X-ray diagnosis of complications of purulent processes in the wrist

To reveal the spreading of a purulent process to the antebrachial fatty spaces a study was made of an x-ray picture of soft tissues of the radiocarpal articulation and the forearm distal half in 126 patients with hand paronychia and phlegmon. In 24 of 95 patients with an unclear clinical picture of purulent discharge, typical x-ray symptoms of changes in soft tissues of the distal third of the forearm were found: typical deformity of fatty spaces with its distinct dynamics with relation to a stage of development of a pathological process. X-ray investigation permits the recognition of complications in hand purulent processes in order to take necessary therapeutic measures.     

A complex x-ray study of patients with enterocutaneous fistulas

The paper is concerned with analysis of the results of x-ray examination of 78 patients with enterocutaneous fistulas of various etiology and site. The authors have shown the characteristic features of x-ray examination of patients in whom the fistulas were at the acute phase of their development. They have also defined the diagnostic value of the employed methods and their efficacy for the diagnosis not only of fistulas but also of related complications (inflammatory infiltrates and abscesses of the abdominal cavity, fatty phlegmon, purulent "fillings", complicated fistulas, etc.). During combined x-ray investigation accurate diagnosis of fistulas was established in 97.4% of the patients, purulent complications were revealed in 94.6%.     

食管癌术后呼吸衰竭的临床诊治分析

目的:探讨食管癌术后发生呼吸衰竭(RF)的原因及防治疗措施。方法:将194例行食管癌手术的患者按术后是否发生呼衰分为观察组(36例)和对照组(158例),比较分析相关因素,对发生RF的患者行气管插管呼吸机辅助和气管切开的抢救。结果:36例RF均在术后24～72h发生,33例痊愈,死亡3例。结论:年龄、肺功能、手术时间、血清白蛋白含量、术后其它并发症及是否吸烟等都是诱发RF的重要因素,术前积极治疗肺部合并症、改善肺功能、缩短手术时间、防止染是预防和减少RF发生的主要措施。     

Studies in Osteoarthritis of the Hip: Part II, * Osteoarthritis of the hip and leg-length disparity

An x-ray method is described for the determination of leg-length inequality in the standing subject, Its precision is compared to that of other methods in current use. The geometrical considerations which are inherent in any radiographic method of leg-length determination are summarized. Sixty-seven patients with OA hip were studied; 62 were considered to be idiopathic and 36 of these idiopathic cases were superolateral in type. Measurements in these 36 patients showed significant leg-length disparity, most of the diseased hips being found on the side of the longer leg. If allowance is made for shortening due to disease, the frequency and bias of the disparity are highly significant. The strong association between OA hip of this type and a long leg suggests a causal relationship.     

X-ray diagnosis of neurogenic osteoarthropathies

The paper is concerned with roentgenoanatomical analysis of the osteoarticular system in 607 patients with syringomyelia (21), tabes dorsalis (42), diabetes mellitus (324), psoriasis (187) and traumatic injuries of the spine and spinal marrow (33). In 58 patients tabetic (18), syringomyelitic (12), diabetic (18), psoriatic (9) and traumatic (1) osteoarthropathy was diagnosed. A study of the x-ray picture of osteoarthropathy revealed 2 types of disease: either with the prevalence of osteolytic or proliferative changes. The x-ray picture of osteoarthropathy was presented. The features of tabetic, syringomyelitic, diabetic and psoriatic arthropathies were described.     

食管癌术后呼吸衰竭的临床诊治分析

目的：探讨食管癌术后发生呼吸衰竭（RF）的原因及防治疗措施。方法：将194例行食管癌手术的患者按术后是否发生呼衰分为观察组（36例）和对照组（158例）,比较分析相关因素,对发生RF的患者行气管插管呼吸机辅助和气管切开的抢救。结果：36例RF均在术后24-72h发生,33例痊愈,死亡3例。结论：年龄、肺功能、手术时间、血清白蛋白含量、术后其它并发症及是否吸烟等都是诱发RF的重要因素,术前积极治疗肺部合并症、改善肺功能、缩短手术时间、防止染是预防和减少RF发生的主要措施。     

Etiology of inflammatory maxillofacial diseases and estimation of the effectiveness of antibacterial drugs in vitro]

The results of identification of 710 clinical strains of anaerobic microorganisms isolated from the pathological foci of patients with maxillofacial diseases are presented. The species composition of the microflora associations in the cases with abscesses, phlegmon, lymphadenitis, osteomyelitis and parodontitis is described. Along with a high frequency of nonsporulating anaerobes, staphylococci, microaerophilic streptococci and in the cases with parodontitis actinomycetes, Bacillus licheniformis and Bacillus coagulans strains (1.6-15% of the isolated strains) were first detected in cases with various forms of the disease. Two groups of the drugs effective against the anaerobes were identified by the data on the antibiotic sensitivity. The lowest MICs along with the activity broad spectrum were defined for gramicidin, levomycetin and nitazol.     

X-ray semeiotics of cranial involvement in endocrine diseases]

The incidence and type of x-ray semeiotics of the skull involvement were studied in 703 patients with endocrine diseases (26 with acromegaly, 36 with hypercorticism, 104 with thyrotoxicosis, 23 with hypothyrosis, 98 with primary hyperparathyrosis, 302 with diabetes mellitus, 114 with hypogonadism). Craniogram analysis involved study of the thickness and structure of the vault bones, shape and size of the skull, status of the sutures, internal plate relief, changes of the base of the skull, of the sella turcica first of all, and facial bones. The characteristic x-ray symptom complexes of the involvement of the skull in some endocrine diseases were distinguished.     

Prediction of coronavirus 3C-like protease cleavage sites using machine-learning algorithms

The coronavirus 3C-like (3CL) protease, a cysteine protease, plays an important role in viral infection and immune escape. However, there is still a lack of effective tools for determining the cleavage sites of the 3CL protease. This study systematically investigated the diversity of the cleavage sites of the coronavirus 3CL protease on the viral polyprotein, and found that the cleavage motif were highly conserved for viruses in the genera of Alphacoronavirus, Betacoronavirus and Gammacoronavirus. Strong residue preferences were observed at the neighboring positions of the cleavage sites. A random forest (RF) model was built to predict the cleavage sites of the coronavirus 3CL protease based on the representation of residues in cleavage motifs by amino acid indexes, and the model achieved an AUC of 0.96 in cross-validations. The RF model was further tested on an independent test dataset which were composed of cleavage sites on 99 proteins from multiple coronavirus hosts. It achieved an AUC of 0.95 and predicted correctly 80% of the cleavage sites. Then, 1,352 human proteins were predicted to be cleaved by the 3CL protease by the RF model. These proteins were enriched in several GO terms related to the cytoskeleton, such as the microtubule, actin and tubulin. Finally, a webserver named 3CLP was built to predict the cleavage sites of the coronavirus 3CL protease based on the RF model. Overall, the study provides an effective tool for identifying cleavage sites of the 3CL protease and provides insights into the molecular mechanism underlying the pathogenicity of coronaviruses.     

Molecular analysis of IgM rheumatoid factor binding to chimeric IgG.

To localize regions on IgG bound by rheumatoid factors (RF), we studied IgM RF binding to chimeric IgG antibodies consisting of murine V regions fused to human constant regions. Using a modified RF ELISA, we showed that polyclonal RF from rheumatoid arthritis patients bound IgG1, 2, and 4 strongly; IgG3 was also bound, although less well. The majority of 18 monoclonal RF from patients with Waldenstrom's macroglobulinemia bound IgG1, 2, and 4 only. In contrast to RF from RA, 14 of 18 monoclonal RF did not react with IgG3. Only 3 of 18 monoclonal RF bound IgG3 well. By shuffling C region domains between IgG3 and IgG4, we showed that sequence variation in the CH3 domain is responsible for the differential binding of monoclonal RF to IgG3 and IgG4. Hybrid IgG3/IgG4 antibodies containing the CH3 domain of IgG4 were bound by monoclonal RF, whereas those containing the CH3 domain of IgG3 were not. To evaluate the contribution of the N-linked carbohydrate moiety at Asn-297 to RF binding sites on IgG, we measured RF binding to aglycosylated IgG antibodies produced by mutating Asn-297 to another amino acid. Glycosylated and aglycosylated IgG1, 2, and 4 were bound identically by monoclonal and polyclonal RF. Aglycosylated IgG3, however, was bound better than glycosylated IgG3 by polyclonal RF and by IgG3-reactive monoclonal RF.     

Prevalence and relevant factors of positive RF in brucellosis patients with arthralgia

BackgroundBrucellosis is a critical zoonotic disease in the world, it is the non-specific arthralgia that make brucellosis patients easily misdiagnosed as rheumatoid arthritis (RA) in endemic regions. Elevated rheumatoid factor (RF) is an essential indicator of RA, and the RF in brucellosis patients is significantly higher than healthy people. Therefore, this study further explored the distribution of RF and the relevant factors of the RF positivity in brucellosis patients with arthralgia, in order to strengthen the recognition of physicians for brucellosis patients with RF positivity, especially in brucellosis-endemic areas, so as to avoid misdiagnosis and untimely treatment that may lead to malignant outcomes.Methodology and principal findingsThe medical records of all 572 brucellosis inpatients were collected in the Sixth People’s Hospital of Shenyang, China from 2015 to 2016. After excluding 106 patients without arthralgia, 5 patients who unwilling to perform RF testing and 16 patients with diseases that may affect RF, 445 brucellosis inpatients with arthralgia were involved in this retrospective cross-sectional study. 143 (32.1%) patients with RF >10 IU/ml were classified into the RF positive group, with an average level of 16.5[12.2, 34.7] IU/ml, of which 45 (10.1%) patients were high-positive with RF >30 IU/ml. Multivariate logistic regression model was used to further analyze the relevant factors of the RF positivity and found that age, wrist joint pain and elevated C-reactive protein (CRP) were positively associated with RF positivity, with OR of 1.02 (P = 0.024), 8.94 (P = 0.008) and 1.79 (P = 0.019), respectively.ConclusionThe prevalence of positive RF in brucellosis patients with arthralgia was critical, nearly one-third of patients had RF positive. Elderly men brucellosis patients with arthralgia, wrist joint pain and elevated CRP were at high risk of positive RF. It is reminded that physicians should focus on differential diagnosis during clinical diagnosis and treatment, especially in brucellosis-endemic regions.     

Independent associations of anti-cyclic citrullinated peptide antibodies and rheumatoid factor with radiographic severity of rheumatoid arthritis

Several recent publications have established a strong association between anti-cyclic citrullinated peptide antibody (anti-CCP)-positive rheumatoid arthritis (RA) and carriage of shared epitope (SE) alleles. Although anti-CCP have also been associated with more severe RA, the issue of whether this is independent of rheumatoid factor (RF) has not been addressed. To identify associations between RF, anti-CCP, SE status and radiological damage, we studied a large cross-sectional cohort with longstanding RA. Individuals (n = 872) enrolled in the study all fulfilled the American College of Rheumatology criteria for RA, had a minimum disease duration of 3 years, and at least one definite radiographic erosion was present in hands or feet. Radiographs were scored blind at study entry by a single musculoskeletal radiologist using a modified Larsen's score. Anti-CCP and RF levels were determined using enzyme-linked immunosorbent assay, and DRB1 typing was performed using polymerase chain reaction based methodology. Both anti-CCP and RF levels were strongly associated with radiographic severity (P < 0.0001). In subgroups stratified for both anti-CCP and RF status, evidence of independent associations of both antibodies with radiographic outcome was found (P < 0.0001). An association of SE alleles with radiographic severity was present only in RF-negative individuals. Anti-CCP positivity was associated with SE status with evidence of a gene-dose effect, most markedly in RF-negative individuals (P < 0.01). Anti-CCP and RF status are independent severity factors for RA, with SE alleles playing at most a secondary role. Our data support the view that previously described associations between SE and radiological severity, especially in RF-negative patients, may be indirect and due to an association with anti-CCP.     

Developmental orthopaedic disease in limbs of foals: between-breed variations in the prevalence, location and severity at weaning

Developmental orthopaedic disease (DOD) affects all breeds and is a common cause of pain and lameness for horses in sports. A thorough knowledge of between-breed variations for the prevalence of DOD, for its distribution among the various joints and for its severity at earlier stages in the disease process is needed in order to improve the relevance and the cost-effectiveness of DOD screening protocols. However, no prevalence study for DOD simultaneously performed on several breeds with similar farming systems and based on radiographic findings (RF) on quite a large number of joints and views, has been reported earlier. The objective of this study was to describe variations in the prevalence, location and severity of DOD in foals at weaning among Warmbloods (Wb), Standardbreds (St) and Thoroughbreds (Tb) with similar farming systems. DOD assessment was based on RF on the limb joints. A total of 392 foals from 21 volunteer stud farmers were included. To determine the statuses of foals regarding DOD, they were X-rayed on the front- and hind-limb digit, carpus, hock and stifle joints. X-ray data were analysed by three experienced equine veterinarians who gave a common assessment about the entity and the severity of RF. Between-breed variations were analysed in two steps: the first implemented for each anatomical site; the second considered only foals affected by DOD to explore RF association patterns on the affected sites, at foal level. The three breeds were represented by 25.0% of Wb, 41.1% of St and 33.9% of Tb. DOD was present in 66.3% of the foals (95% confidence interval (CI) = 61.6% to 71.0%). Prevalence of foals affected by DOD and distribution of the RF severity score on the anatomical sites differed depending on the breed: Wb foals seemed to be the most affected by DOD. Cluster analyses showed no clear association among sites. However, Wb and Tb foals were preferentially classified together because they were affected on the same sites, whereas St foals were distributed in other classes. The most severely affected sites were the proximal part of the hock and the femoro-patellar joint for Wb and St foals, and the fore fetlock and the distal part of the hock for Tb foals. This is the first epidemiological study reporting between-breed variations in DOD distribution and severity, for the limb joints of foals. These results contribute to broaden the knowledge on DOD and are of great interest to improve detection of DOD within a particular breed.     

X-ray characteristics of acute intestinal obstruction in middle-aged and elderly patients

The authors presented clinical and x-ray findings of 188 patients with mechanical intestinal obstruction (92 of them were middle-aged and advanced in years and 96 were under 60). A combined program of x-ray examination included 3 stages: panoramic polypositional roentgenography of the chest and abdominal cavity, dynamic x-ray control over the state of the abdominal cavity, and contrast study of the G.I. tract. A distinctive feature of the x-ray symptomatology of intestinal obstruction in middle-aged and old patients was the absence of classical x-ray symptoms in some cases during panoramic roentgenography of the abdominal cavity. In patients over 60, x-ray symptomatology was characterized by marked colon distension and intestinal distension of various degree in 77.1%     

X-ray diagnosis of disturbed bronchial permeability in chronic bronchitis

The authors presented clinical and x-ray findings of combined investigation of 94 patients with chronic bronchitis. X-ray symptoms of disturbed bronchial permeability (DBP) in this pathology were studied. Bronchograms, bronchosonograms performed in different phases of respiration using broncholytic drugs, video tape recording, coherent-optic processing of bronchograms, and a method of digital processing of bronchograms proposed by the authors were employed. The importance of x-ray examination in the diagnosis of DBP was shown. The classification, nature, site and spreading of DBP were described. X-ray findings were compared with clinical and laboratory findings.     

Clonally related IgM rheumatoid factors undergo affinity maturation in the rheumatoid synovial tissue.

Using hybridoma technology we established a panel of human monoclonal rheumatoid factors (RF) from the synovial tissues of two patients with rheumatoid arthritis (RA), and one patient with polyarticular juvenile RA. Nucleotide sequence analysis of the V regions of these RF indicates that two independently derived antibodies from one of the RA patients are clonally related. One of these antibodies appears to be close to germ-line configuration, whereas the other has accumulated a total of 36 substitutions in both H and L chains. Measurements of the affinity for human IgG of the two RF show that the extensively mutated RF has 100-fold higher affinity for IgG than the RF close to germline. These findings indicate that IgM RF in RA can undergo affinity maturation and suggest that certain RF may be the product of an Ag-driven immune response.     

Variants of phage M13 DNA containing a fragment of the beta-galactosidase gene--a convenient mutation system for the study of oligonucleotide-directed mutagenesis

A model system is developed to test oligonucleotide-directed mutations: T----C transition, T and C deletions (delta T and delta C), C insertion, double mutations (A----G, delta T), (T----C, A----G), and large oligonucleotide deletions (36 or 44 nucleotides). The system includes 9 variants of the phage M13 DNA carrying fragment of beta-galactosidase gene, and oligodeoxyribonucleotides partially noncomplementary to DNA sequence of this gene. Six variants are obtained by the site-localized mutagenesis, the other were described earlier. Induced mutations are easily tested by phenotype change of transformed bacteria (Lac+----Lac-); by formation or loss of the sites for BamHI and EcoRI restrictases; by DNA hybridization with 32P-labeled oligonucleotides; and by DNA sequencing by the Sanger method. The system is used to study the role of some factors, such as completeness of RF DNA synthesis, thermal stability of the oligonucleotide: DNA complex, quality of enzymes and substrates used in polymerase reaction, mutation type or the efficiency of mutagenesis. A number of unexpected mutations were observed in the course of oligonucleotide-directed mutagenesis. Lower yields of some mutants induced by oligonucleotides are shown to be due to the action of repair systems of bacteria.     

An evaluation of exposure metrics in an epidemiologic study on radio and television broadcast transmitters and the risk of childhood leukemia

Electric field strength values calculated by wave propagation modeling were applied as an exposure metric in a case–control study conducted in Germany to investigate a possible association between radio frequency electromagnetic fields (RF‐EMF) emitted from television and radio broadcast transmitters and the risk of childhood leukemia. To validate this approach it was examined at 850 measurement sites whether calculated RF‐EMF are an improvement to an exposure proxy based on distance from the place of residence to a transmitter. Further, the agreement between measured and calculated RF‐EMF was explored. For dichotomization at the 90% quantiles of the exposure distributions it was found that distance agreed less with measured RF‐EMF (Kappa coefficient: 0.55) than did calculated RF‐EMF (Kappa coefficient: 0.74). Distance was a good exposure proxy for a single transmitter only which uses the frequency bands of amplitude modulated radio, whereas it appeared to be of limited informative value in studies involving several transmitters, particularly if these are operating in different frequency bands. The analysis of the agreement between calculated RF‐EMF and measured RF‐EMF showed a sensitivity of 76.6% and a specificity of 97.4%, leading to an exposure misclassification that still allows one to detect a true odds ratio as low as 1.4 with a statistical power of >80% at a two‐sided significance level of 5% in a study with 2,000 cases and 6,000 controls. Thus, calculated RF‐EMF is confirmed to be an appropriate exposure metric in large‐scale epidemiological studies on broadcast transmitters. Bioelectromagnetics 30:81–91, 2009. © 2008 Wiley‐Liss, Inc.     

Immunochemical quantitation of thymine glycol in oxidized and X-irradiated DNA

The present study demonstrates the usefulness of immunochemical assays for quantitating modified bases in oxidized and X-irradiated DNA. Escherichia coli, phi X174 RF I, PM2, and M13 DNA containing thymine glycols introduced by OsO4 oxidation were used as antigens in a direct enzyme-linked immunosorbent assay (ELISA). The number of thymine glycols per DNA molecule was determined by reactivity with antithymine glycol antibody standardized either to the acetol fragment assay or to the number of Escherichia coli endonuclease III-sensitive sites. The number of thymine glycols was also determined in phi X174 RF I DNA X-irradiated in either phosphate or Tris buffer under air. Using a direct ELISA with phi X174 RF I DNA irradiated in a phosphate buffer solution, the anti-thymine glycol antibody detected damage at the level of 40 Gy. The immunochemical assay was sensitive, specific, quantitative, and independent of DNA structure.