determined during the first two parities in 7 Suffolk, 12 Finnsheep, and 15 Romanov ewes at 0 (mating), 60, 110, and 140 d of gestation and 1, 7, 14, 21, and 50 d of lactation. The number of lambs born at first and second parturitions was 1.38 +/- .13 and 1.71 +/- .13 for Suffolk, 2.00 +/- .32 and 2.33 +/- .57 for Finnsheep, and 2.67 +/- .24 and 3.20 +/- .22 for Romanov, respectively, and the concentration of folates at d 0 was 1.17 +/- .21, 1.87 +/- .19, and 2.14 +/- .17 ng/mL, respectively. During gestation, serum concentrations of folates declined in the three breeds, more quickly in Romanov and Finnsheep (from d 0 to 60) than in Suffolk (from d 0 to 110). This decline was followed by an increase in serum concentrations of folates from d 110 to 140 of gestation in the three breeds; the largest increase was observed in Romanov (breed x quadratic effect of time, P = .001). During lactation, Romanov had higher serum concentrations of folates than Finnsheep, which in turn had a higher concentration than Suffolk (P = .001). Colostrum of Romanov had the highest concentration of folates (164.9 +/- 11.9 ng/mL), followed by that of Finnsheep (125.0 +/- 9.5 ng/mL) and Suffolk (98.2 +/- 13.3 ng/mL). On d 7 of lactation, concentration of folates was similar in milk of Romanov (97.1 +/- 5.6 ng/mL) and Finnsheep (94.9 +/- 4.0 ng/mL) and was higher than in Suffolk (72.4 +/- 3.7 ng/mL). From d 14, the concentration of milk folates was similar among breeds and decreased slowly to approximately 40 ng/mL at d 50 (breed x quadratic effect of time, P = .005). The changes in serum concentration of folates during gestation of ewes were similar to those observed in sows, suggesting that exogenous supply of folates may not be optimal in ewes during gestation and lactation.

Feed efficiency, carcass characteristics, and sensory quality of lambs, with or without prolific ancestry, fed diets with different protein supplements.

Data were collected on 130 intact male lambs fed diets based on roughages supplemented with fish meal, soybean meal, or corn gluten-blood meal and slaughtered at 43 kg live weight. A nonsupplemented group served as a control. The lambs represented Romanov (R), Finnsheep (F), a new breed developed in Canada (DLS), Coopworth (C), and Suffolk (S), three first crosses of DLS with R, F, and Booroola Merino (B), and their backcrosses to DLS. Supplemented lambs consumed 16 to 22% less (P less than .05) silage than control lambs. Average daily gains of lambs fed fish meal (226 g) and corn gluten-blood meal (217 g) were higher and feed conversion ratio (4.99 and 5.11) lower than that of lambs fed soybean meal (189 g and 5.48) or control (186 g and 5.76) diets (P less than .05). The cost of feed per kilogram of gain or per kilogram of lean produced was similar in the four treatments but was between C $.23 and .65 cheaper in the protein-supplemented groups when the number of days to reach slaughter weight was considered. The effect of diet on carcass traits and meat quality were minimal. Meat of lambs fed the three protein supplements was less juicy than that of control lambs. With a few exceptions, most of the significant differences among genetic groups in growth, carcass, and sensory traits were mainly between prolific (R and F) and meat-type breeds (C, S, and DLS). Gain in weight was highest in S lambs (199 g/d), but F and R first crosses were the youngest at slaughter (196 and 198 d). The F lambs had higher dressing and kidney fat percentages than meat-type breeds. The DLS lambs had the largest longissimus muscle area (14.0 cm2), whereas C had the smallest (10.7 cm2). The B crosses had larger longissimus muscle area than R and F crosses. The R lambs had more lean and less fat in the 12th rib, whereas C lambs had the lowest lean and a high bone percentage. The toughest and the most tender roasts were those of R and B crossbred lambs, respectively. Roasts from F lambs had the most intense lamb flavor.

Immuno-metabolic factors in schistosomal hepatic fibrosis modulating atherogenesis.

Clinical expression of atherosclerosis is infrequent among patients with schistosomal hepatic fibrosis (SHF), besides, the latter disease is a disease with many immunological expressions. The aim of the present work was to search for a possible immunological and metabolic interaction which would modulate atherogenic mechanisms. The study was carried out on 31 patients with SHF and 20 non-schistosomal subjects (10 with evident clinical atherosclerosis and 10 without). All investigated subjects were males aged above 40 years, and were subjected to the following: serum lipoprotein pattern, total cholesterol, phospholipids, triglycerides, ApoA, ApoB, IgG, IgM, IgA, C3 + circulating immune complexes (CICs) and passive haemagglutination using S mansoni adult worm antigens. The results showed low levels of blood lipids in patients with SHF especially in those with porto-systemic collaterals; serum levels of IgG and IgM were significantly increased in all patients with SHF, while IgA was only increased in patients with collaterals who in turn showed the least incidence of clinically evident atherosclerosis; serum C3 was increased in patients with clinical atherosclerosis, both schistosomal and non-schistosomal. CICs have been higher in patients with SHF without atherosclerosis while decreased in atherosclerosis patients, both schistosomal and non-schistosomal. Our results may consolidate the view of a protective role of liver affection against atherogenesis as well as the important contribution of the immune mechanisms in this context.

Follicular development during the prepuberal period of different morphological types of ovaries in Hampshire and Yorkshire gilts fed two planes of nutrition.

Changes in follicular development of the ovary at 105, 140 and 175 d of age were observed on 48 prepuberal Yorkshire and Hampshire gilts raised on two planes of nutrition. The follicles from the left ovary were counted and measured by histological techniques. Both the nonatretic and the atretic (more than four pyknotic bodies) antral follicles were classified into six categories according to size, and each category was expressed as percentage of the total number. The proportion of nonatretic follicles belonging to the first category (.19 to .36 mm in diameter) was higher in Hampshire than Yorkshire gilts at d 105 (65.4 vs 47.6%; P less than .05), but not at d 140 and 175. The proportion of atretic follicles to the total number observed was higher in Yorkshire at d 175 than at d 140 and 105 (38.6 vs 21.9 vs 11.6%, respectively; P less than .05), whereas in Hampshire, significant differences were observed only between d 140 and 105 (25.2 vs 3.9%, respectively). The low-plane regimen reduced the percentage of nonatretic follicles of the third (.63 to 1.12 mm) and fourth (1.13 to 2.00 mm) categories in Yorkshire gilts from 14.4 and 7.2% to 9.7 and 4.0%, respectively (P less than .05). According to grouping, size and number of antral follicles, three morphological types of ovaries could be distinguished: honey-comb, grape-like and an intermediate class. Reanalyzing the data accounting for types resulted in radical reduction in the residual variation, hence many significant differences between the two breeds could be identified. At 140 and 175 d of age, Hampshires with honey-comb- and grape-like ovaries had greater numbers of medium and large follicles than Yorkshires (P less than .001). It is concluded that the slower follicular development observed at 105 d of age in Hampshire, as compared with Yorkshire gilts, allows accumulation of greater numbers of antral follicles at 140 and 175 d for both morphological types of ovaries.

Study of eosinophilia in relation to serum IgE level and cell mediated immunity (CMI) to soluble egg antigen (SEA) in human schistosomiasis mansoni.

Eosinophil count, delayed intradermal test and lymphoblast transformation test (LTT) using SEA, have been used to study the correlation of eosinophilia with CMI in patients with schistosomiasis mansoni. Only a weak positive correlation was found between the eosinophil count and both in vivo and in vitro manifestations of CMI. When IgE serum level was correlated with eosinophil count, a positive correlation was only found in cases with hepato-splenic disease (those with increased CMI).

The role of porto-systemic shunts in the specific humoral immune response in patients with schistosomal hepatic fibrosis.

The present study was devoted to elucidate the role of collaterals (porto-systemic shunts) in the specific humoral immune response to schistosomal soluble egg antigen (SEA) in patients with schistosomal hepatic fibrosis (SHF). Twenty five patients with SHF with collaterals, ten patients with SHF without collaterals and twenty healthy control subjects constituted the material of this study. In vivo and in vitro tests for humoral immunity to SEA included serum immunoglobulins estimation, immediate intradermal test, indirect haemagglutination test and determination of B lymphocytes count in peripheral blood. Significant differences have been observed between cases without collaterals and those with collaterals; and in the latter group before and after decongestion. These results tend to consolidate the view of the role of collaterals in schistosomal antigenemia and subsequent humoral immune response.

Seasonal changes in breeding activity, testicular size, testosterone concentration and seminal characteristics in rams with long or short breeding season.

Breeding activity (libido), testicular size, testosterone levels and seminal characteristics of 10 DLS adult rams (a population of 1/2 Dorset, 1/4 Leicester and 1/4 Suffolk selected for extended breeding season) were compared with those of 10 adult Suffolk rams. The study lasted 18 mo during which the data were recorded over 30 collection periods. All characteristics varied significantly with the season of the year, being lowest during the summer and highest during the fall. Suffolk rams had higher libido but lower testosterone levels than the DLS rams throughout the study. Testosterone increased earlier and decreased later in the breeding season in DLS compared with Suffolk rams, the interaction breed X period being significant. Testosterone concentration was highly associated with testicular size and libido, accounting for 65 and 28% of the variation in the Suffolk and 37 and 18% in the DLS rams, respectively. Seminal output and quality (motility and percentage of live spermatozoa) were highest in October and November and lowest in April and May. Rams within breeds differed significantly in the seminal characteristics studied. Results of the study showed that selecting the DLS ewes for extended breeding season may have altered the reproductive performance of the rams of that breed.

Study of cell mediated immune responsiveness to soluble egg antigen and phytohaemagglutinin using the lymphoblast transformation test in human schistosomiasis mansoni in Egypt.

Antigeno soluvel de ovo e fitohemaglutinina foram usados para medir a resposta imunologica celular dos pacientes com esquistossomose mansonica atraves do teste de transformacao linfoblastica. Antigeno soluvel de ovo mostrou resposta maior nos casos com hepatosplenomegalia quando comparados com as formas intestinais simples, as respostas mais altas sendo reencontradas nos grupos etarios mais jovens. Fitohemaglutinina mostrou resposta menor nos casos de esquistossomose intestinal simples e resposta maior nos grupos etarios de media idade. Esses resultados corroboram a importancia da resposta imunologica de tipo celular do hospedeiro nas varias manifestacoes da esquistossomose

Cell mediated immune (CMI) responsiveness to soluble egg antigen (SEA) and its relation to the occurrence of schistosomal hepatosplenic disease in patients with schistosomiasis mansoni.

The delayed intradermal test and migration inhibition tests were used to assess the delayed hypersensitivity in patients with BHF and simple intestinal bilharziasis using SEA. All bilharzial patients gave a positive intradermal test. The specificity of the intradermal test using SEA is demonstrated clearly by the negative response in all control groups.

Thyroid function in hepatic schistosomiasis.

Serum thyroxine (T4), serum tri-iodothyronine (T3-uptake) and the free thyroxine index in 17 men suffering from hepatosplenic schistosomiasis did not differ significantly from those of ten healthy male controls. There was no correlation between these values and serum protein levels or liver function tests.

Intravenous fat tolerance in hepatic schistosomiasis.

The elimination rate of lipid after a single intravenous dose of an artificial fat emulsion was studied in 13 schistosomal patients and 13 controls. A strikingly significant lower level was found in the mean incremental values of TG ten minutes after injection in the schistosomal patients than the controls. The shape of the curve up to 120 minutes after injection was of zero order in the controls but exponential in the schistosomal patients. The possible factors responsible for these differences are discussed.