Dysplasia epiphysealis capitis femoris: Meyer dysplasia

The clinical importance of dysplasia epiphysealis capitis femoris (Meyer dysplasia) is that it is easily mistaken for Legg-Calve-Perthes disease, leading to unnecessary diagnostic procedures and treatments. After a review of 578 children (619 hips) with Legg-Calve-Perthes disease, 17 children (27 hips) in whom both the clinical and radiologic pattern was obviously different could be found and a diagnosis of dysplasia epiphysealis capitis femoris was finally made. The mean age was 2.5 (range 1.9-3.6) years. There were 16 boys and 1 girl. Ten children had bilateral involvement (59%). The capital femoral epiphysis was delayed or was smaller in 26 hips, separated or cracked in 15, and cystic in 6. A normal bone structure was established in approximately 2 to 4 years. The final results assessed by the Mose and the Stulberg classification were good in all 27 hips. This study suggests guidelines for evaluating this rare condition based on the authors' findings and a review of the literature.     

Immediate cementless total hip arthroplasty for the treatment of active tuberculosis

We report the results of a primary total hip arthroplasty (THA) in 7 patients with advanced active tuberculous arthritis of the hip and had lost the chance of preserving the hip without replacement surgery. Tuberculosis was confirmed in all cases by the culture or histological examination. All patients were treated with primary THA followed by antituberculous medications for 1 year. Cementless stems and sockets were used in all patients. The average follow-up period was 4.8 years. The reactivation of the infection was not detected in all cases. The result was excellent in all patients according to the Harris Hip Score. Total hip arthroplasty in the tuberculous hip is a safe procedure and produces superior functional results compared with resection arthroplasty or arthrodesis. The results of primary THA in the selected patients was satisfactory as they rapidly recover from the disease.     

A survey of depressive symptoms among South Korean adults after the Korean financial crisis of late 1997: prevalence and correlates

PURPOSE: We examined the prevalence of high levels of depressive symptoms and their association with sociodemographic and health characteristics in an urban Korean population following the financial crisis in late 1997. METHODS: Using data from a cross-sectional survey conducted in Ansan-city, Korea, from June 1999 to June 2000, we examined the prevalence and correlates of depressive symptoms in a randomly selected sample of 4897 (2531 male and 2366 female) subjects aged 18 to 92 years. The prevalence and odds ratios of "probable" and "definite" depressive symptoms, defined as a Center for Epidemiologic Studies Depression Scale (CES-D) score of > or = 16 and > or = 24, respectively, were calculated. RESULTS: The mean CES-D score and prevalence of "probable" and "definite" depression were significantly higher in women (15.63, 41.67%, and 12.05%, respectively) than in men (14.43, 35.05%, and 8.10%, respectively) (p < 0.0001). In multiple logistic regression analysis, being female, unemployed, unmarried, self-assessed as unhealthy, and having a low income were found to be significant predictors of "probable" and "definite" depressive symptoms in Korean adults. CONCLUSIONS: Although current data cannot be directly compared with those reported in the most recently published Korean data from 1994, considerably high mean CES-D score and prevalence of depression speculate that the Korean financial crisis of 1997 had an effect on the development of depressive symptoms in Korean adults.     

Magnetic resonance imaging as a diagnostic tool for breast cancer in premenopausal women

BACKGROUND: Screening mammography has led to earlier diagnosis of breast cancer; however, the increased tissue density of young women can complicate mammographic interpretation. We hypothesized that magnetic resonance imaging (MRI) has value in detection of mammographically occult breast cancers, particularly in premenopausal women for whom the sensitivity of mammography is compromised. METHODS: Data were available for 89 women with biopsy-proven breast cancer who had undergone both mammography and breast MRI. Variables evaluated included menopausal status and radiographic findings. Data were analyzed using Fisher's Exact test; P < .05 was considered significant. RESULTS: Of the 89 women in our study, 69 were perimenopausal or postmenopausal and 20 were premenopausal at the time of diagnosis. The malignant lesion was identified on mammography and MRI for a majority of patients. One third of premenopausal women had negative mammography but positive MRI findings. CONCLUSIONS: Our findings support a role for breast MRI in supplementing conventional mammography for early detection of breast cancer in premenopausal women.     

Increased ipsilateral whole breast vascularity as measured by contrast-enhanced magnetic resonance imaging in patients with breast cancer

BACKGROUND: Tumor-induced neovessel formation identified by gadolinium-enhanced magnetic resonance imaging (MRI) is a commonly used marker for breast malignancy. The purpose of this study was to assess possible differences in whole-breast vascularity as measured by contrast-enhanced MRI in the ipsilateral and contralateral breasts of patients with unilateral breast malignancies. METHODS: Gadolinium-enhanced MRI of the breast using a Siemens 1.0-T scanner with dedicated breast coil was performed on 22 consecutive patients with histologically confirmed unilateral breast carcinoma. Whole-breast vascularity of the breast containing the carcinoma was estimated as increased, decreased, or similar compared with the contralateral unaffected breast. Breast vascularity was then correlated to clinical factors including tumor size, histology, multifocality, nodal involvement, and patient age and menopausal status. RESULTS: Twenty patients had infiltrating carcinomas, and 2 patients had ductal carcinoma in situ. Four were multifocal. Fifteen of 22 patients demonstrated clear evidence of increased whole-breast vascularity in the ipsilateral breast containing the primary breast cancer compared with the contralateral breast. Although there was no clear correlation between the presence of increased whole-breast vascularity in the cancer-bearing breast with tumor size, histology, grade, mammographic appearance, or patient age and menopausal status, increased vascularity was present in 3 of 4 patients with multifocal disease and in 4 of 5 patients with metastatic disease in the axillary nodes. CONCLUSIONS: Measurable increases in whole-breast vascularity can be identified by contrast-enhanced MRI and appear with increased frequency in the cancer-bearing breast. These findings suggest that factors other than tumor size and histology may influence development of macroscopic vessels during tumor progression and may be indicative of angiogenic tumor biology.     

Immunoglobulin G antibodies to herpes simplex type 1 virus detected by radioimmunoassay in serum and cerebrospinal fluid of patients with schizophrenia.

Serum and CSF specimens from 16 schizophrenic patients and 18 nonpsychiatric controls were tested by radioimmunoassay for immunoglobulin G antibody of capsid, envelope and excreted antigens of herpes simplex type 1 virus. There were no significant differences in the antibody levels between the schizophrenic patients and the controls. The etiological role of viruses and virus-like agents in schizophrenia and some methodological aspects are discussed.     

Jaccoud arthropathy and pyrophosphate arthropathy: a rare association

Jaccoud's arthropathy (JA) is a chronic deformity affecting hands and feet, which are voluntarily correctable by the patients. JA was usually reported in association with rheumatic fever and systemic lupus erythematosus. We describe an exceptional association between a pyrophosphate arthropathy and JA of the hands. It is a 48-year-old woman, having a 13 years history of polyarthritis involving shoulders, elbows, hips and knees, and 4 years after, a progressive unlar deviation of the fingers of the hands. Calcium pyrophosphate dihydrate crystals were identified in the synovial knee biopsy. Hands x-rays as RMI don't identify erosions and confirmed the JA.     

Interest in prolactin levels in galactorrhea

The action of prolactin (PRL) in supra-physiological levels on the ovaries or on the hypothalamic-pituitary axis for the release of gonadotropins leads to a reversible inhibition of the cyclic functioning of the pituitary gland and of the ovaries. The consequences are either the production of immature follicles marked by anovulatory or dysovulatory cycles, or the absence of follicle production marked by amenorrhea. Thus, prolactin plays a major role in the productive system by its lactotropic and antigonadotropic effects. Through this study we intend to try to determine the diagnostic value of the association of the cyclic dysfunctions with galactorrhea by measuring the prolactin levels in 2236 patients complaining of galactorrhea. Measurements of FSH and LH levels were also performed in 236 women among those consulting for infertility associated with galactorrhea. The results obtained showed that galactorrhea was associated with prolactenemia in only 17% of cases and of the ovaries was proportional to the prolactin in blood.     

Asymmetric activation of extracellular signal-regulated kinase 1/2 in rat vestibular nuclei by unilateral labyrinthectomy

The expression of phosphorylated extracellular signal-regulated kinase 1/2 (pERK 1/2) was evaluated in the vestibular nuclei (VN) of rats following unilateral labyrinthectomy (UL). Immunohistochemistry revealed a significant asymmetrical increase in pERK 1/2 expression in the VN, 5 min after UL, after which pERK 1/2 immunoreactivity decreased rapidly and was undetectable by 90 min after UL. These results suggest that unilateral deafferentation of the vestibular system triggers intracellular signal pathways that activate ERK 1/2 in the VN.     

Investigation of salicylaldehyde-5-sulfonate as a precolumn derivatizing agent for the determination of n-alkane diamines,lysine, diaminopimelic acid,and isoniazid by capillary zone electrophoresis

Reactions of primary amines with salicylaldehyde-5-sulfonate (SAS) lead to the formation of stable Schiff bases at weakly alkaline pH and at moderate temperature in an ethanol-rich aqueous solution. Some alkane diamines were converted to salicylaldimine with SAS, and the products were resolved and detected by capillary zone electrophoresis (CZE). The reactivity of SAS was applied also to the derivatization of amino acids. Optimal conditions for the analysis of lysine in the presence of diaminopimelic acid, the metabolite of lysine, were investigated. Addition of Na(2)SO(4) into the migrating solution enhanced the stacking effect, and led to increase in the detection limits. Another advantage of the use of SAS is its ability to form stable water-soluble metal chelate as Schiff base ligands. For practical analysis, the copper chelate of the Schiff base of isoniazid, which is known as the most active antibacterial used in the treatment of pulmonary tuberculoses, was investigated, and the detection limit of isoniazid was improved in the magnitude of 11 times compared with the one of free isoniazid.