Clonorchiasis: sonographic findings in 59 proved cases

Clonorchiasis is a parasitic disease of the bile ducts that occurs in endemic areas after ingestion of the raw flesh of freshwater fish. We analyzed the sonographic findings in 59 patients with clonorchiasis, suspected prospectively from sonographic findings and proved subsequently by demonstration of eggs in their stools. Diffuse dilatation of the small intrahepatic bile ducts with no or minimal dilatation of the large intra- and extrahepatic ducts was observed in all cases. The extrahepatic ducts were patent throughout in all except one case. This characteristic finding reflects diffuse intrahepatic bile duct obstruction and resultant proximal dilatation caused by an adult worm or aggregates of worms, as worms reside diffusely in the medium and small intrahepatic bile ducts. Cholangitis and multifocal periductal fibrosis with proximal dilatation may play an additional role. Increased echogenicity of the intrahepatic bile duct wall was present in 39 cases (66%), reflecting cholangitis and periductal fibrosis. In 17 cases (29%), floating or dependent, discrete, nonshadowing, intraluminal, echogenic foci caused by adult worms in the bile were demonstrated in the gallbladder. These echogenic foci were distinguished from stones because they were fusiform, weak in echogenicity, and floated with a change in position. Clonorchiasis should be considered when sonography discloses the characteristic pattern of bile duct dilatation with increased wall echogenicity and nonshadowing, discrete, echogenic foci in the gallbladder lumen.

Normative arm and calf blood pressure values in the newborn

Indirect BP measurement was obtained in the right upper arm in 219 healthy newborn infants with the Dinamap monitor and was compared with values obtained from the calf to establish normative BP values and to help establish a diagnosis of hypertension and coarctation of the aorta in the newborn. There were 174 Mexican-Americans (79.5%), 33 whites (15.0%), and 12 blacks (5.5%). The width of the BP cuff was selected to be 0.4 to 0.5 times the circumference of the extremities. Three supine position readings of BPs and heart rate were obtained from each site and were averaged for statistical analyses. Mean arm BP values (+/- SD) of the neonate less than 36 hours of age were 62.6 +/- 6.9/38.9 +/- 5.7 mm Hg (48.0 +/- 6.2 mm Hg). Neonates older than 36 hours had slightly but significantly (P less than .05) greater values (4 to 6 mm Hg) than did infants younger than 36 hours of age. Active neonates had values 6 to 10 mm Hg greater than quiet neonates (P less than .05). BP values in the calf obtained with the same-sized cuff were almost identical with those obtained from the arm. Differences in consecutively obtained arm and calf BPs (arm values minus calf values) were 1.1 +/- 7.7 mm Hg systolic, -0.01 +/- 6.2 mm Hg diastolic, and 0.9 +/- 6.9 mm Hg mean pressures. Mean heart rate (+/- SD) of neonates less than 36 hours of age was 129.4 +/- 13.2 beats per minute and that of neonates older than 36 hours of age was 139.4 +/- 14.1 beats per minute.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of three embolic agents in pig rete

In ongoing research into potential embolic agents, three substances were evaluated for their effectiveness in occluding the pig rete. Selective injection of these agents produced varying degrees of occlusion, with the most effective a microfibrillar collagen hemostat in a 33% ethanol solution. Angiostat, a collagen particulate, did not produce rete occlusion, and all pigs injected with it developed adverse effects, including coma and apnea. Tisseel, a tissue sealant, produced partial rete occlusion, but was uniformly difficult to manage through long catheters, and its use was discontinued. Microfibrillar collagen hemostat with ethanol appears to have the greatest potential as an embolic agent in low-flow structures.

In vivo DNA loops in araCBAD: size limits and helical repeat

Formation of a DNA loop by AraC proteins bound at the araI and araO2 sites, whose center-to-center distance is 211 base pairs, is necessary for repression of the araBAD promoter, PBAD, of Escherichia coli. To determine the upper and lower size limits of the loop, we constructed PBAD-reporter gene fusion plasmids with various spacings between araI and araO2 and measured their levels of expression. Spacings larger than about 500 base pairs resulted in elimination of detectable repression. No lower limit to spacing was found, suggesting that AraC protein itself possesses significant flexibility and its bending substantially aids formation of small loops. As the spacing between araI and araO2 varied, the activity of PBAD oscillated with an 11.1-base-pair periodicity, implying that the in vivo helical repeat of this DNA is 11.1 base pairs per turn.

Falx ossification--MR visualization

While falx calcification is rarely demonstrated using magnetic resonance, falx ossification, when seen, is characteristic. On magnetic resonance images, falx ossification exhibits a typical appearance consisting of a central marrow-containing portion with signal intensity similar to fat, surrounded by low signal intensity representing cortical bone. Falx ossification was seen in 0.7% of patients and should not be confused with a falx lipoma, a rare congenital entity.

Oncogene expression detected by in situ hybridization in human primary lung cancer

By means of in situ hybridization using biotinylated oncogene probes and the immunohistochemical reaction of avidin-biotin complex-alkaline phosphatase with substrate, we investigated expression of c-myc oncogene in the formalin-fixed, paraffin-embedded tissue sections from seven patients with squamous cell carcinoma (six cases) and small cell carcinoma (one case) of primary lung origin. The expression of c-myc oncogene was greatly enhanced in all cases studied, with individual and cell-to-cell variation. In contrast, all of the specimens incubated with deoxyribonuclease after the standard pretreatment with ribonuclease T1 were negative for the expression of c-myc oncogene. The in situ hybridization permits estimation of a heterogeneous amplification of c-myc oncogene that may be related to secondary alterations occurring during the progression of the malignant lung tumors.

Effects of otic drops on chinchilla tympanic membrane

Experimental studies have shown that if antibiotic otic drops reach the middle ear cavity they produce severe inflammation. However, the effects of these preparations on the tympanic membrane have not been thoroughly investigated. This study was designed to assess morphological changes in the chinchilla tympanic membrane two to 21 days after a single 0.2-mL application of an antibiotic otic preparation (Cortisporin Otic Suspension) to the middle ear cavity. At two days, the epidermal and the mucosal layers were destroyed. By four days, reepithelialization had occurred and all layers of the tympanic membrane subsequently became markedly hyperplastic. Disruption of the fibrous layer, invasion of keratinizing epidermis to the medial surface, and perforation were observed at three weeks. These findings indicate that tympanic membrane damage is a potentially significant aspect of the ototoxic properties of topical otic preparations.

Superior aspect of the perirenal space: anatomy and pathological correlation

To study the anatomy of the superior aspect of the perirenal space, we analysed 50 computed tomographic (CT) scans with reference to the anatomy of Gerota's fascia, and dissected five cadavers laying special emphasis on the ascent of Gerota's fascia. We also reviewed 10 scans of patients with a large lesion in the right upper abdomen regarding localisation of the lesion. We conclude that Gerota's fascia does not cover the upper portion of the kidney and adrenal gland so that the superior aspect of the perirenal space is open towards the upper abdominal extraperitoneal space. Thus, a large lesion arising from the right adrenal gland or kidney easily invaginates the liver through the bare area mimicking a hepatic lesion, and vice versa. This explains the difficulty in localising a large lesion in the right upper abdomen.

Morphologic effects of glycerol and urea on cochlear tissues of the chinchilla

Glycerol and urea are used as test agents in confirming the diagnosis of endolymphatic hydrops. Although both substances act as osmotic diuretics, recent evidence suggests that they may have differing physiologic effects on the inner ear. This study was designed to compare the morphologic effects of urea and glycerol on cochlear tissues, using the chinchilla as an experimental model. Animals were given subcutaneous injections of glycerol (2 g/kg) or urea (1.2 g/kg) over periods of 3 hours, 4 days, or 1 week. Both agents were found to produce ultrastructural changes, including spiral ligament vacuolization, intracellular alterations of the stria vascularis, and increased numbers of Hensen's bodies in outer hair cells. These alterations appeared indicative of metabolic stress, but not toxicity. The morphologic findings provided no evidence that glycerol and urea affect the inner ear by fundamentally different mechanisms of action.

Detection of hepatitis B virus DNA in human serum by dot hybridization using a biotin-labelled probe

A dot blot hybridization technique utilizing a biotin-labelled recombinant DNA probe was used to examine hepatitis B virus (HBV) DNA in serum. The lowest amount of HBV DNA in serum detectable by the color development of an avidin-biotin alkaline phosphatase complex was 40 picogram per 50 microliter. Validity of this method was confirmed by autoradiography using ³²P-labelled and ³H-labelled HBV DNA probes. HBV DNA was found in 100% (34/34) of the HBsAg-positive and in 73.5% (25/34) of the HBsAg-negative subjects. In contrast, all nine cases showing negativity in HBV DNA were also HBsAg-negative. Correlation of HBe antigen/antibody with HBV DNA was investigated in 19 sera of which HBsAg was negative but anti-HBc-positive. Of 13 sera with anti-HBe 10 (76.9%) cases revealed HBV DNA positivity, while four (66.7%) of six sera without anti-HBe were positive in HBV DNA. In conclusion, serum dot hybridization assay utilizing a biotinylated probe proved useful in the detection of a free form of HBV DNA regardless of the presence of HBsAg and irrespective of HBeAg/anti-HBe status. Moreover, it is emphasized that practical advantages in speed, reproducibility, and safety have made this alternative even more attractive than autoradiography using radioisotope-labelled probes.

Hepatitis B virus DNA detection by in situ hybridization in human hepatocellular carcinoma

The distribution of hepatitis B virus (HBV) DNA in tumor tissue sections from six Korean patients with HBsAg positive hepatocellular carcinoma (HCC) was examined by in situ hybridization using a biotin-labeled recombinant, cloned HBV DNA probe. All patients tested were positive for both HBeAg and anti-HBc in their sera. HBV DNA was distributed abundantly in the cytoplasm and rarely in the nuclei of tumor cells. The validity of the in situ hybridization assay was confirmed by the dot blotting technique using a ³²P-labeled HBV DNA probe obtained by nick translation. In conclusion, it is speculated that integration of HBV DNA into host DNA as well as persistant amplified replication of the HBV DNA within the hepatocytes is linked etiologically to the development of human hepatocellular carcinoma.

MR imaging of pineal cysts

Identification of pineal cysts with imaging modalities other than magnetic resonance (MR) has been infrequent, despite a reported autopsy incidence of as high a 40%. We recently identified 15 patients in whom pineal cysts were seen on MR. These cysts ranged from 5 to 15 mm in maximum diameter. The cyst walls were thin, usually measuring less than 2 mm. The signal characteristics of the fluid within the cysts paralleled that of CSF, although it differed somewhat in signal intensity from CSF collections in which there was pulsatile motion. All lesions were midline in location. There was no significant mass effect, although mild flattening of the superior colliculi could be seen. Two cases were operated on; at operation, typical pineal cysts were found, with one containing hemosiderin-laden proteinaceous material, which accounted for its markedly higher signal intensity. It is important that this entity be recognized so that these lesions are not confused with pineal tumors.

Antibiotic sensitivity and mutation rates to antibiotic resistance in Mycoplasma mycoides ssp. mycoides

The antibiotic resistance of Mycoplasma mycoides ssp. mycoides strain T1 was investigated. This strain was resistant to high levels (greater than 100 micrograms ml-1) of rifampicin and nalidixic acid. It was sensitive to streptomycin, spectinomycin and novobiocin; however, single step mutants with high levels of resistance (greater than 100 micrograms ml-1) were readily isolated. With erythromycin and tylosin for which the minimum inhibitory concentration (MIC) for the parent strain was less than 0.1 microgram ml-1, mutants resistant to greater than 100 micrograms ml-1 were obtained in two and three steps respectively. The MIC of tetracycline in single step resistant mutants (0.6 microgram ml-1) was tenfold higher than the parent strain, but could not be increased further. There was only a twofold increase in resistance to chloramphenicol in single step mutants. The frequency of resistant mutants varied with the antibiotic and was between 4 X 10(-6) and 2 X 10(-8). The mutation rate to antibiotic resistance to streptomycin, spectinomycin, novobiocin, erythromycin and tylosin was between 3 X 10(-8) and 5 X 10(-9) per cell per generation. There was a fivefold decrease in mutation rate to resistance to 60 micrograms ml-1 streptomycin compared to that to 20 micrograms ml-1.

Pigmented epithelial cells of the membranous saccular wall of the chinchilla

The posterior-superior portion of the membranous wall of the chinchilla saccule is lined by pigmented epithelial cells which contain golden brown granules having three components (lipid droplets, granular matrix, and dense globules). Histochemical and electronmicroscopic studies indicate that the dense component is a form of melanin. The pigmented cells show morphological features suggestive of fluid transport function; they are also involved in decalcification and phagocytosis of otoconial crystals. These findings provide evidence that the saccular wall epithelium plays an active role in regulating endolymph composition and in clearance of debris from the endolymphatic space.

Endobronchial tuberculosis: clinical and bronchofiberscopic features

The clinical and bronchofiberscopic features of endobronchial tuberculosis in 53 patients were investigated. These patients comprised 4.7% of some 1,132 subjects who had undergone flexible bronchofiberscopic examinations. The peak incidence occurred in the third and fourth decades, a secondary peak appeared in the seventh decade, a five to six times higher incidence was noted in the female than in the male. Staining for acid-fast bacilli was positive in 67.9% of the patients sputums and or specimens of bronchial washings. A barking cough was the most common chief complaint. Next in order were chest pain, production of mucus, dyspnea, hemoptysis, and fever. Twenty-three out of 53 patients showed abnormalities on their chest films.

The flexible bronchoscope revealed tuberculous lesions characterized by mucosal swelling or edema, redness, erosion, ulceration, hypertrophy with luminal narrowing, and cicartical stenosis due to whitish pseudomembrane. The left lower and upper bronchi were involved most frequently.

The majority of the patients who were suffering from a barking cough were resistant to antitussive agents but were responsive to steroid combination chemotherapy with antituberculous drugs.

In conclusion, the bronchofiberscopic approach is not only helpful in the differentiation of endobronchial tuberculosis from bronchogenic cancer but it can also be used for relieving atelectasis.

Localization of a sulphate-activating system within Euglena mitochondria

Intact mitochondria, obtained from Euglena gracilis Klebs var. bacillaris Cori mutant W10BSmL, which lacks plastids, and purified on Percoll density gradients, form adenosine 3'-phosphate 5'-phosphosulphate from sulphate. The optimal conditions include addition of 17 mM-Tricine/KOH, pH 7.6, 18 mM-MgCl2, 250 mM-sucrose, 5.66 mM-sodium ADP (or 0.94 mM-sodium ATP), 1 mM-K2SO4, carrier-free 35SO4(2-) (32.1 microCi) and 1.0 mg of mitochondrial protein in a total volume of 2.65 ml and incubation at 30 degrees C. Experiments with the inhibitor of adenylate kinase P1, P5-di(adenosine 5'-)pentaphosphate indicate that ATP is the preferred substrate for sulphate activation; ADP is utilized by conversion into ATP via adenylate kinase. ATP sulphurylase, adenylylsulphate kinase (APS kinase) and inorganic pyrophosphatase constitute the sulphate-activating system; ADP sulphurylase is undetectable. Fractionation of Euglena mitochondria with digitonin and centrifugation allowed the separation of outer-membrane vesicles and mitoplasts as judged by electron microscopy and selected enzymic markers. The detergent-labile association of the sulphate-activating system with the mitoplasts (similar to that of adenylate kinase), the fact that most of the adenosine 3'-phosphate 5'-phosphosulphate formed by intact mitochondria is found in the surrounding medium, and the ease with which nucleotide substrates reach the activating system in intact organelles, suggest that the enzymes of sulphate activation are located on the outer surface of the mitochondrial inner membrane.

The mycoplasmacidal properties of sodium hypochlorite

The effect of hypochlorite concentration on Mycoplasma mycoides ssp. mycoides viability was tested under a variety of conditions. The experimental variables employed included chlorine-cell contact time, chlorine concentration, carrier system and organic loading. Initial populations of 10(6) c.f.u./ml were killed (no survivors in 1 ml) by hypochlorite solution containing 25 p.p.m. available chlorine in 15 s in the absence of organic load and 50 p.p.m. available chlorine in 5 min in the presence of 1% protein. Higher concentrations of hypochlorite were required to disinfect a porous carrier system in the absence or presence of protein. The results are in contrast to previous reports that M. bovis is killed only by high hypochlorite concentrations.

Kinetics of utilization of organic substrates by Mycoplasma mycoides subsp. mycoides in a salts solution: a flow-microcalorimetric study

The metabolism of various organic substrates by suspensions of Mycoplasma mycoides subsp. mycoides in a salts solution was followed by microcalorimetry. Enthalpy changes associated with metabolism were in good agreement with theoretical values. Substrate utilization showed Michaelis kinetics, allowing saturation constants (Km) and maximum specific rates of substrate utilization (Vmax) to be determined. In cells grown on a complex medium containing glucose, Km values were: glucose, fructose, N-acetylglucosamine, glycerol and pyruvate, less than 5 microM; lactate, 20 microM; glucosamine, 130 microns, and mannose, 1 mM. Values of Vmax for glycerol, pyruvate and lactate were similar and approximately twice those for glucose, mannose, glucosamine and N-acetylglucosamine; Vmax for fructose was one-quarter of that for glucose. In cells grown on complex medium in which glucose was replaced by mannose, glucosamine or N-acetylglucosamine, Vmax and Km for the respective growth sugars and for glucose were not significantly affected. However, in cells grown in the presence of fructose, Vmax for fructose increased to the value observed for glucose. It is suggested that M. mycoides is adapted to, and is constitutive for, the utilization of a single sugar (glucose), and a single amino sugar (N-acetylglucosamine), but that in the presence of fructose a fructose-utilizing pathway is induced.

Cardiomyopathy in a child with hypereosinophilic syndrome

A 9-year-old boy presented with increasing fatigue, anorexia, weight loss, fever, and absolute eosinophilia (48,000/microL). Pulmonary infiltrates occurred 3 months later. A murmur of mitral regurgitation was heard 5 months after onset of illness, and heart failure soon followed. Despite corticosteroid therapy the eosinophilia persisted intermittently until 1 month before death. The patient died within 9 months of the onset of illness. At necropsy there was cardiomegaly with subendocardial fibrosis in the right and left ventricles. Thrombi were present in the left ventricular apex and behind the posterior mitral leaflet. The findings in 12 previously reported pediatric cases are reviewed. The etiopathogenesis of the hypereosinophilic syndrome is discussed: half of the cases in children are associated with leukemia.

A clinical trial with cefoperazone in pneumonia and pyelonephritis

15 cases of pneumonia and 15 cases of pyelonephritis were included in a clinical trial of parenteral cefoperazone. The organisms isolated from patients with bacterial pneumonia were: Staphylococcus aureus (6), Klebsiella pneumoniae (5), Diplococcus pneumoniae (3), Pseudomonas species (2), and 6 others. Amongst those with pyelonephritis, Escherichia coli (12), Enterobacter (1), and 3 other pathogens, were isolated. All were sensitive to cefoperazone. The efficacy of cefoperazone in patients with pneumonia was: good in 11 (73%), fair in 3, and poor in 1. In pyelonephritis, 12 (80%) responded well and in the other 3 response was fair. There were no significant side effects or hypersensitivity reactions.

Cell-mediated immunity to donor antigens in renal allograft recipients

The antigen-stimulated active rosette-forming T-cell (AgARFC) assay was adapted for the preoperative study of 21 consecutive kidney transplants (17 cadaver donors and four living related donors; five retransplants). Recipient peripheral blood lymphocytes were incubated for 15 minutes with donor histocompatibility antigens preparaed by sonication of donor peripheral blood or splenic lymphocytes. Recipient presensitization to donor antigens was expressed as the difference between active rosette formation in the presence (%AgARFC) and in the absence (%ARFC) of donor antigens. This antigen-induced difference is rosette formation (%AgARFC - %ARFC) for all patients ranged from - 7.0% to 24.2%. Of those patients with pretransplant sensitization greater than 6.3% (group I: mean, 13.2 +/- 3.0; n = 7), 71% had severe acute rejection requiring dialysis within the first 2 weeks of transplantation. In contrast, none of the patients with pretransplant values below 6.3% (group II: mean, -0.8 +/- 1.0; n = 14) had rejection requiring dialysis within the first 2 weeks. Group I patients had 43% graft survival at 1 month and 14% survival at 2 months, whereas group II had 86% graft survival at 1 month and 71% at 2 months. The AgARFC assay provided a rapid means of measuring recipient T-cell presensitization to donor alloantigens, which was correlated with the accelerated rejection of renal allografts.

Myelin basic protein-stimulated rosette-forming T cells in multiple sclerosis

A subpopulation of T lymphocytes sensitized to human myelin basic protein in peripheral blood of patients with multiple sclerosis, central nervous system (CNS) tumors, and cerebrovascular accidents was demonstrated by the antigen-stimulated, rosette-forming T-cell assay. A significant increase in the percent of active rosette-forming T cells was detected after in vitro exposure of peripheral blood lymphocytes to human myelin basic protein but not to histones. In contrast, peripheral blood lymphocytes from healthy controls and from patients with benign and malignant breast diseases were unresponsive to stimulation by either antigen. These results demonstrate a functionally active T-lymphocyte subpopulation sensitized to myelin basic protein in patients with multiple sclerosis and in patients with certain other CNS diseases.

A simple cost control format in clinical laboratories

Laboratory scientists must be able to demonstrate their proficiency not just in the analysis of specimens but also financial management. The cost information in real dollar term is the only way to measure the productivity of a laboratory. We have demonstrated a simple procedure in tabulating the income and expenditure of our laboratories. In our hand, we have found the information to be useful and timely for various decisions and plannings.

Composition of O-alkyl and O-alk-1-enyl moieties in the glycerolipids of the human adrenal

A comparison of human adult and fetal adrenals with respect to their levels of glyceryl ether lipids and other lipid components is reported. Fetal glands contained significantly lower levels of alk-1-enyl phosphoglycerides and of cholesterol. Neutral glyceryl ether diesters, and ethanolamine and choline phosphoglycerides were isolated from adult adrenal tissue. The composition of the O-alkyl glycerol groups in these lipid fractions was obtained by means of gas chromatography of the trimethylsilyl ethers and diacetyl derivatives; O-alk-1-enyl glycerols were analyzed as their diacetates. About one-half of the alkyl and alk-1-enyl glycerol moieties present in glyceryl ether diesters contained hydrocarbon side chains with 20, 22, or 24 carbon atoms. Long hydrocarbon chains (C19-24) were also found in the O-alkyl glycerol moieties present in the total lipids of fetal adrenals.

Radiation injury to abdominal aorta and iliac artery sustained in infancy

Late complications of radiation therapy will become more common as treatment of neoplasms in childhood becomes more successful. A patient with a successfully treated Wilm's tumour presented with hypertension 3 years after therapy. Angiography revealed extensive damage to the aorta and left common iliac artery, probably caused by the radiation therapy. The hypertension was the result of renal artery stenosis.

Biological consequences of environmental control through housing

Housing was originally devised as a control of the thermal environment, but numerous other functions have been added with resulting competition and confusion. Current design gives insufficient attention to thermal factors and relies upon supplementary heating and cooling to compensate for faults. These are wasteful of energy, and the exhaust from air conditioners adds to the heat island conditions in city cores. The impact of consumerism on domestic space and the importance of personal space and privacy are reviewed.