Thymoma. A clinicopathologic study of 98 cases with special reference to three unusual cases

98 thymomas were assessed in respect to clinical manifestations, gross and histologic pathological findings and clinicopathologic correlations. 34% of patients were asymptomatic and thymoma was detected fortuitously. The most common presenting symptoms were related to myasthenia gravis, symptoms due to pressure on mediastinal structures were next in frequency. The symptom-diagnosis interval ranged from 0 to 120 months with a median of 4,5 months and was longer in invasive thymomas (median 6 months) than in noninvasive thymomas (median 2 months). 52% of thymomas were encapsulated and showed no cytologic atypia and were therefore classified as benign encapsulated thymomas. 26% showed gross invasion of peripheral structures and 3% were thymic carcinomas on histologic grounds. Histologically 55% of thymomas were epitheloid cell type, 17% spindle cell type and 20% mixed type thymomas. Epidermoid type thymoma occurred in 3% of the cases. 3 cases showed some unusual morphologic feature: one was localized intrapulmonal, another had an outspread like a mesothelioma, and the third was a basaloid carcinoma with unusual goblet cell metaplasia. In the three cases immunohistological methods were used as a diagnostic tool. The lectins UEA-I, PNA and HPA and an anti-keratin allowed the diagnosis of epithelioma (in 2 cases) and showed some more cellular and structural differentiations (in 1 case).     

Albuminuric growth failure. A case of Munchausen syndrome by proxy

A five-year-old girl presented with profound growth failure, lethargy, vomiting and acidosis. A diagnosis of Munchausen syndrome by proxy was made after the demonstration of egg albumin, diphenhydramine and phenothiazine metabolites in her urine. Growth improved dramatically, but a subsequent child in the family died of sudden infant death syndrome.     

取代腺嘌呤和腺苷的合成及生物活性

为了探索芳杂环甲基取代腺嘌呤和腺苷的有效合成方法,本文以腺嘌呤和腺苷为原料设计并合成了7个9-取代腺嘌呤(1～7)、6个N⁶,9-双取代腺嘌呤(12～17),3个N⁶-取代腺嘌呤(23～25)、5个N⁶-取代腺苷(18～22),同时合成了3个3-取代腺嘌呤(9～11),共24个化合物,其中23个为未知化合物。对合成的所有腺苷衍生物和部分腺嘌呤衍生物进行了腺苷受体活性筛选。化合物18在大鼠输精管模型上对腺苷受体的激动活性是腺苷的33倍。     

Ethmoid sinus disease: CT evaluation in 400 cases. Part I. Nonsurgical patients

The unique anatomy of the ethmoid sinuses makes it difficult to interpret "soft-tissue clouding," especially on plain films. The clinical significance of isolated or generalized soft-tissue disease within ethmoid cells is unclear, and the patterns of bone erosion or remodeling must be relied on in establishing a specific differential diagnosis. Of 400 patients studied, 186 had inflammatory disease and 214 had tumors. Squamous cell carcinomas, metastases, and a few aggressive sarcomas were found almost exclusively to have bone destruction, while 94% of the remaining neoplasms were characterized by cavity remodeling. Further differentiation was sometimes possible because of the pattern and degree of tumor enhancement. Of the neoplasms, only the minor salivary gland lesions and neuromas had nonhomogeneous enhancement. Malignant lesions cannot be diagnosed with computed tomography (CT) unless bone destruction is present. Similarly, although the significance of persistent, benign-appearing soft-tissue disease during chemotherapy is unclear, tumor must always be suspected, even after many months of a stable CT appearance.     

Mutations in the BRCA1-associated RING domain (BARD1) gene in primary breast, ovarian and uterine cancers

Germline alterations of BRCA1 result in susceptibility to breast and ovarian cancer. The protein encoded by BRCA1 interacts in vivo with the BRCA1-associated RING domain (BARD1) protein. Accordingly, BARD1 is likely to be a critical factor in BRCA1-mediated tumor suppression and may also serve as a target for tumorigenic lesions in some human cancers. We have now determined the genomic structure of BARD1 and performed a mutational analysis of 58 ovarian tumors, 50 breast tumors and 60 uterine tumors. Seven polymorphisms were detected within the 2.34 kb coding sequence of BARD1 . Somatically acquired missense mutations were observed in one breast carcinoma and one endometrial tumor; in at least one of these cases, tumor formation was accompanied by loss of the wild-type BARD1 allele, following the paradigm for known tumor suppressor genes. In addition, a germline alteration of BARD1 was identified in a clear cell ovarian tumor (Gln564His); again, loss of the wild-type BARD1 allele was observed in the malignant cells of this patient. The Gln564His patient was also diagnosed with two other primary cancers: a synchronous lobular breast carcinoma and a stage IA clear cell endometrioid cancer confined to an endometrial polyp 6 years earlier. These findings suggest an occasional role for BARD1 mutations in the development of sporadic and hereditary tumors.      

Attentional and visual demands for sprint performance in non-fatigued and fatigued conditions: reliability of a repeated sprint test

Background  

Physical performance measures are widely used to assess physical function, providing information about physiological and biomechanical aspects of motor performance. However they do not provide insight into the attentional and visual demands for motor performance. A figure-of-eight sprint test was therefore developed to measure the attentional and visual demands for repeated-sprint performance. The aims of the study were: 1) to assess test-retest reliability of the figure-of-eight sprint test, and 2) to study the attentional and visual demands for sprint performance in a non-fatigued and fatigued condition.     

慢性粒细胞白血病异基因造血干细胞移植34例疗效及生活质量随访

目的：观察异基因造血干细胞移植治疗慢性粒细胞白血病的疗效并进行生活质量评估。 方法：选择2002-03／2007-03在解放军第四军医大学西京医院血液科接受异基因造血干细胞移植18～50岁慢性粒细胞白血病患者34例，其中HLA相合的同胞供者29例，非血缘志愿供者5例。所有患者及其家属对治疗以及研究均知情并签署同意书，医院伦理委员会知情并批准。预处理方案采用改良的马利兰联合环磷酰胺或环磷酰胺联合全身放疗方案。采用标准的环孢素联合短期氨甲喋呤方案预防移植物抗宿主病；无关供者移植加用抗人胸腺细胞球蛋白。所有患者均接受WHOQOL—BREF问卷调查其移植前后的生活质量。 结果：所有患者均获得植入。①移植物抗宿主病出现情况：14.7％（5／34）患者出现急性移植物抗宿主病，41．2％（14，34）患者出现慢性移植物抗宿主病。②移植其他并发症：合并重症肝静脉闭塞病1例；并发纯红细胞性再生障碍性贫血3例，甲状腺功能低下2例，女性雌激素水平低下9例，经积极治疗，大部分获得缓解。③长期生存情况：随访3～60个月，现存活25例（73．5％），其中在慢性期移植者，生存率达82．1％（23／28）。26．4％（9／34）患者在移植后1～50个月时死亡，4例死于白血病复发，5例死于移植并发症。（9生活质量评分：与患者移植前比较，各项指标均有显著的提高（P〈0．05）。 结论：异基因造血干细胞移植是治疗慢性粒细胞白血病的有效方法，尤其在慢性期移植效果较好。移植后长期存活患者的生活质量良好，慢性移植物抗宿主病及女性卵巢功能低下是影响患者生活质量的主要因素。     

PAIg检测诊断ITP的局限性

０　引言　血小板相关抗体（ＰＡＩｇ）是原发性血小板减少性紫癜（ＩＴＰ）的诊断、疗效及预后估计的有效指标．用ＥＬＩＳＡ法定量测定６７例血小板减少患者的ＰＡＩｇ,结果发现其中有２２例非ＩＴＰ患者的ＰＡＩｇ增高,说明ＰＡＩｇ用于诊断ＩＴＰ存在一定的局限性,在无其它临床指标的前提下,不能单凭ＰＡＩｇ的增高而诊断为ＩＴＰ．１　材料和方法１．１　材料　ＰＡＩｇＡ,ＰＡＩｇＧ,ＰＡＩｇ试剂盒,福建太阳生物技术公司提供;酶标仪,华东电子管厂制造;血小板制备盒,福建太阳生物技术公司提供;缺铁性贫血８例,溶血性贫血…