Amebic abscess of the liver manifested by “hemoptysis”: US,CT, and MRI findings

Ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging (MRI) findings of a patient suffering from an amebic abscess of the liver complicated by a bronchohepatic fistula are presented. Subsequent to US, CT provided the specific diagnosis. Multiplanar MRI was valuable to directly visualize the secondary diaphragmatic rupture and the bronchohepatic fistula.     

Invited. Brain edema development after MRI-guided focused ultrasound treatment

The aim of this study was to investigate a potential technique for image-guided minimally invasive neurosurgical interventions. Focused ultrasound (FUS) delivers thermal energy without an invasive probe, penetrating the dura mater, entering through the cerebrospinal fluid (CSF) space, or harming intervening brain tissue. We applied continuous on-line monitoring by MRI to demonstrate the effect of the thermal intervention on the brain tissue. For this, seven rabbits had a part of their skull removed to create access for the FUS beam into the brain through an acoustic window of 11 mm in diameter. Dura was left intact and skin was sutured. One week later, the rabbits were sonicated for 3 seconds with 21 W acoustic power, and the FUS focus was visualized with a temperature-sensitive T1-weighted MRI pulse sequence. The tissue reaction was documented over 7 days with T2-weighted images of the brain. The initial area of the central low signal intensity in the axial plane was .4 ± .3 mm², and for the bright hyperintensity surrounding the lesion, it was 2.3 ± .6 mm² (n = 7). In the coronal plane, the corresponding values were .4 ± .1 mm² and 3.4 ± .9 mm² (n = 5). The developing brain edema culminated 48 hours later and thereafter diminished during the next 5 days. Histology revealed a central necrosis in the white matter surrounded by edematous tissue with inflammatory cells. In summary, the image-guided thermal ablation technique described here produced a relatively small lesion in the white matter at the targeted location. This was accomplished without opening the dura or the need for a stereotactical device. MRI allowed on-line monitoring of the lesion setting and the deposition of thermal energy and demonstrated the tissue damage after the thermal injury.     

Ultrasound for diagnosis of apophyseal injuries

Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.     

Coexistence of Neoplasia and Cortical Dysplasia in Patients Presenting with Seizures

Summary: Tumors and cortical dysplasia are associated with epilepsy, but few studies have examined the coexistence of neoplasia and dysplasia in these patients. We studied 13 patients (age 4–29 years) with recurrent seizures of 1 month to 21-year' duration (median 72 months). Ten patients were aged <21 years. Imaging studies localized the lesion to the temporal lobe (10 patients), parietal lobe (2 patients), and frontal lobe (1 patient). Tumors included ganglioglioma (8 patients), dysembryoplastic neuroepithelial tumor (DNT) (3 patients), and low-grade as- trocytoma (2 patients). Cortical dysplasia, including atypical aggregates of neurons (6 patients), multifocal loss of the cortical laminar architecture (7 patients), and neurons in the molecular layer of the cortex (3 patients) were observed near but separate from the tumor. Coexistence of certain tumors with cortical dysplasia, most frequently observed in the pediatric population, suggests a hamar-tomatous/dysplastic nature of the neoplasms.     

基于贝叶斯多变量联合模型的体检人群脑卒中发病风险因素的纵向研究

背景 脑卒中是目前影响人类健康的主要公共卫生问题之一;健康体检纵向数据累积了大量的健康信息,由于缺失数据多、样本量小等诸多问题,导致其利用率低、重要信息未能得到充分挖掘,进而对常见慢性病的有效防控等工作带来一定困难。目的 基于贝叶斯多变量联合模型,探讨体检人群脑卒中发病风险因素,为慢性病风险因素分析提供新的方法。方法 本研究使用空军军医大学西京医院健康医学中心2008—2015年的体检资料。随访情况：以首次发生脑卒中为结局事件,发生结局事件立即停止随访;若未发生,到2015年体检信息收集完成后结束随访;体检间隔时间为1年。依据随访过程中是否发生脑卒中分为脑卒中组和非脑卒中组。纵向观察变量包括总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、体质指数（BMI）和收缩压（SBP）。采用多因素Cox回归模型分析基线情况对脑卒中结局事件的影响;采用贝叶斯多变量联合模型,分析随访过程中TC、TG、LDL-C、HDL-C、BMI和SBP的纵向变化轨迹对脑卒中发病的影响。结果 本研究共纳入234例研究对象,1 581条纵向随访记录,平均随访时间为...     

Percepciones estudiantiles sobre las propiedades del examen clínico objetivo estructurado en Uruguay. Disponiendo un cuestionario válido para analizar la factibilidad del nuevo formato durante la transición curricular

Introduction

Although an objective structured clinical examination (OSCE) format has been applied in Uruguay since 2004, and providing reliable performance measures, perceptions of it properties and level of student satisfaction have not been determined.

超声波介导的基因输送技术

近年来超声波介导的基因输送技术由于其相对安全性和操作上的简单得到关注。本文对超声波导致的声致穿孔的机制,空化核的作用——增强基因输送的效率,以及细胞和在体基因输送效率作了综述,讨论了超声波介导的基因输送效率的影响因素。此方法充满希望并且载药的空泡可以作为一种新型药物载体在超声作用下实现药物的靶向输送     

"Hour-glass" shape of the uterus in the diagnosis and treatment of cervical pregnancy

This study attempts to point out the importance of the anatomo-clinical finding of an "hour-glass" shape to the uterus in the diagnosis and treatment of cervical pregnancy. From 1973 to 2001, four cases of cervical pregnancy were treated in the 2nd Obstetrical and Gynecological Clinic of the Aristotelion University of Salonica. The incidence was 1:13,111 pregnancies (4 cervical in 52,446 pregnancies). Three of the patients underwent bilateral ligation of the anterior trunk of the internal iliac artery using absorbable ligatures. The fourth patient (a 42-year-old), elected to have a hysterectomy. All patients were well and discharged from hospital on the seventh postoperative day. Two of the three patients treated by ligation of the anterior trunk of the internal iliac arteries subsequently had normal pregnancies and deliveries. We lost contact with the third patient. The finding of an "hour-glass" uterine shape was very helpful in the diagnosis of cervical pregnancy. The Aristotelion University of Salonica has found that treatment by ligation of the anterior trunk of the internal iliac arteries is effective, causes no complications, never ends in hysterectomy, and maintains the normal menstrual cycles and reproductive ability of the woman.     

1049例育龄妇女下生殖道感染情况调查

目的了解育龄妇女下生殖道感染情况,为育龄女性生殖健康提供进一步的数据资料。方法对1049例来自健康体检中心的21~40岁育龄妇女的阴道后穹窿及宫颈分泌物标本进行检测,阴道清洁度、滴虫采用显微镜镜检法,淋球菌、解脲支原体、人型支原体、真菌采用培养法,沙眼衣原体则采用免疫层析法。检测结果进行统计学分析。结果女性生殖道感染的感染率为53.3%,其中混合感染率为9.8%,而清洁度异常率仅为28.4%;前三位病原体感染依次为解脲支原体(35.9%)、衣原体(18.1%)、真菌(6.7%)。结论女性生殖道感染情况严重,具有隐匿性,应加强对无症状感染的育龄妇女的监测。     

69,XXY伴严重生长迟缓及眼球突出病例的产前诊断

目的分析孕中期血清筛查数据和胎儿彩色多普勒与染色体异常之间的关系。方法对一孕中期血清产前筛查18三体风险1:10,血清Free-hCGβ异常减低(值为1.29ng/ml即0.08MOM),胎儿系统结构检查提示胎儿小于孕周,头腹围比(1.63)大于正常(1.25),上唇连续性中断延至鼻底的孕妇进行羊膜腔穿刺,抽取羊水进行细胞遗传学检查。结果羊水细胞染色体核型:69,XXY。结论中孕期妇女血清Free-hCGβ异常减低和胎儿头胸围发育不同步、胎儿唇腭裂提示胎儿染色体畸变可能,血清和超声联合筛查有助于染色体疾病的检出。