The spleen in Hodgkin disease: diagnostic value of CT

Findings of CT of the spleen were compared with those of histologic examination in 35 patients who had Hodgkin disease. CT provides a simple way to calculate splenic size. This index is also of value in the assessment of the histologic state of the spleen. An accuracy rate of 91%, specificity of 94%, and a sensitivity of 89% in diagnosing splenic localization of lymphoma was found in this study.     

HPLC柱切换法血浆直接进样测定糖肾平

采用HPLC柱切换技术,以Merck Lichroprep RP2(25～40μm)为预处理柱填料,以水为预处理流动相,以0.2mol/L乙酸-乙酸铵为净化清洗液,血浆直接进样,在线富集净化样品。血浆样品以0.2ml/min慢速转移通过预处理柱,净化回收率达80%。以ShimpackCLC-ODS为分析柱(15cm×6mm,ID),甲醇-异丙醇-0.2mol/L 乙酸铵(61:5:34)为分析流动相,310nm波长检测,外标法定量测定人体血浆中糖肾平的浓度。血浆样品仅需稀释后即可进样,净化富集样品操作简便,预处理柱可长期反复进样使用。血浆中最低检测浓度为30ng/ml,日内变异系数为2.0%～5.4%,日间变异系数为2.4%～2.7%,在浓度为60～2020ng/ml血浆范围内呈线性关系。     

Peripheral pulmonary lesions: ultrasonography and ultrasonically guided aspiration biopsy

Twenty-five patients, each of whom had peripheral intrathoracic lesions that were smaller than 5.0 X 5.0 cm in size and not diagnosed by conventional methods, underwent real-time sonography and ultrasonically guided aspiration biopsy. The lesions included 18 nodules, two infiltrates, and five cavitary lesions. Sonography showed homogeneous hypoechoic or isoechoic density with well-defined margins in 16 of the nodules, and heterogeneous echogenicity with irregular margins in infiltrates. The cavitary lesions showed a hyperechoic ring with a central sonolucent area. Biopsy specimens were successfully obtained by percutaneous aspiration under ultrasound guidance in 24 (96%) of the patients, and a positive diagnosis was established in 21 (84%) by cytology and/or histology. All 17 malignant lesions were diagnosed by aspiration biopsy, while only four of seven benign lesions were diagnosed by this method. Two patients (8%) experienced minimal pneumothorax after aspiration biopsy. We conclude that real-time sonography, including ultrasonically guided aspiration biopsy, is a useful and safe method for examination of peripheral intrathoracic lesions and has a high diagnostic yield.     

诱导性心室纤颤与晶体停搏液灌注具有相同的胎儿心肌保护作用

研究背景　处于宫内发育期间的胎儿如果患有先天性心脏畸形 ,心脏畸形可能逐渐加重 ,因此胎儿心脏外科干预治疗具有潜在的发展空间。怀孕期间实施畸形纠治可能预防由于病理性的血流方式所导致的心腔或大血管发育不良。但是 ,对最佳的胎儿心肌保护研究策略尚未进行深入研究。本研究应用胎儿双心室工作模型 ,对诱导性心室纤颤和晶体停搏液灌注的心肌保护效果进行对比评估。方法　实验用心脏取自孕龄 115～ 12 5天的胎羊。使用Krebs-Henseleit溶液灌注离体心脏。在动脉导管以远结扎降主动脉 ,肺动脉侧枝均结扎以模拟胎儿循环。 1组离体心脏采用常温诱导性心室纤颤 (n =8) ,另外 1组采用低温晶体停搏液灌注使得心脏停搏 (n =8)。之后均恢复Krebs -Henseleit溶液灌注。通过压力直径关系曲线测定心脏停搏前的心功能基础值以及停搏后的心功能指数。结果　停搏后的心脏收缩功能指数检测显示 ,诱导性心室纤颤与晶体停搏液具有相同的心肌保护效果(停搏后左心室收缩指数分别为 70 %± 5 %vs 6 8%± 15 % ,P =0 .5 2 ;右心室收缩指数分别为 6 8%± 4 .5 %vs 6 5 %± 4 .5 % ,P =0 .2 6 )。对于预防舒张期室壁张力的增加 ,两者的作用相似 (左心室分别为 32 %± 5 .3%vs 38%± 11% ,P =0 .2 4 ;右心室分别为 2 5 %± 3     

Flexible bronchoscopy in the evaluation of mediastinal and hilar lymphadenopathy

Background: The diagnosis in cases of mediastinal and/or hilar lymphadenopathy with no lung parenchymal involvement is often difficult. We undertook this study to assess the diagnostic value of flexible bronchoscopy (FOB) especially transbronchial needle aspiration (TBNA) and transbronchial lung biopsy (TBLB) in these patients.     

Effect of interleukin-5 exposure during in vitro eosinophilopiesis on MAC-1 adhesion molecule expression and function on cultured human eosinophils

We examined the selective effects of interleukin (IL-5) in regulating the maturational expression of surface adhesion molecules on human eosinophils and adhesion to endothelial cells during eosinophiiopolesis in vitro. Expression of the beta 2 integrins (CD11/CD18) and the beta 1 integrin, VLA-4 (CD49d/ CD29), was assessed during development in culture with IL-3, IL-5, and granulocyte-macrophage colony stimulating factor in cultures of human umbilical cord blood-derived eosinophil (CDE) precursor cells. Expression of both CD11b and CD18 subunits of Mac-1 was lower on CDE which were continuously (= chronically) exposed to IL-5 than on CDE which were cultured without IL-5 for the final week of culture. CD11b expression on cells grown without IL-5 was 71.3 +/- 5.92 (mean specific fluorescence value [MSF] as measured by flow cytometry) versus 52.5 +/- 4.48 MSF for Mac-1 alpha (CD11b) on CDE grown in the continued presence of 2 x 10 - 11 mol/L IL-5 (P < .01). Although expression of VLA-4 decreased as CDE matured, expression of CD29 and CD49d were similar regardless of cytokine exposure for the final week of culture. For eosinophils cultured without IL-5, acute stimulation with 10 - 8 mol/L IL-5 increased CD11b surface expression and increased the number of cells adhering to unstimulated human umbilical vein endothelial cells (HUVEC) from 4,570 +/- 780 cells (9.14 +/- 1.56% adhesion) to 8,385 +/- 515 cells (16.8 +/- 1.03% adhesion) (P < .01). Basal adhesion to unstimulated HUVEC of CDE cultured continuously with IL-5 was comparable (8.62 +/- 1.12% adhesion; P = NS), but neither CD11b expression (50.3 +/- 11.8 MSF; P = NS v control) nor adhesion to HUVEC (6.77 +/- 1.35%; P = NS) was enhanced in these eosinophils after acute stimulation with IL-5. Blockade of adhesion to IL-1-stimulated HUVEC caused by the anti-CD49d monoclonal antibody (MoAb), HP2/1, was comparable for cells cultured with IL-5 and without IL-5. However, the anti-CD18 MoAb, R15.7, caused 47.6 +/- 5.08% inhibition of adhesion of eosinophils cultured without IL-5 and only 25.8 +/- 5.20% for cells cultured continuously with IL-5 (P < .01), and failed to block significantly the adhesion of only the latter cells to IL-4-stimulated HUVEC. Our data show that continuous, chronic exposure to low concentrations of IL-5 causes decreased expression of Mac-1 and refractoriness to acute stimulation with IL-5 of adhesion to HUVEC. These data further demonstrate that CDE maturing in the continued presence of IL-5 adhere to HUVEC predominantly through VLA-4 ligation.