Quantification of information transfer via cellular signal transduction pathways

OBJECTIVE: Symptomatic malignant pleural effusions are common sequelae in patients with certain malignancies. Pleurodesis via bedside thoracostomy is the current treatment option most commonly used. To our knowledge, this is the first prospective randomized trial to examine which agent, bleomycin or talc slurry, is superior in terms of effectiveness, safety, and cost. PATIENTS AND METHODS: Between July 1992 and March 1995, 35 patients presenting to our medical center with symptomatic malignant pleural effusions were prospectively randomized to undergo chemical pleurodesis with either bleomycin or talc slurry via bedside thoracostomy. The conditions of patients were assessed and graded before and after treatment concerning pain, dyspnea, and chest radiographs. RESULTS: Twenty-nine patients who underwent 33 treatments (14 with bleomycin and 19 with talc) were available for follow-up. Follow-up ranged from 2 weeks to 8 months (mean, 1.7 months). Both groups demonstrated notable improvement in both pain and dyspnea following treatment, but there were no statistically significant differences between groups in the amount of improvement (two-tailed Student's t test). Permanent control of effusions, defined objectively on chest radiograph, was achieved with 11 bleomycin treatments (79%) and 17 talc treatments (90%) (p=0.388). The procedures were well tolerated and no significant adverse effects were observed. Talc is a much less costly agent than bleomycin ($12.36 cost to our medical center per treatment for talc vs $955.83 for bleomycin). CONCLUSION: Given the similar efficacy and significant cost advantage, we conclude that talc is the agent of choice when utilizing pleurodesis for control of symptomatic malignant pleural effusions.     

Comparison of radiological procedures in preoperative assessment of anchorage strength of spinal implants

PURPOSE: To compare three techniques with regards to their ability to estimate pull out strength of spinal fusion hardware. MATERIAL AND METHODS: VDS-screw fixation strength in 50 human cadaveric vertebral bodies was approximated by means of pull out force measurement. Bone quality was assessed by Dual X-ray Absorptiometry (DXA). Quantitative Computed Tomography (QCT) and T2*-relaxation time. For each of these techniques, correlation with axial pull out force strength was investigated. RESULTS: Highest correlation was found for cancellous bone density measured by QCT (r = 0.72; p < 0.001). Immediately followed by DXA (r = 0.70; p < 0.001), which involves all bone components. Inverted T2*-relaxation time (r = 0.55; p < 0.001) and cortical bone density (QCT) correlated just slightly with pull-out force strength. CONCLUSIONS: Absorptiometrical techniques like QCT and DXA are most appropriate to estimate VDS-screw fixation strength preoperatively.     

Urologic applications of multiplanar and three-dimensional computed tomography

The introduction of helical computed tomography (CT) has resulted in improved quality of multiplanar reformations and three-dimensional reconstructions in the chest and abdomen and has made CT angiography a clinical reality. These imaging techniques are useful for evaluating the urinary tract, adding a new dimension to its display, resulting in improved diagnosis of renal and perirenal disease. This article reviews the indications and techniques utilized for multiplanar and three-dimensional CT for urology. The advantages and limitations are discussed, and normal and pathologic findings in the urinary tract illustrated.     

The eight-amino acid internal loop of PSI-C mediates association of low molecular mass iron-sulfur proteins with the P700-FX core in photosystem I

The PSI-C subunit of photosystem I (PS I) shows similarity to soluble 2[4Fe-4S] ferredoxins. PSI-C contains an eight residue internal loop and a 15 residue C-terminal extension which are absent in the ferredoxins. The eight-residue loop has been shown to interact with PSI-A/PSI-B (Naver, H., Scott, M. P., Golbeck, J. H., Moller, B. L., and Scheller, H. V. (1996) J. Biol. Chem. 271, 8996-9001). Four mutant proteins were constructed. Two were modified barley PSI-C proteins, one lacking the loop and the C terminus (PSI-Ccore) and one where the loop replace the C-terminal extension (PSI-CcoreLc-term). Two were modified Clostridium pasteurianum ferredoxins, one with the loop of barley PSI-C and one with both the loop and the C terminus of PSI-C. Wild-type proteins and the mutants were used to reconstitute barley P700-FX cores lacking PSI-C, -D, and-E. Western blotting showed that PSI-CcoreLc-term binds to PS I, whereas PSI-Ccore does not. Without PSI-D the PSI-CcoreLc-term mutant accepts electrons from FX in contrast to PSI-C mutants without the loop. Flash photolysis of P700-FX cores reconstituted with C. pasteurianum ferredoxin showed that only the ferredoxin mutants with the loop accepted electrons from FX. From this, it is concluded that the loop of PSI-C is necessary and sufficient for the association between PS I and PSI-C, and that the loop is functional as an interaction domain even when positioned at the C terminus of PSI-C or on a low molecular mass, soluble ferredoxin.     

Fine structure of hepatocytes during the etiology of several common pathologies

Hepatocytes respond to injury by a few basic pathological reactions that are reflected in cell death, different types of degeneration, regeneration, or tumorous transformation. At the ultrastructural level, alterations of cell organelles can be observed in different combinations as a result of the injury, depending on the etiological agent(s) or pathological conditions developed. Nuclear bodies, dilation and fragmentation of rough endoplasmic reticulum (rer), swelling of mitochondria, and an increased number of lysosomes occur during acute viral hepatitis. The core and surface components of the hepatitis B virus can be localized in the liver cells in chronic hepatitis and in carriers. Close contact of hepatocytic and lymphocytic cell membranes were observed in chronic active hepatitis. Hepatocytes surrounded by an increased amount of collagen fibers are characteristic of cirrhosis. Loosely arranged, fine fibrils or condensed forms of Mallory bodies are pathognomic for alcoholic injury. A wide spectrum of alterations are noted after drug treatment: the proliferation of smooth endoplasmic reticulum (ser) as an adaptive phenomenon, focal or complete necrosis of the cell, inflammation, and the like. The fine structural analysis of hepatocytic inclusions in storage diseases has a differential diagnostic value. The storage of copper and other elements can be measured by x-ray microanalysis. The study of the hepatocytic differentiation in liver tumors is highly important in establishing the diagnosis and in proving the hepatocytic origin of the tumor.     

Methotrexate and misoprostol for early abortion

The Walkabout is a new hip-knee-ankle-foot orthotic (HKAFO) system with a medial single hip joint (MSH-KAFO) invented by S. McKay in 1992. Compared with other HKAFO systems, the hip joint part is compact and removable, so it has distinguishable, real merits: ease in donning and doffing the device, compatibility with a wheelchair, and cosmesis. We clinically tested five patients, paraplegic because of spinal cord injury, using the MSH-KAFO system. All were males, aged 26-36 yr old. Their functional levels were L-1 (2 cases), T-10 (2 cases), and T-5 (1 case). All patients could stand stably without crutches and walk in parallel bars immediately the first time they wore the braces. After a few hours of crutch-walking exercises, all could walk independently with Lofstrand crutches. Their walking velocities ranged from 10 to 37.5 (mean, 19.9) m/min at the follow-up points (mean, 7.1 mo). With four cases, we measured oxygen uptake for predictions of energy consumption. At comfortable walking, predicted energy consumptions were from 1.31 to 3.89 (mean, 2.75) METs. Compared with the data in literature, these seemed to be at the same level with normal walking and lower than the KAFOs walking level. Our results suggest that MSH-KAFO is a very convenient standing and walking device for paraplegics and is compatible with wheelchair use.     

Enhanced mechanical properties of lightweight Al2O3-C refractories reinforced by combined one-dimensional ceramic phases

We prepared a new lightweight Al₂O₃-C refractory material with a higher strength by using microporous corundum aggregates instead of dense tabular corundum aggregates, which was reinforced by in situ formed SiC whiskers, multi-walled carbon nanotubes (MWCNTs), and mullite rods. A comparative study of the microstructure, mechanical properties, and fracture behavior was carried out for dense and lightweight Al₂O₃-C refractories coked at 1200°C and 1400°C, respectively. By using the microporous corundum aggregates, a better aggregate/matrix interface bonding and an optimized distribution of SiC whiskers were obtained. The SiC whiskers formed inside the microporous corundum aggregates and simultaneously in the matrix by a vapor-solid reaction mechanism, resulting in an enhancement at the microporous aggregate/matrix interface. Furthermore, the in situ formed MWCNTs and well-developed mullite rods at 1200°C in the matrix also contributed to the better interface structure. Thus, due to the improved microporous aggregate/matrix interface, the crack propagation along the aggregate/matrix interface was suppressed, resulting in an increased crack propagation within the aggregates. Consequently, the synergy between microporous corundum aggregates and combined one-dimensional ceramic phases caused a lower bulk density but a markedly higher strength, a higher fracture energy, and a higher toughness of lightweight Al₂O₃-C refractories compared to the dense ones. Overall, our study allows to overcome the traditional concept that a higher strength of refractories is reached by a higher density.