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Residual radiation-induced damage to the kidney of the pig as assayed by retreatment.

The effect of re-irradiation on the previously irradiated kidney was studied in the Large White female pig. Both kidneys of 14-week-old pigs were initially irradiated with a single dose of 3-7 Gy of 250 kV X-rays. The individual kidney glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and the haematocrit (Hct) were serially measured up to 24 weeks after X-irradiation. Doses of 3 and 5 Gy of X-rays had little effect on the GFR. However, 7 Gy of X-rays caused a marked decline in the GFR up to 12 weeks after irradiation; the GFR then began to recover. A similar pattern of response was seen in the ERPF. In contrast, the Hct was reduced in all pigs 4 weeks after X-irradiation. The extent of the decline and subsequent recovery 24 weeks after irradiation appeared to be related to dose. Twenty-four weeks after X-irradiation both kidneys were re-irradiated with a single dose of 7.9 Gy of 60Co gamma-rays; both kidneys of four age-matched control pigs which had not previously received X-irradiation were similarly treated. Individual kidney GFR, ERPF and Hct were again serially measured up to 24 weeks after gamma-irradiation. Re-irradiation resulted in a significantly greater reduction in the GFR, ERPF and Hct compared with that seen after gamma-irradiation alone. Moreover, the severity of the reduction in the GFR and Hct observed after gamma-irradiation was related, in a dose-dependent manner, to the initial X-ray doses employed. These results indicate that the kidney fails to exhibit complete long-term recovery in function following irradiation. Re-irradiation of the kidney in patients should thus be viewed with extreme caution.

Animals↗

Loss of a putative tumor suppressor locus after gamma-ray-induced neoplastic transformation of HeLa x skin fibroblast human cell hybrids.

The nontumorigenic HeLa x skin fibroblast hybrid cell line, CGL1, can be induced to re-express HeLa tumor-associated cell surface antigen, p75-IAP (intestinal alkaline phosphatase), with resulting neoplastic transformation, by exposure to gamma radiation. This has allowed the human hybrid system to be developed into a quantitative in vitro model for radiation-induced neoplastic transformation of human cells. Recently, several gamma-ray-induced IAP-expressing mutants (GIMs) of the nontumorigenic HeLa x skin fibroblast hybrid CGL1 were isolated and all were tumorigenic when injected subcutaneously into nude mice (Mendonca et al., Cancer Res. 51, 4455-4462, 1991). Control cell lines which were negative for p75-IAP (CONs) were also isolated from irradiated populations, and none were found to be tumorigenic. We have now begun to investigate the molecular basis of radiation-induced neoplastic transformation in this system by studying the potential genetic linkage between p75/IAP expression, tumorigenicity and damage to a putative tumor suppressor locus on fibroblast chromosome 11. Previous analysis of rare spontaneous segregants has indicated that this locus is involved in the regulation of tumorigenicity and in the expression of the HeLa tumor-associated cell surface marker intestinal alkaline phosphatase (p75-IAP) in this system. Therefore, analysis by restriction fragment length polymorphism and chromosome painting have been performed for chromosome 11, and for chromosome 13 as a control, for the p75/IAP-positive GIM and p75/IAP-negative CON cell lines. We report that in five of eight of the GIMs large-scale damage to the fibroblast chromosome 11's is evident (four GIMs have lost one complete copy of a fibroblast chromosome 11 and one GIM has both copies of fibroblast chromosome 11 heavily damaged). None of the CONs, however (0/5), have lost a complete copy of either fibroblast chromosome 11. No large-scale damage to the control chromosome 13's was detected in the GIMs or CONs. The data further suggest that both copies of fibroblast chromosome 11 contain an active locus and that radiation-induced loss of either fibroblast chromosome 11 will result in neoplastic transformation in this system. We conclude that it is the loss of a putative tumor suppressor locus on fibroblast chromosome 11 which is responsible at least in part for radiation-induced neoplastic transformation of these human hybrid cells.

Cell Transformation, Neoplastic↗

Development of severe left ventricular outflow tract obstruction over the course of 14 years: an unusual natural history of hypertrophic obstructive cardiomyopathy.

A patient with hypertrophic obstructive cardiomyopathy who when first seen had a normal physial examination, chest x-ray, and electrocardiogram, and no provokable gradient with isoproterenol at cardiac catheterization, was re-evaluated after 14 years. At the time of re-evaluation, she was found to have a typical systolic ejection murmur, cardiomegaly, left ventricular hypertrophy, a pseudoinfarction pattern on electrocardiography, and a significant subaortic gradient both by catheterization and by doppler. This case demonstrates that hypertrophic obstructive cardiomyopathy can be a progressive disease and that patients with this condition warrant careful follow-up. Echocardiography with doppler may provide an excellent noninvasive method of following these patients.

Cardiomegaly↗

Recurrent bilateral mammary fibromatosis (desmoid tumor) imaged with technetium-99m pentavalent dimercaptosuccinic acid [99mTc-(V)DMSA] scintimammography.

BACKGROUND: Breast fibromatosis is a rare, benign, recurring, locally destructive entity. CASE: A 35-year-old woman underwent right-sided lumpectomy, revealing fibromatosis with epithelial hyperplasia. Two years later, she was re-evaluated due to a three times as large mass recurrence on X-ray mammography. (99m)Tc-(V)DMSA scintimammography revealed diffuse increased radiotracer uptake occupying the entire breast. A less widespread similar uptake was observed in the contralateral breast. Mammography did identify neither the posterior margins of the mass nor the left-sided lesion. The patient underwent mastectomy and left-sided open biopsy, revealing bilateral fibromatosis. Ki-67 expression was moderate. CONCLUSIONS: (99m)Tc-(V)DMSA scintimammography can provide information regarding the nature of the lesion, its extent and bilateral involvement (especially in dense breasts) and could prove useful as a predictor of its potential for recurrence.

Adult↗

Strategy for improving hand opening in the tetraplegic upper limb.

In the tetraplegic patient, restoring an adequate grip requires primary restoration of proper hand opening. This opening (or "extensor") surgical stage is performed 3 or 4 months before the closing (or "flexor") stage. Surgical strategy is based on group 5 of the IC, which represents a turning point. Above this group (i.e., in IC groups 2-4), opening is essentially based on passive procedures (such as tenodesis and arthrodesis). Starting at group 5, restoration of active digital extension is [table: see text] feasible, as well as active stabilization of the thumb ray in lower groups. In those lower groups, all efforts should aim at re-establishing an intrinsic balance, keeping in mind the difference between supple and rigid claw deformities, which require different corrective procedures (Table 1).

Fingers↗

Reactivity of [Re[kappa(3)-H(mu-H)B(tim(Me))(2)](CO)(3)] (tim(Me) = 2-mercapto-1-methylimidazolyl) toward neutral substrates.

The complex [Re[kappa(3)-H(mu-H)B(tim(Me))(2)](CO)(3)] (2a) (tim(Me) = 2-mercapto-1-methylimidazolyl) reacts with a variety of neutral substrates to afford new complexes featuring the dihydrobis(2-mercapto-1-methylimidazolyl)borate coordinated in a bidentate or unidentate fashion. By treating 2a with unidentate ligands, the mononuclear complexes [Re[kappa(2)-H(2)B(tim(Me))(2)](CO)(3)(L)] (L = imidazole (5), 4-(dimethylamino)pyridine (6), tert-butylisonitrile (7), triphenylphosphine (8)) were formed, upon replacement of the agostic B-H...Re bond by the correspondent unidentate ligand. With potentially bidentate substrates, 2a is transformed into mononuclear or dinuclear complexes, depending on the atom donor set of the reacting substrates. Reaction of compound 2a with ethylenediamine (en) gave the complex [Re[kappa(1)-H(2)B(tim(Me))(2)](CO)(3)(en)] (9), because of cleavage of the agostic interaction, dechelation of one mercaptoimidazolyl ring, and bidentate coordination of the amine. By contrast, 1,2-bis(diphenyl)phosphinoethane (dppe) is not able to replace the mercaptoimidazolyl ring, and the dimer [Re[kappa(2)-H(2)B(tim(Me))(2)](CO)(3)](2)(mu-dppe) (10) was formed. The novel Re(I) tricarbonyl complexes (5-10) have been fully characterized, including by X-ray diffraction analysis in the case of 6, 8, 9, and 10. The X-ray diffraction study confirmed the unprecedented unidentate coordination mode of the dihydrobis(2-mercapto-1-methylimidazolyl)borate in complex 9.

Journal Article↗

Re-analysis of radiation-induced specific locus mutations in the mouse.

A re-analysis of published data on mouse mutation rates induced by X and gamma rays suggests that the kinetics of induction can be analysed by fitting the data to a parabolic curve. We interpret this to mean that a substantial proportion of the induced mutations results from gross chromosomal changes such as deletions, some of which are one-track and some of which are two-track. This analysis is based on the assumption that the shape of the dose curve, which in the female is concave upward, reflects the manner in which the mutations are induced rather than representing a one-track (linear) curve whose shape has been modified by differential repair.

Animals↗

Thermal stabilization of metal finishing waste with clay.

Thermal treatment of metal finishing waste with locally available clay, in their varying ratios, was carried out at 850 degrees C and above temperatures. In the presence of 1:1 ratio of waste and clay a solidified product was obtained at 950 degrees C. Measurement of an appreciably high compressive strength, approximately 500 kg cm(-2) and a very small (0.4%) water absorption from the solidified product indicated its stable nature. Toxicity Characteristic Leaching Procedure (TCLP) test of the waste showed nearly 85 to 90% decrease of leaching of Fe, Cu, Ni, Zn, Mn and Cr after thermal treatment compared to their leaching without treatment. No hexavalent chromium (Cr(VI)) was observed from the leachate of the solidified product. This indicates the absence of re-oxidation phenomena of chromium during thermal treatment up to 950 degrees C. X - ray diffraction (XRD) of solidified product indicated the presence of hematite, and aluminum silicate as main phases of the solidified product. Involvement of the above waste metals with these phases during thermal treatment could be the reason for their immobilization.

Aluminum Silicates↗

Three-beam X-ray diffraction in a semi-infinite perfect crystal.

The approach to multibeam X-ray diffraction by Shen [Acta Cryst. (1986). A42, 525-533] has been carefully re-examined for three-beam Laue-Laue diffraction in a perfect non-absorbing semi-infinite crystal. A modified version of Shen's theory is shown to be equivalent to the Takagi-Taupin formalism. The perturbation of the two-beam integrated power when a third beam is being excited is thus expressed by non-diverging terms. Both Aufhellung and Umweganregung terms are recovered.

Journal Article↗

Structure refinement of the layered composite crystal Sc2B1.1C3.2 in a five-dimensional formalism.

The crystal structure of a layered compound Sc(2)B(1.1)C(3.2), scandium boride carbide (M(r) = 140.43), has been re-refined as a commensurate composite crystal using 1795 single-crystal X-ray diffraction intensities with I > 2 sigma(I) collected by Shi, Leithe-Jasper, Bourgeois, Bando & Tanaka [(1999), J. Solid State Chem. 148, 442--449]. The crystal is composed of two layered subsystem structures, i.e. Sc--C--Sc sandwiches and graphite-like layers of the composition B(1/3)C(2/3). The structure refinement was performed in a five-dimensional formalism based on the trigonal superspace group P3m1(p00)(0p0)0m0. The unit cell and other crystal data are a = b = 3.387 (1), c = 6.703 (2) A, V = 66.59 (1) A(3), sigma(1) = (9/7 0 0), sigma(2) = (0 9/7 0), Z = 1, D(x) = 3.501 Mg m(-3). Two different three-dimensional sections through the superspace were analyzed, corresponding to two different superstructure models, one with P3m1 and the other with P3m1. A random distribution of B and C was assumed in the graphite-like layer and 41 structural parameters were introduced. R(F)/wR(F) were 0.0533/0.0482 and 0.0524/0.0476, respectively, for the first and second models. Although the difference between these R(F) or wR(F) values was too fine to exclude one of the models definitely, the advantages of using a superspace group were obvious. It not only brought about better convergence of refinement cycles by virtue of fewer parameters, but also gave an insight into the problem of symmetry of the superstructure.

Journal Article↗

Amino acid sequence analysis of the annexin super-gene family of proteins.

The annexins are a widespread family of calcium-dependent membrane-binding proteins. No common function has been identified for the family and, until recently, no crystallographic data existed for an annexin. In this paper we draw together 22 available annexin sequences consisting of 88 similar repeat units, and apply the techniques of multiple sequence alignment, pattern matching, secondary structure prediction and conservation analysis to the characterisation of the molecules. The analysis clearly shows that the repeats cluster into four distinct families and that greatest variation occurs within the repeat 3 units. Multiple alignment of the 88 repeats shows amino acids with conserved physicochemical properties at 22 positions, with only Gly at position 23 being absolutely conserved in all repeats. Secondary structure prediction techniques identify five conserved helices in each repeat unit and patterns of conserved hydrophobic amino acids are consistent with one face of a helix packing against the protein core in predicted helices a, c, d, e. Helix b is generally hydrophobic in all repeats, but contains a striking pattern of repeat-specific residue conservation at position 31, with Arg in repeats 4 and Glu in repeats 2, but unconserved amino acids in repeats 1 and 3. This suggests repeats 2 and 4 may interact via a buried saltbridge. The loop between predicted helices a and b of repeat 3 shows features distinct from the equivalent loop in repeats 1, 2 and 4, suggesting an important structural and/or functional role for this region. No compelling evidence emerges from this study for uteroglobin and the annexins sharing similar tertiary structures, or for uteroglobin representing a derivative of a primordial one-repeat structure that underwent duplication to give the present day annexins. The analyses performed in this paper are re-evaluated in the Appendix, in the light of the recently published X-ray structure for human annexin V. The structure confirms most of the predictions and shows the power of techniques for the determination of tertiary structural information from the amino acid sequences of an aligned protein family.

Algorithms↗

High state of order of isolated bacterial lipopolysaccharide and its possible contribution to the permeation barrier property of the outer membrane.

The conformational properties of the isolated S form of Salmonella sp. lipopolysaccharide (LPS), of Re mutant LPS, and of free lipid A were investigated by using X-ray diffraction and conformational energy calculations. The data obtained showed that LPS in a dried, in a hydrated, and probably also in an aqueous dispersion state is capable of forming bilayered lamellar arrangements similar to phospholipids. From the bilayer packing periodicities, a geometrical model of the extensions of the LPS regions lipid A, 2-keto-3-deoxyoctulosonic acid, and O-specific chain along the membrane normal could be calculated. Furthermore, the lipid A component was found to assume a remarkably high ordered conformation: its fatty acid chains were tightly packed in a dense hexagonal lattice with a center-to-center distance of 0.49 nm. The hydrophilic backbone of lipid A showed a strong tendency to form domains in the membrane, resulting in a more or less parallel arrangement of lipid A units. According to model calculations, the hydrophilic backbone of lipid A appears to be oriented approximately 45 degrees to the membrane surface, which would lead to a shed roof-like appearance of the surface structure in the indentations of which the 2-keto-3-deoxyoctulosonic acid moiety would fit. In contrast, the O-specific chains assume a low ordered, heavily coiled conformation. Comparison of these structural properties with those known for natural phospholipids in biological membranes indicates that the high state of order of the lipid A portion of LPS might be an important factor in the structural role and permeation barrier functions of LPS in the outer membrane of gram-negative bacteria.

Bacteria↗

[Unusual case of the long term presence of esophageal foreign body (non-radiopaque coin) in children].

The authors report an unusual case of a foreign body in the esophagus of a child present for longer than 2 years. As an infant this child had repair of esophageal atresia. She was examined and assessed 2 years ago for suspected foreign body swallowing. Chest and abdominal xrays did not show the presence of any foreign body. Now this child was re-admitted with a foreign body in the esophagus, a piece of meat. X rays showed narrowing at previous anastomosis site and dilatation proximally. At esophagoscopy after removal of the piece of meat, a coin was removed as well (50 Hungarian fills). This coin has low radiopacity so did not contrast well in soft tissue. It is worth pointing out that despite having a foreign body this child did not have any difficulty with swallowing and development was normal.

Child↗

[Slip of the T tube within the common bile duct--a little known complication of the T tube drainage].

Complications related to the T tube drainage of the common bile duct are not uncommon. Some, like dislocations of the T tube out of the common bile duct, could be very serious, particularly if developed during the first few days after surgery, when the abdominal drain in the subhepatic space had been already removed.Then, an emergency reoperation might be necessary. The slip of the T tube upwards or downwards inside the common bile duct is not so rare. Fortunately, it is less dangerous and can usually be resolved without reoperation. It takes place several days after surgery, followed by the right subcostal pain, occasionally with temperature, rise of the bilirubin and with decrease or complete cessation of the bile drainage through the T tube. The diagnosis can be made only on the basis of T tube cholangiography. The re-establishment of the proper T tube position must be done under X-ray visualization. Seven cases of the T tube slip within the common bile duct, its clinical presentation, diagnosis and method of repositioning were presented. Possible mechanism of complication was described. As far as we know, the complications have not been described by other authors.

Adult↗

An early case of pulmonary lymphangioleiomyomatosis diagnosed by video-assisted thoracoscopic surgery.

Pulmonary lymphangioleiomyomatosis (LAM) is a rare and progressive disease of young women that usually causes death from respiratory failure. Here we report an early case that was diagnosed by thoracoscopy. A 28-year-old woman presented to a local clinic with chest pain and her chest X-ray film showed left pneumothorax. After placement of a chest tube, the lung re-expanded fully. Following the recurrence of left pneumothorax, she was referred to our hospital and underwent video-assisted thoracoscopic surgery (VATS). However, left pneumothorax recurred again one month later. She underwent a second thoracoscopic operation, during which a bulla was recognized in the lingular segment of the left lung and was resected. On histological examination of the surgical specimen findings consistent with LAM were obtained. Taking the preoperative imaging findings and the thoracoscopic findings into consideration, a diagnosis of early lymphangioleiomyomatosis was made. Thoracoscopic management of pneumothorax in young women can facilitate the early diagnosis of this condition.

Adult↗

[Reconstruction of severe acetabular bone defects using Burch-Schneider cage].

PURPOSE OF THE STUDY: The Burch-Schneider cages (BSC) are designed to manage severe acetabular defects by bridging large bone gaps and preventing medial and superior migration of the prosthetic cup. The purpose of the study was to evaluate the results of such revisions after prolonged follow-ups. MATERIAL AND METHODS: From 1985 to 2000 sixty-nine acetabular revisions with BSC were performed in 68 patients with an acetabular defect classified as type Paprosky 3A (32) and 3B (37) at our institutions. After meticulous debridement of the entire acetabulum cancellous chips were pressurized into the bone defects to restore the hemispherical shape. The cage flange for the ischium was then placed after slight contouring into the foramen obturatum or inside the ischium. Finally, the cage was fixed against the ilium with at least three screws. The average age at the time of surgery was 67.9 years (range, 51-78), the mean follow-up equalled 8.3 years (range, 5-20), and the mean Harris hip score was 48 points (range, 29-76). A clinical follow-up study was performed with using conventional measures such as Harris hip score, x-ray analysis, strength of the abductor muscles, and ability to walk without support. RESULTS: A total of 55 patients (80.9 %) remained without any revision until the latest follow-up. Six components were removed due to aseptic loosening (8.7 %); five for septic loosening (7.2 %), and two revisions had to be performed for recurrent instability (2.9 %). Moreover, there were another six hips definitely or probably loose according to x-ray analysis resulting in a 17.4 % (12/69) rate of aseptic failure. Successful cage re-replacement was achieved only in two cases while the remaining nine hips ended as resection arthroplasties. At the time of follow-up examinations the average Harris hip score was 74 points (range, 51-91), only twelve patients were able to walk without support (12/68, 17.6 %), and insufficiency of the abductor muscles was found in fifteen hips (15/69, 21.7 %). Consolidation of the bone graft was observed in 79.7 % (55/69) of our hips. DISCUSSION: The severe acetabular bone defect reconstructions have been deteriorating with time as reported by most of the published studies. The results of the current study are no exception. On the other hand, the rate of complications observed in our study was comparable or even lower than in similar studies. CONCLUSIONS: Despite relatively worse results with prolonged follow-ups, the BSC remains a considerable part of the current orthopaedic armamentarium especially when extensive acetabular bone loss is countered. Loosening belongs to the most common complications of the BSC.

Acetabulum↗

[Two cases of supposed metastasizing leiomyosarcoma of the uterus].

Case 1. A 57-year-old female had hysterectomy 10 years ago because of leiomyoma uteri. She was recently found to have a clear-cut round mass shadow in the right middle lung field on her chest X-ray film 3. The mass was resected and microscopically diagnosed as metastatic leiomyosarcoma. Re-examination of the pathological specimen of the uterine tumor resected 10 years ago revealed 5-9 mitosis per 10 high-powered fields (/10 HPF). Case 2. A 54-year-old female who had undergone hysterectomy for myoma uteri 9 years previously was found to have a well-defined oval shadow in the left lower lung field which was resected and pathologically diagnosed as metastatic leiomyosarcoma. Her uterus lesion microscopically revealed 1-2 mitosis/10 HPF. The relationship between metastatic leiomyosarcoma of the lung and mitotic activity of leiomyoma uteri was discussed.

Female↗