Untersuchungen über das „hepatorenale Syndrom” bei chirurgischen Eingriffen an den Gallenwegen

Ohne Zusammenfassung     

Beitrag zur Frage der Bluteosinophilie bei malignen Tumoren

Ohne Zusammenfassung     

Alterations at the Ink4a locus in transplacentally induced murine lung tumors

The malignant phenotype results from multiple genetic alterations, including the activation of oncogenes and inactivation of tumor suppressor genes. Activation of the Ki-ras oncogene has been implicated as an early event in the pathogenesis of lung adenocarcinomas in humans and experimental animal models. Previous studies from this laboratory have shown that, following treatment of pregnant [D2 x B6D2F(1)]F(2) or Balb/c mice with the polycyclic aromatic hydrocarbon, 3-methylcholanthrene (MC), lung tumors from the transplacentally exposed offspring exhibited a high incidence of mutations in the Ki-ras gene. The role of genetic alterations at other oncogenic or tumor suppressor loci that can mediate lung tumor initiation and/or progression have not been well characterized in either human or murine models. Using the transplacental carcinogenesis model, which results in the induction of both lung and liver tumors following in utero exposure to MC, the results of this and our previous studies show that alterations in the Ink4a locus occur in only 15 and 27% of the lung and liver tumors, respectively. Preliminary data also suggests that the type of mutation induced in the Ki-ras gene following the initial exposure to MC may influence lung tumor progression. These results imply that damage to the Ink4a gene is not a frequent pathway to malignant progression in mouse lung and liver tumors following in utero exposure to environmental carcinogens.     

Lung abscesses in children: diagnostic and therapeutic needle aspiration

Three children aged 17 months to 17 years developed right-sided peripheral lung abscesses. Clinical signs were fever and cough. Laboratory cultures were negative, and the patients did not respond to appropriate antibiotic coverage. Under fluoroscopic guidance, purulent material was removed from the abscesses by needle aspiration. The patients became afebrile within 24 hours; none suffered complications of bleeding or pneumothorax. Cultures of the aspirate were positive for microorganisms sensitive to the prescribed treatments. A simple aspiration technique is described and proposed as useful for selected patients when surgical drainage is recommended. There was no morbidity in our cases, and recovery from a typically prolonged course was shortened by the procedure.     

Influence of the direct NO-donor SIN-1 on the interaction between platelets and stainless steel stents under dynamic conditions

It was investigated whether the NO-donor SIN-1, the active metabolite of molsidomine, influenced the activation of platelets, the formation of circulating platelet aggregates, the spontaneous aggregation of platelets and the activation of the clotting system triggered by a body foreign surface in an in vitro closed-loop perfusion model. With human platelet-rich plasma at micromolar concentrations SIN-1 exerted pronounced effects on the interaction between platelets and an exogenous surface. In the absence of SIN-1, the number of circulating single platelets decreased significantly, which could be due either to the formation of circulating platelet aggregates or to the adhesion of platelets to the stent. Both these processes were blocked by the addition of SIN-1. Moreover, the platelets exhibited hyperaggregability in the absence of SIN-1 whereas the NO-donor was able to completely inhibit spontaneous platelet aggregation. Similar results were obtained in flow cytometry experiments. Without SIN-1, high platelet surface densities of both the GPIb/IX and GPIIb/IIIa receptors were observed. In addition, the density of the fibrinogen receptor increased significantly with the number of perfusion cycles. SIN-1 was able to suppress the augmented GPIIb/IIIa receptor expression significantly. Molsidomine seemed to have the potential to reduce the incidence of thrombotic processes triggered by the exogenous surface of the stent.     

Das Aneurin (Vitamin B1)

Ohne ZusammenfassungMit 3 Abbildungen.     

玻璃纤维桩在严重缺损牙齿修复中的应用

目的:在自行研制了弹性模量介于牙釉质和牙本质之间的玻璃纤维增强树脂桩的基础上,追踪观察其在严重缺损牙齿修复中的效果。方法:选择2005-08/2006-10在桂林医学院附属医院行桩核冠修复并能配合修复后半年复查的患者69例,用自行研制的直径分别为1.4,1.8,2.1mm的圆柱形玻璃纤维/树脂复合材料桩钉对84个严重缺损牙进行桩核冠修复,其中52个前牙,32个后牙;桩修复体直径为2.1mm者22个,1.8mm者39个,1.4mm者23个。半年后进行临床和X射线复查,桩完好、根完好、核完好及冠未脱落或松动者为纤维桩修复成功;同时观察有无材料宿主反应。结果:84个桩核冠修复体复查有2个桩和1个核松动、脱落,修复成功率为96.4%;前后牙及不同直径桩修复成功率的对比差异无显著性意义(P>0.05);所有利用纤维桩修复缺损患牙的患者均未发现有材料宿主反应。结论:玻璃纤维增强树脂桩的力学性能达到修复要求,桩可通用于各牙位,直径1.4,1.8和2.1mm等3种规格的桩都适用于临床修复。初步证明玻璃纤维增强树脂桩是一种有价值的修复方式,但还需进行更长期和更大样本的临床观察。     

牛骨形态发生蛋白对骨质疏松性椎体骨折愈合过程中局部血管内皮生长因子表达的作用

目的:观察骨质疏松性椎体骨折愈合过程中,局部血管内皮生长因子动态表达,探讨牛骨形态发生蛋白促进SD大鼠骨质疏松性椎体骨折愈合的作用机制。方法:实验于2005-07/2006-07在解放军兰州军区总医院骨研所完成。①牛骨形态发生蛋白的制备:青海小牦牛大腿骨,-4℃条件下,粉碎,按Urist改良方法提取。②选择雌性SPF级8个月龄SD大鼠96只,去除双侧卵巢建立骨质疏松模型。随机分为2组:实验组和对照组,每组48只。③术后3个月行L5椎体开窗建立人工骨折模型,实验组置牛骨形态发生蛋白10mg 纤维蛋白复合体;对照组注入等量无血清培养液。④于手术后3,7,10,14,21,28,56,84d每组麻醉状态处死6只,用苏木精-伊红染色、免疫组织化学及定量聚合酶链反应检测骨折愈合不同时间的标本血管内皮生长因子及血管内皮生长因子mRNA的动态表达,阳性信号为胞浆内棕色颗粒。结果:96只SD大鼠全部进入结果分析。①骨折愈合不同时间组织学观察:实验组术后7d纤维骨痂形成,21d新生骨组织与旧骨组织出现融合,56～84d软骨性骨痂已逐渐被骨性骨痂取代,骨折部位髓腔再通,出现成熟板层骨,骨折基本愈合。对照组术后7d未见典型纤维性骨痂;21d新生骨组织大都游离与孤立存在,术后28d骨小梁仅有少部分连结成网状,56～84d部分骨缺损存在,不见成熟板层骨,大部分髓腔不通,骨折愈合延迟。②骨折不同时间血管内皮生长因子免疫组织化学结果:实验组血管内皮生长因子在7d左右可见有阳性表达的细胞,14d有分泌高峰,对应循环数(CT值)最小,两组比值最大。而对照组未见明显分泌高峰。③实时荧光定量聚合酶链反应检测结果:对照组在造模后1,2,4,6,8周时,椎体内的血管内皮生长因子mRNA的表达量明显低于实验组(P<0.01)。结论:牛骨形态发生蛋白可促进大鼠骨质疏松性椎体骨折部位血管内皮生长因子的动态表达,可在受体骨折部位局部促进骨折生长。     

骨形态发生蛋白对去势大鼠股骨颈骨形态、骨密度和骨生物力学的影响

目的:观察在去势大鼠股骨颈植入牛骨形成蛋白后其骨形态、骨密度及骨强度的变化。方法:实验于2006-06/12在解放军兰州军区兰州总医院骨科研究所完成。①实验材料:普通级3个月龄wistar雌性大鼠60只。骨形态发生蛋白冻干粉剂(从幼龄牦牛新鲜长骨皮质中提取)。②实验分组:以同一只大鼠左右肢体为对照,右侧为实验侧,左侧为对照侧。③大鼠摘除卵巢制作绝经后骨质疏松模型经双能X射线骨密度仪检测筛选出造模成功的44只大鼠,实验侧距大转子0.5cm处股骨颈植入牛骨形成蛋白冻干粉剂,对照侧植入牛血清白蛋白。④实验评估:术后4周、8周时麻醉下处死大鼠取材,应用苏木精-伊红染色,组织切片后光镜下观察、CT扫描、双能X射线骨密度仪及万能生物力学机观察大鼠股骨颈骨形态学、骨皮质厚度、骨密度及骨强度的变化。结果:纳入造模成功后的44只大鼠均进入结果分析。①股骨颈骨组织形态学观察:4周时实验侧股骨颈局部骨小梁完整、连续性尚好;对照侧股骨颈局部骨小梁稀少、连续性中断,不完整。8周时实验侧股骨颈骨小梁致密,数量增多、完整,连接成网状结构、分布均匀;对照侧股骨颈骨小梁稀疏、变细、间距变大,呈髓腔扩大。②骨皮质厚度、骨密度及生物力学测定:4周时实验侧和对照侧股骨颈皮质厚度无明显差异,骨密度及最大载荷有明显差异(P<0.05);8周实验侧较对照侧骨皮质厚度明显增加、骨密度、最大载荷均增高[皮质厚度:(2.632±0.042),(1.728±0.034)mm,骨密度:(0.210±0.026),(0.182±0.029)g/mm2,最大载荷:(97.2±8.1),(85.6±7.9)N,P均<0.05]。结论:植入牛骨形成蛋白可以提高去势大鼠股骨颈局部骨皮质厚度、骨密度及生物力学强度,这将可能为绝经后骨质疏松性股骨颈骨折的防治提供一种新的途径。