慢性肝病患者脾硬度值与肝硬度值的相关分析

目的 研究慢性肝病患者脾脏硬度(SSM)值与肝脏硬度(LSM)值的相关性.方法 选择200例慢性肝病患者,其中肝硬化组120例,肝炎组80例.采用瞬时弹性成像技术检测两组SSM及LSM程度,并对其SSM值和LSM值进行相关分析.结果 肝硬化组、肝炎组的SSM值与LSM值均有显著相关性(r分别为0.377、0.314,P分别为0.000、0.005).结论 慢性肝病患者的SSM值与LSM值显著相关,临床联合检测SSM及LSM,可全面地评价慢性肝病患者的病情.     

Acromegaly is associated with decreased skin transepidermal water loss and temperature, and increased skin pH and sebum secretion partially reversible after treatment

BackgroundAcromegaly is characterized by an acquired progressive somatic disfigurement, mainly involving the face and extremities, besides many other organ involvement. Wet and oily skin was described in acromegaly patients and it was attributed to hyperhidrosis and increased sebum production but this suggestion has not been evaluated with reliable methods.ObjectiveThe aim of this study was to examine the skin parameters of patients with acromegaly using measurements of skin hydration, sebum content, transepidermal water loss, pH and temperature and particularly the effects of 12 months of treatment on these parameters.Methods52 patients with acromegaly and 24 healthy control subjects were included in this two blinded prospective study. Skin properties were measured on forehead and forearm by Corneometer CM825, Sebumeter SM810, Tewameter TM210 and Phmeter PH900 as non-invasive reliable measuring methods. Serum GH, IGF-1 and all measurements of skin properties on forehead and forearm were repeated at the end of the 3, and 6 months of therapy in 20 cases. Patients were treated with appropriate replacement therapy for deficient pituitary hormones.ResultsThe sebum content and pH of the skin of acromegalic patients were significantly higher and transepidermal water loss and skin temperature were found to be significantly lower in acromegalic patients when compared to the control group both on forehead and forearm. GH and IGF-1 levels were positively correlated with sebum levels and negatively correlated with skin temperature on both forehead and forearm. The sebum levels of the patients were significantly decreased both on forehead and forearm at 3rd and 6th months of treatment.ConclusionThe present study demonstrated increased sebum secretion, decreased transepidermal water loss, alkali and hypothermic skin surface in patients with acromegaly by reliable methods for the first time. These data suggest that GH and/or IGF-I may have a modulatory role on several skin characteristics which can be at least partially reversible with treatment.     

An aggressive aneurysmal bone cyst of the proximal humerus and related complications in a pediatric patient

Clinical behavior of aneurysmal bone cyst (ABC) in younger patients can be more aggressive than that in older children and adults. Angular deformity and shortening can occur due to growth plate destruction or tumor resection. A 11-year-old boy who had been operated twice in another center for an ABC located in the left proximal humerus presented to the author’s institution with complaints of pain, deformity and shortening of the left arm. Plain radiographs revealed left proximal humerus nonunion with a large defect. Reconstruction with nonvascularized fibular autograft was applied and left upper extremity was immobilized in a velpou bandage. At the third-month follow-up, graft incorporation was observed in the distal part; however, proximal part did not show adequate healing on radiographs. Additional immobilization in a sling for 3 months was advised to the patient and his family. However, they were lost to follow-up and readmitted to the author’s institution at the 12th month postoperatively. Radiographs showed failure of the fibular graft fixation and nonunion of the humerus. Autogenic bone grafts, either vascularized or nonvascularized are the best treatment method for the large defects after tumor curettage or resection. Nonvascularized grafts are technically much easier to use than vascularized grafts and provide excellent structural bone support at the recipient side. However, they may take several months to be fully incorporated. In addition, good therapeutic outcomes require patience and collaboration with the patient and parents. Most importantly, the patient should be monitored closely.     

Evaluation of mastoid pneumatization using cone-beam computed tomography

Objectives

The goals of this study were to evaluate mastoid pneumatization using a grading system and to assess the prevalences of pneumatization of temporal structures of the temporomandibular joint (TMJ) and their relationships with age and sex using cone-beam computed tomography.

Methods

For this study, 250 randomly selected patient dental volumetric tomography scans contained within the archives of the Department of Dentomaxillofacial Radiology, Gazi University Faculty of Dentistry were retrospectively reviewed, and the degrees of mastoid pneumatization were separately graded for the right and left areas. A grading system was used for pneumatization as follows: grade 0, pneumatization limited to the mastoid process; grade 1, pneumatization between the mastoid process and the glenoid fossa; grade 2, pneumatization between the deepest point of the glenoid fossa and the tip of the articular eminence; grade 3, pneumatization extending beyond the crest of the articular eminence.

Results

Of the 500 investigated areas, 32.4 % had grade 0 pneumatization, 55.4 % had grade 1, 8.6 % had grade 2, and 3.6 % had grade 3. There were no significant correlations between pneumatization grade and age or sex.

Conclusions

Pneumatization of the mastoid process may extend beyond the external earway and include temporal components of the TMJ in a significant group of patients.     

猪骨羟基磷灰石的体外溶解行为研究

目的：探讨猪骨羟基磷灰石（PHA）的体外溶解行为.方法：运用固体滴定-激光散射监测法测定PHA在0.1 mol·L^-1 KCl溶液中的37℃等温溶解线;以钙离子活度计监测PHA浸泡于超纯水中的Ca^2＋释放动态变化.结果：PHA在pH值为3.0～5.0的0.1 mol·L^-1 KCl溶液中的溶解度与化学合成的羟基磷灰石（HA）差异无统计学意义,但显著低于牛骨羟基磷灰石,溶解度随pH值降低而升高;超纯水浸泡液中Ca^2＋浓度恒定维持在30～35×10^-6范围内,不受浸泡时间和浸泡物质量影响,更新浸泡液后PHA继续释放Ca^2＋至原始浓度.结论：PHA的溶解度与溶液pH值密切相关,在中性溶液中可释放Ca^2＋且浓度稳定.     

PCPA致大鼠失眠后不同时间点神经元线粒体形态和功能的变化

目的探讨大鼠对氯基丙氨酸（PCPA）造模后不同时间点大鼠额叶皮质神经元线粒体形态功能的变化。方法3月龄大鼠进行造模,分别观察PCPA腹腔注射后1、2、3、4d额叶皮质神经元线粒体形态功能的改变;采用超活染色和电镜分别观察线粒体的数目和超微结构变化,同时采用荧光显微镜检测线粒体膜电位改变和WST-1法测定线粒体ATP酶含量。结果3月龄大鼠造模后线粒体数量明显减少,超微结构以第3天变化最为显著;额叶皮层线粒体膜电位和Na＋-K＋-ATP、Ca2＋-Mg2＋-ATP酶活性第2天开始明显下降,第3天下降最明显（P〈0．05）,第4天略有回升。结论以3月龄大鼠进行PCPA制作失眠模型过程中额叶皮层线粒体超微结构和功能变化以连续注射3天最明显。     

Body Temperature Changes of Newborns Under Fluorescent Versus LED Phototherapy

Objective

To determine changes in body temperature (BT) of hyperbilirubinemic newborns under conventional phototherapy with fluorescent lamps and light emitting diodes (LED) at different irradiances.

Methods

Otherwise healthy newborn infants >34 wk gestational age (GA) hospitalized for indirect hyperbilirubinemia, requiring phototherapy in the first 10 d of life were enroled. Infants who received conventional phototherapy with fluorescent lamps (10–15 μW/cm²/nm irradiance) were defined as group 1, LED phototherapy of 26–60 μW/cm²/nm irradiance as group 2, and LED phototherapy of 60–120 μW/cm²/nm irradiance as group 3. Primary outcome measure was mean BT which was defined as arithmetical mean of axillary BT measured at 2 h intervals during the first day of phototherapy.

Results

Thirty patients were enroled in each group. Mean birth weight and GA of the total cohort was 2800?±?530 g and 36.6?±?2 wk, respectively. Baseline demographic variables and serum total bilirubin levels were similar among groups. Mean BT was 36.7?±?0.1 °C in group 1, 36.6?±?0.2 °C in group 2, 37.7?±?0.2 °C in group 3. Mean BT was higher in group 3 compared to group 1 (p?<?0.001) and group 2 (p?<?0.001). Group 1 and group 2 had similar mean BT measurements (p?=?0.09). During phototherapy all the patients in group 3 had at least one BT measurement ≥37.5 °C and 77 % had BT ≥38 °C. Only one patient in group 2 had BT?≥?37.5 °C which was also ≥38 °C. During phototherapy all BT measurements were <37.5 °C in group 1.

Conclusions

LED phototherapy of ≥60 μW/cm²/nm intensity significantly increases BT in hyperbilirubinemic newborns.     

Vancomycin-resistant enterococci colonization in patients with hematological malignancies: screening and its cost-effectiveness

Background and objective

We evaluated the rates of vancomycin-resistant enterococci (VRE) colonization and VRE-related bacteremia in patients with hematological malignancies in terms of routine screening culture and its cost-effectiveness.

Materials and Methods

All patients of the hematology department who were older than 14 years of age and who developed at least one febrile neutropenia episode during chemotherapy for hematological cancers between November 2010 and November 2012 were evaluated retrospectively.

Results

We retrospectively analyzed 282 febrile episodes in 126 neutropenic patients during a two-year study period. The study included 65 cases in the first study-year and 78 cases in the second study-year. The numbers of colonization days and colonized patient were748 days of colonization in 29 patients (44%) in the first study-year and 547 colonization days in 21 patients (26%) in the second study-year, respectively. Routine screening culture for VRE cost $4516,4 (427 cultures) in the first study-year, $5082,7 (504 cultures) in the second study-year depending on the number of patients and their length of stay.

Conclusion

In line with our study results, routine screening of hematological patients for VRE colonization is not costeffective. Routine surveillance culture for VRE should be considered with respect to the conditions of health care setting.