A Comparison Between M.R.I. and C.T. in Acute Spinal Trauma

Magnetic Resonance Imaging (MRI) at 0.3T and Computed Tomography (CT) were compared in the retrospective evaluation of 34 patients with acute spinal cord injury. MRI was highly accurate in the imaging of vertebral body fracture, and spondylitk changes, and is the method of choice for imaging ligament injury, traumatic disc protrusion and spinal cord compression. It was also useful for the identification of subtle subluxations in the sagittal plane. CT remains the method of choice for imaging neural arch fractures. MRI at 0.3T is a valid technique for assessing patients with acute spinal trauma.     

Urinary Enzymes and Protein Patterns as Indicators of Injury to Different Regions of the Kidney

Urinary Enzymes and Protein Patterns as Indicators of Injuryto Different Regions of the Kidney. STONARD, M. D., GORE, C.W., OLIVER, G. J. A., AND SMITH, I. K. (1987). Fundam. Appl.Toxicol. 9, 339–351. Acute experimental models of renaldamage to the proximal tubular, glomerular, and papillary regionsof the rat were produced by administration of hexachloro 1:3-butadiene(HCBD), puromycin aminonucleoside (PAN), and 2-bromoethylamine(BEA), respectively. Several routine indicators of nephrotoxicity,the enzymes alkaline phosphatase and N-acetyl-ß-glucosaminidase,and the molecular weight pattern of protein excretion were determinedon urine samples. Tubular damage produced by HCBD or BEA wasdiscriminated both quantitatively and qualitatively from glomerulardamage produced by PAN. The latter was characterized by a pronouncedincrease in protein excretion, especially proteins with molecularweight >40,000 Da. In contrast, protein excretion in tubulardamage was raised only slightly and characterized by excretionof proteins of a wide range of molecular weights. Proximal tubulardamage caused by HCBD and papillary damage caused by BEA weredistinguished both by conventional urinalysis (volume and specificgravity) and by measurement of the two urinary enzymes. Alkalinephosphatase and glucose were markedly and transiently elevatedin proximal tubular damage and N-acetyl-ß-glucosaminidaseshowed a sustained elevation in papillary damage. It is concludedthat both selective urinary enzymes and the molecular weightpattern of urinary proteins can be used to provide diagnosticinformation about the possible site of renal damage.     

Self-injurious behaviour in people with mental handicap: a total population study

ABSTRACT. A survey of self-injurious behaviour in people receiving services for mental handicap was carried out in one health region. Six hundred and sixteen adults and children were found to have engaged in self-injurious behaviour sufficient to have caused tissue damage in the previous 4 months and 596 of these were screened. Half were resident in hospital while 28% were in non-hospital residential care and the remainder (21%) were living at home. Nearly one-fifth (19%) showed self-injurious behaviour, of one or more types, at a rate of at least once per hour and a further 13% wore protective or restraining devices for all or part of the day or night. Only 2% were enrolled on formal psychological treatment programmes but nearly half were receiving psychotropic drugs (excluding anticonvulsants).     

Differences between human and mouse alpha‐fetoprotein expression during early development

Alpha‐fetoprotein (AFP) is the major serum protein during development. AFP is one of the earliest proteins to be synthesised by the embryonic liver. The synthesis of AFP decreases dramatically after birth and only trace amounts are expressed in the adult liver. The tissue distribution of AFP in early human embryogenesis has not been defined. We have studied the expression pattern of AFP mRNA in human and mouse embryos by in situ hybridisation. In humans, AFP is expressed in the hepatic diverticulum at 26 d postovulation as it differentiates from the foregut endoderm (i.e. in the most primitive hepatocytes). It is also expressed in the endoderm of the gastrointestinal tract and in the yolk sac at this age. AFP is subsequently expressed in the mesonephros and transiently in the developing pancreas. In the mouse, no expression of AFP was observed in the mesonephros but other sites of expression were similar. Thus AFP has a distinct temporospatial expression pattern during the embryonic period and this differs between human and mouse species. It is interesting that AFP is expressed by tumours such as primitive gastrointestinal, renal cell and pancreatic tumours as well as those of hepatocyte origin. This distribution reflects the sites of AFP expression during development.     

Differential expression of peroxisome proliferator activated receptor γ and cyclin D1 does not affect proliferation of asthma‐ and non‐asthma‐derived airway smooth muscle cells

Background and objective: Airway remodelling involves thickening of the airway smooth muscle (ASM) bulk. Proliferation of asthma‐derived ASM cells is increased in vitro, but underlying mechanisms remain unknown. Peroxisome proliferators activated receptor‐γ (PPARγ) regulates the cell cycle. It is suggested that PPARγ agonists have anti‐inflammatory effects, which may be valuable in the treatment of asthma, but information regarding their antiproliferative properties in ASM is lacking. Although corticosteroids reduce airway inflammation, in vitro they inhibit proliferation in only non‐asthma ASM cells by reducing cyclin D1. We therefore investigated the effects of mitogenic stimulation (foetal bovine serum (FBS)), and a PPARγ ligand (ciglitazone), on PPARγ and cyclin D1 expression and proliferation of ASM cells. In addition, we examined the effects of ciglitazone on ASM cell proliferation. Methods: We assessed PPARγ and cyclin D1 mRNA and protein levels using quantitative PCR and immunoblotting. Cell proliferation was assessed using bromodeoxyuridine uptake. Results: In the presence of 5% FBS, PPARγ and cyclin D1 expression decreased over time in non‐asthmatic cells but increased in asthmatic cells (compared with sub‐confluent cells). FBS‐induced proliferation of asthmatic cells increased at all time points, but occurred only at day 7 with non‐asthmatic cells (compared with unstimulated time‐matched control). Ciglitazone increased PPARγ expression in both groups, but did not alter cell proliferation, while fluticasone increased PPARγ protein only in asthmatic cells. Conclusions: Although in the presence of a mitogenic stimulus, PPARγ was differentially expressed in asthma‐ and non‐asthma‐derived ASM; its expression was not related to the increased proliferation observed in asthmatic ASM.     

Exsanguination in a Jehovah''s Witness

A case is reported in which death occurred after a patient's adamant refusal to accept blood transfusion, despite prompt control of blood loss. The management of this situation is discussed. Reconstitution of the circulating volume was followed by survival for 2 hours after surgery. The haemoglobin level fell to 1.8 g/dl.