Primary liposarcoma of the liver: a case report and review of literature.

Liposarcoma is a rare mesenchymal malignant tumor, which usually originates in the retroperitoneum and the extremities. Seven cases of primary liposarcoma of the liver have been previously reported. We present the eighth case, which occurred in an adult female patient.

The role of thymus-expressed chemokine and its receptor CCR9 on lymphocytes in the regional specialization of the mucosal immune system.

Chemokines play an important role in the migration of leukocytes at sites of inflammation, and some constitutively expressed chemokines may direct lymphocyte trafficking within lymphoid organs and peripheral tissues. Thymus-expressed chemokine (TECK or Ckbeta-15/CCL25), which signals through the chemokine receptor CCR9, is constitutively expressed in the thymus and small intestine but not colon, and chemoattracts a small fraction of PBLs that coexpress the integrin alpha(4)beta(7). Here we show that TECK is expressed in the human small bowel but not colon by endothelial cells and a subset of cells in intestinal crypts and lamina propria.

Differential activity of the cytochrome P450 17alpha-hydroxylase and steroidogenic acute regulatory protein gene promoters in normal and polycystic ovary syndrome theca cells.

17alpha-Hydroxylase (CYP17) expression in propagated theca cells isolated from the ovaries of women with polycystic ovary syndrome (PCOS) is persistently elevated, compared with theca cells isolated from normal ovaries. To investigate the mechanism for increased CYP17 messenger RNA accumulation in PCOS theca cells, we examined CYP17 and steroidogenic acute regulatory protein (StAR) promoter activities in normal and PCOS theca cells. Conditions were established to transiently transfect human theca cells with reporter gene constructs containing 5' truncations of the human CYP17 and StAR promoters.

Expression of pituitary-tumour transforming gene in colorectal tumours.

Background: Basic fibroblast growth factor promotes angiogenesis and mitogenesis in colon carcinomas. Pituitary-tumour transforming gene (PTTG1) causes in-vitro and in-vivo transformation, regulates secretion of basic fibroblast growth factor, and inhibits chromatid separation. Most normal tissues show little or no PTTG1 expression but cancer cells express the gene abundantly.

Perinatal spinal cord injury requiring long-term home mechanical ventilation: a report of four cases.

Although perinatal spinal cord injury has been discussed in detail in the literature with respect to aetiology and diagnosis, few studies address long-term outcome, and none address the outcome of long-term home mechanical ventilation in this population. The four patients reported here with perinatal spinal cord injury have used home mechanical ventilation for time periods ranging from 6 to 17 years, with varying results. Their courses with respect to respiratory, neuromuscular, neuropsychological, and nutritional issues are described with reference to the current literature.

Functional outcome of paediatric stroke survivors.

Objective: To examine the medical and functional outcome of paediatric stroke survivors.

Patients: Patients aged 1 month to 18 years diagnosed with stroke over a 10 year period.

Main Outcome Measures: Discharge functional outcome data were collected by reviewing therapy, nursing, and other chart notes relating to specific functional tasks.

Maternal periconceptional use of electric bed-heating devices and risk for neural tube defects and orofacial clefts.

Electric and magnetic fields are of concern as risk factors for adverse reproductive outcomes, including congenital anomalies. Among residential exposures to electric and magnetic fields, electric bed-heating devices such as electric blankets may be a substantial source of such exposures, and their use is fairly common. Two population-based case-control studies were analyzed to investigate whether the periconceptional use of electric blankets, bed warmers, or electrically heated waterbeds increased the risk of women to deliver infants or fetuses with neural tube defects (NTDs) or orofacial clefts.

Group psychotherapy treatment of borderline personalities.

Borderline personalities have been treated in psychotherapy groups for over 40 years. This article elaborates some of the characteristics pertinent to the treatment of these patients. Combined treatment of group and individual therapy addresses the needs for object constancy, the integration of object and self representations, and the possibility of attachment to others.

The effect of newborn early discharge follow-up program on pediatric urgent care utilization.

Introduction: The effects of an early discharge follow-up program on the subsequent use of urgent care services by newborn infants at Kaiser Permanente in Fontana, Calif, was evaluated to test the hypothesis that participation in the follow-up program would result in a significant decrease in utilization of urgent care services.

Method: Through records review, the effects of a new early discharge follow-up program on the rate of use of urgent care services was examined. Use of urgent care services by 324 early discharged newborn infants who were born before the new program was initiated was measured and compared with the use of urgent care services by 315 early discharged newborn infants whose parents had attended the program.

Augmented androgen production is a stable steroidogenic phenotype of propagated theca cells from polycystic ovaries.

To test the hypothesis that the hyperandrogenemia associated with polycystic ovary syndrome (PCOS) results from an intrinsic abnormality in ovarian theca cell steroidogenesis, we examined steroid hormone production, steroidogenic enzyme activity, and mRNA expression in normal and PCOS theca cells propagated in long-term culture. Progesterone (P4), 17alpha-hydroxyprogesterone (17OHP4), and testosterone (T) production per cell were markedly increased in PCOS theca cell cultures. Moreover, basal and forskolin-stimulated pregnenolone, P4, and dehydroepiandrosterone metabolism were increased dramatically in PCOS theca cells.

Bowel management in children and adolescents with spinal cord injury.

There is little in the literature regarding bowel management in children and adolescents with spinal cord injuries (SCI). This study was undertaken to examine specific patterns of bowel care, individual levels of satisfaction with bowel management, the incidence of incontinence in this population, and effects on lifestyle because of time commitment and dependence in bowel management. Surveys were sent to all persons (n = 45) under age 19 with a diagnosis of SCI who had received care at our medical center since 1985.

Maternal occupational and hobby chemical exposures as risk factors for neural tube defects.

In a case-control study, we investigated whether occupational and nonoccupational (hobbies) chemical exposures to women in the periconceptional period increased their risk for having neural tube defect-affected pregnancies. Women were asked about occupational tasks and hobbies performed during the 3 months before through 3 months after conception. Based on her reported occupational tasks and hobbies, an industrial hygienist assigned a priori defined exposure categories to each task and hobby.

Maternal pesticide exposure from multiple sources and selected congenital anomalies.

We explored the relation between various potential sources of maternal periconceptional pregnancy exposures to pesticides and congenital anomalies in offspring. Data were derived from a case-control study of fetuses and liveborn infants with orofacial clefts, neural tube defects, conotruncal defects, or limb anomalies, among 1987-1989 California births and fetal deaths. We conducted telephone interviews with mothers of 662 (85% of eligible) orofacial cleft cases, 265 (84%) neural tube defect cases, 207 (87%) conotruncal defect cases, 165 (84%) limb cases, and 734 (78%) nonmalformed controls.

Parental report of pediatric tracheostomy care.

Objective: There are little data on the actual care given pediatric tracheostomy patients in their homes. Information on the use of supplies and on techniques and frequency of care is valuable for a better understanding of the needs of this population.

Design: Questionnaires were distributed by mail or at clinic visits from May 1995 to June 1996 to a convenience sample of tracheotomized patients at the University of Michigan Pediatric Physical Medicine and Rehabilitation clinic.

Intrathecal methysergide antagonizes the antinociception, but not the hyperalgesia produced by microinjection of baclofen in the ventromedial medulla of the rat.

Microinjection of baclofen, a gamma-aminobutyric acidB (GABA[B]) receptor agonist, in the nucleus raphe magnus (NRM) or nucleus reticularis gigantocellularis pars alpha (NGCpalpha) of the rat produces antinociception at doses of 0.1-1.0 ng and hyperalgesia at doses of 30-150 ng in the tail-flick test.

Bladder management in patients with pediatric onset neurogenic bladders.

Our objective was to determine which clean intermittent catheterization (CIC) methods and supplies were used by patients with pediatric onset neurogenic bladders and to relate methodology and materials to reported urinary tract infections. Data were collected via questionnaires distributed by mail and at clinic visits at our university tertiary care outpatient pediatric rehabilitation clinic. Questionnaires were given to 165 patients.

Cracked acrylic ventricular assist devices after using a Doppler stethoscope and ultrasound transmission gel to predict impending pump failure: a case report.

At Saint Louis University Health Sciences Center, bi-ventricular assist devices were placed in a patient after failure to wean from bypass. These acrylic devices are known to be used for post cardiotomy failure. Acrylics and other plastics are used in extracorporeal circuitry.

The use of methylphenidate in paediatric traumatic brain injury.

Methylphenidate (MPH) has been used safely and effectively for many years in children for the treatment of attention deficit disorder with hyperactivity (ADHD). Behavioural and cognitive sequelae to traumatic brain injury (TBI) have features in common with ADHD, and MPH has been reported to be an effective treatment in adults with TBI. There is little literature documenting the efficacy of MPH in children with TBI.

Mechanistic studies of the inhibition of MutT dGTPase by the carcinogenic metal Ni(II).

Promutagenic 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-dG) levels are increased in DNA of animals exposed to carcinogenic metals, such as Ni(II). Besides being generated directly in genomic DNA, 8-oxo-dG may be incorporated there from 8-oxo-7,8-dihydro-2'-deoxyguanosine 5'-triphosphate (8-oxo-dGTP), a product of oxidative damage to the nucleotide pool. The Escherichia coli dGTPase MutT, and analogous dGTPases in rats and humans, have been suggested as a defense against such incorporation because they hydrolyze 8-oxo-dGTP to 8-oxo-7,8-dihydro-2'-deoxyguanosine 5'-monophosphate (8-oxo-dGMP).

Spondyloepiphyseal dysplasia congenita with ventilator dependence: two case reports.

Home mechanical ventilation has recently become feasible in a number of conditions. Several small series and case reports mention respiratory insufficiency or failure in a subset of patients with spondyloepiphyseal dysplasia congenita. Two cases of successful home mechanical ventilation in children, now 7 years of age, who have spondyloepiphyseal dysplasia congenita and respiratory insufficiency, are reported.

Incidence of maxillofacial involvement in arthrogryposis multiplex congenita.

Purpose: This study determined the incidence of maxillofacial involvement in patients diagnosed with arthrogryposis multiplex congenita (AMC).

Patients And Methods: Twenty-three patients were evaluated by the pediatric physical medicine and rehabilitation, orthopedic surgery, and pediatric oral and maxillofacial surgery departments. Any patient in whom the diagnosis of AMC was in doubt was excluded from the study.

Home mechanical ventilation of children.

The medical records of 89 ventilator-assisted children followed at the University of Michigan Medical Center from 1978 to 1993 were reviewed. The status of these children was remarkably stable. Parameters of communication, nutrition, education, and mobility changed very little over time, and fewer than half had to be re-admitted.

Percutaneous feeding tube placement in pediatric patients: immediate and 30-day results.

Purpose: To evaluate fluoroscopically guided percutaneous feeding tube placement in pediatric patients.

Materials And Methods: Sixty-one procedures were performed. Periprocedural care protocol was changed after patient nine.