氟化物对成纤维细胞和成骨细胞骨形态发生蛋白-2表达的影响

目的观察氟化物对成纤维细胞和成骨细胞骨形态发生蛋白-2（BMP-2）表达的影响。方法采用体外细胞培养的方法，将细胞分为对照组和6个染氟（F^-，0．1、1．0、100．0、1000．0、10000．0、20000．0μg／L）组，分别在5个染氟时间段（2、4、24、48、72h）收集培养上清液和细胞，应用酶联免疫吸附法（ELISA）和免疫组化方法检测BMP-2蛋白，RT-PCR方法检测染氟48hBMP-2mRNA的表达。结果与对照组比较．成纤维细胞染氟48hBMP-2mRNA表达呈普遍增强趋势，但差异无统计学意义（P〉0．05）；免疫组化检查，可见染氟0．1、1．0、1000．0μg／L组成纤维细胞BMP-2阳性着色较对照组增强；染氟72h，培养上清中BMP-2蛋白在1．0、100．0、20000．0μg／L组分别为（0．11±0．01）、（0．11±0．01）、（0．11±0．01），与对照组（0．07±0．01）比较有明显增高（P〈0．05）。与染氟成纤维细胞比较，染氟成骨细胞BMP-2mRNA和蛋白表达升高出现早．持续时间较长．增强程度更为明显。结论成纤维细胞和成骨细胞在氟化物的刺激下，BMP-2mRNA和蛋白表达有所升高，推测BMP-2可能是氟化物诱导成纤维细胞中成骨细胞核心结合因子α1（cbfa1）和骨钙素（OCN）表达的重要中介环节。     

氟对小鼠成骨细胞增殖的影响

目的 观察氟对体外培养小鼠成骨细胞增殖的影响。方法 原代培养小鼠成骨细胞，以0（对照组）、5、10、20、40mg／L剂量染氟，光、电镜观察成骨细胞的形态学变化；采用生长曲线、噻唑蓝（MTT）法及流式细胞仪检测细胞周期，观察细胞数量变化和细胞周期时相分布。结果 第10天时，5、10、20mg／L染氟组从形态学上表现出细胞增殖。而40mg／L组中出现细胞凋亡。染氟24h时，20mg／L组与对照组相比细胞增殖明显，差异具有统计学意义（P〈0．05），随着时间延长，染氟组表现出更强的增殖活性，至72h时，各染氟组成骨细胞增殖均高于对照组（P〈0．05）。24h时各染氟组间细胞增殖水平未见明显差异（P〉0．05），48h以后40mg／L组明显低于其他各染氟组（P〈0．05）。而染氟72h时5mg／L组增殖强度也低于10、20mg／L组（P〈0．05）。与对照组相比，10、20mg／L组处于G0／G1期的细胞数减少，而S期细胞数增加（P〈0．05），同时两组的细胞增殖指数也高于对照组（P〈0．05），生长表现出增殖状态；其中10mg／L组与其他染氟组之间，差异有统计学意义（P〈0．05），表现为细胞增殖能力增强。结论 低剂量的氟在较短作用时间内可以促进体外培养小鼠成骨细胞增殖，随剂量增加和暴露时间延长其促进作用减弱。     

氟对成骨细胞中微小染色体维系蛋白3表达的影响

目的探讨氟对体外培养成骨细胞中微小染色体维系蛋白3（minichromosome maintenance deficient3，MCM3）表达的影响。方法采用免疫组织化学技术、原位杂交技术以及SYBR GreenI嵌合荧光实时定量PCR（realtime RT-PCR）方法，检测不同剂量氟（0、5、10、20、40mg／L，处理10d）对体外培养成骨细胞中MCM3表达的影响。结果0、5、10、20、40mg／L各组细胞中均有MCM3蛋白及其mRNA表达，主要在细胞核中表达，与对照组比较，染氟实验组阳性表达强度高于对照组，阳性细胞数多于对照组，差异有统计学意义（P〈0．05），其中10mg／L组阳性表达高于其他实验组（P〈0．05），呈现双向作用。real time RT-PCR检测显示，各组均可检测到MCM3mRNA．相对定量比由对照组到高剂量组约为102：259：145：135：100：染氟实验组中5、10、20mg／L组表达量高于对照组和40mg／L组，以5mg／L组表达量最高，随着染氟剂量增加，基因表达量降低。结论不同剂量氟对成骨细胞中MCM3表达的影响不同，低剂量氟可以促进MCM3的表达，随剂量增加氟的促进作用减弱。     

氟对骨髓基质细胞增殖和成骨能力的影响

目的探讨氟对体外培养的大鼠骨髓基质细胞（MSCs）增殖能力与成骨能力的影响。方法体外培养大鼠MSCs。噻唑蓝（MTT）比色法分析不同染氟水平下MSCs的增殖能力；光、电镜下观察不同染氟水平下MSCs成骨转化能力和相应超微结构变化。结果与对照组比较，低水平染氟（0．02mg／L）96h后促进MSCs增殖（P〈0．05）；较高水平染氟（0．05～1．00mg／L）72h即可促进MSCs增殖（P〈0．05或〈0．01）；高水平染氟（10．00、20．00mg／L）对MSCs具有抑制增殖和促细胞凋亡作用（P〈0．01）。较高水平染氟（2．00～20．00mg／L）时MSCs成骨转化受抑（P〈0．01），较低水平染氟（0．01～1．00mg／L）时MSCs成骨转化增强（P〈0．01）。结论低水平染氟促进MSCs增殖。成骨转化能力增强；高水平染氟抑制MSCs增殖，促进细胞凋亡，抑制MSCs成骨转化能力。     

氟对成纤维细胞和成骨细胞核心结合因子α1表达的影响

目的观察不同剂量氟化物在不同时间段对成纤维细胞和成骨细胞核心结合因子α1(cbfa1)表达的影响。方法采用细胞培养的方法,将细胞分为对照组和6个染氟组(0．1、1．0、100．0、1000．0、10 000．0、20 000．0μg／L),分别在5个染氟时间段(2、4、24、48、72 h)收集培养细胞培养上清液和细胞,应用酶联免疫吸附(ELISA)法和免疫组化方法检测cbfa1蛋白含量和表达,应用RT-PCR方法检测染氟48 h cbfa1 mRNA的表达。结果①与对照组比较(2．13±0．07),成纤维细胞染氟48 h时,cbfa1蛋白含量在0．1、1．0、100．0、1 000．0、20 000．0μg／L组[(2.35±0．08)、(2．28±0．09)、(2．32±0．09)、(2．25±0．08)、(2．28±0．09)]及染氟72 h的10 000．0μg／L组(2．48±0．22)明显升高;染氟48 h,cbfa1 mRNA表达呈升高趋势,其中10 000．0μg／L组(1．29±0．30)与对照组(1．02±0．12)比较,明显增强;免疫组化结果显示,染氟48 h的0．1μg／L组成纤维细胞内可见明显cbfa1阳性表达。②在成骨细胞,染氟组cbfa1蛋白含量较对照组有不同程度增加;染氟48 h时,0．1、1．0、100．0、1 000．0μg／L组cbfa1 mRNA表达较对照组(1．27±0．20)升高,其中0．1μgL组(1．34±0．19)明显升高。结论氟能提高成纤维细胞和成骨细胞cbfa1蛋白含量,促进cbfa1和cbfa1 mRNA表达,成纤维细胞可能在氟骨症骨周化骨的发生中起重要作用。     

大蒜素逆转内毒素致内皮细胞损伤的实验研究

目的观察大蒜素能否体外逆转做善内毒素致内皮细胞损伤并探讨其可能机制。方法将人脐静脉内皮细胞系ECV304与浓度为100μg／ml的内毒素共同孵育，并用不同浓度的大蒜素加以处理，实验共分三组：（1）空白对照组（加用无血清培养基，n=6）；（2）内毒素对照组（加含内毒素的无血清培养基，c=100μg／ml，n=6）；（3）大蒜素十内毒素组（加含内毒素为100μg／ml的无血清培养基，大蒜素浓度分别为10、20、50μg／ml，n=6）。选用氧化抗氧化，内皮舒张功能及增殖方面的指标研究不同处理因素对内皮细胞的功能影响。结果1．大蒜素十内毒素组培养基中NO2^-、NO3^-含量较内毒素对照组显著降低（P〈0．01），较空白对照组显著增高（P〈0．01或0．05），且效应呈大蒜素剂量依赖性递减，时间依赖性递增。2．大蒜素十内毒素组内皮细胞的T-SOD活力较内毒素对照组显著增高（P〈0．01），并呈时间剂量依赖性，大蒜素50μg／ml组较空白对照组显著升高（P〈0．01）。3．大蒜素十内毒素组培养基中MDA含量较内毒素对照组显著降低（P〈0．01），较空白对照组仍显著升高（P〈0．01），且效应呈大蒜素剂量依赖性。4．大蒜素＋内毒素组较内毒素对照组能促进内皮细胞增殖（P〈0．05），HSP70的表达显著增高（P〈0．01）结论大蒜素能够逆转／改善内毒素致内皮细胞损伤，对防治内毒素参与AS发病方面具有积极作用。     

不同剂量弓形虫ESA鼻内免疫小鼠诱导的粘膜及系统免疫应答

目的观察不同剂量弓形虫排泄一分泌抗原（excreted／secreted antigens，ESA）鼻内免疫小鼠诱导的粘膜及系统免疫应答，确定适宜免疫剂量。方法40只BALB／c小鼠，雌雄各半，随机分为5组，每组8只。分别用5、10、20和30μg ESA滴鼻免疫小鼠2次，间隔14d，对照组用20μl/只PBS滴鼻。于末次免疫后第14d，颈椎脱臼处死小鼠，ELISA法检测鼻咽冲洗液和小肠冲洗液sIgA、血清IgG抗体水平，分离并计数肠上皮内淋巴细胞（intest inalintraepithelial lymphocytes，iIEL）、肠系膜淋巴结淋巴细胞（mesenteric lymph node lymphocytes，MLNL）及脾淋巴细胞。结果实验期间，小鼠健康状况良好。随鼻内免疫ESA剂量的增加，特异性抗体水平不同程度的升高，MLNL、iIEL及脾淋巴细胞也显示不同程度的增生性应答。其中，30μg组小鼠血清IgG、脾淋巴细胞数量与10μg组、5μg组和PBS组比较，差异有统计学意义（P〈0．05或P〈0．01）；30μg组小肠冲洗液sIgA、鼻咽冲洗液sIgA、iIEL和MLNL数量，20μg组小肠冲洗液sIgA和MLNL数量与5／2g组及PBS组比较，差异有统计学意义（P〈0．05或P〈0．01）；20μg组血清IgG与PBS组比较差异有统计学意义（P〈0．05）。结论20μg和30μg ESA鼻内免疫能有效诱导粘膜及系统免疫应答。     

氟斑牙发生与氧化应激的研究

目的探讨氟斑牙发生过程中是否存在氧化应激反应。方法80只SD大鼠按雌雄各半体重均等原则随机分为4组,即饮水氟含量50．00mg／L（H）组、25．00mg／L（M）组、12．50mg／L（L）组和0．08mg／L（C）组。饲养16周后处死大鼠,测血清及肝、肾组织中丙二醛（MDA）含量、超氧化物歧化酶（SOD）、过氧化氢酶（CAT）和谷胱甘肽过氧化物（GSH—Px）活性。结果H、M组及部分L组大鼠下切牙釉质出现棕白相间条纹等典型氟斑牙症状。随着染氟剂量的增加,H、M、L组大鼠血清、肝MDA含量较C组有升高趋势（P〈0．01或P〈0．05）,血清及肝、肾SOD、CAT活性较C组有降低趋势（P〈0．01或P〈0．05）,GSH—Px活性变化无统计学意义（P〉0．05）。结论氟斑牙发生过程中大鼠体内可能存在氧化系统与抗氧化系统的失衡,氧化应激反应可能是氟中毒早期症状之一。     

用单细胞凝胶电泳观察氟砷单独及联合对淋巴细胞DNA损伤

目的 观察氟、砷单独及联合作用对正常人淋巴细胞DNA的损伤作用及特点。方法 采用单细胞凝胶电泳（SCGE）实验，观察不同剂量氟、砷单独及联合应用对正常人淋巴细胞DNA的损伤。结果 人淋巴细胞在浓度为0．1、0．5μmol／L的NaAsO2及浓度为10、50μmol／L的NaF染毒24h后，均引起明显的DNA泳动（彗星尾）并呈现明显的剂量-效应关系；氟砷联合作用淋巴细胞，在0．5μmol／L NaAsO2＋50μmol／L NaF的剂量下，细胞DNA的损伤呈现出协同作用（P〈0．01）。结论 NaAsO2与NaF均可引起DNA损伤；低剂量NaAsO2与NaF联合作用时，则呈现协同作用。     

肝苏颗粒对实验性黄疸大鼠肝功能的保护及其机制

目的 观察肝苏颗粒对实验性黄疸大鼠的保护作用及其机制的初步探讨。方法 采用α-萘异硫氰酸酯（ANIT）灌胃制备大鼠黄疸模型，共60只大鼠，设正常组、模型组、熊去氧胆酸（UDCA）组、肝苏颗粒小剂量组和肝苏颗粒大剂量组，检测不同组血清ALT、TBil和一氧化氮（NO）、IL-6的变化，流式细胞仪检测肝细胞凋亡，免疫组化检测肝细胞Bcl-2、Bax蛋白的表达。结果 肝苏颗粒大、小剂量治疗组和UDCA组与模型组比较，ALT及TBil降低明显，ALT分别为（547．20±79．41）U／L、（573．34±68．79）U／L、（535．60±69．39）U／L、（642．30±92．70）U／L，TBil分别为（47．10 ± 11．54）μmol／L,（50．87±13．46）μmol／L、（45．22±14．46）μmol／L.（66．19±10．67）μmol／L，差异有统计学意义（P〈0．05或P〈0．01）。肝苏颗粒治疗组和UDCA组NO、IL-6水平与模型组比较下降显著，差异有统计学意义（P〈0．01或P〈0．05）。肝苏颗粒治疗组、UDCA组与模型组比较，肝细胞凋亡率下降，差异有统计学意义（P〈0．01或P〈0．05）；肝苏颗粒大剂量治疗组、uDCA组Bcl～2和Bax阳性表达及Bax／Bcl-2相对比率明显低于模型组，差异有统计学意义（P〈0．01或P〈0．05）。结论 肝苏颗粒对实验性黄疽大鼠的肝功能具保护作用，影响血清NO、IL-6及抑制肝细胞凋亡可能是其退黄、恢复肝脏功能的作用机制之一。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.