Necrotizing myopathy with paracrystalline inclusion bodies in hypervitaminosis E

Summary A necrotizing, nonprogressive myopathy with unusual paracrystalline inclusion bodies is described in a patient who underwent long-term treatment with megadoses of vitamin E. The clinical course and morphological findings suggest a close relationship to the administration of the vitamin. The theoretical pathogenesis of muscle damage and the possible origin of paracrystalline inclusion bodies are discussed.Presented at the Jahrestagung der österreichischen Gesellschaft für Neuropathologie in Bad Ischl, on April 17, 1986This study was supported by a grant from the Deutsche Forschungsgemeinschaft (Ba 916)     

云南白药对全髋关节置换术出血量的影响

目的研究云南白药在围术期对全髋关节置换术术中出血量及术后引流量的影响。方法2006至2008年我科收治的股骨颈骨折行全髋关节置换术60例,随机分成两组,分别服用云南白药胶囊和空胶囊;术前术后测定凝血酶原时间(PT),记录全部病人术中出血量及术后24 h引流量。结果实验组和对照组病人的凝血酶原时间(PT)差异有统计学意义(P<0.01);试验组的术中出血量、术后24 h引流量分别为(380±78)ml(、336±77)ml,较对照组(481±77)ml(、418±68)ml明显减少,差异具有统计学意义(P<0.01)。结论云南白药胶囊能够明显减少全髋关节置换术围术期出血量。     

Osteotomy of the tibial tubercle in complex primary total knee replacement

Objective  Stiffness and severe deformity pose a major challenge in total knee arthroplasty. Numerous techniques have been described to gain exposure and improve knee flexion. Tibial tubercle osteotomy provides excellent and safe exposure of the joint, although mechanical and wound complications have been reported. Materials and methods  We present a series of 32 consecutive complex primary total replacements where an osteotomy of the tibial tubercle was utilised. Results  The patients had a mean follow-up of 2 years and 11 months. Following the procedure, with the exception of one case complicated with deep infection, all of the patients had improved clinically. The mean postoperative range of motion had increased to 102° (give P value < 0.005) and there were no cases of delayed union or non-union. A mechanical complication related to technique occurred in one patient; there were no other cases with a postoperative extension lag. Conclusion  In this challenging population group, we have found a tibial tubercle tuberosity osteotomy to greatly facilitate exposure without compromising the clinical and radiographic outcome.     

28 mm Metasul™ bearings in primary total hip arthroplasty

Assessment of possible low-wear with some former metal-on-metal (MoM) total hip arthroplasties (THA) led to the reintroduction of metallic bearings in the late 80’s. The author reports on two studies of Metasul-28 mm cementless THA. In the first one in a general population, impingement has been the main cause of osteolysis and Co level survey has been a good indicator of Metasul bearing behaviour. In the second study, in a group of 83 less than 50-year-old and active patients, Metasul bearings showed good wear resistance at 7.2 years mean follow-up. In both studies, no general toxic effect could have been detected thus far. According to the current knowledge, it is always reasonable to expect low-wear and better THA longevity with use of MoM bearings under the following conditions: 1) use of a CoCr alloy with high carbide concentration; 2) reduce impingement risk (head without sleeve, slimmer as possible neck, perfectly adapted Morse cone from the same manufacturer, well — oriented components); and 3) prefer cementless acetabular fixation.     

Is chronic inflammatory change in the prostate the major cause of rising serum prostate‐specific antigen in patients with clinical suspicion of prostate cancer?

AIM: To evaluate the cause of elevated prostate-specific antigen (PSA) in patients with transrectal needle biopsy negative for prostate cancer. METHODS: Serum PSA concentration, prostate volume, and pathologic findings were examined in 223 patients with negative biopsy for prostate cancer. The degree of prostate inflammation was determined by the extent and degree of inflammation shown by biopsy specimens and is expressed as an inflammation score (range: 0-36). RESULTS: A significant correlation was found between PSA concentration and prostate total volume (P=0.0001). Prostate chronic inflammation showed no correlation with PSA concentration (P=0.485, F=0.488). After allocating patients to normal PSA (4 ng/mL) groups, we found that serum PSA concentrations in both groups were predominantly affected by prostate total volume. CONCLUSIONS: An increase in prostate volume appears to be the major contributor to a high serum PSA concentration in patients with negative biopsy for prostate cancer. However, in contrast to previous reports, there was no correlation between the degree of prostate chronic inflammation and serum PSA concentrations.     

A Chinese adolescent girl with Fechtner-like syndrome

We describe a 15-y-old girl with Fechtner-like syndrome, who is the first Chinese reported to have this rare syndrome. She presented with left homonymous hemianopia and neuroimaging revealed haemorrhage in both parietal and occipital lobes. Peripheral blood smear showed macrothrombocytopenia and intracytoplasmic inclusion bodies inside leucocytes. Thrombocytopenia and proteinuria responded to intravenous immunoglobulin and pulsed methylprednisolone. This case illustrates that life-threatening haemorrhage can occur in patients with Fechtner syndrome. Although there was no effective treatment reported in the literature, high dose steroid and immunoglobulin seemed to be useful in our patient. Our patient also had nephritic-nephrotic syndrome with renal insufficiency, which is unusual in adolescent female patients.     

Cyclosporin A upregulates prostaglandin E2 production in human gingival fibroblasts challenged with tumor necrosis factor alpha in vitro

The effect of Cyclosporin A (CsA) on prostaglandin E₂ (PGE₂) production in human gingival fibroblasts challenged with tumor necrosis factor alpha (TNF-α) was studied. TNF-α (1-100 ng/ml) dose-dependently stimulated PGE₂; formation in 24 h cultures. CsA (1-100 ng/ml) did not induce PGE₂; formation itself but potentiated TNF-α induced PGE; formation in gingival fibroblasts in a manner dependent on the concentrations of both CsA and TNF-α. TNF-α (10 ng/ml) stimulated the release of [³H]-arachidonic acid (A.A) from prelabelled fibroblasts that was potentiated by CsA (100 ng/ml). Addition of exogenous unlabelled AA (5-20 μM/ml) to the cells resulted in enhanced PGE₂: formation that was not potentiated by CsA (100 ng/mi). Furthermore. CsA (100 ng/ml) did not further increase the level of cyclooxygenase-2 mRNA induced by TNF-α (10 ng/ml). although PGE₂ formation was enhanced. The results indicate that CsA and TNF-α act in concert on PGE₂ formation in gingival fibroblasts. which may be of importance in the pathogenesis of gingival overgrowth induced by the drug.     

影响脐血IgE值因素的研究

目的　本研究对影响脐血IgE值的可疑因素进行分析 ,探讨影响儿童食物过敏的可疑因素。方法　选取孕期妇女 10 5名及其所生婴儿 ,采用标准问卷调查获取资料 ,对影响脐血IgE的因素进行分析。 结果　母亲的过敏性疾病史、父亲过敏性疾病史中的皮炎表现型、孕期妇女过敏性疾病发作史、有过敏史妇女孕后期摄入过量的牛奶和鸡蛋均与脐血IgE值的上升有关 ,且上述 5个因素对脐血IgE水平的影响依次降低。 结论　母亲的过敏性疾病史和父亲过敏性疾病史中的皮炎表现型是导致新生儿脐血IgE值升高的主要危险因素 ;同时 ,妊娠期加强对有过敏史妇女的保护 ,防止过敏性疾病的复发 ,在孕后期控制有过敏史妇女牛奶、鸡蛋等大分子食物致敏原的摄入 ,有助于降低脐血IgE值。     

不育症患者精浆中细胞因子测定的临床研究

目的　 探讨精浆中白细胞介素 1β(IL 1β)、白细胞介素 2 (IL 2 )、白细胞介素 4 (IL 4 )、白细胞介素 6 (IL 6 )、白细胞介素 8(IL 8)、白细胞介素 10 (IL 10 )、肿瘤坏死因子 α(TNF α)等细胞因子浓度与不育症患者之间以及精子的各项功能指标之间的相互关系。方法　 应用放射免疫分析(RIA)技术对 12 6例不育男性精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α水平进行了检测。结果　 不育症组精浆IL 1β、IL 2、IL 6、IL 8、TNF α含量均高于生育组 ,两组间均存在显著性差异(P <0 .0 5或P <0 .0 1) ;精浆IL 4、IL 10含量均低于生育组 ,两组间均存在显著性差异 (P <0 .0 1)。不育症组精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α含量在WBC精液组与非WBC精液组、血清AsAb阳性组与血清AsAb阴性组之间均存在显著性差异 (P <0 .0 5或P <0 .0 1) ;精浆中IL 4、TNF α含量在精子活动力、活动率、精子穿透力、顶体完整率、尾部肿胀率正常组与不正常组之间均存在显著性差异 (P <0 .0 5或P <0 .0 1)。 结论　 精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α含量与男性不育症患者之间存在密切关系 ,检测精浆中IL 1β、IL 2、IL 4、IL 6、IL 8、IL 10、TNF α的含量可以反映男性     

前列腺素E1对大鼠肝移植肾功能的保护作用

目的探讨术中应用前列腺素E1（prostaglandin E1，PGE1）对大鼠肝移植肾功能的保护作用。方法大鼠原位肝移植术中经颈内静脉灌注PGE1为治疗组，生理盐水和空白为对照组，观察术后1周存活率、1h的尿量，测定血浆肌酐、尿素氮和肾组织中丙二醛（malondjaldehyde，MDA）、谷胱甘肽（glutathione，GSH）含量，肾组织病理检查。结果PGE1治疗组术后1h尿量较对照组明显增加，肌酐和尿素氮水平均较对照组降低，PGE1治疗组肾组织中GSH含量显著高于两对照组，MDA含量低于两对照组。病理检查PGE1治疗组肾脏组织形态学损伤明显减轻。结论术中应用PGE1能显著改善大鼠肝移植后的肾功能，其机制可能与对抗氧自由基损伤作用有关。