Flexor digitorum profundus tendon avulsion through a recurrent enchondroma--a case report.

Flexor digitorum profundus (FDP) tendon avulsion from the distal phalanx is a well recognised injury, which usually follows a hyperextension force to a flexed distal interphalangeal (DIP) joint. It is commonly seen in contact sport athletes, with a predilection for the ring finger.(2,4) Avulsion of the FDP tendon from pathological bone is an infrequent occurrence. It has, however, been reported to occur in association with an enchondroma of the distal phalanx.(2,3) To our knowledge, an FDP tendon avulsion through a recurrent enchondroma has not been reported. We present the case findings of such an event.

Balloon embolization of the internal iliac artery before aneurysm endograft deployment.

Six patients, ranging from 69 to 81 years of age, underwent iliac artery embolization with use of Detachable Silicon Balloons (DSB) 11-14 days before stent-graft repair of aneurysms. Balloons of 8.8-mm, 9.4-mm, and 9.9-mm sizes were used with 20-30 g of release force. Deployment difficulty was experienced in three cases. Five of six cases were successful, with the iliac artery remaining occluded at the time of endografting; one case required subsequent coil replacement. The average operative time for balloon embolization (75 min +/- 28) was shorter than that in 18 cases of coil embolization performed within the same time period (111 min +/- 105), but the difference was not significant (P = .21). Postoperatively, one patient (17%) reported buttock claudication after the procedure. Use of the DSB represents an alternative to use of coils for embolization of large and tortuous iliac arteries.

Stent versus endovascular graft healing characteristics in the porcine iliac artery.

PURPOSE: To evaluate the healing characteristics of stents versus endovascular grafts in the porcine iliac artery. MATERIALS AND METHODS: A total of 20 iliac arteries in 10 domestic swine were used to evaluate the healing characteristics of stents versus endovascular grafts. Each animal received one stent and one endovascular graft in opposite iliac arteries. The endovascular grafts were constructed with use of 6 cm of expanded polytetrafluoroethylene (ePTFE) (3 mm inner diameter, 30 microm internodal distance) and Palmaz stents (P204 or P188) secured at each end of the graft. A solitary Palmaz stent (P308 or P294) was used on the opposite side. The devices were explanted at 1, 5, and 12 weeks. RESULTS: One of three endovascular grafts and two of three stents were patent at 1 week. Two of three endovascular grafts and all three stents were patent at 5 weeks. All three endovascular grafts and stents were patent at 12 weeks. Gross examination, histologic, and scanning electron microscopy demonstrated differences in the healing response of the two devices. A marked abluminal inflammatory response to the graft material was observed. This resulted in neovascularization of the tissue along the abluminal surface of the graft. In addition, marked neointimal thickening at the unsupported section of the endovascular graft resulted in significant luminal narrowing. CONCLUSION: The porcine model may be used for evaluating the healing characteristics of endovascular grafts. Intravascular placement of ePTFE prosthetic graft material dramatically alters the healing of this type of graft material. The graft material did not prevent the formation of a progressively thickening neointima.

Healing response associated with balloon-dilated ePTFE.

Deployment of endovascular grafts composed of a metallic stent surrounded by expanded polytetrafluoroethylene (ePTFE) stretches the polymer beyond its original dimensions, altering the structural characteristics of the ePTFE. We hypothesized this structural modification would alter the healing response associated with the implant. In this study, 4 mm i.d. of ePTFE (30 microns internodal distance) vascular grafts were balloon dilated using angioplasty balloons having final diameters of 6 (1.5X), 8 (2X), 10 (2.5X), 12 (3X), and 18 (4.5X) mm. Following balloon dilatation of the ePTFE, a circular punch (6 mm in diameter) was used to prepare polymer samples for implantation. The ePTFE circular patches were implanted within subcutaneous tissue and epididymal fat pads of male Sprague-Dawley rats. After 5 weeks, the implants were removed and analyzed for fibrous capsule formation, inflammation, and neovascularization associated with the material. Histological analysis revealed the formation of fibrous capsules only with control subcutaneous implants. The inflammatory response associated with subcutaneously implanted ePTFE was decreased significantly following balloon dilatation to at least 2.5 times the original diameter of the graft. In contrast, ePTFE implanted within adipose tissue demonstrated a significantly greater inflammatory response following balloon dilatation when compared to control implants. Only ePTFE balloons dilated to 6 mm and implanted within adipose tissue demonstrated neovascularization to any extent. These data suggest the structural modifications incurred by ePTFE following balloon dilatation dramatically affect the inflammatory response associated with an implant. Therefore, polymeric materials used for endovascular graft technology require designs that consider changes in polymer healing inherent to device design.

Rhizoremediation of trichloroethylene by a recombinant, root-colonizing Pseudomonas fluorescens strain expressing toluene ortho-monooxygenase constitutively.

Trichloroethylene (TCE) was removed from soils by using a wheat rhizosphere established by coating seeds with a recombinant, TCE-degrading Pseudomonas fluorescens strain that expresses the tomA+ (toluene o-monooxygenase) genes from Burkholderia cepacia PR1(23)(TOM23C). A transposon integration vector was used to insert tomA+ into the chromosome of P. fluorescens 2-79, producing a stable strain that expressed constitutively the monooxygenase at a level of 1.1 nmol/min.mg of protein (initial TCE concentration, 10 microM, assuming that all of the TCE was in the liquid) for more than 280 cell generations (36 days). We also constructed a salicylate-inducible P. fluorescens strain that degraded TCE at an initial rate of 2.6 nmol/min.mg of protein in the presence of 10 microM TCE [cf. B. cepacia G4 PR1(23) (TOM23C), which degraded TCE at an initial rate of 2.5 nmol/min.mg of protein]. A constitutive strain, P. fluorescens 2-79TOM, grew (maximum specific growth rate, 0.78 h-1) and colonized wheat (3 x 10(6) CFU/cm of root) as well as wild-type P. fluorescens 2-79 (maximum specific growth rate, 0.77 h-1; level of colonization, 4 x 10(6) CFU/cm of root). Rhizoremediation of TCE was demonstrated by using microcosms containing the constitutive monooxygenase-expressing microorganism, soil, and wheat. These closed microcosms degraded an average of 63% of the initial TCE in 4 days (20.6 nmol of TCE/day.plant), compared to the 9% of the initial TCE removed by negative controls consisting of microcosms containing wild-type P. fluorescens 2-79-inoculated wheat, uninoculated wheat, or sterile soil.

Effects of balloon dilatation on ePTFE structural characteristics.

The search for less invasive treatments for cardiovascular disease has lead to the development of endovascular stent grafts, metallic and alloy stents surrounded by prosthetic vascular graft material. Introduced intravascularly, the deployment of stent grafts requires balloon dilatation of the device which results in expansion of the stent along with the vascular graft material. We hypothesized that balloon dilatation of stent grafts would alter the physical structure of the prosthetic graft material. In this study, noncompliant angioplasty balloons were used to dilate expanded polytetrafluoroethylene (ePTFE), a material commonly used for endovascular stent-graft technology. The maximal outer diameter (inflated balloon within the lumen) and the recoiled outer diameter (balloon removed) of two types of ePTFE, 3-mm inside diameter (i.d.) thin wall (30-micron internodal distance) and 4-mm i.d. standard wall (30-micron internodal distance), were measured to compare material recoil. Following balloon dilatation, ePTFE samples were prepared for scanning electron microscopic examination and the following parameters were measured: wall thickness, internodal distance, nodal width, interfiber distance, and fiber width. Following primary dilatation, both types of ePTFE recoiled approximately 20% regardless of inflated balloon diameter. However, following eight repetitive balloon dilatations, recoil decreased to approximately 10%. Scanning electron microscopic analysis revealed variations in internodal distance and significant decreases in wall thickness, nodal thickness, and interfiber distance. Fiber width was significantly decreased following dilatation of 3 mm, but not 4 mm ePTFE. Our data support our initial hypothesis that balloon dilatation alters the structure of ePTFE.

2,4-Dichlorophenol degradation using Streptomyces viridosporus T7A lignin peroxidase.

The Streptomyces viridosporus T7A bacterium produces the extracellular lignin peroxidase ALiP-P3. The ALiP-P3-catalyzed oxidation of 2,4-dichlorophenol (DCP) was examined to understand its kinetic behavior. Initial rate data of the oxidation of DCP were obtained by a spectrophotometric peroxidase assay, and the kinetics were best modeled with a random-binding bireactant system, which differs from the ping-pong bireactant system that is typically used for horseradish peroxidase and lignin peroxidase from the fungus Phanerochaete chrysosporium, and suggests that either DCP or H2O2 may bind first to ALiP-P3. Chloride ion measurements indicate that 16% of the reacted DCP was fully dechlorinated by ALiP-P3. Chemical ionization mass spectrometry was also utilized to identify the DCP degradation product as a hydrophobic chlorinated dimer of mass 322.

Effects of calcitonin on 3',5'-cyclic adenosine monophosphate and calcium second messenger generation and osteoblast function in UMR 106-06 osteoblast-like cells.

The UMR 106-06 rat osteosarcoma osteoblast-like cell line possesses calcitonin (CT) receptors in addition to expressing PTH receptors and a highly osteoblast-like phenotype, and may represent an intermediate developmental stage between early osteoblast precursors and mature osteoblasts. Therefore, we examined the effects of CT and PTH on second messenger generation and osteoblastic function in these cells. In UMR-106-06 cells, 10-1000 nM CT produced a dose-dependent stimulation of intracellular free calcium concentration ([Ca2+]i), which reached a plateau between 2-3 min. This stimulatory effect was abolished in the absence of extracellular Ca2+ ([Ca2+]o) and was mimicked by forskolin and (Bu)2cAMP. One hundred nanomolar CT also produced a slight but significant increase in inositol triphosphate production (13%, P less than 0.05) but did not produce a rapid, transient increase in [Ca2+]i. In contrast, PTH produced a rapid, transient increase in [Ca2+]i, which reached a maximum within 30 sec. This stimulatory effect of PTH on [Ca2+]i signal was dose-dependent and accompanied by a parallel stimulation of inositol triphosphate production. PTH, forskolin, and (Bu)2cAMP all produced a marked dose-related suppression of both DNA and collagen synthesis, which paralleled their stimulatory effects on intracellular cAMP levels. In marked contrast, CT only minimally reduced DNA and collagen synthesis despite producing comparable increases in intracellular cAMP. One hundred nanomolar CT also stimulated alkaline phosphatase specific activity by 33% (P less than 0.05). Thus, CT stimulates cAMP, [Ca2+]i, and inositol phosphate second messengers in UMR 106-06 cells. However, in contrast to other agents which elevate intracellular cAMP levels, CT does not suppress DNA synthesis. These results suggest that the linkage of CT receptor second messengers to effects on cell function differ from those of PTH and/or that CT may produce additional second messenger(s) which antagonize the antiproliferative effect of increased cAMP levels in UMR-106-06 cells.