Treatment of massive subretinal hemorrhage from complications of scleral buckling procedures.

Vitrectomy techniques permit removal of subretinal hemorrhage, but the prognosis varies and depends principally on the cause of the hemorrhage. Nine consecutive patients undergoing pars plana vitrectomy with internal drainage of massive subretinal hemorrhage from complications of scleral buckling procedures were studied, to evaluate the long-term results. In all eyes, the final visual acuity was improved, compared with preoperative visual acuity, and was 20/80 or better in seven of nine cases.

Detection of human cytomegalovirus in peripheral blood leukocytes by the polymerase chain reaction and a nonradioactive probe.

This study evaluated the effectiveness of polymerase chain reaction (PCR) combined with a nonradioactive probe for the early detection of cytomegalovirus (CMV) in buffy-coat specimens of immunocompromised patients. Dot-blot hybridization with a digoxigenin-labeled probe was used to detect a 262-bp PCR amplified fragment of the major immediate-early gene of CMV DNA. The results were compared with tissue cultures isolation of CMV.

Activation of protein kinase C down-regulates leukotriene C4 synthase activity and attenuates cysteinyl leukotriene production in an eosinophilic substrain of HL-60 cells.

An eosinophilic substrain of HL-60 cells (HL-60#7) predominantly synthesized cysteinyl leukotrienes after stimulation with the calcium ionophore A23187. Activation of protein kinase C (PKC) by phorbol 12-myristate 13-acetate (PMA) specifically attenuated cysteinyl leukotriene production without affecting the biosynthesis of non-cysteinyl leukotrienes. The inhibition of cysteinyl leukotriene biosynthesis was prevented only by specific PKC inhibitors (staurosporine and bisindolylmaleimide) but not by inhibitors of tyrosine kinases (genistein, tyrphostin 47, and herbimycin A), protein kinase A (KT5720), or the oxidative burst (apocynin).

Investigation of biliary obstruction.

The management of biliary obstruction is increasingly becoming the domain of the endoscopist and interventional radiologist. More than ever, rational investigation and a sound understanding of the benefits and limitations of available techniques are needed to plan treatment and avoid unnecessary surgery.

Leukotriene D4-induced increases in cytosolic calcium in THP-1 cells: dependence on extracellular calcium and inhibition with selective leukotriene D4 receptor antagonists.

Agonist-induced changes in intracellular calcium ion concentration ([Ca++]i) were examined in human monocytic leukemia THP-1 cells loaded with fura 2/acetoxymethyl ester (fura 2/AM). Leukotriene (LT)D4 induced a concentration-dependent biphasic response consisting of a transient phase (up to 5-fold peak increase) followed by a sustained phase, showing characteristics of a receptor-operated calcium channel. Homologous desensitization to LTD4 was observed.

Protein kinase C-dependent regulation of sulfidopeptide leukotriene biosynthesis and leukotriene C4 synthase in neutrophilic HL-60 cells.

In response to calcium ionophore (A23187) stimulation, human granulocyte/macrophage colony-stimulating factor-primed, dimethylsulfoxide-differentiated HL-60 cells (which resemble mature granulocytes) synthesized leukotrienes (LTs) LTA4, LTB4, LTC4, and LTD4. The synthesis of the sulfidopeptide LTs, LTC4 and LTD4, was specifically inhibited in cells incubated in the presence of both A23187 and phorbol-12-myristate-13-acetate (PMA), an activator of protein kinase C (PKC). In contrast, neither the synthesis of LTB4, a product of the nonpeptide branch of the LT pathway, nor the formation of LTA4, the precursor for both branches of the LT biosynthetic pathway, was significantly affected by the presence of PMA during A23187 stimulation.

Microsomal glutathione S-transferase is the predominant leukotriene C4 binding site in cellular membranes.

Dimethyl sulfoxide-differentiated U937 (dU937) cells express high affinity G-protein-coupled receptors for leukotriene (LT)D4 and LTB4 and, as described here, specific binding sites for LTC4. The specific binding of [3H]LTC4 was of low affinity (KD = 26 nM) and high abundance (Bmax = 33 pmol/mg of protein), as compared to LTD4 and LTB4 receptors. In addition, although [3H]LTC4 specific binding was enhanced by divalent cations, it was not inhibited by nonhydrolyzable GTP analogs.

Induction, characterization, and functional coupling of the high affinity chemokine receptor for RANTES and macrophage inflammatory protein-1 alpha upon differentiation of an eosinophilic HL-60 cell line.

Eosinophilic differentiation of a pro-eosinophilic HL-60 cell line resulted in the induction of a high affinity RANTES/macrophage inflammatory protein-1 alpha receptor. The induced receptor is biochemically indistinguishable in RANTES equilibrium-binding studies from the monocytic receptor expressed on THP-1 cell membranes. Continued expression of the receptor requires the continuous presence of the inducing stimulus, and receptor site number declines without a loss of binding affinity with a t1/2 of 11.

ABC of emergency radiology. The wrist.

History including detailed mechanism of injury. Meticulous clinical examination. Appropriate radiograph and systematic assessment.

ABC of emergency radiology. The ankle.

The os trigonum is a common normal variant of the talus and is due to a separate ossification centre arising from the posterior tubercle. The appearance may resemble an old ununited fracture fragment. However, it is triangular, well corticated, in a classic location, and usually bilateral, which enables it to be distinguished from a fracture.

Transabdominal ultrasonography as the primary investigation in patients with suspected Crohn's disease or recurrence: a prospective study.

Traditionally, patients with suspected or known and possible recurrent Crohn's disease have been investigated by small bowel barium radiology, which incurs a relatively high radiation dose. Despite patient selection a significant number have a normal barium examination. A prospective study was performed to evaluate the use of transabdominal ultrasound as the initial investigation in these two groups.

Scaphoid fracture: a new method of assessment.

The value of colour flow Doppler ultrasound scanning in patients with suspected acute carpal scaphoid fracture has been examined. A prospective study of 78 patients with signs and symptoms of carpal scaphoid injury was undertaken over a period of 6 months. Both wrists of all patients were scanned within 12-72 h of injury.