Huge adrenal haemangioma

Adrenal tumours are either functioning or non-functioning. Non-functioning adrenal tumours are generally asymptomatic and usually of enormous proportions at the time of presentation. A case is presented here of a patient with a huge right adrenal haemangioma which was successfully treated surgically. This unusual tumour was 25 cm in diameter, was well encapsulated and weighed 4 kg. The literature pertaining to this interesting case is reviewed.     

Primary adult lactose intolerance protects against development of inflammatory bowel disease

We have compared the incidence of inflammatory bowel disease (IBD) to the prevalence of lactose malabsorption (LM) in several countries. Our observations indicate that IBD is rare where LM is highly prevalent. The correlation between incidence of Crohn's disease and LM is -0.93, p less than 0.01, the correlation between incidence of ulcerative colitis and LM is -0.89, p less than 0.01. We, therefore, propose that LM results in the formation of volatile fatty acids which may inhibit multiplication of potentially pathogenic organisms.     

吡柔比星(THP)膀胱灌注预防腺性膀胱炎术后复发的疗效观察

目的 评价吡柔比星(THP)膀胱灌注预防腺性膀胱炎术后复发的疗效。方法 对30例腺性膀胱炎患者行经尿道汽化电切术,术后定期应用THP(40mg/50ml)膀胱内灌注化疗。结果 30例患者随访5～20个月,平均14.5个月,3例复发(10％)。未见有全身性药物不良反应,仅2例血白细胞降至3000个/ml。结论THP膀胱灌注预防腺性膀胱炎术后复发疗效满意,病人耐受性好,副作用小。     

Potential increased risk of virus transmission due to exclusion of older donors because of concern over Creutzfeldt-Jakob disease. The National Heart, Lung, and Blood Institute Retrovirus Epidemiology Donor Study

BACKGROUND: Concern over the theoretical possibility of disease transmission via blood from donors who develop Creutzfeldt-Jakob disease has led to proposals to exclude older individuals from donating plasma for further manufacture into pooled plasma donations. The impact of extending this age-deferral policy to blood donors was examined with respect to the risk for known transmissible viruses. STUDY DESIGN AND METHODS: Demographic characteristics and confirmed prevalence rates (/10(5) first-time donations) and incidence rates (/10(5) person-years for repeat donors) for viral markers were compared for donors < 50 years old (n = 1,259,805 [85%]) and > or = 50 years old (n = 219,856 [15%]) and for donors < 60 years old (n = 1,409,176 [95%]) and > or = 60 years old (n = 70,485 [5%]). Incidence rates were combined with infectious window-period estimates for each virus, to calculate the risk of virus transmission per 10(6) donations. RESULTS: Unadjusted prevalence rates were significantly greater for younger than for older donor groups for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), and hepatitis C virus (HCV) (p < or = 0.05). Incidence rates (and transmission risk estimates) for HBsAg were significantly higher in the < 50 donor group than in the > or = 50 group (p < or = 0.05), and those for HIV, human T-lymphotropic virus, and HCV were not significantly higher (p > 0.05). Blanket removal of donors over the age of 50 would potentially lead to the following significant increases in the risk of infected units: HIV, 12 percent; HCV, 21 percent; and hepatitis B virus (HBsAg), 22 percent. CONCLUSION: Removal of donors over the age of 60 would not significantly affect the risk of infected units. Deferral of donors > or = 50 years of age from whole-blood donations for unfounded concerns about Creutzfeldt-Jakob disease could have adverse effects on both blood availability and safety.     

Detection of Undiagnosed Coeliac Disease with Atypical Features Using Antireticulin and Antigliadin Antibodies

Eighteen patients with a variety of non-gastrointestinal symptomswere incidentally found to have circulating antireticulin antibodyand on subsequent testing were also positive for antigliadinantibody. They prospectively underwent jejunal biopsy to determinewhether or not they had coeliac disease. Their age range was21–79 years (mean 42 years). Enteropathy was present in13 (72 per cent) and was always associated with circulatingIgA antigliadin antibody. Enteropathy was not present in thefive cases who had only IgG antibody. Clinical improvement occurredin eight of 11 patients who complied with a gluten-free dietand was paralleled by an improvement in the mucosal histologyin seven of eight who were re-biopsied. The most remarkablecases were two patients who presented with severe debility andno apparent haematological or biochemical abnormalities, andwho subsequently made a dramatic recovery on a gluten-free diet.It is concluded that antireticulin antibody detected by routineautoantibody screening and confirmed to have IgA antigliadinantibody specificity is a useful indicator of an otherwise undiagnosedenteropathy. This serves to emphasize that the condition cansometimes be associated with atypical features and significantmorbidity.     

参三七皂苷Rg1预适应对5-氮胞苷诱导大鼠骨髓间充质干细胞向心肌细胞转化的干预

目的:用药物预适应方法进行干细胞诱导已有报道,本实验观察中药参三七皂苷Rg1对5-氮胞苷诱导大鼠骨髓间充质干细胞向心肌细胞转化中的作用。方法:实验于2003-01/05在南京医科大学药理教研室完成。①实验材料:清洁级SD大鼠8只。参三七皂苷Rg18mg,批号20021017,由云南省长春花生物制剂公司提供,加入不含胎牛血清的IMDM培养液10mL,调配成10-4mol/L溶液,4℃保存。5-氮胞苷(Sigma公司,批号021209)。②实验方法:贴壁法体外培养大鼠骨髓间充质干细胞。设立4组:空白对照组常规培养后进行无血清处理,每3d换液1次;5-氮胞苷单用组单纯以10μmol/L的5-氮胞苷进行处理,其终浓度为1×10-8moL/L,连续诱导15d;5-氮胞苷 参三七皂苷Rg1预适应组分别加入0.1,1μmol/L参三七皂苷Rg1培养液处理24h,再各以10μmol/L的5-氮胞苷进行诱导,其终浓度为1×10-8moL/L,连续诱导15d。③实验评估:取第2代骨髓间充质干细胞,绘制生长曲线并计算群体倍增时间。观察诱导后骨髓间充质干细胞的生长形态学特征和细胞超微结构变化。激光共聚焦显微镜测定细胞表面积变化和细胞内钙离子浓度。结果:①5-氮胞苷诱导后骨髓间充质干细胞的生长形态学特征和细胞超微结构变化:骨髓间质干细胞胞体逐渐增大并伸出细长突起,在突起末端出现分支,部分相邻细胞的突起连接成网,形态学上表现出向心肌细胞方向转化的特征。其超微结构呈梭形,有明显的肌丝,细胞核呈单椭圆形,位于细胞中央,间质干细胞形似心肌细胞。②参三七皂苷Rg1预适应对5-氮胞苷诱导的骨髓间充质干细胞增殖特性的影响:与5-氮胞苷单用组比较,5-氮胞苷 参三七皂苷Rg1预适应组从第3天开始细胞数明显增加,细胞生长曲线均无明显的生长平台期,达到高峰后细胞数开始减少。③参三七皂苷Rg1预适应对5-氮胞苷诱导的骨髓间充质干细胞表面积的影响:与空白对照组骨髓间充质干细胞表面积比较,5-氮胞苷单用组明显降低,0.1,1μmol/L参三七皂苷Rg1预适应则能显著升高5-氮胞苷诱导的骨髓间充质干细胞表面积(P<0.01)。④参三七皂苷Rg1对5-氮胞苷诱导的骨髓间充质干细胞内游离钙水平的影响:与空白对照组比较,5-氮胞苷诱导4周后骨髓间充质干细胞内游离Ca2 相对荧光强度均明显升高(t=6.72,P<0.01),且5-氮胞苷 1μmol/L参三七皂苷Rg1预适应组升高幅度大于5-氮胞苷单用组(t=3.13,P<0.05)。结论:①参三七皂苷Rg1预适应在体外可显著刺激5-氮胞苷诱导的鼠骨髓间充质干细胞向心肌细胞转化和增殖,改善细胞形态,刺激细胞内钙离子增加。②参三七皂苷Rg1与5-氮胞苷对骨髓间充质干细胞向心肌细胞定向分化产生协同效应。