Characterization of circulating immune complexes by nephelometry in acute leukaemia

Summary Circulating immune complexes were isolated from 15 patients with acute leukaemia and 13 healthy blood donors by PEG precipitation. These were analysed according to their IgG, IgM and C4 content by optical rate nephelometry. Immune complexes of leukaemic patients contained higher amounts of IgM as compared to those from normal subjects. The clinical relevance of IgM containing immune complexes in leukaemia is discussed.     

Frequency and Clinical Manifestations of Patients with Primary Immunodeficiency Disorders in Iran: Update from the Iranian Primary Immunodeficiency Registry

Primary immunodeficiency disorders (PID) are a heterogeneous group of diseases, characterized by an increased susceptibility to infections. A total of 930 patients (573 males and 357 females) are registered in Iranian PID Registry (IPIDR) during three decades. Predominantly antibody deficiencies were the most common (38.4%), followed by congenital defects of phagocyte number and/or function (28.3%), other well-defined immunodeficiency syndromes (17.7%), combined T- and B-cell immunodeficiencies (11.0%), complement deficiencies (2.4%), and diseases of immune dysregulation (2.3%). Common variable immunodeficiency was the most frequent disorder (20.8%), followed by chronic granulomatous disease, ataxia-telangiectasia, btk deficiency, selective IgA deficiency, and T-B-severe combined immunodeficiency. The frequency of other PID disorders was less than 50 in number (<5%). There is an increasing trend in recognition of more PID in the recent years. Construction of such registry is not only important for its epidemiological aspect but also for its role in increasing the physician's knowledge about such disorders.     

Obstetric brachial plexus palsy: a prospective,population‐based study of incidence,recovery, and residual impairment at 18 months of age

Aim The aim of this investigation was to study the incidence of obstetric brachial plexus palsy (OBPP), to prospectively follow the recovery process, to assess the functional outcome at 18 months of age, and to find early prognostic indicators. Method Of the 38 749 children born between 1999 and 2001 in western Sweden, 114 (70 males, 44 females) had an OBPP. Ninety‐eight children were examined on six occasions at up to 18 months of age. Muscle strength, range of motion, hand preference, and functional abilities were noted, and the severity of the OBPP was classified. Results The incidence of OBPP was 2.9 per 1000 live births, and the incidence of persisting OBPP was 0.46 per 1000. At 3 months of age, the predictive value of regained elbow flexion for complete recovery was 100%, 99% of shoulder external rotation, and 96% of forearm supination. Most of the 18 children with persisting OBPP could perform functional activities but asymmetries were noted. Five children had a mild, 11 had a moderate, and two had a severe impairment. Three had undergone nerve surgery, one with a mild and two with a severe persisting impairment. Interpretation Most children with an OBPP recover completely. Muscle strength at 3 months of age can be used to predict outcome.     

基因芯片研究针刺人迎穴对SHR主动脉弓基因表达的影响

目的应用基因芯片观察针刺人迎穴对SHR主动脉弓基因表达的影响。方法将20只SHR大鼠随机分为模型组、人迎组,10只WKY大鼠作为空白组。人迎组大鼠双侧人迎穴进行针刺干预,并记录各组大鼠收缩压变化。4周后剪取大鼠主动脉弓,进行基因芯片检测。结果与模型组比较,人迎组大鼠收缩压显著降低(P0.05)。模型组与空白组相比,452个基因表达上调,245个基因表达下调;人迎组和模型组相比,261个基因表达上调,986个基因表达下调。KEGG通路分析显示在模型组VS空白组、人迎组VS模型组分别发现了12条、10条显著表达(P0.05)的差异通路。结论针刺人迎穴降压机制可能与调控高血压血管重构的细胞外基质受体相互作用通路及通路中的相关基因表达有关。     

Effects of Cardiac Resynchronization Therapy on Heart Rate Turbulence

Background: Cardiac resynchronization therapy (CRT) improves the clinical status of patients with heart failure (HF), though its effects on heart rate turbulence (HRT) are unknown.
Methods: We measured HRT indices in 58 recipients of CRT systems (mean age = 56 ± 9 years, 41 men) in New York Heart Association HF functional class III–IV, and with a left ventricular (LV) ejection fraction ≤35%. At 6 months of follow-up, 42 patients were responders and 13 nonresponders to CRT, and three patients died suddenly. The HRT indices turbulence onset (TO%) and turbulence slope (TS ms/RR interval) were calculated from digital 24-hour electrocardiogram before and after 6 months of CRT. TO ≥ 0% and TS ≤ 2.5 ms/RR interval were considered abnormal.
Results: Mean TO in the entire population was 0.4 ± 1.5 before CRT, and decreased to −0.8 ± 7.0 during the 6 months of CRT (ns). TS increased significantly from 2.0 ± 1.7 at baseline, to 3.9 ± 3.1 (P < 0.05), and a significantly lower proportion of patients had abnormal HRT indices at 6 months. In contrast to the significant increase observed in responders, not significant change in TS was observed among the nonresponders.
Conclusions: During 6 months of CRT, improvements in HRT indices and a decrease in the proportion of patients with abnormal HRT were observed. CRT may have beneficial effects on baroreflex sensitivity.     

Level of Confidence in Diagnosis: Clinical Examination Versus Dermoscopy Examination

BACKGROUND: Confidence is an important factor in decision making and may influence patient care. OBJECTIVES: To evaluate whether short-training-based dermoscopy increases confidence in the diagnosis of skin lesions. METHODS AND MATERIALS: After a 1-hour course on dermoscopy, 20 pairs of clinical and dermoscopic images of lesions were presented to 19 dermatology residents with little or no dermoscopy experience. After viewing the clinical image, they were asked to assess their confidence in the diagnosis in a seven-point scale, with 1 reflecting that the respondent was 100% confident that the lesion was benign, while number 7 reflected 100% confidence that it was malignant. The same technique was used for dermoscopic images. RESULTS: Ten of the 20 pairs of evaluations showed a significant difference (p<.05). The largest differences were observed in lesions where clinical scores suggested that participants were uncertain about the diagnosis, but tended to decide that the lesion was benign after dermoscopy. Dermoscopy did not improve confidence in the evaluation of dysplastic lesions as well as lesions with obvious clinical diagnoses. CONCLUSIONS: Short-training-based dermoscopy improved confidence in the diagnosis of clinically challenging skin lesions, but the impact was not demonstrable for clinically obvious lesions and dysplastic nevi.