Pneumoperitoneum in association with perforated appendicitis in a Brazilian Amazon woman. Case report.

Radiographic findings of free air in the peritoneal cavity secondary to perforation of a acutely inflamed appendix are extremely rare. It accounts for about 0-7% of all patients with pneumoperitoneum. We report on a 58-years-old Brazilian Amazon woman presenting a 1- week history of abdominal pain, tenderness and distension associated with asthenia and without passage of stool or gas. Abdominal percussion revealed a tympanic sound located on the right hypocondrium. Plain chest radiography revealed a large amount of free air beneath the right leaf of the diaphram. The patient was taken immediately to the operation room and, during surgery, a gangrenous appendix with an apex perforation was verified. Appendectomy was performed as routinely. The patient evolved with pneumonia and septic shock that responded well to intravenous antibiotics and vasoactive drugs. She was discharged to home on the twenty-first post-operative day in good clinical conditions. This case highlights that perforated acute appendicitis is rarely associated with pneumoperitoneum, but it must be considered in the differential diagnosis of patients presenting right abdominal pain and free intraperitoneal air.

The effect of zeranol on live weight gain, feed intake and carcass composition of steers during compensatory growth.

To evaluate the effect of zeranol implants in steers on compensatory ++growth, 80 steer calves (9 mo of age; 200 kg) were fed at two feeding levels (RO = 9.2 MJ ME/kg DM; R1 = 6.9 MJ ME/kg DM) for 119 d (Period 1). During Period 2, steers were full-fed to 400 kg BW with (Z1) or without (ZO) zeranol implants. Ten steers were slaughtered at the end of Period 1 to estimate carcass composition. Differences of 100 kg in BW were achieved by restriction in Period 1. Subsequent to restriction, cumulative ADG remained greater (P less than .05) up to the 24th wk of recuperation and implants increased (P less than .001) BW gain by 31% and 24% for RO and R1, respectively. The average daily energy intake (ME/W(.75) in Period 2 was similar for all treatments. Feed conversion was improved by 21.5% (P less than .05) by implants. At the end of Period 2 the R1ZO had 8.6 kg less muscle (P less than .001), 2.9 kg less bone (P less than .001) and 5.9 kg more fat (P less than .05) than the ROZO. In comparison, the carcasses of the implanted animals did not show significant differences (P greater than .05) due to restriction. Carcass daily gains were increased by previous restriction (P less than .01) and implants (P less than .05). Zeranol increased daily live weight gain and feed conversion in animals in continuous growth as well as in those observed in compensatory growth an tended to eliminate a tendency for higher content of fat in carcasses of nonimplanted animals making compensatory growth.

Purification and characterization of a milk clotting protease from Mucor bacilliformis.

An acid protease having milk clotting activity has been isolated from Mucor bacilliformis cultures. The enzyme was basically purified by ionic exchange chromatography. An average yield of 29 mg purified product was obtained from 100 mL crude extract. As purity criteria, SDS-PAGE, reverse-phase HPLC, and N-terminal analysis were performed. The protease is a protein composed of a single polypeptide chain with glycine at the N-terminus. The mol wt is approx 32,000, and its amino acid composition is very similar to those of other fungal proteases. As expected, its clotting activity was drastically inhibited by pepstatin A action. On the other hand, its instability against heat treatment and its clotting/proteolytic activity ratio indicate that it may be considered as a potential substitute for bovine chymosin.

[Intestinal trichobezoar: differential diagnosis in children with an abdominal mass]. / Tricobezoar intestinal: diagnóstico diferencial en niños con masa abdominal.

Due to it's rare appearance, the intestinal trichobezoar is usually not considered as a differential diagnosis of abdominal masses seen in children. A case of a 10 year old girl with a five month evolved inferior hemi-abdominal mass is cited. The girl appeared severely ill and within 24 hours of her physical examination, showed signs and symptoms of an intestinal obstruction. She was admitted to surgery with the diagnosis of a non Hodgkin lymphoma. Due to its' presentation, we may have even supposed it to be a case of Rapunzel syndrome which grew within the intestine causing obstruction or which may have initially grown in the terminal ileum. The medical literature is reviewed.