Cricoarytenoiditis: CT assessment in rheumatoid arthritis

The cricoarytenoid (CA) joint is a true diarthrodial joint that can be affected by rheumatoid disease. Its strategic location in the airway anatomy makes its evaluation of clinical importance. Direct fiberoptic laryngoscopy (DFL) and high-resolution computerized tomography (HRCT) were used to assess the larynx in 32 rheumatoid patients. Abnormalities were seen in 75% of patients at endoscopic examination. HRCT studies showed abnormalities in 72%. Erosion-luxation of the CA joint and surrounding soft-tissue swelling can be demonstrated on HRCT scans. A radiologic grading of the rheumatoid larynx is proposed, stressing that accurate evaluation of the larynx should be part of the diagnostic evaluation of every rheumatoid arthritic patient, given the high frequency of occurrence of rheumatoid laryngitis.     

Impact of genotyping of Mycobacterium tuberculosis on public health practice in Massachusetts

Massachusetts was one of seven sentinel surveillance sites in the National Tuberculosis Genotyping and Surveillance Network. From 1996 through 2000, isolates from new patients with tuberculosis (TB) underwent genotyping. We describe the impact that genotyping had on public health practice in Massachusetts and some limitations of the technique. Through genotyping, we explored the dynamics of TB outbreaks, investigated laboratory cross-contamination, and identified Mycobacterium tuberculosis strains, transmission sites, and accurate epidemiologic links. Genotyping should be used with epidemiologic follow-up to identify how resources can best be allocated to investigate genotypic findings.     

American Red Cross experience with routine testing for hepatitis B core antibody

The implementation of routine testing of blood donations for hepatitis B core antibody (anti-HBc) has allowed the characterization of the performance of the test in a large number of samples from apparently healthy individuals. This study reports the experience of the American Red Cross in testing 2.3 million donors for anti-HBc. The test protocol reproducibly identified a distinct population of donors. The anti-HBc-positive rate varied by region of the continental United States and by the time of year. In a case-control study, 85 percent of subsequent donations from anti-HBc-positive donors were anti-HBc positive. The predictions made in an earlier pilot study regarding the performance and impact of the test were borne out.     

阿司匹林、布他比妥和咖啡因联用对小鼠的镇痛作用及其急性毒性的定量分析

目的 :应用配方均匀设计法 ,定量分析阿司匹林、布他比妥和咖啡因联用对小鼠的镇痛作用及其急性毒性 ,并探讨该法在多药物联用分析中的应用。方法 :设置 7个水平联用比例和剂量 ,用小鼠甩尾法作镇痛试验 ,综合数理分析结果和专业知识 ,由验证性试验确定理论预期结果 ,并参考配伍对小鼠行为的影响 ,确定最优配方 ;用参数法定量分析 3药联用的急性毒性作用。结果 :阿司匹林 4 1mg/kg ,布他比妥 6.4mg/kg和咖啡因 5mg/kg联用对小鼠的镇痛有协同作用 ,对小鼠的行为影响较小 ;其联用的合适比例为 8.1∶1 .2 5∶1 ;联用时其急性毒性的相互作用表现为相加 (无协同作用 )。结论 :阿司匹林、布他比妥和咖啡因 3药联用效果增强 ,但急性毒性未增 ;配方均匀设计法可用于多药物联用的定量分析 ,但有一定的局限 ,其结果需经实验确证     

Improved efficacy and tolerability of retinoic acid in acne vulgaris: a new topical formulation with cyclodextrin complex ψ

OBJECTIVES: Retinoic acid (RA) has long been used, both topically and systemically, for disorders of keratinization, acne and related disorders. In the present study, the efficacy and tolerability of topical RA prepared as a cyclodextrin beta complex (beta-CD) is investigated in 66 acne vulgaris patients. METHODS: This randomized, double-blind, placebo-controlled study compares nightly topical application of RA/beta-CD complex hydrogel formulation (0.025%), RA/beta-CD complex in moisturizing base (0.025%), hydrogel base, moisturizer base or a commercial RA gel (0.05%) in acne vulgaris patients. Improvement of acne was assessed using a 5-point improvement scale and by measuring sebum and moisture content of the skin using an SM 810 sebumeter/corneometer. RESULTS: After 3 months of treatment, mean scores of acne improvement on the 5-point scale were 4 with the RA/beta-CD complex hydrogel formulation, 4.1 with the RA/beta-CD complex in moisturizing base, 1.2 with hydrogel placebo base, 1.1 with moisturizer placebo base and 3 with the commercial RA product. All patients treated with the commercial product experienced local side-effects. One patient discontinued due to severe irritation. None of the patients treated with the RA/beta-CD complex in the moisturizing base and hydrogel formulation experienced significant local irritation, although the sebum content of the skin decreased after application of the RA/beta-CD preparations. This change was not significant compared to controls. The moisture content of the skin was better preserved in the group treated with the RA/beta-CD complex in the moisturizing base. CONCLUSION: The topical RA/beta-CD complex, in hydrogel and moisturizing base, was more effective than the twice concentrated commercial RA product. There were few topical side-effects with this new formulation, which increases patient compliance. Topical RA/beta-CD (0.025% RA) did not significantly reduce sebum secretion but may help to preserve optimum epidermal moisture content with the proper base formulation. This is the first study in the literature reporting efficacy and tolerability of the topical RA/beta-CD complex in acne vulgaris. We conclude that the topical RA/beta-CD complex displays an improved efficacy and tolerability profile and is an effective treatment alternative for acne vulgaris.     

Orbital colour Doppler imaging in carotid-cavernous sinus fistula

Background: Colour Doppler imaging (CDI) is a recent advance in ultrasonography that allows for colour-encoded blood flow data of a vascular structure to be displayed simultaneously on a conventional real-time gray-scale B mode image. Real time A and B mode ultrasonography have been used for diagnostic evaluation of ophthalmic disorders since the early 1960s. The haemodynamic characteristics of the ophthalmic circulation have recently been studied by the use of CDI.
Method: We present three cases of carotid-cavernous sinus fistulas with different presentations. In each case, orbital CDI was used in evaluating the patient's condition.
Results: Orbital CDI was successful in confirming the diagnosis in all three cases. CDI was capable of showing the haemodynamic changes in the orbital vasculature which resulated from carotid-cavernous sinus fistula.
Conclusion: This non-invasive technique presents as an excellent alternative to invasive vascular studies such as angiography for the diagnosis and evaluation of carotid-cavernous sinus fistulas.