FM sonography in diffuse liver disease: prospective assessment and blinded analysis

FM sonography - a signal-processing technique that uses frequency and phase information as well as amplitude data - shows promise in evaluation of patients with diffuse liver disease. In a prospective blinded review of 37 patients with biopsy-proved liver disease and 42 healthy volunteers, FM sonography was clearly superior to traditional amplitude-based (AM) sonography in distinguishing healthy from diseased subjects. Statistically significant differences were seen in accuracy (FM, 98.7%; AM, 84.8%), sensitivity (FM, 97.3%; AM, 70.3%), and negative predictive value (FM, 97.7%; AM, 78.8%). Our data also suggest that current FM sonographic techniques cannot differentiate among histologic findings associated with different hepatic parenchymal abnormalities. It is unclear, therefore, whether FM imaging can reduce the numbers of patients who require biopsy for diagnosis or the frequency of biopsy procedures in patients with known disease.     

四种口服头孢菌素的体外抗菌活性的比较研究

本文报道口服Cefixime对900株需氧菌和厌氧菌的体外抗菌作用,并与其它口服的头孢克罗、头孢羟氨苄和头孢氨苄进行了比较。Cefixime对链球菌具较强作用,但对葡萄球菌的作用较差;对肠球菌无效。对肠杆菌科细菌的抗菌活性四者之中以Cefixime最强。Cefixime对头孢氨苄耐药株仍具高度活性,其MIC均值可降低60～1200倍以上。绿脓杆菌、硝酸盐阴性杆菌、鲁氏不动杆菌和产碱杆菌对Cefixime和其它3种头孢菌素的敏感性均较差。四者对厌氧菌的作用除厌氧球菌外其抗菌活性都很弱。Cefixime对β-内酰胺酶稳定,口服吸收良好,抗菌作用强,是一个值得进行临床研究的口服头孢菌素。     

Epidemiology of migraine headache in Santiago, Chile: a prevalence study

Objective . To describe the importance of migraine in Santiago, Chile, by analyzing its prevalence, clinical features and impact by age, gender and socioeconomic status. Methods . In 1993, a representative sample of 1,540 adults of the province of Santiago were interviewed using a standard questionnaire. A total of 1,385 (89.9%) subjects responded to the survey. Initially, a designated member of each household responded to the questionnaire. Subsequently, each household member with headaches was asked to respond to questions about severity, frequency, location, duration, associated symptoms and impact in work and social activities of their most frequent headaches. Migraine diagnoses were determined in accordance with the International Headache Society (IHS) criteria of 1988. Results. Recurrent headaches in the past year were found in 516 (36.82%) respondents, 145 (28.1%) males and 371 (71.9%) females. Total prevalence of migraine was found to be 7.3% (95%, CI 5.9–8.6); 11.9% (95% CI 9.6–14.2) in females and 2.0% (95% CI 0.9–3.0) in males. Overall, migraine constituted 19.6% (101/516) of all headaches reported in this sample. The prevalence did not vary significantly by age groups or socioeconomic status (SES). Migraine with aura had an overall prevalence of 3.5% (CI 0.8–7.1), and was significantly more frequent in females. In 60–70% of cases the attacks lasted 2–6 h and the frequency was 3.3 and 3.4 per month in females and males respectively. Both males and females reported significantly high percentages of attacks during work. Conclusions . Migraine prevalence in a sample of adults of Santiago is similar to that reported in previous studies using IHS criteria. Women of all socioeconomic levels are at an increased risk.     

Low HIV-1 proviral DNA burden detected by negative polymerase chain reaction in seropositive individuals correlates with slower disease progression.

During 1989, 316 members of a cohort of homosexual men were tested for HIV-specific DNA by the polymerase chain reaction (PCR) using a pair of gag-region primers. Of 125 HIV-seronegative subjects, 123 (98.4%) were PCR-negative while 158 (82.7%) of 191 HIV-seropositive subjects were PCR-positive. Fewer of the 33 subjects who were seropositive and PCR-negative were at Centers for Disease Control (CDC) stage IV than the seropositive, PCR-positive subjects (6 versus 25%; P = 0.030). The seropositive, PCR-negative group had higher mean CD4 counts (640 versus 490 x 10(6) cells/l; P = 0.006), higher CD4: CD8 ratios (0.92 versus 0.64; P = 0.004), lower immunoglobulin (Ig) G levels (1290 versus 1645 mg/dl; P = 0.002), lower IgA levels (168 versus 251 mg/dl; P less than 0.001), and lower C1q binding activity (8 versus 14%; P = 0.010) than the seropositive, PCR-positive subjects. The median rate of CD4 cell decline in the 3 years preceding the PCR sample was less marked in the seropositive, PCR-negative group than the seropositive, PCR-positive group (-58 versus -77 x 10(6) cells/l per year; P = 0.028). To control for duration of infection, we restricted the analysis to the subgroups of 11 seropositive, PCR-negative subjects and 34 seropositive, PCR-positive subjects who had seroconverted earlier in the cohort study. Both subgroups had similar durations of infection, yet the same pattern of differences persisted.(ABSTRACT TRUNCATED AT 250 WORDS)     

Relationship of alcohol consumption to diet: a population-based study in Hawaii

The relationship of alcohol use to diet was examined in 2272 male and 2337 female adults aged 45 y and older who provided a quantitative diet history during 1977-1979. Mean values for each dietary variable, adjusted for smoking, ethnicity, income, and education, were compared in each sex between abstainers and drinkers and by tertile of ethanol intake. Linear relationships with extent of drinking were also sought. Drinkers were found to be less obese than abstainers. Consumption of carbohydrate, vitamins, calcium, fruits, fruit juices, and raw vegetables was greater among abstainers whereas consumption of fat (particularly polyunsaturated fatty acids), cholesterol, zinc, meat, pickled vegetables, and dried fish was greater among drinkers. Because validations of dietary questionnaires have shown that alcohol consumption is more accurately recalled than food intake, the possibility of a residual confounding effect for these dietary variables should be considered in epidemiologic studies of alcohol and health.     

Management of acute visual loss in children.]

Acute or rapidly progressive visual loss in children needs urgent attention and treatment. It may be unilateral orbilateral. Etiology depends upon the involved areas: eye ball, optic nerve, retro-chiasmatic pathways. Psychogenic origin is quite common in school-age children, however, it has to be considered last. Unilateral visual loss may be overlooked. Acute total transitory visual loss may be due to epilepsy or to migraine. Rapidly progressive visual loss may be due to retinal disease, optic neuritis or cortical blindness. Management of visual loss depends on clinical features, associated symptoms, and aspect of the optic disc. It needs collaboration between ophthalmologist,pediatrician and neuropediatrician. Retinal hemorrhages first call to mind a traumatic origin. Swelling of the optic disc may be due to increased intracranial pressure or due to optic neuritis. When the optic disc is normal it is necessary to rule out organic diseases before establishing the diagnosis of a psychogenic vision disturbance. In emergency, brain neuroimaging is the best way to diagnose intracranial mass and visualize optic pathways.     

先天性胆脂瘤的MRI诊断

目的：探讨MRI对先天性胆脂瘤的诊断价值。方珐：回顾性分析7例经手术病理证实的先天性胆脂瘤的MRI表现，7例均为脑外型，其中6例胆脂瘤位于桥小脑角区，l例胆脂瘤位于脊髓内．结果：先天性胆脂瘤的绝大多数MRI表现为T1WI呈低信号,T2WI呈高信号，信号欠均匀，且病灶具有“见缝就钻”的特点。增强扫描，病灶无强化，但如合并感染可有轻度强化。结论：MRI的表现及特殊序列FLAIR、SPIR像的相互补充应用对先天性胆脂瘤的诊断及鉴别诊断具有重要意义。     

多发性硬化症的治疗时机窗：单克隆抗体治疗的依据

1991—2002年间采用可长期消耗T淋巴细胞的人单克隆抗体(Cam path-1H)治疗58例多发性硬化症(M S)患者,患者的临床症状和炎性替代标记物得到抑制。在M S的复发-缓解(R R)和继发进展(SP)期,Cam path-1H可降低患者的年复发率(分别由2.2降至0.19和由0.7降至0.001,P<0.001)。7年前使