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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five patients with a Chiari I-syringomyelia complex of adult onset were evaluated by magnetic resonance (MR) imaging. All patients underwent suboccipital craniotomy with upper cervical (C-1 and part of C-2) laminectomy, arachnoid retraction, and duraplasty. Postoperative MR studies of four patients disclosed collapse of the syringomyelic cavity, even when the cavity extended into the thoracic region. This appeared to be a progressive process taking place over several weeks. Operative complications are noted and physiological implications are discussed.
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PMID:Chiari I malformation with syringomyelia. Evaluation of surgical therapy by magnetic resonance imaging. 335 31

19-Hydroxy[1 alpha-3H]androstenedione was synthesized and its specific activity was accurately determined. Upon aromatization of the above material by placental microsomal aromatase preparation, a process involving 1 beta hydrogen elimination, only 7.4% of the isotope was lost establishing the alpha orientation of the 3H at C-1 in the substrate. The 19-hydroxy[1 alpha]3H]androstenedione was used as the starting material in the synthesis of 2 beta-hydroxy-19-oxo[1 alpha-3H]androstenedione which therefore had the same specific activity and isotope orientation as its precursor. The nonenzymatic collapse of 2 beta-hydroxy-19-oxo[1 alpha-3H]androstenedione in pH 7.1 buffer to estrone was associated with the elimination of only 2.6% of the isotope indicating that this process proceeds also with stereospecific 1 beta hydrogen elimination. The stereochemistry of hydrogen loss in the nonenzymatic aromatization of the 2 beta-hydroxy-19-oxo derivative is therefore beta and identical with that of estrogen biosynthesis. This provides further evidence in support of the hypothesis that the final enzymatic hydroxylation of the aromatization sequence takes place at position 2 beta of the androgen substrate and that its product, the 2 beta-hydroxy-19-aldehyde, is the proximate precursor of estrogen with the final conversion occurring nonenzymatically.
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PMID:Mechanism of estrogen biosynthesis. Stereochemistry of C-1 hydrogen elimination in the aromatization of 2 beta-hydroxy-19-oxoandrostenedione. 701 54

The uncommon traumatic cervical spine fractures and dislocations were studied in 227 consecutively treated children (1 to 17 years of age). Lower cervical spine injuries (C-3 to C-7) affected 73% of our patients. However, among the 38 patients younger than 8 years of age, 87% had an injury at the C-3 level or higher (P < .0001). There were 19 fatalities (8.4%), all of which were associated with injuries at the C-4 level or higher. Of the 11 patients with atlanto-axial fracture or dislocation, all died soon after the injury. All had an unstable fracture and cord transection that resulted in cardiorespiratory collapse. Injuries at the vertebral levels C-1, C-2, C-3, and C-4 were associated with fatality rates of 17%, 9%, 4.3%, and 3.7%, respectively. No fatalities were encountered among patients with lesions lower than C-4. The authors conclude that the younger the age, the higher the cervical spine injury, and that the fatality rate correlates directly with the level of cervical spine fracture.
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PMID:Predictive factors of the outcome of traumatic cervical spine fracture in children. 784 8

The objective of this study was to evaluate manometric temperature measurement as a non-invasive method of monitoring product temperature during the primary drying phase of lyophilization. This method is based on analysis of the transient response of the chamber pressure when the flow of water vapor from the chamber to the condenser is momentarily interrupted. Manometric temperature measurements (MTM) were compared to product temperature data measured by thermocouples during the lyophilization of water, mannitol, lactose and potassium chloride solutions. The transient pressure response was mathematically modeled by assuming that four mechanisms contribute to the pressure rise: 1) direct sublimation of ice through the dried product layer at a constant temperature, 2) an increase in the temperature at the sublimation interface due to equilibration of the temperature gradient across the frozen layer, 3) an increase in the ice temperature due to continued heating of the frozen matrix during the measurement, and 4) leaks in the chamber. Experimental transient pressure response data were fitted to an equation consisting of the sum of these terms containing three variables corresponding to the vapor pressure of ice, product resistance to vapor flow, and the vial heat transfer coefficient. Excellent fit between the mathematical model and the experimental data was observed, and the value of the variables was calculated from the measured transient pressure response by a least squares method. The product temperature measured by MTM, which measures the temperature at the sublimation interface, was compared with product temperature measured by thermocouples placed in the bottom center of the vials. Manometrically measured temperatures were consistently lower than the thermocouple measurements by about 2 degrees C, this difference being largely accounted for by the temperature gradient across the frozen layer. The resistance of the dried product to mass transfer calculated from MTM was found to agree reasonably well with values measured by a direct vial technique. Product resistance was observed to increase with increasing solute concentration, and to increase continuously as the depth of the dried product layer increases for mannitol and potassium chloride. For lactose, product resistance increases continuously with thickness up to the onset of collapse, at which point the product resistance becomes essentially independent of depth. Scanning electron microscopy was used to explain this observation based on changes in morphology of the solid. The vial heat transfer coefficients obtained from regression analysis were on the order of 10(-3)-10(-4) cal.sec-1. degrees C-1; however, the scatter in the vial heat transfer coefficient data prevents the method from being used for accurate measurement of the vial heat transfer coefficient. The results of the study show that the manometric method shows promise as a process development tool and as an alternative method of in-process product temperature measurement during primary drying.
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PMID:Evaluation of manometric temperature measurement as a method of monitoring product temperature during lyophilization. 909 59

Taiwan suffered a severe and widespread outbreak of enterovirus infection in 1998. More than 400 children were hospitalized, with seventy-eight fatalities due to central nerve system (CNS) involvement and cardiopulmonary collapse. Enterovirus 71 (EV71) was incriminated as the causative agent for the fatal cases. To understand the viral molecular epidemiology in this outbreak, fragments of 207-bp length of the VP4 region in 23 Taiwanese EV 71 isolates were sequenced. Pair-wise comparison revealed a 17.5-24.4% difference between the isolates and the prototype BrCr. However, all the changes in the VP4 region of the isolated strains were synonymous substitutions. Phylogenetic analysis was performed on these 23 isolates and 21 others deposited in GenBank. In this study, forty-four EV71 isolates from the world were separated into three distinct genotypes: A, B and C. The EV71 prototype strain, BrCr/70, is the only strain of genotype A. Group B included strains from the United States, Japan and Taiwan. Most strains in genotype B were isolated prior to 1990. Group C consisted of strains from Japan and Taiwan. Most strains of genotype C were isolated after 1990, they were further divided into 3 clusters: i.e. C-1, C-2 and C-3. In Taiwan, two genotypes, B and C-3, were co-circulating during the outbreak in 1998, although a minor group of genotype B may have appeared in Taiwan before 1986. The majority of the isolates clustered in genotype C-3. Genotype C showed a higher evolutionary rate than genotype B (3.9 x 10(-3) vs. 1.4 x 10(-3)) in the VP4 region. There seems to be a worldwide trend with strains of genotype B appearing earlier than strains of genotype C which took over later in the dominance.
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PMID:Molecular epidemiology of enterovirus 71 in Taiwan. 1133 92

We reviewed the results of 35 operations performed on 29 patients with osteonecrosis of the femoral head in which a pedicle iliac bone was utilized. The average age was 35 years (17-62). There were 28 patients of stage 2 and 7 of stage 3; there were 17 type C-1 hips and 18 type C-2 hips. The pedicle bone was inserted in the anterolateral direction of the femoral head. The average follow-up period was 8 years and 7 months. Collapse of the femoral head occurred in 19 hip joints. Although 16 of 28 stage 2 hips showed collapse, all 7 stage 3 hips resulted in collapse. Thirteen of 17 hips did not show collapse in patients with type C-1 necrosis, whereas 15 of 18 hips developed collapse in patients with type C-2 necrosis. When the bone graft was inserted in the anterolateral direction of the femoral head, incidence of collapse was reduced. These results indicate that deep circumflex iliac pedicle bone graft may be indicated for stage 2 type C-1 necrosis, and that the penetration of the graft into the anterolateral aspect of the lesion is essential for the procedure to succeed.
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PMID:Predictive factors for vascularized iliac bone graft for nontraumatic osteonecrosis of the femoral head. 1622 72

The authors conducted a biomechancial study to determine whether C-1 ring integrity is important in maintaining normal occiput-C-2 separation, specifically when the anterior arch is transected to provide access to the dens during an odontoidectomy procedure. Six human cadaveric occiput-C3 specimens were loaded under axial compression, and the bilateral horizontal separation of the C-1 lateral masses and the vertical compression of the occiput relative to C-2 were recorded. Specimens were first studied after odontoidectomy without C-1 ring transection, then after C-1 anterior arch transection, and finally after C-1 lamina transection. With applied compressive load corresponding to three times the weight of the head, the C-1 ring spread horizontally 1.57 +/- 0.30 mm more when the anterior arch of C-1 was transected than when left intact, resulting in 0.74 +/- 0.44 mm collapse in the occiput-C-2 vertical separation. After laminar transection, the C-1 ring spread 6.55 +/- 2.29 mm more than when it was intact. The resultant vertical separation was a 3.37 +/- 1.89-mm collapse in the occiput-C-2. All changes in C-1 spreading and the occiput-C-2 collapse were statistically significant (p < 0.05, paired Student's t-tests). The C-1 ring continuity prevents horizontal spreading caused by the wedging of C-1 between the occiput and C-2 and thus prevents cranial settling. Therefore, to prevent the subsequent development of disease related to cranial settling, the authors recommend that the surgeon resect part of C-1 only if necessary during odontoidectomy.
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PMID:Biomechanical analysis of cranial settling after transoral odontoidectomy. 1697 51

The natural compound pancratistatin (PST) is a non-genotoxic inducer of apoptosis in a variety of cancers. It exhibits cancer selectivity as non-cancerous cells are markedly less sensitive to PST. Nonetheless, PST is not readily synthesized and is present in very low quantities in its natural source to be applied clinically. We have previously synthesized and evaluated several synthetic analogues of 7-deoxypancratistatin, and found that JC-TH-acetate-4 (JCTH-4), a C-1 acetoxymethyl analogue, possessed similar apoptosis inducing activity compared to PST. In this study, notoriously chemoresistant osteosarcoma (OS) cells (Saos-2, U-2 OS) were substantially susceptible to JCTH-4-induced apoptosis through mitochondrial targeting; JCTH-4 induced collapse of mitochondrial membrane potential (MMP), increased reactive oxygen species (ROS) production in isolated mitochondria, and caused release of apoptosis inducing factor (AIF) and endonuclease G (EndoG) from isolated mitochondria. Furthermore, JCTH-4 selectively induced autophagy in OS cells. Additionally, we investigated the combinatory effect of JCTH-4 with the natural compound curcumin (CC), a compound found in turmeric spice, previously shown to possess antiproliferative properties. CC alone had no observable effect on Saos-2 and U-2 OS cells. However, when present with JCTH-4, CC was able to enhance the cytotoxicity of JCTH-4 selectively in OS cells. Such cytotoxicity by JCTH-4 alone and in combination with CC was not observed in normal human osteoblasts (HOb) and normal human fetal fibroblasts (NFF). Therefore, this report illustrates a new window in combination therapy, utilizing a novel synthetic analogue of PST with the natural compound CC, for the treatment of OS.
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PMID:Selective cytotoxicity against human osteosarcoma cells by a novel synthetic C-1 analogue of 7-deoxypancratistatin is potentiated by curcumin. 2220 68

Cyclophosphamide (CPA) and ifosfamide (IFO) belong to oxazaphosphorine drugs and for a few decades have been widely used for treatment of solid tumours and haematological malignancies. Both drugs are administered in pharmacologically inactive form and require metabolic activation by cytochrome P-450 (CYP). Metabolic transformations taking place under the action of specific CYP isoenzymes lead to the formation of therapeutically essential metabolites and some toxic compounds affecting quality of therapy. The first stage of these conversions is connected with hydroxylation reactions occurring on the C-4 carbon atom within a ring and C-1 atoms of 2-chloroethyl chains. As a result of C-4 hydroxylation 4-hydroxy derivatives (4-OH-CPA and 4-OH-IFO) are formed and remain in tautomeric equilibrium with aldo compounds which in cancer cells spontaneously release cytotoxic phosphoramide mustards and urotoxic acrolein. At the same time hydroxychloroethyl compounds formed during hydroxylation of side-chains are unstable and collapse with the release of inter alia nephro- and neurotoxic chloroacetaldehyde (CAA). Due to formation of toxic metabolites it is essential to use some preventive agents such as mesna and recently examined agmatine. Since CPA and IFO are widely used anticancer drugs, their efficacy is limited not only by their toxicity but also due to occurring resistance. This resistance seems to be a result of changes of expression and activity of enzymes such as CYP and aldehyde dehydrogenase (ALDH) and increase of intracellular levels of glutathione (GSH) and glutathione S-transferase (GST). At present a few methods of overcoming this resistance are being examined including the use of metabolism modulators, antisense oligonucleotides selectively inhibiting gene expression, and introducing genes of some CYP isoenzymes to a cancer tissue.
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PMID:[Classical oxazaphosphorines--metabolism and therapeutic properties--new implications]. 2437 64