AIM:To analyze the clinical and imaging features of the small intestinal lipomas and to evaluate the diagnostic value of multi-slice computed tomography (CT) enterography.METHODS:Fourteen cases (one had two intestinal lesions) of surgically confirmed lipomas of the small intestine were retrospectively analyzed. The location, size, clinical and radiological aspects were discussed.RESULTS:Twelve patients presented with abdominal pain, of whom three complained of paroxysmal colic. Melena or bloody stools was mentioned in five cases. One lesion was detected incidentally during routine physical examination. One lesion was found unexpectedly during the preoperational evaluation for cholecystitis. Examination of the abdomen revealed palpable masses in four cases. Precontrast CT scan showed round or oval well-defined hypo-intense intraluminal masses with the attenuation ranging from -130 HU to -60 HU. On contrast enhancement CT scan, no striking enhancement was seen.CONCLUSION:The small intestinal lipomas are rare and difficult to diagnose merely based on clinical manifestations, while the characteristic features at small intestinal CT enterography can help establish reliable prospective diagnoses.

Objectives -To evaluate the impact of mild to moderate commissural calcification on the immediate outcomes of percutaneous balloon mitral valvuloplasty (PBMV).Methods and results -We analysed the results of 223 consecutive patients (mean age 37.6 +/- 8.7 years) who underwent PBMV for rheumatic mitral stenosis. Commissural calcification was identified with a two-dimensional echocardiography (echo) in 65 (29.1%) patients with the severity of calcification being graded from 0-3.The anatomy and function of the mitral valve were assessed by Wilkins echo score. In patients with no commissural calcification the increase in mitral valve area after PBMV was 0.90 +/- 0.42 cm(2), which was greater than the increase in those with calcification grade 1 (0.83 +/- 0.42 cm2, p<0.05),grade 2 (0.72 +/- 0.38 cm(2), p<0.05) and grade 3 (0.63 +/- 0.13 cm(2), p<0.05). In patients with an echo score of less than or equal to8, the presence of commissural calcification was associated with a smaller increase in mitral valve area (p <0.05) and a smaller reduction in New York Heart Association (NYHA) function class after PBMV (p<0.05). In patients with an echo score of more than 8, commissural calcification had no significant effect on the valve area increase and NYHA function class reduction (p>0.05).Conclusions - Commissural calcification has an adverse effect on the clinical results of PBMV. Detailed pre-procedural assessment of commissural calcification with echocardiography must be performed to provide background information on the immediate outcomes of PBMV.

A cDNA library from plasma membrane glucocorticoid receptor-enriched (mGR++) S- 49 mouse T lymphoma cells was screened with full-length rat intracellular GR (iGR) cDNA, BUGR-2 antibody, and PCR amplimers to portions of the mouse GR cDNA. One or two single-base substitutions resulting in amino acid changes (which do not incapacitate the receptor) were found in all but one clone: Val437 → Gly (located in the first zinc finger), and Glu546 → Gly (in the steroid-binding domain). Two previously unidentified exon 1 variants (1D and 1E), and two of three previously reported variants (1A, 1B) were found to be spliced onto the common exon 2. Exon 1D- and 1E-containing transcripts were confirmed by direct sequencing of amplimers from reverse transcriptase-coupled PCR. RNase protection studies revealed that one of these transcripts was expressed in mGR++ cells only, but not in two mGR-less (mGR−− S-49, and AtT-20 mouse pituitary) cell lines. These studies suggest that at least four promoters may be responsible for the control of GR (iGR and mGR) types in mouse lymphoma cells. J. Cell. Biochem. 74:418–429, 1999. © 1999 Wiley-Liss, Inc.

Using the combination of a cDNA library prepared from membrane glucocorticoid (mGR)-enriched S-49 cells and a mouse leukocyte genomic library, we have cloned a 7.3 kb full-length glucocorticoid receptor 1A cDNA. Primer extension, 5'RACE, and long distance PCR identified the transcription start site as being located at 1026 bp from the ATC codon. The first 1,013 nucleotides (nts) of the full length sequence constitute 5' UTR sequence(exon 1), the next 2349 bp, the coding region, and the last 3,907 bp, the 3'UTR. The entire 5'UTR sequence is unique to transcript 1A. The 3'UTR sequence is similar to 88.5 % conserved with the rat 3'UTR. Western blot analysis compared the molecular weight of in vitro translation products from the cloned 1A cDNA with partially purified cellular mGR. Both preparations contained the novel 150 KD and the 94 KD classical CR peptides, suggesting that transcript 1A encodes both receptor forms. Transfection of mGR-less and glucocorticoid lysis-resistant AtT-20 and HL-60 cells with full-length GR 1A cDNA imparted both mGR expression and glucocorticoid lysis-sensitivity to these cells. (C) 1999 Wiley-Liss, Inc.