Technetium-99-labelled methylene diphosphonate uptake scans in patients with dialysis arthropathy

Patients on long-term haemodialysis suffer from dialysis arthropathy due to the deposition of dialysis amyloid. We investigated the use of 99Tc-labelled methylene diphosphonate bone scans in 17 patients as a possible in vivo diagnostic technique. In most clinically affected joints, with the exception of shoulders and hands, there was increased radioisotope uptake consistent with uptake by periarticular bone. In addition, we describe intense soft-tissue uptake around some clinically affected large joints. In contrast, control groups of patients on haemodialysis without arthropathy and patients without renal failure did not have increased uptake. A semi-quantitative scale of uptake was devised, and the following correlations were significant: pain perception and isotope uptake score in the ankles and feet, and the number of radiological lesions and isotope uptake scores in the wrists and knees. The following sites where the radioisotope might bind in the affected joints are proposed: amyloid deposits, areas of soft-tissue calcification, or areas of increased bone turnover. It is concluded that whereas the scanning technique cannot make a definite diagnosis of amyloid and, therefore, cannot be expected to supersede histological diagnosis, it is a useful adjuvant investigation, of particular importance in those patients unable or unwilling to undergo biopsy.     

Asthma caused by cyanoacrylic glues

Cyanoacrylate-based glues have been reported as producing dermatitis and bronchial asthma. The paper describes the case of a patient occupationally exposed to Loctite 406, who developed irritation of the skin and mucosae of the face and late bronchial asthma. Preventive measures for subjects exposed to cyanoacrylic instant glues are discussed.     

Functional diagnosis of early arthroses of the extremities

Patient history and clinical examination are important for the diagnosis of degenerative joint disease. Here the typical statements of a patient suffering from early osteoarthritis are described and, as far as possible, explained. The joint in question must be systematically examined. Furthermore, the neighboring joints and soft-tissue structures, i.e., muscles, tendons etc., should be examined and evaluated with respect to their importance in hindering the functional chain. The neuroreflectory mechanisms involved herein are described.     

Head lice in Israeli children: parents' answers to an epidemiological questionnaire

BACKGROUND: The aim was to determine the influence of the socioeconomic status of the family and the hygienic practices in the home on the prevalence of head lice infestation in children. METHODS: The study was carried out by analyzing the answers to a standardized epidemiological questionnaire given to parents of school children aged 4-17 in Bet Shemesh, a medium-sized urban town 25 km from Jerusalem. RESULTS: Of 3,000 questionnaires distributed, 958 (31.9%) were completed and returned. The majority of the children (72.4%) had been previously infested with lice. Half of them had other family members, mainly brothers and sisters, who had been infested in the past with lice. In 97.5% of the families the mother was responsible for examining the children for lice, and for carrying out treatment when infestation was present. An association was found between presence of lice infestation and mother's education, age of child, and frequency of shampooing, combing, and examination for lice. There was no association between infestation rates and mother's country of origin, crowding in the home, and the sharing of combs, brushes, hats, scarves, towels, and clothes. CONCLUSIONS: There is evidence that the incidence of lice infestation depends on the hygienic practices in the home rather than on the socioeconomic status of the family or sharing of personal articles among family members.     

Long-term follow-up of patients with adolescent idiopathic scoliosis treated conservatively: an analysis of the clinical value of progression

In a retrospective study, 217 patients with conservatively treated adolescent idiopathic scoliosis (AIS) were investigated. Forty-nine cases were operated and 168 were treated only conservatively and had been out of the brace for at least 4 years at the time of the investigation. The progression between cessation of brace treatment and follow-up (a mean of 6.9 years later) was 5.1 degrees. Almost all progression (4.5 degrees) occurred within 2 years of the end of weaning, however. The incidence of failure with regard to the length of follow-up was also studied. A follow-up of 2 years was sufficient to predict with great accuracy (97%) all incidences of failure.     

Comparison of rat liver preservation with Eurocollins and a modified University of Wisconsin solution: transplantation and isolation of hepatocytes for culture

The efficiency of Eurocollins or modified University of Wisconsin (UW) solution (MUW) in preserving rat livers was compared. After cold storage with one of the solutions, the livers were transplanted or perfused by collagenase for isolation of hepatocytes. Five of the 6 rats receiving a graft preserved with MUW versus none of the 6 rat receiving a graft preserved with Eurocollins solution survived 24 h or more. A significantly greater number of hepatocytes were isolated from livers preserved with MUW than from livers preserved with Eurocollins solution. This suggests a better reperfusion of MUW-preserved livers by collagenase resulting from less endothelial injury. LDH release by cultured hepatocytes, ketone body production and stimulation by glucagon were not significantly different between the two groups. These results confirm the superiority of MUW solution over Eurocollins in preserving liver grafts. They suggest that the advantage of MUW solution results from better protection of vascular endothelium rather than of hepatocytes.     

No excess of DR*3/4 in Ashkenazi Jewish or Hispanic IDDM patients

The gene frequencies, haplotype relative risks, and zygotic assortments of HLA-DR in three ethnically defined samples of insulin-dependent diabetes mellitus (IDDM) patients were determined in a prospective family study. Although DR3 and DR4 were positively associated with IDDM in the probands of 123 northern European, 94 Ashkenazi Jewish, and 49 New York Hispanic families, significant excess of DR*3/4 heterozygotes was observed only among the probands from families of northern European ancestry. There was also a significant decrease in the frequency of Bw62,DR4 haplotypes derived by northern European patients from their mothers compared with their fathers. This difference, together with data reported in the literature, suggests that the expressivity of the susceptible genotype(s) in IDDM patients may be modified by protective maternal effects associated with Bw62,DR4 and probably other DR4 haplotypes. Samples of IDDM patients from populations with high frequencies of these modifiers should have different DR-gene frequencies contributed by fathers and mothers, capable of accounting for the observed Hardy-Weinberg disequilibrium. We postulate that, because the mechanism of action of these modifiers is distinct from that of the susceptibility gene, the difference must be considered in devising strategies for elucidation of the mode of inheritance of the disease and for understanding the molecular nature of the susceptibility.