Synovial chondromatosis of the elbow in a child

Synovial chondromatosis is cartilaginous metaplasia of mesenchymal remnants of synovial tissue of the joints. Its main characteristic is the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies). It usually presents between the third and fifth decades and is rare in children. It presents as a mono-articular pathology affecting large joints such as the knee, hip, and elbow. The main symptoms are pain, swelling, and limitation of movements in the affected joint. Diagnosis is made by panoramic radiographs, computed tomography scan, and mainly magnetic resonance imaging and on surgery. The authors describe of synovial chondromatosis presenting in the elbow of an 11 year-old girl which is unreported to the best of our knowledge.     

Cross‐Imaging Platform Comparison of Ultrasonic Backscatter Coefficient Measurements of Live Rat Tumors

Objective. To translate quantitative ultrasound (QUS) from the laboratory into the clinic, it is necessary to demonstrate that the measurements are platform independent. Because the backscatter coefficient (BSC) is the fundamental estimate from which additional QUS estimates are calculated, agreement between BSC results using different systems must be demonstrated. This study was an intercomparison of BSCs from in vivo spontaneous rat mammary tumors acquired by different groups using 3 clinical array systems and a single‐element laboratory scanner system. Methods. Radio frequency data spanning the 1‐ to 14‐MHz frequency range were acquired in 3 dimensions from all animals using each system. Each group processed their radio frequency data independently, and the resulting BSCs were compared. The rat tumors were diagnosed as either carcinoma or fibroadenoma. Results. Carcinoma BSC results exhibited small variations between the multiple slices acquired with each transducer, with similar slopes of BSC versus frequency for all systems. Somewhat larger variations were observed in fibroadenomas, although BSC variations between slices of the same tumor were of comparable magnitude to variations between transducers and systems. The root mean squared (RMS) errors between different transducers and imaging platforms were highly variable. The lowest RMS errors were observed for the fibroadenomas between 4 and 5 MHz, with an average RMS error of 4 × 10^?5 cm^?1Sr^?1 and an average BSC value of 7.1 × 10^?4 cm^?1Sr^?1, or approximately 5% error. The highest errors were observed for the carcinoma between 7 and 8 MHz, with an RMS error of 1.1 × 10^?1 cm^?1Sr^?1 and an average BSC value of 3.5 × 10^?2 cm^?1Sr^?1, or approximately 300% error. Conclusions. This technical advance shows the potential for QUS technology to function with different imaging platforms.     

Early postoperative feeding and outcome in neonates

OBJECTIVES: The results of neonatal surgery in the Western world have rapidly improved over the past three decades. Early nutrition support is thought to be one of the key factors. We used transgastric, transanastomotic feeding jejunostomy tubes in every infant undergoing upper gastrointestinal surgery when the expected period of fasting has exceeded 7 d. METHODS: Newborns with duodenal atresia, malrotation, and jejunal atresia were treated consecutively between November 1998 and November 1999. We analyzed the outcome of such a practice. There were 17 consecutive babies recruited into the study. Ten babies had duodenal atresia, one associated with esophageal atresia and tracheo-esophageal fistula, six had malrotation, and one had jejunal atresia. The weights of the babies varied between 1.2 and 3.78 kg (mean = 2.1 kg) and they were referred between the ages of 1 and 23 d. Three babies were younger than 32 wk of gestation and weighed less than 1.5 kg; all had multiple bowel atresia, including one with associated pyloric atresia. None of these three survived. Enteral feeding was started by postoperative day 2 in 14 cases. Period of feeding varied between 3 and 20 d, with a mean of 10.4 d in the surviving babies. Three of the tubes had minor mechanical complications. RESULTS: The weight loss or gain during the period of hospitalization was not significant (P = 0.3) Breast milk was the most common nutrient. Thirteen of the 14 babies weighing more than 1.5 kg were discharged and are being followed; the remaining baby died from neonatal septicemia. Excellent results can be obtained with aggressive enteral nutrition support in newborns undergoing upper intestinal surgery. CONCLUSIONS: Transgastric, transanastomotic feeding jejunostomy was well tolerated by the newborns and is preferable to parenteral nutrition.     

Direct real-time evaluation of nitration with green fluorescent protein in solution and within human cells reveals the impact of nitrogen dioxide vs. peroxynitrite mechanisms

3-Nitrotyrosyl adducts in proteins have been detected in a wide range of diseases. The mechanisms by which reactive nitrogen oxide species may impede protein function through nitration were examined by using a unique model system, which exploits a critical tyrosyl residue in the fluorophoric pocket of recombinant green fluorescent protein (GFP). Exposure of purified GFP suspended in phosphate buffer to synthetic peroxynitrite in either 0.5 or 5 microM steps resulted in progressively increased 3-nitrotyrosyl immunoreactivity concomitant with disappearance of intrinsic fluorescence (IC(50) approximately 20 microM). Fluorescence from an equivalent amount of GFP expressed within intact MCF-7 tumor cells was largely resistant to this bolus treatment (IC(50) > 250 microM). The more physiologically relevant conditions of either peroxynitrite infusion (1 microM/min) or de novo formation by simultaneous, equimolar generation of nitric oxide (NO) and superoxide (e.g., 3-morpholinosydnonimine; NONOates plus xanthine oxidase/hypoxanthine, menadione, or mitomycin C) were examined. Despite robust oxidation of dihydrorhodamine under each of these conditions, fluorescence decrease of both purified and intracellular GFP was not evident regardless of carbon dioxide presence, suggesting that oxidation and nitration are not necessarily coupled. Alternatively, both extra- and intracellular GFP fluorescence was exquisitely sensitive to nitration produced by heme-peroxidase/hydrogen peroxide-catalyzed oxidation of nitrite. Formation of nitrogen dioxide (NO(2)) during the reaction between NO and the nitroxide 2-phenyl-4,4,5,5-tetramethylimidazole-1-oxyl 3-oxide indicated that NO(2) can enter cells and alter peptide function through tyrosyl nitration. Taken together, these findings exemplified that heme-peroxidase-catalyzed formation of NO(2) may play a pivotal role in inflammatory and chronic disease settings while calling into question the significance of nitration by peroxynitrite.