<Emphasis Type="Italic">FGFR1</Emphasis> amplification in breast carcinomas: a chromogenic <Emphasis Type="Italic">in situ</Emphasis>hybridisation analysis

Background  

The amplicon on 8p11.2 is reported to be found in up to 10% of breast carcinomas. It has been demonstrated recently that this amplicon has four separate cores. The second core encompasses important oncogene candidates, including the fibroblast growth factor receptor 1 (FGFR1) gene. Recent studies have demonstrated that specific FGFR1 amplification correlates with gene expression and that FGFR1 activity is required for the survival of a FGFR1 amplified breast cancer cell line.     

FREDDY激光器的碎石效率的体外分析

背景和目的　双频双脉冲Nd :Yag(FREDDY)激光 (德国W .O .M .公司生产 )是一个短脉冲 ,双频率 ( 5 3 2nm和 10 64nm)的固体激光器。该激光器功率小 ,成本低 ,目前已在腔内碎石术中得到应用。我们设计了一个试验 ,以测试在不同能量和不同频率下的碎石效率。材料和方法　 40个预先称过重量的硫酸钙石头被分成 4组 ,在 5Hz和 10Hz情况下 ,分别碎石 2min和 4min。一个水下的试验装置包括一个支架和一个容器 ,使得石英玻璃光纤可以直接抵住石头 ,发射激光。光纤被剥离成直径为 2 80 μm的裸露光纤 ,以保证最佳的能量传输。碎石完成后 ,所有的残余颗粒都落在容器内 ,晾干 48小时后 ,再重新称重 ,根据重量缺失的百分比来测试碎石效果。结果　 5Hz时 ,碎石 2min的重量缺失为 2 4%;碎石 4min的重量缺失为 5 4%。 10Hz时 ,碎石 2min的情况与 5Hz时碎石 4min的结果相似 ,重量缺失为 5 1%;碎石 4min的重量缺失为 64 %,原先估计这么高的能量设置 ,重量缺失应该更大些。在高能量发射时 ,可以观察到光纤有损耗 ,这可能是导致碎石效率下降的原因。结论　FREDDY激光器在 5Hz时碎石 4min ,和在 10Hz时碎石 2min的效率是同等的 ,提示传输到结石的能量与碎石效率的相关性很好。而 10Hz、4min组的碎石效率比预期的略有下降 ,     

Neurocytotoxicity: pharmacological implications

Recent data suggest that brain damage in ischemia, hypoglycemia, and several other brain diseases is caused by excitotoxic mechanisms which are triggered by presynaptic release of glutamate and related excitatory amino acids, and which involve an abnormal postsynaptic influx of calcium into cells containing a high density of glutamate receptors. This contention is supported by results demonstrating reduction of infarct size in focal ischemia due to middle cerebral artery (MCA) occlusion, and amelioration of neuronal necrosis in hypoglycemic coma, by antagonist which block the NMDA type of glutamate receptor. These results underscore the pathogenetic role of calcium influx into energy-compromised cells since the NMDA receptor-linked ion channel has a high conductance to calcium. The issue has been clouded by the inability of NMDA antagonists to ameliorate brain damage due to cardiac arrest, or to forebrain ischemia in rats and gerbils. In these conditions, however, an AMPA receptor blocker (NBQX) has been found efficacious. These results demonstrate that the pathophysiology of ischemic lesions is different in the cardiac arrest type of ischemia and in lesions due to MCA occlusion, and demand an explanation of the differences in therapeutic response. Tentatively, the cardiac arrest type of ischemia is so dense that multiple calcium conductances are activated in the energy-deprived tissue, explaining why any drug which acts on only one of them (such as an NMDA antagonist) cannot prevent cellular calcium overload. Furthermore the ultimate brain damage, which is often conspicuously delayed, may be secondary to upregulation of synaptic efficacy, causing increased calcium cycling and calcium-related damage. In this situation, an AMPA receptor blocker may be efficacious because it blocks "fast" excitation and Na+ influx, an "upstream" event which causes "downstream" calcium influx via multiple pathways. In the perifocal ("penumbra") zone of a stroke lesion, the situation is different since depolarisation is initially moderate and/or intermittent. Furthermore, since ATP is still produced (albeit at a reduced rate) the problem is one of a disturbed pump/leak relationship. Then, blockade of a major calcium-carrying channel by NMDA receptor blockers, or of the trigger to depolarisation by an AMPA receptor antagonist, may improve the pump/leak relationship and carry cells in the penumbra over a critical period.     

Cardiac myxoma in a 6-year-old child-constitutional symptoms mimicking rheumatic disease and the role of interleukin-6

A 6-y-old girl with right atrial myxoma presented with remittent fever attacks, general arthralgia and laboratory investigations mimicking rheumatic or autoimmune disease. Interleukin-6 (IL-6) serum concentration was markedly elevated before and normal after tumour resection, whereas myxoma cells stained negatively for IL-6. IL-6 should be considered a myxoma marker: overproduction by myxoma cells and consecutive systemic passage are assumed to cause immunological features.     

下肢严重开放性骨折的皮瓣覆盖

目的 观察以皮瓣覆盖下肢严重开放骨折的疗效，分析常见的并发症及手术时机。方法 自1999年12月～2004年4月间，41例患者，42侧下肢，共43个皮瓣。Ⅲb型骨折38个肢体，Ⅲc型骨折2个肢体，足的截肢性损伤2个肢体。男34例，女7例，年龄14～75岁，平均38．3岁。损伤部位33例在胫骨，10例位于足和踝。创面面积4～450cm^2(平均71cm^2)。本组病例受伤至皮瓣手术平均18．9d(3～43d)，游离皮瓣31例(游离股薄肌皮瓣14例，游离背阔肌皮瓣8例，游离背阔肌加肋骨2例，游离腹直肌皮瓣7例)，有蒂皮瓣12例(小腿外侧皮瓣9例，腓肠肌瓣2例，比目鱼肌肌瓣1例)。结果 1例游离背阔肌皮瓣失败，骨不愈合4例(9．52％)，26例患者术前创面细菌培养阳性，4例出现深部软组织感染(9．52％)。我们将术前细菌培养呈阳性的患者和术前细菌培养呈阴性患者的手术时间做了比较，两组患者受伤至皮瓣手术的平均时间分别为22．4d和8．33d，两者有显著性差异。结论 提倡合理使用抗菌素，早期覆盖创面及植骨。端-侧吻合是适用和安全的。     

AN INVESTIGATION INTO THE PRACTICE AND BENEFITS OF STATUTORY AFTERCARE IN AN INNER CITY PSYCHIATRIC SERVICE

The implementation of statutory aftercare for psychiatric inpatients, as outlined in Section 117 of the Mental Health Act 1983 (England and Wales), was studied by examining current practice in an inner city psychiatric service. Seventy-seven per cent of patients received Section 117 aftercare; 56% of patients did not have an identified key worker. A significant proportion of those receiving statutory aftercare did not have evidence of adequate forward planning. General practitioners did not attend any meetings. Patients who had Section 117 aftercare were compared with those who did not. Using the Cox regression model, it was found there was no significant difference between these two groups in terms of time between discharge and first readmission, readmission rate, and length of first readmission.     

Clinical and biologic characterization of T-cell neoplasias with rearrangements of chromosome 7 band q34

In T cell malignancy, rearrangements of chromosome 14 have been observed with a break in the band that contains the alpha chain gene for the T cell receptor (TCR). Because the beta chain TCR gene is in chromosome band 7q34, we searched for and report finding specific rearrangements of 7q34 exclusively in T cell malignancies. The rearrangements were reciprocal translocations between 7q34 and other points: 1p34, 9q32, 9q34, 15q22, and 19p13. The malignancies containing a 7q34 translocation were either T cell acute lymphoblastic leukemias or T cell lymphoblastic lymphomas that had similarities in clinical, enzyme, immunologic, and cellular characteristics. Hybridization using a probe to the beta-TCR gene disclosed unique rearrangements consistent with clonality in every case. A common pattern with chromosome breakpoints involving TCR genes may be emerging in T cell neoplasia.     

Functional and morphologic characteristics of the leukemic cells of a patient with acute monocytic leukemia: correlation with clinical features

The clinical course of a patient with acute monocytic leukemia and prominent infiltration of the skin and testes is described. In vitro studies demonstrated that the circulating monocyte precursors were capable of adherence to nylon fibers, and phagocytosis of bacteria and latex particles. In vivo, migration of leukemic cells to skin windows was observed. Extreme nuclear folding, marked surface activity, and morphologic features suggesting nuclear and cytoplasmic maturation were seen by light and electron microscopy. The presence of morphologically and functionally more differentiated monocytic cells may account for the marked tiuuse invasion in this patient and, possibly, in other patients with monocytic leukemia.