Osteochondritis dissecans in Perthes' disease Report of 7 cases

We report 7 cases of osteochondritis dissecans following Perthes' disease in 363 hips, i.e., an incidence of 2 percent. Six of the 7 cases belonged to Salter group B (Catterall Groups III-IV), indicating a higher incidence in hips with a worse prognosis. Six cases were asymptomatic and did not require treatment; in 3 of these, there was spontaneous radiographic healing of the lesion.     

Monoamine metabolite levels in cerebrospinal fluid and brain atrophy in lobotomized schizophrenic patients.

Baseline concentrations of homovanillic acid (HVA), 5-hydroxyindole acetic acid (5-HIAA) and MHPG in the cerebrospinal fluid (CSF) were determined in 67 lobotomized and 30 non-lobotomized patients with chronic schizophrenia. In addition, in 69 of these patients the degree of brain atrophy was assessed by a pneumoencephalographic (PEG) technique. There were no significant differences in the concentrations of the monoamine metabolites in the CSF between the two patient groups studied despite the fact that the group of lobotomized schizophrenics had significantly more central and cortical brain atrophy than the group of nonlobotomized schizophrenic patients. The amine metabolite levels were also unrelated to the subtype of schizophrenia, duration of illness, or degree of mental incapacitation.     

Study of the Patterns of Alternative Therapy by the Elderly

The purpose of this study was to examine the pattern of alternative therapy by the elderly. The data were collected from 15–25 May 2001 in Seoul, Korea. The instrument, developed by Shin (2000), was used to examine the patterns of alternative therapy. The collected data were analyzed by using the sas program. The findings revealed:

• 1 Over 66% (66.84%) of the elderly used alternative therapy.
• 2 In regard to the mind–body technique, exercise (19.85%) and praying or Bul‐Gong (16.79%) were most favored. Sa‐Gol (42.75%), ginseng (24.43%), and nok‐yong (24.43%) were the most favorable of the dietary therapies. Of the manual healing methods, ordinary acupuncture (48.83%), physical therapy (24.43%), moxibustion (20.61%) and hand acupuncture (12.98%) were most favored.
• 3 The greatest satisfaction of the alternative therapies was ordinary acupuncture (14.50%).
• 4 The rate of using alternative therapy was significantly different in regard to gender (P = 0.0493). It was concluded that alternative therapies may be effective independent nursing interventions to use with the elderly.

     

Association of hyperhomocysteinemia with genetic variants in key enzymes of homocysteine metabolism and methotrexate toxicity in rheumatoid arthritis patients

Objectives

The study investigated the association between plasma homocysteine, folate and vitamin B12 with 5,10 methylenetetrahydrofolate reductase (MTHFR C677T and A1298C), thymidylate synthase (TYMS 2R → 3R) and methionine synthase (MTR A2756G) polymorphisms and methotrexate (MTX) treatment and toxicity in Tunisian Rheumatoid arthritis (RA) patients.

Methods

A total of 185 patients with RA were included. Homocysteine (Hcy) was assessed by fluorescence polarization immunoassay, and folate and vitamin B12 were measured by chemiluminescence immunoassays. The genetic polymorphisms were analyzed by PCR or PCR-RFLP. Hyperhomocysteinemia (HHC) was considered for Hcy?>?15 µmol/L.

Results

MTHFR C677T polymorphism was associated with HHC in RA patients (multi-adjusted OR, 95% CI 2.18, [1.07–4.57]; p?=?0.031). No association was detected with the remaining polymorphisms. Plasma Hcy, folate, and vitamin B12 did not differ according to each polymorphism, or with MTX treatment or toxicity. However, HHC was more prevalent in patients with than those without MTX toxicity (32.7 vs. 16.7%; p?=?0.035).

Conclusions

The MTHFR 677TT genotype is an independent risk factor for HHC in Tunisians RA patients. HHC could be a useful marker of MTX toxicity in RA patients.

     

Perfusion-Weighted MRI Parameters for Prediction of Early Progressive Infarction in Middle Cerebral Artery Occlusion

ObjectiveEarly progressive infarction (EPI) is frequently observed and related to poor functional outcome in patients with middle cerebral artery (MCA) infarction caused by MCA occlusion. We evaluated the perfusion parameters of magnetic resonance imaging (MRI) as a predictor of EPI.MethodsWe retrospectively analyzed patients with acute MCA territory infarction caused by MCA occlusion. EPI was defined as a National Institutes of Health Stroke Scale increment ≥2 points during 24 hours despite receiving standard treatment. Regional parameter ratios, such as cerebral blood flow and volume (rCBV) ratio (ipsilateral value/contralateral value) on perfusion MRI were analyzed to investigate the association with EPI.ResultsSixty-four patients were enrolled in total. EPI was present in 18 (28%) subjects and all EPI occurred within 3 days after hospitalization. Diabetes mellitus, rCBV ratio and regional time to peak (rTTP) ratio showed statically significant differences in both groups. Multi-variate analysis indicated that history of diabetes mellitus [odds ratio (OR), 6.13; 95% confidence interval (CI), 1.55–24.24] and a low rCBV ratio (rCBV, <0.85; OR, 6.57; 95% CI, 1.4–30.27) was significantly correlated with EPI.ConclusionThe incidence of EPI is considerable in patients with acute MCA territory infarction caused by MCA occlusion. We suggest that rCBV ratio is a useful neuro-imaging parameter to predict EPI.     

Pinoline, a beta-carboline derivative in the serum and cerebrospinal fluid of patients with schizophrenia

Baseline levels of pinoline, 6-methoxy-1,2,3,4-tetrahydro-beta-carboline (6-MeOTHBC) in the serum and cerebrospinal fluid (CSF) were determined with GLC-mass spectrometry in 13 unmedicated schizophrenic patients and 18 non-psychiatric controls. A detectable concentration of 6-MeOTHBC was always present, but no differences were found between the schizophrenic and the control groups. The serum and the CSF levels of 6-MeOTHBC were not significantly related to such variables as sex, age, subtype of schizophrenia, the quality and/or intensity of the psychopathological symptoms, or the duration of illness. The role of the indoleamines in the aetiopathogenesis of schizophrenia is discussed.