Magnetic resonance imaging of painful swollen legs in the emergency department: a pictorial essay

Patients presenting with a painful swollen leg are not infrequently encountered at the emergency department and can pose a diagnostic dilemma for attending physicians. The potential causes of leg pain and swelling include trauma, infection, inflammation, and neurogenic, vascular, and iatrogenic conditions; with magnetic resonance imaging (MRI) being an important tool in evaluation. We describe the MRI features of various conditions causing painful swollen legs. We also discuss the differential diagnosis and the useful clinical and laboratory findings that radiologists should be aware of, in order to arrive at an accurate diagnosis.     

Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture.

The wrist is a common site of injury and the most frequently injured body part among professional golfers. A 37-year-old, right-handed male golfer presented with pain at the ulnar aspect of his left palm, which grew worse after an initial traumatic impact from the golf club handle. There was tenderness over the hypothenar eminence of the left palm. Computed tomography of the left wrist showed an undisplaced fracture through the base of the hamate hook. The golf-induced hamate hook fracture was managed conservatively, with cessation of physical activity involving the left hand and wrist for eight weeks. The patient made a full recovery. Repetitive trauma, exacerbated by improper wrist motion, leads to typical wrist injuries affecting golfers, such as ulnar impaction syndrome, de Quervain’s disease, and tendinopathy affecting the flexor carpi ulnaris and extensor carpi ulnaris, all of which can be diagnosed on imaging.     

LAPAROSCOPIC HERNIOPLASTY

这篇来自德国的文章 ,作者是德国微创外科学会主席、南德外科学会主席 ,德国《外科胃肠病学杂志》主编BITTNER教授。他及他的同事共计施行了腹腔镜疝修补术近 1万例 ,取得了巨大的成就 ,目前在腹外疝的微创外科治疗领域中处于世界领先地位。作者的这篇文章是专为本刊而作 ,文章中有许多新概念、新理论和新技术 ,希望读者能够从中得到收获     

World apheresis registry: report of 2004 data

Centers from 9 countries have applied for a login code to the WAA apheresis registry. Of these 9 centers from 4 countries have been actively entering data during 2004. Registered are at the moment a total of 347 patients (55% women, mean age 54 y, and 45% men, mean age 52 y). Main indications were neurological (33%), vasculitis (9%), and lipid apheresis (8%). In 92% of the patients therapeutic apheresis was performed while in 8% retrieval of components was the reason. A total of 1808 procedures were registered. More than 88% of the patients had acute indications. Access was mainly by peripheral vessels (65%), central dialysis catheter through jugular route (11%) or subclavian (9.4%) while femoral vein and AV fistula were used in 4.3 versus 0.5% of occasions. Anticoagulation was performed by ACD (80.5%), CPD citrate (2.5%), ACD and heparin (7%), ACD and LMW heparin (4%) and only heparin (5.8%). Replacement fluids for therapeutic apheresis removing plasma was mainly by albumin (85%) while plasma (22%) and cryoprecipitate poor plasma (5%) was used to less extent. Adverse events (AE) were registered in 6% of procedures. Distribution was for mild AE (1.4%), moderate (3.4%) and severe (0.6%) In 21 treatments there were 2 AEs while in 2 patients there were 3 AEs. Most frequent AEs were hypotension (35%), tingling around the mouth (24%), chill and fever (5.5%) and urticaria (5.5%). There were significant differences between the centers. The incidence of hypotension varied between 0.36–3.23% between centres. There was no significant difference in severe AEs between the centres. Main procedure used was centrifugation technique for conventional plasma exchange by centrifugation or filtration, while other modes were leukapheresis, erythrapheresis, platelet apheresis, LDL‐apheresis, photopheresis and adsorption. Conclusion: Data from the registry show that centres have various approaches to apheresis. One can learn from each others experience to reduce side effects and improve efficacy.     

Detection of human herpesvirus-8 DNA in oral ulcer tissues of HIV-infected individuals

OBJECTIVE: To determine the frequency of detection of human herpesvirus-8 (HHV-8) in HIV-related oral ulcers. DESIGN: Analysis of archived biopsy material. METHODS: Nested polymerase chain reaction of DNA extracts. RESULTS: HHV-8 DNA was detected in six of 10 oral ulcers of HIV-positive patients without oral Kaposi's sarcoma (KS) lesions and five of 11 oral KS lesions. The positive non-KS samples were derived from various oral sites. CONCLUSIONS: In HIV-positive people, HHV-8 can infect oral tissues that are not affected by KS.     

纳米靶向给药系统载体材料的研究进展

目的:综述及讨论近年来新材料在靶向给药系统载体材料方面的应用及存在问题。资料来源:以网络数据库资源为主,查询Science Direct,Pubmed,Springer,Ovid等数据库1995-01/2006-06关于靶向给药系统载体材料方面的相关文献,检索词“Targetdrug delivery system”and“Materials”,限定文章的语种种类为“English”;同时检索CNKI数据库2001-01/2006-06的相关文章为补充,限定文章语种种类为中文,检索关键词“靶向给药系统,载体材料”。资料选择:对资料进行初审,纳入标准:①关于靶向给药系统的研究。②应用的较新的材料作为药物载体。排除标准:重复性研究。资料提炼:共收集到122篇文献,98篇符合纳入标准,取其中有关新型载体材料应用于靶向给药系统的30篇相关文献进行归纳总结。资料综合:靶向给药是目前药剂学领域的研究热点之一,但多年来转化为产品的研究成果极为少见。其中关键问题之一就是药物载体材料的研究瓶颈,药剂学研究与材料学研究间学科交叉与衔接的严重滞后阻碍了新型给药系统的产业化。结论:新型给药系统载体材料研究开发尤为重要,载体材料应用的安全性一旦解决,必将带来新型给药系统全面用于临床的新局面,从而使药效得到更好的发挥,提高疾病的预防治疗能力。