Expression of a mannose/fucose membrane lectin on human dendritic cells

Dendritic cells (CD) are the most efficient antigen presenting cells for T lymphocytes. CD1a+ CD14- CD with high antigen-presenting capacities can now be obtained easily from adherent peripheral blood monocytes by culture in the presence of granulocyte/macrophage colony-stimulating factor and interleukin-4 (Sallusto et al., J. Exp. Med. 1994. 179: 1109). Human macrophages express a membrane lectin, or sugar-specific receptor, which specifically mediates the binding and endocytosis of mannose- and fucose-terminated glycoproteins and is involved in the phagocytosis of pathogens. A similar lectin activity was sought on cultured human DC using flow cytometry and confocal microscopy to detect binding and internalization of fluoresceinated neoglycoproteins [bovine serum albumin (BSA) substituted with sugar residues]. Several neoglycoproteins, especially alpha-L-fucosyl-, alpha-D-mannosyl-, N,N'-di-acetyl-beta-chitobiosyl- and beta-D-glucosyl-BSA, were endocytosed by cultured human CD1a+ DC as well as by CD1a- CD14- cells which were also obtained in the culture. Fuc-BSA and Man-BSA had the same number of binding sites (1.7 x 10(6)/cell) on CD1a+ DC, and bound with an affinity constant close to 10(7) 1/mol. Inhibition experiments indicated that these two neoglycoproteins bound to the same membrane lectin. CD1a+ and CD1a- cells were both labeled by an antiserum specific for the human macrophage mannose receptor. The membrane lectin specific for mannose and fucose that is evidenced in these experiments on cultured DC may be similar to the macrophage membrane lectin or may share functional and structural properties with it.     

Laparoscopic surgery of adrenal glands: indications and limits

Over the last four years it has been demonstrated that laparoscopy can be used successfully for adrenalectomy, providing certain advantages over conventional open surgery. The aim of this study was to determine the indications for laparoscopic approach in adrenal surgery. From June 1994 to June 1996 laparoscopic transabdominal flank approaches were proposed in patients with a unilateral 8 cm or less, non-malignant tumors of the adrenal gland. For tumors under 4 cm in diameter only secreting tumors were removed. Among 77 patients requiring ablation of the adrenal gland, 50 (65%) underwent a laparoscopic procedure: 29 Conn adenomas, 10 Cushing adenomas, 6 Pheochromocytomas, 4 incidentalomas. One patient had Cushing's disease and underwent bilateral resection. Mean tumor size was 26 mm (7-75 mm). Malignancy was demonstrated in 2 tumors: one cortisone secreting tumor and one leiomyosarcoma. Conversion was required in 4 cases (8%). Mean operative time for unilateral adrenalectomies was 147 minutes (50-300'). There were no deaths. Morbidity included: one hemorrhage via the trocar orifice requiring reoperation, one infarction of the spleen which regressed spontaneously, one parietal hematoma, and one case of phebitis of the lower limb. The endocrinopathy was successfully cured in all patients with secreting tumors. The 27 other patients underwent open adrenalectomy. Laparoscopic approach was not proposed due to suspected malignancy in 13 cases, previous surgery in 8 cases and multiple, bilateral and/or extra adrenal tumors in 6 cases. Laparoscopic approach to the adrenal gland is the procedure of choice in patients with Conn adenomas, Cushing adenomas and in most cases of pheochromocytomas. It is not indicated for malignant and large tumor (> 8 cm). Currently two-thirds of our patients requiring and adrenalectomy are operated laparoscopically.     

Effects of lung volume and fatigue on evoked diaphragmatic phonomyogram in normal subjects

BACKGROUND: A diaphragmatic phonomyogram (PMG) evoked by maximal phrenic nerve stimulation at end expiratory lung volume (FRC) has been previously described as a good index of changes in diaphragmatic contractility with fatigue. A study was undertaken to assess whether this conclusion could be extended to different lung volumes. METHODS: Diaphragmatic compound motor action potentials (CMAPs) were recorded on each side of the chest by the means of surface electrodes placed over the eight intercostal spaces in five healthy subjects. Diaphragmatic PMGs from both sides were recorded with condenser microphones fixed to the skin close to the CMAP recording electrodes. Oesophageal and gastric balloon tipped catheters were employed to measure transdiaphragmatic pressure twitches (TwPDI) which served as the standard measure of changes in diaphragmatic contractility. PMG and TwPDI responses were compared at different lung volumes over inspiratory capacity both before and after fatiguing inspiratory resistive loading. RESULTS: No consistent relationship was found in different subjects or on different days in the same subject between PMG and lung volume or between PMG and TwPDI. However, the PMG:CMAP ratio from both sides at any given lung volume decreased after fatigue in roughly the same proportion as the TwPDI. CONCLUSIONS: These results show that, although PMG can detect changes in diaphragmatic contractility caused by fatigue in normal subjects, lung volume changes need to be controlled and each subject should serve as his or her own control.     

Solar Oven, design, and its field testing in West Lombok regency, Indonesia

Design of four Solar Ovens, box type, are described. All materials used in the latest design are locally available. This is one of the basis of considerations in designing beside simplicity and long life time. Solar oven of the latest design yielded 160°C without load and 50 units have been field tested in West Lombok regency since July 1995. Its cooking ability, materials used, size and shape, social acceptance and further activities are described.     

Hereditary neuralgic amyotrophy and hereditary neuropathy with liability to pressure palsies: two distinct clinical, electrophysiologic, and genetic entities

Fistulas secondary to Crohn's disease occur in about 33% of patients. A colobronchial fistula complicating Crohn's disease is very rare, having been reported only twice previously. We present an unusual fistula secondary to Crohn's colitis that originated from the splenic flexure and crossed the diaphragm to involve the bronchial tree.     

Adaptive digital notch filter design on the unit circle for theremoval of powerline noise from biomedical signals

Investigates adaptive digital notch filters for the elimination of powerline noise from biomedical signals. Since the distribution of the frequency variation of the powerline noise may or may not be centered at 60 Hz. Three different adaptive digital notch filters are considered. For the first case, an adaptive FIR second-order digital notch filter is designed to track the center frequency variation. For the second case, the zeroes of an adaptive IIR second-order digital notch filter are fixed on the unit circle and the poles are adapted to find an optimum bandwidth to eliminate the noise to a pre-defined attenuation level. In the third case, both the poles and zeroes of the adaptive IIR second-order filter are adapted to track the center frequency variation within an optimum bandwidth. The adaptive process is considerably simplified by designing the notch filters by pole-zero placement on the unit circle using some suggested rules. A constrained least mean-squared algorithm is used for the adaptive process. To evaluate their performance, the three adaptive notch filters are applied to a powerline noise sample and to a noisy EEG as an illustration of a biomedical signal     

Characterization of a diffusion-bonded Al-Mg alloy/SiC interface by high resolution and analytical electron microscopy

The interfacial structure of a diffusion-bonded Al-4.55 at. pct Mg/SiC interface was examined by conventional and high-resolution transmission electron microscopy. Formation of Mg₂Si, MgO, and Al₂MgO₄ was observed. The monoclinic Mg₂Si phase formed at the Al/SiC interface, while the oxides MgO and Al₂MgO₄ formed at the monoclinic Mg₂Si/Al interface. It is shown that the formation of these phases can be predicted using simple thermodynamic criteria such as the relative bond strengths between Al, Si, C, O, and Mg. In addition, precipitation of some equilibrium Al₈Mg₅ precipitate was also observed at the interface. The interfacial structure observed in the Al-Mg/SiC system is contrasted with that observed in the pure Al/SiC system.     

Arsenic intoxication presenting with macrocytosis and peripheral neuropathy, without anemia

A case of arsenic intoxication associated with macrocytosis and neuropathy, without anemia, is presented. Evaluation of a 68-year-old man with a long history of peripheral neuropathy and persistent macrocytosis revealed exposure to an insecticide. Analysis of urine and hair revealed elevated levels of arsenic. A short course of d-penicillamine failed to promote urinary excretion of arsenic. Removal of the insecticide resulted in resolution of macrocytosis and slight improvement of neuropathy. This case emphasizes that arsenic intoxication should be considered in patients with macrocytosis with peripheral neuropathy, even in the absence of anemia.