Gastroesophageal reflux disease and respiratory disease

The patients treated for oesophageal atresia present a correlation between the clinical sintomatology after recanalization characterized by disfagia, dispnea, recurrent cough, chronic pneumopaties and oesophageal anomalies. Where morphological alterations accounting for the presence of gastro-oesophageal reflux (GOR) were not evident, possible functional alterations of the motility were considered. The incidence of GOR was considerably high and, expression of a congenital alteration of the lower oesophageal sphincter and of oesophageal peristalsis, becomes even more severe due to further stretching of the gastro-esophageal junction. The authors underline that the early demonstration of histological changes, even before recanalization, and the motility disorders of the oesophagus have to be well studied, while the LES is normalized, in order to prevent and treat the possible appearance of the well-known complications of GOR.     

Regulation of p53 levels by the E1B 55-kilodalton protein and E4orf6 in adenovirus-infected cells

The adenovirus type 5 243R E1A protein induces p53-dependent apoptosis in the absence of the 19- and 55-kDa E1B polypeptides. This effect appears to result from an accumulation of p53 protein and is unrelated to expression of E1B products. We now report that in the presence of the E1B 55-kDa polypeptide, the 289R E1A protein does not induce such p53 accumulation and, in fact, is able to block that induced by E1A 243R. This inhibition also requires the 289R-dependent transactivation of E4orf6 expression. E4orf6 is known to form complexes with the E1B 55-kDa protein and to function both in the transport and stabilization of viral mRNA and in shutoff of host cell protein synthesis. We demonstrated that the block in p53 accumulation is not due to the generalized shutoff of host cell metabolism. Rather, it appears to result from a mechanism targeted specifically to p53, most likely involving a decrease in the stability of p53 protein. The E1B 55-kDa protein is known to interact with both E4orf6 and p53, and as demonstrated recently by others, we showed that E4orf6 also binds directly to p53. Thus, multiple interactions between all three proteins may regulate p53 stability, resulting in the maintenance of low levels of p53 following virus infection.     

Focal transmantle dysplasia: a specific malformation of cortical development

We report 18 patients who presented prior to age 20 years with epilepsy or fixed neurologic deficits. MRI showed signal abnormality extending from the cortex to the superolateral wall of the lateral ventricle. Histology showed cortical disorganization, neuronal cytomegaly, balloon cells, indistinct cortical gray matter-white matter junctions, and variable accompanying astrogliosis. We propose that this transmantle dysplasia is a specific anomaly resulting from abnormal stem cell development.     

Detonation logic elements

We consider the classification of detonation logic elements (DLE), that is, devices in which logical operations are effected by means of explosive signals. The technical implementation of the DLE studied is based on the physical principle of the “corner effect.” Methods of describing the functional properties of DLE using Boolean functions are analyzed. Examples are given of the application of Boolean functions to detonation elements of single-step and two-step logic. Institute of Specialized Mechanical Engineering, N. é. Bauman Moscow State Technical University, Moscow 107005. Translated from Fizika Goreniya i Vzryva. Vol. 30, No. 5, pp. 123–126, September–October, 1994.     

Skin dose from radiotherapy X-ray beams: the influence of energy

OBJECTIVE: To report our clinical experience on the use of oral erythromycin for the treatment of severe gastrointestinal dysmotility in preterm infants. METHODOLOGY: A case series study of seven preterm infants (six were very low birthweight) with severe intestinal dysmotility in a tertiary neonatal centre. RESULTS: All responded favourably without adverse effects and tolerated full enteral feeding within 1-2 weeks of the commencement of the drug. CONCLUSIONS: As prolonged total parenteral nutrition carries significant risk of complications, this therapy could be considered in selected preterm infants who fail to establish enteral feeding after an extended period, and in whom an anatomically obstructive lesion of the gastrointestinal tract has been excluded. Meanwhile, we would caution against the widespread implementation of this therapeutic approach until formal evaluation by randomized controlled trials have established the exact role of erythromycin, or its analogues, in the treatment of intestinal dysmotility in preterm infants.     

Localized esophageal leiomyoma and hypertrophic osteoarthropathy

The authors report the case study of a 13-year-old girl, suffering from epigastric pain related to an important infectious syndrome and from marked hypertrophic pneumosteopathy (clubbed fingers, diffuse cortical hyperostosis). Radiological examination (chest x-ray and computed tomography scan) showed a partly calcified right posterior mediastinal mass. The esophagoscopy showed a fistular emanation from the esophagus to the tumor. The biopsy results were of no diagnostic significance, and the samples demonstrated a bacterial and fungal colonization. An endoscopic sonogram showed an inhomogeneous mass with hyperechoic structures developed between the mucosa and the outer muscular coat of the esophagus. The patient underwent surgery, which showed a large intraparietal tumor of the esophagus, which, through pathological examination, was confirmed to be a benign leiomyoma. Postoperative follow-up was simple and the pneumosteopathic symptoms regressed rapidly. This disease is rare in children under 15 years of age. It is only exceptionally associated with a hypertrophic pneumosteopathy. This pathology is diagnostically challenging to the surgeon. The endoscopic ultrasonography is the best procedure in the assessment of subepithelial tumor and extrinsic compressions of the oesophagus.     

Role of MR imaging with transrectal coil in the evaluation of complex urethral abnormalities

OBJECTIVE: The purpose of this study was to show the usefulness of MR imaging with a transrectal coil (TRC) in the management of various urethral abnormalities. This report also reveals the appearance of various postsurgical changes relating to the therapy of urethral abnormality. CONCLUSION: The high-resolution images obtained with TRC MR imaging were useful in evaluating urethral abnormalities. The imaging guided therapy in most cases. In two patients, TRC MR imaging more accurately depicted abnormality than did voiding cystourethrography and transvaginal sonography. In one case, TRC MR imaging was the only imaging technique that revealed the abnormality of periurethral scarring.