舰船员慢性荨麻疹与马拉色菌相关性研究

目的研究舰船员慢性荨麻疹发病与马拉色菌的关系。方法对126例舰船员慢性荨麻疹患者及45例健康者进行真菌学比较研究。将马拉色菌阳性的82例慢性荨麻疹患者分为A、B两组,A组单用抗组胺药,B组用抗组胺药联合2%酮康唑洗剂治疗。结果舰船员慢性荨麻疹患者皮肤马拉色菌带菌率高于正常对照组(P<0.01),两治疗观察组于治疗结束时,疗效无显著性差异(P>0.05);治疗结束6~8周后,B组疗效高于A组,有显著性差异(P<0.01),且B组真菌学检查马拉色菌转阴率高于A组(P<0.01)。结论舰船员慢性荨麻疹与皮肤马拉色菌有一定相关性,联合抗真菌治疗能提高其远期疗效。     

超声探讨室间隔缺损合并动脉导管未闭的诊断方法

目的:超声探讨室间隔缺损合并动脉导管未闭(VSD PDA)患者的动脉导管未闭(PDA)显示方法.方法:超声测量41例VSD PDA和41例单纯室间隔缺损(VSD)患儿的主动脉峰值流速(Vp),平均流速(Vm),流速时间积分(VTI)和心排指数(CI).除常规在胸骨旁大动脉短轴切面探查以外,彩色多普勒超声心动图在胸骨旁肺动脉分叉切面、胸骨上主动脉弓长轴,向短轴扫查切面及剑突下主动脉短轴切面探查PDA.结果:41例VSD PDA患者检出PDA 29例,占70.73%,漏诊12例,漏诊率29.27%.VSD PDA患者的Vp、Vm、VTI和CI参数明显高于单纯VSD患者,P<0.001.4例在胸骨旁大动脉短轴切面未显示的PDA,其中2例在胸骨旁肺动脉分叉切面发现PDA,1例在胸骨上主动脉弓长轴向短轴扫查切面显示PDA,1例在剑突下主动脉短轴切面显示PDA.结论:VSD患儿主动脉Vp、Vm、VTI和CI参数增高时提示合并PDA存在.探查VSD患儿胸骨旁肺动脉分叉切面、胸骨上主动脉弓长轴向短轴扫查切面及剑突下主动脉短轴切面有助于发现PDA.     

Can a leukocyte depletion filter (LDF) reduce the risk of reintroduction of hepatocellular carcinoma cells?

During liver transplantation for hepatocellular carcinoma (HCC) patients, HCC could theoretically be introduced into the systemic circulation when salvaged blood is used with an autotransfusion device. Several reports have shown that some types of leukocyte depletion filters (LDFs) could completely reduce the risk for reintroducing some types of tumor cells. In this study, we tested the ability of the LDF (RCEZ1T, Pall Biomedical Co, NY, USA) to reduce the risk for reintroducing HCC cells in vitro by using a very sensitive detection method. We divided the test group into 6 groups: group I was 10 cells, group II was 20 cells, group III was 2 x 10(3) cells, group IV was 2 x 10(5) cells, group V was 2 x 10(6) cells, and group VI was 2 x 10(7) cells. The counted cells in 200 mL saline were passed through the RCEZ1T using the force of gravity. To identify the presence of cells, the pellet was resuspended, and polymerase chain reaction (PCR) was performed. Glyceraldehyde-3-phosphate dehydrogenase (GAPDH), a housekeeping gene, was used as a primer. In groups I and II, the HCC cells were completely filtered in all experiments. However, in groups III, IV, and V, the HCC cells were not completely filtered in a few of the repeated experiments, with the unfiltered rate of tumor cells being between 8% and 20%. In group VI, the HCC cells were not completely filtered in all the repeated experiments. In conclusion, the RCEZ1T filter markedly reduced the risk for reintroduction of HCC cells. However, at high HCC cell load the filter cannot completely remove all the tumor cells. Further studies are required to assess the impact in clinical settings.     

DNA探针的高效标记和哺乳动物细胞转化子的检测

本实验采用随机引物法标记探针DNA.探针DNA加热变性成单链,以单链DNA为模板,六聚脱氧核苷酸为引物,在DNA多聚酶I大片段的作用下进行放射性标记.标记探针的比放射性达10~8cpm/μg DNA以上.放射性底物的掺入率为60%.用该方法标记的人高度重复顺序探针,可以检出微微克水平的阳性分子.与人HeLa S_3细胞DNA转化的小鼠LTK~+细胞DNA打点杂交呈阳性,与未经转化的小鼠LTK~-细胞DNA杂交为阴性,证明小鼠转化细胞中存在HeLa细胞DNA,DNA转化是成功的.     

Cerebral hemodynamic and metabolic profiles in fulminant hepatic failure: relationship to outcome.

The purpose of this retrospective study was to examine the potential role of cerebral hemodynamic and metabolic factors in the outcome of patients with fulminant hepatic failure (FHF). Based on the literature, a hypothetical model was proposed in which physiologic changes progress sequentially in five phases, as defined by intracranial pressure (ICP) and cerebral blood flow (CBF) measurements. Seventy-six cerebral physiologic profiles were obtained in 26 patients (2 to 5 studies each) within 6 days of FHF diagnosis. ICP was continuously measured by an extradural fiber optic monitor. Global CBF estimates were obtained by xenon clearance techniques. Jugular venous and peripheral artery catheters permitted calculation of cerebral arteriovenous oxygen differences (AVDO2), from which cerebral metabolic rate for oxygen (CMRO2) was derived. A depressed CMRO2 was found in all patients. There was no evidence of cerebral ischemia as indicated by elevated AVDO2s. Instead, over 65% of the patients revealed cerebral hyperemia. Eight of the 26 patients underwent orthotopic liver transplantation-all recovered neurologically, including 6 with elevated ICPs. Of the 18 patients receiving medical treatment only, all 7 with increased ICP died in contrast to 9 survivors whose ICP remained normal (P < 0.004). Hyperemia, per se, was not related to outcome, although it occurred more frequently at the time of ICP elevations. Six patients were studied during brain death. All 6 revealed malignant intracranial hypertension, preceded by hyperemia. In conclusion, the above findings are consistent with the hypothetical model proposed. Prospective longitudinal studies are recommended to determine the precise evolution of the pathophysiologic changes.     

MTT法和水溶性四氮唑(WST-1)法检测中波紫外线照射HaCaT细胞后活力的比较

目的:观察中波紫外线照射后HaCaT细胞活力的变化并探讨水溶性四氮唑(WST-1)法检测的适用性.方法:将HaCaT细胞分为对照组(假照射组)、300J/m2、600J/m2、900J/m2紫外线照射后24h组(每组6个样本).600J/m2紫外线照射后4h组、8h组、1 2h组、24h组、48h组、72h组(每组6个样本).血球计数板计算HaCaT细胞数量.四甲基偶氮唑盐(MTT)法和水溶性四氮唑(WST-1)法活性测定HaCaT细胞活性.结果:MTT法显示300J/m2、600J/m2、900J/m2紫外线照射HaCaT细胞24h后光密度(OD)值明显较0J/m2组低;WST-1法各组OD值明显比0J/m2组低.MTT法显示600J/m2紫外线照射HaCaT细胞8h、12h、24h、48h、72h后OD值明显比0J/m2组低.WST-1法显示600J/m2紫外线照射HaCaT细胞4h后OD值较0J/m2组低;600J/m2紫外线照射HaCaT细胞8h、12h、24h、48h、72h后OD值明显比0J/m2组低.WST-1法的OD值与细胞计数、MT法OD值呈正相关.结论:随着紫外线剂量的加大和照射后时间延长,HaCaT细胞数量减少,细胞的活力下降,WST-1代谢活性亦降低,呈时间和剂量依赖性.HaCaT细胞可对WST-1进行代谢,适用于该细胞增殖研究.     

Performance measurement of the microPET focus 120 scanner.

The microPET Focus 120 scanner is a third-generation animal PET scanner dedicated to rodent imaging. Here, we report the results of scanner performance testing. METHODS: A (68)Ge point source was used to measure energy resolution, which was determined for each crystal and averaged. Spatial resolution was measured using a (22)Na point source with a nominal size of 0.25 mm at the system center and various off-center positions. Absolute sensitivity without attenuation was determined by extrapolating the data measured using an (18)F line source and multiple layers of absorbers. Scatter fraction and counting rate performance were measured using 2 different cylindric phantoms simulating rat and mouse bodies. Sensitivity, scatter fraction, and noise equivalent counting rate (NECR) experiments were repeated under 4 different conditions (energy window, 250 approximately 750 keV or 350 approximately 650 keV; coincidence window, 6 or 10 ns). A performance phantom with hot-rod inserts of various sizes was scanned, and several animal studies were also performed. RESULTS: Energy resolution at a 511-keV photopeak was 18.3% on average. Radial, tangential, and axial resolution of images reconstructed with the Fourier rebinning (FORE) and filtered backprojection (FBP) algorithms were 1.18 (radial), 1.13 (tangential), and 1.45 mm full width at half maximum (FWHM) (axial) at center and 2.35 (radial), 1.66 (tangential), and 2.00 mm FWHM (axial) at a radial offset of 2 cm. Absolute sensitivities at transaxial and axial centers were 7.0% (250 approximately 750 keV, 10 ns), 6.7% (250 approximately 750 keV, 6 ns), 4.0% (350 approximately 650 keV, 10 ns), and 3.8% (350 approximately 650 keV, 6 ns). Scatter fractions were 15.9% (mouse phantom) and 35.0% (rat phantom) for 250 approximately 750 keV and 6 ns. Peak NECR was 869 kcps at 3,242 kBq/mL (mouse phantom) and 228 kcps at 290 kBq/mL (rat phantom) at 250 approximately 750 keV and 6 ns. Hot-rod inserts of 1.6-mm diameter were clearly identified, and animal studies illustrated the feasibility of this system for studies of whole rodents and mid-sized animal brains. CONCLUSION: The results of this independent field test showed the improved physical characteristics of the F120 scanner over the previous microPET series systems. This system will be useful for imaging studies on small rodents and brains of larger animals.     

Saccular Aneurysm of the Azygos Anterior Cerebral Artery: Three Case Reports

The azygos anterior cerebral artery, a rare anomaly in the circle of Willis in which only a single vessel supplies the medial aspects of both anterior cerebral hemispheres, is closely associated with saccular aneurysms. We present three cases of azygos anterior cerebral artery aneurysms among the 781 cerebral aneurysms surgically treated at our institution in an 11-year period. These three cases all involved elderly women who presented with subarachnoid hemorrhage. Conventional cerebral angiography and CT angiography revealed small saccular aneurysms at the distal ends of the azygos anterior cerebral arteries. These aneurysms were clipped successfully using a bifrontal interhemispheric approach. Hence, the pathogenesis of these particular aneurysms relating to hemodynamic change, associated anomalies, and surgical pitfalls is discussed with review of literature.     

The tuberous breast revisited.

BACKGROUND: The tuberous breast presents a problem for which many surgical solutions have been described. Current teaching describes how the tuberous breast deformity is the result of skin shortage as well as herniation of breast tissue through the nipple-areola complex. However, through careful clinical observation we now believe that the only abnormality present is herniation of breast tissue through the nipple-areola complex. METHODS: Using this principle, we have refined a one-stage surgical procedure that can be used to correct any type of tuberous breast deformity. Since 2001 we have performed our technique on a series of 13 tuberous breasts of widely varying appearances in eight patients (age 17-24 years) with a follow up varying between 3 and 56 months. Our new understanding of the tuberous breast deformity has also made it possible to develop an objective, reproducible method for defining the tuberous breast based on the degree of areola herniation. RESULTS: All patients reported high levels of satisfaction with the procedure. Assessment of the results by an independent panel of attending surgeons showed all results to be good/excellent. Moreover, the results have improved with time and no revisions have been needed. Our method of defining the tuberous breast (based on the ratio of areola herniation:areola diameter) enabled us to identify a cut-off to decide (objectively) when a breast was tuberous. This allowed us to anticipate when an areola reduction/tightening procedure would be necessary to avoid a 'double-bubble' deformity. CONCLUSION: We propose a one-stage surgical procedure which is applicable to all degrees of tuberous breast deformity. The results appear to confirm our theory that the only abnormality present in the tuberous breast is herniation of breast tissue through the nipple-areola complex. In patients with small breasts and a tuberous deformity, correction of the herniation changes the tuberous breast into a simple hypoplastic breast. The volume deficit can then be corrected by augmentation (if desired by the patient). In patients with sufficient breast volume, correction of the herniation alone will correct the deformity.