Prolapsed hyperplastic gastric polyp causing pancreatitis: case report.

A huge hyperplastic gastric polyp prolapsed into the duodenum. The compression and obstruction of the ampulla of Vater by this polyp caused acute pancreatitis. An overview of imaging findings, general considerations about hyperplastic gastric polyps, and a review of the literature are provided.

Self-administered joint counts in rheumatoid arthritis: comparison with standard joint counts.

OBJECTIVE: To test the reliability and validity of a self-administered 36 joint count developed after the Rapid Assessment of Disease Activity in Rheumatology (RADAR) questionnaire for assessing pain/tenderness. METHODS: Two self-administered formats (mannequin and text) were evaluated in 60 patients with rheumatoid arthritis (RA). Reliability between both formats was tested by Spearman rank correlation. Criterion validity/accuracy was tested by Spearman correlation coefficient between each self-report format and a joint count performed by a physician. Construct validity was ascertained by correlation of each format with other variables of disease activity. RESULTS: Reliability between the 2 formats was high (R = 0.94). Correlations between each format and the physician's joint count were also high (R = 0.77 for mannequin, 0.75 for text). Patients consistently rated their joint pain/tenderness higher than the physician (means 29, 27, and 12 for text, mannequin, and physician, respectively; p < 0.01). Construct validity of the text, mannequin, and physician formats compared with the modified Health Assessment Questionnaire showed R = 0.61, 0.65, 0.63; with Steinbrocker functional class R = 0.41, 0.46, 0.56; with pain R = 0.59, 0.61, 0.62; with global evaluation R = 0.66, 0.71, 0.84; and with morning stiffness R = 0.64, 0.59, 0.60, respectively. CONCLUSION: Although both self-administered formats exhibited adequate reliability and construct validity, a systematic difference between patient and physician/trained assistant performed joint counts was observed, with patients consistently rating their pain/tenderness higher. We thus do not believe they can replace standard physician/trained assistant evaluation in obtaining clinical research data in rheumatology.

Binding of radioiodinated SPECT ligands to transfected cell membranes expressing single muscarinic receptor subtypes.

The equilibrium dissociation constant and the kinetic rate constants were determined for the binding of (R)-[3H]3-quinuclidinyl benzilate ([3H]QNB) and [125I]3-quinuclidinyl-4-iodobenzilate ((R,R)- and (R,S)-[125I]IQNB) to transfected cell membranes expressing one single muscarinic acetylcholine receptor (mAChR) subtype. The association and dissociation kinetics for the m2 subtype were more rapid than for the m1 and m3 subtypes. The differential kinetic properties may be useful for the single photon emission computed tomographic (SPECT) evaluation of regional mAChR subtype alterations in disease states.

Accumulations of cyclic AMP and inositol phosphates in guinea pig cerebral cortical synaptoneurosomes: enhancement by agents acting at sodium channels.

Activation of alpha 1-adrenergic receptors by norepinephrine in guinea pig cortical synaptoneurosomes augments accumulations of cyclic AMP elicited by 2-chloroadenosine and concomitantly increases formation of inositol phosphates. Various agents that affect calcium channels or sites of action of calcium have little or no effect on cyclic AMP accumulation elicited either with 2-chloroadenosine, or with a 2-chloroadenosine/norepinephrine combination, nor did they markedly affect formation of inositol phosphates elicited by norepinephrine. However, EGTA reduces both cyclic AMP accumulation and inositol phosphate formation. Agents such as batrachotoxin, scorpion (Leiurus) venom and pumiliotoxin B that are active at voltage-dependent sodium channels enhance accumulations of cyclic AMP and inositol phosphates. These effects are blocked by tetrodotoxin. It is proposed that enhanced influx of sodium ions increases phosphatidylinositol metabolism, resulting in formation of diacylglycerols and inositol phosphates, and that the former, through activation of protein kinase, causes an enhancement of cyclic AMP accumulations in brain tissue.

Accumulations of inositol phosphates and cyclic AMP in brain slices: synergistic interactions of histamine and 2-chloroadenosine.

2-Chloroadenosine, 5'-N-ethylcarboxamidoadenosine, N6-cyclohexyladenosine and other adenosine analogs enhance histamine-elicited, but not norepinephrine- or carbamylcholine-elicited accumulations of inositol phosphates in [3H]inositol-labeled guinea-pig cerebral cortical slices. The adenosine analogs alone have no effect on accumulations of inositol phosphates. The effect of 2-chloroadenosine is blocked by the adenosine receptor antagonists theophylline and 1,3-dialkyl-8-p-sulfophenylxanthines. The rank order of activity of the six adenosine analogs with respect to augmentation of histamine-elicited accumulation of inositol phosphates in guinea-pig cerebral cortical slices is different from the rank order at an A2-adenosine receptor that mediates synergistic accumulations of cyclic AMP by adenosine analogs and histamine in guinea-pig cerebral cortical slices.