Double nuclei in endomyocardial biopsy: A comparative study of the incidence in myocarditis and chronic right ventricular overloading

Summary The incidence of double nuclei in myocarditis and in cases with right ventricular overloading (CRVO) was histopathologically assessed in a minimum of 100 longitudinally cut myocytes in specimens obtained at right ventricular endomyocardial biopsy. In myocarditis, the incidence of double nuclei was shown to be 5.8 ± 1.8 and in CRVO and in normal heart tissue it was seen in 3.0 ± 0.8 and 3.2 ± 0.9% (m±S.D.), respectively, of the population of myocytes. It is concluded that double nuclei result from either the activity or the reparative process of myocarditis and that it is not the expression of chronic right ventricular overloading. It is suggested that quantitative assessment of the frequency of double nuclei is an useful method in the interpretation of myocardial biopsy.This study was supported by a Grant from the Japan Research Promotion Society for Cardiovascular Diseases     

Frequency of erythrocyte pyruvate kinase deficiency in Chinese infants

The incidence of deficiency of the enzyme pyruvate kinase (PK) in Chinese infants was determined. Both the standard assay of erythrocyte pyruvate kinase enzyme activity and a fluorescent screening test (standardized) were used. The results of these two tests were compared. Of 1,159 infant cord blood samples studied, 26 (or 2.2%) had abnormally low levels of PK activity using the screening test, as did 24 of the samples tested by the enzyme assay. The results indicate that the frequency of a defective PK gene in the population of Guangzhou is significantly lower (p less than .05) than the previously reported defective gene frequency of 3.4% in Hong Kong. They also demonstrate the critical importance of standardization of the screening test, if most accurate estimates of gene frequency are to be derived by using this test.     

Measurement of the ratio of glomerular filtration rate to plasma volume from the technetium-99m diethylene triamine pentaacetic acid renogram: comparison with glomerular filtration rate in relation to extracellular fluid volume

Individual kidney glomerular filtration rate (IKGFR) can be measured from the renogram from the rate of uptake of technetium-99m diethylene triamine penta-acetic acid (^99mTc-DTPA). A blood sample is required to derive IKGFR in millilitres per minute, which is then usually normalised to body surface area. We describe a technique which does not require a blood sample, is already normalised for plasma volume and uses the robust Patlak plot for measuring renal uptake. The rate of kidney uptake, dR(t)ldt, at time = 0, as a fraction of the injected dose, is equal to the fraction of the plasma volume (PV) filtered per minute, i.e. IKGFR/PV. The gradient dR(0)/dt cannot be accurately measured directly but is equal to [ · LV(0)], where is the renal uptake constant (proportional to IKGFR) and LV is the count rate over a left ventricular ROI. LV(0) was obtained by extrapolation of LV(t), while a is the slope of the Patlak plot up to 3 min. GFR/PV (i.e. right plus left kidneys) in patients with normal renal function was about 0.04 min^–1, as would be expected from normal values of GFR (120 ml/min) and plasma volume (3 l). GFR/PV correlated significantly with the ratio of GFR to extracellular fluid volume (ECV), measured from the terminal exponential of the plasma clearance curve (GFR/PV = 3.2.GFR/ECV + 5.3 ml/min/1 [r = 0.82,n = 82]). GFR/PV (r = 0.74) and GFR/ECV (r = 0.82) both correlated inversely and non-linearly with plasma creatinine in 43 studies where the measurement was made within 1 week of the^99mTcDTPA study. They also correlated significantly with the plasma cyclosporin trough level in 14 patients with dermatomyositis on the 30 occasions when this measurement was made within 1 week of the renogram (r = –0.38,P < 0.05 for GFR/PV andr = –0.77,P < 0.001 for GFR/ECV). The ratio of GFR/PV to GFR/ECV is the ratio of extracellular fluid volume to plasma volume, and this was 4.0 (SD 0.99). We conclude that both GFR/PV and GFR/ECV can be easily measured with^99mTc-DTPA and are physiologically valid expressions of GFR. Although GFR/PV and GFR/ECV correlate with each other, the question is raised as to which of the two fluid volumes is the most appropriate for normalising GFR. Correspondence to: A.M. Peters     

嗜肺军团菌血清10型致军团病爆发流行并分离培养成功

１９９２年２～３月，北京市郊某宾馆发生了一起上呼吸道感染流行。流行病学调查及细菌学检查证明，这是一起嗜肺军团菌血清１０型（Ｌｐ１０）引起的宾馆军团病爆发流行，感染率为２４．３２入（９／３７），患病率为１３．５１％（５／３７）。由Ｌｐ１０引起的军团病爆发流行在世界上属首次报道，而Ｌｐ１０分离培养成功在国内尚属首次。     

急性低压缺氧对人体血清内源性类洋地黄物质含量的影响

用放射免疫法测定了16名健康飞行人员清晨和急性低压缺氧后（10：00）的血清内源性类洋地黄物质（EDLS）含量，并以16名健康地面人员相应时间的测定作对照。结果发现，实验组与对照组清晨血清EDLS含量分别为0．63±0．07与0．60±0．07ng／ml，两组相比，光显著性差异（P＞0．05）。实验组急性低压缺氧后，血清中的EDLS含量0．63±0．10ng／ml，与相应测定的对照组0．52±0．10ng／ml相比，有显著性差异（P＜0．01）。结果提示，急性中度缺氧能增加EDLS分泌、而正常人血清EDLS含量有明显生理性波动。急性中度缺氧后，血清中EDL含量的增加，可能是一种保护性的应激反应。     

Distribution of normal and abnormal fluid collections in the glenohumeral joint: Implications for MR arthrography

Although magnetic resonance (MR) images of the glenohumeral joint frequently demonstrate intraarticular fluid, no specific criteria have, to the authors' knowledge, been published that allow accurate assessment of the amount of fluid present. Also, despite the increasing use of MR arthrography of the shoulder, the optimal amount of intra-articular fluid that should be used with this technique has not been determined. The authors progressively distended the glenohumeral joint in six cadaveric shoulder specimens with a dilute gadopentetate dimeglumine solution and obtained MR images after injection of 2, 5, 10, 15, and 20 mL of the solution. The pattern of fluid distribution was evaluated, and these results were then used to estimate the amount of fluid that was present in the glenohumeral joint on MR images of 20 shoulders obtained in 12 asymptomatic volunteers. In 14 of these shoulders, intraarticular fluid was present; however, in none was more than 2 mL evident. Results of the cadaveric study also indicated that 15 mL of intraarticular fluid appears to be the optimal amount for MR arthrography.     

乳腺良恶性病变组织c-met蛋白和转化生长因子α的表达及意义

应用免疫组化法测定５０例乳腺癌和１２例乳腺良性病变组织中ｃｍｅｔ蛋白及转化生长因子α（ＴＧＦα）的表达。结果：乳腺癌组织中ｃｍｅｔ蛋白及ＴＧＦα表达阳性率分别为２６．０％和４２．０％,乳腺良性病变组织中两者表达阳性率分别为８．３％和２５．０％;组织学分级为Ⅰ级,雌激素受体（ＥＲ）、孕激素受体（ＰＲ）及癌胚抗原（ＣＥＡ）为阴性的病例中,ｃｍｅｔ蛋白及ＴＧＦα表达阳性率明显低于组织学分级Ⅲ级,ＥＲ、ＰＲ及ＣＥＡ为阳性者（ｃｍｅｔ及ＰＲＰ＜０．０１;ＴＧＦα、ＰＲ和ＣＥＡＰ＜０．０５;余Ｐ＞０．０５）。本实验结果提示：ｃｍｅｔ蛋白及ＴＧＦα表达可能与乳腺癌发生发展及体机内分泌状态有较密切关系     

23例胆囊癌回顾性分析

对23例手术并经病理证实为胆囊癌的病例进行回顾性分析。23例患者,男性8例,女性15例,平均年龄64．7±8．6（岁）,21例伴有胆囊结石或／和胆管结石,占91．30％,平均胆石症病程6．9年,临床术前诊断符合率34．78％（8／23）,肿瘤切除率43．48％（10／23）,组织学类型22例为腺癌,1例为未分化癌。认为胆囊癌多与胆石症并发存在,常发生于病史长,年龄较大的胆石症患者,故对长期病程的高龄胆石症病人要警惕癌变的可能,对这些高危人群宜尽早手术。     

下肢深静脉功能不全诊治的实验和临床研究

目的研究治疗不同程度下肢原发性深静脉瓣膜功能不全的有效方法。方法①观察以自体大隐静脉片、自体阔筋膜片和人造血管片作深静脉瓣膜包窄术的效果;②分别采用股或静脉瓣修复加包窄术、股或（和）静脉瓣包窄术、股浅静脉瓣修复和包窄加静脉瓣包窄术、自体带瓣腋静脉段静脉移植外加人造血管环包术、股静脉瓣包窄加静脉外代瓣术、静脉外代瓣术,共治疗１２１例（１３３条患肢）;③以静脉插管造影和彩色多普勒超声检查作为诊断和评估疗效的观察指标。结果①以膨体聚四氟乙烯人造血管片作包窄材料的效果最好;②彩超检查与静脉造影比较准确率为９１８６％;③本组患者平均随访３７８年,治愈率９１７３％。结论治疗下肢深静脉瓣膜功能不全,应根据病情选用不同的手术方法。     

实验性大鼠胚胎脊髓移植对损伤脊髓影响的观察

目的 建立了一个胚胎脊髓（ｆｅｔａｌ ｓｐｉｎａｌ ｃｏｒｄ）组织的低温保存方法笔一个损伤移植模式。方法 通过病理学、组织化学和免疫组织化学的研究,选用胎龄１４天的Ｗｉｓｔａｒ大鼠,分离胚胎脊髓,逐步降温,最后置于液氮中保存。１５天后取出,快速复温,并植入损伤大鼠脊椎内。全部动物于伤后８周处死。结果 经过低温保存的移植物能够在异体脊髓内存活并与宿主组织融合,其在损伤移植区的胶质细胞增生少于对照组。