Preoperative and postoperative levels of interleukin-6 in patients with acute appendicitis: comparison between open and laparoscopic appendectomy.

Background: Cytokine interleukin-6 (IL-6) is an early marker of systemic inflammatory response and tissue damage. This study aimed to evaluate the levels of IL-6 after open and laparoscopic appendectomy to compare the degree of surgical stress associated with these procedures.

Methods: The levels of IL-6 were measured pre- and postoperatively in the plasma of 37 consecutive patients with a diagnosis of acute appendicitis.

Interleukin 13 mutants of enhanced avidity toward the glioma-associated receptor, IL13Ralpha2.

Interleukin 13 (IL13) binds a receptor that is highly overexpressed in malignant gliomas, IL13Ralpha2. IL13 protein is composed of four helices: alpha-helix A, B, C, and D, and we found a new "hot spot" in alpha-helix D that is crucial for the binding of IL13 to IL13Ralpha2. Lys-105 plus Lys-106 and Arg-109 represent this hot spot.

Insight in early psychosis: a 1-year follow-up.

Insight was investigated in 180 individuals consecutively admitted to a comprehensive early psychosis treatment program. Insight was assessed on admission and after 3, 6 and 12 months. Insight improved significantly over 12 months, and was negatively correlated with both positive and negative symptoms, and positively correlated with depressive symptoms at admission.

Molecular targeting with recombinant cytotoxins of interleukin-13 receptor alpha2-expressing glioma.

A restricted receptor for interleukin 13 (IL-13R alpha2) is over-expressed in high-grade astrocytoma (HGA), but not in normal organs. In order to design and examine new anti-HGA therapies, which are molecularly directed against IL-13R alpha2, we established an IL-13R alpha2-expressing syngeneic immunocompetent murine model of HGA. The model was obtained by transfecting G-26 murine glioma cells with IL-13R alpha2.

The responsiveness of generic health status measures as assessed in patients with rheumatoid arthritis receiving infliximab.

Objective: We used a variety of health status measures in 2 groups of patients with rheumatoid arthritis (RA) to assess both the smallest distinguishable difference and the relative responsiveness to change of these measures, when used in clinical practice.

Methods: Two groups of patients were studied. Group 1: 24 patients with stable RA tested on 2 occasions; Group 2: 60 patients receiving methotrexate tested before and 14 weeks after treatment with infliximab.

Epigenetics in high-grade astrocytomas: opportunities for prevention and detection of brain tumors.

Human high-grade astrocytomas (HGA) are the most prevalent incurable brain tumors. We found that the vast majority of HGA patients overexpress a restricted receptor for an immune regulatory cytokine, interleukin 13 (IL-13). Interestingly, the HGA-associated restricted receptor protein IL-13Ralpha2 is expressed in the testes, and its gene is localized to chromosome X.

Insight in schizophrenia: a meta-analysis.

There has been an increase in the study of insight in schizophrenia in the last 20 years. Insight is operationally defined according to five dimensions which include: the patient's awareness of mental disorder, awareness of the social consequences of disorder, awareness of the need for treatment, awareness of symptoms and attribution of symptoms to disorder. Despite the development of psychometrically sound measurement tools, the results from previous studies have been inconclusive regarding the nature of the relationship between insight and symptomatology.

IL-13Ralpha2 is a glioma-restricted receptor for interleukin-13.

We have found that binding sites for interleukin-13 (IL-13) are overexpressed in a vast majority of high-grade astrocytomas (HGAs). These binding sites for IL-13 are distinct from the physiological receptor in that it does not bind IL-4. We also demonstrated that IL-13 receptor alpha 2 protein chain (IL-13Ralpha2), an IL-4-independent receptor for IL-13, is abundant among HGAs, but not in normal organs.

Alanine-scanning mutagenesis of alpha-helix D segment of interleukin-13 reveals new functionally important residues of the cytokine.

We documented that alpha-helices A, C, and D in human interleukin-13 (IL13) participate in interaction with its respective receptors. We hypothesized that alpha-helix D is the site II of the cytokine that binds IL13Ralpha1, a component of the normal tissue heterodimeric signaling IL13/4 receptor (IL13/4R), and that alpha-helix D independently binds a monomeric IL13Ralpha2 receptor, which is a non-signaling glioma-restricted receptor for IL13. Therefore, we alanine-scanned mutagenized helix D of IL13 to identify the residues involved in the respective receptors interaction.

Cancer genetics/epigenetics and the X chromosome: possible new links for malignant glioma pathogenesis and immune-based therapies.

Human high-grade gliomas (HGGs) are rapidly progressing heterogeneous brain tumors of unknown etiology and there are no effective treatment modalities available. The recent discovery of cancer-specific antigens has opened new doors for specific tumor-targeted treatments using passive and active immunotherapeutic strategies. In particular, SEREX (serological analysis of recombinant cDNA expression libraries) has aided in the discovery of numerous new tumor antigens.

A randomized trial to assess the efficacy of surgery in addition to radiotherapy in patients with a single cerebral metastasis.

Background: Cerebral metastasis is a common oncologic problem that occurs in 15-30% of cancer patients; approximately half such metastases are single. Previous retrospective studies and two randomized trials reported that the addition of surgical extirpation prior to radiation therapy increased survival, neurologic function, and quality of life compared with radiation alone in patients with a single brain metastasis.

Methods: A randomized controlled trial was conducted in which patients with a single brain metastasis were allocated to undergo radiation alone or surgery plus radiation.

Early patellofemoral revision following total knee arthroplasty.

A consecutive series of 289 Miller-Galante (Zimmer, Warsaw, IN) total knee arthroplasties were studied, with particular reference to the patellofemoral joint. Sixteen knees were initially excluded; the remaining 273 arthroplasties were followed for 14 to 44 months. Thirty patients (11%) had patellofemoral pain.

Diagnosis and treatment of respiratory symptoms of initially unsuspected gastroesophageal reflux in infants.

Gastroesophageal reflux (GER) in infants is most commonly thought of as repeated excessive vomiting and failure to thrive, with most infants responding favorably to medical therapy. However, GER may also manifest exclusively with a variety of respiratory symptoms that, if not detected and treated early, may lead to life-threatening complications. During the period of 1987 to 1992, 39 neonates and infants underwent Nissen fundoplication for the treatment of respiratory symptoms attributed to GER.

Focal gastrointestinal perforations not associated with necrotizing enterocolitis in very low birth weight neonates.

Nine very low birth weight (VLBW) neonates (< 1,000 g) undergoing abdominal exploration for peritonitis were found to have focal perforations of the gastrointestinal (GI) tract and no clinical or histologic evidence of necrotizing enterocolitis (NEC) or other mechanical cause. Although most patients presented initially with clinical findings suggestive of NEC, none developed the traditional clinical or radiographic findings associated with this diagnosis. Most patients initially had normal bowel gas patterns or transient bowel distension on abdominal x-ray, followed within hours by a paucity of bowel gas or a totally gasless abdomen.

Duodenal hematoma. A mechanical cause for enterogastric reflux in cholescintigraphy.

Enterogastric reflux occurs in normal and abnormal conditions. When pronounced, it is a nonspecific indicator of pathology. There are relatively few published reports discussing enterogastric reflux as a prominent finding on cholescintigraphy.

Nosocomial influenza in a general hospital for indigent patients.

Surveillance of influenza virus infections was maintained on the medical and pediatric wards of a general hospital serving indigent patients of Harris County, Texas during the winter of 1987-88. Influenza A/Sichuan/2/87(H3N2) was the predominant virus during the community epidemic. Influenza A(H3N2) virus was isolated from six of 17 adult patients (35%) suspected to have nosocomial infections; two of these patients died of fulminating pneumonia.

Stress fracture of the first rib from serratus anterior tension: an unusual mechanism of injury.

Fracture of the first rib usually results from high-impact, direct trauma. Stress fractures are less common and are associated with minimal morbidity. The case of a patient with a stress fracture resulting from the use of an exercise machine is reported.

Multiple peripheral aneurysms of the posterior inferior cerebellar artery associated with a cerebellar arteriovenous malformation: case report.

The authors describe a rare case of multiple peripheral aneurysms of the posterior inferior cerebellar artery found in association with a midline cerebellar arteriovenous malformation. Successful trapping of the aneurysms and excision of the arteriovenous malformation was accomplished with an excellent clinical result. The literature concerning aneurysms of the posterior inferior cerebellar artery, cerebellar arteriovenous malformations, and combined intracranial vascular abnormalities is discussed.