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PubMed1988

[Sonography of adrenal gland diseases in the newborn infant].

Diseases and morphological changes of the adrenal gland play an important role especially in the newborn, because malformations, congenital errors of metabolism, connatal tumours and birth injuries become symptomatic in this period of life. In this paper, the possibilities of neonatal adrenal ultrasonography for diagnosis and in the aspect of differential diagnosis are discussed. The characteristic sonographic appearance is the thin echogenic core surrounded by a thick transonic zone. Adrenal haemorrhage as well as the neuroblastoma disturb these structures and show their own characteristic pattern. In congenital adrenal hyperplasia the organ is enlarged in a fold-like manner. In agenesis or displacement of the kidney the adrenal gland presents as an elongated mass in the renal fossa and on the psoas muscle.

Adrenal Gland Diseases↗

PubMed1992

[Urinary fistula after radical hysterectomy with lymph node excision].

In 908 radical hysterectomies including dissection of pelvic lymph nodes, 13 (= 1.43%) urogenital fistulas were seen. They occurred postoperatively between the 7th and 15th day. In 12 cases it was a uretero-vaginal and once a vesico-vaginal fistula. The operation report of 7 cases with uretero-vaginal fistula reveals difficulties in separating the ureter in its prevesical part proceeding from tumour spread, endometriosis, scar or bleeding. Since 1985 a percutaneous nephrostomy has been performed (5 cases). 4 fistulas were cured spontaneously, one of them had a percutaneous nephrostomy. In all cases, urography was normal. In 7 cases, ureterocystoneostomy had to be performed. This was done once with fixation of the psoas muscle and 6 times according to Boari. All patients were cured without any complications and with an undisturbed drainage assessed 1 year later by urography. 1 patient, who refused any follow-up, died subsequently. The only vesico-vaginal fistula has been closed by Latzko's procedure. In recent years the problems concerning urogenital fistulas resulting from surgery of cervical cancer have receded. However, if patients adopt an offensive attitude against surgical therapy of stage T2b, the rate of incidence of this complication can be expected to increase.

Adult↗

PubMedDate not supplied

[Diagnosis and therapy of hip dysplasia in the older child].

Diagnosis of congenital hip dysplasia is based on normal values of the acetabulum, but also criteria such as deficiency of the acetabular rim and an increased distance from the tear drop figure. Instability of the hip joint is seen in arthography. Acetabuloplasty is the way to treat it. Unstable joints will deteriorate, stable ones are frequently improving spontaneously. The technique of open reduction from an inguinal approach medial of the psoas muscle is described. There are many advantages. Simultaneous shortening osteotomy and acetabuloplasty to permit immediate movements out of the hip spica are recommended to avoid stiffening and contractures. Hip dysplasia is corrected by a lateral acetabuloplasty that levers down the acetabular roof in the triradiate cartilage. After consolidation of the cartilage triple pelvic osteotomy for acetabular rotation is the method to correct dysplasia in adolescents and adults. The closer the osteotomies are performed to the hip joint, the better rotation is possible. Our technique has proved successful now in 12 years.

Acetabulum↗

PubMed1988

Unusual CT features in ruptures of abdominal aortic aneurysms.

The authors present two cases of impending rupture of abdominal aortic aneurysms correctly diagnosed by means of some unusual CT findings. The clinical signs were not clear. On CT examination, despite the absence of haematomas, minor, but precise, changes allowed the correct diagnosis: loss of definite contours of the aneurysm, non-homogeneous peri-aortic and peri- and para-renal adipose tissue, thickening of the renal fascia and a thin fluid collection over the psoas muscles.

Acute Disease↗

PubMed1992

Effect of Ca2+ on weak cross-bridge interaction with actin in the presence of adenosine 5'-[gamma-thio]triphosphate).

In the presence of the nucleotide analog adenosine 5'-[gamma-thio]triphosphate (ATP[gamma S]), effects of Ca2+ on stiffness and equatorial x-ray diffraction patterns of single skinned fibers of the rabbit psoas muscle were studied. It is shown that cross-bridges in the presence of ATP[gamma S] have properties of the weak-binding states of the ATP hydrolysis cycle. Raising the Ca2+ concentration up to pCa 4.5 has little effect on actin affinity of cross-bridges in the presence of ATP[gamma S]. However, the rate constants for cross-bridge dissociation and reassociation from and to actin are reduced by about 2 orders of magnitude. In addition, nucleotide affinity of the cross-bridge is much smaller at high Ca2+ concentrations. Implications for interpretation of fiber stiffness recorded during isotonic shortening and the rising phase of a tetanus are discussed.

Actins↗

PubMed2002

Engineering competitive magnesium binding into the first EF-hand of skeletal troponin C.

The goal of this study was to examine the mechanism of magnesium binding to the regulatory domain of skeletal troponin C (TnC). The fluorescence of Trp(29), immediately preceding the first calcium-binding loop in TnC(F29W), was unchanged by addition of magnesium, but increased upon calcium binding with an affinity of 3.3 microm. However, the calcium-dependent increase in TnC(F29W) fluorescence could be reversed by addition of magnesium, with a calculated competitive magnesium affinity of 2.2 mm. When a Z acid pair was introduced into the first EF-hand of TnC(F29W), the fluorescence of G34DTnC(F29W) increased upon addition of magnesium or calcium with affinities of 295 and 1.9 microm, respectively. Addition of 3 mm magnesium decreased the calcium sensitivity of TnC(F29W) and G34DTnC(F29W) approximately 2- and 6-fold, respectively. Exchange of G34DTnC(F29W) into skinned psoas muscle fibers decreased fiber calcium sensitivity approximately 1.7-fold compared with TnC(F29W) at 1 mm [magnesium](free) and approximately 3.2-fold at 3 mm [magnesium](free). Thus, incorporation of a Z acid pair into the first EF-hand allows it to bind magnesium with high affinity. Furthermore, the data suggests that the second EF-hand, but not the first, of TnC is responsible for the competitive magnesium binding to the regulatory domain.

Animals↗

PubMed1984

Hip pain in patient with Crohn's disease. Occult retroperitoneal abscess as cause.

A 20-year-old man with Crohn's disease was seen as an outpatient for pain in the left hip and gait disturbance. Initially, arthritis of the hip was suspected, because of the absence of fever or abdominal abnormalities. Two weeks later, fever, malaise, and pneumaturia developed and urine culture grew Escherichia coli. Laparotomy revealed a large occult retroperitoneal abscess on the left side, which had been irritating the psoas muscle. Surgical drainage effected complete recovery of hip function. The abscess in this patient had a very unusual presentation and was diagnosed chiefly through a high index of suspicion after a careful physical examination.

Abscess↗

PubMed1988

The prevalence of macroscopic sarcocysts in New Zealand cattle at slaughter.

A survey carried out to determine the prevalence of visible Surcocystis spp. infection in 100 slaughtered cattle in a South Island abattoir revealed 64% infected. Although all ages, genders, breeds and export grades were infected, only host age had a statistically significant effect on the infection rate. Infections were most common in the rectus abdominis and the psoas muscles (47% and 41% respectively). Most infections were light, with less than ten macrocysts seen, though infections of more than 50 macrocysts occurred. The average macrocyst length was 4.WO.10 mm (SE) (n = 233), the average cyst wall thickness 5.3 +/- 0.2 microm (SE) (n = 45). It is thought that the actual prevalence of infection is higher than that recorded and reasons for this are discussed.

Journal Article↗

PubMed2004

Unusual migration in abdomen of a wire for surgical localization of breast lesions.

We report a case of migration of a surgical localization wire from the breast to the abdomen. A 41-year-old female underwent presurgical needle localization of a deep-sited left-sided breast lesion. Migration of the localization wire in the chest wall occurred during the procedure documented by imaging. Computed tomography (CT) examination showed no evidence of the wire in the left lower lung field, no peritoneal free fluid, active bleeding, or abnormalities of abdominal organ, but a metallic-density representing the localization wire was seen for a length of 13 cm from the right diaphragmatic crus to the right psoas muscle, close to the inferior vena cava. A following CT examination showed the wire partially outside the inferior vena cava and partially inside the right iliac vein. The wire was successfully taken out by an angiographic interventional procedure.

Abdomen↗

PubMed1966

Cytochemistry of phosphatases of the sarcoplasmic reticulum. I. Biochemical studies.

A microsomal fraction was isolated from rabbit psoas muscle by a modification of Muscatello's method. The fraction contained a Mg-dependent ATPase which had a pH optimum of 7.5. Activity was further stimulated by addition of Na or K or other monovalent cations to the reaction mixture, but synergistic activation by Na and K, and ouabain inhibition, could not be demonstrated. The enzyme hydrolyzed only ATP (adenosine triphosphate) and ITP (inosine triphosphate) at appreciable rates, but Na or K stimulated activity only when ATP was used as substrate. Activity was inhibited by Ca and by low concentrations of Na deoxycholate, and was sensitive to inhibition by thiol group reagents. The enzyme could be distinguished from another enzyme, also present in the fraction, which was Ca-activated, and which exhibited a wider substrate specificity, different pH activation characteristics, lower specific activity, lack of stimulation by Na or K, and less sensitivity to inhibition by deoxycholate and by thiol group reagents. These findings formed the basis for demonstration of the Mg-dependent ATPase in situ.

Adenosine Triphosphatases↗

PubMed1966

Cytochemistry of phosphatases of the sarcoplasmic reticulum. II. In situ localization of the Mg-dependent enzyme.

The distribution of the Mg-dependent ATPase associated with a microsomal fraction of rabbit psoas muscle was studied histochemically and its localization in relation to the vesicles of the fraction and to the structure of intact fixed muscle was determined. Although enzyme activity was retained after fixation in hydroxyadipaldehyde and in glyoxal, it was lost after fixation in glutaraldehyde or after 4 hr fixation in formaldehyde. Activity was optimally demonstrated when incubations were conducted at 17 degrees C, in media containing 125 mM Trismaleate buffer, pH 7.5, 5 mM ATP, 4 mM MgCl(2), and 1 mM Pb(NO(3))(2). After such incubations, activity was present throughout the sarcoplasmic reticulum, but was absent from the T system. Activation by Na or K could not be demonstrated histochemically. However, the other biochemical properties of the enzyme in the isolated vesicles and in intact muscle were similar with respect to Mg dependence, substrate specificity, inhibition by Ca, N-ethyl maleimide, p-hydroxymercuribenzoate, and lack of inhibition by ouabain.

Adenosine Triphosphatases↗

PubMed1969

The effect of various protein fractions on Z- and M-line reconstitution.

Extraction of thin, glycerinated bundles of rabbit psoas muscle with a low ionic strength solvent results in removal first of M lines and then of Z lines. When these extracted myofibrillar bundles are allowed to interact, at adjusted ionic conditions, with the dilute myofibrillar extract or with the fractions obtained at 40% ammonium sulfate saturation from either the myofibrillar extract or from the Bailey extract of natural actomyosin, reconstitution of Z lines occurs. The ammonium sulfate fraction from the Bailey extract of natural actomyosin restores the tetragonal lattice structure of the Z line. Other structural features such as I-band tufts or cross-bridges, M lines and H-zone binding also occur with some of the proteins used for recombination. Although it has not yet been possible to identify exactly the protein(s) constituting the Z line, it appears unlikely that tropomyosin or troponin alone is the major protein of the Z line. A more likely candidate is alpha-actinin or a combination of alpha-actinin with another protein(s). In addition, this study demonstrates that basic morphological differences exist between cross-sections through the Z-line lattice and cross-sections through tropomyosin crystals.

Animals↗

PubMed1978

Assays of the metabolic viability of single giant mitochondria. Experiments with intact and impaled mitochondria.

Single giant mitochondria isolated from mice fed cuprizone were assayed for their metabolic viability. Two tests were devised. One test optically detected the accumulation of calcium phosphate within the mitochondria under massive loading conditions (including the presence of succinate and ATP). The accumulation corresponds to a test of energy coupling from either electron transport or the hydrolysis of ATP since it is blocked by either antimycin A or oligomycin. The other assay tested for the production of ATP from ADP and Pi, using myofibrils. Myofibrils prepared from glycerinated rabbit psoas muscle contract only in the presence of ATP and not in the presence of ADP. Myofibrillar contraction is unaffected by the presence of antimycin A or oligomycin. However, myofibrils in the presence of mitochondria that are phosphorylating ADP to ATP do contract. This contraction is blocked by antimycin A and/or oligomycin. Hence, the ATP which causes myofibrillar contraction is produced by oxidative phosphorylation. At low mitochondrial concentration, only the myofibrils in close proximity with mitochondria contract in the presence of ADP. Therefore the assay can be used to test the viability of individual mitochondria. Individual giant mitochondria were found to be viable, using both of these assays. Comparable results were obtained in mitochondria impaled with microelectrodes. The potentials and resistances were unaffected by concomitant calcium phosphate accumulation or oxidative phosphorylation.

Adenosine Diphosphate↗

PubMed1987

ADP binding to myosin cross-bridges and its effect on the cross-bridge detachment rate constants.

We have studied the binding of adenosine diphosphate (ADP) to attached cross-bridges in chemically skinned rabbit psoas muscle fibers and the effect of that binding on the cross-bridge detachment rate constants. Cross-bridges with ADP bound to the active site behave very similarly to cross-bridges without any nucleotide at the active site. First, fiber stiffness is the same as in rigor, which presumably implies that, as in rigor, all the cross-bridges are attached. Second, the cross-bridge detachment rate constants in the presence of ADP, measured from the rate of decay of the force induced by a small stretch, are, over a time scale of minutes, similar to those seen in rigor. Because ADP binding to the active site does not cause an increase in the cross-bridge detachment rate constants, whereas binding of nucleotide analogues such as adenyl-5'-yl imidodiphosphate (AMP-PNP) and pyrophosphate (PPi) do, it was possible, by using ADP as a competitive inhibitor of PPi or AMP-PNP, to measure the competitive inhibition constant and thereby the dissociation constant for ADP binding to attached cross-bridges. We found that adding 175 microM ADP to 4 mM PPi or 4 mM AMP-PNP produces as much of a decrease in the apparent cross-bridge detachment rate constants as reducing the analogue concentration from 4 to 1 mM. This suggests that ADP is binding to attached cross-bridges with a dissociation constant of approximately 60 microM. This value is quite similar to that reported for ADP binding to actomyosin subfragment-1 (acto-S1) in solution, which provides further support for the idea that nucleotides and nucleotide analogues seem to bind about as strongly to attached cross-bridges in fibers as to acto-S1 in solution (Johnson, R.E., and P. H. Adams. 1984. FEBS Letters. 174:11-14; Schoenberg, M., and E. Eisenberg. 1985. Biophysical Journal. 48:863-871; Biosca, J.A., L.E. Greene, and E. Eisenberg. 1986. Journal of Biological Chemistry. 261:9793-9800).

Adenosine Diphosphate↗

PubMed2006

Association between rmpA and magA genes and clinical syndromes caused by Klebsiella pneumoniae in Taiwan.

BACKGROUND: The association of the magA gene with the hypermucoviscosity phenotype relevant to the pathogenesis of Klebsiella pneumoniae liver abscess has been reported in Taiwan. Similarly, the rmpA gene, known as a positive regulator of extracapsular polysaccharide synthesis that confers a mucoid phenotype, may be another candidate gene causing hypermucoviscosity. However, the association of rmpA with K. pneumoniae clinical syndromes is unreported. We aimed to investigate the clinical correlation between rmpA and primary Klebsiella abscess, focusing on sites other than the liver. METHODS: From July 2003 through December 2004, a total of 151 K. pneumoniae isolates recovered from 151 patients with bacteremia were collected from 2 large medical centers in southern Taiwan. Clinical data were collected from medical records. The genes rmpA and magA were amplified by polymerase chain reaction using specific primers. RESULTS: The prevalences of hypermucoviscosity, rmpA, and magA were 38%, 48%, and 17%, respectively. As determined by statistical multivariate analysis, strains carrying rmpA were significantly associated with the hypermucoviscosity phenotype, and there was a significant correlation with purulent tissue infections, such as liver abscess and lung, neck, psoas muscle, or other focal abscess. CONCLUSION: Our data support a statistical correlation between the rmpA gene and virulence in terms of abscess formation for these hypermucoviscous K. pneumoniae strains. Hypermucoviscosity associated with rmpA, together with a thorough physical examination, may be helpful as a guide to carry out appropriate diagnostic tests on patients with an initially unknown source of K. pneumoniae bacteremia, particularly when looking for the occurrence of an underlying abscess.

Bacteremia↗

PubMed2002

Laparoscopic interstitial laser coagulation of renal tissue with and without hilar occlusion in the porcine model.

PURPOSE: To evaluate the safety and efficacy of interstitial laser coagulation (ILC), applied via a laparoscopic approach, with and without hilar occlusion in the porcine model. MATERIALS AND METHODS: In nine female farm pigs, bilateral renal mobilization was performed via a transperitoneal laparoscopic approach. Using a 600- micro m bare-tip silicon diode laser fiber inserted 0.5 cm into the lower pole of each kidney, diode laser energy (wavelength 805 nm) was applied for 15 minutes at 6 W. In each pig, the left renal hilum was clamped during ILC. Animals were sacrificed immediately (N = 3) or at 2 weeks (N = 3) or 4 weeks (N = 3). The kidneys were inspected grossly, and the lesions were evaluated microscopically. Nicotinamide adenine dinucleotide (NADH) histochemical staining was performed to assess viability. RESULTS: Grossly, parenchymal lesions appeared firm and white with a central zone of carbonization, cavitation, or both. Histopathology examination revealed cellular inflammation in acute lesions; chronic lesions demonstrated coagulative necrosis with progressive fibrosis. The NADH staining showed residual viable cells within the treatment zone of survival animals but not in acute animals. The mean size of the treatment zone in kidneys with unoccluded blood flow was 2.4 x 2.1 x 2.0 cm, 4.0 x 3.3 x 2.8 cm, and 3.3 x 3.5 x 2.0 cm in the acute, 2-week, and 4-week group, respectively. Hilar occlusion resulted in a slightly, but statistically insignificantly, larger lesion. In the 2-week survival group, one animal had a left subcapsular hematoma on the hilar-occluded side. In another 2-week animal, extension of the ILC zone was noted beyond the kidney into the psoas muscle. In the 4-week survival group, two animals developed gross hematuria; one had a left perinephric urinoma and urine leak noted at necropsy. CONCLUSIONS: Renal ILC may represent an alternative minimally invasive technique for ablation of renal tumors. However, histologic evidence of viable cells within the treatment zone mandates refinement of the technique in the animal model before further application in humans. Hilar occlusion does not appear to enhance tissue ablation.

Animals↗

PubMed2003

Recurrent hernia following endoscopic total extraperitoneal repair.

BACKGROUND AND PURPOSE: A retrospective study was conducted to identify the reasons for recurrence following endoscopic total extraperitoneal (TEP) repair of inguinal hernias and to develop a strategy to prevent recurrence. METHOD: Between January 1996 and December 2001, 1193 TEP hernia repairs were performed in 694 patients. Following reduction of the hernia sac and dissection of the preperitoneal space up to the psoas muscles laterally, a Prolene mesh (15 x 15 cm) was placed. The mesh was fixed medially to the Cooper ligament with two or three spiral tacks. In six patients, the hernia recurred following endoscopic TEP repair within the same period. Four of these patients elected to undergo laparoscopic transabdominal preperitoneal (TAPP) repair of the recurrent hernia. RESULTS: Medial recurrences developed in three of the four patients because of medial displacement of the mesh. One patient was found to have a missed indirect hernia sac. All the patients who underwent laparoscopic TAPP repair had an uneventful recovery and are well at follow-up. CONCLUSION: In addition to medial fixation of the mesh to the Cooper ligament, complete proximal dissection of the peritoneum from the spermatic cord and additional fixation of the mesh to the anterior abdominal wall, with careful avoidance of possible injury to the adjacent nerves, may prevent recurrences.

Adult↗

PubMed1994

Extraperitoneal inguinal pelviscopy: diagnostic tool for nonpalpable testes.

In patients with nonpalpable testes, intraperitoneal laparoscopy is not a direct approach to the tissues in which the gonad is likely to be located. Accordingly, the technique may be time-consuming and accompanied by complications. In 23 patients, the retropubic space was insufflated with carbon dioxide through a suprapubic puncture, and a pelviscope was advanced beyond the deep inguinal ring into the extraperitoneal pelvic cavity using the vas deferens as a guide. The nonpalpable testis was located in all patients, being deep to the inguinal ring in 17 and in the iliac fossa in 4. In the two patients with bilateral nondescent, three testes were deep to the inguinal ring, and one was lying over the psoas muscle. No complications were encountered. Extraperitoneal pelviscopy is simple, easy, and safe and provides a direct approach to the pelvic and abdominal extraperitoneal tissues.

Adolescent↗