Collagenous colitis: Clinical and histological spectrum in ten patients

Collagenous colitis is characterized by the presence of a thick subepithelial collagen band in the colonic mucosa. The condition was diagnosed on rectal biopsy in 10 patients (one male, nine females) who presented with watery diarrhoea. Although rectal mucosal erythema was present in three and ulceration in two, the mucosa was of normal endoscopic appearance in five of the patients. There was marked variability in the thickness of the submucosal collagen band, both between and within individuals. Empirical drug therapy included sulphasalazine, glucocorticoids and antidiarrhoeals. All patients reported symptomatic improvement.     

Alternative graphical representations of genotypes in a pedigree

Three representations of the conditional independences due toMendelian segregation of genes in a pedigree are proposed. Thecomputational costs of performing calculations using the techniqueof peeling with each of these representations is compared byconsidering the weights of triangulations of the graph producedby each representation.     

Long-term result of guided nerve regeneration with an inert microporous polytetrafluoroethylene conduit

Thedevelopmentinmicrosurgicaltechniqueshasgreatlyimprovednervefunctionalrecovery .However ,owingtotheinabilitytocoaptateandsuturethousandsofnervefiberstotheirfunctionallysimilarnervefibersandinaccuratesutureofthenervestumps ,regeneratednervefiberspartiallylosethechancetoselectivelyregrowintotheirtargetendoneurialtubes,1 4whichresultsinaninevitablemismatchofmotorandsensorynervefibers .Thus,thecontact guidance basedmicrosurgicalnerverepairhasfailedtoachieveconsistentsatisfactoryfunctionalrecover…     

Studies of neurotrophin biology in the developing trigeminal system

The accessibility of the primary sensory neurons of the trigeminal system at stages throughout their development in avian and mammalian embryos and the ease with which these neurons can be studied in vivo has facilitated investigation of several fundamental aspects of neurotrophin biology. Studies of the timing and sequence of action of neurotrophins and the expression of neurotrophins and their receptors in this well characterised neuronal system have led to a detailed understanding of the functions of neurotrophins in neuronal development. The concepts of neurotrophin independent survival, neurotrophin switching and neurotrophin cooperativity have largely arisen from work on the trigeminal system. Moreover, in vitro studies of trigeminal neurons provided some of the first evidence that the neurotrophin requirements of sensory neurons are related to sensory modality. The developing trigeminal system has been studied most extensively in mice and chickens, each of which has particular advantages for understanding different aspects of neurotrophin biology. In this review, I will outline these advantages and describe some of the main findings that have arisen from this work.     

Neurite outgrowth-regulating properties of GABA and the effect of serum on mouse spinal cord neurons in culture

Time-lapse photography was used to examine the effects of γ-aminobutyric acid (GABA) on the outgrowth and motility of neurites in cultures from mouse spinal cord. GABA at concentrations of 100, 10 and 1 μ m caused significant inhibition of neurite outgrowth and the motility of growth cones was significantly reduced by treatment with 100 and 10 μ m GABA. This effect was mimicked by the GABA_B receptor agonist baclofen, whereas the GABA_A receptor agonist muscimol had no effect. The effect of GABA on outgrowth and motility seems to be dependent on the type of serum employed. The results reported here were obtained only when heat-inactivated serum was used and not when non heat-inactivated serum was added to the culture medium. They suggest that GABA has a role in the regulation of process outgrowth within the embryonic mouse spinal cord.     

Long-term follow-up after total parathyroidectomy without parathyroid reimplantation in chronic renal failure

Forty-three patients with secondary or autonomous hyperparathyroidismcomplicating chronic renal failure (CRF) underwent total parathyroidectomy(PTX) (follow-up 2–18 years, mean 8.7 years). Five wereon conservative treatment for CRF, 35 on regular dialysis, andonly three had a functioning allograft. At PTX, the most frequentfindings were uncontrollable hypercalcaemia, musculo-skeletalpain, radiographic changes in the phalanges, and raised plasmaparathyroid hormone (PTH) concentration. Pre-operatively, allpatients were loaded with dihydrotachysterol or 1--OH cholecalciferol.Postoperatively, they were maintained on tapering doses of thesame drugs and, briefly, oral calcium supplements. Five glandswere identified and removed in two patients, four in 35 patients,three in three patients and only two in one patient. All hadchanges of hyperplasia and adenoma formation, except for onewith a parathyroid carcinoma. Prompt symptomatic and radiographicimprovement occurred, with normalization of plasma calcium andalkaline phosphatase. Postoperative PTH levels were availablein 33 patients (23 by intact PTH assay): they were persistentlyhigh in 10/33 (2/23 intact); normal in seven (6 intact); lowin 11 (3 intact), and undetectable in four (3 intact). Thus,PTX was incomplete in the majority of patients. Following transplantation,3/20 (3/18 intact) patients still had detectable PTH. Only onepatient developed symptomatic recurrent parathyroid diseaserequiring re-operation, and complications were few. Small dosagesof vitamin D continue to be required, but not calcium supplementation,and no clinical effects of possible adynamic bone have beennoted. At later renal transplantation in 27 patients, an easilytreatable, uncomplicated hypocalcaemia was noted in 33%. Upto 18 years after operation (median 9 years) almost all patientsare well, without clinical or radiographic bone disease. ‘Total’PTX seems preferable to alternative surgical approaches, includingreimplantation of parathyroid tissue, because residual tissueis usually left behind.     

A COMPARATIVE STUDY OF THE SAFETY AND EFFICACY OF DYSPROSIUM-165 HYDROXIDE MACRO-AGGREGATE AND YTTRIUM-90 SILICATE COLLOID IN RADIATION SYNOVECTOMY--A MULTICENTRE DOUBLE BLIND CLINICAL TRIAL

The aim of our study was to compare the safety and efficacyof a new preparation, Dysprosium-165 Hydroxide Macro-aggregate(¹⁶⁵Dy) with Yttrium-90 Silicate (⁹⁰Y) for radiation synovectomyof the knee in patients with RA and OA. A multicentre doubleblind clinical trial with subjects randomized to receive ¹⁶⁵Dyor ⁹⁰Y was undertaken in Sydney, Melbourne and Perth. Seventyknees of 59 patients were studied, using as clinical end pointmeasurements pain in the knee on walking, pain in the knee atrest and stiffness in the knee after rest. Cytogenetic damage,knee retention and extra-articular spread of the radionuclideto regional lymph nodes, liver, urine and blood were evaluated.There was no significant difference in clinical response inthe two treatment groups for either RA or OA. Chromosomal changesoccurred with equal frequency and the knee retention and extra-articularleakage of radiocolloids to regional lymph nodes and liver werecomparable in the two groups. For radiation synovectomy of theknee, ¹⁶⁵Dy is at least as safe and as effective as ⁹⁰Y andhas the advantage of a short half-life (2.334 h) and hence requiresa shorter period of post-injection immobilization and hospitalization. KEY WORDS: Radiation synovectomy, Dysprosium-165, Yttrium-90, Rheumatoid synovitis, Osteoarthritis