Irradiation does not modify mechanical properties of cancellous bone under compression.

Background: Gamma radiation sterilization can make cortical bone allograft more brittle, but whether it influences mechanical properties and propensity to form microscopic cracks in structurally intact cancellous bone allograft is unknown.

Questions/purposes: We therefore determined the effects of gamma radiation sterilization on structurally intact cancellous bone mechanical properties and damage formation in both low- and high-density femoral cancellous bone (volume fraction 9%-44%).

Methods: We studied 26 cancellous bone cores from the proximal and distal femurs of 10 human female cadavers (49-82 years of age) submitted to a single compressive load beyond yield.

Therapeutic effectiveness of rituximab in a patient with unresponsive autoimmune pulmonary alveolar proteinosis.

Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterised by the accumulation of lung surfactant in the alveoli. In most cases it is an autoimmune disease with antibodies directed against the growth factor granulocyte-macrophage colony stimulating factor (GM-CSF). Standard of care consists of whole lung lavages in symptomatic patients.

Alterations in damage processes in dense cancellous bone following gamma-radiation sterilization.

Structurally intact cancellous bone allograft is an attractive tissue form because its high porosity can provide space for delivery of osteogenic factors and also allows for more rapid and complete in-growth of host tissues. Gamma radiation sterilization is commonly used in cancellous bone allograft to prevent disease transmission. Commonly used doses of gamma radiation sterilization (25-35 kGy) have been shown to modify cortical bone post-yield properties and crack propagation but have not been associated with changes in cancellous bone material properties.

[Parvovirus B19 myocarditis in a young man with previous non-bacterial meningitis].

History And Clinical Findings: A 22-year old man presented with fatigue, dyspnea NYHA III and presyncopes that had persisted since a non-bacterial meningitis 3 months before.

Investigations: Transthoracic echocardiography revealed a dilated left ventricle with an ejection fraction (EF) reduced to 35-40 % due to global hypokinesia. No pericardial effusion was seen; ECG and lung function test were normal.

Multiple symmetric lipomatosis presenting with polyneuropathy.

We describe an unusual case of multiple symmetric lipomatosis (MSL) that presented with severe polyneuropathy, and review the literature. To the best of our knowledge, this is the first description of polyneuropathy as the presenting sign of MSL and the first report of this syndrome in Israel. MSL has to be included in the differential diagnosis of unexplained polyneuropathy.

Mycobacterium simiae infection in Israeli patients with AIDS.

Mycobacterium simiae is an environmental organism that has rarely been associated with human disease. In Israel M. simiae is frequently isolated from clinical specimens, and it usually colonizes damaged lungs.

Inadvertent sulfonylurea-induced hypoglycemia. A dangerous, but preventable condition.

Two patients with severe hypoglycemia due to inadvertent use of oral hypoglycemic agents are described. Unintentional substitution of tablets with sulfonylurea drugs was related in both cases to a similarity in shape and color of the pills. In one case glyburide was interchanged with an artificial sweetener, while in the other case chlorpropamide was dispensed by a pharmacist instead of quinidine bisulfate.

Recurrent erythema nodosum, arthritis and IgA nephropathy.

Erythema nodosum and IgA nephropathy are nosologic entities with an immunologic background. IgA nephropathy is a specific disease of the kidneys, while erythema nodosum may be associated with other illnesses. We report a unique case in which intermittent hematuria due to IgA nephropathy was superimposed on recurrent attacks of erythema nodosum and arthritis.

Labetalol in the treatment of essential hypertension: a single-blind dose ranging study.

The hypotensive efficacy of labetalol was evaluated in 29 patients with essential hypertension in a single-blind dose ranging study. After a two-week period of placebo treatment, labetalol was given in oral doses of 0.6 g/d, 0.

Hyperammonemia complicating mesenteric vein thrombosis.

Hyperammonemic coma developed in a 69-year-old woman with prolonged symptoms of abdominal pain, dysphagia, and fever. At laparotomy for an acute condition within the abdomen, mesenteric vein thrombosis was found and partial intestinal resection was performed. Following surgery, the patient regained consciousness and blood ammonia levels became normal.

Insulin clearance contributes to the variability of nocturnal insulin requirement in insulin-dependent diabetes mellitus.

We have previously described, in insulin-dependent diabetic subjects (IDDM), a small, but significant, increase in the insulin clearance rate (ICR) during 0600-0800 h as compared with 0100-0300 h. To determine whether this increase was also seen at more physiologic levels of insulin replacement, we calculated ICR during euglycemic clamp studies in 13 patients with IDDM with a constant infusion of insulin at 20 mU/min/m2 and during insulin replacement from the Biostator GCIIS without exogenous glucose. During the euglycemic clamp study with constant insulin infusion at 20 mU/min/m2, the ICR was 16% higher at 0600-0800 h than at 0100-0300 h (264 +/- 50 ml/min/m2 versus 228 +/- 51 ml/min/m2; P less than 0.

Influence of penicillamine and various analogs on matrix-induced bone formation in rats.

D-penicillamine and a variety of analogs have been tested for their ability to interfere with the various stages of bone development using a model for endochondral bone formation. At the highest dose tested (40 mg/rat/day), D-penicillamine inhibited mineralization, D-2-Amino-3-methyl-3-[(2-acetamidoethyl)dithio]butanoic acid (II), at a relatively low dose (10 mg/day), decreased the amount of insoluble collagen in skin, mesenchymal cell proliferation on Day 3, and inhibited bone formation on Day 14. Several other compounds tested, sodium 4-[(D-1, 1-dimethyl-2-amino-2-carboxyethyl)-dithio]butanesulfinate (IV), 2-acetamidoethyl-2-acetamidoethanethiolsulfonate (V), and sodium 4-mercaptobutanesulfinate trihydrate (VI), also inhibited osteogenesis on Day 14.

Serum angiotensin converting enzyme activity in normal adults and patients with different types of hypertension.

The serum converting enzyme activity (SCEA) was measured in 86 healthy individuals (1.44 +/- 0.82 u, mean +/- SD), 39 patients with essential hypertension (1.

Dressler's syndrome after right ventricular infarction.

Undiagnosed myocardial infarction of the right ventricle presented as Dressler's syndrome. Radioisotopic diagnostic procedures including first-pass and multigated acquisition nuclear angiography ( MUGA ) and thallium-201 perfusion studies enabled a retroactive diagnosis of myocardial infarction, showed it to be in the right ventricle, and clarified the aetiology of the unexplained fever and pleuropericarditis.

Renin, aldosterone, and serum-converting enzyme activity during normal and hypertensive pregnancy.

Plasma renin activity, plasma aldosterone, and serum-converting enzyme activity were measured in 13 normotensive pregnant women in three sequential periods: 19-21, 29-31, and 38-40 weeks of gestation. The converting enzyme activity was also measured in a group of 6 women with hypertensive pregnancy and an age-matched control group of 35 normal nonpregnant women. Plasma renin activity and plasma aldosterone values were both significantly elevated in the three periods of pregnancy, but plasma aldosterone levels were relatively lower during the first two periods.

Spontaneous bacterial pleuritis in a patient with cirrhosis.

Empyema of the left pleural cavity developed suddenly in a nonalcoholic cirrhotic patient. Cultures of the pleural fluid under anaerobic conditions grew Clostridium perfringens, an organism normally found in the enteric flora. The infection developed in an old pleural effusion.