Beta2 integrin/ICAM-1 adhesion molecule interactions in cutaneous inflammation and tumor promotion

The beta2 integrin (CD 18/CD 11 a, b, c) family of proteins mediate adherence of leukocytes to vascular endothelium and the associated ligand, intercellular adhesion molecule-1 (ICAM-1; CD 54), interacts with beta2 integrin proteins to allow transendothelial migration of leukocytes into sites of inflammation. The present study examines the function of these proteins in a murine model of acute cutaneous inflammation induced following topical application of 12-O- tetradecanoylphorbol-13-acetate (TPA) to the dorsal epidermis of SENCAR mice and in a model of skin multistage carcinogenesis. At 24 h following topical application of TPA to the dorsal epidermis of mice, dermal leukocytes expressed higher levels of beta2 integrin protein compared with the lower levels of beta2 integrin protein expression by peripheral blood leukocytes. ICAM-1 protein was localized to epidermal keratinocytes and vascular endothelium in TPA-treated skin and to proliferating papilloma cells. Intravenous (i.v.) injection of either 50 microg anti-beta2 integrin antibody alone or in combination with anti-ICAM-1 antibody significantly inhibited both TPA-stimulated neutrophil infiltration into the dermis (P < 0.001) and myeloperoxidase (MPO) activity (P < 0.03 anti-beta2 integrin antibody; P < 0.01 anti- beta2 integrin + ICAM-1 adhesion molecule antibodies), but had no effect on TPA-induced epidermal hyperplasia. In addition, injection of either anti-ICAM-1 adhesion molecule antibody alone (P < 0.004) or in combination with anti-beta2 integrin antibody (P < 0.001) significantly inhibited TPA-induced production of 7,8-dihydroxy-2'-deoxyguanosine (8- OHdG) immunoreactive proteins by epidermal keratinocytes. Beta2 integrin/ICAM-1 adhesion molecules work in concert to regulate migration, retention and functional activation of leukocytes within the dermis during TPA-induced skin inflammation and within stromal tissue of papillomas that form during multi-stage carcinogenesis. Agents that inhibit these receptor/ligand interactions may be useful in defining the roles of specific cell populations in cutaneous inflammation and multistage carcinogenesis and may also have potential as anti-promoting and anti-progression agents.      

敏定偶用于35岁以上妇女的疗效、安全性和周期控制

<正> 口服避孕药在投放市场之初,应用于各种年龄段的妇女。然而资料显示早期使用的高剂量口服避孕药会增加心肌梗塞的发病率;在1975年,美国食品药物管理局(FDA)不建议40岁以上的妇女服用避孕药,对30岁以上的吸烟妇女建议她们要么停止吸烟要么改换避孕方式。随着研究的进一步深入及低剂量口服避孕药的问市,已证实任何年龄的非吸烟     

Immediate food hypersensitivity reactions on the first known exposure to the food

We report 8 infants with immediate hypersensitivity reactions to foods (milk, egg, or peanut), occurring at the first-known exposure. Each developed symptoms within the first hour, but these generally settled within 2 hours. Sensitisation to the food concerned was demonstrated by positive immediate allergen skin prick tests in every case. Symptoms experienced included irritability, erythematous rash, urticaria, angio-oedema, vomiting, rhinorrhoea, and cough. Five infants were being followed prospectively and 4 were clinically tolerant of the food by age 16 months. The most likely route of sensitisation was via breast milk. None of the infants experienced similar reactions while being breast fed, suggesting that the reaction was dose dependent. As 5 out of a group of 80 infants being followed prospectively developed an immediate reaction at their first known exposure to a food, this appeared to be a not uncommon presentation of food hypersensitivity in infancy.     

Intramedullary hip screw fixation of reverse oblique and transverse trochanteric femur fractures

Introduction  Reverse oblique and transverse trochanteric femur fractures (31A3) are relatively rare. They are associated with a high failure rate, particularly in cases where extramedullary implants are used. This study investigated a second-generation intramedullary nail in this specific fracture type. Methods  Flinders Medical Centre is a level 1 trauma centre and the largest user of the Intramedullary Hip Screw (IMHS, Smith and Nephew, Memphis, USA) in the Southern Hemisphere. Two hundred and forty-eight IMHS cases completed between September 2003 and August 2005 were retrospectively analysed. All fractures were classified using the AO/ASIF system (Muller et al., The comprehensive classification of fractures of the long bones, Springer, Berlin, 1990) and 31A3.1, 2, 3 fractures were selected. The case notes and radiology were reviewed over a 1-year follow-up. Results  Twenty-six cases were classified as 31A3 fractures. Thirty-eight percent of the cases received a long stem IMHS. Mean patient age was 81.9 years with a 1-year mortality of 11.5%. Two of the 26 cases (7.7%) had surgical complications, including one cut-out (associated with a tip-apex distance of 40.9 mm) and one loss of reduction. Both cases required re-operation. There were no femoral shaft fractures or non-unions in this series. Conclusions  This second-generation intramedullary implant, the IMHS, performed well in this often difficult to fix fracture. The complication rate is considerably less than the rate published for extramedullary implants and is comparable to previous studies using a range of intramedullary techniques.     

Aorta-atrial fistula, a rare complication of prosthetic valve endocarditis

A 51-year-old male with a history of a mechanical Carbomedicsaortic and mitral valve replacement in 2003 and several re-operationsbecause of endocarditis of the mitral valve in 2007 presentedwith heart failure 68 days after operation. Echocardiographyconfirmed the presence of a fistulous connection between theaorta and the left atrium. Because of the multiple surgicalinterventions and high operative risk, an initial conservativemedical treatment was initiated and the clinical course wasuneventful to this date.     

The prevalence of headache with emphasis on tension-type headache in rural Tanzania: a community-based study

The aim of the study was to assess the prevalence of headache with special attention to tension-type headache (TTH) in a rural area in northern Tanzania. A door-to-door study was performed using a standardized and validated questionnaire. A total of 7412 participants were screened. The total headache prevalence during the past year was 12.1%; the overall 1-year prevalence of TTH was 7%; 5% reported episodic TTH and 0.4% chronic TTH. Borderline cases (International Headache Society code 2.3) were described in 1.6%. The prevalence of headache was highest in the 41–50-year-old group in women and in the 61+ age group in men. This is the first account of the prevalence of TTH in a rural Tanzanian population, and shows that headache in general and, more specifically, TTH are prevalent disorders that deserve attention. However, the prevalence of primary headache seems to be lower than in Western countries.