Aluminum bone disease in children: radiographic features from diagnosis to resolution

Two children with chronic renal failure developed aluminum intoxication as a result of long-term ingestion of aluminum hydroxide for the control of hyperphosphatemia. In each child, bone biopsy confirmed severe osteomalacia, the absence of features of hyperparathyroid bone disease, and massive aluminum deposition at the bone-osteoid junction. Radiographs during the period of aluminum intoxication demonstrated osteopenia, pathologic fractures, fraying of the metaphyses of the long bones, and widening of the physis. When aluminum hydroxide therapy was discontinued (each patient) and aluminum was removed with chelation therapy (one patient), radiographs demonstrated a distinctly unusual pattern of healing. Calcification of the long bones began at the most recently formed osteoid and then proceeded toward the diaphysis. This unusual healing pattern created lucent defects and a transient "bone within a bone" appearance, which resolved with further healing.     

MANAGEMENT OF KALA AZAR – AN UPDATE

Kala azar continues to be a medical problem in India and with the increase in incidence of HIV Infection it is likely that kala azar will be encountered more frequently and in its atypical forms. To aid diagnosis, several immunological tests are now available and they are more sensitive and specific than the aldehyde test. Like many other diseases today, the treatment of kala azar is hampered by drug resistance. Newer drugs are available and so are new delivery systems. Kala azar develops frequently in the HIV infected person before development of AIDS. The presentation is atypical and leishmanial species other than L. donovani may also be the infecting agents. A combination of sandfly control, detection and treatment of patients and prevention of drug resistance continues to the ideal approach for the control of the disease.KEY WORDS: Kala azar, Leishmaniasis, HIVWHO estimates that more than 200 million people in the world are exposed to leishmanial parasites and more than 500,000 people develop clinical visceral leishmaniasis each year [1]. Major epidemics have occurred in the eastern part of our country and some other parts of the world [2]. Large scale drug failure has been the outstanding feature of the Indian epidemic of 1991, leading to increased morbidity and mortality. Certain clinical manifestations like lymphadenopathy which were not seen in Indian kala azar earlier, have been reported from Bihar and West Bengal [3]. With the increasing incidence of HIV infection, more atypical presentations are being noted [1]. Due to the development of widespread resistance to conventional drugs, several new drugs and other modalities of treatment have been developed and the conventional drugs are being tried in modified dosages with variable success.     

颅眶沟通性脑膜瘤14例

1临床资料经病理检查证实为颅眶沟通性脑膜瘤的14(男5,女9)例患者,年龄12～68岁,病程1～5 a.临床表现主要有头痛、突眼、视力减退、眼球运动受限、视乳头水肿,首发症状为头痛者8例,突眼者4例,视力减退者2例;肿瘤大小: 颅内>眶内10例,眶内>颅内4例.     

Relationship of gestational age and cervical dilation to the timing of delivery.

OBJECTIVE: To determine the effect of gestational age and cervical dilation on pregnancy continuation in women with idiopathic preterm labor who were treated with parenteral tocolysis. METHOD: A total of 950 women with singleton gestations, intact membranes and preterm labor treated with tocolysis prior to 34 weeks' gestation were retrospectively studied. These women were identified from the March of Dimes prematurity prevention program database. For analysis, women were categorized into five gestational age groups and three cervical dilation groups. The primary outcomes measured were the percentage of women who remained undelivered at 48 h and at 14 days post-initiation of therapy. RESULT: Overall, 82% of women remained undelivered after 48 h and 65% remained undelivered at 14 days. As cervical dilation advanced, the number of women remaining undelivered at 48 h and 14 days significantly decreased. However, even at > or = 4 cm, 52% of women remained undelivered at 48 h. If the cervix was dilated < 2 cm, gestational age did not influence the number of days gained prior to delivery. However, if the cervix was dilated > or = 2 cm, women at < 25 weeks' gestation were more likely to deliver compared to women at the same dilation but with more advanced gestational ages. CONCLUSION: Overall, 82% of women in preterm labor and 52% of those presenting with > or = 4-cm cervical dilation, delivered after 48 h. Therefore there appears to be ample opportunity for most women in preterm labor with intact membranes, even those at advanced dilations, to receive a complete course of corticosteroid therapy.     

山茱萸化学成分的研究

从山茱萸(Cornus officinalis Sieb.et Zucc.)的果实中分得一新的双环烯醚萜甙化合物,命名为山茱萸新甙(cornuside)。通过波谱分析(IR,MS,¹HNMR和¹³CNMR)和理化常数测定,确定了它的结构。     

肠缺血再灌注大鼠肺及血液白细胞介素6、白细胞介素8和肿瘤坏死因子α变化与辅酶Q10的干预

目的:观察大鼠肠缺血再灌注时肺及血液白细胞介素6、白细胞介素8和肿瘤坏死因子α的变化以及辅酶Q10的影响。方法:实验于2006-12/2007-02在滨州医学院药理学实验室和免疫学实验室(山东省重点学科三级实验室)完成。①实验分组:清洁级健康Wistar大鼠30只,体质量290～390g,随机数字表法分为假手术组、肠缺血再灌注组,辅酶Q10处理组(缺血再灌注 辅酶Q10),每组10只。②实验方法:建立肠缺血再灌注模型,钝性分离肠系膜上动脉的根部,假手术组不作其他处理;肠缺血再灌注组再灌前30min时经股静脉注入生理盐水10mL/kg;辅酶Q10处理组再灌前30min时经股静脉注入辅酶Q1010mg/kg。③实验评估:酶联免疫吸附法(ELISA)检测各组动物血液、肺组织匀浆及肺泡灌洗液中的白细胞介素6、白细胞介素8和肿瘤坏死因子α含量;光镜下观察肺组织形态学变化。肺泡灌洗液沉渣进行白细胞计数和分类。结果:纳入大鼠30只,均进入结果分析。①肺组织形态学变化:假手术组肺组织无病理改变;肠缺血再灌注组肺间质明显水肿,中性粒细胞浸润,有少量的出血和纤维蛋白渗出;辅酶Q10处理组肺间质轻度水肿,少量的中性粒细胞。②肺泡灌洗液白细胞计数组间无显著性差异,多形核细胞分类肠缺血再灌注组明显高于假手术组(P<0.05),而辅酶Q10处理组与其他两组间差异无显著性意义(P>0.05)。③各组动物血液、肺组织匀浆及肺泡灌洗液中的白细胞介素6、白细胞介素8和肿瘤坏死因子α含量:与假手术组比较,肠缺血再灌注组血液、肺组织匀浆及肺泡灌洗液中白细胞介素6、白细胞介素8和肿瘤坏死因子α显著升高(P<0.05或P<0.01)。与肠缺血再灌注组比较,辅酶Q10处理组血液、肺组织匀浆和肺泡灌洗液中白细胞介素6含量显著降低(P<0.05);白细胞介素8和肿瘤坏死因子α含量在血液中显著降低(P<0.05);而在肺组织匀浆中含量未见显著降低(P>0.05);在肺泡灌洗液中含量亦未见显著降低(P>0.05)。结论:辅酶Q10可能通过抑制白细胞介素6、白细胞介素8和肿瘤坏死因子α炎性因子的释放,对大鼠肠缺血再灌后肺损伤有一定的保护作用。