Contrast-enhanced color Doppler ultrasonography in suspected parathyroid lesions

Purpose: To assess the usefulness of US contrast media in the evaluation of patients with primary hyperparathyroidism, with a nodule showing US features of a primary parathyroid lesion but lacking the color Doppler US appearance of a parathyroid mass.Material and Methods: Thirteen patients (7 female, 6 male; age range 51-79 years) were examined with US before and after administration of a stabilized galactose-based microbubble contrast agent. Ten patients underwent surgery and the final histological examination demonstrated parathyroid adenoma in 9 cases and a mesenchymal benign nodule in 1 case. Three nodules were proved to be of thyroid origin at fine-needle aspiration biopsy.Results and Conclusion: The use of a US contrast agent resulted in a diagnostic gain compared to unenhanced studies in 12/13 cases. Color Doppler findings characteristic of parathyroid lesions were observed in 7/13 cases, of thyroid nodules in 4/13 cases, and nonspecific patterns in 2/13 cases. Contrast-enhanced color Doppler US can be proposed in selected patients in whom unenhanced color Doppler provides uncertain findings. Its ideal application should be the evaluation of cervical lesions without detectable intranodular flow at unenhanced Doppler studies. In these cases, the contrast agent helps in visualizing typical color Doppler signals of the parathyroid lesions ("vascular pole" and "mixed pattern").     

ISO9000族标准导入下社区卫生服务中的医患沟通

将ISO9000族标准导入社区卫生服务质量管理使卫生工作要求客观化、标准化,也使社区卫生服务医惠沟通内涵曼丰富、外延得到扩展.文章将社区卫生服务中的医患沟通分为五环节,说明ISO9000族标准八项基本原则提出的新要求,并按照PDCA循环分析了在实施族标准过程中医患沟通质量管理各阶段基本工作要求和方法.     

Immunity in lamprey III. Occurrence of the complement-like activity

The serum of Arctic lampreys (Lampetra japonica) lyses rabbit erythrocytes (E^R), with optimal activity at 4°C. This lytic activity is relatively heat stable, is inactivated after incubation with zymosan (5 mg/ml) for 1 hr at 15°C, and is controlled by Mg⁺⁺ dependent factors present in normal lamprey serum. Hemolysis of sheep erythrocytes (E^S) was obtained with lamprey hemolysin using bullfrog serum as complement (C). The optimal conditions were established for sensitizing E^S with lamprey hemolysin to fix bullfrog C. Under the same conditions hemolysis was not induced with zymosan-treated bullfrog C and lamprey serum. These findings suggest that lamprey serum possesses components that function via the alternate pathway, instead of the classical pathway usually found in more advanced vertebrates.     

Effect of glutamine on preimplantation mouse embryo development in vitro

OBJECTIVES: The purpose of this research was to study the independent effect of the amino acid glutamine on preimplantation mouse embryo development in vitro. STUDY DESIGN: Two-cell stage mouse embryos were cultured in human tubal fluid medium in the presence and absence of 1 mmol/L of glutamine. Outcomes for morphology and cleavage rates were compared with Fisher's and Mann-Whitney's tests, respectively. RESULTS: Glutamine increased the proportion of embryos that developed to the blastocyst stage (86.4%) compared with those cultured without glutamine (59.1%) (P =.052). The percentages of embryos developing to the morula or hatching blastocyst stages were comparable in the 2 groups. Blastocyst total cell numbers were significantly higher in the glutamine group (34+/-1.7 vs 18.5+/-3.5, respectively; values are mean+/-SEM, P =.044). CONCLUSION: The amino acid glutamine independently improves preimplantation mouse embryo development in vitro. Further studies are needed to examine the applicability of these results to humans.     

Detection rates of bacteria in chronic otitis media with effusion in children

This study was performed to investigate polymerase chain reaction-based detection of bacterial DNA in middle ear fluid and assess the correlation between the PCR-positive rate with several factors associated with middle ear effusion. The purpose was to gain a further understanding of bacterial infection as a major cause of otitis media with effusion. Of the 278 specimens of middle ear fluid, 39 (14%) tested positive by ordinary culture. The overall detection rate of bacterial DNA using the PCR method was 36.7% for middle ear effusion, and bacterial DNA detection rates of Hemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis in the middle ear effusion were 29.1%, 4.7% and 10.8%, respectively. The bacterial DNA detection rate was higher in ears with a history of acute otitis media than those without the history. High detection rates were observed in patients younger than 48 months who have had a higher tendency to present with acute otitis media. We concluded that PCR is a more sensitive method for the detection of bacteria in middle ear effusion than ordinary culture, and acute otitis media is a major contributor to the pathogenesis of otitis media with effusion.     

Contrast-enhanced MR imaging of experimental acute tubular necrosis

Purpose: To demonstrate the involvement of the various renal structures in acute tubular necrosis (ATN).Material and Methods: In 15 rats, using a T1-/T2-weighted sequence, either gadodiamide alone, or gadodiamide in combination with sprodiamide (a susceptibility agent) were used to enhance the various anatomical substrates of the kidney. The results were compared to those of pathological verification.Results: Experimentally induced ATN of the rat kidney causes profound changes in the medulla, leaving the cortex largely intact. The difference between the normal cortex and the partially necrotic outer medulla, on the one hand, and the papillary region, was significantly enhanced with the combination, whereas a larger region composed of the inner and outer medulla was enhanced after the gadolinium chelate alone.Conclusion: The results varied considerably between the two procedures; the double contrast demonstrated a clear difference between the inner and outer medulla, and the gadolinium chelate alone demonstrated a clear difference between the medulla and the cortex. These results demonstrated a clear difference in the compartmentalization between the inner and outer medullary regions, providing complementary information about the pathological condition of the kidney.     

传媒社会学顽野中的医患纠纷

探讨了医患纠纷是如何被纳入传媒的视野,并成为它关注的"焦点"。研究发现,媒体利益的二重性,新闻工作者的利益驱动,电视(或视频)的力量以及受众的力量是医患纠纷被纳入传媒视野的内在动力。换言之,医患纠纷成为传媒关注的"热点"是在把关人和受众的"合谋"下完成的。     

Spinal Cord Infarction Following Vertebral Angiography: Clinical and Pathological Findings

Abstract

Spinal cord damage from radiographic contrast material has been known to occur in both spinal and nonspinal angiographic procedures. Reported here is cervical spinal cord injury (SCI) during vertebral angiography. During the procedure, the patient displayed signs of acute cervical spinal cord irritation that should have been taken as a warning of impending injury. Autopsy 9 years later showed evidence of central cervical spinal cord necrosis. The pathological findings are similar to those seen in animal models of contrast media-induced SCI; and the pathophysiological mechanisms of such injury are discussed.