Pseudoprominent aorta: radiographic findings and CT correlation

The presence of a persistent left-sided superior vena cava (LSVC) in the absence of a right-sided superior vena cava (RSVC) may be suspected on a posteroanterior (PA) chest radiograph because of a prominent-appearing ascending aorta, which results from the absence of the RSVC. In the absence of an RSVC, the right upper lobe abuts and outlines the course of the ascending aorta, allowing better demonstration of its profile. This report describes a patient with this finding on a PA chest radiograph. Computed tomographic correlation is presented.     

Live births after autologous transplant of cryopreserved mouse ovaries

The fertility of mice after autologous transplantation of ovaries, before or after cryopreservation, was investigated in this study. Female mice were randomly assigned to either sham-operated (n = 14), ovariectomized (n = 11), fresh (n = 12) or cryopreserved (n = 11) ovarian transplant groups. Ovaries were cryopreserved in 1.4 M dimethyl sulphoxide (DMSO) by cooling to -55 degrees C at 0.5 degree C/min (ice nucleation at -7 degrees C), plunged in liquid nitrogen and then thawed at room temperature. Oestrous cyclicity was observed 7 days after sham operation or 15 days after fresh or cryopreserved ovarian transplant. Ovariectomized animals did not demonstrate oestrous cyclicity but were mated, and no pregnancies resulted. Live births were recorded from all sham-operated, all fresh transplant, and 8/11 (73%) cryopreserved transplant animals. Overall mean +/- SEM litter sizes from fresh (4.32 +/- 0.44) and cryopreserved (4.71 +/- 0.57) transplant groups were smaller (P < 0.05) than those of sham-operated animals (12.54 +/- 0.44), although the sizes were not significantly different (P > 0.05) from each other. Animals were mated at least four times, with four litters of live pups from 4/4 sham-operated, 1/10 fresh and 1/9 cryopreserved ovarian transplant animals. Litter sizes from pups of sham-operated and transplant animals were not significantly different from each other. Following autologous transplantation of mouse ovaries, before or after cryopreservation, offspring appeared normal, with high rates of fertility.      

Hepaticocystic duct — A case report

Summary A case of an anomalous extrahepatic biliary system is reported in which the common hepatic duct was found to enter the gallbladder, whereas the cystic duct drained the entire biliary system into the duodenum. In this case, the gangrenous gallbladder was removed and the continuity between the common hepatic duct and the gastrointestinal tract was restored by means of Roux-en-Y anastomosis. The identification and treatment options of this rare anomaly are briefly discussed.

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Conduit hépatico-cystique. A propos d'un cas

Résumé Un cas d'anomalie du système biliaire extra-hépatique est rapporté, dans lequel le conduit hépatique commun pénétrait la vésicule biliaire, tandis que le conduit cystique drainait la totalité du système biliaire dans le duodénum. Dans ce cas, la vésicule gangreneuse était enlevée et la continuité entre le conduit hépatique commun et le tractus digestif était restauré par une anastomose sur anse en Y de Roux. L'identification et les options thérapeutiques de cette anomalie rare sont brièvement discutées.

     

多功能一次性穿刺器的研制与应用

0　引言　胸腹腔等穿刺术是临床上常用的诊疗操作技术 .常规的操作方法工序多 ,耗时、耗力 ,易感染 ,气胸等并发症 .经过长期的临床实践 ,我们研制了一种实用新型多功能一次性穿刺器 ,临床应用取得了满意的效果 .1　穿刺器结构　穿刺器由穿刺针、皮肤固定卡、三通、排出管、刻度液袋和一次性注射器组成 ,每个部件衔接吻合为一整件 .整套穿刺器和一次性手套、洞巾和即时贴纱布共同放入塑料袋内密封 (图 1 ) ,实施消毒灭菌 .2　临床应用　 1 997-0 1开始临床应用 ,共行胸腔、腹腔、膀胱、心包穿刺 4 66(男 380 ,女 86)例 ,年龄 1 5～ 80岁 .其…     

Relation of psychological distress to the international normalized ratio in patients with venous thromboembolism with and without oral anticoagulant therapy

Summary. Background: Psychological distress might affect the international normalized ratio (INR), but effects might vary depending on oral anticoagulant (OAC) therapy. Objectives: To investigate the association of psychological distress with INR and clotting factors of the extrinsic pathway in patients with and without OAC therapy. Patients and methods: We studied 190 patients with a previous venous thromboembolism (VTE); 148 had discontinued OAC therapy and 42 had ongoing OAC therapy. To assess psychological distress, all patients completed validated questionnaires to measure symptoms of depression, anxiety, worrying, anger and hostility. INR, fibrinogen, factor (F)II:C, FV:C, FVII:C and FX:C were measured as part of outpatient thrombophilia work‐up. Results: In VTE patients without OAC therapy, the odds of a reduced INR (< 1.00) were significantly increased from 1.5 to 1.8 times for an increase of 1 standard deviation (SD) in symptoms of depression, anxiety, worrying and anger, respectively, after adjusting for gender, age, body mass index, socioeconomic status, hematocrit and C‐reactive protein. Worrying, anger and hostility also showed significant direct associations with FVII:C. In patients with OAC therapy, INR was unrelated to a negative affect; however, lower FVII:C related to anxiety and worrying as well as lower FX:C related to anger and hostility were observed in patients with OAC therapy compared with those without OAC therapy. Conclusions: Psychological distress was associated with a reduced INR in VTE patients without OAC therapy. The direction of the association between psychological distress and activity in some clotting factors of the extrinsic coagulation pathway might differ depending on whether VTE patients are under OAC therapy or not.     

Human megakaryocytes express clusterin and package it without apolipoprotein A-1 into alpha-granules

Clusterin, a 70-Kd disulfide-linked two-chain plasma glycoprotein circulates in blood as a high-density lipoprotein particle and is highly induced after tissue injury and tissue remodeling. In this study, peripheral blood leukocytes were assayed for clusterin expression. The protein was predominantly detectable in human platelets by immune cytochemistry. The content of clusterin was determined and amounts to 2.5 +/- 1.3 micrograms/10(9) platelets, thus representing about 2% of the blood pool. Clusterin purified from human platelets had the same molecular weight as plasma clusterin under nonreducing conditions and was composed of two disulfide-linked nonidentical subunits of the same size. Both preparations were sensitive to reduction yielding the two subunits of 35 Kd. In contrast to plasma clusterin, the platelet form was not complexed to apolipoprotein A-I. By immunogold labeling, alpha-granule localization of clusterin was observed. Complete release of platelet clusterin occurred at optimal doses of A23187, phorbol myristate acetate (PMA), and thrombin. Because clusterin mRNA was detected by hybridization in situ in bone marrow- derived megakaryocytes, platelet clusterin is most likely produced and packaged into alpha-granules during megakaryocyte development.     

Posttransplant T-cell lymphoproliferative disorders--an aggressive, late complication of solid-organ transplantation

T-cell non-Hodgkin's lymphomas are an uncommon occurrence after solid- organ transplantation. We describe a morphologically and immunophenotypically distinct group of T-cell lymphoproliferative disorders that occurred late in the course of six patients with solid- organ transplants. The patients ranged in age from 31 to 56 years (median, 43). Three were male; all were splenectomized. The interval from transplant to the diagnosis of lymphoma ranged from 4 to 26 years (median, 15). Symptoms at presentation were related to sites of involvement. Pulmonary, marrow, and CNS involvement were present in five, four, and one case, respectively. No patient had lymphadenopathy. Five patients had an elevated lactate dehydrogenase level (range, 226 to 4,880 IU/L; median, 1,220 IU/L). Five of six patients had a leukoerythroblastic reaction. All cases had large-cell histology and frequently contained cytoplasmic granules. Those cases tested expressed CD2, CD3, and CD8 and were negative for B-cell antigens. T-cell receptor beta- and gamma-chain genes were clonally rearranged in three of three and one of three cases, respectively. All T-cell posttransplant lymphoproliferative disorders (T-PTLDs) studied were negative for Epstein-Barr virus (EBV), human T-cell leukemia/lymphoma virus type 1 (HTLV-1), human T-cell leukemia/lymphoma virus type 2 (HTLV-2), and human herpes virus type 8 (HHV-8) genomes. Treatment with acyclovir (three patients) or chemotherapy (three patients) resulted in two responses. All patients had an aggressive course, with a median survival duration of 5 weeks. In conclusion, a clinically aggressive T- PTLD may be a late complication of solid-organ transplantation and does not appear to be related to EBV, HTLV-1, HTLV-2, or HHV-8 infection.     

Evaluation of toothbrush bristles' deterioration used by preschool children

Abstract:  The toothbrush is an effective instrument for oral diseases prevention. The flexibility and status of bristles, as well as the size of the handle are fundamental for an effective toothbrushing. Thus, the assessment of physical characteristics of toothbrushes is important. This study evaluated the deterioration and wear of bristles of toothbrushes used by preschool children. For the sample selection, five elementary schools were assorted from a city of the São Paulo State northwest region, one from each city area. All toothbrushes used by preschool children who aged between 5 and 6 years old and who attended the assorted schools were visually analysed by two calibrated examiners, according to the criteria proposed by Rawls HR, Mkwayi-Tulloch NJ, Casella R, Cosgrove R ( J Dent Res 1989; 12:1781): 0 – it is impossible to state if the toothbrush was used or not; 1 – the bristles seem to be separated within some tufts; 2 – most tufts are separated, many cover other tufts and present a large number of curved and inclined bristles; 3 – most tufts are covered by others and bristles are folded and tipped. In total, 333 toothbrushes were evaluated. The data obtained revealed that 57.96% of the toothbrushes presented adequate condition for utilization (scores 0 and 1), whereas 42.04% presented inadequate bristles for their function (scores 2 and 3). It was concluded that a great number of toothbrushes presented deterioration of the bristles. Thus, there is the need to guide and promote awareness among teachers, parents and children as well as the need to replace toothbrushes.     

Evidence for diversity within Propionibacterium acnes: a comparison of the T-cell stimulatory activity of isolates from inflammatory acne, endocarditis and the laboratory

BACKGROUND: Propionibacterium acnes is primarily associated with the pathogenesis of acne vulgaris but reports are increasing in number implicating P. acnes in other diseases such as abscess formation, meningitis and endocarditis. The pathogenicity of P. acnes is thought to be partly due to the interaction of the bacterium with the immune system. Historically, investigations have focused on humoral and cell-mediated immune responses to P. acnes antigens without attention to the possibility that different antigens may be expressed by different isolates. OBJECTIVE: Investigations were performed to determine whether there were differences between a laboratory strain of P. acnes (P-37) and fresh clinical isolates in their ability to stimulate naive and adult lymphocytes. MATERIAL AND METHODS: The fresh isolates were collected from a patient with inflammatory acne and a patient with P. acnes-induced prosthetic valve endocarditis. The lymphocyte transformation assay was used to detect responses to whole-cell suspensions of stationary phase P. acnes isolates during 7 days of incubation. RESULTS: The acne isolate was significantly more stimulatory for cord blood mononuclear cells (CBMNCs) than the laboratory isolate (P. acnes P-37) at day 4 of incubation. There were no significant differences between the three strains at any other time points. However, the isolate cultivated from inflammatory acne was significantly more stimulatory for peripheral blood mononuclear cells (PBMNCs) from acne donors than the endocarditis isolate or the laboratory strain at most time points. There were no significant differences between the endocarditis strain and the laboratory strain. CONCLUSION: It can be hypothesized that in case of P. acnes-induced endocarditis lymphocyte stimulation is a disadvantage for the microorganism and therefore a lack of lymphocyte stimulation may be relevant to the pathogenesis of endocarditis.