Evaluation of the biliary tract: The value of performing magnetic resonance cholangiopancreatography in conjunction with a 3‐D spoiled gradient‐echo gadolinium enhanced dynamic sequence

The 3‐D gradient‐echo (GRE) sequence allows thinner sections and better resolution of biliary obstruction. When the presence of biliary obstruction is identified using magnetic resonance cholangiopancreatography, the addition of the 3‐D GRE sequence may be helpful for diagnosing biliary obstruction. By showing the changes in the bile duct wall, within the duct lumen and around the bile duct, this technique can be helpful for distinguishing benign from malignant stricture as well as a stone from an enhancing intraluminal mass.     

叶酸受体介导的靶向纳米给药系统研究进展

叶酸受体在许多恶性肿瘤细胞表面过度表达,而在正常细胞中则几乎不表达或只有少量表达。利用叶酸受体表达的特性,通过将叶酸修饰于药物载体表面,可使药物靶向输送至叶酸受体过度表达的肿瘤细胞中,从而避免对正常细胞产生毒性,提高药物疗效;而纳米给药系统因粒径较小等原因可使药物在肿瘤部位浓集。本文对近年来叶酸受体介导的靶向纳米给药系统进行了综述。     

Interleukin-10 and Transforming Growth Factor-β in Early and Late Lesions of Patients with Leishmania major induced Cutaneous Leishmaniasis

Background

Cutaneous leishmaniasis is a neglected parasitic disease, which imposes massive human distress and financial costs to the endemic countries. Better understanding of host immune response to the parasite leads to helpful strategies for disease control. Interleukin (IL)-10 and transforming growth factor (TGF)-β are important immune regulatory cytokines, which appear to develop non-healing forms of leishmaniasis. However, there is little information about the function of IL-10 and TGF-β in old world cutaneous leismaniasis. The aim of this study was to analyze the role of IL-10 and TGF-β in human cutaneous leishmaniasis due to Leishmania major infection.

Methods

Biopsies were obtained from lesions of twenty proven cases of L. major induced cutaneous leishmaniasis. IL-10 and TGF-β positive cells were detected by immunofluorescence staining of frozen sections and compared between two groups of patients with early and late lesions.

Results

The mean percentage of IL-10 positive cells were significantly (P= 0.035) higher in late lesions (0.51±0.24) than early ones (0.15±0.07). Similar results were obtained for TGF-β with mean percentages of 0.16±0.05 and 0.53±0.28 in early and late lesions respectively (P= 0.008).

Conclusion

IL-10 and TGF-β are present in lesions of L. major induced cutaneous leishmaniasis and contribute to the pathogenesis of long lasting disease forms.     

The Multiple Forms of Leishmania major in BALB/C Mice Lung in Iran

Cutaneous leishmaniasis is one of the most important parasitic diseases, which are endemic in different parts of Iran. Leishmania major and L. tropica are the primary causative agents of this disease. The aim of the present study was to detect the multiple forms of L. major in lung. Ppromastigotes of L. major at stationary phase were injected to BALB/c mice. After 60 days, the different forms of Leishmania parasites were checked in lung tissue. Promastigote and amastigote forms of Leishmania parasites were detected.     

IL-23 and IL-27 Levels in Macrophages Collected from Peripheral Blood of Patients with Healing Vs Non-Healing Form of Cutaneous Leishmaniasis

Background

In this study the level of IL-23 and IL-27 produced by macrophages derived from peripheral blood mononuclear cell culture collected from patients with healing or non-healing form of cutaneous leishmaniasis lesion were compared before and after treatment with live Leishmania to explore whether IL-23 or IL-27 plays any role in healing process of cutaneous lesions induced by L. major.

Methods

Twenty patients resident in Isfahan Province, with healing or non-healing form of cutaneous leishmaniasis lesion caused by Leishmania major participated in this study. In vitro productions of IL-23 and IL-27 by peripheral blood derived macrophages, before and after stimulation with live L. major (MRHO/IR/75/ER) promastigotes were evaluated using ELISA method. Patient with healing form of lesion received no treatment and patient with non-healing form of lesion received at least 2 courses of glucantime.

Results

The mean production of IL-23 and IL-27 from macrophages of patients with healing form of lesion was significantly higher than patients with non-healing form of lesion. The levels of IL-23 and IL-27 in culture supernatants before and after stimulation in healing form of CL was significantly higher than non- healing form of CL (P < 0.001).

Conclusion

IL-23 and IL-27 might play a role in human leishmaniasis and further studies are needed to understand the role of IL-23 and IL-27 in leishmaniasis.     

温州市鹿城区预防接种室消毒与污染状况调查

为了解我区预防接种室局部消毒的质量和微环境污染状况,对我区街道和村的预防注射室消毒及污染情况进行了调查。其中酒精消毒液浓度、染菌量和空气、操作台面、手染菌量合格率分别为37．5％、36．6％、38．1％、68．3％、43．2％．街道卫生院的酒精消毒液浓度、台面和手染菌量合格率高于村卫生室;酒精和空气染菌量街道卫生院和村卫生室两级单位无明显差别。一次性注射器无菌试验合格率为100％．调查结果表明,我区预防注射室的消毒质量不高,环境污染比较严重。本文分析了原因,提出了改进建议。     

Effects of repetitive superficial chemical peels on facial sebum secretion in acne patients

BACKGROUND: Glycolic acid and Jessner's solution are popular superficial chemical peel agents for the treatment of facial acne, and increased sebum secretion is one of the major aetiological factors of acne. OBJECTIVE: To compare the effects of 30% glycolic acid peels and Jessner's solution peels on sebum secretion in facial acne patients. METHODS: Thirty-eight patients with mild to moderate facial acne were included. Twenty-seven patients were treated with 30% glycolic acid peels and 11 patients with Jessner's solution peels. Each peel was performed twice with an interval of 2 weeks. Before and 2 weeks after each peel, sebum levels of forehead, nose, chin and cheeks were measured by using a Sebumeter (SM810 Courage & Khazaka, Cologne, Germany). RESULTS: The sebum levels were not significantly changed by two peels treatments of 30% glycolic acid peels or Jessner's solution peels on the facial skins of patients with facial acne. CONCLUSIONS: The two types of peels, 30% glycolic acid peels and Jessner's solution peels, did not affect sebum secretion of the facial skins of patients with facial acne after the two peels treatments. The accumulative effects of more than two peels treatments using these modalities need further evaluation.     

Red cell transfusions in total knee and total hip replacement surgery

To explore how red cell transfusions were used to support patients who underwent primary and revision hip and knee replacements classified within diagnosis-related group (DRG) 209 (major joint and limb reattachment procedures), we studied abstracted patient discharge records from 151 United States hospitals in 1986. A total of 9684 units of whole blood and/or separated red cells was used to support 6472 patients. The transfusion use varied by surgical procedure, with patient gender as an influencing factor. Large proportions of patients underwent surgery without requiring transfusion. Among transfused patients, the majority received 1 to 3 units of red cells; however, a minority of patients required multiple transfusions, thereby utilizing a disproportionate share of the blood resource. Comparison of transfusion practice within the seven most active hospitals revealed significant differences (p less than or equal to 0.01) in the percentage of patients actually transfused, but not in the mean number of units of red cell components transfused per transfused patient. Similar findings emerged from comparison of transfusion practice when all hospitals were segregated into five hospital classes on the basis of orthopedic surgical service activity. These effects were seen for both total knee and total hip replacement procedures. It can be concluded that the lack of clearly defined criteria for transfusion contributed to the variations observed.     

Conscious sedation for interventional neuroradiology: a comparison of midazolam and propofol infusion

Purpose

The aim of this study was to compare two conscious sedation techniques, midazolam (M) and propofol (P), for interventional neuroradiology by assessment of the incidence of complications and satisfaction scores.

Methods

Forty patients were randomized to receive 0.75 μg · kg^?1 fentanyl and a M or P bolus followed by an infusion; (M I5 μg · kg^?1 + 0.5 μg · kg^?1 · min^?1: P 0.5 mg · kg^?1 + 25 μg · kg^?1 min^?1). The incidences of complications and untoward events requinng intervention were documented. These included respiratory depression, excessive pain, inappropriate movements and the inability to examine the patient. The satisfaction of the anaesthetic technique from the perspective of both the neuroradiologist and the patient was scored.

Results

The incidence and types of complications were not different between the two groups. Pain occurred in 12 patients (6M, 6P), inappropriate movements in 17 (7M, 10P) and respiratory changes in 10 patients (2M, 8P).

Conclusions

Both techniques were satisfactory and the incidence of complications was similar for both groups.     

ELONGATED STYLOID PROCESS SYNDROME (EAGLE'S SYNDROME)

A 45 year old man presented with persistent pain in throat and otalgia. Clinical and radiographic evaluation confirmed the diagnosis of elongated styloid process syndrome. Surgical shortening of the styloid processes gave relief. The etiopathogenesis, presentation and management of the condition is discussed.KEY WORDS: Eagle''s syndrome, Styloid process