[Clinical evaluation of vocal fold paralysis in 207 children].

Objective: To investigate the etiology and clinical characteristics of vocal fold paralysis in children. To provide useful information for diagnosis, management and prognosis in the clinical work. Methods: Two hundred and seven children with vocal fold paralysis in Children's Hospital of Fudan University were retrospectively studied, and followed-up. Results: All the patients had hoarseness.151 cases had vocal paralysis in the left side and the main etiology was pulmonary arterial hypertension.43 cases had bilateral vocal paralysis and all of them had respiratory problems.The main etiology were congenital tracheoesophageal malformations.13 cases had vocal paralysis in the right side.In terms of etiology, 8 cases were related to intracranial lesions, 2 cases were idiopathic. Conclusions: The main etiologies of left vocal fold paralysis were cardiovascular diseases, and bilateral vocal paralysis were congenital tracheoesophageal malformations.The main etiologies of right vocal fold paralysis were neoplastic and central lesion.The prognosis of bilateral vocal fold paralysis and right vocal fold paralysis was poor.

Successful treatment of severe kerion Celsi in an immunocompromised girl with evacuation of pus, terbinafine and short course glucocorticosteroids.

A 6-year-old girl with a 2-year history of idiopathic thrombocytopenic purpura complained of a 4-week history of scalp desquamation together with small pustules. During the recent 10 days, she complained of high fever with multiple abscesses formation with no response to intravenous antibiotics. She received varied doses of oral prednisone therapy for 2 years. Microscopy showed endothrix infection. We prescribed terbinafine 125 mg/d and prednisone 10 mg/d. After 1 week, she returned to our office with severe ache and persistent high fever. She refused any topical drugs because of pain. Manual pressure to remove pus from sinuses and infected scale under general anesthesia was done and about 100 ml pus was discharged from kerion lesions. Prednisone (1 mg/kg/d) was started and fever disappeared on the same day. Prednisone was tapered to withdraw in 10 days. A total of a 3-month course of oral terbinafine (125 mg/d) resulted in mycological clearance. Hair regrowth was satisfactory 8 months later.

Magnetic resonance angiography manifestations and prognostic significance in HIV-negative tuberculosis meningitis.

OBJECTIVE: To evaluate the patterns, related factors and prognostic value of abnormal magnetic resonance angiography (MRA) in human immunodeficiency virus negative tuberculous meningitis. MATERIALS AND METHODS: We performed a prospective study in patients aged >14 years. Abnormality on MRA was correlated with clinical, laboratory and magnetic resonance imaging findings. Modified Barthel index was used to assess outcome at 6 months after inclusion. RESULTS: Of 101 patients included, MRA was abnormal in 45 (44.6%). The distribution of MRA abnormality was classified as disseminated irregular calibres of intracranial arteries with or without reduction in distant branches (29.7%, pattern 1) and localised stenosis at the base of the brain (26.7%, pattern 2). In logistic regression analysis, pattern 2 was related to stage of the disease (P = 0.002), basal exudates (P = 0.03) and infarction (P = 0.000), while pattern 1 was related to duration of disease (P = 0.050), hydrocephalus (P = 0.032) and age (P = 0.002). Pattern 1 was also correlated with infarction (P = 0.000), particularly infarction in the tubercular zone (P = 0.035) in univariate analysis. MRA abnormality was associated with paradoxical worsening (P = 0.022) and poor prognosis in univariate analysis (P = 0.035). CONCLUSION: MRA abnormality is associated with stroke and poor outcomes. Although it indicates mild vascular injury, pattern 1 MRA abnormality is nevertheless associated with infarction and needs proper intervention.

Interleukin-17-secreting T cells in neuromyelitis optica and multiple sclerosis during relapse.

Growing evidence suggests that interleukin (IL)-17 and IL-17-secreting CD4(+)T (Th17) cells are involved in the pathogenic mechanisms of multiple sclerosis (MS). IL-17-secreting CD8(+)T cells were recently identified as a novel subset of CD8(+)T cells. We aimed to analyze the role of Th17 and IL-17 secreting CD8(+)T cells in the pathogenesis of neuromyelitis optica (NMO) as well as MS. Fourteen patients with NMO, 20 with MS and 16 control participants (CTL) were enrolled between November 2008 and December 2009. The proportion of Th17 cells and IL-17 secreting CD8(+)T cells were counted using flow cytometry, and serum levels of IL-6, IL-17, IL-21, IL-23, and transforming growth factor-beta (TGF-ß) were measured by enzyme-linked immunosorbent assay. Patients with NMO had a larger proportion of Th17 cells than patients with MS (3.72% versus [vs.] 2.58%, p=0.02) and CTL (3.72% vs. 1.36%, p<0.001). The proportion of Th17 cells in patients with MS was also markedly higher than in the CTL (2.58% vs. 1.36%, p<0.001). IL-17-secreting CD8(+)T cell counts in NMO patients were markedly higher than in MS patients (1.61% vs. 1.09%, p=0.036) and CTLs (1.61% vs. 0.58%, p<0.001). The proportion of IL-17-secreting CD8(+)T cells in MS patients was also higher than in CTLs (1.09% vs. 0.58%, p=0.002). Serum IL-17 and IL-23 levels were increased in patients with NMO and MS, while serum IL-21 concentration was higher only in NMO patients compared to CTL. We concluded that Th17 cells were highly activated in patients with NMO. IL-17-secreting CD8(+)T cells were increased in patients with NMO and MS during relapse and have an important role in the pathological mechanism of NMO and MS.

Simultaneous determination of polycarboxylic acids by capillary electrophoresis with a copper electrode.

The simultaneous determination of polycarboxylic acids including oxalic acid, citric acid, malonic acid, malic acid, tartaric acid, aspartic acid and glutamic acid was achieved by capillary electrophoresis with a copper disk electrode (d = 200 microm). In the system. 0.2 mmol/l cetylpridinium bromide (CPB) was used as an electroosmotic flow (EOF) modifier to reverse the direction of EOF. The effects of the solution pH and CPB concentration on separation were evaluated to achieve the optimum separation conditions. At the working potential of +0.14 V (vs. saturated calomel electrode), the calibration curves for all polycarboxylic acids studied were linear with 2 approximately 3-orders of magnitude and all the detection limits (S/N = 3) were below 15 fmol except malonic acid. Furthermore, the oxalic and citric acids in urine were successfully separated and determined with high sensitivity.

[Bioavailability of a controlled-release suspension of phenylpropanolamine in healthy volunteers].

A high-performance liquid chromatographic analysis of phenylpropanolamine (PPA) in human plasma is presented. Using direct UV detection the method is sufficiently sensitive to 25 ng/ml for PPA. Single-dose pharmacokinetics of PPA in 10 healthy volunteers taking controlled release suspension (C) or tablet (T), each containing 150 mg PPA was compared. The study described here has shown that the (C) AUC(0-infinity)/(T) AUC(0-infinity) = 1.02 (P greater than 0.4). The controlled-release product of PPA is equivalent to PPA tablet.