Transabdominal vesical sonography of urethral syndrome and stress incontinence

BACKGROUND: Transabdominal ultrasonography was used to study the bladder neck morphology in women with urethral syndrome or stress urinary incontinence, in order to determine the ultrasonographic findings of these conditions. METHODS: A total of 210 female patients with a normal bladder, asymptomatic trigonitis, urethral syndrome, and stress incontinence were studied. The mucosal thickness around the bladder neck, the length of the anterior base plate of the bladder, and the anteroposterior vesical wall angle (APVA) at the bladder neck were measured on sagittal transabdominal vesical ultrasonograms with the patient in the supine position. RESULTS: Patients with asymptomatic trigonitis or urethral syndrome had thicker mucosa around the bladder neck than the subjects with a normal bladder, and the subjects with stress incontinence had normal mucosa. The APVA was 158 +/- 17 (mean +/- SD) degrees in the subjects with a normal bladder. It was smaller in symptomatic patients and decreased to 109 +/- 10 degrees in those with conservative therapy-resistant incontinence. The anterior edge of the vesical base plate was visible approximately 2 cm from the bladder neck in subjects without incontinence, while it tended to be absent in patients with incontinence and an APVA of less than 126 degrees. CONCLUSION: A small APVA appears to reflect bladder neck descent, while a small APVA without a visible anterior base plate edge may reflect hypotonia of the vesical base plate. Transabdominal vesical ultrasonography with the patient in the supine position provides useful information and can be carried out as a routine examination in female patients with micturition disorders.     

Natural Killer Activity and Antibody-Dependent Cell-Mediated Cytotoxicity in Multiple Myeloma

Natural killer (NK) activity and antibody-dependent cell-mediatedcytotoxicity (ADCC) were studied by routine methods in 11 patientswith untreated malignant monoclonal gammopathy. NK and/or ADCCactivity was clearly reduced in three patients with advanceddisease. Moreover, sera from some myeloma patients impairedthe ADCC and NK activity. A large quantity of purified monoclonalIgG from one patient appeared to inhibit NK and ADCC activityas did high concentrations of pooled polyclonal immunoglobulinfrom healthy persons. In two of these 11 patients, other malignancieswere diagnosed prior to chemotherapy. One of these patients,who had nonsecretory myeloma, had marked impairment of NK andADCC activity; the other, with IgG myeloma, had normal NK andADCC activity.     

“Para-lesional” Saline Injection Method for Assessment of Small Gastric Cancers by Endoscopic Ultrasonography

Abstract: Accurately diagnosing the depth of invasion in small early gastric cancers is essential for determining whether endoscopic resection of a lesion is indicated. It is often difficult, however, to demonstrate such small lesions by conventional endoscopic ultrasonography (EUS) which is considered to be a useful tool for assessing depth of invasion. To facilitate demonstration by EUS, we injected 2-5 ml of saline into the submucosal layer at an appropriate point 1 -2 cm from the lesion. With the collection of saline serving as a guide, the lesion was demonstrable on the same EUS image (“para-lesional” injection method). Using this method, we were able to evaluate all 12 of the small early gastric cancers we examined. Five of these lesions were endoscopically resected uneventfully after EUS examination. The accuracy of the diagnosis of vertical invasion with this method was 83% (10/12). Histologically, fibrotic changes were observed beside the lesion, but no EUS-related effects were recognized beneath the lesion. The present results suggest that the “para-lesional” injection method is useful for assessing small early gastric cancers by conventional EUS.     

牙龈卟啉单胞菌对脐静脉血管内皮细胞产生sICAM-1的影响

目的：观察牙龈卟啉单胞菌（Porphyromonas gingivalis,P.gingivalis)对人类脐静脉血管内皮细胞（human umbilical vein endothelial cells,HUVECs)产生可溶性细胞间粘附分子－1（soluble intercellular adhesion molecule-1,sICAM-1)的影响。方法：应用厌氧袋法培养P.gingivalis，并用其感染HUVECs，采和酶联免疫吸附实验（enzyme-linked immunosorbent assay,ELISA)测定培养上清中sICAM-1的含量，结果：HUVECs基础表达少量的sICAM-1;P.gingivalis剂量依赖性增强HUVECs产生sICAM-1蛋白的水平；紫外线、超声波和65℃的热处理都不能抑制P.gingivalis的作用；sICAM-1蛋白水平在P.gingivalis刺激后的4h未见改变，增高的作用从刺激后的8h开始，在12h,16h和20h继续增加。结论：活的和灭活的P.gingivalis都剂量依赖性和时间依赖性地增强HUVECs产生sICAM-1,P.gingivalis可能同样诱导牙龈血管内皮细胞表达sICAM-1，升高的sICAM-1可能参与调节牙周病炎症反应和免疫反应过程。