Cytokines in Bacteremia, Strait et al. 5189:4845-9. 33. Creasey AA, Stevens P, Kenney J, et al. Endotoxin and cytokine profile in plasma of baboons challenged with lethal and sublethal Escherichiu coli. Circ Shock. 1991; 33234-91. 34. Harris I ABSTRACTObjective: To estimate the frequency of abnormal clinical symptoms, laboratory tests, and diagnostic imaging studies in the ED assessment of elderly (2-65 yr) patients with acute cholecystitis, and to compare these factors in the young-old (65-74 yr), middle-old (75-84 yr). and old-old ( 2 8 5 yr) population groups. Methods: A retrospective, cross-sectional study was performed by review of ED records, hospital charts, and surgical operative reports of consecutive elderly ED patients determined at surgery to have acute cholecystitis. Records were reviewed between April 1990 and April 1995 at a large Midwestern tertiary care facility with 65,000 annual ED patient visits. Clinical signs and symptoms were compared in the young-old, middle-old, and old-old population groups. Results: Of the 168 patients reviewed, 141 (84%) had either epigastric or right upper quadrant abdominal pain, and 8 (5%) had no pain whatsoever. Only 61 patients (36%) had back or flank pain radiation. Ninetysix (57%) experienced nausea, 64 (38%) had emesis, and 13 (8%) had visible jaundice. Ninety-four (56%) patients were afebnle and 69 (41%) had no increase of white blood cell count. Twenty-two (13%) patients had no fever and all tests were normal. No statistical difference was noted in any symptom or laboratory factor for the 3 age groups, except jaundice was more common among the patients aged 2 8 5 years. Ultrasonography was diagnostic for 91%, and CT was beneficial for only 1 patient. Eight patients had normal results on their ultrasonographic and CT studies. Conclusion: Classic symptoms and abnormal blood test results are frequently not present in geriatric patients with acute cholecystitis. Increasing age does not appear to affect the clinical and test markers used by clinicians to diagnose this illness. A high degree of awareness is essential for correct diagnosis of acute cholecystitis in geriatric patients.

exocytosis; cytokine production and cellular response to cytokine stimulus. DSP analysis provided additional spatial transcriptomic data, highlighting differential inflammatory signature expression between the tumour and tumour capsule. Conclusion Our results demonstrate that the phenotype of tumour endothelium contributes to pathways which promote immune privilege in HCC. Spatial transcriptomics can provide further insight of how endothelial profiling correlates with immune cell infiltration in HCC. We have identified several new genes which need further validation but could be novel therapeutic targets that reprogramme the tumour endothelium and boost the efficacy of current immunotherapies.