Non-specific symptoms in adult patients referred to a Lyme centre

Objectives

There is controversy whether non-specific symptoms can be related to previous Lyme borreliosis (LB). Positive serology can be considered a proxy for previous or persistent LB. We assessed non-specific symptoms and serology in patients suspected of LB referred to a Lyme centre.

UVB irradiation modulates systemic immune responses by affecting cytokine production of antigen-presenting cells

The immunosuppressive effects of UVB irradiation have been well documented. The production of cytokines by keratinocytes is considered to play a major role in the induction of local as well as systemic immunosuppression. It is thought that partly due to the interaction of locally produced cytokines with antigen-presenting cells (APC) systemic effects, like antigen-specific tolerance, can be induced. In this study we examined the effect of UVB irradiation on cytokine profiles of peripheral APC as well as the functional consequences. Our results indicate that UVB irradiation impairs T(h)1-mediated immune responses in vivo by suppression of the systemic IL-12p70 production. Splenic APC from UVB-exposed mice showed an enhanced production of prostaglandin E(2), IL-1, IL-6 and tumor necrosis factor-alpha after in vitro stimulation. Also, spleen cells from UVB irradiated IL-4(-/-) mice showed increased IL-6 levels. These APC were less efficient in inducing IFN-gamma production by CD4(+) T cells and suppressed IgM production by B cells. We conclude that the altered cytokine profile of peripheral APC can be responsible for the systemic effects of UVB irradiation on the T(h)1/T(h)2 balance as well as on B cell responses.     

Economics and public health: an arranged marriage

Economists are often defined as people who know the price ofeverything, and the value of nothing. After reading ‘Economicsand public health: Engaged to be happily married!’ (WernerBrouwer et al.) one might want to add that economics is nota good training for marriage consultancy. Where WB et al. seemarital bliss, I see the relationship between public healthand economics more like an arranged marriage, based on considerationsother than the mutual attraction of the partners. Certainly,     

高效液相色谱法测定西咪替丁制剂中西咪替丁的含量

目的 :建立西咪替丁制剂中西咪替丁的含量测定方法。方法 :以WatersNONa PakC18为色谱柱 ,甲醇 水 三乙胺 ( 2 5∶75∶0 .1 ,磷酸调节pH至 4 .0± 0 .1 )为流动相 ,甲硝唑为内标物 ,检测波长 2 2 5nm。结果 :线性范围 0 .5～30 μg/ml(r=0 .9993) ,片剂和注射剂的平均回收率±RSD分别为 99.4 5%± 0 .63和 1 0 0 .30 %± 0 .55%。 结论 :方法简便、准确 ,适用于西咪替丁制剂的含量测定     

Serial endoscopic ultrasound in the assessment of response to chemoradiotherapy for carcinoma of the esophagus

The aim of the study was to assess whether endoscopic ultrasound (EUS) could accurately measure the locoregional response to chemoradiotherapy in patients with carcinoma of the esophagus. Seventeen patients with esophageal carcinoma underwent EUS examination before and on completion of chemoradiotherapy. The EUS findings were correlated with the results of histologic examination of the esophagectomy specimen. The accuracy of EUS in these patients was compared with the accuracy of EUS in a control group of 17 patients treated by surgery alone. In 16 of 17 patients EUS-determined tumor (T) stage was unchanged following treatment and in one patient there was T-stage progression. No patient demonstrated downstaging of the primary tumor according to classical EUS criteria. In 10 of 17 patients a reduction in maximum tumor depth of >-2 mm was observed (range 2 to 18 mm). Histologic examination revealed that four patients with squamous cell carcinoma had experienced a complete pathologic response. These four patients had significantly lower posttreatment EUS tumor depths compared to patients without a complete response (5.0 vs. 9.0 mm; P <0.05). Based on the post-treatment EUS examination, the accuracy was 59% for T stage and 59% for node (N) stage. The accuracy of EUS in patients treated by surgery alone was 94% for T stage and 94% for N stage, indicating a significant reduction in the accuracy of EUS in patients following chemoradiotherapy (P <0.05). The accuracy of EUS examination in patients with carcinoma of the esophagus treated by chemoradiotherapy was poor. EUS did not detect downstaging of the primary tumor, even in the presence of a complete pathologic response. EUS assessment of maximum tumor depth was a better measure of response to therapy. Presented at the Association of Surgeons of Great Britain and Ireland, Edinburgh, May 1998, and published as an abstract in British Journal of Surgery 85 (Suppl 1):9, 1998.     

Lumbar sympathectomy in critical limb ischaemia: surgical, chemical or not at all?

The value of surgical and chemical lumbar sympathectomy was studied in patients with critical lower-limb ischaemia without the option of vascular reconstruction. Clinical success rates, defined as improvement of ischaemia stage, and limb salvage rates were recorded for 76 limbs of 70 consecutive patients. Chemical lumbar sympathectomy patients were older and had more concomitant diseases than surgical lumbar sympathectomy patients. The short-term (6-week) success rate in 36 cases treated with surgical lumbar sympathectomy (44%) was better than in 40 cases treated with chemical lumbar sympathectomy (18%) (P = 0.01). The long-term (1-year) success rate was 47% for surgical lumbar sympathectomy and 45% for chemical lumbar sympathectomy (P = NS). The 1-year limb salvage rates were 61% for surgical lumbar sympathectomy and 58% for chemical lumbar sympathectomy (P = NS). Complications were minor in both groups. Lumbar sympathectomy still has a limited role in the treatment of critical limb ischaemia in patients without the option of vascular reconstruction. Both surgical and chemical lumbar sympathectomy can be performed with very little morbidity and may provide a benefit over the natural course of the arterial insufficiency.     

线粒体相关疾病蛋白质组学研究进展

作为后基因时代的一门新学科,蛋白质组学研究技术为线粒体蛋白质组的研究提供了有力的支持,使得从整体上研究线粒体蛋白质组在生理、病理过程中的变化成为可能. 本文回顾了近年来国外学者应用蛋白质组学研究方法揭示相关疾病线粒体蛋白质存在相应的变化,以及通过对线粒体蛋白质组的研究去发现线粒体蛋白质在疾病发生发展中的作用,从而为寻找与疾病密切相关的疾病特异性蛋白提供线索.     

T1ρ-mapping for assessing knee joint cartilage in children with juvenile idiopathic arthritis — feasibility and repeatability

Background

Ongoing arthritis in children with juvenile idiopathic arthritis (JIA) can result in cartilage damage.

Objective

To study the feasibility and repeatability of T_1ρ for assessing knee cartilage in JIA and also to describe T_1ρ values and study correlation between T_1ρ and conventional MRI scores for disease activity.

Materials and methods

Thirteen children with JIA or suspected JIA underwent 3-tesla (T) knee MRI that included conventional sequences and a T_1ρ sequence. Segmentation of knee cartilage was carried out on T_1ρ images. We used intraclass correlation coefficient to study the repeatability of segmentation in a subset of five children. We used the juvenile arthritis MRI scoring system to discriminate inflamed from non-inflamed knees. The Mann-Whitney U and Spearman correlation compared T_1ρ between children with and without arthritis on MRI and correlated T_1ρ with the juvenile arthritis MRI score.

Results

All children successfully completed the MRI examination. No images were excluded because of poor quality. Repeatability of T_1ρ measurement had an intraclass correlation coefficient (ICC) of 0.99 (P<0.001). We observed no structural cartilage damage and found no differences in T_1ρ between children with (n=7) and without (n=6) inflamed knees (37.8 ms vs. 31.7 ms, P=0.20). However, we observed a moderate correlation between T_1ρ values and the juvenile arthritis MRI synovitis score (r=0.59, P=0.04).

Conclusion

This pilot study suggests that T_1ρ is a feasible and repeatable quantitative imaging technique in children. T_1ρ values were associated with the juvenile arthritis MRI synovitis score.