Asymptomatic renal abscess: Evaluation with gadolinium DTPA-enhanced MRI

Incidental detection of renal mass in a transplant patient is a diagnostic challenge. These patients are at risk for the development of neoplasms and, more commonly, infection with atypical organisms. Symptomatology may be lacking in either, and both conditions may present with similar symptoms. Magnetic resonance imaging (MRI) evaluation with gadolinium DTPA is helpful in the evaluation of asymptomatic renal mass, with enhancement effectively excluding simple and hemorrhagic cysts. Because the MRI appearances of renal cell neoplasm and renal abscess overlap, both must be considered in the differential diagnosis.     

带蒂球结膜瓣转移术治疗翼状胬肉

目的 :探讨带蒂结膜瓣转位移植术治疗翼状胬肉的临床效果。方法 :施行带蒂结膜瓣转位移植术治疗翼状胬伙肉 2 4 0例 ,2 5 2只眼 ,手术在手术显微镜下进行 ,干净彻底切除胬肉组织 ,在上方球结膜制作 4 mm× 10 mm大小 ,外眦端游离 ,内眦端带蒂的菲薄结膜瓣游离端向下须超过胬肉宽度 2 mm,以起拦截作用。移植片与结膜创缘对合 ,缝合 7针～ 10针。结果 :本组翼状胬肉 2 4 0例 ,2 5 2只眼 ,术后随访 6个月～ 5 a,复发 9例 ,占 3.6 % ,取得了较好效果。结论 :本手术取材容易 ,操作简便 ,效果可靠 ,即使在肉眼下亦可施行 ,适合在基层医院开展。     

下颌角截骨移植隆颏术

目的 探讨利用自体下颌角截骨块同期移植隆颏的手术方法。方法 经口腔入路，利用下颌角肥大截骨术的下颌角骨块，塑形为适合颏部的形状，Ⅰ期移植于颏部，且以钛钉坚强内固定。结果 本组35例患者行双侧下颌角截骨＋下颌骨外板磨削术＋自体下颌角移植隆颏术，术后移植骨愈合良好，颏部形态符合美学标准。结论 下颌角截骨Ⅰ期移植隆颏术，操作方法简单，预期效果可靠，移植骨块与颏部解剖结合，无排异反应。     

The development of glial fibrillary acidic protein-positive cells and the appearance of laminin-like immunoreactivity in fetal olfactory bulb transplants

Embryonic rat olfactory bulbs were transplanted into the site vacated by aspiration of an olfactory bulb from a neonatal rat. This paper presents our findings related to the development of glial fibrillary acidic protein (GFAP) positive (+ve) glial cells and the appearance of laminin-like immunoreactivity in these transplants. The GFAP + ve glial cells formed perivascular end-feet on the invading vasculature and formed a glia limitans along the glia surface of the transplant. This reconstituted glia limitans was continuous with that of the host brain, there being no glia limitans at the donor-host interface. Thus, the donor tissue was well-integrated with that of the host brain.     

介入治疗移植肾动脉狭窄的疗效观察

目的　评价介入治疗移植肾动脉狭窄 (TRAS)的疗效。资料与方法　 2 0 0 0年 1月～ 2 0 0 2年 11月 ,采用经皮血管内成形术 (PTA)和 /或内支架治疗 2 0例TRAS患者 ,其中PTA治疗 14例次 ,内支架治疗 9例次。对治疗前后的血压、降压药物和血肌酐进行随访。结果　采用PTA治疗者 ,收缩压、舒张压、降压药物和血肌酐由术前的(15 7± 17)mmHg、(97± 7)mmHg、(1.5± 1.0 )种、(5 12± 2 96 ) μmol/L ,术后 1周降为 (137± 11)mmHg(P <0 .0 5 )、(86± 7)mmHg(P <0 .0 1)、(0 .9± 1.0 )种 (P >0 .0 5 )、(2 76± 2 2 6 ) μmol/L(P <0 .0 5 ) ,术后 6个月降为 (12 8±10 )mmHg(P <0 .0 1)、(83± 7)mmHg(P <0 .0 1)、(0 .8± 0 .9)种 (P >0 .0 5 )、(14 5± 5 5 ) μmol/L(P <0 .0 1)。采用内支架治疗者 ,收缩压、舒张压、降压药物和血肌酐由术前的 (15 4± 31)mmHg、(93± 12 )mmHg、(1.6± 1.0 )种、(338±14 2 ) μmol/L ,术后 1周降为 (134± 17)mmHg(P >0 .0 5 )、(82± 7)mmHg(P <0 .0 5 )、(0 .8± 1.0 )种 (P >0 .0 5 )、(197±76 ) μmol/L(P <0 .0 5 ) ,术后 6个月为 (132± 9)mmHg(P >0 .0 5 )、(83± 4 )mmHg(P <0 .0 5 )、(0 .5± 0 .8)种 (P >0 .0 5 )、(2 0 4± 16 9) μmol/L(P <0 .0 5 )。总     

Transplant aspirative cytology: Analysis of morphological and immunocytochemical parameters in renal allograft dysfunction

We have analyzed 245 transplant aspirative cytologies (TACs) from 96 renal allograft patients. TACs were divided in two chronological groups: Early (TACs performed during the first 3-mo post-transplantation) and late (TACs performed after the third month post-transplantation), in order to assess the effect of allograft tolerance on TAC features. Both morphological and immunocytochemical aspects were evaluated, including CD4, CD8, IL2-R, and HLA-DR immunolabeling. A final diagnosis for each case of allograft dysfunction was achieved by other independent diagnostic means. Four diagnostic groups were considered in the present study: acute rejection (AR), chronic rejection (CR), acute tubular necrosis (ATN), and Cyclosporin A toxicity (CsA-T). In addition, a control group (C) was established from patients with stable allograft function. We found that immunocytochemical analysis of TACs is particularly helpful in the diagnosis of late allograft dysfunction, a time period when the simple cytological study of renal infiltrate is not informative enough to help take therapeutic decisions.     

Chemokines and soluble adhesion molecules in renal transplant recipients with cytomegalovirus infection

Cytomegalovirus (CMV) infection is associated with leucocyte infiltration in various organs, which supports a role for chemokines and adhesion molecules in the pathogenesis of CMV infection. In a prospectively conducted study of renal transplant recipients, 10 patients with CMV disease, five patients with asymptomatic CMV infection and 10 patients who did not have any CMV infection were included. During CMV infection, and in particular during CMV disease, plasma levels of the chemokines IL-8, macrophage inflammatory protein-1alpha (MIP-1alpha) and monocyte chemotactic protein-1 (MCP-1) and the soluble adhesion molecules vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and L-selectin increased and were positively correlated with the degree of CMV pp65 antigenaemia. Furthermore, a decrease in plasma levels of these chemokines and adhesion molecules was observed following ganciclovir therapy in the patients with CMV disease. This could suggest a role for these molecules in the pathogenesis of CMV infection.     

Hepatocyte localization of hepatitis B core and surface antigens in renal transplant recipients

Summary A prospective series of 45 liver biopsies taken from 22 renal transplant patients was investigated for the presence of hepatitis B antigen core (HBc) and surface (HBs) components by electron microscopy. At the time of each biopsy serum HBs Ag was sought by radioimmunoassay. Sections were taken for the detection of HBs Ag by immunofluorescence.In seropositive patients, intravesicular tubular structures resembling HBs Ag were found in 61% of biopsies while the intranuclear core HBc was present in 69%. No correlation could be made between the ultrastructural pattern of the viral components and the intensity of the histological liver damage. During the follow up, there was an accumulation of both HBs and HBc Ag even in a period as short as 1 year. The 9 liver specimens examined after three years of transplantation showed a marked accumulation of both antigens. Thus the expression of HB Ag at the hepatocellular level seems to correlate better with the duration of antigenaemia than with the histological pattern.Lastly, on matched semithin and ultrathin sections, the ground glass appearance of cytoplasm appeared to correlate with smooth endoplasmic reticulum distorsion, irrespective of the simultaneous presence or absence of intravesicular tubular structures. The sanded nuclei expressed a rare massive accumulation of core antigen.