Eruptive pseudo‐angiomatosis lesions are associated with intravascular neutrophils and do not harbour Epstein–Barr virus

Background Eruptive pseudo‐angiomatosis (EPA) is a rare, relatively newly described cutaneous disorder characterized by the sudden onset of several bright red, angioma‐like papules surrounded by blanched halo. Its aetiology is unknown; however, viral infection or mosquito bites have been speculated as possible causes. Objective This study aims to determine the clinical and histopathological features of EPA, and whether it is associated with Epstein–Barr virus (EBV) infection. Methods We conducted a retrospective chart review of 25 EPA cases from 2006 to 2008. In order to determine latent EBV infection, EBV‐encoded small RNA (EBER) in situ hybridization was performed in 18 subjects. To determine EPA's distinguishing histological characteristics, we compared the cases with 22 control cases of perivascular lymphocytic infiltration for haematoxylin and eosin, CD3, CD4, CD8, CD31 and c‐kit staining patterns. Results The patient sample's female‐to‐male ratio was 2.1 : 1, and the patients’ age ranged from 5 to 79 years (average 46 years). The lesions appeared during the months of July to September in all but 3 patients. Skin biopsies demonstrated capillary ectasia with perivascular mononuclear cellular infiltrates in the upper dermis. Most patients were otherwise healthy, and routine laboratory results were all normal except in one patient who had diabetes. The skin lesions faded without any treatment in 1–2 weeks. Results of EBER in situ hybridization were all negative. The only histological distinguishing feature of EPA was the presence of intravascular neutrophils, which was found to be present in 19 of the 20 EPA cases (95%), in contrast to only 3 of the 22 control subjects (14%) (P < 0.0001). Conclusion The sudden onset of lesions during the summer months among our patients supports the ‘paraviral eruption’ concept of this probably underdiagnosed condition. The significant presence of intravascular neutrophils may be a diagnostic clue of EPA in South Korea.     

Nasopharygeal carcinoma in Queensland,Australia: A review of 10 years experience

The purpose of this study was to compare the treatment outcomes of patients with nasopharyngeal carcinoma in Queensland in a 10‐year period during which synchronous chemoradiotherapy has come into use and to compare characteristics of patients of different racial origins and their prognostic factors. Eighty‐one patients treated between 1991 and 2001 at the Queensland Radium Institute, Brisbane, Queensland for histologically confirmed nasopharyngeal carcinoma were included. Seventeen patients were treated using the Intergroup protocol, 32 patients with miscellaneous synchronized chemoradiotherapy, 6 patients with neoadjuvant regimens and 26 patients with radiotherapy only. Asian patients were found to present earlier than White Australian patients (P < 0.02). No significant difference was identified in the histological presentation between the two ethnic groups. Asian patients were more likely to have a relapse and poor loco‐regional control. Overall survival, however, was not different. Patients treated according to the Intergroup protocol had better disease‐specific survival and relapse‐free survival than the other groups. The median follow up was 36 months. Twenty‐five patients (30%) developed recurrent disease. The 5‐year salvage survival or survival after relapse was 15%. Our experience with the Intergroup protocol in our population is similar to other studies, with likelihood of improved results.     

急性冠脉综合征采用氯吡格雷和阿司匹林治疗后引起的出血并发症

介绍:CURE(theClopidogrelinUnstableAnginatoPreventRecurrentEvents,氯吡格雷预防不稳定型心绞痛复发事件)研究显示不稳定型心绞痛(UAP)和非ST段抬高的心肌梗死(NSTEMI)患者联合使用阿司匹林(ASA)和氯吡格雷的益处。我们试图评价在一些未选择的丹麦患者中引入CURE标准是否增加出血的危险。材料和方法:CURE标准完成于2001年12月Odense大学医院的心脏科。本研究主要观察了2个为期1年的时间段:第1段,从2000年12月到2001年11月;第2段,从2001年12月到2002年12月。回顾病例表,登记主要的出血并发症和初级临床终点(非致死性的心肌…     

Cyclooxygenase-2 expression in human colorectal cancer is unrelated to overall patient survival.

PURPOSE: Cyclooxygenase-2 (COX-2) expression in human colorectal cancer and adenoma tissue seems to be higher than in normal mucosa. However, data about the relation between COX-2 expression and patient survival are inconclusive as yet. Therefore, we studied COX-2 expression in surgery tissue and survival time in a cohort of 747 colorectal cancer patients. EXPERIMENTAL DESIGN: Surgical specimens of primary colorectal cancer from 747 individuals were immunostained for COX-2 and evaluated under a transmission light microscope. COX-2 expression was scored according to intensity and extent of staining, resulting in the COX-2 immunoreactivity score (IRS-COX2). All possible cutoff points for IRS-COX2 were analyzed for a relation between COX-2 expression and patient survival. RESULTS: Both univariable and multivariable analysis have shown that the COX-2 expression in human tumor epithelial cells was unrelated to overall patient survival and to disease-free survival, irrespectively of the cutoff point for IRS-COX2. The survival rates for 1, 3, 5, and 10 years were 81.0%, 66.8%, 60.2%, and 49.8% (median: 117.3 months; 95% confidence interval, 102.3-132.0), respectively. In the multivariable analysis, only node and metastasis were significantly related to overall patient survival. Similar results were obtained when stage IV and rectal cancer patients were excluded from the analysis. CONCLUSIONS: COX-2 expression in tumor epithelial cells does not seem to be related to survival of colorectal cancer patients. Besides COX-2, there are several targets, such as the peroxisome proliferator-activated receptors, that are involved in carcinogenesis and may be modulated by nonsteroidal anti-inflammatory drugs. Further studies are needed to determine their prognostic relevance.     

新兵训练下肢疲劳性骨折的研究

目的 :研究下肢疲劳性骨折的发病机制 ,探讨新兵基础训练期间疲劳性骨折发生的危险因素 ,制定疲劳性骨折的预防措施 ,指导新兵完成好训练任务。方法 :选择 1978— 2 0 0 1年我院下肢疲劳性骨折 12 6例 (胫骨 12 5例 ,股骨 1例 )分析其X线及CT征象 ,了解及发生的危险因素。对某部 2 0 6名新兵训练期间控制 5km跑作为干预方案 ,对同期训练的某部新兵 2 10名未行干预作为对照组。结果 :干预组疲劳性骨折发生率为 0 97% ,对照组为 3 3 3 % ,两者存在着显著差异 (P <0 0 1)。结论 :控制 5km跑为主的干预方案能降低疲劳性骨折的发生率 ,适合基层部队新兵训练中推广。