CHAP syndorme consists of choreoathetosis, orofacial dyskinesia, affective change, hypotonia, and pseudobulbar signs. CHAP syndrome was firstly des- cribed with onset 1 to 7 days after induced profound hypothermia and complete circulatory arrest for con- genital heart lesion repair. Since then, only a few cases have been reported until now. Case We report a patient who demonstrated all of the elements of the CHAP syndrome in severe cachexic state. Brain SPECT(99mTC-ECD) shows decreased perfusion in left fronto-parieto-temporal lobe. Comments The pathogenesis of CHAP syndrome is obscure. However our case led us to suggest that more essential component pre- disposing to the CHAP syndrome is hypoxia rather than hypothermia. Furthermore, it seems to be related with circulatory insufficiency in extrapyramidal nervous systems.
Anoxia ; Brain ; Heart ; Humans ; Hypothermia ; Movement Disorders ; Muscle Hypotonia ; Nervous System ; Perfusion

Objective To optimize a W/O microemulsion formulation of troxerutin and evaluate its physical properties such as morphology, droplet size, stability and content of troxerutin. Methods The W/O microemulsion was optimized using a pseudoternary phase diagram and the area of the microemulsion region was used to screen and determine microemulsion components.HPLC assay was used for determination of the loading content. Results The optimal formulation contained lecithin, ethanol, isopropyl myristate and water (23.30:11.67:52.45:12.59).The microemulsion was physicochemically stable with round shape and uniform size, and the mean droplet size was about 50. 20 nm. Conclusion Microemulsion was developed successfully.It will expect to be the new preparation for troxerutin.

Objective To investigate the development of ultrastructure in grafts from a xenograft model of human hemangioma on nude mice.Methods Human infantile hemangioma tissue was obtained in surgery and planted into subcutaneous layer of nude mice in small pieces.The grafts were harvested on the 2~(nd),5~(th),15~(th),30~(th),45~(th) day and then at 2~(nd),3~(rd),4~(th),6~(th) month for transmission electron microscopic view.Results In early stage after transplantation,signs of degeneration and necrosis were more evident.On the 30~(th) day,the number of endothelial cells increased and some of the endothelial cells were larger in size with high nuclear to plasm ratio.At the 2~(nd) month,the number of endothelial cells increased,while some of these cells turned flat.Later,high endothelial cells decreased in number and collapse and pyknosis of plasm,formation of secondary lysosome,margination of chromatin,fragmentation of nucleus were evident with surrounding deposition of adipose and collagen.Conclusions With xenotransplantation of human infantile hemangioma tissue onto nude mice,the grafts may survive ischemia and proliferate,and then gradually involute.The development resembles a natural course of human infantile hemangioma.

Tomography, X-Ray Computed ; trends

To investigate the therapeutic effect and molecular mechanism of the main flavonoid components of Silybum marianum (S. marianum) on nonalcoholic fatty liver disease (NAFLD), we identified nine flavonoids in S. marianum through TCMSP, PubChem database and corresponding literatures. The potential therapeutic targets of NAFLD were predicted by SwissTargetPrediction, GeneCards and Venny 2.1.0 platform, while the protein-protein interaction (PPI) network of potential targets was analyzed using String platform and Cytoscape software. Then GO and KEGG pathway enrichment analysis were performed using David 6.8 database, followed by molecular docking verification using AutoDock software. In vitro, components with higher degree value in the "components-targets-pathway" network were chosen for further analysis. L02 cells were used to establish lipid accumulation model and treated with different components. Furthermore, the effects of four pure active compounds from S. marianum on lipid accumulation in hepatocytes were analyzed by oil red O staining. The results showed that the main nine flavonoids extracted from S. marianum contained 24 potential NAFLD targets. Several critical pathways closely related to NAFLD process were identified by GO and KEGG enrichment analysis, including phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) pathway, type 2 diabetes pathway, tumor necrosis factor (TNF) pathway and insulin resistance pathway. The results of molecular docking further indicated that the core components displayed strong binding abilities with key targets respectively, and silandrin showed better binding activity as compared to other components. The results obtained from L02 cells showed that the lipid accumulation was reduced by treatment with isosilybin A, isosilybin B, silydianin and silychristin, while the activity of isosilybin B was better than that of isosilybin A. Taken together, we concluded that the main flavone components of S. marianum could improve lipid accumulation through multiple signaling pathway in hepatocytes, and this could be a potential new strategy for the treatment of NAFLD.

Pulmonary arteriovenous malformations (PAVMs) are direct communications between pulmonary arteries and pulmonary veins, resulting in right-to-left shunts that may cause cyanosis, dyspnea, and digital clubbing. Neurological complications such as intrace rebral hemorrhage or brain abscess may result from cerebral thrombosis or emboli. In most cases, they remain unrecognized until the late te enage years. Here, we report a case of a 6-year-old boy who presented with perioral cyanosis, digital clubbing, and dyspnea on exertion. A plain chest X-ray showed a focal nodular opacity in the right lower lobe (RLL), and a diagnosis of a large PAVM in the RLL was confirmed by chest computed tomography. A right lower lobe ctomy was successfully performed without any complications. Although their incidence in children is low, PAVMs should be suspected as a possible cause of cyanosis and dyspnea of non-cardiac origin, and should be treated promptly to prevent further neurological complications.
Arteriovenous Malformations ; Brain Abscess ; Child ; Cyanosis ; Dyspnea ; Hemorrhage ; Humans ; Incidence ; Intracranial Thrombosis ; Pulmonary Artery ; Pulmonary Veins ; Thorax

We reviewed the magnetic resonance imaging (MRI) of intracranial teratoma to detect the characteristic findings. Five patients with intracranial teratoma were evaluated with MRI from January 1988 to December 1990. Four male and one female patients with age ranging from 6 to 14 years were surgicelly confirmed MRI was done with 2.0T superconducting system(Spectro 20000, Goldstar, Seoul) and gadolinium enhancement was done in 4 patients. We retrospectively reviewed the clinical, operative, pathologic, and radiologic findings. Intracranial teratomas showed fatty component, calcification and cystic component filled with sebum or serous fluid. Peripheral rim enhancement was seen in three and irregular enhancement in two cases. There were hydrocephalus in all teratoma, but neither surrounding edema nor surrounding tissue invasion was seen. Low signal intensity rim was noted around the solid component of all tumors and they were not enhanced. MRI showed multicomponent of intracranial teratoma including the solid and cystic component, and low singal rim which might be the characteristic findings of the intracranial teratoma.
Edema ; Female ; Gadolinium ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging* ; Male ; Retrospective Studies ; Sebum ; Teratoma*

Hyperthyroidism is a well known cause of atrial fibrillation. It is also known that control of hyperthyroidism can usually curb thyrotoxic atrial fibrillation and restore sinus rhythm. In this study, 282 patients with hyperthyroidism were investigated to quantify the incidence of atrial fibrillation, and to identify the vulnerable groups. In addition, we compared two groups of subjects with atrial fibrillation-one group with hyperthyroidism and the other group without
Aged ; Atrial Fibrillation ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Hyperthyroidism ; Incidence ; Male ; Sex Ratio ; Thyroid Gland

OBJECTIVETo study the methods and effects of the reconstruction of tumor-induced bone defects with vascularized fibula graft.

METHODSFrom Oct. 1996 to Jan. 2005, 89 patients with bone defects were treated with fibula graft using different methods. Among the patients, 48 patients were male and 41 patients were female, ranging in age from 12 to 67 years, with an average of 35 years. Thirty-five patients were treated with inlay bone grafting after excision of focus, 15 patients were treated with single or double-strut fibula graft after tumor resection, 16 patients were treated with fibular head graft for juxta articular tumor resection, and 23 patients were treated with double-strut fibula combined with iliac graft after marginally resection.

RESULTSEnneking evaluation system was used to evaluate therapeutic effects. Among 35 patients treated with inlay bone graft after excision, 29 patients were followed up, and 26 patients got an excellent result, 1 good and 2 poor. Among 15 patients treated with single or double-strut fibula graft after tumor resection, 12 patients were followed up, and 8 patients got an excellent result, 1 good, 1 poor and 2 bad. Among 16 patients treated with fibular head graft for juxta articular tumor resection, 12 patients were followed up, and 7 patients got an excellent result, 3 good,1 poor and 1 bad. Among 23 patients treated with double-strut fibula combined with iliac graft after marginally resection, 17 patients were followed up, and 11 got an excellent result, 3 good, 1 fair and 2 bad.

CONCLUSIONThese treatment methods can greatly enrich the treatment methods for bone tumor, and satisfy the reconstruction after bone tumor excision in different position of the four limbs. These methods are reliable and can be chosen according to disease types.

Adolescent ; Adult ; Aged ; Bone Neoplasms ; surgery ; Bone Transplantation ; methods ; Child ; Female ; Fibula ; blood supply ; transplantation ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Treatment Outcome ; Young Adult

OBJECTIVETo observe the effects of nicotine on endogenous carbon monoxide (CO) concentration and nitric oxide synthase (NOS) activity in the corpus cavernosum of adult male rats, and explore the possible mechanism of cigarette smoking affecting erectile dysfunction.

METHODSForty adult male rats were equally divided into three treatment groups to receive subcutaneous injection of nicotine at 0.5 mg/kg pre d for 1, 2 and 3 months, and a control group to receive saline only. After treatment, the corpus cavernosum was harvested for detection of CO concentration by modified two-wavelength spectrophotometry and NOS activity by improved Griess measurement.

RESULTSCO concentration and NOS activity were decreased by 9.05 and 13.37%, respectively, after 1 month of nicotine injection (P < 0.01), 16.47 and 22.5% after 2 months (P < 0.01), and 22.99 and 31.74% after 3 months (P < 0.01), as compared with (13.664 +/- 0.404) umol/mg prot and (9.721 +/- 0.470) U/mg prot in the control group.

CONCLUSIONNicotine can reduce endogenous CO concentration and NOS activity in the corpus cavernosum of adult male rats, which suggests the involvement of endogenous CO and NOS in the pathophysiological process of smoking-induced erectile dysfunction .

Animals ; Carbon Monoxide ; metabolism ; Erectile Dysfunction ; chemically induced ; Male ; Nicotine ; toxicity ; Nitric Oxide Synthase ; metabolism ; Penis ; metabolism ; Rats ; Smoking ; adverse effects