Oligodendroglioma with unusual meningeal spread

Summary An oligodendroglioma with an unusual generalized meningeal spread is reported. The generalization is hardly due to therapeutic procedures, and the case may therefore contribute to a modification of the conception of the oligodendrogliomas.

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Zusammenfassung Ein Oligodendrogliom mit ungewöhnlicher generalisierter meningealer Aussaat wird berichtet. Die Generalisation kann kaum auf therapeutische Eingriffe bezogen werden. Der Fall mag daher zu einer Modifizierung der Auffassung der Oligodendrogliome beitragen.

     

Use of complex surgical procedures,patterns of tumor spread,and CA-125 predicts a risk of incomplete cytoreduction: A Korean Gynecologic Oncology Group study (KGOG-3022)

Objectives

We aimed to develop a risk model to predict a risk of suboptimal cytoreduction in primary surgery of ovarian cancer.

Methods

The clinical records and computed tomography (CT) data of 358 patients with stages II–IV epithelial ovarian cancer were reviewed. Tumor spread patterns identified by principal component analysis, CA-125, and a newly developed surgical skill index were integrated into a logistic model along with other variables. Internal validation was performed using bootstrapped re-sampling and calibration was assessed by goodness-of-fit test.

Results

Among the 358 patients, optimal cytoreduction, which was defined as no residual tumor, was achieved in 145 patients (40.5%). The surgical capacity of an individual institution was estimated by a surgical skill index, which was the frequency of complex surgeries in patients with advanced disease. In a multivariate model, two distinctive CT patterns of tumor spread (diffuse spread pattern and upper abdominal extension pattern), a surgical skill index, and serum CA-125 independently predicted a risk of suboptimal cytoreduction (P = 0.006, P = 0.013, P = 0.031, and P = 0.001, respectively). The model showed a C-statistic of .73 (95% confidence interval .67 to .79), which was significantly higher than tumor stage or ascites. Rigorous internal validation by bootstrapped re-sampling successfully confirmed the model.

Conclusions

We identified two distinct tumor spread patterns of ovarian cancer, which can be integrated to improve a prediction model. Our model may be useful in patient referral or clinical trials for patient stratification.     

Mycobacterium avium uses apoptotic macrophages as tools for spreading

Background

Mycobacterium avium (MAC) lives and replicates in macrophages and causes disseminated disease in immunocompromised individuals. As a host response to control disease, many macrophages become apoptotic a few days after MAC infection. In this study, we hypothesized that MAC can survive autophagic and apoptotic macrophages and spread.

Methods

Electron, time-lapse video, fluorescence microscopy. Apoptosis was determined by ELISA and TUNEL assays. Autophagy was seen by migration of LC3-1.

Results

Apoptotic macrophages harbor chiefly viable MAC. MAC escapes both the vacuole and the macrophage once apoptosis is triggered, leaving the bacteria free to infect nearby macrophages in the process of spreading. In addition, some MAC species will have apoptotic bodies and are released in healthy macrophages following apoptotic body ingestion. Because autophagy precedes apoptosis, it was established that heat-killed MAC, and viable MAC induces autophagy in macrophages at similar rates, but MAC still survives.

Conclusion

MAC spreading from cell-to-cell is triggered by the macrophage’s attempt to kill the bacterium, undergoing apoptosis.     

微博时代的中医药文化传播创新路径探讨

微博的出现极大地改变了信息的传播方式,也为中医药文化的传播开辟了一条新的途径。本文通过回顾当前中医药文化的传播路径及微博在信息传播中的特点,提出将微博用于中医药文化的传播当中,并对未来的研究及工作进行了展望。研究结果有助于中医药文化传播路径的创新。     

Spatial spread of neural excitation: comparison of compound action potential and forward-masking data in cochlear implant recipients

The feasibility of using the electrically evoked compound action potential (ECAP), measured with the NRT system (Neural Response Telemetry) and the NRT software (version 2.04), to quantify the longitudinal spread of neural excitation was examined in four subjects fitted with the Nucleus CI24M cochlear implant. The ECAP and psychophysical forward-masking profiles were measured using stimulation on each of three electrodes, in basal, middle and apical positions. Spatial spread profiles derived from the ECAP measure produced broader functions than those derived from the psychophysical measure. These results, together with investigation of the change of ECAP spread pattern with stimulation current, suggest that functions derived from this ‘simple’ method were more influenced by the spread of electric field from excited neuron to electrode array than by breadth of the neural excitation pattern. The recently released NRT version 3.0 permits the masker and probe pulses to be delivered to separate electrodes, thus removing a fundamental limitation of version 2.04. Results from a pilot study, in which this capability was exploited, suggest that the spatial functions from this ‘advanced’ method may provide a better correlation with results from psychophysical forward masking.     

Biomechanical evaluation of different abduction splints for the treatment of congenital hip dysplasia

Background

Abduction splints for the treatment of hip dysplasia normally operate on curbing the legs at the hip flexion and abduction. The forces are absorbed in different designs of shoulder straps and thus diverted to the shoulder and the spine. The present study is the first comparing these undesired forces of two spread orthoses and subsequently the transmitted forces to the infant's spine.

Methods

Between March 2009 and October 2009 the hips of 290 infants were investigated by ultrasound within the first 3 days after birth. Thereof 20 infants with a hip dysplasia Graf type IIc, D or IIIa met our inclusion criteria and were investigated with a Tübinger and a Superior abduction splint. Biomechanical evaluation was performed by using a high-sensitive strain gauge sensor applied to the infant's orthoses between pelvic harness and shoulder straps.

Findings

The transmitted forces to the infant's shoulders correlated significantly with their body mass (P < 0.05). Maximal forces on the shoulder of the infants and subsequently transmitted forces on the spine were significantly higher (P < 0.05) with the Tübinger splint (range 7.6 N to 32.3 N; arithmetic mean M: 13.7 N) in comparison to the Superior orthosis (range 0.0 N to 3.5 N; M: 0.7 N).

Interpretation

The Superior orthosis works with primary load transmission to the pelvic bone. Using the Tübinger splint the shoulders of the newborn infants are loaded with a maximum of 93.9% of their body mass. This may influence the development of the growing infant's spine.     

散结膏的制备与质量控制

目的制备散结膏,建立散结膏的质量控制方法。方法以大黄、当归、香附、柴胡、黄芪等为组方制备散结膏;采用薄层色谱(TLC)法对当归、香附、柴胡、黄芪进行鉴别,并利用高效液相色谱(HPLC)法测定大黄中的大黄素的含量。结果所制制剂为棕黑色软膏,各项检查均符合《中国药典》相关规定,大黄素检测的线性范围0.04~0.40μg/m l(r=0.999 9),平均回收率为100.29%(RSD=1.79%,n=6)。结论该制剂制备工艺简单可行,所建立的质量控制方法可靠,制剂质量稳定。     

医学图书馆为继续医学教育服务浅议

作为医学信息集散地和知识传播前沿的医学图书馆在21世纪应尽快转变职能方式，增加服务手段，以继续教育的蓬勃开展为契机，充分发挥图书馆应有的作用。调整馆藏结构，用现代思想观念指导服务，同时重视发挥馆员的知识传播和宣传辅导作用，帮助读者有针对性地利用图书馆资源，达到继续医学教育的目的，从而进一步推动医学的发展。