MAGNETIC RESONANCE IMAGING FACILITATES ASSESSMENT OF PERIANAL CROHN'S DISEASE

Three illustrative cases of magnetic resonance imaging (MRI) in patients with perianal Crohn's disease are presented. Modern MRI techniques provided excellent visualization of perineal anatomy, inflammatory tissues and an anorectal stricture. It also allowed detailed delineation of the patho-anatomy of fistulous abscess and any communication to more proximal bowel. This report illustrates the potential of modern MRI as an important investigative adjunct in evaluating the anorectal manifestations of Crohn's disease.     

Diffusion‐Weighted MRI in Creutzfeldt‐Jakob Disease: A Better Diagnostic Marker Than CSF Protein 14‐3‐3?

Two middle-aged patients presented with rapidly progressive dementia and ataxia, nonspecific electroencephalography findings, and negative cerebrospinal fluid (CSF) protein 14-3-3. Both patients underwent brain magnetic resonance imaging (MRI) scans that demonstrated abnormalities on diffusion-weighted imaging (DWI) sequences, and both were later confirmed to have Creutzfeldt-Jakob disease. (CJD) by tissue examination. Because a recent position paper from the American Academy of Neurology characterized CSF protein 14-3-3 as a gold standard for clinically diagnosing CJD, the authors reviewed studies of CJD in which DWI-MRI imaging and CSF protein 14-3-3 studies were both performed. Among 19 reported cases of CJD with DWI-MRI lesions, CSF protein 14-3-3 was negative in 6 cases and positive in 2 others. The authors' findings suggest that multifocal cortical and subcortical hyperintensities confined to gray matter regions in DWI-MRI may be a more useful noninvasive diagnostic marker for CJD than CSF protein 14-3-3. These observations provide a compelling rationale for a prospective comparative study.     

Neuromelanin-containing neurons of the substantia nigra accumulate iron and aluminum in Parkinson's disease: a LAMMA study

The Laser Microprobe Mass Analyzer (LAMMA) is a sensitive instrument for identifying and localizing trace elements in tissue samples. Using LAMMA, we have examined melanin-containing neurons of the substantia nigra in patients with Parkinson's disease (PD) and controls. We found that iron significantly accumulates within neuromelanin granules of patients with PD compared to controls. Increased aluminum was found in the neuromelanin granules of 2 of 3 PD cases but in no controls. The accumulation of iron and aluminum, which are known to promote oxidant stress, may account for the selective degeneration of neuromelanin-containing neurons in PD.     

Graves病的发病与社会心理因素

对１０７例甲状腺机能亢进症患者和９１名正常人采用艾森克个性问卷及自编社会环境的调查显示：４６．９４％的患者起病前有负性生活事件发生，个性特征甲亢组神经不稳定型及掩饰性评分显著高于正常组，有显著性差异，此结果提示甲亢患者存在明显个性缺陷和负性生活事件，这些因素可作为甲亢发病的一种诱因。     

Close correlation between high-density lipoprotein and triglycerides in normotriglyceridaemia.

The relationship between high-density-lipoprotein (HDL) particle size subclasses and the levels of the major lipoprotein lipids was studied in 74 men consecutively referred to the lipid clinic. HDL (density 1.070-1.21 kg l-1) was separated by polyacrylamide gradient gel electrophoresis (GGE) into five size-defined subclasses, in order of decreasing size as follows: HDL2b, HDL2a, HDL3a, HDL3b and HDL3c. Cholesterol and triglyceride concentrations in very-low-density (VLDL), low-density (LDL) and high-density (HDL) lipoproteins were determined. The level of VLDL triglycerides was negatively correlated with HDL2b (r = -0.66, P less than 0.0001), and positively correlated with HDL3b concentrations (r = 0.65, P less than 0.0001). Both correlations were restricted to subjects with VLDL triglyceride concentrations of less than 1.80 mmol l-1, i.e. those with normotriglyceridaemia. Patients with a history of myocardial infarction and/or angina pectoris (n = 18) had significantly lower HDL2b levels than subjects with asymptomatic hyperlipidaemia (n = 50), i.e. 0.16 vs. 0.22 mg protein ml-1 (P less than 0.05), despite essentially similar cholesterol and triglyceride levels in the VLDL, LDL and HDL fractions, including HDL2 and HDL3 cholesterol.     

肝脏螺旋CT动态增强扫描时肝动脉期肝实质一过性异常强化的研究

目的　研究肝脏螺旋CT动态增强扫描时肝动脉期肝实质一过性异常强化 (transienthepaticabnormalenhancement,THAE)的表现特征 ,探讨其产生原因及临床意义。方法　 1999年 1月至2 0 0 1年 9月 92 6例患者因各种原因接受了肝脏或上腹部螺旋CT扫描。CT扫描常规先作全肝或上腹部螺旋CT平扫 ;注射对比剂开始后 2 5～ 3 0s行肝动脉期扫描 ,65～ 70s行门静脉期扫描 ;对部分病例还行病灶局部延迟扫描 ,延迟时间为 3、5及 10～ 15min。肝动脉期共检出 82例 (男 72例 ,女 10例 ;年龄 2 6～ 78岁 )具有THAE ,着重对其在平扫和增强各期图像上的表现、与肝内或肝外病灶的关系以及门静脉系统情况做详细观察和记录。结果　 82例 (8 9% )共有 12 2处肝动脉期THAE ,其中 110处(90 2 % )平扫未显示THAE区域密度异常 ,12处 (9 8% )呈稍低密度 ;所有 12 2处THAE在肝动脉期都为均匀的高密度影 ;在门静脉期 ,10 9处 (89 3 % )转为等密度而不能分辨 ,余 13处 (10 7% )为均匀稍高密度影 (其中 10处作了延迟扫描 ,均转为等密度 )。 83处 (68 0 % )THAE呈边缘光滑的楔形或扇形 ,2 9处呈不规则形 (2 3 8% ) ,余为其他形状。THAE紧贴肝内肿瘤或其他病灶的有 46处 (3 7 7% ) ,邻近肝外肿瘤或其他病灶 2 0处 (16 4% ) ,余 5 6处 (45     

Glutamate receptors in striatum and substantia nigra: Effects of medial forebrain bundle lesions

We examined NMDA-sensitive [³H]glutamate, [³H]AMPA, [³H]kainate and metabotropic-sensitive [³H]glutamate binding sites in neostriatum and substantia nigra pars reticulata (SNr) in rats after unilateral 6-hydroxydopamine lesions of the medial forebrain bundle. One week after the lesion, NMDA, AMPA, kainate and metabotropic receptors were decreased in the ipsilateral neostriatum, whereas at three months NMDA receptors were increased while AMPA, kainate and metabotropic receptors were not changed. In the SNr at one week, only AMPA and metabotropic receptors were significantly decreased whereas three months after the lesion NMDA, AMPA and kainate binding sites were decreased. The early decrease of excitatory amino acid receptors in the striatum is likely to reflect degeneration of dopaminergic fibers, suggesting that specific subpopulations of excitatory amino acid binding sites are located on dopaminergic terminals.     

Lipoprotein(a) concentration in diabetes: relationship to proteinuria and diabetes control

Diabetic patients are at increased risk of cardiovascular disease, particularly when proteinuria is present. Lipoprotein(a)[Lp(a)] levels were assessed in 37 patients with insulin dependent (IDDM) and in 75 patients with non-insulin dependent (NIDDM) diabetes who showed varying degrees of proteinuria and glycaemic control. Median Lp(a) in 112 diabetic patients was significantly greater than in 116 healthy controls (113 vs 48 mg/L; p <0.01). 86 of the patients had first morning urine albumin concentration < 30 mg/L (normoalbuminuria = NA), 16 patients 30–200 mg/L (microalbuminuria = MA) and ten patients < 200 mg/L (albuminuria = ALB). There was no significant difference in median Lp(a) concentration between the three groups (NA = 108, MA = 163, ALB = 98 mg/L; p > 0.5). No significant difference in median Lp(a) concentration was found between patients with IDDM, NIDDM treated with insulin, or NIDDM treated with oral agents and/or diet (120, 98, 115 mg/L respectively; p > 0.7). When the 86 NA patients were divided on the basis of median fructosamine concentration (357 umol/L), no significant difference was found in median Lp(a) levels between those grouped below or above this median (98 mg/L vs 118 mg/L; p < 0.5). Across all diabetics studied there was no significant correlation present between Lp(a) and urinary protein or glycaemic control. These cross-sectional results suggest that median Lp(a) concentration is increased in both IDDM and NIDDM patients, but this increase is not related to the degree of proteinuria or short-term glycaemic control.     

Distribution of prion protein in German patients with Creutzfeldt-Jakob disease is different from that in Japanese patients

We investigated the distribution of prion protein (PrP) in 14 German patients with sporadic Creutzfeldt-Jakob disease (CJD) and compared it with that observed in Japanese patients. Immunohistochemical study revealed diffuse gray matter stainings including synaptic structures in all cases. In addition, 4 patients showed plaque-type deposition which was very rarely observed among sporadic Japanese patients without known mutation of the PrP gene but with valine at codon 129. A higher incidence of PrP plaques in German sporadic CJD may be related to the racial difference in the PrP gene.     

蝮蛇抗栓酶治疗急性心肌梗塞的观察

用蝮蛇抗栓酶对7例急性心肌梗塞患者进行早期治疗,收到显著的效果.心绞痛消失时间1天～3天,平均1.5天.心电图ST段复位到基线时间1天～16天,平均10.2天.治疗后血液粘稠度下降.