Whole body MR imaging in ankylosing spondylitis: a descriptive pilot study in patients with suspected early and active confirmed ankylosing spondylitis

Background  

Ankylosing spondylitis is a chronic inflammatory rheumatic disorder which usually begins in early adulthood. The diagnosis is often delayed by many years. MR imaging has become the preferred imaging method for detection of early inflammation of the axial skeleton in ankylosing spondylitis.     

Results of total and subtotal colon resections in children.

AIM: The treatment of long-segment neuronal intestinal malformations confronts the paediatric surgeon with the problems of diagnosis, suitable surgical methods and postoperative care. The evidence based only on ganglion cells is inadequate to decide about the required extent of resection and does not exclude hypoganglionosis and disseminated dysganglionosis. For the surgical treatment, pouch procedures as well as the usual resection techniques according to Rehbein, Soave, and Duhamel are discussed. Since studies with greater numbers of patients are rare, we present here our own results. METHODS: 48 patients with long segment intestinal malformations were treated in our hospital between 1990 and 2000. A total of 35 patients were examined 1.5-6 years after definitive surgical therapy. Rehbein's anterior resection was performed in all cases. RESULTS: Our findings showed that the surgical treatment with Rehbein's technique offers good results, both with respect to complications as well as to the postoperative course, although a 4 cm long aganglionic segment remains in situ. We found that results were better after ascendorectostomy (n = 22) compared to ileorectostomy (n = 11). Earlier publications of this group (13) show that the histology of the proximal resection margin is decisive for the prognosis. Hypo- and aganglionic segments should be completely resected while short IND segments of the colon or terminal ileum may remain in situ. However, the additional effect of the aganglionic segment of the distal rectum and the decreased peristaltic flow of the pre-anastomotic bowel has to be taken into account. Further investigations are required to find out whether a combination of Soave's endorectal pull-through with a remaining neuronal dysplastic segment proximal to the resection margin may give better results or if the frequency of postoperative enterocolitis and incontinence increased in cases of long segment intestinal neuronal malformations. Accurate diagnosis of myenteric plexus is decisive for an optimal treatment and therefore, considering our results, it is essential that in case of newborns getting to hospital with colon obstruction and suspicion of neuronal intestinal malformation full thickness biopsies from the distal and proximal colon may be taken simultaneously with the enterostomy. Generally ileostomy is performed in patients suspected of long-segment neuronal intestinal malformations. Mucosa suction biopsies from the distal and proximal stoma side are less informative compared to full thickness biopsies.     

Aquagenic pruritus. Water-induced activation of acetylcholinesterase

Four patients with aquagenic pruritus (AP), one patient with polycythemia rubra vera, one patient with cold urticaria, and three normal control volunteers were studied to better understand the pathophysiology of water-induced itching. Punch biopsy specimens were taken before and after water contact; the specimens were immediately frozen, sectioned, and stained histochemically for acetylcholinesterase (AChE) activity. This was localized in the nerve fibers surrounding eccrine sweat glands and was quantified by microspectrophotometry. In AP and polycythemia rubra vera after water exposure a significantly increased AChE activity suggesting acetylcholine release was observed, whereas in the patient with cold urticaria and the controls, a significant decrease was noted. Two related patients with AP had an inherited abnormality of serum cholinesterase, which, however, had no obvious correlation with their particular disease. The proof of AChE activation might support the clinical diagnosis and indicate a hypothetical involvement of eccrine sweat glands in the pathogenesis of AP.     

慢性低氧时小鼠肺组织低氧诱导因子-1α的表达

目的：研究低氧时小鼠肺组织中低氧诱导因子-1α(HIF-k)表达的变化。方法：实验用雄性小鼠，低氧仓浓度分别为10％、7％、5％。用免疫荧光组织化学技术及共聚焦显微术，检测小鼠在低氧条件下肺组织中HIF-1α表达的变化。结果：正常组小鼠肺组织HIF-1α无表达，低氧组HIF-1α表达增加，且随低氧时间的延长及低氧强度的增加而增强。结论：低氧可诱导小鼠肺组织中HIF-1α的表达增强，(HIF-k)可能参与肺组织细胞凋亡的发生。     

<Emphasis Type="Italic">TCF7L2</Emphasis>variant genotypes and type 2 diabetes risk in Brazil: significant association,but not a significant tool for risk stratification in the general population

Background  

Genetic polymorphisms of the TCF7L2 gene are strongly associated with large increments in type 2 diabetes risk in different populations worldwide. In this study, we aimed to confirm the effect of the TCF7L2 polymorphism rs7903146 on diabetes risk in a Brazilian population and to assess the use of this genetic marker in improving diabetes risk prediction in the general population.