Solitary osseous sarcoidosis: a rare reason for pathologic fracture.

Sarcoidosis with osseous involvement as the initial manifestation is rare. Due to lack of other organ involvements, the diagnosis is somehow difficult to establish. We report a case with osseous sarcoidosis as the initial and major manifestation that developed spontaneous bone fracture. Our case emphasizes the importance of histological evidence and exclusion of other diseases i.e. rheumatoid arthritis, before making the diagnosis of osseous sarcoidosis.

Predictors for neuropsychiatric development in Chinese adolescents with systemic lupus erythematosus.

The aim of our study is to investigate the relationship between neuropsychiatric systemic lupus erythematosus (NPSLE) development and clinical factors to elucidate potential predictors at the time of SLE onset as well as during NP flares. Sixty-seven adolescents between the ages of 10 and 18 years with SLE were retrospectively reviewed, and their clinical characteristics and laboratory findings were analyzed. Twenty-four (35.82%) patients with NPSLE were included in the analysis. Renal involvement at the time of SLE onset was significantly less common in patients who developed NP symptoms (P = 0.0038), but renal involvement during the entire follow-up (FU) period was not significantly different between patients with NP and those without NP. Photosensitivity at the time of SLE diagnosis was significantly more common in patients with NP (P = 0.0080). No differences were found in the clinical and laboratory results between the time of SLE onset and NP onset in the same late-onset NP group. Our results suggest that NP development is negatively correlated with renal involvement at the onset of SLE, but not during the entire FU period, and NP development is positively correlated with photosensitivity at the time of SLE onset. We could not identify any factors that might predict the occurrence of NP symptoms during an NP flare.

Polynomial time algorithm for minmax scheduling with common due-window and proportional-linear shortening processing times.

This article deals with common due-window assignment and single-machine scheduling with proportional-linear shortening processing times. Objective cost is a type of minmax, that is, the maximal cost among all processed jobs is minimized. Our goal is to determine an optimal schedule, the optimal starting time, and size of due-window that minimize the worst cost, which consist of four parts: earliness, tardiness, starting time and length of the due-window. Optimal properties of the problem are given, and then an optimal polynomial algorithm is proposed to solve the problem.

Tuberculosis should not be ignored in patients with peripheral gangrene.

Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patients with tuberculosis (TB). We diagnosed a female patient with gangrene of her left toe caused by TB infection. She presented with fever, lymphadenectasis, and peripheral gangrene of the left toe. Lymph node biopsy confirmed tuberculous lymphadenitis and the computer tomography angiography showed vasculitis. The patient underwent antituberculous therapy and her condition was gradually improved. Although it is rare, TB should be considered as a possible cause of peripheral gangrene.

Role of IL-1ß, IL-6, IL-8 and IFN-γ in pathogenesis of central nervous system neuropsychiatric systemic lupus erythematous.

We discussed the role of IL-1ß, IL-6, IL-8 and IFN-γ in the pathogenesis of central nervous system neuropsychiatric systemic lupus erythematous (CNS-NPSLE). Serum and cerebrospinal fluid samples were collected from CNS-NPSLE patients, non-CNS SLE patients, patients with intracranial infection and normal subjects. Levels of IL-1ß, IL-6, IL-8 and IFN-γ in serum and cerebrospinal fluid were detected by ELISA, and the results were compared across the groups. All subjects received cerebral MRI. The risk threshold for each cytokine in CNS-NPSLE group was set as 2.5%. The positive rates of cytokines for different lesions in cerebral MRI findings in CNS-NPSLE group were compared. The correlations between cytokine levels and cerebral MRI findings were analyzed. All groups did not show significant differences in age and gender (F=1.34, P>0.05; x (2)=2.05, P>0.05); The IL-1ß, IL-6, IL-8 and IFN-γ levels of serum and cerebrospinal fluid in CNS-NPSLE group were obviously higher than those of the normal control (serum Z14 =6.22, 6.04, 6.22, 5.70; cerebrospinal fluid Z14 =6.38, 7.10, 6.97, 6.34, P<0.0083); IL-1ß, IL-6 and IL-8 levels of cerebrospinal fluid of CNS-NPSLE group were higher than those of the non-CNS SLE group (Z12 =2.73, Z12 =3.18, Z12 =3.86; P<0.0083); IL-1ß, IL-6, IL-8 and IFN-γ levels of cerebrospinal fluid of CNS-NPSLE group were higher than those of the serum (Z=3.19, 6.30, 5.44, 3.19, P<0.05); IL-6>20.0679 pg/ml and IL-8>87.1811 pg/ml in the cerebrospinal fluid predicted a higher risk of CNS-NPSLE (x (2)=11.98, P<0.05; x (2)=4.65, P<0.05); The positive rates of IL-1ß and IL-6 in the cerebrospinal fluid of CNS-NPSLE patients with demyelinating diseases were considerably higher than those of CNS-NPSLE patients with normal MRI findings (x (2)=10.89, P<0.005; x (2)=18.47, P<0.005). The positive rates of IL-6 and IFN-γ in the cerebrospinal fluid of CNS-NPSLE patients presenting with multiple ischemic foci were significantly higher than those with normal MRI findings (x (2)=5.56, P<0.005; x (2)=14.59, P<0.005). Some cytokines are involved in the pathogenesis of CNS-NPSLE and correlated with cerebral MRI findings in CNS-NPSLE.

[Relationship between periodontal disease and rheumatoid arthritis].

OBJECTIVE: To study a population of rheumatoid arthritis patients and determine the extent of periodontal disease in these patients, in order to investigate the relationship between periodontal disease and rheumatoid arthritis. METHODS: The experimental group was composed of 70 patients with rheumatoid arthritis and the control group consisted of 70 age- and gender-matched individuals without rheumatoid arthritis. The relationship between periodontal status in rheumatoid arthritis and control groups as well as the relationship between periodontal status and rheumatological findings in patients were analyzed. RESULTS: The percentage of periodontal disease was statistically significant between experimental and control group (P < 0.01). The difference of average number of missing teeth and bleeding on probing in the experimental group and control group were not statistically significant (P >0.05). There were more number of periodontal disease index 5 or 6 in experimental group than in control group ( P < 0.05). Rheumatoid arthritis patients with moderate to severe bone loss had deeper degree of morning stiffness, erythrocyte sedimentation rate levels and serum C-reactive protein levels than patients with no or mild bone loss. CONCLUSION: Individuals with rheumatoid arthritis are more likely to experience periodontal disease compares to healthy subjects. They are also very likely to suffer from moderate to severe periodontitis.