Cubital tunnel syndrome: diagnosis by high-resolution ultrasonography

The purpose of this study was to evaluate the morphologic changes in the ulnar nerve in cubital tunnel syndrome with high-resolution ultrasonography. The mean values of the short axis (cm) x long axis (cm) at the arm, epicondyle, and forearm levels were 0.057 +/- 0.01, 0.068 +/- 0.019, and 0.062 +/- 0.01 in control group; 0.069 +/- 0.04, 0.139 +/- 0.06, and 0.066 +/- 0.023 in the symptomatic side in patients with cubital tunnel syndrome; and 0.063 +/- 0.029, 0.068 +/- 0.029, and 0.057 +/- 0.012 in the normal side in patients with cubital tunnel syndrome. No significant difference was found in the area (short axis x long axis) of the ulnar nerve at the arm, epicondyle and forearm levels between the left and right ulnar nerve in the control group and between the control group and the normal side in symptomatic patients. However, the mean value of the area of the ulnar nerve at the epicondyle level in symptomatic patients was significantly larger than that of the control group and that of the contralateral side in patients, and the P value was less than 0.001. High resolution ultrasonography can detect morphologic changes in the ulnar nerve accurately, and it could therefore be useful as a screening and even follow-up modality in patients with cubital tunnel syndrome.

Studies on segmented polyetherurethane for biomedical application: effects of composition and hard-segment content on biocompatibility

Segmented polyetherurethane (SPEU) materials based on polytetramethylene oxide (PTMO, Mw 1000 and 2000) with various hard-segment contents were synthesized and their biocompatibilities studied via different tests. The static contact angle data reveal that the higher hard-segment-content SPEU material possesses a lower contact angle, implying that the surface of the higher hard-segment-content SPEU is more hydrophilic than its low hard-segment-content SPEU counterpart. The catalyst- and additive-free PTMO-based SPEU materials in this study possess neither a hemolytic nor a cytotoxic response that could be considered non toxic for biomedical applications. By using L-929 cell lines, a cell-seeding test indicated that the higher hard-segment-content SPEU material possesses quicker cell attachment and proliferation behaviors. In vitro platelet adhesion tests indicated that the lower hard-segment-content SPEU possesses less platelet adhesion than the high hard-segment-content SPEU material. Both ex vivo canine artery-artery (A-A) and arterio-venous (A-V) shunting tests revealed that the extent of platelet adhesion reaction is less for lower hard-segment content SPEU. In addition, the blood compatibility of SPEU material synthesized from PTMO 1000 excels over PTMO 2000 SPEU material by near the same levels as the hard-segment-content SPEU.

Giant ossified cavernous hemangioma of an extremity associated with an equinovarus deformity

A 39-year-old woman suffered from swelling and tenderness of the right leg for 31 years. Imaging studies showed a large soft tissue lesion on the right side extending from the proximal portion of the thigh to the ankle. She underwent several operations due to the leg mass and associated equinovarus deformity of the right ankle. The pathologic findings were those of an ossified cavernous hemangioma. This appears to be one of the largest hemangiomas to be reported. It revealed the three types of calcification characteristic of hemangiomas. Equinovarus deformity of the ankle caused by contracture of the calf in this case was probably related to repeated bleeding.

Triangular fibrocartilage perforations with bilateral negative ulnar variant wrists: a case report

Triangular fibrocartilage (TFC) constitutes the major part in the triangular fibrocartilage complex, which stabilizes the distal radioulnar joint and functions as a cushion for axial compression forces. Tears in the TFC are often encountered with positive ulnar variance and regarded as part of a degenerative process of the ulnocarpal joint. They are occasionally seen as the result of trauma and are less likely to be found in a young population, especially in those who are in the first two decades of life, without causative traumatic injury. We report the case of a 12-year-old boy with bilateral negative ulnar variances with incidental findings of TFC tears in both wrists. This is a rare case, as he had no history of a traumatic event.

Lipoblastomatosis of the shoulder: unusual MR appearance

Lipoblastomatosis is a rare benign lipomatous tumour of childhood and infancy, classically showing high signal identical to fat on T1 weighted images. A case of histologically proven lipoblastomatosis in an infant is presented, in which MRI showed low signal on T1 weighted images identical to that of muscle instead of high signal. This appearance has not been previously reported.

Aromatic hydrocarbon receptor polymorphism: development of new methods to correlate genotype with phenotype

Differential CYP1A1 inducibility, reflecting variations in aromatic hydrocarbon receptor (AHR) affinity among inbred mouse strains, is an important determinant of environmental toxicity. We took advantage of the Ahr polymorphism in C57BL/6 and DBA/2 mice to develop an oligonucleotide-hybridization screening approach for the rapid identification of DNA sequence differences between Ahr alleles. Oligonucleotides containing single-base changes at polymorphic sites were immobilized on a solid support and hybridized with C57BL/6 or DBA/2 AHR cDNA radiolabeled probes. The observed hybridization patterns demonstrate that this approach can be used to detect nucleotide differences in the Ahr coding region with very high accuracy. In parallel experiments, we used a yeast two-hybrid system to assess phenotypic differences in AHR function. AHR activation, as measured by beta-galactosidase reporter activity in Saccharomyces cerevisiae strain SFY526, was determined following treatment with varying doses of the AHR ligand beta-naphthoflavone (BNF). We found that the C57BL/6 AHR has about a 15-fold higher affinity for BNF than the DBA/2 AHR, in much better agreement with results reported for whole-animal studies than the values observed by in vitro ligand-binding assays. Using C57BL/6 and DBA/2 AHR chimeric proteins, we also confirmed the previously reported observation that an A375V change is principally responsible for the high- to low-affinity AHR phenotype. There has been no straightforward method to reliably and reproducibly phenotype large numbers of humans for CYP1A1 inducibility or AHR affinity. Screening human AHR cDNAs by oligonucleotide-hybridization and yeast two-hybrid methodologies will be invaluable for the rapid and unequivocal determination of changes in DNA sequence and receptor-ligand affinities associated with human AHR polymorphisms.

Effect of mild acid treatment on the survival, enteropathogenicity, and protein production in vibrio parahaemolyticus

Vibrio parahaemolyticus is an important food-borne enteropathogen that encounters various adverse conditions in its native environment or during infection. Effects of mild acid treatment on survival under stress conditions, enteropathogenicity, and protein production in this pathogen were investigated. Logarithmically grown cells, at pH 7.5 shifted to pH 5.0 for 30 min, were more resistant to subsequent acid challenge at pH 4.4. A two-phase adaptive procedure (pH 5.8 for 30 min; pH 5.0 for 30 min) was better than a single-phase procedure for enhancing the acid tolerance of this pathogen. The acid-adapted cells were cross-protected against the challenges of low salinity and thermal inactivation. One-dimensional polyacrylamide gel electrophoresis revealed that proteins with molecular masses of 6.4, 9.0, 13.6, 16.3, 18.9, 22.9, 24.4, 28.3, 33. 9, 36.9, 41.2, 47.6, 58.1, 65.6, 80.5, 88.2, and 96.9 kDa were induced or significantly enhanced, while proteins of 25.3, 30.1, 30. 7, and 91.7 kDa were significantly inhibited. Two-dimensional polyacrylamide gel electrophoresis revealed that 20 species of proteins were induced or significantly enhanced, while 26 species were inhibited. In assays conducted using the suckling mouse model, enteropathogenicity of the acid-adapted cells was significantly enhanced in terms of intestine/body weight ratio and in vivo recovery of infected cells.

Pictorial review: Radiological diagnosis of duodenal abnormalities

This article depicts the radiological findings of many common gastrointestinal entities. Specifically, examples of disease processes that affect the stomach, gall bladder, small intestine, pancreas and colon are shown. In most cases there is correlation between ultrasound, computed tomography (CT) and fluoroscopic imaging. The major emphasis of the article, however, is to demonstrate classic barium imaging of a large number of gastrointestinal disease processes.

Involvement of serine proteinase in infectious pancreatic necrosis virus capsid protein maturation and NS proteinase cleavage in CHSE-214 cells

An investigation of virus-specific protein maturation in infectious pancreatic necrosis virus (IPNV) infected Chinook salmon embryo cells (CHSE-214) was undertaken. The precursor protein (pVP2-1) of the major mature capsid protein (VP2) was processed sequentially from pVP2-1 to pVP2-2 and VP2. Experiments using serine proteinase inhibitors showed that the maturation of the VP2 was blocked in the pVP2-1 post-translational cleavage steps. A protinin, a potent proteinase inhibitor, at 800 μg ml(-1) blocked pVP2-2 to VP2 and the cleavage of VP4 (28 kDa) to VP4-1 (25 kDa). Therefore, our data showed that the maturation of the capsid protein (VP2) and cleavage of VP4 (NS proteinase) can be blocked by serine proteinase inhibitors.

Isolation and characterization of tilapia (Oreochromis mossambicus) insulin-like growth factors gene and proximal promoter region

To understand the molecular mechanism which controls the transcription of the insulin-like growth factors (IGFs) gene, we have cloned and sequenced the cDNA for the proximal promoter region of the tilapia IGFs gene and have characterized its activity by chloramphenicol acetyltransferase (CAT) transient transfected expression assays. Tilapia (Oreochromis mossambicus) IGF-I cDNA (549 bp) was amplified by PCR from single-stranded cDNA of growth hormone (GH)-induced liver RNA using a pair of oligonucleotides specific for fish IGF-I as amplification primers. Tilapia IGF-I and IGF-II 5' termini were analyzed by rapid amplification of cDNA 5' ends (5'RACE). Analysis of the 5'RACE results revealed two transcription start sites in IGF-I and one transcription start site in IGF-II. Different fragments of the 5' flanking region were transfected into human lung adenocarcinoma cells. In the cell line, maximum promoter activity was located in the distal 657 basepairs of the IGF-I 5' flanking region and in the distal 450 basepairs of the IGF-II 5' flanking region. The in vivo actions of the IGFs promoter on developmental stage expression were investigated further in transgenic zebrafish in which an IGFs promoter-driven green fluorescent protein (GFP) encoding the cDNA transgene was microinjected into embryos. Morphologic and RT-PCR studies of the transgenic zebrafish indicated that IGF-I promoter-driven GFP transcripts appeared for the first time in the 1-K-cell stage and the IGF-II promoter-driven GFP transcripts appeared for the first time in the 32-cell stage. Fluorescent (GFP) distribution was apparent within 48 h in IGF-II-transgenic zebrafish embryos, especially in eye, muscle, corpuscle, floor plate, horizontal myoseptum, yolk sac extension, and yolk sac. These results indicate that the IGF-I and IGF-II promoters are active in tissue and in a development-specific manner. Our findings also indicate that the IGF-II promoter influences the growth of fish embryos earlier than does IGF-I, and IGF-II has higher levels of expression than does IGF-I. These results suggest that the IGF-II promoter plays a growth factor role in teleost embryo development.

Application of the surface rendering technique of three-dimensional ultrasound in prenatal diagnosis and counselling of Klippel-Trenaunay-Weber syndrome

Klippel Trenaunay-Weber syndrome is a complex developmental disorder characterized by a triad of cutaneous haemangioma, varicosities of the body, and unilateral limb hypertrophy. We describe the prenatal diagnosis of Klippel-Trenaunay-Weber syndrome at 15 weeks' gestation using the surface rendering technique of three-dimensional ultrasound. The vivid three-dimensional images of the affected fetus are invaluable in prenatal diagnosis and parental counselling.

High resolution computed tomography of temporal bone fracture

BACKGROUND

High resolution computed tomography (HRCT) is highly efficient in demonstrating the anatomy of the temporal bone. This study evaluates its application to temporal bone fractures (TBF).

METHODS

We collected data from 26 cases of TBF in the past two years. All cases underwent HRCT examination. The clinical information was reviewed and correlated with the imaging findings.

RESULTS

Eighty-six percent of the cases had longitudinal fractures. Axial scans were the most useful in identifying the fracture line. Mastoid opacification on routine head computed tomography (CT) was also useful in indicating possible TBFs. Complications of TBF, such as ossicular chain disruption, facial nerve damage or otorhino-liquorrhea, were identified clearly using HRCT.

CONCLUSIONS

To minimize or prevent the sequelae of TBF, accurate radiologic evaluation is necessary as soon as possible after injury. HRCT of the temporal bone delineates the bony and soft tissue anatomy with high accuracy and we recommend it as the diagnostic modality of choice.

Zinc uptake into fibroblasts is inhibited by probenecid

Cellular zinc transport has not been fully characterized. The role of an anion carrier was investigated by treating normal human fibroblasts, and those carrying a mutation which affects zinc transport, acrodermatitis enteropathica (AE), with the anion carrier inhibitor, probenecid. Zinc uptake (2, 10, or 20 micromol 1(-1) 65zinc) was determined during initial rates of uptake (15 min) following treatment with 0, 10 or 20 mmol 1(-1) probenecid. Probenecid stimulated extracellular zinc binding in normal and AE fibroblasts. Probenecid inhibited the internalization of zinc in normal, but not AE, fibroblasts. Normal fibroblasts exhibited an apparent Km which was reduced by 53% and 44% in the 10 and 20 mmol 1(-1) probenecid treated cells. The Vmax was also reduced in the normal fibroblasts by 51% and 50% in the 10 and 20 mmol 1(-1) probenecid treated cells. The results suggest that a probenecid-sensitive anion carrier is involved in the internalization of zinc in human fibroblasts. The lack of an effect of probenecid on the internalization of zinc in the AE fibroblasts suggests that the mutation involves a probenecid-sensitive anion transport system, and that there may be a secondary mechanism for zinc transport in these cells.

Radiologic and pathologic correlation of adenomyomatosis of the gallbladder

BACKGROUND

To demonstrate the radiologic-pathologic correlation of adenomyomatosis of gallbladder (GBA) and emphasize the role of high-resolution real-time ultrasound (RTUS) in the diagnosis of GBA.

METHODS

Ten (four male and six female, mean age = 49 years) patients with proven GBA (three diffuse, three segmental, and four fundal) diagnosed by histopathology or confirmed by oral cholecystography (OCG) were reviewed. Radiologic studies included OCG (n = 8), RTUS (n = 8), and computed tomography (CT; n = 4). Six patients subsequently underwent cholecystectomy.

RESULTS

Histopathologic correlation between pathologic specimens and OCG, RTUS, and CT was possible in six patients. The diagnostic criteria with ultrasound included numerous tiny intramural cysts containing echogenic foci with reverberation artifacts and associated segmental or diffuse gallbladder wall thickening. OCG with fatty meal demonstrated intramural diverticula. Localized fundal GBA was better visualized on RTUS and CT scan than on OCG.

CONCLUSION

Accurate diagnosis of GBA may be made by either OCG or high-resolution RTUS preoperatively. CT scan may used as an alternative method to help make the diagnosis in equivocal cases.

Applicability of direct in situ reverse transcription-polymerase chain reaction on bone marrow smears

In situ reverse transcription (RT)-polymerase chain reaction (PCR) is a promising laboratory tool for biomedical investigation at the molecular level in tissues. Direct in-cell amplification of the breakpoint cluster region (BCR)-Abelson (ABL) fusion transcript of chronic myeloid leukemia (CML) has recently been accomplished in Italy using bone marrow mononuclear cell suspensions. The goals of this study are to determine if in situ RT-PCR amplification is possible on bone marrow spirate smears and to demonstrate any unique factors in this procedure. A commercially available method was used because of the existence of published protocols for adaptation. Bone marrow (BM) aspirate smears (n = 17) from patients with CML in blast crisis (positive case material) or other hematological malignancies (negative case material) were evaluated. Satisfactory amplification of the BCR-ABL fusion transcript occurred, and distinct blue cytoplasmic granules that varied in intensity were found in most CML blasts. The negative case materials lacked the specifically amplified granular signals. Overall signal strength and backgrounds were readily affected by the quality of the specimen as well as by changes in assay parameters. In conclusion, the direct in situ RT-PCR technique is applicable for bone marrow aspirate smear evaluation. However, it remains an investigative tool until optimization for sensitivity, specificity, and accuracy can be achieved.

Triangular fibrocartilage of wrist: presentation on high resolution ultrasonography

This study consisted of two parts. Part I is for detection of the normal triangular fibrocartilage by high resolution ultrasonography and Part II is a preliminary study to evaluate high resolution ultrasonography in the diagnosis of tears of the triangular fibrocartilage. Normally, the triangular fibrocartilage was seen in all cases in Part I as an inverse triangular structure of homogeneous hyperechogenicity on transverse and oblique sagittal scans at the level of the distal radioulnar joint. At its waist it measured from 2.3 to 4.2 mm (mean, 3.0 +/- 0.5 mm) on oblique sagittal scan and from 2.5 to 3.7 mm (mean, 3.2 +/- 0.4 mm) on transverse scan. Under normal conditions, the triangular fibrocartilage is thicker than 2.5 mm on both transverse and oblique sagittal sections with a confidence level of 95%. In Part II, eight of the 47 wrists were found to be hypoechoic in the triangular fibrocartilage region, which proved to be tears by arthrography. Six cases showed a homogeneous hyperchoic triangular fibrocartilage measuring from 1.8 to 2.8 mm (mean, 2.3 +/- 0.5 mm) in transverse section and from 0 to 2.2 mm (mean 1.2 +/- 1.1 mm) in oblique sagittal section; five of these proved to be tears by arthrography. In contrast, 33 wrists had a homogeneous hyperechoic triangular fibrocartilage measuring from 2.5 to 4 mm (mean, 3.1 +/- 0.4 mm) and 2.5 to 4.2 mm (mean, 3.1 +/- 0.6 mm) on transverse and oblique sagittal sections, respectively; 27 proved to be normal triangular fibrocartilage by arthrography. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 68.4%, 96.4%, 92.9%, 81.8%, and 85.1%, respectively. HRUS can display the normal triangular fibrocartilage as a homogeneous hyperechoic and inverted triangular structure. The torn triangular fibrocartilage appears as a hypoechoic region or as thinning (< 2.5 mm) of the hyperechoic structure on either transverse or oblique sagittal section. HRUS has an acceptable accuracy in the diagnosis of triangular fibrocartilage tear.

Plasma levels of antioxidant vitamins, selenium, total sulfhydryl groups and oxidative products in ischemic-stroke patients as compared to matched controls in Taiwan

The possible involvement of oxidative damage and antioxidant protection has been suggested in the pathogenesis of stroke which is the second-leading cause of death in Taiwan. In this study we investigated the relationship between ischemic stroke and plasma status of antioxidants and oxidative products. Plasma levels of vitamin A, alpha-tocopherol, carotenoids, selenium (Se), total SH groups (T-SH), thiobarbituric acid-reactive substances (TBARS) and protein carbonyl, a marker of protein damage, were determined in ischemic-stroke patients (n = 36, blood sampled within 24 hrs after the clinical event) in comparison with 21 matched controls. The cholesterol-adjusted carotenoids and vitamin E were significantly lower (P < 0.05) in the plasma of ischemic-stroke patients than those of the controls. TBARS were higher (P < 0.05) in the patients than in the controls but Se, T-SH and protein carbonyls were not significantly different between the two groups. Separation of the patients into small-artery ischemic stroke (SAIS, n = 17) and large-artery ischemic stroke (LAIS, n = 19) groups revealed that both carotenoids/cholesterol and vitamin E/cholesterol ratios were significantly lower in both LAIS and SAIS groups than the controls (n = 21) while vitamin A/cholesterol was not different among the three groups. TBARS were only significantly higher in the LAIS group. The results demonstrated that, within 24 hrs after the clinical event, the acute-ischemic stroke patients had lowered levels of cholesterol-adjusted carotenoids and alpha-tocopherol but elevated levels of TBARS in the plasma as compared to the matched controls. It remains to be resolved as to whether enhanced lipid peroxidation is a cause or a result of lowered antioxidants in ischemic stroke.

Constitutive activation of the aromatic hydrocarbon receptor

The ligand-activated aromatic hydrocarbon receptor (AHR) dimerizes with the AHR nuclear translocator (ARNT) to form a functional complex that transactivates expression of the cytochrome P-450 CYP1A1 gene and other genes in the dioxin-inducible [Ah] gene battery. Previous work from this laboratory has shown that the activity of the CYP1A1 enzyme negatively regulates this process. To study the relationship between CYP1A1 activity and Ah receptor activation we used CYP1A1-deficient mouse hepatoma c37 cells and CYP1A1- and AHR-deficient African green monkey kidney CV-1 cells. Using gel mobility shift and luciferase reporter gene expression assays, we found that c37 cells that had not been exposed to exogenous Ah receptor ligands already contained transcriptionally active AHR-ARNT complexes, a finding that we also observed in wild-type Hepa-1 cells treated with Ellipticine, a CYP1A1 inhibitor. In CV-1 cells, transient expression of AHR and ARNT leads to high levels of AHR-ARNT-dependent luciferase gene expression even in the absence of an agonist. Using a green fluorescent protein-tagged AHR, we showed that elevated reporter gene expression correlates with constitutive nuclear localization of the AHR. Transcriptional activation of the luciferase reporter gene observed in CV-1 cells is significantly decreased by (i) expression of a functional CYP1A1 enzyme, (ii) competition with chimeric or truncated AHR proteins containing the AHR ligand-binding domain, and (iii) treatment with the AHR antagonist alpha-naphthoflavone. These results suggest that a CYP1A1 substrate, which accumulates in cells lacking CYP1A1 enzymatic activity, is an AHR ligand responsible for endogenous activation of the Ah receptor.

Cloning of porcine neuron growth inhibitory factor (metallothionein III) cDNA and expression of the gene in Saccharomyces cerevisiae

Growth inhibitory factor (GIF), a member of the metallothionein (MT) family, is also known as MTIII. This protein distinguishes itself from other MT isoforms by exerting an inhibitory effect on cortical neuron growth instead of metal ion buffering. In this work, we cloned MTIII genes from a porcine brain cDNA library. Two species of clones were isolated that vary with respect to one nt in the coding sequence. This discrepancy results in the translation of two MTIII primary structures having a different amino acid at residue 46. Herein, both MTIII cDNAs were constructed into an expression vector and transformed into yeast cells, respectively. The yeast carrying either MTIII gene displayed a similar metal tolerance when cultured in a medium containing metal. The resistance to metal toxicity was attributed to the expression of MTIII gene which was confirmed by RNA and protein analyses. The characteristics of the protein stability, metal binding affinity and ultraviolet absorption spectrum of the yeast produced MTIII are also compared with those of MTII. The comparison reveals that both MTs have similar physical characteristics. Moreover, circular dichroism spectrum of Cd saturated MTIII was analyzed as well. Typical Cys-Cd bands for MTII appear in the spectrum, indicating similar metal-thiol interactions for MTIII to those for other MT isoforms.

[Analysis of the measurement on of the maxillofacial soft tissue's parameters association with vertical dimension]

The rehabilitation of vertical dimension of occlusion(VDO) exactly is one of the most important procedure for dental prosthesis in the field of prosthodontics.In this study,total of 19 subjects with normal range occlusion were selected.We measured 33 parameters relating to VDO of their facial soft tissue at intercusping position,with the technique of digital imaging analysis.The results as follows:we established a set of normal values of facial soft tissue parameters,which is suitable for the age group of 21-24 years old.It would provide an objective criterion for the rehabilitation of VDO.Also the normal values in this studies had been compared with other other studies,and it showed that the values of some parameters in our study,such as CH-CH',nasolabial angle were very close to oter data.Furthermore,it was found that both the position of the upper lip and the lower lip of the subjects were more anterior to that of white men,while the degrees of nasolabial and labiomental convexity were less obvious.