Percutaneous transluminal renal angioplasty: initial and long-term results

Renal artery stenosis in 201 patients with hypertension was treated with percutaneous transluminal renal angioplasty (PTRA). A total of 213 procedures were performed as treatment of 262 separate stenosis. The stenosis was caused by atherosclerosis in 134 cases and by fibromuscular dysplasia (FMD) in 52 cases; the cause was indeterminate in 27 cases. Of the 213 procedures, 172 were successful or resulted in improvement, for a technical success rate of 80.8%. The initial clinical results could be evaluated in 210 cases; cure or improvement was achieved in 80%. There were 23 cases in which neither technical nor clinical success was achieved. Data on the remaining 187 cases were the basis of this long-term follow-up study. The cumulative patency rate at 5 years was 80% in the atherosclerosis group, 89% in the FMD group, and 74% in the indeterminate group. The mortality was less than 1%. Because spasm occurred in 33 cases, causing an infarction in ten instances, antispasmodic medication seems warranted. These long-term results indicate that PTRA is the treatment of choice in patients with renovascular hypertension.     

US location of the adductor canal hiatus: morphologic study

In the lower extremities, the adductor canal hiatus is a site of predilection for arterial stenoses and occlusions. The high incidence of vascular disease in this region is thought to be due to a local factor. To gain more insight into the mechanisms leading to such disease, the authors used ultrasound to locate the adductor canal hiatus in dissecting room preparations and in healthy volunteers.     

Fetal rhombencephalon: normal US findings

Using ultrasound (US), the authors examined 25 embryos that were 8-10 menstrual weeks old for gestational age and the presence of a small cystic structure (3-4 mm) in the posterior aspect of the cranium. This structure was seen in all embryos. The US images of an in vitro embryo at 8 weeks menstrual age were also evaluated for anatomic correlation. Analysis of these US images determined that the cystic structure was the open rhombencephalon or hindbrain. Follow-up US studies or postpartum clinical examinations of the 25 in utero embryos demonstrated no abnormal posterior cranial cystic structures or neurologic deficits. This first-trimester structure should be considered a normal finding, since it develops into the normally proportioned fourth ventricle after the 11th menstrual week.     

卵巢移植在宫颈癌治疗中的临床应用价值

目的:探讨卵巢移植在宫颈癌患者中应用的可行性、临床价值、并发症及其预防。方法:应用计算机检索中国全文期刊数据库1985/2006卵巢移植相关的文献,检索词为“卵巢移植、宫颈癌”,限定语言种类为中文,同时检索Pubmed数据库1995/2006有关宫颈癌卵巢移植的文献,检索词为“cervical cancer,ovarian transplantation”,限定语言种类为“English”,共收集51篇文献,进行归纳总结。结果:①对于年轻的宫颈鳞癌患者,保留卵巢并行自体异位移植手术是安全的,也是必要的。②宫颈癌患者卵巢自体移植的方法有卵巢组织移植术、带蒂卵巢器官移植术(卵巢移位术)、游离卵巢器官移植术等术式。③移位术后卵巢的功能较原位卵巢下降,卵巢器官移植术后较移位术后下降显著,辅以放疗后进一步加重卵巢功能的损伤。④卵巢移植术后常见的并发症有移植部位结节和包块、症状性卵巢囊肿、移植部位疼痛和卵巢功能衰退,但是可以预防的。结论:卵巢移植术使年轻宫颈癌患者的卵巢得以保留,但由于移植后卵巢功能减退及术后辅助放疗对卵巢的影响、移植后宫颈癌卵巢转移等问题限制了临床应用,如能对上述问题加以预防和治疗,卵巢移植术在宫颈癌患者中会有广阔的应用前景。     

罗格列酮对伴有糖尿病冠状动脉粥样硬化性心脏病患者纤溶系统的影响：预防支架术后再狭窄的可行性

目的:观察罗格列酮对伴有糖尿病的冠状动脉粥样硬化性心脏病(冠心病)患者纤溶系统的影响,由此对罗格列酮防止支架术后再狭窄机制作初步探讨。方法:选择2006-02/12于苏州大学附属第一医院就诊的伴有2型糖尿病的冠心病患者78例,均知情同意。①实验分组及方法:按随机数字表法分为两组(n=39),常规治疗组对其基础疾病进行治疗,包括常规针对冠心病和糖尿病治疗;罗格列酮组在此基础上加用罗格列酮口服,4mg/d。②实验评估:两组观察对象均在入院时及治疗3个月后分别抽取外周血,分离血浆,检测一氧化氮、组织型纤溶酶原激活物和纤溶酶原激活物抑制剂1含量。测定一氧化氮采用硝酸还原酶法,测定组织型纤溶酶原激活物和纤溶酶原激活物抑制物1采用酶联免疫法。结果:78例患者全部进入结果分析,无脱落。①罗格列酮组患者外周血浆一氧化氮含量升高的幅度显著高于常规治疗组(P<0.01)。②罗格列酮组患者外周血浆组织型纤溶酶原激活物含量升高的幅度显著高于常规治疗组(P<0.01)。③罗格列酮组患者外周血纤溶酶原激活物抑制物1含量降低的幅度显著高于常规治疗组(P<0.01)。结论:对于伴有糖尿病的冠心病患者,在常规治疗基础上加用罗格列酮能促进纤溶系统的激活,防止血栓的形成,有效防止支架术后再狭窄。     

Epigenetic silencing of microRNA-199b-5p is associated with acquired chemoresistance via activation of JAG1-Notch1 signaling in ovarian cancer

Epithelial ovarian cancer is a highly lethal and aggressive gynecological malignancy. The high mortality rate is due in part to the fact that many advanced cancer patients become refractory to current chemotherapeutic agents, leading to tumor recurrence and death. However, the underlying mechanisms leading to chemoresistance remain obscure. Here, we report that the loss of miR-199b-5p due to progressive epigenetic silencing leads to the activation of the JAG1-mediated Notch1 signaling cascade, thereby leading to the development of acquired chemoresistance in ovarian cancer. Using miRCURY LNA™ microRNA array and Q-PCR analyses of two pairs of cisplatin-sensitive and –resistant ovarian cancer cell lines, we identified miR-199b-5p as significantly down-regulated in cisplatin-resistant ovarian cancer cells and confirmed that miR-199b-5p is clinically associated with advanced and poor survival ovarian cancers. Interestingly, the loss of miR-199b-5p could be restored by 5-Aza-dC-mediated demethylation, and methylated specific PCR (MS-PCR), bisulfite-sequencing and pyrosequencing revealed that the promoter region of miR-199b-5p was hypermethylated. Computational and mechanistic analyses identified JAG1 as a primary target of miR-199b-5p. Notably, the reduced expression of miR-199b-5p was found to be inversely correlated with the increased expression of JAG1 using an ovarian cancer tissue array. Enforced expression of miR-199b-5p sensitized ovarian cancer cells to cisplatin-induced cytotoxicity both in vitro and in vivo. Conversely, re-expression of miR-199b-5p and siRNA-mediated JAG1 knockdown or treatment with Notch specific inhibitor γ-secretase (GSI) attenuated JAG1-Notch1 signaling activity, thereby enhancing cisplatin-mediated cell cytotoxicity. Taken together, our study suggests that the epigenetic silencing of miR-199b-5p during tumor progression is significantly associated with acquired chemoresistance in ovarian cancer through the activation of JAG1-Notch1 signaling.     

Impact of gender on asthma in childhood and adolescence: a GA2LEN review

A number of studies have shown gender differences in the prevalence of wheeze and asthma. The aim of this review was to examine published results on gender differences in childhood and adolescent asthma incidence and prevalence, define current concepts and to identify new research needs.
A Medline search was performed with the search words (gender OR sex) AND (child OR childhood OR adolescence) AND (asthma). Articles that reported on abscence or prescence of gender differences in asthma were included and reviewed, and cross-references were checked. Boys are consistently reported to have more prevalent wheeze and asthma than girls. In adolescence, the pattern changes and onset of wheeze is more prevalent in females than males. Asthma, after childhood, is more severe in females than in males, and is underdiagnosed and undertreated in female adolescents. Possible explanations for this switch around puberty in the gender susceptibility to develop asthma include hormonal changes and gender-specific differences in environmental exposures. This aspect needs consideration of the doctors and allergists who diagnose and treat asthmatic individuals.
In conclusion, sex hormones are likely to play an important role in the development and outcome of the allergic immune response and asthma in particular. By obtaining functional data from appropriate models, the exact underlying mechanisms can be unravelled. To examine the effect of gender-specific differences in environmental exposures and changes of asthma prevalence and severity in puberty, larger populations may need to be investigated.