The management of stage I--II Hodgkin's disease with irradiation alone or combined modality therapy: the Stanford experience

At Stanford University, between 1968 and 1978, 230 patients with pathologic stage I--II Hodgkin's disease were treated on prospective clinical trials with either irradiation alone or irradiation followed by 6 cycles of adjuvant combination chemotherapy. The actuarial survival at 10 yr was 84% for patients in either treatment group. Freedom from relapse at 10 yr was 77% among patients treated with irradiation alone and 84% after treatment with combined modality therapy [p(Gehan) = 0.09]. Freedom from second relapse at 10 yr was 89% and 94%, respectively [p(Gehan) = 0.56]. Several prognostic factors were evaluated in order to identify patients at high risk for relapse or with poor ultimate survival after initial treatment with irradiation alone. Systemic symptoms, histologic subtype, age, and limited extranodal involvement (E-lesions) did not affect the prognosis of patients and failed to identify patients whose survival could be improved by the routine use of combined modality therapy. Patients with large mediastinal masses (mediastinal mass ratio greater than or equal to 1/3) had a significantly poorer freedom from relapse when treated with irradiation alone than when treated initially with combined modality therapy [45% versus 81% at 10 yr, p(Gehan) = 0.03). The 10-yr survival of these patients, however, was not significantly different (84% versus 74%). The implications of these observations on the management of patient with early stage Hodgkin's disease are discussed.     

长爪沙鼠肠道形态与能量需求的研究

目的分析物种差异与肠道形态及能量代谢的关系,阐明长爪沙鼠的能量需求。方法长爪沙鼠、SD大鼠、ICR小鼠各10只,分别单独饲养于代谢笼内,收集5 d动物24 h内的粪便、尿液。尿液及粪便经分别测量体积与重量后,送检尿能与粪能。收集结束后,所有动物称重,麻醉后腹主动脉采血致死,取动物肠道,测量肠长度。结果大鼠维持的消化能和代谢能分别为314.56 k J/d、314.55 k J/d,小鼠分别为10.608 k J/d、9.799 k J/d,沙鼠分别为99.828 k J/d、99.927 k J/d。大鼠每增加1 g体重需要的消化能和代谢能分别是19.273 k J和18.831 k J,小鼠分别是71.842 k J和72.390 k J,沙鼠分别是56.142 k J和55.965 k J。大、小鼠的消化道总长大于沙鼠,大鼠小肠最长,而沙鼠有较大的盲肠百分比。结论三种动物在肠道长度和能量需求方面有显著差异。     

Some properties of marrow derived adherent cells in tissue culture

It has previously been shown that monolayer cultures derived adherent cells (MDAC), apparently consisting of fibroblasts, macrophages, epithelioid cells, and fat cells, can support long-term stem cell proliferation in vitro. In the present study, the hematopoietic support capability of murine MDAC monolayers was confirmed and the cultured cells further characterized with respect to the following properties: esterase I activity, complement (C3) receptors, IgG (Fc) receptors, colony stimulating activity (csa) production, and collagen synthesis. The cultures were also examined immunohistochemically to localize fibronectin, laminin, and collagen synthesis and to identify the collagen subtypes synthesized. MDAC morphology was as described in previous studies, although fat cells were few in number. It was found that MDAC included some cells with esterase I activity and C3 receptors. Fc receptors were not, however, detected, nor did the cultures produce csa, indicating that mononuclear phagocytes were not present. MDAC synthesized collagen types I and III and also fibronectin. Staining for epithelial basement membrane proteins (collagen types IV and V and laminin) was negative. The results indicate that the vast majority of these cultured MDAC were fibroblasts.     

Obstructive sleep apnea: diagnosis with ultrafast CT

Patients with sleep-disordered breathing often have physiologic and anatomic abnormalities of the upper airway that are demonstrable while awake. An ultrafast computed tomographic (CT) scanner was used to measure the oropharyngeal and nasopharyngeal cross-sectional areas of 11 patients with obstructive sleep apnea. Twenty-four healthy volunteers served as control subjects. The percentage of change in cross-sectional area during quiet tidal breathing was used as a measure of airway compliance. Compared with weight-matched control subjects, patients with obstructive sleep apnea had smaller oropharyngeal airways (40.4 vs 177.8 mm2) (P less than .001) and smaller nasopharyngeal airways (31.3 vs 134.2 mm2) (P less than .001). In addition, their oropharyngeal airways were significantly more compliant (75% vs 27%) (P less than .001). Patients with obstructive sleep apnea are characterized by a small, collapsible oropharyngeal airway and by nasopharyngeal airway narrowing. These abnormalities can cause sleep-disordered breathing. Ultrafast CT scanning allows rapid, noninvasive assessment of airway variables.     

Aprotinin or tranexamic acid in cardiac surgery: a propensity analysis

Canadian Journal of Anesthesia/Journal canadien d'anesthésie -     

结肠粘膜重建尿道的实验研究

目的：探讨结肠粘膜重建尿道的可能性。方法：选择6条雌性杂种成年犬，在全麻下切开尿道，剥离全段尿道粘膜，取相等长度的结肠粘膜替代尿道粘膜，12周后将犬处死，取其尿道作病理检查。结果：犬尿道病理组织学检查示移植于尿道的结肠粘膜全部成活，大部分腺上皮已转变为移行上皮。结论：应用结肠粘膜重建尿道是一种新的方法，这种技术可应用于包皮或膀胱及颊粘膜不适合时的尿道重建。     

Hydrosalpingeal fluid inhibits in-vitro embryonic development in a murine model

Recent evidence describing a suboptimal clinical outcome in women with hydrosalpinges who undergo in-vitro fertilization (IVF) and embryo transfer suggests a potential deleterious effect of this fluid on in- utero embryo development. Consequently, we evaluated in-vitro mouse embryo development in the presence of hydrosalpingeal fluid (HF) collected from 10 infertile women of reproductive age. Chemical analyses showed both similarities and differences of these fluids to reported values for fluids collected from non-diseased Fallopian tubes. The HF had a significant deleterious effect upon mouse embryo cleavage and development to the expanded and hatched blastocyst stage, although the effect was variable among patients. Dilution of HF to 30% concentration with culture medium failed to negate this effect. This argues against the effect resulting from a relative lack of critical, supportive component(s) in the HF. Additionally, further experiments performed with cultures under an oil overlay significantly reduced the embryotoxicity of the HF. This evidence suggests there may be a lipophilic factor that can impair embryo development. The relatively poor IVF-embryo transfer success in women with proximally patent hydrosalpinges may be explained, at least in part, by reflux of a lipophilic embryotoxic factor(s) into the uterine cavity.