低场强MRI对于颅内转移瘤诊断价值的分析

目的:评价探讨低场强磁共振检查在脑转移瘤中的诊断价值。方法:用0.3 T开放型磁共振成像系统对30例脑转移瘤患者的磁共振平扫、水抑制(FIR)和增强扫描-采用静脉快速推注顺磁性造影剂Gd-DTPA(0.2 ml/kg)结果进行分析。结果:30例中单发病灶8例,多发22例,平扫发现48个病灶,FIR发现72例,增强扫描发现96个病灶,65个病灶直径大于3 cm;发现最小病灶直径3 mm;伴发空洞54例。增强扫描发现平均每个病人有3.2个病灶。结论:MRI是脑转移瘤不可缺少的检查方法,低场强磁共振检查既可准确发现微小和特殊部位的转移灶,又可得到病灶的边缘形态和内部情况以便于治疗方案的确定。     

Salvage definitive chemo‐radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: Retrospective review

To determine the overall survival and gastrointestinal toxicity for patients treated with salvage definitive chemo‐radiotherapy after primary surgery for locoregional relapse of oesophageal carcinoma. A retrospective review of 525 patients who had a resection for oesophageal or oesophagogastric carcinoma at Princess Alexandra Hospital identified 14 patients treated with salvage definitive radiotherapy or chemo‐radiotherapy, following localized recurrence of their disease. We analysed the patient and treatment characteristics to determine the median overall survival as the primary end point. Gastrointestinal toxicity was examined to determine if increased toxicity occurred when the stomach was irradiated within the intrathoracic radiotherapy field. The median overall survival for patients treated with curative intent using salvage definitive chemo‐radiotherapy was 16 months and the 2‐year overall survival is 21%. One patient is in clinical remission more than 5 years after therapy. Age <60 years old and nodal recurrence were favourable prognostic factors. Treatment compliance was 93% with only one patient unable to complete the intended schedule. Fourteen per cent of patients experienced grade 3 or 4 gastrointestinal toxicity. Salvage definitive chemo‐radiotherapy should be considered for good performance status patients with oesophageal carcinoma who have a locoregional relapse after primary surgery. The schedule is tolerable with low toxicity and an acceptable median survival.     

Mechanisms of white cell reduction in red cell concentrates by filtration: the effect of the cellular composition of the red cell concentrates

The effect of platelets on the removal of white cells (WBCs) from 16 to 24-hour-old red cell (RBC) concentrates by filtration was studied. RBC concentrates with various concentrations of platelets and WBCs were filtered on a cellulose acetate column filter and on three polyester flatbed filters. The microscopic study revealed that lymphocytes and most monocytes were captured in the smaller pores of the fiber network, irrespective of the brand of filter, the type of filter material, or the prefiltration platelet amount in the RBC concentrates. In contrast, efficient granulocyte depletion depended on granulocyte-platelet interaction and on the filter material. In the presence of platelets, granulocytes were captured in the top part of the column filter or in the coarse layers of two of the flatbed filters, where platelets covered the fibers. Platelet depletion of the RBC concentrates prior to filtration diminished the contribution of these parts of the filters to granulocyte capture. A larger part of the column filter or the fine layers of the flatbed filters were now required for granulocyte capture. In one of the flatbed filters, granulocyte-platelet interaction occurred mainly in the fine layers, which ended in blockage of this filter after the filtration of variable volumes (250-600 mL) of standard RBC concentrates. A quantitative estimation of the effect of platelets on the WBC-reduction capacity found that all three flatbed filters had a highly significant decrease (p = 0.001) in WBC-reduction capacity for platelet-depleted or buffy coat-depleted RBC concentrates, as compared with standard RBC concentrates.(ABSTRACT TRUNCATED AT 250 WORDS)