Threatened abortion: sonographic distinction of normal and abnormal gestation sacs

In an attempt to determine whether sonographic evaluation alone can distinguish normal from abnormal gestation sacs, a retrospective analysis was performed of ultrasound (US) scans from 168 women with threatened abortion. Gestation sacs were judged to be abnormal on the basis of specific sonographic criteria including large size (greater than or equal to 25 mm mean sac diameter) without an embryo; distorted shape; thin (less than or equal to 2 mm), weakly echogenic, or irregular choriodecidual reaction; absence of a double decidual sac; and low position. Two criteria - large sac and distorted shape - had 100% specificity and were called major criteria. The remaining criteria were individually less specific, although 100% specificity was achieved when three or more of these minor criteria were demonstrated. When one major or three minor criteria were present, 53% of abnormal gestations were correctly identified without any false-positive diagnoses. The authors conclude that experienced sonographers can reliably identify many abnormal gestation sacs on a single examination.     

Pyoderma gangrenosum, erythema elevatum diutinum and IgA monoclonal gammopathy

A patient with erythema elevatum diutinum (EED) developed pyoderma gangrenosum (PG). Investigation revealed an IgA kappa monoclonal gammopathy. Previous reports of PG in association with EED are reviewed and the spectrum of the neutrophilic dermatoses discussed.     

急性缺血再灌注肾损伤过程中Mg2+及K+协同胰岛素的对抗效应

目的:在肾移植术后可能发生急性缺血再灌注性肾损伤.作者前期实验表明在肾缺血再灌注期间注射胰岛素可减轻缺血再灌注肾损伤,在此基础上,在胰岛素溶液中加入天冬氨酸钾镁,观察Mg2 ,K 协同胰岛素对家兔急性肾缺血再灌注损伤的影响,并分析其可能机制.方法:实验于2002-02/04在泸州医学院生理实验室完成,动物实验方法符合动物伦理学要求.①实验材料及方法:选用健康成年日本大耳白兔27只,按随机数字表法分为3组(n=9),即缺血再灌注组、缺血再灌注胰岛素处理组及对照组,前两组采用钳夹肾动脉法建立急性肾缺血再灌注肾损伤模型,缺血再灌注胰岛素处理组再灌注的同时给予胰岛素溶液,含胰岛素3 U/kg,葡萄糖1.5 g/kg,K 4 mg/kg,Mg2 1.7 mg/kg.②实验评估:分别观察3组动物缺血再灌注2 h,48 h后,血清尿素氮、血糖、血清及肾组织中丙二醛含量以及肾组织超微结构变化.结果:23只动物进入结果分析.①肾缺血再灌注48 h后,缺血再灌注组血清尿素氮含量显著高于对照组(P＜0.01),缺血再灌注胰岛素处理组与对照组差异无显著性意义(P＞0.05).②缺血再灌注组血清及肾组织中丙二醛含量显著高于对照组(P＜0.05),缺血再灌注胰岛素处理组丙二醛含量显著低于缺血再灌注组(P＜0.05).③缺血再灌注2 h后,3组动物血糖均较术前增高,但以缺血再灌注组增高更为显著,与对照组比较差异具有显著性意义(P＜0.05),缺血再灌注胰岛素处理组与对照组差异无显著性意义(P＞0.05).④对照组肾组织超微结构正常,缺血再灌注组肾组织呈变性和坏死改变,缺血再灌注胰岛素处理组肾组织轻度变性.结论:Mg2 ,K 可协同胰岛素减轻家兔急性缺血再灌注性肾损伤,其作用途径可能和降低血糖、抗自由基损伤、改善能量代谢、减轻钙超载、防止低血钾等因素有关.