Infarction of omentum and epiploic appendage: Diagnosis, epidemiology and natural history

Epiploic appendagitis and segmental omentum infarction are considered to be rare conditions, which may mimic an abdominal surgical emergency. The purpose of our study was to describe clinical findings, US and CT appearance of infarction of an epiploic appendage and omentum, and to determine their epidemiological characteristics and natural history. We retrospectively studied clinical, US and CT findings at hospital admission and follow-up of all patients who were diagnosed at our institution with epiploic appendagitis or omentum infarction between June 1988 and November 1997. We found a relatively high incidence of 40 cases: 20 patients with epiploic appendagitis, 11 with omentum infarction, and 9 in whom it was not possible to discriminate between the both. All 40 patients recovered under conservative treatment without complications. We conclude that US and CT features allow a reliable diagnosis, thereby obviating unnecessary surgery. Discriminating between both conditions is of no practical relevance since treatment and prognosis are identical. Received: 30 November 1998; Revised: 30 March 1999; Accepted: 6 September 1999     

Recent status of primary sclerosing cholangitis in Japan

Patients with primary sclerosing cholangitis (PSC) in Japan have two peaks in age distribution, one in their twenties and the other in their fifties and sixties. PSC patients in Japan have different characteristics from those in other countries: there is a higher incidence of eosinophilia (27%) and positivity for anti-nuclear antibody (30%), less frequent complication with inflammatory bowel diseases (IBD; 21%), and more frequent complication with chronic pancreatitis (15%). In younger patients in Japan (those aged less than 40 years), the incidence of positivity for anti-nuclear antibody was lower (20% vs 38% P < 0.05), complication with IBD was more frequent (39% vs 9% P < 0.01), complication with chronic pancreatitis was less frequent (4% vs 22% P < 0.01), and damage to both the intra- and extrahepatic bile ducts was more frequent (89% vs 56% P < 0.01) than in older patients (those aged 40 years or more). These findings suggest that younger PSC patients in Japan have characteristics similar to those of patients in other countries, and that in Japan older PSC patients have a different pathogenesis from that of younger patients. Received for publication on Feb. 16, 1999; accepted on April 5, 1999     

急性非淋巴细胞白血病中MGMT与p53基因突变的研究

目的 探讨肿瘤抑制基因ｐ５３、ＭＧＭＴ在急性非淋巴细胞白血病（ＡＮＬＬ）中的改变。方法 用聚合酶链反应－单链构象多态性（ＰＣＲ－ＳＳＣＰ）技术对３１例ＡＮＬＬ患者、２２例正常人ｐ５３基因第５、６、７、８外显子和ＭＧＭＴ基因第１、４外显子进行突变分析。结果 ３１例ＡＮＬＬ中５例存在ｐ５３基因突变、４例存在ＭＧＭＴ基因突变,其中２例ｐ５３与ＭＧＭＴ同时发生突变。结论 ｐ５３基因突变在白血病发生中起一定     

急性白血病抗凋亡基因BCL-2的表达及其意义

目的：探讨ＢＣＬ－２基因转录在急性白血病中的作用。方法：应用逆转录／聚合酶链反应（ＲＴ－ＰＣＲ）检测２０例急性白血病患者细胞中ＢＣＬ－２ｍＲＮＡ的表达。结果：９例完全缓解（ＣＲ）患者中２例（２２．２％）呈ＢＣＬ－ｍＲＮＡ阳性,而１１例不缓解（ＮＲ,包括难治及复发）患者均呈ＢＣＬ－２ｍＲＮＡ阳性（１００％）,两组ＢＣＬ－２ｍＲＮＡ阳性比例的差异非常显著（Ｐ＜０．０１）。结论：急性白血病ＢＣＬ－２的表达升高可直接影响化疗效果,且是判断患者预后的有用指标。     

T gamma/delta lymphocytes in renal transplant recipients.

T gamma/delta lymphocytes are able to perform allospecific cytotoxicity and natural killer cytotoxicity in vitro. However, very little is known about their function in vivo. To investigate the possible involvement of T gamma/delta lymphocytes in the immune response to renal allografts, fine-needle aspiration biopsies and peripheral blood of 15 renal transplant recipients were studied during the first 4 weeks after transplantation. In addition peripheral blood of patients before transplantation, half a year and one year after transplantation was studied. No increase in the percentage of T gamma/delta lymphocytes in the fine-needle aspiration biopsies, including those taken during acute rejection episodes, was found. A significant decrease in the percentage of T gamma/delta lymphocytes was observed in peripheral blood after transplantation. We conclude that T gamma/delta lymphocytes seem to play no major role in the immune response to renal allografts.     

Comparative patterns of i-antigen expression, F-cell frequency and Hb A2 level in acute myeloid leukemia and in acute lymphoid leukemia

Hb F, Hb A₂ and i-antigen expression were investigated in adulthood acute leukemias. The study of i-antigen expression by immuno-agglutination and immunofluorescence showed that it is preferentially increased among AML patients. A similar result was obtained for F-cell frequency which was often increased in AML, while it was normal in ALL. Hb A₂ level was significantly lower in AML than in ALL. These differences between AML and ALL red cell patterns further suggest that the leukemic clone involves the erythroid lineage in AML but not in ALL.     

纳洛酮加清开灵治疗野生蕈中毒30例疗效观察

目的：观察纳洛酮与清开灵合用治疗急性野生蕈中毒的临床疗效。方法：采用随机数字表法将86例患者随机分为3组。治疗组30例以纳络酮加清开灵治疗，纳洛酮组26例单用纳洛酮治疗，清开灵组30例单用清开灵治疗。观察3组患者症状好转时间、症状消失时间、重症清醒时间。治疗5天为1疗程，共治2－8疗程。结果：治疗组在症状好转时间、症状消失时间、清醒时间均明显短于纳洛酮组和清开灵组（P＜0．05，P＜0．01）。结论：纳洛酮与清开灵合用，可以从不同途径作用于脑组织，尽快改善中毒症状，减少脑损伤，二者合用尚可减少纳洛酮的用量，从而减少纳洛酮的心血管效应。     

同胞脐血移植治疗儿童急性白血病

脐血移植可以根治白血病、再生障碍性贫血、血红蛋白病及先天性免疫缺陷等疾病，尤其适合于儿童患者。临床资料表明同胞脐血移植的效果优于无关供者的脐血移植。对12例白血病或重症再障患儿进行了脐血HLA配型，结果配型完全相合4例，进行脐血移植3例，均成功植活，体重最大50kg。可以在胎儿出生时留取脐血配型，同时将脐血进行低温保存。提示剖宫产和自然分娩、体内采集脐血和体外采集脐血对脐血的采集体积无明显影响。单份同胞脐血可以重建几乎全部儿童患者的造血功能。对同胞脐血移植的病例，主张在分娩时留取脐血进行HLA配型，减少产前穿刺对孕妇及胎儿的损伤，同时脐血进行冷冻，若配型相合再进行脐血移植。