SEVEN COMMON DUCT STONES AT CHOLECYSTECTOMY AFTER A CLEAR DUCT ON ERCP

SUMMARY A clear common bile duct at ERCP does not guarantee a clear common bile duct when laparoscopic cholecystectomy is performed at a later date.     

In vivo and in vitro MR imaging of renal tumors: histopathologic correlation and pulse sequence optimization

Magnetic resonance (MR) imaging has given mixed results in the detection of renal masses. To identify the reasons for this and to determine the optimal pulse sequences for evaluating renal tumors, the authors imaged 12 primary renal tumors in vivo and 17 in vitro at 0.35 T. Histopathologic findings for each specimen were closely correlated with the MR images. Four of seven solid tumors imaged in vivo were isointense with surrounding normal renal parenchyma at all pulse sequences. The other three tumors were hyperintense in vivo at T2-weighted sequences. At heavily T2-weighted sequences eight solid tumors were hyperintense in vitro and four were hypointense. There was no correlation between signal intensity and specific tissue type or histologic pattern for solid tumors. The five cystic tumors were well seen both in vivo and in vitro on T2-weighted images. However, the signal intensity of the cyst fluid was an unreliable indicator of benignancy. SE MR imaging at 0.35 T has significant limitations in the detection of solid renal masses.     

Nocardia choroidal abscess in a patient with systemic lupus erythematosus

Purpose: Nocardia asteroides, a respiratory saprophyte in humans, may cause localized infection of the lungs in debilitated or immunosuppressed individuals. Haematogenous spread to the eye via the choroidal circulation may result in choroidal abscess formation. Method: We report the development of a choroidal abscess in the left eye of a woman treated with steroids and cyclophosphamide for systemic lupus erythematosus. Haematogenous spread of N. asteroides from a localized infection of the lung (empyema) is thought to have been the cause of the choroidal abscess. Results: Surgical drainage of the empyema combined with intravenously administered antibiotics resulted in resolution of the choroidal abscess and improvement of vision. Conclusions: A choroidal abscess, caused by haematogenous spread of N. asteroides, may respond to appropriate systemic antibiotic treatment alone and not require ocular treatment.     

社会支持和应对方式对肾移植患者生存质量的影响

目的:调查社会支持和医学应对方式对肾移植患者生存质量的影响。方法:于2005-01/02选择在首都医科大学附属北京友谊医院门诊随访的成功接受肾移植手术患者60例,移植肾功能正常,均自愿参加问卷调查。应用以下3个量表:①世界卫生组织生存质量测定量表简表:包括生理领域、心理领域、社会关系领域和环境领域4个因子及自评总分,各个领域得分越高,代表该领域的生存质量越好。②领悟社会支持量表:包括家庭支持、朋友支持和其他人支持3个因子,同时以领悟社会支持总分反映个体感受的社会支持总程度,得分越高,表明个体感受到的支持程度越高。③医学应对问卷:包含面对,回避和屈服3个分量表,分量表得分越高,表明个体越倾向于采用这种应对方式。计算肾移植患者各量表得分,并与常模进行比较。分析肾移植患者领悟社会支持得分、所采用的医学应对方式得分与患者生存质量各领域得分的相关性。结果:60例患者全部进入结果分析,无脱落。①肾移植患者生存质量在生理领域、心理领域,社会关系领域及环境领域的得分均低于常模,其中在生理领域的差异有显著性意义(13.2±2.2,15.1±2.3,P<0.05)。②除生存质量的自评总分与家庭支持有关外(r=0.302,P<0.05),其余4个因子均与家庭支持无相关性(P>0.05)。生存质量各因子及自评总分均与朋友支持、其他人支持和领悟社会支持总分相关(P<0.01)。③肾移植患者回避的应对方式与生存质量中的社会关系领域呈正相关(r=0.311,P=0.016)。结论:肾移植患者生理领域的生存质量较低,生存质量受患者领悟社会支持程度及采取医学应对方式的影响。     

B-lymphocyte Fc receptor-associated non-H-2 antigens are determined by a single polymorphic locus which is linked of the Mls locus

Certain non-H-2 alloantigens are associated with murine B-lymphocyte Fc receptors in that pretreatment of spleen cells with alloantibodies against these antigens inhibited binding of Ig complexes to B-cell Fc receptors. This inhibition was specific in that: (a) as has been shown previously, the Fc portion of the alloantibody was not required to produce inhibition; and (b) antibodies against some non-H-2 antigens but not antibodies against others (including some that were expressed on B cells) caused such inhibition. Backcross experiments revealed that the B-cell Fc receptor-associated non-H-2 antigens were determined by the gene(s) of a single background locus in each of the three strains tested (A/J, B10, and CBA/J). This locus was poly-morphic in that at least four different B-cell Fc receptor:associated non-H-2 antigens were identified (one each in the A/J, B10, and CBAJJ and one antigen shared or crossreactive between the B10 and CBA/J). These antigens were primarily but not exclusively expressed on B lymphocytes as determined by immunofluorescence studies, and on the basis of capping experiments they did not appear to be identical to B-cell Fc receptors. Linkage studies revealed that the locus which determined these antigens was not linked to the albino locus nor the heavy chain allotype locus and expression was neither sex-limited nor an X-linked recessive trait. However, this locus was closely linked but not identical to the Mls locus (apparent recombination frequency 6.8 percent). Thus, two closely linked non-H-2 loci both determine the expression of antigens which have characteristics similar to Ia antigens. One locus is polymorphic and determines the expression of antigens which are primarily expressed on B cells and are specifically associated with the Fc receptors of these cells. The other (Mls locus) determines antigens which are stimulatory in mixed lymphocyte cultures. These observations suggest that there may be a second gene complex which is the analogue of the I region of the H-2 complex.     

Cellular and genetic control of antibody responses in vitro. III. Immune response gene regulation of accessory cell function

The possibility was investigated that Ir genes regulate the function of cells other than T or B cells in the primary IgM responses to the synthetic antigens trinitrophenylated poly-L-(Tyr,Glu)-poly-D,L-Ala--poly-L-Lys [TNP-(T,G)-A--L]and trinitrophenylated poly-,-(His,Glu)-poly-D, L-Ala--poly-L-Lys [TNP-(H,G)-A--L]. The primary responses of (B10 × B10.A)F(1) spleen cells to both antigens were abrogated by Sephadex G-10 passage, and restored by the addition of spleen adherent cells. The cell type in the spleen adherent cell population active in reconstituting the responses to TNP-(T,G)-A--L and TNP-(H,G)-A--L was a non-T, non-B, radiation-resistant, glass-adherent spleen cell. The responses of Sephadex G-10-passed (responder x nonresponder)F(1) spleen cells to TNP-(T,G)-A--L or TNP-(H,G)-A--L were reconstituted by spleen adherent cells from only responder strains. Spleen adherent cells from F(1) mice reconstituted the responses to both antigens. Spleen adherent cells from each of the strains tested reconstituted the non- Ir gene-controlled response to a third antigen, TNP-keyhole limpet hemocyanin. The inability of spleen adherent cells from nonresponder strains to reconstitute the responses to either TNP-(T,G)-A--L or TNP-(H,G)-A--L was not a result of active suppression induced by the presence of nonresponder adherent cells, since a mixture of responder and nonresponder spleen adherent cells reconstituted the responses to both antigens. The use of spleen adherent cells from recombinant strains demonstrated that the autosomal dominant genes controlling the ability of spleen adherent cells to function as accessory cells in the responses to TNP-(T,G)-A--L and TNP-(H,G)-A--L are located in the K or I-A regions of the responder H-2 complex, the same region(s) of H-2 as the Ir genes controlling overall in vitro and in vivo responsiveness to these antigens.     

单螺旋和3股螺旋蚕丝纤维支架的力学性能及其细胞黏附性能比较

目的:经蚕茧缫丝脱胶而成的丝状纤维是一种无生理活性的天然结构性蛋白,这种结构使丝状支架具有良好的力学性质和生物相容性。观察采用单螺旋和3股螺旋蚕丝两种不同编织方法制备的丝状支架力学性能和细胞黏附性能的差异。方法:实验于2005-10/2006-05在华中科技大学同济医学院附属协和医院骨科实验室完成。将蚕丝用不同的编织方法制备单螺旋、3股螺旋两种丝状支架,直径4.5mm。实验方法:①丝状支架的力学检测:两种丝状支架各取10cm置于AGS-H多功能材料力学实验机的夹具中,固定后以10mm/min的速度行拉断试验。②对SD大鼠骨髓基质干细胞分离培养。实验评估:①通过拉断实验测定最大载荷、最大拉伸长度及弹性模量。②对骨髓基质干细胞进行苏木精-伊红染色。③扫描电镜观测骨髓基质干细胞与丝状支架的黏附情况。结果:①力学性能检测结果:单螺旋、3股螺旋两种丝状支架的最大载荷、最大拉伸长度、弹性模量[分别为(870±32),(846±20)N;(14.60±0.85),(13.90±0.64)mm;(6519±287),(6373±375)MPa]差异无显著性意义(P>0.05)。②免疫组织化学鉴定结果:骨髓间充质干细胞的细胞膜抗原CD44有阳性表达,CD34均为阴性表达。③骨髓基质干细胞与丝状支架的黏附情况:两种编织方法的丝状支架的丝状纤维表面均光滑,有较多的骨髓间充质干细胞黏附在丝状纤维上。结论:单螺旋和3股螺旋两种丝状支架的力学性能和细胞黏附性能相近。