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To evaluate the diagnostic role of ultrasound in spontaneous renal allograft rupture we reviewed 18 cases observed in our centre in 10 years. Ultrasound studies were performed immediately before surgery in 15 cases. Renal allograft rupture occurred during the first 3 weeks after transplantation in 17 cases (94%). Clinical findings were consistent with previous reports. The diagnosis was confirmed by surgical exploration in 17 cases, and by necropsy in the remaining one. Nine patients were treated by corsetage and eight by graft nephrectomy, while one patient died before surgery. Acute rejection was present in nine cases, and severe acute tubular necrosis in five; no renal tissue was available for histological study in four patients. On ultrasound examination, perirenal haematoma was the most frequent finding, while subcapsular/intrarenal haematoma or findings suggesting rejection or urinary tract obstruction were less frequently observed. In six cases, disruption of the white linear echoes of the capsule of the graft could be seen; this finding has not been described previously. Ultrasound has a definite role in presurgical evaluation of suspected renal transplant rupture.

To evaluate the diagnostic role of ultrasound in spontaneous renal allograft rupture we reviewed 18 cases observed in our centre in 10 years. Ultrasound studies were performed immediately before surgery in 15 cases. Renal allograft rupture occurred during the first 3 weeks after transplantation in 17 cases (94%). Clinical findings were consistent with previous reports. The diagnosis was confirmed by surgical exploration in 17 cases, and by necropsy in the remaining one. Nine patients were treated by corsetage and eight by graft nephrectomy, while one patient died before surgery. Acute rejection was present in nine cases, and severe acute tubular necrosis in five; no renal tissue was available for histological study in four patients. On ultrasound examination, perirenal haematoma was the most frequent finding, while subcapsular/intrarenal haematoma or findings suggesting rejection or urinary tract obstruction were less frequently observed. In six cases, disruption of the white linear echoes of the capsule of the graft could be seen; this finding has not been described previously. Ultrasound has a definite role in presurgical evaluation of suspected renal transplant rupture.

This paper presents a laboratory exercise for teaching enzyme technology through an approach that integrates concepts of enzymology and molecular biology. This Laboratory Exercise is based on the extraction of trehalase (EC 3.21.28) from a Escherichia coli strain Mph2 (carrying the plasmid pTRE11 that harbors the gene TreA+) and immobilization of the enzyme on chitin. Therefore, the students participate in bacterium cultivation, protein extraction from E.coli periplasmic space, preparation of chitin particles and enzyme immobilization. Trehalase was chosen because it can be easily released by osmotic shock and it is not necessary to purify it from the osmotic shock fluid (OSF) because it is free of any other glycosidase. This lab exercise also teaches how to determine the kinetic parameters (Michaelis constant- Km and maximum velocity- Vm) for free and immobilized enzymes. It is obvious that the determination of kinetic parameters using the Michaelis-Menten model is not a novelty. Nevertheless, an experimental class that includes the comparison of these parameters for free and immobilized enzymes, using the students´ own experimental data, would be extremely useful for teaching the subject. The students can identify and compare these parameters, as well as discuss the differences and similarities among them. This discussion points towards issues such as enzyme conformation and structural rigidity related to changes in kinetic parameters mainly Km. This Laboratory Exercise was designed for graduate students that have a good background in Biochemistry and have joined courses involving either Enzymology or Enzyme Technology.

Three siblings with SBD from consangineous parents are reported. The prenatal diagnosis of a short-limbed form of dwarfism was made by ultrasonography and the final diagnosis in the index case by radiography, demonstrating a short-limbed, platyspondylic dwarf with a snail-like configuration of the ilium and vertebral bodies, flat on AP and round on lateral view. The histological examination showed a generalized, severe disturbance of cartilage formation with marked hypercellularity of proliferating and resting zones, reduction of intercellular matrix, and shortening of the irregular columns of proliferating cartilage. The ultramicroscopic findings were nonspecific. This is the first report of SBD after the original description, bringing the total to 14 cases in 5 families. The correct radiological diagnosis and the differential diagnosis, in particular thanatophoric dysplasia, are essential for genetic counselling and obstetrical guidance of families affected with this autosomal recessive dysplasia.

94 patients diagnosed as having sarcoidosis were studied in Galicia in order to evaluate the frequency of bone manifestations, as well as to analyse the clinical and radiological features. Bone lesions were found in 10 patients (10.6%) with a median age of 47.4 years, the predominant sex being female in this group (70%). The lesions were of two types: a) osteolytic on metacarpal (4 cases), nasal bones (1 case), sacrum (1 case), femur (1 case); b) osteosclerosis on femur and fibula (1 case), acrosclerosis (3 cases), metacarpal (1 case). The first lesions were associated to chronic types of sarcoidosis with skin and lung involvements. The second lesions were associated to a sub-acute type of Löfgren. We highlight the behaviour of both types of bone lesions and comment on the physiopathology of the sclerotic lesions.

The mucous melanoma is a rare affection with has a very poor prognosis by its difficult diagnosis and unsatisfactory treatment. We have three patients with mucous melanoma nasal, which has been studied (clinic evolution, diagnosis and treatment) in our Hospital.

We describe the case of a patient suffering from relapsing abdominal pain and vomiting over 4 years, in whom various radiological and endoscopic examinations remained normal. CT scan and MRI eventually showed a mesenteric mass corresponding to metastasis of an ileal carcinoid; this tumor was diagnosed only at laparotomy as well as his mesenteric and hepatic metastases. The different localization and clinical manifestations of carcinoid tumours as well as the difficulties of radiological diagnosis of tumours of the small bowel are mentioned; the diagnostic value of sonography. CT-scan and MRI in the diagnosis of hepatic metastasis is discussed.

Three siblings with SBD from consangineous parents are reported. The prenatal diagnosis of a short-limbed form of dwarfism was made by ultrasonography and the final diagnosis in the index case by radiography, demonstrating a short-limbed, platyspondylic dwarf with a snail-like configuration of the ilium and vertebral bodies, flat on AP and round on lateral view. The histological examination showed a generalized, severe disturbance of cartilage formation with marked hypercellularity of proliferating and resting zones, reduction of intercellular matrix, and shortening of the irregular columns of proliferating cartilage. The ultramicroscopic findings were nonspecific. This is the first report of SBD after the original description, bringing the total to 14 cases in 5 families. The correct radiological diagnosis and the differential diagnosis, in particular thanatophoric dysplasia, are essential for genetic counselling and obstetrical guidance of families affected with this autosomal recessive dysplasia.

We present ultrasound (US) and computed tomography (CT) findings in 7 patients with periportal and peripancreatic tuberculous adenitis. In US scans, hypoechoic adenopathies were found in 6 patients while in the other one a hypoechoic, poorly marginated mass was seen. CT studies showed hypodense (25-35 HU) enlarged lymph nodes with immediate postcontrast peripheral rim enhancement in 3 patients. An infiltrating inhomogeneous mass was present in other patient and soft tissue density lobulated masses were found in delayed postcontrast scans of 2 patients. The US findings are of no help in distinguishing tuberculosis from other causes of adenitis. The CT appearance has been variable and only the hypodense nodes with peripheral enhancement in postcontrast scans are suggestive of this entity.

The case of a patient with diffuse idiopathic skeletal hyperostosis (DISH) and upper airway oedema, is described. The patient presented with alveolar hypoventilation and obstructive apnoeas during sleep. Intravenous steroids (methylprednisolone, 160 mg.day-1) for 5 days did not reduce the oedema. However, it was rapidly reversed by the use of nasal continuous positive airway pressure (nCPAP). In addition, daytime pulmonary gas exchange was improved and sleep apnoea abolished. This beneficial effect made tracheostomy unnecessary. This case report suggests that CPAP can be a potentially useful therapeutic alternative to tracheostomy in the clinical management of upper airway oedema.

Die Verfasser berichten uber Ultraschall- und CT-Befunde an 7 Patienten mit periportaler und pankreatischer tuberkuloser Adenitis. Bei Ultraschall-Scans zeigten sich echoarme Adenopathien bei 6 Patienten. Der 7. Patient wies eine echoarme, unscharf definierte Masse auf. CT-Untersuchungen zeigten vergroserte Lymphknoten geringer Dichte (25-35 HU) mit unmittelbar nach Kontrastmittelgabe auftretender peripherer Randverstarkung bei 3 Patienten. - Eine infiltrierende inhomogene Masse fand sich bei einem Patienten, lobulare Tumormassen von Weichteildichte bei nach Kontrastmittelgabe verzogerten Scans bei 2 Patienten. Die Ultraschallbefunde liefern keine Unterscheidungsmerkmale bei Tuberkulose und anderen Ursachen von Adenitis. Die CT-Darstellung schwankt in ihrer Aussage; lediglich die dichtearmen Knoten mit peripherer Verstarkung bei Scans nach Kontrastmittelgabe deuten auf Tb. We present ultrasound (US) and computed tomography (CT) findings in 7 patients with periportal and peripancreatic tuberculous adenitis. In US scans, hypoechoic adenopathies were found in 6 patients while in the other one a hypoechoic, poorly marginated mass was seen. CT studies showed hypodense (25-35 HU) enlarged lymph nodes with immediate postcontrast peripheral rim enhancement in 3 patients. An infiltrating inhomogeneous mass was present in other patient and soft tissue density lobulated masses were found in delayed postcontrast scans of 2 patients. The US findings are of no help in distinguishing tuberculosis from other causes of adenitis. The CT appearance has been variable and only the hypodense nodes with peripheral enhancement in postcontrast scans are suggestive of this entity.

Retractile mesenteritis is a rare disorder characterized by either focal or diffuse thickening of the mesentery due to chronic inflammation and fibrosis. Six cases are reported in which stenosis of the colon, an uncommon complication of retractile mesenteritis, was the predominant radiologic finding. Diagnosis was suggested by the tapered, serrated appearance of the stenotic segment on barium enema complemented by the findings on sonography and CT.

The reactions of 6-substituted-2-aminopyridines with bromoacetone and 3-bromo-2-butanone have been investigated. In contrast to bromoacetone which gives a high yield of the imidazo[1,2-a]pyridine, bromobutanone also produces significant amounts of material derived from substitution on the exocyclic nitrogen atom. These adducts, which are not a source of imidazopyridine in the reaction mixture, may be isolated and cyclised under more forcing conditions. The reactions of 2-aminopyridine with 2-chlorocyclohexanone and phenacyl bromide have been re-examined and all the major products identified.