MRI in subacute combined degeneration

We describe a patient with clear lesions in the spinal cord on MRI due to subacute combined degeneration. T2-weighted images clearly showed abnormal high signals in the posterior columns, which disappeared on recovery from the disease.     

Comparison of p53 expression in proximal and distal gastric cancer: Histopathologic correlation and prognostic significance

Background: The overexpression of p53 has been found to be correlated with prognosis of some carcinomas, including gastric cancer, but no studies have reported on its relationship to the location of gastric cancer. In the present study, we compared the p53 expression of proximal and distal gastric cancer concerning histopathology and prognosis. Methods: A total of 170 tumors in the patients with proximal (80 cases) and distal (90 cases) gastric cancer were studied by immunohistochemical methods. Results: p53 immunopositivity was detected in 28.8% of all tumors. The p53-positive expression in proximal gastric cancer was higher than in distal gastric cancer (38.8% vs. 20.0%, p<0.05). A 5-year survival analysis showed that there is no significant difference between tumors that are p53 positive and p53 negative. No correlation was found between p53 expression and histopathology of gastric cancer. Conclusion: p53 nuclear staining is not useful as a prognostic indicator or as a parameter in gastric cancer.     

病毒性心肌炎心肌肌钙蛋白Ⅰ检测的临床意义

目的:对病毒性心肌炎患儿血中肌钙蛋白I(cTn I)含量进行检测,探讨与临床的关系。方法:采用放射免疫法对24例病毒性心肌炎患儿血中cTn I进行定量检测,同时检测血清心肌酶谱的改变情况,并就两种指标进行相关性探讨。结果:病毒性心肌炎患儿血中cTn I含量明显增高(4.5±2.2 )vs(2.3±0.3)ng/ml,P<0.01),并与CKMB,LDH_1的含量呈明显的正相关。结论:cTnl I是诊断病毒性心肌炎的敏感指标,可以反映出心肌受损的程度。     

快速杂交法定量检测HBV DNA及临床应用

目的：介绍一种快速定量检测HBV DNA的方法及临床初步应用。方法：对40例乙型肝炎病毒表面抗原阳性的慢性乙型肝炎患者共79份血清标本，采用Digene第二代杂交捕获试验(Hybrid Capture Ⅱ,HCⅡ,v2.0)定量检测HBV DNA，并与分枝链DNA信号扩增试验(bDNA，v1.0)作比较。结果：79份HBsAg阳性血清中，HCⅡ检出HBV DNA57份(72．2％)，bDNA法为45份(57％)，HCⅡ敏感性略高于bDNA法；2种方法定量检测HBV DNA的符合率为85.9％，相关性良好(r＝0．95)；19例抗病毒治疗乙肝患者，治疗后平均HBV DNA载量下降2(Log10)数量级，6例发生e抗原血清转换的患者平均HBV DNA载量下降3(Log10)数量级以上，且HBV DNA阴转早于e抗原血清转换。结论：HCⅡ比bDNA更为简便、经济、快速，可用于临床HBV DNA水平的定量检测、监控及抗病毒药物的筛选、考核。     

显微外科技术在尿道下裂修复中的应用

采用显微外科技术行阴囊纵膈皮瓣尿道下裂修复术18例，均获成功。其手术要点为：将阴茎腹侧纤维索条切除，充分伸展阴茎，皮瓣保留足够长度与宽度，克保血运；在显微镜下采用7－0尼龙丝线缝合，形成皮管，不缝皮肤，只缝皮下。硅胶管支架引流，加压包扎阴茎。本文对手术成功的原因进行了初步讨论。     

体外循环浅低温心脏不停跳心内直视手术的临床研究

目的:探讨体外循环浅低温心脏不停跳心内直视手术的方法、疗效评价及其对心肌保护作用。方法:总结2004年3月～2008年12月间12例施行浅低温心脏不停跳心内直视手术病例,并行循环不阻断主动脉,鼻咽温维持在32～35℃,阻断上、下腔静脉,完成心内直视手术。结果:全组无围手术期死亡,心脏手术结束能顺利停机,术后血流动力学平稳,无严重心律失常,血尿发生率0%,无1例发生空气栓塞。1例心房切口缝合针眼渗血,行再次开胸止血,1例术后第32h发生急性肺梗塞,均经治疗痊愈。结论:浅低温心脏不停跳心内直视手术技术安全可行,是一种接近生理状态的心肌保护方法,可避免再灌注损伤,有较理想的心肌保护效果。     

Radiculopathy following intrathecal baclofen pump implantation]

INTRODUCTION: Intrathecally delivered baclofen has been used as a treatment for severe spasticity since 1984. After a successful intrathecal baclofen trial, a programmable drug delivery system was implanted. Few early complications such as infection or hematoma are observed after this surgery. OBJECTIVE: To describe an unusual and unknown complication of intrathecal baclofen therapy. METHOD: We report 2 cases of complications of intrathecal baclofen therapy, radiculalgy, that appeared early after pump implantation. The clinical symptoms and computed tomography (CT) results are described. RESULTS: The first patient described pain, which evoked left S1 radiculopathic features. The second had left L5 radiculopathic involvement. The mean pain level was estimated on a 10-point visual analog scale as 7.5 (range 4-9). Lumbar CT scan showed a conflict between the symptomatic root and the catheter and eliminated other causes of the symptoms. Treatment with analgesic drugs was successful in 1 patient. The other presented with proximal disconnection of the catheter, which led to surgical replacement of the catheter. The pain disappeared after this surgery. CONCLUSION: Intrathecal baclofen therapy with a subcutaneously implanted progammable pump can be complicated by radiculalgy secondary to a conflict between the catheter and symptomatic root. The diagnosis is made by CT lumbar scan. If medical treatment is not sufficient, surgery could be proposed to replace the catheter.     

Magnetic Resonance Imaging Findings on Carbon Monoxide Intoxication

Four patients who had carbon monoxide intoxication were examined by brain magnetic resonance imaging (MRI) and computed tomography (CT). Three were unconscious in the acute stage of intoxication. On regaining consciousness. neuropsychological symptoms and signs remained. In these patients, T2-weighted MRI demonstrated hyperintensity lesions in the cerebral cortex, most prominent in the watershed zone. The fourth patient had only memory disturbance and was not unconscious during the acute intoxication. The T1-weighted MRI showed hyperintensity in the bilateral pallidal regions. MRI demonstrated lesions more clearly than did CT.     

Type classification of anomalous pancreaticobiliary junction by ERCP

The role of endoscopic retrograde cholangiopancreatography (ERCP) in the preoperative assessment of anomalous pancreaticobiliary junction was retrospectively evaluated in 74 consecutive patients (19 males and 55 females; aged 0–80 years). Sixty-three patients had congenital biliary dilatation and 11 did not. Type classification of congenital biliary dilatation was possible by ERCP alone in 45 patients (71%). The main causes of classification failure were previous bilio-enteric anastomosis and restriction of postural changes during ERCP due to general anesthesia in pediatric patients. Classification of anomalous junction was possible in 69 patients (93%). Technical difficulty in ERCP caused classification failure in 5 patients. Neoplastic lesions were found in 12 patients (16%) and all but 1 were correctly diagnosed by ERCP. We conclude that ERCP plays an important role in the preoperative diagnosis and type classification of anomalous pancreaticobiliary junction and congenital biliary dilatation.