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Blood flow in the appendiceal wall or right lower quadrant mass on color Doppler US scans suggests appendicitis, but absence of flow cannot definitively distinguish a normal from an abnormal appendix.

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Fibronectin (FN), a 420 kDa glycoprotein, consists of two similar subunits linked by a disulphide bond near the C-terminal end. FN is present in soluble and matrix forms in various body fluids and tissues and has been shown to bind to variety of organisms. We characterized the conditions required for 125I-FN binding to Bacille Calmette-Guérin (BCG). The binding was dose-dependent, reached saturation within 3 min, and was essentially irreversible for at least 24 h under optimal binding conditions at pH 6.0. In contrast, the binding was reversible (greater than 90% in 24 h) when the pH was increased to 10.0. Scatchard analysis of the dose-response experiments produced a straight line, suggesting the presence of a single class of FN receptor on BCG. 125I-FN binding was trypsin-sensitive, suggesting that the BCG-binding molecule is a protein. The number of FN receptors was determined to be 8000-15,000 per bacterium. 125I-FN binding was pH dependent, with maximal binding at acidic pH. 125I-FN binding was sensitive to the presence of NaCl, with 0.08 M-NaCl inhibiting binding by 85%. These data demonstrate that soluble FN binds to a trypsin-sensitive cell-surface component of BCG in an essentially irreversible manner.

A female infant with a right-sided aortic arch and ligamentum arteriosum underwent a left pneumonectomy for perinatal interstitial emphysema. Radiographic, bronchoscopic, and surgical evidence of compression of the right bronchial tree by the aorta, ligamentum arteriosum, right pulmonary artery, and thoracic spine subsequently developed. This report documents a rare example of postpneumonectomy syndrome following left lung resection.

The authors review the color Doppler ultrasonographic (US) features of appendicitis and other diseases that can manifest with acute lower abdominal pain. Causes of acute abdominal pain, other than appendicitis, include gynecologic abnormalities (ovarian cyst, ovarian torsion, pelvic inflammatory disease), gastrointestinal abnormalities (infectious enteritis, Crohn disease, mesenteric lymphadenitis, intussusception), and urinary tract diseases. On color Doppler images, inflammatory and infectious processes usually show locally increased blood flow, whereas cysts and twisted masses have absent blood flow. Enlarged lymph nodes also are avascular. Color Doppler US is a useful adjunct to gray-scale US in evaluating acute lower abdominal pain in children and can aid in defining and clarifying gray-scale abnormalities.