Lesser sac abscesses and fluid collections: drainage by transhepatic approach

Twelve abscesses and fluid collections in the lesser peritoneal sac were drained percutaneously using an access route across the intervening liver. This rather unusual access was chosen when other approaches were contraindicated because of surrounding colon, stomach, or spleen. All collections were drained successfully, and no specific complications such as hemorrhage, bile leak, or liver abscess occurred. Placement of an abscess drainage catheter should be done through the peripheral portion of the liver if possible. The technique offers a new, safe approach to percutaneous drainage of hitherto inaccessible collections.     

Long term language deficiencies in children with otitis media during their first year of the life

A cohort of lower socio-economic children who experienced multiple and prolonged episodes of otitis media (OM) during their first year of life were compared to an equivalent group of children who were largely free of OM during their first year. Both groups were followed until 9 years of age. The data indicate that children with positive histories of OM performed poorer on a variety of Iinguisitc tasks across the nine year age span than the children with the positive histories of OM. The results suggest that the effect of the otitis media and its accompanying hearing loss on communication skills may extend throughout childhood.     

青钱柳酸A的结构研究

青钱柳酸Ａ的结构研究钟瑞建，舒任庚，倪小兰，徐昌瑞，黎莲娘（江西中医学院，南昌３３０００６；中国医学科学院，中国协和医科大学药物研究所，北京１０００５０）胡桃科植物青钱柳（ＣｙｃｌｏｃａｒｙａＰａｌｉａｒｕｓＩｌｊｉｎｓｋ为我国特产，民间用其叶制成保...     

The role of UV-B light in skin carcinogenesis through the analysis of p53 mutations in squamous cell carcinomas of hairless mice

Mutation spectra of the p53 gene from human skin carcinomas have been connected to solar UV radiation. For comparison we have characterized the mutation spectrum of the p53 gene in a very large sample of squamous cell carcinomas from hairless mice induced with UV of wavelength 280-320 nm (UV-B), which have substantiated the mutagenic effects of UV-B radiation in vivo. Tumors from hairless mice, random bred SKH:HR1 as well as inbred SKH:HRA strains, which are analyzed for mutations in the conserved domains of the p53 protein present a very specific mutation spectrum. The observed mutation frequency after chronic UV-B radiation in the p53 gene ranged from 54% (SKH-HRA) to 73% (SKH-HR1) among the 160 tumors analyzed. Over 95% of the mutations were found at dipyrimidine sites located in the non-transcribed strand, the majority were C-->T transitions and 5% were CC-->TT tandem double mutations. Four distinct UV-B mutation hot spots have been identified for the first time: two major ones at codons 267 (33%) and 272 (19%) and two minor ones at codons 146 (10%) and 173 (4%). The codon 267 hot spot consists of a CpG preceded by a pyrimidine, which confirms in vivo an important role for this UV-B mutable site in UV-B-induced skin tumors that is not found in other types of mouse tumors. Comparison with mutation spectra from human skin carcinomas fully validates the merits of the hairless mouse model for studying the molecular mechanisms of skin carcinogenesis. For example, the murine hot spot at codon 272 does have a full equivalent in human skin carcinomas. In contrast, the human equivalent of the murine codon 267 lacks the dipyrimidine site and therefore fails to be a pronounced hot spot in human skin carcinomas; however, this site is one of the major hot spots in human internal cancers (evidently not induced by UV radiation but probably by deamination of the 5 methyl cytosine).      

Detection of hepatic metastases: analysis of pulse sequence performance in MR imaging

Forty-three patients with liver metastases were imaged using 14 different pulse sequences (average, 7.5 sequences per patient) to allow direct comparison of their performance. "T2-weighted" spin-echo (SE) images, "T1-weighted" inversion recovery (IR) images, and "T1-weighted" SE images were obtained using a wide range of timing parameters. Pulse sequence performance was quantitated by measuring liver signal-to-noise (S/N) ratios and cancer-liver signal difference-to-noise (SD/N) ratios. Data were standardized to reflect a constant imaging time of 9 minutes for all pulse sequences. The SE 2,000/120 (TR [repetition time]/TE [echo time]) sequence resulted in the greatest SD/N ratio of the T2-weighted SE sequences but also yielded the low S/N ratios, poor anatomic resolution, and motion artifacts common to all T2-weighted SE images. IR sequence images were also sensitive to motion artifacts because of the use of a long TR (1,500 msec). Short TR/TE T1-weighted SE sequences (SE 260/18) had the greatest SD/N ratio (P less than .05), S/N ratio, and anatomic resolution. Furthermore, extensive signal averaging appears to be a powerful solution to all types of motion artifacts in the abdomen.     

Dehydration in the Elderly: A Short Review

Dehydration is the most common fluid and electrolyte problem among the elderly. The usual causes of water loss are frequently absent in dehydrated elderly patients. Age-related changes in total body water, thirst perception, renal concentrating ability, and vasopressin effectiveness probably predispose to dehydration. Dehydration related to infection, high-protein tube feedings, cerebral vascular accidents, and medication-related hypodypsia are particularly relevant for elderly patients. Appropriate treatment depends on accurately assessing the water deficit and slowly correcting that deficit.     

Endocrine abnormalities in ovulatory women with polycystic ovaries on ultrasound

Polycystic-appearing ovaries (PAO) on ultrasound have been described in a variety of endocrinopathies and also occur in ovulatory women. By some investigators this is merely referred to as 'PCO' (polycystic ovaries). Although there is controversy in this regard, we do not consider women with PAO/PCO who have no known endocrine disturbance to have polycystic ovary syndrome (PCOS) and therefore prefer not to use the term 'PCO' which is often equated with PCOS. We studied 15 ovulatory women with normal-appearing (NAO) ovaries on ultrasound and 15 matched ovulatory women with PAO/PCO. Compared to ovulatory women, 25 other women were studied who were considered to have PCOS. Of these, 15 were overweight and 10 were of normal weight. All the PCOS women had serum concentrations of luteinizing hormone (LH), testosterone, unbound testosterone, androstenedione and dihydroepiandrosterone sulphate (DHEAS) which were significantly higher (P < 0.01) than values in the normal women, regardless of ovarian morphology. These values were similar in the two groups of ovulatory women with NAO and PAO/PCO. Fasting insulin was elevated in women with PCOS with increased body weight (P < 0.01) and was higher than in ovulatory women with NAO and PAO/PCO and than in women of normal weight with PCOS. Serum insulin- like growth factor (IGF)-I and binding protein (BP)-3 were similar in all groups but serum IGFBP-1 was significantly (P < 0.01) lower in those women with PCOS with increased body weight, compared to all other groups. Compared to values in ovulatory women with NAO, serum IGFBP-1 was also significantly (P < 0.05) lower in women with PAO/PCO and those women with PCOS of normal weight. These lower values were similar in women with PAO/PCO and in normal weight women with PCOS. On an individual basis, an elevation of at least one serum androgen value was found in 33% of women with PAO/PCO. These data confirm that increased body weight accentuates the metabolic alterations in PCOS, but suggest that subtle endocrine disturbances, similar to those that are found in PCOS, may be uncovered in up to a third of ovulatory women with PAO/PCO. It appears that a disturbance of the IGF/IGFBP-1 axis is common and apparently closely associated with alterations in ovarian morphology.      

Paternal uniparental disomy of chromosome 6 and transient neonatal diabetes mellitus

Transient neonatal diabetes mellitus occurs in growth-retarded infants, has an incidence of 1 in 400000 live births and has been associated with both paternal uniparental disomy of chromosome 6 and paternal duplications of 6q. We analysed samples from our cohort of patients with transient neonatal diabetes mellitus for uniparental disomy of chromosome 6 using polymorphic microsatellite repeat analysis. We report here the fifth case of paternal uniparental disomy of chromosome 6 associated with classic transient neonatal diabetes mellitus and estimate that uniparental disomy of chromosome 6 accounts for approximately one fifth of cases of transient neonatal diabetes mellitus.     

抗体/腺病毒复合物为载体的基因定位递送

临床基因治疗方案中基因载体在疾病部位的靶向递送仍是急待解决的问题。本研究将腺病毒与一种生物素化的特异性抗腺病毒六邻体的多克隆IgG结合，固定于结合了亲和素的胶原蛋白膜上，成功获得腺病毒载体基因靶向定位递送体系。体外稳定性研究结果表明该体系中病毒载体可有效保持活性。通过这种特异性抗体偶联方式，将携带单纯疱疹胸苷激酶（HSVtk）编码基因片断的腺病毒结合在胶原膜上转染大鼠平滑肌细胞（A10），加入更昔洛韦（ganciclovir）后，只有生长在胶原膜上及膜邻近50μm内的细胞被杀死。在使用非特异性抗体的对照实验中，整个培养基范围内的细胞几乎全被杀死。以绿色荧光蛋白（GFP）为报告基因对猪的心肌进行转基因实验，结果显示注射特异性抗体偶联病毒的胶原凝胶比直接注射病毒悬液获得更高效的心室基因表达。所有研究结果表明，通过生物素和特异性抗体使病毒载体固定在胶原蛋白基质上，可达到有效的局部定位基因表达，避免向非病灶部位的扩散，是基因治疗中一种极具发展潜力的载体定位递送方法。