Determination of urinary calculi by binocular stereoscopic microscopy

Because of the inadequacies of chemical methods for identifying urinary calculi, mineralogical methods have been developed, but these methods are sometimes time consuming and expensive. The aim of the study was to evaluate urinary calculi with binocular stereoscopic microscopy (BSM), X-ray diffraction (XRD), scanning electron microscopy (SEM), and biochemical methods and to determine the specificity of BSM. A total of 30 pediatric patients with urinary calculi (17 girls and 13 boys), from 6 months to 19 years of age, were included in the study. The calculi obtained were evaluated with a Novex-AP 8 BSM, a Shimadzu 6000 XRD device, a Jeol JXA 733 SEM, and a biochemical kit from Merck. In 2 cases BSM rapidly determined that the material was not from the urinary system. Except for 2 cases, BSM results were identical to the results obtained by XRD. In 2 non-identifiable cases, the samples were struvite with an amorphous structure. The sensitivity of BSM was 93%. The small size of calculi did not permit biochemical analysis in 4 cases. In another group of 4 cases, the results of biochemical analysis did not agree with the XRD. In 7 cases, calcium phosphate was found by biochemical assay, although it was not confirmed by XRD. The sensitivity of biochemical analysis was 58%. BSM is more reliable than biochemical methods. BSM can be used for a rapid, reliable evaluation of the urinary calculi. It gives additional information about the nidus, the crystalline structure, and the order of deposition of components. The clinician can perform this investigation himself, obtaining very useful information about stone formation that allows an immediate start of medical treatment, decreasing recurrences. Received: 20 February 2001 / Revised: 15 November 2001 / Accepted: 17 December 2001     

贵州两种牛带绦虫感染免疫抑制小鼠生化指标的动态观察

目的 观察贵州省两种牛带绦虫感染小鼠生化指标动态改变。方法 将鉴定确认的都匀亚洲带绦虫和从江牛带绦虫成熟孕节内虫卵分别经次氟酸钠孵化后经皮下注射、感染小鼠，同时用地塞米松（1mg／d）皮下注射对小鼠进行免疫抑制。在40、60、75d剖杀，取血检测肝功能、肾功能、心肌酶等指标。结果肝功能TP、ALB、ALT、ALT、ASP随着感染时间延长有明显变化，肾功能指标BUN、CREA、UA，心肌酶CK、LDH明显升高，且随着囊尾蚴寄生时间延长，各种生化指标呈倍数递增。结论都匀牛亚洲带绦虫与从江牛带绦虫感染小鼠随时间延长。肝功能、肾功能、心肌酶都有明显改变，引起生化指标明显改变。     

286例非酒精性脂肪肝患者血液生化指标和肝纤维化指标的分析

目的:探讨血液生化和肝纤维化指标在非酒精性脂肪肝患者临床诊断中的意义。方法:对符合B超诊断的286例非酒精性脂肪肝患者进行血液生化指标(TG、TC、HDL-c、LDL-c、ALT、AST、GGT、ALP)和肝纤维化指标(PCⅢ、HA、CⅣ、LN)检测,并以体检健康者作为对照。结果:非酒精性脂肪肝患者TG和TC水平均高于对照组(P<0.01),HDL-c和LDL-c与对照组相比分别呈下降和升高的趋势;重度非酒精性脂肪肝组ALT、AST和GGT明显升高(P<0.01),ALP升高不显著(P>0.05);非酒精性脂肪肝患者PCⅢ、HA、CⅣ和LN均高于健康组(P<0.05),重度组与轻、中度组之间PCⅢ、HA、CⅣ和LN差异均有显著性(P<0.01),中度脂肪肝与轻度脂肪肝之间PCⅢ、HA、CⅣ和LN差异无显著性(P>0.05)。结论:非酒性脂肪肝患者多项血液生化指标异常,重度非酒性脂肪肝患者尚存在不同程度的肝纤维化趋向。多项血液生化指标的检测可作为非酒精性脂肪肝筛查的重要依据,而肝纤维化指标的检测可进一步作为非酒精性脂肪肝病情监控和疗效评估的重要依据。     

利用孕妇外周血作非侵入性产前检查的研究进展

近年来人们对利用孕妇外周血作非侵入性产前诊断 (因其材料简便易获 )的研究越来越多。非侵入性产前诊断可用于诊断常见的染色体疾病 ,检测胎儿性别 ,甚至诊断单基因遗传病等。对孕妇外周血的研究主要包括三方面的内容 :血清生化指标测定、胎儿有核红细胞 (NRBC)的研究及胎儿 DNA的研究等     

Beta-catenin and adenomatous polyposis coli (APC) mutations in adenomas from hereditary non-polyposis colorectal cancer patients

It is known that cisplatin (CDDP) potentiates the cytotoxicity of 5-fluorouracil (5-FU), and that the biochemical mechanism is an increase in the intracellular reduced folate levels in the tumor cells. We investigated the effect of consecutive administration with lower-dose CDDP on intracellular accumulation of reduced folate and the activity of methionine synthase, a key enzyme in intracellular methionine synthesis. When CDDP (1 mg/kg) was administered i.p. to ascitic Yoshida sarcoma-bearing rats for 4 consecutive days, both the reduced folate levels and methionine synthase activity in the cells significantly increased, as the same as a single 5 mg/kg dose of CDDP. Furthermore, when Yoshida sarcoma-bearing rats were pre-treated with 1 mg/kg CDDP for 5 consecutive days, [14C]L-methionine incorporation into the isolated ascitic cells was significantly inhibited as compared to that in non-treated cells, suggesting that consecutive administration of lower-dose CDDP is capable of inducing the intracellular modulation of reduced folate levels and methionine synthase activity via inhibition of cellular uptake of methionine. In addition, 5-day administration of lower-dose (1 mg/kg) CDDP potentiated the antitumor effect of 5 mg/kg S-1, a new oral preparation of tegafur, given for 7 consecutive days, and this combined effect was almost similar to the antitumor effect of a combination of S-1 and a single conventional dose (5 mg/kg) of CDDP. Consecutive lower-dose CDDP also may be concluded to act as an important modulator of the enhancement of 5-FU cytotoxicity in experimental tumors.     

Ultrastructure of Tri-Ortho-Cresyl Phosphate poisoning in the chicken

Summary Electron-microscopic investigations of the spinal cord in adult chickens poisoned with TOCP (Tri-Ortho-Cresyl Phosphate) show pathological alterations as early as the first day after appearance of the clinical symptoms. Of the same qualitative order as in the peripheral nervous system, they refer to the nerve fibres in the white matter in form of primarily diseased axons, with proliferation of the endoplasmic reticulum and disintegration of the neurofilaments. In the grey substance of the anterior horn, in particular, one sees severe structural alterations in the boutons terminaux while the motoneurons are hardly modified. The most striking finding already in the early stage is a massive swelling of the spherical synaptic vesicles in the boutons of theS-type, attributed to axo-somatic synapses.This work was supported by the Swiss National Foundation (Grant No. 3503). Part of the work was carried out at the Research Laboratory, McLean Hospital, Belmont/Mass. under the direction of J. D. Robertson.     

Postoperative 12-lead ECG predicts peri-operative myocardial ischaemia associated with myocardial cell damage

Peri-operative myocardial ischaemia is the single most important risk factor for an adverse cardiac outcome after non-cardiac surgery. The present study examines whether intermittent 12-lead ECG recordings can be used as an early warning tool to identify patients suffering from peri-operative myocardial ischaemia and subsequent myocardial cell damage. Fifty-five vascular surgery patients at risk for or with a history of coronary artery disease were monitored for peri-operative myocardial ischaemia using intermittent 12-lead ECG recordings taken pre-operatively and at 15 min, 20 h, 48 h, 72 h and 84 h postoperatively. The effectiveness of the 12-lead ECG was gauged by examining concordance with continuous 3-channel Holter monitoring and capturing peri-operative myocardial ischaemia by serial analyses of creatine kinase myocardial band isoenzyme and cardiac troponin T and I. The incidence of peri-operative myocardial ischaemia detected by 12-lead ECG was 44% and was identifiable in most patients (88%) 15 min after surgery. The incidence of peri-operative myocardial ischaemia detected by continuous monitoring was 53%, with the most severe episodes occurring intra-operatively and during emergence from anaesthesia. The concordance of the 12-lead method with continuous monitoring was 72%. The concordance of creatine kinase myocardial band isoenzyme activity with the 12-lead method was 71% and with Holter monitoring 57%. The concordance of mass concentration of creatine kinase myocardial band with 12-lead ECG recordings was 75%, and the corresponding value for Holter monitoring was 68%. The concordance of cardiac troponin T and I levels with the 12-lead method was 85% and 87%, respectively, and concordance with Holter monitoring was 72% and 66%, respectively. The postoperative 12-lead ECG identified peri-operative myocardial ischaemia associated with subsequent myocardial cell damage in most patients undergoing vascular surgery.     

Increased bone turnover as reflected by biochemical markers in patients with potentially unstable fixation of the tibial component

Introduction Whether biochemical markers of bone metabolism can be used in assessing the conditions of implant fixation is unknown. In this study, the serum levels of three bone markers were measured prospectively in patients undergoing total knee arthroplasty (TKA) to determine if patients with different fixation conditions of the tibial component showed any differences in the levels of the markers.Materials and methods The fixation of the tibial component in 40 knees (40 patients, 14 male and 26 female, average age 71 years) was assessed by radiostereometric analysis (RSA), and based upon the pattern of migration, implants with stable fixation (n=25) and potentially unstable fixation (n=15) were identified. Serum levels of carboxyterminal propeptide of type I procollagen (PICP), osteocalcin (OC) and cross-linked carboxyterminal telopeptide of type I collagen (ICTP) were assessed and compared between the two fixation groups. Blood samples were obtained preoperatively (baseline) and repeated postoperatively at 1 week, 3, 6, 12, and 24 months.Results The baseline levels of the markers were statistically the same (p>0.05) between the two fixation groups. Postoperatively, ICTP levels in the unstable group were significantly higher than in the stable group from 6 to 24 months (p=0.02). Levels of OC in the unstable group were higher at 12 and 24 months compared with the stable group, reaching statistical significance only at 12 months (p=0.03). No difference in the levels of PICP was found between the two groups.Conclusion The findings indicate a more active bone turnover probably at the bone-cement/implant interface in knees with potentially unstable fixation. It reveals the potential value for biochemical markers in monitoring implant fixation and aseptic loosening and suggests a possibility for improving implant fixation by drugs which inhibit osteolysis.     

Prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women

Hypovitaminosis D can result in low bone mass. The prevalence of hypovitaminosis D has public health implications, especially where data are lacking. Since diet and sunlight are the two souces of vitamin D, the results obtained in one geographical region may not be universally applicable. The aim of this study is to characterize the prevalence and seasonal variation of hypovitaminosis D and its relationship to bone metabolism in community dwelling postmenopausal Hungarian women. We determined serum levels of 25-hydroxyvitamin D (25-OH-D), PTH, osteocalcin (OC), degradation products of C-terminal telopeptides of type-I collagen (CTx), dietary calcium intake and BMD at L2–L4 lumbar spine (LS) and femur neck (FN) in 319 randomly selected ambulatory postmenopausal women. The prevalence of hypovitaminosis D (serum 25-OH-D50 nmol/l) was 56.7%. On comparing patients with normal and low 25-OH-D, a significant difference was found in age (61.6±8.5 years versus 67.3±9.9 years; P<0.001), PTH (3.9±1.9 pmol/l versus 4.3±2.7 pmol/l; P<0.05), FN BMD (0.802±0.123 g/cm² versus 0.744±0.125 g/cm²; P<0.001) and dietary calcium intake (714.4±199.4 g/day versus 607.9±233 g/day; P<0.001). Osteoporotic patients had a significantly lower 25-OH-D (37.6±19.8 nmol/l versus 56.4±24 nmol/l; P<0.001) and dietary calcium intake (519.2±244.5 mg/day versus 718.2±164.3 mg/day; P<0.001). After controlling for all other variables, 25-OH-D was found to be significantly associated with age, the average hours of sunshine in the 3 months prior to 25-OH-D level determination and dietary calcium intake (r ²=0.190; P<0.001). For FN BMD, significant independent predictors were age, body mass index, 25-OH-D and dietary calcium intake (r ²=0.435; P<0.001). The prevalence of hypovitaminosis D during spring, summer, autumn and winter was 71%, 46.3%, 49.4% and 56.7%, respectively. There was significant seasonal variation in 25-OH-D, PTH, OC, calcium intake and FN BMD. There is a high prevalence of hypovitaminosis D in healthy postmenopausal Hungarian women, and FN BMD is associated with serum 25-OH-D and dietary calcium intake.     

The effect of 1-year transdermal estrogen replacement therapy on bone mineral density and biochemical markers of bone turnover in osteopenic postmenopausal systemic lupus erythematosus patients: a randomized,double-blind,placebo-controlled trial

We studied the effect of 1-year transdermal estrogen replacement therapy (ERT) on bone mineral density (BMD) and biochemical markers of bone turnover in osteopenic postmenopausal systemic lupus erythematosus (SLE) patients in a randomized, double-blind, placebo-controlled trial. SLE patients were randomly allocated to treatment (estradiol; 50 g transdermal 17-estradiol; n=15) or placebo (n=17) group. Both groups received 5 mg continuous oral medroxyprogesterone acetate, 500 mg calcium and 400 IU vitamin D₃. L₁–L₄ spine (LS), left femur and total hip BMD were measured at baseline and at 6 and 12 months. Serum osteocalcin (OC) and degradation products of C-terminal telopeptides of type-I collagen (CTx) levels were measured at baseline and 3, 6, 9, and 12 months. There was a significant difference in the percentage change of LS BMD at 6 months between the two groups (103.24±3.74% (estradiol group) vs 98.99±3.11% (placebo group); P<0.005). There was a significant decrease within the estradiol group in the CTx levels between baseline and all subsequent visits (P<0.05). There was no significant difference in SLE disease activity index, Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) damage index and corticosteroid dose during the study period. Transdermal estradiol may prevent bone loss in postmenopausal SLE women at the lumbar spine and femur, with no increase in disease activity among postmenopausal SLE women receiving transdermal ERT. The high dropout rate (8/15) leads us to the conclusion that efficacy of HRT in a high-risk group such as SLE women can be attained only in a small number of patients, provided all inclusion/exclusion criteria are strictly adhered to.