First Documented Pathologies in Tenontosaurus tilletti with Comments on Infection in Non-Avian Dinosaurs.

In 2001, a nearly complete sub-adult Tenontosaurus tilletti was collected from the Antlers Formation (Aptian-Albian) of southeastern Oklahoma. Beyond its exceptional preservation, computed tomography (CT) and physical examination revealed this specimen has five pathological elements with four of the pathologies a result of trauma. Left pedal phalanx I-1 and left dorsal rib 10 are both fractured with extensive callus formation in the later stages of healing. Left dorsal rib 7 (L7) and right dorsal rib 10 (R10) exhibit impacted fractures compressed 26 mm and 24 mm, respectively. The fracture morphologies in L7 and R10 indicate this animal suffered a strong compressive force coincident with the long axis of the ribs. All three rib pathologies and the pathological left phalanx I-1 are consistent with injuries sustained in a fall. However, it is clear from the healing exhibited by these fractures that this individual survived the fall. In addition to traumatic fractures, left dorsal rib 10 and possibly left phalanx I-1 have a morphology consistent with post-traumatic infection in the form of osteomyelitis. The CT scans of left metacarpal IV revealed the presence of an abscess within the medullary cavity consistent with a subacute form of hematogenous osteomyelitis termed a Brodie abscess. This is only the second reported Brodie abscess in non-avian dinosaurs and the first documented occurrence in herbivorous dinosaurs. The presence of a Brodie abscess, known only in mammalian pathological literature, suggest mammalian descriptors for bone infection may be applicable to non-avian dinosaurs.

Transverse testicular ectopia in a fertile elderly male presenting with incarcerated inguinoscrotal hernia.

Transverse testicular ectopia is a rare congenital anomaly characterized by the unilateral descent of both testes into one hemiscrotum. Fewer than 100 occurrences of this condition have been reported worldwide, almost all of them in children. In this report, we describe transverse testicular ectopia (TTE) identified in a 55-year-old, apparently fertile, male who presented to a rural hospital in Belladere, Haiti, for elective repair of an incarcerated left inguinoscrotal hernia. Preoperative palpation of the scrotum had revealed apparently normal, well-developed left and right testicles. However, during open herniorrhaphy, both testicles were found to have descended on the left side and reside in an enlarged left hemiscrotum. Surgeons who frequently repair inguinal hernias should be aware of this rare clinical entity and its recognized association with inguinal hernia; they should also be aware of the appropriate surgical management options available to them when this condition is unexpectedly identified during inguinal exploration.

The impact of risk on preference values: implications for evaluations of postmenopausal osteoporosis therapy.

OBJECTIVE: The objective was to assess the impact of different levels of risk of disease on a woman's preferences for health states. Women were provided with health scenarios incorporating different levels of lifetime risks for breast cancer, hip fracture, and coronary heart disease (CHD). In this way, we were able to determine the incremental effect of changes in risks of each disease on preference values. METHODS AND DATA: Preference values and utility scores were obtained for six health scenarios by both the feeling thermometer (FT) and standard gamble (SG) methods. Scenarios presented the different lifetime risks of CHD, breast cancer, and hip fracture associated with and not associated with long-term use of hormone replacement therapy (HRT) and raloxifene. Risks of breast cancer were based on perceived risks and population risks. The sample population consisted of 40 healthy female volunteers aged between 45 and 65 years randomly selected from the Ottawa-Carleton district. RESULTS: Based on their perceived risk of breast cancer, the women had higher value scores for the raloxifene risk profile than for both HRT (p = .002) and no therapy (p = .003), with similar results for analyses based on population risks and from utility scores. Regression analysis showed that the risk of breast cancer (p < .001) was the only disease risk that was statistically significantly associated with women's preferences. CONCLUSIONS: Women had significant preferences over the different risk profiles, primarily due to the incremental effect on changes in values for the risk of breast cancer. Therefore, studies evaluating therapies for osteoporosis should consider patient preferences for living with different risk profiles.

Percutaneous removal of a large mobile right atrial thrombus using a basket retrieval device.

This report documents the removal of a large mobile serpiginous right atrial thrombus using percutaneous intravascular techniques with fluoroscopic and transesophageal echocardiographic guidance. Technical aspects and potential complications are discussed.

A human anti-HIV autoantibody enhances EBV transformation and HIV infection.

A highly specific, human IgG mAb, F223, which reacts with both HIV-1-infected cells and uninfected lymphoid cells, has been derived. F223 reacts with gp120 but fails to neutralize viral infection. The antibody does enhance HIV-1 infection in a complement-dependent manner. The autoantigen recognized by F223 is expressed on a small percentage of T cells and NK cells and the majority of B cells. Immunoprecipitation demonstrates F223 reactivity with an as of yet unidentified 159-kDa protein in uninfected lymphoid cells. This reactivity with uninfected cells is inhibited by free gp120 demonstrating the cross-reactive nature of this antibody. The F223 light chain demonstrates strong homology to VLlambda2 family genes whereas the heavy chain is most homologous (84%) to the germline gene VH3-H.11. In vivo usage of VH3 family genes by F223 and an anti-HIV-1 (gp41) human mAb, 3D6, with related autoreactivity, suggests that VH3 sequences may be important components of potentially pathogenic human anti-HIV-1 envelope autoantibodies. F223 was isolated from an HIV-1 infected individual with lymphoma and in vitro F223 significantly enhances EBV transformation of normal B cells and increases immunoglobulin production without affecting B cell proliferation. Characterization of this antibody response may provide important insights and mechanistic information on HIV pathogenesis.

Lack of association between acquisition of TT virus and risk behavior for HIV and HCV infection in Vietnam.

BACKGROUND: The search for the cause of chronic hepatitis among individuals with non-A to G hepatitis has led to the discovery of a post-transfusion hepatitis-related DNA virus, designated TT virus (TTV), which, based on viral sequences, belongs to a new virus family. The principal modes of infection with TTV are poorly understood, and its role in human immunodeficiency virus type 1 (HIV-1) infection is unclear. OBJECTIVE: To determine if injection drug use (IDU) and high-risk heterosexual activity (HRHA), principal modes of acquiring HIV-1 infection, place individuals at greater risk of acquiring TTV. METHODS: The authors analyzed DNA, extracted from sera or filter paper-blotted whole blood, obtained during August 1997 and June 1998 from 324 Vietnamese (148 male; 176 female), for TTV sequences by hot-start, heminested polymerase chain reaction. RESULTS: Prevalence of TTV viremia was similar among individuals engaging in IDU or HRHA (23.4% vs. 20.2%; P > 0.5), with no age- or gender-specific differences. No association was found between TTV viremia and co-infection with HIV-1 or hepatitis C virus (HCV). Phylogenetic analysis of 30 TTV sequences revealed two distinct genotypes and four subtypes that did not segregate according to gender, HIV-1 and HCV risk behaviors, or geographic residence. CONCLUSIONS: Among HIV-1- or HCV-infected Vietnamese, who presumably acquired their infection by either the parenteral or nonparenteral route, the data indicate no clear association between acquisition of TTV infection and risk behavior for HIV-1 or HCV infection, suggesting that the usual route of TTV transmission in Vietnam is other than parenteral or sexual.

Minimal incidence of serum antibodies reactive with intact primary isolate virions in human immunodeficiency virus type 1-infected individuals.

Immunoglobulin G reactive with primary isolate virions was detected in 36% of serum samples from individuals infected with human immunodeficiency virus type 1. Of these individuals, serum samples from only 7% captured significant quantities of virus. Virion-specific antibody correlated with CD4 counts and, of more significance, primary isolate neutralization. Further dissection of this response should lead to the identification of antibodies and antigenic epitopes for vaccine purposes.

Inversion-recovery echo-planar MR in adult brain neoplasia.

PURPOSE: A T1-weighted multishot inversion-recovery (IR) echo-planar MR imaging (EPI) sequence was developed to improve intracranial tissue differentiation; its diagnostic utility was compared with that of conventional axial T1-weighted spin-echo and axial T2-weighted turbo spin-echo sequences. METHODS: Eighteen patients with known or suspected primary or metastatic brain neoplasia were imaged in a 1.5-T unit with IR-EPI sequences. Three observers measured gray/white matter contrast-to-noise ratios and subjectively compared IR-EPI sequences with T1-weighted spin-echo and T2-weighted turbo spin-echo sequences for gray/white matter discrimination, visibility of intracranial and vascular structures, overall lesion conspicuity, size of lesion(s), and presence and severity of artifacts. RESULTS: Twenty-four lesions (including neoplasia, infarction, treatment-associated encephalomalacia, nonneoplastic white matter signal abnormalities, and basilar artery dolichoectasia) were detected in 12 patients. Basilar artery dolichoectasia was not included in subsequent statistical analysis. Pulsatile flow artifacts were markedly reduced on IR-EPI sequences relative to those on T1-weighted spin-echo sequences. Gray/white matter contrast was greater on IR-EPI images than on T1-weighted spin-echo images. Periaqueductal gray matter, basal ganglia, optic tracts, cranial nerve V, and claustrum were seen better or as well on IR-EPI images as compared with T1-weighted spin-echo images. IR-EPI was more sensitive to magnetic sensitivity effects, with resultant decreased visibility of cranial nerves VII and VIII and the orbital portion of the optic nerves. For noncontrast sequences, lesion conspicuity was better on IR-EPI images than on T1-weighted spin-echo images in 16 (70%) of 23 lesions and was equal on the two sequences in seven (30%) of 23 lesions. Lesion size, including surrounding edema, was greater on IR-EPI images than on T2-weighted turbo spin-echo images in two (9%) of 23 cases and equal in 21 (91%) of 23 cases. Hyperintense foci of methemoglobin were more conspicuous on T1-weighted spin-echo images. CONCLUSION: Multishot IR-EPI is superior to conventional T1-weighted spin-echo imaging for parenchymal tissue contrast and lesion conspicuity, and is equal to T2-weighted turbo spin-echo imaging in sensitivity to pathologic entities.

Gradual loss of IgG antibodies against GB virus C/hepatitis G virus in a patient with AIDS.

GB virus C/hepatitis G virus (GBV-C/HGV) is a positive-sense, single-stranded RNA virus belonging to the family Flaviviridae and is distantly related to hepatitis C virus (HCV). GBV-C/HGV can be transmitted by the parenteral and the sexual route. Among individuals infected with human immunodeficiency virus type 1 (HIV-1) by the sexual route, we and others have demonstrated a high prevalence of GBV-C/HGV infection. Recently, Woolley and colleagues reported that AIDS patients co-infected with GBV-C/HGV had a significantly lower mean CD4 cell count than AIDS patients without GBV-C/HGV infection, suggesting that GBV-C/HGV antibody may be lost with progression to AIDS. To our knowledge no data are available on the loss of antibody against GBV-C/HGV in AIDS patients. We now report on an HIV-infected patient who exhibited gradual loss of IgG antibodies against GBV-C/HGV, as well as HCV, with progression of HIV disease.

Src phosphorylates the insulin-like growth factor type I receptor on the autophosphorylation sites. Requirement for transformation by src.

The insulin-like growth factor type I (IGF-I) receptor can become tyrosine phosphorylated and enzymatically activated either in response to ligand or because of the activity of the Src tyrosine kinase (Peterson, J. E., Jelinek, T., Kaleko, M., Siddle, K., and Weber, M. J. (1994) J. Biol. Chem. 269, 27315-27321). The goal of the present study was to analyze the mechanistic basis and functional significance of the Src-induced phosphorylation and activation of the IGF-I receptor. 1) We mapped the sites of IGF-I receptor autophosphorylation to peptides representing three different receptor domains: tyrosines 943 and 950 in the juxtamembrane region; tyrosines 1131, 1135, and 1136 within the kinase domain; and tyrosine 1316 in the carboxyl-terminal domain. The juxtamembrane and kinase-domain peptides were phosphorylated both in vivo and in vitro. The carboxyl-terminal site, although phosphorylated in vitro and in src-transformed cells, was not a major site of ligand-induced phosphorylation in vivo. 2) We determined that the sites of Src-induced phosphorylation of the IGF-I receptor are the same as the ligand-induced autophosphorylation sites and that the Src kinase can catalyze these phosphorylations directly. 3) We showed that cells cultured from mice in which the IGF-I receptor has been knocked out by homologous recombination are defective for morphological transformation by src. Thus, the Src kinase can substitute for the receptor kinase in phosphorylating and activating the IGF-I receptor, and this receptor phosphorylation and activation are essential for transformation by src.

Three-dimensional diagnosis and management of Class II malocclusion in the mixed dentition.

Class II malocclusion is a commonly observed problem, occurring in about one third of the United States population. The numerous treatment approaches that have been advocated to treat this malocclusion presumably produce differing treatment effects within the skeletal, dentoalveolar, and soft tissue components of the face. In the first section of this article, the three-dimensional components of Class II malocclusion are described, with transverse maxillary discrepancy, mandibular skeletal retrusion, and increased lower anterior facial height observed as common findings in a mixed dentition sample of Class II subjects. Second, the literature concerning two seemingly diverse treatment methods (extraoral traction and functional jaw orthopedics) is reviewed in detail. Last, cephalometric data are presented from a retrospective clinical study and is used to evaluate the treatment effects produced by cervical traction and the FR-2 appliance of Fränkel in comparison with an untreated sample of mixed dentition Class II patients. The results of this study indicated that although both skeletal and dentoalveolar components of Class II, Division 1 malocclusion were altered in the Class I direction by either a facebow or a Fränkel appliance, these two appliance systems accomplished the correction in dramatically differing ways. Cervical traction affected the skeletal and dentoalveolar components of the maxilla and mandible, whereas the FR-2 appliance had less of an effect on maxillary and dentoalveolar components and a greater effect on mandibular length. Thus, these two treatment modalities produce decidedly different treatment effects in patients with Class II malocclusions.

Optimization of radiation dose and image quality in mammography: a clinical evaluation of rhodium versus molybdenum.

Mammography was done with a conventional molybdenum anode/filter combination and either a molybdenum/rhodium (Mo/Rh) or rhodium/rhodium (Rh/Rh) combination to compare the contrast characteristics and penetrating ability of the different techniques. Each pair was rated as being equal, one slightly better than the other, or one much better than the other. The "preferred" image was also selected. The entrance surface exposure and the mean glandular dose were determined for each exposure. Mo/Mo was compared with Mo/Rh in 26 patients and to Rh/Rh in 23. Mo/Mo was judged to produce better or equal contrast and penetration in all cases except one using the Mo/Rh combination. Mo/Rh was the preferred image only once and Rh/Rh not at all. In comparison to the conventional Mo/Mo technique, the average dose was reduced by approximately 25% with Mo/Rh and by 50% with Rh/Rh.

Permanent testicular damage induced in rats by a single dose of tunicamycin.

Tunicamycin administered as a single subcutaneous dose of 200 micrograms/kg caused permanent destruction of seminiferous tubules in adult male rats. The fertility of females was unimpaired by doses of up to 450 micrograms/kg. Degenerative changes in seminiferous tubule epithelium commenced 3 to 5 days after injection and by day 19 affected 95% of tubule profiles in sections. In 95% of tubules only Sertoli cells survived to day 56. Tubules without any surviving cells were present from day 19 and slowly increased in number, a variable proportion becoming mineralised. No regeneration occurred within one year. Leydig cells became more prominent because of the atrophy of seminiferous tubules, but their total mass did not differ significantly from that of control rats, nor did the plasma concentration of testosterone. Changes in tissues other than the tests were transient. The testicular damage seems to have resulted from localised ischaemia caused by tunicamycin-induced vasoconstriction.

c phosphorylation and activation of the IGF-I receptor in src-transformed cells.

Using a panel of src mutants partially defective for malignant transformation, our laboratory has previously identified the insulin-like growth factor (IGF-I) receptor as a protein whose tyrosine phosphorylation correlates with transformation by src in embryonic chick cells (Kozma et al., 1990; Kozma and Weber, 1990). It has not been clear, however, whether src-induced phosphorylation altered the enzymatic or signaling properties of the IGF-I receptor and thus whether the IGF-I receptor could be a functionally significant target for pp60v-src. To examine the effect of src expression on the activity of the IGF-I receptor, the human IGF-I receptor was expressed in Rat-1 fibroblasts co-expressing the temperature-sensitive v-src mutant, tsLA29. The IGF-I receptor exhibited an elevated level of tyrosine phosphorylation in src transformed cells even in the absence of IGF-I treatment. Increased receptor phosphorylation occurred rapidly when cells expressing a temperature-conditional src mutant were shifted from the restrictive to the permissive temperature. Src-induced phosphorylation of the receptor was correlated with an increase in the in vitro tyrosine kinase activity of the receptor, both toward itself and exogenous substrates. The src-induced increase in receptor activity was shown to be dependent on tyrosine phosphorylation, as treatment with a tyrosine-specific phosphatase lowered receptor activity. A kinase-defective mutant of the IGF-I receptor also became constitutively phosphorylated in src-transformed cells, ruling out a possible autocrine mechanism for this phosphorylation. Collectively these data indicate that pp60v-src induces ligand-independent phosphorylation and activation of the IGF-I receptor by an intracellular mechanism, consistent with the possibility that receptor phosphorylation could contribute to the genesis of the transformed phenotype.

Prevalence of hypertrophic cardiomyopathy in an outpatient population referred for echocardiographic study.

Although hypertrophic cardiomyopathy (HC) is believed to be a relatively uncommon cardiac disease, the frequency with which it occurs in the general or cardiac population has not been defined. To address this issue, the patient population of a community-based echocardiography laboratory was used to assess the prevalence of HC in 714 consecutively studied outpatients with (or suspected of having) heart disease. The most common cardiac disease identified was mitral valve prolapse (73 patients [10%]), and HC was present in 4 patients (0.5%). Ages were 50 to 69 years. Maximal left ventricular wall thicknessess were 15 to 22 mm (mean 19); only 1 had evidence of obstruction to left ventricular outflow by virtue of marked mitral valve systolic anterior motion. Before echocardiographic study, each of the 4 patients with HC had signs or symptoms of cardiac disease, but the correct diagnosis had not been suspected. Of 11 other patients who were referred for echocardiographic study because of a clinical suspicion of HC, none proved to have this disease. The present study demonstrates that HC is a particularly uncommon disease entity occurring in about 0.5% of an unselected outpatient population referred for echocardiographic study.

Toxic pyrolysis products of solvents, paints, and polymer films.

The organic chemicals used for solvents, paint, and polymer films are resistant to heat, but if the temperature is raised sufficiently, all will pyrolyze or degrade thermally to form new, lower-molecular-weight chemical species. The solvents include nonhalogenated and halogenated varieties, and their possible occupational exposures and reaction products are described. Paint and paint-like coatings, when pyrolyzed, always produce smoke, but toxic metals included as pigment may produce hazardous fumes. The condition "meat wrapper's asthma" is described to illustrate the effects once believed due to PVC pyrolysis.

Comparison of full- and half-dose gadolinium-DTPA: MR imaging of the normal sella.

PURPOSE: This study compares sellar intensities in 17 patients without sellar pathology using half (0.05 mmol/kg, nine patients) and full-dose (0.1 mmol/kg, eight patients) gadopentetate dimeglumine (Gd-DTPA). METHODS: Sellar MR studies of eight patients who received full and nine patients who received half-dose Gd-DTPA were compared, retrospectively. Sequences included pre-, immediate, and delayed postcontrast T1-weighted coronal images (1.5 T). Intensity measurements were obtained by two observers using a uniform region of interest. RESULTS: Comparison of normalized intensities revealed no significant difference between intensities obtained from immediate half- and full-dose techniques for any of the tissues examined (Student's t test, P < .90). Delayed scans likewise demonstrated no significant intensity differences between full- and half-dose studies. CONCLUSION: Our findings suggest that a 50% reduction in dosage of Gd-DTPA for sellar MR at 1.5 T results in no significant diminution in intensity of enhancement of the pituitary gland or adjacent tissues.