黄色肉芽肿性胆囊炎的CT诊断(附5例报告)

目的 探讨黄色肉芽肿性胆囊炎的CT表现及其发病机理,提高XGC诊断水平。方法 回顾性分析经手术病理证实5例黄色肉芽肿性胆囊炎的CT表现及手术病理资料。结果 5例均可见不同程度胆囊壁增厚,2例见壁内低密度结节．2例显示黏膜线;5例均伴有胆囊结石,2例肝脏局限性受侵。结论 黄色肉芽肿性胆囊炎是特殊类型的胆囊炎性疾病,脾囊壁增厚及壁内低密度结节是诊断黄色肉芽肿性胆囊炎的特征性CT表现。     

黄色肉芽肿性胆囊炎的临床诊断及治疗

目的：对黄色肉芽肿性胆囊炎的临床诊断以及治疗进行探讨分析。方法：回顾分析我院近期收治的26例黄色肉芽肿性胆囊炎患者临床资料。结果：手术前诊断为胆囊息肉并发胆囊炎6例，胆囊肿瘤8例，手术中快速进行病理诊断26例为黄色肉芽肿性胆囊炎，其中并发胆囊肿瘤2例，手术后常规病理检查均验证为黄色肉芽肿性胆囊炎，其中合并胆囊胰癌2例。结论：了解黄色肉芽肿性胆囊炎的发病机制，采集完整的手术前病史，快速检查病理，细微分析手术前辅助检查以及对手术中标本准确标记都可以提高胆囊肿瘤与黄色肉芽肿性胆囊炎的鉴别率，避免不必要的扩大切除。     

黄色肉芽肿性胆囊炎31例临床病理分析

目的探讨黄色肉芽肿性胆囊炎(XGC)的临床病理特点及发病机制,以提高对本病的认识。方法对31例经病理确诊的XGC进行回顾性分析,常规苏木素-伊红(HE)染色,部分病例作免疫组织化学染色。结果31例XGC临床表现与一般的慢性胆囊炎类似。CT显示胆囊壁增厚与壁内低密度结节。术中可因胆囊壁增厚或结节/肿块及与周围器官粘连或内瘘形成,而误诊为癌。病理大体见胆囊壁黄色结节或肿块,镜下见急慢性炎症背景上有特征性泡沫细胞肉芽肿形态。结论XGC可能是由胆囊炎症、结石嵌顿和胆汁淤积所诱导的,与免疫反应有关的迟发性肉芽肿性病变。     

黄色肉芽肿性胆囊炎临床病理分析

目的 探讨黄色肉芽肿性胆囊炎临床病理特征以及诊断、鉴别诊断、生物学行为和治疗原则。方法 报道9例黄色肉芽肿性胆囊炎,并进行临床表现、组织形态学和免疫组织化学的观察研究,结合文献对其诊断、鉴别诊断和发病机理进行探讨。 结果 黄色肉芽肿性胆囊炎好发于中老年女性,临床表现与一般慢性胆囊炎相似,少数病例类似于胆囊肿瘤的表现,病理学上有独特的以含有中性脂肪和脂褐素的巨噬细胞和泡沫细胞为主的肉芽肿性炎症结构,免疫组化染色肉芽肿内组织细胞和泡沫细胞溶菌酶均为阳性。结论 本病属于良性肿瘤样炎症性病变,在临床和病理上要与胆囊恶性肿瘤及胆固醇沉着症鉴别,最后确诊须靠病理学检查。治疗宜行胆囊切除术,预后良好     

黄色肉芽肿性胆囊炎42例临床病理分析

XCG是一种在炎性胆囊内可以形成瘤样肿块的疾病,在临床上易与癌瘤相混淆,在病理检查上易被忽视.国外Christensen和Ishak1970年首次描述胆囊纤维黄色肉芽肿[1].1983年国内黄应堂等作了第一次报道[1],以后逐渐增多.现收集我院从1990年1月～2005年1月术后病理诊断42例,结合临床及病理资料作一简要讨论.     

黄色肉芽肿性胆囊炎超声声像图回顾性分析

目的评价超声对黄色肉芽肿性胆囊炎的诊断价值。方法回顾性分析经手术和病理证实的33例黄色肉芽肿性胆囊炎超声特征。结果超声能清楚显示病变部位、数目、大小、边界以及局部胆囊壁的情况,并可观察病变内部血流情况。结论超声对胆囊隆起性病变有较好的显示率,对判断病变的性质有较高的诊断价值。     

黄色肉芽肿性胆囊炎的诊治(附24例分析)

目的探讨黄色肉芽肿性胆囊炎(Xanthogranulomatouscholecystitis,XGC)的诊断与治疗。方法对经病理诊断的24例临床资料进行总结分析。结果占同期850例胆囊切除术的2.5%。全部病例均行B超及CT检查。术前拟诊7例,诊断为胆囊癌8例。术中均见胆囊与周围组织不同程度浸润粘连。20例经术中冰冻切片病理检查确诊,4例未确诊。手术方式:单纯胆囊切除12例,附加胆总管探查、T管引流5例及胃大部切除2例,4例行肝楔性切除+肝十二指肠韧带骨骼化清扫,1例行胆囊大部切除+肝段切除。结论XGC是一种特殊类型的胆囊炎,术前难以明确诊断。影像学检查易与胆囊癌混淆。确诊依赖病理检查,胆囊切除是基本的手术方式,预后良好。     

黄色肉芽肿性胆囊炎21例超声误诊原因分析

目的探讨超声诊断黄色肉芽肿性胆囊炎（XGC）的价值。方法回顾性分析21例经手术、病理证实的XGC,使用美国Acusonl28xp及飞利浦HDI 5000彩色多普勒血流显像仪,探测胆囊大小、胆囊壁回声改变及胆囊壁上异常团块内的血流信号及其频谱。结果提示慢性胆囊炎伴结石13例,胆囊癌7例,胆囊腺肌症1例。术后病理回顾性分析均为XGC。结论当超声提示慢性胆囊炎反复发作;胆囊结石：胆囊壁明显增厚;胆囊壁上团块频谱呈低速低阻时,应高度考虑XGC可能。     

黄色肉芽肿性胆囊炎的CT表现（附5例分析）

目的探讨CT对黄色肉芽肿性胆囊炎（XGC）的诊断价值。方法回顾性分析5例经手术病理证实的黄色肉芽肿性胆囊炎的CT表现,分析其影像学特点。结果4例胆囊有不同程度的增大,5例胆囊壁均有增厚,内均可见形态不规则的低密度灶,4例黏膜线完整,胆囊结石4例,肝脏局部性受侵3例,增强后动脉期的出现“夹心饼干征”3例,环形强化3例。结论增强后动脉期的“夹心饼干征”和环形强化,对黄色肉芽肿性胆囊炎的诊断有重要价值。     

黄色肉芽肿性胆囊炎误诊为胆囊癌五例分析

黄色肉芽肿性胆囊炎（xanthogranulomatous cholecystitis，XGC）是一种以胆囊慢性炎症为基础，伴有黄色肉芽肿形成，重度增生性纤维化及泡沫状组织细胞为特征的炎性病变，临床上非常少见。由于XGC的胆囊壁不断增厚，并与周围器官或组织发生粘连而形成肿块，临床和影像学表现易与胆囊癌混淆，术中探查所见也极似胆囊癌，因而易被误诊为胆囊癌进行治疗。现将本院2000年～2005年收治的5例总结如下。     

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.     

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.     

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.