Clinical features of chronic fatigue syndrome--symptoms

Chronic fatigue syndrome (CFS) is a clinically defined condition characterized by long-lasting disabling fatigue, resulting in severe impairment in daily functioning and associated symptoms such as memory and concentration difficulties, muscle aches, sleep disturbances, and headache. Common symptoms encountered in CFS patients were reviewed and top 10 common symptoms were described in detail with special reference to the particular features of each symptom helpful to diagnose CFS.     

Exfoliative cheilitis: report of a case

Exfoliative cheilitis, one of a spectrum of diseases that affect the vermilion border of the lips, is uncommon and has no known cause. However, factors such as stress and some psychiatric conditions are associated with the onset of the disease. This condition is disabling because esthetics and normal functions such as eating, speaking and smiling are compromised. The lack of specific treatment makes exfoliative cheilitis a chronic disease that radically affects a person"s life. This report attempts to further investigate the clinical course of the disease and provides detailed illustrations of the cyclical nature of the disease.     

Bioactive apatite coating on titanium using an alternate soaking process

We developed a novel apatite coating method that consisted of two-step of chemical treatment: a combined pretreatment of concentrated acid etching and alkaline treatment, followed by alternate soaking. In this study, the effects of the number of reaction cycles, solution temperature, and soaking time on apatite deposition on titanium surface using alternate soaking were investigated. Results revealed that the deposited amount of apatite mainly depended on the number of reaction cycles, and was independent of solution temperature and soaking time. Characterization results revealed that apatite formation using alternate soaking basically depended on ion exchange and adsorption on the pretreated surface. Further, apatite coating using alternate soaking on a 200-grid titanium mesh confirmed that this coating method was applicable for substrates with complicated shapes.     

Network Meta-analysis and Pharmacoeconomic Evaluation of Fluconazole,Itraconazole, Posaconazole,and Voriconazole in Invasive Fungal Infection Prophylaxis

Invasive fungal infections (IFIs) are associated with high mortality rates and large economic burdens. Triazole prophylaxis is used for at-risk patients with hematological malignancies or stem cell transplants. We evaluated both the efficacy and the cost-effectiveness of triazole prophylaxis. A network meta-analysis (NMA) of randomized controlled trials (RCTs) evaluating fluconazole, itraconazole capsule and solution, posaconazole, and voriconazole was conducted. The outcomes of interest included the incidences of IFIs and deaths. This was coupled with a cost-effectiveness analysis from patient perspective over a lifetime horizon. Probabilities of transitions between health states were derived from the NMA. Resource use and costs were obtained from the Singapore health care institution. Data on 5,505 participants in 21 RCTs were included. Other than itraconazole capsule, all triazole antifungals were effective in reducing IFIs. Posaconazole was better than fluconazole (odds ratio [OR], 0.35 [95% confidence interval [CI], 0.16 to 0.73]) and itraconazole capsule (OR, 0.25 [95% CI, 0.06 to 0.97]), but not voriconazole (OR, 1.31 [95% CI, 0.43 to 4.01]), in preventing IFIs. Posaconazole significantly reduced all-cause deaths, compared to placebo, fluconazole, and itraconazole solution (OR, 0.49 to 0.54 [95% CI, 0.28 to 0.88]). The incremental cost-effectiveness ratio for itraconazole solution was lower than that for posaconazole (Singapore dollars [SGD] 12,546 versus SGD 26,817 per IFI avoided and SGD 5,844 versus SGD 12,423 per LY saved) for transplant patients. For leukemia patients, itraconazole solution was the dominant strategy. Voriconazole was dominated by posaconazole. All triazole antifungals except itraconazole capsule were effective in preventing IFIs. Posaconazole was more efficacious in reducing IFIs and all-cause deaths than were fluconazole and itraconazole. Both itraconazole solution and posaconazole were cost-effective in the Singapore health care setting.     

中风步态44例临床分析

本文应用临床步态分析方法,测定了50例健康中老年人。44例中风患者的时间距离值(TD)。结果表明,中风病人与健康者TD值差异显著。作者认为,中风病人的治疗目标应以其本身TD值结合功能分级为基础较妥;所测量的7项参数中,步速、步角、步宽这三项参数尤为重要。     

胎盘免疫调节因子对子宫内膜异位症大鼠免疫功能的影响

目的:观察胎盘免疫调节因子对大鼠子宫内膜异位症动物模型的治疗效果和对大鼠免疫功能的影响。方法:实验于2005-10/2006-12在广西医科大学医学科学实验中心及广西肿瘤防治研究所实验病理室完成。①实验材料:健康6个月龄雌性SD大鼠60只,体质量为200～250g;健康产妇胎盘在经广西医科大学第一附属医院伦理委员会同意和产妇知情同意后获得。②实验干预及分组:利用自体子宫组织移植的方法,建立雌性子宫内膜异位症大鼠模型40只,随机分为胎盘免疫调节因子小剂量组、中剂量组、高剂量组和模型对照组,分别肌注胎盘免疫调节因子剂量为0.375,0.75,1.5mg/kg和等体积生理盐水,1次/d,连续8周。③用两脚规测量移植物的体积(V=长×宽×高/mm3),采用ATP生物荧光法测定大鼠脾细胞增殖能力;采用中性红法测定腹腔巨噬细胞的吞噬功能。采用ELISA法检测治疗后各组大鼠血清中白细胞介素2水平。结果:建模成功40只,均进入结果分析。①各组移植物外观及体积:用药后8周,各胎盘免疫调节因子组移植物体积不同程度缩小(P<0.05),呈扁平状,粘连受到明显的抑制。②各组大鼠脾细胞增殖试验、腹腔巨噬细胞吞噬功能及血清白细胞介素2水平的变化:胎盘免疫调节因子中,高剂量用药组脾细胞增殖能力较模型对照组升高(P<0.05);各剂量胎盘免疫调节因子组腹腔巨噬细胞吞噬功能、白细胞介素2水平均较模型对照组升高(P<0.05)。结论:胎盘免疫调节因子治疗大鼠子宫内膜异位症显示了较好的疗效,可显著缩小子宫异位内膜的体积,提高大鼠的免疫功能。     

Antithrombotic effects of PAR1 and PAR4 antagonists evaluated under flow and static conditions

Introduction

Thrombin-mediated activation of human platelets involves the G-protein-coupled protease-activated receptors PAR1 and PAR4. Inhibition of PAR1 and/or PAR4 is thought to modulate platelet activation and subsequent procoagulant reactions. However, the antithrombotic effects of PAR1 and PAR4 antagonism have not been fully elucidated, particularly under flow conditions.

Materials and Methods

A microchip-based flow chamber system was used to evaluate the influence of SCH79797 (PAR1 antagonist) and YD-3 (PAR4 antagonist) on thrombus formation mediated by collagen and tissue thromboplastin at shear rates simulating those experienced in small- to medium-sized arteries (600 s^- 1) and large arteries and small veins (240 s^- 1).

Results

At a shear rate of 600 s^- 1, SCH79797 (10 μM) efficiently reduced fibrin-rich platelet thrombi and significantly delayed occlusion of the flow chamber capillary (1.44 fold of control; P < 0.001). The inhibitory activity of SCH79797 was diminished at 240 s^- 1. YD-3 (20 μM) had no significant effect at either shear rate. The antithrombotic effects of SCH79797 were significantly augmented when combined with aspirin and AR-C66096 (P2Y₁₂ antagonist), but not with YD-3. In contrast, no significant inhibition of tissue factor-induced clot formation under static conditions was observed in blood treated with SCH79797 and YD-3, although thrombin generation in platelet-rich plasma was weakly delayed by these antagonists.

Conclusions

Our results suggest that the antithrombotic activities of PAR1 and/or PAR4 antagonism is influenced by shear conditions as well as by combined platelet inhibition with aspirin and a P2Y₁₂-antagonist.     

Development of HPLC method for the determination of levosulpiride in human plasma

A rapid and simple high performance liquid chromatography (HPLC) method was developed and validated for determination of levosulpiride in human plasma. After extraction with ethylacetate/methylene chloride (5:1, v/v), analysis of levosulpiride in plasma samples was carried out using a reverse phase C18 column with fluorescence detector (maximum excitation at 300 nm and maximum emission at 365 nm) for separation and quantification. A mixture of methanol-20 mM phosphate buffer (pH 3.5, 16:84, v/v) was used as a mobile phase. The method was specific and sensitive with a limit of quantification of 5 ng/ml. This HPLC method was validated by examining the precision and accuracy for inter- and intra-day analysis in the concentration range of 5-150 ng/ml. The relative standard deviation (R.S.D.) in inter- and intra-day validation were 8.16-19.75 and 3.90-11.69%, respectively. In stability tests, levosulpiride in human plasma was stable during the storage and assay procedure. The method was applied to the bioequivalence study of two levosulpiride tablet formulations (25 mg) after a single oral administration.     

Prognostic Factors for Chronic Spontaneous Urticaria: A 6-Month Prospective Observational Study

Purpose

Chronic urticaria (CU) has a substantial impact on the quality of life. Little clinical data on the prognosis of CU has been reported. This study aimed to investigate the control status and remission rate of CU and to explore potential predictors of good responses to the treatment during a 6-month treatment period.

Methods

A total of 75 patients with chronic spontaneous urticaria (CSU) were enrolled from 3 university hospitals in Korea. Urticaria control state was classified into 2 groups: group I (remission and well-controlled) and group II (partly and uncontrolled). CU-specific quality of life (CU-QoL) and the urticaria activity score (UAS) were measured before and after the treatment. Autologous serum skin test (ASST), and anti-nuclear and anti-thyroid antibodies were measured at the enrollment into the study. Aspirin intolerance was confirmed by an oral provocation test.

Results

Of 59 patients completing the study, 21 (35.6%) arrived at well-controlled status and only 2 (3.4%) achieved remission, whereas 26 (44.1%) remained at partly controlled status and 10 (16.9%) were at uncontrolled status. Mean changes in CU-QoL (36.5±2.7 vs 20.6±4.3, P=0.017) and UAS (-7.9±0.8 vs -3.0±1.0, P=0.001) were significantly different between groups I and II. The presence of serum autoantibodies and aspirin intolerance had no influence on the control of urticaria in this study. However, ASST positivity was identified as a significant predictor of CU control in multivariate analysis (OR=6.106, P=0.017).

Conclusions

The proportion of CSU patients that achieved remission or a well-controlled state was 39% for the 6 months of stepwise treatment. Longer observations are necessary to assess the exact prognosis of CSU. ASST results may be a useful parameter for predicting a better response to treatment and both UAS and CU-QoL are helpful to monitor therapeutic response.