Pathological diagnosis were obtained after surgery and endoscopy detection. Results: 87 lesions were located in duodenal bulb (43.7%). Other lesions were located in descending potion (56.3%). After EUS, 42 cases were diagnosed as cyst, 39 as Brunner’s adenoma, 23 as minor papilla, 19 as lipoma, 18 as polyp, 11 as ectopic pancreas, 10 as stromal tumour, 5 as malignant tumour, 3 as neuroendocrine tumour (carcinoid Bioactive Compound Library cost tumour), 2 elevated lesions were pressured by outside organs, another 27 lesions

had no diagnosis. Endoscopic therapy were carried in 48 patients, surgery in 12 patients, endoscopic follow-up in 33 patients from 3 months to 22 months. The diagnostic accuracy of EUS was 83.8% (78/93). Conclusion: EUS can clearly expose five layers of gastrointestinal tract and histological structure of adjacent organs, which is of great help to achieve definite diagnosis of elevated lesions in duodenal selleck chemicals llc tract. Key Word(s): 1. Endoscopic; 2. EUS; 3. duodenal; Presenting Author: ZENGDIAN CHEN Additional Authors: CHENGDANG WANG Corresponding Author: ZENGDIAN CHEN, CHENGDANG WANG Affiliations: Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University Objective: To preliminary study the colonoscopy outcome and clinical symptoms of

the inspectors who was lacking of warning signs and to verify the value and necessity of colonoscopy in it. Methods: Colonoscopy of 4304 patients from Jan. 2006 to Dec. 2011 were reviewed, according to the definition of lower digestive tract symptoms lacking of warning signs. It was a retrospective case study. Results: In all the 4304 patients, the male/female ration was 1:1.14, with average age 48.0 ± 13.5 years old. And it was the most common between 3 to 12 months. 82.1% of the outcome was negative. Comparing the outcomes concluding

symptom association lesions, symptom independent lesions and negative cases, it showed that females who was younger than 40 years with more than 3 months course were common in negative group. Moreover, in organic lesion cases, it could find that the male patients less than 3 month course were more common than ones more than 12 month course. 215 cases were diagnosed as colorectal cancer, and it was 5.0% PIK3C2G of all inspectors. Cases with less than 40 years were 24, between 40 to 60 years were 82 and more than 60 were 109. They was 1.9%, 3.8% and 11.8% respectively of the corresponding age group. Conclusion: It showed that the clinical symptoms were not the influent factor of the colonoscopy in those inspectors lacking of warning signs. However, the risk factors of the colorectal cancer included sex (male), age (>60) and course (<3 month). What’s more, the cancer relevance ratio was positive correlation with age. In a word, it was the first choice to use colonoscopy to inspect lower digestive tract, especially for those more than 60 year old. Key Word(s): 1. Colonoscopy; 2. Screening; 3. Organic lesion; 4.

Pathological diagnosis were obtained after surgery and endoscopy detection. Results: 87 lesions were located in duodenal bulb (43.7%). Other lesions were located in descending potion (56.3%). After EUS, 42 cases were diagnosed as cyst, 39 as Brunner’s adenoma, 23 as minor papilla, 19 as lipoma, 18 as polyp, 11 as ectopic pancreas, 10 as stromal tumour, 5 as malignant tumour, 3 as neuroendocrine tumour (carcinoid Saracatinib tumour), 2 elevated lesions were pressured by outside organs, another 27 lesions

had no diagnosis. Endoscopic therapy were carried in 48 patients, surgery in 12 patients, endoscopic follow-up in 33 patients from 3 months to 22 months. The diagnostic accuracy of EUS was 83.8% (78/93). Conclusion: EUS can clearly expose five layers of gastrointestinal tract and histological structure of adjacent organs, which is of great help to achieve definite diagnosis of elevated lesions in duodenal LBH589 ic50 tract. Key Word(s): 1. Endoscopic; 2. EUS; 3. duodenal; Presenting Author: ZENGDIAN CHEN Additional Authors: CHENGDANG WANG Corresponding Author: ZENGDIAN CHEN, CHENGDANG WANG Affiliations: Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University Objective: To preliminary study the colonoscopy outcome and clinical symptoms of

the inspectors who was lacking of warning signs and to verify the value and necessity of colonoscopy in it. Methods: Colonoscopy of 4304 patients from Jan. 2006 to Dec. 2011 were reviewed, according to the definition of lower digestive tract symptoms lacking of warning signs. It was a retrospective case study. Results: In all the 4304 patients, the male/female ration was 1:1.14, with average age 48.0 ± 13.5 years old. And it was the most common between 3 to 12 months. 82.1% of the outcome was negative. Comparing the outcomes concluding

symptom association lesions, symptom independent lesions and negative cases, it showed that females who was younger than 40 years with more than 3 months course were common in negative group. Moreover, in organic lesion cases, it could find that the male patients less than 3 month course were more common than ones more than 12 month course. 215 cases were diagnosed as colorectal cancer, and it was 5.0% fantofarone of all inspectors. Cases with less than 40 years were 24, between 40 to 60 years were 82 and more than 60 were 109. They was 1.9%, 3.8% and 11.8% respectively of the corresponding age group. Conclusion: It showed that the clinical symptoms were not the influent factor of the colonoscopy in those inspectors lacking of warning signs. However, the risk factors of the colorectal cancer included sex (male), age (>60) and course (<3 month). What’s more, the cancer relevance ratio was positive correlation with age. In a word, it was the first choice to use colonoscopy to inspect lower digestive tract, especially for those more than 60 year old. Key Word(s): 1. Colonoscopy; 2. Screening; 3. Organic lesion; 4.

For example, the gemcitabine (Gemzar, Eli Lilly, Indianapolis, IN) for metastatic pancreatic cancer increased survival from 4.41 months to 5.65 months (P = 0.0025),23 and in another example, SCH772984 the addition of bevacizumab (Avastin, Genentech, South San Francisco, CA) to chemotherapy for advanced colon cancer improved median survival from 15.6 months to 20.3 months with a hazard ratio of 0.66.24 Now that sorafenib has been shown to improve survival in advanced HCC, studies evaluating the agent in patients with earlier stage disease are ongoing, and may provide even greater gains. Nevertheless, this is an important

advance for patients with HCC and will likely lead to further approvals based on combinations of new agents with sorafenib and additional new single agents to use in the front-line setting and after progression on sorafenib and beyond.25 In clinical practice, the decision to initiate sorafenib is guided by a patient’s tumor burden, liver disease, and ability to carry out daily

activities/performance status (PS). For patients with Child A cirrhosis and good PS, studies have proven a benefit of 400 mg orally twice a day. Baseline hematologic and chemistry parameters should be drawn, as well click here as an alfa-fetoprotein (AFP) when relevant. Although AFP as an endpoint was not well studied in the sorafenib trials, it may provide additional insight into the clinical activity in any one patient.26 The success in keeping patients on therapy requires proactive management of side effects by the treating physician. Patients should be assessed within 7-10 days of starting drug for adverse events. Careful questioning regarding changes in general activity, oral intake, skin changes, nausea, vomiting and stool changes are important as these are the most common toxicities. In addition, careful examination of the skin is required with particular attention

to areas exposed to repetitive trauma such as the hands and feet as these are areas where skin toxicity is most noticeable and symptomatic. During this first follow-up repeat hematology and chemistries are drawn including a phosphorus level as hypophosphatemia selleck kinase inhibitor has been associated with sorafenib. In addition, a transient rise in total bilirubin can occur after initiation of sorafenib though this often returns to baseline quickly. If a patient is tolerating the drug well, then the same dose can be continued with a follow-up at 2 week intervals until the patient has proven to be stable on the drug. For patients experiencing toxicities consideration to either dose reduce or hold the drug should be made depending on the severity. Reintroduction of the drug can occur once toxicities have approached baseline. Consideration can be given to reintroduce the drug at the same level with close follow-up or, if toxicity was significant, dose reduction by one level.

In Fig. 1, we depicted possible interactions between HSCs and immune cells during liver diseases, especially liver fibrosis.

Several types of immune cells have protective roles, but the others have opposite effects on liver fibrosis. Certain types of immune cells such as NKT, macrophages, and Th17 cells have dual roles in liver fibrogenesis. Therefore, further investigations are needed to identify more specific functions of each cell type, thereby providing therapeutic targets or developing cell-based therapies for the treatment of liver fibrosis. This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (no. 2011–008306) and the KAIST High Risk High Return Volasertib mw Project (HRHRP). No conflict of interest exists for all authors. “
“Metabolic factors have been associated with JNK animal study liver damage in patients with genotype 1 chronic hepatitis C

(G1 CHC). We tested visceral adiposity index (VAI), a new marker of adipose dysfunction in G1 CHC, patients to assess its association with host and viral factors and its link to both histological findings and sustained virological response (SVR). Two hundred thirty-six consecutive G1 CHC patients were evaluated by way of liver biopsy and anthropometric and metabolic measurements, including insulin resistance (IR), homeostasis model assessment (HOMA), and VAI using waist circumference, body

mass index, triglycerides, and high-density lipoprotein cholesterol. All biopsies were scored by one pathologist for staging and grading and graded for steatosis, which was considered moderate to severe if ≥30%. Multiple linear regression analysis revealed that VAI score was independently associated with higher HOMA score (P = 0.009), log10 hepatitis C virus RNA levels (P = 0.01), necroinflammatory medroxyprogesterone activity (P = 0.04), and steatosis (P = 0.04). Multiple logistic regression analysis revealed that IR (OR 3.879, 95% CI 1.727-8.713, P = 0.001), higher VAI score (OR 1.472, 95% CI 1.051-2.062, P = 0.02), and fibrosis (OR 2.255, 95% CI 1.349-3.768, P = 0.002) were linked to steatosis ≥30%. Logistic regression analysis revealed that older age (OR 1.030, 95% CI 1.002-1.059, P = 0.03), higher VAI score (OR 1.618, 95% CI 1.001-2.617, P = 0.04), and fibrosis (OR 2.608, 95% CI 1.565-4.345, P < 0.001) were independently associated with moderate to severe necroinflammatory activity. No independent associations were found between VAI score and both fibrosis and SVR. Conclusion: In G1 CHC patients, higher VAI score is independently associated with both steatosis and necroinflammatory activity and has a direct correlation with viral load. (HEPATOLOGY 2010.) Metabolic factors, namely steatosis and insulin resistance (IR), are frequent findings in patients with genotype 1 chronic hepatitis C (G1 CHC).

Look-back procedures should also be used to reveal and confirm transfusion-transmitted infections and the potential risk they present for transmission via pdCFCs [99]. Efforts need to be taken at a policy level to improve global collaboration between government officials and clinicians. This partnership will be essential to define emergency see more strategies for pathogen outbreaks in the future.

The creation of a long-term, international pharmacovigilance system to monitor pathogen safety and quality issues related to new and existing pdCFCs and recombinant products is also required to assess and improve their safety [76]. The EUHASS project, a European, prospective, multicentre adverse event reporting scheme, has been established with the objective of improving pharmacovigilance [100]. Extensive progress has been made in improving

viral inactivation processes CP-868596 ic50 for plasma products since the epidemics of the 1970s and 1980s. Due to improvements in their manufacturing processes, pdCFCs now have a strong safety record and a very low risk of transfusion-mediated infection with HBV, HCV and HIV. Today, blood derivatives can be considered reasonably safe, and free of classical pathogens (HIV, HBV, HCV) for which extensive screening is in place. However, the threat of emerging pathogens, both known and unknown, is still relevant to current clinical practice. Certain pathogens that are resistant to virucidal processes, such as non-enveloped viruses and prions, also remain a concern. Recombinant CFCs are considered to have a lower risk of transmitting infectious agents than Verteporfin cell line pdCFCs, particularly those products which do not contain

any exogenous animal or human components [89]. However, due to increasing demand and cost restraints, especially in developing countries, pdCFCs are likely to continue to be used. It is therefore vital that the pathogen safety and quality of pdCFCs continue to be monitored to identify and manage any emerging pathogens which have the potential to threaten the safety of pdCFCs in the future. This is particularly relevant in view of the fact that some clotting factors are still only available in a plasma-derived form. The authors thank Professor Brian Colvin for his valuable assistance in the development of the scientific content of this article. The authors also thank Andreas Tiede for his help in the development of their slides for the Global Summit. Lassila, R. received honoraria/consultation fees from: Alexion, Baxter, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CSL Behring, Leo Pharma, Novo Nordisk, Octapharma, Pfizer, Sanofi, Sanquin and SOBI; Perno, C-F. received grants/research support from: Janssen, Merck Sharp and Dohme and ViiV Healthcare. Received honoraria/consultation fees from: Bristol-Myers Squibb, Gilead, Janssen, Merck Sharp and Dohme, Pfizer, Roche and ViiV Healthcare.

05). 12 patients received conservative treatment, 33.3% of them had a response; peritoneal-venous shunting was established in 13 cases, with ascites controlled in 92.3% of them; 11 cases underwent microsurgical intervention, with a response rate of 63.6%. Conclusion: The chylous ascitic fluid in cirrhosis remains the characteristics of ascites of portal hypertension, with the SAAG markedly elevated, and the SAAG level probably decides on TG level. Lymphoscintigraphy may help to determine the leakage of lymphatic fluid, while direct lymphangiography is more valuable in

revealing presence of lymphatic abnormalities. Key Word(s): 1. cirrhosis; 2. chylous ascites; Presenting Author: HAITAO SHI Additional Authors: LEI DONG, AMENG SHI, JUHUI ZHAO, YAPING LIU, HONG LI, GANG ZHAO Corresponding Author: HAITAO SHI, LEI DONG Affiliations: Department of Gastroenterology, CAL-101 cost the Second Affiliated Hospital of Xi’an Jiaotong

University Objective: Chlorogenic acid (CGA), a kind of polyphenol widespread in plant food and coffee drinks, has been reported to possess antioxidant and anti-inflammatory activities. Our previous study showed CGA could inhibit liver fibrosis in rats. However, the specific underlying mechanism remains unclear. The aim of this study is to investigate whether the anti-fibrosis effects of CGA are related to suppression of oxidative stress. Methods: Male Sprague-Dawley (SD) rats were administrated with CCl4 together with or without CGA for 8 weeks. Serum BI 2536 alanine aminotransferase (ALT) activity and Histopathological analyses were carried out. The levels of malondialdehyde (MDA) and glutathione (GSH) Phospholipase D1 in liver tissue were detected with chromatometry. The mRNA expression of collagen I, tissue inhibitor of metalloproteinase-1 (TIMP-1) was detected by Real-time PCR. The protein expression of α-smooth muscle actin (α-SMA) was detected by Real-time PCR. A cell line of rat hepatic stellate cells (HSCs) was stimulated with platelet-derived growth factor (PDGF). The inhibitory effect of CGA on cell proliferation was measured with MTT assay. Intracellular ROS level was detected with DCFH-DA dye assay. The protein expression of NADPH oxidase (NOX) subunits (p47phox,

gp91phox) was detected by Western blot. The mRNA expression of collagen I and TIMP-1 were detected by Real-time PCR. Results: In vivo studies showed that the liver fibrosis grade, serum ALT activity, expressions of α-SMA, collagen I, TIMP-1 were increased in CCl4-intoxicated rats, all of which were attenuated by CGA treatment. Furthermore, CGA reduced MDA level and increased GSH level in liver tissue. In vitro, PDGF increased cell proliferation, ROS level and the expression of NOX subunits, collagen I and TIMP-1 which were significantly decreased by CGA. Conclusion: Our results suggest that CGA ameliorates CCl4-induced liver fibrosis, at least in part, through suppression of oxidative stress. Key Word(s): 1. Chlorogenic acid; 2. liver fibrosis; 3.

Hepatic encephalopathy (HE) is a frequent complication of both acute and chronic liver disease. In the United States, 600,000 patients have been estimated to have cirrhosis; 30% to 45% of these patients develop overt hepatic encephalopathy (OHE),1 and 60% develop minimal hepatic encephalopathy (MHE).2 Annually, 25,000 deaths are caused by cirrhosis in the United

States; this makes it the third most common cause of death after heart disease and check details cancer among persons 45 to 65 years of age.3 After the first episode of HE, the 1-year survival rate is 42%, and the 3-year survival rate is only 23% without liver transplantation.4 HE can be classified as MHE or OHE. MHE is a discrete clinical entity characterized by a normal clinical examination, although cognitive deficits can be elicited by

neuropsychological testing. MHE may cause subtle but definite impairments in motor skills, attention, visual perception, and fine motor activities and thus lead to reduced function and quality of life.2 According to etiology, HE can be classified into three groups.5 Type A is associated with acute liver failure, type C is associated with cirrhosis, and type B is defined as HE due to portosystemic shunting in the absence of intrinsic liver disease. Selleckchem Sirolimus Type C, which is the most common type encountered, can be self-limited and caused by a precipitating factor or can be persistent and chronic. Our understanding of the pathophysiology of HE remains incomplete. However, it is clear that an increased ammonia level is frequently implicated and click here that astrocytes are the primary cells involved. Acute liver failure may be associated with astrocyte

swelling, which may be profound and result in brain edema, increased intracranial pressure, and brain herniation leading to death in 30% of patients. In contrast, the characteristic feature in patients with cirrhosis and HE is the presence of Alzheimer type II astrocytosis.6 The Alzheimer type II astrocyte is considered a manifestation of cerebral edema in chronic liver failure and is characterized by cytoplasmic enlargement, an enlarged swollen nucleus with a basophilic nucleolus, and chromatin clumping.6 The exact mechanism by which ammonia causes astrocyte swelling is unclear; however, astrocytes are the only cells in the brain that can detoxify ammonia. These cells contain glutamate transporters, which facilitate the intracellular movement of glutamate. Down-regulation of glutamate transporter 1 has been observed in rodents with hyperammonemia; this leads to abnormal glutamatergic neurotransmission and may be responsible for some of the neurological manifestations of HE.7 Cultured astrocytes exposed to ammonia develop a mitochondrial permeability transition, which can lead to astrocyte swelling.8 Within astrocytes, glutamate combines with ammonia to form glutamine. Glutamine in turn may cause osmotic stress resulting in further astrocyte edema.

Hepatic encephalopathy (HE) is a frequent complication of both acute and chronic liver disease. In the United States, 600,000 patients have been estimated to have cirrhosis; 30% to 45% of these patients develop overt hepatic encephalopathy (OHE),1 and 60% develop minimal hepatic encephalopathy (MHE).2 Annually, 25,000 deaths are caused by cirrhosis in the United

States; this makes it the third most common cause of death after heart disease and Omipalisib in vitro cancer among persons 45 to 65 years of age.3 After the first episode of HE, the 1-year survival rate is 42%, and the 3-year survival rate is only 23% without liver transplantation.4 HE can be classified as MHE or OHE. MHE is a discrete clinical entity characterized by a normal clinical examination, although cognitive deficits can be elicited by

neuropsychological testing. MHE may cause subtle but definite impairments in motor skills, attention, visual perception, and fine motor activities and thus lead to reduced function and quality of life.2 According to etiology, HE can be classified into three groups.5 Type A is associated with acute liver failure, type C is associated with cirrhosis, and type B is defined as HE due to portosystemic shunting in the absence of intrinsic liver disease. LBH589 supplier Type C, which is the most common type encountered, can be self-limited and caused by a precipitating factor or can be persistent and chronic. Our understanding of the pathophysiology of HE remains incomplete. However, it is clear that an increased ammonia level is frequently implicated and Cell press that astrocytes are the primary cells involved. Acute liver failure may be associated with astrocyte

swelling, which may be profound and result in brain edema, increased intracranial pressure, and brain herniation leading to death in 30% of patients. In contrast, the characteristic feature in patients with cirrhosis and HE is the presence of Alzheimer type II astrocytosis.6 The Alzheimer type II astrocyte is considered a manifestation of cerebral edema in chronic liver failure and is characterized by cytoplasmic enlargement, an enlarged swollen nucleus with a basophilic nucleolus, and chromatin clumping.6 The exact mechanism by which ammonia causes astrocyte swelling is unclear; however, astrocytes are the only cells in the brain that can detoxify ammonia. These cells contain glutamate transporters, which facilitate the intracellular movement of glutamate. Down-regulation of glutamate transporter 1 has been observed in rodents with hyperammonemia; this leads to abnormal glutamatergic neurotransmission and may be responsible for some of the neurological manifestations of HE.7 Cultured astrocytes exposed to ammonia develop a mitochondrial permeability transition, which can lead to astrocyte swelling.8 Within astrocytes, glutamate combines with ammonia to form glutamine. Glutamine in turn may cause osmotic stress resulting in further astrocyte edema.

It seems likely that both the inflammatory nature of adipose tissue and the amount

of abdominal fat accumulation are critical factors in tissue damage. This is what we have previously observed for cardiac dysfunction and morpho-functional abnormalities.3, 4 Thus, both these targets should be addressed in the treatment. Indeed, NASH develops, and potentially progresses to cirrhosis, on a chronic inflammatory background.5, 6 However, liver disease seems to be associated with systemic degenerative disease and metabolic derangements independently of VAT accumulation.7 Adipose tissue is a dynamic organ resulting from the balance of new fat deposition and reabsorption. Several factors are involved in this turnover, such as diet, physical activity, but also inflammation, which is considered per Saracatinib supplier se a major determinant of insulin resistance.8, 9 The portal/fatty acid flux theory suggests that visceral fat, via its unique location and enhanced lipolytic activity, releases toxic free fatty acids, which are delivered in high concentrations

directly to the liver. This leads to the accumulation and storage of hepatic fat and the development of hepatic insulin resistance.9 Nonetheless, a study by van der Poorten et al. has recently shown that visceral fat remained an Nutlin-3a in vitro independent predictor of liver inflammation and fibrosis even when measures of insulin resistance, adipokines, and increasing age are considered.10 A 4-week aerobic program can result in a significant reduction of VAT, thus positively affecting the levels of circulating free fatty acids and hepatic lipid accumulation, but appears to be too short a time frame to reduce insulin resistance. Monoiodotyrosine Unfortunately, the disruption of inflammatory biomarkers has been not addressed by Johnson et al.1 This is what Promrat et al. were able to demonstrate,2 providing evidence

that patients undergoing consistent abdominal adipose tissue loss have improved lobular inflammation and also reduced insulin resistance. Altogether, these results support that both the disruption of inflammation and the reduction of VAT should be targets of therapeutic strategies to reduce local tissue damage. This has been supported for cardiac dysfunction11, 12 and there is some rationale also for treatment of both NAFLD and NASH. However, it must be recognized that it is frequently difficult to keep the patient focused on maintaining changes in lifestyle habits. Alexis Elias Malavazos M.D.*, Giulia Gobbo M.D.†, Roberta Francesca Zelaschi M.D.*, Emanuele Cereda M.D., Ph.D.

, 2009). These features include escape behaviour, cryptic coloration and structure, noxiousness or toxicity and encounter behaviour (Duellman & Trueb, 1994). Among urodeles, the family Salamandridae has the greatest diversity see more of antipredator mechanisms (Brodie Jr, Nussbaum & DiGiovanni,

1984). In the salamandrid genus Pleurodeles and in the closely related genus Echinotriton, unique strategies to decrease palatability and increase survival rates have been described (Nowak & Brodie Jr, 1978; Brodie Jr, 1983; Brodie Jr et al., 1984). When attacked by a potential predator (or provoked with an adequate artificial stimulus), sharp spines appear on the lateral trunk sides. This phenomenon was first mentioned in Pleurodeles waltl by Leydig (1879). This author examined preserved and living material and rebutted earlier (orally referred) notions that the lateral spines of

this animal were horny structures. Leydig suggested that the lateral spines of P. waltl are ribs that lie in a lymphatic sheath immediately beneath the skin. A study performed 99 years later by Nowak & Brodie Jr (1978) yielded similar conclusions. The present study shows new information on the morphological and functional integration of the body wall and the ribs. It also provides new data on how P. waltl protrudes its ribs and on the mechanism in the framework of the antipredator behaviour. We apply photo- and X-ray imaging along with computed tomography (CT) to examine the (micro-) anatomical features of the ribs and histological techniques VX-809 research buy to study the emersion point of the ribs. We also discuss possible mechanisms preventing self-intoxication or microbial infection that could result from damaging the integrity of the skin. In this context, it is important to clarify whether the tips of the ribs Progesterone really penetrate the skin or remain covered by integument.

If the rib tips are uncoated, it should be determined whether the skin of P. waltl shows distinct and permanent pores or whether the body wall is penetrated de novo by every single antipredator posturing. Five male and four female adult (3–5 years old) P. waltl were used in the present study. The animals were obtained commercially and kept in a 300 L tank with a 12-h dark/12 h light cycle and fed with larval chironomids, earthworms and fish pieces. For behavioural experiments, the reactions to ‘predator-like stimulations’ were documented using a Canon EOS 350D digital camera (Canon Inc., Tokyo, Japan). To simulate a predator attack, the animals were touched repeatedly – but gently – with a cotton bud until they showed defensive behaviour. The animals recovered rapidly after the experiments and all showed natural behaviour such as feeding or mating immediately after the experiments. For radiographic analyses, dorsoventral radiographs were made with a Siemens Polydoros 80 S machine (Siemens AG, Munich, Germany).