含栅栏状肉芽肿样小体(巨菊形团)的低度恶性纤维肉瘤--报道1例转移病例

自Ｌａｎｅ等 1997年详细报道了ＨＳＣＴＧＲ后 ,一直没有该肿瘤转移潜能的证据 ,该文报道 1例 2 8岁女性右上臂三角肌内ＨＳＣＴＧＲ(8 7ｃｍ× 5 5ｃｍ× 4 0ｃｍ大小 ) ,术后 4年右肺转移 ,并于 6年后行肺部手术 ,取出 0 6ｃｍ～ 1 2ｃｍ大小转移性结节 3枚。肿瘤从大体形态到超微结构及免疫组化表现与前文相似。本文总结出该病光镜下由梭形细胞为主 ,构成 3种图像 :①纤维瘤样区 ,为肿瘤的主要成分 ,无核分裂象 ;②细胞区 ,细胞丰富 ,核浓染 ,胶原减少 ,罕见核分裂象 ;③特征性病变 (有诊断意义 ) ,即由丰富细胞核环绕的玻璃样变小体 …     

慢性硬膜下血肿168例的诊治和预后

0　引言　 1 992 - 0 5～ 1 999- 0 5我科收治慢性硬膜下血肿 (CS-DH) 1 6 8例 ,其中 1 6 4例经颅骨钻孔冲洗引流术治疗 ,4例保守治疗 ,结果 1 6 5例治愈 ,3例死亡 .结论 :CSDH的诊断主要依靠 CT检查 ,手术简单 ,防止并发症可改善预后 .1　临床资料　男 1 6 3例 ,女 5例 ,年龄 32～ 79岁 ,平均 5 4岁 .有明确的外伤史 1 4 5例 (86 .3% ) ,原因不明 2 3例(1 3.7% ) ,病程 3wk～ 6 a.头昏、头痛、呕吐 1 1 6例 ,肢体运动障碍 6 8例 ,智力及精神障碍 46例 ,语言障碍 1 0例 ,感觉障碍2 1例 ,排尿障碍 5例 ,癫痫 3例 ,视乳头水肿 92例 ,锥体…     

Inflammatory markers in cystic fibrosis

Plasma neutrophil elastase-alpha 1 antiproteinase complex, lactoferrin and C-reactive protein (CRP) were determined over a 15-month period in 26 patients with cystic fibrosis, of whom 21 were chronically infected with Pseudomonas aeruginosa. Median concentrations of both neutrophil products and CRP were greater in patients who were clinically stable than in healthy subjects without cystic fibrosis. CRP concentrations increased further at the onset of symptomatic exacerbations. Thirty-five courses of intravenous antibiotics and 22 courses of oral ciprofloxacin were reviewed and revealed similar improvements in clinical scores and lung function tests for both forms of treatment. Intravenous antibiotics reduced the plasma concentrations of both neutrophil products and CRP, while oral ciprofloxacin only significantly reduced the concentration of neutrophil elastase-alpha 1 antiproteinase complex. Plasma concentrations of inflammatory markers were significantly greater in exacerbations associated with fever and leukocytosis. Statistical modelling demonstrated negative within-patient relationships between lung function and both CRP and lactoferrin, and positive relationships between the three inflammatory markers. Neutrophil granule products and CRP reflect the pulmonary inflammatory state in cystic fibrosis and may be of value in monitoring treatment.     

Night blindness and conjunctival xerosis caused by vitamin A deficiency in patients with cystic fibrosis.

Forty three patients with cystic fibrosis, aged 8-44 years (median 16 years), were examined for evidence of vitamin A deficiency. Eight patients had abnormal dark adaptation tests and three had conjunctival xerosis. Serum vitamin A and retinol binding protein concentrations were significantly lower in the affected patients who were also more likely to have abnormal liver function tests. Five patients were treated with 100,000-200,000 IU water miscible vitamin A orally and their daily vitamin supplements were increased to maintain normal concentrations. In four patients dark adaptation tests were repeated. Three were normal, but one patient required three further doses of water miscible vitamin A and a daily supplement of 12,000 IU vitamin A before her dark adaptation threshold returned to normal. Adolescents with cystic fibrosis are liable to develop night blindness and conjunctival xerosis, particularly if they have liver disease or fail to take daily vitamin supplements.     

Anthropometry underestimates body protein depletion in haemodialysis patients

The body composition of 62 haemodialysis patients (41 males) and 63 controls (30 males) was assessed using anthropometry and in vivo neutron activation analysis of body nitrogen. There was no significant difference between patients and controls in body mass index (BMI) and percentage body fat. Arm muscle circumference was significantly reduced in males. Lean body mass was strongly correlated with body nitrogen in controls (r = 0.951) but less so in patients (r = 0.876). The mean standardised body nitrogen index (NI) was reduced in male patients by 13% (95% confidence interval -9 to -17%) and in females by 4% (95% confidence interval +4 to -12%). Of the 16 patients with a NI below the control range, arm muscle circumference was below the control range in only 3 and BMI less than 18 kg/m2 in 2. NI was correlated negatively with the duration of renal replacement therapy, duration of haemodialysis, the number of previous failed transplants and the total dose of steroids received but not with current energy or protein intakes. Steroid dose was the only significant independent variable. Anthropometry underestimates body protein depletion in haemodialysis patients and the degree of protein loss is related to the cumulative dose of corticosteroids previously received.     

T-cell hybridomas specific for self and foreign thyroglobulins.

We have used somatic cell fusion techniques to produce and characterize murine T-cell hybridomas with specificity for self and foreign thyroglobulin (Tg). Two interleukin-2 (IL-2)-releasing I-Ak-restricted hybrid clones with specificity for self determinants on syngeneic Tg were derived from Tg-specific T-cell lines. These two autoreactive hybridomas were independently derived and were clonotypically distinct as determined by restriction fragment length polymorphism of the Ti beta-chain gene, but showed a similar pattern of cross-reactivity against rat and human (but not porcine) Tg. A third T-cell hybridoma showed a previously unknown specificity for the immunizing (non-inbred) Tg, but not for syngeneic Tg, indicating responsiveness to an allelic determinant. Although T-cell hybridization techniques have previously had only minimal application in experimental autoimmunity, this represents an approach to the study of Tg-specific T-cell responses at the molecular level.