Requirement for multiple lymphocyte subsets in protection by a live attenuated vaccine against retroviral infection

STUDY DESIGN: A case report and literature review of thoracic hyperkyphosis deformity secondary to glucocorticoid-induced osteoporosis in Cushing's disease. OBJECTIVES: To identify the pathophysiology of glucocorticoid-induced osteoporosis and to outline the diagnosis and treatment options for a patient with severe spinal deformity secondary to unrecognized excess glucocorticoid activity. SUMMARY OF BACKGROUND DATA: Glucocorticoid-induced osteoporosis is seen in patients exposed to supraphysiologic levels of endogenous or exogenously administered glucocorticoids. In these patients, glucocorticoids act to suppress bone formation and increase bone resorption by indirect and direct effects. These patients have a high prevalence of trabecular bone loss, resulting in much higher rates of vertebral body collapse and pathologic fracture and thus causing an increased propensity toward kyphotic spinal malalignment. METHODS: The literature was reviewed and case reports studied. This case report highlights the pathophysiology of the disease process that caused the spinal deformity and the surgical intervention used to correct the kyphotic deformity after the metabolic problem was resolved. RESULTS: This patient has responded well to treatment and surgical intervention to correct a thoracic hyperkyphotic deformity without complication. CONCLUSIONS: Unrecognized endogenous production of glucocorticoids in Cushing's disease should be considered in young adult patients with progressive osteoporotic spinal deformities.     

The crystal structure of human procathepsin K

Cathepsin K is a cysteine protease present in human osteoclasts that plays an important role in bone resorption. Cathepsin K is synthesized as an inactive proenzyme and activated under conditions of low pH. Autoproteolytic processing of the N-terminal 99 amino acid propeptide produces the active, mature form of cathepsin K. It is presumed that the activation of procathepsin K in vivo occurs in the bone resorption pit, which has a low-pH environment. We have determined the structure of human procathepsin K at 2.8 A resolution. The structure of the mature enzyme domain within procathepsin K is virtually identical to that of mature cathepsin K. The fold of the propeptide of procathepsin K is similar to that observed in procathepsins B and L despite differences in length and sequence. A portion of the propeptide occupies the active site cleft of cathepsin K. Hydrophobic interactions, salt bridges, and hydrogen-bonding interactions are observed in the structure of the propeptide and between the propeptide and the mature enzyme of procathepsin K. These interactions suggest an explanation for the stability of the proenzyme. The structure of procathepsin K contributes to an understanding of the molecular basis of inhibition by the propeptide portion of the molecule and activation of this important member of the cysteine protease family.     

Tinnitus: etiology and management

Tinnitus is the perceived sensation of sound in the absence of acoustic stimulation. Individuals who suffer from it are commonly between the ages of 40 and 80 years. Tinnitus is often classified as objective or subjective, yet the pathophysiologic cause is still unknown. Subjective tinnitus is largely identified with hearing loss. Management of tinnitus is based on an individual approach; there is no single treatment or regimen for it.     

Cotton growth and yield as influenced by different timing of late-season foliar nitrogen fertilization

Foliar fertilization to meet the nitrogen (N) requirement of the cotton crop during the latter fruiting stages is a production practice that is not well understood. The objective of this study was to investigate the benefits of late-season foliar-N fertilization on growth and yield of cotton in relation to soil-N level and timing based on weeks after first flower (WAFF) and nodes above white flower (NAWF). A 4-year field study was conducted with four foliar-N treatments consisting of a control with no foliar-N, and one, two, or three foliar-N sprays under different soil-N regimes. In 1990, the foliar-N treatments were based on WAFF sprayed during fifth, sixth and seventh WAFF. Foliar-N significantly increased nodes above white flower (NAWF) over the control with no significant differences among the three foliar-N treatments. A negative relationship (r2=0.98) existed between NAWF and days after planting (DAP). Foliar-N also significantly increased plant height, leaf number, leaf area, leaf dry weight, boll number, boll dry weight and yield. The same foliar-N treatments were applied on low and high soil-N regimes in 1991 and 1992, and in 1993 on four different soil-N regimes, 0, 55, 82, and 110 kg N ha-1 at NAWF = 7, 6 and 5. No significant difference was found in NAWF among the four foliar-N treatments within each soil-N level during 1991. Significant differences between the control and the three foliar-N sprays were found for leaf area, boll number, and boll dry weight. In 1992, the NAWF of control plants showed a similar response to the 1990 control plants. In contrast, the foliar-N sprayed plants extended the highest NAWF for an additional week, after which it steadily declined below 5. Foliar-N significantly increased yield in 1990, yield and yield components in 1991 and 1992, and yield in 1993. Neither WAFF nor NAWF appear to be good indicators for timing late-season foliar-N fertilization. The study clearly demonstrated, however, that late-season foliar-N fertilization is beneficial to cotton plants, although the precise timing of such N application is still unclear.     

Use of computed radiography in the study of an historic painting

The authors demonstrate the use of radiography in the investigation of an historic painting and describe the potential benefits of computed radiography compared with conventional screen-film radiography. The subject for the comparison was a 16 x 19-foot oil-on-canvas painting, Scipio Africanus Freeing Massiva, by Giovanni Battista Tiepolo. Radiographs of the painting were obtained by using a portable, industrial radiographic unit and both conventional screen-film and photostimulable phosphor plate cassettes. For this investigation, computed radiography had a number of advantages over screen-film radiography, largely due to its wider dynamic range and its capabilities for enhancing the digital images with image processing tools such as magnification, edge enhancement, colorization, and airbrushing. The ability to electronically combine images from the large painting into a single composite image file was extremely valuable, as this technique was much less cumbersome and resulted in much higher quality composite images than could be achieved with conventional radiography. An additional advantage of computed radiography includes the capability to easily archive and transmit these images in a digital format for subsequent review.     

UVB irradiation alters cellular responses to cytokines: role in extracellular matrix gene expression

Chronic myeloid leukemia course was evaluated versus sex in 271 patients. Chronic stage involved more pronounced leukocytosis, thrombocytosis and splenomegaly in females, the latter showing higher susceptibility to anemia. As a result, treatment has to deal with a greater mass of tumor. A relatively longer survival time in males (44 and 42 months, respectively) suggest a higher effectiveness of therapy in such patients. When diagnosed, leukocytosis, thrombocytosis, enhanced splenomegaly and anemia should be regarded as factors of unfavorable prognosis.     

Fast fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging of the brain: a comparison of multi-shot echo-planar and fast spin-echo techniques

PURPOSE: To evaluate fast spin-echo and multi-shot echo-planar fluid-attenuated inversion recovery (FLAIR) sequences in paediatric brain imaging. MATERIALS AND METHODS: Matched images from 32 patients with suspected tumour or white matter disease were independently evaluated by two paediatric neuroradiologists. The observer preferences for image quality and lesion detection were analysed for differences between fast spin-echo FLAIR and multi-shot echo-planar FLAIR. Diagnostic quality was compared with that of fast spin-echo T2-weighted images. RESULTS: Images of a diagnostic quality equivalent to that of fast spin-echo T2-weighted images were achieved with both FLAIR techniques. Grey and white matter differentiation and cerebrospinal fluid (CSF) nulling were significantly better on fast spin-echo FLAIR sequences. CSF flow artefact was reduced on multi-shot echo-planar FLAIR. There was no difference in lesion detection. Fast spin-echo FLAIR images were visually preferred at the expense of longer imaging time. CONCLUSION: Fast FLAIR techniques are complementary to fast spin-echo T2-weighted sequences in imaging of the paediatric brain. We find that the fast spin-echo FLAIR sequence is preferable to the multi-shot echo-planar technique.     

Flexor digitorum accessorius longus muscle: an etiology of tarsal tunnel syndrome?

Body image, as measured by the Appearance Evaluation and Body Areas Satisfaction scales of the Multidimensional Body-Self Relations Questionnaire (T.F. Cash, 1994b), was assessed in 59 obese women before, during, and after 48 weeks of weight loss treatment. Before treatment, positive ratings of body image were associated with higher levels of self-esteem, lower levels of dysphoria, and fewer previous diets. After 24 weeks and a mean weight loss of 19.4 kg (SD = 6.5), participants showed significant (p < .0001) improvements in body image. A small weight gain from Week 24 to Week 48 was associated with a slight but significant worsening in both measures of body image. Nevertheless, after 48 weeks and a mean weight loss of 16.3 kg (SD = 7.1), body image was significantly improved from baseline (p < .0001). Changes in body image were not related to changes in weight. Future studies are needed to separate the effects of treatment and weight loss on body image in obese persons.