Dietary habits in patients with dumping syndrome-like symptoms after proximal selective vagotomy

Patients who had undergone proximal selective vagotomy and who had severe postprandial dumping symptoms took in less food, energy, and nutrients than those who were mildly symptomatic or who were healthy.     

Infection of human T-cell leukemia virus type I and development of human T-cell leukemia lymphoma in patients with hematologic neoplasms: a possible linkage to blood transfusion

Among 354 adult patients with either hematological malignancy or aplastic anemia, eight were positive for anti-HTLV-I antibodies; six of eight had received multiple transfusions. There was an approximately 3.5-fold increase (P less than .001) of HTLV-I seropositivity in the patients with hematologic disease (8 of 354, 2.23%) compared to the healthy adults older than 20 years (34 of 5252, .65%). Two hematological patients, one with Hodgkin's disease and one with acute promyelocytic leukemia, were found to be positive for HTLV-I, and developed and died of adult T-cell leukemia/lymphoma (ATL) subsequently. Both were long-term survivors of the primary disease and had received multiple transfusions. The latent period from blood transfusion to onset of ATL was 6 months and 11 years, respectively. Immunocompromised patients, who were seropositive for HTLV-I, may be at increased risk for ATL compared to healthy carriers of HTLV-I, and the latent period may be shorter.     

Activated immunocompetent cells in human skin lymph derived from irritant contact dermatitis: an immunomorphological study

By means of microsurgical lymph cannulation, skin lymph was sampled in the course of a sodium lauryl sulphate (SLS)-induced irritant contact dermatitis in human volunteers. The lymph cells were isolated by centrifugation, and then characterized immunocytochemically using different monoclonal antibodies, and in the late phase of the skin reaction also by electron microscopy. Analyses of lymph cells before the induction of the contact dermatitis revealed median values of about 60% T cells (CD4/CD8 ratio about 2:1), 4% Langerhans cells (LCs), and 1% B cells. The remainder were varying proportions of erythrocytes and uncharacterized cells. During the skin reaction, and even after resolution of the clinical signs of dermatitis, a relative and absolute increase of T and B cells, as well as of HLA-DR positive cells, paralleled the previously reported increase of LCs; a high percentage of the T cells were CD4 and CD8 negative. In addition, surface markers such as CD11a, CD25, CD54 and CD58 were detected on lymph cells sampled during the irritant skin reaction. Cell rosettes observed in the lymph throughout the experiment were analysed in the late phase of the skin reaction, and showed a central LC with three to five peripheral, in part activated, T cells, ultrastructurally revealing gap junction-like structures between the two cell types. These data indicate that immunocompetent cells in the skin are activated by a variety of non-immunological stimuli such as operative trauma and irritant contact dermatitis.     

Vulnerability and protective factors for posttraumatic stress disorder

A review is given of pre-, peri- and post-traumatic factors that increase or decrease the risk of developing posttraumatic stress disorder (PTSD). With the exception of extremely severe stressors, vulnerability and protective factors explain much of the probability of developing PTSD. The etiology of PTSD is multifactorial, and variables related to the individual, their life situation at the time of exposure, the stressor, and the recovery environment tend to interact.     

Fibril Amyloid Enhancing Factor (FAEF)-Accelerated Amyloidosis in the Hamster is Not Dependent on Serine Esterase Activity and Mononuclear Phagocytosis

Cells of the mononuclear phagocytic system (MPS) were described as playing a decisive role in amyloidogenesis. A relationship between the amyloid enhancing factor (AEF) and MPS cells was suggested and recently AEF activity was attributed to a serine esterase (SE) of leucocytic origin. In the present study, no correlation was found between the SE content and AEF activity in either peritoneal cell lysates or AEF preparations of different origin. Furthermore, pretreatment of fibril AEF (FAEF) with the SE inhibitor phenylmethylsulphonyl fluoride (PMSF) did not affect its activity in the hamster. Blockade of the MPS by dextran sulphate did not inhibit deposition of amyloid after intravenous injection of FAEF but amyloid deposition was inhibited when FAEF was administered intraperitoneally. These results suggest that MPS cells could be involved in transport of AEF, but that phagocytic activity of MPS cells is not essential in AA-amyloid fibrillogenesis. It is concluded that these results are not consistent with the previously suggested nature of the AEF or with the proposed central role of the MPS in amyloidogenesis.     

Rotator cuff calcifications: treatment with ultrasound-guided percutaneous needle aspiration and lavage

 Objective. To analyze the results of ultrasound (US)-guided needle puncture, aspiration and lavage in the treatment of symptomatic calcific tendinitis of the rotator cuff. Design and patients. Atraumatic pain in 61 shoulders of 58 patients was resistant to conservative therapy. The average age of the treated patients was 42 years (range 26–49 years), follow-up was 12 months, and the mean diameter of the calcifications was 1.6 cm (range 1.1–2.9 cm). With US guidance and local anesthesia, two needles were placed within each calcification. The calcification was punctured 10–15 times and saline solution injected and aspirated using the needles until the aspirate was free of calcific particles. Results and conclusions. Based on radiographs at 1 year follow-up, 74% (45 of 61) of the calcifications decreased, including 28% (17 of 61) which disappeared totally, and 26% (16 of 61) were unchanged. Calcifications with a faint or absent shadow on US proved to be nearly liquid (slurry calcification in 93% (14 of 15) of cases and could be aspirated. Clinical results were excellent in 74% (45 of 61), moderate in 16% (10 of 61) and poor in 10% (6 of 61) of cases. US offers technical advantages over fluoroscopy, and the typical US image of a slurry calcification helps to select the most suitable patients for aspiration treatment. The results are comparable with those using fluoroscopic guidance.