Under‐recognized soft‐tissue structures inferior and lateral to the head of the clavicle: Anatomy with computed tomography correlation

This study was undertaken to provide an anatomical explanation for two soft‐tissue structures anecdotally found on axial computed tomography (CT) scan, which are inferior (SI) and lateral (SL) to the head of the clavicle and adjacent to the sternoclavicular joint (SCJ). Three sets of cryosection images were reviewed to identify the anatomical structures corresponding to SI and SL. To demonstrate that SI and/or SL communicate with the SCJ cavity in the living, 312 consecutive chest CT scans were assessed for coexistence of SCJ and SI/SL air. To prove that under‐recognition of SI and SL is due to the use of thick‐section CT scan, another 50 consecutive chest CT scans were evaluated: visibility of SI and SL, and continuity between them on thick (5 mm)‐section images were compared with those on thin (0.75 mm)‐section images. The anterior portions of SI and SL were extensions from the SCJ cavity in the cryosection images, with the articular cartilage and disc occupying variable volumes of SI. The posterior portions of the SI and SL corresponded to the thyroid strap muscles. Air was present in 1 SI, 6 SLs, and 10 SCJs. Four of five patients with SI or SL air had coexisting SCJ air. Thick sections provided significantly poor visibility of SI and SL and continuity compared with thin‐section images. SI and SL are constant shadows on thin‐section CT scan, and their anterior and posterior portions represent extensions of the SCJ cavity and the strap muscles, respectively. The use of thick sections may be responsible for the under‐recognition of SI and SL on CT scan. Clin. Anat. 23:803–810, 2010. © 2010 Wiley‐Liss, Inc.     

Localization of motor entry points and terminal intramuscular nerve endings of the musculocutaneous nerve to biceps and brachialis muscles

To determine the 3D location of the intramuscular motor nerve endings of the biceps brachii and brachialis, we identified from 56 fresh cadaveric arms the regions where the intramuscular branches were most densely located in relation to a reference line connecting the medial epicondyle of humerus and the coracoid process. For the biceps, these points were most densely distributed at a length from 64.6 to 70.3% point of the reference line with the coracoid process as starting point, at a width of 21.6–32.6 mm lateral to the reference line. For the brachialis muscle, these points were located at a length of 75.4% point and width of 27.1–35.4 mm lateral to the reference line. At these points, the biceps was located at a depth of the upper two-third portion and the brachialis at the lower one-third portion of the upper arm, from skin to humeral bone.     

PTEN modulates hepatitis B virus-X protein induced survival signaling in Chang liver cells

PTEN gene, a novel tumor suppressor is frequently mutated or deleted in several malignancies including human hepatocellular carcinoma (HCC). We report previously that human hepatitis B virus-X (HBx) protein achieves protection from apoptotic cell death through-PI3K-Akt-Bad signaling that is p53-independent in liver cells (JBC; 276, 16969 (2000)). In this report, we demonstrated the PTEN effect on HBx induced anti-apoptotic signaling in Chang liver cells (CHL). Expression of PTEN in CHL cells downregulate HBx induced PI3K, Akt activities, Akt, Bad phosphorylations, decreased caspase 3 activity and protection from DNA fragmentations. PTEN suppression of CHL cell growth at G1 phase (JBC;278,4057(2003)) in cell cycle analysis, which is overcome by HBx activated Akt/PKB further confirmed that same PI3K/Akt pathway is involved in cell survival and apoptosis by HBx and PTEN. PTEN suppression of HBx-mediated cell survival through PI3K pathway is specific, since PTEN does not suppress the effect of HBx on the protection from Fas-mediated apoptosis. Taken together, these findings demonstrate that PTEN potently modulate HBx-mediated signaling and is a viable target in therapeutic approaches to inhibit the formation of HCC caused by HBV infections.     

Lactobacillus casei suppresses experimental arthritis by down-regulating T helper 1 effector functions

Although the beneficial effects of probiotics on wide variety of diseases have been shown, little is known about how probiotics modulate the immune system. In this study we elucidated the underlying mechanisms how Lactobacillus casei (L. casei) protects against rheumatoid arthritis (RA) progression by investigating the effector functions of CD4(+) T cells. Oral administration of L. casei suppressed collagen-induced arthritis (CIA) and reduced paw swelling, lymphocyte infiltration and destruction of cartilage tissue. L. casei administration reduced type II collagen (CII)-reactive proinflammatory molecules (IL-1beta, IL-2, IL-6, IL-12, IL-17, IFN-gamma, TNF-alpha and Cox-2) by CD4(+) T cells. L. casei administration also reduced translocation of NF-kappaB into nucleus and CII-reactive Th1-type IgG isotypes IgG2a and IgG2b, while up-regulating immunoregulatory IL-10 levels. Our results suggest that oral administration of L. casei suppresses the type II collagen-reactive effector function of Th1-type cellular and humoral immune responses in arthritic inflammation.     

Failure of epidural analgesia converted to epidural anesthesia for cesarean delivery in a patient with bronchial atresia in labor

Bronchial atresia is a rare anomaly characterized generally by obstruction in the bronchial system, mucus accumulation, emphysematous changes and bulla formation in the peripheral lung. Regional anesthesia is the choice for cesarean delivery in a parturient patient with this anomaly. We report a patient with a diagnosis of bronchial atresia in whom the conversion of epidural analgesia to epidural anesthesia for cesarean delivery failed during labor, needing the application of general anesthesia for a successful delivery.     

CXCR3 polymorphism is associated with male gender and pleuritis in patients with systemic lupus erythematosus

Background

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease involving multiple organs. Chemokines and their receptors play an important role in the pathogenesis of SLE. Lymphocytes expressing CXCR3, chemokine receptors of CXCL4, 9, 10, and 11, increase in patients with SLE and animal models, particularly in those with skin manifestations and nephritis. We investigated CXCR3 genetic polymorphisms in patients with SLE and their association with clinical manifestations.

Methods

A total of 346 patients with SLE and 540 healthy controls were investigated for CXCR3 intron 1 polymorphisms rs2280964 and rs34334103 by Taqman analysis.

Results

rs2280964 and rs34334103 were not associated with all patients with SLE, but rs34334103 showed a significant association with male patients with SLE. Among the clinical manifestations, pleuritis was associated with the rs34334103 polymorphism.

Conclusion

The CXCR3 polymorphism rs34334103 was associated with male gender and pleuritis in patients with SLE.