B超诊断右眼视网膜下囊虫病1例

患者女,41岁,右眼视力下降3个月,曾在一年前因舌体多发小结节行手术活检,病理诊断为猪囊虫病。1995年12月20日右眼超声检查:采用日本 ALOKA SSD—650型超声实时显像仪。探头频率为5.0MHz。应用直接探查法,患者取仰卧位,轻轻闭上眼睑,将耦合剂均匀涂于右眼上,然后旋转探头,行多切面,多方位扫查。寻找最佳图像,冻结,摄片,如图。超声所见:于右眼球近中央颞侧处视网膜下,可见一大小为0.5cm×0.4cm 的椭圆形的囊性肿物,向玻璃体内凸出。囊壁薄而光滑,内部呈液性回声。在囊内可见一圆形强回声光团,此为囊尾幼的关节回声。囊肿不随眼球运动而活动。囊内可见囊虫虫体强回声反射,且有活动。超声诊断:右眼视网膜下囊虫病。视网膜隆起性脱离。讨论眼囊虫病可发生于眼的任何部位,如玻璃体内,视网膜下,眼球肌肉内及结膜下等。发生在网膜下较少见。眼囊虫病可引起许多严重的并发症;视网膜脱离、白内障、青光眼、玻璃体机化、眼球萎缩等。早期,准确的诊断,及时治疗可避免以及减少并发症。当今应用 B 超显象实时扫描,可准确判断囊虫的位置、形态、大小及囊虫引起的合并症。为临床诊断及治疗提供可靠的依据。(1996—05—16收稿)     

超声在胭窝囊肿诊断中的意义

目的探讨超声对胭窝囊肿的诊断价值。方法回顾性分析50例胭窝囊肿的声像图并与手术结果对照分析。结果胭窝囊肿声像图表现可以分为2型3个亚型：1型：单纯囊肿型,独立存在于胭窝软组织间,与关节腔不相通;①囊液清澈型：2l例,囊壁薄、光滑,囊内为无回声,透声好。②囊液混浊型11例,囊壁增厚,毛糙,内可见细小密集光点漂浮,或有分隔光带。与合并出血或感染有关。2型膝关节后疝型18例,与关节腔相通。结论超声对胭窝囊肿具有特异性诊断价值,能分型,对临床保守及手术治疗具有指导意义。     

超声诊断仪的眼科应用

本文使用汕头CTS—5型超声波诊断仪,探查眼眶肿瘤等6种眼部疾患:眶内肿瘤41例,正确诊断39例,错误诊断2例;视网膜脱离13例,异常11例;眼球内异物6例,有3例阳性;脉络膜黑色素瘤2例,有1例异常;视网膜囊虫症2例,皆阳性;玻璃状体出血及玻璃状体混浊共17例,仅2例阳性。眶内肿瘤出现两种基本波型。(1)实质性肿物回声图,图形特点:球后闻隙延长,球后反射波减少,加大增益球后反射波升高增多,血管瘤、假性肿瘤、泪腺混合瘤、癌瘤等属于此类图形;(2)囊性肿物回声图,图形特点:入、出囊肿波之间为平段,提高灵敏度也无反射波出现。认为超声检查对眶内肿瘤鉴别诊断有实用价值。     

应用高频超声探讨白内障的声像图特征

目的应用高频超声探讨白内障的声像图特征,为临床诊疗提供依据。方法高频超声探头直接扫查法,观察晶体形态及内部回声、玻璃体、球壁及球后组织情况,总结健康人40只眼和白内障128只眼晶体混浊的声像图分型及分期。结果白内障声像图特征:晶体增厚,囊膜不规则增厚,浅深层皮质均见强回声光点分布,核中心区变小,直到消失。病变早期大多数前囊中心瞳孔暗区消失,出现搭桥样连续强回声带反射。晶体混浊的声像图分5型:囊下皮质型74例(57.8%),绕核型25例(19.5%),核型11例(8.5%),完全型12例(9.4%),特殊类型6例(4.8%)。结论高频超声对白内障及并发症有明确的显像,对指导临床治疗、降低手术风险具有重要的意义,可作为诊断白内障及其合并症的常规及术前检查的一种重要手段。     

75例卵巢肿瘤蒂扭转的超声检查分析

目的探讨超声对于卵巢肿瘤蒂扭转的诊断价值。方法采用腹部探头和阴道探头同时对75例卵巢肿瘤蒂扭转患者进行了检查,并与手术和病理结果进行比较分析。结果超声诊断正确65例,正确率86.7%。有10例漏诊或误诊,其中5例仅诊断为卵巢肿瘤,未诊断出合并蒂扭转;2例误诊为黄体破裂,2例误诊为盆腔脓肿,1例误诊为阑尾脓肿。超声声像显示肿块多呈类圆形,多数边界不清,囊性者囊壁增厚水肿,内透声欠佳。内部回声除依据各自病理类型不同而有相应超声声像改变外,内部回声不均匀,可见点状弱回声。部分肿块与子宫间可见瘤蒂扭转呈局部低回声团块或麻花状改变,局部探头加压时压痛明显。结论超声检查无创、操作简便、准确性高,对于卵巢肿瘤蒂扭转具有较高诊断价值。为了减少误诊,检查时应注意与其他急腹症相鉴别。     

186例脑囊虫病的临床与CT诊断价值分析

目的：探讨脑囊虫病临床与CT诊断价值。方法：对186例病例进行分析。CT为日本东芝TCT—300EZ，扫描厚／距5～10mm，大部分病例平扫后行增强扫描。结果：根据CT分型，检查结果为脑实质型186例。其中急性脑炎型8例，多发或单发囊型(囊泡型)35例，单发结节型及环状强化型88例，慢性钙化型20例，混合型35例；脑实质合并脑膜型3例；脑实质型合并脑室型1例。结论：典型的临床症状，CT扫描出现不规则低密度水肿影或囊泡加头节，增强扫描出现点状、结节状、环状及壁结节是诊断脑囊虫病的重要依据，CT检查对脑囊虫病的诊断具有重要的价值。     

彩色多普勒超声诊断胰腺假性囊肿25例分析

目的 探讨彩色多普勒超声在胰腺假性囊肿诊断中的应用.方法 回顾性分析25例胰腺假性囊肿患者的超声影像学特点.结果 彩色多普勒超声监测显示胰腺假性囊肿边界多光滑、整齐、囊壁较厚,常呈椭圆形或者是类圆形;囊腔的后壁回声增强,其侧方常可见回声.囊腔内部为无回声区,内可见条状分割,部分患者囊腔内可见细小的光点或絮状小团块.彩色多普勒血流显像提示囊壁上有点状血流信号.结论 彩色多普勒超声诊断胰腺假性囊肿具有准确性高、无创伤等优点,并可与真性囊肿、周围器官囊肿以及肿瘤相鉴别.     

腺性膀胱炎的超声表现及其分型探讨

目的探讨腺性膀胱炎的超声表现及其分型。方法研究对象为腺性膀胱炎患者,例数100例,患者收取时间在2015年2月1日至2018年2月10日,对患者进行超声诊断,并进行超声分型,探讨其的诊断效果。结果 100例患者经过超声检查后,将病理检查作为对照,腺性膀胱炎患者超声的检出率98.00%和病理检出率无显著差异(P> 0.05);100例腺性膀胱炎患者主要类型为:①乳头型、人体膀胱壁局部呈现息肉样改变或者乳头状,突入人体膀胱腔内,病变回声强;②弥漫增厚型、膀胱壁呈现不同程度的增厚情况,病变较轻患者仅仅只是累及人体膀胱三角区附近,增厚膀胱壁不光滑,其回声强弱不均;③结节型、膀胱壁呈现局限性结节状隆起,向膀胱内进行生长,其病变表面十分光滑,内部呈现中等回声。结论超声能作为腺性膀胱炎首选诊断方式,具有较高的检出率,其分型主要包括乳头型、弥漫增厚型以及结节型等。     

肾脾包虫囊肿的影像学诊断

目的提高对脾肾包虫囊肿及其破裂感染影像学表现的认识。方法报告6例经手术病理证实的肾脾包虫囊肿的超声与CT所见,并分析本病的破裂感染及鉴别诊断。结果单纯型包虫囊肿2例,超声显示为边缘清晰的囊性无回声区。CT呈水样均匀低密度囊性肿物,边缘光整。多子囊型4例,声像图母囊内见子囊形成的小无回声区,呈“囊中囊”征象。CT显示为母囊内多个更低密度的子囊。多子囊型中破裂感染1例,其内外囊分离,内囊膜塌陷,伴内外囊壁不规则钙化。结论B超与CT对肾脾包虫囊肿的诊断、分型及有无破裂感染的诊断颇为准确。     

42只白内障晶状体病变的声像图诊断分析

目的 分析白内障晶状体病变超声图像表现,以提高该病超声诊断准确率.方法 采用直接眼睑检查法,对30只正常人眼和42只白内障眼晶状体进行观察.结果 超声图像分四型:①囊膜型:晶状体的前囊膜形成完整的梭形结构;②皮质型:晶状体的皮质区域回声增强;③核型:晶状体的核心区域回声增强;④完全型:整个晶状体显示弥漫性强回声.结论 晶状体前后囊膜形成完整的梭形结构,早期白内障的诊断即可成立.高频探头诊断白内障具有较高的临床实用价值,应作为白内障的一项常规检查.     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.