Pneumothorax preceding pulmonary blastoma in a child

Serial plain radiographic, ultrasound and CT findings of an unusual case of pulmonary blastoma are described with a review of the literature.     

Relationship between structure and histamine releasing action of polymyxin B and its analogues

The relationship between the structures of polymyxins and their histamine releasing action on rat mast cells was studied. Analogues of polymyxin B (PB) had different hydrophobic properties, positive charge and peptide chains (deca-, nona- and heptapeptides). The biologic activities of cyclic and decyclic heptapeptides (analogues of PB), and polymyxin M and its decyclic form were investigated. Removal of some amino acid residues from the polymyxin peptide chain decreased but did not completely block its histamine releasing action. There a correlation between the hydrophobicity of the investigated compounds (calculated by Rekker's method) and their histamine releasing action. The native forms of polymyxin M and cyclic heptapeptide (analogue of PB) possessed a higher histamine releasing action compared to their decyclic forms. Modification of PB did not change its noncytotoxic secretagogue properties. These data suggest that hydrophobicity and the cyclic ring are important features in determining the histamine releasing properties of the polymyxins.     

Analysis of cell death and vertebral end plate bone mineral density in the annulus of the aging sand rat.

BACKGROUND CONTEXT: The relationship between disc degeneration and end plate sclerosis is poorly understood. The sand rat is an excellent, economical small-animal model in which disc degeneration is age related, spontaneous, reliable, and well characterized. This model is used here to evaluate disc degeneration, disc cell viability, and vertebral end plate bone mineral density (BMD) in lumbar sites. PURPOSE: To determine the proportion of live and dead cells and end plate bone mineral density in the aging sand rat annulus. STUDY DESIGN: Young and old sand rats were used in work approved by the Institutional Animal Care and Use Committee. Outcome measures were the percentage of live/dead annulus cells in the disc and the BMD of cranial and caudal end plates of lumbar vertebrae. METHODS: Bone densitometry was used to obtain endplate BMD on lumbar spines of 16 young sand rats aged 2 to 6 months and 26 older animals aged 22 to 46 months. X-ray films were analyzed for wedging, end plate calcification, and disc-space narrowing. Additional discs were also harvested and incubated with fluorochromes, and the percentage of live or dead cells were determined for the outer, inner annulus, and entire annulus. RESULTS: Radiographically old animals had significantly greater incidence of lumbar wedging (p<0.004) and a significantly greater incidence of end plate calcification and disc-space narrowing (p<0.01). In the live-dead study, the mean percentage of dead annulus cells for the three age groups were significantly different for the outer annulus (p<0.001), inner annulus (p=0.005), and total annulus (p<0.0001). The percentages of dead cells for the entire annulus were 46.14%+/-7.99% (age 2-6 months), 48.13%+/-17.32% (age, 13-19 months), and 76.80%+/-7.27% (age 26-38 months). The percentage of dead disc cells correlated significantly with age for outer annulus, inner annulus, and total annulus (p<0.006). The percentage of dead cells in the entire annulus and the inner annulus correlated significantly with end plate BMD (p<0.02). CONCLUSIONS: Data are novel and show that in very aged sand rats, end plate BMD is significantly greater than that of young animals. Live/dead cell analyses showed increasing cell death in both outer and inner annulus, which correlated significantly with age and with end plate BMD.     

Serologic test for syphilis as a surrogate marker for human immunodeficiency virus infection among United States blood donors

BACKGROUND: This study evaluated the usefulness of the serologic test for syphilis (STS) in preventing the transmission of human immunodeficiency virus (HIV), hepatitis B and C viruses, and human T- lymphotropic virus via the transfusion of seronegative, infectious window-period blood. STUDY DESIGN AND METHODS: Demographic and laboratory information on blood donations made between January 1992 and June 1994 in 18 American Red Cross regions was analyzed. It was assumed that the same proportion of HIV-positive and HIV-infectious window- period donations reacted on STS and were negative on other screening tests (hepatitis B and C viruses and human T-lymphotropic virus). This proportion multiplied by the estimated number of HIV-infectious window- period donations is the number of post-screening HIV-infectious donations removed by STS. RESULTS: Of 4,468,570 donations, 12,145 (0.27%) were STS positive and 377 (0.008%) were HIV positive. Among donations that were negative on other screening tests, STS-reactive donations were 12 times more likely to be HIV positive (odds ratio = 11.9; 95% CI = 5,26). However, of an estimated 13 infectious window- period donations, 0.2 would have been removed because of a reactive STS, at a cost of over $16 million. CONCLUSION: STS is a poor marker and a costly strategy for preventing post-screening HIV infections and other blood-borne diseases.     

Variations in aggrecan localization and gene expression patterns characterize increasing stages of human intervertebral disk degeneration

During disk degeneration, annulus dehydration and matrix fraying culminate in the formation of tears through which nucleus and annulus disk material may rupture, causing radicular pain. Annular tears are present in more than half of the patients in early adulthood and are almost always present in the elderly. Aggrecan, which provides the disk with a shock absorber function under loading, is a key disk extracellular matrix (ECM) component. The objective of the present study was to assess the immunolocalization of aggrecan in the annulus, and to assess molecular gene expression patterns in the annulus ECM utilizing microarray analysis. Immunohistochemistry was performed on 45 specimens using an anti-human aggrecan antibody. Affymetrix microarray gene expression studies used the extracellular matrix ontology approach to evaluate an additional 6 grade I–II, 9 grade III, and 4 grade IV disks. Grade III/IV disks were compared to healthier grade I/II disks. Healthy and less degenerated disks showed a general uniform aggrecan immunolocalization; more degenerated disks contained regions with little or no identifiable aggrecan localization. In degenerated disks, molecular studies showed a significant downregulation of aggrecan, ADAMTS-like 3, and ADAMTS10. Collagen types III and VIII, fibronectin, decorin, connective tissue growth factor, TIMP-3, latent TGF-β binding protein 2 and TGF-β1 were significantly upregulated with fold changes ranging from 2.4 to 9.8. Findings here help us better understand changes in the immunohistochemical distribution of a key proteoglycan during disk aging. Such information may have application as we work towards biologic therapies to improve the aging/degenerating disk matrix.     

Conventional versus endoscopic powered adenoidectomy: A comparative study

Background: Adenoidectomy is a commonly performed ENT surgery. It is conventionally performed using the curettage method. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative.     

Conventional Versus Endoscopic Powered Adenoidectomy: A Comparative Study

Background

Adenoidectomy is a commonly performed ENT surgery. It is conventionally performed using the curettage method. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative.

Methods

Sixty consecutive cases requiring adenoidectomy were randomized into two groups of thirty each. Group A underwent conventional adenoidectomy using the curettage method and Group B underwent endoscopic assisted micro-debrider adenoidectomy. The parameters studied were intra-operative time, intra-operative bleeding and completeness of resection, collateral damage, post operative pain and recovery time.

Result

Sixty cases of adenoidectomy were done using conventional surgery and powered endoscopic adenoidectomy in the study period from Aug 04 to Dec 05. The time taken in Group A (conventional surgery) varied from 22–39 minutes (95% Confidence Interval (CI) −27.7 – 30.9)and in Group B (powered endoscopic surgery) from 27–55 minutes(95% CI 36.6 – 41.9) (p<0.05). The average blood loss in Group A was 21 ml (range 10–50) as compared to 31.67 ml (range 10-60) in Group B (p<0.05). The resection was invariably complete in Group B whereas seven(23%) cases had more than 50% residual adenoid tissue in Group A. Three cases in group A had collateral damage whereas in Group B, there were no added injuries. Post operative pain was studied only in cases undergoing adenoidectomy alone. Group A (n=8) demonstrated a pain score of 1.64–2.63–3.63 (95% CI) whereas Group B (n=11) demonstrated a pain score of 1.19–2.13–3.06 (95% CI). This difference was not statistically significant. In group A, the mean recovery period was 3.5 days and 2.93 days in Group B(p<0.05).

Conclusion

Endoscopic powered adenoidectomy was found to be a safe and effective tool for adenoidectomy. The study parameters where endoscopic powered adenoidectomy fared better were completeness of resection, accurate resection under vision, lesser collateral damage and faster recovery time. On the other hand, conventional adenoidectomy scored in matter of lesser operative time and intra-operative bleeding.Key Words: Adenoidectomy, Powered adenoidectomy, Endoscopic adenoidectomy