The bipartite tarsal navicular bone: Radiographic and computed tomography findings

Two cases of bipartite tarsal navicular bone are presented. The radiographic and computed tomography (CT) findings of this anatomical variant are described. Correct recognition of this entity is important, both because it may be the cause of symptoms perse, and because it may be misdiagnosed as a fracture. When plain films are not diagnostic, CT scanning is helpful in distinguishing between a fracture and this variant.     

Rupture of the posterior tibial tendon: CT and surgical findings

Computed tomography (CT) was performed in 42 patients with 49 clinically suspected tears of the posterior tibial tendon. Twenty-eight of the 49 suspected tears were subsequently surgically explored and repaired. Three patterns of tendon abnormalities were recognized on CT scans: type I-intact, hypertrophied, heterogeneous tendon; type II-attenuated tendon; and type III-absence of a portion of a tendon. Types I and II correlated with partial rupture seen during surgery, and type III correlated with complete rupture of the tendon. CT findings were accurate in 96% of the patients who underwent surgery. In four cases (14%), tendon rupture was seen on CT scans, but the extent of the injury was underestimated and the rupture was misclassified. Reactive periostitis of the distal tibia was seen in 71% of diseased tendons and may represent an important factor in the diagnosis of tendon rupture.     

Thrombo ASS in the prophylaxis of vascular disorders in antiphospholipid syndrome

The aim of the study was to try thrombo ASS in combined therapy of patients with antiphospholipid syndrome (APS), to evaluate its efficacy in prevention of recurrent vascular defects. Thrombo ASS tablets (50-100 mg) were included in combined treatment of 45 patients with APS (6 males and 39 females, mean age 36.1 +/- 11.7 years, mean APS duration 10.2 +/- 9.0 years) and 8 patients with SLE (1 male and 7 females) matched for age. Antiphospholipin antibodies and clinical status were assessed before treatment and after the treatment within 9 months. It was found that addition of thrombo ASS to combined treatment of APS improves coagulation and microcirculation due to effective muscular blood flow, increases number of platelets in peripheral blood. Tablets covered with coating resistant to gastric juice reduce frequency of gastric side effects.     

拉米夫定抗乙型肝炎病毒治疗中耐药突变的后续治疗

拉米夫定(lamivudine)抗乙型肝炎病毒治疗中耐药突变发生率高,文献报道在拉米夫定治疗1,2,3,4,5a时分别为14%,38%,49%,66%,69%.耐药突变可导致血清HBVDNA水平阳转或明显上升,肝功能严重受损,甚至病情恶化死亡.关于拉米夫定抗乙型肝炎病毒治疗中耐药突变的后续治疗目前国内外尚无统一用药方案,单药治疗(如:继续使用拉米夫定、阿德福韦、恩替卡韦)在临床使用中已经取得了一定疗效,联合抗病毒治疗和中医药治疗是今后研究的方向.     

Role of antiphospholipid antibodies in occlusion of retinal vessels in various vascular eye diseases

A strong association between the presence of antiphospholipid antibodies (aPLab) and arterial and venous thrombosis was observed during the past decade. aPLab represent a heterogeneous group of immunoglobulins that include the lupus anticoagulant (LA), anticardiolipin antibodies (aCL), and antibodies responsible for false-positive test for syphilis. aPLab react with negatively charged, rarely with neutral phospholipids and/or phospholipid-binding proteins. aPLab are associated with vascular occlusion in autoimmune diseases, e.g. systemic lupus erythematosus (SLE). The role of aCL in ocular vascular occlusive disease involving retinal vessels is unclear. The aim of this study was to determine the relationship between aPLab and occlusive retinal disease. A relationship between aCL (IgG), LA, and thrombotic retinal events has been detected in SLE patients, but no association between aPLab and other occlusive retinal diseases (central retinal vein thrombosis, isolated retinal vasculitis, optic nerve vasculitis). In our study the incidence of aCL IgG was higher in patients with Behcet disease with non-occlusive thrombosis than in patients with retinal occlusive events or in patients without occlusions or thrombosis. It seems that different mechanisms are responsible for these conditions.     

Vascular symptoms of Behcet's disease

AIM: To characterize vascular symptoms of Behcet's disease (BD) in patients treated for the last 10 years in the Institute of Rheumatology. MATERIAL AND METHODS: Vascular symptoms of BD were studied in 151 patients with BD (mean age 33.5 +/- 9.5 years, duration of the disease 14.0 +/- 10.1 years, 104 males and 47 females, 67.4% carried HLA B51(5) antigen). Duplex vascular scanning was made to detect venous thrombosis. RESULTS: Thrombotic complications were found in 37 of 151 (24.5%) patients with BD (30 males and 7 females, mean age 37.1 +/- 9.1 years, mean duration of the disease 7.3 +/- 9.7 years). Venous thromboses prevailed (36 patients). Four males (2.6%) had arterial lesions: aneurysms of the iliac arteries (n = 1), thrombosis of the iliac artery (n = 1), pulmonary infarction and thrombosis of the pulmonary arteries (n = 2). Combination of venous and arterial manifestations occurred in 3 patients. One patient had thrombosis of the venous sinus, occlusion of the retinal vessels was diagnosed in 7 patients. CONCLUSION: Incidence of vascular disorders was observed in 1/4 of the patients. This corresponds to those observed worldwide and concerns venous thrombosis and other thromboses. Among the examinees, vascular disorders were associated with a young age, earlier development of thrombotic complications in males than in females.