Silicone fluid-induced pulmonary embolism

Silicone fluid injection for mammary augmentation is a well-known illegal procedure. It has been associated with many complications, including local tissue granulomatous reaction, chronic infection, and sclerosis, but pulmonary involvement in human beings has been documented in only six cases. We describe three more such cases of pulmonary embolism. These three patients were all female, young, and previously healthy. They received the procedures only for cosmetic reasons. Unfortunately, one of them died and another lived with the sequelae of pulmonary fibrosis. The mortality rate of the nine total patients with pulmonary embolism induced by silicone fluid, including our three cases, is 33%. Because of this high mortality rate and long-term sequelae of pulmonary fibrosis, no silicone fluid injection should be given for cosmetic reasons, especially in mammary augmentation in which a large volume of silicone fluid is more likely to be used, and the early use of corticosteroid therapy may be helpful.

Midgut volvulus as a complication of intestinal malrotation in adults

Seven adults with midgut volvulus as a complication of malrotation are presented. All patients were men with an average age of 33 years. Four presented with long histories of intermittent abdominal pain. In three patients, the twisted, corkscrew appearance of the barium column in the duodenum and proximal jejunum in an upper gastrointestinal series made the diagnosis. In the remaining patient, small-bowel follow-through performed three years before surgery showed intestinal malrotation. Three patients presented with the acute onset of severe abdominal pain. Plain films showed small-bowel obstruction and pneumatosis intestinalis in two patients and only nearly complete small-bowel obstruction in the third. Barium studies were not done in this group because of the need to proceed to exploratory laparotomy and the risk of perforation. In one patient, abdominal angiography suggested the diagnosis by showing abnormal courses of the mesenteric vessels to the volvulized segment of small bowel. All three of these patients showed ischemic segments of bowel at laparotomy.

Tissue contents of endothelin vary according to thyroid hormone status in rat

Endothelin-1 (ET-1) is a 21-residue peptide isolated from the conditioned medium of cultured porcine endothelial cells and is widely distributed throughout the body, with relatively high levels in the kidney and lung. In this study we examined the influence of thyroid hormone status on immunoreactive endothelin (ir-ET) levels in the plasma, lung, and kidney tissues of rats. Three weeks after surgical removal of the thyroid gland from male rats, the ir-ET levels in the lung and kidney were reduced by 39% and 42%, respectively. Similarly, ir-ET levels were decreased by 46% in the lung and 45% in the kidney of rats rendered hypothyroid by treatment with 0.1% (wt/wt) n-propylthiouracil (PTU) in the drinking water for 30 days. Replacement with daily L-thyroxine (T4) injections (5 micrograms/100 g) prevented this decrease. However, thyrotoxicosis induced by daily L-T4 injections (10 micrograms/100 g) also caused a decrease of the lung ir-ET levels by 49%, but had no significant effect on the renal ir-ET levels. However, the plasma ir-ET levels were similar in each group. Fast protein liquid chromatography study verified the presence of ir-ET-1 in the plasma and tissue extracts. This study demonstrates that thyroid hormone status affects tissue levels of ir-ET differently and that a euthyroid status is required for the maintenance of physiologic concentrations of ir-ET in the lung of male rats.

Role of locus coeruleus and serotonergic drug actions on schedule-induced polydipsia

Schedule-induced polydipsia (SIP) poses a general buffering property to reduce the heightened arousal produced by a schedule of intermittent feeding. It thus provides a unique opportunity to study CNS integration in stress-coping reactions. In the present study, we examined the role of the locus coeruleus (LC) and the pharmacological actions of serotonergic (5-HT2) analogs on SIP. Water intake, licking, and bar presses per minute in rats were recorded as indices of SIP activity after they had been subjected to 1-h performance of a fixed-interval 1-min operant pellet conditioning. Our results showed that SIP was progressively decreased after lesions were placed bilaterally in the LC areas and then followed by further lesioning in the bilateral ventral tegmental area. Neurotoxin DSP-4 also had an inhibitory action on the SIP potency. In addition, SIP was attenuated by 2,5-dimethoxy-4-iodoamphetamine (0.1, 0.5, or 1.0 mg/kg, IP), a 5-HT2 agonist, and activated by ritanserin (2.5 mg/kg, IP), a 5-HT2 agonist. After bilateral LC lesions, SIP was attenuated and the activating effect of RIT was abolished. Our data suggest that the LC is involved in the central integration of SIP and that the modulating effects of 5-HT2 receptors on SIP depend upon the integrity of LC function.

Computed tomographic findings of small-bowel volvulus

Computed tomographic examinations of two cases of small-bowel volvulus were reviewed. At laparotomy, both cases were proved to be secondary to adhesions. CT examinations showed focal, wedge-shaped, edematous mesentery with trapped fluid between mesenteric folds radiating toward the site of torsion. One case showed the superior mesenteric vein spiraling around the superior mesenteric artery. At laparotomy, affected small-bowel loops showed ischemia in both cases. CT performed in patients with acute abdomen may show findings suggestive of small-bowel volvulus.

CT diagnosis of small-bowel obstruction: efficacy in 60 patients

We retrospectively compared the CT findings in patients with and without surgically proved small-bowel obstruction to evaluate the role of CT in diagnosing the presence and cause of obstruction. In the patients with obstruction, we compared the CT findings with findings on plain abdominal radiographs and contrast studies of the small intestine. CT criteria used for the diagnosis of obstruction were dilated small-bowel loops proximal to the suspected site of obstruction and collapsed or normal-appearing loops of small bowel distal to the obstruction. Receiver-operating-characteristic analysis suggested the optimum balance of sensitivity and specificity was achieved when 2.5 cm was used to indicate dilatation of the small bowel. On the basis of these criteria, the presence of obstruction was correctly diagnosed in 27 (90%) of 30 patients with proved obstruction, and obstruction was not diagnosed in the patients without obstruction. The cause of the obstruction was evident on CT in 14 of the 30 obstructed patients: abscess (five), neoplastic lesion (three), peritoneal carcinomatosis (three), and other (three). Adhesions were responsible for the obstruction in 13 of 15 patients in whom the cause was not shown on CT. In six patients in whom findings on plain abdominal radiographs were normal, the CT scan was positive for obstruction. However, in the three patients whose CT scans were falsely negative for obstruction, findings suggesting obstruction were seen on plain films. Of 15 patients who had both CT and contrast studies of the small intestine, CT offered more information concerning the cause of obstruction in six (40%), primarily by demonstrating significant extraluminal abnormalities. CT and gastrointestinal contrast studies gave concordant results in eight patients with obstruction. In only one patient did the gastrointestinal contrast study give more diagnostic information. We conclude that CT scanning demonstrates accurately the presence of high-grade small-bowel obstruction and may be the technique of choice when extraluminal abnormalities are suspected or when prompt, efficient, and comprehensive evaluation is required.

Imaging of the biliary sump syndrome

Side-to-side choledochoduodenostomy is a safe and effective surgical technique to improve biliary drainage in selected patients. The segment of common bile duct between the anastomosis and the ampulla of Vater may act as a stagnant reservoir or sump. When debris, stones, or infected bile accumulates in the sump, usually because of malfunction of the ampulla of Vater, recurrent abdominal pain or symptoms of cholangitis, pancreatitis, or biliary obstruction may develop. This uncommon (0.14-1.30%) complication is known as the sump syndrome. On imaging studies, diagnostic findings are debris or stone(s) in the common bile duct. Suggestive findings are dilated bile or pancreatic ducts, and changes due to pancreatitis, cholangitis, or liver abscess. Patients with this syndrome frequently have multiple imaging studies before the condition is recognized. The purpose of this essay is to illustrate the imaging findings of this syndrome.

Quantitative measurement of muscle and subcutaneous fat thickness in newborn by real-time ultrasonography: a useful method for site and depth evaluation in vaccination

In order to quantify muscle thickness and choose the appropriate site for intramuscular injection of vaccines in neonates, we used ultrasonography to measure muscle and subcutaneous fat thickness of anterolateral mid-thigh, upper outer quadrant of buttock and middle area of deltoid in fifty full term (group 1) and thirty low birth weight (group 2) infants. A Hitachi EUB40 real-time scanner and a 5 MHz transducer was used in the study. We delineated the normal distribution of muscle and subcutaneous fat thickness in mid-thigh, buttock and deltoid areas of full term and low birth weight infants. There was no significant difference between male and female infants in the two groups. Muscle and subcutaneous fat thickness in the thigh area was 11.8 +/- 1.9 mm and 3.8 +/- 0.4 mm, respectively, in group 1; 8.6 +/- 1.7 mm and 2.7 +/- 0.5 mm in group 2. Figures in the buttock area were 10. 1 +/- 1.5 mm and 3.7 +/- 0.5 mm in group 1, 6.9 +/- 1.2 mm and 2.7 +/- 0.7 mm in group 2; and in the deltoid area were 5.2 +/- 0.7 mm and 3.4 +/- 1.5 mm in group 1 and 3.8 +/- 0.8 mm and 2.3 +/- 0.6 mm in group 2. There was significant logarithmic correlation between muscle thickness and body weight (r = 0.6, 0.8, 0.6) and muscle thickness and body length (r = 0.4, 0.6, 0.6) in thigh, buttock and deltoid areas of the low birth weight infants. In contrast, there was significant logarithmic correlation only between buttock muscle and body weight (r = 0.5) in the full term infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Psammopemmins (A-C), Novel Brominated 4-Hydroxyindole Alkaloids From an Antarctic Sponge, Psammopemma sp

Two specimens of a marine sponge Psammopemma sp. collected from Prydz Bay, Antarctica, have been found to contain three new brominated 4-hydroxyindole alkaloids: psammopemmin A (4), -B (5) and -C (6). These novel secondary metabolites, which also incorporate a unique 2-bromopyrimidine moiety, have been assigned structures on the basis of detailed spectroscopic analysis and derivatization.

CT of abdominal abscess with fistulous communication to the gastrointestinal tract

We review CT of 24 cases of intraabdominal abscess with fistulous communication to the GI tract confirmed by GI contrast study or fistulogram. Underlying causes of fistulization included recent GI tract surgery (13), diverticulitis (four), unknown etiology (three), malignant neoplasm (two), trauma (one), and pancreatitis (one). Thirteen (54%) abscesses showed air-fluid levels, 14 (58%) showed air bubbles, and seven (29%) showed both. Bowel contrast material was administered in 21 cases, and optimal bowel opacification was effected in 16. However, contrast extravasation into the abscess was noted in only six cases. We conclude that an air-fluid level may indicate the presence of a fistulous communication to the GI tract, but its absence does not necessarily mean there is no communication. Also, recognition of contrast within the abscess is uncommon even with optimal bowel opacification. In cases of clinical suspicion of internal fistula, a fistulogram or GI contrast study should be performed.

[Tuberous sclerosis associated with pulmonary lymphangioleiomyomatosis]

Lymphangioleiomyomatosis (LAM) is a rare disease of women of childbearing age in which there is hyperplasia of atypical smooth muscle along lymphatics in the lung, thorax, and abdomen. Since Lautenbacher's first description in 1918, less than 100 cases of Bourneville's tuberous sclerosis (BTS) with involvement of the lungs have been reported. Their clinical, radiologic and pathologic manifestations are so strikingly similar to those of pulmonary lymphangioleiomyomatosis (PLM) that some authors have considered PLM to be a form fruste of BTS. We present a case of PLM with clinical pictures of dermatologic stigmata and kidney angiomyolipoma of tuberous sclerosis but free of neurologic symptoms. After the development of a recurring spontaneous pneumothorax, she had a downhill course and progressive pulmonary functional defect.

Pyloric deformation from peptic disease. Radiographic evidence for incompetence rather than obstruction

We have used double-contrast radiographic techniques to clarify what changes in the configuration and movements of the gastroduodenal junction result when peptic lesions involve the distal gastric segment between the proximal (PPL) and the distal pyloric muscle loop (DPL). Among 50 cases of pyloric ulceration diagnosed during a four-year study period, 18 cases fulfilled all study criteria. Ulcers maintained a consistent location with regard to the muscular structures of the pylorus, and by affecting these structures, led to many strange deformations of the gastric outlet including permanent pseudodiverticula and reversal of pyloric angulation. The most common site for peptic lesions in the pyloric segment was the protuberance of the lesser curvature called the pyloric torus; many torus lesions extended into and destroyed the DPL. This led to widening of the gastric outlet and radiographic evidence of increased duodenogastric reflux. Pyloric closure was further impaired in this setting because the mucosa no longer prolapsed into the gastric outlet and did not occlude the pyloric lumen as it normally does. Less common lesions involved the greater curvature and the PPL. In one patient, scarring of the PPL led to an antral web and gastric hyperperistalsis. This was the only patient who required operation for chronic gastric outlet obstruction. One-third of the 18 patients had reflux esophagitis in addition to peptic pyloric disease. In most patients without additional ulcerogenic risk factors, treatment with antisecretory agents led to the healing of ulcer craters. We conclude that the morphologic and functional changes of the gastric outlet caused by peptic lesions depend, in part, on the effect the ulcer has on the underlying pyloric musculature.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical studies of neonatal hyperbilirubinemia treated with blood exchange transfusion]

From April 1984 to November 1989, 194 cases of neonatal hyperbilirubinemia treated with blood exchange transfusions (BET) were studied. The patients included 127 male and 67 female neonates, with an age ranged from 13 hours to 16 days. The most common cause was idiopathic (52.6%), followed by G-6-PD deficiency (23.7%), and sepsis (12.9%). Most of the neonates received BET at the 4th day of birth (23.2%), but there were still 30 cases (15.5%) that received BET after 1 week of age. There were 17 cases (8.8%) with maximum serum bilirubin lower than 20 mg/dl before receiving BET, five of them were LBW infants; 11 cases (5.7%) were greater than 40 mg/dl. The mean of maximum serum bilirubin was 26.9 +/- 7.96 mg/dl. Most of the cases received BET once (145 cases) or twice (33 cases). There were two cases that received up to six BET's. One was G-6-PD deficiency and one idiopathic in etiology. No significant difference of BET frequency between sex or body weight (p greater than 0.05) was found. Newborns with higher serum bilirubin due to G-6-PD deficiency, received more BET (p less than 0.05). No significant differences of the pH value (7.33 +/- 0.08 vs 7.35 +/- 0.10) and bicarbonate values (21.20 +/- 3.99 vs 22.00 +/- 3.83 mM/L) occurred before and after blood exchange transfusion (p greater than 0.1). The serum calcium decreased significantly after BET (3.88 +/- 0.91 vs 3.15 +/- 6.97 mEq/L, p less than 0.05). There were 11 deaths in this series, the mortality rate was 5.7%. Three cases (1.5%) were dead within 6 hours after BET.(ABSTRACT TRUNCATED AT 250 WORDS)

[A survey on weight and height of children (1 month-7 years) and plotting of growth curves (1 month-18 years) in Taiwan, 1987-1988]

From July 1987 to December 1988, 19,625 children in Taiwan were measured for their body weights and heights. They were 9,564 boys and 10,061 girls and were seen either in a well baby clinic of a large community hospital or in the local kindergartens. We divided these children into 64 groups according to their sex and ages. The mean values and standard deviation of body weight and height were tried to correlate with those from children of school age reported for 1987 by the Ministry of Education. Furthermore, body weight and height growth curves were drawn for these children, aged from 1 month to 18 years.

Somatic embryogenesis and plant regeneration in diploid Allium fistulosum × A. cepa F1 hybrid onions

Procedures were developed for disinfestation of non-dormant basal plate tissue excised from field grown basal plate tissue of diploid Allium fistulosum × A. cepa F1 hybrid onions. Contamination levels varied with the season and vegetative development of plant material. Callus initiated from basal plate tissue and immature inflorescences of the F1 hybrids was maintained on a BDS-based medium containing 0.75 mg/l picloram and 2.0 mg/l BA. When this medium was supplemented with vitamins and glycine, and with proline at 2.5 gm/1, somatic embryos began to form. Their development continued on a BDS-based shoot promotion medium containing 0.03 mg/l picloram and 0.32 mg/l 2iP supplemented with vitamins, glycine and proline. Genotypes differed significantly in the numbers of structures regenerated. Plantlets from somatic embryos were rooted into BDS or half-strength BDS medium without growth substances and were successfully transferred to sterilized potting mix in plastic commercial corsage boxes.

[Bronchoscopic examination in immuno-compromised host with hypoxemia due to Pneumocystis carinii pneumonia--case report]

The differential diagnosis of newly developed pulmonary infiltrate in CXR film of immunocompromised host including infection, neoplasm, pulmonary edema, pulmonary hemorrhage, cytotoxic drug induced pneumonitis, radiation pneumonitis and transfusion induced pneumonitis. If clinical course changed rapidly and the patient had fever, cough and dyspnea, then, opportunistic infection should be considered at first. Fiberoptic bronchoscopy with bronchoalveolar lavage (BAL), brushing and trans- bronchial biopsy (TBLB) will give most of informations. If the patient had hypoxemia, high, flow O 2 (even pure O 2) should be given to the patient and pulse oximeter used to monitor his state of oxygenation continuously. BAL should be done at first for its high yield in infectious cases. If the condition allowed us to perform more procedures, brushing and TBLB should also be considered. We present one case of polyarteritis nodosa with Pneumocystis carinii pneumonia after longterm endoxan and corticosteroid treatment. This patient had typical history and diagnostic procedures.

Small bowel enteroclysis survey

A survey questionnaire was sent to 125 radiology programs to determine the frequency and indications for the use of small bowel enteroclysis. Sixty-seven of the 84 respondents perform small bowel enteroclysis while 17 do not. The 3 most common indications for enteroclysis are detection of unexplained gastrointestinal bleeding, partial small bowel obstruction, and Crohn's disease. We conclude that although small bowel enteroclysis is a well-established examination, there are wide differences in the frequency with which it is performed, the techniques of examination, and indications for its use.

Renal sinus malignant lymphoma: a case report

We report a case of renal sinus non-Hodgkin's lymphoma without contiguous adenopathy. Magnetic resonance and computed tomography images of this rare tumor were correlated with a pathologic specimen. On computed tomography the renal sinus lymphoma was evaluated as a well circumscribed, low-density mass owing to the mixture of the lymphomatous cells and fat tissues. Magnetic resonance showed the replacement of the renal sinus fat tissues with a spoke-like solid mass. The renal artery and vein were also evaluated thoroughly and were without tumor thrombosis.

Developmental variation of the diaphragm and liver in Fischer 344 rats

The nature and frequency of a developmental variation of the diaphragm and liver in Fischer 344 rats are described. Totals of 20, 98 and 55 (25 for caesarean-sectioning and 30 for natural delivery) mated female rats were used for Experiments 1, 2, and 3, respectively. Each rat was intubated (gavage) with either an aqueous suspension of 0.2% METHOCEL, 0.25% methyl cellulose, or distilled water as a single daily dose from days 6 through 15 (inclusive) of gestation. On the 20th day of gestation, a caesarean-section was performed, and the uterine contents of each rat were examined. A gross necropsy was performed on the pups of 30 mated female rats on day 21 postpartum. The visceral examinations conducted on these fetuses and pups included an evaluation of a developmental variation in the diaphragm and liver. The variation consisted of a thin fibrous central tendon of the diaphragm with an area of liver (0.5-3 mm diameter) that protruded within the thin central tendon of the diaphragm. The incidence (mean % of fetuses affected per litter) of the diaphragm/liver developmental variation was 9% and 11% for METHOCEL- and water-treated groups, respectively. A thin central tendon was present in the diaphragm of all fetuses of methyl cellulose-treated dams; these fetuses did not have a raised area of the liver present within the diaphragm's central tendon. However, in a few weaned pups of the Fischer 344 rats in this study, liver protruded within the central tendon of the diaphragm.(ABSTRACT TRUNCATED AT 250 WORDS)

Magnetic resonance imaging of renal vein and inferior vena cava thrombosis in a patient with glomerulonephritis: a case report

We report a case of bilateral renal vein and inferior vena cava thrombosis in a patient with membranous glomerulonephritis. To the best of our knowledge, this is the first case demonstrated by magnetic resonance imaging.

Umbilical vein blood flow measurement in nonimmune hydrops fetalis

Twenty-five measurements of fetal umbilical vein blood flow were performed in 22 cases of nonimmune hydrops fetalis using real-time and pulsed Doppler duplex ultrasound. The umbilical vein diameter, blood velocity, and blood flow in fetuses with hemoglobin Bart's hydrops fetalis were usually higher than those in fetuses with hydrops fetalis from other causes. Umbilical vein blood flow measurement appears to be an effective technique for differentiating hemoglobin Bart's from non-Bart's hydrops in this series. This hemodynamic characteristic of umbilical vein blood flow may be helpful in determining the etiology of nonimmune hydrops fetalis.

Base line tenting: a sign of duodenal ulcer disease

Indirect signs such as clover-leaf deformity, pseudodiverticulum formation, eccentric location of pyloric channel, and flattening of the fornix are of considerable value in the radiologic detection of an ulcer crater. We have found another indirect sign, base line tenting (BLT) to be very useful in the detection and diagnosis of duodenal ulcer disease. This is characterized by interruption of the base line of the bulb, with 2 associated perpendicular lines extending from the base and converging to a point in the duodenal bulb. After we observed this sign in various patients with peptic ulcer disease, a prospective investigation was performed involving 62 patients with duodenal ulcer disease over a period of 2 years. We found the BLT sign in 52 (83.8%). To date, no false-positive incidence has been identified. We concluded that BLT is a most valuable sign in the radiologic identification of duodenal ulcer disease.

A map of membrane populations isolated from rat exorbital gland

We combined separation procedures based on three independent physical properties, sedimentation coefficient, density, and partitioning in an aqueous polymer two-phase system, to generate a three-dimensional subcellular fractionation of rat exorbital lacrimal gland. The distributions of protein and five enzymatic markers define a total of 13 physically and biochemically distinct membrane populations. These include epithelial cell apical membranes, purified 330-fold with respect to the initial homogenate; basal-lateral membranes, purified 80-fold; mitochondria, purified 19-fold; and a major endoplasmic reticulum population, purified 22-fold. Also apparent is a major Golgi population, which is extensively overlapped by other membrane populations; two populations that can be visualized as forming transitions between the endoplasmic reticulum and Golgi membranes; and several populations with unknown subcellular origins. Most of the markers have complex distributions among the isolated membrane populations; this complexity is consistent with current concepts of the synthesis and recycling of membrane constituents and the regulation of cytosolic electrolyte activities.

Unusual manifestations of giant colonic diverticulum

Giant colonic diverticulum is an uncommon complication of diverticulosis, with only 52 previously reported cases. Complications secondary to the giant air cysts occurred in only six instances, and all but one occurred in the sigmoid colon. Two additional cases are described, presenting atypical location, age, and complication by pneumoperitoneum.

Natural history of adult Hirschsprung's disease

The natural history of adult Hirschsprung's disease was reviewed in 22 patients (four from our hospital and 18 from the literature). The diagnosis in nearly half the patients was made before age 30, and the oldest patients were 69 years of age. Male to female ratio was 4:1. Almost all patients had severe constipation since birth. Barium enema showed rectal narrowing in 77%, and colonic dilation in 100%. Anorectal manometry was performed in only four patients; three showed no relaxation with rectal distention. In all patients, rectal biopsy showed no ganglion cells. Appropriate operation for Hirschsprung's disease improved symptoms in over 80% of patients. Hirschsprung's disease should be considered in all adult patients who have had severe constipation since birth, especially if they are male.

Diagnosis of obstructive jaundice in infants: Tc-99m DISIDA in duodenal juice

Technetium-99m di-isopropylphenylcarbamoylmethylimidodiacetic acid cholescintigraphy, together with measurements of radioactivity in duodenal juice, was used to evaluate 23 infants with prolonged obstructive jaundice. Four patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was distinct differentiation of biliary atresia from neonatal hepatitis when the time-activity curves were analyzed. In neonatal hepatitis the radioactivity in duodenal juice is obviously higher, peaking above 1500 cpm/100 microliter per mCi dose. In biliary atresia the pattern is flattened, with maximal activity below 500 cpm/100 microliter per mCi dose.

A new, safe balloon enema tip

The rectum can be perforated by an enema tip during a barium enema examination due to direct trauma during insertion or the undesirable mechanical properties of the balloon catheters. The author describes a newly designed, safer tip.

Strain differences in the response of mouse testicular stem cells to fractionated radiation

The survival of spermatogonial stem cells in CBA and C3H mice after single and split-dose (24-hr interval) irradiation with fission neutrons and gamma rays was compared. The first doses of the fractionated regimes were either 150 rad (neutrons) or 600 rad (gamma). For both strains the neutron survival curves were exponential. The D0 value of stem cells in CBA decreased from 83 to 25 rad upon fractionation; that of C3H stem cells decreased only from 54 to 36 rad. The survival curves for gamma irradiation, which all showed shoulders, indicated that C3H stem cells had larger repair capacities than CBA stem cells. However, the most striking difference between the two strains in response to gamma radiation was in the slopes of the second-dose curves. Whereas C3H stem cells showed a small increase of the D0 upon fractionation (from 196 to 218 rad), CBA stem cells showed a marked decrease (from 243 to 148 rad). The decreases in D0 upon fractionation, observed in both strains with neutron irradiation and also with gamma irradiation in CBA, are most likely the result of recruitment or progression of radioresistant survivors to a more sensitive state of proliferation or cell cycle phase. It may be that the surviving stem cells in C3H mice are recruited less rapidly and synchronously into active cycle than in CBA mice. Thus, it appears that the strain differences may be quantitative, rather than qualitative.

Resolution of apical and basal-lateral membrane populations from rat exorbital gland

We performed analytical fractionation studies with the goal of isolating basal-lateral and apical membrane vesicles from epithelial cells of rat exorbital lacrimal gland. A density region designated window II contained elements of three physically and biochemically distinct membrane populations. These were resolved by countercurrent distribution in an aqueous polymer two-phase system. One population contained 50% of the NADPH-cytochrome c reductase activity recovered from window II and appeared to be of intracellular origin. A second population contained 70% of the recovered Na-K-ATPase, maximally enriched 42-fold with respect to the initial homogenate. This population was the major locus of alanine transport activity, roughly 85% of which was mediated by systems believed to be characteristic of epithelial cell basal-lateral membranes. It also contained portions of the alkaline phosphatase, galactosyltransferase, acid phosphatase, and NADPH-cytochrome c reductase activities. A third population accounted for 33% of the recovered alkaline phosphatase and was a secondary locus of Na-alanine transport activity, 45% of which could be attributed to systems believed to be characteristic of epithelial cell apical membranes.

Esophagotracheal fistula from a pharyngoesophageal diverticulum

Pharyngo-esophageal (Zenker's) diverticula are rarely associated with tracheal fistulas; however, the diagnosis should be suspected in the diverticulum patient who presents with spasms of coughing while eating since, if found, it changes the surgical management. The roentgenographic findings, diagnostic modalities, and surgical management of such a patient are herein presented.

Basal-lateral and intracellular membrane populations of rat exorbital lacrimal gland

With the goal of isolating and identifying plasma membrane vesicle populations from epithelial cells of the rat exorbital lacrimal gland, we have designed an analytical fractionation of homogenates of the gland parenchyma. This fractionation utilizes separation procedures based on three independent physical properties of subcellular particles: sedimentation coefficient, density, and density after interaction of membrane cholesterol with digitonin. A commonly accepted marker for basal-lateral membranes, Na-K-ATPase, is associated with at least two physically distinct membrane populations. One population can be identified as basal-lateral membrane fragments on the basis of its fractional and specific contents of Na-K-ATPase; it accounts for 50% of the total Na-K-ATPase activity, enriched 29-fold with respect to the initial homogenate. With these values we calculate that the sample of basal membranes has been purified 60-fold with respect to the initial homogenate. The remaining Na-K-ATPase activity appears to be associated, at three- to fivefold lower specific activities, with intracellular membrane populations. We speculate that these populations have been derived from the Golgi complex.

Psoas abscess resulting from perforating carcinoma of the sigmoid colon. Report of a case

We report a case of a left psoas abscess resulting from a perforating carcinoma of the sigmoid colon. The chief complaints were edema of the left leg and pain in the left thigh. Single and double contrast barium-enema film demonstrated an extrinsic inflammatory mass distorting the sigmoid colon. A preoperative diagnosis of sigmoid carcinoma was not made on these examinations, nor on flexible colonoscopy. Carcinoma of the colon should be considered as a cause of an unexplained psoas abscess.