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This report describes a symptomatic case of vena caval perforation caused by a vena cava filter. Functional small bowel obstruction due to vascular compromise was caused by a prong of the filter. [ABSTRACT FROM AUTHOR]

A primary leiomyosarcoma of the superior vena cava was diagnosed with magnetic resonance imaging. MRI demonstrated tumor extension into the right heart and innominate veins and compared favorably with the superior vena cavagram. [ABSTRACT FROM AUTHOR]

Introduction: Sex differences in prenatal growth may contribute to sex-dependent programming effects on postnatal phenotype., Methods: We integrated for the first time phenotypic, histomorphological, clinico-chemical, endocrine and gene expression analyses in a single species, the bovine conceptus at mid-gestation., Results: We demonstrate that by mid-gestation, before the onset of accelerated growth, the female conceptus displays asymmetric lower growth compared to males. Female fetuses were smaller with lower ponderal index and organ weights than males. However, their brain:body weight, brain:liver weight and heart:body weight ratios were higher than in males, indicating brain and heart 'sparing'. The female placenta weighed less and had lower volumes of trophoblast and fetal connective tissue than the male placenta. Female umbilical cord vessel diameters were smaller, and female-specific relationships of body weight and brain:liver weight ratios with cord vessel diameters indicated that the umbilico-placental vascular system creates a growth-limiting environment where blood flow is redistributed to protect brain and heart growth. Clinico-chemical indicators of liver perfusion support this female-specific growth-limiting phenotype, while lower insulin-like growth factor 2 (IGF2) gene expression in brain and heart, and lower circulating IGF2, implicate female-specific modulation of key endocrine mediators by nutrient supply., Conclusion: This mode of female development may increase resilience to environmental perturbations in utero and contribute to sex-bias in programming outcomes including susceptibility to non-communicable diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Estrella, Gatford, Xiang, Javadmanesh, Ghanipoor-Samami, Nattrass, Shuaib, McAllister, Beckman, Thomsen, Clifton, Owens, Roberts, Hiendleder and Kind.)

Evaluation of several versions of phenomenological theory of gas permeability in selective polymeric membranes is presented, along with the appropriate experimental methods for verification of these versions. The main focus is on a description of stationary mass transfer across membranes (films) containing dispersion inclusions of various shapes of one polymer in a matrix of another. Considering heterogeneous media as a membrane material, it was assumed that diffusion and sorption properties of inclusions are different from those of the dispersing medium. The problem of choosing optimal shape of inclusions is evaluated from the point of view of targeted permeability and selectivity of a membrane with respect to gases. To confirm this theoretical approach, the experimental results of the studies of diffusion (permeability) of permanent gases in polymeric membranes of different structures were used. The target gases included noble gases, hydrogen, nitrogen, oxygen, CO2, and methane. The target polymers included glassy polyvinyltrimethylsilane (PVTMS, T(gl)=155-180 °C), rubberlike polydimethylsiloxane (PDMS, T(gl)=-120 °C), and two-phase block-copolymers based on these materials within a wide range of composition, including the region of phase inversion. In addition, available experimental literature data on gas permeation parameters for polyarylat-polysiloxane, polysulfon-polysiloxane, and polycarbonate-polysiloxane block-copolymers are utilized. In order to describe the stationary gas permeability for two-phase systems (from diluted dispersion of one polymer in another to concentrated dispersion and complete phase inversion) the empiric approaches based on modified Maxwell equations are offered. The requirements for two-phase systems with high permeability and selectivity parameters for gas separation are identified. The permeability parameters are predicted for C1-C4 hydrocarbons in block-copolymers based on PDMS dispersion in PVTMS, phase inversion, and PVTMS dispersion in PDMS. Thus, the perspectives of designing heterogeneous membranes based on block-copolymers with predetermined molecular-selective properties are demonstrated., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Parent-of-origin-dependent (epi)genetic factors are important determinants of prenatal development that program adult phenotype. However, data on magnitude and specificity of maternal and paternal genome effects on fetal bone are lacking. We used an outbred bovine model to dissect and quantify effects of parental genomes, fetal sex, and nongenetic maternal effects on the fetal skeleton and analyzed phenotypic and molecular relationships between fetal muscle and bone. Analysis of 51 bone morphometric and weight parameters from 72 fetuses recovered at day 153 gestation (54% term) identified six principal components (PC1-6) that explained 80% of the variation in skeletal parameters. Parental genomes accounted for most of the variation in bone wet weight (PC1, 72.1%), limb ossification (PC2, 99.8%), flat bone size (PC4, 99.7%), and axial skeletal growth (PC5, 96.9%). Limb length showed lesser effects of parental genomes (PC3, 40.8%) and a significant nongenetic maternal effect (gestational weight gain, 29%). Fetal sex affected bone wet weight (PC1, p < 0.0001) and limb length (PC3, p < 0.05). Partitioning of variation explained by parental genomes revealed strong maternal genome effects on bone wet weight (74.1%, p < 0.0001) and axial skeletal growth (93.5%, p < 0.001), whereas paternal genome controlled limb ossification (95.1%, p < 0.0001). Histomorphometric data revealed strong maternal genome effects on growth plate height (98.6%, p < 0.0001) and trabecular thickness (85.5%, p < 0.0001) in distal femur. Parental genome effects on fetal bone were mirrored by maternal genome effects on fetal serum 25-hydroxyvitamin D (96.9%, p < 0.001) and paternal genome effects on alkaline phosphatase (90.0%, p < 0.001) and their correlations with maternally controlled bone wet weight and paternally controlled limb ossification, respectively. Bone wet weight and flat bone size correlated positively with muscle weight (r = 0.84 and 0.77, p < 0.0001) and negatively with muscle H19 expression (r = -0.34 and -0.31, p < 0.01). Because imprinted maternally expressed H19 regulates growth factors by miRNA interference, this suggests muscle-bone interaction via epigenetic factors., (© 2014 American Society for Bone and Mineral Research.)

Laparoscopic marsupialization of lymphocele carries 13% recurrence rate, 6% injury to other organs, 12% omentoplasty, 6% open conversion and 1.8 average hospital days. A novel, simplified technique of intraperitoneal catheter drainage of lymphocele is described. Under ultrasound guidance and using the Seldinger technique, a 13F Hickman catheter was introduced into the lymphocele and connected subcutaneously to a small peritoneal window performed 5 cm apart. During the last 8 years the procedure was performed under local anesthesia in 14 patients on an outpatient basis with success (e.g. resolution of both hydronephrosis and lymphocele). One wound infection required removal of the catheter without recurrence. In another patient laparoscopy showed retraction of the catheter under the peritoneum as cause for lymphocele recurrence. In all cases absence of injury to the GU tract was confirmed by absence of extravasation of indigo carmine given intravenously. Intraperitoneal catheter drainage of post-transplant lymphocele is an effective outpatient procedure. It avoids the drawbacks of general anesthesia required by open and laparoscopic marsupialization procedures and deserves to be evaluated in a multicenter study.

Certain immunological activities, particularly cell-mediated immunity, decline with advancing age. Gaining insight into the underlying mechanism(s) is complicated by the fact that human T-cells comprise several functionally and phenotypically distinct populations and subpopulations. Proliferative studies designed to identify differences between old and young subjects that are based entirely on unfractionated peripheral blood lymphocytes (PBLs) or pan T-cell responses run the risk, therefore, of missing subtle but perhaps crucial changes in a particular T-cell type.

The growth characteristics in vitro of interleukin 2 (IL 2)-dependent human CD4+ alpha beta-T cell receptor-positive helper T cell clones (TCC) were studied in relation to alterations in surface phenotype, cytokine responsiveness, and susceptibility to activation-induced cell death (AICD). TCC derived from peripheral blood T cells had finite lifespans averaging 33 population doublings (PD) with a recorded maximum lifespan of 80 PD (n = 208). First analyses of the TCC were undertaken at ca. 25 PD, at which time all cells of all TCC expressed high intensity CD45RO and low intensity CD45RA, as well as high intensity CD95 (fas) and MHC class II antigens. The expression of these molecules remained elevated throughout the proliferative lifespan of the clones, but for those TCC which were initially CD28+ (the majority), the density of expression of the latter was diminished in most late-passage clones. Concomitant with this, late-passage cells showed reduced responsiveness to CD28-mediated costimulation by CHO transfectants expressing human CD80 compared to early-passage cells. Additionally, the level of expression of IL 2R gamma c and IL 7R chains was commonly reduced, as was the response to IL 2 and IL 7. Despite unchanged levels of fas expression on TCC with time, late-passage cells were more susceptible to AICD than early, passage cells. These observations further document functional and phenotypic alterations in long-term cultured human T helper cells, which may be considered as biomarkers of immunosenescence. This may contribute to an improved understanding of the mechanisms underlying depressed T cell function in old age.

Cytokine mRNA expression was analyzed by reverse transcriptase (RT)/PCR in extensively purified normal peripheral CD4+CD45R T cell subsets. Both CD45RA+ and CD45 RO+ populations produced mRNAs for interleukin (IL)-2, IL-2 receptor (alpha chain), IL-6 receptor and tumour necrosis factor (TNF)-beta within 3-4 h of activation. Whilst IL-3 and RANTES were also expressed in both subsets, CD45RO+ cells were clearly the major producers of these cytokines. In contrast, mRNA transcripts for IL-1 alpha, IL-4, IL-5, IL-6, IL-10, interferon gamma (IFN-gamma) and the T cell receptor for IL-1 were almost exclusively induced in CD45RO+ T cells. A population of CD4+ T cells co-expressing intermediate levels of both CD45RA and CD45RO, namely CD45RA+/CD45RO+, appeared to be the major producers of IL-6. Addition of cycloheximide (CHx) 4 h after T cell activation resulted in substantial superinduction of IL-2 mRNA in the CD4+CD45RO+ population but had little effect on CD4+CD45RA+ cells. Taken together, these results show that normal CD4+CD45R T cell subsets exhibit distinct cytokine mRNA profiles and that these differ from the patterns displayed by Th1 and Th2 type T helper clones. Furthermore, they suggest for the first time that IL-2 mRNA turnover is differentially regulated in CD45R T cell subsets.

This study used a panel of mAb and multiparameter flow cytometry to assess the composition of PBL from healthy aged individuals. The results showed that while total lymphocyte numbers altered only marginally in the aged (> or = 70 years) there were significant changes in the distribution of various sub-populations; for example, there were lower numbers of CD3+ and CD8+ cells, and higher numbers of CD16+ (NK) cells. As a direct result of these changes the numbers of CD2+ cells remained unchanged in the aged compared with young adult controls (18-25 years). The number of CD4+ T cells expressing CD45RO isoform (memory cells) exceeded the number of CD4+CD45RA+ (naive) cells in aged donors, whereas the converse was true for young donors. In addition, associated with this increase in CD45RO+ cells, the aged showed an expanded population of CD45RO+ T cells displaying low surface levels of CD45RO. These data suggest that shifts in the distribution of regulatory T cell subsets may play a role in age-related changes in immune response.

T cell responsiveness to in vitro stimulation is severely diminished in the aged. Recent studies would suggest that this may be due, at least in part, to a reduction in interleukin 2 (IL-2) secretion and high-affinity IL-2 receptor (HA-IL-2R) expression. In this report we confirm and extend these studies to show that the fall in IL-2 production is not due to reduced numbers of IL-2 mRNA producing T cells but rather to a decline in the relative amount of IL-2 mRNA expressed per cell. Although we found an age-related reduction in the number of high-affinity binding sites on phytohaemagglutinin-activated T cell blasts by ligand-binding studies, we did not observe alterations in the number of cells that expressed both chains of the HA-IL-2R by two-colour immunofluorescence using monoclonal antibodies specific for p55 (alpha) chain and p75 (beta) chain. However, we did observe a substantial diminution in the number of activated T cells expressing p55 alone in the aged. Given that IL-2 upregulates p55 expression and is involved in the formation of HA-IL-2R, our results suggest that defective IL-2 expression is the primary lesion in age-related T cell senescence.

A case of silent extraperitoneal rectal perforation secondary to colonoscopic polypectomy is presented. Computed tomography (CT) demonstrated pathways of gas diffusion from the perirectal site to different compartments of the retroperitoneum, to the mediastinum and peritoneum.

The role of accessory cells (AC) in the temporal expression of several key T-cell-activation-associated antigens has been studied in healthy aged subjects. Compared to responses seen in young adults, phytohaemagglutinin (PHA) induced weak proliferation in peripheral blood mononuclear cells from the aged and lower numbers of T cells expressing CD71, CD25, CD38 or HLA-DR. T cell responses to the monoclonal antibody OKT3, however, were normal. Whereas HLA-DR+ T cell numbers could be increased by raising the AC content (up to 50%) in cultures comprising purified T cells and graded numbers of autologous AC, CD25+ T cell numbers remained largely unaltered. Co-stimulation with PHA + phorbol myristate acetate in the absence of AC restored both proliferation and CD25 expression in the aged. These results indicate that T cells from the healthy aged show selective deficiencies in their capacity to respond to mitogenic stimuli and suggest that impaired PHA responsiveness is due, at least in part, to defective AC-derived signals.

In agreement with previous studies, we found that the proliferative response of unfractionated T-cells to phytohaemagglutinin (PHA) was severely impaired in healthy aged individuals (70-85 years). On the other hand, we did not observe significant differences between aged and young adults in T-cell responsiveness to mab OKT3 (anti-CD3). PHA responses in "old" T-cells could be substantially improved, however, by the addition of recombinant interleukin-2 (rIL-2) or KOLT2 (anti-CD28 mab). When individual CD4+ T-cell subpopulations were isolated from young and old donors and stimulated with PHA in the presence of autologous accessory cells, age-related deficiencies were seen in both CD4+CD45RA+ (naive) and CD4+CD45RO+ (memory) cell populations. Further analysis using a panel of coactivators in cultures depleted of accessory cells identified specific abnormalities in the CD2 or alternate pathway of T-cell activation. These were predominantly seen in CD4+ naive T-cells. The capacity of rIL-2, KOLT2, and PMA to restore, at least partially, T-cell responsiveness in the aged suggests a defect(s) in an early signal transduction mechanism.

Intra-aortic counterpulsation balloon pumps (ICBP) used in the setting of cardiogenic shock or high risk cardiac surgery, have been identified on chest films in the inflated state during diastole (1). We report characteristic computed tomography (CT) findings of an inflated ICBP, discuss its radiographically identified complications, and suggest that the presence of this device should be excluded before suspecting other etiologies for intra-aortic gas.

Blunt injury to the abdominal aorta has been previously reported. Due to the severity of the lesion, radiologic studies other than aortography are rarely undertaken prior to emergency surgery. We report a case in which CT initially demonstrated an angiographically and surgically proven rupture of the infrarenal abdominal aorta due to blunt trauma.

We studied T cell activation in the healthy aged (greater than 70 years) by examining lymphocyte proliferative responses to various mitogenic stimuli in accessory cell (AC)-dependent and AC-independent systems. Results show that despite a near normal response to the anti-CD3 monoclonal antibody (mAb) OKT3, peripheral blood mononuclear cells (PBM) from the elderly exhibit a profound reduction in phytohaemagglutinin (PHA)-responsiveness (approximately 30% of young adults). This deficit becomes even more severe at suboptimal doses of PHA. Adding exogenous interleukin-2 (IL-2) or pretreating the AC population with gamma interferon (IFN-gamma) returns the level of proliferation to that seen with young adults. Furthermore, replacing "old" AC with AC from young adults or with U937 (a monocytic cell line) in T cell/AC cell-mixing experiments restores PHA-responsiveness in 70% of cases. On the other hand, AC from the aged fully support PHA responses in T cells from young adults. In AC-depleted cultures, purified T cells from the aged respond normally to the co-mitogenic stimuli, PHA + PMA. Taken together, these results suggest that the age-associated diminution in PHA-responsiveness is due, at least in part, to specific deficiencies in T cell/AC communication.

A thin-walled, posttraumatic false aneurysm of the descending aorta in a 32-year-old man was obvious on chest radiography, computed tomography, and aortography. The wall of the aneurysm was not visualized on a magnetic resonance imaging study. However, a segmental absence of the lateral wall of the descending aorta indicated the level of the abnormality. This finding was not observed on 100 consecutive normal aortas studied with gated magnetic resonance imaging. It was observed in 2 of 50 normal aortas on nongated thoracic magnetic resonance imaging.

Three monoclonal antibodies (mAbs), FMC4, FMC14 and FMC15, which react with invariant sites of major histocompatibility complex (MHC) class II (Ia-like) molecules were studied in various serological assays. Sequential immunodepletion experiments show that all three epitopes are present on the same class II molecules. However, a minor subset may exist which does not express epitope 15. In competitive binding assays, using several different B-lymphoblastoid cell lines (B-LCLs), e.g. BRISTOL-8 8392, B-85, RAJI, 8866, CESS-B and LD-B, FMC4 did not block the binding of FMC14, or FMC15, and vice versa. In contrast, mutual inhibition was observed between FMC14 and FMC15. Furthermore, pairwise combinations of saturating amounts of FMC4 + FMC14 and FMC4 + FMC15 gave additive binding whilst FMC14 + FMC15 did not. These results demonstrate that epitopes 4 and 14/15 are spatially distinct; 14 and 15 on the other hand appear to be spatially related. However, contrary to this partial and reciprocal inhibition was consistently observed between FMC4 and FMC14 on two other LCLs, namely DAUDI and BALM-2. Furthermore, on certain cells, FMC14 and FMC15 show markedly disparate binding. Taken together, these observations indicate that the juxtaposition of certain epitopes on class II antigens can vary according to the cell type. This demonstrates a hitherto unreported heterogeneity of antigenic determinants and of their topographical distribution on the class II molecule.

A 4-year-old girl presenting with vomiting, abdominal pain, and renal failure was found to have gross hepatosplenomegaly, a renal mass, and bilateral pleural effusions. A diagnosis of acute lymphoblastic leukaemia (ALL) was suggested by a peripheral white cell count (WCC) of 119,000 x 10(6)mm3, 57% blasts, 22% lymphocytes, and confirmed by bone marrow examination. Lymphocyte surface marker studies at diagnosis enabled classification as a T-ALL, with a significant proportion of the T cells also bearing receptors for the third component of complement (C3). Seventy-two percent of the peripheral blood mononuclear cells reacted with anti-Ia monoclonal antibody (FMC44), and a smaller proportion (25%) carried receptors for the Fc portion of IgG. The T-classification of this ALL was verified at central nervous system (CNS) relapse and at a subsequent nodal relapse. Double-marker studies on cells from the infiltrated lymph node prepared in suspension confirmed the presence of Ia-positive T cells. The Ia marker is usually a useful discriminant between T and non-T cells in normal and ALL cell populations. The case described here highlights the need for a panel of markers to be used in classification of childhood ALL and supports the suggestion that there is a distinct subtype of Ia-positive T-ALL.

A somatic cell hybrid line which secreted antibody reacting selectively with a proportion of the white cells in human blood was prepared. The hybridoma appeared to be monoclonal, and the antibody secreted stained 67% of the lymphocyte population in blood. It reacted less well with granulocytes and monocytes. The lymphocytes stained comprised 80% of the T cells and 50% of the B cells. The antibody showed no recognizable pattern in its reactivity with cell lines and leukaemic cells, although B cells tended to react less well than T cells, null cells, or myeloid leukaemic cells. The expression of the antigenic determinant is discussed in relation to the classification of leucocytes. This determinant and certain other markers exhibited differential expression on closely related cells, and yet were shared by more distantly related cells.

Left latissimus dorsi muscle cardiomyoplasty is a surgical procedure in which the muscle is mobilized as a pedicled flap, moved into the left pleural and mediastinal cavities, and used for surgical repair and/or mechanical augmentation of a failing left ventricle. Chest radiographs in four patients who had undergone this procedure were evaluated. In all four patients, there was bandlike or diffuse increase in density in the left midhemithorax with loss of the left heart border. These findings, which could be misinterpreted as lung disease, represent the transposed muscle flap. CT showed the exact anatomic position of the flap in relation to the intrathoracic structures. Familiarity with the postoperative radiographic appearance of this type of myoplasty is important to avoid misinterpretation.

The expression of six different membrane markers by cells of the human B lymphocyte lineage has been studied, using monoclonal antibodies. B cells representing various stages of differentiation/maturation have been examined, using normal cells, leukaemia cells, and continuous cell lines. The expression of the six markers has been compared with maturation stages defined by immunoglobulin expression. The HLA/beta 2-microglobulin complex is present throughout the B cell lineage, whilst the Ia (p28,33) marker is present from the earliest stage that can be attributed to the B lineage, but is lost during plasma cell differentiation. A marker detected by monoclonal antibody FMC 1 is present only on mature B lymphocytes, being absent from pre-B cells or plasma cells. FMC 7 detects an antigen found on a relatively mature subpopulation, whereas FMC 8 detects early as well as mature B cells. FMC 3 expression is found on a proportion of cells at any maturation stage, suggesting that expression of this marker is controlled by factors unrelated to maturation.

A coarctation of the thoracic aorta associated with intercostal collateral arterial aneurysms was diagnosed with computed tomography in a mildly hypertensive 59-year-old woman.

Acute acalculous cholecystitis (AAC) is usually seen as a complication of major surgery or trauma. Although this entity is well-known in the surgical literature, little has been written about it in the radiologic literature. A review of patient records from 1975 through 1982 revealed 16 patients with pathologically confirmed AAC on whom at least 1 sonographic study had been performed. Thickening of the gallbladder wall, a subserosal "halo" of edema, pericholecystic abscess, and marked gallbladder distention were consistent findings in AAC. In the proper clinical setting, these otherwise nonspecific findings allow a prompt and accurate diagnosis.