Morpho-functional status of the lymph nodes of rats during rehabilitation after exposure to vapors of dimethyl sulfate]

By means of histological methods inferior tracheobronchial lymph nodes have been investigated in 48 Wistar rats in 2 weeks and 3 months after cessation of inhalation of DNSV at maximum possible dose (0.1 mg/m3) for 2 and 14 days. Cell composition of the lymph nodes and cross sections of structural components have been compared. The cross section of the cortex decreases, while that of the medulla increases in comparison with corresponding parameters of the acute experiment. In 2 weeks and 3 months after DMSV effect for 2 days the part (%) of poorly differentiated cells and middle lymphocytes increases, while content of plasma cells in the medullary cords decreases. During rehabilitation after DMSV effect for 14 days a low level plateau is noted (as in the acute experiment). However, in lymphoid nodules++ within content of the poorly differentiated cells and middle lymphocytes in the cortical germinative centers in 2 weeks and 3 months the number of the poorly differentiated and reticular cells increases essentially, as well as mitotically dividing cells (in comparison to the acute experiment). In the medullary cords of the lymph nodes after 3 months of rehabilitation content of immature plasma cells is essentially higher than in 2 weeks of rehabilitation and than in the acute experiment. During rehabilitation the level of cells destruction in the lymph nodes noticeably decreases in comparison to the acute experiment.     

Tetraploid/diploid mosaicism: case report and review of the literature

We report a girl with tetraploid/diploid mosaicism who presents failure to thrive and multiple minor anomalies. The clinical features of the proband are compared with the 13 previously reported cases with similar karyotype.     

Laparoscopic nephrectomy for pyonephrosis during pregnancy: case report and review of the literature

The maternal and fetal complications of pyonephrosis during pregnancy can be devastating, thus the call for urgent but safe intervention. Laparoscopic nephrectomy has been used safely and effectively in nonpregnant patients with pyonephrotic kidney. We report on a case of a 28-year-old pregnant woman with pyonephrotic kidney that we believe to be the first such case managed by transperitoneal laparoscopic nephrectomy. A review of the reported cases of laparoscopic nephrectomy for different indications and by different approaches during pregnancy is also presented.     

Treatment of promyelocytic leukemia during pregnancy. A case report and review of the literature

In spite of the fact that acute promyelocytic leukemia during pregnancy is rare and that there is little precedent in the literature for treatment with combined chemotherapeutic agents, the rate of success with current chemotherapeutic regimens is very encouraging. Judging from previous reports and our own experience, it is possible to give combination chemotherapy to pregnant women with AML/APL with the result that mother and infant survive, whereby the incidence of complication is within an acceptable range. No comprehensive studies on life-time teratogenic or carcinogenic effects are available at present.     

Chondrocyte differentiation and bone growth during the development of the cartilaginous skeleton of chickens]

Certain local alterations in functional and reproductive activity of chondrocytes were stated at the development of the cartilage skeleton. In epiphyses chondrocytes gradually pass into the phase of rest (G0) with subsequent multiplication during the process of skeletal development. In these structures biosynthesis of nonsulfated proteoglycans predominate, in time, while in other cartilage zones--that of sulfated ones. Proofs are furnished on gradual transition of epiphyseal chondrocytes into the state peculiar for cells of the proliferative zone accompanied by an intensified biosynthesis of sulfated proteoglycans and collagenous proteins. Owing to these peculiarities they can be compared with the cells of the reserve zone in the mammalian metaepiphyseal cartilage. It was stated that intensity of chondrogenesis and growth of bones are affected by several processes: intensity of chondrocyte multiplication, the rate of their repeated division in the proliferative zone, the velosity with which the cells transfer into the state of hypertrophy and the rate of the periostal bone formation at the border-line of metaphysis and diaphysis.     

Persistent Tn polyagglutination syndrome during febrile neutropenia: a case report and review of the literature

Introduction

Crohn's disease is a chronic inflammatory bowel disease of unknown etiology which may affect any part of the bowel. Fistulas are a common and often serious complication of Crohn's disease. The treatment for fistulizing Crohn's disease can be medical, surgical or a combination of the two. Recently, adalimumab, a fully human anti-tumor necrosis factor monoclonal antibody, has been suggested as a safe and effective treatment for the induction and maintenance of remission in adult patients with moderate to severe Crohn's disease, who are refractory to conventional therapy or intolerant to infliximab. However, large studies focusing on evaluating the efficacy of adalimumab in fistulizing Crohn's disease have not yet been published.

Case presentation

We report the cases of three patients, of European Caucasian ethnicity and Greek nationality, with active luminal and fistulizing Crohn's disease. All of the cases were treated successfully with adalimumab. Patient 1 (a 44-year-old man) and patient 2 (an 18-year-old woman) developed early post-surgical enterocutaneous fistulas, while patient 3 (a 20-year-old woman) had peri-anal fistulizing Crohn's disease. Adalimumab treatment (160 mg subcutaneously at week zero, 80 mg at week two, and 40 mg every other week) was used for three different indications: (1) after the failure of other conservative medical treatments for Crohn's disease (patient 1); (2) as a monotherapy in treating a naive patient (patient 2); (3) after an intolerance to infliximab (patient 3). A remission of the active luminal and fistulizing disease was achieved soon after the initiation of adalimumab and sustained thereafter with maintenance doses. No further surgical intervention was required and no adverse effects were observed in any of the cases.

Conclusions

Fistulizing Crohn's disease remains a challenge in clinical practice. Adalimumab seems to be an effective, well-tolerated and safe treatment option for the induction and maintenance of remission in patients with moderate to severe peri-anal fistulizing Crohn's disease. Furthermore, adalimumab seems to be a promising treatment option for patients with moderate to severe fistulizing Crohn's disease with enterocutaneous fistulas. However, this clinical observation needs to be investigated in further clinical trials.     

Exposure to endotoxin during estrus alters the timing of ovulation and hormonal concentrations in cows

The effect of intramammary (IMM) or intravenous (IV) administration of E. coli endotoxin (LPS), at the onset of estrus, at the time of ovulation was examined. Steroid and gonadotropin concentrations around ovulation were also determined. Lactating Holstein cows (n=33) were assigned to saline-controls (n=12) and treated with LPS-IV (0.5mug/kg; n=13) or LPS-IMM (10mug; n=8). Synchronized cows were observed continuously for estrus. LPS (or saline) was injected within 30min from the onset of standing estrus, at peak estradiol concentrations. The typical rise of body temperature, somatic cell count, cortisol, and NAGase activity was noted. One-third of both LPS-IV- and LPS-IMM-treated cows were manifested by an extended estrus to ovulation (E-O) interval of around 75h or did not ovulate, compared with about 30h in the other 2/3 of LPS cows and all controls. Estradiol concentrations 24h before and after LPS did not differ between groups. However, LPS-IV cows with extended intervals exhibited another estrus and an additional rise of estradiol followed by delayed ovulation. LPS-treated cows with a delayed E-O interval had low or delayed LH surge; two LPS-treated cows did not exhibit LH surge and did not ovulate. All control cows exhibited normal hormone levels. Delayed ovulation was associated with a delayed rise of luteal progesterone. The results indicated that exposing cows to endotoxin during estrus induced a decreased and delayed LH surge in one-third of the cows. This was associated with delayed ovulation, which reduces the chances of successful fertilization.     

Exposure to bisphenol A during embryonic/fetal life and infancy increases oxidative injury and causes underdevelopment of the brain and testis in mice

We investigated the modifications in endogenous antioxidant capacity and oxidative damage in the brain, liver, kidney and testis in mice exposed to bisphenol A (BPA), an environmental endocrine disrupter. Mice were exposed to BPA throughout embryonic/fetal life and during lactation by feeding their pregnant/lactating mothers BPA at 5 or 10 microg per milliliter of drinking water. At the age of four weeks, male mice were sacrificed. Exposure to BPA increased the activity of catalase and glutathione peroxidase in the liver and kidney, respectively. It also increased thiobarbituric acid-reactive substances in the brain, kidney and testis, and decreased the wet weight of the brain, kidney and testis. Our results suggest that exposure to BPA throughout embryonic/fetal life and during infancy induces tissue oxidative stress and peroxidation, ultimately leading to underdevelopment of the brain, kidney and testis.     

Ingestion of superwarfarin leading to coagulopathy: a case report and review of the literature

Superwarfarins are found in many pesticides, including D-con, Prufe I and II, Ramik, Talon-G, Ratak, and Contrac. Ingestion of can lead to significant morbidity and even mortality. Physicians need to consider this diagnosis in any patient presenting with coagulopathy of unclear etiology. We present a patient with superwarfarin-induced coagulopathy and review previous cases in adults in the literature. The patient is a 60-year-old man who presented to our medical center with painless hematuria. Laboratory studies revealed an elevated prothrombin time (PT) (42.5 seconds), partial thromboplastin time (PTT) (64.6 seconds), and international normalized ratio (INR) of 7. Liver-associated enzymes were normal, and complete blood cell count (CBC) showed no evidence of disseminated intravascular coagulation. Subsequent work-up included the absence of an inhibitor by mixing study and deficiencies of vitamin K-dependent coagulation factors. The patient's warfarin level was negative. A brodifacoum level was positive, confirming superwarfarin-induced coagulopathy. The patient is currently doing well with normal coagulation studies after receiving high doses of vitamin K for several weeks. The cause of his exposure to superwarfarin remains uncertain. Physicians need to be cognizant of this unusual cause of coagulopathy in adults. The appropriate diagnostic work-up and unique features of therapy are discussed.     

Retroperitoneal hematoma with bone resorption around the acetabular component after total hip arthroplasty: a case report and review of the literature

ABSTRACT: INTRODUCTION: Vascular complications related to cup-fixating screws penetrating the medial acetabular wall during total hip arthroplasty are not uncommon but rarely are associated with serious adverse events in the late post-operative period. CASE PRESENTATION: We present the case of a 77-year-old Japanese woman who developed progressive extensive bone resorption and large hematoma in the acetabulum 13 years after total hip arthroplasty. On admission to our hospital, she was on oral warfarin (1.5mg/day) for atrial fibrillation. About 5 months after the initiation of anticoagulant therapy, she suffered a major fall followed by massive subcutaneous and pelvic girdle bleeding, predominantly on the medial side of the right thigh, but a fracture or damage of total hip arthroplasty was not evident on an emergency orthopedic evaluation. One year after the accident, a routine follow-up examination showed an asymptomatic osteolytic lesion in the acetabulum on the right pelvis, and 2 years later our patient noticed progressive pain in her right hip during walking. A large osteolytic lesion was noted in the right acetabulum on a plain radiograph. On high-resolution computed tomography and magnetic resonance imaging, a huge granulomatous lesion in the acetabulum was suggestive of chronic hematoma in intrapelvic and extrapelvic gluteal regions. A closer computed tomography examination showed that one of the screws used for fixation of the acetabular component in the total hip arthroplasty had penetrated the acetabular bone and had reached the pelvic cavity. Surgery was performed in a single session by means of two approaches: anterior midline transperitoneal address to resect the low-density mass lesion followed by posterolateral acetabular implant re-settlement. CONCLUSIONS: Though rare, total hip arthroplasty-related late vascular complications could be serious and potentially affect the limb and quality of life.     

Metastatic cervical carcinoma to the thyroid gland: a case report and review of the literature

Although metastases within the thyroid gland are rare, they are not as infrequent as generally believed. Asymptomatic breast, lung, and renal cell carcinomas may metastasize to the thyroid. When they become symptomatic, diagnosis relies upon fine needle aspiration cytology. We report the case of a squamous cell cervical cancer that presented metastatic lesions to the thyroid gland four years after the initial diagnosis. The procedures used to confirm the diagnosis, stage, and subsequently manage the patient are described. We present both a review of the necessary clinical investigation and the therapeutic options open to these patients. We conclude that patients who present swelling or palpable nodules in the thyroid side and have a history of a previous malignancy must be considered for metastatic disease.     

石膏样小孢子菌面部感染1例并文献回顾

报道1例由石膏样小孢子菌感染所致的面癣.患者为5岁男童,外伤后致右侧面颊部红斑、丘疹、脓疱20余日于我科就诊.真菌镜检显示菌丝阳性;真菌培养生长石膏样小孢子菌.皮损外用酮康唑乳膏两周后复诊,痊愈.随诊观察1个月未见复发.     

Ectopic ACTH syndrome due to pheochromocytoma: case report and review of the literature.

A 51-year-old female was diagnosed preoperatively to have a pheochromocytoma producing ACTH. This diagnosis was based upon her paroxysmal hypertension, hyperpigmentation, and hypokalemia. Elevated levels of serum and urine corticosteroids, plasma ACTH, urinary VMA, and catecholamines fell after a right adrenal pheochromocytoma was removed. Subsequently this tumor was found to have a high content of ACTH. Review of the literature indicates a mortality rate of 57% for this syndrome. Proper preoperative recognition and management can result in total cure.     

Exposure risks to pesticide applicators posed by the use of electric backpack sprayers and stretcher-mounted sprayers in orchards

Abstract

The introduction of the pesticide registration system in pesticide risk assessments has promoted the scientific and safe use of pesticides, and the assessment of occupational exposure risk. In the present study, we performed an experiment in a citrus orchard subject to normal orchard management practices. By measuring the exposure of applicators’ (farmers and technicians) body parts to 45% malathion emulsifiable concentrate during its application using electric backpack sprayers (0.25?KPa) and stretcher-mounted sprayers (1.5?KPa), the unit exposure (UE) was determined. The risks of exposure for pesticide applicators who adopted five different protective measures (A: no personal protective equipment (PPE), i.e., no clothes, no gloves, no caps, and no socks; B: short-sleeved top and shorts; C: short-sleeved top, shorts, and a single pair of gloves; D: short-sleeved top, shorts, a single pair of gloves, and a cap; E: long-sleeved top, long pants, a single pair of gloves, and a cap) were also assessed. The results were as follows: 1) The total levels of exposure for pesticide applicators using electric backpack sprayers and stretcher-mounted sprayers were 3613.63?µg and 5654.28?µg, respectively. When electric backpack sprayers were used, the body parts that had the highest exposure were the head (13.8%), hands (19.9%) and back (14.0%), and when stretcher-mounted sprayers were used, the hands (32.5%) and lower legs (21.1%) had the highest level of exposure; 2) In the absence of PPE, the UE values for farmers who used electric backpack sprayers and farmers who used stretcher-mounted sprayers were significantly different. However, when PPE was used, the difference in UE values between the farmers using the two different types of sprayers was not significant; 3) When protective measure A was adopted, the risk quotient (RQ) values of the farmers and technicians who used electric backpack sprayers for the application of malathion were 1.44 and 0.54, respectively; the corresponding RQ values when protective measure B was adopted were 0.97 and 0.28, respectively. When stretcher-mounted sprayers were used for the application of chlorpyrifos, the RQ value of the farmers who adopted protective measure E was 0.43 while other types of PPE use resulted in RQ values greater than 1. In contrast, the RQ value for technicians was 1.62 when protective measure A was used and 1.02 when protective measure B was adopted, whereas other types of PPE use resulted in RQ values less than 1. Therefore, besides increasing the awareness of personal protection among pesticide applicators, improvement in the management of pesticide use and the enhancement of standard operations are of practical significance for controlling occupational exposure to pesticides.     

Regulation of Rat Brain Synaptosomal [3H]Hemicholinium-3 Binding and [3H]Choline Transport Sites Following Exposure to Choline Mustard Aziridinium Ion

Abstract: Choline uptake by cholinergic nerve terminals is increased by depolarization; the literature suggests that this results from either the appearance of occult transporters or the increased activity of existing ones. The present experiments attempt to clarify the mechanism by which choline transport is regulated by testing if the preexposure of synaptosomes to choline mustard aziridinium ion prevents the stimulation-induced appearance of hemicholinium-3 binding sites and/or choline transport activity. Choline mustard inhibited irreversibly most of the “ground-state” (basal) high-affinity choline transport but only 50% of “ground-state” hemicholinium-3 binding sites. Exposure of both striatal and hippocampal synaptosomes to the mustard, before stimulation, inhibited K⁺-stimulated increases in choline transport and of [³H]hemicholinium-3 binding. We conclude that the mechanism by which choline transport is regulated involves the increased activity of a pool of transport sites that are occluded to hemicholinium-3 but are available to choline mustard aziridinium ion, and presumably to choline, before stimulation. However, the concentration of mustard needed to inhibit the stimulation-induced increase of [³H]hemicholinium-3 binding and choline transport was lower for striatal synaptosomes than for hippocampal synaptosomes. In the absence of extracellular Ca²⁺ or presence of high Mg²⁺ levels, the choline mustard did not prevent the appearance of extra striatal hemicholinium-3 binding sites. Also, high Mg²⁺ levels removed the ability of the mustard to inhibit K⁺-stimulated increases of either [³H]hemicholinium-3 binding or choline transport by hippocampal synaptosomes. In contrast, the preexposure of hippocampal synaptosomes to the mustard in the presence of a calcium ionophore (A23187) reduced the concentration of inhibitor needed to prevent the activation of [³H]hemicholinium-3 binding and choline uptake. Thus, we conclude that the ability of the choline mustard to alkylate the pool of choline transporters that are activated by stimulation appears dependent on the entry of extracellular Ca²⁺.     

Trigger finger secondary to anomalous lumbrical insertion: a case report and review of the literature

Trigger finger is a relatively common clinical entity, most frequently caused by stenosing tenosynovitis. Several other conditions not related to tenosynovitis also have been described as a cause of triggering, and these have been reviewed. We present a rare anomaly of the fourth lumbrical muscle insertion as a cause of triggering of the right little finger. This was completely relieved following excision of the anomalous muscle. This rare anatomic variant should be added to the list of potential causes of trigger finger.     

Accessibility of Myofilament Cysteines and Effects on ATPase Depend on the Activation State during Exposure to Oxidants

Signaling by reactive oxygen species has emerged as a major physiological process. Due to its high metabolic rate, striated muscle is especially subject to oxidative stress, and there are multiple examples in cardiac and skeletal muscle where oxidative stress modulates contractile function. Here we assessed the potential of cysteine oxidation as a mechanism for modulating contractile function in skeletal and cardiac muscle. Analyzing the cysteine content of the myofilament proteins in striated muscle, we found that cysteine residues are relatively rare, but are very similar between different muscle types and different vertebrate species. To refine this list of cysteines to those that may modulate function, we estimated the accessibility of oxidants to cysteine residues using protein crystal structures, and then sharpened these estimates using fluorescent labeling of cysteines in cardiac and skeletal myofibrils. We demonstrate that cysteine accessibility to oxidants and ATPase rates depend on the contractile state in which preparations are exposed. Oxidant exposure of skeletal and cardiac myofibrils in relaxing solution exposes myosin cysteines not accessible in rigor solution, and these modifications correspond to a decrease in maximum ATPase. Oxidant exposure under rigor conditions produces modifications that increase basal ATPase and calcium sensitivity in ventricular myofibrils, but these effects were muted in fast twitch muscle. These experiments reveal how structural and sequence variations can lead to divergent effects from oxidants in different muscle types.     

Effect of Different Photoperiod Exposure on [3H]Imipramine Binding and Serotonin Uptake in the Rat Brain

Seasonal rhythmicity in the occurrence of acute depressive episodes and the therapeutic efficacy of light exposure suggest the possible involvement of the pineal gland or other biological oscillators in the pathophysiology of depressive illness. We have performed studies to clarify whether different light/dark (LD) cycle schedules may induce changes in the biochemical targets of antidepressants in the rat CNS. In particular, we have investigated the effect of short- (LD 8:16) or long-day (LD 14:10) photoperiods on different biochemical parameters of serotonergic neurons. A significant increase in the density of [3H]imipramine ([3H]IMI) binding and in the Vmax of 5-[3H]hydroxytryptamine (5-[3H]HT) uptake was found in the hypothalamus of LD 8:16-with respect to LD 14:10-exposed rats, whereas no difference was found in the kinetic properties of postsynaptic 5-HT receptors and in 5-HT metabolism in the hypothalami and cerebral cortices of rats exposed to the two different photoperiods. A seasonal rhythm of [3H]IMI binding sites and 5-HT uptake seems to exist only in certain brain areas, such as the hypothalamus, because no differences were found in the cerebral cortex of LD 14:10- and LD 8:16-accustomed rats. [3H]IMI binding and 5-HT uptake were significantly increased in the hypothalamus of rats accustomed to a light/dark-inverted cycle (DL 10:14) and killed 6 h after the stopping of lighting in comparison to rats exposed to normal LD 14:10 cycles and killed 6 h after the beginning of lighting. Therefore, a circadian modification of the serotonergic presynaptic sites seems to be present and related to light/dark exposure. Because the existence of endogenous compounds able to modulate [3H]IMI binding and 5-HT uptake, other than 5-HT, has been postulated in the mammalian brain, the involvement of these substances in the periodic changes observed could be suggested.     

Appearance of Depolarization- and Maitotoxin-Induced [Ca2+]i Elevation in Single LAN-1 Human Neuroblastoma Cells on Exposure to Retinoic Acid

Abstract: LAN-1 is a human neuroblastoma cell line that, in the undifferentiated state, does not respond to membrane depolarization with an elevation of [Ca²⁺]_i, monitored by fura-2 single-cell microfluorimetry. The exposure of LAN-1 cells to the differentiating agent retinoic acid induced the appearance of [Ca²⁺]_i elevation elicited by 55 mM K⁺. Maitotoxin, a putative activator of voltage-sensitive Ca²⁺ channels, did not evoke an elevation of [Ca²⁺]_i in undifferentiated LAN-1 cells, but produced a marked and sustained increase in [Ca²⁺]_i when superfused in retinoic acid-treated cells. Both high K⁺- and maitotoxin-induced [Ca²⁺]_i elevation in retinoic acid-differentiated LAN-1 cells was reversed by the lanthanide Gd³⁺, an inorganic Ca²⁺-entry blocker, and by the snail toxin ω-conotoxin GVIA, which interacts with the N sub-type of voltage-sensitive Ca²⁺ channels. In contrast, both Bay K 8644 and nimodipine, dihydropyridines that selectively activate or block, respectively, the L-channel sub-type, were completely ineffective. The tumor promoter phorbol 12-myristate 13-acetate (100 nM), a protein kinase C activator, inhibited the elevation of [Ca²⁺]_i due to Ca²⁺ influx elicited by membrane depolarization. K⁺-induced [Ca²⁺]_i elevation appeared 24 h after the addition of retinoic acid and reached the highest magnitude after 72 h. Furthermore, 8 days after the removal of the differentiating agent from the culture medium, the high K⁺-induced increase of [Ca²⁺]_i was still present. In conclusion, the results of the present study demonstrated that retinoic acid-induced differentiation of LAN-1 cells, which lack a high K⁺-evoked [Ca²⁺]_i increase in the undifferentiated state, induces the functional expression of an ω-conotoxin GVIA-sensitive, dihydropyridine-insensitive N-type voltage-sensitive Ca²⁺ channel that can be activated by maitotoxin and negatively modulated by protein kinase C.