Deep cutting injury from the edges of a snowboard.

A laceration deep enough to reach the bone occurs very rarely in skiing or snowboarding. Two such cases are presented here. In one case, the popliteal fossa of a skier was cut during a collision with a snowboarder. All structures posterior to the knee were severed and the leg became ischaemic. The other case was of a snowboarder who sustained a deep cut to the distal forearm during landing after a jump, resulting in a "spaghetti wrist".

The role of leptin during the development of mouse preimplantation embryos.

Leptin is known to regulate diverse reproductive functions, and recent studies have implicated involvement of leptin in the early mouse embryo development. The aim of the present study was to investigate the expression of leptin and its functional receptor (OB-Rb) in mouse oocyte and preimplantation embryo, and to examine whether leptin influenced the early embryo development. Leptin mRNA was detected in blastocyst and hatched blastocyst, and OB-Rb mRNA was detected in oocytes, 1-cell, 2-cell, morula, blastocyst and hatched blastocyst. As for the origin of leptin, leptin mRNA was identified in both the oviduct and uterus of the pregnant mouse. Furthermore, in the pregnant mouse, the levels of leptin in uterine fluid were higher than those in the non-pregnant mouse. Supplementation of culture medium with leptin promotes the development of preimplantation embryos from 2-cell stage to the blastocysts, fully expanded blastocysts and hatched blastocysts. Leptin significantly increased the total cell number of blastocysts, and the effect was preferentially observed in the trophectoderm. These findings raise the possibility that leptin regulates the development of mouse preimplantation embryo through a paracrine pathway.

Expression of LDL receptor and uptake of LDL in mouse preimplantation embryos.

OBJECTIVES: The aim of this study is to address the role of low-density lipoprotein (LDL) on mouse preimplantation embryos. METHODS: The temporal expression of low-density lipoprotein receptor (LDLR) and side-chain cleavage cytochrome P450 (P450scc) mRNAs in mouse oocytes and preimplantation embryos up to the hatched blastocyst stage were analyzed by RT-PCR and nested PCR techniques. Simultaneously, the expression of LDLR in the protein level was analyzed by fluorescent immunohistochemistory at oocyte, 4-cell embryo and blastocyst. Uptake of LDL was analyzed using the LDL labeled with the fluorescent probe DiO. RESULTS: LDLR mRNA was detected at oocyte, 8-cell, morula, blastocyst and hatched blastocyst stages. P450scc mRNA was detected at oocyte, 1-cell, 2-cell, 4-cell, blastocyst and hatched blastocyst stages. LDLR protein was detected in blastocyst. P450scc protein was detected in oocyte, 4-cell, and blastocyst. LDL-DiO was taken into embryo at blastocyst stage and this uptake was competitively suppressed by excess unlabeled LDL. CONCLUSIONS: It is suggested from the present study that LDLR may play an essential role in uptake of exogenous LDL into blastocyst stage and cholesterol derived from LDL may be the source of steroid hormone synthesis.

Large-scale manufacturing of all four 2'-deoxynucleosides via novel strategies including a chemo-enzymatic process.

A chemical synthesis of 2-deoxyribose-1-phosphate 2 and its enzymatic conversion into purine 2'-deoxynucleosides (dNus) are shown. Besides the chemo-enzymatic process for purine dNus, a modified process for practical dC preparation is also established. Consequently, a series of practical manufacturing processes of all four dNus have been realized via novel strategies.

Role of vascular reflex in nasal mucosal swelling in nasal allergy.

OBJECTIVE: In patients with nasal allergy, antigen challenge on the unilateral nasal mucosa results in nasal secretion not only in the ipsilateral but also in the contralateral nasal cavities that can be inhibited almost completely by premedication with atropine sulfate. The present study was performed to elucidate if centrally mediated vascular reflex induced by antigen challenge plays a role in nasal mucosal swelling in subjects with nasal allergy. METHODS: Variations of mucosal swelling and mucosal blood flow in the ipsilateral and the contralateral nasal cavities after unilateral antigen challenge were evaluated by acoustic rhinometry and laser Doppler flowmetry in 20 patients with perennial nasal allergy. RESULTS: Unilateral antigen challenge caused ipsilateral and contralateral nasal mucosal swelling in 17 and 13 patients, respectively. Incidence of contralateral nasal mucosal swelling after unilateral antigen challenge was significantly higher compared with that after control disc challenge (P < .001). In 10 patients in whom unilateral antigen challenge caused bilateral nasal mucosal swelling, significant swelling of the nasal mucosa lasted for more than 30 minutes in the ipsilateral nasal cavity after antigen challenge compared with only 15 minutes in the contralateral nasal cavity. Peak values of contralateral mucosal swelling were 45.3% of those of ipsilateral nasal mucosa. CONCLUSIONS: Centrally mediated vascular reflex is partially involved in the onset of nasal mucosal swelling observed after antigen challenge in subjects with nasal allergy. However, nasal mucosal swelling that persists and proceeds even 20 minutes after antigen challenge is caused by the direct effects of chemical mediators on the nasal vasculature.

Effect of cooling condition on leucite crystals in dental porcelains.

X-ray diffractometry (XRD) was used to analyze the crystal phases of three commercial dentin and incisal porcelains prepared by normal cooling, quenching in water, and controlled slow annealing after normal firing. There were no remarkable differences in the contents of either tetragonal and cubic leucite in the fired porcelain discs prepared under the three cooling conditions. Furthermore, there were no significant differences in the parameters of the a-axis and c-axis of tetragonal leucite, and the a-axis of cubic leucite among them. These results suggest that the cooling condition has little effect on the microstructural changes of leucite crystals in the dental porcelains, since the leucite crystals were formed at a higher temperature range than the firing- and cooling-temperature range and were stabilized by incorporation of additives into the lattice.

The effect of ramatroban (BAY u 3405), a thromboxane A2 receptor antagonist, on nasal cavity volume and minimum cross-sectional area and nasal mucosal hemodynamics after nasal mucosal allergen challenge in patients with perennial allergic rhinitis.

The thromboxane A2 receptor antagonist, ramatroban (BAY u 3405), was orally administered for 4 weeks at a daily dose of 150 mg (b.i.d.) to 10 patients with perennial allergic rhinitis who had a positive reaction to house dust challenge on nasal mucosa. Nasal cavity volume and minimum cross-sectional area were measured, and changes in nasal mucosal swelling were determined following allergen challenge with house dust. The influence on nasal mucosal hemodynamics was also investigated. Nasal cavity volume and minimum cross-sectional area were measured by acoustic rhinometry, and blood flow in the nasal mucosa was measured by laser Doppler flowmetry. Percent changes in values from baseline nasal cavity volume were significantly decreased by allergen challenge before ramatroban administration, but no significant decrease was noted after ramatroban administration. Similarly, percent changes in values from baseline nasal cavity minimum cross-sectional area were significantly decreased by allergen challenge before administration of ramatroban, but not after administration. Percent changes in values from baseline nasal mucosal hemodynamics were significantly increased by allergen challenge both before and after ramatroban administration, which thus had no effect on mucosal hemodynamics. These findings suggest that ramatroban might inhibit the increase in nasal mucosal swelling but has no effect on nasal mucosal hemodynamics.

[Indocyanine green video angiographic findings of frosted branch angitis in a child].

A 10-year-old boy presented with typical fundus findings of frosted branch angitis in both eyes. Fluorescein angiography showed late-phase hyperfluorescence in some active areas of vascular lesions. Indo-cyanine green (ICG) angiography showed similar but less extensive hyperfluorescence along the frosted vessels and in the disc. ICG angiography also showed filling delay in the choriocapillaris. These findings suggest that frosted branch angitis is a manifestation of inflammation in the retina and the choroid. Laboratory studies showed increase in the toxoplasma titer at 1:10,240 and in the serum levels of alpha 1 and alpha 2 globulin. Frosted branch angitis in this case seemed to be the consequence of local allergic reaction, or immune complex deposition, presumably due to toxoplasma infections.

Intraosseous neurilemmoma of the fibula.

We present a case of intraosseous neurilemmoma of the fibula in a 56-year-old woman. The case showed the typical radiographic appearance except for the presence of spotted calcifications that mimicked a cartilaginous tumor. Enhanced MR images revealed the heterogeneity of the tumor, which consisted of Antoni type A and B tissue.

MR findings indicative of hemosiderin in giant-cell tumor of bone: frequency, cause, and diagnostic significance.

OBJECTIVE: We studied the frequency, cause, and diagnostic significance of MR findings indicative of large amounts of hemosiderin in giant-cell tumor of bone. MATERIALS AND METHODS: The clinical, MR, and histologic findings in 16 patients with giant-cell tumors of bone were reviewed. Eight tumors occurred in uncommon locations or in patients who were not in the usual age range; the other eight were more typical. Areas of decreased MR signal intensity considered to be caused by hemosiderin were identified. The number and distribution of RBCs within the tumor were studied histologically, and the presence of hemosiderin was determined on histologic sections made with iron stains. RESULTS: In 10 cases in which MR images showed areas of low signal intensity, large amounts of hemosiderin were noted histologically. The low-signal-intensity areas were nodular, zonal, whorled, or diffuse and occupied at least one fifth of the tumor volume. On histologic examination, many erythrocytes were in direct contact with the tumor cells, and the hemosiderin was seen in both mononuclear and multinuclear tumor cells. CONCLUSION: Hemosiderin is commonly seen on MR images of giant-cell tumors of bone (63%) and is probably related to the extravasated erythrocytes in the tumor and the phagocytic function of the tumor cells. This MR finding supports the diagnosis, even in giant-cell tumors in uncommon locations or in patients who are not in the typical age range.

Long-term results of congenital dislocation of the hip treated with the Pavlik harness.

We present the radiographic and clinical results of 158 hips (127 congenital dislocations of the hip, 31 acetabular dysplasias) that were followed-up for > 20 years after the application of the Pavlik harness. The mean Sharp angle of these hips was larger than that of the normal Japanese hip, and the mean center-edge angle was smaller. Thirty hips (19%) were classified as class III, according to Severin's classification. Of 48 unaffected hips in the unilateral cases, 15 hips (31%) had steep acetabula. We believe an intrinsic factor disturbs the normal development of acetabular cartilage in both hips of the patients. Thirty-five hips (22.2%) showed variable grades of deformity of the femoral head, neck, or both. Clinically, most of the treated hips were good in the 3rd decade.

MR appearance of periosteal chondrosarcoma of the foot.

OBJECTIVE: To assess the role of MRI in evaluating periosteal chondrosarcoma in the foot, an anatomically complicated location. MATERIALS AND METHODS: Three cases of surgically and histologically confirmed periosteal chondrosarcomas occurring in the foot (58-year-old woman, 57-year-old woman, and 63-year-old man) were retrospectively reviewed with an emphasis on MR findings. RESULTS: Magnetic resonance successfully delineated the hypovascular nature and lobulating pattern of the lesion suggesting the cartilaginous component, the periosteal location with sparing bone marrow, and the extent of involvement of adjacent structures. These findings were either not seen or less clearly seen on CT in the former two cases. CONCLUSION: In cases of periosteal chondrosarcomas in the foot MRI can play a significant role both in the characterization of the lesion and in planning surgical therapy.

Congenital multiple cystic dilatation of the intrahepatic biliary ducts (two cases with simple type of Caroli's disease).

Two cases of Caroli's diseases (simple type) precisely diagnosed prior to the operation by the direct cholangiography, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography, were reported. They both had a long cystic duct, and association of cystic lesions of bilateral kidneys was revealed in one of them. Excessive biliary output had been observed postoperatively in both of them. A cholecystectomy and choledochodrainage successfully gave rise to favourable results in both cases reported.