Showing papers by "Military Medical Academy published in 1994"

Desmoid tumours in familial adenomatous polyposis.

Abstract: Desmoids are rare, benign fibromatous lesions, which can arise in patients with familial adenomatous polyposis (FAP), a disorder caused by germline adenomatous polyposis coli (APC) gene mutation. This study investigated the risk of desmoids in FAP, the relation between specific APC gene mutations and desmoid formation, and the clinical characteristics of FAP patients with desmoids. Eighty three of 825 FAP patients (10%) from 49 of 161 kindreds (30%) had desmoids. The absolute risk of desmoids in FAP patients was 2.56/1000 person years; comparative risk was 852 times the general population. APC gene mutations were similar in families with and without desmoids. The female/male ratio was 1.4 (p = NS). Previous abdominal surgery was noted in 68% of patients with abdominal desmoids (55% developed within five years postoperatively). Desmoid risk in FAP family members of a desmoid patient was 25% in first degree relatives v 8% in third degree relatives. Desmoids are a comparatively common complication of FAP associated with surgical trauma and familial aggregation. Desmoid development was not linked to specific APC gene mutations and was not found predominantly in women. Studies of chemopreventive therapy, given within five years after abdominal surgery, should be considered in FAP patients with a family history of desmoid disease.

Serum copper and zinc levels and copper/zinc ratio in patients with breast cancer

Abstract: Serum copper, zinc levels, and the Cu/Zn ratio were evaluated in 31 patients with breast cancer and 35 healthy controls. Copper and zinc were determined by atomic absorbtion spectrophotometry. The mean serum copper level and the mean Cu/Zn ratio in patients with breast cancer were significantly higher than the control group (p < 0.001 and p < 0.001). In addition, the mean serum zinc level in patients with breast cancer was significantly lower than the control group (p < 0.001). Neither serum copper and zinc levels nor the Cu/Zn ratio were of value in discriminating of the disease activity and severity. Interestingly, the Cu/Zn ratio in premenopausal patients was higher than postmenopausal patients (p < 0.05) and this was not related to age. The further combined biological and epidemiological studies are necessary to investigate the roles of copper and zinc in breast cancer.

Solitary fibrous tumour arising from sublingual gland: report of a case

Abstract: A solitary fibrous tumour is a pleural tumour which may rarely be detected at non-pleural sites. In this report, the case of a solitary fibrous tumour arising from the sublingual salivary gland is described.

Liposome-entrapped superoxide dismutase reduces ischemia/reperfusion 'oxidative stress' in gerbil brain.

Abstract: Bilateral common carotid artery occlusion (15 min.) followed by two hours of recirculation reduced mitochondrial superoxide dismutase (SOD) and glutathione reductase (GR) activities, and increased susceptibility of mitochondrial membranes to in vitro lipid peroxidation in brain regions (i.e., cortex, striatum and hippocampus) of Mongolian gerbil. Intraperitoneal bolus injection (2 mg/kg b.w.) of liposome-entrapped CuZn superoxide dismutase (l-SOD) increased the endogenous SOD activity in normal brain tissue and, when given at the end of ischemia, counteracted both the ischemic reduction of endogenous SOD and the increased peroxidation of mitochondrial membranes. 1-SOD treatment was ineffective in reducing brain swelling, suggesting that superoxide radicals are not a main participant in the process of (post)ischemic brain edema formation.

Generalized gingival enlargement due to accumulation of amyloid-like material.

Abstract: Hyaline or amyloid-like substances may be seen in several oral lesions. Some of these originate from epithelial cells and some from connective tissue components. In this study, amyloid-like material causing gingival enlargement in three patients, with eyelid involvement in two, was examined using histochemistry, immunohistochemistry and electron microscopy. These accumulations did not share the classical features of amyloid such as green birefringence under polarized light after Congo red staining. Our findings suggest that epithelial degeneration plays an important role in the pathogenesis of these amyloid-like accumulations. These substances may be the result of defective amyloidogenesis and our cases may represent an oral counterpart of ligneous conjunctivitis or colloid milium of the skin.

Effects of bromocriptine and haloperidol on ethanol withdrawal syndrome in rats.

Abstract: The effects of bromocriptine and haloperidol, either alone or in combination, on ethanol withdrawal syndrome (EWS) have been investigated in rats. Bromocriptine (5 mg/kg 1P) inhibited wet dog shakes behavior and catatonia but potentiated the intensity of abnormal gait. The latency of the audiogenic seizures was prolonged by bromocriptine treatment. Haloperidol (0.5 mg/kg SC) decreased the intensity of stereotyped behavior but potentiated catatonia and agitation. It did not antagonize the behaviors induced by bromocriptine when injected in combination except the increased latency of the audiogenic seizures. The total intensity score of the EWS was not significantly different from that in untreated control. The results suggest that brain dopaminergic system may be involved to a limited extent in mediating the EWS in rats.

Assessment of tumour necrosis and detection of mediastinal lymph node metastasis in bronchial carcinoma with technetium-99m sestamibi imaging: comparison with CT scan

Abstract: Thirty-eight patients with four major types of bronchial carcinoma were studied to evaluate technetium-99m sestamibi imaging in the assessment of tumour necrosis and the detection of hilar and mediastinal lymph node metastasis. Quantitative analysis was also performed to ascertain whether tumour uptake values correlate with histological types of bronchial carcinoma. Of the patients, 34 showed tumour uptake on planar imaging (n = 38) and 27 on single-photon emission tomography (SPET) (n = 29), the overall sensitivity in the localisation of primary tumour being 89% with planar imaging and 93% with SPET. Four types of tumour uptake pattern were identified: (1) focal uptake, (2) focal uptake with a central hypoactive focus, (3) ring-like uptake and (4) no uptake (negative uptake). Tumour necrosis was diagnosed in 12 patients based upon histopathology (n = 2) and density measurements and type of contrast enhancement on computed tomography (CT) scan (n = 12). Defective tumour uptake was seen in 11 of these patients on planar images (focal uptake with a central hypoactive focus, n = 7; ring-like uptake, n = 2; and no tumour uptake, n = 2) and in 12 patients on SPET (focal uptake with a central hypoactive focus, n = 7, ring-like uptake, n = 3, and no uptake, n = 2). Hilar and mediastinal lymph node involvement was detected in ten patients on CT scan, nine on planar images and 11 on SPET. A total of 26 metastatic lymph nodes were detected on CT scan; 24 of these were seen on planar, and all 26 on SPET images. SPET disclosed five further lymph nodes with metastasis, all of which were confirmed by histopathological examination of the surgical material (n = 3). The sensitivity in establishing the hilar and mediastinal disease was 90% on planar images, and 100% on SPET slices, but when the number of lymph nodes was taken into account, these values were 62% and 100%, respectively. Also, brain metastases were detected with SPET in three patients. The results of quantitative analysis of tumour uptake did not differentiate between squamous cell carcinoma and adenocarcinoma. We conclude that 99mTc-sestamibi, particularly with SPET imaging, is potentially useful in the follow-up of patients with bronchial carcinoma by differentiating residual or recurrent disease from postradiotherapy necrosis, and is as sensitive as CT scan in the detection of hilar and mediastinal lymph node metastasis.

Premarin-induced ischemic colitis.

Abstract: There are numerous literature reports of oral contraceptive-induced (estrogen and progesterone) ischemic bowel disease. However, Premarin-induced (equine conjugated estrogen) intestinal ischemia has rarely been reported. We describe three cases of Premarin-induced ischemic colitis. In contrast to or

The visualization of granulomatous disease with somatostatin receptor scintigraphy.

Abstract: In-111 labeled pentetreotide scintigraphy was applied to three patients with proven granulomatous disease (two with sarcoidosis, one with tuberculosis). All revealed accumulation of In-111 labeled pentetreotide in the granulomatous lesions, which was considered to be due to the presence of activated lymphocytes in these regions. This method may be of value in assessing the activity and extent of sarcoidosis and tuberculosis.

Distribution of coagulase-negative staphylococci, including the newly described species Staphylococcus schleiferi, in nosocomial and community acquired urinary tract infections.

Abstract: Four hundred and four coagulase-negative staphylococci were isolated from 4905 urine specimens obtained from 4192 inpatients and outpatients. The distribution of the strains was as follows: 193Staphylococcus epidermidis (47.8 %), 171Staphylococcus saprophyticus (42.3 %), 29Staphylococcus haemolyticus (7.2 %), 5Staphylococcus warneri (1.2 %), 3Staphylococcus schleiferi (0.7 %), 2Staphylococcus hominis (0.5 %) and 1Staphylococcus simulans (0.2 %). All threeStaphylococcus schleiferi strains were isolated from inpatients: a 64-year-old female, a 68-year-old male and a 3-month-old male with colony counts of 468,000 cfu/ml, 324,000 cfu/ml and 764,000 cfu/ml respectively. These findings show that among coagulase-negative staphylococci,Staphylococcus schleiferi, a newly described species of coagulase-negative staphylococci not previously reported as a uropathogen, may also cause hospital acquired urinary tract infection.

Supernumerary Molars and Paramolars

Abstract: Thorough X-ray examination is a valuable adjunct in the clinical assessment of supernumerary teeth. Three cases of supernumerary teeth comprising paramolars and molars are presented with radiographic documentation. All the patients received surgical treatment after full clinical and radiographic evaluation.

Peeling skin syndrome.

Abstract: Peeling skin syndrome is a rare autosomal recessive disease characterized histologically by separation of the stratum corneum above the stratum granulosum. The cardinal clinical features are generalized, inflammatory, spontaneous, continual peeling of the skin and pruritus. Other historic and clinical findings include a positive family history, parentalconsanguini ty, short stature, primaryamenorrhea, sexual infantilism, anosmia, easily removed hairs, palmoplantar keratoderma with chapping, palmoplantar erythema, distal onycholysis,and koilonychia. 1-5 Aminoaciduria, low plasma tryptophan levels,and elevated levels of serum iron, copper, and 19E have also been observed.2-5 We describe a patient with peeling skin syndrome and provide a review of the literature.

Tc-99m MIBI uptake in pulmonary sarcoidosis. Preliminary clinical results and comparison with Ga-67.

Abstract: During tumor imaging research, the authors incidentally discovered that Tc-99m MIBI is taken up by pulmonary sarcoidosis. In order to evaluate this uptake, they performed Tc-99m MIBI planar and SPECT imaging in 7 patients and compared it with Ga-67. Six out of 7 patients showed evident uptake of Tc-99m MIBI in enlarged hilar lymph nodes. One of the patients, who had been on corticosteroid treatment, showed only faint uptake (negative result), in whom Ga-67 uptake was seen in hilar lymph nodes although it was less evident than the uptake in the other patients. The lymph nodes were better demonstrated with Tc-99m MIBI. The fact that enlarged hilar lymph nodes in a patient on corticosteroid treatment showed faint uptake suggests that Tc-99m MIBI could be helpful for assessing the response to treatment. The preliminary experience in a limited number of patients showed that Tc-99m MIBI is taken up by pulmonary sarcoidosis and it appears to be a potential alternative to Ga-67. Further study is necessary to evaluate its ultimate role in pulmonary sarcoidosis imaging.

Deterioration of mixed cryoglobulinemia during treatment with interferon-alpha-2a.

Abstract: A 60-year-old female developed mixed cryoglobulinemia associated with liver cirrhosis caused by the hepatitis C virus. During treatment with rIFN-alpha-2a, deterioration of cryoglobulinemia was recognized. The possible mechanisms underlying the deterioration are discussed.

High Division of the Axillary Artery

Abstract: A case is presented here in which the axillary artery divided into two branches, the lateral branch being situated more deeply with respect to the medial branch. The superficial branch gave rise to on

The effect of chronic exposure to formaldehyde, phenol and organic chlorohydrocarbons on peripheral blood cells and the immune system in humans.

Abstract: The aim of this study was to evaluate immunological, hematological and biochemical parameters in subjects chronically exposed to inhaled formaldehyde (F), phenol (Ph) and isomers of organic chlorohydrocarbons (Chc) released from Ksylamit. Twenty-two office workers had been exposed for 6 months to vapors of Ksylamit, used for protection of felt plates inside the office building. The concentration of Ksylamit vapor was measured at the end of the 6-month period and the level of Ph and F in the air inside the building was 1.3 mg/m3 and 0.8 mg/m3, respectively. Most of the workers had ailments due to the irritant effect of inhaled Ksylamit, but no remarkable increase in morbidity was found during the 6 months of exposure and in a 3-year follow-up. Morphological parameters of blood and the number of natural killer (NK) cells in the group of exposed subjects were within the range observed in healthy subjects matched for age and sex. The number of T-lymphocytes and NK cell cytotoxicity were significantly decreased. Phytohemagglutinin (PHA)- and alloantigen-induced lymphocyte proliferation was diminished. Some biochemical parameters suggested liver damage, although these parameters did not correlate with the levels of Ph and methanol excreted in the urine. Eight subjects with the highest levels of Ph in the urine had decreased erythrocyte and T-helper lymphocyte numbers, and increased numbers of eosinophils and monocytes. The results obtained prove that the functions of both the immune and hematopoietic systems could be affected by chronic exposure to these toxic substances.

Superoxide dismutase and catalase activity in psoriatic patients treated topically with ointment containing 2-chloroethyl-3-chloropropyl sulfide.

Abstract: The purpose of this study was to determine dismutase and catalase activities in erythrocytes of psoriatic patients with psoriasis vulgaris topically treated with an ointment (in accordance with recommendations of the Helsinki Declaration), in which 2-chloroethyl-3-chloropropyl sulfide (CLEPS) is an active compound SOD activity in hemolysates was determined according to the method of Misra and Fridovich [12] and calculated as units per g of hemoglobin CAT activity in hemolysates was determined by Beers and Sizer method [2] and expressed in U/g Hb SOD activity in the control group was 161 +/- 048 U/g Hb x 10(3) However, the activity of CAT was 572 +/- 117 U/g Hb x 10(4) Before treatment SOD activity was decreased by ca 225% (125 +/- 053 U/g Hb x 10(3)) while that of CAT by about 7% (530 +/- 141 U/g Hb x 10(4)), in comparison with the normal control After treatment with the ointment, activity of both enzymes increased by about 18% to 155 x 10(3) U/g Hb and by about 165% to 625 x 10(4) U/g Hb, respectively The results of our investigations showed that the ointment (containing mustard gas derivative) applied on psoriatic skin, causes increased of SOD and CAT activity in erythrocytes after regression of psoriatic lesions and treatment termination

Use of hemoperfusion in experimental intoxication with nerve agents.

Abstract: The aim of this study was to evaluate the efficiency of hemoperfusion (HP) through coated resin adsorbent Synachrom E-5 in animal intoxications with organophosphate inhibitors of cholinesterases type of nerve agents. Five anesthetized dogs were intoxicated with 2 to 6 LD50 of VX substance and another 4 with 2 to 3 LD50 sarine. Both nerve agents were given i.m. after starting 5 h HP. The clinical and laboratory tests were monitored during each HP. HP therapy prevented the development of serious signs of intoxication provided that the administered quantity of both sarine and the VX substance was only 2 doses of LD50. Specific antidote therapy was necessary to prevent cardiorespiratory failure in animals intoxicated with a higher dose of poison. The results obtained show that HP through Synachrom E-5 in intoxication with nerve agents sarine and the VX type is only partially successful.

Isolation, cultivation and phenotypic characterization of rat thymic dendritic cells.

Abstract: Rat thymic dendritic cells (TDC) were isolated from thymic cell suspension by Nycodenz gradients of different densities and osmolarities. After cultivation of these cells for 3 days in the conditioned medium (TE-R 2.5 + HT supernatant) prepared by cocultivation of a medullary thymic epithelial cell line (TE-R 2.5) and hydrocortisone resistant thymocytes, the purity (75-85%) and survival of TDC significantly increased. The supernatant contained moderate activities of IL-1 and IL-6, low levels of TNF-alpha and IL-2 and factor(s) that strongly stimulated the proliferation of a mouse macrophage cell line RAW 264.7. TDC survival in culture was significantly increased by GM-CSF and decreased by IL-6 and IFN-gamma. The phenotype of TDC was studied by flow cytometry using a panel of monoclonal antibodies (mAb) to rat cell surface markers. It was found that almost all freshly isolated TDC expressed major histocompatibility complex (MHC) class I and class II molecules as well as CD45. Most TDC were LFA-1 (CD11a)+, CD18+, ICAM-1 (CD54)+ and CD53 (OX- 44)+, but only certain subsets expressed CD11b and thymocyte markers Thy1, CD2, CD4 and CD8. Upregulation in the expression of almost all the markers was observed after cultivation of TDC. In addition, cultivated, but not freshly isolated TDC expressed CD25 (IL-2R alpha) and CD45RC (OX-22) molecules. Cultivated TDC had strong accessory function in autologous thymocyte proliferation.

Comparison of the effect of endothelium on the responses to sumatriptan in rabbit isolated iliac, mesenteric and carotid arteries.

Abstract: The contractions induced by the 5-hydroxytryptamine (5-HT) and 5-HT1-like receptor agonist sumatriptan in open ring segments of rabbit iliac, mesenteric and common carotid arteries were studied isometrically in vitro. The alteration of the responses by removal of the endothelium and by inhibitors of nitric oxide synthase and cyclooxygenase was investigated. 5-HT induced concentration-dependent contractions of all these three arterial segments. Sumatriptan did not induce any contraction of quiescent mesenteric and iliac arteries, but when a moderate tone was given with a threshold concentration of prostaglandin F2 alpha, it elicited contractions of both arteries (Emax values for sumatriptan in mesenteric and iliac arteries were 84.7% and 29.7% of the phenylephrine maximal effect and EC50 values were 0.22 +/- 0.14 and 0.33 +/- 0.06 microM, respectively). Sumatriptan had no contractile effect at all in carotid arteries in which 5-HT-induced contractions seemed to be mediated by 5-HT2 receptors only. Removal of the endothelium did not affect the responses to 5-HT in iliac, mesenteric and carotid arteries. The contractions induced by sumatriptan were not influenced by removal of the endothelium in the mesenteric artery, while sumatriptan responses were potentiated in the endothelium-denuded preparations of the iliac artery (Emax = 50.8% of the phenylphrine maximal effect; EC50 = 0.46 microM). L-NG-monomethyl arginine (100 microM), a nitric oxide synthase inhibitor, also potentiated the sumatriptan responses in the endothelium-intact segments of the iliac artery. Indomethacin (0.1 microM), a cyclooxygenase inhibitor, did not affect the sumatriptan responses. These results suggest that sumatriptan-induced contractions of the rabbit iliac, but not mesenteric artery, were depressed by itself through the release of nitric oxide upon stimulation of 5-HT1-like receptors located on the endothelium, whereas neither on vascular smooth muscle nor on endothelium, 5-HT1-like receptors were present in the rabbit carotid artery.

Visualization of gastrointestinal bleeding during Tc-99m DTPA renal scintigraphy.

Abstract: A 21-year-old man underwent ileolleostomy, and right hemicolectomy following an abdominal gunshot injury. An enterocutaneous fistula developed in the right hypochondrium. The patient started to have melena 7 days after surgery. Melena discontinued 4 days after initialization of medical therapy. On day 15 after the operation, an elevated serum urea level of 75 mg/dL was detected. Tc-99m DTPA renal scintigraphy revealed mildly impaired renal function and an unexpected area of tracer accumulation in the mid and distal right periureteric region suggested the possibility of a urine leakage. However the patient's IVP revealed no urinary tract abnormality. Two days later, a Tc-99m RBC scintigraphy was performed and demonstrated a bleeding site at the same localization, previously interpreted as urine leakage on Tc-99m DTPA renal scintigraphy.