Intestinal permeability in HIV infection: proper controls are necessary.
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Biomedical subjects
Publications and source records attributed to K Katz.
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Children suffering from Gaucher's disease were examined by magnetic resonance imaging (MRI) during a characteristic episode of "bone crisis". An unexpectedly high intramedullary as well as subperiosteal signal was observed on both the T1- and T2-weighted sequences in 5 patients, suggesting a subacute hemorrhage or hematoma. It is conceivable that such a painful hemorrhage is an important component of the "bone crisis" phenomenon. Furthermore, in these cases this is a specific sign which may enable differentiation of bone crises from other types of bone pain associated with Gaucher's disease.
The hip motion of 158 preterm infants with gestational ages between 25 and 36 weeks was measured. The results of this study, compared with those of previous studies of term infants, show that hip motion changes with increasing gestational age above 25 to 27 weeks.
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Of thirty-four occurrences of bone pain in seventeen children and young adults who had type-I Gaucher disease, twenty-five were finally diagnosed as bone crises. On the basis of a bone scan with technetium-99m methylene diphosphonate, a correct diagnosis of bone crisis was made for twenty-three occurrences, with a sensitivity of 0.92. At the onset of a crisis, the bone scan typically showed decreased uptake of radionuclide at the involved site. After six weeks, a repeat bone scan of the long bones showed a ring of increased uptake surrounding an area of decreased uptake. At six months, the appearance of the bones on the radionuclide scan was normal.
There is a widely held misconception that low-molecular-weight polyethylene glycols are "highly lipophilic" permeability probes and therefore are transported across lipid cell membranes. The relative lipophilicity of polyethylene glycols 400 and 600 were examined by determining their partition coefficients (Kd) in water and organic solvents of increasing relative polarity. The Kd of polyethylene glycol 414 between hexane and water was 0.000015, indicating that there are only 1.5 parts of polyethylene glycol 414 in hexane for 100,000 parts of polyethylene glycol 414 in water. When the Kd was determined in organic solvents with increasing relative polarity or "water character", there was a linear increase in Kd. The relative urinary recovery of individual molecular weight fractions of polyethylene glycol 400 in normal volunteers was analyzed. After oral ingestion, there was a progressive decrease in relative urinary recovery of increasing molecular weight fractions of polyethylene glycol 400 suggesting that increase in the molecular size limited polyethylene glycol intestinal permeability. There was excellent correlation between the relative urinary recovery and the hydrophilicity of the intravenously administered polyethylene glycol 400 fractions. It is concluded that polyethylene glycols 400 and 600 are strongly hydrophilic. Since partitioning of polyethylene glycol into lipid phase is negligible in lipid/water mixtures, they are unlikely to be transported via lipid pathways. The intestinal permeability of polyethylene glycols are governed by their molecular size, and once in circulation their urinary excretion appears to be governed in part by their plasma or water solubility.
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A 9-year-old girl was treated by humeral lengthening for a 8.5 cm deficit caused by a septic arthritis 2 days after birth. A Wagner distraction apparatus was used after an osteotomy was done distal to the deltoid insertion. Six centimeters of length were gained. A second lengthening of about 7.5 cm is planned at the end of the patient's growth. No complications were encountered; by dividing the lengthening into two procedures, none are anticipated. At 1-year follow-up, there was a full range of shoulder, elbow, and hand motion; the humeri were virtually the same length.
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This study was undertaken to investigate the pattern of injuries and the management of 28 patients who attempted suicide by jumping from a height. Most of the patients had serious psychiatric disorders. All but two of the patients sustained multiple injuries. The most common injury patterns were fractures of the spine and lower extremities. It was concluded that, in addition to urgent orthopaedic and surgical care, early psychiatric assessment and therapy with transfer to a psychiatric department as soon as possible facilitates the recovery and rehabilitation of these patients.
The sitting problems of cerebral-palsied children with total body involvement are discussed. A moulded seat-insert has been devised which resolves most of these problems. Custom-made for each child, the insert incorporates a head-support and the seat components are connected by hinges to allow some range of movement.
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A series of twenty-three pathological fractures in nine children who had Gaucher disease was reviewed. Infiltration of the medullary space by Gaucher cells, erosion of bone, osteonecrosis in the area of the fracture, and disuse osteoporosis were the main etiological factors. Bone scans indicated that the osteonecrosis was due to osseous ischemia that occurred two to twelve months before the pathological fracture. Fracture-healing was prolonged, taking as long as two years for completion in some patients. Inadequate periods of immobilization and early weight-bearing led to malunion.
The authors describe a technique of continuous pelvic traction applied to a select group of 46 patients with low back pain, who had not responded to at least two weeks of treatment by bed rest and analgesic medication before hospitalization. The traction technique included the use of force equivalent to 25% of body weight, directed at an angle of (15) to the plane of the bed. A mechanical analysis of the technique is described and the results of treatment and the efficacy of the technique discussed.