A large 12-month extension study of an 8-week trial to evaluate the safety and efficacy of triple combination (TC) cream in melasma patients previously treated with TC cream or one of its dyads

This was a 12-month extension of a randomized, investigator-blinded, multicenter, 8-week trial with triple combination (TC) cream in facial melasma. A total of 585 patients were enrolled in the study and 569 patients received study medication. Three hundred eighty-nine patients completed 6 months of treatment and 327 patients completed 12 months of treatment. TC cream demonstrated a favorable safety profile: only 14 patients (2.5%) discontinued the study due to treatment-related adverse events (AEs). The 2 cases of skin atrophy were mild and did not lead to withdrawal. From the 23 cases of mild telangiectasia, only 2 resulted in discontinuation. All others were transient. Results confirmed those of a previous smaller study, with both physicians and patients reporting clinically significant improvements in melasma. By month 12, 80% of patients had lesions completely cleared or nearly cleared. Once daily application of TC cream applied intermittently over a long period is a safe, tolerable, and effective treatment for moderate to severe melasma of the face.     

Adequate symptom relief justifies hepatic resection for benign disease

Background  

The purpose of this study was to evaluate the long-term results of partial liver resection for benign liver lesions.     

Genetic variability in the coat protein genes of lettuce big-vein associated virus and Mirafiori lettuce big-vein virus

Summary. Available data suggests that lettuce big-vein disease is caused by the ophiovirus Mirafiori lettuce big-vein virus (MLBVV) but not by the varicosavirus Lettuce big-vein-associated virus (LBVaV), although the latter is frequently associated with the disease. Since the disease occurs worldwide, the putative coat protein (CP) open reading frames of geographically distinct isolates of MLBVV and LBVaV were sequenced. Comparison of both nucleotide and amino acid sequences showed a high level of sequence similarity among LBVaV isolates. Phylogenetic analysis of LBVaV CP nucleotide sequences showed that most of the Spanish isolates clustered in a phylogenetic group whereas English isolates were more similar to the USA isolate. An Australian isolate was closely related to the Dutch isolate. Genetic diversity among MLBVV CP nucleotide sequences was higher ranging from 0.2% to 12%. Phylogenetic analysis of MLBVV CP nucleotide sequences revealed two distinct subgroups. However, this grouping was not correlated with symptom development on lettuce or the geographic origin of the MLBVV isolates. Finally, a quick method based on RFLP analysis of RT-PCR amplicons was developed for assigning MLBVV isolates to the two subgroups.     

Effect of Treatment with Clutaurine on Human Antibody - Dependent Cell - Mediated Cytotoxicity (ADCC)

The effects of in vitro and in vivo treatment with glutaurine, a newly discovered parathyroid hormone possessing immunostimulative activity, on human antibody-dependent cell-mediated cytotoxicity (ADCC) were studied in 15 tumor patients and healthy subjects in a xenogeneic test system using chicken erythrocytes as target cells. A marked increase in “K” cell activity was observed in 8 tumor patients with originally low cytotoxic capacity, while originally normal ADCC activity of other tumor patients and healthy subjects was not significantly influenced by glutaurine treatment. The changes in cytotoxicity were not accompanied by changes in lymphocyte populations.

Incubation of effector ceils with glutaurine in vitro caused no change in ADCC activity in lymphocyte populations. Some similarities between the effects of glutaurine treatment on ADCC and that of dialysable leukocyte extracts are discussed.     

Single-detector helical CT in PET-CT: assessment of image quality

OBJECTIVE: CT in positron emission tomography (PET)-CT imaging is often performed as a single scan from the base of the skull to the groin, potentially resulting in degradation of the quality of CT scans depending on the position of the patient's arms and mode of breathing and the use and timing of IV contrast injection. The aim of our study was to assess the impact of artifacts on the diagnostic quality of CT scans using a single-detector helical CT scanner in PET-CT imaging. MATERIALS AND METHODS: Two radiologists retrospectively evaluated the diagnostic image quality of CT scans obtained with PET-CT in 81 patients with lymphoma. The severity of the artifacts related to the position of the patient's arms beside the body, the influence of breathing motion, and the presence of contrast material in the upper thoracic veins were ranked using a 4-point scale. RESULTS: Performing CT with the patient's arms positioned beside the body resulted in streak artifacts, predominantly in the upper abdomen, that were graded as mild in 22%, moderate in 40%, and severe in 38% of the scans. A patient's weight significantly correlated with the degree of severity of the artifacts (p < 0.05). Shallow breathing by the patient during scanning caused blurring and double-imaging, again predominantly in the upper abdomen, that were graded as mild in 23%, moderate in 49%, or severe in 28% of the scans. In 84% of the CT scans obtained with IV contrast material, the image quality of the upper thoracic region was moderately (27%) or severely (57%) degraded by streak artifacts from highly concentrated contrast material in the upper thoracic veins. CONCLUSION: The use of a single-detector CT scanner in whole-body PET-CT decreases the image quality of CT scans because of streak artifacts that occur predominantly in scans of the upper abdomen. Scanning with the patient's arms raised eliminates the streak artifacts in scans of the abdominal region. With the new generation of PET-CT devices equipped with MDCT scanners, breathing motion artifacts can be expected to be eliminated if protocols for breath-hold CT are applied. Reversing the direction of CT scanning allows one to avoid imaging the thoracic region at a time when undiluted IV contrast material is still present in the upper thoracic veins.     

Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study

Background  

This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services.     

Old and New in MÉniÈre Disease

The clinical experience is increasing, but still there is no uniform understanding in the substrate of Ménière's disease. The criteria of the diagnosis is loose and great controversy exists in the therapeutic efforts. A bewildering number of concepts and methods have been suggested and praised as the best answers in solving the problem until the next claim of success shatters the popularity of earlier allegations. The array of articles in the world literature for the past 25 years treats the entity of Ménière's disease in general and from the viewpoint of etiology, pathology, histology, clinical diagnosis and treatment. This review is concerned primarily with the treatment aspect of the literature. All the published ideas, regimens and techniques have one significant feature in common. They all claim success but not in 100% of the cases. Recovery varies from about 60% to 80%. Those cases considered “improved” are 20% to 30% and the rate of failure is between 10% and 25%. The diagnostic tools and capabilities have improved considerably. For treatment, except for reasonable medical or surgical palliation, nothing more can be offered than was offered a half century ago.     

半肢骨骺发育异常1例

１　病例报告　男,７岁．因双下肢不等长,右膝及右踝关节骨性肿大就诊．无明显外伤史,亦无红、肿、热、痛病史．查体：发育正常,营养良好．双下肢不等长,左６０ｃｍ,右６４ｃｍ,有跛行．右膝及右踝内侧肿大,肤色正常,关节活动无异常．Ｘ线：右侧半身诸关节（肩、肘、腕、髋、膝、踝）骨骺及干骺发育均较左侧增大,肢体较长,骨骺出现亦较对侧提早．如右尺骨茎突骨骺较左侧提早出现（图１）．右肘关节肱骨小头骨骺较左侧增大（图２）．右髋臼发育浅平,边缘毛糙,右股骨头骨骺较左侧明显增大,其距泪滴之距离较左侧大１．０ｃｍ,呈…