Computed tomography of the superior mesenteric artery syndrome.

An acute presentation of the superior mesenteric artery syndrome was diagnosed in a 13-year-old Chinese boy in whom no predisposing cause was found at surgery. Duodenogram combined with dynamic computed tomography, including 2-dimensional multiplanar reconstructions, was useful in confirming the diagnosis prior to definitive surgery.

An unusual complication of emergency tracheal intubation.

A 68-year-old woman presented with dyspnoea having undergone a short period of tracheal intubation during an episode of congestive cardiac failure 10 days earlier. On the fourth day of admission, she suddenly developed acute respiratory distress followed by a cardiac arrest and was found to have an enlarging neck mass. Following intubation and resuscitation, computerised tomography was carried out and surgical exploration revealed a retropharyngeal abscess and a pseudo-aneurysm of the common carotid artery resulting from pharyngeal rupture which most probably occurred as a complication of the original tracheal intubation.

Pneumomediastinum: an acute presentation of the superior mesenteric artery syndrome.

The authors report a case of the superior mesenteric artery syndrome presenting acutely with a Boerhaave-type syndrome. Pneumomediastinum was seen on the chest X-ray. There were no known predisposing factors or previous history typical of this syndrome.

Migration and lymphatic spread of calcified paraffinomas after breast augmentation.

A 62 year old Chinese woman presented 25 years after having both breasts augmented with paraffin injections. Development of paraffinomas and multiple episodes of paraffin-related mastitis eventually resulted in bilateral mastectomies. The unusual distribution of migrated calcified paraffinomas in the thoracic wall and its lymphatic system is documented on computed tomography.

Case report: magnetic resonance imaging of primary lymphoma of the cauda equina.

Malignant lymphoma of the central nervous system is usually confined within the cranium, with primary involvement of the spinal cord and nerve roots being very rare. The occurrence of primary lymphoma in the cauda equina in a 16-year-old Chinese male is reported. Contrast enhancement during magnetic resonance imaging is useful in accurately demonstrating disease extent prior to surgery.

Cystic renal cell carcinoma: radiological features and clinico-pathological correlation.

The radiological appearances of 11 cystic renal cell carcinomas (RCC) presenting over a 13-year-period are reviewed and correlated with their clinicopathological features. The tumours occurred in seven males and four females with a mean age of 59.1 years (range 27-87 years).

Dexamethasone stimulation of rat insulin-like growth factor binding protein-1 promoter activity involves multiple cis-elements.

Insulin-like growth factor binding protein-1 (IGFBP-1) modulates the mitogenic actions of IGF-I and IGF-II. Dexamethasone increases IGFBP-1 mRNA abundance and gene transcription in rat liver and in H4-II-E rat hepatoma cells. A glucocorticoid response element (GRE) located at nucleotide (nt) -91/-77 is required for dexamethasone to stimulate rat IGFBP-1 promoter activity in transient transfection assays in H4-II-E cells.

Organization and chromosomal localization of the gene encoding the mouse acid labile subunit of the insulin-like growth factor binding complex.

After birth, most of insulin-like growth factor I and II (IGFs) circulate as a ternary complex formed by the association of IGF binding protein 3-IGF complexes with a serum protein called acid-labile subunit (ALS). ALS retains the IGF binding protein-3-IGF complexes in the vascular compartment and extends the t1/2 of IGFs in the circulation. Synthesis of ALS occurs mainly in liver after birth and is stimulated by growth hormone.

Clinics in diagnostic imaging (14). Cavernous haemangioma of the liver.

A 64-year-old woman, being managed for carcinoma of the cervix, was incidentally found to have a solitary liver lesion on computed tomography (CT). The rounded lesion was well-defined and hypodense on unenhanced CT. Dynamic and delayed contrast CT demonstrated the typical enhancing pattern of cavernous haemangioma.

Cloning and characterization of a functional promoter of the rat pp120 gene, encoding a substrate of the insulin receptor tyrosine kinase.

Cloning of the 5 -flanking region of the rat pp120 gene has indicated that it is a housekeeping gene: it lacks a functional TATA box and contains several Sp1 binding sites and multiple transcription initiation sites at nucleotides -101, -71, -41, and -27 spread over a GC-rich area. A fragment between nucleotides -21 and -1609 exhibited promoter activity when ligated in a sense orientation into a promoterless luciferase reporter plasmid and transiently transfected into rat H4-II-E hepatoma cells. 5' progressive deletion and block substitution analyses revealed that the three proximal Sp1 boxes (boxes 3, 5, and 6) are required for basal transcription of the pp120 gene.

Case report: Acute haemorrhagic presentation of trigeminal neuroma.

The acute presentation of trigeminal neuroma, due to sudden haemorrhage, in a 26-year-old Chinese man, is described. The clinical, CT and MRI features are reviewed together with the other four cases reported in the literature.

Structure and regulation of the ALS gene.

The mouse ALS gene spans at least 6 kb. It contains 2 exons which encode a protein highly homologous to human and rat ALS. It was localized to mouse chromosome 17 by flourescent in situ hybridization.

Dexamethasone stimulation of rat insulin-like growth factor binding protein-1 (IGFBP-1) promoter activity involves the interaction of multiple transcription factors.

Using an improved procedure for transient transfection of H4-II-E rat hepatoma cells, we characterized the cis elements in the proximal promoter of the rat insulin-like growth factor binding protein-1 (rat IGFBP-1) gene that are required for basal (unstimulated) and dexamethasone-stimulated promoter activity. Three sites are required for optimal basal promoter activity: an AP-2 site (nt -286 to -293), the M4 region of the insulin response element (nt -108 to -99), and a hepatocyte nuclear factor-1 (HNF-1) site (nt -62 to -50). In addition to the glucocorticoid response element (nt -91 to -77), participation of two of three accessory sites is required for optimal stimulation by dexamethasone: the M4 and HNF-1 sites, and a third site located between nt -252 and -236.

Altered striatal function in a mutant mouse lacking D1A dopamine receptors.

Of the five known dopamine receptors, D1A and D2 represent the major subtypes expressed in the striatum of the adult brain. Within the striatum, these two subtypes are differentially distributed in the two main neuronal populations that provide direct and indirect pathways between the striatum and the output nuclei of the basal ganglia. Movement disorders, including Parkinson disease and various dystonias, are thought to result from imbalanced activity in these pathways.

Identification of cis-elements mediating the stimulation of rat insulin-like growth factor-binding protein-1 promoter activity by dexamethasone, cyclic adenosine 3',5'-monophosphate, and phorbol esters, and inhibition by insulin.

Insulin-like growth factor-binding protein-1 (IGFBP-1) modulates the action of IGFs on target cells. IGFBP-1 transcription is highly regulated by hormonal and metabolic factors. In rat H4-II-E hepatoma cells, IGFBP-1 messenger RNA is stimulated by dexamethasone, cAMP, and phorbol esters, and dominantly inhibited by insulin.

Comparison of technetium 99m nanocolloid and indium 111 leucocytes in the diagnosis of orthopaedic infections.

It has been suggested that technetium 99m nanocolloid is as effective an inflammatory radiopharmaceutical as indium 111 leucocytes. This study compares the efficacy of 99Tcm nanocolloid and 111In leucocytes in the detection of orthopaedic infection in 19 patients with a high clinical suspicion of infection. The two scintigrams were performed within 24 h of each other.

Case report: thromboembolism during transfemoral arteriography--radiographic demonstration with histopathological correlation.

Thromboembolism is a well described complication of transfemoral arteriography. Its origin and course is rarely demonstrated. We describe a case of thromboembolism with histopathological correlation demonstrating the origin and course during contrast injection.

Cycloheximide stabilizes insulin-like growth factor-binding protein-1 (IGFBP-1) mRNA and inhibits IGFBP-1 transcription in H4-II-E rat hepatoma cells.

The insulin-like growth factor-binding proteins (IGFBPs) are a family of six proteins that modulate the biological activity of IGF-I and IGF-II and determine their bioavailability to tissues. One of the IGFBPs, IGFBP-1, is distinctive in the dynamic response of its levels in human plasma to metabolic changes. Parallel changes occur in IGFBP-1 mRNA and IGFBP-1 transcription in rat liver.

What future for traditional Chinese medicine outside China?

In certain countries of east and south-east Asia, traditional Chinese medicine continues to be used by many people. However, the pattern of use favours the advance of the drug-retailing side of this sector rather than medical care, and there is consequently some concern about the professional status of practitioners in the long term.

Chinese medicine in Malaysia and Singapore: the business of healing.

Traditional Chinese medicine as it persists in several East and Southeast Asian countries, has undergone major changes. Such changes have reinforced the trading aspects of traditional Chinese medical practice with relatively little advantage for the medical care component. This paper examines the nature of changes in contemporary ethnic Chinese medical practice in Malaysia and Singapore with the aim of understanding their implications for the persistence of this medical tradition.

Post-transcriptional regulation of insulin-like growth factor binding protein-2 mRNA in diabetic rat liver.

IGFBP-1 and IGFBP-2 mRNAs are increased in the livers of streptozotocin-diabetic rats. A corresponding increase is observed in transcription of the IGFBP-1 but not the IGFBP-2 gene, indicating that the increase in steady-state levels of IGFBP-2 mRNA is a post-transcriptional effect. IGFBP-1 and IGFBP-2 mRNAs also differ in the rapidity of their response to insulin treatment: hepatic IGFBP-1 mRNA is normalized within 1 h, IGFBP-2 mRNA decreases more slowly.