The natural history of the cervical foramen in symptomatic and asymptomatic individuals aged 20-60 years as measured by magnetic resonance imaging. A descriptive approach

STUDY DESIGN: This study was intended to identify normal degenerative morphologic evolution in the bony foramen in asymptomatic subjects by decade in comparison with symptomatic subjects of like decades. OBJECTIVES: To determine normal degenerative changes in the cervical spine caused by the aging process that predispose a person to foraminal stenosis and radiculopathy. SUMMARY OF BACKGROUND DATA: Cervical radiculopathy is a common problem caused by degenerative changes as people age. The characteristics of the foramen that result in stenosis are not known. METHODS: Five to six symptomatic and asymptomatic people in each decade volunteered for magnetic resonance imaging. Lordosis, disc heights, and ratio of spinal cord diameter to spinal canal diameter were measured at C4-C5, C5-C6, and C6-C7 from sagittal magnetic resonance images. Foraminal heights, widths, and areas were measured at the isthmus of the same foramen from oblique images. RESULTS: Foraminal heights, widths, and areas were larger in asymptomatic patients than in symptomatic patients. Morphologic analysis showed that inferior facet hypertrophy tended to decrease the width of the foramen in aging people. Disc heights, lordosis, and ratio of spinal cord diameter to spinal canal diameter showed no significant differences. CONCLUSIONS: Foraminal height affects overall foraminal area but tends to change little with age. Width also affects overall area and not only decreases in older people but also significantly affects the available area for the exiting nerve root.     

Value of CT angiography for postoperative assessment of patients with iliac artery aneurysms who have received endovascular grafts

OBJECTIVE: To determine the pathologic outcome in human immunodeficiency virus (HIV)-seropositive individuals with nonspecific bronchoalveolar lavage (BAL) cytology. STUDY DESIGN: The study group consisted of 126 cytologically negative or nonspecific BAL specimens from HIV-seropositive adults. Concurrent microbial cultures and transbronchial biopsies, as well as subsequent pulmonary cytology, lung biopsy or autopsy results were reviewed. Additionally, the cytologic morphology of specimens from patients found to have a potential bacterial pathogen was reviewed. RESULTS: In the 126 cases with nonspecific BAL cytology, a potential pulmonary pathogen was identified from a concurrent or subsequent pathologic specimen in 27% of cases, while no pathogen was identified in 73% of cases. Bacteria and fungi were the most common pathogens identified. Microbial cultures alone identified the pathogen in 59% of cases, while transbronchial biopsy added information in only 9%. Specimens with marked acute inflammation often yielded bacterial pathogens on microbial culture. CONCLUSION: A potential pulmonary pathogen can be identified in 27% of HIV-seropositive individuals with negative BAL cytology using other diagnostic modalities. Bacterial pathogens are most common and are usually identified by microbial culture. Marked acute inflammation in a BAL specimen is often associated with bacterial pneumonia.     

Antibodies to beta2-glycoprotein I in systemic lupus erythematosus: new laboratory marker of antiphospholipid syndrome

Antibodies to beta 2-glycoprotein in the serum of patients with antiphospholipid syndrome (APS) were found by many investigators, but their results appeared contraversional. We studied clinical significance of antibodies to beta 2-glycoprotein I (anti-beta 2-GPI) in patients with SLE. 69 patients with verified SLE were examined for lupus anticoagulant (LA), antibodies to cardiolipin (aCL) and anti-beta 2-GPI. 44(65%), 46(67%), 49(71%), 19(28%), 16(23%) patients were positive for LA, IgG-aCL, IgM-aCL, IgG-anti-beta 2-GPI and IgM-anti-beta 2-GPI, respectively. Hyperproduction of IgG-anti-beta 2-GPI correlated with APS development as a whole, its separate clinical symptoms (venous and arterial thromboembolism, obstetric pathology and thrombocytopenia) and some comcomitant clinical signs (trophic crural ulcer, hemolytic anemia, valvular heart disorders). Moreover, an increase in concentration of IgM-anti-beta 2-GPI was associated with habitual abortion. Both isotypes of anti-beta 2-GPI occurred more frequently in the sera positive by LA and aCL. It is interesting that we discovered IgG-anti-beta 2-GPI more often in early than late postthrombolytic period. Thus, anti-2b2-GPI is a new serological marker of APS. Its detection is clinically important for upgrading diagnosis of APS.     

Cyclophosphamide, methotrexate, and chronic oral tegafur modulated by folinic acid in the treatment of patients with advanced breast carcinoma

BACKGROUND/AIMS/METHODS: The distribution characteristics of a human colon carcinoma cell line, KM12-HX cells, were examined. After intraportal vein (i.p.v.) or intravenous (i.v.) injection into rats, almost all the injected tumor cells are distributed to liver or lung, respectively, both after 30 s and 30 min. Our previous kinetic analysis of the fate of tumor cells revealed that the cumulative amount of tumor cells distributed in the liver is a factor determining the degree of metastasis. Thus, we examined the mechanism of initial efficient trapping of tumor cells by the liver in more detail. RESULTS: Thirty minutes after tumor cells were injected into the left ventricle of the heart, the distribution of tumor cells was more restricted in several tissues (kidney, small intestine, large intestine and spleen), as compared with the distribution of microspheres undergoing 100% extraction, indicating that the first-pass extraction of KM12-HX cells is incomplete in these organs. The hepatic first-pass distribution of these tumor cells was unaffected by pretreatment of liposomes, such that the preinjected amount was sufficient to saturate the phagocytotic function of macrophages. Thus, the mechanism of initial distribution of the tumor cells to the liver is different from the mechanism of liposome uptake by macrophages. Considering that the diameter of microvessels in sinusoid and KM12-HX cells is approximately 7 and 12 microm, respectively, it is possible that these tumor cells are trapped physically in hepatic microvessels. In fact, after i.p.v. injection of microspheres 5 microm in diameter, only 20% of the dose was distributed to liver and the rest to other tissues. In contrast, almost 100% of microspheres 10 microm in diameter were distributed to the liver. CONCLUSIONS: These results support the hypothesis that the initial organ distribution of blood-borne tumor cells is determined by mechanical and physical properties of the cells.     

Butylated hydroxytoluene modulates DNA methylation in rats

This study was a replication of an earlier Cochran & Ganong study that investigated the perception of nurses and patients regarding the stressors faced by patients in the intensive care unit environment. As the original study was American in origin, one of the aims of the present study was to discover if the results would be replicated in a United Kingdom (UK) intensive care unit. Data collection was by the use of an environmental stress questionnaire that was an adaptation of the original data collection tool modified for use in a UK intensive care unit. The study was undertaken in two intensive care units producing a sample size of 71 patients and 71 nurses. There appears to be a wide variation in the perception of nurses and patients regarding the stress faced by patients in the intensive care unit. Similarities were noted between subject groups as to the nature of the stressors, although nurses tended to rate items over which they believed they had control as being more stressful than did the patients. Patients tended to rate items related to their illness and physical comfort as being most stressful. The results are in keeping with those from the Cochran & Ganong study.     

Structure of a highly acidic O-specific polysaccharide of lipopolysaccharide of Pseudoalteromonas haloplanktis KMM 223 (44-1) containing L-iduronic acid and D-QuiNHb4NHb

An acidic O-specific polysaccharide was obtained by mild acid degradation of the lipopolysaccharide isolated by phenol-water extraction of Pseudoalteromonas haloplanktis strain KMM 223 (44-1). L-Iduronic acid (IdoA) was found to be a component of the polysaccharide and identified by NMR spectroscopy and after carboxyl-reduction followed by acid hydrolysis and acetylation, by GLC-MS as 2,3,4-tri-O-acetyl-1,6-anhydroidose. On the basis of 1H and 13C NMR spectroscopic studies, including 1D NOE, 2D NOESY, HSQC and HMBC experiments, the following structure of the branched pentasaccharide repeating unit of the polysaccharide was established: -->4)-beta-D-GlcpAI-(1-->4)-beta-D-GlcpAII-(1-->3)-beta-D-++ +QuipNHb4NHbII- (1-->2)-alpha-L-IdopA-(-->4 increases 1 alpha-D-QuipNAc4NAcI where QuiNAc4NAc and QuiNHb4NHb are 2,4-diacetamido-2,4,6-trideoxyglucose and 2,4,6-tri-deoxy-2,4- di[(S)-3-hydroxybutyramido]glucose, respectively. This is the first report of L-iduronic acid in a lipopolysaccharide and of D-QuiNHb4NHb in nature.     

Determination of avermectins in plasma at nanogram levels using high-performance liquid chromatography with fluorescence detection

An analytical method is described for the determination of the avermectins in plasma based upon high-performance liquid chromatography of fluorescent derivatives of these compounds. The analyte is isolated by adsorption chromatography on Florisil, dehydrated in an acetic anhydride-pyridine mixture, and the fluorophore is further separated by chromatography on silica gel in advance of introduction into a reversed-phase system. This method, which can be applied to samples containing as little as 0.2 ng drug per ml, has an accuracy of 5% mean relative error and a precision of 8% relative standard deviation. A study and discussion of several factors which affect the analytical reaction are included.     

Comparison of the isoacceptor makeup of transfer RNA for 2 early stages in the development of loach embryos

The chromatographic profiles of isoacceptor tRNA's for 9 amino acids from the loach embryos at two early developmental stages were compared by the method of chromatography on sepharose column in the decreasing gradient of ammonium sulphate concentration to elucidate the possible role of tRNA in the control of early embryogenesis processes. Certain differences both in the proportions of some isoacceptor peaks and their relative positions on the chromatographic profile were found for 8 aminoacyl tRNA. Methionyl-tRNA was represented by one constant peak.     

Identification of a novel polyproline recognition site in the cytoskeletal associated protein, proline serine threonine phosphatase interacting protein

Protein-protein interactions are often mediated by the recognition of proline-rich domains by SH3 or WW modules. Previously, we demonstrated that the PEST-type protein-tyrosine phosphatase, PTP HSCF (hematopoietic stem cell fraction), bound to a novel cytoskeletal associated protein, proline serine threonine phosphatase interacting protein (PST PIP), via an interaction between the proline-rich COOH terminus of the PTP and a site within the putative coiled-coil domain of PST PIP. Here we describe a more detailed analysis of this interaction. Earlier data suggested that the NH2 terminus of PST PIP was important for binding to the phosphatase, and deletion of the NH2-terminal 50 amino acids of the PST PIP resulted in an apparently misfolded protein that was incapable of binding PTP HSCF. To examine the region involved with binding to PTP HSCF, alanine-scanning mutants were produced at intervals throughout PST PIP. This analysis demonstrated that a tryptophan at position 232 was essential for binding in vitro. Transfection experiments demonstrated that the Trp232 mutant protein was capable of association with the cortical cytoskeleton but was not bound to PTP HSCF in vivo. Alanine scanning of a peptide derived from the COOH-terminal proline-rich domain of PTP HSCF revealed that a subset of prolines, as well as other residues, was required for efficient binding to PST PIP, and introduction of alanines at some of these positions in the protein resulted in decreased binding to PST PIP in vitro and in vivo. Analysis of in vivo tyrosine phosphorylation of the Trp232 mutant of PST PIP in the presence of v-Src revealed that this protein was phosphorylated more efficiently than the wild-type molecule. Thus, the interaction between PTP HSCF and PST PIP is mediated by a novel site in the cytoskeletal associated protein which interacts with residues within the proline-rich COOH terminus of the phosphatase.