Nonpalpable breast lesion localization: limited efficacy of sonography

We attempted to use hand-held, high-resolution breast sonography to localize for biopsy 11 solid, nonpalpable lesions detected by mammography. Using sonography, we identified and localized only one of four lesions presenting as poorly defined masses and only one of seven lesions presenting as clusters of tiny calcifications. This 18% rate of success is too low to justify the use of sonography for all patients undergoing needle localization. Mammography remains the procedure of choice for localizing solid, nonpalpable breast masses and clustered calcifications.     

金艾康合并化学药物治疗肿瘤临床疗效观察

目的：探讨金艾康（汉防己甲素片）合用化学药物治疗肿瘤的临床增效作用。方法：通过比较治疗组与对照组（金艾康合并化学药物者为治疗组,单用化学药物者为对照组,每组各为３０例）的总缓解率与毒副反应来评价金艾康对化疗药物的增效作用。结果：治疗组与对照组的总缓解率分别为８０％与６６．７％,其中部分毒副反应如消化道反应与肢端订木症状等治疗组明显低于对照组。结论：金艾康具有对化学药物治疗肿瘤增效作用,其作用机理可     

Amniotic sheets

Seventeen cases of an aberrant sheet of tissue in the amniotic cavity are described to expand and clarify previous observations of this entity. The sheet of tissue demonstrates a thickened base and a free edge that undulates. The fetus moves freely about the sheet of tissue. There are no associated fetal deformities, and infants have no manifestations of the amniotic-band syndrome. Evidence suggests that these sheets may originate from "wrapping" of the amniochorionic membrane over a uterine synechia. These benign sheets of tissue should not be confused with the amniotic-band syndrome.     

Obstetrical magnetic resonance imaging: maternal anatomy

Eleven patients whose pregnancies were at 34-36 weeks of gestational development underwent magnetic resonance (MR) imaging. Images of the maternal pelvis were assessed for anatomical changes of pregnancy in comparison with MR images of five non-pregnant volunteers. The relationship of the fetal presenting part to the internal os of the cervix was seen in all patients. Effacement of the cervix was identified when present. The maternal spine demonstrated disk abnormalities in nine patients. Changes in venous flow patterns were readily identified in all patients. The inferior vena cava was flattened or obliterated, a high signal was present in the iliac vessels (TE 56), and large collateral vessels were present.     

Initiation of growth of baboon primordial follicles in vitro

Factors that cause some primordial follicles to enter the growth phase while the others remain quiescent are unknown. The hypothesis was tested that primate primordial follicles can survive and initiate growth in vitro in serum-free medium. Superficial pieces of ovarian cortex, containing mostly primordial follicles, were obtained from baboon fetuses during late gestation and cultured for 0, 2, 4, 7, 10 or 20 days in Waymouth MB 752/1 medium supplemented with insulin, transferrin, selenium, linoleic acid, and bovine serum albumin (ITS +). Histological examination of cortical pieces revealed that after 2 and 4 days in culture, the total number of primordial follicles had decreased by 55 and 76% (P < 0.01) respectively, relative to day 0 of culture. This was associated with a sustained, 5- to 8-fold increase in total primary follicles (P < 0.01) beginning on day 2 of culture. There was also a gradual increase in the total number of early secondary and secondary follicles. The average diameter of follicles and oocytes increased gradually throughout culture for all follicular categories (P < 0.01), except secondary follicles and oocytes. Immunohistochemical localization of proliferating cell nuclear antigen (PCNA), a marker for cell proliferation and growth, showed that PCNA was generally absent in primordial follicles on day 0, but was observed after 2 or 4 days in culture in both granulosa cells and oocytes of most growing follicles. Comparison of cortical pieces cultured for 10 or 20 days with ITS + versus 10% fetal bovine serum (FBS) showed a more pronounced decrease in the numbers of primordial follicles and more primary, early secondary and secondary follicles in ITS + compared to FBS-treated cortical pieces (P < 0.01 at 20 days). These results show that primordial follicles from non-human primates can survive and develop to the secondary stage in vitro in serum-free conditions.      

Development of the atrioventricular valve tension apparatus in the human heart

 Using various microscopical techniques we studied the development of the atrioventricular valves in human hearts between 5 and 19 weeks of development. Within the atrioventricular cushions two different layers could be recognized that remained present in all ages studied. The atrial layer, being present at the side of the atrioventricular orifice, was positive for laminin while the ventricular layer, that was connected to the myocardium, was positive for fibronectin and collagen III. Fate-mapping of these two layers, morphometrics, and scanning electron microscopy, supplemented with in vivo labeling of cushion tissue in chicken hearts have lead to new insights in the process of valve development. The cushions became freely movable prevalvular leaflets by delamination of ventricular myocardium underneath the cushion tissue. This myocardium gradually retracted towards annulus and papillary muscles and finally disappeared, resulting in fibrous, non-myocardial valves. The atrial layer of the cushions remained present as a jelly-like surface on the valve leaflets while the ventricular layer of the cushions became the compact fibrous tissue of the leaflets and the chords. Chordal development was first visible at 10 weeks of development when gaps were formed in the ventricular layer of the cushions on top of the papillary muscles. These gaps enlarged into the interchordal spaces while the cushion tissue in between the gaps lengthened to form the chords. We conclude that the leaflets as well as the chords of the atrioventricular valves are derived from atrioventricular cushion tissue. Myocardium is only important for loosening of the leaflets while keeping connection with the developing papillary muscles. Errors in delamination or retraction of myocardium or remodeling of cushion tissue into chords form the basis for various congenital valve anomalies. Accepted: 20 April 1998