云南边境地区氯喹及与青蒿琥酯伍用治疗前后恶性疟原虫pfcrt 和pfmdr1抗药性有关基因点突变的变化特征

目的　了解氯喹单用及与青蒿琥脂伍用治疗恶性疟前后 ,pfcrt和 pfmdr1抗药性有关基因的点突变变化特征。　 方法　使用PCR RFLP技术检测基因点突变。　结果　氯喹及与青蒿琥脂伍用治疗前后的所有样本都发现有恶性疟原虫pfcrt基因氨基酸编码 76突变为苏氨酸的特征。但是 ,氯喹治疗前 ,5 0 % pfmdr1基因氨基酸编码 86为天冬酰氨酸 (野生型 ) ,而剩余的 5 0 %为野生型和突变型 (苏氨酸 )的特征。氯喹治疗后 ,在 18个复燃的病例中 ,83 .3 %的 pfmdr1基因 86位点为野生型 ,剩余的 16.7%是混合型。氯喹与青蒿琥脂伍用治疗前 ,3个样本携带混合型基因型 ,剩余的 (86% )为野生型 ,但治疗后 ,所有样本只携带野生型。　结论　这些结果可能支持这样的假说 :pfcrt基因突变起主导作用 ,但 pfmdr1基因突变增强了氯喹抗药性的效果。     

Anomalous unilateral single pulmonary vein: Two cases mimicking arteriovenous malformations and a review of the literature

Total anomalous pulmonary venous drainage is a rare congenital anomaly. It usually involves a pulmonary to systemic venous shunt and most cases have a septal defect in order to survive. Anomalous pulmonary venous drainage with pulmonary venous shunting is an extremely rare and entirely benign entity. We present two such cases, in which there was atresia of the left superior pulmonary vein and drainage via a tortuous collateral vein to the left inferior pulmonary vein. This collateral was mistaken on plain film and CT for a pulmonary arteriovenous malformation. Awareness of this anomalous unilateral single pulmonary vein and its radiological appearances may help in avoiding unnecessary pulmonary angiography.     

Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience

Background  

This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.     

Chemopreventive activity of oltipraz against induction of glandular stomach carcinogenesis in rats by N-methyl-N'-nitro-N-nitrosoguanidine [published erratum appears in Carcinogenesis 1998 May;19(5):955]

The modifying effects of oltipraz on induction of glandular stomach carcinogenesis by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) were investigated in a total of 120 male 6-week-old Wistar rats, divided into six groups. Groups 1-3 (30 animals each) were given 100 p.p.m. MNNG in their drinking water for 10 weeks as an initiation treatment for gastric cancer induction and respectively fed diets supplemented with 0.04%, 0.02% and 0% oltipraz for 12 weeks, starting 1 week before and finishing 1 week after the carcinogen exposure. Groups 4-6 (10 animals each) were similarly treated without the application of MNNG. At the end of the 80th experimental week, all surviving animals were autopsied and examined histopathologically for the existence of gastric proliferative lesions. The incidence and multiplicity of adenocarcinomas were significantly (P < 0.01) lower in group 1 than in group 3. In addition, the multiplicity of atypical hyperplasias in the pyloric region was significantly (P < 0.05) decreased in group 1 as compared with the group 3 value. No gastric proliferative lesions were found in groups 4-6. In an additional short-term experiment, oltipraz significantly reduced cell proliferative activity (P < 0.01) and elevated glutathione levels (P < 0.05) in the glandular stomach mucosa of rats treated with MNNG. Thus our results clearly indicate that oltipraz can inhibit induction of proliferative glandular stomach lesions by MNNG in the rat.      

Nonpalpable breast lesions: accuracy of prebiopsy mammographic diagnosis

Mammograms of 220 patients who underwent spot localization for removal of nonpalpable breast lesions were reviewed for accuracy of interpretation. Results of subsequent biopsy indicated malignancy in 77 cases. The interpretations of mammograms obtained before biopsy were incorrect in 71 cases (27 false-negative and 44 false-positive studies). Among the false-negative cases, 70% of the abnormalities were determined histologically to be noninfiltrative cancers. An aggressive screening program with preoperative localization and biopsy is needed in questionable cases, since mammographic signs of early or nonpalpable malignancy are often subtle and nonspecific.     

Child-OIDP index in Brazil: Cross-cultural adaptation and validation

Background  

Oral health-related quality of life (OHRQoL) measures are being increasingly used to introduce dimensions excluded by normative measures. Consequently, there is a need for an index which evaluates children's OHRQoL validated for Brazilian population, useful for oral health needs assessments and for the evaluation of oral health programs, services and technologies. The aim of this study was to do a cross-cultural adaptation of the Child Oral Impacts on Daily Performances (Child-OIDP) index, and assess its reliability and validity for application among Brazilian children between the ages of eleven and fourteen.     

Establishment of human T-cell leukemia virus type I T-cell lymphomas in severe combined immunodeficient mice

Human T-cell leukemia virus type I (HTLV-I) is recognized as the etiologic agent of adult T-cell leukemia (ATL), a disease endemic in certain regions of southeastern Japan, Africa, and the Caribbean basin. Although HTLV-I can immortalize T lymphocytes in culture, factors leading to tumor progression after HTLV-I infection remain elusive. Previous attempts to propagate the ATL tumor cells in animals have been unsuccessful. Severe combined immunodeficient (SCID) mice have previously been used to support the survival of human lymphoid cell populations when inoculated with human peripheral blood lymphocytes (PBL). SCID mice were injected intraperitoneally with PBL from patients diagnosed with ATL, HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), or from asymptomatic HTLV-I-seropositive patients. Many of these mice become persistently infected with HTLV-I. Furthermore, after human reconstitution was established in these mice, HTLV-I-infected cells displayed a proliferative advantage over uninfected human cells. Lymphoblastic lymphomas of human origin developed in animals injected with PBL from two ATL patients. The tumor cells represented outgrowth of the original ATL leukemic clone in that they had monoclonal or oligoclonal integrations of the HTLV-I provirus identical to the leukemic clone and predominantly expressed the cell surface markers, CD4 and CD25. In contrast, cell lines derived by HTLV immortalization of T cells in vitro did not persist or form tumors when inoculated into SCID mice, indicating differences between in vitro immortalized cells and ATL leukemic cells. This system represents the first small animal model to study HTLV-I tumorigenesis in vivo.     

Complete persistence of the hyoido-stapedial artery in man

Summary The authors report a case of total persistence of the hyoïdo-stapedial artery (HSA) discovered fortuitously in an adult. The external carotid artery terminated as the superficial temporal, middle deep temporal and transverse facial arteries; the HSA arose from the intrapetrous internal carotid artery, coursed within the middle ear and the middle cranial fossa where it gave off the middle meningeal artery before leaving the skull via the foramen spinosum to become the maxillary artery.

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Persistance complète de l'artère hyoïdo-stapédienne chez l'homme: à propos d'un cas (origine carotidienne intrapétreuse de l'artère maxillaire)

Résumé Les auteurs rapportent un cas de persistance totale de l'artère hyoïdo-stapédienne (AHS) de découverte fortuite chez un adulte. L'artère carotide externe se termine en artère temporale superficielle, temporale moyenne profonde et transverse de la face; l'AHS naît de la carotide interne intrapétreuse, chemine à l'intérieur de l'oreille moyenne et de la fosse cérébrale moyenne où elle abandonne l'artère méningée moyenne avant de quitter le crâne en passant par le trou petit rond pour devenir l'artère maxillaire.