Large colloid cyst in lateral ventricle simulating brain tumour

Summary This case report describes a patient presenting with symptoms of increased intracranial pressure, whose computerized tomographic (CT) scan was highly suggestive of a large low-grade glioma invading the basal ganglia. Magnetic resonance imaging (MRI) revealed a well-demarcated space-occupying mass of increased intensity in the left lateral ventricle and adjacent white matter. Following stereotactic biopsy, which yielded a homogeneous jelly-like material, the mass was removed microsurgically and was found to be most like a colloid cyst on histological examination. Discussion focusses on the clinical and differential diagnostic implications of this very unusual combination of findings.     

An Evaluation of Technetium-99m Tin Colloid--Its Value in the Diagnosis of Renal Transplant Rejection

The value of the Technetium-99m tin colloid (TTC) scan in thediagnosis of renal transplant rejection occurring more than1 month following transplantation was assessed. To our knowledge,use of this agent has not previously been reported. Gamma cameraimaging was performed on 15 occasions in 14 patients in whomplasma creatinine was rising and in three patients in whom renalfunction was stable. Both a qualitative and a quantitative assessmentof images was made. The radioactivity recorded over the graft at 12–16 mmpost injection was expressed as a percentage of that recordedat 0–4 min. In the nine patients in whom graft perfusionwas adequate to allow interpretation of the TTC scan and inwhom rejection was diagnosed by biopsy (six cases) or on clinicalgrounds (three cases), the index ranged from 45 to 153%. Intwo patients the graft was poorly perfused and the accumulationof TTC was predictably low despite the presence of rejection.In the seven patients with either a stable creatinine or withrising creatinine not due to rejection, the index ranged from5 to 43%. Previously reported studies have shown that sulphur colloidsmay be of value in diagnosing graft rejection. This study suggeststhat Tc99m tin colloid may be regarded as a suitable alternativescanning agent and that some simplification of data collectionand analysis can be achieved.     

Mycetoma of the calf

 Actinomycetous infections typically involve either the head and neck or the extremities following a traumatic implantation. Classic clinical associations are draining sinus tracts. This case report describes the pathologic and MR findings of a relatively acute mycetomatous process involving the soft tissues. Pathologic findings in this case included an occasional granule composed of gram positive, thin branching elements. These and other findings were consistent with actinomycetes bacterium infection. The discussion centers around the use of MR, both with and without gadolinium, in evaluating this type of granulomatous infection. Infiltration of the adjacent subcutaneous tissues was easier to appreciate on both the T1-weighted images without gadolinium and the T1-weighted images with gadolinium when compared to the T2-weighted images. Signal characteristics as described in this case report may suggest a granulomatous process.     

天冬胶作为血管栓塞剂毒性实验的初步报告

目的:从其毒性和相关特性方面研究天冬胶作为血管栓塞剂的可行性。方法:昆明小鼠腹腔注射天冬胶后观察外貌行为、食物消耗、体重情况。最后检测WBC、血小板、RBC和Hb浓度;测定血清ALT、肌酐和尿素氮浓度。病理检查心、肝、肾、脾、脑、腹膜、生精组织及腹壁肌肉。大腿肌肉注射天冬胶的小鼠1、3、7 d后各处死,取局部肌肉标本送病理检查。结果:1.仅实验组给药后第1天反应稍差及食量显著低于对照组(P<0.001)外,第2天起各组外貌行为无异常、食量无显著差异(均P>0.05)。2.各组小鼠的体重随时间而增加,除实验组2于实验1周后增长速度显著低于实验组1(P<0.02)和对照组(P<0.001)外,其他无显著差异。3.各组血WBC、血小板、RBC、Hb及血清ALT、肌酐和尿素氮浓度无显著差别。4.仅1个实验组小鼠肝脏内可见多灶性淋巴细胞和其他炎症细胞浸润区,其他组肝脏表现正常。实验组腹膜出现少许慢性炎症细胞的浸润和间皮细胞的增生。其他均无病理改变。大腿肌肉内仅见少许残留异物,无病理改变。结论:天冬胶使用安全、生物相容性较好,作为血管栓塞剂有较好的前景。     

Professor Ahmed Shafik (1933–2007)

Most cases of anal abscess are caused by anal fistula and invasion of the surrounding tissues by a mixed colonic flora. Treatment consists of excision of the abscess and, in case of fistula, fistulectomy. Primary anorectal and perianal forms of actinomycosis are very rare and caused by actinomyces, as ubiquitous anaerobics bacterium. We report a case of perianal actinomycosis. The patient had a short history of painless perineal induration without fever and leukocytosis with normal results at routine blood examination. After excision, sulfur granules drained from the cavity and pathological investigations indicated perianal actinomycosis. Appropriate surgery and antibiotic treatment healed the perianal infection. After exclusion of possible diagnoses such as Crohn’s disease, tuberculosis and malignant growths, the rare case of perianal actinomycosis should be considered in the differential diagnosis of painless perianal masses.     

维丁胶性钙预防关节腔内注射皮质类固醇引起骨关节的损害

目的：采用维丁胶性钙预防关节内注射皮质类固醇对骨关节的损害。方法：４５只健康新西兰白兔，随机分为三组，每组１５只。Ａ组：右膝关节内注射醋酸强的松龙７．５ｍｇ／ｋｇ。Ｂ组：用药同Ａ组，同时每周肌注维丁胶性钙三次，每次１ｍｌ。Ｃ组：右膝关节内注射生理盐水０．３７５ｍｌ／ｋｇ，作为对照。于实验的第３、５、７、９、１１周的第１天，每组取３只动物作髋关节和膝关节Ｘ光照片，并取膝关节及股骨头标本作病理组织学和超微结构检查。结果：Ａ组。用药２次后，Ｘ线照片、病理组织学检查和超微结构观察均有骨关节损害的表现，并随给药次数的增加而加重。Ｂ组。用药６次后才出现轻度病理组织学和超微结构改变。Ｃ组。各项指标均正常。从而证实维丁胶性钙有预防或减轻皮质类固醇所致骨关节损害的作用。结论：在疼痛治疗中，关节内注射皮质类固醇应尽量减少注射次数和延长间隔时间，并同时应用维丁胶性钙肌注有一定预防骨质损害作用。     

Crystalloids, colloids and kids: a review of paediatric burns in intensive care

This is a retrospective review of all burns patients admitted to a paediatric intensive care unit (PICU) over a 7 year period. Resuscitation fluid therapy and clinical course are presented. Ninety-eight new burns victims were admitted with a mortality rate of 10.2%, all in burns of greater than 25% body surface area (BSA). The incidence of ARDS was 20%, with an 18% mortality rate. Of 85 patients with burns greater than 5% BSA, 33 received the hospital-recommended colloid-based resuscitation formula, 46 received a combination of crystalloids and colloids and in 6 patients the resuscitation regimen was not able to be determined. The aetiology, age distribution, sex ratio, severity of burns and length of stay in hospital did not alter significantly over the study period. The number of burns admissions to PICU increased, as did their duration of intubation and ICU stay. The hospital-recommended resuscitation formula consistently underestimated the fluid volume required for adequate resuscitation. No statistically significant difference in adverse effects was found between the resuscitation groups. This study is unable to recommend a definitive approach to the fluid resuscitation of burns shock in paediatrics and the best approach is one of meticulous fluid resuscitation titrated on clinical effect.     

Computer simulations and the use of radiolabelled sulphur colloid to measure the efficiency of the mononuclear phagocyte system

Technique are described whereby the clearance of the radiolabelled blood borne colloid can be continuously and reproducibly measured non-invasively from the same animal in vivo or from the isolated perfused intact liver in vitro. Using these techniques, the rate of removal of radiolabelled sulphur colloid by the mononuclear phagocytes in vivo and in vitro was shown to be biexponential. The pattern of clearance of colloid and the factors contributing to this were analysed with the aid of a computer program which mimicked the in vitro liver perfusion.     

Functional analysis of different regions of the positive-acting CYS3 regulatory protein of Neurospora crassa

In the filamentous fungus Neurospora crassa during conditions of sulfur limitation, CYS3, a major positive-acting regulatory protein, turns on the expression of an entire set of genes which encode permeases and enzymes involved in the acquisition of sulfur from environmental sources. CYS3 functions as a homodimeric protein and possesses a b-Zip domain that confers sequence-specific DNA binding. Expression of various hybrid GAL4-CYS3 fusion proteins in yeast was used to detect regions involved in gene activation. An amino-terminal serine/threonine-rich domain of CYS3 alone strongly activated expression of β-galactosidase, the yeast reporter. Moreover, mutant CYS3 proteins with amino-acid substitutions in this region that showed increased expression in Neurospora also displayed an enhanced activation potential in yeast. The cys-3 gene of the exotic N. crassa Mauriceville strain and of N. intermedia were cloned and demonstrated to be functional for gene activation and for sulfur-mediated regulation by complementation of a loss-of-function cys-3 mutation. The amino-terminal serine/threonine-rich region is highly conserved in these two CYS3 proteins, in agreement with the possibility that it serves as the activation domain. Surprisingly, an extended promoter region of the cys-3 gene in the Mauriceville strain and in N. intermedia was very well conserved with that of the standard N. crassa gene, including the presence of three CYS3-binding sites possibly involved in autogenous control. Results are presented which indicate that synthesis of the CYS3 regulatory protein is highly regulated and can be detected in the nucleus of cells subjected to sulfur de-repression, but is not found in the nucleus or the cytoplasm of S-repressed cells. The amino-acid substitutions of the CYS3 protein present in a temperature-sensitive cys-3 mutant and in a second-site revertant of a cys-3 null mutation are presented and are shown to affect their DNA-binding activities. Received: 9 January / 5 March 1998