Filtered platelet concentrates from pooled buffy coats show comparable storage lesions when stored for 9 d at 20-24 degrees C or when supplemented with thromboSol at 2-6 degrees C

The present study investigated the quality of platelet concentrates from pooled buffy coat (PCBC) along different production steps and during storage to characterize storage lesions reflected by platelet activation, changing metabolic and cell turnover status (pH, LDH activity). These criteria were compared in conventionally stored PCBCs (20-24 degrees C, n = 8, Group I) to cold stored PCBCs (2-6 degrees C, n = 8, Group II) when supplemented with ThromboSol. Platelet activation was measured on days 1, 3, 7 and 9 by flow cytometry using fluoresceinisothiocyanate-labeled monoclonal antibodies (mAbs) against glycoprotein IIb/IIIa (CD41a, PAC-1 and LIBS-1), P-selectin (CD62P) or CD40 ligand receptor (CD40L) in combination with a phycoerythrin-labeled panspecific platelet marker against GPIb (CD42b). The platelet activation assessed with mAbs PAC-1, CD41a, LIBS-1 and CD40L showed an overall activation of 98 +/- 4% (mean value +/- 1 SD) at day 7 in both groups, except for CD62P, which was significantly lower in Group II. A storage-dependent greater platelet loss occurred in Group II compared to Group I, 42% vs. 19% (p < 0.05 on day 9). We could demonstrate that platelets stored in ThromboSol show about the same in-vitro activation as conventionally stored PCBCs, but their clinical usefulness needs to be investigated.     

Rectal submucosal tumor-like lesion originating from intestinal tuberculosis

We present the case of a 55-year-old man who underwent transsacral local excision for a rectal submucosal tumor-like lesion suspected to originate from tuberculosis. The lesion, 2 cm in size, was found incidentally in the posterior wall of the lower rectum during anal fistulectomy. The lesion was apart from the primary crypt of the anal fistula. Barium enema and colonoscopy revealed a protuberant submucosal growth with a shallow depression of the overlying mucosa. Although computed tomography and magnetic resonance imaging showed a well defined round mass within the rectal wall, digital rectal examination suggested extramural origin. Since repeated endoscopic biopsies were negative, we selected the transsacral approach for excisional biopsy to achieve histological diagnosis. The lesion was confined to the rectal wall and the full-thickness rectal wall was excised. Histologically, a foreign-body granuloma with acute inflammation was the main component of the lesion. Caseating granulomas and Langhans' giant cells, consistent with tuberculosis, were also found.     

Haemophilus ducreyi Associated with Skin Ulcers among Children,Solomon Islands

During a survey of yaws prevalence in the Solomon Islands, we collected samples from skin ulcers of 41 children. Using PCR, we identified Haemophilus ducreyi infection in 13 (32%) children. PCR-positive and PCR-negative ulcers were phenotypically indistinguishable. Emergence of H. ducreyi as a cause of nongenital ulcers may affect the World Health Organization’s yaws eradication program.     

手术联合物理疗法治疗宫颈癌前病变的影响分析

目的：探究手术联合物理疗法治疗宫颈癌前病变的疗效。方法：284例宫颈癌前病变患者,以数字法随机分成观察组（142例）进行切除手术联合物理疗法和对照组（142例）只进行切除手术。对比两组疗法疗效。结果：观察组疗效优者85.91%,优良率为92.96%,对照组疗效优者73.35%,优良率77.46%,差异均有统计学意义（均P〈0.05）。观察组病变消失率85.91%,病变持续率为14.09%,对照组的病变消失率为73.35%,病变持续率为26.65%,差异均有统计学意义（均P〈0.05）。观察组在随访期间出现的宫颈接触出血为8例（5.63%）、白带混血为6例（4.23%）,出现宫颈糜烂加重为2例（1.40%）,显著低于对照组的31例（21.28%）、6例（4.23%）和12例（8.45%）,差异均有统计学意义（均P〈0.05）。结论：手术联合物理疗法治疗宫颈癌前病变,能提升治疗效果,减少术后并发症的发生,宫颈功能恢复效果显著,值得临床推荐。     

卡波姆妇用凝胶治疗宫颈糜烂的安全性有效性评价

本文基于卡波姆妇用凝胶产品,通过对宫颈糜烂的发病机制及治疗方法的理论研究、文献研究、卡波姆妇用凝胶产品调查、专家论证,初步评价卡波姆妇用凝胶的安全性和有效性。     

大蒜油对小鼠肝损伤的预防作用

目的研究大蒜油对由对乙酰氨基酚造成的肝损伤的预防作用。方法将75只小鼠随机分组：对照组、模型组、大蒜油高、中、低剂量组,每组15只小鼠。大蒜油组灌胃相应剂量大蒜油,对照组和模型组灌胃等体积玉米油;2 h后除对照组外各组灌胃对乙酰氨基酚,饲养8h,禁食1 6h称重,摘除眼球取血,测定生化指标;摘取肝脏,做病理切片。结果模型组血清A L T、A ST水平与对照组相比显著升高,两者与对照组比较差异均有统计学意义;大蒜油各剂量组均能降低生化值。大蒜油组无肝坏死,肝脏颜色较为红润,包膜光滑。结论大蒜油对对乙酰氨基酚造成的肝损伤有一定的预防作用。     

Idiopathic Hypertrophic Spinal Pachymeningitis with an Osteolytic Lesion

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a chronic, progressive, inflammatory disorder characterized by marked fibrosis of the spinal dura mater with unknown etiology. According to the location of the lesion, it might induce neurologic deficits by compression of spinal cord and nerve root. A 58-year old female with a 3-year history of progressive weakness in both lower extremities was referred to our institute. Spinal computed tomography (CT) scan showed an osteolytic lesion involving base of the C6 spinous process with adjacent epidural mass. Magnetic resonance imaging (MRI) revealed an epidural mass involving dorsal aspect of cervical spinal canal from C5 to C7 level, with low signal intensity on T1 and T2 weighted images and non-enhancement on T1 weighted-enhanced images. We decided to undertake surgical exploration. At the operation field, there was yellow colored, thickened fibrous tissue over the dura mater. The lesion was removed totally, and decompression of spinal cord was achieved. Symptoms improved partially after the operation. Histopathologically, fibrotic pachymeninges with scanty inflammatory cells was revealed, which was compatible with diagnosis of idiopathic hypertrophic pachymeningitis. Six months after operation, motor power grade of both lower extremities was normal on physical examination. However, the patient still complained of mild weakness in the right lower extremity. Although the nature of IHSP is generally indolent, decompressive surgery should be considered for the patient with definite or progressive neurologic symptoms in order to prevent further deterioration. In addition, IHSP can present as an osteolytic lesion. Differential diagnosis with neoplastic disease, including giant cell tumor, is important.     

Evaluation of characteristics and surgical outcomes in cervical spondylotic amyotrophy

Background:

Cervical spondylotic amyotrophy (CSA) is a rare clinical syndrome resulting from cervical spondylosis. Surgical treatment includes anterior cervical decompression and fusion (ACDF), and laminoplasty with or without foraminotomy. Some studies indicate that ACDF is an effective method for treating CSA because anterior decompression with or without medial foraminotomy can completely eliminate anterior and/or anterolateral lesions. We retrospectively evaluated outcome of surgical outcome by anterior cervical decompression and fusion (ACDF).

Materials and Methods:

28 CSA patients, among whom 12 had proximal type CSA and 16 had distal type CSA, treated by ACDF, were evaluated clinicoradiologically. The improvement in atrophic muscle power was assessed by manual muscle testing (MMT) and the recovery rate of the patients was determined on the basis of the Japanese Orthopedic Association (JOA) scores. Patient satisfaction was also examined.

Results:

The percentage of patients, who gained 1 or more grades of muscle power improvement, as determined by MMT, was 91.7% for those with proximal type CSA and 37.5% for those with distal type CSA (P < 0.01). The JOA score-based recovery rates of patients with proximal type and distal type CSA were 60.8% and 41.8%, respectively (P < 0.05). Patient satisfaction was 8.2 for those with proximal type CSA and 6.9 for those with distal type CSA (P < 0.01). A correlation was observed among the levels of improvement in muscle power, JOA score based recovery rate, patient satisfaction and course of disease (P < 0.05).

Conclusion:

ACDF can effectively improve the clinical function of patients with CSA and result in good patient satisfaction despite the surgical outcomes for distal type CSA being inferior to those for proximal type CSA. Course of disease is the fundamental factor that affects the surgical outcomes for CSA. We recommend that patients with CSA undergo surgical intervention as early as possible.