Triad Group Research Articles

Preserving hepatic artery flow during portal triad blood inflow occlusion improves remnant liver regeneration in rats after partial hepatectomy

BackgroundIn the present study, we compared preservation of the hepatic artery flow during liver blood inflow occlusion with total portal triad blood flow clamping (the Pringle maneuver) to examine their effects on liver regeneration in rats after partial hepatectomy. Materials and methodsMale Wistar rats were randomized to a control group (without hepatic inflow occlusion), an occlusion of the portal triad (OPT) group (OPT for 30 min under portal blood bypass), and an occlusion of the portal vein (OPV) group (OPV only for 30 min under portal blood bypass). All the rats underwent partial hepatectomy at the end of hepatic blood control. Liver regeneration was assessed on days 3 and 7 after hepatectomy. Liver damage, extracellular signal-regulated kinase-1/2 activation, and cytokine expression of the remnant liver in the first 24 h after hepatectomy were also assessed. ResultsSignificantly greater liver regeneration, at a level similar to that of the control group, as indicated by the percentage of the initial liver weight, proliferating cell nuclear antigen and Ki-67 labeling indexes, and technetium-99m galactosyl human serum albumin liver uptake, was observed in the OPV group on day 3 after hepatectomy (P < 0.05 versus the OPT group). Liver damage, as represented by alanine aminotransferase and aspartate aminotransferase measurement and histopathologic examination, was substantially alleviated in the OPV group compared with the OPT group. In contrast to the control and OPV groups, the OPT group had markedly increased extracellular signal-regulated kinase-1/2 activation, heat shock protein 70, and interleukin-6 expression in response to ischemia and partial hepatectomy. ConclusionsOur results have indicated that compared with the Pringle maneuver, clamping the portal vein while preserving the hepatic artery flow during partial hepatectomy is better for remnant liver regeneration at an early posthepatectomy stage.

Atherogenic dyslipidemia as evidenced by the lipid triad: prevalence and associated risk in statin-treated patients in ambulatory care

Objective:The prevalence of atherogenic dyslipidaemia (AD) can be assessed using the lipid triad (low high-density lipoprotein cholesterol [HDL-C] <35 mg/dl, high triglyceride (TG) levels (≥200 mg/dl) and a high total cholesterol HDL-C ratio (TC/HDL-C>5). The aim of the present analysis was (1) to describe the prevalence of the lipid triad, (2) to quantify the associated cardiovascular risk on the basis of the PROCAM score, and (3) to calculate the additional risk reduction that can be obtained by adding nicotinic acid (NA) to a pre-existing statin therapy (model based on the outcomes of a previous randomized controlled study).Methods:Descriptive post-hoc analysis of the German 4E registry in 24,500 patients receiving statins for primary cardiovascular prevention in ambulatory care.Results:The sample comprised 24,500 patients in primary prevention, who had an overall 10-year risk of 16.2%. The prevalence of patients with lipid triad was 24.0%. The mean estimated risk reduction in the total sample (calculated on the basis of a mean LDL-C decrease by 24.3% and other lipid parameter changes) achieved after 6-week statin treatment was 46.6%, the estimated additional relative risk reduction by NA 45.1% (total effect compared to baseline about 70%). In the lipid triad group, the additional relative risk reduction by NA treatment was 42.9%. Relative treatment effects were consistent, irrespective of age and gender. Limitations of this analysis include the use of the TC/HDL-C ratio instead of the direct small dense LDL-C measurements, and the unknown variations of effect size of NA induced lipid reduction when used in combination with statins.Conclusions:Our model calculations indicate that the residual risk which persists after statin treatment could be substantially lowered if besides LDL-C also HDL-C and TG would be addressed, e.g. by adding NA to statin therapy. Definitive prospective studies are needed to confirm this hypothesis.

Pulmonary Chondroma: A Tumor Associated With Carney Triad and Different From Pulmonary Hamartoma

The Carney triad is the clinical association of gastric stromal sarcomas, pulmonary cartilaginous tumors, and extra-adrenal paragangliomas. The pulmonary tumors are its second commonest component and have been misinterpreted clinically and pathologically as metastases from the gastric tumors and pulmonary cartilaginous hamartomas, respectively. They have not been previously described in detail in the pathology literature or compared with pulmonary cartilaginous hamartomas. Forty-two patients with pulmonary cartilaginous tumors as a component of Carney triad were identified. Clinical, radiographic, and pathologic findings in the cases were tabulated. Hematoxylin and eosin-stained sections of the neoplasms were evaluated for a series of histologic features. A subgroup of 41 tumors from the latter was compared with those in a group of pulmonary cartilaginous hamartomas. Patients with Carney triad group were predominantly young women. Their pulmonary neoplasm(s) were usually asymptomatic, often multiple, well circumscribed, medium-sized (mean diameter=2.8 cm), and composed almost exclusively of cartilage and bone surrounded by a fibrous pseudocapsule. The cartilage was usually myxoid, less frequently hyaline, and commonly calcified, ossified, or both. They showed no fat, smooth muscle or entrapped respiratory epithelium, tissues that were common in pulmonary hamartoma (P<0.0001). None of the tumors metastasized or was fatal. The pulmonary neoplasms in the Carney triad are well-differentiated benign cartilaginous tumors that are best designated as chondromas. They differ pathologically from pulmonary cartilaginous hamartomas on the basis of the presence of a thin fibrous pseudocapsule, frequent bone metaplasia, and calcification, and also the absence of entrapped epithelium and fat.

Polypose naso-sinusienne diffuse et co-morbidité: A propos de 65 cas traités par chirurgie endonasale

Nasal polyposis is an inflammatory disorder which pathophysiology remains unclear. Several clinical associations are described according to co-morbidities (asthma, allergy...).To analyze the efficacy of a standardized surgical procedure in 65 patients with nasal polyposis, enrolled in three categories according to the presence of co-morbidities (asthma, allergy...).Open prospective study of non-randomized cases from a single institution.An inception cohort of 65 consecutive patients with nasal polyposis observed from January 1994 to December 1997. The same surgical procedure was performed in all patients. At the end of the study, an evaluation was performed to collect all the information concerning nasal and bronchial symptoms, asthma conditions, and medical treatment.60 patients have finally completed the study. Polyposis was isolated in 29 patients, asthma was present in 21 patients, associated with aspirin intolerance in 10 patients (ASA Triad). Nasal obstruction and olfactory dysfunction was improved in 37 and 42 patients, respectively (p<0.0001), without a statistical significance between all groups. After surgery, topical treatment with steroids and local recurrences were more frequently observed in the ASA Triad group without statistical significance.Nasal polyposis appears to be less controlled in the ASA Triad group compared to isolated nasal polyposis, although such conclusion is not statistically significant.

Rotavirus protein involved in genome replication and packaging exhibits a HIT-like fold.

Rotavirus, the major cause of life-threatening infantile gastroenteritis, is a member of the Reoviridae. Although the structures of rotavirus and other members of the Reoviridae have been extensively studied, little is known about the structures of virus-encoded non-structural proteins that are essential for genome replication and packaging. The non-structural protein NSP2 of rotavirus, which exhibits nucleoside triphosphatase, single-stranded RNA binding, and nucleic-acid helix-destabilizing activities, is a major component of viral replicase complexes. We present here the X-ray structure of the functional octamer of NSP2 determined to a resolution of 2.6 A. The NSP2 monomer has two distinct domains. The amino-terminal domain has a new fold. The carboxy-terminal domain resembles the ubiquitous cellular histidine triad (HIT) group of nucleotidyl hydrolases. This structural similarity suggests that the nucleotide-binding site is located inside the cleft between the two domains. Prominent grooves that run diagonally across the doughnut-shaped octamer are probable locations for RNA binding. Several RNA binding sites, resulting from the quaternary organization of NSP2 monomers, may be required for the helix destabilizing activity of NSP2 and its function during genome replication and packaging.

Validity of MMPI-2 profiles in chronic back pain patients: differences in path models of coping and somatization.

To show clinical utility and empirical validity of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) chronic pain patient subgroups by identification of differential multivariate relationships across groups. This study used structural equation modeling to test cognitive coping strategies and somatization as mediator variables in path models with pain severity and depression used as exogenous (independent) variables and patient's activity level as the final endogenous (dependent) variable, across MMPI-2 profiles. Hierarchical cluster analysis, performed on a sample of 569 chronic low back patients, resulted in four cluster profiles identifiable as those found in previous work with the MMPI-2 (within normal limits, V-type, neurotic triad, and depressed-pathological). Somatization mediated the relationship between depression and activity level for the neurotic triad group but not the other three groups. A positive linear relationship was found between somatization and depression for the within normal limits, neurotic triad, and depressed-pathological groups, whereas their linear association was negative for the V-type group. Cognitive coping strategies mediated the relationship between depression and activity level for the within normal limits group. In addition, cognitive coping was predictive of activity level for the within normal limits, V-type, and neurotic triad groups but not for the depressed-pathological group. Consistent with previous cluster analytic studies, this study replicated four MMPI-2 cluster profile groups in chronic pain patients. These results have also shown that several multivariate relationships between variables are different across MMPI-2 groups, providing evidence for the validity for these MMPI-2 subgroups.

Isotopy classes of embeddings and homotopy

Haefliger's theorem (3) that the group of isotopy classes of embeddings of Sx in Sn when n − x &gt; 2 is isomorphic to the triad group πx+1(G; G(n − x),SO), where G(n − x) is the H-space of homotopy equivalences of Sn−x−1 of degree 1, , and SO is the stable special orthogonal group, is generalized in this paper by replacing Sx and Sn by arbitrary compact connected smooth manifolds Xx, Mn without boundary. The embedding and knot problems are reduced to homotopy theory. The question of P.L. manifolds is discussed in section 4. The case Mn = Sn will be considered first; the generalization is stated in section 3.

MODIFICATION OF VERBAL INTERACTIONS IN TRIAD GROUPS: PRELIMINARY REPORT.

Studies of group behavior within an operant conditioning fmmework have been relstively sparse. The studies that have been performed (e.g., Cieutat, 1959; Oakes, Drogc, & August, 1960) have demonstrated that verbal conditioning principles can be employed ro manipulate simultaneously the duration of talking by several Ss. The purpose of the present study was to investigate the conditions under which the verbal interactions in triads of Ss could be modified. The assumption was made that the verbal behavior of a given S is regulated at least to some extent by the verbal behavior of other Ss in the group. A series of 5 reinforcement programs was investigated to determine to what extent manipulation of the verbal behavior of 2 Ss in a triad group (Non-critical Ss or NCSs) would have on the third S (Critical S or CS). 90 Ss (in 30 triads) were placed in individual isolation booths and given psychiatric case histories to discuss. The reinforcement was points which registered on their counters contingent upon duration of talking and the person to whom they talked. The points were exchangeable for gifts at [he end of the experimental session. The best reinforcement procedure involved direct manipulation of CS's behavior. Reinforcement programs involving simultaneous manipulation of the NCSs in addition to the CS failed to produce changes in the CS's duration of talking. The reinforcement programs were also unsuccessful in producing increases in the amount of talking by the NCSs to the CS although there were substantial decrements in the interactions between NCSs. Because of the large variabiliry among triads of Ss, results are tentative. The study susgesred that the effectiveness of any reinforcement program may be dependent upon a number of variables, such as the operant level of talking by CS, the operant duration of talking directed by the NCSs to CS, the sex of the members composing the triads, and possibly the length and/or number of conditioning sessions. These are variables which have to be taken into account in subsequent research.

Paroxysmal wave and spike activity and diagnostic sub-classification

One-hundred seventy-eight cases, presenting wave and spike activity in standard EEG recording, were reviewed with respect to type or types of seizures. The wave and spike activity was descriptively subclassified on the basis of frequency per sec. of the paroxysmal discharge. It was found that: 1. 1. ( a) Only 16 per cent had seizures classified as the petit mal triad, without seizures of other types. This is in close agreement with the 1941 report of Jasper and Kershman; ( b) twenty-two and a half per cent had seizures classified as grand mal (only); ( c) seventy per cent of the total group had seizures of the petit mal triad, plus other seizures types (and, conversely, 30 per cent had no seizures classified as the petit mal triad). This is in closer agreement with the findings of Gibbs et al. than with those of Jasper and Kershman. 2. 2. Considering “variants” of the wave and spike as being slower or faster than the “classical” three per sec. paroxysmal pattern, or admixed with it, such variants were more evident in the clinical grand mal than the clinical petit mal triad group. Particularly, most cases exhibiting the fast 4 per sec. variant had grand mal epilepsy. Rarely did these cases exhibit petit mal symptomatology. 3. 3. Presumed organic etiology of seizures was found infrequently in those cases showing the classical 3 per sec. pattern. However, when slow variants are considered, the incidence of idiopathic and presumed organic etiology was equal; these data do not indicate that organic etiology can be accurately predicted from the fact that a slow wave and spike appears in the EEG. Idiopathic epilepsy does seem to be related to the 3 per sec. paroxysmal wave and spike.