Non-coronary cardiac events,younger age,and IVIG unresponsiveness increase the risk for coronary aneurysms in Italian children with Kawasaki disease

Clinical Rheumatology - Kawasaki disease (KD) is the most frequent cause of acquired heart disease in children in high-income countries because of coronary artery involvement. Risk factors for...     

A community needs assessment among Asian American elders

Despite a significant increase in the size of the Asian American elderly population, little is known about their social service needs and the level of service being provided them. This study used a survey methodology to examine all Asian American senior programs (N = 20) in a major American metropolitan region. The response rate was 90% with respondent agencies serving as the unit of analysis. Findings suggest that Asian elderly clients were primarily women and 'old-old', and that many of them were on SSI. Services provided were primarily tangible and facilitative, rather than clinical. Services needed but not provided were emergency psychiatric care, home attendants, home-delivered meals, legal services, medical services, and protective services. Findings of this study provide useful information for further research and program planning for Asian American elders in urban settings.     

Differentialdiagnose kavernöser Lungenstrukturen

Zusammenfassung Der 56-j?hrige Mann klagte seit ca. vier Wochen über Husten mit rostbraunem Auswurf, Kraftlosigkeit und über einen Gewichtsverlust von ca. 15 kg. An Vorerkrankungen waren ein Herzinfarkt, 2 Lungenembolien und ein Ulcus cruris des rechten Unterschenkels bekannt. Die k?rperliche Untersuchung zeigte einen reduzierten Allgemeinzustand, ein abgeschw?chtes, aber vesikul?res Atemger?usch über allen Lungenabschnitten; au?erdem fiel ein entzündlich ger?tetes Ulcus am rechten Kn?chel auf. Im Labor fanden sich Entzündungszeichen (Leukozytose, CRP, BSG-Erh?hung). Die Thoraxaufnahme (p.a.) lie? im Bereich des linken Lungenoberfeldes eine ca. 7,5 cm gro?e Kaverne erkennen. In der Phlebographie wurde eine frische Thrombose aller dreier Unterschenkelfaszikel sowie ein Zustand nach Thrombose der V. poplitea, femoralis und iliaca mit ausgepr?gtem Kollateralkreislauf über oberfl?chliche Venen nachgewiesen. Bei Verdacht auf Lungentuberkulose wurde zun?chst eine 4-fach Therapie eingeleitet. Zus?tzlich wurde die tiefe Beinvenenthrombose mit intraven?ser Heparingabe (zun?chst 25.000 i.E. über 24 h) therapiert. In der Bronchoskopie ergaben sich weder mikroskopisch noch kulturell Hinweise für eine Lungentuberkulose. Innerhalb von zwei Wochen konnte eine fast vollst?ndige Rückbildung der Kaverne erreicht werden. Die ursprüngliche Arbeitshypothese einer tuberkul?sen Kaverne war aufgrund der raschen Rückbildung und des fehlenden Nachweises von Mykobakterien unwahrscheinlich geworden. Wegen eines weiteren klinisch typischen thrombembolischen Ereignisses wurde ein CT des kleinen Beckens angefertigt, in dem eine ausgedehnte Thrombosierung der V. cava bis zum Abgang der Nierenvenen zur Darstellung kam. Es handelte sich in diesem Fall um die Kaverne einer einschmelzenden Infarktpneumonie.     

Differential matrix degradation and turnover in early cartilage lesions of human knee and ankle joints

OBJECTIVE: To determine whether there are differences in matrix turnover within early cartilage lesions of the ankle (talocrural) joint compared with the knee (tibiofemoral) joint that may help explain differences in the prevalence of osteoarthritis in these 2 joints. METHODS: Cartilage removed from lesions of the tali and femoral condyles was analyzed for type IIB collagen messenger RNA, C-terminal type II procollagen propeptide (CPII), the collagenase cleavage neoepitope (Col2-3/4C(short)), and the denaturation epitope (Col2-3/4m). The content of collagen, glycosaminoglycan, and epitope 846 of aggrecan was quantitated. RESULTS: In ankle lesions, there was an up-regulation of markers of synthesis (CPII [P = 0.07]; epitope 846 [P < or = 0.0001]), but these were down-regulated in the knee (CPII [P = 0.1]; epitope 846 [P = 0.004]). In lesions of the knee, but not the ankle, there was an up-regulation of collagen degradation markers (P = 0.008). On a molar basis, there was 24 times more cleavage epitope than denaturation epitope in knee lesions compared with ankle lesions. CONCLUSION: The up-regulation of matrix turnover that is seen in early cartilage lesions of the ankle would appear to represent an attempt to repair the damaged matrix. The increase in collagen synthesis and aggrecan turnover seen in ankle lesions is absent from knee lesions. Instead, there is an increase in type II collagen cleavage. Together with the differences in collagen denaturation, these changes point to an emphasis on matrix assembly during early lesion development in the ankle and to degradation in the knee, resulting in fundamental differences in matrix turnover in these lesions.     

Intraepithelial carcinoma of the anus in homosexual men

Anal warts (condylomata acuminata) from seven homosexual men revealed intraepithelial carcinoma (carcinomain situ) within the condylomatous tissue or in adjacent anal mucosa. All lesions displayed morphologic evidence of papillomavirus infection and two of the seven revealed histologic changes characteristic of herpes simplex infection. This association of viral infection with malignant transformation indicates that persistent or recurrent anal warts should be excised and thoroughly examined by histologic techniques. Since four of the seven patients had histories suspicious for or diagnostic of the acquired immunodeficiency syndrome (AIDS), we further suggest that homosexual men with persistent or recurrent perianal lesons be evaluated for the presence of the syndrome.     

A right hemisphere dominance for bimanual grasps

To find points on the surface of an object that ensure a stable grasp, it would be most effective to employ one area in one cortical hemisphere. But grasping the object with both hands requires control through both hemispheres. To better understand the control mechanisms underlying this “bimanual grasping”, here we examined how the two hemispheres coordinate their control processes for bimanual grasping depending on visual field. We asked if bimanual grasping involves both visual fields equally or one more than the other. To test this, participants fixated either to the left or right of an object and then grasped or pushed it off a pedestal. We found that when participants grasped the object in the right visual field, maximum grip aperture (MGA) was larger and more variable, and participants were slower to react and to show MGA compared to when they grasped the object in the left visual field. In contrast, when participants pushed the object we observed no comparable visual field effects. These results suggest that grasping with both hands, specifically the computation of grasp points on the object, predominantly involves the right hemisphere. Our study provides new insights into the interactions of the two hemispheres for grasping.     

Glyoxal Fixation and Its Relationship to Immunohistochemistry

Abstract

Glyoxal is a popular substitute for formalin and in many ways acts like it, although there are significant differences. When formulated correctly, glyoxal fixatives produce superior morphological detail in only 1-9 h, but crosslinking does not occur. Glyoxal has a unique reactivity with arginine, producing a cyclic imidazole in place of the highly charged guanidinium group, thus reducing eosinophilia in arginine-rich tissue elements. In the absence of crosslink-induced masking of epitopes, most antibodies work directly on glyoxal-fixed specimens without the need for antigen retrieval. The arginine reaction does cause loss of immunoreactivity in arginine-rich antigens, however. Fortunately, the imidazole is readily removed by a simple antigen retrieval process: pH 8.6 Tris HCl buffer for 10 min at 125°C. The conformational basis for needing antigen retrieval, and how it works on a molecular level is explained for both glyoxal and formalin fixation. (The J Histotechnol 29:65, 2006)

Submitted November 4, 2005; accepted with revisions March 15, 2006.     

Challenges in diagnosis of motor neuron disease: A case series of ALS mimic syndromes

Amyotrophic lateral sclerosis (ALS) is most often a sporadic disorder that affects both upper and lower motor neurons. Because the prognosis of ALS is uniformly poor compared to other motor neuron disorders, defining the diagnosis can help guide appropriate clinical management and improve quality of life for patients. However, the diagnosis of ALS is often challenging and there may be overlapping clinical features with other rare diseases. We present four patients who were referred to our center because of the clinical suspicion of ALS, in whom more detailed assessments revealed an alternative diagnosis, and we discuss the limitations of the modified-El Escorial criteria.