Coronary artery bypass grafting with bilateral internal thoracic arteries for Bland-White-Garland syndrome in an adult

A 46-year-old man with anomalous origin of the left coronary artery from the pulmonary artery (Bland-White-Garland syndrome) is reported. We successfully performed coronary artery bypass grafting with the use of bilateral internal thoracic arteries and ligation of the anomalous left coronary artery. The patient was discharged from the hospital after an uneventful postoperative course and postoperative coronary angiography, which revealed patent internal thoracic arteries and no leakage of blood flow from the anomalous left coronary artery to the pulmonary artery. This surgical procedure is technically simple and useful for adult patients with Bland-White-Garland syndrome. To our knowledge, this is one of only a few reports on coronary artery bypass grafting with bilateral internal thoracic arteries as a treatment of Bland-White-Garland syndrome.     

X‐ray studies on crystalline complexes involving amino acids and peptides. XXXVI. Crystal structures of hydrated glycyl‐l‐histidine andl‐histidyl‐l‐alanine complexes with oxalic acid

Abstract: The crystal structures of the complexes of oxalic acid with glycyl‐l ‐histidine and l ‐histidyl‐l ‐alanine were determined. The three crystallographically independent peptide molecules in the complexes have closed conformations. The terminal carboxyl group of the dipeptide and the oxalate ion in the Gly–His complex exhibit unusual ionization states and are connected by a symmetric O‐ ‐ ‐O hydrogen bond. The peptide aggregation in the complex is almost identical to that in the corresponding semisuccinate complex and is similar to one of the predicted aggregation patterns for Ala–Ala, demonstrating that dipeptide aggregation is controlled primarily by main‐chain interactions and is substantially unaffected by disturbing influences such as those arising from polar side chains, ions and water molecules. The peptide molecules in the highly pseudosymmetric crystals of the His–Ala complex, however, exhibit a hitherto unobserved aggregation pattern. Thus, in spite of the repeated occurrence of a few patterns, the possibility of the existence of new patterns needs to be taken into account.     

Myelodysplastic syndromes: Their history,evolution and relation to acute myeloid leukaemia

Summary The myelodysplastic syndromes (MDS) constitute a heterogeneous group of clonal disorders arising from a multipotent haemopoietic progenitor which share a leukaemic propensity, 30% of cases culminating in acute myeloid leukaemia (AML). Their pathogenesis probably entails multiple steps, phenotypic progression being determined by either expansion or evolution of the abnormal clone. The clonal origin of certain cases of de novo AML is analogous to that of MDS and evidence that they share a common pathogenesis and distinct biological characteristics is beginning to emerge.D. M. Layton is supported by a grant from the Leukaemia Research Fund.     

Acephalic spermatozoa and abnormal development of the head-neck attachment: a human syndrome of genetic origin.

A series of 10 young sterile men with acephalic spermatozoa or abnormal head-mid-piece attachments is presented. Nine of these patients had 75-100% spermatozoa with minute cephalic ends and 0-25% abnormal head-middle piece attachments. Loose heads ranged between 0-35 for each 100 spermatozoa and normal forms were rare. Two patients were brothers. On ultrastructural examination, the head was generally absent and the middle piece was covered by the plasma membrane. When present, heads implanted at abnormal angles on the middle piece. A testicular biopsy showed abnormal spermiogenesis. The implantation fossa was absent and the flagellar anlage developed independently from the nucleus, resulting in abnormal head-middle piece connections. In one patient azoospermia was induced with testosterone to attempt to increase the normal sperm clone during the rebound phenomenon, but all newly formed spermatozoa were acephalic. In another patient with high numbers of defective head-mid-piece connections, microinjections of spermatozoa resulted in four fertilized oocytes, but syngamy and cleavage did not take place, suggesting an abnormal function of the centrioles. The findings indicate that acephalic spermatozoa arise in the testis as the result of an abnormal neck development during spermiogenesis. The familial incidence and the typical phenotype strongly suggest a genetic origin of the syndrome.     

儿童冠状动脉异常起源肺动脉的16层螺旋CT诊断

目的 评价儿童冠状动脉异常起源肺动脉的多层螺旋CT(MSCT)诊断价值.资料与方法 MSCT应用于8例冠状动脉异常起源肺动脉患儿检查中,平均年龄4.12岁(5个月～10岁),其中4例采用无心电门控CT血管成像,MSCT参数:准直0.625～1.25mm,层厚0.625～1.25mm,螺距为0.562,旋转速度0.5s/r,床进5.62mm/r,0.31～0.625mm重建间隔,4例采用回顾性心电门控.结果 8例冠状动脉起始、右冠状动脉近端、左冠状动脉主干、左前降支及左回旋支近端显示率100%.7例左冠状动脉异常起源于肺动脉瓣窦上的肺动脉总干,1例右冠状动脉异常起源于肺动脉总干右后壁,1例伴右上肺静脉异位引流入上腔静脉,1例伴右冠状动脉高位开口.结论 冠状动脉异常起源肺动脉为少见的先天性心脏病,MSCT可作为一种可靠的,有潜力的无创伤性诊断方法 应用于其诊断中.     

肾细胞癌的细胞起源:肾脏特异性单克隆抗体的免疫组化研究

近年公认肾细胞癌起源于近曲小管,作者应用4种肾小管抗原的单克隆抗体(mAb)对38例成人肾及32例肾细胞癌进行免疫组化研究;发现这些mAb在肾脏有稳定的染色类型,肾细胞癌多数表达近曲小管抗原,少数表达远曲小管、集合管抗原。经肿瘤细胞类型分析,透明细胞癌主要起源于近曲小管,颗粒细胞癌可能起源于远曲小管。     

超声心动图诊断单纯右肺动脉异常起源于升主动脉

目的 探讨单纯右肺动脉异常起源于升主动脉的超声心动图诊断价值.方法 回顾性分析5例单纯右肺动脉异常起源于升主动脉患者的超声心动图特征.结果 5例右肺动脉均起源于升主动脉近端左后壁,除合并动脉导管未闭外,无其他心内畸形;均存在重度肺动脉高压.3例手术,1例术前漏诊动脉导管未闭,1例院外多次彩色超声漏诊右肺动脉异常起源或误诊为大动脉转位.结论 单纯右肺动脉异常起源于升主动脉在解剖、血流动力学上有许多相似之处,把握共性并多部位、多切面探测有助于超声心动图作出准确诊断并减少漏、误诊.     

基于microRNA表达的肿瘤起源分类

摘要： 由于采用标准诊断方法难以识别癌变的原发部位,诊断新发的癌症中约有3%~5%来源于原发部位不明的肿瘤。MicroRNAs（miRNAs）近来被证实能够协助病理学家提高对原发部位不明肿瘤的诊断准确性。本文将着重讨论基于肿瘤诊断的miRNA最新研究进展,及该领域的未来发展方向。