Early primary biliary cholangitis is characterised by brain abnormalities on cerebral magnetic resonance imaging.

BACKGROUND: Brain change can occur in primary biliary cholangitis (PBC), potentially as a result of cholestatic and/or inflammatory processes. This change is linked to systemic symptoms of fatigue and cognitive impairment. AIM: To identify whether brain change occurs early in PBC. If the change develops early and is progressive, it may explain the difficulty in treating these symptoms. METHODS: Early disease brain change was explored in 13 patients with newly diagnosed biopsy-proven precirrhotic PBC using magnetisation transfer, diffusion-weighted imaging and 1 H magnetic resonance spectroscopy. Results were compared to 17 healthy volunteers. RESULTS: Cerebral magnetisation transfer ratios were reduced in early PBC, compared to healthy volunteers, in the thalamus, putamen and head of caudate with no greater reduction in patients with greater symptom severity. Mean apparent diffusion coefficients were increased in the thalamus only. No 1 H magnetic resonance spectroscopy abnormalities were seen. Serum manganese levels were elevated in all PBC patients, but no relationship was seen with imaging or symptom parameters. There were no correlations between neuroimaging data, laboratory data, symptom severity scores or age. CONCLUSIONS: This is the first study to be performed in this precirrhotic patient population, and we have highlighted that neuroimaging changes are present at a much earlier stage than previously demonstrated. The neuroimaging abnormalities suggest that the brain changes seen in PBC occur early in the pathological process, even before significant liver damage has occurred. If such changes are linked to symptom pathogenesis, this could have important implications for the timing of second-line-therapy use.

Whole body fat: content and distribution.

Obesity and its co-morbidities, including type II diabetes, insulin resistance and cardiovascular diseases, have become one of the biggest health issues of present times. The impact of obesity goes well beyond the individual and is so far-reaching that, if it continues unabated, it will cause havoc with the economies of most countries. In order to be able to fully understand the relationship between increased adiposity (obesity) and its co-morbidity, it has been necessary to develop proper methodology to accurately and reproducibly determine both body fat content and distribution, including ectopic fat depots. Magnetic Resonance Imaging (MRI) and Spectroscopy (MRS) have recently emerged as the gold-standard for accomplishing this task. Here, we will review the use of different MRI techniques currently being used to determine body fat content and distribution. We also discuss the pros and cons of MRS to determine ectopic fat depots in liver, muscle, pancreas and heart and compare these to emerging MRI techniques currently being put forward to create ectopic fat maps. Finally, we will discuss how MRI/MRS techniques are helping in changing the perception of what is healthy and what is normal and desirable body-fat content and distribution.

Geology and preliminary dating of the hominid-bearing sedimentary fill of the Sima de los Huesos Chamber, Cueva Mayor of the Sierra de Atapuerca, Burgos, Spain.

Sediments of the Sima de los Huesos vary greatly over distances of a few meters. This is typical of interior cave facies, and caused by cycles of cut and fill. Mud breccias containing human bones, grading upwards to mud containing bear bones, fill an irregular surface cut into basal marks and sands. The lack of Bedding and the chaotic abundance of fragile speleothem clasts in the fossiliferous muds suggests that the deposit was originally a subterranean pond facies, and that after emplacement of the human remains, underwent vigorous post-depositional rotation and collapse and brecciation, caused by underlying bedrock dissolution and undermining. The fossiliferous deposits are capped by flowstone and guano-bearing muds which lack large-mammal fossils. U-series and radiocarbon dating indicates the capping flowstones formed from about 68 ka to about 25 ka. U-series analyses of speleothem clasts among the human fossils indicate that all are at, or close to, isotopic equilibrium (> 350 ka). The distribution of U-series dates for 25 bear bones (154 +/- 66 ka) and for 16 human bones (148 +/- 34 ka) is similar and rather broad. Because the human bones seem to be stratigraphically older than chose of the bears, the results would indicate that most of the bones have been accumulating uranium irregularly with time. Electron spin resonance (ESR) analyses of six selected bear bones indicates dates of 189 +/- 28 ka, for which each is cordant with their corresponding U-series date (181 +/- 41 ka). Combined ESR and U-series dates for these samples yielded 200 +/- 4 ka. Such agreement is highly suggestive that uranium uptake in these bones was close to the early-uptake (EU) model, and the dates are essentially correct. Another three selected samples yielded combined ESR U-series dates of 320 +/- 4 ka with a modeled intermediate-mode of uranium uptake. The dating results, therefore, seem to provide a firm minimum age of about 200 ka for the human entry: and suggestive evidence of entry before 320 ka.

Sterilization of bacteria by means of microwave heating.

Despite the simplicity and convenience of microwave heating, descriptions in the current literature of attempts to provide a thorough sterilization process have not been encouraging nor has any manufacturer of sterilization equipment introduced such a device to the market. Trials conducted at Providence Hospital using a commercial microwave oven operating at 2450 MHz resulted in a satisfactory sterilization process, that is, the destruction of heat-resisting spore forms (B. stearothermophilus), provided that the materials undergoing sterilization were placed in sealed containers with sufficient water present to provide steam during the heating process. Suggestions are made for further investigation involving the microwave spectrum of the molecule of dipicolinic acid as well as the possibilities of practical applications which could result in reducing hospital costs.