Sphincter preservation in patients with low rectal cancer treated with radiation therapy with or without local excision or fulguration

Twenty-six patients with small cancers limited to the lower two-thirds of the rectum were treated with conservative surgery and radiation therapy (XRT). The selection factors for this approach were age, refusal of a permanent colostomy, or the high risk of local recurrence because of inadequate surgical margin or palpable residual tumor after local surgical treatment alone. In patients treated with local excision or fulguration followed by XRT, there was a 6% local failure rate (one in 17); in 16 of 17 patients receiving radiation doses above 4,500 cGy, the local control was complete for follow-up periods of 6 months to 7 years. In nine patients treated with XRT for residual tumor, local failure occurred in five (56%). The disease-free survival for those without residual tumor versus those with residual tumor was 88% and 44%, with median follow-up periods of 20 and 23 months, respectively. Serious late complications occurred only if total doses were greater than 6,300 cGy. Local excision combined with XRT proved to be a safe alternative to radical surgery in selected patients and resulted in excellent local control while allowing preservation of anal sphincter function.     

Small-cell carcinoma of the lung: patterns of treatment failure in patients treated primarily by chemotherapy

Treatment failure patterns in 75 patients with small-cell carcinoma of the lung who were treated primarily by chemotherapy were reviewed. Of 10 patients with localized disease who underwent complete staging work-ups, six had metastases to the chest, four to the central nervous system, four to bone, and one to the lymph nodes. Of 32 patients with disease considered to be localized but who did not undergo complete staging work-ups, 23 had metastasis to the chest, 11 to the central nervous system, four to bone, and two to the lymph nodes. Of 33 patients with documented distant metastasis 23 had metastasis to the chest, 14 to the central nervous system, 15 to bone, and six to the lymph nodes. Median survival times of patients showing complete response to treatment was 17 months; for those showing partial response it was 7 months.     

高频超声显像在乳腺肿瘤诊断与鉴别诊断中的应用

目的:探讨超声在乳腺肿瘤的诊断与鉴别诊断中的应用价值。方法:阅读国内外相关文献进行综述。结果:高频二维超声可以清晰显示乳腺及肿瘤的细微结构;彩色多普勒血流显像可以提供有关肿瘤周边及内部的血流情况;彩色多普勒能量图丰富了血流信息,提高了多普勒探测的敏感性。结论:灰阶超声、CDFI、CDE几种技术相结合,必将提高乳腺肿瘤诊断与鉴别诊断的准确性。     

Archival fixed and analysed preimplantation human embryonic cells: a DNA resource for retrospective PCR analysis at the cellular level

Biopsies of human embryonic cell preparations previously analysed by cytogenetic and/or fluorescent in-situ hybridization (FISH) chromosome probes provide a unique reference DNA resource for the archival preimplantation genetic diagnosis (PGD) of the transferred embryo. DNA polymerase chain reaction (PCR) may be utilized on these fixed cell preparations to verify equivocal FISH/PGD results. Retrospective PCR screens of the genotype of biopsied embryonic cell(s) may be of benefit in the case of a suspected genetic mutation. Currently, carrier detection or linkage analysis is often not possible because of early death of the fetus, or of patients with a lethal disease. Alternatively, fixed/stained 'failed fertilized' oocytes provide a resource to extend genetic analysis to infertile patients. A successful research is described which minimizes loss of individual analysed fixed/stained oocytes, metaphase chromosomes, and embryonic cell samples. Initial DNA amplification takes place in situ using a modified PCR protocol. Comparative cellular studies using primer sets previously used for PGD analyses show that 65% of the preparations amplified unequivocally using the modified protocol and primers for a CA repeat motif gene sequence, in comparison with 81% using the original PCR protocol. With further refinement and optimization, the methods outlined have the potential to retrospectively screen archival fixed chromosomes, gametes, and embryonic cells for clinical application, and enable the further study of the fixed human preimplantation embryo at the morphological, cell and molecular level.      

基于声速微扰的松质骨超声参数分析和计算

在生物组织非均匀连续介质模型的基础上，采用声速微扰法，通过分别改变入射频率、松质骨孔隙度及骨小梁特征尺寸等三个参数，对松质骨中的超声背向散射系数和由于散射而引起的衰减进行了分析。分析结果表明：由于散射而引起的衰减占松质骨中总的超声衰减的26％左右；当松质骨孔隙度在0．61附近时，衰减和背向散射系数均达到最大值。     

Cryopreservation of single human spermatozoa

A procedure is described that allows cryopreservation and efficient post-thaw recovery of either a single or a small group of human spermatozoa. This is achieved by injecting them into cell-free human, mouse or hamster zonae pellucidae before the addition of cryoprotectant. The method involves a combination of physical micromanipulation procedures and glycerol-mediated cryoprotection. Zonae were tracked by positioning them in straws between two small air bubbles prior to freezing. Spermatozoa from poor specimens were cryopreserved and their fertilizing ability after thawing was compared with that of fresh spermatozoa from fertile men. Human eggs used for fertilization testing were either 1 day old or in-vitro matured. Only 2% of the frozen zonae were lost and >75% of spermatozoa cryopreserved in this manner were recovered and prepared for intracytoplasmic sperm injection. The feasibility of cryopreserving a single spermatozoon was assessed. Fifteen motile spermatozoa were frozen in 15 zonae, of which 14 were recovered after thawing. Ten were injected into spare eggs, of which eight became fertilized. Spermatozoa recovered mechanically from human zonae fertilized the same proportion of oocytes as fresh fertile control spermatozoa. The recovery and fertilization rates with spermatozoa frozen in animal zonae were 87 and 78% respectively. The fertilization rate was marginally higher (P < 0.05) than that for spermatozoa frozen in human zonae, perhaps because the latter may have acrosome reacted more frequently. The zona pellucida appears to be an ideally suited sterile vehicle for storage of single spermatozoa.      

Dengue disease severity in Indonesian children: an evaluation of the World Health Organization classification system

Background  

Dengue disease severity is usually classified using criteria set up by the World Health Organization (WHO). We aimed to assess the diagnostic accuracy of the WHO classification system and modifications to this system, and evaluated their potential practical usefulness.     

原发性膀胱透明细胞癌(附二例报告并文献复习)

目的：探讨原发性膀胱透明细胞癌的临床、病理、组织化学特性和诊治方法。方法：回顾分析2例患者临床资料，结合文献复习讨论。结果：2例肿瘤发生于膀胱右侧壁近膀胱颈处，以血尿就诊。组织学以大片透明样癌细胞、腺管样结构为特征。电镜下癌细胞核大而畸形，细胞器较少，部分癌细胞内有细胞内微小腺腔。免疫组化示PAS（＋）、AB（＋）。1例行膀胱部分切除术，30个月后出现淋巴结转移；1例行肿瘤电切术，15个月后未见复发。结论：此病以血尿为主要症状，病理检查才能确诊，应与转移性癌及肾源型腺瘤相鉴别，治疗以根治性手术为主，预后较其他非尿路上皮癌好。     

Examining impulsivity as an endophenotype using a behavioral approach: a DRD2 TaqI A and DRD4 48-bp VNTR association study

Background  

Research on the genetic basis for impulsivity has revealed an array of ambiguous findings. This may be a result of limitations to self-report assessments of impulsivity. Behavioral measures that assess more narrowly defined aspects of impulsivity may clarify genetic influences. This study examined the relationship between possession of the DRD2 TaqI A and DRD4 48 bp VNTR genetic polymorphisms and performance on a behavioral measure of impulsivity, the delay discounting task (DDT), and three traditional self-report measures.     

二尖瓣环收缩期最大位移达峰时间评价扩张型心肌病患者左心室长轴收缩功能的超声心动图研究

Objective To evaluate the value of peak time(PT) and corrected peak time(PTc) in the assessment of left ventricular long axis systolic function in patients with dilated cardiomyopathy(DCM).Methods Thirty-one DCM cases and thirty-six healthy cases were investigated using echocardiography.To obtain image of apical four-chamber view and apical two-chamber view, PT was measured by the technique of tissue motion annular displacement.The value of PTc was corrected by R-R interval.The critical value of PT and PTc was obtained by ROC curves.Results Compared with the PT of control group, the PT of DCM group at the site of septal and lateral were significantly increased ( P ＜0.05), but the PT at the site of anterior and inferior were no significantly increased ( P ＞0.05).The PTc at the four sites were significantly increased compared with control group ( P ＜0.05).The areas of under the ROC curve of PTc was 0.849 (95 % CI 0.699～0.929, P = 0.000), sensitivity and specificity of diagnosis cardiac dysfunction were 80.6 % and 66.7% respectively.Conclusions The PTc was significantly increased in patients with DCM.PTc was useful to evaluate left ventricular dysfunction in DCM patients.