The subdiaphragmatic cistern: historic and radioanatomic findings

Background  

In the past, sporadic demonstrations of the existence of a subarachnoid subdiaphragmatic cistern have been published. The aim of this study was to evaluate the anatomical characteristics of the subdiaphragmatic cistern of the pituitary gland.     

Activation of the food-derived mutagen 2-amino-1-methyl-6-phenylimidazo[4, 5-b]pyridine by rabbit and human liver microsomes and purified forms of cytochrome P-450

The specificity of rabbit cytochrome P-450 involved in the mutagenicactivation of 2-amino-1-methyl-6-phenylimid-azo[4, 5-b]pyridine(PhIP) was assessed using control and induced rabbit liver andlung microsomes, and six purified forms of cytochrome P-450.The number of revertants produced/2.5µg PhIP by controlrabbit liver was 260 ± 196/10 µg of microsomalprotein (mean ± SD; n = 3), and this increased to 1265± 248 when 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD)-inducedliver microsomes were used as the activation source in the Amestest. Microsomes form phenobarbital-, rifampicin-and acetone-pretreatedrabbits showed no increase in activity over controls. Controllung microsomes did not activate PhIP to a mutagen, whereasTCDD-induced lung microsomes produced 1443 ± 136 (mean± SD; n=4) Ames/Salmonella revertants/100 µg protein.In reconstitution experiments cytochrome P450 forms 4 and 6were found to be efficient activators of PhIP to a mutagen.Form 6 was 3.1-fold more active than form 4 and produced 4577revertants/10 pmol with a 20-min preincubation step in the Amestest. Cytochrome form 5 produced 17 revertants/10 pmol and forms2, 3b and 3c were not active in metabolizing PhIP to a mutagen.A highly significant statistical correlation existed betweenthe capacity of control and induced liver microsomes to activatePhIP to a mutagen and their cytochrome P-450 form 4 (r = 0.97,r² = 0.94) and form 6 (r = 0.95, r² = 0.90) content. These datastrongly support the involvement of polycyclic hydrocarbon-inducibleforms of cytochrome P450 in the activation of PhIP in the rabbit.Anti-rabbit forms 4 and 6 IgGs recognized proteins in sevenhuman liver microsomes of comparable mol. wt to rabbit cytochromeP-450 forms 4 and 6. However, no correlation existed betweenthe content of these proteins and the capacity of human livermicrosomes to activate PhIP.     

Spinal decompression and vertebroplasty in Paget's disease of the spine

Paget's disease is an osteometabolic disorder affecting in particular long bones. The spine is the second most commonly involved site in Paget's disease. This pathology can cause low back pain, spinal stenosis, myeloradiculopathy, and vertebral collapse. Medical therapy is the first choice for the treatment of Paget's disease of the spine; in case of failure, surgery remains a valid option. In the present article, we report a case of a patient with leg disability due to myelopathy caused by spinal Paget's disease treated with spinal decompression and vertebroplasty. To our knowledge, this is the first case report in which these procedures have been performed together in the same operation to treat spinal pathologies due to Paget's disease.     

“Ischemic” ST elevation in a woman with left ventricular hypertrophy

We report the case of a woman who presented with ST elevation and episodes of chest pain, mimicking an acute myocardial infarction. At coronary angiography no sign of coronary stenosis was found and ECG anomalies were related to asymmetric left ventricular hypertrophy and aortic stenosis.     

Management of Flood syndrome: What can we do better?

Approximately 20% of cirrhotic patients with ascites develop umbilical herniation. These patients usually suffer from multisystemic complications of cirrhosis, have a significantly higher risk of infection, and require accurate surveillance– especially in the context of the coronavirus disease 2019 pandemic. The rupture of an umbilical hernia, is an uncommon, life-threatening complication of large-volume ascites and end-stage liver disease resulting in spontaneous paracentesis, also known as Flood syndrome. Flood syndrome remains a challenging condition for clinicians, as recommendations for its management are lacking, and the available evidence for the best treatment approach remains controversial. In this paper, four key questions are addressed regarding the management and prevention of Flood syndrome: (1) Which is the best treatment approach–conservative treatment or urgent surgery? (2) How can we establish the individual risk for herniation and possible hernia rupture in cirrhotic patients? (3) How can we prevent umbilical hernia ruptures? And (4) How can we manage these patients in the conditions created by the coronavirus disease 2019 pandemic?