Impact of clinical history on fracture detection with radiography

The effect of knowledge of localizing symptoms and signs in the detection of fractures was studied. Forty radiographs of the extremities were examined twice by seven radiologists; the sessions were separated by 4 months. In 26 cases, a subtle fracture was present; 14 cases were normal. In half of the cases at each session, the precise location of pain, tenderness, or swelling was provided. The observer was asked to determine if the case was normal or abnormal (provide the exact location of the fracture) and to indicate the degree of confidence in the diagnosis. Responses were converted to a numeric scale for analysis. Analysis of receiver operator characteristic parameters indicates that clues regarding location of trauma facilitate detection of fractures. The improvement is based largely on an increased true-positive rate without an increased false-positive rate, regardless of the decision criteria of the radiologist (overall willingness to "overread" or "underread"). This has direct clinical applicability and reinforces the plea of radiologists for precise clinical information.     

Lymph node infarction – a rare complication associated with disseminated intra vascular coagulation in a case of dengue fever

Background  

Lymph node infarction is known to occur in association with many non-neoplastic and neoplastic conditions however its occurrence in association with DIC is not reported hitherto in the literature.     

Ovine concanavalin A-induced suppressor cells: generation, assay, age-related effects and re-evaluation of mechanism of suppression.

Preactivation of ovine peripheral blood and lymph node mononuclear cells with mitogenic doses of concanavalin A (Con A) induced cells which suppressed mitogen-stimulated proliferative responses of untreated autologous and allogeneic responder cells. The degree of suppression varied with preactivating doses of Con A, length of preactivation time, and ratio of preactivated to responder cells. The role of macrophages in generation of suppressor cells was not evaluated. However, macrophages were not required to mediate suppression in cocultures, as lymphoblasts depleted of macrophage by plastic adherence and nylon wool columns mediated equal, and often greater, suppression than unseparated, preactivated cells. Suppressor cell activity in peripheral blood increased from the neonatal period to adulthood. Supernatants from Con A preactivated cell cultures with detectable interleukin-2 activity abrogated suppression when added at 0 and 24 hr of the 72 hr coculture period, suggesting that Con A-induced suppressor cells exert their function by decreasing available levels of IL-2 in the cocultures.     

Analysis of antibody responses to phenotypically distinct lentiviruses.

To define the immune responses against phenotypically and pathogenically distinct lentiviruses, we used an immunoblotting assay to study antibodies to viral proteins of ovine lentivirus (OvLV) in 16 experimentally and 12 naturally infected sheep. Two distinct phenotypes of OvLV were used to experimentally infect lambs: strain 85/34, a "rapid/high" isolate which rapidly induced lysis in infected primary macrophage cultures and replicated to relatively high titers, and strains 84/28 and 85/14, "slow/low" isolates which induced slowly progressive syncytia with minimal lysis in vitro and replicated only to low titers in the same cell type. Serum antibodies against four major viral structural proteins, gp105, p25, p16, and p14, were detected. In a longitudinal study of experimentally infected lambs, the antibody to p25 (major gag protein) usually appeared first (average, about 3 weeks postinoculation [p.i.]) and was followed in about 2 weeks by p16, p14, and gp105 almost simultaneously. Six of 16 animals did not develop anti-p14 antibody by the time of necropsy at 9 to 29 weeks p.i. Two of 10 lambs which developed antibody to p14 had the antibody only transiently from 3 to 8 or 13 weeks p.i. and lost it by the time of necropsy at 21 or 22 weeks p.i. In contrast, antibodies to the other three structural proteins remained fairly constant until the time of necropsy. There were differences in the antibody responses of the experimentally infected lambs to the two phenotypes of OvLV. Seven of 10 (70%) lambs which were inoculated with the rapid/high strain developed antibody to p14, whereas only 17% of the lambs inoculated with the slow/low strains had antibody to this protein. In the longitudinal study, no decline was observed in the activity of any specific antibody such as that which occurs with anti-p24 antibody in human immunodeficiency virus infection, except in the case of anti-p14 antibody in two lambs. There were no significant differences in antibody titers against p25, p16, and p14 in final blood samples between rapid/high virus- and slow/low virus-infected groups. However, the rapid/high virus-infected group developed a fivefold-higher geometric mean titer of anti-env product (gp 105) antibody than did the slow/low virus-infected group (P 相似文献   

Clinical and genetic features of variegate porphyria in a Chinese patient

Acute porphyria is rare in orientals. We describe a Chinese woman with recurrent generalised tonic-clonic seizures and abdominal pain. Genomic DNA studies identified a heterozygous base substitution from guanine to adenine at nucleotide position 503, resulting in substitution of arginine by histidine at position 168 of the protein (R168H). This genetic abnormality is similar to the mutation reported in Caucasians with variegate porphyria. To the best of our knowledge, this is the first report in the English literature a Chinese patient with variegate porphyria with an identifiable mutation. A brief review of porphyria is presented.     

Bladder pheochromocytoma encountered on sonography

Pheochromocytomas of the bladder are rare neoplasms, constituting <0.06% of all vesical tumours. Common presenting features of this tumour include episodes of sweating, hypertension, haematuria and postmicturition syncope. We describe a case of bladder pheochromocytoma in a 66‐year‐old man whose only symptom of macroscopic haematuria was initially assessed with ultrasonography. Clinical presentation highlights the need for a high index of suspicion during sonographic evaluation of bladder neoplasms because such tumours might present without symptoms of adrenergic excess.     

腺病毒载体介导的PML生长抑制因子对前列腺癌细胞生长和致瘤能力的抑制效果

为探讨用腺病毒载体携带ＰＭＬ（ＰｒｏｍｙｅｌｏｃｙｔｉｃＬｅｕｋｅｍｉａ）基因作为前列腺癌基因治疗的可能性，应用重组人携带ＰＭＬ基因腺病毒（ＡｄＰＭＬ）感染培养的前列腺癌细胞，观察表达ＰＭＬ蛋白的癌细胞与对照组癌细胞的体外生长和裸鼠体内致瘤能力变化，对荷瘤裸鼠瘤体周围注射ＡｄＰＭＬ，观察治疗组和对照组肿瘤生长的变化。结果显示，感染ＡｄＰＭＬ的前列腺癌细胞体外生长和裸鼠体内致瘤能力明显下降，荷瘤裸鼠瘤体周围注射ＡｄＰＭＬ后肿瘤生长速度明显减慢。证实了ＰＭＬ是一种生长抑制因子，提示其可能被应用于前列腺癌的基因治疗研究     

Acute coronary syndromes

The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or ‘primary’ percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.