The nonlinear fracture behavior of quasi-brittle materials is closely related with the cohesive force distribution of fracture process zone at crack tip. Based on fracture character of quasi-brittle materials, a mecha...The nonlinear fracture behavior of quasi-brittle materials is closely related with the cohesive force distribution of fracture process zone at crack tip. Based on fracture character of quasi-brittle materials, a mechanical analysis model of half infinite crack with cohesive stress is presented. A pair of integral equations is established according to the superposition principle of crack opening displacement in solids, and the fictitious adhesive stress is unknown function . The properties of integral equations are analyzed, and the series function expression of cohesive stress is certified. By means of the data of actual crack opening displacement, two approaches to gain the cohesive stress distribution are proposed through resolving algebra equation. They are the integral transformation method for continuous displacement of actual crack opening, and the least square method for the discrete data of crack opening displacement. The calculation examples of two approaches and associated discussions are given.展开更多
By using Fourier transformation the boundary problem of periodical interfacial cracks in anisotropic elastoplastic bimaterial was transformed into a set of dual integral equations and then it was further reduced by me...By using Fourier transformation the boundary problem of periodical interfacial cracks in anisotropic elastoplastic bimaterial was transformed into a set of dual integral equations and then it was further reduced by means of definite integral transformation into a group of singular equations. Closed form of its solution was obtained and three corresponding problems of isotropic bimaterial, of a single anisotropic material and of a bimaterial of isotropy- anisotropy were treated as the specific cases. The plastic zone length of the crack tip and crack openning displacement ( COD) decline as the smaller yield limit of the two bonded materials rises, and they were also determined by crack length and the space between two neighboring cracks . In addition , COD also relates it with moduli of the materials .展开更多
Right lobe living donor liver transplantation(LDLT)is a major development in adult LDLT that has significantly increased the donor pool by providing larger graft size and by decreasing risk of small-for-size graft syn...Right lobe living donor liver transplantation(LDLT)is a major development in adult LDLT that has significantly increased the donor pool by providing larger graft size and by decreasing risk of small-for-size graft syndrome.However,right lobe anatomy is complex,not only from the inflow but also from the outflow perspective.Outflow reconstruction is one of the key requirements of a successful LDLT and venous drainage of the liver graft is just as important as hepatic inflow for the integrity of graft function.Outflow complications may cause acute graft failure which is not always easy to diagnose.The right lobe graft consists of two sections and three hepatic venous routes for drainage that require reconstruction.In order to obtain a congestion free graft,several types of vascular conduits and postoperative interventions are needed to assure an adequate venous allograft drainage.This review described the anatomy,functional basis and the evolution of outflow reconstruction in right lobe LDLT.展开更多
Folate deficiency and its association with cancer have been studied in the literature, but its clinical impact is still unknown. Folate deficiency and its result on gastric cancer is a mysterious part of oncology, wit...Folate deficiency and its association with cancer have been studied in the literature, but its clinical impact is still unknown. Folate deficiency and its result on gastric cancer is a mysterious part of oncology, with ongoing studies hopefully clarifying its impact on gastric cancer management. Lee et al studied folate deficiency and its impact on staging and clinical results. Here we try to contribute to the field by expressing our own thoughts about the paper.展开更多
Antibodies are employed ubiquitously in biomedical sciences,including for diagnostics and therapeutics.One of the most important uses is for immunohistochemical(IHC)staining,a process that has been improving and evolv...Antibodies are employed ubiquitously in biomedical sciences,including for diagnostics and therapeutics.One of the most important uses is for immunohistochemical(IHC)staining,a process that has been improving and evolving over decades.IHC is useful when properly employed,yet misuse of the method is widespread and contributes to the“reproducibility crisis”in science.We report some of the common problems encountered with IHC assays,and direct readers to a wealth of literature documenting and providing some solutions to this problem.We also describe a series of vignettes that include our approach to analytical validation of antibodies and IHC assays that have facilitated a number of biological insights into prostate cancer and the refutation of a controversial association of a viral etiology in gliomas.We postulate that a great deal of the problem with lack of accuracy in IHC assays stems from the lack of awareness by researchers for the critical necessity for end-users to validate IHC antibodies and assays in their laboratories,regardless of manufacturer claims or past publications.We suggest that one reason for the pervasive lack of end-user validation for research antibodies is that researchers fail to realize that there are two general classes of antibodies employed in IHC.First,there are antibodies that are“clinical grade”reagents used by pathologists to help render diagnoses that influence patient treatment.Such diagnostic antibodies,which tend to be highly validated prior to clinical implementation,are in the vast minority(e.g.<500).The other main class of antibodies are“research grade”antibodies(now numbering>3800000),which are often not extensively validated prior to commercialization.Given increased awareness of the problem,both the United States,National Institutes of Health and some journals are requiring investigators to provide evidence of specificity of their antibody-based assays.展开更多
Hepatic alveolar echinococcosis is a rare but potentially life threatening serious parasitic disease, developing as a result of intrahepatic growth of Echinococcus multilocularis larvae. It may present as an invasive ...Hepatic alveolar echinococcosis is a rare but potentially life threatening serious parasitic disease, developing as a result of intrahepatic growth of Echinococcus multilocularis larvae. It may present as an invasive mass causing biliary obstruction or portal hypertension due to invasion of the biliary and vascular structure of the liver. The only curative treatment of the disease is surgical resection; however, early diagnosis is the key point to achieve complete cure. In advanced disease, complications are common. We retrospectively analyzed 12 cases of hepatic alveolar echinococcosis and reviewed the relevant literature. A high index of suspicion and specific radiologic findings are very helpful in the diagnosis of the disease. While benzimidazole derivatives are used for the control of disease, endoscopic retrograde cholangiopancreatography is particularly effective in the biliary involvement, even in the late stage of disease.展开更多
Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylori has been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some othe...Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylori has been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some other nongastric diseases. Among them, coronary heart disease attracts much debate. Many studies have demonstrated a close relationship between insulin resistance and atherosclerosis. Chronic inflammation and alterations in counter-regulatory hormones are deemed responsible for the etiology of insulin resistance. We aimed to examine the effect of H. pylori on insulin resistance. Sixty-three patients were enrolled in the study. Patients were divided into two groups according to H. pylori presence. HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insülin resistance. Thirty-six patients were H. pylori positive and 27 were H. pylori negative. There was no difference between the two groups with regard to age, gender, or body mass index. HOMA-IR level was 1.73±.1.1inthe H. pylori-negative group, whereas it was 2.56 ±.1.54 in the H. pylori-positive group (P < 0.05). This study provides the first direct evidence for an association between chronic H. pylori infection and insulin resistance.展开更多
Inflammatory bowel disease(IBD)refers to a group of disorders characterized by chronic inflammation of the gastrointestinal(GI)tract.The elevated levels of nitric oxide(NO)in serum and affected tissues;mainly synthesi...Inflammatory bowel disease(IBD)refers to a group of disorders characterized by chronic inflammation of the gastrointestinal(GI)tract.The elevated levels of nitric oxide(NO)in serum and affected tissues;mainly synthesized by the inducible nitric oxide synthase(iNOS)enzyme;can exacerbate GI inflammation and is one of the major biomarkers of GI inflammation.Various natural and synthetic agents are able to ameliorate GI inflammation and decrease iNOS expression to the extent comparable with some IBD drugs.Thereby,the purpose of this study was to gather a list of natural or synthetic mediators capable of modulating IBD through the NO pathway.Electronic databases including Google Scholar and PubMed were searched from 1980 to May 2018.We found that polyphenols and particularly flavonoids are able to markedly attenuate NO production and iNOS expression through the nuclear factorκB(NF-κB)and JAK/STAT signaling pathways.Prebiotics and probiotics can also alter the GI microbiota and reduce NO expression in IBD models through a broad array of mechanisms.A number of synthetic molecules have been found to suppress NO expression either dependent on the NF-κB signaling pathway(i.e.,dexamethasone,pioglitazone,tropisetron)or independent from this pathway(i.e.,nicotine,prednisolone,celecoxib,β-adrenoceptor antagonists).Co-administration of natural and synthetic agents can affect the tissue level of NO and may improve IBD symptoms mainly by modulating the Toll like receptor-4 and NF-κB signaling pathways.展开更多
Our aim was to analyze patients diagnosed with left-sided portal hypertension prospectively and to document the complications at follow-up. Twenty-four patients with isolated splenic vein thrombosis (diagnosed by ultr...Our aim was to analyze patients diagnosed with left-sided portal hypertension prospectively and to document the complications at follow-up. Twenty-four patients with isolated splenic vein thrombosis (diagnosed by ultrasonography or angiography or intraoperatively) and/or isolated fundal varices (diagnosed by endoscopy or endosonography) were involved in this study. Demographics, clinical presentation, diagnostic and therapeutic procedures, and morbidity and mortality were recorded in their follow-up. There were 11 and 13 left-sided portal hypertension cases associated with pancreatic diseases and nonpancreatic disorders, respectively. Chronic abdominal pain and gastroin-testinal bleeding were the two most common complaints. All patients except one had isolated esophageal (2 cases) or fundal (21 cases) varices. Thirteen patients had splenomegaly on ultrasonography. On Doppler sonography, the splenic vein could be evaluated in 21 of the 24 patients (9 and 6 had complete and partial occlusion, respectively, and 6 had patent blood flow). Urgent intervention with the- rapeutic endoscopy and splenectomy was performed for two patients each. Medical therapy was begun for three patients according to the underlying diseases. Three patients underwent elective surgery. Two patients were lost to follow-up after the first visit and the mean follow-up of the remaining 22 patients after diagnosis of left-sided portal hypertension was 20 months. Only one patient (with pancreas cancer) had gastrointestinal bleeding at follow-up. All patients with pancreas and gastric cancer died within 2-12 months. Left-sided portal hypertension has various etiologies. It may be difficult to diagnose this entity both endoscopically and radiologically. Treatment should be directed at the underlying diseases. Recurrent hemorrhage due to left-sided portal hypertension is not usual and the prognosis depends mainly on the underlying etiology.展开更多
The aim of this study was to evaluate the clinicalmanifestations of cutaneous graft-versus-host disease (GVHD) developed after allogeneic haematopoietic cell transplantation. In all, 67 patients were evaluated: 49 pat...The aim of this study was to evaluate the clinicalmanifestations of cutaneous graft-versus-host disease (GVHD) developed after allogeneic haematopoietic cell transplantation. In all, 67 patients were evaluated: 49 patients developed acute GVHD, 17 patients developed de novo chronic GVHD and 29 developed secondary chronic (15 limited, 14 progressive) GVHD following acute cutaneous GVHD. Of the 46 patients with chronic GVHD, lichenoid lesions were observed in 32 and sclerodermoid lesions were observed in 12. In four patients with sclerodermoid cutaneous GVHD, these lesions occurred after a lichenoid phase. Oral lesions were present in 61%of the patients and six of them had only oral mucosal involvement without any skin lesions. Nail lesions were observed in 31%of the patients. During the follow-up period 15 patients with GVHD died and in 7 of them the cause of death was related to chronic GVHD. In conclusion, GVHD has a wide spectrum of cutaneous manifestations, which can be used as an important tool for the early diagnosis of the disease.展开更多
A 47-year-old woman presented with a 2-month history of generalized arthralgia and a 10-day history of oral aphthous ulcers. After hospitalization, papulopustular lesions and perianal ulcerations developed. Pathergy t...A 47-year-old woman presented with a 2-month history of generalized arthralgia and a 10-day history of oral aphthous ulcers. After hospitalization, papulopustular lesions and perianal ulcerations developed. Pathergy test was positive and ophthalmological examination was normal. The presence of oral aphthous ulcers, genital ulcerations, papulopustular lesions and arthralgia, and the positive pathergy test suggested the diagnosis of disease (BD). In a few days, positive pathergy reactions and papulopustular lesions evolved into bullous lesions, whichwere diagnosed dermatopathologicallyas pyoderma gangrenosum. Two days after the presentation of papulopustular lesions, the patient experienced diarrhoea accompanied by bloody stools and mucus. Histopathological examination of biopsy specimens showed no vasculitis but revealed findings suggestive of Crohn’ s disease. The patient responded well to treatment with systemic steroids and 5-aminosalicylic acid. Our case demonstrates that the differential diagnosis of BD and inflammatory bowel disease may be perplexing and that these two diseases may be closely related.展开更多
The aim of the present study was to investigate changes in pulmonary function tests (PFTs) in patients with acute pancreatitis (AP), to compare them with those changes in healthy controls, and to analyze the relations...The aim of the present study was to investigate changes in pulmonary function tests (PFTs) in patients with acute pancreatitis (AP), to compare them with those changes in healthy controls, and to analyze the relationship between these parameters and computed tomography severity index (CTSI) and Ranson’s criteria scores as markers of disease severity. This study included 40 patients with AP without a diagnosis of any pulmonary disease and 40 sex-and age-matched healthy controls. All participants were evaluated with simple PFTs and single-breath carbon monoxide (CO) diffusion tests. Patients with AP were also evaluated according to their CTSI and Ranson’s criteria scores as markers of disease severity. The forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, and peak expiratory flow, which determine lung capacity, were similar in the two groups. The forced expiratory volume during the middle half of the FVC (FEF25-75%), CO diffusing capacity (DLCO), and ratio of DLCO to alveolar ventilation (DLCO/VA), which determines alveolar membrane permeability, revealed a statistically significant decline in pulmonary gas exchange in patients with AP (P < 0.05). Correlation analysis showed that there is a significant negative relationship between CTSI and Ranson’s criteria scores with FEF25-75%, DLCO, and DLCO/V A (P < 0.05). We suggest that AP may cause impaired alveolar gas exchange without manifest pulmonary diseases. The effect of AP on FEF 25-75%, DLCO, and DLCO/VA appears to be dependent not only on the disease, but also on its severity. FEF25-75%, DLCO, and DLCO/VA may give additional prognostic information in patients with AP in the initial evaluation.展开更多
Background: Several groups have shown the involvement of oxidative stress in the pathophysiology of vitiligo. Methods: In this study, we examined the erythrocyte and plasma activities of glutathione peroxidase and Cu/...Background: Several groups have shown the involvement of oxidative stress in the pathophysiology of vitiligo. Methods: In this study, we examined the erythrocyte and plasma activities of glutathione peroxidase and Cu/Zn superoxide dismutase, plasma nitrite/nitrate levels, and erythrocyte catalase activity in 23 vitiligo patients and 25 controls. Results: The results show that erythrocyte superoxide dismutase activity and plasma nitrite/ nitrate levels are high in vitiligo patients. Conclusions: Our study confirms that oxidative stress is involved in the pathophysiology of vitiligo, as indicated by the high levels of erythrocyte superoxide dismutase activity and plasma nitrite/nitrate.展开更多
基金Foundation items: the National Key Basic Research and Development Program (973 Program)(2002CB412709) the National Natural Science Foundation of China (10272068, 50178015) Science Foundation of Shandong Province of China (Y202A02)
文摘The nonlinear fracture behavior of quasi-brittle materials is closely related with the cohesive force distribution of fracture process zone at crack tip. Based on fracture character of quasi-brittle materials, a mechanical analysis model of half infinite crack with cohesive stress is presented. A pair of integral equations is established according to the superposition principle of crack opening displacement in solids, and the fictitious adhesive stress is unknown function . The properties of integral equations are analyzed, and the series function expression of cohesive stress is certified. By means of the data of actual crack opening displacement, two approaches to gain the cohesive stress distribution are proposed through resolving algebra equation. They are the integral transformation method for continuous displacement of actual crack opening, and the least square method for the discrete data of crack opening displacement. The calculation examples of two approaches and associated discussions are given.
基金the National Natural Science Foundation of China (19872076) the Postdoctoral Science Foundation of China (00-2001)the National Natural Science Foundation of China for Out-sanding Young Scientists (19925209)
文摘By using Fourier transformation the boundary problem of periodical interfacial cracks in anisotropic elastoplastic bimaterial was transformed into a set of dual integral equations and then it was further reduced by means of definite integral transformation into a group of singular equations. Closed form of its solution was obtained and three corresponding problems of isotropic bimaterial, of a single anisotropic material and of a bimaterial of isotropy- anisotropy were treated as the specific cases. The plastic zone length of the crack tip and crack openning displacement ( COD) decline as the smaller yield limit of the two bonded materials rises, and they were also determined by crack length and the space between two neighboring cracks . In addition , COD also relates it with moduli of the materials .
文摘Right lobe living donor liver transplantation(LDLT)is a major development in adult LDLT that has significantly increased the donor pool by providing larger graft size and by decreasing risk of small-for-size graft syndrome.However,right lobe anatomy is complex,not only from the inflow but also from the outflow perspective.Outflow reconstruction is one of the key requirements of a successful LDLT and venous drainage of the liver graft is just as important as hepatic inflow for the integrity of graft function.Outflow complications may cause acute graft failure which is not always easy to diagnose.The right lobe graft consists of two sections and three hepatic venous routes for drainage that require reconstruction.In order to obtain a congestion free graft,several types of vascular conduits and postoperative interventions are needed to assure an adequate venous allograft drainage.This review described the anatomy,functional basis and the evolution of outflow reconstruction in right lobe LDLT.
文摘Folate deficiency and its association with cancer have been studied in the literature, but its clinical impact is still unknown. Folate deficiency and its result on gastric cancer is a mysterious part of oncology, with ongoing studies hopefully clarifying its impact on gastric cancer management. Lee et al studied folate deficiency and its impact on staging and clinical results. Here we try to contribute to the field by expressing our own thoughts about the paper.
基金This work was supported by the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Cancer Center Support Grant(NIH/NCI grant P30 CA006973)the NIH/NCI SPORE in prostate Cancer P50 CA058236,the NIH/NCI U01 CA196390+1 种基金The Patrick C.Walsh Prostate Cancer Research Fund,US Department of Defense Prostate Cancer Research Program(W81XWH-14-2-0182,Prostate Cancer Biorepository Network PCBN)the Prostate Cancer Foundation.
文摘Antibodies are employed ubiquitously in biomedical sciences,including for diagnostics and therapeutics.One of the most important uses is for immunohistochemical(IHC)staining,a process that has been improving and evolving over decades.IHC is useful when properly employed,yet misuse of the method is widespread and contributes to the“reproducibility crisis”in science.We report some of the common problems encountered with IHC assays,and direct readers to a wealth of literature documenting and providing some solutions to this problem.We also describe a series of vignettes that include our approach to analytical validation of antibodies and IHC assays that have facilitated a number of biological insights into prostate cancer and the refutation of a controversial association of a viral etiology in gliomas.We postulate that a great deal of the problem with lack of accuracy in IHC assays stems from the lack of awareness by researchers for the critical necessity for end-users to validate IHC antibodies and assays in their laboratories,regardless of manufacturer claims or past publications.We suggest that one reason for the pervasive lack of end-user validation for research antibodies is that researchers fail to realize that there are two general classes of antibodies employed in IHC.First,there are antibodies that are“clinical grade”reagents used by pathologists to help render diagnoses that influence patient treatment.Such diagnostic antibodies,which tend to be highly validated prior to clinical implementation,are in the vast minority(e.g.<500).The other main class of antibodies are“research grade”antibodies(now numbering>3800000),which are often not extensively validated prior to commercialization.Given increased awareness of the problem,both the United States,National Institutes of Health and some journals are requiring investigators to provide evidence of specificity of their antibody-based assays.
文摘Hepatic alveolar echinococcosis is a rare but potentially life threatening serious parasitic disease, developing as a result of intrahepatic growth of Echinococcus multilocularis larvae. It may present as an invasive mass causing biliary obstruction or portal hypertension due to invasion of the biliary and vascular structure of the liver. The only curative treatment of the disease is surgical resection; however, early diagnosis is the key point to achieve complete cure. In advanced disease, complications are common. We retrospectively analyzed 12 cases of hepatic alveolar echinococcosis and reviewed the relevant literature. A high index of suspicion and specific radiologic findings are very helpful in the diagnosis of the disease. While benzimidazole derivatives are used for the control of disease, endoscopic retrograde cholangiopancreatography is particularly effective in the biliary involvement, even in the late stage of disease.
文摘Helicobacter pylori causes a lifelong infection in the stomach after exposure. H. pylori has been shown to be associated with peptic ulcer and gastric cancer development. Moreover, it is held responsible for some other nongastric diseases. Among them, coronary heart disease attracts much debate. Many studies have demonstrated a close relationship between insulin resistance and atherosclerosis. Chronic inflammation and alterations in counter-regulatory hormones are deemed responsible for the etiology of insulin resistance. We aimed to examine the effect of H. pylori on insulin resistance. Sixty-three patients were enrolled in the study. Patients were divided into two groups according to H. pylori presence. HOMA-IR (homeostasis model assessment of insulin resistance) level was used to assess insülin resistance. Thirty-six patients were H. pylori positive and 27 were H. pylori negative. There was no difference between the two groups with regard to age, gender, or body mass index. HOMA-IR level was 1.73±.1.1inthe H. pylori-negative group, whereas it was 2.56 ±.1.54 in the H. pylori-positive group (P < 0.05). This study provides the first direct evidence for an association between chronic H. pylori infection and insulin resistance.
文摘Inflammatory bowel disease(IBD)refers to a group of disorders characterized by chronic inflammation of the gastrointestinal(GI)tract.The elevated levels of nitric oxide(NO)in serum and affected tissues;mainly synthesized by the inducible nitric oxide synthase(iNOS)enzyme;can exacerbate GI inflammation and is one of the major biomarkers of GI inflammation.Various natural and synthetic agents are able to ameliorate GI inflammation and decrease iNOS expression to the extent comparable with some IBD drugs.Thereby,the purpose of this study was to gather a list of natural or synthetic mediators capable of modulating IBD through the NO pathway.Electronic databases including Google Scholar and PubMed were searched from 1980 to May 2018.We found that polyphenols and particularly flavonoids are able to markedly attenuate NO production and iNOS expression through the nuclear factorκB(NF-κB)and JAK/STAT signaling pathways.Prebiotics and probiotics can also alter the GI microbiota and reduce NO expression in IBD models through a broad array of mechanisms.A number of synthetic molecules have been found to suppress NO expression either dependent on the NF-κB signaling pathway(i.e.,dexamethasone,pioglitazone,tropisetron)or independent from this pathway(i.e.,nicotine,prednisolone,celecoxib,β-adrenoceptor antagonists).Co-administration of natural and synthetic agents can affect the tissue level of NO and may improve IBD symptoms mainly by modulating the Toll like receptor-4 and NF-κB signaling pathways.
文摘Our aim was to analyze patients diagnosed with left-sided portal hypertension prospectively and to document the complications at follow-up. Twenty-four patients with isolated splenic vein thrombosis (diagnosed by ultrasonography or angiography or intraoperatively) and/or isolated fundal varices (diagnosed by endoscopy or endosonography) were involved in this study. Demographics, clinical presentation, diagnostic and therapeutic procedures, and morbidity and mortality were recorded in their follow-up. There were 11 and 13 left-sided portal hypertension cases associated with pancreatic diseases and nonpancreatic disorders, respectively. Chronic abdominal pain and gastroin-testinal bleeding were the two most common complaints. All patients except one had isolated esophageal (2 cases) or fundal (21 cases) varices. Thirteen patients had splenomegaly on ultrasonography. On Doppler sonography, the splenic vein could be evaluated in 21 of the 24 patients (9 and 6 had complete and partial occlusion, respectively, and 6 had patent blood flow). Urgent intervention with the- rapeutic endoscopy and splenectomy was performed for two patients each. Medical therapy was begun for three patients according to the underlying diseases. Three patients underwent elective surgery. Two patients were lost to follow-up after the first visit and the mean follow-up of the remaining 22 patients after diagnosis of left-sided portal hypertension was 20 months. Only one patient (with pancreas cancer) had gastrointestinal bleeding at follow-up. All patients with pancreas and gastric cancer died within 2-12 months. Left-sided portal hypertension has various etiologies. It may be difficult to diagnose this entity both endoscopically and radiologically. Treatment should be directed at the underlying diseases. Recurrent hemorrhage due to left-sided portal hypertension is not usual and the prognosis depends mainly on the underlying etiology.
文摘The aim of this study was to evaluate the clinicalmanifestations of cutaneous graft-versus-host disease (GVHD) developed after allogeneic haematopoietic cell transplantation. In all, 67 patients were evaluated: 49 patients developed acute GVHD, 17 patients developed de novo chronic GVHD and 29 developed secondary chronic (15 limited, 14 progressive) GVHD following acute cutaneous GVHD. Of the 46 patients with chronic GVHD, lichenoid lesions were observed in 32 and sclerodermoid lesions were observed in 12. In four patients with sclerodermoid cutaneous GVHD, these lesions occurred after a lichenoid phase. Oral lesions were present in 61%of the patients and six of them had only oral mucosal involvement without any skin lesions. Nail lesions were observed in 31%of the patients. During the follow-up period 15 patients with GVHD died and in 7 of them the cause of death was related to chronic GVHD. In conclusion, GVHD has a wide spectrum of cutaneous manifestations, which can be used as an important tool for the early diagnosis of the disease.
文摘A 47-year-old woman presented with a 2-month history of generalized arthralgia and a 10-day history of oral aphthous ulcers. After hospitalization, papulopustular lesions and perianal ulcerations developed. Pathergy test was positive and ophthalmological examination was normal. The presence of oral aphthous ulcers, genital ulcerations, papulopustular lesions and arthralgia, and the positive pathergy test suggested the diagnosis of disease (BD). In a few days, positive pathergy reactions and papulopustular lesions evolved into bullous lesions, whichwere diagnosed dermatopathologicallyas pyoderma gangrenosum. Two days after the presentation of papulopustular lesions, the patient experienced diarrhoea accompanied by bloody stools and mucus. Histopathological examination of biopsy specimens showed no vasculitis but revealed findings suggestive of Crohn’ s disease. The patient responded well to treatment with systemic steroids and 5-aminosalicylic acid. Our case demonstrates that the differential diagnosis of BD and inflammatory bowel disease may be perplexing and that these two diseases may be closely related.
文摘The aim of the present study was to investigate changes in pulmonary function tests (PFTs) in patients with acute pancreatitis (AP), to compare them with those changes in healthy controls, and to analyze the relationship between these parameters and computed tomography severity index (CTSI) and Ranson’s criteria scores as markers of disease severity. This study included 40 patients with AP without a diagnosis of any pulmonary disease and 40 sex-and age-matched healthy controls. All participants were evaluated with simple PFTs and single-breath carbon monoxide (CO) diffusion tests. Patients with AP were also evaluated according to their CTSI and Ranson’s criteria scores as markers of disease severity. The forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, and peak expiratory flow, which determine lung capacity, were similar in the two groups. The forced expiratory volume during the middle half of the FVC (FEF25-75%), CO diffusing capacity (DLCO), and ratio of DLCO to alveolar ventilation (DLCO/VA), which determines alveolar membrane permeability, revealed a statistically significant decline in pulmonary gas exchange in patients with AP (P < 0.05). Correlation analysis showed that there is a significant negative relationship between CTSI and Ranson’s criteria scores with FEF25-75%, DLCO, and DLCO/V A (P < 0.05). We suggest that AP may cause impaired alveolar gas exchange without manifest pulmonary diseases. The effect of AP on FEF 25-75%, DLCO, and DLCO/VA appears to be dependent not only on the disease, but also on its severity. FEF25-75%, DLCO, and DLCO/VA may give additional prognostic information in patients with AP in the initial evaluation.
文摘Background: Several groups have shown the involvement of oxidative stress in the pathophysiology of vitiligo. Methods: In this study, we examined the erythrocyte and plasma activities of glutathione peroxidase and Cu/Zn superoxide dismutase, plasma nitrite/nitrate levels, and erythrocyte catalase activity in 23 vitiligo patients and 25 controls. Results: The results show that erythrocyte superoxide dismutase activity and plasma nitrite/ nitrate levels are high in vitiligo patients. Conclusions: Our study confirms that oxidative stress is involved in the pathophysiology of vitiligo, as indicated by the high levels of erythrocyte superoxide dismutase activity and plasma nitrite/nitrate.
