Reactivity of white blood cell flux to hyperoxia in patients infected with human immunodeficiency virus

Purpose: The aetiology of the apparently vasoocclusive phenomena in human immunodeficiency virus (HIV)‐related retinopathy is not well understood. Several hypotheses, including infectious damage of the retinal vasculature and altered retinal haemodynamics, have been postulated. Direct measurement of oxygen tension in the retina is not possible in vivo and indirect methods have to be employed. The objective of this study was to investigate the retinal vascular response to 100% oxygen breathing in patients with HIV. Methods: Twelve patients infected with HIV and 12 healthy individuals, matched for age, sex and smoking habits, were studied in an open study using the blue‐field entoptic technique for the measurement of retinal white blood cell (WBC) flux. Reactivity in retinal blood flow during 100% O₂ breathing over 15 min was measured and expressed as percentage change over baseline. Results: WBC velocity during oxygen inhalation decreased over baseline by 9.0 ± 5.8% in HIV‐infected patients and by 18.6 ± 5.4% in healthy participants (p < 0.04 between groups, anova ). The decrease in WBC velocity was paralleled by a decrease in WBC density. This decrease tended to be more pronounced in healthy participants (13.6 ± 7.9%) than in HIV‐infected patients (8.0 ± 10.8%), but the difference was not statistically significant (p = 0.1 between groups, anova ). WBC flux decrease was 16.2 ± 11.4% in HIV‐infected patients and 29.5 ± 9.5% in the control group and was significant between groups (p = 0.007 between groups, anova ). Conclusion: Our results indicate a reduced reactivity of WBC flux to systemic hyperoxia in patients with HIV. Whether abnormal retinal haemodynamics in HIV‐infected persons contributes to the pathogenesis of HIV‐related microvascular diseases or is a consequence of the structural changes associated with the disease is unknown.     

Effect of the duration of immunomodulatory therapy on the clinical features of recurrent episodes in Vogt–Koyanagi–Harada disease

Purpose: To evaluate the duration of immunomodulatory therapy (corticosteroids, immunosuppressive drugs) with regard to the rate of relapses and clinical features (exudative retinal detachment or anterior uveitis) in inflammatory episodes of Vogt–Koyanagi–Harada disease. Methods: Data of all 42 patients diagnosed with acute uveitis associated with VKH disease during the period of January 2005 to December 2008 at the Pitié‐Salpêtrière Hospital or at the Lariboisière Hospital in Paris, France were extracted by chart review. Results: There were 31 patients (73.8%) with episodes of recurrence and were included in the study. At the first recurrence, 81% (13 patients) of exudative retinal detachments (ERD) were associated with an initial immunomodulatory treatment conducted ≤6 months (3.76 months ± 2.67). Conversely, an initial treatment duration of >6 months was associated with anterior uveitis signs for 66% of patients (eight patients) with anterior first recurrence (p = 0.0061). On second episode of recurrence, 75% of patients (three patients) who developed exudative retinal detachment had been managed by immunomodulatory therapy for ≤6 months with the total duration of immunomodulatory treatment ≤6 months during previous inflammatory episodes. Conversely, all 16 patients who presented anterior uveitis with additional manifestations (optic disc oedema, macular oedema, vitritis and/or ‘Sunset glow’ fundus) have been treated for more than 6 months or treated during the initial occurrence lasting more than 9 months (p = 0.0035). Conclusions: The duration of systemic corticosteroids (and/or immunosuppressive drug therapy) for ≤6 months at first and second recurrence was associated with features of further exudative retinal detachment instead of anterior uveitis in VKH disease.     

Concordant childhood acute lymphoblastic leukemia in monozygotic twins

Two 4-year-old monozygotic Chinese, female twins developed concordant childhood acute lymphoblastic leukemia (ALL) within an interval of about 2 weeks. Based on morphology and cytochemistry findings of the bone marrow blast cells, a diagnosis of ALL, L1 was made. Immunophenotyping showed the blast cells of both twins expressed similar antigens, i.e. HLA-DR, CD10, CD13, CD19, CD22 and CD34. Identical blood group, same HLA (human leucocyte antigen) genotype, sex and similar appearance suggest that the twins are monozygotic. Since the bone marrow leukemic cells of both twins were identical in morphology and expressed the same antigens with almost similar percentages of positivity, it is likely that the blast cells were derived from the same single clone. Based on the single clone hypothesis, the leukemogenic event must have arisen in utero in one twin and the cells from the abnormal clone then spread to the other twin via shared placental anastomoses.     

中国人颧骨形态的观察

本文采用中南地区出土的成年整颅800个,其中男性382,女性108,共1680例。观察项目有:①颧骨的一般特征;②颧骨的变异,包括完全二分颧骨和不完全二分颧骨的出现率;③颧面、颧颞、颧眶孔的出现率。观察结果:中南和华北、华东地区颧骨有一致的种族特征;其不完全二分颧骨中南地区和南京地区t值为9.8,地区差异非常显著。     

中成药与保健食品中违禁添加的20种降压类化学药物的LC-MS/MS法检测

建立了液相色谱-串联质谱法快速测定中成药与保健食品中违禁添加的20种降压类化学药物.采用C18色谱柱,以甲醇-0.1％甲酸(75:25)为流动相,采用电喷雾电离(ESI)源、多反应监测(MRM)扫描方式,20种药物的检测限均低于20 ng.通过与标准谱库中的保留时间和多反应检测质谱图(MRM)的对比,可快速鉴别样品中违禁添加的20种降压类药物.