Background:Herpesvirus-like particles have been reported to be detectable by electron microscopy in lesional biopsy of patients with pityriasis rosea(PR).We report a study investigating the association of PR with huma...Background:Herpesvirus-like particles have been reported to be detectable by electron microscopy in lesional biopsy of patients with pityriasis rosea(PR).We report a study investigating the association of PR with human herpesvirus-8(HHV-8)infection.Methods:Our setting is a teaching clinic affiliated to a university.We recruited eight patients aged 28-47 years(mean:34.5 years)diagnosed with PR during a one-year period.We collected acute blood specimens at presentation and convalescent blood specimens three to four weeks later.We also collected skin scrapings from the herald patch where present and from truncal secondary lesions.Results:We detected HHV-8 DNA by a nested PCR(polymerase chain reaction)targeting,respectively,a 233-bp and a 160-bp fragment of ORF 26.PCR for HHV-8 DNA was negative in the peripheral blood mononuclear cells and plasma of acute and convalescent specimens of all patients,and negative in all skin scrapings.We detected anti-HHV-8 IgG and IgM antibodies by the indirect immunofluorescence.Four patients had IgG antibodies against HHV-8,but with no significant rise of titre.None were positive for anti-HHV-8 IgM antibody.Conclusion:We conclude that PR is not associated with HHV-8 infection.展开更多
OBJECTIVES: The aim of this study was to compare treadmill exercise(TEX) and dipyridamole stress on the uptake and retention of N-13 ammonia. BACKGROUND: Size and severity of stress-induced myocardial perfusion defect...OBJECTIVES: The aim of this study was to compare treadmill exercise(TEX) and dipyridamole stress on the uptake and retention of N-13 ammonia. BACKGROUND: Size and severity of stress-induced myocardial perfusion defects are clinically important. Because ammonia uptake and retention seems to be related to perfusion, viability, and metabolism, exercise stress might induce larger perfusion defects than dipyridamole stress. METHODS: Twenty-six patients underwent TEX and dipyridamole stress N-13 ammonia positron emission tomography(PET). Images were assessed with a 17-segment model and a five-point score. Summed stress score(SSS), summed rest score(SRS), and summed difference score(SDS) were calculated. Left ventricular(LV) defect sizes were measured quantitatively with a 70% threshold for abnormal perfusion. RESULTS: Compared with dipyridamole stress, TEX yielded larger SSS(9.1± 5.7 vs. 6.9± 5.9; p < 0.01), SDS(5.8± 4.7 vs. 3.7± 4.6; p < 0.02), and percentage of LV stress defect(19.3± 11.5% vs. 13.8± 13.6% ; p < 0.02). CONCLUSIONS: In patients achieving adequate exercise, TEX N-13 ammonia PET myocardial perfusion imaging(MPI) yields larger stress perfusion defects than dipyridamole stress and might reflect the true myocardial ischemic burden. Treadmill exercise might be the preferred method of stress for routine N 13 ammonia PET MPI.展开更多
Arteriovenous malformation is a well-known cause of lower gastrointestinal bleeding in the elderly and usually appears as flat or elevated bright red lesions endoscopically. Here we present a 59-year-old woman with a ...Arteriovenous malformation is a well-known cause of lower gastrointestinal bleeding in the elderly and usually appears as flat or elevated bright red lesions endoscopically. Here we present a 59-year-old woman with a large fungating polypoid mass in the transverse colon. Histologically, the larger vessels were located mainly in the submucosa, and smaller vessels were also observed within the mucosa. Verhoeff s elastic stain showed internal and external elastic lamina in the malformed vessels. We report an extremely rare case of a large, pedunculated,polypoid arterioveneous malformation with the first description of our complete pathological findings.展开更多
PURPOSE: To describe skull base osteomyelitis, an uncommon complication of chronic otitis media in the post-antibiotic era, as a cause for diplopia. DESIGN: Case report. METHODS: The records of a patient with skull ba...PURPOSE: To describe skull base osteomyelitis, an uncommon complication of chronic otitis media in the post-antibiotic era, as a cause for diplopia. DESIGN: Case report. METHODS: The records of a patient with skull base osteomyelitis were reviewed. RESULTS:Apatient presentedwith a sixth nerve palsy and tenth nerve palsy. Magnetic resonance imaging, bone scan, and gallium scan were helpful in establishing the diagnosis. Cultures grew Pseudomonas. The treatment required longterm intravenous antibiotics. CONCLUSIONS: Pseudomonas skull-based osteomyelitis can produce a sixth nerve palsy as a result of the involvement of the clivus. Although uncommon in the post-antibiotic era, early recognition, appropriate diagnostic testing, and aggressive systemic antibiotic treatment might prevent permanent neurologic sequel.展开更多
Previous studies on the association of smoking with acne vulgaris have reported conflicting results. The objective of this study was to investigate such an association. Our setting was three primary carepractices in H...Previous studies on the association of smoking with acne vulgaris have reported conflicting results. The objective of this study was to investigate such an association. Our setting was three primary carepractices in HongKong and one primary care practice in India. Patient characteristics in all four practices are similar. All medical records in these practices incorporate a section in which the smoking habits of each patient is routinely documented. We searched our database and retrieved 632 records of patients with acne seen in the previous 5 years. We also retrieved 632 records of age-andsex-matched controls. Fifty- three out of 379 male patients with acne and 25 out of 379 male controls were smokers (P= 0.001; OR, 2.3; 95% CI, 1.43.8). Six out of 253 female patients with acne and three out of 253 female controls were smokers (OR, 2.0; 95% CI, 0.5- 9.4). We conclude that smoking is likely to bear a positive correlation with acne for men. Our numbers are too small for a definite conclusion to be drawn for females.展开更多
Atypical cases of pityriasis rosea (PR) are fairly common and less readily recognized than typical eruptions. We present four patients for whom we believe atypical PR is the most likely diagnosis. A 33-year-old man ha...Atypical cases of pityriasis rosea (PR) are fairly common and less readily recognized than typical eruptions. We present four patients for whom we believe atypical PR is the most likely diagnosis. A 33-year-old man had purpuric lesions bilaterally on the legs with classical rash on the trunk. A 28-year-old woman had intensely pruritic and urticarial lesions. A 10-yearold girl had hundreds of small papular lesions 1-3 mm in size. A pregnant woman aged 26 had oral haemorrhagic ulcers with classical PR eruption on her trunk. The oral ulcers erupted and remitted at the same time as the generalized eruption. We reviewed the literature and proposed a classification based on rashmorphology,rashsize,rashdistribution,numberoflesions, site of lesions, severity of symptoms and course of the eruption. We believe that it is difficult to make a clear division to define typical and atypical PR, and that it is important not to ascribe any unusual or atypical skin eruption with PR unless other dermatoses have been excluded.展开更多
文摘Background:Herpesvirus-like particles have been reported to be detectable by electron microscopy in lesional biopsy of patients with pityriasis rosea(PR).We report a study investigating the association of PR with human herpesvirus-8(HHV-8)infection.Methods:Our setting is a teaching clinic affiliated to a university.We recruited eight patients aged 28-47 years(mean:34.5 years)diagnosed with PR during a one-year period.We collected acute blood specimens at presentation and convalescent blood specimens three to four weeks later.We also collected skin scrapings from the herald patch where present and from truncal secondary lesions.Results:We detected HHV-8 DNA by a nested PCR(polymerase chain reaction)targeting,respectively,a 233-bp and a 160-bp fragment of ORF 26.PCR for HHV-8 DNA was negative in the peripheral blood mononuclear cells and plasma of acute and convalescent specimens of all patients,and negative in all skin scrapings.We detected anti-HHV-8 IgG and IgM antibodies by the indirect immunofluorescence.Four patients had IgG antibodies against HHV-8,but with no significant rise of titre.None were positive for anti-HHV-8 IgM antibody.Conclusion:We conclude that PR is not associated with HHV-8 infection.
文摘OBJECTIVES: The aim of this study was to compare treadmill exercise(TEX) and dipyridamole stress on the uptake and retention of N-13 ammonia. BACKGROUND: Size and severity of stress-induced myocardial perfusion defects are clinically important. Because ammonia uptake and retention seems to be related to perfusion, viability, and metabolism, exercise stress might induce larger perfusion defects than dipyridamole stress. METHODS: Twenty-six patients underwent TEX and dipyridamole stress N-13 ammonia positron emission tomography(PET). Images were assessed with a 17-segment model and a five-point score. Summed stress score(SSS), summed rest score(SRS), and summed difference score(SDS) were calculated. Left ventricular(LV) defect sizes were measured quantitatively with a 70% threshold for abnormal perfusion. RESULTS: Compared with dipyridamole stress, TEX yielded larger SSS(9.1± 5.7 vs. 6.9± 5.9; p < 0.01), SDS(5.8± 4.7 vs. 3.7± 4.6; p < 0.02), and percentage of LV stress defect(19.3± 11.5% vs. 13.8± 13.6% ; p < 0.02). CONCLUSIONS: In patients achieving adequate exercise, TEX N-13 ammonia PET myocardial perfusion imaging(MPI) yields larger stress perfusion defects than dipyridamole stress and might reflect the true myocardial ischemic burden. Treadmill exercise might be the preferred method of stress for routine N 13 ammonia PET MPI.
文摘Arteriovenous malformation is a well-known cause of lower gastrointestinal bleeding in the elderly and usually appears as flat or elevated bright red lesions endoscopically. Here we present a 59-year-old woman with a large fungating polypoid mass in the transverse colon. Histologically, the larger vessels were located mainly in the submucosa, and smaller vessels were also observed within the mucosa. Verhoeff s elastic stain showed internal and external elastic lamina in the malformed vessels. We report an extremely rare case of a large, pedunculated,polypoid arterioveneous malformation with the first description of our complete pathological findings.
文摘PURPOSE: To describe skull base osteomyelitis, an uncommon complication of chronic otitis media in the post-antibiotic era, as a cause for diplopia. DESIGN: Case report. METHODS: The records of a patient with skull base osteomyelitis were reviewed. RESULTS:Apatient presentedwith a sixth nerve palsy and tenth nerve palsy. Magnetic resonance imaging, bone scan, and gallium scan were helpful in establishing the diagnosis. Cultures grew Pseudomonas. The treatment required longterm intravenous antibiotics. CONCLUSIONS: Pseudomonas skull-based osteomyelitis can produce a sixth nerve palsy as a result of the involvement of the clivus. Although uncommon in the post-antibiotic era, early recognition, appropriate diagnostic testing, and aggressive systemic antibiotic treatment might prevent permanent neurologic sequel.
文摘Previous studies on the association of smoking with acne vulgaris have reported conflicting results. The objective of this study was to investigate such an association. Our setting was three primary carepractices in HongKong and one primary care practice in India. Patient characteristics in all four practices are similar. All medical records in these practices incorporate a section in which the smoking habits of each patient is routinely documented. We searched our database and retrieved 632 records of patients with acne seen in the previous 5 years. We also retrieved 632 records of age-andsex-matched controls. Fifty- three out of 379 male patients with acne and 25 out of 379 male controls were smokers (P= 0.001; OR, 2.3; 95% CI, 1.43.8). Six out of 253 female patients with acne and three out of 253 female controls were smokers (OR, 2.0; 95% CI, 0.5- 9.4). We conclude that smoking is likely to bear a positive correlation with acne for men. Our numbers are too small for a definite conclusion to be drawn for females.
文摘Atypical cases of pityriasis rosea (PR) are fairly common and less readily recognized than typical eruptions. We present four patients for whom we believe atypical PR is the most likely diagnosis. A 33-year-old man had purpuric lesions bilaterally on the legs with classical rash on the trunk. A 28-year-old woman had intensely pruritic and urticarial lesions. A 10-yearold girl had hundreds of small papular lesions 1-3 mm in size. A pregnant woman aged 26 had oral haemorrhagic ulcers with classical PR eruption on her trunk. The oral ulcers erupted and remitted at the same time as the generalized eruption. We reviewed the literature and proposed a classification based on rashmorphology,rashsize,rashdistribution,numberoflesions, site of lesions, severity of symptoms and course of the eruption. We believe that it is difficult to make a clear division to define typical and atypical PR, and that it is important not to ascribe any unusual or atypical skin eruption with PR unless other dermatoses have been excluded.
