Oral and cutaneous lesions in Crohn's disease. A case report

Cutaneous and buccal manifestations of Crohn's disease are common. They are diagnostically helpful either by their specificity or from a biopsy which whilst access is easy offers less satisfactory results with buccal lesions. Stomatological clinical aspects are varied, most commonly of aphthoid or vesicular stomatitis type (as in the case reported here).     

Evidence for dissolution rate-limited absorption of COL-3, a matrix metalloproteinase inhibitor,leading to the irregular absorption profile in rats after oral administration

Purpose. This study was undertaken to elucidate the underlying mechanism of the irregular absorption profiles of COL-3, a matrix metalloproteinase inhibitor, with a double- or plateau-peak concentration after a single oral dose administration of COL-3 suspension to rats. Methods. The gastrointestinal absorption profiles of COL-3 in rats were assessed by comparing serum drug concentration curves after the following various modes of drug administration: oral and intraduodenal doses, oral doses of COL-3 in fine and coarse suspensions, intraduodenal dosing to the bile-duct intact and cannulated (BDC) rats, and oral doses with and without food. In addition, the biliary excretion of COL-3 in the BDC rats was examined. Results. Neither variable gastric emptying nor enterohepatic recycling was the source of the irregular gastrointestinal absorption of COL-3 in rats. Reduction in particle size, presence of food and endogenous bile emerged as the determinants of the oral absorption of COL-3 by enhancing the dissolution of the solid drug in the gastrointestinal fluids. Flip-flop of the absorption and elimination rate constants was noted only for COL-3 after intraduodenal administration of the coarse suspension to the BDC rats with the bile flow diverged out of the body. Conclusions. Variability in dissolution rate-limited absorption was the main cause of the irregular absorption of COL-3 after oral administration of its solid dosage form.     

Natural history of hyperlactataemia in human immunodeficiency virus-1-infected patients during highly active antiretroviral therapy

A study on the course of hyperlactataemia during highly active antiretroviral therapy (HAART) and the association between hyperlactataemia and antiretroviral drugs was conducted at the outpatient department, Rigshopitalet, Copenhagen. Lactate levels were monitored in 848 patients during a study period of 1 y. Longitudinal analysis was performed on all human immunodeficiency virus-1-infected patients who had plasma lactate > 2.1 mM. Hyperlactataemia was found in 178 patients (21%), of whom 7 patients needed treatment modification, owing to symptomatic hyperlactataemia in 3 and neuropathy in 4 patients, while 171 remained on unchanged therapy. Lactate levels increased in 20 patients during the study period, but the increases were modest with a mean of 0.6 mM (range 0.1-1.7 mM). The association between antiretroviral drugs and hyperlactataemia was studied using logistic regression in 263 patients with data on their treatment regimen available in electronic form. Only stavudine and ritonavir were significantly associated with hyperlactataemia, with odds ratios of 5.1 and 2.6, respectively. In conclusion, symptomatic hyperlactataemia is uncommon, while asymptomatic hyperlactataemia is a frequent and apparently benign condition unlikely to progress to lactic acidosis. A significant association between stavudine and hyperlactataemia was confirmed. The unexpected association between ritonavir and hyperlactataemia will need confirmation in future studies.     

颅内动脉瘤栓塞后并发脑缺血的原因分析

1 临床资料我们总结2004-02/2004-06在第四军医大学唐都医院神经外科住院行栓塞治疗颅内动脉瘤患者27(男12,女15)例,年龄32～72岁.     

胸腹部联合损伤73例诊治分析

1临床资料 1995-07／2003-12收治胸腹联合伤73（男52，女21）例，年龄3～72（平均47）岁，急诊入院69例，受伤至急诊入院时间为1／3～16h，致伤原因：穿透伤26例，其中刀刺伤23例，枪伤3例，闭合伤47例，其中车祸38例，坠落伤9例，入院时伴休克50例，呼吸急促36例，胸痛29例，腹痛20例，胸腹联合痛14例，昏迷10例，气管移位11例，伤侧呼吸音减弱或消失17例。     

Delayed posttraumatic Propionibacterium acnes endophthalmitis in a child.

A 7-year-old boy presented with granulomatous anterior uveitis after an unrecognized penetrating injury in the same eye 2 months previously. The uveitis was unresponsive to topical corticosteroid therapy, lensectomy with anterior vitrectomy, and administration of intraocular and subconjunctival injections of vancomycin. Pars plana vitrectomy, capsulectomy, and injection of intravitreal vancomycin were eventually performed, leading to complete resolution of the intraocular inflammation. Culture and histopathologic examination of a capsular specimen confirmed sequestered Propionibacterium acnes infection. This case demonstrates that P. acnes may cause delayed endophthalmitis following penetrating trauma and may persist within capsular remnants in the aphakic eye.     

Depression in individuals with epilepsy

Opinion statement