Impact of three-phase bone scintigraphy on the diagnosis and treatment of complex regional pain syndrome type I or reflex sympathetic dystrophy

To determine the impact of three-phase bone scintigraphy [TPBS] on the diagnosis and management of complex regional pain syndrome type I [CRPSI] or reflex sympathetic dystrophy [RSD]. Twenty consecutive patients with a recent clinical evidence of CRPSI were referred for TPBS as part of their routine management plan. All patients underwent neurological examinations with special attention to the evaluation of clinical features of vasomotor, sudomotor, motor and sensory dysfunction. Patients were followed prospectively. When both the clinical and TPBS results supported the diagnosis of CRPSI, patients were started on treatment. Of the 20 patients, TPBS supported the diagnosis of RSD in 9 who were treated with steroids and physiotherapy. Complete follow-up was available for 7 of them and all had a satisfactory response to treatment. For the remaining 11 patients RSD was diagnosed clinically but not confirmed by TPBS. On follow-up there was no evidence that TPBS failed to identify RSD in these 11 patients. The results indicate that TPBS confirmed the clinical diagnosis of RSD, and, more importantly, had a significant impact on its management.

Renography within 1 hour of renal transplantation: technical feasibility and clinical utility

Renographies obtained within 1 h of renal transplantation were studied prospectively to evaluate their technical feasibility and potential clinical impact on successful treatment of immediate posttransplantation complications such as arterial or venous thrombosis, which require prompt diagnosis and management. Subjects and During December 1996 to December 1998, 127 renal transplants were performed. Ninety-four patients had complete renographic studies within 1 h of surgery. It was not possible to perform renography on 26 patients who were not sent to the Department of Nuclear Medicine within 1 h of transplant and 7 other patients who could not undergo a complete renogram because of their postoperative condition. There was no complication attributed to transporting patients to the Department of Nuclear Medicine for these studies so soon after surgery. Of the 94 renographies obtained immediately following transplant surgery 46 were abnormal. However, when compared with the usual policy of obtaining baseline renograms between 12 and 72 h after surgery, treatment was changed for only 2 patients. Radionuclide renography within 1 h of transplant surgery was technically feasible. Based on the results of this study the clinical utility of obtaining renography within 1 h posttransplant was minimal and hence we recommended that it should not be performed routinely but could be used on an individual basis when imminent intervention is highly likely

Molecular pharmacogenetic studies of drug responses to obsessive-compulsive disorder and six functional genes / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the associations between the drug responses to obsessive -pulsive disorder (OCD) and six functional genes related with serotonin and dopamine.</p><p><b>METHODS</b>One hundred and thirteen OCD nuclear families were collected. The OCD patients were treated with serotonin reuptake inhibitors (SRIs) for 8 weeks and the drug responses were assessed using the Yale-Brown obsessive-compulsive scale (Y-BOCS). The patients were divided into drug responders group and non-responders group according to the reducing rate of Y-BOCS score. The genotypes of six genes were determined with the Amp-FLP and Amp-RFLP techniques and analyzed by transmission disequilibrium test (TDT). The six genes are serotonin 2A receptor (5-HT2A), serotonin transporter (5-HTT), dopamine D2 receptor ( DRD2), dopamine D4 receptor (DRD4), catechol-O- methyltransferase (COMT) and monoamine oxidase A (MAOA).</p><p><b>RESULTS</b>No association was found between the six genes and different drug responses groups. However, there was significant difference between the drug responders and non-responders in homozygosity at the 5-HT2A -1438G/A locus (chi(2)=4.69, P=0.03).</p><p><b>CONCLUSION</b>The results suggested that the 5-HT2A may play some roles in the effects of drug treatment on OCD.</p>