Pancreatic regional blood flow links the endocrine and exocrine diseases.

An increasing number of studies have demonstrated that disease states of the endocrine or exocrine pancreas aggravate one another, which implies bidirectional blood flow between islets and exocrine cells. However, this is inconsistent with the current model of unidirectional blood flow, which is strictly from islets to exocrine tissues. This conventional model was first proposed in 1932, and it has never to our knowledge been revisited to date. Here, large-scale image capture was used to examine the spatial relationship between islets and blood vessels in the following species: human, monkey, pig, rabbit, ferret, and mouse. While some arterioles passed by or traveled through islets, the majority of islets had no association with them. Islets with direct contact with the arteriole were significantly larger in size and fewer in number than those without contact. Unique to the pancreas, capillaries directly branched out from the arterioles and have been labeled as "small arterioles" in past studies. Overall, the arterioles emerged to feed the pancreas regionally, not specifically targeting individual islets. Vascularizing the pancreas in this way may allow an entire downstream region of islets and acinar cells to be simultaneously exposed to changes in the blood levels of glucose, hormones, and other circulating factors.

Suggested policy and legislation reforms to reduce deleterious effect of pesticides in Lebanon.

Countrywide pesticide management activities are resource draining, even for developed countries, which sometimes fall short in achieving the optimum protection against pesticides deleterious effects on humans and environment. Additionally, in Lebanon, basic flaws exist at different levels of pesticide management cycle. In this study, through an extensive review of relevant literature regarding the pesticides impact on humans and environment in Lebanon and adopted policies in existing legislation, several gaps have been identified. Accordingly, recommendations to reduce pesticide risk through a combination of reforms at the policy level and its tools, particularly legislation, are proposed. In our opinion, the starting point is to adopt a minimum list of lower risk pesticides supported by a combination of: "prescriptions" based on a comprehensive registration and an effective implementation systems, a suitable IPM/ICM government-supported credit system, traceability systems of agricultural commodities and pesticides containers, Pesticide stock management system to reduce the quantity of obsolete pesticides, and containers recycling system. For a global sustainability of pesticides risk reduction, a binding global intervention fostered by the UN, based on human rights for safe food, is called upon to ban hazardous pesticides-except those of WHO class IV- trafficking in developing countries scoring low in an international official assessment of their pesticides lifecycle management. At the same time, global funds should support pesticides alternatives and the enhancement of the developing countries capacities for pesticides lifecycle management, which is a part of a larger global matrix in risk reduction.

Anti-proliferative effects of mesenchymal stem cells (MSCs) derived from multiple sources on ovarian cancer cell lines: an in-vitro experimental study.

Mesenchymal stem cells (MSCs) have surfaced as ideal candidates for treatment of different therapeutically challenging diseases however their effect on cancer cells is not well determined. In this study, we investigated the effect of MSCs derived from human bone marrow (BM), adipose tissue (AT), and umbilical cord derived MSCs (UC-MSCs) on ovarian cancer.Measurements of ovarian tumor marker proteins were computed by ELISA. Proliferative, apoptosis and anti-inflammatory effects of the MSCs were measured by Flow cytometry (FCM). MMPs expression was measured by RT-PCR.The co-culture of cancer cell lines OVCAR3, CAOV3, IGROV3 and SKOV3 with the conditioned media of MSCs (CM-MSC) and MSCs showed an increase in cellular apoptosis, along with a reduction in the level of CA-125 and a decline of LDH and beta-hCG. A decrease in CD24 of the cancer cell lines in co-culture with the CM-MSCs showed a reduction of the cancer tumorigenicity. In addition, the invasion and aggressiveness of cancer cell lines was significantly decreased by CM-MSC; this was translated by a decrease in MMP-2, MMP-9, and CA-125 mRNA expression, and an increase in TIMP 1, 2, and 3 mRNA expression. An increase in IL-4 and IL-10 cytokines, and a decrease in GM-CSF, IL-6, and IL-9, were also noted.In conclusion, mesenchymal stem cells derived from different sources and their conditioned media appear to have a major role in inhibition of cancer aggressiveness and might be considered as a potential therapeutic tool in ovarian cancer.

Optimized anaerobic-aerobic sequential system for the treatment of food waste and wastewater.

Considering that modern wastewater and solid waste processing facilities seek efficient energy recovery methods, this study investigates anaerobic-aerobic sequential systems for combined treatment of raw wastewater with food waste. The optimum loading rate was found to be 1.6mgVSL-1d-1 resulting in a stable operation of the anaerobic compartment. Yet, the increase in ammonia concentration resulted in gradual accumulation of VFA, until reaching a tipping point of 3000mgL-1 beyond which an abrupt increase in VFA to above 6000mgL-1 was observed, with acute stability loss and performance deterioration. The aerobic system was modeled using computational fluid dynamics methods. Optimum performance was achieved at an average strain rate magnitude of 12.7s-1 yielding a DO concentration of 4mgL-1 which have resulted in 74% conversion of ammonia nitrogen. Under optimum conditions, the studied AASS yielded high total removal rates of 93% VS and 94% COD, with a high specific methane yield of 845LkgVS-1 and a CO2-to-CH4 ratio of 0.63.

Dietary fat intake and polymorphisms at the PPARG locus modulate BMI and type 2 diabetes risk in the D.E.S.I.R. prospective study.

CONTEXT: Fat-rich diets are involved in many disorders such as obesity and type 2 diabetes (T2D). The Pro12Ala variant of peroxisome proliferator-activated receptor-γ (PPARγ) is known to modulate body mass index (BMI) and T2D risk. OBJECTIVE: Our aim was to study the interaction effect between PPARγ gene (PPARG) polymorphisms Pro12Ala and 1431C>T and fat intake on incident T2D and BMI in a 9-year prospective cohort drawn from the French general population, the D.E.S.I.R. (Data from an Epidemiological Study on the Insulin Resistance Syndrome) study (n=4676). METHODS: Nutritional intake was assessed by a food frequency self-questionnaire completed by each participant. Statistical analyses included logistic regression, analysis of covariance and haplotype analysis, with adjustment for confounding variables. RESULTS: A high fat consumption (the third sex-specific tertile of fat intake, as a percentage of energy intake) was associated with an increased T2D risk among ProPro and CC homozygotes (P(interaction)=0.05, odds ratio (OR) (95% confidence interval (95% CI))=1.73 (1.19-2.52) P=0.004 and OR=1.85 (1.27-2.71) P=0.001, respectively) but not in Ala and T carriers. There was a significant interaction effect between Pro12Ala and 1431C>T on BMI (P(interaction)=0.004); Ala was associated with lower BMI in CC homozygotes and with higher BMI in T carriers while the opposite was found for ProPro. There was also an interaction effect between Pro12Ala and dietary fat intake on BMI (P(interaction)=0.02); AlaAla individuals had a higher BMI than Pro carriers among high fat consumers (27.1 ± 1.0 versus 24.9 ± 0.1 for AlaAla and Pro+, respectively). There was no interaction effect between the 1431C>T single-nucleotide polymorphism and fat intake on BMI. CONCLUSION: Our results indicate strong genetic and nutritional interaction effects on BMI and T2D risk at the PPARG locus in a general population.

Intensifying glycaemic control with insulin reduces adiponectin and its HMW isoform moderately in type 2, but not in type 1, diabetes.

INTRODUCTION: As the impact of diabetes control was not tested on adiponectin (ADPN) levels, this study was designed to assess whether or not controlling hyperglycaemia can affect ADPN. PATIENTS AND METHODS: A total of 15 T1D and 48 T2D patients with HbA(1c) greater than 10% were studied at the time of hospitalization for uncontrolled diabetes. Total, and high-, medium- and low-molecular-weight (HMW, MMW, LMW) ADPN were measured at the time of study inclusion, on days 1 and 8, and at 1, 3 and 6 months after insulin treatment. RESULTS: While diabetes control improved, total and HMW APDN decreased on days 1 and 8, but remained steady thereafter in T2D patients. In T1D patients, ADPN levels remained unchanged throughout the study. CONCLUSION: Glycaemic control with insulin reduces ADPN in T2D patients in the short-term, but was ineffective in T1D.

Use and utility of ankle brachial index in patients with diabetes.

Ankle brachial index (ABI) is a simple method to screen peripheral arterial disease (PAD) and to evaluate cardiovascular (CV) prognosis in the general population. Measuring it requires a hand-held Doppler probe but it can be done also with an automatic device. ABI is an effective tool for clinical practice or clinical studies. However, in diabetic patients, it has some specific caveats. Sensitivity of the standard threshold of 0.9 appears to be lower in diabetic patients with complications. Moreover, highly frequent arterial medial calcifications in diabetes increase ABI. It has been demonstrated that measurements >1.3 are well correlated with both an increased prevalence of PAD and CV risk. Therefore, ABI thresholds of less than 0.9 and more than 1.3 are highly suspicious for PAD and high CV risk in diabetic patients. However, when there is concomitant clinical peripheral neuropathy or high risk of arterial calcification, the efficiency of ABI seems to be limited. In this case, other methods should be applied, toe pressure, in particular. Thus, the ABI could be used in patients with diabetes, but values should be interpreted with precision, according to the clinical situation.

Tractography of peripheral nerves and skeletal muscles.

The assessment of human peripheral nerves and skeletal muscles by means of diffusion tensor imaging and tractograpy has been a recent area of research. These techniques have been successfully applied in both volunteers and patients, providing non-invasively, quantitative microstructural parameters (mainly mean fractional anisotropy and apparent diffusion coefficient) and offering a three-dimensional visualization tool of nerves and muscles fibers. DTI and tractography may reveal abnormalities that are beyond the resolution of conventional MR techniques and hence open the way to potential clinical applications. In this article, we will first summarize the current state of DTI and tractography in the evaluation of peripheral nerves and skeletal muscles as well as their potential future clinical applications. Then, we will address important technical considerations, which understanding is necessary to appropriately apply DTI and tractograhy, and in order to understand the current limitations of these innovative and promising techniques.

[Plain radiographs of the wrist and hand]. / Les radiographies simples du poignet et de la main.

The purpose of this review is to describe the value of the different radiographic projections of the wrist and hand, provide criteria for quality control and key interpretation points. Plain radiographs of the hand and wrist are still, in this era of cross-sectional imaging, of great importance in the assessment and understanding of bone and joint disorders, particularly in the setting of trauma. Indeed postero-anterior and lateral views have to be completed with additional projections depending on the suspected lesion and clinical presentation.

Diffusion tensor imaging and tractography of the median nerve in carpal tunnel syndrome: preliminary results.

The purpose was to demonstrate the feasibility of in vivo diffusion tensor imaging (DTI) and tractography of the human median nerve with a 1.5-T MR scanner and to assess potential differences in diffusion between healthy volunteers and patients suffering from carpal tunnel syndrome. The median nerve was examined in 13 patients and 13 healthy volunteers with MR DTI and tractography using a 1.5-T MRI scanner with a dedicated wrist coil. T1-weighted images were performed for anatomical correlation. Mean fractional anisotropy (FA) and mean apparent diffusion coefficient (ADC) values were quantified in the median nerve on tractography images. In all subjects, the nerve orientation and course could be detected with tractography. Mean FA values were significantly lower in patients (p=0.03). However, no statistically significant differences were found for mean ADC values. In vivo assessment of the median nerve in the carpal tunnel using DTI with tractography on a 1.5-T MRI scanner is possible. Microstructural parameters can be easily obtained from tractography images. A significant decrease of mean FA values was found in patients suffering from chronic compression of the median nerve. Further investigations are necessary to determine if mean FA values may be correlated with the severity of nerve entrapment.

[Case report: positive signals from automated blood-culture system with negative direct Gram examination]. / A propos d'hémocultures détectées positives en système automatisé mais dont l'examen direct est négatif.

Detection of positive haemoculture is usually managed by an automated system. When a bottle is detected positive but that the Gram coloration does not reveal germs by direct examination, transfer onto chocolate blood agar generally allows to confirm or infirm bacteraemia. In light of a case of Fusobacterium nucleatum bacteraemia, we discuss the opportunity of pairing it with an enrichment broth. M. N, hospitalized in the hepatogastroenterology department, runs a fever of undetermined origin. Three pairs of blood samples are collected on May 7th, 2004, another pair on May 9th, 2004 and a last pair on May 10th, 2004. They are incubated in a Bactec 9120 analyzer. A positive signal is detected in the two last anaerobic haemocultures pairs after four days of incubation, but in both cases, the Gram coloration does not bring germs to light. A systematic transfer of the broth onto chocolate blood agar with incubation under CO2 enriched atmosphere and anaerobiosis is carried out. After 24 hours, the solid media remain sterile. The samples found positive by the Bactec(TM) are then transferred onto Schaedler broth in order to favour a potential growth of fastidious germs. The culture will prove to be positive only in this enrichment medium, allowing the identification of F. nucleatum. An hepatic abscess will then be revealed in the patient. It thus appears judicious to associate an enrichment medium with transplanted solid medium when the context is evocative of a real infection (clinic, positivity delays...).

Low-dose ECG-gated 64-slices helical CT angiography of the chest: evaluation of image quality in 105 patients.

The purpose of this study was to evaluate image quality of low-dose electrocardiogram (ECG)-gated multislice helical computed tomography (CT) angiograms of the chest. One hundred and five consecutive patients with a regular sinus rhythm (72 men; 33 women) underwent ECG-gated CT angiographic examination of the chest without administration of beta blockers using the following parameters: (a) collimation 32 x 0.6 mm with z-flying focal spot for the acquisition of 64 overlapping 0.6-mm slices, rotation time 0.33 s, pitch 0.3; (b) 120 kV, 200 mAs; (c) use of two dose modulation systems, including adjustment of the mAs setting to the patient's size and anatomical shape and an ECG-controlled tube current. Subjective and objective image quality was evaluated by two radiologists in consensus on 3-mm-thick scans reconstructed at 55% of the response rate (RR) interval. The population and protocol characteristics included: (a) a mean [+/-standard deviation (SD)] body mass index (BMI) of 24.47 (+/-4.64); (b) a mean (+/-SD) heart rate of 72.04 (+/-15.76) bpm; (c) a mean (+/-SD) scanning time of 18.3 (+/-2.73) s; (d) a mean (+/-SD) dose-length product (DLP) value of 260.57 (+/-83.67) mGy/cm; (e) an estimated average effective dose of 4.95 (+/-1.59) mSv. Subjective noise was depicted in a total of nine examinations (8.5%), always rated as mild. Objective noise was assessed by measuring the standard deviation of pixel values in a homogeneous region of interest within the trachea and descending aorta; SD was 15.91 HU in the trachea and 22.16 HU in the descending aorta, with no significant difference in the mean value of the standard deviations between the four categories of BMI except for obese patients, who had a higher mean SD within the aorta. Interpolation artefacts were depicted in 22 patients, with a mean heart rate significantly lower than that of patients without interpolation artifacts, rated as mild in 11 patients and severe in 11 patients. The severity of interpolation artefacts was significantly linked to a low heart rate in affected patients. The overall image quality of CT scans was rated as diagnostic in 94 patients (89.5%) while 11 examinations (10.5%) were found to be partially nondiagnostic owing to the cyclic presence of severe interpolation artefacts, which can be compensated for by additional reconstructions at a different temporal window. In these cases, interpolation artefacts could have been avoided by reducing the pitch from 0.3 to 0.2 at the expense of increased patient dose. Low-dose ECG-gated CT angiograms of the chest can be obtained in routine clinical practice with 64-slice CT technology without altering the diagnostic value of CT scans.

An experimental in vitro model for dynamic direct exposure of human cells to airborne contaminants.

The aim of this study was to establish a dynamic in vitro model for direct exposure of human cells to gaseous contaminants to investigate the cellular responses to airborne chemical exposures. Nitrogen dioxide (NO2) was selected as a model gas compound. Standard test atmospheres were generated (2.5-10 ppm), using a dynamic direct dilution method. Human cells including: A549 pulmonary type II-like epithelial cell lines and skin fibroblasts were grown on porous membranes. Human cells on snapwell inserts were placed in horizontal diffusion chambers and exposed to various airborne concentrations of NO2 directly at the air/liquid interface for 1 h at 37 degrees C. Cytotoxicity of the test gas was investigated using the MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium), NRU (neutral red uptake) and ATP (Adenosine triphosphate) assays. Dose-dependent effects of NO2 were observed in human cells tested which resulted in a significant reduction of cell viability at concentrations normally encountered in workplace environments (p<0.05). Our findings suggest that the dynamic direct exposure method can be used for in vitro inhalational and dermal toxicity studies and potentially as an advanced technology for biomonitoring of airborne contaminants in future occupational and environmental toxicity assessments.

A novel in vitro exposure technique for toxicity testing of selected volatile organic compounds.

Exposure to vapours of volatile chemicals is a major occupational and environmental health concern. Toxicity testing of volatile organic compounds (VOCs) has always faced significant technological problems due to their high volatility and/or low solubility. The aim of this study was to develop a practical and reproducible in vitro exposure technique for toxicity testing of VOCs. Standard test atmospheres of xylene and toluene were generated in glass chambers using a static method. Human cells including: A549-lung derived cell lines, HepG2-liver derived cell lines and skin fibroblasts, were grown in porous membranes and exposed to various airborne concentrations of selected VOCs directly at the air/liquid interface for 1 h at 37 degrees C. Cytotoxicity of test chemicals was investigated using the MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) and NRU (neutral red uptake) assays following 24 h incubation. Airborne IC(50) (50% inhibitory concentration) values were determined using dose response curves for xylene (IC(50)=5350+/- 328 ppm, NRU; IC(50)=5750+/- 433 ppm, MTS in skin fibroblast) and toluene (IC(50)=0 500+/- 527 ppm, NRU; IC(50)=11,200 +/- 1,044 ppm, MTS in skin fibroblast). Our findings suggest that static direct exposure at the air/liquid interface is a practical and reproducible technique for toxicity testing of VOCs. Further, this technique can be used for inhalational and dermal toxicity studies of volatile chemicals in vitro as the exposure pattern in vivo is closely simulated by this method.

Toxicity assessment of industrial chemicals and airborne contaminants: transition from in vivo to in vitro test methods: a review.

Exposure to occupational and environmental contaminants is a major contributor to human health problems. Inhalation of gases, vapors, aerosols, and mixtures of these can cause a wide range of adverse health effects, ranging from simple irritation to systemic diseases. Despite significant achievements in the risk assessment of chemicals, the toxicological database, particularly for industrial chemicals, remains limited. Considering there are approximately 80,000 chemicals in commerce, and an extremely large number of chemical mixtures, in vivo testing of this large number is unachievable from both economical and practical perspectives. While in vitro methods are capable of rapidly providing toxicity information, regulatory agencies in general are still cautious about the replacement of whole-animal methods with new in vitro techniques. Although studying the toxic effects of inhaled chemicals is a complex subject, recent studies demonstrate that in vitro methods may have significant potential for assessing the toxicity of airborne contaminants. In this review, current toxicity test methods for risk evaluation of industrial chemicals and airborne contaminants are presented. To evaluate the potential applications of in vitro methods for studying respiratory toxicity, more recent models developed for toxicity testing of airborne contaminants are discussed.

In vitro cytotoxicity testing of airborne formaldehyde collected in serum-free culture media.

The purpose of this study was to identify a suitable sampling model for on-site toxicity assessment of soluble air contaminants such as formaldehyde, a well known industrial and indoor air contaminant. The in vitro cytotoxicity of formaldehyde, the selected model for soluble air contaminants, was studied using the MTS (tetrazolium salt) assay in two carcinoma cell lines, A549 epithelial lung and HepG2 hepatocarcinoma, and in skin fibroblasts. The cytotoxic effects of airborne formaldehyde were evaluated using test atmospheres in concentrations below 10 ppm (12.3 mg/m3), generated by a dynamic diffusion method and bubbled (0.3 L/min) through serum-free culture media for one or four hours. Human cells were treated with formaldehyde air samples, and cell viability was determined after four hours incubation. In parallel, the concentration of airborne formaldehyde was monitored, using the 3500 NIOSH method. Cell viability of the HepG2 cells exposed to formaldehyde air samples (8.75 ppm x 4 h) was reduced to less than 50% (31.6 +/- 1.24%). The HepG2 cell lines were found to be more sensitive (IC50 = 103.79 +/- 23.55 mg/L) to formaldehyde than both A549 cell lines (IC50= 198.36 +/- 9.54 mg/L) and skin fibroblasts (IC50 = 196.68 +/- 36.73 mg/L) (P < 0.01). An average of 96.8% was determined for collection efficiency of formaldehyde in serum-free culture media. The results of this study suggest that absorption of soluble air contaminants, such as formaldehyde, in serum-free culture media can be used as a suitable sampling model for on-site toxicity assessments.

[Paranasal sinuses: postoperative imaging]. / Imagerie des sinus opérés.

Radiologic assessment after sinus surgery requires not only a good knowledge of the primary disease, but also a mandatory understanding of every surgical technique and approach. After having described these techniques, we will illustrate immediate, possible but rare, post-operative complications. The various pathologies responsible for a delayed recurrence will also be illustrated. A chapter will be dedicated to paranasal sinuses malignant tumors follow up after surgery.

[Imaging of non-traumatic intracerebral hematoma]. / Magerie des hématomes intracérébraux non traumatiques.

Intracerebral hematoma is mainly due to the spontaneous rupture of small vessels damaged by chronic hypertension or amyloid angiopathy. In some cases, intracerebral hemorrhage may be associated with a vascular malformation, a tumor, venous thrombosis or hemorrhagic transformation of a cerebral infarct. The objective of brain imaging is to identify the hematoma according to its different stages and to find a potential underlying cause because of the risk of recurrence and the possibilities of treatment. In emergency, a diagnosis of hematoma may be obtained by CT scan or MRI but the etiologic work-up requires early MRI. According to the patient's age, the medical history and the location of the hematoma, it may be necessary to perform conventional angiography in order to exclude an intracranial vascular malformation. The aim of this review is to detail the different aspects of intracerebral hemorrhages and to discuss the main causes that can be found at brain imaging.