Biomedical subjects
Publications and source records attributed to L Louis.
Pigmented villonodular synovitis is an uncommon proliferative disease of the synovium, which is usually monoarticular, presenting as chronic monoarthritis of the knee. To our knowledge, the case under discussion is only the second report in the English language medical literature of isolated involvement of the proximal tibiofibular joint.
OBJECTIVES: To (a) compare ultrasound (US; including grey scale and colour and power Doppler) and magnetic resonance imaging (MRI; with high resolution and fat saturation sequences) with a clinical yardstick in the evaluation of chronic Achilles tendinopathy, and (b) examine whether either imaging method predicted 12 and 24 month clinical outcome. METHODS: Forty five patients with symptoms in 57 Achilles tendons were diagnosed with tendinopathy by an experienced sports medicine doctor. All patients underwent US examination (12 MHz probe) with colour and power Doppler, and 25 consecutive patients also underwent MRI with high resolution T1 weighted and STIR sequences. RESULTS: US identified abnormal morphology in 37 of the 57 symptomatic tendons (65%) and normal morphology in 19 of 28 asymptomatic tendons (68%). Baseline US findings did not predict 12 month clinical outcome. The addition of colour and power Doppler did not improve the diagnostic performance of US. MRI identified abnormal morphology in 19 of 34 symptomatic tendons (56%) and normal morphology in 15 of 16 asymptomatic tendons (94%). Lesser grades of MR signal abnormality at baseline were associated with better clinical status at 12 month follow up. CONCLUSIONS: US and MRI show only moderate correlation with clinical assessment of chronic Achilles tendinopathy. Graded MRI appearance was associated with clinical outcome but US was not.
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We report a case of adenocarcinoma arising in a cystoplasty, done for tuberculosis, 36 years before. The only sign present was hematuria. The literature is review.
Prostatic intraepithelial neoplasia (PIN) fulfils the majority of requirements for a premalignant change in the human prostate. Forty-eight patients were diagnosed to have high grade PIN on prostatic needle biopsy. During a follow-up period, 23 (47.9%) were found to have adenocarcinoma on subsequent biopsies. We compared the patients age, the digital examination, the transrectal ultrasound appearance (TRUS) and the serum PSA level between those in whom cancer was detected subsequently and those with PIN alone. There was a statistically significant difference in the transrectal ultrasound appearance (TRUS) and the serum PSA level between the two groups (p < 0.001, p < 0.016 respectively). In conclusion, patients with high grade PIN, elevated serum PSA with hypoechoic zone on TRUS should be rebiopsied 3 months after the initial diagnosis. If the results are negative, close follow-up is mandatory.
OBJECTIVE: Nocturnal penile tumescence (NPT) was performed in all patients and was evaluated as normal or abnormal according to standardized general criteria. The results of NPT were then compared to penile duplex ultrasonography parameters peak systolic velocity (normal > 35 cm/sec) and diastolic velocity (normal < 5 cm/sec), and to the flow rate needed to maintain erection (normal < 15 ml/min) with pharmaco-infusion cavernosometry. RESULTS: Of the 50 patients, 26 showed normal NPT where 25 patients (96%) had normal penile systolic velocity, 18 patients (69%) had normal penile diastolic velocity, and 22 patients (85%) showed normal flow to maintain erection. On the other hand, 24 showed abnormal NPT, where 7 patients (29%) had abnormal penile blood flow velocity and 18 patients (75%) showed high flow rate to maintain erection. CONCLUSION: From this study, we can conclude that normal NPT appears to have a good correlation with normal systolic blood velocity and normal cavernosometry. However, this correlation is low when compared with diastolic blood velocity. On the other hand, a low correlation exists between abnormal NPT and abnormal systolic and diastolic blood flow or abnormal cavernosometry. According to this observation, we can presumed that NPT, penile duplex and infusion cavernosometry considering together should be performed in order to achieve a reasonably accurate diagnosis.
The role of the different components of the corpus cavernosum is very important in the physiopathology of erectile dysfunction. The precise function of collagen fibers in erectile physiology is controversial. We measured the different types of collagen (I, III, IV) in the corpus cavernosum of 26 impotent and potent men using cell image analysis and immunohistochemistry. We found differences in the distribution of collagen I, III, IV in each pathological group (arterial, caverno-venous, psychogenic). The augmentation of collagen I and the light diminution in collagen III makes the corpus cavernosum less compliant which translates clinically as an alteration in the filling of the vascular spaces and by dysfunction of the veno-occlusive mechanism. The diminution in collagen IV shows an alteration in the function of endothelial cells. The fact that in the psychogenic group we found also a diminution in collagen IV content, makes us infer that psychogenic impotence could be the first stage of an organic impotence.
The site of synthesis of Hageman factor (HF, Factor XII) has not been previously demonstrated with certainty. We have studied the production and release of HF in the isolated perfused rat liver and have compared rates of synthesis in this system with absolute rates of degradation measured in vivo. Rat livers, perfused for 5 h with a recycling fluid consisting of a perfluorochemical emulsion (Fluosol 43), were used to demonstrate a cumulative increase of HF in the perfusate as measured by a specific and sensitive radioimmunoassay. The rate of increase in the perfusate pool of HF during the final 4 h of perfusion yielded a mean synthetic rate of 3.5 micrograms/h per 100 g body wt, which was approximately 0.2% of the synthetic rate of albumin in the same system. The cumulative appearance of albumin and transferrin was linear after 1 h and calculated rates of synthesis were 2,012 micrograms/h per 100 g and 263 micrograms/h per 100 g body wt, respectively. De novo synthesis of HF was confirmed by demonstrating incorporation of [14C]lysine into specific immunoprecipitates of HF, and by the observations that both specific incorporation of labeled amino acid and net release of immunoassayable HF were inhibited by the administration of cycloheximide. Finally, it was evident that the rates of synthesis observed in the isolated perfused liver agreed closely with absolute rates of degradation of HF measured in vivo with 125I-rat HF (4.0 micrograms/h per 100 g). From these data we conclude that the liver is the principal site of synthesis of HF.
In view of conflicting evidence for a major hepatic role in the synthesis of circulating plasminogen, the precursor of the fibrinolytic enzyme plasmin, we carried out the present study with a sensitive assay in order to measure the accumulation of small quantities of plasminogen in a recycling rat liver perfusion system. We have purified plasminogen from Sprague-Dawley rat plasma and have raised a monospecific antiserum against it in rabbits. Isolated rat liver perfusions were performed with an oxygenated recycling perfusate consisting of a perfluorotributylamine/Pluronic F-68 emulsion (Fluosol 43) free of plasma proteins and blood cells. The system was shown to be capable of synthesizing albumin and transferrin. The cumulative appearance of plasminogen in the perfusate was measured by a sensitive, specific radioimmunoassay. Plasminogen concentration increased progressively during the first 2 hr of perfusion; the observed average net synthesis in five separate experiments was approximately 35 microgram/hr per 100 g of body weight. Exposure of the perfused liver to 18 microM cycloheximide inhibited additional increase in the titer of plasminogen. Evidence for de novo synthesis was provided by the incorporation of 14C-labeled leucine into specific immunoprecipitates of plasminogen and the inhibition of this incorporation by cycloheximide. Analysis of the immunoprecipitates by sodium dodecyl sulfate/polyacrylamide gel electrophoresis revealed a single peak of radioactivity corresponding to Mr of 82,000. These data indicate that the liver is a major site of plasminogen production.
Human neutrophils were labeled with In-111 oxine by incubation at room temperature, and the fate of the oxine and the intracellular location of the In-111 were determined. Neutral (1:3) In-111 oxine complex diffuses rapidly across the cell membrane and then dissociates. Some of the oxine leaves the cell and the In-111 binds intracellularly. After short periods of incubation the label is distributed mostly to four soluble components, a small proportion of which had a distribution similar to that of specific and azurophil granules. After longer incubation periods there was relatively less radioactivity with the soluble components and probably more attached to the particulate material. A small peak of radioactivity also appeared in the region of DNA distribution, but no confirmation could be obtained for the association of the In-111 radioactivity with DNA.
Non-entrapped and liposome-entrapped Clostridium perfringens neuraminidase (0.5-0.6 unit) was injected into rats and its fate as well as its effect on plasma and erythrocyte N-acetylneuraminic acid was investigated. The following observations were made. (1) Although removal of both non-entrapped and liposome-entrapped neuraminidase from the circulation was completed within 5h after injection, their recovery in tissues was distinctly different; 7-10% of the injected non-entrapped enzyme was found in the liver and none in the liver lysosomal fraction or the spleen. In contrast, 20-26% of the liposome-entrapped enzyme was found in the liver of which 60-69% was in the lysosomal fraction. Spleen contained 3.6-5.0% of the enzyme. (2) The presence of the non-entrapped neuraminidase in blood led to the extensive desialylation of plasma and to a decrease in the concentration or total removal from the circulation of some of the plasma glycoproteins. (3) Injection of non-entrapped neuraminidase also led to the partial desialylation of erythrocytes the life span of which was diminished and their uptake by the liver and spleen augmented. (4) Entrapment of neuraminidase in liposomes before its injection prevented the enzyme from acting on its substrate in plasma or on the erythrocyte surface, and values obtained for plasma glycoproteins and erythrocyte survival were similar to those observed in control rats. (5) Entrapment in liposomes of therapeutic hydrolases intended for the degradation of substances stored within the tissue lysosomes of patients with storage diseases could prevent the potentially hazardous enzymic action of hydrolases in blood and at the same time direct the enzymes to the intracellular sites where they are needed.
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