Extraadrenal adrenaline formation by two separate enzymes.

Adrenaline (A) is synthesized in the adrenal medullae by the enzyme phenylethanolamine-N-methyltransferase (PNMT). After surgical removal of the adrenal medullae tissue A levels ranged from 22% of control in the heart to 125% of control in the liver. Use of a novel assay to measure tissue A formation revealed that many tissues can synthesize A using PNMT and another enzyme that N-methylates both noradrenaline and dopamine.

Chondrosarcoma of the epiglottis with regional and distant metastasis.

Chondrosarcoma of the epiglottis is extremely rare and there are no previously reported cases of this neoplasm with regional or distant metastases. The first case of this entity and its histopathologic considerations are presented. Accurate grading of this malignancy is essential, since a more poorly differentiated pathologic condition in these tumors indicates aggressive biologic properties consequently leading to frequent local recurrences and metastasis.

Delayed erosion of intraperitoneal chemotherapy catheters into the bowel. Report of two cases.

Erosion of a silastic catheter into the small bowel occurred in two patients who previously had received multiple courses of uncomplicated intraperitoneal (IP) chemotherapy. Although bowel perforation is a recognized complication at the time of Tenckhoff catheter insertion, late erosion of the catheter into the bowel after its use for IP chemotherapy has not been previously reported. Catheter injection with radiographic contrast confirmed the diagnosis, evidence for which included nonspecific clinical findings of intraabdominal infection and pain during chemotherapy infusion.

Epidemiology of bone and soft tissue sarcomas.

Although bone and soft tissue sarcomas are not common, a significant number of patients who develop these tumors will die with metastatic disease. Part of the reason is that many of the patients have advanced disease at diagnosis. Identification of an etiologic agent should allow for diagnosis at an earlier stage.

Temporal analysis of murine lymphocyte subpopulations by monoclonal antibodies and dual-color flow cytometry after burn and nonburn injury.

The immune suppression that frequently accompanies severe injury undoubtedly contributes to subsequent infectious complications. Various lymphocyte subpopulations may be identified by surface antigen expression, and alterations in antigen expression by lymphocytes may reflect host immune competence. Using monoclonal antibodies (Moabs) and dual-color flow cytometry, we studied lymphocyte phenotypic expression in mice after either controlled burn injury or hind-limb amputation, with use of peripheral blood, lymph node, and spleen for cell preparation.

Myocardial creatine kinase exchange rates and 31P NMR relaxation rates in intact pigs.

In this study, we used 31P NMR to investigate the relationship between cardiac workload and creatine kinase flux in intact pigs. NMR measurements were performed on anesthetized miniature swine in which a surface coil was surgically implanted on the surface of the left ventricle. Cardiac workload was varied by infusion of norepinephrine.

Intra-abdominal injury following blunt trauma. Identifying the high-risk patient using objective risk factors.

The initial physical examination is frequently unreliable in identifying patients with blunt trauma at high risk for having serious intra-abdominal injury. Intra-abdominal injury may be associated with specific injuries or risk factors, but the usefulness of such objective clinical criteria in predicting intra-abdominal injury has not previously been determined. The presence or absence of each of 11 clinical indicators and their association with serious intra-abdominal injury were analyzed in 3223 patients with blunt trauma.

Severe toxicity from ingestion of a topical minoxidil preparation.

A 36-year-old man ingested several products, including a topical minoxidil solution. Within two hours of the ingestion the patient was difficult to arouse, tachycardic, and hypotensive with a systolic BP of 90 mmHg. Dopamine was required for two days to maintain his BP.

Digital tomosynthesis: phantom and patient studies with a prototype unit.

A prototype digital linear tomographic system has been developed and used in patient and phantom studies. Phantom work demonstrated 0.6 line pairs/mm of spatial resolution, a slice thickness of 5 mm to 6 mm, range of reconstruction of 1 cm to 20 cm above tabletop, reconstruction time of 2 to 45 seconds per slice depending on matrix size, and a 280 mm field of view at the tabletop.

Antigen-specific immune response in the inner ear.

The specificity of inner ear immune responses was investigated by challenging each inner ear of presensitized animals with different antigens. Animals presensitized systemically with keyhole limpet hemocyanin (KLH) and bovine serum albumin (BSA) were challenged with KLH in the right and BSA in the left inner ears. Two weeks later perilymph anti-KLH levels were increased significantly in the right inner ears compared to the levels in the left inner ears.

The cardiovascular actions of centrally administered neuropeptide Y.

The cardiovascular actions of intracerebroventricular (i.c.v.

The transoropalatal approach to the atlantoaxial-clival region: considerations for the head and neck surgeon.

The transoropalatal approach to the atlantoaxial-clival area provides excellent exposure for neurosurgical decompression and fusion procedures. The technique has been effectively applied in the treatment of bony and soft tissue abnormalities of the anterior spinal region. Although this approach is safe and reliable, it is not part of the otolaryngologist's usual surgical armamentarium.

Serial magnetic resonance and carotid duplex examinations in the management of carotid dissection.

We followed 2 patients with extracranial internal carotid dissection and associated occlusion or preocclusive stenosis with serial magnetic resonance and carotid duplex examinations. These studies demonstrated progressive anatomic resolution in both cases.

Attachment of peptide growth factors to implantable collagen.

Ingrowth of fibrovascular tissue from the woundbed into collagen-based dermal substitutes and survival of cultured epithelium after transplantation may be enhanced by attachment of heparin binding growth factor 2 (HBGF2) and epidermal growth factor (EGF) to collagen. Biotinylation of collagen and the growth factors allows immobilization of HBGF2 and EGF by high affinity binding of tetravalent avidin. Biotinylated HBGF2 and EGF (B-GF) were exposed to complexes of biotinylated collagen (B-COL)-avidin (A) and detected with peroxidase-labeled avidin (AP) followed by chromagen formation on nitrocellulose paper.

Familial aortic dissecting aneurysm.

A family is described in which nine members over two generations had an aortic dissecting aneurysm or aortic or arterial dilation at a young age. The family has been followed up since 1977 after the death of a second teenager from a kindred of 11. None of the patients had the Marfan syndrome or a history of systemic hypertension.

Elevation of inner ear antibody levels following direct antigen challenge of the endolymphatic sac.

The effect of direct antigen challenge of the endolymphatic sac (e.sac) on inner ear antibody levels was investigated in guinea pigs. Two weeks following e.

The effect of thermal injury on murine neutrophil oxidative metabolism.

The ability of polymorphonuclear leukocytes to kill bacteria and yeast is reflected by cellular chemiluminescence or similarly by the production of H2O2 during oxidative metabolism. With the use of flow cytometry and 2'7' dichlorodihydrofluorescein-diacetate, we determined the direct effect of thermal injury and the indirect effect of burn serum on murine polymorphonuclear leukocyte oxidative metabolism after stimulation on days 1, 5, and 10 after 25% total body surface area burn. Control or burn peritoneal leukocytes and 10% control or burn serum were incubated in vitro with 2'7' dichlorodihydrofluorescein-diacetate for 15 minutes, then stimulated with phorbol 12-myristate 13-acetate.

Short- and long-term clinical outcome after Q wave and non-Q wave myocardial infarction in a large patient population.

Prognosis for patients with non-Q wave myocardial infarction is controversial although a number of studies have shown a less favorable outlook after hospital discharge for patients with non-Q wave than for those with Q wave infarction. Therefore, the in-hospital and 1-year prognosis was investigated in a sufficiently large patient population (n = 2,024) to allow stratification by subgroups, in particular by age and previous myocardial infarction. Patients with non-Q wave infarction (n = 444; 22% of the total study population) were somewhat older (65 vs.

Pretreatment with phorbol esters abrogates mast cell adenosine responsiveness.

Adenosine potentiates preformed mediator release from mouse bone marrow-derived mast cells stimulated with specific Ag or the calcium ionophore A23187. When these mast cells were cultured for 30 to 120 min with the phorbol ester PMA (10(-8) or 10(-7) M), protein kinase C activity was increased and Ag-stimulated beta-hexosaminidase release was modestly inhibited, whereas A23187-stimulated release was synergistically enhanced. However, in both cases, exogenous adenosine failed to augment beta-hexosaminidase release.

Care of the multiply injured patient with cervical spine injury.

Cervical spine injuries can be disastrous. The treatment begins at the accident scene by obtaining an appropriate history, physical examination, and evaluation of the mechanics of the accident. Emergency medical stabilization takes precedence, but the cervical spine should be stabilized until an injury in this area is ruled out.

Axial bone density in rheumatoid arthritis: comparison of dual-energy projection radiography and dual-photon absorptiometry.

The usefulness of dual-energy projection radiography (DEPR) in the evaluation of rheumatoid arthritis was compared with that of dual-photon absorptiometry (DPA). Bone density measurements of the lumbar spine and the proximal femur were obtained with DPA in 75 patients (45 women and 30 men). For comparison, the bone density of the lumbar spine was measured with DEPR in a subset of 52 patients (33 women and 19 men).