Restoration of ovarian endocrine function by ovarian transplantation.

Cancer treatment can cause changes in sex hormone production, premature ovarian failure and infertility. As survival rates for young cancer patients improve, protection against iatrogenic infertility caused by chemotherapy or radiotherapy assumes a higher priority.     

肝细胞肝癌放射治疗研究进展

肝细胞肝癌（hepatocellular carcinoma,HCC）是世界范围内癌症死亡率较高的肿瘤之一。肝切除术（partial hepatectomy）是重要的治疗手段,然而,许多患者因肿瘤分期晚或潜在的慢性肝病和/或肝硬化不能接受肝切除术或肝移植术(liver transplantation)。此类患者,目前可选择肝动脉栓塞化疗（transarterial chemoembolization,TACE）、射频消融（radiofrequency ablation,RFA）、放射治疗、靶向治疗及免疫治疗等方法。肝癌诊断、治疗方式、对肝脏辐射耐受性的生物学理解和放疗技术的进步使得肝癌放射治疗的有效性和安全性都在不断提高,肝癌患者的生存和预后不断改善。     

Effect of pregnancy on intraobserver and intertechnique agreement in intraocular pressure measurements

AIM: To evaluate the effect of pregnancy on intraobserver and intertechnique agreement for intraocular pressure (IOP) measurements. MATERIAL AND METHODS: Right eyes of 88 healthy women who were likely to become pregnant and of 94 healthy age-matched females were included in the study. Complete ocular examinations were performed on each eye. IOP measurements were obtained by Goldmann, Schiotz and non-contact tonometers (NCT) during 3-week exam periods before (within 6 weeks of conception) and during pregnancy (first, second and third trimesters) for pregnant cases, and in similar time intervals for control subjects. In each exam period, three readings with each of three separate tonometers were obtained, at least 1 day apart. Intraobserver and intertechnique agreements for IOP measurements were assessed. RESULTS: The mean visual acuity, keratometry and refractive error of both control and pregnant subjects did not change significantly during the study (all p values >0.01). In late pregnancy, pregnant cases demonstrated significant decreases in IOP measurements obtained with each of the three tonometers, and in intraobserver agreement with Goldmann and Schiotz tonometers (all p values <0.01). Intertechnique agreement of both Goldmann and Schiotz tonometers with NCT decreased significantly in the third trimester. Both intraobserver and intertechnique agreement in IOP measurements of control subjects were not found to change significantly during the study (all p values >0.01). CONCLUSION: IOP significantly decreased in the third trimester of pregnancy. Perfect intraobserver agreement in IOP readings of pregnant subjects was obtained with NCT. This may suggest that NCT is a viable option for IOP measurements during the follow-up of pregnant patients at risk for glaucoma.     

危及器官不同定义对乳腺癌调强放疗计划的影响

目的:探讨危及器官的不同定义对左侧乳腺癌逆向调强放疗计划的影响。方法:各20例改良根治术和保乳术的左侧乳腺癌患者纳入本研究,放疗前均行增强定位CT薄层扫描。当靶区包括内乳区时,比较将全心（A组）和全心+冠状动脉左前降支（LAD）（B组）作为危及器官时计划靶区（PTV）和各危及器官（OAR）的剂量-体积的变化。结果:2组计划的PTV、双侧肺的剂量-体积无明显差异,但B组的心脏和LAD的部分剂量-体积参数明显低于A组,而患侧肺的部分剂量-体积参数却高于A组,差异均具有统计学意义（P<0.05）。结论:为更好地保护心脏、LAD,左侧乳腺癌放疗内乳区时应增加LAD作为独立的危及器官。     

Expression of Heat Shock Protein 70 in Rabbit Liver After Contrast-Enhanced Ultrasound and Radiofrequency Ablation

Heat shock proteins (HSPs) induced by thermal ablation therapy may help presenting tumor antigen to the host immune system and be a valuable adjuvant in the ablation therapy of liver cancer. This paper described our preliminary study on the expression of HSP70 in rabbit liver after contrast-enhanced ultrasound (CEUS) and radiofrequency (RF) ablation. Twenty-five male New Zealand white rabbits were divided into five groups as: control group (n=5), ultrasound group (n=5), CEUS group (n=5), RF group (n=5) and CEUS + RF group (n=5). Clinical ultrasound and RF ablation equipment were used in the present experiment. Sonazoid was used as the contrast agent. All the animals were sacrificed 24 h after the procedure, and HSP70 was detected by immunohistochemistry staining and Western blot analysis. In the groups without RF ablation, there was no evidence of HSP70 expression in the liver tissue of the control group and ultrasound group, whereas positive HSP70 expression was detected in the liver tissue of the CEUS group, with a mean optical density of 0.33. In the RF and CEUS + RF groups, there were cells showing HSP70 expression in the normal liver tissue far from the ablation region. The mean densities of HSP70 expression were 0.31 in the RF group and 0.35 in the CEUS + RF group, respectively. With regard to the distribution of HSP70 expression of the RF and CEUS + RF groups, the marginal areas were stronger than liver tissue 1 cm away from the margin, and the ablated tissues showed no evidence of HSP70 expression. The mean density of HSP70 expression in the marginal areas were 0.47 in the RF group and 0.42 in the CEUS + RF group, respectively. CEUS using Sonazoid may produce HSP70 expression in the normal liver parenchyma after CEUS examination and RF ablation. (E-mail: moriyasu@tokyo-med.ac.jp)     

Culdocentesis Followed by Saline Solution–Enhanced Ultrasonography: Technique for Evaluation of Suspected Ectopic Pregnancy

Study ObjectiveTo evaluate the use of a technique consisting of culdocentesis followed by saline solution–enhanced pelvic ultrasonography in cases suspect for ectopic pregnancy in which an accurate diagnosis could not be made using routine transvaginal ultrasound.DesignRetrospective clinical study (Canadian Task Force classification III).SettingAcademic medical center.PatientsTwenty patients with an initial diagnosis of pregnancy of unknown location.InterventionsIn 20 patients with symptoms of early pregnancy and serum quantitative human chorionic gonadotropin concentration, ectopic pregnancy could not be confirmed or ruled out. Transvaginal ultrasound-guided culdocentesis was performed, and 300 to 400 mL of normal saline solution was injected into the posterior cul-de-sac and pelvis. Transvaginal ultrasound was repeated with particular attention to the floating fallopian tubesMeasurements and Main ResultsUsing this technique, a tubal pregnancy was visualized in 15 of 20 patients, and ectopic pregnancy was ruled out in 5 patients. In all patients, appropriate management was provided according to the final diagnosis, and consisted of either methotrexate, laparoscopic salpingostomy or salpingectomy, or expectant management in patients with abnormal intrauterine pregnancies.ConclusionUltrasound-guided culdocentesis followed by saline solution–enhanced pelvic ultrasound can be considered as a diagnostic tool in patients with suspected ectopic pregnancy in whom other methods fail to demonstrate this diagnosis.     

CT of the chest in the evaluation of idiopathic pulmonary arterial hypertension in children

Background Idiopathic pulmonary arterial hypertension (IPAH) is a rare disease in children. By definition it is a diagnosis of exclusion, and CT of the chest is primarily performed to exclude other causes. Previous studies have defined CT features suggestive of the diagnosis of IPAH, but these have all been limited to the adult population. Objective Contrast-enhanced chest CT and high-resolution CT findings in IPAH were evaluated in an attempt to define features consistently seen in children with this condition. Materials and methods The chest CT scans performed at initial presentation were reviewed in 17 children with echocardiographic or angiographic evidence of IPAH. Result There were nine boys and eight girls, ranging in age from 1 month to 17 years. The extrapulmonary findings included cardiomegaly with right-sided cardiac enlargement, which was seen in 13 children. The central pulmonary arteries were enlarged in 15 children, with peripheral enlargement in two. In six children this resulted in bronchial compression. In addition, mediastinal and hilar lymphadenopathy was noted in three children. Prominent intrapulmonary features included a peripheral vasculopathy, with enlarged tortuous vessels, seen in eight children. Ill-defined ground-glass centrilobular opacities were also noted in eight children, representing the most common parenchymal abnormality. Other findings included septal lines in five, diffuse ground-glass opacification in four and focal hyperlucent zones in three. Mosaic attenuation was seen in one child. Conclusion A variety of imaging findings are identified in IPAH. Features particularly consistent with the diagnosis include peripheral vasculopathy and centrilobular opacities in the setting of cardiomegaly and central pulmonary arterial enlargement.