Undifferentiated (embryonal) sarcoma of the liver: radiologic- pathologic correlation

Undifferentiated (embryonal) sarcoma (UES) is an uncommon malignant mesenchymal hepatic tumor that occurs in older children and young adults. Fourteen cases are correlated with radiologic and pathologic findings. Radiologic findings reflect the spectrum of solid to cystic appearances observed in the gross specimens. Sonography typically demonstrates a large mass that may be predominantly solid with many small anechoic spaces or may be cystic. Computed tomography reveals a hypodense mass with hyperdense septa of variable thickness and a dense peripheral rim corresponding to the fibrous pseudocapsule of the tumor. Angiographically, UES is usually hypovascular with tumoral vessels, although hypervascular and avascular patterns occur. Prognosis of UES is poor, with a median survival of less than 1 year. Radiologists should be familiar with this malignant tumor since it may present as a large cystic hepatic mass, suggestive of a benign lesion.     

Ultrastructural evidence, by immunoperoxidase technique, for a tubular reabsoprtion of endogenous albumin in normal rat.

The reabsorption of endogenous albumin in the proximal tubules of the normal Munich-Wistar rat has been studied using immunoperoxidase techniques. The lumina of the superficial proximal tubules were found to remain open after in situ fixation, allowing good penetration of the conjugates. Labeling typical of an endocytotic process was observed only in the proximal tubules. This fact suggests that the glomerular filtration barrier is not an absolute one for denogenous albumin.     

自体外周血干细胞经冠状动脉移植治疗急性心肌梗死：近期疗效随访

目的:观察经皮经腔冠状动脉内移植外周血干细胞治疗急性心肌梗死的可行性与近期临床疗效。方法:①实验对象:选取2003-11/2005-01辽宁省人民医院收治的急性心肌梗死患者70例,男56例,女14例,年龄(60±10)岁,体质量(73±11)kg,急性心肌梗死病程(5±2)d,均对本实验知情同意,实验方案经辽宁省人民医院伦理委员会批准。70例患者随机数字表法分为细胞移植组、常规治疗组,35例/组。两组基线资料基本相似。②实验方法:常规治疗组单纯给予药物治疗 冠状动脉造影术或支架植入术。细胞移植组在常规治疗的基础上应用粒细胞集落刺激因子皮下注射动员自体骨髓干细胞,连续5d,第6天经血细胞分离机分离采集外周血干细胞悬液57mL,经over the wire球囊导管中心腔注入梗死相关动脉,注入CD34细胞数量为(7.25±7.33)×107个。③实验评估:在外周血干细胞动员、采集及经冠状动脉回输过程中观察患者不良反应。于术前及术后6个月检查两组患者左室形态、心功能、室壁节段性运动积分的改变。结果:术后6个月,细胞移植组全部完成随访,常规治疗组23例完成随访。①手术前后超声心动图参数值的变化:与术前比较,术后6个月细胞移植组左室收缩末容积、室壁节段性运动积分指数均明显下降(P<0.05),左室射血分数显著升高(P<0.05)。术后6个月与常规治疗组比较,细胞移植组左室射血分数明显升高,室壁节段性运动积分指数显著降低,差异有显著性意义(P<0.05)。②安全性评估:外周血干细胞动员时不良反应占37.1%,分离和采集过程不良反应占15.3%,经冠状动脉内回输过程不良反应占20.0%。结论:经皮经腔冠状动脉移植自体外周血干细胞治疗急性心肌梗死,可在近期有效地减少心肌梗死缺血面积,减轻左室重构,改善心功能。     

广东东莞地区中老年非暴力性骨折107例及无骨折求诊者392例超声骨密度测定

目的:应用超声骨密度/骨质量测量仪对东莞地区中老年非暴力性骨折患者进行检测,探讨各参数的变化规律及临床意义,并确立骨折的骨密度阈值。方法:①实验对象:选择2003-09/2006-08在东莞石龙人民医院进行超声骨密度测定的非暴力性骨折东莞地区中老年患者107例,男30例,女77例;同期同龄进行超声骨密度测定的无骨折求诊者392例,作为对照组,男83例,女309例。②实验分组:根据年龄分为3个时期:46～60岁为老年前期、61～75岁为老年期、76岁以上为高龄期,以及相应男女组及骨折与非骨折组。③实验方法:采用法国DMS公司UBIS5000型超声骨密度/骨质量测量仪对中老年非暴力性骨折者、无骨折就诊者进行超声骨密度测量。④实验评估:比较两组男女及不同年龄段超声振幅衰减平均值、超声传播速度、骨硬度指数、T值(代表患者测量值如超声振幅衰减平均值和20岁正常人的测量值之间的差异)、Z值(代表患者测量值如超声振幅衰减平均值和同龄正常人的测量值之间的差异)。结果:两组499例患者全部进入结果分析。①总体比较:男、女性骨折组与非骨折组比较,除超声传播速度差别无统计学意义外(P>0.05),其余指标(超声振幅衰减、骨硬度指数、T值、Z值)非骨折组高于骨折组(P<0.01)。②分年龄组比较:老年前期组与总体一致,老年组、高龄组主要指标无统计学意义。应用方差分析对女性骨折组各年龄组之间进行比较,除骨硬度指数外(P<0.05),其余指标差异无显著性;男性骨折组各年龄组之间比较得出与女性一样结果。③男性与女性骨折组比较:除T值男性组高于女性组外(P<0.01),其余指标(超声振幅衰减、超声传播速度、骨硬度指数、Z值)差异均无统计学意义。结论:①中老年人群骨质下降至一定程度(相应测量参数为骨折阈值)时容易发生脆性骨折。②致脆性骨折的骨质量条件与性别、年龄因素无明显相关性。③东莞地区步入老年期后不论男女骨质疏松现象相当普遍,是否会出现骨折关键在于有否外力作用,对其预防性诊断很有价值。     

人类风湿性关节炎滑膜-软骨-NOD．scid小鼠嵌合体模型的建立

目的:建立能反应自身免疫特点的类风湿性关节炎动物模型,为进一步研究该病发病机制奠定基础。方法:实验于2006-03/12在南方医科大学实验动物中心完成。①实验材料:SPF级2～4个月龄NOD.scid小鼠20只,体质量17～22g,雌雄各半;人类风湿性关节炎滑膜组织(佛山市第一人民医院风湿科提供,患者知情同意);骨关节炎滑膜及正常软骨(南方医院创伤骨科提供,患者及供者知情同意)。②实验分组:将小鼠随机分为2组,类风湿性关节炎滑膜组和骨关节炎滑膜组,雌雄不限,每组10只。③实验过程:每组小鼠背部皮下植入的正常软骨组织,随后将类风湿性关节炎滑膜和骨关节炎滑膜植入软骨之上。④造模10周后麻醉下处死小鼠,用放射免疫法检测血清中肿瘤坏死因子α含量,移植物进行组织病理学观察,并进行组织学积分。结果:①模型鼠一般情况:实验期间NOD.scid小鼠无手摸皮骨感、活动度差、毛稀疏等典型移植物抗宿主疾病表现,模型鼠在SPF环境下10周存活率100%。②肿瘤坏死因子α含量:类风湿性关节炎滑膜组鼠血清中肿瘤坏死因子α放射含量类风湿性关节炎组明显高于骨关节炎组[(0.80±0.06),(0.70±0.03)μg/L,t=4.466,P<0.001]。③组织病理学观察:苏木精-伊红染色,骨关节炎滑膜组只见少量的滑膜细胞增生和炎症细胞,移植的滑膜组织主要被纤维组织形成的条索状物代替,无明显地软骨被侵蚀破坏发生;类风湿性关节炎滑膜组可明显见到大量的滑膜细胞增生和生化中心形成,病变部位的组织结构间质变为疏松,变为境界不清晰的颗粒状或块状无结构强嗜酸性红染物质;软骨边缘被滑膜组织侵蚀破坏明显;类风湿性关节炎滑膜组滑膜增生、软骨侵蚀和软骨降解积分均高于骨关节炎滑膜组(P<0.04)。结论:在NOD.scid体内可成功建立类风湿性关节炎动物模型。     

大连理工大学图书馆员的人格因素和职业现状分析

目的:通过对图书馆员的人格因素和职业现状分析,为图书馆的人力资源管理提供参数。方法:于2005-06/08纳入大连理工大学伯川图书馆馆员72人作为人格测试组,男7人,女65人;同时纳入2005-07前在职的全部馆员122人作为职业现状分析组,男26人,女96人。采用国际公认的卡特尔16种人格因素问卷,对人格测试组进行人格测试。问卷从16个相对独立的人格维度对人进行描绘,全套测试题共187题,每题设有a,b,c3种可供选择的答案。将测试结果输入心理测试软件系统,给出粗分和标准分,再运用软件进行数据的统计分析。对职业现状分析组的全体馆员进行了性别,年龄结构,男女馆员在各工作部门的分布,及馆员的学历构成,技术职称和领导职务的担任比例统计分析。观察人格测试组卡特尔16种人格因素问卷人格类型的次元因素和综合个性应用评价分数,并对全体馆员的自然状况列表进行统计分析,分析其职业现状。结果:发放卡特尔16种人格因素问卷72份,回收完整问卷46份,回收率63.9%,有效率100%。最终人格测试组46人进入结果分析,男5人,女41人。职业现状分析组122人,全部进入结果分析。①人格测试组聪慧性、幻想性、自律性均高于全国专业技术人员常模,差异有显著性意义(9.74±1.22;8.88±1.22;13.11±2.36,11.83±1.25;13.89±2.59,12.40±1.47;t=4.780,3.676,3.901,2.783,P<0.001～0.01)。被试馆员怀疑性和紧张性低于全国专业技术人员常模,差异有显著性意义(9.39±2.85,10.56±1.57;9.76±3.72,11.19±1.65;t=-2.783,-2.606,P<0.01,0.05)。②女性图书馆员占总人数的78.7%,男性图书馆员在年龄结构上处于年龄段的两端,在生理上处于成年早期(30.7%)和晚期(38.4%);女性馆员的年龄集中于30～50岁的年龄段(86.3%)。③男馆员在综合办公室、自动化部和技术服务部的人数分布方面占据优势地位(38.4%,11.5%,11.5%);而女性馆员集中于期刊咨询部、文献建设部、流通阅览部和回溯建库等信息服务咨询部门(24%,15.6%,40.6%,4.2%)。④男馆员在获得博士、双学士、学士学位,及本科、中专学历方面的人数比例大于女性馆员,而女性馆员在获得硕士学位及大专和较低学历方面所占的比例大于男性馆员。⑤男性馆员在高级技术职称和馆级领导高端决策层占优势,在初级和较低技术职称中占比例较大;女性馆员在中级技术职称中级领导层上占比例大于男性馆员。结论:图书馆员女性化,而男性馆员在知识结构、职称、高端决策层领导职务的担任和承担高技术性工作方面的整体水平优于女性馆员。更应着重分析女性图书馆员的生理、心理特点,人格因素和职业特征,进行人力资源的优化组合。     

Ex vivo cardiovascular magnetic resonance measurements of right and left ventricular mass compared with direct mass measurement in excised hearts after transplantation: a first human SSFP comparison

Background

CMR is considered the ‘gold standard’ for non-invasive LV and RV mass quantitation. This information is solely based on gradient-recalled echo (GRE) sequences while contrast dependent on intrinsic T1/T2 characteristics potentially offers superior image contrast between blood and myocardium. This study aims, for the first time in humans, to validate the SSFP approach using explanted hearts obtained from heart transplant recipients. Our objective is establish the correlation between and to validate steady-state free precession (SSFP) derived LV and RV mass vs. autopsy mass of hearts from cardiac transplants patients.

Methods

Over three-years, 58 explanted cardiomyopathy hearts were obtained immediately upon orthotopic heart transplantation from the OR. They were quickly cleaned, prepared and suspended in a saline-filled container and scanned ex vivo via SSFP-SA slices to define LV/RV mass. Using an automatic thresholding program, segmentation was achieved in combination with manual trimming (ATMT) of extraneous tissue incorporating 3D cardiac modeling performed by independent and blinded readers. The explanted hearts were then dissected with the ventricles surgically separated at the interventricular septum. Weights of the total heart not excluding papillary and trabecular myocardium, LV and RV were measured via high-fidelity scale. Linear regression and Bland-Altman plots were used to analyze the data. The intra-class correlation coefficient was used to assess intra-observer reliability.

Results

Of the total of 58 explanted hearts, 3 (6%) were excluded due to poor image quality leaving 55 patients (94%) for the final analysis. Significant positive correlations were found between total 3D CMR mass (450 ± 111 g) and total pathology mass (445 ± 116 g; r = 0.99, p < 0.001) as well as 3D CMR measured LV mass (301 ± 93 g) and the pathology measured LV mass (313 ± 96 g; r = 0.95, p < 0.001). Strong positive correlations were demonstrated between the 3D CMR measured RV mass (149 ± 46 g) and the pathology measured RV mass (128 ± 40 g; r = 0.76, p < 0.001). The mean bias between 3D-CMR and pathology measures for total mass, LV mass and RV mass were: 3.0 g, -16 g and 19 g, respectively.

Conclusions

SSFP-CMR accurately determines total myocardial, LV and RV mass as compared to pathology weighed explanted hearts despite variable surgical removal of instrumentation (left and right ventricular assist devices, AICD and often apical core removals). Thus, this becomes the first-ever human CMR confirmation for SSFP now validating the distinction of ‘gold standard’.     

Routine evaluation of left ventricular diastolic function by cardiovascular magnetic resonance: A practical approach

Background

Cardiovascular magnetic resonance (CMR) has excellent capabilities to assess ventricular systolic function. Current clinical scenarios warrant routine evaluation of ventricular diastolic function for complete evaluation, especially in congestive heart failure patients. To our knowledge, no systematic assessment of diastolic function over a range of lusitropy has been performed using CMR.

Methods and Results

Left ventricular diastolic function was assessed in 31 subjects (10 controls) who underwent CMR and compared with Transthoracic echocardiogram (TTE) evaluation of mitral valve (MV) and pulmonary vein (PV) blood flow. Blood flow in the MV and PV were successfully imaged by CMR for all cases (31/31,100%) while TTE evaluated flow in all MV (31/31,100%) but only 21/31 PV (68%) cases. Velocities of MV flow (E and A) measured by CMR correlated well with TTE (r = 0.81, p < 0.001), but demonstrated a systematic underestimation by CMR compared to TTE (slope = 0.77). Bland-Altman analysis of the E:A ratio and deceleration time (DT) calculated from each modality showed excellent agreement (bias -0.29, and -10.3 ms for E:A and DT, respectively). When assessing morphology using TTE, CMR correctly identified patients as having normal or abnormal inflow conditions.

Conclusion

We have shown that there is homology between CMR and TTE for the assessment of diastolic inflow over a wide range of conditions, including normal, impaired relaxation and restrictive. There is excellent agreement of quantitative velocity measurements between CMR and TTE. Diastolic blood flow assessment by CMR can be performed in a single scan, with times ranging from 20 sec to 3 min, and we show that there is good indication for applying CMR to assess diastolic conditions, either as an adjunctive test when evaluating systolic function, or even as a primary test when TTE data cannot be obtained.     

Study of malaria in a village of lower Myanmar

Malaria endemicity in lower Myanmar has been studied to identify the causes for the prevalence of malaria in Yeasitkan village of lower Myanmar. Vector mosquitoes were collected by mosquito net in cattlesheds and in human dwellings (indoor and outdoor) by biting and catching procedure for the identification of species, insecticide susceptibility test and sporozoites detection. Larvae of mosquitoes were also collected in and around the village for vector identification and for breeding sources. Malaria infection in humans was examined by blood examination and blood antibody detection by ELISA method. Results showed that malaria infection was 43.2% in children under 10 years of age and An. dirus and An. minimus were found as main vectors. Total parasite positive rate was found to be 41.28% and in this 78.87% were P. falciparum infections and remaining 18.31% were of P. vivax. Spleen positive rate has been found very high in children between 2 and 9 years (52.94%). Study indicates that villages near to dam areas are more prone to malaria infection.