Association Between Diaphragmatic Paralysis and Ipsilateral Cervical Spondylosis on MRI

Lung - Diaphragmatic paralysis (DP) is an important cause of dyspnea with many underlying etiologies; however, frequently no cause is identified despite extensive investigation. We hypothesized...     

Epstein-barr virus in multiple sclerosis

Recent seroepidemiologic and pathologic evidence suggests that prior infection with Epstein-Barr virus (EBV) may be necessary for the development of multiple sclerosis (MS). EBV infects more than 90% of all humans, most of whom remain healthy. In contrast, 99% of MS patients have evidence of prior infection with EBV. EBV infects resting B lymphocytes, immortalizing them into long-lived memory B cells that survive largely undetected by the immune system in the peripheral circulation. MS patients show elevated titers to EBV years before developing any neurologic symptoms. Postmortem pathologic analysis of brains of patients with MS has revealed diffuse EBV-associated B-cell dysregulation in all forms of MS. Theories of pathogenesis of EBV in MS include antigenic mimicry, immortalization of B-cell clones, and cytotoxic T-cell dysfunction against virally infected B cells. This article reviews the existing evidence of the relationship between EBV and MS and considers the therapeutic implication of this evidence.     

Outcomes following liver transplantation for seronegative acute liver failure: experience during a 12-year period with more than 100 patients.

Seronegative hepatitis is a common cause of acute liver failure (ALF) requiring liver transplantation. The primary aim of this study was to examine outcomes following transplantation in this group and to identify factors associated with early (<2 months) mortality. Patients studied were 110 consecutive cases of seronegative ALF transplanted at the Queen Elizabeth Hospital, Birmingham, between January 1992 and January 2004. Univariate analysis of 44 pretransplantation recipient, donor, and operative variables was performed initially to identify factors associated with early posttransplantation mortality. Variables identified as significant or approaching significance were analyzed using stepwise multiple logistic regression analysis. Survival following transplantation for seronegative hepatitis was 83%, 81%, and 73% at 2, 12, and 60 months, respectively. The majority (71%) of deaths occurred within the 1st 2 months and sepsis / multiorgan dysfunction was the most common cause of early death. Univariate analysis revealed 9 variables predicting early death. Subsequent multivariate analysis identified high donor body mass index (BMI; a possible surrogate marker for hepatic steatosis) as the most important predictor of early death (P = .009; odds ratio, 1.2; 95% confidence interval, 1.0-1.3). Recipient age >50 (P = .015; odds ratio, 4.2; 95% confidence interval, 1.3-14.1) and non-Caucasian recipient ethnicity (P = .015; odds ratio, 4.9; 95% confidence interval, 1.2-19.2) were other variables associated with early death on multivariate analysis. This study specifically examined factors that determine the early outcome of transplanted seronegative ALF patients. In conclusion, we found that donor and recipient factors identify patients who have a high chance of early death after transplantation.     

北京城区居民体质指数与慢性病危险因素关系分析

对 1 995～ 1 998年营养与食品安全所老年与临床营养室在北京地区慢性病社区防治研究中积累的1 2 4 6例 2 5～ 74岁居民的部分体检资料进行分析 ,观察不同人群体质指数 (BMI)、腰围 (WC)水平与慢性疾病相关因素 血清总胆固醇 (TC)、高密度脂蛋白胆固醇 (HDL C)、甘油三酯 (TG)、收缩压 (SBP)、舒张压 (DBP)、血糖 (FBG)及与高血压、高脂血症、糖尿病的检出率的关系。结果 :该人群超重及肥胖率男性为 41 7%及1 4 6 % ,女性为 32 0 %及 2 0 4%。超重及肥胖组高血压、高脂血症、糖尿病的检出率明显高于BMI正常组。相关分析结果表明BMI、WC与TC、TG、SBP、DBP呈显著正相关 ;与HDL C、HDL C TC呈显著负相关 ,WC与FBG呈显著正相关。提示为早期预防慢性病 ,应对BMI>2 4的人群给予充分关注