Endoscopic appearance and location dictate diagnostic yield of biopsies in eosinophilic oesophagitis.

BACKGROUND: Acknowledging that eosinophilic esophagitis (EoE) is a disease with variable involvement throughout the oesophagus, studies have suggested a minimum of five biopsies to diagnose EoE. Although it is accepted that furrows and exudates appear to represent areas of inflammation, no research to date has looked specifically at EoE endoscopic findings to see if eosinophilic infiltrate correlates with specific endoscopic findings. AIM: To evaluate the distribution of eosinophils in EoE and determine whether endoscopic appearances predict the degree of eosinophilia at various locations of the oesophagus. METHODS: We performed a prospective cross sectional study of EoE (treated and untreated) patients to study the distribution of eosinophils according to endoscopic findings. The oesophagus of 10 EoE patients were biopsied up to 32 times in a circumferential manner. The mucosal changes were documented at the site of each biopsy. Histological determination of eosinophil counts and related histopathology of the oesophagus were then correlated with endoscopic findings. Similar biopsy assessments were made in treated (resolved) EoE patients (n = 6) to determine the permanence of specific endoscopic appearances. RESULTS: A total of 16 patients were biopsied (10 EoE, 6 treated EoE). A total of 432 biopsies were obtained in all with 294 biopsies from 10 EoE subjects. Eosinophil density was increased distally in the majority of EoE patients. Biopsies performed in areas of exudates and furrows demonstrated higher eosinophil counts. Lines and normal-appearing oesophagi in EoE subjects were not commonly associated with elevated eosinophil counts (>15 eos/HPF). Rings alone without associated furrows or plaques did not demonstrate elevated eosinophil counts and were seen in resolved EoE (Rx-EoE) as well as in active EoE patients. CONCLUSIONS: Eosinophilic esophagitis remains a variable disease with some patients manifesting extensive disease throughout the oesophagus. Characteristics of furrows and exudates found during endoscopy are associated with higher peak eosinophil counts, requiring fewer biopsies to make a diagnosis. Lines and otherwise normal appearances of the oesophagus suggest a milder mucosal eosinophilia, requiring substantial biopsies to adequately identify fields with diagnostic eosinophil counts.

Mob1p interacts with the Sid2p kinase and is required for cytokinesis in fission yeast.

A great deal is now known about how cells regulate entry into mitosis, but only recently have the mechanisms controlling exit from mitosis and cytokinesis begun to be revealed. In the budding yeast Saccharomyces cerevisiae, Mob1p interacts with the Dbf2p kinase and cells containing mutations in these genes arrest in late anaphase [1] [2]. Proteins related to Mob1p are present in both plants and animals, but information about Mob1p function has been obtained only from budding yeast. Here, we describe the identification and characterization of Mob1p from Schizosaccharomyces pombe. Mob1p associates with the Sid2p kinase and like Sid2p, Mob1p is required for the initiation of cytokinesis, but not for mitotic exit. Mob1p localizes to the spindle pole body (SPB) and to the cell-division site during cell division, suggesting that it might be involved in transducing the signal to initiate cell division from the SPB to the division site. Mob1p is required for Sid2p localization, and Mob1p localization requires the function of the cdc7, cdc11, cdc14, spg1, sid1, sid2, and sid4 genes, suggesting that together with Sid2p, Mob1p functions at the end of the signaling cascade required to regulate the onset of cytokinesis at the end of mitosis.

[Evaluation of the effect of d,l-carnitine on lipid metabolism of patients after prolonged dialysis]. / Ocena wplywu preparatu D,L-karnityny na gospodarke lipidowa u chorych przewlekle dializowanych.

An effect of carnitine (Bicarnesine) on lipid metabolism in 14 patients treated with prolonged dialyses has been analysed. Carnitine has been administered orally in the dose of 30 mg/kg b.w. three times per week for 8 weeks and every day for the next 8 weeks. Carnitine, total triglycerides, total and HDL cholesterol, and glucose have been determined in serum. Blood lipoproteins have been assayed with electrophoresis in agarose gel. Total and free carnitine concentrations increased by 3.5 times within 16 weeks. Triglycerides level did not change significantly in all examined patients except a group of 6 patients with baseline hypertriglyceridemia, in which a significant but transient decrease in triglycerides level has been noted after 4 weeks of treatment. At the same time, normalization of blood lipoproteins has been observed. In the eighth week, a transient decrease in HDL-cholesterol has been noted. Result suggest, that carnitine despite an increase in total and free carnitine blood levels did not regulate lipid metabolism disorders. Moreover, its administration to patients treated with prolonged dialyses seems to be unfavourable due to several adverse reactions.