Case Report: Gianotti-Crosti Syndrome Associated with Human Herpesvirus-6 Infection

We report a case of Gianotti-Crosti syndrome associated with human herpesvirus-6 (HHV-6) infection. An eight-month-old girl developed monomorphous papules on her cheeks, buttocks, and extremities after the subsidence of exanthema subitum. Viral antibody analysis confirmed primary HHV-6 infection. HHV-6 may be added to the list of causative agents of Gianotti-Crosti syndrome.     

The bioavailability and nonlinear pharmacokinetics of MK-679 in humans

MK-679 (R(?)-3-((3-(2-(7-chloro-2-quinolinyl)ethenyl)phenyl)(3-(dimethylamino)-3-oxopropyl)thio)methyl)thio(propanoic acid) is a potent and specific LTD₄-receptor antagonist. The disposition of MK-679 was investigated in a three-way crossover study in 12 healthy males receiving single intravenous doses of 75, 250, and 500 mg of MK-679. A greater than proportional increase in the area under the plasma concentration—time curve of MK-679 was observed with increase in dose. The plasma concentration data for each subject fitted well to the differential equations for a two-compartment model with linear tissue distribution and Michaelis-Menten elimination from the central compartment, indicating that the elimination of MK-679 in humans is saturable. In a previous study, the disposition of MK-679 in humans was also dose-dependent when given together with its S(+)-isomer, L-668,018. Thus, the disposition of MK-679 in humans is dose-dependent regardless of the presence of its stereoisomer. Also, the bioavailability of MK-679 was determined in six healthy males receiving simultaneously an oral dose of 250 mg of MK-679 and intravenous infusion of 1 mg ¹⁴C-MK-679. Results of this study indicate that the oral bioavailability of MK-679 is nearly quantitative.     

Rigid contact lens decentration: a risk factor for corneal warpage

Clinically significant contact lens induced corneal warpage is seen in a small proportion of soft and rigid contact lens wearers. Previous studies using the keratometer have found no correlation between the fit of the lens and the induced topographic changes. In this study, using computer-assisted topographic analysis, seven eyes (four patients) with rigid contact lens-induced corneal warpage were noted to have topographic abnormalities that correlated with the decentered resting position of the contact lens on the cornea. The warpage topography for each of these corneas was characterized by a relative flattening of the cornea underlying the resting position of the contact lens. Lenses that rode high, for example, produced flattening superiorly and resulted in a relatively steeper contour inferiorly that simulated the topography of early keratoconus patients who had not worn contact lenses. After discontinuing contact lenses the corneal topography returned to a normal pattern in five eyes. Two eyes retained asymmetry that is not characteristic of normal corneas. Up to 6 months was required for the corneas to return to a stable topography after contact lens wear was discontinued.     

Effect of Yag-laser anterior capsulotomy on the biochemical content of aqueous humor

Elevation of prostaglandins and protein in the aqueous humor is an immediate response to Yag-laser anterior capsulotomy. There was a significant correlation between prostaglandins and thromboxane to the elevation of intraocular pressure. The elevation of protein concentration was proportional to the elevation of prostaglandin F1, but not to thromboxane. The biochemical changes in the aqueous humor were more severe as laser power was increased above 3 mj. While the role of prostaglandins in the elevation of intraocular pressure is uncertain, the present data recommend the selection of laser power below 3 mj to avoid pressure rise instead of inhibition of all prostaglandin synthesis by medication.     

体外循环中血浆内皮素、血管紧张素Ⅱ和前列环素的变化及临床意义

目的:分析体外循环心内直视手术中血浆内皮素、血管紧张 和前列环素的变化及临床意义。 方法 :应用放免法分别于 7个时点测定 30例心内直视手术病人血浆内皮素、血管紧张素 和前列环素 (终产物 6 - keto-PGF1α)水平。结果 :血浆内皮素水平在转机时高于术前 (P <0 .0 5 ) ,转流中逐渐升高 ,停转流时达高峰 (P <0 .0 1) ,术后 2 h及 2 4 h逐渐降低 ,但仍高于术前 (P <0 .0 5 )。血管紧张素 水平在转机时高于术前 (P <0 .0 5 ) ,转流 30 min降低 ,主动脉开放时升高 ,停转流时达高峰 (P <0 .0 1) ,术后 2 4 h呈下降趋势 ,但仍高于术前 (P <0 .0 5 )。 6 - keto- PGF1α在转流即刻显著升高 ,以后各时点降低。结论:体外循环期间血浆内皮素、血管紧张素 水平显著增高 ,6 - keto- PGF1α水平逐渐降低。体外循环期间加入内皮素、血管紧张素 拮抗剂或前列环素合成剂有利于心功能恢复     

纸质病案保存期限的思考

本文作者比较了不同时期的纸质病案的使用率,讨论了旧病案的缺点,如难于保存,占用空间及实用价值不大.作者提出了改进保存病案的办法.