Arteriovenous malformations of the extremities: MR imaging

Eight patients with angiographically proved arteriovenous malformations (AVMs) of the extremities (seven congenital, one posttraumatic) were evaluated with magnetic resonance (MR) imaging using a 0.35-T superconducting system and spin-echo pulse sequences. Congenital AVMs appeared as accumulations of dilated tortuous blood vessels infiltrating the involved muscles. A posttraumatic acquired AVM of the shoulder consisted of a large feeding artery associated with a pseudoaneurysm and a soft-tissue mass. MR imaging allowed precise anatomic localization and provided details concerning the size and extent of the AVMs. The relationship of AVMs to specific muscle groups, bones, and vascular structures could be accurately determined. Although major feeding and draining vessels were identified, the exact arteries and veins supplying and draining the AVM could not be ascertained. Images obtained in the transverse plane consistently yielded the most useful information. MR imaging and angiography may be complementary techniques in the initial evaluation, follow-up, and treatment planning of AVMs of the extremities.     

Low-dose ibuprofen in self-medication of mild to moderate headache: a comparison with acetylsalicylic acid and placebo

A double-blind, threefold crossover, double-dummy trial was performed, investigating the efficacy of 200 mg ibuprofen compared with 500 mg acetylsalicylic acid and placebo in patients who usually treated their headaches with over-the-counter drugs. Ninety-five patients suffering from mild to moderate migraine or episodic tension-type headache were included. Seventy-seven patients entered the intention-to-treat analysis and 65 completed all three treatments. For the main response criterion, a minimum 50% decrease of headache intensity on a visual analogue scale at I h after treatment, ibuprofen was significantly superior to acetylsalicylic acid and placebo. This was true for migraine attacks and tension-type headache episodes. Towards the end of the observation period (150 min), the differences between ibuprofen and acetylsalicylic acid were no longer significant. In conclusion, ibuprofen was at least equivalent to acetylsalicylic acid and superior to placebo.     

Sensitization of trigeminal nociception specific for migraine but not pain of sinusitis.

Neurology. 2002;59:1450-1453.
Trigeminal pain processing was studied in 14 patients with unilateral migraine attacks and 14 age- and sex-matched patients with comparable unilateral headache from frontal sinusitis. Using a nociception-specific blink reflex method (nBR), a facilitation of nBR responses predominantly on the headache side was observed in migraine, but not in sinusitis. The facilitation of trigeminal nociception may be specific for migraine rather than a consequence of peripheral pain such as frontal sinusitis.
Comment: Here we have evidence for the central hyperexcitability of migraine, not found in the previously cited article by Boska et al. SJT     

ELISA versus PCR for diagnosis of chronic Chagas disease: systematic review and meta-analysis

Background  

Most current guidelines recommend two serological tests to diagnose chronic Chagas disease. When serological tests are persistently inconclusive, some guidelines recommend molecular tests. The aim of this investigation was to review chronic Chagas disease diagnosis literature and to summarize results of ELISA and PCR performance.     

无牙颌颞下颌关节紊乱病患者总义齿修复前后咬合垂直距离改变与髁状突在关节凹内位置的关系

目的:观察咬合垂直距离改变对无牙颌颞下颌关节紊乱病患者两侧颞颌关节髁状突位置的影响。方法:于1994-01/1997-12选择本院口腔修复门诊收治的无牙颌患者中符合颞下颌关节紊乱病诊断标准,同时垂直距离减低的患者48例。实验方案经医院伦理委员会审批,患者均知情同意。将48例无牙颌颞下颌关节紊乱病患者根据垂直距离减低程度的不同分为3组:减低1.8～6.0mm组18例,减低6.1～10.0mm组20例,减低10.1￣14.0mm组10例。通过重新制作一副全口义齿的方法治疗,咬合垂直距离恢复在合适的范围内,3组全口义齿的咬合垂直距离恢复前分别平均为63.4,60.6,54.2mm,恢复后咬合垂直距离分别平均为67.8,68.4,66.4mm,平均抬高4.4,7.8,12.2mm。通过拍摄正中颌位时颞下颌关节薛氏位X射线片测量各组前、后、上关节间隙。结果:垂直距离恢复前,减低1.8～6.0mm组关节后间隙,减低6.1～10.0mm组关节前、后间隙、减低10.1￣14.0mm组关节上、后间隙左右侧相比较,差异有显著性意义(P<0.05)。垂直距离恢复后,3组关节间隙左右侧差异无显著性意义。结论:无牙颌咬合垂直距离减低后可以导致两侧髁状突位置发生不对称改变。     

成纤维细胞的力学生物学(下)

一、肌腱内成纤维细胞的力学生物学反应 肌腱内的成纤维细胞可以合成胶原蛋白及其他一些大分子。成纤维细胞可以将这些分子排列成组织性较高的单元，并使纤维的方向与张力方向平行。无论是培养的肌腱还是独立的成纤维细胞都可以对力做出相应的反应。     

In-111-labeled white blood cell uptake in noninfected closed fracture in humans: prospective study

Since indium-111 white blood cell (In-111 WBC) scintigraphy is often used to evaluate for osteomyelitis in bone fractures, it is important to know if noninfected fractures have In-111 WBC uptake. Twenty-seven noninfected closed fracture sites in 19 patients were prospectively evaluated with technetium-99m methylene diphosphonate bone scintigraphy and In-111 WBC scintigraphy. In-111 WBC uptake was present in 41% of the 27 sites. In the 11 positive sites, the In-111 WBC uptake was 1+ (definite but minimal) in 55%, 2+ (moderate) in 36%, and 3+ (marked) in 9%. The visual intensity of the radioactive uptake on In-111 WBC scintigrams relative to that on bone scintigrams was less in 82%, equal in 9%, and greater in 9%. The visual size of the area of uptake on In-111 WBC scintigrams and bone scintigrams was smaller in 36%, equal in 55%, and greater in 9%. Factors that may help distinction of In-111 WBC uptake due to fracture alone from infection associated with fracture are discussed.     

De novo acute B-cell leukemia with translocation t(14;18): an entity with a poor prognosis.

Three cases of de novo acute B-cell lymphoblastic leukemia are presented, all with an unusual phenotype, involvement of translocation t(14;18) and additional chromosomal abnormalities, including translocation t(8;14) and deletion of chromosome 9. In contrast to normal FAB-L2 or FAB-L3 acute lymphoblastic leukemia (ALL), these leukemias did not express cytoplasmatic and membranous immunoglobulin. The combination of translocation t(14;18) and additional chromosomal events on the other chromosome 14 account for the lack of immunoglobulin expression. In one case a low grade follicular lymphoma was found next to a high grade Burkitt type ALL. The translocation t(14;18) takes place as a mistake in the VDJH joining in pre-B cells in the bone marrow. It is proposed that some cases of de novo ALL may arise as a blast crisis induced by genetic events, secondary to the primary t(14;18) translocation. This type of ALL seems to have a poor prognosis.