Intracranial trajectories of sympathetic nerve fibers originating in the superior cervical ganglion in the rat: WGA-HRP anterograde labeling study

Intracranial trajectories of sympathetic nerve fibers originating in the superior cervical ganglion (SCG) in the rat were investigated by means of anterograde labeling following the injection of wheat germ agglutinin-horseradish peroxidase conjugate (WGA-HRP) into the unilateral SCG. The trajectory of the sympathetic fiber innervating the pineal gland and its continuing structures was found advancing along the abducent nerve, through the cavernous plexus, then along the trochlear nerve. Labeled sympathetic fibers showed two patterns of distribution in the blood vessels on the basal surface of the brain. The sympathetic fibers originating in the unilateral SCG were intermingled with those fibers from the contralateral SCG in the pineal gland, its continuing structures and the choroid plexus of the third ventricle as well as in the cerebral blood vessels.     

Further evidence of noradrenergic regulation of rat hypothalamic estrogen receptor concentration: possible non-functional increase and functional decrease

The regulation of estrogen receptors by the alpha 2-noradrenergic system was studied. A single injection of the alpha 2-noradrenergic antagonist, yohimbine, caused a biphasic effect on the concentration of cytosol estrogen receptors in the mediobasal hypothalamus and anterior pituitary gland. A short-latency increase was seen at 1.5-3 h, followed by a longer-lasting decrease at 8-16 h. Scatchard analysis revealed that the apparent, short-latency increase is in the concentration of binding sites, not in the affinity of the receptor for [3H]estradiol. The increase in the concentration of cytosol estrogen receptors is not blocked by pretreatment with the alpha 2-noradrenergic agonist, clonidine. In addition, no increase is detected in the concentration of cell nuclear estrogen receptors accumulating in response to a saturating dose of estradiol. Therefore, the apparent increase in the concentration of cytosol estrogen receptors may not represent a functional increase in receptors. The decrease in the concentration of estrogen receptors, which occurs 8-16 h after yohimbine treatment, is also seen after injection of the alpha 2-adrenergic antagonist, idazoxan, and is not due to a change in the in vitro rate of association of the receptors with [3H]estradiol. Furthermore, the decrease seems to be a functional decrease in the concentration of receptors capable of cell nuclear accumulation in response to estradiol injection, as indicated by the results of experiments in which the concentration of cell nuclear estrogen receptors was assayed after estradiol injection. These experiments provide further support for the hypothesis that the alpha-noradrenergic system, and perhaps specifically the alpha 2-subtype, is involved in decreasing the concentration of estrogen receptors in parts of the brain and pituitary gland. This interaction provides a mechanism by which the environment could regulate the sensitivity of certain neurons to estradiol. However, the finding that the initial increase in the concentration of cytosol estrogen receptors after yohimbine treatment is not followed by the predicted increase in cell nuclear estrogen receptors after estradiol injection raises questions about the physiological relevance of the apparent increase under some conditions.     

腮腺腺淋巴瘤的MR诊断和临床表现

目的：分析腮腺腺淋巴瘤的MRI表现及临床特征,探讨MR和临床表现在该病诊断中的应用价值。方法回顾性分析经手术病理证实的6例腮腺腺淋巴瘤患者的影像资料,并结合文献复习。结果6例患者12个病灶,MR均表现为双侧单发,病灶或病灶主体位于腮腺浅叶后下极,MR平扫T1加权像呈低信号,T2加权像呈中等或者高信号,增强扫描呈中等程度强化。结论腮腺腺淋巴瘤有一定的临床表现,MR表现也具备一定的特点,对术前诊断有较大的帮助。     

The Hollow Adrenal Gland Sign: An Ominous Alert

Teaching Point: The hollow adrenal gland sign is common, and may be specific, in patients with septic shock, and is a predictor of poor prognosis.     

中西医结合治疗糖尿病下肢动脉硬化闭塞症临床观察

目的观察中西医结合治疗糖尿病下肢动脉硬化闭塞症（DLASO）的临床效果。方法将59例DLASOⅠ、Ⅱ期病人随机分为治疗组30例,对照组29例,对照组给予常规治疗,治疗组在常规治疗基础上加用温通活血中药,观察临床疗效,并检测血糖、血脂、血液流变学指标和股动脉血流参数。结果两组疗效比较差异有显著性（uc=2.28,P〈0.05）;治疗组血糖、血脂、血液流变学指标和股动脉血流参数均有明显改善（t=2.17～13.80,P〈0.05、0.01）。结论温通活血中药对Ⅰ、Ⅱ期DLASO有显著疗效。     

辛伐他汀治疗冠心病患者下肢动脉粥样硬化斑块疗效观察

目的探讨辛伐他汀40mg/d对冠心病患者下肢动脉粥样硬化的影响。方法将96例经冠状动脉造影和下肢动脉超声诊断的冠心病下肢动脉粥样硬化患者随机分为辛伐他汀40mg组及辛伐他汀20mg组,每组48例,于给药前、给药3个月和9个月后采用高频超声检测下肢动脉,记录下肢动脉内膜中层厚度（IMT）。结果辛伐他汀20mg或40mg治疗3个月和9个月后,40mg组较20mg组作用更为明显（P〈0.01）,治疗3个月和9个月后辛伐他汀40mg组的下肢动脉IMT均较治疗前明显下降（P〈0.01）,而辛伐他汀20mg组IMT无显著改变（P〉0.05）。结论辛伐他汀40mg/d对冠心病患者的下肢动脉粥样硬化斑块具有稳定和延缓作用。     

临床护理干预在乳腺纤维瘤手术中的应用

目的探究临床护理干预在乳腺纤维瘤手术中的应用,总结临床护理干预的重点。方法选择100例乳腺纤维瘤患者,对其进行手术临床护理干预,分析术前、术后的护理重点。结果 100例患者,16例患者在手术过程中放置引流条,通过临床护理干预,拔除引流条时间最短为18 h,最长为超过36 h。16例患者拔除引流条的平均时间为25 h。100例患者,进行临床护理干预,手术切口一期愈合为97例,愈合率为97.0%。结论对乳腺纤维瘤患者,需要做好临床护理,提高成功率,值得临床推广。     

Tear film lipid layer thickness measurement from Ocular Surface Analyzer as a marker to monitor treatment of meibomian gland dysfunction in a study comparing physiological detergent-free eyelid wipes with conventional therapy: A randomized trial

Purpose:To compare the efficacy of physiological, non-detergent eyelid wipes with conventional lid hygiene in patients with meibomian gland dysfunction (MGD).Methods:Fifty participants with MGD were recruited and randomized into two groups. Participants in group I used Evolve Pure™ Eyewipes twice a day to clean the eyelid debris along with standard therapy (antibiotic and lubricants) and participants in group II followed lid hygiene with warm compresses along with standard therapy. Symptoms, ocular surface assessment (lipid layer thickness, tear meniscus height, non-invasive tear film breakup time, and meibography), slit-lamp biomicroscopy (eyelash contamination, meibomian gland blockage, meibomian gland secretion, and meibomian gland telangiectasia) and tear film osmolarity were noted at baseline and 90 days after therapy.Results:Significant improvement in symptoms and signs of MGD was observed in both groups after treatment (P < 0.001); however, the clinical improvement was better with the use of eyelid wipes. Lipid layer thickness increased significantly in group I (P = 0.0006) and group II (P = 0.0002), which was maintained even after adjusting for sociodemographic variables such as age, sex, and severity score of symptoms and signs.Conclusion:Lipid layer thickness of the tear film is a sensitive marker in monitoring response to treatment in patients with MGD. The use of physiological detergent-free eyelid wipes is non-inferior to lid hygiene and warm compresses, which remains the mainstay for treatment of MGD; the clinical improvement with eyelid wipes was noted to be better.     

Ki-67 Labeling Index as a Marker of Malignancy in Ocular Surface Neoplasms

Purpose To evaluate the relationships among histopathological type, clinical malignant grade, and Ki-67 labeling index (LI) in sebaceous gland carcinoma (SGC), conjunctival squamous cell carcinoma (SCC), and conjunctival intraepithelial neoplasia (CIN), with pterygium and normal conjunctiva as controls.Methods This retrospective study was conducted at the Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. We used tissue specimens obtained from 20 patients (four SGC, four SCC, four CIN, four pterygium, and four normal conjunctiva). Ki-67 immunohistochemical analysis was performed in all 20 cases.Results The Ki-67 labeling index (LI) was 46.1 ± 3.0% (average ± SD) in SGC, 28.4 ± 4.5% in SCC, 20.0 ± 7.2% in CIN, 9.0 ± 2.2% in pterygium, and 6.8 ± 2.3% in normal conjunctiva. Ki-67 LI was significantly (Mann-Whitney U test, P < 0.05) higher in SGC than in SCC, and higher, but not significantly, in SCC than in CIN. Ki-67 LI was significantly (P < 0.05) higher in SCC and CIN than in pterygium.Conclusions These results suggest that Ki-67 LI may be a sensitive marker for ocular malignant tumor grading. Jpn J Ophthalmol 2004;48:524–529 © Japanese Ophthalmological Society 2004