Cholangiocarcinoma complicating primary sclerosing cholangitis: cholangiographic appearances

Cholangiograms from 104 patients (and serial cholangiograms in 66 patients) with primary sclerosing cholangitis (PSC) were reviewed. In 13 patients the additional diagnosis of cholangiocarcinoma was made at biopsy or autopsy. Cholangiograms from patients with both PSC and carcinoma were compared with cholangiograms from patients with PSC alone. Marked dilatation of ducts or ductal segments (100% vs. 24%) and the appearance of a polypoid mass (46% vs. 7%) were common findings in the group of patients whose disease was complicated by malignancy. In the malignant group, polypoid masses were larger, measuring 1 cm or greater in diameter. On serial cholangiograms, four of 15 patients with progressive stricture formation and four of five with progressive ductal dilatation proved to have carcinomas. The frequent occurrence of bile duct carcinoma as a complication of PSC in this group of patients indicates that PSC has a strong tendency to undergo malignant degeneration. Cholangiographic findings which suggest malignant degeneration include markedly dilated ducts or ductal segments, presence of a polypoid mass 1 cm or greater in diameter, and progressive stricture formation or ductal dilatation.     

Thrombogenicity of hydrophilically coated guide wires and catheters

The thrombogenicities of stainless steel spring guide wires and two hydrophilically coated guide wires were compared. The guide wires were placed in canine femoral arteries for 30 minutes. The guide wires were removed, the thrombi were stripped off, and the clots were weighed. Clot weights obtained with the two hydrophilically coated guide wires were significantly less than those obtained with the stainless steel spring guide wires. The thrombogenicities of hydrophilically coated catheters and noncoated nylon catheters were compared with and without the use of heparin. Carotid arteries, jugular veins, femoral arteries, and femoral veins were used. Catheters were left in place for 45 minutes. The animals were heparinized and killed. The vessels were then removed en bloc with the catheter clamped in place. The vessels were incised, and the clot was removed and weighed. In arterial and venous catheterization, no significant difference in clot deposition was shown between the hydrophilically coated catheters and the noncoated nylon catheters. A striking reduction of thrombogenicity was achieved with heparinization of the catheters in both arteries and veins.     

低剂量X-线子宫内照射引起的胎鼠中枢神经系统损害

通过让受孕的SD大鼠于其妊娠第15d(G—15)或第18d(G—18)接受0.5Gy的X-线照射,研究了低剂量X-线照射对其儿鼠中枢神经系统形态发生的影响。被照射的和未经照射的(对照)幼鼠均在生后第7d 或第26d,以混合醛固定液经心灌流。脑组织经常规组织学程序处理后,于光镜和电镜下检查。结果显示:在 G-15和 G-18接受照射并于出生后第26d 取材的鼠脑中,海马和齿状回内散布着一些深染、固缩的小神经元群.多呈双侧分布。其在 G-15和 G-18受照射的幼鼠中的发生率分别为57%和33%。同时在14%～22%的 G-15或 G-18受照射并于出生后第26d 处死的动物中,见到明显的小脑损害,其皮质颗粒层内呈现许多大小不等的透亮小区,其中含有数量减少的异染色的小细胞,细胞周围的神经毡明显变得稀疏。本实验动物海马结构之所以对电离辐射敏感,可用照射时间正好与细胞形态发生阶段相吻合来解释。小脑皮质颗粒细胞的病理改变可能是电离辐射影响了其前驱细胞或外颗粒层中的增殖细胞和/或迁移细胞所致。     

Whole-breast US imaging: four-year follow-up

Between March 1980 and April 1981, 1,140 women underwent physical examination, xeromammography, and whole-breast ultrasound (US) using a whole-breast water path system. Results of each study were interpreted independently by separate observers in a blind fashion. Biopsy revealed 125 cancers in 127 breasts. Findings were considered to be suspicious for carcinoma in 199 women based on physical examination, in 201 based on mammograms, and in 255 based on US scans. Physical examinations were able to reveal 91% (115/127) of the cancers, reflecting the referral nature of the population, and failed to detect 12 lesions. Mammograms disclosed 94% (119/127) of the cancers, including 12 clinically occult lesions, but did not show eight palpable cancers. US scans disclosed only 64% (81/127) of the cancers, all of which were palpable. In a 4-year follow-up, no cancers have appeared in the group that had suspicious findings by US only. We conclude that US should not be used routinely to screen women for breast cancer.     

Automatic implantable cardioverter-defibrillator: radiographic appearance

The automatic implantable cardioverter-defibrillator is used in patients with ventricular tachyarrhythmias resistant to medical or surgical therapy. The device, which has a unique radiographic appearance, senses ventricular tachycardia or fibrillation and automatically delivers a cardioverting or/defibrillating electric shock.