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Objective The aim of this study was to identify liver proteome changes in a mouse model of severe insulin resistance and markedly decreased leptin levels. Methods Two-dimensional differential gel electrophoresis was utilized to identify liver proteome changes in AKT1+/−/AKT2−/− mice. Proteins with altered levels were identified with tandem mass spectrometry. Ingenuity Pathway Analysis was performed for the interpretation of the biological significance of the observed proteomic changes. Results 11 proteins were identified from 2 biological replicates to be differentially expressed by a ratio of at least 1.3 between age-matched insulin resistant (Akt1+/−/Akt2−/−) and wild type mice. Albumin and mitochondrial ornithine aminotransferase were detected from multiple spots, which suggest post-translational modifications. Enzymes of the urea cycle were common members of top regulated pathways. Conclusion Our results help to unveil the regulation of the liver proteome underlying altered metabolism in an animal model of severe insulin resistance.

Deciphering the multitude of epigenomic and genomic factors that influence the mutation rate is an area of great interest in modern biology. Recently, chromatin has been shown to play a part in this process. To elucidate this relationship further, we integrated our own ultra-deep sequenced human nucleosomal DNA data set with a host of published human genomic and cancer genomic data sets. Our results revealed, that differences in nucleosome occupancy are associated with changes in base-specific mutation rates. Increasing nucleosome occupancy is associated with an increasing transition to transversion ratio and an increased germline mutation rate within the human genome. Additionally, cancer single nucleotide variants and microindels are enriched within nucleosomes and both the coding and non-coding cancer mutation rate increases with increasing nucleosome occupancy. There is an enrichment of cancer indels at the theoretical start (74 bp) and end (115 bp) of linker DNA between two nucleosomes. We then hypothesized that increasing nucleosome occupancy decreases access to DNA by DNA repair machinery and could account for the increasing mutation rate. Such a relationship should not exist in DNA repair knockouts, and we thus repeated our analysis in DNA repair machinery knockouts to test our hypothesis. Indeed, our results revealed no correlation between increasing nucleosome occupancy and increasing mutation rate in DNA repair knockouts. Our findings emphasize the linkage of the genome and epigenome through the nucleosome whose properties can affect genome evolution and genetic aberrations such as cancer.

Background and Aim Mitochondrial dysfunction contributes to the pathophysiology of diabetic cardiomyopathy. The aim of this study was to investigate the acute changes in the mitochondrial proteome in response to insulin stimulation. Methods and Results Cardiac mitochondria from C57BL/6 mice after insulin stimulation were analyzed using two-dimensional fluorescence difference gel electrophoresis. MALDI-TOF MS/MS was utilized to identify differences. Two enzymes involved in metabolism and four structural proteins were identified. Succinyl-CoA ligase [ADP forming] subunit beta was identified as one of the differentially regulated proteins. Upon insulin stimulation, a relatively more acidic isoform of this protein was increased by 53% and its functional activity was decreased by ∼32%. Conclusions This proteomic remodeling in response to insulin stimulation may play an important role in the normal and diabetic heart.

Background: laparoscopic cholecystectomy is standard treatment in gallbladder disease. Acute cholecystitis has been relative contraindication of laparoscopic cholecystectomy. With the accumulation of experience in laparoscopic surgery, laparoscopic cholecystectomy is being gradually applied for the treatment of acute cholecystitis Objective: to evaluate and compare the outcome of laparoscopic cholecystectomy in acute and chronic cholecystitis in terms of complications, conversion rates, reason of conversion, need for special modifications of the operative technique, and hospital stay. Methods: A prospective study done Between April 2007 and January 2010, in the department of general surgery, medical city teaching hospital, Baghdad. Evaluation of all patients admitted with symptomatic gall bladder disease, who underwent laparoscopic cholecystectomy were included in this study. They were classified as group A (having acute cholecystitis) and group B (having chronic cholecystitis), The diagnosis of AC was based on clinical, ultrasonographic, and operative finding; also histological diagnosis. Results: A total of 197 patients. 46 (23%) had acute cholecystitis (group A) while 151 patients (76.6%) had chronic cholecystitis (group B). In group A, Gall bladder decompression was required in 4 (8.7%) patients. One patient (2.2%) had wound infection, and one patient (2.2%) developed a subhepatic biliary collection. While epigastric port hernia occurs in one patient (2.2%). In group B, One patient (0.7%) had wound infection, and one patient (0.7%) had umbilical port hernia. Conversion rate was 3(6.5%) for group A and 0% for group B. There was no procedure related mortality in either group. The hospital stay (6-24 hours) was the same for both groups (group A; mean 9.13±6.89 hours, group B; mean 15.77±8.99 hours). Conclusion: laparoscopic cholecystectomy is safe in all patients presented with symptomatic gall bladder disease.

Background: The most important advances in medical education in the last decade are the shift in focus from learning objectives to learning outcomes. The advantages of active over passive learning are researched-based. The aim of this study was to evaluate the students reading habits; utilization of lectures, group study, resources utilized during study, and if there is a need to change the curriculum.Methods: A prospective study was done in Medical City Teaching Hospital, from January 2007 to January 2008, including 438 students from the college of medicine, university of Baghdad. A questionnaire consist of 28 questions was given to them. These questionnaire elicited responses regarding reading habits, utilization of lectures, group study, and resources utilized during study. The t-test was used for statistical analysis, the results were considered significant if P value < 0.05.Results: In this study students were dependant on passive learning mainly. There was greater use of the lecture notes, and less use of library, textbooks, Journals and online sources. The willing of the students to have active learning was significant (P value < 0.05)Conclusion: We would like to conclude that teaching methods are changing, and we should consider that in our curriculum, we should concentrate on active learning. There is a public expectation that we, in the academic and clinical community, will produce safe, ethical and professional doctors.

Background: To find an operation that can be effectively carried out in both adults and children, equally applicable in the elective as well as in the emergency situation and for the good – risk as well as the poor – risk patients. Done by expert and junior surgeons in a short time. Patients and Methods: Twenty patients with portal hypertension and bleeding varices aged 9-45 years were treated with shunting procedures (group 1, n=10), or a modified Sugiura operation (group 2, n=10) in accordance with the following therapeutic protocol: after resuscitation and diagnostic endoscopy, an emergency modified Sugiura operation was carried out if bleeding could not be controlled over 24 hours. When bleeding could be controlled, the patients underwent full investigation and were then treated with either shunting procedure or with a modified Sugiura operation. The Fisher exact probability test was applied for statistical analysis. Results: Patients were evaluated at 1-3 years. The rates for operative deaths, recurrent hemorrhage, encephalopathy, late deaths, and patient survival at 1-3 years were as follows: 30%, 10%, 40%, 10% and 60% for group 1; 10%, 0%, 0%, 10%, and 80% for group 2, respectively. Within 3 months after the modified Sugiura operation, varices disappeared in most of the patients and hypersplenism was relieved in all. Conclusion: We conclude that the modified Sugiura operation is probably a reasonable treatment for variceal hemorrhage because it is effective in arresting hemorrhage and it’s recurrence, with no encephalopathy, and a good survival rate.

Gastrointestinal (GI) hemorrhage is a problem, the management of which needs the right decision at the right time and close cooperation between physicians and surgeons. We herewith report a renal transplant recipient who developed severe GI bleed and intestinal perforations seven months after renal transplantation. Despite extensive investigations, the exact cause of the problem could not be identified.