原因不明不育患者减数分裂同源染色体重组的研究

在第一次减数分裂前期,同源染色体之间的重组对同源染色体正确分离起着重要作用。重组异常是染色体不分离的重要风险因子,并可能进一步导致不育。而不育症作为一个重要的健康问题,影响着10%～20%夫妇,其中含有男方因素引起的不育占50%。尽管男性不育的发病率高,但目前关于因减数分裂导致精子发生过程失败的机制仍知之甚少。近年来发展的免疫荧光技术使我们可以直视减数分裂重组事件,为研究人类精子形成的过程提供了新的手段。     

Unexplained polyarthralgia and celiac disease

Celiac disease is an immunological disorder whose best-known manifestations are gastrointestinal symptoms. However, early joint manifestations are common and frequently overlooked features of celiac disease. We report a case in which unexplained inflammatory polyarthralgia and iron-deficiency anemia led to the diagnosis of celiac disease. Autoimmune thyroiditis was also a feature. Early diagnosis and treatment of celiac disease protect patients against complications such as digestive neoplasis. A simple and rapid tool for achieving the early diagnosis is the measurement of the serum of anti-gliadin, anti-endomysial and anti-tissue transglutaminase antibodies. However, a duodenal biopsy remains the only means of making the definitive diagnosis of celiac disease.     

Death after Kidney Transplantation: An Analysis by Era and Time Post-Transplant

Open in a separate window     

Unexplained cervical lymphadenopathy in children: predictive factors for malignancy

Purpose

The purpose of this study was to determine clinical factors that are able to predict the likelihood of malignancy of unexplained cervical lymphadenopathy in children.

Methods

The data of 175 cases with unexplained cervical lymphadenopathy, including sex, age, fever, number of involved regions, and location and size of the largest node, were collected. Receiver operating characteristic analysis was performed to find out the optimal parameter for size of the largest node. Logistic regression was applied to determine independent predictors for malignancy.

Results

On the basis of receiver operating characteristic analysis, the ratio of maximal width to maximal length (ratio) was confirmed as the optimal parameter of size for malignancy prediction, and its threshold, which maximized sensitivity and specificity, was 0.5. Multivariate binary logistic regression model indicated that number of involved regions (odds ratio [OR], 5.169; 95% confidence interval [CI], 1.291-20.691; P = .020), location of the largest node (OR, 12.423; 95% CI, 3.657-42.205; P = .000), and ratio (OR, 52.080; 95% CI, 16.089-168.588; P = .000) were significant independent predictors of malignancy.

Conclusions

Higher ratio (>0.5), multiple cervical regions of adenopathy (≥2), and region II or III location of the largest node are associated with malignancy. These data should be helpful to supplement clinical judgment in determining which enlarged cervical nodes harbor cancer.     

Donation After Cardiac Death in Liver Transplantation: An Additional Source of Organs With Similar Results to Donation After Brain Death

Background

As new sources of organs are needed, liver transplantation using donors after cardiac death (DCD) is progressively increasing, but outcomes with this method are still questioned. This study was accomplished to verify that DCD outcomes are comparable to those seen in donation after brain death (DBD).

Death After Graft Loss: An Important Late Study Endpoint in Kidney Transplantation

Traditional study endpoints utilized in renal transplantation have included graft survival, and death with a functioning graft. We analyzed the risk factors for death after allograft loss (DAGL) among a total of 78564 primary renal transplants reported to the United States Renal Data System (USRDS) from 1988 to 1998. Cox models were used to investigate risk factors for DAGL. Of 15528 deaths, 10816 occurred before, and 4712 occurred after graft loss. Overall annual adjusted death rates were more than 3-fold higher after graft loss as compared to before graft loss (9.42% vs. 2.81%). By Cox model, dialysis for more than 2 years was associated with a more than 2-fold relative risk for DAGL (RR = 2.2, Cl = 1.88-2.53), while transplant time was not associated with DAGL. Infection related graft losses showed a strong association with DAGL (RR = 1.64, Cl = 1.31-2.07). Acute rejection and thrombosis as causes of graft loss were also significantly associated with the risk for DAGL (RR = 1.35, Cl = 1.23-1.47 and RR = 1.39, Cl = 1.39). Patient survival after graft loss is poor. The lack of association between DAGL and transplant time, as opposed to the strong relation to pretransplant dialysis time, would suggest the adverse effects of previous uremia-mediated damage may be contributing to this phenomenon, along with the adverse effects of loss of renal function.     

Greener Gases Starter Pack: a tool for transitioning to more sustainable anesthetic volatile agents

Canadian Journal of Anesthesia/Journal canadien d'anesthésie -     

Unexplained polyuria and non-obstructive hydronephrosis in a urological department

Nephrol Dial Transplant 2004; 19:     

Cholera, Chloroform, and the Science of Medicine: A Life of John Snow

In the year that John Snow was voted the greatest doctor ofall time in one medical publication, and which also sees the150th anniversary of his first administration of chloroformto Queen Victoria, the appearance of this life is well timed.The authors are three epidemiologists and two historians fromMichigan State University. Their original intention was to featurethe public health aspect of Snow’s work, concentratingon the Golden Square cholera epidemic of 1854, which includesthe well-known story of the Broad