Magnetic resonance imaging of the postoperative hip

Magnetic resonance imaging (MRI) is ideally suited to imaging the patient with painful hip arthroplasty due to its superior soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation. MRI is the most accurate imaging modality in the assessment of periprosthetic osteolysis and wear-induced synovitis, and can also assess regional tendons and neurovascular structures. This article discusses the technical aspects of MRI around metallic implants as well as the appearance of potential complications following hip arthroplasty, including osteolysis, wear-induced synovitis, infection, hemarthrosis, fracture, loosening, component displacement, heterotopic ossification, tendinopathy, and neurovascular impingement. The specific complication of metal hypersensitivity following metal-on-metal prostheses is reviewed.     

IgE- and T-lymphocyte-Dependent Hypersensitivity Responses Induced in Mice by Exposure to Shrimp (Fenneropenaeus chinensis) Proteins

Shellfish allergy is a common cause of food-induced anaphylaxis in the human, and shrimp is one of the most frequently reported causes of allergic reactions. To identify the immunoglobulin E (IgE)-binding proteins of Chinese shrimp (Fenneropenaeus chinensis), the crude extracts were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS–PAGE) and Western blotting. After exposure of shrimp extracts to mice, the levels of shrimp allergen-specific IgE were determined by indirect ELISA. Histological and immunohistochemical staining of intestinal tract were further performed for immunological analysis. IgE-binding components with molecular masses of 40, 37, 28, 22, and 20 kDa at a high frequency are supposed to be major allergens of F. chinensis. In vivo experiments showed that shrimp extracts could lead to allergen-specific IgE reactivity, and increase mast cell degranulation and numbers of T lymphocytes. IgE- and T-lymphocyte-dependent hypersensitivity plays important roles in allergic reactions triggered by F. chinensis allergens.     

The severity of atopic dermatitis and analysis of the food hypersensitivity reactions

Aim of this study is to evaluate the dependence between the occurrence of food hypersensitivity reactions and the severity of atopic dermatitis. The detailed personal history about the food hypersensitivity reactions was recorded and the severity of atopic dermatitis was evaluated with SCORAD index. The statistical evaluation of the dependence between the occurrence of food hypersensitivity reactions and the severity of atopic dermatitis was performed. Two hundred and eighty-five patients were examined – 90 men and 195 women, average age 26.2 (s.d. = 9.5). The significant dependence between the severity of atopic dermatitis and the occurrence of food hypersensitivity reactions was confirmed; 96% of patients with severe form of atopic dermatitis suffer from food reactions. In evaluating the single foods, the significant dependence was found between the severity of atopic dermatitis and the reactions to nuts, apples, and fishes.     

Acute liver failure caused by drug-induced hypersensitivity syndrome associated with hyperferritinemia

Drug-induced hypersensitivity syndrome(DIHS) is a severe reaction usually characterized by fever,rash,and multiorgan failure,occurring 2-6 wk after drug introduction.It is an immune-mediated reaction involving macrophage and T-lymphocyte activation and cytokine release.A 54-year-old woman was diagnosed with rheumatic arthritis and initiated salazosulfapyridine by mouth.About 10 d later,she had a high fever,skin rash and liver dysfunction.She was admitted to hospital and diagnosed with a drug eruption.She wa...     

焦虑大鼠内脏敏感性增高以及行直结肠扩张后血清皮质酮的变化及意义

目的内脏高敏感性是肠易激综合征( 1BS)症状最重要的病理生理机制之一,焦虑可能与内脏高敏的发生密切相关。本研究旨在探讨焦虑对大鼠直结肠敏感性的作用以及血清皮质酮与内脏高敏的关系。方法Wistar大鼠随机分为对照组和焦虑组两组,通过对大鼠行空瓶刺激2周建立以焦虑为主要表现的慢性情绪应激模型。造模期间,观察大鼠的攻击、探究和修饰三种行为,对其进行情绪性行为学分析。造模结束后,以腹部回缩反射(AWR)评分为指标观察大鼠对直结肠气囊扩张(CRD)的反应性,评估内脏敏感性。然后将两组各随机分为扩张组和非扩张组,对扩张组行CRD ,并取血清,对血清皮质酮定量测定。结果空瓶刺激期间,同对照组相比,焦虑组探究、攻击行为明显增多,修饰行为减少(P <0 0 1)。焦虑组在2 0mmHg、40mmHg、60mmHg和80mmHg的扩张压力下的AWR评分均显著高于对照组(P <0 0 1)。焦虑组与对照组相比血清皮质酮水平明显升高(P <0 0 1) ,但各组扩张后皮质酮水平较扩张前仅有轻微升高,无显著差异(P >0 0 5 )。结论焦虑对IBS内脏高敏起一定作用,其发挥作用的机制可能并非单一通过下丘脑_垂体_肾上腺皮质系统(HPA轴)来实现,推测还可能与脑内单胺类神经递质NE浓度的改变有关。     

不同脱敏剂对牙列缺损行固定桥修复牙体预备后牙本质过敏影响的对比

目的：探讨不同脱敏剂对牙列缺损行固定桥修复牙体预备后牙本质过敏的影响。方法选取因牙列缺损就诊且行固定桥修复的患者90例,根据在固定修复牙体预备后采用的不同脱敏剂将患者分为保护膜和 Gluma 脱敏剂组,每组45例患者。比较两组患者治疗后疼痛感、临床疗效和患者满意度。结果治疗后两组的疼痛感均显著降低,而保护膜组患者疼痛感明显的低于 Gluma 脱敏剂组患者;保护膜组疗效显著的患者数以及总有效率均明显的高于 Gluma脱敏剂组患者,且差异具有统计学意义;两组患者的满意度的分布以及总满意度的差异均无统计学差异。结论牙本质保护膜措施应用于牙列缺损行固定桥修复牙体预备后患者改善疼痛和敏感的疗效明显的优于 Gluma 脱敏剂涂抹措施,值得临床推广。     

Basophil activation by mosquito extracts in patients with hypersensitivity to mosquito bites

Hypersensitivity to mosquito bites (HMB) is a cutaneous disorder belonging to the group of Epstein–Barr virus (EBV)‐associated T/natural killer (NK)‐cell lymphoproliferative diseases, and is primarily mediated by EBV‐infected NK cells. It is characterized by intense local skin reactions accompanied by general symptoms after mosquito bites, and infiltration of EBV‐infected NK cells into the bite sites. However, the mechanisms underlying these reactions have not been fully examined. We recently described the activation of circulating basophils by mosquito extracts in vitro in a patient with HMB. To further investigate this finding, we studied four additional patients with HMB. All patients showed typical clinical features of HMB after mosquito bites and they had NK lymphocytosis and high peripheral blood EBV DNA loads. We found evidence of EBV infection in NK cells through in situ hybridization that detected EBV‐encoded small RNA‐1, and flow cytometry showed HLA‐DR expression on almost all NK cells. Basophil activation tests with the extracts of epidemic mosquitoes Culex pipiens pallens and Aedes albopictus showed positive responses to one or both extracts in all samples from patients with HMB, suggesting the presence of mosquito antigen‐specific IgE and its binding to basophils. In particular, the extract of Aedes albopictus was able to activate basophils in all available patient samples. These results indicate that basophils and/or mast cells activated by mosquito bites may be involved in initiation and development of severe skin reactions to mosquito bites in HMB.