The additional value of an oblique image plane for MRI of the anterior and posterior distal tibiofibular syndesmosis

Objective  

The optimal MRI scan planes of collateral ligaments of the ankle have been described extensively, with the exception of the syndesmotic ligaments. We assessed the optimal scan plane for depicting the distal tibiofibular syndesmosis.     

2,4-二氨基-5-氯-6-取代苄氨基喹唑啉类化合物的合成及其抗疟、抗肿瘤和抗菌活性

本文报道标题化合物的合成及其抗疟、抗肿瘤和抗菌活性,该类化合物是以5-氯-2,4, 6-三氨基喹唑啉与各种取代苯甲醛缩合成相应的Schiff碱,然后经NaBH₄还原,再甲酰化或亚硝化制得.经对感染伯氏疟原虫(P.berghei)的鼠抑制性治疗筛选,有八个化合物剂量20mg/kg×4d时抑制率100%,Ⅰ₃,Ⅰ₄,Ⅲ₄三个化合物剂量5mg/kg×4d时抑制率在90%以上;体外抗肿瘤试验有4个化合物的活性优于MTX和SIPl759,以Ⅰ₄最佳。对L1210白血病细胞株的IC₅₀为2.20×10^-9 m mol/L;经对18种常用菌株进行体外筛选,发现对肺炎双球菌(D.pneumoniae)有较好的活性。     

Mobitz Type II Second‐Degree Atrioventricular Block with Narrow QRS and Junctional Extrasystoles: What is the Mechanism?

A 74‐year‐old man underwent an electrophysiological study because of Mobitz type II second‐degree atrioventricular (AV) block with narrow QRS and frequent junctional extrasystoles. During the study, there were very frequent single His bundle depolarizations with multiple coupling intervals that reproduce the ECG findings. In this case, some His bundle extrasystoles result in retrograde concealed conduction and prolonged local refractoriness in the AV node that manifest as block of the next atrial impulse.     

The comparisons on total RNA from different source-original neurons applied in LMPC

Objective To compare the quality and quantity of total RNA from different source-original neurons applied in LMPC technique. Methods (1) Aglient 2100 bioanalyzer and RT-PCR were used to check the concentration and fragmentation of total RNA from unfixed, temporal fixed and fixed 12 h hypothalamus sections; (2) Different neurons of PVN and SON were collected by LMPC, CRH, TRH, AVP, OT mRNA level were measured by RT-PCR; (3) Labeled neurons by injecting CTB into stomach and non-labeled neurons in DMV collected by LMPC were checked for house keeping genes by RT-PCR. Results (1) Unfixed section had higher concentration and better quality of total RNA compared with fixed sections applied in LMPC; relative short amplicons such as GAPDH, NSE, MCH and MC4R were successfully obtained from fixed and unfixed and long amplicon of GR can only be obtained from unfixed material; (2) In magnocellular PVN and SON the expressions of AVP and OT were more special than those in the parvocellular PVN. Oppositely, the expressions of CRH, TRH in the parvocellular were more special than the other two; (3) The expressions of house keeping genes had no significant difference between labeled and non-labeled DMV neurons. Conclusion The quality and quantity of total RNA from unfixed brain tissues were better than fixed tissues applied in LMPC and the CTB tracer which may differentiate neurons had no significant effect on physiology of the neurons applied in LMPC. The results showed that the LMPC technique is suitable for the qualitative and quantitative study on individual neurons at mRNA level.     

Generalized hypertrichosis after treatment with topical minoxidil

Generalized hypertrichosis is a common side-effect of oral minoxidil treatment for hypertension. However, hypertrichosis is uncommon after treatment with topical minoxidil for alopecia, and normally only occurs in areas close to the side of application. A 16-year-old girl is presented who developed generalized hypertrichosis 3 months ater applying topical minoxidil for treatment of diffuse alopecia in doses greater than that prescribed. Four months after discontinuing treatment, the abnormal hair gradually diminished and disappeared.     

The whole leg radiographStanding versus supine for determining axial alignment

The whole leg radiograph (WLR), the standard technique for determining axial alignment, is usually taken in a standing position, although some prefer the supine position. To determine the difference between these two positions, we performed a standing and a supine WLR in 20 patients with a varus alignment. We found an average of 2 degrees more varus deviation in the standing position than in the supine position.     

MIXED TUMORS WITH FOLLICULAR DIFFERENTIATION: COMPLEX NEOPLASMS OF THE PRIMARY EPITHELIAL GERM

Background. Some mixed tumors of the apocrine variety also show characteristics of follicular and/or sebaceous differentiation. This can be explained because of the common embryologic origin of the three structures in the primary epithelial germ of the superficial ectoderm. Methods. Twenty specimens of apocrine mixed tumors were studied by conventional microscopy. The specimens were evaluated searching for some features of folliculo-sebaceous differentiation. Results. Certain features of folliculo-sebaceous differentiation were found in 45% of the samples examined. Additionally, different tumoral architectures were observed, resembling several well-characterized adnexal organoid neoplasms. In some tumors, there were also follicular structures of mesenchymal origin, similar to the dermal hair papilla and the arrector pili muscle. Conclusion. Apocrine mixed tumors of the skin illustrate the ability of pluripotential primordial cells to differentiate in different directions within an individual tumor. Moreover, mixed tumors appear as a compendium of different folliculo-sebaceous neoplasms. We suggest that these proliferations should be interpreted as “complex neoplasms of the primary epithelial germ.”     

Rectal wall contractility in response to an evoked urge to defecate in patients with obstructed defecation

PURPOSE: The aim of this study was to examine rectal sensory perception and rectal wall contractility in response to an evoked urge to defecate and to identify differences between control subjects and patients with obstructed defecation. METHODS: Twenty control patients (10 men; median age, 47 (range, 17–78) years) and 29 female patients with disabling obstructed defecation (median age, 48 (range, 18–70) years) entered the study. Under radiologic control, an infinitely compliant barostat balloon was inserted over a guide wire into the proximal part of the rectum. Additionally, a latex balloon was introduced into the distal part of the rectum. This latex balloon was inflated until an urge to defecate was experienced. Simultaneously, rectal wall contractility was assessed by measuring the variations in barostat balloon volume. These variations were expressed as percentage changes from baseline volume. RESULTS: By comparing controls and patients with obstructed defecation, a significant difference was found regarding mean distending volume required to elicit an urge to defecate (135±38vs. 214±87 ml of air;P<0.001, Mann-WhitneyU-test). In all controls, the evocation of an urge to defecate induced a pronounced increase in rectal tone, proximal to the distal stimulating balloon. By comparing controls and patients, the increase in rectal tone was found to be significantly higher in control subjects (35±10vs. 9±10 percent;P<0.001). Twenty-five patients (86 percent) showed no or only minimum (<20 percent) increase in rectal tone during the perception of an urge to defecate. In 14 of these patients, the threshold for this perception was increased. Only four patients (14 percent) showed a relatively normal increase (>20 percent) in rectal tone. However, their threshold for perception was greatly increased. CONCLUSION: The assembly used in this study provides a useful tool for investigation of rectal evacuation. In all of our patients, obstructed defecation was associated with abnormal rectal sensory perception and/or altered rectal wall contractility.Read at the meeting of The American Society of Colon and Rectal Surgeons, Philadelphia, Pennsylvania, June 22 to 26, 1997.