Amygdala volume and depressive symptoms in patients with borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) is characterized by a high prevalence of comorbid psychiatric disorders, including major depression (MD). The aim of this study was to examine whether a co-occurrence of MD is associated with structural changes in the amygdala of BPD patients. METHODS: Twenty-five right-handed, female patients with BPD and 25 matched healthy control subjects were examined. Diagnoses of BPD and MD were made according to DSM IV. Depressive symptomatology was determined with the Hamilton Depression Scale (HAMD). Magnetic resonance imaging scans were performed with 1.5 T Magnetom Vision (Siemens, Erlangen, Germany). The software program "BRAINS" was applied for brain volumetry and segmentation. The amygdala was delineated as "region of interest." RESULTS: Comparison of amygdala volumes between the whole group of BPD patients and control subjects revealed no significant difference. Amygdala volumes in both hemispheres were significantly larger in BPD patients with MD compared with those without MD. There was a significant correlation in BPD patients between left amygdala volume and depressive symptoms as measured by HAMD. CONCLUSIONS: Correlation of amygdala volume with depression in BPD patients might indicate a causal relationship. Future studies should clarify whether amygdala enlargement is a risk factor for MD in BPD patients or a consequence of the affective disorder.     

Maxadilan interacts with receptors for pituitary adenylyl cyclase activating peptide in human SH-SY5Y and SK-N-MC neuroblastoma cells

Receptors for pituitary adenylyl cyclase activating peptide (PACAP) have been identified in human SH-SY5Y neuroblastoma cells with PACAP being 1000-fold more potent than vasoactive intestinal peptide (VIP) in [(125)I]PACAP binding inhibition and stimulation of cAMP accumulation. Maxadilan, a vasodilator peptide from the salivary gland of the sand fly Lutzomyia longipalpis also specifically bound to SH-SY5Y cells, and was equipotent to PACAP in [(125)I]PACAP and [(125)I]maxadilan binding inhibition, and stimulation of cAMP accumulation. Maxadilan and PACAP also increased the cytosolic free calcium concentration. In human SK-N-MC neuroblastoma cells PACAP, VIP and maxadilan equipotently stimulated cAMP accumulation. The maximal effects of VIP and maxadilan were additive and reached those of PACAP alone. In human T47D breast carcinoma cells PACAP and VIP were also equipotent in the stimulation of cAMP accumulation, but maxadilan was inactive. The results are consistent with the interaction of maxadilan with PACAP specific PAC(1)receptors in SH-SY5Y cells, but not with VPAC receptors, not differentiating between VIP and PACAP in T47D cells. Moreover, maxadilan is a PAC(1)receptor specific agonist which allows discrimination of co-expressed PAC(1)and VPAC receptors in SK-N-MC cells.     

Larger amygdala volumes in first depressive episode as compared to recurrent major depression and healthy control subjects.

BACKGROUND: The aim of our study was to test the hypothesis that amygdala volumes are reduced in patients with recurrent major depression compared with first episode patients. METHODS: Using structural magnetic resonance imaging, we compared 30 inpatients with first-episode depression and 27 inpatients with recurrent major depression (DSM-IV) with healthy volunteer subjects from the local community matched for age, gender, and handedness. RESULTS: Patients with first-episode depression showed enlarged amygdala volumes compared with patients with recurrent major depression and healthy control subjects. No significant differences were found between patients with recurrent depression and healthy control subjects. No significant correlations were found between amygdala volumes and age of onset, illness duration, or severity of depression. CONCLUSIONS: Larger amygdala volumes in patients with first-episode depression may result from higher amygdala metabolism and blood flow. Additionally, disease progression with stress-related excitotoxic processes during recurrent depressive episodes might result in decreased amygdala volumes. Prospective investigations to investigate amygdala changes during the course of depression are needed.     

运动性心律失常

运动性心律失常是指发生于机体剧烈运动期间或之后的心律失常。临床表现不一,从心悸、头晕、晕厥、心绞痛、急性心肌梗死和充血性心力衰竭,甚至到心脏性猝死。运动性心律失常可见于心肌缺血,如患有动脉粥样硬化性心脏病以及患有原发性或继发性心肌病的患者。然而,也可能发生在似乎健康的个体。在后一组人群中,运动性心律失常可以是良性的,但也可以是获得性(如药物诱发)或先天性(如先天性长QT综合征或致心律失常性右室发育不良)心电活动或结构的异常而呈恶性。这种潜在病理生理学机制的复杂性,使运动性心律失常的诊断和治疗成为临床医学上的…     

Cytopathological and immunocytochemical findings of pancreatic anaplastic carcinoma with ZEB1 expression by means of touch imprint cytology

Pancreatic anaplastic carcinoma (PAC) is rare and has an aggressive clinical course. We report an autopsy case of PAC focusing on the cytopathological characteristics of the tumor and immunocytochemical staining for vimentin, E‐cadherin, and zinc finger E‐box binding homeobox 1 (ZEB1), which markers are associated with epithelial markers of epithelial‐mesenchymal transition (EMT). A 50‐year‐old woman presented to our hospital with a chief complaint of jaundice. A pancreatic head tumor and multiple liver nodules were detected on abdominal computed tomography. Biliary cytology under endoscopic retrograde cholangiopancreatography suggested ductal adenocarcinoma. Three months after admission, she died of multiorgan failure. At autopsy, touch imprint cytology using squash preparation of the pancreatic tumor identified two different cell types; numerous isolated malignant cells with large and pleomorphic nuclei and a few clusters showing irregularly overlapped nuclei and irregular contours within the necrotic background. Immunocytochemically, isolated cells were positive for vimentin and ZEB1, and negative for E‐cadherin. Conversely, clusters were negative for vimentin and ZEB1, and positive for E‐cadherin. Histologically, the tumor was composed of sarcomatous cells with small foci of adenocarcinoma, which were consistent with a diagnosis of PAC. Immunohistochemical staining of the adenocarcinoma and sarcomatous cells corresponded to those of the clusters and isolated malignant cells, respectively. Immunostaining of these EMT markers is useful to distinguish sarcomatous cells from adenocarcinoma and can contribute to the accurate diagnosis of pancreatic tumors with EMT.     

实时灰阶超声造影和螺旋CT诊断肝肿瘤的比较研究

目的比较实时超声造影和螺旋CT显示肝肿瘤血流信号的特点.方法对29例肝肿瘤(原发性肝癌16例,转移性肝癌2例,血管瘤6例和肝局灶性结节增生5例)分别进行超声造影和CT检查.结果超声造影显示肝恶性肿瘤的整体型、血管瘤的周边型及局灶性结节增生的中央型出现率显著高于其他病变(P<0.01).CT示恶性肿瘤中94.4%(17/18) 动脉期强化、门脉期低密度;血管瘤中83.3%(5/6)呈结节状强化;肝局灶性结节增生动脉期均明显强化.超声造影和CT鉴别肝肿瘤的能力无显著差异.结论超声造影和CT都能敏感地显示不同肝肿瘤的血供特征.     

螺旋CT肝脏双期扫描及门静脉血管三维重建在小肝癌诊断的临床应用

目的 探讨螺旋CT肝脏双期扫描及门静脉血管三维重建在小肝癌诊断中临床应用价值。方法 25例直径≤3cm小肝癌行螺旋CT肝脏双期扫描及门静脉血管三维重建。三维重建方法采用最大强度投影(MIP)。结果 (1)CT平扫,18例病灶呈低密度,7例病灶呈等密度。肝动脉期,25例病灶强化呈高密度,强化类型分为均匀一致性,斑点状及环状强化。门静脉期25例病灶均呈低密度。(2)门静脉血管MIP三维重建能较好显示小肝癌病灶与肝内门静脉血管关系,肝内门静脉血管分支于病灶处稀少,部分中断或被轻度推移,肿瘤内无门静脉分支血管。结论 螺旋CT肝脏双期扫描及门静脉血管三维重建是诊断和评价小肝癌的有效方法,提高了小肝癌的检出率及诊断正确率,可较好显示病灶与门静脉的关系,为其外科手术提供导向。     

螺旋CT在肺动脉栓塞诊断中的价值

目的:评价螺旋CT在诊断肺动脉栓塞中的作用。方法:16例肺动脉栓塞患者行螺旋CT肺动脉造影 (SCTA)检查,层厚3mm,扫描时间0.8s,对比剂注射速度3.5ml/s,总量100ml,扫描延迟时间15s。结果:16例 共644支,其中134支肺动脉及分支显示了栓塞,占20.8%。228支肺段肺动脉中,有56支显示肺动脉栓塞,占分 析肺动脉支的24.5%。204支亚段肺动脉中37支显示肺动脉栓塞,占分析肺动脉支15.4%。肺动脉栓塞的CT形 态:①直接征象为不同程度的肺动脉分支内充盈缺损。中心型充盈缺损17支,偏心型充盈缺损44支,附壁血栓型 34支,完全阻塞型39支。②间接征象胸膜下肺梗死灶,内乳动脉一侧增粗,肺纹理稀少,胸水,肺动脉高压。结论: 螺旋CT肺动脉造影是诊断肺动脉栓塞的快速、有效、无创伤的诊断方法。     

The clinical impact of carbohydrate malabsorption

Malabsorption of carbohydrates such as fructose, lactose or sorbitol can often be detected among patients suffering from so-called non specific abdominal complaints. Sometimes the differential diagnosis may be difficult. So far successful treatment consists of dietary interventions only. Nevertheless, many questions are remaining still unanswered.