An abscess mimicking a left incarcerated groin hernia.

We present the case of a 79-year-old man with an irreducible and painful left groin mass. Obtaining a detailed history of present illness and assessment of radiological findings revealed an abscess in a groin hernia sac, which was formed secondary to perforation of the descending colon. Various examinations, however, failed to reveal the cause of the bowel perforation. Percutaneous drainage improved his symptoms. He was discharged home 24 days after admission with no further sequelae. An abscess in a groin hernia sac is very rare. Although neither bowel perforation nor hernia is rare, surgeons do not sufficiently consider the possibility of an abscess in a groin hernia sac. Thus, surgeons often encounter unexpected abscesses in the groin hernia sac during operations. Our case points to the necessity of obtaining a detailed history of present illness as well as assessment of radiological findings, and presents a therapeutic option for an abscess in a groin hernia sac.

Patient skin dose during neuroembolization by multiple-point measurement using a radiosensitive indicator.

BACKGROUND AND PURPOSE: Although neuroembolization has recently spread quickly, sufficient attention has not been focused on the associated radiation exposure. The purpose of this research was to evaluate the patient's entrance skin dose (ESD) during neuroembolizations in 6 institutions. MATERIALS AND METHODS: This study was approved by all of the 6 institutional review boards, and all of the patients gave informed consent. This study included a total of 103 consecutive neuroembolizations in the 6 institutions. Patient ESDs during the procedures were evaluated by using caps that had 44 radiosensitive indicators adherent to the surface. The patient ESDs were calculated from the color difference of the indicators. To check for effects on the scalp, clinical follow-up was performed at 1-2 days, 2 weeks, and 3 months after the procedure. RESULTS: The averages of total fluoroscopic time, total number of digital subtraction angiography frames, and dose area product were 67.1 +/- 41.6 minutes, 883 +/- 626, and 257 +/- 150 Gy x cm(2), respectively. The average maximum ESD for each patient was 1.9 +/- 1.1 Gy (range, 0.4-5.6 Gy; median, 1.5 Gy). The average maximum ESDs of each institution ranged from 1.0 to 2.4 Gy. Epilation was observed in 6 patients. CONCLUSIONS: The maximum ESDs during neuroembolizations exceed the thresholds for radiation skin injuries in some cases.

AIDS-related cerebral toxoplasmosis with hyperintense foci on T1-weighted MR images: a case report.

The neuroradiological findings are helpful for the diagnosis of toxoplasmic encephalitis. The T1 hypersignal intensity foci on brain magnetic resonance (MR) images without contrast enhancement are presented and can be a pathognomonic sign of this disease.

Enhancement of osteogenesis on hydroxyapatite surface coated with synthetic peptide (EEEEEEEPRGDT) in vitro.

Some dental implants are coated with hydroxyapatite (HA), which preferentially binds to bone. Several matrix proteins have an arginine-glycine-aspartic acid (RGD) sequence where cells attach via an integrin receptor. We hypothesized that coating an HA surface with an RGD-containing peptide might enhance the attachment and differentiation of osteoblasts. The HA disks (diameter 34 mm, thickness 1 mm) were treated with a solution (50 mM Tris/HCl and 150 mM NaCl, pH 7.4) containing the peptide EEEEEEEPRGDT, in which the E repetition exerts a high affinity to HA. After washing with phosphate-buffered saline, KUSA/A1 mouse osteoblastic cells were inoculated onto the HA surface and cultured. After 30 min, the number of cells attached to the surface was counted. The DNA content and alkaline phosphatase (ALP) activity were measured after 10 days in culture. Expression of bone matrix proteins was also examined by means of reverse transcriptase-polymerase chain reaction at 7 days; the mineralized area of the culture was also evaluated by staining with Alizarin Red S after 10 days. Treatment with the peptide stimulated cell attachment and increased DNA content and ALP activity. Furthermore, matrix protein expression and mineralized nodule formation were enhanced to a greater extent on the peptide-treated surface than on the nontreated surface. Our results indicate that coating an HA surface with RGD-containing peptide enhances osteoblast attachment and differentiation. This peptide treatment of HA-coated implants may stimulate the osseointegration of the implants.

Labeling patterns of chloroplastidic isoprenoids in cultured cells of liverwort Ptychanthus striatus.

Incorporation studies administering 2H- and 13C-labeled mevalonate (MVA) and 13C-labeled glucose to suspension cultured cells of the liverwort, Ptychanthus striatus, were carried out in order to examine the biosynthesis of the phytyl side-chain of chlorophyll a. Administration of 13C- and 2H-labeled MVA provided evidence for the involvement of the MVA pathway in the phytyl side-chain biosynthesis and preferential labeling of the farnesyl diphosphate (FPP)-derived portion. An alternate labeling pattern in the phytyl side-chain was observed which was slightly different to the non-equivalent labeling in other liverworts, such as Heteroscyphus planus and Lophocolea heterophylla and in the hornwort, Anthoceros punctatus. The labeling pattern observed after the administration of 13C-labeled glucose revealed the simultaneous involvement of the non-MVA pathway in the phytol biosynthesis of P. striatus cells.

Novel asymmetric oxy-michael addition reaction of the chiral ketones to the achiral gamma--or delta-hydroxy-alpha,beta-unsaturated carbonyl compounds.

A novel asymmetric oxy-Michael addition reaction was developed. In the presence of a catalytic amount of base, chiral ketones 1 and 2, derived from D-glucose and D-fructose, respectively, reacted with omega-hydroxy enones or enoates 3a-e, 17 and 21 to form the hemiacetal-derived alkoxide which underwent stereoselective intramolecular Michael addition to give cyclic acetals. Although the stereoselectivities in the formation of the five-membered acetal rings were modest, six-membered ring formation proceeded with high stereoselectivity and the utility of the reaction was demonstrated by a simple syntheses of natural products.

Allylstannylation of carbon-carbon and carbon-oxygen unsaturated bonds via a radical chain process.

In the presence of a radical initiator, allyltributylstannanes bearing an electron-withdrawing group at the beta-position smoothly reacted with electron-deficient terminal alkenes to give allylstannylated products in good yields. The stannyl group was introduced into the terminal carbon with high regioselectivity. The allylstannylation of homochiral 8-phenylmenthyl acrylate proceeded with moderate to good diastereoselectivity. Terminal and electron-deficient internal alkynes as well efficiently underwent the radical-initiated allylstannylation in an anti addition mode. The reaction of terminal alkynes showed the same regioselectivity as that of terminal alkenes. The present radical reaction was applicable to allylation of aromatic aldehydes and ketones.

Defective development of NK1.1+ T-cell antigen receptor alphabeta+ cells in zeta-associated protein 70 null mice with an accumulation of NK1.1+ CD3- NK-like cells in the thymus.

Development of natural killer 1.1+ (NK1.1+) CD3+ (NK1.1+ T) cells was analyzed in zeta-associated protein 70 (ZAP-70) null ((-/-)) mice. Both NK1.1+ TCRalphabeta+ and NK1.1+ TCRgammadelta+ cell populations were absent in the thymus and spleen. By contrast, the number of NK1.1+ CD3- cells was increased in these tissues. The NK1.1+ CD3- thymocytes in ZAP-70(-/-) mice had surface phenotypes in common with NK or NK1.1+ T cells. However, some of them were discordant either with NK cells or with NK1.1+ T cells. The NK1.1+ CD3- cells produced interferon-gamma upon stimulation with NK1.1 cross-linking in the presence of interleukin-2 and exhibited a substantial cytotoxicity against YAC-1 cells. Moreover, the generation of NK1.1+ T cells with invariant Valpha14Jalpha281 chains was induced from the NK1.1+ CD3- thymocytes following stimulation with phorbol myristate acetate and ionomycin in a neonatal thymic organ culture. An introduction of TCRalpha and beta transgenes to the ZAP-70(-/-) mice resulted in generation of an NK1.1+ TCRalphabeta(dim) population, whereas no substantial CD4+ CD8- or CD4- CD8+ population that expressed the introduced TCRalphabeta was generated in the mainstream T lineage. These findings demonstrate that ZAP-70 kinase is indispensable for the development of NK1.1+ T cells and that the unique NK1.1+ CD3- thymocytes in ZAP-70(-/-) mice contain immediate precursors of NK1.1+ T cells.

Nonequivalent labeling of the phytyl side chain of chlorophyll a in callus of the hornwort Anthoceros punctatus.

Callus cultures of the hornwort Anthoceros punctatus were induced from the apical portions of the gametophytes. Calli can accumulate rosmarinic acid, which is suggested as an intermediate for anthocerotonic acid, a rare phenylpropanoid dimer with a cyclobutane ring, indicating that calli possess the ability to produce secondary metabolites found primarily in intact plants. Biosynthesis of chloroplastidic terpenoids of liverworts showed preferential labeling of the farnesyl diphosphate (FPP)-derived portion in the phytyl side chain of chlorophyll a (1) when calli of A. punctatus are incubated with (2)H- and (13)C-labeled mevalonate. This finding suggests either that cytoplasmic FPP (or isopentenyl diphosphate, IPP) is taken into chloroplasts and condensed with endogenous IPP derived from a nonmevalonate pathway, or that FPP is synthesized within chloroplasts from extraplastidically formed IPP (or mevalonate) and then condensed with endogenous IPP in a different subplastidic fraction.

Effects of nasal continuous positive airway pressure on pulmonary haemodynamics and tissue oxygenation in patients with obstructive sleep apnoea.

We investigated the acute effects of nasal continuous positive airway pressure (CPAP) on pulmonary haemodynamics and tissue oxygenation in eight men with obstructive sleep apnoea (OSA) by means of right heart catheterization. They were tested at four dosage levels of nasal CPAP: 0, 5, 10, and 15 cmH2O. Nasal CPAP significantly reduced the cardiac index at the 10 and 15 cmH2O doses. The mean pulmonary artery pressure was significantly elevated with 10 and 15 cmH2O, and pulmonary capillary wedge pressure was significantly increased with 15 cmH2O of nasal CPAP. Pulmonary vascular resistance was significantly increased with 10 cmH2O of nasal CPAP. The 5 cmH2O dose of nasal CPAP did not affect significantly these parameters. Mixed venous oxygen tension was unchanged at any pressure. We conclude that tissue oxygenation was maintained in the OSA patients during administration of nasal CPAP, even though a high CPAP clearly affected pulmonary haemodynamics.

Activated leukocytes, endothelial cells, and effects of pentoxifylline: observations by VEC-DIC microscopy.

Using video-enhanced contrast (VEC)-differential interference contrast (DIC) microscopy, ultrastructural observations were made of the activation of polymorphonuclear leukocytes (PMNLs), the interaction between activated PMNLs and endothelial cells (ECs), and the effects of pentoxifylline (PTX). The ECs were obtained from a commercial source as human umbilical cord vein endothelial cells (HUVECs) or were obtained from pig or rat brains. They were cultured on a coverglass with DMEM for about 1 week. The human PMNLs were obtained from the authors' venous blood. The control appearance of the PMNLs resembled an elastic ball covered with fine villi. The PMNL was activated spontaneously and became flattened on the glass surface within 10 min in the observation chamber. The activation of the PMNLs was estimated arbitrarily from the polymorphous changes in cell shape, agitation of the intracellular granules, and apparent increase in adhesiveness. Preadministered PTX prevented such PMNL activation, and the PMNLs remained round for more than 15 min. PMNL activation was accelerated by chemoattractants (PAF, fMLP, and PMA). In one case, a PMNL that had been activated by PMA tended to recover its round shape with PTX, but finally ended by swelling and bursting. When PMNLs were introduced into the EC-containing chamber, they became entrapped by the ECs and activated, with degranulation followed by release of a smoke-like material. After about 3 h, the EC with an attached PMNL shrank and fell into a state of coagulation necrosis. When PTX was introduced at the time of adhesion of the flattened PMNL, the PMNL appeared to be deactivated, becoming smaller and assuming its previous round shape, and detached from the EC. PTX prevented the spontaneous activation of PMNLs, and of deactivated PMNLs even after their adherence to the endothelium.

[Traffic accidents in obstructive sleep apnea patients and effect of nasal CPAP treatment].

We studied the traffic accident rates and daytime sleepiness in obstructive sleep apnea syndrome (OSAS) patient, and evaluated the effectiveness of long-term nasal CPAP treatment. Traffic accidents were observed in 42% of 14 male OSAS patients (46 +/- 7 years old) and near-miss accidents were also observed in 64% during the past three years. Stanford Sleepiness Scale showed 4.7 +/- 1.0, suggesting marked excessive daytime sleepiness (EDS). During NCPAP treatment for 11 +/- 9 months, no traffic and near-miss accidents were reported. After NCPAP treatment, SSS decreased to 2.0 +/- 0.8, and the score of Uchida-Kraeplin test for the evaluation of working ability increased significantly. These results suggest the improvement of EDS and working ability following NCPAP treatment. We conclude that OSAS patients have the tendency of daytime sleepiness and high traffic accidents rates, and NCPAP treatment is effective to improve such problems.