Thrombosis of the spermatic vein in children

We describe 3 children in whom thrombosis of the spermatic vein vessels caused swelling of the spermatic cord and epididymis with edema of the scrotum. Venography of the spermatic vein demonstrated the thrombosis and, therefore unnecessary exploration was avoided.     

The edge-to-edge technique: a simplified method to correct mitral insufficiency

OBJECTIVE: Repair of mitral regurgitation (MR) is more demanding in case of prolapse of the anterior leaflet, posterior leaflet with calcified annulus, or prolapse of both leaflets. We evaluated a repair which consists of anchoring the free edge of the prolapsing leaflet to the corresponding free edge of the facing leaflet: the 'edge-to-edge' (E-to-E) technique. The correction results in a double orifice valve when the prolapse is in the middle portion of the leaflet and in a smaller valve orifice when the prolapse is close to a commissure. METHODS: Out of 432 patients with MR submitted to valve repair between January 1991 and September 1997, 121 (mean age 56 +/- 15.8 years) underwent E-to-E correction. The most prevalent etiology was degenerative disease (82 patients, 68%). The mechanism of MR was anterior leaflet prolapse (61 patients), posterior leaflet prolapse (24 patients), prolapse of both leaflets (28 patients) and other complex mechanisms (8 patients). In 72 patients, a double orifice was created, the paracommissural repair was done in 49 patients. RESULTS: Hospital mortality was 1.6%. Overall survival was 92 +/- 3.1% at 6 years with 95 +/- 4.8% freedom from reoperation. Mortality was unrelated to the type of repair. Mitral stenosis was never observed after the correction. At the follow-up (mean 2.2 +/- 1.5 years), all patients but 15 are class I or II. Symptoms at the follow-up are not related to residual MR. CONCLUSIONS: Midterm results of this alternative repair technique are promising, considering the high prevalence of complex anatomical lesions. The technique is simple, easily reproducible and rapidly feasible also when mitral exposure is suboptimal.     

Evaluation of a simplified method for site-specific determination of mutans streptococci levels

To determine the oral mutants streptococcal "load" of an individual, saliva samples reflecting the number of colonized tooth surfaces, are often applied. Sometimes a plaque sample from a specific site would be an advantage, for example in connection with local antimicrobial treatments. The aim of the present paper was to evaluate a chairside method for determination of mutans streptococci interproximally. One hundred subjects participated. Four approximal tooth surfaces of each individual were sampled using toothpicks. The toothpicks were then let to contaminate a pad on a specially designed plastic strip and, for comparison, a MSB-agar plate. The strips were incubated in the standard "Strip mutans" broth. The yield of colony forming units on the strip surface corresponded significantly with that on agar plates. Being a simple chair-side method for the evaluation of the site-specific load of mutans streptococci, it is suggested that the method will be used in various investigations to clarify its potential in different clinical situations.     

Pressure-controlled mechanical ventilation: a simplified titration method of the extrinsic positive expiratory pressure

For the inverse problem of equivalent dipole localization, a new residual function was proposed which is based on spatio-temporal correlation of background electroencephalogram (EEG). This residual has the advantage that it allows the calculation of a confidence region for estimated dipole parameters. This method was applied to two sets of visual evoked potential (VEP) data. The localization was compared by using the volume of the confidence region. The outcome of the equivalent dipole localization was compared for three different residual functions: 1) least square; 2) based on spatial correlations in the background EEG; and 3) the proposed new function which is based on spatial and temporal correlations in the background EEG. It was found that the proposed residual function leads us to the highest accuracy and the fastest convergence in the equivalent dipole localization and that even for two-dipole localization, the present method yields more accurate solutions with less iterations than the conventional methods.     

Stress technetium-99m tetrofosmin myocardial scintigraphy: a new one-hour protocol for the detection of coronary artery disease

The primary objective of this study was to evaluate in a random double-blind design, the sedative and behavioural responses of children undergoing outpatient paediatric dental procedures receiving either chloral hydrate (CH) alone or in combination with hydroxyzine. Forty American Society of Anaesthesiologists class I children (21 to 36 months of age) were randomly allocated to receive either 70 mg/kg CH alone or with 2 mg/kg hydroxyzine. The degree of crying, movement and overall behaviour was evaluated during treatment at different times. The combination of chloral hydrate/hydroxyzine (CH/H) significantly decreased crying and movement in relation to the effect induced by CH alone (p < 0.05) only at 45-60 min following the insertion of a rubber dam, whereas the overall behavior in both groups was no different throughout the dental procedures. In conclusion, our study demonstrated that hydroxyzine increased the effect of CH. However, because of the presence of high rates of oxygen desaturations and of deep sedation, careful use of this drug combination should be stressed.     

Giant cell leiomyosarcoma of the spermatic cord: a report

Presentation of the case of one patient with a leiomyosarcoma of the spermatic cord with presence of numerous giant cells, a remarkably unusual finding. Presence of this type of cells, as well as their positivity for histiocytic markers in immunohistochemical staining, raise considerable problems for the differential diagnosis of this neoplasia with malignant fibrous histiocytomas, which probably requires a different, more aggressive therapeutical approach.     

Photoimmunodetection: a nonradioactive labeling and detection method for DNA

We describe a simple detection system for DNA based on antibody detection of UV-induced photoproducts. It includes a convenient and inexpensive labeling procedure, which is completed in 5-10 min. The only equipment required is a UV source such as an ordinary transilluminator or a DNA crosslinker. Using a monoclonal antibody specific for thymine dimers, coupled to horseradish peroxidase, we are able to detect subpicogram amounts of UV-irradiated DNA directly, and approximately 10 pg homologues DNA indirectly by hybridization with an irradiated probe.     

DNA optical sensor: a rapid method for the detection of DNA hybridization

A DNA optical sensor system is proposed based on the combination of sandwich solution hybridization, magnetic bead capture, flow injection and chemiluminescence for rapid detection of DNA hybridization. Bacterial alkaline phosphatase (phoA) gene and Hepatitis B virus (HBV) DNA were used as target DNA. A biotinylated DNA probe was used to capture the target gene onto the streptavidin-coated magnetic beads and a calf intestine alkaline phosphatase (CAP)-labelled DNA probe was used for subsequent enzymatic chemiluminescence detection. The detection cycle was less than 30 min, excluding the DNA hybridization time, which was about 100 min. Both the phoA gene and HBV DNA could be detected at picogramme or femtomole level. No response signal was obtained when target DNA did not exist in the sample. Successive sample detection could be made by removing the magnetic field and a washing step.     

Pulsed ultrafiltration mass spectrometry: a new method for screening combinatorial libraries

In response to the need for rapid screening of combinatorial libraries to identify new lead compounds during drug discovery, we have developed an on-line combination of ultrafiltration and electrospray mass spectrometry, called pulsed ultrafiltration mass spectrometry, which facilitates the identification of solution-phase ligands in library mixtures that bind to solution-phase receptors. After ligands contained in a library mixture were bound to a macromolecular receptor, e.g., human serum albumin or calf intestine adenosine deaminase, the ligand-receptor complexes were purified by ultrafiltration and then dissociated using methanol to elute the ligands into the electrospray mass spectrometer for detection. Ligands with dissociation constants in the micromolar to nanomolar range were successfully bound, released, and detected using this method, including warfarin, salicylate, furosemide, and thyroxine binding to human serum albumin, and erythro-9-(2-hydroxy-3-nonyl)adenine binding to calf intestine adenosine deaminase. Repetitive bind- and-release experiments demonstrated that the receptor could be reused. Thus, pulsed ultrafiltration mass spectrometry was shown to provide a simple and powerful new method for the screening of combinatorial libraries in support of new drug discovery.     

A simplified screening test for the identification of individuals with diminished vision in developing countries

The mammalian visual system, particularly retinal ganglion cells, has been used for studying the functions of neurotrophic factors on neurons for many years. The major biological effects of neurotrophic factors on retinal ganglion cells observed so far are the promotion of viability and axonal regeneration. However, there are still some controversies regarding the effects of neurotrophic factors on retinal ganglion cells in the literature. This review is aimed to summarize the available information on the biological actions of these neurotrophic factors on survival and axonal regeneration of retinal ganglion cells and the expressions of neurotrophic factor receptors in the retina. Generally, brain-derived neurotrophic factor, neurotrophin-4/5, fibroblast growth factor and glial cell line-derived neurotrophic factor increase the survival of retinal ganglion cells while the effect of ciliary neurotrophic factor on the viability of adult retinal ganglion cells is controversial. The ciliary neurotrophic factor is the only effective factor in promoting long distance axonal regeneration of retinal ganglion cells whereas brain-derived neurotrophic factor and neurotrophin-4/5 only enhance neurite sprouting within the retina.     

A simplified PCR-based method for the detection of Renibacterium salmoninarum utilizing preparations of rainbow trout (Oncorhynchus mykiss, Walbaum) lymphocytes

A method for the detection of Renibacterium salmoninarum by PCR is described. A rapid, reliable procedure was developed for the extraction of DNA, which could be applied to infected kidney homogenates and head kidney lymphocyte preparations. The target for DNA amplification was a 376-bp region of the gene encoding the 57-kDa major surface antigen (MSA). The PCR was specific for R. salmoninarum and allowed the detection of 10 to 100 cells of the pathogen. Use of the PCR for the examination of experimentally infected rainbow trout showed it to be as reliable as plate culture methods for the detection of R. salmoninarum in infected kidneys.     

Bone scintigraphy in the detection of chronic recurrent multifocal osteomyelitis

In this study, we describe the importance of the whole-body bone scan in diagnosing the multifocality of chronic recurrent multifocal osteomyelitis (CRMO) and in distinguishing it from unifocal acute hematogenous osteomyelitis. MATERIALS: The medical records and two-phase, whole-body bone scans of 14 patients (mean age 10.5 yr) with the diagnosis of CRMO, were retrospectively reviewed. The diagnosis of CRMO was based on bone biopsy in 9 patients and clinical course/laboratory findings in 5. Bone scans were evaluated for geographic and anatomic locations of their lesions. Correlative radiographs of areas of abnormal uptake were performed to assess the radiographic appearance of the lesions. RESULTS: The presentation of the disease was localized to one painful, tender and swollen periarticular site 86% of the time. The number of lesions detected by bone scan varied from 1-18 (mean 6). Most lesions were metaphyseal, proximal or distal tibial lesions. Purely sclerotic or mixed (sclerosis and lysis) lesions were found on radiographs. Bilateral lesions were seen in 64% of patients. Biopsies were negative for organisms in all patients and exhibited subacute or chronic histologic changes in most instances. Complications of chronic hyperemia included marked overgrowth (5), diffuse demineralization (1), angular deformity (1) and length discrepancy (1). CONCLUSION: The identification of the multifocal configuration of the disease process by two-phase (soft-tissue and delayed) whole-body bone scintigraphy results in appropriate diagnosis and therapy of CRMO. Additional sites for possible bone biopsy become apparent for exclusion of other diagnoses. Supportive (nonsteroidal, anti-inflammatory medication) instead of antimicrobial therapy can be initiated with significant cost savings.     

The fast-reacting fetal fibronectin test: a screening method for better prediction of the time of delivery

OBJECTIVE: Our aim was to determine from what time onward fetal fibronectin is consistently detectable in the cervicovaginal secretions before delivery and to what extent the actual time of delivery can be better determined by this procedure than by the sole use of the Bishop score. STUDY DESIGN: A fast-reacting fetal fibronectin test was performed on 206 women on their expected date of confinement. In addition, the cervical status was evaluated with use of a modified Bishop score. Follow-up evaluations were subsequently carried out in the course of the routine examinations. RESULTS: Women with a positive fetal fibronectin test result and a high Bishop score were delivered after a median of 1.7 days. Conversely, women with a negative fetal fibronectin test result and a low Bishop score were delivered after a median of 7.1 days. CONCLUSION: Determination of fetal fibronectin in combination with the Bishop score makes it possible to predict the actual time of delivery with a greater degree of accuracy.