Lymphedema associated with sirolimus in renal transplant recipients

Lymphoceles are common in renal transplant recipients who receive sirolimus (SRL). However, a recent MEDLINE search revealed no reports of lymphedema related to SRL. We describe three cases of lymphedema that resolved or improved on discontinuation of SRL. No other likely causes of lymphedema were discovered. Recognizing the association may lead to early discontinuation of SRL, which may prevent permanent disfigurement. It may also prevent unnecessary investigations. The mechanisms of this phenomenon are not clear. We hypothesize that increased lymph flow along with disrupted lymphatics in the affected extremities may explain this complication of SRL. Further studies are necessary to confirm our findings.     

Rescue in situ thrombolysis for acute coronary thromboembolism in an angiographically normal coronary artery

Coronary thromboembolism in an angiographically normal coronary artery is extremely uncommon. There are few instances where normal coronary arteries have been documented just prior to an episode of acute thromboembolic insult. We now report such a case of acute coronary thromboembolism in a patient with widely patent coronary vessels documented just prior to the event during preoperative screening angiogram with successful in situ revascularization.     

Hydatic pulmonary embolism complicating a cardiac hydatic cyst. A case report

Hydatic pulmonary embolism: complication of a cardiac hydatic cyst:a case report hydatic cardiac cyst is a rare condition and represents only 0.5 to 2% of all visceral localisations of the hydatid disease. We reported a 28 year old patient with a multiple hydatic pulmonary embolism caused by the rupture of a hydatic cyst of the interventricular septum. The diagnosis was established by transthoracic echocardiography and CT Scan. Surgery was performed without delay and the outcome was good after a five month follow-up. This case illustrates the diagnostic value of the non invasive imaging means in hydatic cyst of the heart and underlines the importance of surgery realized before complications occur.     

The type III aortic dissection. Diagnosis, outcome, contribution of the endovascular therapies to their management--a case report

The dissection of the descending aorta is a serious affection regarding to its mortality and its complications. It becomes chronic after the 14th day following the first signs of dissection. The authors report the case of a 55 years old patient who has presented a type III dissection diagnosed at the chronic period. The persistance of the pain has indicated the implantation of a stent at the intimal tear. This new endovascular treatement of the aorta diseases is a promising and less invasive alternative to the surgical treatement. It may reduce the morbidity and the mortality of this pathology but it needs an accurate and performant imaging techniques.     

Carcinoid tumors of the appendix. A report of 46 cases

Carcino?d tumors of the appendix are rare. The appendix constitutes the most frequent localization of these tumors. We studied of a retrospective way all cases that had an appendectomy in the service of general surgery of Sfax on a period of 7 years going from 1995 to 2001. During this period, 9584 patients had an appendectomy in our service. Among which, 46 cases (0.48%) of carcinoid tumor of the appendix have been diagnosed. In more than 95% of cases, patients were admitted due to acute appendicitis; but none of them had the signs of the carcinoid syndrome. The treatment was a simple appendectomy in 44 cases (95%). The right hemicolectomy was necessary in two cases, because of an invasion of the appendicular base in a case and a tumor greater than 2 cm in the other case. There is no reported case of lymph node or systemic metastasis. The authors discuss data in the literature and analyse the features of the clinical picture, diagnosis, and try to define a convenient attitude of treatment of these tumors.     

Predictors of personality disorders among Alexandria University students

Personality disorders (PDs) represent a common and serious public health problem. The aim of the present work was to determine the prevalence of different PDs among first grade students of Alexandria University and to investigate some ecological factors of the problem. A cross-sectional study was carried out and included 1086 students. The Arabic Version of Personality Diagnostic Questionnaire-4+(PDQ-4+) was applied. Results revealed that more than one quarter of the studied sample had at least one PD (26.1%). Cluster C was the most frequently occurring (24.9%). The commonest subtypes recorded were avoidant PD (20.4%) and obsessive-compulsive PD (20.2%) followed by paranoid PD (15.0%). Significant predictors of PD delineated on the logistic regression analysis were mainly psychosocial factors including parental inconsistent discipline, intrafamilial conflicts, parental rejection and control, decreased familial and friends' social support, and sexual abuse. A positive history of conduct disorder, chronic medical illness or psychiatric problem also significantly predicted the occurrence of PD. Lack of freedom in college selection and smoking emerged as recent events that predicted the PD status of students.     

Use of Immunomatrix Methods to Improve Protein-Protein Interaction Detection

Immunoprecipitation (IP) and coimmunoprecipitation (co-IP) are keytechniques for studying protein-protein interactions. Thesemethods utilize immobilized protein A or protein G to isolateantibody-bound target antigens. The main disadvantage oftraditional immunoprecipitation and coimmunoprecipitation is thatthe conditions used to elute the precipitated antigen alsorelease the antibody, contaminating the antigen and destroyingthe antibody support. To overcome these problems, we describe twomethods to generate a reusable antibody support by cross-linkingthe antibody to immobilized protein A or protein G, or bycoupling it directly to the resin. Ourstudies have demonstrated that the immobilization efficiency forthe antibody coupling method was similar for several species ofantibody. Furthermore, we illustrate that using both methods ofantibody immobilization yields IP and co-IP results similar totraditional protocols but eliminates the antibody heavy and lightchains contamination.     

Enteral nutritional supplementation prevents mesenteric lymph node T-cell suppression in burn injury

OBJECTIVE: To determine the effects of an immune-enhancing diet supplemented with glutamine, arginine, fish oil, and dietary nucleotides on mesenteric lymph node T-cell functional disturbances encountered after burn injury in rats. DESIGN: A prospective animal study. SETTING: University medical center research laboratory. SUBJECTS: Adult male Sprague-Dawley rats. INTERVENTIONS: Rats received a 30%, total body surface, full-thickness burn. Burn-injury rats received the IMPACT diet supplemented with glutamine, arginine, fish oil, and nucleotides or arginine, fish oil, and nucleotides, or an isocaloric/isonitrogenous diet without supplementation with glutamine, arginine, fish oil, or nucleotides. MEASUREMENTS AND MAIN RESULTS: Two days after injury, we found a significant decrease in the proliferation and interleukin-2 production by mesenteric lymph node T cells derived from rats fed on conventional chow compared with sham rats. The burn-related suppression of mesenteric lymph node T-cell proliferation and interleukin-2 production was prevented when the rats were fed on a high-protein diet rich in glutamine, arginine, fish oil, and nucleotides. We found that the immunostimulatory effects of the enriched diet are dependent on the presence of glutamine, arginine, fish oil, and nucleotides as feeding of rats on the isocaloric/isonitrogenous diet deficient in glutamine, arginine, fish oil, and nucleotides did not prevent the burn-related suppression of mesenteric lymph node T-cell dysfunction. Finally, our studies suggested that immunostimulatory effects of the diet are mediated by prostaglandin E(2) regulation of T-cell activation signaling molecule P59fyn. CONCLUSION: These results suggest that a diet rich in arginine, fish oil, and nucleotides, with and without glutamine, can effectively prevent T-cell dysfunction encountered after burn injury.