Granular Cell Myoblastoma of the Gallbladder

A case of granular cell myoblastoma of the gallbladder in a 39-year old Japanese female is presented. Granular cell myoblastomas arising in the biliary tract are a rare occurrence. This tumor has not yet been reported in the gallbladder.     

胰岛素作用相关的蛋白酪氨酸磷酸酶及其抑制剂

胰岛素作用相关的蛋白酪氨酸磷酸酶及其抑制剂尹义存邹大进综述胰岛素受体（ＩＮＳＲ）是受胰岛素（ＩＮＳ）调节的酪氨酸蛋白激酶（ＰＴＫａｓｅ）。该受体与ＩＮＳ结合后发生自身磷酸化。受体调节区的某些位点的磷酸化最终可导致内在的酪氨酸（Ｔｙｒ）磷酸转移酶的激...     

Identification of high-risk subgroups in infective endocarditis and the role of echocardiography

The outcome of infective endocarditis remains poor. It has anoverall mortality of around 30%, rising in high-risk subgroupsto 50% and 100%. The prognosis can be improved by identificationof high-risk patients and special management. Patients with infective endocarditis are found to be at highrisk for death or serious complications when one or more ofthe following factors exist: old age (especially >60 yearsold), delayed diagnosis, staphylococcal infection, aortic valveendocarditis, large valvular vegetation, congestive heart failure,embolization in the central nervous system or coronary artery,prosthetic valve infection, recurrent events, and failed antibiotictherapy. These factors often coexist and interrelate with oneanother. Early diagnosis and active treatment are critical for a betterclinical outcome. However, infective endocarditis is difficultto diagnose because of the atypical clinical manifestationsand frequent negative results from blood culture. Echocardiographyplays an indispensable role in the diagnosis and managementof suspected or known infective endocarditis. By detecting andmonitoring certain pathological changes associated with thedisease, e.g. vegetation, abscess formation, or valvular destruction,echocardiography helps to diagnose the disease early, to identifypatients at high risk, to monitor the patients, and to optimizethe timing and mode of surgical intervention. Serious complicationscan thus be avoided or cured at an early stage and the prognosissignificantly improved.     

Three-Dimensional Echocardiographic Evaluation of Aortic and Mitral Valve Stenosis

Dynamic volume rendered three-dimensional echocardiography allows the spatial recognition of anatomy and function of the aortic and mitral valves with acceptable image quality. The aortic valve can be best visualized in a view from the ascending aorta down to the valve level, thus allowing an overview of the aortic aspect of the valve in a surgeon's perspective in ∼ 80% of patients. Planimetric measurement of the aortic valve area was possible in 88% of patients, and there is no systematic overestimation or underestimation of aortic valve area compared with two-dimensional echocardiography and catheterization. The entire valvular circumference of the mitral valve can be assessed from both a left atrial and a left ventricular perspective. Advantages of the three-dimensional transesophageal echocardiography mitral valve area determination compared with transthoracic two-dimensional planimetry and Doppler-derived pressure half-time method are present in patients with severely calcified mitral valves and in those with combined aortic regurgitation.