Intestinal perforation in temporal arteritis, associated with paroxysmal nocturnal hemoglobinuria

Patients with peripheral arterial occlusion may be treated with one of three distinct treatment strategies: observation and/or anticoagulation alone, operative intervention, or catheter-directed thrombolytic therapy. The severity of symptoms is the most important clinical parameter with which to formulate clinical strategies. Patients with non-lifestyle limiting claudication may be best managed without arteriographic investigation, managing symptoms conservatively with exercise, cessation of smoking, and occasionally the oral pharmacologic agent pentoxifylline. Patients with threatened limbs in the form of rest pain or tissue loss carry a high risk of limb loss without intervention. These patients should undergo arteriography with consideration of endovascular intervention for focal lesions and bypass grafting for more diffuse disease. Patients with more acute symptoms may be best treated with catheter-directed thrombolytic therapy, addressing unmasked lesions responsible for the occlusion with an operative or endovascular approach. In all cases, the appropriate therapy must be tailored to the clinical presentation, the anatomic distribution of disease, and the experience of the clinical team.     

Fluostatins A and B, new inhibitors of dipeptidyl peptidase III, produced by Streptomyces sp. TA-3391. II. Structure determination

We describe the management of a 25-year-old primigravida with severe respiratory insufficiency secondary to CHarcot-Marie-Tooth disease type I scheduled for Caesarean section. Incremental subarachnoid anaesthesia via a microcatheter was utilised. Mother and baby made an uneventful recovery and were discharged home on the tenth postoperative day.     

Pneumonia caused by granulomatous Pneumocystis carinii in a patient with the acquired immunodeficiency syndrome

A 54-year-old man was admitted to the hospital because of fever and general fatigue. A chest roentgenogram on admission showed lobular opacities and ill-defined opacities in both lower lobes. The pneumonia was successfully treated with antibiotics. The acquired immunodeficiency syndrome was diagnosed because ELISA and PCR tests for antibodies to the human immunodeficiency virus were positive and the CD 4+ lymphocyte count was 39 per cubic millimeter. Examination of bronchoalveolar lavage fluid revealed no Pneumocystis carinii. Trimethoprim and sulfamethoxazole were given prophylactically, but were withdrawn because of a rash. The patient began to receive aerosolized pentamindine and was discharged. On the next day, he was readmitted to the hospital because of a high fever. A chest roentgenogram showed diffuse miliary opacities. Chest CT scan also showed diffuse small nodular opacities in both lungs. Examination of a transbronchial biopsy specimen revealed well-defined, noncaseating granulomas with pneumocystis organisms in their centers. Cultures for tuberculosis and fungi were all negative. We diagnosed granulomatous pneumonia caused by Pneumocystis carinii, which is an atypical manifestation of Pneumocystis carinii pneumonia. The patient died of sepsis and cardiac tamponade. Microscopically, the lung tissue was found to have foamy intra-alveolar exdates, which is a typical histological feature of Pneumocystis carinii pneumonia.     

The effect of vasopressin V1- and V2-receptor antagonists on hemodynamics in early and late phase after myocardial infarction in rats

The use of a cheap, self-made external fixator for the treatment of unstable fracture dislocation of the PIP joint is described. The first experience in 5 patients is promising.     

Acute myocardial infarction in a patient during dobutamine stress echocardiography

Combined chemotherapy/radiotherapy treatments appear to yield better results in locally advanced non-small-cell lung cancer (NSCLC) than radiotherapy alone. The optimal induction chemotherapy regimen remains to be established. In the present study, chemotherapy with cisplatin and vinorelbine was used prior to radical radiotherapy in Stage III-B NSCLC. Thirty-three patients were entered prospectively into a Phase II study. Treatment consisted of three cycles of chemotherapy with cisplatin 100 mg/m2 on day 1 and vinorelbine 30 mg/m2 on days 1 and 8, followed by thoracic radiotherapy (60 Gy). Twenty-two percent of the 33 patients had grade 3-4 leukopenia, and there were six episodes (in 4 patients) of neutropenia-associated fever. Gastrointestinal toxicity was generally moderate. Peripheral neuropathy was present in 42% of the patients, although in most of them it was slight. The main radiotherapy toxicity was esophagitis grade I-II. Evaluation of response after the third chemotherapy course showed an objective response in 16 patients (48%), whereas in three patients (9%) the disease progressed during therapy. The median survival of the entire group was 13 months. Cisplatin plus vinorelbine followed by radiotherapy is an effective schedule for patients with locally advanced non-small-cell lung cancer.     

Synthesis, characterization and photocatalytic reactivity of Ti-containing micro- and mesoporous materials

Ti-oxides incorporated within the framework of microporous zeolites and mesoporous molecular sieves were found to exhibit high and unique photocatalytic activity for the decomposition of NO into N₂ and O₂ as well as the reduction of CO₂ with H₂O to produce CH₄ and CH₃OH. Spectroscopic investigations of these catalytic systems using photoluminescence, UV-vis, XAFS (XANES and FT-EXAFS) and IR analyses revealed that the charge transfer excited state of the isolated tetra-coordinated Ti-oxides plays a vital role in these photocatalytic reactions. The reactivity of such Ti-oxides was found to depend strongly on their local structures which were controlled by the unique framework structures of the micro- and mesoporous material supports.     

Prognostic factors of esophageal cancer]

A number of molecules involved in the process of invasion and metastasis of cancer cells have been demonstrated as a biological prognostic parameter. In esophageal cancer, overexpression of the oncogenes (c-erbB, int-2/hst-1/cyclin D1, MDM2), altered expression of suppressor genes (p 16, DCC), and abnormal expression of adhesion molecules (E-cadherin, alpha-catenin) has been reported as markers of high malignant potential. Proliferation markers (Ki-67, AgNORs, PCNA) and angiogenetic factors (intratumoral microvessel density, VEGF) are also related to the prognosis of the patients with various cancers including esophageal cancer. Prognostic significance of p53 is still controversial. In addition to the clinicopathological parameters, combination of these biological markers would be important to predict the clinical outcome of the cases and to establish an individualized strategy of the treatment of each case according to the biological behavior of the cancer cells.     

Mechanism of short-term memory and repetition in conduction aphasia and related cognitive disorders: a neuropsychological, audiological and neuroimaging study

The minimal nitrogen cycle involves five reduction reactions and three oxidation reactions, each of which poses interesting problems in bioinorganic chemistry, energy transduction and protein structure/function relationships. Many of the major recent developments in this field have depended on the acquisition of protein crystal structures, including structures of enzymes with bound substrates or products and in protein-protein complexes. These enzymes include nitrogenase, nitrite reductases, hydroxylamine oxidoreductase and a fungal nitric oxide reductase.     

Effects of surfactants on glucosyltransferase production and in vitro sucrose-dependent colonization by Streptococcus mutans

OBJECTIVE: To study the distribution of myocardial structural elements in a univentricular experimental model (Halobatrachus didactylus) and the changes induced by acute exposure to a sublethal concentrations of cadmium. DESIGN: 15 specimens of H. didactylus (marine teleost) were divided in three groups: CTRL: the control group, the fish were injected with a saline solution; 24 H: 1 mg/kg of cadmium chloride was injected and fish were sacrificed after 1 day post injection; 7 D: fish where subjected to the same cadmium concentration and sacrificed after 7 days post injection. INTERVENTIONS: Histological sections (5 microns) of ventricle were coloured by PicroSirius method and used to determine the fraction area occupied by the several myocardium structural elements, using specific software Optimas Bioscan 5.2. MEASUREMENTS AND RESULTS: The different structural elements of H. didactylus myocardium displayed in different ways and its distribution along the ventricular wall remained unchanged on exposure to cadmium. The structural elements of H. didactylus myocardium showed a characteristic pattern: collagen type I revealed a heterogeneous distribution, with fractional area values greater in epicardial and endocardial layers; collagen type III, has a homogeneous distribution with the myocardial wall thickness with lesser fractional area values than collagen I; cardiac muscle tissue showed a tendency to occupy a greater fractional area in the epicardial-endocardial region. Cadmium toxicity resulted in an increase in the fractional area occupied by muscle tissue to the detriment of the area occupied by the intertrabecular spaces (lacunae), with no alterations in the other structural components. CONCLUSIONS: On our H. didactylus fish model, cadmium may have induced a myocardial edema which resulted in an increase in the fractional area occupied by muscle tissue, with no alterations in other structural components of the myocardium or in the relative ventricular mass.     

Bubble Entrapment on Solidified Shell caused by Unsteady Steel Flow in Mold

The molten steel flow in the continuous casting mold and entrapment of inclusions and bubbles on the inner surface of the solidified shell are examined to clarify the mechanism of internal defects in steel products. Defects on steel sheets are caused by bubbles and inclusions entrapped on the solidified shell during casting. It was found that bubbles penetrate deeply due to an unbalanced time‐dependent flow. This phenomenon can be explained by the Large Eddy Simulation model, which can predict the time‐dependent flow. The number of inclusions increases as the bubble diameter and the distance of the position of entrapment from the top free surface increase. This indicates that bubbles collect inclusions while traveling in the molten steel in the continuous caster. A simple mathematical model is presented to explain the mechanism by which inclusions become attached to bubbles.