[Computerized axial tomography in tumors of the maxillofacial area].
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Aged↗
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[Arthroscopic subacromial decompression--indications in os acromiale?].
A total of 122 patients with subacromial pathology without tears in the rotator cuff underwent arthroscopic subacromial decompression (ASD) and were re-examined 1-3 years after the operation. All patients' data were recorded before and after operation with reference to a 100-point shoulder score. The group included 12 patients who proved to have an os acromiale on X-ray. Postoperatively scores wee significantly higher (p < 0.05). Patients with os acromiale had a slightly but not significantly worse outcome than the others. Results were excellent in 43% of all patients, good in 17%, and fair in 25%, while 15% were considered failures. Again patients with an os acromiale had a slightly, but not significantly, worse result. Patients with a preoperative pain history of more than 1 year had a significantly worse result than those with a preoperative course of less than 1 year (p < 0.05). This was true for both groups without any differences between them. Older patients also scored worse in both groups. Other factors, e.g. sex, preoperative range of motion, and muscle atrophy, did not significantly influence the result. Our results after ASD in patients with subacromial pathology without rupture of the rotator cuff and with os acromiale are encouraging. Therefore, this minimally invasive procedure seems to be a reasonable alternative to other complex procedures with ORIF in selected cases.
Acromion↗
Pelger-Huët anomaly mimicking 'shift to the left'.
A case report is presented of an 83-year-old male patient with respiratory distress, body temperature of 38.5 degrees C, bilateral white infiltrates on chest X-ray and ECG showing acute myocardial infarction. Clinical evaluation led to the suspicion of severe infection accompanying lung congestion due to the infarction, mostly because his white blood cell differential count showed a persistent severe 'shift to the left'. Re-examination of his blood smear showed that the 'shift to the left' did not consist of band forms but of a 'Pelger-Huet' anomaly of the granulocytes. Recognition of this anomaly in the light of rapid clinical and radiological improvement precluded the administration of antibiotics for the diagnosis of severe infection with pulmonary involvement, which responded to diuretic therapy alone.
Aged↗
Rhenium-186-HEDP palliative treatment in disseminated bone metastases due to prostate cancer.
Prostate carcinoma is the most commonly associated with osseous metastases malignancy in males. The lesions, being usually of a mixed sclerotic/lytic variety and less often of the pure sclerotic type, need to be treated by a bone seeking radioactive element with an as low as possible radiobiological burden on the surrounding (peritumoral) tissues. Rhenium-186-HEDP was used to treat these osseous metastatic lesions due to its bone seeking kinetics attractive radiochemical properties. Of a total of 16 prostate cancer patients. 3 experiment loss of pain, 8 experienced obvious and 2 some improvement. No change was observed in 3 patients. Ten patients manifested a flare syndrome increasing pain approximately 2 to 6 days, after Re-186-HEDP i.v. application. Six patients showed a definite and 9 a slight decrease in platelet levels and absolute number of polymorphonuclear white blood cells, up to fourth week following treatment. One patient underwent a whole blood transfusion and in 2 peripheral neuropathy was observed lasting about 9 to 12 days. Re-186-HEDP appears to be a promising new metal ion complex for the palliation of painful bone metastases in prostate cancer. Compared to Sr-89 therapy, it shows a longer analgetic efficacy and has the advantage of emitting gamma rays, a fact which facilitates dosimetric calculations.
Aged↗
Mechanism of the reductive half-reaction in cellobiose dehydrogenase.
The extracellular flavocytochrome cellobiose dehydrogenase (CDH; EC ) participates in lignocellulose degradation by white-rot fungi with a proposed role in the early events of wood degradation. The complete hemoflavoenzyme consists of a catalytically active dehydrogenase fragment (DH(cdh)) connected to a b-type cytochrome domain via a linker peptide. In the reductive half-reaction, DH(cdh) catalyzes the oxidation of cellobiose to yield cellobiono-1,5-lactone. The active site of DH(cdh) is structurally similar to that of glucose oxidase and cholesterol oxidase, with a conserved histidine residue positioned at the re face of the flavin ring close to the N5 atom. The mechanisms of oxidation in glucose oxidase and cholesterol oxidase are still poorly understood, partly because of lack of experimental structure data or difficulties in interpreting existing data for enzyme-ligand complexes. Here we report the crystal structure of the Phanerochaete chrysosporium DH(cdh) with a bound inhibitor, cellobiono-1,5-lactam, at 1.8-A resolution. The distance between the lactam C1 and the flavin N5 is only 2.9 A, implying that in an approximately planar transition state, the maximum distance for the axial 1-hydrogen to travel for covalent addition to N5 is 0.8-0.9 A. The lactam O1 interacts intimately with the side chains of His-689 and Asn-732. Our data lend substantial structural support to a reaction mechanism where His-689 acts as a general base by abstracting the O1 hydroxyl proton in concert with transfer of the C1 hydrogen as hydride to the re face of the flavin N5.
Binding Sites↗
Atomic resolution structure of the HFBII hydrophobin, a self-assembling amphiphile.
Hydrophobins are proteins specific to filamentous fungi. Hydrophobins have several important roles in fungal physiology, for example, adhesion, formation of protective surface coatings, and the reduction of the surface tension of water, which allows growth of aerial structures. Hydrophobins show remarkable biophysical properties, for example, they are the most powerful surface-active proteins known. To this point the molecular basis of the function of this group of proteins has been largely unknown. We have now determined the crystal structure of the hydrophobin HFBII from Trichoderma reesei at 1.0 A resolution. HFBII has a novel, compact single domain structure containing one alpha-helix and four antiparallel beta-strands that completely envelop two disulfide bridges. The protein surface is mainly hydrophilic, but two beta-hairpin loops contain several conserved aliphatic side chains that form a flat hydrophobic patch that makes the molecule amphiphilic. The amphiphilicity of the HFBII molecule is expected to be a source for surface activity, and we suggest that the behavior of this surfactant is greatly enhanced by the self-assembly that is favored by the combination of size and rigidity. This mechanism of function is supported by atomic force micrographs that show highly ordered arrays of HFBII at the air water interface. The data presented show that much of the current views on structure function relations in hydrophobins must be re-evaluated.
Amino Acid Sequence↗
Transformation in the use of radiation therapy of Hodgkin lymphoma: new concepts and indications lead to modern field design and are assisted by PET imaging and intensity modulated radiation therapy (IMRT).
The role of radiation therapy (RT) in Hodgkin lymphoma has changed substantially; it has evolved from a first-line comprehensive single agent into a complementary adjuvant following chemotherapy. Yet, the significant contribution of adding radiotherapy has repeatedly been confirmed by recent information from several prospective randomized trials in early stage patients (CCG, Canada NCIC, and EORTC/GELA H9F). In a recent study that included patients of all stages adding radiotherapy impacted significantly on overall survival. Even in advanced-stage disease, in patients with less than CR, and/or bulky disease or in programs that use short-course chemotherapy (e.g. Stanford V) involved-field radiation therapy (IFRT) remained essential. Randomized studies and most recently the GHSG HD 10 and HD 11 documented excellent results with low-dose IFRT of only 20 Gy in both early stage and in intermediate-stage patients. It is now standard of care to use IFRT rather than the extended radiation fields of the past (mantle, inverted Y, and STLI/TLI). Even smaller volumes than IFRT, such as 'lymph-node fields' are advocated by paediatrics groups and are under consideration for future adults treatment programs. This change in RT concept has been motivated by need to reduce normal tissue exposure in order to markedly lessen the risk of late complications. The small fields of current radiotherapy allow more conformal and innovative approaches that have not been technically feasible in the past. They also mandate better targeting. Both the accuracy and the confirmality of 'min-radiation' are augmented, by using new advances in imaging, treatment planning, and new radiation delivery systems. The PET/CT/Simulator integrated hardware with innovative software allows more accurate PET and CT (or MRI) parallel volume contouring, radiation 'dose painting' (dose tailored to PET residual activity) and field 'sculpting'. Introducing intensity modulated radiotherapy technology (IMRT)--a technology that was originally designed for small tumors treated with very high doses--to the field of lymphoma provides safer and more accurate radiotherapy to selected patients with very bulky residual disease and permits re-irradiation of relapsed disease.
Combined Modality Therapy↗
Cystic lymphangioma: its orofacial manifestations.
A patient age five years, nine months with cystic lymphangioma was studied to determine the causes of malocclusion and the optimum time for its treatment. The main findings were unilateral anterior and posterior crossbite and displacement of the mandibular midline due to maxillary deformity and mandibular rotation. The force of the cystic lymphangioma mass caused deformity of the maxilla and rotation of the mandible. The patient had no functional impairment of speech or mastication. A decision was made to defer treatment of malocclusion until complete surgical excision of the cystic lymphangioma can be undertaken, thereby minimizing the chance of malocclusion re-occurrence.
Cephalometry↗
The re-emerging burden of rickets: a decade of experience from Sydney.
AIM: To define the demographics and clinical characteristics of cases presenting with nutritional rickets to paediatric centres in Sydney, Australia. METHODS: Retrospective descriptive study of 126 cases seen from 1993 to 2003 with a diagnosis of vitamin D deficiency and/or confirmed rickets defined by long bone x ray changes. RESULTS: A steady increase was seen in the number of cases per year, with a doubling of cases from 2002 to 2003. Median age of presentation was 15.1 months, with 25% presenting at less than 6 months of age. The most common presenting features were hypocalcaemic seizures (33%) and bowed legs (22%). Males presented at a younger age, with a lower weight SDS, and more often with seizures. The caseload was almost exclusively from recently immigrated children or first generation offspring of immigrant parents, with the region of origin predominantly the Indian subcontinent (37%), Africa (33%), and the Middle East (11%). Seventy nine per cent of the cases were born in Australia. Eleven cases (all aged <7 months) presented atypically with hyperphosphataemia. CONCLUSIONS: This large case series shows that a significant and increasing caseload of vitamin D deficiency remains, even in a developed country with high sunlight hours. Cases mirror recent immigration trends. Since birth or residence in Australia does not appear to be protective, screening of at risk immigrant families should be implemented through public health policies.
Child, Preschool↗
Caroli's disease: central dot sign re-examined by CT arteriography and CT during arterial portography.
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Adult↗
Intracranial placement of a nasogastric tube. A lesson to be re-learnt?
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Adult↗
Re: Effect of sunscreens on UV radiation-induced enhancement of melanoma growth in mice.
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Animals↗
Physical characteristics of freeze-dried griseofulvin-lipids nanoparticles.
We have attempted to prepare micronized drug particles and to maintain the micronized state long-term in order to improve the solubility of a practically insoluble drug, griseofulvin (GF). GF nanoparticles (GFNPs) prepared by high-pressure homogenization were micronized to about 45 nm (mean particle size). GFNPs were subjected to transmission electron microscopy (TEM) observation. The mean particle size remained at about 50 nm for 3 months at 25 degrees C. However, increased to about 300 nm in 6 months. After 5% (w/v) sugar was added, GFNP was freeze-dried and rehydrated. The mean particle size of the rehydrated GFNPs was about 160 nm when the sugar was a monosaccharide. In contrast, it was about 55-65 nm when the sugar was a disaccharide. The powder X-ray diffraction pattern of the monosaccharide-containing freeze-dried GFNPs revealed a crystal state of sugar. On the other hand, that of the disaccharide-containing freeze-dried GFNPs indicated an amorphous state of sugar. From this result, it is considered that the high viscosity of an amorphous sugar prevents GFNPs from aggregating through retardation of molecular movement. Freeze-dried GFNPs stored for six months at 25 degrees C showed a good re-dispersibility. After the rehydration the mean particle size of GFNPs was 55-65 nm. It was found that freeze-dried GFNPs containing sucrose, maltose or trehalose were stable for longer periods than GFNP suspensions.
Antifungal Agents↗
Heterobimetallic oxalato-bridged Cu(II)Re(IV) complexes. Synthesis, crystal structure and magnetic properties.
Three copper(II)-rhenium(IV) bimetallic complexes of formula [ReCl(4)(mu-ox)Cu(phen)(2)] (1), [ReCl(4)(mu-ox)Cu(phen)(2)].CH(3)CN (2), and [ReCl(4)(mu-ox)Cu(terpy) (H(2)O)][ReCl(4)(mu-ox)Cu(terpy)(CH(3)CN)] (3) (ox = oxalate anion, phen = 1,10-phenanthroline, and terpy = 2,2':6,2"- terpyridine) have been synthesized and their crystal structures determined by single-crystal X-ray diffraction. Complex 1 crystallizes in the triclinic system, space group P(-1), with a = 9.776(2), b = 11.744(3), c = 14.183(3) A, alpha =102.09(2) degrees, beta = 109.42(2) degrees, gamma = 107.11(2) degrees, and Z = 2, whereas 2 and 3 crystallize in the monoclinic system, space groups P2(1)/n and P2(1)/c, respectively, with a = 12.837(3), b = 17.761(4), c = 12.914(3) A, beta = 91.32(2) degrees, and Z = 4 for 2, and a = 8.930(2), b = 18.543(4), c = 27.503(6) A, beta = 94.67(2) degrees, and Z = 4 for 3. The structures of 1 and 2 are made up of neutral [ReCl(4)(mu-ox)Cu(phen)(2)] bimetallic units. Re(IV) and Cu(II) metal ions exhibit distorted octahedral coordination geometries, being bridged by a bis(bidentate) oxalato ligand. The presence of acetonitrile molecules of crystallization in 2 causes a somewhat greater separation between the bimetallic complexes and a different packing of these units in the crystal structure with respect to 1. The copper-rhenium separation across oxalato is 5.628(2) in 1 and 5.649(3) A in 2. The structure of 3 is made up of two different and neutral bimetallic units, [ReCl(4)(mu-ox)Cu(terpy)(H(2)O)] and [ReCl(4)(mu-ox)Cu(terpy)(CH(3)CN)]. In the first one, the oxalate group behaves as a bis(bidentate) ligand occupying one equatorial and one axial position in the elongated octahedral environment of Cu(II). The water molecule is axially coordinated. In the second one, the oxalate group behaves as a bidentate/monodentate ligand occupying the axial position in the square pyramidal environment of Cu(II). The acetonitrile molecule occupies a basal coordination position around the copper atom. These units are arranged in such a way that a chlorine atom of the first unit (Cl(1)) points toward the copper atom (Cu(2))of the second one (3.077(2) A for Cl(1)(.)Cu(2)), forming a tetranuclear species. The copper-rhenium separation across bis(didentate) oxalato is 5.504(3) A, whereas that through bidentate/monodentate oxalato is 5.436(2) A. The magnetic behavior of 2 and 3 has been investigated over the temperature range 1.8-300 K. A very weak and nearly identical antiferromagnetic coupling between Re(IV) and Cu(II) through bis(bidentate) oxalato occurs in 2 (J = -0.90 cm(-1)) and 3 (J = -0.83 cm(-1)); it is ferromagnetic in 3 through both the bidentate-monodentate oxalato (J = +5.60 cm(-1)) and the chloro (J = +0.70 cm(-1)) bridges.
Journal Article↗
Crystal structures of medium-chain acyl-CoA dehydrogenase from pig liver mitochondria with and without substrate.
The three-dimensional structure of medium-chain acyl-CoA dehydrogenase from pig mitochondria in the native form and that of a complex of the enzyme and a substrate (product) have been solved and refined by x-ray crystallographic methods at 2.4-A resolution to R factors of 0.172 and 0.173, respectively. The overall polypeptide folding and the quaternary structure of the tetramer are essentially unchanged upon binding of the ligand, octanoyl (octenoyl)-CoA. The ligand binds to the enzyme at the rectus (re) face of the FAD in the crevice between the two alpha-helix domains and the beta-sheet domain of the enzyme. The fatty acyl chain of the thioester substrate is buried inside of the polypeptide and the 3'-AMP moiety is close to the surface of the tetrameric enzyme molecule. The alkyl chain displaces the tightly bound water molecules found in the native enzyme and the carbonyl oxygen of the thioester interacts with the ribityl 2'-hydroxyl group of the FAD and the main-chain carbonyl oxygen of Glu-376. The C alpha--C beta of the fatty acyl moiety lies between the flavin and the gamma-carboxylate of Glu-376, supporting the role of Glu-376 as the base that abstracts the alpha proton in the alpha--beta dehydrogenation reaction catalyzed by the enzyme. Trp-166 and Met-165 are located at the sinister (si) side of the flavin ring at the surface of the enzyme, suggesting that they might be involved in the interactions with electron transferring flavoprotein. Lys-304, the prevalent mutation site found in patients with medium-chain acyl-CoA dehydrogenase deficiency, is located approximately 20 A away from the active site of the enzyme.
Acyl-CoA Dehydrogenase↗
Pneumatic lithotripsy for the management of ureteric calculi.
OBJECTIVE: To determine the efficacy of Swiss lithoclast in the management of ureteric calculi and complications encountered in lithoclasty. DESIGN: A prospective observational study. PLACE AND DURATION OF STUDY: Department of Urology, Lahore General Hospital, Lahore (October 1999 - September 2001). SUBJECTS AND METHODS: Thirty ureteric stones (in 20 subjects) were treated over a 2-year period. Site, size and number of stones were noted in these patients. Swiss lithoclast, introduced through a ureteroscope, was used to break the stone. The Lithotripsy time was 30 min. Stone breakage was assessed by plain X-ray KUB or retrograde pyelography. RESULTS: Fragmentation was complete in 90 % cases. At one week follow up, 90% of patients were stone-free and at 3 months follow-up 95 % of patients had spontaneous passage of the fragments. Re-treatment was required in 5% cases. Mean hospital stay was 2.4 days. Complications (including both significant and minor) occurred in 25% of cases. CONCLUSION: Lithoclasty is safe, simple and effective procedure for ureteric calculi. However, complications of the procedure may prolong the usual 48 hours hospital stay seen in uncomplicated cases.
Adolescent↗
Changes in the structural properties and rate of hydrolysis of cotton fibers during extended enzymatic hydrolysis.
An extended enzymatic hydrolysis of cotton fibers by crude cellulase from Trichoderma pseudokoningii S-38 is described with characterization of both the enzyme changes of activities and cellulose structure. The hydrolysis rates declined drastically during the early stage and then slowly and steadily throughout the whole hydrolysis process the same trend could be seen during the following re-hydrolysis process. Morphological and structural changes to the fibers, such as swelling, frequent surface erosion, and variation in the packing and orientation of microfibrils, were investigated by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Observation of X-ray diffraction and IR spectra suggests that the hydrolysis process results in a gradual increase in the relative intensity of the hydrogen bond network, and a gradual decrease in the apparent crystal size of cellulose. The I(alpha) crystal phase was hydrolyzed more easily than was the I(beta) crystal phase. Apart from the inactivation of CBHs activity, changes in the packing and arrangement of microfibrils and the structural heterogeneity of cellulose during hydrolysis could be responsible for the reduction in the rate of reaction, especially in its later stages. The results indicate that the enzymatic hydrolysis of cellulose occurs on the outer layer of the fiber surface and that, following this, the process continues in a sub-layer manner.
Adsorption↗
Cytoplasmic requirements for the radio-induced modulation of IgG receptors on B-cells.
The effect of X-ray irradiation on IgG membrane receptors of B murine lymphocytes was studied. Cells were obtained from peripheral lymph nodes of RK mice and teased in Hank's solution. The cells were irradiated or kept as control samples, incubated at 37 degrees C, with or without drugs with known biochemical action at metabolic or structural levels, and labelled with fluorescein-conjugated anti-IgG antisera. The results show that X-ray irradiation results in a modulation of IgG receptor molecules on B-cells. The disappearance phase which takes only 10 min, is temperature dependent, and is prevented with metabolic inhibitors, microtubular disruptors, db-cAMP and local anesthetics. The re-appearance phase is also temperature dependent but apparently does not have either energy or cytoskeleton participation. The phenomenon is interpreted as partial and transient internalization of IgG molecules in the membrane.
2,4-Dinitrophenol↗