Conservative management of early endometrial adenocarcinoma with repeat curettage and hormone therapy under assistance of hysteroscopy and laparoscopy

We report a rare case of early-stage endometrial adenocarcinoma in a 22 year old nullipara with polycystic ovaries undergoing conservative treatment. Pretreatment evaluation including tumour grade, depth of myometrial invasion, tumour size, hormone receptor status and flow cytometric analysis indicated a favourable prognosis. The patient underwent repeat endometrial curettage and a 6 month period of therapy with megestrol acetate and tamoxifen. A combination contraceptive pill was then prescribed to ensure withdrawal of the menstrual cycle thereafter. Now, 1 year after the last curettage, there is no evidence of disease. During the treatment period, hysteroscopy allowed for a more precise approach in panoramically examining the tumour nest in the endometrial cavity, and the subsequent endometrial response to hormone therapy. Laparoscopy using bulldog clamps applied to the isthmic portion of the Fallopian tubes prevented i.p. spread of endometrial tissue from retrograde regurgitation during hysteroscopy. Laparoscopic ovarian electrocautery resulted in the reduction of abnormal hypervascularization on the surface of polycystic ovaries postoperatively but caused a peri-ovarian adhesion complication. It is interesting that this case posed a unique opportunity to demonstrate the tumour regression under the assistance of laparoscopy and hysteroscopy.      

ACE inhibition in the treatment of children after renal transplantation

Currently, there are no data available on long-term effects of angiotensin-converting enzyme inhibitors (ACE-I) on graft function in children after renal transplantation. We therefore analyzed all children who were transplanted at our institution between 1989 and 1998 and followed for at least 2 years. Those treated with ACE-I, mainly because of failure of other antihypertensive medications, were compared to those without ACE-I. The ACE-I-treated children (n=19) showed significantly better blood pressure control during the 1st year of follow-up (p<0.05). In children with chronic allograft dysfunction (n=8), treatment with ACE-I stabilized graft function, with improvement in creatinine clearance in 50% (p<0.01). Serum potassium and hemoglobin levels remained stable. One patient discontinued ACE-I because of renal artery stenosis. Taken together, ACE-I were effective and safe in the treatment of hypertension in children following renal transplantation. Children with chronic allograft dysfunction experienced a stabilizing effect on graft function.     

Locomotor Behaviour of Selective Dopamine Agonists in Mice: Is Endogenous Dopamine the Only Catecholamine Involved?

The purpose of the study was to determine the effect alone and in combination of the selective dopamine (DA) agonists SKF 38393 (D1-) and B-HT 920 (D2-) on the locomotor activity of reserpine pretreated mice (5 mg kg-1 i.p.). After 4 h, reserpine-B-HT 920 (up to 20 mg kg-1 s.c.) did not induce locomotor activity whereas SKF 38393 was markedly effective at high doses (greater than or equal to 30 mg kg-1 s.c.). In contrast, at 24 h, reserpine-B-HT 920 (0.2-6 mg kg-1 s.c.) elicited considerable locomotor activity and SKF 38393 (1-100 mg kg-1 s.c.) was effective at lower doses when compared with the corresponding 4 h reserpine experiments. When, however, these animals additionally received alpha-methyl-p-tyrosine (alpha MPT; 300 mg kg-1 i.p., at 4 h before the DA agonists) neither B-HT 920 (0.2-20 mg kg-1 s.c.) nor SKF 38393 (1-100 mg kg-1 s.c.) had an effect of their own. When B-HT 920 was tested in the presence of a fixed-dose of SKF 38393 (10 or 3 mg kg-1 s.c., combination experiments) B-HT 920 (0.6-20 mg kg-1 s.c.) induced considerable locomotor activity at 4 h post reserpine. At 24 h post reserpine the dose-response curve of B-HT 920 (0.06-20 20 mg kg-1 s.c.) was shifted to the left and the maximum effect was greatly increased. When additional alpha MPT was given, the dose response curve was the same but the maximum effect was markedly reduced.(ABSTRACT TRUNCATED AT 250 WORDS)     

光学成像示踪细胞

因光具适应性、灵敏性、分辨率和无创性,其作为科学研究工具由来已久,也是光学成像(optical imaging,OI的基础。光学成像包括多种成像技术及方法,具有成像快速     

T-cell reaction to local anaesthetics: relationship to angioedema and urticaria after subcutaneous application — patch testing and LTT in patients with adverse reaction to local anaesthetics

BACKGROUND: Local anaesthetics are known to elicit T-cell reactions after epicutaneous application, namely contact dermatitis. In addition, adverse reactions like urticaria and angioedema are rather common after submucosal or subcutaneous injection. The pathogenesis of these side-effects, which appear frequently hours after application, is unknown, but thought to be not immunoglobulin E-mediated, since immediate skin tests are mostly negative. OBJECTIVES: We investigated whether patients who developed urticaria and angioedema after subcutaneous application have a T-cell sensitization to local anaesthetics, which might be responsible for the symptoms. METHODS: Twenty patients with generalized and/or local cutaneous reactions after LA were examined with intradermal testing using a standard panel of six LAs and patch testing using between seven and nine LAs in vaseline and four LAs in PBS. In 10 patients, a lymphocyte transformation test (LTT) was performed. RESULTS: Only 2/20 patients had an immediate skin reaction (positive intradermal test), whereas 6/20 patients had a positive delayed skin reaction (positive patch test). In 6/10 subjects the LTT was positive. CONCLUSIONS: Delayed appearance of urticaria and angioedema after subcutaneous application of local anaesthetics may be related to a T cell- mediated sensitization, which might be detected by patch testing or LTT.     

Measurement of T1, T2, and magnetization transfer properties during embryonic development at 7 Tesla using the chicken model

Purpose

To evaluate whether techniques of high field magnetic resonance imaging may be used to characterize embryonic tissue during proliferation and differentiation.

Materials and Methods

Thirteen chicken embryos with incubation times between 5 days and 16 days have been measured in a small animal magnetic resonance imager (ClinScan, Bruker) at 7 Tesla using the built‐in resonator. T1, T2‐, and magnetization transfer imaging was performed using fast spin‐echo with inversion recovery, half acquisition single shot turbo spin‐echo, and spoiled gradient‐echo sequences with and without off‐resonance pulse, respectively. T1, T2, and magnetization transfer ratio (MTR) maps were calculated on a pixel‐by‐pixel basis.

Results

T1‐, T2‐, and MTR maps showed good image quality allowing for delineation of embryonic organs. During embryonic development, a decrease of T1 and T2 relaxation times was found, whereas, embryonic tissue typically showed an increase of magnetization transfer, for example, liver properties at day 5: T1 = 2431 ± 163 ms, T2 = 122 ± 12 ms, MTR = 9.2 ± 4.2%; liver properties at day 16: T1 = 1763 ± 89 ms, T2 = 71 ± 4 ms, MTR = 16.9 ± 2.2%.

Conclusion

Embryonic tissues show changing relaxation and magnetization transfer properties during development, therefore, high field MRI seems suitable for characterization of tissue replacement derived from embryonic stem cells. J. Magn. Reson. Imaging 2008;28:1510–1514. © 2008 Wiley‐Liss, Inc.