白血病患者血清甲状腺激素水平测定的研究

为了解白血病患者血清甲状腺激素水平的变化,采用放免分析方法测定６７例不同类型白血病患者血清甲状腺激素水平,结果表明急性非淋、慢粒急变及急淋患者,血清三碘甲状腺原氨酸（Ｔ３）水平较正常显著降低,Ｐ〈０．０５,四碘甲状腺原氨酸（Ｔ４）水平无明显变化;促甲状腺激素（ＴＳＨ）仅慢粒急变时较正常升高（Ｐ〈０．０５）,游离Ｔ４（ＦＴ４）急非淋及慢粒急亦患者较正常降低（Ｐ〈０．０５）,而反三碘甲状腺原氨酸（ｒＴ３）较正常升高（Ｐ〈０．０１）,急淋ＦＴ４及ｒＴ３较正常升高（Ｐ〉０．０５）。提示甲状腺激素水平的变化主要在急非淋及慢粒急变者,在急淋变化不突出。     

糖尿病患者T细胞亚群、甲状腺功能与中医辨证的关系

了解Ｔ淋巴细胞亚群及甲状腺功能与糖尿病中医辨证的关系。方法将４１例糖尿病患分为气阴两虚型和阴阳两虚型两组,采用间接免疫荧光法和放射免疫法分别测定Ｔ淋巴细胞亚群及甲状腺功能。结果气阴两虚型ＣＤ＾４＋,ＣＤ＾＋８及ＣＤ＾４＋８／ＣＤ＾＋无变化,Ｔ３,Ｔ３／ｒＴ３降低;阴阳两虚型ＣＤ＾＋８值升高,ＣＤ＾＋４／ＣＤ＾＋８值降低,Ｔ３,Ｔ４,ＦＴ３,ＦＴ４,Ｔ３／Ｒｔ３值降低,ｒＴ３升高。与正常对照组均有     

羊水过少的B超诊断性试验分析

目的 探讨产前Ｂ超测定羊水平段诊断羊水过少的最佳界值。方法 对妊娠≥３６周的孕妇进行Ｂ超测定羊水最大平段,剖宫产时实际测定羊水量,确定２．０ｃｍ、２．３ｃｍ、２．６ｃｍ、３．０ｃｍ、３．３ｃｍ、３．８ｃｍ等７个界点,分别计算其敏感性、特异性、阳性预测值和阴性预测值,对各界点的敏感性和（１－特异性）作受试者工作特性曲线。结果 当Ｂ超测定羊水平段界点为３．３ｃｍ,可获得较高的诊断敏感性和特异性,其值为８０．５６％和７８．７９％。结论 Ｂ超测定羊水平段界点值为３．３ｃｍ时,可产前诊断为羊水过少。     

手术治疗甲状腺疾病的临床研究（附2092例报告）

目的：探讨甲状腺疾病的外科治疗。方法：回顾性研究近２０年来甲状腺疾病２０９２例。结果：３手术治愈率１００％,死亡率为零,术后并发症甲亢４．４％,甲状腺癌３．３％,甲状腺瘤０．４４％。结论：手术治疗甲头腺疾病是安全、有效、合理可行的。术前充分准备是减少并发症的关键。     

甲状腺乳头状癌核内包涵体及核的形态结构定量分析

目的:定量揭示甲状腺乳头状癌核内包涵体及核的几何形态结构特点,为甲状腺乳头状癌的病理诊断提供定量诊断参数。方法:取甲状腺乳头状癌100例,常规切片、HE染色,在40倍物镜下采集核内包涵体及核的图像,用Image-Pro Plus测试包涵体及核的面积、周长、长轴、短轴、形状因子PE（Form PE）、形状因子AR（Form AR）、规化形状因子（RFF）、轴比、核内包涵体的面积密度以及包涵体与核质的面积比。结果:（1）甲状腺乳头状癌核内包涵体的面积约为（13.575±9.045） μm2（95%CI 13.339~13.810）,其在核内的面积密度约为25.761%±10.683%（95%CI 25.483~26.039）;其周长约为（12.720±4.275） μm（95%CI 12.609~12.831）,长轴（4.547±1.466） μm（95%CI 4.509~4.585）,短轴（3.482±1.178） μm （95%CI 3.451~3.512）;其轴比约为0.772±0.121（95%CI 0.769~0.775）,Form PE、Form AR和RFF约等于1;其与核质的面积比约为0.380±0.237（95%CI 0.374~0.386）,其面积、周长、长轴和短轴的变异系数为66.6%、33.6%、32.2%、33.8%。（2）具有核内包涵体的癌细胞,其核的面积、周长、长轴和短轴及其相应变异系数显著大于没有核内包涵体的细胞核（P<0.05）。（3）核内包涵体、含有核内包涵体的核及没有核内包涵体的核,其面积、周长、长轴和短轴的频数分布均呈正偏态分布。结论:（1）甲状腺乳头状癌核内包涵体形状大致呈圆形;约为核面积的1/4,核周长、长轴和短轴的1/2;其面积、周长、长轴和短轴的变异程度均较大。（2）具有包涵体的癌细胞,其核的异型性明显,诊断阅片时应重点观察。（3）包涵体及核的上述尺寸参数的频数分布均呈正偏态分布。     

Clinical,cytological, and pathological characteristics of metastatic renal cell carcinoma to the thyroid: A study of 14 cases at a Japanese single institution

A preoperative diagnosis of metastatic renal cell carcinoma to the thyroid (MRCCT) is important for determining clinical management but is challenging even in cases with a clinical history of renal cell carcinoma (RCC). This study aimed to elucidate the clinical, cytological, and pathological characteristics of MRCCT. Fourteen MRCCT cases extracted from 18 320 malignant thyroid tumors were included in this study. Twelve MRCCT (85.7%) occurred as solitary lesions and the most frequently suspected lesions on ultrasonography were follicular tumors. On cytology, 46.2% of cases were reported as RCC or suspected RCC; a medical history of RCC and immunocytochemistry were helpful in interpretation. RCC metastasized to a follicular adenoma in 50.0% of the solitary lesions. MRCCTs with a long interval from the initial presentation, solitary lesion, and Ki-67 labeling index <10% showed significantly longer disease-free survival. MRCCT is characterized by a long interval from the initial presentation of RCC, appearance as a solitary nodule, ultrasonographic similarity to follicular tumors, sharing cytological findings with primary thyroid tumors, and high frequency of metastasis within follicular adenoma. A long interval from the initial presentation, occurrence as a solitary lesion, and low Ki-67 labeling index may be favorable prognostic factors.     

Transcranial Doppler sonography in craniosynostosis

In the management of craniosynostosis, there is a need for quantitative assessment of treatment methods and outcome. Radiology and pressure studies are well documented, but so far little attention has been given to cerebral blood flow changes and their possible relevance. This paper reports our initial experience using transcranial Doppler sonography to calculate the cerebrovascular resistance and cerebral blood velocities in the major basal vessels before and after surgery for craniosynostosis. Ten patients were studied using the Scimed 2-MHz probe through the temporal and frontal windows of the skull. Measurements were taken under standard physiological conditions before, during and after surgery. Preliminary results suggest that this non-invasive technique may be helpful in predicting and assessing the outcome following surgery for craniosynostosis.     

Breast cancer angiogenesis: A quantitative morphologic and doppler imaging study

Background: Tumor growth and metastases require the development of new vessels (angiogenesis). Angiogenesis, assessed by microvessel count using immunocytochemical stain of endothelial cells, has been shown to predict metastases and correlate with early death. Recently developed color Doppler mapping can detect the “tumor flow signals” in breast cancer and help to distinguish it from benign lesions. The question is, does this tumor vascularization assessed by color Doppler mapping correlate with the angiogenesis assessed by immunocytochemistry? Methods: Eighty-four patients admitted for breast surgery were studied. The final diagnosis was made by pathology for 52 malignancies and 32 benign lesions. The color Doppler mapping of the breast lesion was made preoperatively. The following parameters were assessed: (a) vessel location (peripheral or central); (b) density of color Doppler signals; and (c) maximum systolic velocity. Tumor angiogenesis was assessed by microvessel count under light microscopy using the platelet/endothelial cell adhesion molecule antibodies (CD31) method. The correlation between maximum velocity and microvessel count of breast cancer was examined. The clinical significance of maximum flow velocity of breast cancer with various clinicopathologic factors was assessed. Results: Color signals were detected in 48 cases of 52 malignancies (92%). All tumors demonstrated signals at the periphery of the lesion but in only 13 (27%) were the signals detected within the tumor. Color signals were scored as + + or + + + in 44 (92%) patients. Pulsed wave blood flow was shown in all these 48 tumors, with maximum velocities varying from 4 to 36 cm/s. Among the 32 benign lesions, color signals were detected in 10 (31%) and all were peripheral and scored subjectively as +. Evaluation of these color Doppler mapping parameters shows no significant correlation with microvessel counts using CD31 monoclonal antibodies. However, there was a positive association (p<0.05) between nodal metastases and higher tumor flow velocity in T1 (<2 cm) breast tumors but not in larger tumors. Conclusion: Although the color Doppler mapping has been shown to be useful in distinguishing benign from malignant breast lesions, the intensity of signal and velocity of flow had no correlation with the extent of angiogenesis of breast cancer. The presence of high-flow tumor signal in early breast carcinoma is significantly associated with the presence of axillary lymph node metastases.     

Mitotic counts in rat adenohypophysial thyrotrophs and somatotrophs: Effects of short-term thyroidectomy,thyroxine, and thyrotropin-releasing hormone

The question of whether thyroxine (T₄) and thyrotropin-releasing hormone (TRH) affect mitoses in pituitary thyrotrophs (Tt) and somatotrophs (St) of hypothyroid rats was investigated. Fifteen day thyroidectomized (Tx) rats were used. Groups of Tx animals received T₄ or TRH or both. Except 6 and 24 h TRH groups, the animals were sacrificed 12 h after injections. Unoperated euthyroid rats served as controls. In Tx group adenohypophysial mitoses were significantly increased. T₄ diminished mitoses in Tx rats. Mitotic counts were decreased in 6 and 24 h Tx groups, but increased in 12 h TRH group. TRH plus T₄ in Tx animals had a synergistic effect on adenohypophysial mitoses. In unoperated controls few mitoses were observed in Tt and more mitoses in St. In Tx rats more mitoses were seen in Tt than in St. T₄ alone failed to reduce mitoses in Tt but increased them in St. We concluded that T₄ affects Tt and St replication. In normal rats mitoses occur mainly in St. In Tx rats mitotic activity increased in Tt. TRH plus T₄ have a synergistic motogenic effect on St. T₄ but not TRH affects St replication. It appears that the presence, of T₄ is necessary for St multiplication.     

Can nuchal cord cause transient increased nuchal translucency thickness?

When detected in a first trimester scan, an increased thickness of nuchal translucency (NT) may be associated with chromosomal, cardiac or genetic disorders. However, less attention has been devoted to the outcome of those fetuses who have confirmed normal anatomies and karyotyping, but have abnormal first trimester scans. Thus, a challenging new issue is how to counsel such cases of transient increased NT in which the translucency rapidly vanishes with no evidence of other underlying abnormalities. Two cases of transient increased thickness of NT are reported. In both, a nuchal cord was ultrasonographically demonstrated and a thorough work-up revealed chromosomally and anatomically normal fetuses. The pathophysiological theories behind these observations and their significance are discussed. Based on these observations, we suggest that transvaginal sonography combined with Doppler flow studies should be utilized for the presize detection of cord patterns to accomplish the work-up in cases of increased NT.