Early ultrasonographic changes in Fowler syndrome features and review of the literature.

Background: Fowler syndrome is characterized by hydranencephaly, brain stem and basal ganglion calcifications, a glomeruloid vasculopathy of the brain vessels, and a fetal akinesia deformation sequence with muscular hypoplasia. The natural progression of the ultrasonographic features of Fowler syndrome has never been described.

Methods: Case report and review of the literature.

Gynecologists' attitudes towards hormone therapy in the post "Women's Health Initiative" study era.

Objective: To assess the impact of the Women's Health Initiative (WHI) study on gynecologists' attitudes regarding hormone therapy (HT).

Methods: Questionnaires were mailed to a random sample of Lebanese gynecologists (n=178). The questionnaires solicited practice patterns of HT for postmenopausal women and information provided while counseling before and after the WHI study.

MR appearance of clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts): radiologic-pathologic correlation.

Clear cell sarcoma of tendons and aponeuroses (CCSTA) is a rare aggressive soft tissue tumor that frequently produces melanin. Its MR findings are rarely described in the literature. We report the case of a previously healthy 54-year-old man with clear cell sarcoma of the thigh who presented with a large painless mass of 1 year's duration.

[A case of alcohol-induced ketoacidosis?].

We report a case of severe ketoacidosis. Initially the patient showed metabolic acidosis, the anion gap was positive and there was neither hyperlactatemia nor intoxication with acid substances. As the rate of glycemia was high (17.

Pancreatic beta-cells expressing GLP-1 are resistant to the toxic effects of immunosuppressive drugs.

Glucose intolerance is often observed after pancreatic islet cell transplantation. The administration of immunosuppressive agents (ISD), necessary to avoid tissue rejection, is in part responsible for hyperglycemia. To investigate whether mouse insulinoma (MIN6) cells transfected with the glucagon like peptide-1 (GLP-1) fragment of the proglucagon gene (RIP/GLP-1 MIN6 cells) are resistant to the toxicity derived from the administration of ISD.

Adenovirus-mediated XIAP gene transfer reverses the negative effects of immunosuppressive drugs on insulin secretion and cell viability of isolated human islets.

Immunosuppressive drugs are routinely used to provide tolerance after whole pancreas and islet cell transplantations. While they are essential in inhibiting graft rejection, little is known about their effect on islet function and beta-cell viability. In this study, we report that tacrolimus, sirolimus, and mycophenolic acid, when added to cultures of freshly isolated human islets, induce a downregulation of the synthesis and secretion of insulin.

A change in serum myoglobin to detect acute myocardial infarction in patients with normal troponin I levels.

We sought to determine the sensitivity of a change in myoglobin for acute myocardial infarction (AMI) in patients who had normal levels of troponin I at presentation. Myoglobin increases as soon as 1 to 2 hours after symptom onset in AMI. The change in myoglobin may help identify AMI in patients with normal cardiac levels of troponin I on admission.

Animal models of inflammatory bowel disease.

In inflammatory bowel disease (IBD), experimental models have proven to be important tools for detecting potential therapeutic agents and for investigating the mechanisms of pathogenesis. This review is intended to cover recent advances in basic IBD model applications. The use of more than 20 animal models has allowed the detection of numerous protective pharmacological agents, including a number of immunomodulatory agents that have entered the therapeutic armamentarium.

Methacholine challenge test: correlation with symptoms and atopy.

Methacholine challenge test (MCT) is a diagnostic test to assess airway hyperresponsiveness, one feature of asthma. Our study presents the results of MCT, done in our pulmonary function laboratory, correlated with patients' symptoms and allergic status. This is a cross-sectional study, where 134 patients were included : 60 patients had a PC-20 < or = 32 mg/ml (MCT+ group), while 74 had a PC-20 > 32 mg/ml (MCT- group).

[Hemophagocytosis associated with an Escherichia coli sepsis: a case report].

Introduction: Hemophagocytic lymphohistiocytosis syndrome (HLS) is defined by activated macrophage proliferation. These cells phagocyte the blood elements. This syndrome can be primary as an autosomal recessive disease or secondary to neoplasia, immune diseases or infections-viral, parasitary or bacterian.

Glucagon-like peptide 1 inhibits cell apoptosis and improves glucose responsiveness of freshly isolated human islets.

The peptide hormone, glucagon-like peptide 1 (GLP-1), has been shown to increase glucose-dependent insulin secretion, enhance insulin gene transcription, expand islet cell mass, and inhibit beta-cell apoptosis in animal models of diabetes. The aim of the present study was to evaluate whether GLP-1 could improve function and inhibit apoptosis in freshly isolated human islets. Human islets were cultured for 5 d in the presence, or absence, of GLP-1 (10 nm, added every 12 h) and studied for viability and expression of proapoptotic (caspase-3) and antiapoptotic factors (bcl-2) as well as glucose-dependent insulin production.

The prognostic significance of serial myoglobin, troponin I, and creatine kinase-MB measurements in patients evaluated in the emergency department for acute coronary syndrome.

Study Objective: We sought to determine the value of serial measurements of myoglobin, cardiac troponin I (cTnI), and creatine kinase-MB (CK-MB) to predict 30-day adverse events in patients evaluated in the emergency department (ED) for possible acute coronary syndrome.

Methods: Serum myoglobin, cTnI, and CK-MB levels were measured at presentation, 90 minutes, 3 hours, and 9 hours in patients evaluated in the ED for possible acute coronary syndrome. In 764 consecutive patients, the ability of each individual marker and combination of markers to predict a 30-day adverse event (death or myocardial infarction) over time was calculated.

Use of limited MR protocol (coronal STIR) in the evaluation of patients with hip pain.

Objective: To assess the role of a limited MR protocol (coronal STIR) as the initial part of the MR examination in patients with hip pain.

Design And Patients: Eighty-five patients presenting with hip pain, and normal radiographs of the pelvis, and who underwent our full MR protocol for hips were included retrospectively in the study. The full protocol consists of coronal T1-weighted and short tau inversion-recovery (STIR), and axial T2-weighted sequences.

Insulin and glucose regulate the expression of the DNA repair enzyme XPD.

Nucleotide excision repair (NER) of damaged DNA is operated by a complex network of DNA repair enzymes that include a protein termed xeroderma pigmentosum complementation group D (XPD). We have previously reported that the expression of XPD is regulated by activation of the insulin receptor and that mutations of the tyrosine kinase domain of the receptor inhibit the insulin-dependent increase in XPD messenger RNA (mRNA) and protein levels. In the present study, we characterize the insulin-dependent signaling pathway leading to the control of XPD expression.

Juvenile ossifying fibroma: CT and MR findings.

We describe the CT findings in four patients and the MR imaging in one patient with juvenile ossifying fibroma. Three lesions involved the maxillary sinus and extended to the surrounding structures; one lesion was confined to the maxillary bone. CT scan revealed well-defined, expansile lesions with variable amount of calcifications.

Performance of multiple cardiac biomarkers measured in the emergency department in patients with chronic kidney disease and chest pain.

Objective: To evaluate the individual components of a cardiac multimarker panel in the detection of acute myocardial infarction (AMI) in patients with chest pain across a spectrum of renal dysfunction.

Methods: A total of 817 consecutive patients evaluated for a possible AMI in the emergency department (ED) enrolled in a prospective study of cardiac biomarkers assessed using a point-of-care device with myoglobin (MYO), cardiac troponin I (cTnI), and creatine kinase myocardial band (CK-MB), recorded at 0, 1.5, 3, and 9 hours.

Emergency evaluation of chest pain in patients with advanced kidney disease.

Background: Increased rates of myocardial infarction, heart failure, arrhythmias, and death occur in patients with chronic kidney disease. We sought to evaluate the processes of care and outcomes in patients with chronic kidney disease presenting to an emergency department with chest discomfort.

Methods: We enrolled 817 consecutive patients who underwent evaluation for a possible acute myocardial infarction in a prospective study of cardiac biomarkers.

Unenhanced spiral CT scan in the initial evaluation of renal colic: AUBMC experience.

Background And Objective: Until recently, intravenous urography and ultrasonography have been the standard diagnostic modalities in the initial evaluation of acute flank pain. However, since 1995 the role of non-enhanced CT scan (NECT) has become more important in establishing the diagnosis of renal colic. In this retrospective descriptive study, we evaluated the usefulness of NECT in the diagnosis and management of patients with suspected urinary tract stones at the American University of Beirut-Medical Center (AUBMC).

Radiology of perinephric fluid collections.

The perinephric spaces consist of the subcapsular, perirenal, anterior and posterior pararenal spaces. Fluid may collect in one or more of these compartments; this can be readily demonstrated by cross-sectional imaging, particularly computed tomography (CT). This pictorial review illustrates the radiological manifestations of perinephric fluid collections with their differential diagnosis including perinephric abscess, perirenal urine collection, subcapsular and perirenal hematoma, renal lymphangiomatosis, pancreatic pararenal fluid collections and transudate fluid associated with nephropathies.