Endoscopic extraction of eroded Marlex mesh in a Kock pouch

We report a case of recurrent calculi in a Kock pouch continent urinary diversion. An open operation was avoided by successfully excising the Marlex mesh and removing it with the associated calculi in an endoscopic fashion.     

Treatment of experimental pyelonephritis in the monkey

Previous studies show that chronic pyelonephritis and end stage renal disease may follow acute pyelonephritis in children and adolescents when improperly or inadequately treated. Our study shows that there is a significant decrease in renal function following untreated acute bacterial pyelonephritis due to nephron loss. The acute inflammatory response is responsible for much of the renal damage, although damage from renal ischemia is an additional significant factor. The present study used a combination of an antibiotic and a xanthine oxidase inhibitor (allopurinol) as compared to antibiotic therapy alone begun 72 hours after infection. Both were successful in eradicating the infection rapidly, but did not entirely prevent renal damage. Treatment prior to 72 hours thus is important. It appears that the combined treatment, designed to eradicate the bacteria as well as reduce the post-ischemic reperfusion damage and the phagocytic burst of phagocytosis is ideal, as this combined treatment was effective in preventing almost all renal damage and loss of renal function.     

A randomized controlled trial of electromagnetic therapy in the primary care management of venous leg ulceration

OBJECTIVE: The aim was to establish the potential efficacy, tolerabilityand side-effect profile of electromagnetic therapy as an adjunctto conventional dressings in the treatment of venous leg ulcers. METHOD: A prospective, randomized, double blind controlled clinicaltrial was carried out in a dedicated leg ulcer clinic basedin one urban general practice. Nineteen patients with leg ulcersof confirmed venous aetiology were assessed. The main outcomemeasures were rate and scale of venous leg ulcer healing, changesin patient-reported pain levels, quality of life, degree ofmobility, side effect profile and acceptability to patientsand staff. RESULTS: Sixty-eight per cent of patients attending this dedicated clinicachieved improvements in the size of their ulcer (4, 21%, healedfully) and in reduced pain levels (P < 0.05) during the trial,despite the chronicity of ulcer histories. Patients treatedwith electromagnetic therapy at 800 Hz were found at day 50to have significantly greater healing (P < 0.05) and paincontrol (P < 0.05) than placebo therapy or treatment with600 Hz. All patients reported improved mobility at the end ofthe study. The electromagnetic therapy was well tolerated bypatients, with no differences between groups in reporting adverseevents, and proved acceptable to staff. CONCLUSION: Despite the small numbers in this pilot study, electromagnetictherapy provided significant gains in the healing of venousleg ulcers and reduction in pain. Keywords. Electromagnetic therapy, RCT, leg ulcers, primary care.     

The effect of glutaurine on thyroid hormones in the rat

Glutaurine (gamma-L-glutamyl taurine), a proposed hormone isolated from parathyroid gland oxyphil cells, was examined for its effect on circulating thyroid hormones in the rat. In acute experiments performed over a 24 hr. period, glutaurine depressed plasma triiodothyronine (T3) levels in a dose-dependent manner; however, thyroxine (T4) levels were not affected significantly. In chronic experiments performed over a 2 wk. period, glutaurine significantly increased T3 levels, but, as with acute studies, the effect of T4 levels was not significantly altered. Following acute glutaurine administration, TSH levels were elevated above control. The increased T3 observed following chronic glutaurine administration may be due to a secondary increase in TSH levels. These data support the hypothesis that glutaurine aids in peripheral thyroid hormonal regulation. Observed differences between acute and chronic glutaurine action are though to result from the effect of glutaurine on the negative feedback inhibiting action of TSH.     

Reactive arthritis of the temporomandibular joints and cervical spine in a child

Background  

Temporomandibular joint (TMJ) arthritis is frequently seen in children with chronic arthritis. It has rarely been described in a non-infectious acute setting. We report a case of reactive arthritis isolated to the TMJs and cervical spine.     

Platelet-derived growth factor (PDGF) BB acts as achemoattractant for human malignant mesotheliomacells via PDGF receptor b - integrin a3b1 interaction

Platelet-derived growth factor BB (PDGF BB) and the PDGF receptor b are expressed on mesotheliomacells, but their biological function has not yet been defined. In the present study we used Boyden chambersfitted with filters coated with the adhesive matrix proteins fibronectin, laminin, collagen type IV or the non-matrixadhesive molecule poly-L-lysine (PLL). Mesothelioma cells migrated towards PDGF BB at concen-trationsranging from 0.78 to 12.5 ng/ml if matrix proteins were present as adhesive substrates. This migrationwas integrin dependent since the same cells failed to migrate if the adhesive interactions necessary for migra-tionwere provided by molecules other than integrins. Migration of mesothelioma cells on fibronectin, lamininor collagen-type IV in response to PDGF BB was inhibited if the cells were pretreated with blocking anti-bodiesto a3b1 integrin. These findings describe for the first time PDGF BB as a chemoattractant for malig-nantmesothelioma cells and that collaboration between PDGF receptor b and integrin a3b1 is necessaryfor the motile response of these cells to PDGF BB.©Kluwer Academic Publishers     

Diffraction ellipsometry studies of osmotically compressed muscle fibers

Microstructural features of relaxed, skinned muscle fibers compressed with polyvinylpyrollidone were examined by optical diffraction ellipsometry. This technique is sensitive to the optical anisotropy within the muscle, including that due to intrinsic properties of the protein molecules as well as that due to the regular arrangement of proteins in the surrounding medium. The change in polarization state of light after interacting with the muscle is described by the differential field ratio (DFR) and birefringence (n). Compression of single fibers (sarcomere length = 2.6 m) with 0%–21% polyvinylpyrrolidone caused an increase of up to 23% and 31% for DFR and n, respectively. The largest increase in both parameters occurred at intermediate sarcomere lengths. Theoretical modelling of the results suggest that the average S-1 tilt angle may be reduced upon compression of the filament lattice. This is supported by experiments in which S-1 was enzymatically cleaved with -chymotrypsin. Separate experiments comparing fibers with intact membranes and skinned fibers compressed to an equivalent lattice spacing showed little difference in DFR or n.     

Interleukin-1 beta regulation of islet and thyroid autoimmunity in the BB rat.

Daily injections of high dose human recombinant interleukin-1 beta (IL-1 beta) accelerated the onset of both insulin-dependent diabetes mellitus and lymphocytic thyroiditis in genetically prone BB rats. In diabetes-resistant BB rats, high dose IL-1 beta failed to induce diabetes. Additionally, the presence of neutralizing IL-1 beta antibodies in these rats strongly correlated with inhibition of lymphocytic thyroiditis. Since low dose IL-1 beta protects diabetes-prone rats from IDDM, we conclude that IL-1 beta is a potent modulator of autoimmune diabetes and thyroid disease in genetically susceptible rats.