Vascular Endothelial Growth Factor Expression and Cyclosporine Toxicity in Renal Allograft Rejection

The aim of this study was to evaluate the influence of vascular endothelial growth factor (VEGF) on renal function and on development of interstitial fibrosis (IF) in renal allografts. Tubular and interstitial expressions of VEGF and TNF-α, and density of macrophages in the interstitium were examined in 92 patients with nonrejected kidneys, acute rejection (AR), chronic allograft nephropathy (CAN), borderline changes (BC) and acute cyclosporin A (CsA) toxicity. Follow-up biopsy specimens from patients with AR and BC were evaluated for development of IF. A significant difference in tubular and interstitial VEGF expressions was found between patients with AR, BC, CAN and CsA toxicity (p < 0.001). Macrophage infiltration was positively correlated with VEGF and TNF-α expressions (p < 0.001). VEGF expression increased with increasing expression of TNF-α (p < 0.001). Renal function in first 6 months after initial biopsy was better in patients with marked tubular VEGF expression (p < 0.01); however, in follow-up, development of IF and graft loss was found earlier in these patients (p < 0.01 and p < 0.05, respectively). Increased renal VEGF expression has protective properties immediately following renal allograft but allows for increased risk of early IF, and therefore poor graft outcome in the long term.     

Esthesioneuroblastoma in a young child. Case report

Esthesioneuroblastoma is an uncommon malignant neoplasm that arises from olfactory mucosa, often with intracranial extension.A case report of the youngest victim in the literature (2-year-old boy) is presented.     

RELATIONSHIP OF HLA-DR EXPRESSION WITH REJECTION AND MONONUCLEAR CELL INFILTRATION IN RENAL ALLOGRAFT BIOPSIES

DNA methods have resulted in improved renal allograft survival rates in cadaveric renal transplantation. This paper describes the impact of DNA typing by PCR-SSP on a living-related renal transplant (LRRT) programme. It evaluates error rates in serology, acute rejections, graft function and survival rates between the two typing methods. Serological typing was carried out on CTS 120 antisera Class 1, 60 antisera Class 2, 72 antisera Terasaki Class 1 and 72 antisera Class 2 antigens. Low-resolution PCR-SSP typing was carried out by 24 primers for HLA-A, 48 for HLA-B and 24 for HLA-DR. Of the 585 transplants: 159 (Group I) were serology based; 172 were serology and PCR-SSP based for HLA-DR (Group II); and 254 were serology and PCR-SSP based for HLA-A and -B, and only PCR-SSP based for HLA-DR (Group III). Error rates in serology compared with PCR-SSP were 24% for HLA-A, 16% for HLA-B and 35% for HLA-DR. Acute rejections were 39%, 30% 26% in Groups I, II and III, respectively ( P= 0.02). Graft function of serum creatinine <1.5 mg/dl at 1 year was found in 26% of the Group I patients compared with 48% of those in Group III ( P <0.0001). One- and 3-year graft survival was 93% and 87% for Group II compared with 81% and 69% for Group I, respectively ( P= 0.0001). Matching by this combination of serology and PCR-SSP is not only economical for a developing country but also improves graft survival by 12% and 18% at 1 and 3 years, respectively.     

利培酮与氯丙嗪治疗精神分裂症对照研究

目的　评价利培酮治疗精神分裂症的疗效和副作用。方法　将 5 9例精神分裂症住院病人随机分为利培酮 ( 4 mg/d)1组 ( 1 9例 )、利培酮 ( 6 mg/d) 2组 ( 2 0例 )和氯丙嗪组 ( 2 0例 ) ,治疗 8周。用阳性与阴性症状量表 ( PANSS)评定疗效 ,用副反应量表 ( BPRS)及锥体外系副反应量表 ( TESS)评定副反应。结果　利培酮两个剂量组与氯丙嗪组之间疗效无显著性差异。在认知因子、阴性因子、PANSS总分减分率方面 ,利培酮组与氯丙嗪组有显著性差异。利培酮的副反应有锥体外系反应、失眠、头昏等。结论　利培酮是一种安全有效的抗精神病药物 ,在改善认知功能和阴性症状方面 ,利培酮优于氯丙嗪 ,少数病例可出现锥体外系反应。     

Suicide attempts and risk factors among children and adolescents

The purpose of this study was to determine the prevalence of suicide attempts, and to identify the risk factors for suicide attempts in Turkish children and adolescents between the ages 10 and 20 years. Multi-step, stratified, cluster sampling was used. A stratified sample of 4256 students was selected as representative of the city's school children population. Data was obtained with a pair of structured questionnaires designed to evaluate the presence and risk factors of suicide attempts, both in the children and adolescents and their parents. These questionnaires investigated family environment, subject characteristics, and various risk factors for suicide attempts. Child Beck Depression Inventory (CBDI) was administered to all children and adolescents. After the data quality control process, the study sample was reduced to 4143 children and adolescents. Children and adolescents were divided two groups according to the experience or non-experience of suicide attempts: group 1 (n=80) and group 2 (n=4063), respectively. Three categories of independent variables were assessed: adolescent, family, and socioeconomic characteristics. Logistic regression models were based on the children and adolescents and on parent reports. The prevalence of suicide attempts as reported by the children and adolescents was 1.93% (n=80).The mean age of group 1 was higher than that of group 2 (p=0.002, t=-3.172), as was the mean score of CBDI (p=0.000, t=-9.083). Logistic regression analysis indicated that having problems with parents, using illicit drugs, and psychiatric problems in relatives best predicted suicide attempts in Turkish children and adolescents.     

Temporal trends in correlates of HIV testing uptake in South Africa: evaluation and population-level impacts of socio-economic factors and information sources

Aim

The primary objective of this study was to investigate temporal changes in HIV testing rates and quantify the degree to which these trends can be attributed to certain socio-economic characteristics, as well as exposure to information sources.

Subjects and methods

Data from a nationally representative sample of 30,020 sexually active black Africans who participated in the first, second, third and fourth South African National HIV, Behaviour and Health Surveys conducted in 2002, 2005, 2008 and 2012, respectively. Multivariable logistic regression models and population-attributable risks were calculated for the socio-economic characteristics and the information sources.

Results

The socio-economic characteristics of the survey participants remained stable over time, while HIV testing rates increased substantially from 20% in 2002 to 70% in 2012. However, there was little improvement in condom use rates. Combined impact of education, employment and geographical locations were associated with increased levels of HIV testing rates. Most of the survey participants (> 80%) were exposed to several mass-media and interpersonal information sources. The combined impact of mass-media tools on HIV testing rates ranged between 48 and 60%, while 40–50% of the HIV tests were collectively attributed to the interpersonal information sources.

Conclusion

We observed significant temporal changes in population-level impacts of several key socio-economic characteristics and information sources on HIV testing rates. Widespread nationwide HIV awareness efforts led to significant increases in access to testing facilities and substantial increases in HIV testing rates over time. However, this increase was not mirrored in condom use behaviour.

     

Gardner综合征之软组织肿瘤的追踪观察与研究

目的：分析研究Gardner综合征一家系12例患者的软组织肿瘤的自然演变过程与结肠息肉癌变之间的关系。方法：自1989年3月至1998年10月对一家系12例Gardner综合征患者进行了长期追踪观察，采用人体体表摄影，X线平片照像，消化道气钡双对比造影，纤维结肠镜及手术切除，10年中每年观察1-2次，重点患者2次以上。结果：12例均患有软组织肿瘤。活检证实；硬纤维瘤4例。皮脂腺囊肿2例。脂肪瘤2例。神经纤维瘤2例。混合性肿瘤2例。在结肠息肉癌变的5例患者中软组织肿瘤均有不同程度的变化。表现为突然增大，增多，表面发生溃破等。结论：软组织肿瘤的突然增大增多与结肠息肉癌变有密切关系。     

Placental teratoma: A case report

We present a rare case of a placental teratoma found within the fetal membranes of an otherwise normal placenta. Lack of a recognizable umbilical cord and no recognizable skeletal development are used as differential diagnostic criteria for a placental teratoma. In our case, an umbilical cord was absent; nevertheless, the tumor contained two vascular channels covered only by fetal membranes without Wharton's jelly.