Skeletal metastases from hepatoma: frequency, distribution, and radiographic features

Over the past 6 years, the authors evaluated 300 patients with hepatoma as part of phase 1 and 2 treatment protocol trials. Analysis of the available clinical data and radiographic studies revealed 22 patients (7.3%) with skeletal metastases demonstrated by radiography, computed tomography (CT), and/or nuclear scintigraphy. The plain film appearance of skeletal metastases from hepatoma was osteolytic in all cases. CT scanning best demonstrated the expansile, destructive nature of these metastases, which were often associated with large, bulky soft-tissue masses. Skeletal metastases from hepatomas demonstrated increased radiotracer uptake on standard bone scans and were gallium avid, similar to the hepatoma itself. In addition, they could be targeted therapeutically with I-131 antiferritin immunoglobulin. The most frequent sites of skeletal metastases were the ribs, spine, femur, pelvis, and humerus. An initial symptom in ten patients was skeletal pain corresponding to the osseous metastases. In five patients, pathologic fractures of the proximal femur or humerus developed and required total hip replacement or open-reduction internal fixation. Patients with long-standing cirrhosis or known hepatocellular carcinoma who also have skeletal symptoms should be evaluated for possible osseous metastases.     

叶绿素衍生物在犬膀胱粘膜内代谢的研究

目的：为了了解叶绿素衍生物（ＣＰＤ４）口服后在膀胱粘膜内含量变化的状况，以便为临床应用提供实验依据。方法：１３条实验犬分为３个不同剂量组，应用荧光检测法作服药后不同时段膀胱粘膜ＣＰＤ４含量的测定。结果：ＣＰＤ４用于实验犬的合适剂量是１００ｍｇ／ｋｇ，明显低于此值将显著影响组织的吸收，从而降低光动力作用。在禁食组中，组织内吸收的最高峰值出现在服药后２ｈ，而进食组却推迟出现在服药后６￣１２ｈ。结论：为     

脑内GABA能神经元对红藻氨酸中枢性心血管效应的影响

采用侧脑室微最注射法证明,谷氯酸受体哑型激动剂红藻氨酸(KA)可依剂量性地升高大鼠血压和加快心率。预先给予GABA合成抑制剂氮基脲140 mg/kg ip或GABA拮抗剂印防己毒1 mg/kg iv均可明显增强KA的作用;而GABA转氨酶抑制剂氨氧乙酸25μg/rat icv明显减弱KA的作用。结果表明,脑内GABA能神经元功能受抑,KA的中枢性心血管效应增强。从而推测,脑内GABA能神经元与谷氯酸能神经元之间相互制约,共同参与中枢性调节心血管的活动。     

Human red blood cell Wright antigens: a genetic and evolutionary perspective on glycophorin A-band 3 interaction

The Wright (Wra/Wrb) blood group polymorphism is defined by an allelic change (Lys658Glu) in the band 3 protein; nevertheless, the Wrb antigen apparently requires glycophorin A (GPA) for surface presentation. To gain insight into the structural basis for this protein-protein interaction and delineate its relationship with Wrb antigen expression, we investigated GPA and band 3 sequence polymorphisms occurring in rare humans and nonhuman primates. The lack of GPA or amino acid residues 59 through 71 of GPA results in the absence of Wrb from human red blood cells (RBCs) exhibiting the MkMk, En(a-), or MiV phenotype. However, the SAT homozygous cells carried a Glu658 form of band 3 and a hybrid glycophorin with the entire GPA extramembrane domain from residues 1 through 71, yet expressed no Wrb antigen. This finding suggests that formation of the Wrb antigenic structure is dependent on protein folding and that the transmembrane junction of GPA is important in maintaining the required conformation. Comparative analyses of GPA and band 3 homologues led to the identification in the interacting regions of conserved and dispensable amino acid residues that correlated with the Wrb positive or negative status on nonhuman primates. In particular, the chimpanzee RBCs cells expressed Wrb and the Glu658 form of band 3, which is identical to humans, but their GPA contained the Gly rather than Arg residue at position 61. Taken together, the results suggest that (1) Arg61 of GPA and the proposed Arg61-Glu658 charge pair are not crucial for Wrb antigen exhibition and (2) the role of GPA for interaction with band 3, including Glu658, probably involves a number of amino acid residues located in the alpha-helical region and transmembrane junction.     

Neck neoplasms: MR imaging. Part I. Initial evaluation

Untreated neoplasms of the neck (tumors of the oropharynx, supraglottic area, carotid body, and thyroid, in addition to malignant lymphadenopathy) were evaluated in 23 patients with magnetic resonance (MR) imaging. The results were compared with computed tomographic (CT) scans in 20 patients. Contrast between tumor and fat was best on relatively T1-weighted images (500/30-35 [TR msec/TE msec]), whereas separation of tumor and muscle was best with relatively T2-weighted pulse sequences (1,500/90). Balanced images (1,500/30-35) provided best overall image quality and best demonstrated vascular anatomy. MR imaging was usually superior to CT in showing the relationship of tumor mass to muscle. MR imaging and contrast material-enhanced CT were equivalent in most patients in defining vascular anatomy, but MR imaging was superior when intravenous contrast material was not administered. However, CT was more helpful in showing bone and cartilage anatomy, and in some patients CT also was better in showing airway abnormalities. Despite these limitations, MR imaging is a promising imaging technique for studying neoplasms of the neck.     

Analgesic Effect of Oral Glucose in Neonates

The International Association for the Study of Pain, has defined pain as “an unpleasant sensory and emotional experience connected with actual or potential tissue damage or described in terms of such damage”. It was thought that the newborn baby does not experience pain because of incompletely developed nervous system. However, it has been shown that neurological system known to be associated with pain transmission and modulation, is intact and functional. A study was conducted in our center to study the analgesic effect of administration of oral glucose in various concentrations, in neonates undergoing heel punctures, for collection of blood for investigations. This was compared with the analgesic effects of breast milk (which contains lactose). 125 full term normal neonates with no history of birth asphyxia or underlying neurological abnormality, requiring heel punctures for collection of blood for various investigations were selected for the study. They were matched for gestational age, birth weight and sex distribution and divided into 5 groups of 25 each. One group comprised control subjects and was administered sterile water. 3 groups were administered 1 ml of varying strengths of glucose solutions i.e. 10%, 25% and 50% respectively. The last group was given 1 ml of expressed breast milk (EBM). Prior to heel pricks, state of arousal, baseline heart rate (HR) and transcutaneous oxygen saturation (SpO₂) were recorded by pulse oximeter in each neonate. Autolet, a mechanical device for capillary sampling, was used for heel pricks to give equal strength of painful stimulus in each procedure. Audio tape recorder was used to record the cry. The oral solution was administered slowly over 30 seconds by means of a syringe placed in the mouth. Heel puncture was done after 2 minutes, taking all aseptic precautions. HR and SpO₂ were monitored using pulse oximeter. Pain response was assessed, by recording duration of crying, change in HR, change in SpO₂ and facial action score after the procedure. Mean duration of cry and total cry over 5 minutes was significantly less in groups given 25% and 50% glucose solutions as compared to the control group and babies given EBM. Difference in mean increase in HR, fall in SpO₂ were statistically significant between control group, EBM group and neonates given 25% and 50% glucose solutions respectively. Compared to control group, all other administered solutions (10%, 25%, 50% glucose and EBM) were found to reduce physiological and behavioral responses in neonates undergoing heel punctures. 25% and 50% glucose solutions were found to have maximal analgesic effect and both were found to be equally effective. EBM and 10% glucose solution have an equal analgesic effect but less than 25% or 50% glucose. This simple, cheap and safe method of oral analgesia can be easily used in neonates undergoing heel prick procedures during routine neonatal care.Key Words: Analgesic effect, Breast milk, Glucose, Neonates