Metal endoclips for the closure of the appendiceal stump in laparoscopic appendectomy

Closure of the appendiceal stump in laparoscopic appendectomy is the most crucial part of the procedure. In this retrospective clinical study, we describe a technique for laparoscopic appendectomy, in which the appendiceal stump is secured by metal endoclips. Medical data of the patients who underwent laparoscopic appendectomy for acute appendicitis between January 2005 and January 2011 at our institution were reviewed. The patients who had their appendiceal stump secured by metal endoclips were recruited for the study. The outcome measures were the rate of intraoperative and postoperative complications, operative time, and the length of hospital stay. A total of 233 patients were included to the study. The rate of intraoperative and postoperative complications, the mean operative time, and median length of hospital stay were 3 and 4%, 31.1 (15–75) min, and 18 (8–96) h, respectively. The closure of the appendiceal stump with metal endoclips in laparoscopic appendectomy is simple, quick, and safe with outcomes comparable to those of other methods.     

肺硬化性血管瘤的CT特征及病理对照分析

目的探讨肺硬化性血管瘤（PSH）的cT特征,提高对本病诊断的准确性。方法回顾性分析22例经手术、病理证实的PSH的cT特征,所有的病例均行cT平扫和动态增强扫描。结果病灶位于右肺者12例,左肺10例,4例位于肺门区,其余均位于肺外围;22例病灶呈圆形或椭圆形,14例病灶密度均匀（14／22,占63．63％）,其中2例出现轻度分叶（2／22,占9．09％）;8例病灶密度欠均匀（8／22,占36．36％）,边缘可见点状钙化,1例可见“空气新月征”。增强以后均有比较明显的强化,密度值达90～148HU。病灶与周围血管关系密切。结论cT对于肺硬化性血管瘤的诊断有一定价值,增强扫描能更好的显示病变特点,对该病的诊断及鉴别诊断有重要意义。     

A hyperparathyroid case with pulmonary edema: can hypercalcemia trigger pulmonary edema?

Most cases of pulmonary edema presenting with hypercalcemia are associated with malignant hypercalcemia and related with metastatic calcification. Most patients have predisposing factors such as hematological and solid organ malignancies and chronic renal failure. Pulmonary edema, induced by moderate hypercalcemia, which is associated with primary hyperparathyroidism, has not been reported previously. A 72-year-old female patient was admitted to the emergency service with pulmonary edema and moderate hypercalcemia because of primary hyperparathyroidism. In this presented case, we have discussed the 72-year-old female patient admitted with acute pulmonary edema who had primary hyperparathyroidism.     

标准化方法对大鼠尿液 1H磁共振谱 代谢物分析结果的影响

目的：采用磁共振（magnetic resonance, MR）波谱技术测试不同性别大鼠尿液代谢物并用不同标准化方法进行预处理,探讨不同标准化方法对分析结果的影响。方法：大鼠尿液MR 图谱数据经过中心化（mean-centering and not scaling,Ctr）和自动规格化（unit variance scaling,UV）两种不同标准化方法处理后用正交偏最小二乘判别分析（orthogonal to partial least squares discriminant analysis, OPLS-DA）法分析,通过相关系数的计算确定不同性别大鼠尿液中含量有差异的代谢物。结果：数据进行中心化处理后判别出两组大鼠尿液中缬氨酸、乙酸、鸟氨酸、氨基马尿酸、苯乙胺、氧氨嘧啶、甲胺、二甲胺、尿囊素、延胡索酸、丙氨酸、柠檬酸和化学位移在δ4.14的一种未知代谢物等13种代谢物含量有差异。进行自动规格化处理后,判别出以上除柠檬酸外的12种代谢物以及硫胺、肌酸酐、甲酸和化学位移在δ2.92的一种未知代谢物等4种代谢物含量有差异。结论：自动规格化处理是代谢组学研究中比较灵敏的数据预处理手段。     

Serum ribonuclease activity in the diagnosis of prostate cancer in men with serum prostate-specific antigen levels between 2.5 and 20 ng/mL

Objectives:

To evaluate the diagnostic value of serum ribonuclease activity for prostate cancer detection and to compare its performance with serum PSA.

Design and methods:

111 subjects with serum PSA levels between 2.5 and 20 ng/mL underwent prostate biopsy. The diagnostic performance of serum ribonuclease activity, PSA, free PSA, complex PSA and PSA derivatives was studied in regard to discriminating prostate cancer from BPH.

Results:

Of 111 patients, 27 (24.3%) were positive for prostate cancer. Median serum ribonuclease level in patients with prostate cancer was significantly higher than the non-cancer patients (21.3 U/mL vs. 6.6 U/mL, P < 0.001). Area under curve (AUC) values for ribonuclease activity level, PSA, f/tPSA and cPSA were 0.696, 0.514, 0.617 and 0.662, respectively. Of 27 patients with prostate cancer, radical prostatectomy was performed in 15. Of these 15 cases, four (26.7%) had clinical insignificant tumors; all with undetectable serum ribonuclease activity. When median values of various diagnostic parameters were compared in regard to predicting clinically significant and insignificant cancers, only serum ribonuclease activity was found to be significant.

Conclusions:

Although serum ribonuclease activity had no additional benefit beyond serum PSA in the diagnosis of patients with PSA levels between 2.5 and 20 ng/mL, it may be helpful to discriminate the clinically significant prostate cancers and thus select the proper treatment accordingly.     

FiNuTyper: Design and validation of an automated deep learning-based platform for simultaneous fiber and nucleus type analysis in human skeletal muscle

Aim

While manual quantification is still considered the gold standard for skeletal muscle histological analysis, it is time-consuming and prone to investigator bias. To address this challenge, we assembled an automated image analysis pipeline, FiNuTyper (Fi ber and Nu cleus Typer ).

Methods

We integrated recently developed deep learning-based image segmentation methods, optimized for unbiased evaluation of fresh and postmortem human skeletal muscle, and utilized SERCA1 and SERCA2 as type-specific myonucleus and myofiber markers after validating them against the traditional use of MyHC isoforms.

Results

Parameters including cross-sectional area, myonuclei per fiber, myonuclear domain, central myonuclei per fiber, and grouped myofiber ratio were determined in a fiber-type-specific manner, revealing that a large degree of sex- and muscle-related heterogeneity could be detected using the pipeline. Our platform was also tested on pathological muscle tissue (ALS and IBM) and adapted for the detection of other resident cell types (leucocytes, satellite cells, capillary endothelium).

Conclusion

In summary, we present an automated image analysis tool for the simultaneous quantification of myofiber and myonuclear types, to characterize the composition and structure of healthy and diseased human skeletal muscle.