Serial analysis of matrix metalloproteinase-2 in dialysate of rat sclerosing peritonitis models

Background. Sclerosing peritonitis (SP) is a serious complication of continuous ambulatory peritoneal dialysis (CAPD). In order to carry out CAPD safely, it is important to analyze the development of SP. Methods. We prepared animal models of SP by the intraperitoneal administration of chlorhexidine gluconate (CHX) or talc, using male Sprague-Dawley rats. The peritoneal equilibration test and histological examinations were performed in the model rats, and dialysate drained from them was analyzed by gelatin zymography. Results. In the two types of SP animal models, matrix metalloproteinase-2 (MMP-2) level in dialysate correlated with the changes of inflammation, thickness of peritoneum, D/D0 glucose level (glucose level of drained dialysate obtained 90 min after the injection of 2.5% glucose containing peritoneal dialysis fluid divided by that obtained immediately after the injection), and net ultrafiltration. Conclusions. From these results, MMP-2 level in drained dialysate was considered to change with the development and progression of SP in rat models. Thus, MMP-2 has potential as a diagnostic marker for SP. Received: November 9, 2000 / Accepted: February 13, 2001     

高频超声对甲状腺弥漫硬化型乳头状癌的诊断价值

目的:探讨高频超声对甲状腺弥漫硬化型乳头状癌(DSV)的诊断与鉴别诊断价值。方法:2006-2010年共搜集DSV13例,所有病例均经手术后病理证实,分析声像图特征。结果:13例DSV甲状腺内部呈弥漫性不均匀改变和沙粒状钙化,无肿块及结节表现11例,2例伴有结节性甲状腺肿,颈部淋巴结转移9例。结论::DSV多发生在年轻女性,高频超声声像图表现为甲状腺内部回声弥漫性不均匀且伴有广泛沙粒状钙化,甲状腺内无明显肿块及结节,应与桥本甲状腺炎、亚急性甲状腺炎相鉴别。     

Evaluation of the Role of MHC Class II Alleles,Haplotypes and Selected Amino Acid Sequences in Primary Sclerosing Cholangitis

Background and Aims: Genetic susceptibility to primary sclerosing cholangitis is associated with several different HLA haplotypes, though a single "shared" susceptibility allele has yet to be identified. Most recently, attention has focussed on the MICA alleles in close proximity to the HLA class I, B locus. However, although there are strong associations with MICA*008, implicating this or a closely linked allele as major risk factors, this explanation alone does not account for all of the MHC-encoded susceptibility and resistance to PSC. The present study re-examines HLA class II associations in a large single centre series of well-characterised PSC patients. The specific aims of the study were to test existing associations and to develop hypotheses which together may account for all, or the majority, of the MHC-encoded susceptibility in PSC. Methods: A total of 148 adult white northern European patients and 134 control subjects were studied. HLA DRB1, DQA1, DQB1 alleles and DRB1*04, DRB1*13 and DRB3 subtypes were determined by standard PCR-genotyping. Results: The primary associations with the DRB3*0101-DRB1*0301-DQA1*0501-DQB1*0201 and DRB1*1301-DQA1*0103-DQB1*0603 haplotypes were confirmed (O.R.=2.69, p <0.0000025 and O.R.=3.8, p <0.0005). In addition the strong protective influence of the DRB1*04-DQB1*0302 haplotype was reaffirmed (O.R.=0.26, p <0.000025) and a previously unreported negative (i.e. protective) association with the DRB1*0701-DQB1*0303 haplotype was also demonstrated (O.R.=0.15, p <0.005). Further analysis suggested that susceptibility/resistance encoded by the second and third susceptibility haplotypes and by the two resistance haplotypes may be determined by specific amino acids at DQ&#103 -87 and DQ&#103 -55, respectively.     

Sclerosing angiomatoid nodular transformation of the spleen,a rare cause for splenectomy: Two case reports

BACKGROUND Sclerosing angiomatoid nodular transformation(SANT)is a rare benign disease of the spleen with unknown origin.Clinical symptoms are inhomogeneous,and suspicious splenic lesion often found incidentally,leading to splenectomy,as malignancy cannot securely be ruled out.Diagnosis is made histologically after resection.CASE SUMMARY Two cases of German,white,non-smoking,and non-drinking patients of normal weight are presented.The first one is a 26-year-old man without medical history who was exhibiting an undesired weight loss of 10 kg and recurring vomiting for about 18 mo.The second one is a 65-year-old woman with hypertension who had previously undergone gynecological surgery,suffering from a lasting feeling of abdominal fullness.Both showed radiologically an inhomogeneous splenic lesion leading to splenectomy approximately 6 and 9 wk after surgical presentation.Both diagnoses of SANT were made histologically.Follow-up went well,and both were treated according to the recommendation for asplenic patients.CONCLUSION SANT is a rare cause of splenectomy and an incidental histological finding.Further research should focus on clinical and radiological diagnosis of SANT as well as on treatment of patients with asymptomatic and small findings.     

鼻,咽,喉部血管瘤42例治疗分析

鼻，咽，喉部毛细血管瘤１３例，采用Ｎｄ－ＹＡＧ激光治疗１～２次，瘤体灼除。随访１年以上，无并发症及复发。２９例海绵状血管瘤，瘤体均在１ｃｍ直径范围以上，分别采用Ｎｄ－ＹＡＧ激光治疗９例，硬化剂鱼肝油酸钠治疗８例，注射硬化剂鱼肝油酸钠同时加用Ｎｄ－ＹＡＧ激光治疗１２例。其疗效对比发现，硬化剂同时加用Ｎｄ－ＹＡＧ激光治疗组疗效好，疗效短，无并发症，随访年以上无复发。     

Sclerosing pancreatitis showing rapidly progressive changes with recurrent mass formation

Summary Conclusion Sclerosing pancreatitis might develop repeatedly or might rapidly extend to the whole pancreas with recurrent mass formation. Background Nothing is known concerning course or development of sclerosing pancreatitis. Methods A 63-yr-old male was followed up for 2.5 yr. Results The patient was admitted because of a tumor in the body and tail of the pancreas. Serum pancreatic enzymes were transiently elevated, but tumor markers were all negative. Imaging studies showed a tumor 7 cm in size. The main pancreatic duct was normal in the head and obstructed at the body on endoscopic retrograde pancreatography (ERCP). The K-ras oncogene mutation was positive in pure pancreatic juice. Distal pancreatectomy was performed because pancreatic cancer was highly suspected. Pathological findings showed that the tumor was a densely fibrotic mass without malignant cells. Inflammatory cell infiltration was observed in the stroma. One year later, another mass 3 cm in size was noted in the remnant pancreatic head. ERCP revealed diffuse irregular narrowing of the main pancreatic duct, its branches, and the common bile duct. Liver dysfunction improved and an elevation of serum pancreatic enzymes subsided without any specific treatment, and the mass diminished in size. The patterns of various imaging studies on the second tumor were the same as those of the previous resected mass. Corticosteroid was not administered.     

Immunoglobulin-G4 related mastitis: A case report

IntroductionIgG4-related mastitis (IgG4-RM) is exceedingly rare with only ten cases reported in the literature to date. Organs that are affected with IgG4-related disease (IgG4-RD) all share the same histopathological hallmarks consisting of dense lymphocytic infiltration, storiform fibrosis and obliterative phlebitis.Presentation of caseThis case report highlights a case of IgG4-RM found incidentally in a 52-year-old woman during a routine breast screen and it explores the current literature about IgG4-RM and IgG4-RD.DiscussionIgG4-RM and IgG4-RD, in general, is a new entity in the field of medicine and its aetiology is not well understood. In the literature, IgG4-RM often presents as a painless palpable breast lump in isolation or with other systemic manifestations. IgG4-RM is considered benign and has excellent prognosis post-conservative treatment with steroid or surgical excision.ConclusionIgG4-RM is diagnosed exclusively on histological analysis. It is hard to distinguish IgG4-RD from malignant breast lesions purely on clinical examination and imaging studies. Increasing awareness of this condition among clinicians will assist them in managing patients better. Extensive whole body imaging is not recommended unless symptomatic.     

药物联合内镜下治疗食管胃底静脉曲张破裂出血56例

目的观察药物联合内镜下治疗食管胃底静脉曲张破裂出血的临床疗效及安全性。方法对56例食管胃底静脉曲张破裂出血患者联合药物及内镜下治疗,单纯食管静脉曲张采用套扎或硬化治疗,但急性出血时首选组织粘合剂注射,对合并的胃底曲张静脉同时行组织粘合剂注射。术后观察不良反应、并发症和近期疗效。结果 53例止血成功,成功率94.64%,1例仍有便血,2例发生脑梗死,考虑组织粘合剂引起的异位栓塞。结论药物联合内镜下治疗食管胃底静脉曲张破裂出血安全、有效,但需警惕异位栓塞的发生。     

脾硬化性血管瘤样结节样转化1例

患者女,41岁,主因“左上腹阵发性隐痛1个月,加重1天伴绞痛1h”入院.查体未见明显异常,肿瘤标志物、血常规、肝肾功能、电解质均正常.CT:脾实质前部团块状稍低密度灶,边界不清,密度欠均匀,增强呈向心性强化,动脉期病灶边缘环状强化,门静脉期强化范围稍扩大,延迟期强化范围推进至病灶中央,但中央裂隙样低密度灶始终未见强化.