Persistent synovitis treated with radiation synovectomy using yttrium- 90: a retrospective evaluation of 83 procedures for 45 patients

The objectives were to investigate the efficacy and safety of yttrium- 90 colloid (Y-90) synovectomy in joints with persistent synovitis and to examine the effect of a second synovectomy using a double dose after an initial inadequate response. Of the 45 patients at the University Hospital Utrecht who underwent Y-90 synovectomy between July 1987 and October 1995, the effectiveness and side-effects of all yttrium procedures (n = 83) were assessed retrospectively. Glucocorticoids were administered together with the yttrium, except in 1987. Radiation synovectomy had an overall success rate of 75% (complete or almost complete remission of synovitis) initially, i.e. within 1 month of the procedure, partly due to co-administration of glucocorticoids. However, in October 1995, only 17 joints (22%) were still in remission with a mean (S.D.) duration of remission of 20.8 months (22.0), range 1-95 months (median 16 months). In 60 joints (78%), synovitis was present at that time because of an unsatisfactory initial response to the Y-90 injection (19 joints) or recurrent synovitis during follow-up (41 joints); the mean (S.D.) duration of remission of these 60 joints was 3.3 months (5.9), range 0-22 months. A second injection of a double dose of Y-90 after an initial inadequate response (n = 8) did not contribute significantly to a better result. Short-term side-effects occurred in two cases after two Y-90 injections (2%) without glucocorticoid co-administration: a post-injection flare-up of synovitis and a local skin burn lesion. Persistent synovitis can be treated by Y-90 synovectomy with an overall success rate of 75% within 1 month. However, prolonged remission of synovitis is only achieved in 29% of joints with a good initial response. It does not appear worthwhile to perform a second synovectomy with a double dose if the initial response was inadequate. Y-90 synovectomy leads to only minor short-term side-effects (2%).      

衣原体感染与分泌性中耳炎的关系

1 临床资料 1998/2003年分泌性耳炎44例50耳,单耳38例,双耳6例;男30例,女14例;病程2 wk～6 mo,年龄14～67岁. 行鼓膜穿刺术抽出中耳积液100 μL混悬于200 μL生理盐水中,以8000 r/min离心5 min,去除上清液后加细胞裂解缓冲液50 μL混匀,100℃沸水浴10 min, 1000 r/min离心5 min,取上清液2 μL做PCR反应.     

Gene expression down-regulation in CD90+ prostate tumor-associated stromal cells involves potential organ-specific genes

Background  

The prostate stroma is a key mediator of epithelial differentiation and development, and potentially plays a role in the initiation and progression of prostate cancer. The tumor-associated stroma is marked by increased expression of CD90/THY1. Isolation and characterization of these stromal cells could provide valuable insight into the biology of the tumor microenvironment.     

Healing of bone defects by an osteopromotion technique using solvent-dehydrated cortical bone plate: a clinical and radiological study

Osseous defects of the jaws following trauma, cysts, infection or congenital deformity may show poor osteogenesis and the affected area may never be completely filled with bone. It is widely accepted in guided tissue regeneration that physically halting soft connective tissue proliferation into bone allows bone regeneration. This concept is called the "osteopromotion principle." The purpose of the present study was to evaluate the effect of solvent-dehydrated cortical bone plates as a barrier to allow bone regeneration by assessing the osteopromotion principle. 30 patients (18 male, 12 female) with cystic lesions of the jaws were assigned to two different groups. The patients in Group A were treated by enucleation. In Group B, were treated by removal of the lesion and placing a solvent-dehydrated cortical bone plate on top of the cyst cavity to avoid ingrowth of connective tissue. Both groups were evaluated radiographically using spiral-computed tomography (CT) before surgery and 12 months postoperatively. In group B, all cystic cavities showed complete bone healing in 12 months. At the same period, invasion of the soft connective tissue were observed in the patients treated only by enuclation. This study demonstrates that solvent-dehydrated cortical bone plates can be used as a barrier in treatment of cyst cavities and they hinder ingrowth of connective tissues and promote successful bone healing.     

小光斑飞点扫描准分子激光角膜内磨镶术护理

1临床资料我院眼科准分子近视矫正中心2000-09/2004-06共完成LASIK手术5678(男2841,女2837)例11350眼.年龄18～49(平均25.8±6.3)岁.术前行角膜、晶状体、玻璃体和眼底检查,排除有无角膜炎症、晶体混浊、玻璃体混浊等眼科疾病.     

Apparent diffusion coefficient in differentiation of pediatric posterior fossa tumors

Purpose

To investigate the contribution of preoperative apparent diffusion coefficient (ADC) values in the differential diagnosis of pediatric posterior fossa tumors.

Methods

Forty-two pediatric patients (mean age 7.76 ± 4.58 years) with intra-axial tumors in the infra-tentorial region underwent magnetic resonance imaging. ADC measurement was performed using regions of interest, obtained from the solid component of the mass lesions. ADC ratios were calculated by dividing the ADC values from the mass lesions by the ADC values from normal cerebellar parenchyma. Lesions were categorized as juvenile pilocytic astrocytoma (JPA), ependymoma and medulloblastoma based on histopathological diagnosis. ADC values of the lesions and histopathological diagnoses were statistically correlated.

Results

Histopathological diagnosis showed that 14 lesions were JPA, 10 were ependymoma; 18 were medulloblastoma. Both ADC values and ADC ratios were significantly correlated with tumor types (p <0.05). Astrocytoma was distinguished from ependymoma with sensitivity 85.7% and specificity 90% using an ADC ratio ≥1.7 and medulloblastoma was distinguished from ependymoma with sensitivity 100% and specificity 88.89% using an ADC ratio ≤1.18.

Conclusion

Preoperative ADC values could differentiate the main histological subtypes of pediatric posterior fossa tumors with high sensitivity and specificity.