Fragile X premutation screening in women with premature ovarian failure

We have screened 132 women with premature ovarian failure for fragile X (FRAXA) premutations. Three out of 23 (13%) pedigrees with the familial premature ovarian failure and 3/106 (3%) of women with the sporadic form of premature ovarian failure have FRAXA premutations compared with an expected prevalence of 1:590 (P=0.02). The mechanism of the association between FRAXA premutations and premature ovarian failure is unknown but as a genetic marker, FRAXA screening will be particularly valuable in predicting premature ovarian failure in some pedigrees and in the identification of families at risk of transmitting fragile X syndrome.      

Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI

Objectives:

To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers.

Methods:

The oblique coronal closed- and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test.

Results:

The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (−16.6%). In the open-jaw position, both the medial and the lateral edges shifted medially (to 17.6% vs −23.6%, Wilcoxon matched-pair test, p < 0.001). OA had no significant influence (generalized estimation equation model, p = 0.952). The disc position differed significantly from asymptomatic individuals (t-test, p < 0.001) who showed a medial disc position and full coverage of the condyle.

Conclusions:

In patients with TMJ pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar.     

地西泮的肠胃循环对中枢抑制作用的影响

研究了小鼠ig不同酸度溶液和活性碳对地西泮肠胃循环的干扰,是否影响其中枢抑制作用。HPLC法测定证实,酸性液体(pH1)ig可使小鼠iv地西泮后1h胃中地西泮排泌量显著增加。以iv地西泮后睡眠持续时间、自主活动抑制及转棒试验跌落率的恢复速度和死亡率为指标,比较了酸性活性碳(2g·kg^-1)、中性活性碳和生理盐水对地西泮中枢抑制作用的影响。结果表明,酸性碳组动物其地西泮所致中枢抑制状态的恢复速度明显加快,死亡率降低。     

The combined contraceptive vaginal device (NuvaRing®): A comprehensive review

Objectives?The aim of this study is to review the development of NuvaRing® over the past decade to illustrate its use-effectiveness and acceptance as an alternative contraceptive option for women.

Methods?The data were extracted from the literature using computerised MEDLINE system. NuvaRing® is a new combined hormonal contraceptive vaginal ring made of ethylene-vinyl-acetate copolymer, releasing 120?μg etonorgestrel and 15?μg ethinyloestradiol per day. This ring is inserted on any day from day 1 to day 5 of a menstrual cycle for 21 days, thereafter removed for 7 days ring-free period and discarded.

Results?Complete inhibition of ovulation is observed during treatment with this device. Clinical exposure to NuvaRing® for 1786 women-years has resulted in 21 pregnancies, giving a Pearl Index of 1.18. Withdrawal bleeding (4.7–5.3 days) is regular (97–99% of cycles) with rare incidence of irregular bleeding (2.6–6.4%). The cycle control is good with the use of this combined contraceptive vaginal ring. NuvaRing® is well tolerated and accepted by women as compared to oral pill.

Conclusions?NuvaRing® is an effective vaginal contraceptive option for women. However, further study is needed for monitoring its long-term effectiveness and impact on patient's quality of life since the NuvaRing^R is marketed in many countries.     

Marked elevation of serum macrophage migration inhibitory factor levels in patients with pemphigus vulgaris

Background There is ample evidence for involvement of macrophage migration inhibitory factor (MIF) in autoimmune and inflammatory diseases. Objective The aim of this study was to determine whether MIF levels were raised in the sera of patients with pemphigus vulgaris (PV). Methods Serum MIF levels were measured using ELISA method in 22 patients with active PV and 21 age‐ and sex‐matched healthy controls and the results were compared with each other. Results The mean serum MIF levels was significantly higher in PV patients than in control subjects (11.99 ± 1.63 pg/m vs. 1.83 ± 0.22 pg/ml; P‐value = 0.0001). Conclusions Elevated MIF levels in the sera of PV patients could participate in disease induction by activation of T cells as well as induction of autoantibody production by B cells. Given that MIF counter‐regulates the effects of steroids, MIF antagonists may prove to be very effective, novel steroid‐sparing agents for this life‐threatening conundrum.