Successful embolization of a large superior gluteal artery pseudoaneurysm emerging during anticoagulant therapy

Gross hemorrhage is the most serious complication of anticoagulant therapy. We report the discovery and treatment of a large pseudoaneurysm of the superior gluteal artery in one patient who had been receiving oral anticoagulant therapy. We diagnosed the pseudoaneurysm by contrast-enhanced computed tomography, and embolized the artery with stainless steel coils. The exact cause of the pseudoaneurysm remains unclear, however, minor trauma appears most likely.     

核素显像对小儿消化道出血的病因诊断

目的探讨核素显像对小儿消化道出血，特别是对Ｍｅｃｋｅｌ憩室、肠重复畸形的病因诊断的价值。方法对２６例腹痛、便血为主要症状的患儿行９９ｍ锝酸盐（９９ｍＴｃＯ－４）显像，其中１２例显像阴性者于检查后２４小时有活动性出血者，再行９９ｍ锝标记红细胞显像。所有病例的诊断均经手术、病理及内窥镜等检查所证实。结果９９ｍＴｃＯ－４显像诊断Ｍｅｃｋｅｌ憩室和肠重复畸形的敏感性、特异性、准确性分别为８５．７％（１２／１４）、９１．７％（１１／１２）及８８．５％（２３／２６）。结论核素显像具有无创、方法简单易行等特点，特别是对异位胃粘膜诊断具有较好的灵敏性和特异性。核素显像可作为下消化道出血病因诊断的有效方法。     

Glucose attenuation of atropine-induced deficits in paradoxical sleep and memory

When administered systemically, glucose attenuates deficits in memory produced by several classes of drugs, including cholinergic antagonists and opiate agonists. Glucose also enhances memory in aged rats, mice, and humans. In addition, glucose ameliorates age-related reductions in paradoxical sleep. Because deficits in paradoxical sleep are most marked in those individual aged rats that also have deficits in memory, treatments which improve one of these functions may similarly improve the other. The present experiments show that glucose attenuates deficits in paradoxical sleep and memory after atropine administration, with similar dose-response curves for both actions. In the first experiment, rats received saline, atropine (1 mg/kg), glucose (100 mg/kg) or combinations of atropine + glucose (10, 100, 250, and 500 mg/kg) 30 min before assessment on a spontaneous alternation task. In the second experiment, 3-h EEGs were assessed for spontaneous daytime sleep in rats administered saline, atropine (1 mg/kg), glucose (100 mg/kg) or combinations of atropine + glucose (10, 100 and 250 mg/kg). In both experiments, glucose significantly attenuated deficits at an optimal dose of 100 mg/kg. A third experiment assessed blood glucose levels after injections of atropine + glucose (100 mg/kg) and determined that blood glucose levels were similar to those produced by other treatments which enhance memory. These results are consistent with the view that paradoxical sleep and at least one test of memory are similarly influenced by atropine and glucose.     

Intracerebroventricular injection of choline increases plasma oxytocin levels in conscious rats

In the present study, we examined the effect of intracerebroventricularly (i.c.v.) injected choline on both basal and stimulated oxytocin release in conscious rats. I.c.v. injection of choline (50–150 μg) caused time- and dose-dependent increases in plasma oxytocin levels under normal conditions. The increase in plasma oxytocin levels in response to i.c.v. choline (150 μg) was greatly attenuated by the pretreatment of rats with atropine (10 μg; i.c.v.), muscarinic receptor antagonist. Mecamylamine (50 μg; i.c.v.), a nicotinic receptor antagonist, failed to suppress the effect of 150 μg choline on oxytocin levels. Pretreatment of rats with 20 μg of hemicholinium-3 (HC-3), a specific inhibitor of choline uptake into nerve terminals, greatly attenuated the increase in plasma oxytocin levels in response to i.c.v. choline injection. Osmotic stimuli induced by either oral administration of 1 ml hypertonic saline (3 M) following 24-h dehydration of rats (type 1) or an i.c.v. injection of hypertonic saline (1 M) (type 2) increased plasma oxytocin levels significantly, but hemorrhage did not alter basal oxytocin concentrations. The i.c.v. injection of choline (50, 150 μg) under these conditions caused an additional and significant increase in plasma oxytocin concentrations beyond that produced by choline in normal conditions. These data show that choline can increase plasma oxytocin concentrations through the stimulation of central cholinergic muscarinic receptors by presynaptic mechanisms and enhance the stimulated oxytocin release.     

Spontaneous disappearance of a suprasellar arachnoid cyst: case report and review of the literature

Introduction Suprasellar arachnoid cysts are uncommon developmental anomalies that are most often diagnosed in childhood. Because the natural history and pathogenesis of these remain poorly defined, optimal treatment guidelines are not yet established.Case report We report a case of spontaneous disappearance of a suprasellar arachnoid cyst that persisted after a ventriculoperitoneal shunt performed 10 years earlier. A 5-year-old boy presented with impaired visual acuity and urinary incontinence. Magnetic resonance (MR) imaging showed a large suprasellar cyst with noncommunicating hydrocephalus. A ventriculoperitoneal shunt was put in place to alleviate current aggravation of hydrocephalus symptoms. Because of the persistent size of the cyst and signs of brainstem compression on a repeat computed tomography (CT), we recommended surgical exploration and decompression. However, the boy’s parents declined any further surgical treatment, and the patient was subsequently lost to follow-up for 10 years. When the patient returned to our clinic at the age of 15 years, a repeat MR scan showed a complete disappearance of the cyst. His family denied any significant interval history.Discussion This case represents only the third reported case of spontaneous disappearance of a suprasellar arachnoid cyst. We discuss possible mechanisms and clinical characteristics of the disappearance of the arachnoid cyst with review of the literature.     

自然流产模型小鼠绒毛滋养层细胞凋亡及相关调控蛋白的表达

目的探讨自然流产模型小鼠绒毛滋养层细胞凋亡异常与自然流产的关系。方法建立正常妊娠模型CBAXBALB/c和自然流产模型CBAXDBA/2。采用DNA缺口原位末端标记技术(TUNEL)测定两组模型孕13 d绒毛滋养层细胞凋亡情况;免疫组织化学SABC法测定两组模型孕13 d绒毛组织Bcl-2、Bax、Fas、FasL 4种凋亡调控蛋白的表达,并以MBIS-2000医用彩色病理图像免疫组织化学测量系统对其表达进行半定量分析,结果用平均灰度值表示。结果自然流产模型小鼠绒毛滋养层细胞凋亡指数明显高于正常妊娠模型(P<0.01)。Bax表达亦高于正常妊娠模型(P<0.05);FasL表达低于正常妊娠模型(P<0.01);Fas和Bcl-2表达两组无明显差异。结论早孕期绒毛滋养层细胞凋亡异常是自然流产机制之一,Bcl-2/Bax,Fas/FasL途径可能是诱导早孕期绒毛滋养层细胞凋亡的重要因素。     

老年人自发性气胸的临床分析

目的探讨老年人自发性气胸的诊断及治疗,以提高老年人自发性气胸的诊治水平。方法回顾性分析我科1996年2月3日～2006年2月23日我科89例老年人自发性气胸的诊治经过。结果老年人自发性气胸的临床症状易被原发病掩盖,其临床特点有:(1)临床表现多不典型,症状以紫绀、气急多见,无明显胸痛;(2)以继发性气胸为多;(3)老年自发性气胸并发症、伴发病多;(4)肺复张时间长,负压吸引效果差;(5)交通型和张力型在老年自发性气胸当中较为多见;(6)易误诊;(7)由于基础疾病存在,肺功能差,发生气胸后易出现肺部感染、呼吸衰竭等并发症,死亡率高。结论老年人各器官储备功能差,肺功能差,同时多并存基础疾病,老年人自发性气胸后易出现肺部感染、呼吸衰竭等并发症,死亡率高,早期诊断和积极合理的治疗是降低老年人自发性气胸病死率的关键。     

自然流产患者滋养细胞肝素表皮生长因子的表达及意义

目的　探讨自然流产患者滋养细胞肝素表皮生长因子 (HB EGF)的表达及其与滋养细胞增殖细胞核抗原 (PCNA)的关系。方法　选择自然流产患者和正常妊娠者各 2 0例 ,采用免疫组织化学法分析滋养细胞HB EGF和PCNA的表达。结果　HB EGF主要存在于细胞质 ,合体滋养层和细胞滋养层均有表达 ,部分流产滋养细胞不表达。自然流产患者滋养细胞HB EGF和PCNA的表达显著低于正常妊娠者 (P <0 .0 1) ,成正相关 (r =0 .4 5 4 ,P <0 .0 1)。结论　HB EGF的表达和滋养细胞增殖相关 ,HB EGF下降可能与自然流产的发生相关     

血红素氧合酶-1与脑出血的继发性损害

自发性脑出血是指非外伤性脑实质出血,发病率高,死亡率高[1],且脑出血后患者多遗留不同程度的神经功能障碍。因此,探讨脑出血后脑组织损伤的病理生理机制对于改善脑出血病情及预后是十分必要的。大量研究表明自发性脑出血后造成的脑损伤存在多种机制[2]:早期血肿机械占位效应、     

Endoscopic observation of pathophysiology of ventricular diverticulum

Background Although there have been reports dealing with ventricular diverticulum (VD) analyzed by cisternography and computed tomography (CT), those focusing on magnetic resonance imaging (MRI) or neuroendoscopic findings are rare. Case report We present a case of noncommunicating hydrocephalus caused by aqueductal stenosis with cystic lesion located in supracerebellar region. Third ventriculostomy was performed on this case. The conventional CT and MRI were compatible with usual VD, but neuroendoscopic examination suggested otherwise. The endoscopic view inside of the cystic lesion demonstrated passing veins and no membrane. We diagnosed this cystic lesion as a unique subtype of advanced VD mimicking spontaneous ventriculostomy. Endoscopic observation of the cyst was very useful for accurate diagnosis and safe treatment.