Sclerosing Cholangitis Associated with Autoimmune Hemolytic Anemia and Hyperthyroidism

A patient presented with autoimmune hemolytic anemia and sclerosing cholangitis. Six years later he was found to be hyperthyroid. Although sclerosing cholangitis has been associated with other autoimmune disorders, it has not been reported in association with either autoimmune hemolytic anemia or hyperthyroidism. Sclerosing cholangitis is a chronic fibrosing inflammatory disease process which may include parts or all of the biliary tree including the gallbladder. Although this disorder has been reported to occur with a variety of autoimmune disorders, it has not been previously associated with autoimmune hemolytic anemia and hyperthyroidism.     

Normal High-Resolution Karyotypes in 26 Unrelated Individuals with Hereditary Colorectal Neoplasia

High-resolution karyotype analysis was performed on peripheral blood cultures from 26 patients with hereditary colorectal neoplasia. The aims of this study were: first, to determine the frequency of cytogenetically visible chromosome 5q deletions in familial adenomatous polyposis and, thus, whether routine karyotype analysis should be included in screening regimens for affected families; and, second, to search for chromosomal abnormalities in hereditary nonpolyposis colorectal cancer that might assist in localizing the gene or genes responsible. No cytogenetic abnormalities were detected among 21 unrelated patients with familial adenomatous polyposis and five with hereditary nonpolyposis colorectal cancer. We conclude that cytogenetic analysis is of no value in the management of families with typical familial adenomatous polyposis or Gardner's syndrome, and should be confined to those families with atypical features such as mental retardation or facial dysmorphism.     

Faulty sausage production causing methaemoglobinaemia

A family outbreak of methaemoglobinaemia following ingestion of sausages made using 'saltpetre' is reported. Saltpetre is a generic term for several potassium and sodium based compounds. On this occasion imprecise ordering led to the use of sodium nitrite rather than the usual potassium nitrate, with extremely serious consequences.     

Comparison of different fixation methods following sagittal split ramus osteotomies using three-dimensional finite elements analysis. Part 1: advancement surgery-posterior loading

The purpose of this study was to evaluate the mechanical behavior of different fixation methods used in bilateral sagittal split ramus osteotomy (BSSRO). Part 1 comprises of the results of the analysis for mandibular advancement, four different fixation configurations of six hole fragmentation mini plates with monocortical screws and lag screws and posterior loading conditions in the molar and premolar region. The finite element analysis method (FEA) appears suitable for simulating complex mechanical stress situations in the maxillofacial region. The mechanical behavior of selected lag screws with linear or triangular configuration and double parallel or single oblique six hole mini plates with monocortical screws were compared by FEA after 5 mm BSSRO advancement procedure. Four separate three-dimensional finite element models of the mandible were created to simulate the BSSRO and corresponding fixation methods. These models consisted of 122,717 elements and 25,048 nodes. The mechanical parameters of the materials studied were adopted from the literature or were based on manufacturer's information. 500 N posterior occlusal loads were simulated on the distal segments. The commercial finite element solver MSC Marc software was utilized to calculate the stress fields on both the segments and fixative appliances. It was concluded that the use of 2.0mm lag screws placed in a triangular configuration following the BSSRO advancement surgery provides sufficient stability with any rotational movement and less stress fields at the osteotomy site, when compared with the other rigid fixation methods used in the current study.     

Histological evaluation of changes in the temporomandibular joint after direct and indirect trauma: an experimental study

Abstract – Direct or indirect trauma to the temporomandibular joint (TMJ) may cause several injuries such as fibrous adhesion, ankylosis and fracture. The aim of this study was to examine and compare the histological changes of TMJ and adjacent soft tissue after direct or indirect trauma to TMJ. In this study, a total of 35 healthy young adult guinea pigs were exposed to direct and indirect trauma to their TMJ, and histologic evaluation was done after 24 h, 7, 15 and 45 days. Hemorrhage was the most frequent complication, following that enlargement of the disc, adhesion of the disc to the condyle and fracture of the condyle were seen in both groups. There were regenerative changes in adjacent muscles of the TMJ in indirect trauma group when compared to direct trauma group. Regenerative changes were more obvious on days 15 and 45. As a result, it may be suggested that when a trauma comes to the maxillo-mandibular complex, even TMJ is indirectly affected, TMJ and its adjacent soft tissues should also be examined clinically and followed closely.     

抑瘤素表达产物诱导大鼠肝干细胞WB-F344体外分化

目的:抑瘤素是一种肝细胞促分化因子,能够诱导胚胎肝细胞分化为具有各种代谢功能的成熟肝脏。构建以抑瘤素为主的肝干细胞体外诱导微环境,观察其诱导大鼠肝脏来源的干细胞WB-F344体外分化。方法:实验于2002-10/2004-07在解放军军事医学科学院放射与辐射医学研究所完成。①实验材料:表达抑瘤素的CHO-OSM-EGFP细胞株由李晓利等构建。WB-F344细胞由姚鹏博士惠赠。②实验方法:将终浓度为20%稳定表达抑瘤素的中国仓鼠卵巢细胞上清中加入浓度为1U/mL胰岛素、1×10-7mol/L地塞米松,与WB-F344细胞共培养。空白对照组中未加入诱导分化成分CHO-OSM-EGFP细胞上清、胰岛素、地塞米松。③实验评估:采用流式细胞术分析细胞周期和细胞凋亡,光学显微镜观察细胞形态,RT-PCR分析白蛋白及甲胎蛋白基因表达。结果:①诱导后的WB-F344细胞较空白对照组G2/M S期细胞所占比例明显减低,增殖指数下降约2.8倍,G0/G1细胞所占比例明显增加。②实验组WB-F344细胞形态发生明显改变,由最初的多角形变为长梭性,细胞伸出小管状伪足,核质比例下调,形态趋于成熟大鼠肝脏实质细胞。③RT-PCR结果显示,诱导后WB-F344细胞表达白蛋白,不表达甲胎蛋白。诱导前WB-F344细胞表达甲胎蛋白,不表达白蛋白。结论:在以抑瘤素为主的诱导微环境中,WB-F344细胞表现出生长抑制,形态及功能趋于成熟的大鼠肝细胞     

Helicobacter pylori in bronchiectasis: a polymerase chain reaction assay in bronchoalveolar lavage fluid and bronchiectatic lung tissue

BACKGROUND: A number of studies have implicated an association between H. pylori and diverse extra-gastroduodenal pathologies. Chronic inflammation and increased immune response have been observed in bronchiectasis, likely gastroduodenal inflammatory diseases. H. pylori has been found in the trachea-bronchial aspirates of mechanically ventilated patients. Furthermore, the seroprevalence of H. pylori was found to be significantly higher in patients with bronchiectasis than in the control group. The present study was performed to investigate the possible role of H. pylori in the pathogenesis of bronchiectasis. METHODS: Prospectively, bronchoalveolar lavage fluid (BALF) was obtained from patients with bronchiectasis (n=26) and control (n=20). BALF was subjected to polymerase chain reaction (PCR) to determine the presence of H. pylori and serum IgG against H. pylori was determined with micro-ELISA kit. In addition, PCR was performed to determine H. pylori in surgically removed lung tissues from patients with bronchiectasis (n=97). RESULTS: H. pylori DNA was not detected in the BALF or in lung tissue samples. In addition, anti-H. pylori IgG level in patients with bronchiectasis did not show statistically significant difference from that of the control. CONCLUSIONS: Our study provided evidence that there might be no direct association between H. pylori and bronchiectasis; however, the indirect role of soluble products of H. pylori could not be excluded.     

Stories of a long life with HIV: A qualitative study of a narrative intervention

Background

The dominant story of HIV in Denmark portrays HIV as compatible with a nearly normal life. International research on the experiences of elderly people diagnosed with human immunodeficiency virus (HIV) in the 1980s to mid-1990s challenges this narrative.

Aims

To gain knowledge on the experiences of elderly long-term survivors of HIV in Denmark and to evaluate if a narrative intervention ‘giving voice’ to this specific group was experienced as improving their quality of life.

Methods

In collaboration with relevant stakeholders, we developed a narrative intervention at REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care focusing on the experiences and stories of people having lived a long life with HIV. Nineteen women and men living with HIV were included in the study. The intervention's evaluation design was based on ethnographic fieldwork that included participant observation and focus group interviews. The qualitative data were analysed using thematic content analysis.

Results

The findings show that the dominant story on HIV does not adequately cover the experiences of elderly Danes who have lived a long life with HIV. The participants continue to suffer from late complications and physical, existential, emotional and social challenges. The narrative intervention helped improve how participants experienced their quality of life.

Conclusion

Long-term elderly Danish survivors diagnosed with HIV in the 1980s to mid-1990s suffer from complex symptoms and problems related to living their lives with HIV and treatment. They found that telling and sharing their life stories with other people with HIV gave them a sense of coherence, meaning and direction in life.

Relevance

The study documents the experiences of a group of long-term survivors of HIV in Denmark, making it relevant for organisations supporting people with HIV and for health care professionals working with this group. Furthermore, the study adds to the knowledge base on the use of narrative methods in rehabilitation.