Lymphatic vessel density as prognostic factor in breast carcinoma: relation to clinicopathologic parameters

Angiogenesis and lymphangiogenesis are essential for breast cancer growth and progression. This study aimed at investigating lymphatic microvessel density (LVD) and microvessel density (MVD) as prognostic markers in breast carcinoma. Forty breast carcinomas were immunostained for D2-40, CD31 and VEGF. Median lymphatic and blood microvessel densities, as well as VEGF expression, were related to each other and to clinicopathologic parameters including lymph node (LN) status. The efficacy of haematoxylin and eosin (H&E) in detecting lymphatic vessel invasion (LVI) compared to D2-40 immunostaining was also investigated. D2-40 stained normal lymphatic endothelium and myoepithelial cells, but with different staining patterns. D2-40 LVD related significantly to CD31 counts (r=0.470; p=0.002), and LN metastasis (Mann-Whitney U=101.500; p=0.043); however, it did not relate to age, tumor grade, tumor size or LVI. D2-40 identified LVI in 3 more cases (7.5%) than those detected by H&E. VEGF was expressed in 85%of cases, and was significantly related to CD31 and D2-40 counts (p=0.033 and 0.007, respectively). In conclusion, D2-40 LVD showed a significant association with LN metastasis, and can be considered to segregate patients with positive from those with negative LNs. D2-40 enhances the detection of LVI relative to H&E staining reflecting a potential for lymphatic metastatic spread and possible poor prognosis.     

Splanchnic compartmentation in schistosomal portal hypertension

Twenty-five cases with portal hypertension of schistosomal origin taken at random were studied. The transumbilical portal pressure, the transsplenic portal pressure, the left gastric vein portal pressure, and the superior mesentric vein portal pressure were measured at the same time in each. The transumbilical portal pressure-transsplenic portal pressure gradient, the transumbilical portal pressure-left gastric vein portal pressure gradient; the transsplenic portal pressure-left gatric vein portal pressure gradient; the transumbilical portal pressure-superior mesenteric portal pressure gradient; the transplenic portal pressure-superior mesenteric portal pressure gradient; and the left gastric vein portal pressure-superior mesenteric portal pressure gradients were found to be of particular value in defining five different hemodynamic patterns or splanchnic compartments, especially when correlated with the changes in the splanchnic vasculature as demonstrated by transumbilical portography and splenoportography. The type of pattern and the clinicopathological stage were considered in the selection of the most appropriate surgical procedure to alleviate the portal hypertension and/or its consequences.     

Intensified insulin therapy during fasting of Ramadan in type 1 diabetic patients

Evaluate safety of insulin glargine/aspart regimen in type 1 diabetics who are willing to fast Ramadan. Thirty-three patients with type 1 diabetes (mean age ± SD; 21.9 ± 8.7 years) were included. One week before the study, clinical and laboratory evaluations were undertaken. Patients on basal/bolus insulin had their doses adjusted. Those with another insulin regimen were changed to glargine/aspart regimen with adjustment of doses. At the beginning of Ramadan, patients were shifted to glargine once-daily and aspart before Iftar (sunset-meal), Suhur (sunrise-meal) and a meal in between. Total dose was reduced to 90% of pre-Ramadan dose. Patients were instructed to report any hypoglycemia, severe hyperglycemia or ketosis, and their self-monitored plasma glucose at five planned visits in Ramadan. All clinical and laboratory evaluations were repeated at the end-of-Ramadan. At the end of Ramadan, there was no report of severe hypoglycemia, hyperglycemia or diabetic ketoacidosis. Twenty patients suffered 70 hypoglycemia events; one discontinued fasting in 2 days. There was no significant change in HbA1c (p = 0.373) between pre-Ramadan (Mean ± SD; 6.5 ± 1.2%) and end-of-Ramadan level (Mean ± SD; 6.9 ± 1.2%). Moreover, there was no significant change (p = 0.251) in fructosamine level between pre-Ramadan (2.8 ± 0.9 mol/L) and end-of-Ramadan (3.2 ± 1.1 mol/L). Insulin dose had increased by 7% of the starting dose (p = 0.0496). There was no significant (p?>?0.05) change in weight, BMI and lipid profile at the end–of-Ramadan. Patients with type 1 diabetes can fast Ramadan safely, using low-peak basal insulin and rapid-acting pre-meal insulin, under strict blood glucose-monitoring and close supervision.     

中国精神分裂症患者认知电位P300研究的系统评价

目的 评价中国精神分裂症患者认知电位P300的特点及影响因素.方法 制定原始文献的纳入标准、排除标准及检索策略,检索PubMed、EMBase、Web of knowledge、Cochrane Library、PsycINFO、中国期刊全文数据库、万方数据库、维普中文科技期刊数据库及中国生物医学文献光盘数据库等.应用加强观察性流行病学研究报告的质量(STROBE)为参照评价标准评价文献质量.采用Stata 11软件对满足纳入标准的研究资料进行Meta分析.结果 共有38篇文献符合纳入标准进行Meta分析.随机效应合并分析显示,精神分裂症患者P300波幅低于正常对照组[总效应Z=7.98,合并SMD=-0.937,95％CI( -1.167～ -0.706),P＜0.000 01],潜伏期大于正常对照组[总效应Z＝7.69,合并SMD=0.969,95％CI(0.722～1.215),P＜0.000 01],差异均有统计学意义.敏感性分析结果显示,两组的合并效应结果稳定性均较好.Meta回归显示波幅与检验仪器(P＝0.036)有关,而潜伏期可能与是否用药(P＝0.099)有关.结论 精神分裂症患者存在认知电位P300异常,表现为波幅降低和潜伏期延长,两个指标的稳定性均较好.     

FS03.7Tape stripping procedure: influence of anatomic site, application pressure, duration and removal

Background and Objectives:  Tape stripping is a common method for investigating stratum corneum (SC) physiology as well as bioavailability and bioequivalence of topical drugs. However, little is known concerning the influence of procedures (anatomic site, pressure, pressure duration, tape removal rate) inherent in each stripping protocol.
Methods:  Tape stripping was performed using tapes on the forearm, forehead and back. On the forearm different pressures (165 and 330 g cm⁻²), durations of pressure (2s and 10s), and removal rate (slow and rapid removal) was performed. Changes in skin physiology were evaluated by measurement of transepidermal water loss (TEWL) and hydration.
Results:  A significant influence of all parameters on the TEWL‐increase as a function of tape strip number was observed. The fastest increase was demonstrated on the forehead, followed by the back and, lastly, the forearm. Rapid removal produced a protracted increase in comparison to the slow removal. 10s pressure induced a faster increase of TEWL than 2s pressure. Likewise, the 330 g cm⁻² pressure induced an earlier increase than the 165 g cm⁻². Skin hydration was not influenced by the variables tested.
Conclusion:  Tape stripping results are influenced dramatically by all investigated parameters. A standardized procedure is necessary for a comparable study design. A dynamic SC stress test to more closely investigate SC cohesion is proposed based on the present observations.     

Increased release of the soluble form of the adhesion molecules L-selectin and ICAM-1 but not E-selectin during attacks of angina pectoris

Summary Myocardial ischemia leads to the activation of neutrophils as well as endothelial cells. The interaction between these cells is dependent on certain adhesion glycoproteins which are expressed on their surface. Adhesion of neutrophils to endothelium, mediated by adhesion molecules, has been shown to result in coronary capillary plugging and impairment of coronary blood flow. In certain conditions, upon cell activation, adhesion proteins may be released in soluble form into the circulating blood. The purpose of our study was to verify whether myocardial ischemia occurring during angina episodes results in the release of the soluble adhesion molecules, L-selectin, E-selectin, and intracellular adhesion molecule-1 (ICAM-1), into the circulation. Plasma samples were collected by venepuncture from 15 patients admitted to the emergency room with chest pain caused by attacks of angina pectoris and 15 patients with noncardiac chest pain. To confirm the diagnosis, all patients underwent an exercise stress test and, if not conclusive,^99mTc MIBI SPECT or coronary arteriography. Another set of plasma samples were taken from each patient in the absence of chest pain. In addition, blood for analysis was obtained from 15 sexand age-matched healthy subjects. Soluble adhesion molecules plasma levels were measured by standard enzyme-linked immunosorbent assay. In patients with angina pectoris, plasma levels of soluble L-selectin estimated during chest pain were significantly higher than in the control group and decreased in the absence of chest pain. Similarly, the mean concentration of soluble ICAM-1 at the time of angina onset was significantly elevated in the patients in comparison with the control group and remained higher, although not significantly, in the absence of chest pain. In patients with noncardiac chest pain, plasma levels of soluble L-selectin did not differ significantly from those observed in control subjects. In this group of patients, the plasma levels of soluble ICAM-1 estimated during pain onset and in the absence of this symptom were not significantly elevated. On the contrary, the mean values of soluble E-selectin in the patients with ischemic cardiac pain during chest pain and in the absence of this symptom, as well as those in the patients with noncardiac chest pain during or without symptoms, remained unchanged in comparison with the control group. During attacks of angina pectoris an increase in the plasma levels of the soluble adhesion molecules, ICAM-1 and L-selectin, was noted, possibly reflecting activation of neutrophils and endothelial cells during myocardial ischemia. However, Eselectin plasma levels remained unchanged in response to myocardial ischemia.Presented in part at the American College of Cardiology Session, Anaheim, CA, 1997, and published in abstract form in JACC 1997; 29/2 supplement A, 336A.The work was supported in part by grant from Komitet Badañ Naukowych.     

510.6nm激光对兔血管平滑肌细胞、内皮细胞选择性损伤作用的研究

目的 观察激光照射后兔血管平滑肌细胞、内皮细胞形态结构变化特点，观察激光对血管壁的损伤是否有选择性，为防止再狭窄提供实验依据。方法 用能量密度为50、100、150和200J／cm^2的铜蒸气激光照射兔腹主动脉，分别用光镜、电镜、图像分析方法，观察激光照射后第24小时，血管平滑肌细胞、内皮细胞形态、结构变化。结果 100J／cm^2能量密度的激光照射后，血管平滑肌细胞出现细胞核固缩，细胞质凝集贴边，细胞核面积均值缩小等损伤性改变。经同等剂量激光照射，而内皮细胞无明显变化。结论 经100J／cm^2的铜蒸气激光照射可损伤在体血管平滑肌细胞，而对内皮细胞无明显作用。激光对血管壁的损伤具有一定的选择性。