Routine fetal genitourinary tract screening

To evaluate routine fetal genitourinary tract obstetrical ultrasound screening, and to determine what size renal pelvis is indicative of significant renal disease, we reviewed 4,832 examinations, which had been performed over 2 years, of 3,530 consecutive obstetrical patients. Any fetus that had a renal pelvis greater than 5 mm or a definable cystic area was identified for follow-up. The fetuses of 39 patients (1.1%) who underwent 112 examinations fulfilled these criteria and constitute the basis of this report. A variety of examination criteria were recorded and analyzed in relationship to the follow-up, which ranged from 2-3 days to 21 months. The fetuses of the 39 patients were grouped into three categories: those with renal pelves between 5 and 9 mm in size; those with renal pelves larger than 10 mm; and those with cystic abnormalities. Those with renal pelves larger than 10 mm had either an obstructing lesion or exceptional extrarenal pelves. The clinical and pathologic aspects of these three groups are detailed, discussed, and analyzed. Criteria for significant fetal renal hydronephrosis and aspects of a loculated appearance are given.     

Erythroid and nonerythroid spectrins

Recent developments have contributed important information to understanding the role of spectrins in the RBC membrane skeleton and nonerythroid cells. Many questions can now be framed, informed by structural knowledge of various spectrin subunit types and alternatively spliced variants, that previously could not have been addressed. Their solution in the coming years will likely lead to further advances with direct relevance to biology and medicine.     

Neuropeptide Y: localization in the central nervous system and neuroendocrine functions

Neuropeptide Y (NPY) is a 36-amino acid peptide first isolated and characterized from porcine brain extracts. A number of immunocytochemical investigations have been conducted to determine the localization of NPY-containing neurons in various animal species including both vertebrates and invertebrates. These studies have established the widespread distribution of NPY in the brain and in sympathetic neurons. In the rat brain, a high density of immunoreactive cell bodies and fibers is observed in the cortex, caudate putamen and hippocampus. In the diencephalon, NPY-containing perikarya are mainly located in the arcuate nucleus of the hypothalamus; numerous fibers innervate the paraventricular and suprachiasmatic nuclei of the hypothalamus, as well as the paraventricular nucleus of the thalamus and the periaqueductal gray. At the electron microscope level, using the pre- and post-embedding immunoperoxidase techniques, NPY-like immunoreactivity has been observed in neuronal cell body dendrites and axonal processes. In nerve terminals of the hypothalamus, the product of the immunoreaction is associated with large dense core vesicles. In lower vertebrates, including amphibians and fish, neurons originating from the diencephalic (or telencephalic) region innervate the intermediate lobe of the pituitary where a dense network of immunoreactive fibers has been detected. At the ultrastructural level, positive endings have been observed in direct contact with pituitary melanotrophs of frog and dogfish. These anatomical data suggest that NPY can act both as a neurotransmitter (or neuromodulator) and as a hypophysiotropic neurohormone. In the rat a few NPY-containing fibers are found in the internal zone of the median eminence and high concentrations of NPY-like immunoreactivity are detected in the hypothalamo-hypophyseal portal blood, suggesting that NPY may affect anterior pituitary hormone secretion. Intrajugular injection of NPY causes a marked inhibition of LH release but does not significantly affect other pituitary hormones. Passive immunoneutralization of endogenous NPY by specific NPY antibodies induces stimulation of LH release in female rats, suggesting that NPY could affect LH secretion at the pituitary level. However, NPY has no effect on LH release from cultured pituitary cells or hemipituitaries. In addition, autoradiographic studies show that sites for 125I-labeled Bolton-Hunter NPY or 125I-labeled PYY (2 specific ligands of NPY receptors) are not present in the adenohypophysis, while moderate concentrations of these binding sites are found in the neural lobe of the pituitary. It thus appears that the inhibitory effect of NPY on LH secretion must be mediated at the hypothalamic level.(ABSTRACT TRUNCATED AT 400 WORDS)     

Transvaginal and transabdominal sonography: prospective comparison

Transvaginal (TV) and transabdominal (TA) sonography were compared in a prospective study. A total of 230 examinations (126 pelvic, 104 pregnancy) were performed on 215 patients, ranging in age from 14 to 80 years. The improved anatomic detail on TV scans yielded new information in 138 (60%) examinations and better visualization of pelvic structures in 51 (22%) examinations. There was no important difference in diagnostic information provided by the two imaging modalities in 36 (16%) cases, and TV images were worse in five (2%). The clinical diagnosis was altered on the basis of TV sonographic findings in 54 (24%) cases and confirmed with certainty in 166 (72%). Diagnostic problems posed by TA scanning were not resolved by TV scanning in ten (4%) instances. Statistical analysis indicated that TV scanning was significantly better than TA scanning in the visualization of gestational sac contents (P less than .005), detection of fetal heart motion (P less than .001), and evaluation of the endometrial canal in the retroverted or retroflexed uterus (P less than .001). TV scanning was significantly better than TA scanning in visualization of the ovaries in patients with uterine leiomyomas (P less than .005) but not significantly better in peri- and postmenopausal patients (P greater than .05).     

Renal allografts: prospective analysis of Doppler sonography

Fifty-six consecutively transplanted renal allografts were prospectively evaluated with serial Doppler sonographic examinations. Thirty-eight episodes of transplant rejection in 32 patients (63% proved pathologically) and 24 episodes of acute tubular necrosis (ATN) in 24 patients were encountered. The Doppler spectral waveform was characterized by means of the pulsatility index (PI), systolic/diastolic ratio (SDR), diastolic/systolic ratio (SDR), diastolic/systolic ratio (DSR), and resistive index (RI). Accuracy was optimized with use of top normal values as follows: PI = 1.8, SDR = 4.0, DSR = 0.25, RI = 0.75. There were no significant differences in the indices for those patients undergoing rejection versus those with ATN. The sensitivity for predicting transplant rejection was adversely affected by the history of either ATN or a previous rejection episode in the same allograft. Comparison with concurrent radionuclide examinations revealed similar sensitivities for rejection with scintigraphy and sonography. Differentiation of ATN from rejection was more reliable with scintigraphy than with sonography.     

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。     

许旺细胞增殖和分化过程中的信号通路

目的:探讨许旺细胞增殖和分化过程中细胞内各种信号通路及其关联性。资料来源:应用计算机检索Medline 1994-01/2006-12和Embase 1994-01/2006-12期间的有关许旺细胞增殖和分化相关的信号通路的文献,检索词“Schwann cell;proliferation;differentiation;signal transduction”,并限定文章语言种类为英文。资料选择:选取与许旺细胞增殖和分化相关的有关信号通路的文献,进行初审,删除与信号通路不相关的研究,然后查找余下的文献全文。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索54篇与许旺细胞增殖和分化相关的有关信号通路的文献研究,纳入30篇文章。14篇有关许旺细胞增殖,12篇许旺细胞分化,4篇是其他的相关信号通路。资料综合:许旺细胞的分化和基因表达是通过各种细胞外信号来调控的,多种信号通路相互联系。来自于受体酪氨酸激酶,丝裂原活化蛋白激酶,磷酯酰肌醇-3激酶通路的信号在许旺细胞增殖和分化过程中都有很重要的作用,它们之间的平衡决定了细胞最后的功能。而细胞内膜受体G蛋白偶联的环磷腺苷浓度促进了细胞的各种功能,也参与调节了其他信号通路。结论:许旺细胞增殖和分化过程是多种信号通路相互联系完成的,阐明不同信号通路之间的关系以及它们的交互作用对于揭示许旺细胞的生物学功能有重要的意义。