Preoperative sonographic diagnosis of acute appendicitis caused by Ascaris lumbricoides

Acute appendicitis caused by Ascaris lumbricoides is an uncommon variant of a common disease. We describe a case in which sonography was used for preoperative diagnosis of ascaris appendicitis.     

Femoral hernia

BACKGROUND: Atopy is reported to play an insignificant role in wheezing during infancy in contrast to later childhood. For this reason skin testing may not be included in a workup of wheezing infants. OBJECTIVE/METHOD: In order to evaluate the degree and evolution of skin sensitization to allergens in infants with asthma, we have retrospectively analyzed the skin test results from 40 referred asthmatic children less than 36 months of age, who had had more than three wheezing episodes and whose symptoms improved on treatment with beta-agonist and anti-inflammatory agents. RESULTS: Skin sensitization (epicutaneous) to common indoor and outdoor aeroallergens and foods were demonstrated in 23 (58%) of these patients. Asthmatic children with the onset before 12 months of age and duration of less than 12 months were sensitive predominantly to foods. Those with later onset asthmas and longer duration developed sensitivity first to indoor and then to outdoor allergens. The most common food, indoor, and outdoor allergens were egg, dust mite, and pollens, respectively. Six of these patients had repeat skin tests later. Two demonstrated a decrease in skin sensitivities to foods, one gained a new sensitivity to grass, while three remained unsensitized. CONCLUSION: Skin sensitization to allergens was common in selected asthmatic infants and evolves in the order of exposures: foods, indoor allergens, and outdoor allergens. Repeat skin tests showed changing skin test patterns in some patients.     

Fast fluid-attenuated inversion-recovery imaging: first experience with a 3D version in epilepsy

Breast reconstruction has been the subject of many controversies. It now seems generally agreed however that the operation has no deleterious influence on the follow up of breast cancer patients and that it has favorable psychologic effects. Breast reconstruction can be performed either by using prostheses or analogous tissues. These two different modalities have each their own advantages and limitations. Deep knowledge of the techniques and their indications allows to select the most appropriate approach in the individual patient and, thus, to improve long term results.     

Stimulation of cis-diamminedichloroplatinum(II) accumulation by modulation of passive permeability with genistein: an altered response in accumulation-defective resistant cells

The effect of the tyrosine kinase inhibitor genistein on the accumulation of cisplatin (DDP) was investigated in DDP-sensitive and -resistant human 2008 ovarian carcinoma cell lines. DDP accumulation after a 1-h exposure was maximally increased by concurrent 40 micrometer genistein. The maximal stimulation of accumulation was observed after 2 h of total genistein exposure and was 83 +/- 13% (n = 5) higher than controls. With resistant C13(*) cells, however, the stimulation of accumulation was delayed until 4 h and was increased only 46 +/- 18% compared to controls. Revertant RH4 cells that retained the accumulation defect behaved like the C13(*) cells. Genistein stimulated [3H]mannitol accumulation (a marker of passive permeability) by 43 +/- 9% (n = 3) in 2008 cells, and the effect was maximal after 2 h of total genistein exposure. Changes in [3H]mannitol accumulation in 2008 parent cells were highly correlated with DDP accumulation (r = 0.9010). These experiments also revealed that [3H]mannitol accumulation after 2 h in C13(*) cells was reduced 38% compared to 2008 cells, a decrease that reflected the DDP accumulation defect. Fluid-phase pinocytosis determined with lucifer yellow CH as a marker showed no difference between 2008 and C13(*) cells and no effect of genistein. Genistein was demonstrated to clearly inhibit protein-tyrosine phosphorylation initiated by the epidermal growth factor receptor kinase. Differences were noted in the phosphotyrosine pattern between the 2008 and C13(*) cells. Under the conditions that had the maximal effect on DDP accumulation in 2008 cells, genistein decreased the IC50 of DDP 8.2-fold in 2008 cells and 4.7-fold in C13(*) cells. We conclude that: (a) genistein stimulates DDP accumulation by modulating the passive permeability of the plasma membrane; (b) C13(*) cells are less permeable to passively diffusing small molecules, which offers a mechanism for the DDP accumulation defect without invoking carrier proteins; (c) the effect of tyrosine kinase inhibition on passive permeability is altered in C13(*) cells; and (d) pinocytosis contributes insignificantly to DDP accumulation. Genistein, a dietary isoflavone, thus seems to be a promising clinical candidate for combination with DDP.     

Ribonuclease A variants with potent cytotoxic activity

Select members of the bovine pancreatic ribonuclease A (RNase A) superfamily are potent cytotoxins. These cytotoxic ribonucleases enter the cytosol, where they degrade cellular RNA and cause cell death. Ribonuclease inhibitor (RI), a cytosolic protein, binds to members of the RNase A superfamily with inhibition constants that span 10 orders of magnitude. Here, we show that the affinity of a ribonuclease for RI plays an integral role in defining the potency of a cytotoxic ribonuclease. RNase A is not cytotoxic and binds RI with high affinity. Onconase, a cytotoxic RNase A homolog, binds RI with low affinity. To disrupt the RI-RNase A interaction, three RNase A residues (Asp-38, Gly-88, and Ala-109) that form multiple contacts with RI were replaced with arginine. Replacing Asp-38 and Ala-109 with an arginine residue has no effect on the RI-RNase interaction. In addition, these variants are not cytotoxic. In contrast, replacing Gly-88 with an arginine residue yields a ribonuclease (G88R RNase A) that retains catalytic activity in the presence of RI and is cytotoxic to a transformed cell line. Replacing Gly-88 with aspartate also yields a ribonuclease (G88D RNase A) with a decreased affinity for RI and cytotoxic activity. The cytotoxic potency of onconase, G88R RNase A, and G88D RNase A correlate with RI evasion. We conclude that ribonucleases that retain catalytic activity in the presence of RI are cytotoxins. This finding portends the development of a class of chemotherapeutic agents based on pancreatic ribonucleases.