Estrogen receptors in the external anal sphincter

Inasmuch as anal competence in women is reduced after the age of 50 years, it may be dependent on effects of estrogens. In this study, samples of the external anal sphincter were analyzed for the presence of estrogen receptors and were found to be present at a median concentration of 5.0 fmol per milligram of protein (range, 1.9 to 13) in women (n = 7), and 1.1 fmol per milligram of protein (range, 0 to 3.2) in men (n = 7). These findings are of interest with regard to the treatment of idiopathic anal incontinence.     

Antibodies against dengue virus E protein peptide bind to human plasminogen and inhibit plasmin activity

Both mice and rabbits immunized with dengue virus E protein peptide spanning amino acids 100–119 (D4E) produced antibodies that reacted not only with the D4E peptide itself but also with human plasminogen, as shown by ELISA and Western blot. Sera from dengue virus-hyperimmunized mice and dengue patients also contained antibodies against D4E and plasminogen. Furthermore, such sera all contained plasmin inhibitory activity. Using affinity-purified anti-D4E antibodies and free D4E peptide for competitive inhibition, we demonstrated that the inhibition of plasmin activity was due to anti-D4E antibodies rather than other substances in the sera. Taken together, these results suggest dengue virus E protein amino acids 100–119 are a cross-reactive immunogenic region, and antibodies against this region may interfere with human fibrinolysis.     

Optimizing Suicide Gene Therapy for Head and Neck Cancer

An effective “suicide gene” therapy strategy in experimental studies has been the use of the herpes simplex virus thymidine kinase gene(HSV-tk) to sensitize tumors to the cytotoxic effects of ganciclovir administration. Previous studies using this model have focused on utilizing maximal viral titers and high levels of ganciclovir that are not compatible with human dosing. Because of the high ganciclovir doses and the maximal viral titers, this strategy has limited application to actual clinical scenarios. In the following studies the authors investigate tumor regression in an oral squamous cell carcinoma animal model as a function of variable adenoviral titers and more physiologic ganciclovir dosing. Using adenoviral titers ranging from 1 × 10⁸ to 2 × 10⁹ plaque forming units(pfu) to treat oral tumors, they found no statistical difference in tumor regression among the different viral doses, despite differences in mitotic activity. Each treatment group, however, demonstrated a significant effect on tumor regression when compared with controls. Furthermore, the authors were able to reduce the level of ganciclovir administration to 10 mg/kg twice daily from established levels of 100 to 150 mg/kg twice daily while maintaining significant tumor responses to the HSV-tk therapy. Mean survival of animals treated with this lower ganciclovir dose was significantly higher than in controls and was equal to established means based on previous studies using higher ganciclovir doses. The optimization of this suicide gene therapy strategy is imperative in order to minimize theoretical and known viral and ganciclovir toxicities while establishing a foundation upon which to design appropriate and effective clinical trials.     

BTA在膀胱癌诊断中的应用

为了探求对膀胱肿瘤诊断及术后复发监测的理想手段，从１９９５年９月～１９９６年６月，采用ＢＴＡ试剂检测方法对２０２例血尿患者及７１例膀胱肿瘤术后的患者进行了诊断检测，诊断膀胱癌的敏感度为９６％、特异度为８３％、准确度为８６％，２６例膀胱肿瘤患者中仅６例（２３％）尿脱落细胞阳性，正常对照均为阴性。认为ＢＴＡ试剂是一种快速、有效、无创性诊断膀胱肿瘤的方法。     

小肝癌的病理与螺旋CT诊断

原发性肝癌(primaryhepatocellularcarcinoma,PH CC)在我国是居第3位的恶性肿瘤,每年患者达11万之多,预后甚差[1]。肝癌的早期诊断,是提高患者5年生存率的重要手段,也是影像学面临的重大课题。直径>3cm的病灶,各种影像学技术的检出敏感性均很高,无统计学差异。而对于小肝癌(SHCC),特别是微小肝癌(MHCC)的检出仍有一定困难,其检出敏感性有一定差异。以往文献报道术中超声、CT动脉门脉造影(CTAP)和碘油CT的敏感性最高,但均为创伤性检查,临床应用有严格指征。1989年螺旋CT机问世,其连续快速扫描和容积数据采集成像技术的应用,特别是近…     

巨大浆膜下子宫肌瘤的CT与MRI诊断

目的:探讨巨大浆膜下子宫肌瘤(giant subserous hysteromyoma,GSH)的CT与MRI表现,以期提高诊断水平。方法:回顾性分析15例GSH的CT平扫、增强扫描及14例MRI平扫1、0例增强扫描表现并与手术病理结果对照。结果:5例CT表现呈非均匀实性的GSH在增强后内部呈多个大小不等的结节状改变,其间可见分隔结构,4例呈非均匀实性的GSH增强后呈"漩涡状"混杂密度,3例GSH瘤体边缘见低密度带。MRI T1WI所有肌瘤表现为等、低信号,T2WI表现为低或混杂信号,5例瘤体内部为结节状改变,其间可见高信号分隔结构,7例瘤体边缘见低信号带。结论:GSH的CT与MRI表现有一定的特征性,具有较高的诊断价值。     

超声刀在腹腔镜胆囊切除术中的应用研究

目的　探讨超声刀在腹腔镜胆囊切除术中的应用价值。方法　将 86例腹腔镜胆囊切除术患者随机分为超声刀组 ( 3 4例 )与电刀组( 5 2例 ) ,分别使用超声刀与单极电刀完成手术 ,比较术中及术后的效果。结果　 86例手术顺利完成 ,无中转开腹。手术时间分别为 ( 4 5±7)min和 ( 62± 9)min(P <0 0 1) ,术中出血量分别为 ( 5± 0 .8)ml和 ( 2 0± 5 )ml(P <0 .0 1) ,术后肠道功能恢复时间分别为 ( 2 0± 4)h和 ( 2 4±6)h(P <0 0 1) ,两组均无胆瘘发生。结论　超声刀在腹腔镜胆囊切除术中较电刀更快捷 ,出血更少 ,术后恢复更快     

Ultrastructural identification of cholinergic neurons in the external cuneate nucleus of the gerbil: acetylcholinesterase histochemistry and choline acetyltransferase immunocytochemistry

Summary Using acetylcholinesterase histochemical and choline acetyltransferase immunocytochemical localization methods, this study has provided conclusive evidence for the existence of cholinergic neurons in the external cuneate nucleus of gerbils. By light microscopy, both acetylcholinesterase and choline acetyltransferase labelling was confined to the rostral portion of the external cuneate nucleus. Ultrastructurally, acetylcholinesterase reaction products were found in the nuclear envelope, cisternae of rough endoplasmic reticulum and Golgi saccules of some somata and large dendrites as well as in the membranes of small dendrites, myelinated axons and axon terminals. These neuronal elements were also stained for choline acetyltransferase; immunoreactivity was associated with nuclear pores, nuclear envelope, perikaryal membrane and all the membranous structures within the cytoplasm. Of the total choline acetyltransferase-labelled neuronal profiles analysed, 79% were myelinated axons, 15% dendrites, 4% somata and 2% axon terminals. The immunostained axon terminals consisted of two types containing either round (Rd type; 62.5%) or pleomorphic (Pd type; 37.5%) vesicles. Both were associated directly with choline acetyltransferase-positive dendrites. In contrast to the paucity of choline acetyltransferase-labelled axon terminals, numerous choline acetyltransferase-positive myelinated axons were present. It may thus be hypothesized that most, if not all, of the external cuneate nucleus cholinergic neurons are projection cells; such cells may give rise to axonal collaterals which synapse onto their own dendrites for possible feedback control. Choline acetyltransferase-positive dendrites were contacted by numerous unlabelled presynaptic boutons, 60% of which contained round or spherical synaptic vesicles (Rd boutons) and 40% flattened vesicles (Fd boutons), suggesting that these neurons are under strong inhibitory control. The preferential concentration of cholinergic components in the rostral external cuneate nucleus may be significant in the light of the highly organized somatotopy in the external cuneate nucleus and its extensive efferent projections to medullary autonomic-related nuclei. Our results suggest that the cholinergic neurons may be involved in somatoautonomic integration.     

支气管肺隔离症1例报道

男性,28岁,体检发现右下肺肿块1月余,无明显自觉症状.以往有肺结核病史.胸部X线平片(图1)显示右肺下叶后基底段一6 cm×4 cm×5 cm的团块影,边缘清晰,双肺上叶可见陈旧性结核灶.CT增强扫描(图2)显示右下肺肿块,中央CT值约40HU,增强后无强化,肿块内侧可见一粗大的血管断面伴随,血管与肿块关系密切.CT血管造影(CTA)MIP重建显示一较大的血管自膈下发出一直径约1cm的供血动脉,并可见引流的肺静脉影(图3).     

侵袭性真菌感染及治疗策略

近年来，全球侵袭性真菌感染（invasive fungal infections，IFI）的发病明显增加，儿童IFI亦呈增加趋势，而且在医院内感染中居重要位置。由于IFI常发生在有严重基础疾病的患儿，其临床表现和组织病理变化与其他许多疾病很相似，使诊断存在一定难度，临床上容易出现误诊和漏诊，延误治疗，病死率很高。所以，IFI的诊治已成为儿科当前的重要问题。