Power Doppler imaging of hepatic tumours: Differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma

We evaluated the usefulness of power Doppler imaging in the differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma. Forty-seven patients with hepatocellular carcinoma and 18 patients with metastatic adenocarcinoma were evaluated using power Doppler imaging. The colour signals of hepatic tumours were graded as follows: 1, colour signals only in the marginal area; 2, small dot or dotted line colour signals within the tumours; 3, continuous solid line colour signals within the tumours. The grade 3 colour signals were classified in the following three patterns; winding line pattern, stretched line pattern and mixed pattern. The colour signals of hepatocellular carcinoma were grade 1 in seven patients, grade 2 in 11 and grade 3 in 29. The colour signals of metastatic adenocarcinoma were grade 1 in three patients and grade 3 in 15. Of the 29 hepatocellular carcinoma patients with a grade 3 signal, 26 patients had winding line patterns and three had mixed patterns. Of the 15 metastatic adenocarcinoma patients with a grade 3 signal, 12 patients had stretched line patterns and three had mixed patterns. In conclusion, power Doppler imaging is useful in the differential diagnosis between hepatocellular carcinoma and metastatic adenocarcinoma to evaluate the colour signal pattern within the tumour.     

A female infant successfully treated by ganciclovir for congenital cytomegalovirus infection

An 11 month old female infant, diagnosed as having congenital cytomegalovirus (CMV) infection and suffering from pneumonia and intractable diarrhea, was treated with 9-(1,3-dihydroxy-2-propoxymethyl) guanine (DHPG), intravenously for 8 weeks. Watery diarrhea ceased and pneumonia associated with massive endotracheal aspirates was reduced. No leukopenia, thrombocytopenia or other side effects were observed during the therapy. The clinical findings suggest that DHPG might be an effective and safe agent for the treatment of both intestinal and lower respiratory CMV infection in young infants.     

Carbamazepine-Induced Cardiovascular Abnormalities in Chick Embryos

ABSTRACT  Carbamazepine dissolved in propylene glycol was administered to chick embryos in order to determine its teratogenicity in the cardiovascular system. A single dose of 3, 5, 7, or 10 mg was administered at 72 hours of incubation (Hamburger-Hamilton stage 18). On day 10 of incubation, embryos were removed and examined for cardiovascular abnormalities. Cardiovascular abnormalities were noted in 37.8%, 54.8%, 76.9%, and 88.0% of live embryos in groups treated with 3, 5, 7, and 10 mg, respectively. Our experiment represented a statistically significant increase of cardiovascular abnormalities and showed a significant dose-dependent increase. Infundibular ventricular septa1 defect was the primary cardiac anomaly observed in this study. A high percentage of this anomaly was accompanied by hypoplastic right 6th aortic arch artery and/or persistent left 4th aortic arch artery. A small number of double outlet right ventricle was found.     

Chronic urticaria associated with aseptic meningitis: An atypical urticarial vasculitis?

The patient was a 7-year-old girl with early onset urticarial cutaneous lesions and was later complicated with aseptic meningitis. Her skin lesions occurred in the infantile period and were diagnosed as urticaria, but did not disappear with antihistamines and were recurrent and persistent. In addition, she had experienced an episode of headache about once a month since 1991, when she was 4 years old, and was diagnosed as aseptic meningitis. All studies including skin biopsy for urticarial vasculitis (UV) and systemic lupus erythematosus (SLE) were negative except for the data from non-specific inflammations. A systemic corticosteroid therapy dramatically reduced her symptoms. An unusual clinical course for this patient is described. It might suggest that this case is a presentation of the disease entity of UV, chronic urticaria and possibly SLE. To our knowledge, a similar case has not been previously reported.     

基于复杂网络分析高颖教授防治多发性硬化复发与残疾的用药规律

[目的] 旨在总结高颖教授防治多发性硬化复发与残疾的用药规律以及治疗思路。[方法] 针对复发与残疾具有一定疗效的中药处方,采用python、Gephi软件进行复杂网络分析,同时针对核心中药群进行聚类分析。[结果] 152个有效处方的复杂网络分析显示：共162个节点,3 883条边,平均节点度为47.94。其中核心节点为熟地黄、郁金、山茱萸、茯苓等。在矩阵列表中,共生成3 884组相互关联的配伍,其中权重最高为熟地黄与山茱萸。[结论] 核心方药为熟地黄、郁金、山茱萸、茯苓、豨莶草、知母、女贞子、萆薢、威灵仙、黄芩等,常用的配伍为熟地黄与山茱萸、熟地黄与茯苓、山茱萸与茯苓等,主要治法以补益肝肾为主,兼清热化湿、解毒通络,蕴涵动态变化、阴阳协调、攻补权衡的灵活辨治思路。     

Alveolar soft-part sarcoma of the retroperitoneum

A 33-year-old woman was referred to Iida Municipal Hospital because of left back pain. Computed tomography showed a tumor (17 x 11 x 10 cm) in the left retroperitoneal space. T1- and T2-weighted magnetic resonance imaging showed an inhomogeneous mass with marginal blood vessels. The tumor was resected via lumbar oblique incision with the thoraco-abdominal approach. The tumor weighed 1800 g and consisted of nests of 5-100 large, loosely arranged, polygonal cells, surrounded by capillaries, resembling alveoli. The tumor cells were rich in cytoplasm, containing periodic acid-Schiff- and diastase-positive granules and typical crystals. The pathological diagnosis was alveolar soft-part sarcoma (ASPS). Alveolar soft-part sarcoma is a rare soft-tissue tumor that accounts for approximately 0.5-1% of soft-tissue sarcomas. Such tumors originating in the retroperitoneal space are extremely rare. Herein is reported a case of ASPS of the retroperitoneum with radiological and pathological findings.     

Clinical efficacy of the FLUTTER device for airway mucus clearance in patients with diffuse panbronchiolitis

Abstract Expectoration of mucus is important in preventing the development of airway inflammation in patients with diffuse panbronchiolitis (DPB). To evaluate the clinical efficacy of the FLUTTER device in clearing mucus from the airways of patients with DPB who have difficulty expectorating, we assessed pulmonary function and symptoms in patients treated with FLUTTER. Eight patients in a stable clinical condition with DPB were included in the study. The study was divided into two consecutive, 1-week periods. The initial week was an observation week. During the following week, patients used FLUTTER four times daily. Expectorated sputum was collected in a container and weighed every day during 2 weeks. Pulmonary function, partial oxygen pressure and partial carbon dioxide pressure in arterial blood were measured in all patients on the last day of the observation week and the FLUTTER treatment week. A symptom score for difficulty of expectoration was determined by questionnaire. A pneumothorax developed in one patient during using FLUTTER. The mean daily sputum weight and peak expiratory flow rate increased significantly after treatment with FLUTTER ( P < 0.04 and P< 0.02, respectively). Symptom score improved significantly after using FLUTTER ( P < 0.02). We conclude that the use of FLUTTER is effective in clearing mucus from the airways. However, the development of a pneumothorax may complicate use of the procedure in some cases.