肺栓塞1例

[背景 ]对肺栓塞的认识普遍较低 ,容易漏诊、误诊 .[病例报告 ]患者年龄为 5 7岁 ,女性 ,以原因不明的呼吸困难为主要症状 ,超声心动图检查示右心房右心室扩大及肺动脉高压 .进一步做CT肺血管造影检查确诊为肺栓塞 .[讨论 ]可根据临床表现及非特异性检查 (胸部X线片、超声波及心电图等检查 )确诊肺栓塞 ,当疑似为肺栓塞时可做有确诊意义的CT肺血管造影检查 .     

丝裂霉素C在复发性青光眼中的应用

目的 :观察丝裂霉素C(MMC)在抗青光眼手术中应用的近期及远期效果。方法 :4 2只复发性青光眼在二次手术中一次性应用MMC术后观察及随访。结果 :术前眼压 34.0 5± 4 .0 5mmHg ,明显高于随访半年期 13.13± 3.30mmHg以及随访 2年期 14 .33± 3.30mmHg ,差异有显著性 (P <0 .0 1)。术后近期眼压 6 .75± 1.4 3mmHg ,明显低于随访半年期 (P <0 .0 1)。功能性滤过泡所占比率为 95 .2 %。结论 :术中一次性应用MMC ,远期观察其降压效果明显 ,且无严重并发症发生     

Immunophenotypic analysis of human spleen compartments.

Microanatomical compartments of the human spleen are yet under evaluation as most of the present information comes from experiments on animals with different anatomical structures. Immune staining of stromal and blood-born cells by cell surface antigens facilitates the differentiation of functional microanatomical compartmentalization of immune organs, including the spleen. Twenty-two specimens from healthy adult subjects with the average age of 35.6 +/- 13.8 (Range 17 to 58) years were included in this study. Monoclonal antibodies used in this study were supplied from the 5th, 6th and 7th International Workshops and Conferences on Human Leukocyte Differentiation Antigens. Tetraspan antigens presented a rather unique staining pattern in the human spleen, suggesting special roles for each (CD9, CD53, CD63, CD151 and CD231) in certain locations. Sinus lining cells presented a distinctive antigenic profile, sharing both endothelial cell (CD31, CD36, CD54, CD62P, CD102, CD105, CD106 and CD146) and macrophage lineage characteristics. The sheathed capillaries were not restricted to the perifollicular zone alone. Extracellular matrix receptors (CD49 a, CD49 b, CD49 c, CD49 e, CD49f, CD29 and CD44) stained the penicillary arterioles and vascular smooth muscle. These molecules were also found on the vascular endothelium. Leukocyte antigens (CD11a, CD11b, CD22, CD43, CD45, CD45RB, CD45RO and CD50) were mainly expressed in the white and red pulp of the spleen at different intensities, excluding the penicillary arterioles. Activation antigens (CD26, CD71 and CD98) presented a diffuse and broad staining pattern. In conclusion, microanatomical compartmentalization, microcirculation and function of the human spleen were evaluated using a wide panel of monoclonal antibodies.     

Central nervous system site of action for the hypotensive effect of clonidine in the cat

The purpose of our study was to determine whether clonidine exerts its centrally mediated hypotensive action at three sites that influence arterial pressure located in the medulla, specifically associated with the intermediate area of the ventrolateral medulla. The "intermediate area" lies approximately 1.5 mm caudal to the border of the trapezoid body (caudal border) and 4 mm lateral to the midline. One of the sites that influence arterial pressure lies in the nucleus reticularis rostroventrolateralis. The second site lies in close proximity to the rostral part of the nucleus reticularis lateralis (rLRN) and also near the A1 area. The third site lies in the most rostral area and medial to the nucleus reticularis rostroventrolateralis, that is in the nucleus paragigantocellularis lateralis. Unilateral microinjections of 0.22 and 0.43 nmol of clonidine into the rLRN produced dose-dependent decreases in arterial pressure. The 0.43 nmol dose of clonidine had no effect when unilaterally or bilaterally microinjected into either the nucleus reticularis rostroventrolateralis or into the nucleus paragigantocellularis lateralis. Microinjection of the alpha-2 adrenoceptor antagonist, idazoxan (16.6 nmol), unilaterally into rLRN had no effect per se, but prevented the hypotensive effect of a subsequent microinjection of clonidine. Similarly, bilateral microinjection of idazoxan into rLRN counteracted the hypotensive effect of i.v. administered clonidine. These data indicate that clonidine acts at alpha-2 adrenoceptors in the rLRN to produce hypotension.     

Hepatosplenic schistosomiasis. Pathophysiology and treatment.

HSS represents a special model of intrahepatic portal hypertension characterized by a presinusoidal portal block and a well-preserved liver parenchyma. Symmers' fibrosis appears in a small but significant proportion of patients with a high worm load. Its pathogenesis is not well established, although experimental and clinical studies point to egg granulomata as the main pathogenetic factor. The eggs carried continuously through the portal circulation produce inflammation and gross amputation of the intrahepatic veins, portal and periportal granulomas, and, eventually, a coarse perilobular fibrosis ("pipe-stem"). Portal hypertension, esophageal varices, and hepatosplenomegaly are the main consequences of these morphologic changes. Gastrointestinal bleeding is the most frequent cause of death. Unlike in cirrhosis, advanced liver failure is not seen except when HSS is associated with liver lesions from other causes such as virus and alcoholism. Helminthiasis treatment is based on chemotherapy with praziquantel or oxamniquine. Bleeding esophageal varices are managed by sclerotherapy or surgical procedures. Splenectomy with gastroesophageal devascularization seems to be the best choice.     

金属表面TiO2薄膜的溶胶-凝胶法制备及其血液相容性研究

通过溶胶 凝胶法制备TiO2 薄膜对 316L不锈钢和NiTi形状记忆合金进行表面改性处理。研究发现 ,经 5 0 0℃处理 1h的薄膜结构致密 ,膜层均匀平滑 ,薄膜主要由锐钛矿相TiO2 构成 ,随热处理温度的提高 ,锐钛矿相逐渐转变为金红石相。电化学腐蚀和动态凝血时间及溶血率测试表明 ,通过溶胶 凝胶法制备TiO2 膜进行表面改性的 316L不锈钢和NiTi合金的抗模拟体液腐蚀性提高 ,动态凝血时间延长 ,溶血率下降 ,说明溶胶 凝胶法制备TiO2 膜可以提高金属植入物的血液相容性     

Qualitative difference between the cytotoxic T lymphocyte responses to melanocyte antigens in melanoma and vitiligo

Vitiligo is a skin disorder characterized by depigmented macules secondary to melanocyte loss. An unusual facet is its relation to melanoma: cytotoxic T lymphocytes directed to melanocyte antigens are found in both conditions and imply a breakdown of tolerance, yet the resulting immune reaction is the opposite. The mechanisms at the basis of these opposite effects are not known. Here, we performed a direct comparison of whole melanocyte-specific T cell populations in the two diseases. We demonstrate that neither precursor frequencies of Melan-A/MART-1-specific T lymphocytes nor their status of activation differ significantly. However, by using a tetramer-based T cell receptor down-regulation assay, we documented a higher affinity of vitiligo T cells. We calculated that the peptide concentration required for 50% of maximal receptor down-regulation differed by 6.5-fold between the two diseases. Moreover, only vitiligo T cells were capable of efficient receptor down-regulation and IFN-gamma production in response to HLA-matched melanoma cells, suggesting that this difference in receptor affinity is physiologically relevant. The differences in receptor affinity and tumor reactivity were confirmed by analyzing Melan-A/MART-1-specific clones established from the two diseases. Our results suggest that the quality, and not the quantity, of the melanocyte-specific cytotoxic responses differs between the two pathologies.     

Blinded, Externally Controlled Multicenter Evaluation of Light Microscopy and PCR for Detection of Microsporidia in Stool Specimens

The quality parameters for the detection of microsporidia in identical sets of 50 stool samples were determined for six laboratories where technicians used light microscopy and for six laboratories where technicians used PCR. The average overall sensitivities were 67% (89% for patient samples only) for the PCR laboratories and 54% (80% for patient samples only) for the light microscopy laboratories. Specificities were 98 and 95%, respectively. Differences in results were most apparent between the individual laboratories rather than between the two major methods used.     

Oral hairy leukoplakia. Histopathologic and cytopathologic features of a subclinical phase

Accurate diagnosis of oral hairy leukoplakia (OHL) is important because it may be an early indicator of undiagnosed HIV infection; moreover, it may be a prognostic indicator. Our purpose was to investigate the histopathologic features of subclinical OHL and to evaluate and support the rationale of detecting subclinical OHL with cytopathology. The Epstein-Barr virus (EBV) was detected by immunohistochemistry and in situ hybridization in 4 cases of macroscopically normal lateral borders of tongue mucosa from 8 AIDS necropsies and in none of 8 controls. The histopathologic features were specific when based on nuclear changes: Cowdry type A inclusion, ground glass, and nuclear beading. Smears were obtained from 50 patients with AIDS, without OHL, from the scraping of lateral borders of the tongue. Numerous clusters of the cells were associated with Candida organisms (30% of cases). Nuclear changes were observed in 12 patients (24%) on both sides of the tongue. We describe the histopathologic features of subclinical OHL, and our observations suggest that cytopathology can detect OHL in the subclinical phase.     

Timing of in-vitro fertilization of cumulus-free and cumulus-enclosed human oocytes

In humans, in contrast to other species, sperm capacitationrequires a very short time, as in-vitro fertilization has beenobtained after only 45 mm of contact between oocytes and spermatozoacapacitated for 1 h. No fertilization occurred, whatever theduration of sperm capacit.ation, when gamete mixing did notexceed 30 mim. On the contrary, 85% of cumulus-free mature oocytesexposed to sperm for 1–4 h were fertilized. The presenceof the pre-ovulatory, fully-expanded or compact cumulus massdid not represent a physical barrier to sperm progression, aswe observed no delay in fertilization when oocytes were enclosedin the cumulus. The use of a short insemination protocol (1–4h instead of 17–20 h) did not reduce the fertilizationrate of denuded or cumulus-enclosed oocytes and had no significanteffect on the morphological appearance of the embryos or theircleavage rates.