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Abstract: The authors report the first case of gas embolism arising during an upper gastrointestinal endoscopy to a patient carrier of a biliary drain placed by radiological way. The hypothesis of a biliary-vascular fistula with abnormal connection between the biliary tree and the hepatic vascular system and finally an arteriovenous intrapulmonary shunt was retained to explain the physiopathology. The immediate stop of the endoscopic procedure and the implementation of symptomatic treatment allowed a favorable neurological outcome without sequelas. The realization of an upper gastrointestinal endoscopy to a patient carrier of a biliary drain has to lead the anaesthesiologists and the gastroenterologists to take care given the incurred risk of gas embolism. [Copyright &y& Elsevier]

Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) exert various effects on immune cells. Here we studied, whether they influence the cytokine expression pattern in peripheral blood mononuclear cells (PBMCs) or antigen specific T-cells. In PBMCs BDNF and NGF had interindividually variable effects on T helper cell type (Th)1- and Th2-cytokines. However, there was a high correlation between the modulating properties of these neurotrophins (r=0.97) concerning the expression of interleukin (IL) 4, transforming growth factor-β and tumour necrosis factor-α mRNA at a concentration of 100 ng/ml. In myelin basic protein-specific T-cell lines BDNF and NGF increased interferon -γ mRNA to a moderate extent, but not IL4. No major effects were detected at the cytokine protein level. In conclusion, our results suggest a partial effect of neurotrophins on immune cells, which may be modified by other signals. [Copyright &y& Elsevier]