CLINICAL EFFICIENCY OF OPEN AND ENDOSCOPIC INTERVENTIONS WITH OBSTACLES OF THE TERMINAL DEPARTMENT OF CHOLEDOCH IN PATIENTS WITH GALLSTONE DISEASE OF ELDERLY AND SENILE AGE

Summary. Purpose. To optimize the tactics of endoscopic interventions for cholelithiasis complicated by obstruction of the terminal portion of the common bile duct to reduce the incidence of postoperative complications and mortality in elderly and senile people. Materials and methods. The results of examination and treatment of 221 elderly and senile patients with cholelithiasis complicated by obstruction of the terminal section of the common bile duct were analyzed. Results. Using of existing methods and proposed new methods of endoscopic management of cholelithiasis complicated by obstruction of the terminal section of the common bile duct allow to reliably reduce the incidence of postoperative complications in elderly and senile patients from 19.8 to 9.5%, postoperative mortality from 10.3 to 2.9% Conclusions. In elderly and senile patients with obstruction of the terminal section of the common bile duct and common bile duct stones who bear high operational risk, endoscopic papillosphincterotomy with stone removal is a sufficient method of treatment. In case of unremovable common bile duct stones, endoscopic papillosphincterotomy and stenting allow to avoid revision of the common bile duct, and in high-risk patients those methods allow to refrain from open surgery.

Alternative Hydrophobic Core in Proteins—The Effect of Specific Synergy

Proteins with a high degree of sequence similarity representing different structures provide a key to understand how protein sequence codes for 3D structure. An analysis using the fuzzy oil drop model was carried out on two pairs of proteins with different secondary structures and with high sequence identities. It has been shown that distributions of hydrophobicity for these proteins are approximated well using single 3D Gaussian function. In other words, the similar sequences fold into different 3D structures, however, alternative structures also have symmetric and monocentric hydrophobic cores. It should be noted that a significant change in the helical to beta-structured form in the N-terminal section takes places in the fragment much preceding the location of the mutated regions. It can be concluded that the final structure is the result of a complicated synergy effect in which the whole chain participates simultaneously.

Dimensioning of Required Volumes of Interconnected Detention Tanks Taking into Account the Direction and Speed of Rain Movement

This article is aimed at defining the impact of the direction and velocity of waves of rainfall as they pass over interconnected stormwater detention tank systems. The simulations were conducted for a real urban catchment area as part of the Storm Water Management Model (SWMM) 5.1 programme. The results permit us to conclude that the direction and velocity of a moving wave of rainfall have a significant influence on the required volumes of interconnected stormwater detention tank systems. By comparing the modelling test results for stationary rainfall and rainfall moving over the urban catchment area, it has been demonstrated that differences in the required volume of the detention tank located at the terminal section of a stormwater drainage system are inversely proportional to the adopted value of the diameter of the outfall channel for upstream storage reservoirs. In extreme cases, the differences may be up to several dozen percentage points. Furthermore, it has been proven that the arrangement of the stormwater detention tanks in relation to one another and the adopted diameter of the outfall channel are key factors in identifying the degree to which the detention tanks are hydraulically dependent on one another.

Description of immature stages and natural history of Stigmella schinivora (Lepidoptera: Nepticulidae), a leaf-miner associated with the Brazilian peppertree

Stigmellaschinivoravan Nieukerken, 2016 was described from Cataratas de Iguazú, Misiones, Argentina, based on adults reared fromSchinusterebinthifoliusRaddi (Anacardiaceae) leaf mines. The aim of this study is to describe for the first time the external morphology of the immature stages ofS.schinivorawith the aid of light and scanning electron microscopy, based on mines collected on the same host plant, but in Laranjeiras do Sul, Paraná, Brazil. Data on natural history, including histology of the mines, are also provided. The larva passes through four instars, all endophytic, having chewing mouth parts and feeding on the palisade parenchyma. The first three instars are apodous and have a subcylindrical body, bearing only one pair of setae on the tenth abdominal segment; the fourth instar is eruciform, with well-developed ambulatory calli on thorax and abdomen and setae on all tagmata. A serpentine mine is constructed on the adaxial surface, progressively increasing in width during larval development. With the exception of the widened, terminal section, the mine is left filled with larval feces. The fully developed larva of last instar exits through a slit made at the distal end of the mine, building a silk cocoon on the leaf abaxial surface where pupation occurs. This is the first record ofS.schinivorafrom Brazil, which was only known from the type locality in Argentina.

A new technique of ultrasound guided percutaneous renal biopsy by perforated probe and perpendicular needle trajectory

The percutaneous biopsy of native kidneys according to the classical methodology is performed under real time ultrasound guidance with the needle introduction along a trajectory of about 30°, aimed to the lower pole of the kidney. Recently, a variant of the classical technique has been introduced by which a perforated ultrasound probe is used to guide the needle along a perpendicular trajectory to the terminal section of the lower kidney pole where the front and back margins of the cortical kidney tissue join each other without renal sinus interposition so to offer to the needle a 3-4 cm thick cortical tissue front which allows to obtain a cortical tissue sample suitable for histological examination even with a single needle pass, while at the same time limiting the possibility of damaging the smaller kidney calices of the lower group whose lesion causes hematuria. In this paper, we present a large survey (50 patients) to compare to data from the literature obtained by using similar needle gauge and with a similar follow-up period after biopsy. The result of this comparison confirms the efficacy of this variant of the classical technique because in front of a statistically lower number of needle passes, it allowed to obtain 100% of samples suitable for histological analysis, in absence of major complications and with a statistically lower post-biopsy hemoglobin drop in comparison to that observed in a group of 44 patients biopsied with a greater number of needle passes, in the only study of the literature which is directly comparable to our study in relation to needle gauge and duration of monitoring.

Trimeric Autotransporter DsrA Is a Major Mediator of Fibrinogen Binding in Haemophilus ducreyi

ABSTRACTHaemophilus ducreyiis the etiologic agent of the sexually transmitted genital ulcer disease chancroid. In both natural and experimental chancroid,H. ducreyicolocalizes with fibrin at the base of the ulcer. Fibrin is obtained by cleavage of the serum glycoprotein fibrinogen (Fg) by thrombin to initiate formation of the blood clot. Fg binding proteins are critical virulence factors in medically important Gram-positive bacteria.H. ducreyihas previously been shown to bind Fg in an agglutination assay, and theH. ducreyiFg binding protein FgbA was identified in ligand blotting with denatured proteins. To better characterize the interaction ofH. ducreyiwith Fg, we examined Fg binding to intact, viableH. ducreyibacteria and identified a novel Fg binding protein.H. ducreyibound unlabeled Fg in a dose-dependent manner, as measured by two different methods. In ligand blotting with total denatured cellular proteins, digoxigenin (DIG)-Fg bound only twoH. ducreyiproteins, the trimeric autotransporter DsrA and the lectin DltA; however, only the isogenicdsrAmutant had significantly less cell-associated Fg than parental strains in Fg binding assays with intact bacteria. Furthermore, expression of DsrA, but not DltA or an empty vector, rendered the non-Fg-bindingH. influenzaestrain Rd capable of binding Fg. A 13-amino-acid sequence in the C-terminal section of the passenger domain of DsrA appears to be involved in Fg binding byH. ducreyi. Taken together, these data suggest that the trimeric autotransporter DsrA is a major determinant of Fg binding at the surface ofH. ducreyi.

Molecular and Biological Characterization of Deformed Wing Virus of Honeybees (Apis mellifera L.)

ABSTRACT Deformed wing virus (DWV) of honeybees (Apis mellifera) is closely associated with characteristic wing deformities, abdominal bloating, paralysis, and rapid mortality of emerging adult bees. The virus was purified from diseased insects, and its genome was cloned and sequenced. The genomic RNA of DWV is 10,140 nucleotides in length and contains a single large open reading frame encoding a 328-kDa polyprotein. The coding sequence is flanked by a 1,144-nucleotide 5′ nontranslated leader sequence and a 317-nucleotide 3′ nontranslated region, followed by a poly(A) tail. The three major structural proteins, VP1 (44 kDa), VP2 (32 kDa), and VP3 (28 kDa), were identified, and their genes were mapped to the N-terminal section of the polyprotein. The C-terminal part of the polyprotein contains sequence motifs typical of well-characterized picornavirus nonstructural proteins: an RNA helicase, a chymotrypsin-like 3C protease, and an RNA-dependent RNA polymerase. The genome organization, capsid morphology, and sequence comparison data indicate that DWV is a member of the recently established genus Iflavirus.

Identification of PimR as a Positive Regulator of Pimaricin Biosynthesis in Streptomyces natalensis

ABSTRACT Sequencing of the DNA region on the left fringe of the pimaricin gene cluster revealed the presence of a 3.6-kb gene, pimR, whose deduced product (1,198 amino acid residues) was found to have amino acid sequence homology with bacterial regulatory proteins. Database comparisons revealed that PimR represents the archetype of a new class of regulators, combining a Streptomyces antibiotic regulatory protein (SARP)-like N-terminal section with a C-terminal half homologous to guanylate cyclases and large ATP-binding regulators of the LuxR family. Gene replacement of pimR from Streptomyces natalensis chromosome results in a complete loss of pimaricin production, suggesting that PimR is a positive regulator of pimaricin biosynthesis. Gene expression analysis by reverse transcriptase PCR (RT-PCR) of the pimaricin gene cluster revealed that S. natalensis ΔPimR shows no expression at all of the cholesterol oxidase-encoding gene pimE, and very low level transcription of the remaining genes of the cluster except for the mutant pimR gene, thus demonstrating that this regulator activates the transcription of all the genes belonging to the pimaricin gene cluster but not its own transcription.