Catechin glycoside fromUlmus davidiana

Catechin and catechin glycoside named uldavioside A were isolated from the Korean folk medicineUlmus davidiana. Based on chemical and physicochemical evidences, their structure have been determined as (+)-catechin (1) and (+)-catechin-5-O-β-D-apiofuranoside (2).     

Cytomegalovirus antigenemia as a useful marker of symptomatic cytomegalovirus infection after renal transplantation--a report of 130 consecutive patients

In earlier work we demonstrated that CMV immediate early antigens can be detected in peripheral blood leukocytes of patients with active CMV infection. We now report a comparison of the antigenemia assay and an anti-CMV ELISA in a prospective longitudinal study of 130 renal transplant recipients who were monitored for active CMV infection during the first 3 months after transplantation. Active CMV infection developed in 56 patients. The antigenemia assay had a sensitivity of 89% and a specificity of 93% in the diagnosis of active CMV infection; for the ELISA these figures were 95 and 100%, respectively. In 22 of the 56 patients a CMV syndrome occurred. Antigenemia was demonstrated in all 22 patients while an antibody response occurred in 21 of them. The antigenemia assay became positive 8 +/- 7 days before the onset of symptoms while the antibody response was observed 4 +/- 9 days after the onset of symptoms. The pattern of antigenemia was helpful for monitoring the course of the infection. The maximum level of antigenemia was significantly higher and its duration significantly longer in symptomatic than asymptomatic infection. We conclude that CMV antigenemia is a sensitive, specific, and early marker of CMV infection. The antigenemia assay is of great value in monitoring patients with a high risk of CMV infection.     

Randomized clinical trial of mitomycin C as an adjunct to radiotherapy in head and neck cancer

A randomized prospective clinical trial was carried out to assess the usefulness of the addition of mitomycin C to radiation therapy used alone or in combination with surgery for the treatment of squamous cell carcinoma of the head and neck region. One hundred and twenty patients with biopsy proven tumor of the oral cavity, oropharynx, larynx, hypopharynx, and nasopharynx were randomly assigned to receive or not receive mitomycin C; all other aspects were similar in the two treatment groups. One hundred and seventeen patients were evaluable with a median follow-up time of greater than 5 years. Acute and chronic normal tissue radiation reactions were equivalent in the two treatment groups. Hematologic and pulmonary toxicity were observed in the drug treated patients. Actuarial disease-free survival at 5 years was 49% in the radiation therapy group and 75% in the radiation therapy plus mitomycin C group, p less than 0.07. Local recurrence-free survival was 66% in the radiation therapy group and 87% in the radiation therapy plus mitomycin C group, p less than 0.02. The findings demonstrate that mitomycin C can be administered safely as an adjunct to radiation therapy in the treatment of head and neck cancer. The drug improves local tumor control without enhancing normal tissue radiation reactions.     

Frequency of the fragile X syndrome in infantile autism

In a Swedish multicenter study, 102 cases of infantile autism (I.A.) were examined for fragile X (q27). The fragile X syndrome was observed in 13 of the 83 (16%) boys with I.A., but in none of the 19 girls with I.A.     

Objective evaluation for severity of atopic dermatitis by morphologic study of skin surface contours

BACKGROUND/AIMS: Wide variation in outcome methodology can make the interpretation of patient outcomes confusing and the comparison of the results of different studies almost impossible. It is important to objectively measure and record the severity of atopic dermatitis (AD) for routine clinical practice and research. The aim of this study was to evaluate whether morphologic study of skin surface contours might be helpful to objectively quantify the severity of AD. METHODS: Thirty atopic patients (12 females, 18 males) participated in this study. Moisturizer was applied twice daily for 2 weeks. Bioengineering methods such as D-Squame, corneometer, evaporimeter, and spectrophotometer were measured at the start of the study and after 1 week and 2 weeks. In addition, we assessed moisturizer effects after 3 h of moisturizer application.The stereoimage optical topometer (SOT) based on a new concept of stereoimage was applied for this study. We compared SOT, other bioengineering methods, and the severity scoring of atopic dermatitis (SCORAD) index. RESULTS: After 3 h of application with moisturizer, the results measured by SOT, conventional optical profilometer (COP), D-Squame, and corneometer showed significant differences (P<0.05). After 1 and 2 weeks, there were significant changes in the results measured by SOT, COP, D-Squame, corneometer, spectrophotometer, and SCORAD index. We observed a significant correlation between bioengineering methods and the SCORAD index (P<0.05). CONCLUSION: These data indicate that morphologic study of skin surface contours are useful in evaluating of AD severity. If we would combine methods to evaluate the physiologic changes and those such as SOT to measure the morphological changes of skin surface, we could evaluate more objectively and quantitatively the severity of AD.     

双腔T型管在胆道手术中的应用

本文介绍了在胆道手术中应用双腔T型管胆道引流,该方法优于普通T型管行总胆管引流法。特别是对于电解质紊乱的预防、消化功能的恢复、减少胆道感染效果明显,对长期不能拔除T型管患者应用双腔T型管引流尤为重要。     

Vesicocalicostomy as ultimate solution for recurrent urological complications after cadaveric renal transplantation in a patient with poor bladder function

We report a case of a neurogenic bladder in which hydronephrosis recurred early after renal transplantation. After 2 unsuccessful attempts at ureteroneovesicostomy of the donor ureter a vesicocalicostomy was performed, since reconstruction with the donor pelvis or ureter was impossible owing to the extended fibrosis and scar formation around the renal hilus and ureter. During the 23 months of followup renal function has been good without serious infectious sequela with a regimen of self-catheterization and no antibiotic maintenance therapy.     

Nonsurgical treatment of abdominal or pelvic abscess in consecutive patients with Crohn''s disease

BACKGROUNDS: There is little agreement about the efficacy of nonsurgical treatment for abscess associated with Crohn's disease. Furthermore, there is no study on characteristics of abscess or patient that nonsurgical treatment could be worth trying as initial treatment. AIMS: To evaluate the outcome of nonsurgical treatment in Crohn's disease-related abscess and identify factor leading to failure of nonsurgical treatment of this complication. PATIENTS: Twenty-four patients, who consecutively admitted for Crohn's disease-related abscess to our institution during a 7-year period, underwent nonsurgical treatment as initial therapy. METHODS: Outcome data such as recurrence and intractability, and clinical features were retrospectively analysed. Univariate analysis with patient-related factors and abscess-related factors was performed for risk factor identification. RESULTS: Median follow-up period was 47.5 months. Of the eligible patients, 19 patients were treated medically and 5 patients underwent percutaneous catheter drainage with medical treatment. Overall success rate of nonsurgical treatment in our centre was 66.7%. The cumulative recurrence rate at 7 months was 12.5%. All recurrences occurred within 7 months from complete resolution on follow-up imaging. Univariate analysis showed that the significant factors which lead to failure of nonsurgical treatment were presence of associated fistula and concurrent steroid use (P=0.019 and P=0.019, respectively). CONCLUSION: Nonsurgical treatment can be considered as initial treatment modality for the Crohn's disease-related abscess without concurrent steroid therapy or relevant fistula.     

Abdominal obesity and smoking are important determinants of C-reactive protein in renal transplant recipients.

BACKGROUND: C-reactive protein (CRP) is a predictor of coronary heart disease, total mortality and chronic allograft nephropathy in renal transplant recipients. The determinants of CRP have been investigated in the general population, but not in renal transplant recipients. CRP might reflect metabolic aberrations in association with central obesity and systemic atherosclerosis. However, it may also reflect a low-grade immune-mediated response to the graft. In this study we investigated the factors associated with CRP in a renal transplant population. METHODS: Between August 2001 and July 2003, renal transplant recipients with a functioning graft for more than 1 year (n = 847) were eligible for investigation at their next visit to the outpatient clinic. A total of 606 patients (55% male, aged 51+/-12 years) participated at a median (interquartile range) time of 6.0 (2.6-11.4) years post-transplant. RESULTS: Median CRP concentration was 2.0 (0.80-4.8) mg/l and mean 24 h creatinine clearance was 62+/-22 ml/min. CRP was significantly associated with body mass index, waist circumference and waist-to-hip ratio (P-value < 0.0001). None of the transplant characteristics except creatinine clearance was associated with CRP. In multiple regression analysis, waist circumference, log sICAM-1 concentration, gender, creatinine clearance and current smoking were independently associated with CRP. CONCLUSIONS: In renal transplant recipients waist circumference and smoking are the two most important modifiable independent determinants of CRP. Furthermore, CRP is independently associated with the endothelial function parameter sICAM-1 and, in univariate analyses, associated with multiple cardiovascular risk factors. CRP is not associated with any of the transplant-related factors, except for renal transplant function.