Unusual burn injury due to application of white vinegar and aspirin mixture

Traditional medicine remedies are believed to provide relief from pain; nevertheless, it can be a risky procedure if these remedies are prepared inappropriately. Here, we describe a patient who suffered from a split‐thickness leg burn after applying a self‐inflicted mixture consisting of white vinegar and aspirin prepared for knee pain. This case report highlights a rare cause of a chemical burn that could become more common with increasing use of traditional remedies worldwide.     

Neurocognitive Outcome and White Matter Anisotropy in Childhood Acute Lymphoblastic Leukemia Survivors Treated with Different Protocols

Neurocognitive outcome affects the quality of life of ALL survivors. This study is aimed to assess the prevalence of neurocognitive dysfunction by psychometric and imaging tools in survivors of childhood ALL, treated with 3 different protocols and the effect of time elapsed since the end of chemotherapy. Sixty-two ALL survivors aged 6–18 years and treated in the period 1997–2007 and 60 healthy age and sex matched controls were subjected to neurocognitive testing using Wechsler Intelligence Scale for Children, Benton visual retention (BVRT) and Trail Making test (TMT), followed by diffusion weighed and diffusion tensor MRI for calculation of fraction anisotropy (FA). Survivors underwent revision of protocol and type of CNS therapy. Three different protocols were used: modified BFM 83, BFM 90, and CCG. Survivors treated with modified CCG protocol showed a significant decrease in all cognitive tests compared to control (p<.05); BFM 90 group had a significant lower IQ and longer TMT compared to both control and BFM 83 group and no significant difference was found in results of cognitive tests between BFM 83 and control group. Frontal FA was lower in CCG treated group compared to control, BFM 90 and BFM 83 groups (p<.05); meanwhile it was significantly lower in BFM 90 and BFM 83 groups compared to control group. We concluded that patients treated with modified CCG protocol showed the worst neurocognitive outcome among three assessed protocols. Frontal lobe FA might be an early marker for predicting the neurotoxicity in childhood ALL survivors.     

磁共振弥散张量成像评价新生儿脑损伤

磁共振弥散张量成像技术（diffusion tensor imaging,DTI）是一种无创性的磁共振成像方法,通过计算表观弥散系数、各向异性系数、相对各向异性系数、纵向弥散系数等参数能够定量评价脑组织正常结构、脑发育状况与脑损害,是目前唯一可在活体上观察脑白质纤维走行及微结构变化的成像技术.本文对其在评价新生儿脑损伤与脑发育中的应用进展予以介绍.     

Cortical thickness at the time of the initial attack in two patients with paediatric relapsing–remitting multiple sclerosis

BackgroundMultiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system with a low incidence in the paediatric population; cortical atrophy is often striking, even in the early stages of the disease. Evidence of cortical thinning in childhood MS is scant.AimsThis study aimed to assess cortical thickness in paediatric patients during the initial attack of remitting–relapsing MS.MethodsWe report two cases of remitting–relapsing MS, with initial attacks at 12 and 16 years of age. We analysed brain cortical thickness (CTh) in these patients and compared these data to the CTh of a control group comprised of six 12-year-old females and six 16-year-old males.ResultsBoth cases exhibited a total brain CTh significantly below that of the control group. This difference was also observed when analysing the CTh of all lobes except the left parietal lobe in one of the cases.ConclusionsCortical atrophy is already present at the time of onset of MS. Studies with larger patient populations that have a more homogenous clinical presentation could identify the time of onset of cortical atrophy and use this parameter as a prognostic and/or treatment marker of MS.     

应用弥散张量磁共振成像定量分析正常成人大脑白质纤维各向异性特征

目的定量分析正常成人大脑不同部位白质纤维各向异性所存在的差异.方法测量52名正常志愿者大脑白质纤维不同部位的FA值和ADC值,测量的部位有:外囊、内囊前肢、内囊后肢、胼胝体膝部和胼胝体压部.结果 FA值以胼胝体压部为最高是0.893±0.0645.统计分析大脑白质各部位间FA值的差别均有统计学意义(P＜0.01).结论 FA值可定量分析大脑不同部位的白质纤维的各向异性程度.     

浅谈仲景辛凉解表法

辛凉解表法虽首创于刘完素,完善于温病,但却溯源于仲景,仲景四方大青龙汤、越婢汤、麻杏石甘汤、白虎汤完整的体现了辛凉解表的思想。表热的根本在于卫气的阻滞,解表法最在意使卫气恢复流通,辛温、辛凉解表均不离辛者,以辛味发散或透达,邪气可随之出表,若单着眼于出汗者,已然失其本意。辛热开通气机,本不在发汗,汗液乃是随同郁热的开通一同从腠理而出,不同于西药单纯以发汗带出热量,而郁热并未解除。所以,纵使辛温解表,热如麻黄、桂枝也非为单纯发汗而设,乃取其辛散开通之意,汗液自蒸蒸而协同邪热一并而出。     

Characterisation of enamel white spot lesions using X-ray micro-tomography

OBJECTIVES: The aim of this study was to characterise the mineral density (MD) of natural enamel white spot lesions (WSLs) using X-ray micro-tomography calibrated with different density hydroxyapatite phantoms. METHODS: Seven natural WSLs from four extracted non-carious premolar teeth were scanned at a voxel size of 7.6 microm using a desktop X-ray micro-tomography system. Five hydroxyapatite phantoms (sintered pellets of hydroxyapatite powder) with densities ranging from 1.52 to 3.14 g/cm(3) were used as calibration standards for each scan. Three-dimensional image reconstruction enabled MD gradients throughout the lesion to be quantified using an MD calibration equation derived from hydroxyapatite phantoms. Background noise generated during the measurement of MD was reduced using a Gaussian filter. RESULTS: Gaussian filter reduced the signal-to-noise ratio (standard deviation) significantly while the basic MD information (average value) remained intact. The mineral gradients through the WSLs examined were compared and are discussed in terms of existing literature. The MD of sound enamel, apparent intact surface layer of WSL, and lowest level of WSL was found to be 2.65-2.89 g/cm(3), 2.23-2.58 g/cm(3) and 1.48-2.03 g/cm(3), respectively. Our MD results are comparable with other studies. CONCLUSIONS: X-ray micro-tomography is a sensitive in vitro technique capable of characterising and quantifying MD of small non-cavitated WSLs. This method has a promising potential for future carious and quantitative remineralisation studies.