Hippocampal formation and related structures of the limbic lobe: anatomic-MR correlation. Part II. Sagittal sections

Magnetic resonance (MR) images in the sagittal plane display the lengths of the parahippocampal gyrus, subiculum, dentate gyrus, hippocampus, fimbria, fornix, hippocampal fissure, choroidal fissure, and temporal horn, and the anatomic relationships of these structures to the surrounding brain. Correlation of these images with anatomic specimens provides criteria for identifying these structures confidently on routine clinical MR imaging.     

Iliocaval arteriovenous fistula presenting with multiple organ failure

Iliac arteriovenous fistulas are an uncommon condition, which may be spontaneous or traumatic in nature. Such fistulas classically present with a triad of high‐output cardiac failure, pulsatile abdominal mass with a bruit and unilateral leg ischaemia or venous congestion. We describe a case of an iliocaval fistula secondary to rupture of a common iliac artery aneurysm, with an unusual presentation of multiple organ failure, masquerading as sepsis. We describe the CT findings of iliocaval fistula, which was the means of diagnosis in this study.     

Comparison of vasa vasorum after intravascular stent placement with sirolimis drug‐eluting and bare metal stents

The cytostatic drug, sirolimis has shown prevention in neointimal hyperplasia after stent placement. Recent studies have shown persistent inflammation seen with drug‐eluting stents (DES) may result in late stent thrombosis. The aim of this study is to compare effects of bare metal stents (BMS) and sirolimis DES on the neointima and vasa vasorum in stented rabbit aortas. Stents were implanted in eight New Zealand rabbits for 9 weeks. Group I rabbits received BMS. Group II rabbits received sirolimis DES. A balloon‐mounted BMS or DES was placed in the infrarenal aorta. Following euthanasia, aortas were perfused with barium sulfate and sectioned for histology. After 9 weeks the qualitative intrastent luminal diameter was fairly uniform in both the DES and the BMS. The thickness of neointima was similar in both groups. The number of vasa vasorum in the sirolimis DES increased compared with the BMS (P < 0.05). An increased number of vasa vasorum produced by the DES when compared with the BMS shows a difference in response to local vessel injury in rabbits. This result suggests that vasa vasorum may play a role in the persistent inflammation generated by sirolimis‐coated stents.     

Near-haploid acute lymphoblastic leukemia: a unique subgroup with a poor prognosis?

We describe two adolescent girls with acute lymphoblastic leukemia (ALL) whose leukemia cells were near-haploid. Their lymphoblasts stained in a block pattern with periodic acid Schiff and had "common ALL" surface markers confirmed by indirect immunofluorescence. Each patient had two populations of blasts, one near-haploid and one hyperdiploid, which was an exact doubling of the near-haploid karyotype. The first patient had a predominant population of cells with 26 chromosomes and a few with 52, while the second had a predominance of cells with 56 and a minority with 28. Flow cytometric analysis of DNA content initially detected the minor near-haploid population in the second patient, which was confirmed later by cytogenetic review of the marrow sample. In addition to our two patients, only four patients have been reported with near-haploid ALL. Of these six, five were girls, five were adolescents, and five had short survivals (median, 10 mo). All six had disomy of chromosome 21 with or without disomy for chromosomes 10, 14, 18, or X (four patients each). Thus, near-haploid ALL may represent a unique subgroup of ALL with a poor prognosis. To detect these and other possible subgroups, we have included cytogenetic analysis and flow cytometric analysis of DNA content in our initial evaluation of patients with ALL.     

A case of pityriasis rubra pilaris associated with membranous nephropathy

Pityriasis rubra pilaris (PRP) is a rare idiopathic dermatosis which may be associated with autoimmune diseases, HIV infection, and internal malignancies. Its association with renal diseases is, however, much less recognized. We report a case of PRP with associated membranous nephropathy (MN), which resolved spontaneously with resolution of the dermatosis. This is only the second reported association between PRP and MN of which we are aware. Further reports of such an association will strengthen the evidence for the two conditions being linked and may thereby shed light on the pathogenesis of both PRP and MN.     

整字与部分对笔画构成汉字的影响

目的：利用整字、部件与笔画的启动探讨笔画构成汉字过程中整体与部分的关系。方法：实验于2005-09/12在北京师范大学认知神经科学与学习国家重点实验室完成。受试者23人,实验材料为能够组成笔画数为四划、五划的高频汉字（字频〉196次/106）的笔画组共128组,所有笔画组的空间排列均符合笔顺,将所有笔画组平均分配到整字启动、部件启动、笔画启动、无启动4个实验组内。每个实验组内包含16个四划笔画组与16个五划笔画组。材料中增加实验刺激总数25%的笔画组作为填充材料,填充材料不能组成汉字。实验中要求受试者用给出的笔画组（四划或五划）构成汉字,判断是否能够组成一个真实的汉字。 结果：整字、部件、笔画与无启动条件的反应时分别为1445,1596,1484,1555ms。错误率分别为5.5%,12.5%,8.6%,14.7%。整字启动条件下反应时最短,错误率最低。笔画启动条件下其次。部件启动与无启动条件下反应时较长,错误率较高。 结论：在笔画构成汉字的过程中,主要以整字加工为主,笔画加工也起到了重要作用。     

Medication use in European primary care patients with lower respiratory tract infection: an observational study

Background

It is largely unknown what medication is used by patients with lower respiratory tract infection (LRTI).

Aim

To describe the use of self-medication and prescribed medication in adults presenting with LRTI in different European countries, and to relate self-medication to patient characteristics.

Design and setting

An observational study in 16 primary care networks in 12 European countries.

Method

A total of 2530 adult patients presenting with LRTI in 12 European countries filled in a diary on any medication used before and after a primary care consultation. Patient characteristics related to self-medication were determined by univariable and multivariable logistic regression analysis.

Results

The frequency and types of medication used differed greatly between European countries. Overall, 55.4% self-medicated before consultation, and 21.5% after consultation, most frequently with paracetamol, antitussives, and mucolytics. Females, non-smokers, and patients with more severe symptoms used more self-medication. Patients who were not prescribed medication during the consultation self-medicated more often afterwards. Self-medication with antibiotics was relatively rare.

Conclusion

A considerable amount of medication, often with no proven efficacy, was used by adults presenting with LRTI in primary care. There were large differences between European countries. These findings should help develop patient information resources, international guidelines, and international legislation concerning the availability of over-the-counter medication, and can also support interventions against unwarranted variations in care. In addition, further research on the effects of symptomatic medication is needed.     

Prothrombin complex concentrate and recombinant prothrombin alone or in combination with recombinant factor X and FVIIa in dilutional coagulopathy: a porcine model

Summary. Background: This study was conducted to assess whether newly developed recombinant clotting factor concentrates enable the reversal of dilutional coagulopathy. Methods: In 50 anesthetized pigs, ～ 60% of the blood volume was withdrawn and replaced with hydroxyethyl starch. Pigs were randomized to receive either 200 mg kg^?1 fibrinogen (n = 10), fibrinogen and 35 IU kg^?1 prothrombin complex concentrate (PCC) (n = 10), fibrinogen and 4 mg kg^?1 recombinant human factor II (rhFII) concentrate (n = 10), fibrinogen and a three‐factor combination (3F) of 4 mg kg^?1 rhFII, 0.006 mg kg^?1 recombinant human FVIIa and 0.32 mg kg^?1 recombinant human FX (n = 10), or saline (n = 10). Thereafter, a standardized liver laceration was performed to induce uncontrolled hemorrhage. Survival time and blood loss were determined, and standard coagulation tests and thrombelastometry were performed. Results: Fibrinogen combined with rhFII or PCC improved survival. Blood loss was significantly decreased in all groups as compared with the animals receiving saline. Clotting time was significantly shortened in the animals treated with fibrinogen and PCC, as well as in those treated with fibrinogen and 3F. One animal died after administration of fibrinogen and PCC. Conclusion: Following hemodilution, a combination of fibrinogen and PCC, rhFII or 3F enhances coagulation and final clot strength. Mortality was reduced statistically significantly only in the animals treated with fibrinogen and rhFII or PCC, whereas administration of the combination of fibrinogen and PCC caused a fatal thromboembolic complication. The combination of fibrinogen and rhFII might be effective in reversing dilutional coagulopathy and may reduce blood loss in cases of dilutional coagulopathy.