Double-stranded RNA and bacterial lipopolysaccharide enhance sensitivit to TNF-{alpha}-mediated cell death

The effect of double-stranded RNA (dsRNA) and bacterial lipopolysaccharideon the sensitivity to tumor necrosis factor (TNF)--medlatedcell death was studied In an In vitro system. Since secretionof TNF- Is a part of the early host response to viral and bacterialinfection, we examined whether mimicking the Infection withviral and bacterial products could affect the response of cellsto TNF-. Incubation of WEHI 164 fibrosarcoma cells with dsRNAor lipopolysaccharide (LPS) significantly increased their sensitivityto TNF--mediated lysis and to TNF-secreting inflammatory T cell-mediatedlysis. Thus, these products could induce Increased sensitivityto TNF- In cells In an inflammatory focus, possibly contributingto selective elimination of Infected but not healthy cells bythis non-specific cytokine. Additionally, our data show thatboth dsRNA and LPS, as well as TNF- Itself, rapidly Induce nuclearfactor-xB (NF-*B), a DNA-bindlng protein Implicated In regulationof gene expression. We suggest that NF-xB could regulate genescrucial for the induction of cell death by TNF-.     

Preliminary evaluation of pelvic vascular bed isolation chemotherapy in the treatment of advanced cervical carcinoma

ＰｒｅｌｉｍｉｎａｒｙｅｖａｌｕａｔｉｏｎｏｆｐｅｌｖｉｃｖａｓｃｕｌａｒｂｅｄｉｓｏｌａｔｉｏｎｃｈｅｍｏｔｈｅｒａｐｙｉｎｔｈｅｔｒｅａｔｍｅｎｔｏｆａｄｖａｎｃｅｄｃｅｒｖｉｃａｌｃａｒｃｉｎｏｍａＪｉａｎｇＳｅｎａｎｄＰｏｓｔｇｒａｄｕａｔｅ...     

MRI and MRS in HMG-CoA lyase deficiency

3-Hydroxy-3-Methylglutaryl coenzyme A lyase (HMG-CoA) deficiency is a rare inborn error of leucine catabolism. The disease is characterized by recurrent episodes of metabolic acidosis, hyperammonemia without ketosis, hypoglycemia, lethargy, hepatomegaly, and seizures. This study has evaluated the magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) findings of three patients with HMG-CoA deficiency. The common findings on all of the MRI scans were multiple, coalescent, marked lesions in periventricular white matter and arcuate fibers, most prominently in frontal or periatrial regions that were superimposed on diffuse, slightly hyperintense subcortical white matter signal. Involvement of the caudate nucleus and the dentate nucleus were observed in the reported patients. MRS studies by both STEAM and PRESS spectra of all patients revealed a decrease in N-acetylaspartate and elevation in both myoinositol and choline. A pathologic peak at 1.33 ppm, which is compatible with lactate, and a particular peak at 2.42 ppm in all patients were also found. The combination of both MRI and MRS findings could be considered as being specific in patients with HMG-CoA lyase deficiency.     

Cowden's disease

A 24-year old male patient developed multiple lesions of keratoacanthoma in the epidermal verrucous naevus. He also had multiple papillomatous lesions on the lips, buccal mucosa, gingiva and tongue, with positive family history of similar lesions. He also had multiple skin tags and patchy palmoplantar keratoderma and minimal kyphoscoliosis.     

Free tissue transfer for skull base reconstruction analysis of complications and a classification scheme for defining skull base defects

OBJECTIVE: The role of free flaps in skull base reconstruction is discussed in detail. Twenty-six microvascular free tissue transfers performed in 22 patients are reviewed in detail. A classification scheme for skull base defects is presented. SETTING: Tertiary referral center. PATIENTS: Twenty-two patients with neoplasms that involve the skull base underwent a combined craniotomy and facial approach for resection. The resultant defects were reconstructed with a variety of microvascular free flaps. RESULTS: All 22 patients were ultimately successfully reconstructed with a free flap. One patient required a second free flap following ablative surgery for a recurrent tumor. The initial free flaps in three patients were unsuccessful and a second flap was required. The classification scheme was applied to all defects. CONCLUSIONS: The creation of a functional separation of the intracranial and extracranial cavities can be extremely difficult to accomplish, especially when multiple cavities (nasal, oral, pharyngeal) are violated. Free flaps provide a solution to this problem in select cases. Skull base defects can and should be classified for the purpose of communication, treatment planning, prognosis of reconstruction, and judging therapeutic outcome.     

Performing Testicular or Epididymal Sperm Retrieval Prior to the Injection of hCG

Purpose: Our purpose was to determine the feasibility and efficacy of performing testicular or epididymal sperm retrieval prior to the injection of human chorionic gonadotropin (hCG). Methods: This report deals with 87 sperm-positive percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sperm aspiration (PTSA), or testicular sperm extraction (TESE) cycles. All sperm retrieval procedures were performed prior to administration of hCG to the women. Retrieved spermatozoa were cultured in vitro in simple medium for approximately 40 hr prior to intracyto-plasmic sperm injection. Results: In all but one cycle in which TESE was performed for nonobstructive azoospermia, motile sperm were available for ICSI. The overall fertilization rate was 53%. Pregnancy rate per transfer and implantation rate per embryo were 41.2 and 15.7%, respectively. Conclusions: Satisfactory fertilization and pregnancy rates can be achieved when PESA, PTSA, or TESE is performed prior to the injection of hCG followed by in vitro culture of spermatozoa approximately 40 hr before ICSI. Scheduling of testicular or epididymal sperm retrieval cases in this way appears to ease the workload on laboratory and operating room personnel. Furthermore, withholding hCG when sperm is absent may obviate the unnecessary risk of ovarian hyperstimulation when spermatozoa cannot be retrieved.