Hickman nodule: a mimic of metastatic disease

A characteristic small subcutaneous soft-tissue mass can be seen on the computed tomographic scans of patients after removal of Hickman catheters. The mass is indistinguishable from subcutaneous metastatic deposits seen with a variety of malignant tumors. This potentially confusing finding can be differentiated from true metastatic disease by the characteristic location of the subcutaneous nodule in the second or third anterior intercostal space, along the midclavicular line, and by the absence of other subcutaneous masses.     

VALUE OF BASAL PLASMA CORTISOL ASSAYS IN THE ASSESSMENT OF PITUITARY-ADRENAL INSUFFICIENCY

A basal plasma cortisol value taken in a physically unstressed state in 68 patients with or without hypothalamic-pituitary-adrenocortical disease was compared with the maximal plasma cortisol concentration during an insulin tolerance test. There was a strong positive correlation between the values. Basal cortisol levels above 300 nmol/l (RIA method) almost excluded ACTH-cortisol insufficiency and those below 100 nmol/l strongly suggested dysfunction. A repeated basal cortisol estimation within a month was especially valuable in categorizing patients with levels between 100 and 200 nmol/l. We suggest that a basal cortisol measurement may be used as a first laboratory test in patients evaluated for possible hypothalamic-pituitary-adrenocortical insufficiency; in many patients, this approach obviates more sophisticated and expensive testing.     

肝硬化门静脉高压症患者内脏血流动力学紊乱的研究

门静脉高压症是一种由多种病因引起门静脉系统血液动力学紊乱的临床综合征。本研究,应用多普勒超声检测,正常人和肝硬化门静脉高压症患者门静脉系统血流量,以了解肝硬化门静脉高压症中门静脉血流动力学的变化。临床资料１９９６年３月至１９９７年４月用多普勒超声（ＤＵＳ）检测２０例健康成人和３４例门脉高压患者门静脉系统血流动力学参数。２０例健康成人（男１６例,女４例,平均年龄为４９．９５±１５．４９岁）为我院行健康体检者。３４例门脉高压患者中,男３１例,女３例,平均年龄为５０．００±１２．７８岁,病因为肝炎后肝…     

The importance of the pylorus as a regulator of solid and liquid emptying from the stomach

The role of the pylorus in the control of gastric emptying of liquids and digestible solids was investigated in the present study by pylorus excision in six pigs. The pylorus was left intact in another six pigs. Antro-pyloro-duodenal motility was recorded by a sleeve sensor and side holes. Liquid emptying was significantly more rapid in pylorus excised than in pylorus intact animals, during intraduodenal infusion of isosmolar dextrose (712 mL vs 107 mL), fatty acid (402 mL vs 46 mL), amino acids (752 mL vs 112 mL), 25% dextrose (392 mL vs 51 mL) and 3 normal saline (705 mL vs 157 mL). In pylorus excised animals, in contrast to pylorus intact animals, the manometric pattern of isolated pyloric pressure waves at the distal stomach was rarely seen (P < 0.05). In a second series of experiments, pylorus excised animals emptied significantly more (P < 0.04) meat over 120 min (181 g) than pylorus intact animals (80 g), but the proportion of particle sizes emptied was unaltered. In the pig, localized pyloric contractions are important for retardation of gastric emptying when nutrient or hyperosmolar solutions enter the duodenum. By contrast, the pylorus is unimportant in determining the size of solid particles emptied from the stomach.     

The effects of three recombinant growth factors, IL-3, GM-CSF, and G- CSF, on the blast cells of acute myeloblastic leukemia maintained in short-term suspension culture

The blast stem cells of acute myeloblastic leukemia (AML) respond in cell culture to growth factors by both self-renewal and terminal divisions. Both of these functions have been shown to be stimulated by the recombinant growth factors granulocyte-macrophage colony- stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF). In this paper, recombinant gibbon interleukin-3 (IL-3), homologous to human IL-3, was tested on blast cells and compared with the effects of GM-CSF, G-CSF, and medium conditioned by the bladder cell line 5637 (5637-CM). We found that IL-3 was an effective stimulator of blast renewal and terminal divisions. However, great patient-to-patient variation was found. A graphic method of presenting complex comparisons between growth factors is also included.     

The roles of von Willebrand factor and factor VIII in arterial thrombosis: studies in canine von Willebrand disease and hemophilia A

We have studied the roles of von Willebrand factor (vWF) and factor VIII in arterial thrombosis in four canine phenotypes: normal (n = 6), hemophilia A (n = 11), von Willebrand disease (vWD) (n = 9), and hemophilia A/vWD (n = 1). vWF activity was determined by botrocetin- induced agglutination of fixed human platelets and vWF antigen (vWF:Ag) by Laurell electroimmunoassay and crossed immunoelectrophoresis. Plasma from normal dogs and those with hemophilia A had vWF activity, vWF:Ag, and a full range of vWF:Ag multimers on gel electrophoresis equivalent to normal canine plasma pool. Platelet cytosol contents were isolated by freezing and thawing, triton X-100 solubilization, or sonication of washed platelets with and without protease inhibitors and inhibitors of platelet activation. Washed platelets were also stimulated with calcium ionophore and MgCl2. There was no measurable vWF activity or vWF:Ag in platelet lysates or releasates in any dog regardless of phenotype. All dogs were studied using a standard arterial stenosis and injury procedure to induce arterial thrombosis. Thromboses were detected by cyclic reductions in Doppler blood flow velocity. Vessels were examined by light and scanning electron microscopy. Thrombosis developed in the arteries of normal (9 of 10) and hemophilia A dogs (16 of 16) but in none of the vWD dogs (0 of 10). Infusion of canine vWF cryoprecipitate into vWD dogs markedly shortened bleeding time but did not support thrombosis as seen in dogs with vWF in the plasma and subendothelium. Thrombosis, then, fails to occur when vWF is absent from the plasma and subendothelial compartments or present only in the plasma compartment. These data are consistent with the hypothesis that vWF in the plasma and subendothelium supports thrombosis. Neither plasma FVIII nor platelet vWF is essential for thrombosis in this model.     

Synergism between interleukin-6 and interleukin-3 in supporting proliferation of human hematopoietic stem cells: comparison with interleukin-1 alpha

Currently available evidence suggests that in the steady state, the majority of hematopoietic stem cells are dormant in cell cycle and reside in the so-called G0 period. Studies in our laboratory indicated that once a stem cell leaves G0, its subsequent proliferation requires the presence of interleukin-3 (IL-3). Recently it was reported that interleukin-1 (IL-1) may stimulate stem cells to become sensitive to IL- 3. In a separate study, we observed that interleukin-6 (IL-6, also known as B cell stimulatory factor-2/interferon beta 2) possesses synergism with IL-3, shortening the G0 period of murine hematopoietic stem cells. We report here that human IL-6 and IL-3 act synergistically in support of the proliferation of progenitors for human blast cell colonies and that IL-1 alpha reveals no synergism with IL-3 when tested against purified human marrow progenitors. Panned My-10+ human marrow cells were plated in culture and on day 14 of incubation, either IL-3, IL-6, IL-1 alpha or a combination of these factors was added to the cultures. Blast cell colony formation was analyzed daily between days 18 and 32 of culture. IL-6 or IL-1 alpha alone failed to support blast cell colony formation. In the presence of IL-3 alone, blast cell colonies continued to emerge between days 21 and 27. When a combination of IL-3 and IL-6 was added, blast cell colonies developed earlier than in cultures with IL-3 alone and twice as many blast cell colonies were identified. IL-1 alpha failed to augment IL-3-dependent blast cell colony formation. Replating studies of the individual blast cell colonies revealed various types of single as well as multilineage colonies. These observations suggest that IL-6 shortens the G0 period of human hematopoietic stem cells and that the reported synergistic activities of IL-1 on primitive hematopoietic cells may be indirect.     

The effects of orthodontic appliances on Candida in the human mouth

Background.  Candida is an opportunistic pathogen present in about 50–60% of the healthy human population, and becomes pathogenic when the host immune defence is undermined such as in HIV infection. Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis, and the presence of orthodontic and other oral appliances seems to alter the oral ecological environment, hence may tip the balance to favour the candidal presence.
Objective.  The purpose of this paper was to review the literature with specific attention to prevalence; intra-oral density of the candidal organisms; and Candida carriage status in orthodontic patients before, during, and after treatment.
Conclusions.  The limited amount of literature demonstrated that the density of Candida increases; the most common Candida species isolated in the orthodontic patients was C. albicans ; and that there seems to be a direct relationship between the presence of a removable appliance, Candida , and low salivary pH levels. No healthy patients developed Candida infection from the orthodontic appliances. However, there seems to be a trend that some non- Candida carriers converted to Candida carriers following the insertion of the appliances by unknown mechanism. This may indicate a more cautious approach when providing orthodontic treatments to immunocompromised children concerning the possible increased risk of candidal infection.