Transjugular intrahepatic cavoportal shunt for Budd–Chiari syndrome

Budd–Chiari syndrome (BCS) is characterized by obstruction of the hepatic venous outflow tract. Therapeutic options for BCS are limited. We report a case of a 21-year-old woman with protein S and C deficiency with gross ascites. Treatment with transjugular intrahepatic portosystemic shunt (TIPS) was attempted, which revealed occluded hepatic veins, so transcaval TIPS was performed. No serious procedure-related complication occurred. After successful shunt creation, the patient's symptoms subsided and she was discharged and followed up for 6 months.     

用微机对青霉素皮试作辅助判断的临床应用的探讨

目的探讨微机对青霉素皮试结果作辅助判断的准确性。方法我们根据青霉素皮试常规观察指标设计了青霉素皮试观察记录单,分三个时段观察青霉素皮试的结果。计算机程序判断青霉素皮试的结果是对观察记录经过综合分析得出的。结果应用计算机对376例青霉素皮试的结果进行辅助判定,其结果表明计算机程序对青霉素皮试结果的判断正确性不低于人工判定,经χ2检验P>0.05,说明两者判断结果无显著性。     

Das Lidekzem

Lidekzeme sind pathogenetisch heterogen. Ihre Behandlung ist durch die anatomischen und funktionellen Gegebenheiten der Periorbitalregion erschwert. Dies macht sie, neben ihrer h?ufigen Therapieresistenz und Rezidivneigung, zu einer gro?en diagnostischen und therapeutischen Herausforderung für Haut- und Augen?rzte.Auch ein vergleichsweise kleinfl?chiges Lidekzem kann aufgrund der belastenden Symptomatik und der hohen ?sthetischen Bedeutung dieser K?rperregion einen hohen Leidensdruck verursachen. Diese interdisziplin?re übersichtsarbeit zum Thema behandelt vor allem aktuelle pathogenetische und therapeutische Aspekte der Lidekzeme. Dr.A.Wollenberg Klinik und Poliklinik für Dermatologie und Allergologie der Ludwig-Maximilians-Universit?t München, Frauenlobstr.9-11, 80337 München, E-Mail: wollenberg@lrz.uni-muenchen.de     

A sequential study of visual evoked potential in patients with vitamin B12 deficiency neurological syndrome.

OBJECTIVE: Visual pathways are vulnerable to vitamin B(12) deficiency but there is paucity of studies evaluating visual evoked potential (VEP) changes following vitamin B(12) supplementation. Our aim was to evaluate the visual evoked potential changes in patients with vitamin B(12) deficiency neurological syndrome and their changes after vitamin B(12) therapy. METHODS: Seventeen patients with vitamin B(12) deficiency neurological syndromes diagnosed on the basis of megaloblastic bone marrow or low serum vitamin B(12) level or both were subjected to testing of visual acuity, field of vision, colour vision and neurological examination. Cranial magnetic resonance imaging was done in 9 patients and pattern reversal VEP was carried out on admission. P(100) latency and amplitude were measured. Visual function and VEP studies were repeated at 3 and 6 months after vitamin B(12) therapy. RESULTS: The patients' age ranged between 17 and 69 years; 7 were females and 16 were lactovegetarians. The duration of symptoms ranged between 10 days and 10 years. Visual acuity, colour vision, field of vision and fundus oculi were normal. VEP revealed prolongation of P(100) latency in 10 patients (17 eyes) which was mild in 2, moderate in 10 and marked in 5 eyes. Six months after treatment, P(100) latency improved to normal in all except 4 eyes. VEP abnormality was related to duration of illness and antiparietal cell antibodies. CONCLUSIONS: VEP is frequently prolonged in patients with vitamin B(12) deficiency neurological syndrome although asymptomatic. It usually returns to normal after treatment.     

Levels, Complement Activity and Polymorphisms of Mannan-Binding Lectin in Patients of Bronchial Asthma with Allergic Rhinitis

Activation of complement pathways, leading to production of C3a and C5a anaphylatoxins, has been postulated in the pathogenesis of asthma and allergic airway inflammation. The present study was undertaken to investigate the role of mannan-binding lectin (MBL), an initiator of the lectin pathway of complement, in asthma and allergic rhinitis. MBL levels and MBL-induced complement activity were determined in 19 patients of bronchial asthma with allergic rhinitis and 20 unrelated, age-matched controls of Indian origin. MBL levels and activity were correlated with percent eosinophilia and percent predicted FEV1 values of the patients. Association of single nucleotide polymorphisms (SNPs) in exon 1 and intron 1 of the MBL with the disease, clinical markers, MBL levels and MBL-induced complement activity was analysed using standard statistical tools. Significantly higher MBL levels and activity were observed in patients of bronchial asthma with allergic rhinitis as compared to the controls. We identified five SNPs, of which two, A816G in exon 1 and G1011A in intron 1 of the MBL, were novel. SNP G1011A was significantly associated with the disease ( P =  0.0024, OR = 5.8696, 95% CI: 1.7316 < OR < 19.8963). Individuals with 'A' allele at position 1011 showed increased MBL levels, activity and disease severity. Our results suggest that 'A' allele at position 1011 leading to high MBL levels and complement activity may be contributing to the severity of bronchial asthma and allergic airway inflammation.     

Influence of finishing time on marginal sealing ability of new generation composite bonding systems

Although variation in finishing techniques has been shown to affect microleakage, little research has been published on the influence of finishing time on the marginal sealing ability of new generation composite bonding systems. The objective of the present study was to evaluate the influence of finishing time on the enamel and dentine marginal sealing ability of four new generation composite systems. Two class V preparations, which were solely in enamel or dentine, were made on the buccal surfaces of 96 freshly extracted molar teeth. The teeth were randomly divided into four groups of 24 and restored with composite resin (Silux Plus^®) utilizing the following bonding systems: Scotchbond Multi-purpose^®, Fuji Bond LC^®, Prime & Bond 2·0^® and Bisco One-step^®. Half of the restorations in each group were finished immediately after light polymerization and stored for 1 week. For the remaining restorations, finishing was delayed for 1 week. The storage medium was isotonic saline at 37°C throughout the experiment. All restorations were then thermocycled, subjected to dye penetration testing, sectioned and scored. The results suggest that the finishing of composite restorations, bonded with the bonding systems evaluated, should be carried out immediately after light polymerization. Delayed finishing does not improve but instead can be detrimental to the marginal seal of the restorations. The effects of delayed finishing are, however, both bonding system and tissue specific.