CYP2D6和GST在白种人晚期肾病中的遗传变异

目的生物转化酶细胞色素P4502D6(CYP2D6)和谷胱苷肽转移酶-M1(GST-M1)、谷胱苷肽转移酶-T1(GST-T1)共同代谢内源性和外源性毒素,一部分人群由于相应基因变异导致这些酶缺乏表达,我们检测白种人群中晚期肾病(ESRD)病人这些酶的基因多态性是否比健康者有较高的频率.方法从列克星顿及周围地区征募330名晚期肾病病人和303名健康者,均为白种人,给予他们进行CYP2D6和GST-M1和T1基因分型.结果在ESRD病人中CYP2D6和GST-M1和GST-T1以及CYP2D6和GST-M1或GST-T1都缺乏分别为2.1%和4.2%;而在健康者中均为0.3%(P<0.01).结论CYP2D6和GST-M1和/或GST-T1酶缺乏在ESRD病人中有较高的频率,提示这些酶缺乏可以预计慢性肾病进展的可能性.     

Esophageal Stricture Complicating Stevens-Johnson Syndrome

Esophageal stricture may occur as a late complication of the Stevens-Johnson syndrome. Our patient suffered multiple complications, including bilateral blindness and developed significant dysphagia two months after the onset of the Stevens-Johnson syndrome. Early radiologic and endoscopic documentation of the stricture of the distal esophagus led to the initiation of treatment with esophageal dilatation. A program of esophageal dilatation and antacid therapy was successful in relieving the dysphagia and in returning the patient to her normal diet. With early diagnosis and treatment of esophageal stricture surgical intervention may be avoided.     

Charcot-like joints in calcium pyrophosphate dihydrate deposition disease

Two cases of Charcot-like joints in patients with pseudogout who were otherwise neurologically intact are presented. The arthropathy of pseudogout should include Charcot-like joints and it is emphasized that an apparent Charcot joint should raise the question of pseudogout.     

Computed tomography in the diagnosis and localization of intraabdominal abscesses

Computed tomographic scanning of the abdomen in 50 patients evaluated for suspected intraabdominal abscess resulted in an overall accuracy of 92 percent. It proved the most accurate diagnostic tool in determining the presence of intraabdominal abscess. Computed tomography of the abdomen is a useful diagnostic adjunct to clinical judgment and may assist in localizing intraabdominal abscesses and planning early surgical intervention.     

Use of glucagon in conjunction with the end-to-end anastomosis (EEA) stapling device for low anterior anastomoses

Summary We have found intravenous glucagon useful in overcoming the spasm of the rectal stump that one sometimes encounters while performing transanal end-to-end anastomosis using the EEA stapling device.     

Massive abdominal wall desmoid tumor

The management of a massive abdominal wall desmoid tumor in a young woman with Gardner's syndrome is discussed. Treatment options included primary radiation, subtotal excision with radiation, primary chemotherapy or radical resection with abdominal wall reconstruction. The advantages and disadvantages of the various treatment options are discussed, and the technique of resection and reconstruction is explained. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. No reprints are available.