Heterogeneous MR arthrography findings in patients with subacromial impingement syndrome – Diagnostic subgroups?

BackgroundSubacromial Impingement Syndrome (SIS) is frequently diagnosed, but treatment results vary greatly. It is increasingly reported that SIS symptoms are caused by various underlying mechanisms that need distinctive treatment strategies. We evaluated a set of specific MRI Arthrography (MRA) characteristics that have been related with underlying mechanisms for SIS in the literature, in patients with SIS.MethodsIn 47 patients diagnosed with SIS, MRA characteristics were evaluated and categorized into categories of potential underlying mechanisms: (1) extrinsic: e.g. acromion shape; (2) intrinsic: e.g. tendinosis; (3) dynamic: e.g. signs of glenohumeral (micro-)instability. Control values were obtained from the literature. With cluster analysis, potential patient subgroups were assessed.ResultsIn 17 (36.2%) patients originally diagnosed with SIS, specific other conditions were found, including rotator cuff tears and labrum lesions. In the remaining 30, all had positive signs of at least one of the predefined underlying mechanisms. Patients could be categorized into 2 groups: predominantly findings corresponding with extrinsic/structural causes, or with dynamic/(micro)instability.ConclusionsMRA characteristics in patients with SIS symptoms are heterogeneous and many patients have specific other shoulder conditions causing symptoms. Patients without specific other conditions have MRA characteristics associated with either extrinsic (structural), or dynamic (e.g. micro-instability) underlying mechanisms.     

Is there a correlation between morphological and cytogenetic findings in placental tissue from early missed abortions?

Summary A retrospective study of 200 missed abortions was performed to determine whether morphological criteria alone are sufficient to ascertain a chromosomal aetiology. Placental changes were clasified into five morphological and four morphometric groups, according to the severity of alterations, and were then correlated with the cytogenetic data. The rate of chromosome anomalies was approximately 50% and was thus not significantly different within the groups II–V, but it was 80% in group I, which covered the most severe placental alterations, namely the partial hydatidiform moles. There was a high incidence of triploidies in group I, trisomies with obligatory early lethality in groups II and III, and X-monosomies in group III. Our findings do not support previous evidence regarding the specificity of certain villous alterations in association with chromosome aberrations. Indeed, they indicate that the placental villi may react similarly to chromosomal and nonchromosomal disturbances and that placental morphology depends on the severity and the temporal onset of the underlying disorder rather than on its type. With respect to chorionic villus samplings (CVS), this would mean that an abnormal villous structure may be suggestive for a chromosome anomaly but does not exclude a normal karyotype.Dedicated to Professor Marlis Tolksdorf on the occasion of her 65th birthday     

Sézary syndrome with hyposplenism

Phenotypic, functional and clinical analysis of two patients with Sezary Syndrome are presented. Both patients had an elevated lymphocyte count with the helper/inducer cell phenotype by analysis with monoclonal antibodies (OKT3+, T4+, T6-, T8-, M1-), had the characteristic cerebriform nucleus of Sezary cells, and were Fc-IgG receptor negative. The functional tests revealed no proliferative, cytotoxic or immunoregulatory activity of patient E.P.'s leukemic cells, while the lymphocytes of patient A.N. responded to mitogen stimulation and had helper cell capacity in pokeweed mitogen driven B cell differentiation and maturation. Both patients presented skin involvement, pruritus, hepatomegaly and patient E.P. showed generalized lymphadenopathy. The spleen size of patient A.N. was below the normal range with an estimated spleen weight of approximately 160 g (normal 180-229 g). Patient E.P. had an extremely small spleen size with an estimated weight of approximately 20 g as shown by abdominal sonography and spleen scintigraphy and had Howell-Jolly bodies within the erythrocytes. The size of the spleen in various other diseases with T cell proliferations is discussed with respect to the possible proliferative centers of the various T-cell subpopulations.     

Down's syndrome,Edwards' syndrome,Patau's syndrome —synthesis of glycosaminoglycans

Synthesis of glycosaminoglycans (GAGS) by fibroblasts derived from seven patients with Down's syndrome, five patients with Edwards' syndrome, and two patients with Patau's syndrome were studied in cell culture. The aneuploid strains were compared with diploid fibroblasts from age-matched controls. In terms of hyaluronic acid and sulfated GAG synthesis, the amount of synthesized hyaluronic acid was not significantly different between postnatal aneuploid strains and controls.     

Cytologic and histologic findings in multiple renal hybrid oncocytic tumors in a patient with Birt-Hogg-Dubé syndrome: a case report

BACKGROUND: Birt-Hogg-Dubé (BHD) syndrome is a rare autosomal dominant neoplastic syndrome characterized by multiple skin lesions, lung cysts and renal tumors. A variety of histologic types of renal tumors have been reported, including clear cell renal cell carcinoma (RCC), papillary RCC, chromophobe RCC, oncocytoma and a recently described hybrid oncocytic tumor, which is thought to be highly associated with BHD. CASE: We report a case of a 48-year-old woman with BHD who initially presented to our institution with spontaneous pneumothorax and was found to have multiple lung cysts and renal tumors on computed tomography. We describe the fine needle aspiration findings of one of the renal tumors, which was suggestive of so-called hybrid oncocytic tumor. We also describe the gross and histologic findings of the multiple kidney tumors that the patient subsequently had excised. CONCLUSION: When multiple kidney tumors from a single patient appear oncycytic on fine needle aspiration, especially when focal clear cells are present, the possibility of oncocytomas and hybrid tumors associated with BHD must be entertained.     

Recurrent Nicolau syndrome associated with subcutaneous glatiramer acetate injection—a case report

Background

Glatiramer acetate is worldwide used as first line treatment in relapsing remitting multiple sclerosis. Local skin reactions associated with glatiramer acetate are common, however, only isolated cases of severe local injection site reactions known as Nicolau Syndrome have been reported so far.

Case presentation

We describe the case of a recurrent Nicolau Syndrome occurred during longstanding glatiramer acetate treatment in a woman with multiple sclerosis. The haemorrhagic patch necrotized and was treated locally as a deep second degree burn with excision of dead skin tissue and was healed. Treatment with glatiramer acetate was definitely suspended.

Conclusions

GA injections can be complicated by isolated or recurrent Nicolau Syndrome, a potentially life-threatening condition of which neurologists should be aware.

     

丝状真菌SC—2产β—胡萝卜素的研究

利用改良的ＳＭＡ培养基富集培养从植物的落花上分离筛选出的产β－胡萝卜素的菌株ＳＣ－２。该菌株在以棉籽饼粉为主要原料的培养基上生长良好。最高生物量达５４ｍｇ干菌体／ｍｌ培养液。胡萝卜素含量１．８５ｍｇ／ｇ干菌体。ＨＰＬＣ测定β－胡萝卜素占总胡萝卜素的９０．５％。     

Olanzapine-associated neuroleptic malignant syndrome: Is there an overlap with the serotonin syndrome?

BACKGROUND: The neuroleptic malignant syndrome is a rare but serious condition mainly associated with antipsychotic medication. There are controversies as to whether "classical" forms of neuroleptic malignant syndrome can occur in patients given atypical antipsychotics. The serotonin syndrome is caused by drug-induced excess of intrasynaptic 5-hydroxytryptamine. The possible relationship between neuroleptic malignant syndrome and serotonin syndrome is at present in the focus of scientific interest. METHODS: This retrospective phenomenological study aims to examine the seventeen reported olanzapine - induced neuroleptic malignant syndrome cases under the light of possible overlap between neuroleptic malignant syndrome and serotonin syndrome clinical features. RESULTS: The serotonin syndrome clinical features most often reported in cases initially diagnosed as neuroleptic malignant syndrome are: fever (82%), mental status changes (82%) and diaphoresis (47%). Three out of the ten classical serotonin syndrome clinical features were concurrently observed in eleven (65%) patients and four clinical features were observed in seven (41%) patients. CONCLUSION: The results of this study show that the clinical symptoms of olanzapine-induced neuroleptic malignant syndrome and serotonin syndrome are overlapping suggesting similarities in underlying pathophysiological mechanisms.     

Is interleukin-18 associated with polycystic ovary syndrome?

Background  

Recent research show that polycystic ovary syndrome (PCOS) may have an association with low-grade chronic inflammation, IL-18 is considered as a strong risk marker of inflammation.     

Molecular cytogenetic evaluation of chromosome instability inTriticum aestivum—Secale cereale disomic addition lines

The genetic stability of wheat/rye (‘Chinese Spring’/‘Imperial’) disomic addition lines was checked using the Feulgen method and fluorescent in situ hybridization (FISH). Feulgen staining detected varying proportions of disomic, monosomic, and telosomic plants among the progenies of the disomic addition lines. The greatest stability was observed for the 7R addition line, while the most unstable lines were those with 2R and 4R additions. Chromosome rearrangements were also detected using FISH. Based on the specific hybridization patterns of repetitive DNA probes pSc119.2 and (AAC)5, as well as ribosomal DNA probes (5S and 45S), isochromosomes were identified in the progenies of 1R and 4R addition lines. The results draw attention to the importance of continuous cytological checks on basic genetic materials by using FISH, because this method reveals chromosome rearrangements that could not be detected either with the conventional Feulgen staining technique or with molecular markers.     

Clonal derivatives of a human B-lymphoblastoid cell line producing prolactin—A cytogenetic characterization

The IM-9-P cell line is a variant of the human B-lymphoblastoid cell line IM-9 which ectopically secretes prolactin (hPRL). The heterogeneous line IM-9-P and three sublines of clonal origin, two of them positive and one negative for PRL gene expression, were subjected to cytogenetic analysis and compared with the reference line IM-9 which showed a normal female diploid karyotype. G-banding revealed several rearrangements in the chromosomes. Nine altered chromosomes including one stable marker chromosome were common to all analysed karyotypes of IM-9-P cells and their clones. A second marker chromosome mar2 occurred only in the karyotypes of the hPRL producing clones, but not in the non-producing clone. None of the visible alterations involve chromosome 6 which carries the PRL gene in humans.     

Isodicentric X chromosome in a patient with Turner syndrome — implications for localization of the X-inactivation center

Summary Cytogenetic analyses have previously shown that the region Xq11.2–q21 is retained in all structurally abnormal X chromosomes. From these observations the conclusion has been drawn that this critical region on the proximal long arm of the X chromosome contains the locus controlling X-inactivation. Structurally abnormal X chromosomes without the X-inactivation center would allow nullisomy, disomy, or trisomy for genes on the X chromosome, and this condition is presumed nonviable. We studied a 28-year-old woman with primary amenorrhea and features of Turner syndrome who had an unusual isodicentric chromosome of the short arm of X. This patient provided us with the opportunity to more closely define the location of the X-inactivation center. High resolution chromosome analysis showed a 46,X,idic(X)(pterq13.2::q13.2pter) chromosome pattern in 94% of her cells and a 45,X complement in 6%. Replication studies showed this derivative X chromosome to be late-replicating (inactive) in all cells analyzed. DNA analysis confirmed the breakpoint of the isodicentric chromosome to be proximal to PGK1. Based on these results, the locus for the X-inactivation center can be refined to be within Xq11.2–q13.2.     

On the origin of the supernumerary chromosome in autosomal trisomies — with special reference to Down's syndrome

Summary The differential staining methods for chromosomes have led to the demonstration of more chromosomal polymorphisms. Not rarely, these polymorphisms allow in autosomal trisomies the detection of parental origin of the supernumerary chromosome. In addition, the malsegregation may be ascribed to 1st or 2nd meiotic division in informative families.This approach of analyzing possible causes of trisomies is subject to a considerable bias. Trisomic phenotypes are twice as frequent for 2nd meiotic errors than for 1st meiotic errors. Also, rare chromosome variants seldom occur in matings where malsegregation in 1st meiotic division can be detected. In the present paper this bias is analyzed mathematically on the family as well as on the population level.From this mathematical analysis and from the data in the literature we conclude that Down's syndrome as a whole is caused about 5–10 times more often by a malsegregation in 1st meiotic than by an error in 2nd meiotic division.Mainly from experimental studies in rodents, causes for errors in 1st and 2nd meiotic division are becoming apparent. They are summarized in the context of the results of the present paper.Human population cytogenetics, a subject originated by Court Brown, has not, as yet, required mathematics at all unless we include—as I think we may correctly—the exact study of such variables as parental age and chromosomal measurements. L. S. Penrose (1970)We dedicate this paper to Professor Emeritus P. E. Becker, M.D., with our best wishes for his retirement.     

What associates Charles Bonnet syndrome with age-related macular degeneration?

Charles Bonnet syndrome (CBS) is a condition related to patients with visual loss due to age related macular degeneration or glaucoma that are having complex visual hallucinations. The CBS was first described by Swiss physician Charles Bonnet in 1760. Affected patients, who are otherwise mentally healthy people with significant visual loss, have vivid, complex recurrent visual hallucinations (VHs). One characteristic of these hallucinations is that they usually are "Lilliputian hallucinations" as patients experience micropsia (hallucinations in which the characters or objects are distorted and much smaller than normal). The prevalence of Charles Bonnet Syndrome has been reported to be between 10% and 40%; a recent Australian study has found the prevalence to be 17.5%. The high incidence of non-reported CBS is thought to be as a result of patient's fear to report the symptoms as they could be labeled as mentally insane since those type of visual hallucinations could be found in variety of psychiatric and neurological disorders such as drug or alcohol abuse (delirium tremens), Alice in Wonderland syndrome (AIWS), psychosis, schizophrenia, dementia, narcolepsy, epilepsy, Parkinson disease, brain tumors, migraine, as well as, in long term sleep deprivation. VHs can also be presented as the initial sign of the Epstein-Barr virus infection in infectious mononucleosis. Patients who suffer from CBS usually possess insight into the unreality of their visual experiences, which are commonly pleasant but may sometimes cause distress. The hallucinations consist of well-defined, organized, and clear images over which the subject has little control. It is believed that they represent release phenomena due to deafferentiation of the visual association areas of the cerebral cortex, leading to a form of phantom vision. Cognitive defects, social isolation, and sensory deprivation have also been implicated in the etiology of this condition. This study was conducted on 350 patients diagnosed with Age-Related Macular Degeneration (AMD) and shows incidence of CBS in 13% of patients with AMD. Furthermore, we have found higher incidence of CBS in patients with massive loss of vision in peripheral visual field which is not age related.     

The Potato—Its origin,cytogenetic relationships,production, uses and food value

About eight billion bushels of potatoes are produced annually throughout the world, 400 million of them in the United States. In the United States and England they are used principally for human consumption; in other European countries as livestock food and as raw material for the manufacture of starch, alcohol and other by-products.     

Outbreak of Guillain-Barré syndrome associated with water pollution.

Sixteen cases of Guillain-Barré syndrome occurred in the third week of a diarrhoea epidemic caused by water pollution in EL-Sult, Jordan. Of 30 000 people exposed to polluted water, 5000 developed diarrhoea, 74 typhoid, and 30 infectious hepatitis. Thirteen of the 16 patients with Guillain-Barré syndrome had been mildly affected by diarrhoea 8-24 days before the onset of peripheral neuropathy. Paralysis progressed rapidly, reaching a peak in one to five days, and recovery began three to seven days after the start of the most severe symptoms. All but four patients had recovered completely after one year. Rapid progress of paralysis and a delayed interval between maximum weakness and start of recovery were both associated with poor prognosis.