EPHX1基因及EPHX2基因多态与慢性苯中毒易感性的关系

目的探讨EPHX1基因及EPHX2基因多态与慢性苯中毒易感性的关系。方法采用病例对照研究，以268名苯中毒工人为病例组，268名接触苯而无中毒表现的工人为对照组。应用TaqMan PCR分析技术检测EPHX1基因rs2854451、rs3738047、rs2234922和rs1051741及EPHX2基因rs751141位点单核苷酸多态。结果在携带EPHX1 rs373804GG基因型个体中，同时携带EPHX1 rs2234922 G等位基因个体慢性苯中毒的发病风险降低（P=0．02），而在携带EPHX1 rs2234922AA基因型个体中，同时携带EPHX2 rs751141A等位基因个体慢性苯中毒的发病风险升高（P=0．03）；饮酒与EPHX1基因rs1051741多态（xH^2=5．28,P=0．02）或rs2234922多态（xH^2=6．71，P=0．01）存在联合作用，在饮酒人群中携带突变型个体较野生纯合型苯中毒发病危险性降低（P=0．04和P〈0．01）；EPHX1基因单倍型分析显示，携带AGAC等位基因组成的单倍型2个体或GAGT等位基因组成的单倍型4个体慢性苯中毒的发病风险增高（P〈0．001），而携带GGGT等位基因组成的单倍型6个体或AAGT等位基因组成的单倍型10个体慢性苯中毒的发病风险降低（P〈0．001）。多因素Logistic回归分析提示吸烟对慢性苯中毒发病风险具有一定的修饰作用（OR=0．313，95％CI：0．123—0．794,P=0．015）。结论EPHX1基因多态性可能与慢性苯中毒发生危险性相关，而EPHX2基因多态与慢性苯中毒易感性关系需进一步研究。     

上皮性卵巢癌ERCC1表达与顺铂化疗耐药的关系

目的 探讨切除修复交叉互补基因(ERCC1)在原发性上皮性卵巢癌顺铂化疗耐药中的意义.方法 用组织芯片仪制备组织芯片并结合免疫组织化学技术,检测56例上皮性卵巢癌病人癌组织中ERCC1蛋白的表达情况,并以38例正常卵巢组织作为对照,分析其与顺铂化疗耐药的关系,同时分析ERCC1在原发性上皮性卵巢癌中的表达与临床手术-病理分期(FIGO,2000)、病理学类型、分化程度、发病年龄、发生部位以及疾病发生的相关性.结果 38例正常卵巢组织中ERCC1阳性表达者17例(44.74%),56例上皮性卵巢癌组织ERCC1阳性表达者31例(55.36%),二者比较差异无显著性(χ2=1.022,P＞0.05).上皮性卵巢癌中ERCC1的表达与临床手术-病理分期、病理学类型、分化程度、发病年龄、发生部位及发病率均无明显的相关性(P>0.05).上皮性卵巢癌顺铂化疗耐药组ERCC1的阳性表达率为76.67%,明显高于敏感组的30.77%,差异有显著性(χ2=11.87,P<0.05).结论 上皮性卵巢癌ERCC1表达与顺铂化疗耐药相关.     

经岩乙状窦前入路的相关影像学研究

目的:为该入路提供影像解剖依据,减少术后并发症。方法:对10例成人头颅标本先行高分辨率CT岩骨薄层扫描,后用磨钻对标本轮廓化骨迷路,分别测量与该入路有关的后半规管及乙状窦沟与周围骨质的距离。结果:CT扫描测量乙状窦沟宽是11.44±1.79mm,深是5.27±1.93mm,乙状窦沟底到乳突外表面的距离是10.38±3.90mm,乙状窦沟前壁到外耳道后壁的距离是13.66±2.18mm。后半规管最外侧至乳突外表面的最近距离是13.44±1.86mm,至乙状窦沟前缘的距离是9.65±1.76mm,其最后部至岩骨后壁的距离是2.92±0.98mm。对应的解剖测量结果分别是11.26±1.58mm、5.12±1.88mm、10.26±3.78mm、13.74±1.96mm、13.86±1.98mm、9.82±1.91mm和3.12±1.08mm。CT扫描测量与解剖测量结果统计学上无显著性差异(P>0.05)。结论:CT扫描测量结果可代表实际的相关解剖结构的距离,CT岩骨薄层扫描可指导经岩乙状窦前入路中岩骨后外侧壁的安全磨除。     

Skeletal muscle regeneration induced by chorio-allantoic grafting

To examine whether the expression pattern of fast-muscle type troponin-T (TnT) isoforms was fixed in cell lineage, breast muscle pieces (pectoralis major) from chick embryos and young and adult chickens were grafted on to chorio-allantoic membrane of 9-day-old chick embryos and cultured until the host embryos hatched out. Muscle fibre formation of the grafts was investigated by histological and immunohistochemical methods with anti-fast-muscle type and anti-slow-muscle type TnT sera, and the expression of fast-muscle type TnT in the grafts from chick embryos and young chickens was studied by SDS-polyacrylamide gel electrophoresis (SDS-PAGE), two-dimensional SDS-PAGE, and immunoblotting. In the chorio-allantoic grafting, the breast muscle initially degenerated forming pyknotic nuclei and hyaline cytoplasm. The surviving cells, which were supposed to be satellite cells, regenerated new muscle fibres of the same type as those of the grafted muscle in respect of TnT isoform expression. Therefore, we considered that the ability to express specific isoforms of TnT was fixed in the satellite cells, and that chorio-allantoic grafting was a useful technique for studying muscle differentiation. This revised version was published online in August 2006 with corrections to the Cover Date.     

The Role of Surgical Resection in the Management of Small Cell Carcinoma of the Lung

To assess the role of surgical resection in the management ofsmall cell carcinoma of the lung, experience with 118 patientswho were treated between 1973 and 1985 was reviewed. Twenty-fivepatients underwent surgical resection followed by combinationchemotherapy in all except one. The remaining 93 pa tients weretreated by combined chemotherapy and radiation therapy. The 5-year survival rate for patients with stage I disease undergoingsurgical resection was 50.8%. For all 25 patients operated on,the 5-year survival rate was 30.7%. In the patients not operated on, only those with complete responsehad long-term survival, for whom the 5-year survival rate was11.9% We consider that surgical resection is definitely indicatedin patients with stage I disease. If the response to initialchemotherapy is very good, patients with stage 11 or T3N0M0disease also probably should receive resection. Patients withN2 disease are not candidates for resection, unless distantmetastases are controlled completely by intensive chemotherapy.     

Weber-Christian disease with benign cytophagic histiocytes in the skin lesion

We describe an 8 year old female with Weber-Christian disease who manifested erythema on her legs and an intermittent high fever. A wedge skin biopsy revealed lobular panniculitis and bean-bag cells, which were characteristic to cytophagic histiocytic panniculitis (CHP). However, she showed no evidence of liver dysfunction, hyperlipidemia, or coagulation disorders usually seen in CHP. Moreover, she responded well to oral corticosteroids therapy with resultant advanced subcutaneous fat atrophy.     

Epidemiologic Study of Neonatal Subcutaneous Gangrene Caused by Multi-Resistant Staphylococcus aureus

ABSTRACT. Forty-five cases of neonatal subcutaneous gangrene were admitted between Nov. 1985 and Feb. 1987, with a mortality of 6.6%. This paper presents the first epidemiologic study of 20 cases of this disease caused by multi-resistant Staphylococcus aureus. Eight of 20 cases were caused by an epidemic strain belonging to phage 29 (group I) and carrying 2.8, 3.3, 4.2 and 28.5–34.0 kb plasmid DNA. The restriction endonudease analysis confirmed that the plas-mid DNA of approximately similar size in different isolates were identical or highly homologous. According to the results of an epidemiologic study the source of infection of one patient who died was her grandmother and the other one was her mother, so the family members can also be the source of neonatal infection caused by multi-resistant S. aureus.     

Duration of inter-facility neonatal transport and neonatal mortality: Systematic review and cohort study

BACKGROUND: Regionalization of perinatal health services has been actively discussed, although important determinants such as effect of duration of neonatal transport on neonatal outcomes have not been investigated well as yet. Therefore the purpose of the present paper was to investigate the association between duration of inter-facility transport and perinatal mortality. METHODS: For the systematic review, six major databases were searched. Any comparative studies investigating associations between duration of inter-facility neonatal transport and their outcomes, published in the English language were selected. The studies were screened and reviewed by two independent researchers. For the cohort study, study subjects included every neonate transported to neonatal wards in Osaka, Japan between 1980 and 2000 in an existing surveillance called Neonatal Mutual Cooperative System. They are followed up until 28 days of age, or discharge if earlier. Other variables were also considered as effect modifiers or confounders, including calendar year, birthweight (BW), gestational age (GA), sex, maternal/paternal age, Apgar scores at 1 and 5 min, place of birth and personnel accompanying the neonate during transport (transport personnel), body temperature before transport and on admission, severity of illness, and intraventricular hemorrhage (IVH) grade. Cox regression analyses were performed to obtain principal results, and sensitivity analysis to support them. RESULTS: Systematic review: only one cross-sectional study conducted in an urban area in India was identified. That study showed that neonates with a long duration of transport had 79% higher odds of death than those transported for a short duration after adjusting for the confounding effects. For the cohort study, among 16 429 subjects, full data were available for 4966 neonates. There was strong evidence that those transported for >90 min had more than twice the rate of neonatal death (rate ratio [RR] 2.26, 95% confidence interval [CI]: 1.26-4.04), and some evidence that those transported for between 60 and 89 min had an 80% higher rate of neonatal death (RR 1.81, 95%CI: 1.07-3.06), both compared with those transported for between 30 and 59 min, after adjusting for the confounding effects. A sensitivity analysis on missing values also supported the results. CONCLUSION: There is evidence of an association between duration of transport and increased neonatal mortality, which can be applied to organization of perinatal health services. A prospective cohort study is needed for further investigation.