Preoperative localization of clinically occult breast lesions: experience at a referral hospital

The authors performed 601 preoperative needle localization procedures for occult breast abnormalities in 1987. Whereas most previous series have been based on mammograms obtained and interpreted at the reporting institutions, this study population includes a large number of patients (79%) examined and referred from other facilities. One hundred nine cancers were diagnosed in the 601 cases (18%). Biopsies performed for masses yielded a 23% (64 of 278) frequency of cancer and those for calcification, 14% (45 of 323). The benign to malignant ratio (4.5:1) in this mixed group of patients is higher than that cited in reports of other large series. An analysis of the factors that might influence these statistics is presented.     

Erythema-multiforme-like eruption due to topical contactants: expression of adhesion molecules and their ligands and characterization of the infiltrate

Erythema-multiforme-like reactions are a rare manifestation of allergic contact sensitivity, the pathomechanisms of which and their possible relationship to erythema multiform: remain unclear. We present our histopathological and immunohistochemical findings regarding the expression of several adhesion molecules and inmumophenotypic markers of the infiltrate in skin biopsy specimens from 2 cases of erythema-multiforme-like reactions due to contact sensitizers and 3 -cases of typical post-herpetic erythema multiforme. The histopathological pattern of erythema multiforme-like reactions was characterized by an upper-dermal perivascular tymphoid infiltrate with exocyiosis and keratinocyte necrosis: in 1 of the cases, there were foci of spongiosis and an admixture of eosinophils in the infiltrate. In comparison with biopsy specimens from cases of typical erythema multiforme, in both cases of erythema-multiforme-like reactions, the epidermal expression of ICAM-I was more prominent, the % of CD4⁺ cells in the infiltrate was higher and the % of CD69⁺ cells was lower. There were no other significant differences in the cell phenotype of the infiltrate or in adhesion molecule expression in biopsy samples from both disorders.     

Fibrinolytic treatment with tissue plasminogen activator in a thrombosed modified Blalock-Taussig shunt]

Thrombolytic therapy of a systemic pulmonary fistula is a rare method of treatment in newborns with thrombosed systemic-pulmonary shunt. We report the case of a newborn girl with a complex congenital heart defect. On the ninth day of life a modified right Blalock-Taussig shunt was performed. The ductus arteriosus was not ligated. Six days later the baby developed severe hypoxemia. The results of echocardiography and cardiac catheterization showed a total thrombosis of the fistula and complete absence of flow throughout the shunt. After insertion of an arterial catheter into the proximal end of the shunt we started fibrinolytic treatment with recombinant tissue plasminogen activator (r-TPA) in continuous infusion. After 14 hours of treatment we confirmed by angiography complete clot dissolution. The baby left the hospital in good condition when she was 23 days old. In the follow-up (4th month of life) the shunt is still permeable. Thrombolytic therapy with r-TPA locally applied in case of acute thrombosis of a systemic-pulmonary shunt appears to be a good therapeutic option avoiding the risks of a new surgical procedure.     

间硝苯地平对DOCA－salt高血压大鼠肥厚心肌膜碎片二氢吡啶结合位点的影响

用ＤＯＣＡ－ｓａｌｔ高血压大鼠心肌肥厚模型，观察间硝苯地平（ｍ－Ｎｉｆ）对肥厚心肌膜碎片二氢吡啶（ＤＨＰ）结合位点的影响。结果显示：预防或治疗性给予ｍ－Ｎｉｆ（２０ｍｇ·ｋｇ￣（－１）·ｄ￣（－１））１２或９周，血压降低，心室重和心肌线粒体钙含量减少，且肥厚心肌ＤＨＰ结合位点密度显著降低（４５０±２５，４６２±３６ｆｍｏｌ·ｍｇ￣（－１）ｖｓ８３６±４７ｆｍｏｌ·ｍｇ￣（－１）ｐｒｏｔｅｉｎ，Ｐ＜０．００１）。提示：ｍ－Ｎｉｆ预防和逆转ＤＯＣＡ－ｓａｌｔ高血压大鼠心肌肥厚的作用可能与其减少肥厚心肌ＤＨＰ结合位点密度和血压降低有关。     

膝关节韧带损伤的MRI诊断

目的：分析膝关节韧带损伤的MRI表现及诊断价值。资料与方法：回顾性分析22例经手术或关节镜检查证实的膝关节韧带损伤的MRI资料。结果：22例膝关节损伤患者中，共有37条韧带损伤，MRI检出其中的34条，其敏感性为91．9％，准确性为95．5％。交叉韧带损伤的MRI表现为韧带连续性中断，局灶或弥漫性肿胀，信号强度增加及断端移位。侧副韧带损伤的MRI表现为韧带连续性中断和／或韧带肿胀增粗，信号升高。结论：MRI是诊断膝关节韧带损伤的理想的非创伤性检查方法。