轮状病毒中枢神经及肺部感染

研究背景 轮状病毒性胃肠炎是婴幼儿期最常见腹泻疾病之一。国内外对轮状病毒中枢神经及肺部感染告道甚少。 研究方法 用电镜、免疫电镜、酶联免疫吸附与阻断试验确诊轮状病毒中枢神经及肺部感染。 研究结果 200例轮状病毒性胃肠炎患儿中,并发轮状病毒性脑膜炎一例,轮状病毒性肺炎2例,其中1例同时合并胸膜炎、胸腔积液。 结论 轮状病毒中枢神经及肺部感染预后良好。     

Extracorporeal membrane oxygenation (ECMO) as lung or heart assist

Extracorporeal membrane oxygenation (ECMO) may serve as extracorporeal lung assist (ECLA) in patients with acute respiratory failure (ARF) or as extracorporeal heart assist (ECHA) in patients with low output syndrome (LOS) after open heart surgery. From 1988 to 1992 seven patients underwent ECMO in our hospital; four suffered from ARF and three from LOS. Various bypass techniques were employed. Two ARF patients, aged 58 and 18 years, had veno-venous bypass; in the latter, ECMO was reinstituted as a veno-arterial bypass one week after weaning. In a three-year-old boy, the ECMO outflow tubing was primarily connected to the pulmonary artery, and shortly afterwards relocated to the common carotid artery. In a 31-year-old man with ARF, and three LOS patients, a 56-year-old woman, and two men aged 68 and 70 years, ECMO was veno-arterial with direct access to the ascending aorta. A heparin-coated system was used, and all but one patient, who was treated with warfarin, received a daily low dose of heparin, which was withdrawn after from one to nine days.
Six patients were weaned off ECMO after 4.5 to 21 days. Three ARF patients recovered completely; the child died. In one LOS patient, ECMO was withdrawn due to a poor general condition. Two others were weaned off ECMO and the intra-aortic balloon pump, and the inotropic support was significantly reduced, but both died of multiple system organ failure. Although no firm conclusions can be drawn from these few case reports, the heparin-coated system used as ECLA appears promising, whereas ECHA seems to imply a poor prognosis in patients who are not candidates for cardiac transplantation.     

Asbestos fiber type in malignant Mesothelioma: An analytical scanning electron microscopic study of 94 cases

Although the association between asbestos exposure and malignant mesothelioma is indisputable, controversy continues regarding the relative contribution of the various types of asbestos fibers to the development of mesothelioma. We examined the types of asbestos fibers recovered from lung parenchyma in more than 90 cases of malignant mesothelioma from the United States, using an analytical scanning electron microscope. Almost half of the patients were former asbestos insulators or shipyard workers. The fibers were recovered from lung tissues obtained at autopsy or surgical resection by means of a sodium hypochlorite digestion procedure. Amosite absestos was identified in 81% of the cases and accounted for 58% of all fibers 5 μm or greater in length. Tremolite/actinolite/anthophyllite were identified in 55% of the cases and accounted for 10% of all fiber types. Chrysotile was identified in 21% of the cases and accounted for 3% of fibers exceeding 5 μm in length. Crocidolite was found in 16% of the cases and accounted for 3% of fibers exceeding 5 μm in length. Nonasbestos mineral fibers (commonly found in the lungs of the general population) were observed in 71% of the cases and accounted for 25% of all fibers 5 μm or greater in length. The findings in this study are at odds with the assertion that crocidolite asbestos is responsible for most mesotheliomas in the United States. © 1993 Wiley-Liss, Inc.     

In vivo multiple-mouse imaging at 1.5 T.

A multiple-mouse solenoidal MR coil was developed for in vivo imaging of up to 13 mice simultaneously to screen for tumors on a 1.5 T clinical scanner. For the coil to be effective as a screening tool, it should permit acquisition of MRIs in which orthotopic tumors with diameters >2 mm are detectable in a reasonable period of time (<1 hr magnet time) and their sizes accurately measured. Using a spin echo sequence, we demonstrated that this coil provides sufficient sensitivity for moderately high resolution images (156-176 microm in plane-resolution, 1.5 mm slice thickness). This spatial resolution permitted detection of primary brain tumors in transgenic/knockout mice and orthotopic xenografts. Brain tumor size as measured by MRI was correlated with size measured by histopathology (P < 0.001). Metastatic tumors in the mouse lung were also successfully imaged in a screening setting. The multiple mouse coil is simple in construction and may be implemented without any significant modification to the hardware or software on a clinical scanner.     

用显微分光光度计对几种不同类型肺癌癌细胞DNA含量的初步观测

本文用显微分光光度计对39例手术切除的不同组织学类型的人体肺癌标本癌细胞核的DNA含量进行了测量。其中高、中、低分化的鳞癌分别为3、6和5例;高、中、低分化的腺癌分别为3、5和5例;未分化癌大细胞型和小细胞型各为3例和6例。结果发现各类型肺癌的DNA含量均有统计学上的差异(P<0.01)。各DNA含量直方图的峰值部位及分布范围亦不同。从而提示了根据DNA含量的不同,可能有助于肺癌组织学类型及其分化程度的判别:而DNA含量直方图对肺癌类型的判别亦可能是有益的。     

肺肿瘤细胞雌激素、孕激素和凝集素受体的组化研究

用酶联亲合组化法对46例肺肿瘤细胞进行了雌激素受体(ER)和孕激素受体(PR)检测。同时测定14例肺瘤肿患者血清雌二醇(E_2)浓度。结果表明:肺肿瘤 ER 阳性率为36.9%,PR 阳性率为13.0%。阳性率与性别、病理类型及血浆 E_2浓度无关。认为肺癌的发生发展可能与雌激素有依赖关系,提示内分泌疗法可能会成为原发肺肿瘤的一种治疗手段。另用 ABC 法对上述46例肺肿瘤中的29例进行了花生凝集素受体(PNA-R)和麦胚凝集素受体(WGA-R)的检测,PNA-R 在腺癌大都为顶浆型分布,鳞癌和透明细胞癌则多为胞膜型分布。结果提示 PNA-R 是肺癌分化过程中的一种标志,对肺癌分型、预后判断有一定协助作用。同时将29例肺肿瘤 PNA-R 与 ER 状况作对比研究,探讨了二者之间的相关性及可能的发生机制。