Nocardiosis of the lung: chest radiographic findings in 21 cases

Pulmonary manifestations of nocardial infection were present in 21 patients, with microbiologic proof in all and pathologic proof in 12. An analysis of the findings in these patients, combined with a review of previous reports of nocardiosis, suggests several important conclusions for radiologists. First, nocardiosis may occur in otherwise healthy persons but is most common in compromised patients, especially those being treated with anti-inflammatory agents, particularly corticosteroids, for chronic obstructive pulmonary disease and other systemic diseases. As pathologic manifestations are both suppurative and granulomatous, the chest radiographic manifestations are pleomorphic and not specific. Consolidations and large irregular nodules, often cavitary, are most common; nodules, masses, and interstitial patterns also occur. Pleural effusions are quite common, and lymph nodes may be enlarged. Difficulty and slowness of culture growth, along with the lack of a serologic test for nocardiosis, necessitate its inclusion in the differential diagnosis for both compromised and noncompromised patients in whom an apparent pulmonary infection cannot be rapidly diagnosed.     

长期运动对十二指肠黏膜一氧化氮合成和铁贮存的调控效应

目的:观察长期运动对十二指肠黏膜一氧化氮合成和铁贮存的影响及一氧化氮对铁贮存的调节作用。方法:实验于2004-04/09在江苏大学医学院铁代谢研究室完成。①健康雌性SD大鼠40只,随机分为静息组、静息并应用一氧化氮抑制剂组、运动组、运动并应用一氧化氮抑制剂组,每组10只。②静息并应用一氧化氮抑制剂组和运动并应用一氧化氮抑制剂组饮用水中含有一氧化氮抑制剂(1g/L),运动组和运动并应用一氧化氮抑制剂组的大鼠游泳3个月。③3个月后分析各组大鼠血浆铁饱和度,一氧化氮浓度以及十二指肠黏膜一氧化氮含量和非血红素铁含量。结果:实验过程中死亡11只,进入结果分析29只(静息组8只、静息并应用一氧化氮抑制剂组5只、运动组8只、运动并应用一氧化氮抑制剂组8只)。①运动及一氧化氮抑制剂对大鼠血浆铁饱和度和一氧化氮浓度的影响:运动组的血浆铁饱和度低于静息组(P<0.01);运动并应用一氧化氮抑制剂组的血浆铁饱和度低于静息并应用一氧化氮抑制剂组(P<0.05),并且高于运动组(P<0.05)。运动组血浆一氧化氮浓度显著高于静息组(P<0.01);运动并应用一氧化氮抑制剂组的血浆一氧化氮浓度低于运动组(P<0.01),与静息并应用一氧化氮抑制剂组差别不显著(P>0.05)。②运动及一氧化氮抑制剂对大鼠十二指肠黏膜一氧化氮和非血红素铁含量的影响:运动组的十二指肠一氧化氮含量高于静息组(P<0.01);静息并应用一氧化氮抑制剂组的一氧化氮含量低于静息组(P<0.01);运动并应用一氧化氮抑制剂组的一氧化氮含量低于运动组(P<0.01),但高于静息并应用一氧化氮抑制剂组(P<0.01),与静息组差别不显著。与静息组比较,运动组和静息并应用一氧化氮抑制剂组的十二指肠黏膜非血红素铁含量均降低(P<0.05)。结论:静息状态下十二指肠黏膜细胞一氧化氮合成具有较高的紧张性,可能参与维持非血红素铁含量。长期运动可刺激十二指肠黏膜一氧化氮合成,降低铁贮存。但其机制是否涉及运动诱导的一氧化氮的直接作用以及是否参与铁吸收的调节有待于进一步研究。     

Bone marrow microvascular density and angiogenic growth factors in multiple myeloma.

There is evidence that angiogenesis plays an important role in the progression of multiple myeloma (MM). Hepatocyte growth factor (HGF) and tumor necrosis factor-alpha (TNF-alpha) are cytokines that potently stimulate angiogenesis. We evaluated the microvascular density (MVD) of bone marrow biopsies (after immunostaining with anti-CD34 antibodies) and serum levels of HGF and TNF-alpha in 43 patients with newly diagnosed MM. Twenty-four of these patients reached a plateau phase after treatment and were reevaluated for MVD, HGF and TNF-alpha. MVD values and serum levels of HGF and TNF-alpha were elevated in newly diagnosed MM patients in comparison with healthy controls. Pre-treatment MVD, HGF and TNF-alpha increased with advancing stage of MM disease. In patients reaching the plateau phase, a significant reduction in MVD, HGF and TNF-alpha levels occurred. A positive correlation was noted between pre-treatment MVD and serum levels of TNF-alpha and lactic dehydrogenase but not with HGF. However, HGF strongly correlated with beta2-microglobulin (beta2M), TNF-alpha and lactate dehydrogenase (LDH). We conclude that angiogenesis in MM, as expressed by the bone marrow MVD and the serum levels of angiogenic molecules such as HGF and TNF-alpha, increases with advancing clinical stage and decreases after effective chemotherapy.     

DIGITAL ISCHAEMIA: AN UNUSUAL PRESENTATION OF DYSBARISM

SUMMARY Dysbaric symptoms following ascent from a scuba dive are due to symptomatic nitrogen or air emboli with clear patterns of associated injury. This case report highlights an unusual presentation of dysbaric injury treated successfully with a prostacyclin analogue.     

The clinical and prognostic significance of erythrocyte sedimentation rate (ESR), serum interleukin‐6 (IL‐6) and acute phase protein levels in multiple myeloma

Summary Interleukin‐6 (IL‐6) and acute phase proteins are commonly increased in patients with multiple myeloma. Several of these acute phase proteins are believed to predict prognosis and influence survival. We measured interleukin‐6 (IL‐6), C‐reactive protein (CRP), alpha‐1‐antitrypsin (a₁AT), acid alpha‐1‐glycoprotein (a₁AG), haptoglobin (HAP), transferrin (TRF), hemoglobin (Hb), beta‐2‐microglobulin (β₂M) and erythrocyte sedimentation rate (ESR) in 42 newly diagnosed multiple myeloma patients and 25 normal controls. At the time of blood collection, nine patients were at stage I of disease, 14 at stage II, and 19 at stage III according to the Durie and Salmon myeloma staging system. Mean ± SD values of IL‐6, CRP, a₁AT, a₁AG, HAP, β₂M, and ESR were significantly higher and Hb significantly lower than those found in the controls. Univariate analysis, using the log‐rank test, showed that among the acute phase proteins, serum CRP (P < 0.002), a₁AT (P < 0.008) and ESR (P < 0.008) were significantly correlated with survival. However, when a multivariate Cox proportional hazard model was performed, ESR, CRP, a₁AT, a₁AG and β₂M were identified as independent prognostic factors, while the others were not. We conclude that ESR, a simple and easily performed marker, was found to be an independent prognostic factor for survival in patients with multiple myeloma.     

Impact of Body Mass Index on Left Ventricular Function

Background

Obesity is associated with increased cardiovascular morbidity and mortality. A direct effect of isolated obesity on cardiac function is not well established. The study was designed to determine the direct effect of various grades of isolated obesity on echocardiographic indices of systolic and diastolic left ventricular function.

Methods

Fifty one obese and 25 normal weight, serving personnel without any other pathological condition were studied. Group I (n=25) consisted of subjects with normal weight and body mass index (BMI <25kg/m²), Group II (n=34) of overweight subjects (BMI 25-29.9 kg/m²) and Group III (n=17) of obese subjects (BMI >30 kg/m²). Echocardiographic indices of systolic and diastolic function were obtained and dysfunction was assumed when at least two values differed by ≥ 2 SD from the normal weight group.

Result

Ejection fraction, fractional shortening were increased (p<0.05) in Group II and III. Left ventricular dimensions were increased (p< 0.001) but relative wall thickness was unchanged. Systolic dysfunction was not observed in any of the obese patients. The mitral valve pressure half time (p< 0.01), left atrial diameter (p < 0.01) and the deceleration time were increased (p< 0.01) in obese subjects, while other diastolic variables were unchanged. No difference were found between obesity subgroups. Subclinical diastolic dysfunction was more prevalent among obese subjects. BMI correlated significantly with indices of left ventricular systolic and diastolic function.

Conclusion

Subclinical left ventricular diastolic dysfunction was noted in all grades of obesity which correlates with BMI.Key Words: Obesity, Systolic function, Diastolic function, Echocardiography     

运动对铁吸收的影响及其作用途径

目的:综合分析运动对铁吸收的影响及其作用途径。资料来源:检索Pubmed1950-01/2006-04有关运动对铁吸收的影响及其作用途径的文献,检索词为“iron absorption,iron metabolism,exercise”。同时检索万方数据库1994-01/2006-03有关运动对铁吸收的影响及其作用途径的文献,检索词为“铁吸收,铁代谢,运动”。资料选择:初选后,有关铁吸收、运动对铁吸收影响及其调节机制的文献被选中。发表于2002年后的文献被优先选择,排除重复实验和Meta分析。资料提炼:检索到9000篇文献,大部分是关于铁吸收调节机制的文献,其中40篇有关运动和铁吸收及其调节机制,30篇作为代表性研究文献被引用。资料综合:运动可导致低铁状态,影响运动能力,这种低铁状态的形成及其调节与铁吸收相关。但是,对于运动如何影响铁吸收存在两种截然相反的观点,一种观点认为运动促进铁吸收;另一种观点认为运动降低铁吸收。最近的研究已经显示运动可能通过机体铁水平、一氧化氮、Hepcidin、促红细胞生成素、低氧以及基因突变(如HFE突变)调节铁吸收。结论:有关运动影响铁吸收的研究仍是初步的,在运动情况下如何调节铁吸收尚有待研究,这对于进一步分析运动诱导的低铁状态的本质以及运动员和运动健身人群是否需要以及如何补充铁具有重要意义。     

X型胶原蛋白与骨骼生长发育关系的研究进展

X型胶原是近年来发现的一种新型胶原,它只存在于生长发育期的即将骨化的软骨内,以液态均相的形式分布于细胞外基质,并启动软骨骨化。它具有特异性合成、局限性分布、一过性存在的特征。许多骨骼系统疾病与X型胶原的异常有着密切的关系。