Lateral meniscal cyst causing irreversible peroneal nerve palsy.

We report an unusual case of irreversible foot drop occurring secondary to a large lateral meniscal cyst. We discuss the presentation and management of this rare case and highlight some of the less common causes of foot drop.

Sample-sample and wavenumber-wavenumber two-dimensional correlation analyses of attenuated total reflection infrared spectra of polycondensation reaction of bis(hydroxyethyl terephthalate).

Polycondensation reaction of bis(hydroxyethylterephthalate) was monitored in situ by attenuated total reflection (ATR)/infrared (IR) spectroscopy. The obtained spectra are analyzed by means of generalized two-dimensional (2D) sample-sample and wavenumber-wavenumber correlation spectroscopies. The sample-sample correlation analysis reveals the correlations among the concentration features of the components, and the wavenumber-wavenumber correlation analysis elucidates the relations among the spectral features. Before the experimental data are analyzed by the 2D correlation spectroscopies, a synthetic two-component spectral model composed of the first and the last experimental spectra, is examined. The results of an analysis of the real data are related to those obtained from the synthetic data. It is found that the sample-sample correlation analysis of the IR data of polycondensation explains the concentration variance in the system and classifies two groups of the samples. The wavenumber-wavenumber correlations are derived upon the results of the sample-sample correlations and explained in terms of the spectral variations of three components. The convolute patterns in both types of correlations are attributed to the weak presence of ethylene glycol.

Hypersensitivity pneumonitis induced by spores of Lyophyllum aggregatum.

OBJECTIVES: Lyophyllum aggregatum (LA) is called Shimeji in Japanese and is eaten commonly as a mushroom. Shimeji mushrooms are cultivated in an indoor environment all year round. This study aimed to clarify the clinical features of hypersensitivity pneumonitis (HP) induced by LA. PATIENTS AND SETTING: Ten patients showed mild respiratory symptoms including dry cough, sputum, and low-grade fever. We tried to characterize the clinical features and the findings using chest high-resolution CT (HRCT), pulmonary function tests (PFTs), and BAL fluid (BALF) tests in patients with HP induced by LA. HP was diagnosed from clinical features, HRCT findings, BALF findings, lung histology, and lymphocyte stimulation tests (LSTs) for LA. RESULTS: Laboratory findings showed mean (+/- SD) elevated levels of C-reactive protein (0.78 +/- 1.3 mg/dL), erythrocyte sedimentation rate (48 +/- 23 mm/h), and gamma-globulin (26.9 +/- 7.6%). PFTs revealed a slight decrease in the percentage diffusing capacity of the lung for carbon monoxide, possibly due to the presence of epithelial granulomas in the alveoli. Although 4 of 10 patients showed normal findings on the chest radiograph (CXR), chest HRCT findings of all patients showed centrilobular small nodules and diffuse ground-glass opacities. The BALF testing revealed an increase in total cell counts, showing predominantly activated T lymphocytes. The CD4/CD8 cell ratio was significantly decreased (0.5 +/- 0.3). The results of the LSTs were positive in seven of seven cases. CONCLUSIONS: Since patients with HP induced by LA typically have mild respiratory symptoms and sometimes normal CXR findings, their conditions might remain undiagnosed. However, the chest HRCT images showed the typical subacute phase of HP.

Helicity redistribution during relaxation of astrophysical plasmas

We present the first 3D numerical MHD simulations that show that Taylor's relaxation conjecture is not satisfied in some MHD evolution of magnetic configurations encountered in solar physics. We show that magnetic helicity can be slowly injected through the boundary into a magnetic configuration which then evolves into a MHD disruption, with the formation in finite time of a current sheet through which reconnection occurs, leading to a release of magnetic energy. While helicity is well conserved during the process, it is shown that the relaxed state is far from the constant- alpha linear force-free field that would be predicted by Taylor's conjecture.

[A case of acute eosinophilic pneumonia induced by inhalation of acetylene].

A 17-year-old high school student, while carrying out soldering one morning, inhaled 100% acetylene, and experienced nausea and bilateral lower limb numbness several hours later. In the evening his symptoms worsened, dyspnea followed, and the patient was referred to our hospital the next day. On admission chest radiography and CT scanning revealed peripheral ground-glass opacity, patchy infiltrate and Kerley's B line in the right lung fields, and bilateral pleural effusion. Since the laboratory findings revealed leukocytosis without eosinophilia, increased CRP, and hypoxemia, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBLB) was subsequently performed. Fluid analysis revealed marked increases in the total cell and eosinophil counts, and the biopsy result showed eosinophilic and lymphocytic infiltration of the alveolar septa. As a result, the case was diagnosed as acute eosinophilic pneumonia (AEP). Although inhalation of acetylene is known to induce pulmonary edema, all the typical findings of AEP but pulmonary edema were seen. This case demonstrates that AEP may be induced by inhalation of acetylene.

A Twisted Flux Rope Model for Coronal Mass Ejections and Two-Ribbon Flares.

We present a new approach to the theory of large-scale solar eruptive phenomena such as coronal mass ejections and two-ribbon flares, in which twisted flux tubes play a crucial role. We show that it is possible to create a highly nonlinear three-dimensional force-free configuration consisting of a twisted magnetic flux rope representing the magnetic structure of a prominence (surrounded by an overlaying, almost potential, arcade) and exhibiting an S-shaped structure, as observed in soft X-ray sigmoid structures. We also show that this magnetic configuration cannot stay in equilibrium and that a considerable amount of magnetic energy is released during its disruption. Unlike most previous models, the amount of magnetic energy stored in the configuration prior to its disruption is so large that it may become comparable to the energy of the open field.

A 21-aminosteroid, U-74006F, attenuates endotoxin-induced lung injury in awake sheep.

The purpose of the present study was to examine the efficacy of U-74006F, a 21-aminosteroid, on lung dysfunction induced by endotoxaemia in awake sheep with lung lymph fistula and haemodynamic monitoring. We measured pulmonary haemodynamics, lung lymph balance, circulating leucocyte count, arterial blood gas tensions, and levels of thromboxane (Tx) B2 and 6-keto-prostaglandin (PG) F1 alpha in plasma and lung lymph. We performed two experiments. In experiment 1 (n = 6), we intravenously infused Escherichia coli lipopolysaccharide endotoxin (1 microgram/kg) over 30 min and observed the parameters over 5 h. In experiment 2 (n = 6), we pretreated sheep with an intravenous bolus of U-74006F (2 mg/kg) 30 min before the infusion of endotoxin in the same manner of experiment 1, and continuously infused U-74006F (0.5 mg/kg per h) over 5 h after the bolus during the experiment. The U-74006F significantly suppressed the early pulmonary hypertension, the late increase in pulmonary permeability and the elevations of TxB2 and 6-keto-PGF1 alpha levels in plasma and lung lymph during the early period following endotoxaemia, although the compound did not change the time course of leucocytopenia and hypoxaemia. These findings suggest that the administration of U-74006F attenuates the lung dysfunction induced by endotoxaemia in awake sheep.

Effects of recombinant human superoxide dismutase on tumor necrosis factor-induced lung injury in awake sheep.

Tumor necrosis factor alpha (TNF) is a mediator of acute lung injury after endotoxemia, but the precise mechanism of TNF-induced lung injury remains unclear. To clarify the role of oxygen radicals, especially superoxide anion, in TNF-induced lung injury, we examined the effects of recombinant human superoxide dismutase (rhSOD; 4,200 U/mg) on lung physiological and biochemical changes after TNF infusion in awake sheep (n = 17). We prepared chronically instrumented sheep for lung lymph collection and hemodynamic monitoring. Recombinant human TNF (3.5 micrograms/kg iv) induced a biphasic response in awake sheep. Pulmonary hypertension peaked within 15 min of initiation of TNF and remained elevated for 3 h, followed by increased lung vascular permeability. rhSOD attenuated the pulmonary hypertension in both early and late phases but caused no change in the timing or magnitude of lung fluid balance changes during the late phase. Thromboxane A2 (thromboxane B2) and prostacyclin (6-ketoprostaglandin F1 alpha) metabolite levels in plasma and lymph increased after the TNF infusion, and rhSOD attenuated these changes. The intravenous infusion of rhSOD resulted in the appearance of significant levels of SOD activity in both plasma and lung lymph before and after TNF infusion. These findings suggest that superoxide anion may be implicated in the pathogenesis of the pulmonary hypertension induced by TNF in sheep.

Pharmacokinetic evaluation of (glycolato-O,O')diammine platinum(II) in lung lymph in sheep.

The pharmacokinetics of (glycolato-O,O')diammine platinum(II) (254-S), especially the distribution and behavior in the lung lymph in sheep, was investigated and compared with that of cis-diamminedichloroplatinum(II) (CDDP). The blood and lung lymph fluid were collected from the carotid artery and a lung lymph fistula, respectively, in conscious sheep following intravenous infusion of 100 mg/body of 254-S and CDDP for 30 min. The concentrations of these platinum complexes were measured by using atomic absorption spectrometry. We analyzed the data using an anatomically based model including part of the lymphatic circulation. The ultrafilterable platinum of 254-S showed much larger area under the curve (AUC) and transfer rate constants than that of CDDP, even though the mean residence times were the same. The total platinum showed the opposite pharmacokinetic behavior. In anesthetized sheep, when lung tissue samples were obtained by biopsy at the same times as those of blood and lung lymph sampling after infusion of these drugs, 254-S distributed in lung tissue appeared to move more easily into lung lymph than CDDP, which tended to be retained in lung tissue. These differences in pharmacokinetic behavior between 254-S and CDDP seemed to be caused by differences in their strength of protein binding; the association constants of 254-S for plasma and lymph protein were much less than those of CDDP. From these results, 254-S may have favorable therapeutic effects on intrathoracic malignancies such as lung cancer and lymph metastasis.

[Primary plasma cell leukemia associated with hypercalcemia].

A 34-year-old male was admitted to our hospital because of anorexia and nausea in September, 1987. On admission, anemia, thrombocytopenia and hypercalcemia were observed, and the peripheral blood showed leukocytosis with atypical plasma cells (50%). Bone marrow aspiration showed hypercellularity, with a presence of atypical plasma cells (82%). The M-type protein in the serum and urine was identified as lambda Bence Jones protein by immunoelectrophoresis. On systemic skeletal X-rays, osteolytic lesions were not detected. Thus, a diagnosis of plasma cell leukemia associated with hypercalcemia was made. Hypercalcemia was treated successfully with overhydration. However the disease was refractory to combination chemotherapy, and at 10 months after diagnosis, he died of septic candidiasis. Hypercalcemia associated with plasma cell leukemia in its initial stage is rare.