Huge malignant solitary fibrous tumor of the pleura.

Introduction: Solitary fibrous pleural tumors are rare mesenchymal tumors that can be mistaken for mesothelioma. A positive staining of vimentin, negative staining of cytoplasmic keratin, and expression of the CD34 antigen can confirm their diagnosis. These tumors should be surgically excised although they are benign because they have malignant potential and tendency for recurrence.

Surgical management of sternoclavicular joint infection.

Objective: Sternoclavicular joint (SCJ) infections are rarely encountered and their management is not well standardised. We reviewed our experience with the management of this condition in order to evaluate the role of surgery in the management of the SCJ infection and to provide an algorithm for its treatment.

Methods: It is a multicentre study in which we retrospectively reviewed the data files of the patients who were referred to us for surgical management of SCI infection.

17,18-epoxyeicosatetraenoic acid targets PPARγ and p38 mitogen-activated protein kinase to mediate its anti-inflammatory effects in the lung: role of soluble epoxide hydrolase.

This study sought to assess putative pathways involved in the anti-inflammatory effects of 17,18-epoxyeicosatetraenoic acid (17,18-EpETE), as measured by a decrease in the contractile reactivity and Ca(2+) sensitivity of TNF-α-pretreated human bronchi. Tension measurements performed in the presence of 12-(3-adamantan-1-yl-ureido)-dodecanoic acid (AUDA), a soluble epoxide hydrolase (sEH)-specific inhibitor, demonstrated that 17,18-EpETE reduced the reactivity of TNF-α-pretreated tissues. The overexpression of sEH detected in patients with asthma and TNF-α-treated bronchi contributed to the maintenance of hyperresponsiveness in our models, which involved intracellular proinflammatory cascades.

Relaxing effects of 17(18)-EpETE on arterial and airway smooth muscles in human lung.

Human cytochrome P-450 epoxygenase enzymes metabolize eicosapentaenoic acid (EPA), an omega-3-polyunsaturated fatty acid (PUFA), and leads to the production of 17(18)-epoxyeicosatetraenoic acid, or 17(18)-EpETE. The aim of the present study was to delineate the mode of action of 17(18)-EpETE on human pulmonary artery (HPA) and distal bronchi. Isometric tension measurements demonstrated that 17(18)-EpETE induced concentration-dependent relaxing effects in pulmonary artery and airway smooth muscles.

CPI-17 silencing-reduced responsiveness in control and TNF-alpha-treated human bronchi.

Under pathophysiologic conditions, the modulation of Ca2+ sensitivity and reactivity of bronchial smooth muscle is controlled by protein kinase C-dependent phosphorylation of the newly described protein, CPI-17. The goal of the present study was to assess the key role of this regulatory protein in airway hyperresponsiveness (AHR) using control and TNF-alpha-treated human bronchi as well as a specific siRNA duplex against human CPI-17 transcripts. Validity of a mixed transfection strategy was assessed using the reversible permeabilization method to introduce X-TremeGene (X-TG)-siRNA complexes in an overreactive model of human bronchi treated with TNF.

Effects of omega-hydroxylase product on distal human pulmonary arteries.

The aim of the present study was to provide a mechanistic insight into how 20-hydroxyeicosatetraenoic acid (20-HETE) relaxes distal human pulmonary arteries (HPAs). This compound is produced by omega-hydroxylase from free arachidonic acid. Tension measurements, performed on either fresh or 1 day-cultured pulmonary arteries, revealed that the contractile responses to 1 microM 5-hydroxytryptamine were largely relaxed by 20-HETE in a concentration-dependent manner (0.

EET displays anti-inflammatory effects in TNF-alpha stimulated human bronchi: putative role of CPI-17.

The aim of the present study was to investigate the anti-inflammatory effects of 14,15-epoxyeicosatrienoic acid (EET) on reactivity and Ca(2+) sensitivity in TNF-alpha-stimulated human bronchi. Tension measurements performed on either control, TNF-alpha-, or TNF-alpha + EET-pretreated bronchi revealed that 100 nM 14,15-EET pretreatments significantly reduced the reactivity of TNF-alpha-pretreated tissues to contractile agonists. EET also normalized the relaxing response to isoproterenol in TNF-alpha-treated bronchi.

Functional effects of 20-HETE on human bronchi: hyperpolarization and relaxation due to BKCa channel activation.

Airway smooth muscle (ASM) metabolizes arachidonic acid (AA) through various enzymatic pathways, including cytochrome P-450 (CYP-450) omega-hydroxylase, which leads to the production of 20-hydroxyeicosatetraenoic acid (20-HETE). The goal of this study was to delineate the mode of action of 20-HETE in human ASM cells. Isometric tension measurements demonstrated that 20-HETE induced a concentration-dependent relaxant effect in ASM on bronchi precontracted with either methacholine or AA.

Relaxing effects of 5-oxo-ETE on human bronchi involve BK Ca channel activation.

The present study investigated the ability of 5-oxo-EicosaTetraEnoic acid (5-oxo-ETE) for modulating airway smooth muscle (ASM) tone in human bronchi. 5-Oxo-ETE induced a concentration-dependent relaxing effect on human bronchi pre-contracted with methacholine (MCh) and arachidonic acid (AA). This relaxing response was highly sensitive to Iberiotoxin (IbTx), a large conducting Ca(2+)-activated K(+) channel (BK(Ca)) inhibitor.

Epoxyeicosatrienoic acid relaxing effects involve Ca2+-activated K+ channel activation and CPI-17 dephosphorylation in human bronchi.

The aim of the present study was to provide a mechanistic insight into how 14,15-epoxyeicosatrienoic acid (EET) relaxes organ-cultured human bronchi. Tension measurements, performed on either fresh or 3-d-cultured bronchi, revealed that the contractile responses to 1 microM methacholine and 10 microM arachidonic acid were largely relaxed by the eicosanoid regioisomer in a concentration-dependent manner (0.01-10 microM).

Seat-belt injuries in children involved in motor vehicle crashes.

Background: The efficacy of seat belts in reducing deaths from motor vehicle crashes is well documented. A unique association of injuries has emerged in adults and children with the use of seat belts. The "seat-belt syndrome" refers to the spectrum of injuries associated with lap-belt restraints, particularly flexion-distraction injuries to the spine (Chance fractures).

A simple, inexpensive, life-saving way to perform iterative laparotomy in patients with severe intra-abdominal sepsis.

Between 1 June 1993 and 31 December 1998, 17 patients underwent temporary abdominal closure with 3L urological irrigation bags, because in most cases, there was massive sepsis leading to the conclusion that primary closure was not advisable. Indicative of the seriousness of these conditions, Apache score averaged 19 (range 10-30). The technique consisted of suturing a double thickness of irrigation bags to each side of the wound, and joining the two bags in the midline with running sutures.

Cytosolic free Ca2+ concentration in canine aortic endothelial cells lining the polyester arterial prosthesis.

A rise in baseline cytosolic free Ca2+ in canine vascular endothelial-like cells (VEC) lining the luminal surface of the polyester arterial prosthesis is described. In one, three and six month implantation experiments we employed six adult mongrel dogs, polyester arterial prostheses Arteknit Ra K, fluorescent Ca2+ indicator Fura-2 and digital imaging microscopy to study cytosolic free Ca2+ in cultured VEC. The electron microscopy scanning of the luminal surface in different regions of the graft were also performed.

Pancreatic inflammation, apoptosis, and growth: sequential events after partial pancreatectomy in pigs.

Positive signs of pancreas regeneration were observed in rats after induced pancreatitis and partial pancreatectomy (1,2). Although the human pancreas did not regenerate after partial anatomic resection (3), the pig pancreas exhibited growth responses to bombesin after partial pancreatectomy (4). This study was undertaken to establish the time course of pancreatic inflammation, apoptosis, and hypertrophy and/or hyperplasia after partial pancreatectomy in pigs.

[Pancreatic pseudocyst: Evolution of therapeutic concepts].

Objective: To reassess the therapeutic options for pancreatic pseudocysts, resulting from the refinement of imaging techniques of the pancreas over the past 15 years.

Data Sources: An extensive review of the literature for the period 1970 to 1994. When pertinent, the authors' experience with 45 patients was added to the literature data.

UVAL-MED a universal visual associative language for medicine.

We describe UVAL-MED, a Universal visual associative language for medicine, and propose its use in combination with diagnostic reasoning and decision support systems. When fully developed, our system will automatically translate SNOMED terms to UVAL-MED terms. Grammar and syntax for UVAL-MED are defined and its features as a language-independent tool are discussed.

An intelligent interactive simulator of clinical reasoning in general surgery.

We introduce an interactive computer environment for teaching in general surgery and for diagnostic assistance. The environment consists of a knowledge-based system coupled with an intelligent interface that allows users to acquire conceptual knowledge and clinical reasoning techniques. Knowledge is represented internally within a probabilistic framework and externally through a interface inspired by Concept Graphics.

Concept graphics: a language for medical knowledge.

This paper makes a case for Concept Graphics, a novel form of medical knowledge representation. Concept Graphics are assemblies of icons each of which has a precise meaning. Individual icons are metaphors of the object or process they represent.

Moxalactam as single-agent prophylaxis in the prevention of wound infection following colon surgery.

A single agent systemic antibiotic (moxalactam) when used prophylactically in patients undergoing colon surgery was associated with a wound infection rate comparable to that achieved by a combination of oral neomycin and intravenous metronidazole. The data obtained demonstrated that the reduced infection rate was not the result of a reduction in the bacterial content of the colon alone but due to the prophylactic agents used for elective colon surgery.

Traumatic aneurysms of the descending thoracic aorta.

From July 1979 to December 1985 we observed 51 patients with traumatic lesions of the descending thoracic aorta. Twenty-nine had acute ruptures, mostly accompanied by multiple injuries, and 27 had to be operated upon immediately. Twenty-two patients (19 males, 3 females) had chronic traumatic aneurysms of the descending thoracic aorta (more than six weeks after trauma).

[Colonothoracic fistulas: presentation of 2 cases].

Two cases of colothoracic fistulae are reported. The first one is secondary to pulmonary actinomycosis, the second to complicated colic diverticulitis. The etiologies of colothoracic fistulae are multiple and can be divided in intrathoracic or intraabdominal origin.