Ileoscopy in 39 hematochezia patients with normal colonoscopy

AIM： To assess the role of retrograde terminal ileoscopy in hematochezia patients with normal colonoscopy. METHODS： Between January 1997 and March 2005, 39 hematochezia patients （males 36, females 3, mean age 44.7 years） with a reported normal colonoscopy underwent a repeat colonoscopy. After reaching the cecum, attempt was made to localize the ileocecal valve and intubate the terminal ileum. Any abnormality in the mucosa of the terminal ileum was carefully recorded and biopsies were obtained from suspiciouslooking lesions. RESULTS： During the study period there were 39 patients admitted for hematochezia in whom colonoscopy till cecum did not reveal any abnormality. Fulllength colonoscopy till the cecum could be performed in all the patients. The terminal ileum could be intubated in 36 patients. No abnormality was noted in 31 patients. Ileal ulcers were noted in two patients. Noclularity along with ulceration of the ileal mucosa, a Dieulafoy＇s lesion, and an angiomatous malformation were noted in one patient each. Histological examination of the biopsies obtained from the ulcers revealed typical tuberculous lesion in the patient with nodularity and ulceration. One of the patients had typhoid ulcers and another had non-specific ulcers. CONCLUSION： Retrograde terminal ileoscopy gives limited but valuable information, in patients with hematochezia and should be attempted in all such patients.

APPLICATION OF INTERNAL FIXATION IN THE TREATMENT FOR TUBERCULOSIS OF THE SPINE

This is a study of 18 patients who had surgical treatment for spinal tuberculosis. All patients were admitted with the spinal tuberculosis and treated with a combination of anterior debridement and bone graft with poterior internal fixaton using the Luque or Dick technique. The patients were able to walk within a few days postoperation. Three to seven years follow-ups show no recurrence. kyphosis and/or solid fusinon.

Epithelioid haemangioendothelioma of the lung:one case report with positive pulmonary hilar lymph nodes

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumor that occurs among young women and typically presents as bilateral multiple nodules. In this report, we described an unusual case of PEH presented as a single mass in a 46-year-old man, with 6 positive pulmonary hilar lymph nodes. Histologic findings were compared with conventional PEH, except those features such as round to oval-shaped nodules, hypocellular/cellular peripheral zone, hyaline, myxomatous intercellular stroma and intracellular vacuoles, and we found the patient's pulmonary hilar lymph nodes were metastasis and cholesterol crystal were discovered in the focal infarction areas. Immunohistochemically, the tumor cells were strong positive for CD34, CD31, factor VIII related endothelial antigen and vimentin. The patient died 3 and half months after the surgery without receiving any radiotherapy or chemotherapy. This report may contribute to the data on clinical and histological finding of this rare tumour.

Choroidal Tuberculoma in an Immunocompetent Young Patient

TUBERCULOSIS （TB） remains one of the leading causes of preventable morbidity and mortality from infectious disease worldwide.1 It is a chronic progressive granulomatous infection caused by Mycobacterium tuberculosis （M. tuberculosis）.

Genes and regulatory networks involved in persistence of Mycobacterium tuberculosis

The causative agent of tuberculosis,Mycobacterium tuberculosis,is one of the most successful of human pathogens.It can evade the host immune response and establish a persistent infection or enter a dormant state within the host which can be reactivated if the host becomes immuno-compromised.Both of these features are major obstacles to tuberculosis eradication.Dormancy and reactivation of M.tuberculosis are tightly coordinated dynamic processes involving numerous genes and their products.Molecular mechanisms underlying M.tuberculosis persistence may provide an opportunity for the discovery of effective drug targets for tuberculosis control.Here,we review the genes required for M.tuberculosis persistence and propose a regulatory network for the action of these genes using text mining.This should provide fresh insights into the persistence mechanisms of M.tuberculosis and suggest candidates for new drug targets and immune intervention.