螺旋CT在确定Krukenberg瘤合并腹膜转移治疗方法的价值

目的应用螺旋CT协助确定Krukenberg瘤合并腹膜转移的手术可切除性 ,以帮助制订合理的治疗方案。方法回顾性分析 2 2例手术病理或临床追踪证实为胃肠来源的Krukenberg瘤合并腹膜转移的CT资料 ,各种转移灶的不同CT表现对治疗方法、手术难度与生存时间的影响进行分析 ,以确定螺旋CT在这类患者选择治疗方案 (即是否考虑手术切除 )时的价值。结果卵巢肿块与周围脏器粘连、累及周围血管及腹膜广泛转移 ,特别是形成腹膜肿块者手术难度均增大 ,影响生存率 ;而淋巴结转移对手术难度影响不大 ,但影响生存率。结论螺旋CT能准确显示Krukenberg瘤大部分原发灶和转移灶并对其可切除性提供术前资料 ,为确定治疗方案提供可靠依据     

SC1: a marker for astrocytes in the adult rodent brain is upregulated during reactive astrocytosis

Astrocytes are the most abundant cell type in the mammalian central nervous system (CNS), and are involved in many processes critical for normal CNS maintenance and function. We have used double-label immunocytochemistry and in situ analysis to show that the SPARC (secreted protein acidic and rich in cysteine)-related protein SC1, co-localizes with the astrocyte marker glial fibrillary acidic protein (GFAP) in the adult rodent brain. Thus, SC1 is an astrocyte marker that may be used to investigate astrocyte heterogeneity and analyze glial cell lineages during neural development. Consistent with the presence of SC1 and GFAP in astrocytes, both proteins were markedly upregulated following reactive astrocytosis induced by focal mechanical trauma. Therefore, SC1 may play an important role in reactive astrocytosis subsequent to a wide variety of neural trauma, including neurodegenerative diseases and acute neural damage.     

Acute splenic complications in children with sickle cell–hemoglobin C disease

Objective: To determine the frequency and severity of acute splenic complications in children and adolescents with sickle cell (SC) hemoglobin C disease.Methods: The medical records of 271 patients with SC disease seen at our center were reviewed to evaluate the incidence and severity of acute complications involving the spleen.Results: Sixteen (6%) children had acute splenic complications. Thirteen (5%) had 16 episodes of acute splenic sequestration (ASSC), with the initial event occurring at a mean age of 8.9 years (range, 2 to 17 years). Splenomegaly had been noted before the initial event in 6 (46%) of the 13 cases, and 3 (23%) had a history of painful splenic infarction. Two young children (aged 4 and 6 years) had a hemoglobin value less than 2 gm/dl, one without history of splenic enlargement. Three (23%) children had a second episode of ASSC. Three additional patients had a history of acute painful splenic infarction, two of whom also had splenic hemorrhage. Eight (3%) of the 271 children required splenectomy (1 after the initial episode of ASSC, 3 after a second episode of ASSC, 2 as a result of pain accompanying chronic infarction and ASSC, and 2 because of splenic hemorrhage). No deaths resulted from ASSC.Conclusions: We conclude that (1) acute splenic complications in children and adolescents with SC disease are relatively uncommon, (2) most episodes of ASSC occur in preadolescents, (3) ASSC can be life threatening, even in younger children, and (4) prior splenomegaly is not a good predictor of ASSC. Thus it is vital that the parents of all children with SC disease be instructed to palpate their child's spleen regularly. (J Pediart 1997;130:961-5)     

PERSONALITY CORRELATES OF PHYSIOLOGICAL RESPONSES TO MOTION PICTURES

Skin conductance (SC) and heart rate (HR) responses to rest, to a bland and to a stressor motion picture film were examined in 20 student subjects (Ss). Ss were divided equally into a high ego strength (Es) and a low Es group on the basis of their scores on the Barron scale of the MMPI. These groups were balanced for film presentation order and did not differ significantly on trait anxiety as measured by the Taylor manifest anxiety scale. The Zuckerman multiple affect adjective check list was administered before and after both the stressor and the bland film. High Es Ss were more responsive in SC and HR under all three conditions and showed a greater range of SC values than did low Es Ss. Subjective states paralleled physiological states. High Es Ss reported significantly greater state anxiety than did low Es Ss.     

Flow in coronary artery bypass grafts to totally and partially occluded left anterior descending coronary arteries

Flow was determined by electromagnetic flowmeter in vein bypass grafts in 20 patients with a totally occluded left anterior descending (LAD) coronary artery and on 61 patients with a partially occluded LAD. The median flow in LAD grafts was 14.5 ml/min with total LAD occlusion, and 40 ml/min with partial LAD occlusion (p less than 0.001). In cases of total LAD occlusion, the presence of mild or moderate anteroseptal wall dysfunction was associated with more satisfactory flow than was the case with severe anteroseptal wall dysfunction (p less than 0.02). Flows over 25 ml/min were found only when the LAD distal to total occlusion was 1.5 mm or greater. Unsatisfactory flows were consistently found with total LAD occlusion, poor ventricular function, and a distal LAD less than 1.5 mm. Repeat catheterizations to determine an unsatisfactory patency rate under these conditions would be necessary to alter our policy of grafting all suitable vessels beyond a total occlusion.     

Use of indigo carmine for twin amniocentesis and its effect on bilirubin analysis

Indigo carmine is used commonly to mark the first-entered amniotic sac in twin amniocenteses. The presence of this dye significantly affects amniotic fluid bilirubin analysis. A method of chloroform extraction is recommended for determination of bilirubin in amniotic fluid previously contaminated by indigo carmine.     

Chemoradiation therapy and resection for carcinoma of the esophagus: short-term results

The purpose of this report is to record the results of a treatment protocol for patients with carcinoma of the esophagus. In May, 1980, we initiated a program of chemoradiation therapy preliminary to resection in patients in whom the protocol was applicable. The chemotherapy consisted of mitomycin-C, 10 mg as a bolus intravenous injection on day 1, and 5-fluorouracil, 1,000 mg per square meter of body surface area in 1,000 ml of 5% glucose solution in distilled water given intravenously on each of days 1 through 4. The radiation therapy consisted of 3,000 rads in three weeks using cobalt 60 or 6 MeV or greater, with ports to cover the tumor and mediastinum. This protocol was given to patients with primary carcinoma of the esophagus whose disease remained or became operable during or following the course of the chemoradiation. Among the patients treated according to the protocol, the operability rate was increased. The resectability rate remained about the same as in our previous experience. The operative mortality was lessened appreciably. The percentage of resected specimens of the esophagus showing residual tumor decreased. However, the absence of any residual tumor in the surgical specimen has not conferred any improved chance of long-term survival to date. There has been a two-year survival of 33% (7/21) among the small group having chemoradiation therapy prior to resection, and this figure is roughly the same as that in our previously reported series of patients treated by preoperative irradiation (4,500 rads in three weeks) and resection without the chemotherapeutic adjunct.(ABSTRACT TRUNCATED AT 250 WORDS)     

A Golgi study of the superficial pyramidal cells in the somatosensory cortex of socially reared old adult rats

Following a series of investigations into the appearance of the basal dendritic skirt of pyramidal cells in the supragranular layers of the occipital cortex of the aged rat, we now extend our findings to the somatosensory cortex of these same animals. Specifically, the total number of dendritic branches increased from 414 to 630 days of age due primarily to an increase in third and sixth order branches. The total number of branchless segments which we have suggested may be a vestige of a portion of the dendritic tree was greater in the 414-day-old group than in the 630-day-old group. The dendritic density was also measured in four specific ranges from the soma (0 to 50 μm, 50 to 100 μm, 100 to 150 μm, 150 to 200 μm). Only the 50 to 100-μm range did not show an increase in density with age. By utilizing an orientation factor in the concentric circle analysis, the increase in dendritic density for the range nearest the soma was found to be only in the upper sector of the dendritic domain. This suggests a shift in the dendritic tree away from the region of primary input in layer IV toward the pial surface. We consider that the increases in dendritic parameters measured are a compensatory-type growth as we earlier suggested in the occipital cortex. The functional meaning of this growth remains undetermined.