Primary osteosarcoma of the skull

Primary osteogenic sarcoma of the skull is an exceedingly rare condition. An adult male patient is described, who had a painless swelling in the right forehead that had rapidly enlarged in the previous 6 months. Radiological investigations showed a large destructive mass lesion involving the right side of the frontal bone with extension into the frontal sinus, causing marked extradural compression of brain parenchyma. Histopathological examination confirmed the lesion to be primary osteogenic sarcoma.     

维甲酸和联合应用神经营养因子对新生大鼠神经干细胞分化的影响

目的研究全反式维甲酸（ATRA）及联合应用神经营养因子（BDNF，GDNF）对体外培养的神经干细胞（NSCs）分化的影响。方法取新生SD大鼠的前脑室下带（SVZ）区，按NSCs的常规培养方法分离、培养。用免疫细胞化学法鉴定巢蛋白（nestin）、微管相关蛋白-2（MAP-2）、胶质原纤维酸性蛋白（GFAP）的表达，以此来观察ATRA、BDNF、GDNF单独或联合应用对次代神经球细胞分化的作用。结果原代及次代神经球均显示nestin阳性，并可分化为MAP-2阳性神经元样细胞及GFAP阳性胶质细胞样细胞。1μmol／LATRA可促进NSCs分化为MAP-2阳性细胞的比例达（29．14±5．00）％，显著高于对照组的（7．19±1．21）％，差异有高度统计学意义（P〈0．001）。ATRA联合应用10ng／ml的BDNF或GDNF，与单独使用ATRA比较，并不显著提高NSCs分化为MAP-2阳性细胞的比例。结论ATRA可促进神经干细胞向神经元方向分化，ATRA联合应用BDNF或GDNF无明显的协同作用。     

Relations between age, metabolic control, disease adjustment and psychological aspects in insulin-dependent diabetes mellitus

The relations between age, metabolic control, disease adjustment, and psychological factors in boys and girls with recently diagnosed insulin-dependent diabetes mellitus (IDDM) were studied. Older girls had significant higher postremission glycosylated haemoglobin A (Hb A_lc) levels ( p = 0.008). Girls with more hospitalizations had a lower developmental level ( p = 0.05), and had significantly more problems in the behavioural rating ( p = 0.05). Boys with more hospitalizations had a more external locus of control ( p = 0.01), more difficulties with disease adjustment, more emotional problems, and were also clinically assessed as having more behavioural problems. Boys showing more difficulties in psychological adjustment to the disease also had higher postremission Hb A_1clevels ( p = 0.02). Although Swedish children with IDDM of short disease duration do not differ from healthy children in important psychological aspects, older girls and a small group of problematic younger boys are at risk of developing metabolic imbalance after a short disease duration.     

Metabolic effects of growth hormone treatment: an early predictor of growth response?

Fourteen children receiving one year of recombinant human growth hormone (rhGH) treatment underwent measurement of serial changes in body composition (measured by skinfold thickness, bioelectrical impedance, and H2(18)O dilution), resting energy expenditure (REE, estimated by ventilated hood indirect calorimetry), and total free living daily energy expenditure (TEE, measured by the doubly labelled water technique). Mean height velocity increased from 4.9 to 8.6 cm/year after six months of treatment. Fat free mass (FFM) increased more during the first six weeks (24.4 g/day) than from six to 26 weeks of treatment (6.8 g/day); fat mass decreased by 7.2 g/day and 1.1 g/day respectively. The six week increase in REE (kJ/day) was maintained after six months of treatment, though expressed per kilogram FFM (kJ/kgFFM/day), returned to pretreatment values by three months. Height velocity increases at six months correlated with six week changes in fat mass measured by skinfold thickness and REE, though use of this relationship to predict growth response in individuals is limited by the wide 95% prediction intervals. No significant changes in growth, body composition, or energy expenditure were observed between six and 12 months of treatment, in either patients who had initially responded well to treatment or those who were poor initial responders to treatment and who had their dose of rhGH doubled after six months.     

HIV-1tat induced apoptosis of T-cells is not mediated by TGF-β

Recent reports have demonstrated that the HIV-1 transactivator protein,tat, induces apoptosis in T-lymphocyte cell lines, as well as in peripheral blood mononuclear cells, and stimulates a cascade of events resulting in up-regulation of the potent immunosuppressive cytokine, transforming growth factor-β (TGF-β). In this study we evaluated the ability of TGF-β to mediatetat induced apoptosis in T-lymphocyte cell lines. T-cells treated exogenously with either TGF-β1 or a combination of tat and pan-specific TGF-β neutralizing antibodies showed little change in the amount of apoptosis. When treated with pan-specific TGF-β neutralizing antibodies, Jurkat cells that stably expresstat protein (Jurkat-tat) showed only a modest decrease in apoptosis, while CEM-TART cells (CEM T-cells expressing both HIV-1tat andrev) demonstrated little change in the amount of apoptosis. In conclusion, we have demonstrated that TGF-β does not play a significant role in mediatingtat induced T-cell apoptosis.     

Hydrogen ion excretion and urine osmolality in patients with obstructive uropathy secondary to Schistosoma haematobium.

Sixty-one patients with urinary schistosomiasis were studied to determine the effects of obstruction and bacteriuria on renal function. 39 (12 with bacteriuria) had demonstrable obstruction and 22 (5 with bacteriuria) had no obstruction. Total hydrogen ion excretion (T.H.+) for obstructed patients with sterile urine did not differ from that in controls; patients with bacteriuria with and without obstruction had a significantly lower T.H.+ (all P values less than 0.05). Obstructed patients (with or without bacteriuria) had significant impairment of maximal (U max) and minimal (U min) urine osmolality. Patients with bilateral obstruction and bacteriuria had a significantly lower U max (P less than 0.01 than obstructed patients without bacteriuria. The T.H.+ is mainly associated with bacteriuria but that the effects of unilateral or bilateral obstruction and bacteriuria on urine osmolality are additive. These abnormalities are usually corrected after therapy.     

Risk factors for invasive fungal infection in neonates

Invasive fungal infection is an uncommon, but increasing cause of morbidity and mortality in neonates. There are few controlled studies defining risk factors for the development of fungal infection in a contemporary neonatal population. This retrospective case-control study was undertaken to investigate antenatal, demographic and postnatal variables that may be potentially important in the development of fungal infection. Two gestation-matched controls were identified for each index case. Information about perinatal and demographic variables, as well as important neonatal outcomes, was obtained from case notes. Microbiological data collected included the presence of fungal colonization, and organisms responsible for invasive fungal infection. Over a 5-y period, 24 infants with invasive fungal infection and 48 controls were identified. Candida albicans was the organism identified in 75% of cases of fungal septicaemia, and in all cases complicated by fungal meningitis. Preceding fungal colonization, pulmonary haemorrhage and intrauterine growth restriction were factors significantly and independently associated with invasive fungal infection. Fifty-four percent of infants with invasive fungal infection died, and 82% of survivors developed chronic lung disease.

Conclusion : Some new and potentially important risk factors for the development of invasive fungal infection in a contemporary population of infants admitted to a neonatal intensive care were identified.