横纹肌肉瘤中小窝蛋白-3的表达及鉴别诊断意义

目的 研究小窝蛋白-3(caveolin-3)在横纹肌肉瘤(RMS)中的表达特点与鉴别诊断价值.方法 选取20例RMS、30例其它软组织肿瘤.用免疫组化SP法及原位杂交分别检测caveolin-3的蛋白和mRNA的表达水平.用免疫组化SP法分别检测20例RMS中desmin和myoD1蛋白的表达水平.结果 SP法caveolin-3蛋白在RMS阳性表达率为80%(16/20),其它软组织肿瘤皆为阴性(0/30),两者之间的表达差异具有统计学意义(P＜0.05).原位杂交在15例RMS中有13例检测到caveolin-3 mRNA表达,阳性表达率为86.7%(13/15),在26例其它软组织肿瘤中的阳性表达率为7.7%(2/26),两者之间的表达差异亦有统计学意义(P＜0.05).SP法RMS中desmin和myoD1蛋白的阳性率分别为84.2%(16/19)、89.5%(17/19),与caveolin-3蛋白的表达差异均无统计学意义(P＞0.05).结论 caveolin-3在RMS中的表达有较高的敏感度和特异性,可作为临床鉴别诊断RMS和其它软组织肿瘤的有用的新型标记物.     

Magnetic resonance imaging of the ovarian cyst: its diagnostic value of endometrial cyst

The role of magnetic resonance imaging (MRI) in diagnosing the ovarian cyst was reviewed with emphasis on its diagnostic value of endometrial cyst. 94 cystic ovarian masses in 77 patients were evaluated using 0.15 Tesla MRI just before laparotomy at Okayama University Hospital from 1984 to 1987 and these images were followed up by histopathological data. From these obtained images, 6 parameters; that is (1) laterality and (2) delineation of the cyst, (3) presence or absence of septal image, and (4) homogeneity, (5) signal intensity and (6) T1 value of the cyst contents, were extracted and analyzed respectively. In 95.5% of endometrial cysts, homogenous internal pattern was observed in all 3 images (short spin echo (SE), inversion recovery (IR) and long SE) and its signal intensity was at the same level or higher than that of myometrium. On the other hand, in all cases of follicular cyst, para-ovarian cyst, corpus luteum cyst and in 95.0% of serous cystadenoma and in 90.9% of mucinous cystadenoma, cyst contents showed either lower signal intensity than the myometrium or similar to it in T1 contrast images (short SE and IR). 93.1% of dermoid cyst showed heterogenous signal intensity in all 3 images and their signal intensity levels were widely ranging. High signal intensity of cyst contents in all 3 images could be observed in 72.7% of endometrial cyst, 5.0% of serous cystadenoma with internal hemorrhage, 9.1% of mucinous cystadenoma with internal hemorrhage and 3.4% of dermoid cyst consisted of fatty tissue only. Endometrial cyst showed markedly shortened T1 value (209.6 +/- 102.7 ms) and the other hemorrhagic cyst showed comparatively short value (360-970 ms). On the other hand, T1 value of non hemorrhagic cyst was as high as the level of urine. All of endometrial cysts were clearly defined from the other pelvic structures. In result, endometrial cysts were found to exhibit the characteristic findings in MRI images such as homogenous high signal intensity of internal fluid and clear delineation of cyst contour. The diagnostic accuracy of MRI in endometrial cyst were considered 96.8% in our cases.     

Postmortem coronary angiography: the clinico-morphological aspects of its interpretation and the diagnostic value

Review of literature on the clinico-morphological interpretation and diagnostic value of the postmortem coronarography is presented. Characteristic of a basic coronarographic appearance of obstructive conditions in the heart coronary system, compensatory processes and decompensation of the disturbed coronary circulation is given. Diagnostic symptoms and syndromes are presented from the viewpoint of leading parameters of the coronary hemodynamics.     

Spectrophotometric assessment of pigmented skin lesions: methods and feature selection for evaluation of diagnostic performance

This study documents the optical reflectance characteristics of pigmented skin lesions and evaluates their potential for improving the differential diagnosis of malignant melanoma from benign pigmented skin lesions. Optical reflectance spectra in the wavelength range 320-1100 nm were obtained from 121 lesions already selected by expert dermatologists as suspicious of malignancy. Characteristic differences in spectra from benign and malignant lesions were studied. Feature extraction showed significant differences between lesion groups classified by histology. Seven of the most relevant features were used in the discriminant analysis of reflectance spectra from 15 melanoma and 32 compound naevi which resulted in a sensitivity of 100% and specificity of 84.4% when compared with histology. This simple objective technique appears to perform as well as the expert dermatologist and may improve the diagnostic accuracy of non-specialists such as trainees and GPs. Further prospective clinical study of reflectance spectrophotometry in a larger patient group is now required.     

The PD subscales: an empirical evaluation

Harris and Lingoes' (1955) six PD subscales were assessed empirically for their convergent validity and for their utility to discriminate amongst male offenders on the two outcome measures of successful completion of sentences at a correctional halfway house and reincarceration at a 1-year follow-up. The results provided varying degrees of convergent validity for the six constructs devised by Harris and Lingoes. In addition, four of the six subscales predicted success in the halfway house program; one of the six subscales predicted reincarceration. The results were viewed with respect to the overall validity of the PD subscales and with respect to the utility of the subscales to guide dispositions with regard to the placement of offenders into halfway houses.     

Virtual tracheo-bronchial endoscopy: educational and diagnostic value

Summary The use of Helical CT significantly improves image quality of examinations in a number of clinical settings. It is particularly suited to the study of the tracheo-bronchial tree as a result of new ways of image processing (developed by GEMS research) which can produce virtual endoscopic images without the use of an endoscope. We present our initial anatamo-radiological findings and their educational value as well as our thoughts on potential future clinical applications.

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L'endoscopie trachéo-bronchique virtuelle : intérêt pédagogique et diagnostique

Résumé L'acquisition hélicoïdale en scanner apporte une amélioration significative de la qualité des examens dans de nombreuses indications. Elle est particulièrement adaptée, grâce à des modes nouveaux de traitement d'image (protocole de Recherche GEMS), à l'étude de l'arbre respiratoire, par l'obtention d'images endoscopiques virtuelles, ne nécessitant aucune sonde endoscopique. Nous en présentons les premières confrontations anatomo-radiologiques et leur intérêt pédagogique ainsi qu'une réflexion sur les éventuelles perspectives d'applications cliniques.

     

隆突性皮肤纤维肉瘤中载脂蛋白D的表达及意义

目的研究载脂蛋白D在隆突性皮肤纤维肉瘤中的表达特点及诊断价值,并探讨组织芯片技术的可行性。方法制备包括25例隆突性皮肤纤维肉瘤、30例皮肤纤维组织细胞瘤、10例恶性纤维组织细胞瘤、4例纤维肉瘤、10例神经纤维瘤、5例结节性筋膜炎在内的组织芯片,用免疫组化SP法及原位杂交分别检测载脂蛋白D的蛋白及 mRNA表达水平。结果免疫组化载脂蛋白D在隆突性皮肤纤维肉瘤中阳性表达率为92.0%（23/25）,在皮肤纤维组织细胞瘤中的阳性表达率为6.7%（2/30）,二者之间的表达差异有统计学意义（χ2=36.79,P〈0.05）。原位杂交在22例隆突性皮肤纤维肉瘤有20例检测到载脂蛋白D mRNA表达,阳性表达率为90.9%,在皮肤纤维组织细胞瘤中这阳性表达率则为7.7%（2/26）,二者之间表达差异亦有统计学意义（χ2=33.24,P〈0.05）。结论载脂蛋白D可作为临床鉴别诊断隆突性皮肤纤维肉瘤与皮肤纤维组织细胞瘤的新型标记物;应用组织芯片技术可对组织样本进行高通量的有效检测。     

Histological evaluation of the human testis--approaches to optimizing the clinical value of the assessment: mini review

Testicular biopsy is a crucial assessment in reproductive practice with diagnostic and prognostic importance for assisted reproductive technologies (ARTs) and risk of testicular neoplasia. Endocrine and genetic tests cannot reliably distinguish obstructive azoospermia (OA) from non-obstructive azoospermia (NOA) or predict recovery of mature spermatids by testicular sperm extraction (TESE). Currently, divergent histological reporting systems and the use of imprecise terminology seriously degrade the value of the literature on TESE recovery rates and hamper evaluation of treatments and research on genotype-phenotype relationships. The rising incidence of testis cancer and carcinoma in situ (CIS), especially in infertile populations, requires that every effort be made for its early detection. We provide a systematic approach to the histological classification of spermatogenic disorders and detection of CIS in adult patients. We evaluate a large consecutive series of bilateral biopsies from infertile men and report (i) the frequency of bilateral or discordant patterns that supports the use of bilateral biopsy for comprehensive evaluation and (ii) a high prevalence of mixed patterns, particularly within the hypospermatogenesis classification, that helps account for reported success of TESE. We propose a new diagnosis code for testicular biopsies that addresses the needs of ART clinicians and allows data storage and retrieval of value in clinical practice and research.     

Posttraumatic stress disorder: an empirical evaluation of core assumptions

The diagnosis of posttraumatic stress disorder (PTSD) rests on several core assumptions, particularly the premise that a distinct class of traumatic events is linked to a distinct clinical syndrome. This core assumption of specific etiology ostensibly distinguishes the PTSD diagnosis from virtually all other psychiatric disorders. Additional attempts to distinguish PTSD from extant conditions have included searches for distinctive markers (e.g., biological and laboratory findings) and hypothesized underlying mechanisms (e.g., fragmentation of traumatic memory). We review the literature on PTSD's core assumptions and various attempts to validate the construct within a nomological network of distinctive correlates. We find that virtually all core assumptions and hypothesized mechanisms lack compelling or consistent empirical support. We consider the implications of these findings for conceptualizing PTSD in the forthcoming edition of the American Psychiatric Association's diagnostic manual.     

The diagnostic value of beta-catenin immunohistochemistry

beta-catenin is a 92-kDa protein that binds to the cytoplasmic tail of E-cadherin. It acts in the nucleus to stimulate cell proliferation and is degraded by complexing with the adenomatous polyposis coli gene. When it is mutated, it is ineffectively degraded and results in unchecked proliferative activity that plays a role in a subset of neoplasms. When there are alterations in beta-catenin degradation, it accumulates to a sufficient extent to be detected in the nuclei of tumor cells immunohistochemically, a feature that can be exploited in the differential diagnosis of selected neoplasms. Immunohistochemistry for beta-catenin may be useful in the differential diagnosis of selected tumors of soft tissue, the gastrointestinal tract, including the pancreas, lung, and female genital tract.