Genome-wide scan identified QTLs underlying femoral neck cross-sectional geometry that are novel studied risk factors of osteoporosis.

A genome-wide screen was conducted using a large white sample to identify QTLs for FNCS geometry. We found significant linkage of FNCS parameters to 20q12 and Xq25, plus significant epistatic interactions and sex-specific QTLs influencing FNCS geometry variation. INTRODUCTION: Bone geometry, a highly heritable trait, is a critical component of bone strength that significantly determines osteoporotic fracture risk. Specifically, femoral neck cross-sectional (FNCS) geometry is significantly associated with hip fracture risk as well as genetic factors. However, genetic research in this respect is still in its infancy. MATERIALS AND METHODS: To identify the underlying genomic regions influencing FNCS variables, we performed a remarkably large-scale whole genome linkage scan involving 3998 individuals from 434 pedigrees for four FNCS geometry parameters, namely buckling ratio (BR), cross-sectional area (CSA), cortical thickness (CT), and section modulus (Z). The major statistical approach adopted is the variance component method implemented in SOLAR. RESULTS: Significant linkage evidence (threshold LOD = 3.72 after correction for tests of multiple phenotypes) was found in the regions of 20q12 and Xq25 for CT (LOD = 4.28 and 3.90, respectively). We also identified eight suggestive linkage signals (threshold LOD = 2.31 after correction for multiple tests) for the respective geometry traits. The above findings were supported by principal component linkage analysis. Of them, 20q12 was of particular interest because it was linked to multiple FNCS geometry traits and significantly interacted with five other genomic loci to influence CSA variation. The effects of 20q12 on FNCS geometry were present in both male and female subgroups. Subgroup analysis also revealed the presence of sex-specific quantitative trait loci (QTLs) for FNCS traits in the regions such as 2p14, 3q26, 7q21 and 15q21. CONCLUSIONS: Our findings laid a foundation for further replication and fine-mapping studies as well as for positional and functional candidate gene studies, aiming at eventually finding the causal genetic variants and hidden mechanisms concerning FNCS geometry variation and the associated hip fractures.     

胫腓骨交叉愈合对踝关节运动的影响

目的探讨胫腓骨交叉愈合后对踝关节运动的影响。方法回顾性分析1999年9月～2003年11月期间7例胫腓骨交叉愈合患者的临床资料。左侧4例,右侧3例。其中2例开放性骨折行钢板内固定,5例闭合性骨折行髓内钉固定。术后随访中测定踝关节的跖屈、背伸。结果7例患者获平均30个月(10～54个月)随访。参照Kofoed踝关节评分系统评价:优6例,良1例。胫腓骨交叉愈合对踝关节的背伸有6.3°左右的影响,对正常行走步态影响轻微。5例患者踝关节有不同程度不适感。结论胫腓骨交叉愈合可能对踝关节退变有重要影响,可通过术中应用合适长度的髓内钉远端锁钉、避免钻孔过深、采用微创手术及早期功能锻炼等方法来预防胫腓骨交叉愈合。     

COMPUTERIZED TOMOGRAPHY IN TUBERCULOUSMENINGITIS

This paper reports computerized tomography(CT) findings in 21 cases of tuberculous meningitis,normal in 5 and abnormal in 16. ' The cases withabnormal CT findings were hydrocephalus, tuber-culoma, exudation in basal cisterns, brain edema andcerebral infarction. The incidence of hydrocephalusincreased with the duration and severity of illness.The Iocations of tuberculomas corresponded withpatients' clinical pictures. The study also indicatedthat patients wih normal or slighly changed scanshad good prognosis, but patients with severe hydrocephalus and exudation m basal cisterns had poorprognosis in spite of active medical treatment. CThas been proved valuable in diagnosis and treatmentof tuberculous meningitis.     

Group coping skills training for anxiety and depression: its application with chronic patients

The literature on group coping skills training is reviewed and a model involving the use of a wide range of coping strategies with patients heterogeneous in terms of presenting problem is advocated. This study evaluates the effect of such an approach with a chronic inpatient and day-hospital patient population (n = 36) presenting with problems of anxiety and depression. Results suggest that the use of such groups can facilitate the transition from hospital to community. Further they are associated with symptomatic improvement that is of clinical significance in up to 50% of cases, which is largely maintained at 1 year follow-up and which is associated with a positive change in social functioning. In the light of this experience suggestions are made regarding the screening of patients and ways of enhancing group cohesion.     

Common bile duct calculi: updated experience with dissolution with methyl tertiary butyl ether

The authors describe their experience with methyl tertiary butyl ether (MTBE) in a larger series of patients than previously reported in order to acquaint physicians with both its effectiveness for dissolution of common bile duct calculi and the limitations of its use. Ten patients with 13 biliary calculi underwent percutaneous stone dissolution treatment with the experimental cholesterol solvent, MTBE. Three stones completely dissolved within 30 minutes, seven were reduced in size, and three were visibly unaffected. All stones not completely dissolved were easily extracted by means of a stone basket except for one in a patient taken to surgery. Although MTBE perfusion is an effective technique for management of biliary calculi, practitioners should be aware that its use is quite time consuming and its odor difficult to control.     

Prostatectomy by transurethral balloon Laserthermia™ (PROSTALASE™) in the canine

Prostatectomy by transurethral balloon Laserthermia (PROSTA-LASE?) was performed in a canine model. This balloon device monitored by transrectal ultrasound can cylindrically irradiate with a laser beam. The treatment was performed in 8 canines using 15 watts for 20 minutes at 60°C at a 5 mm depth of the prostate from the urethral surface. Immediately following the laser therapy, an area of coagulation necrosis was observed around the urethra to a depth of 4–5 mm from the surface. After 1 week, cavitation formation was seen in 3 or 4 canines by ultrasound, and the urethral reepithelialization was shown in 1 of 2 canines. After 2 weeks, cavitation formation was observed in both canines, and the urethra was completely reepithelialized in one canine. There was no tissue damage in the bladder neck of urethral sphincter and no urinary incontinence in any animal. This system is thought to be simple and, satisfactorily performed, is an effective transurethral prostatectomy. © 1994 Wiley-Liss, Inc.     

Tumors of the skull base

Recognition of the many benign and malignant tumors that occur in the skull base is now simple, given three-dimensional CT scanning and MRI with enhancement. Recent developments in surgical technique have allowed these tumors to be approached, but only in the past two to three years has radical surgery been possible.     

广西武鸣华侨农场心血管病危险因素的调查研究

对广西武鸣华侨农场4158人进行基线普查,410人进行膳食调查和作8小时夜尿电解质测定,并将高血压低发区广西的资料与高发区的北京作对比.结果显示,体重指数高是高血压一个重要的危险因素,而体重过重又与膳食中摄入碳水化合物和总热量大有关.另一主要的危险因素是钠,膳食中摄入钠高,尿Na和Na/K比值高者,血压水平和高血压的患病率亦高.     

Gastric ulceration caused by heater probe coagulation

A double-contrast upper gastrointestinal examination on a woman who had undergone endoscopic heater probe therapy one day earlier for multiple arteriovenous malformations revealed shallow, irregular, and linear ulcers at the sites of heater probe coagulation. Multiple shallow ulcers may therefore develop as a direct complication of heater probe therapy. Radiologists should be aware of this complication to avoid diagnostic confusion in these patients.     

Fetal lumbar spine: measuring axial growth with US

Ultrasound (US) can be used to visualize vertebral segments, suggesting a quantitative means of studying vertebral column growth in utero and thus a means of detecting developmental abnormalities. US images of the lumbar spine were obtained in 128 clinically normal fetuses between the gestational age of 11 through 41 weeks. A large-aperture, dynamically focused US system capable of regional magnification was used. Average lumbar spacing was calculated from distance between centrums of at least four lumbar bodies. The average distance between lumbar centrums increased nearly linearly throughout the second and third trimesters (r2 = 0.98). Enhanced anatomic display implies new capabilities for recognizing developmental abnormalities antenatally.