MR of the heart under pharmacologic stress

Magnetic resonance imaging is one method for assessing cardiac function and perfusion at rest and under stress conditions. In this article, the potential of stress magnetic resonance imaging for evaluating ischemic heart disease is reviewed, and technical aspects of some developments that may contribute to comprehensive magnetic resonance imaging assessment of heart disease under rest and stress are discussed.     

Organ injury scaling: spleen and liver (1994 revision)

A case of haemangiopericytoma of the greater omentum is reported here. We discuss the presentation, treatment and prognosis of these rare tumours.     

Quantification of the nucleocytoplasmic distribution of wild type and modified proteins using confocal microscopy: interaction between 90-kDa heat shock protein (Hsp90 alpha) and glucocorticosteroid receptor (GR)

Elastin is a major protein component of the vascular wall and is responsible for its unusual elastic properties. Polymers of its repeating VPGVG sequences have been synthesised and shown to exhibit an inverse temperature transition where, as temperature rises, the polymer collapses from an extended chain to a beta-spiral structure with three VPGVG units per turn, each pentamer adopting a type II beta-turn conformation. These studies, however, have not established whether the temperature-driven conformational change is an intrinsic property of the individual pentameric sequences or a global, co-operative effect of many pentamers within the beta-spiral structure. Here, we examine by circular dichroism the behaviour of elastin-like peptides (VPGVG)n, where n varies between 1 and 5. Remarkably, we find that all lengths of peptide undergo an extended left and right arrow beta-turn transition with increasing temperature, suggesting that the induction of the beta-spiral occurs at the level of single pentameric units. The origin of this effect is a positive DeltaS term for the transition. At 35 degreesC, the average transition midpoint temperature, the value of TDeltaS is about 15 kcal mol-1. With larger oligomers (n=3), there is only a modest rise in DeltaS, suggesting that the dominant entropic effect resides within the monomer and that interactions between these units make only a small contribution to the energetics of the transition. Charges at the termini, and residue replacements or additions, regulate the transitions for the short peptides in a manner similar to that observed for the longer polymers. The behaviour of the same peptides in trifluoroethanol and SDS solutions is consistent with formation of the beta-turn being driven by interactions between non-polar groups. The significance of this behaviour for the rational design of temperature-induced responses in proteins is discussed.     

Fourier-transform Raman spectra of ivory. III: Identification of mammalian specimens

The FT-Raman spectra of six mammalian ivories, other than elephant and mammoth, are presented and spectral differences formulated into a protocol for the identification of animal species from the ivory samples. In this study, sperm whale, walrus, wart hog, narwhal, hippopotamus and domestic pig are considered. The results, which are obtained non-destructively from a variety of specimens, suggest that FT-Raman spectroscopy provides a potentially useful method for the identification of mammalian ivory.     

Radiographic sizing for meniscal transplantation

Allograft or synthetic meniscal replacement has the potential to delay the arthritic sequelae of the meniscectomized knee. Meniscal implants must, however, be side and size specific. A cadaveric study was performed in which medial and lateral menisci were painted with a radiopaque tantalum powder-cyanoacrylic mixture. Radiographs of this preparation demonstrated reproducible relationships between each meniscus and established bony landmarks. When corrected for magnification, meniscal size could be derived from plain films. Meniscal width equaled the distance (coronal) from the peak of the tibial eminence to the periphery of the tibial metaphysis on anteroposterior films. Meniscal length was measured from lateral radiographs. Medial meniscal length was 80%, and lateral meniscal length was 70% of the measured sagittal length of the tibial plateau. Measurement error averaged 7.8% by these parameters.     

Cyclohexane transformation during water chlorination

Cyclohexane transformation was studied during water chlorination. Three mechanisms of cyclohexane transformation in the presence of chlorine were determined. Over 70 reaction products were identified. Five of them have mutagenic activity.     

Past, present, and future of obesity surgery

The ribulose bisphosphate carboxylase/oxygenase rbcL and rbcS genes of a carbon monoxide-oxidizing bacterium, Hydrogenophaga pseudoflava DSM 1084, were cloned and sequenced. The cloned rbcL and rbcS genes had open reading frames of 1422 and 351 nucleotides encoding RbcL and RbcS with calculated molecular masses of 52,689 and 13,541, respectively. The known active site residues in other RbcL proteins were conserved in the H. pseudoflava proteins. The H. pseudoflava RbcS protein lacked the 12-residue internal sequence found in the plant enzymes. The 2 genes were separated by a 134 bp intergenic region and cotranscribed as a 2.0 kb rbcLS mRNA. Novel two perfect 9 bp direct repeats overlapping with two dyad symmetries were found in the rbcLS promoter region.     

Surgical treatment of cicatricial biliary strictures

BACKGROUND/AIMS: Cicatricial biliary strictures are usually associated with high morbidity and mortality rates, frequently related to technical difficulties of their surgical repair, mainly in hilar lesions. Interference with bile duct blood supply during surgical attempts for correction is a major factor for unsuccessful results. The aim of this study is to evaluate, after an extended follow-up period, the results obtained with a modified technique for surgical correction of cicatricial biliary strictures. METHODOLOGY: The medical records of 57 patients surgically treated for cicatricial biliary strictures between January 1984 and July 1995 were reviewed and the immediate and long term results retrospectively analyzed. Patients consisted of 46 females and 11 males. The average age was 43 years. The etiology of the biliary lesion was: cholecystectomy alone (23); cholecystectomy with duct exploration (8); T tube CBD drainage (6); Biliary-enteric anastomosis stricture (16); choledochoplasty (2) and trauma (2). In 28 cases (49.1%) the stricture was located in the upper third of the bile duct, in 28 (49.1%) in the middle third and in one case (1.7%) it was low. All patients were submitted to longitudinal Roux-en-Y hepaticojejunostomy with mucosa apposition after dissection of the anterior aspect of the biliary tract. No transanastomotic stents were used. RESULTS: Ten patients (17.5%) presented 11 postoperative complications: biliary fistula (4), duodenal fistula (1), wound infection (5), and acute pancreatitis (1). Average hospital stay was 11 days and there were no postoperative mortalities. The follow-up study was possible in 54 patients and ranged from one to ten years, with an average of 2.9 years. Four patients of 28 (14%) with hilar lesions developed stricture recurrence and cholangitis episodes, whereas no patients bearing lesions below the biliary junction had such complications. CONCLUSION: Roux-en-Y hepaticojejunostomy with mucosa apposition without transanastomotic stent performed after minimal dissection of the biliary duct, thus avoiding major interference with the bile duct blood supply, is a safe and efficient method for the surgical repair of cicatricial biliary strictures. Using this technique excellent results can be obtained in the lesions below the biliary junction and acceptable results may be achieved in patients with hilar lesions.