肺包虫囊肿的CT诊断

目的:观察肺包虫囊肿的CT表现,评价CT对本病的临床应用价值。材料和方法:回顾性地分析了17例经临床手术病理证实的肺包虫囊肿的CT表现。以10mm层厚。行平扫后增强扫描。结果:17例肺包虫囊肿中,单发12例,多发5例。共29个病灶。75％分布于肺边缘区域。破裂7例。感染9例。主要征像为园形或卵园形均匀的水样密度的囊性病灶。特征性的征象为囊壁上点状或细弧线形钙化;囊内多于囊的显示;破裂时的新月征、水上浮莲征、腔内蛇影征。继发感染时囊周片状炎性实变。结论:将CT应用于肺包虫囊肿的诊断能发现隐蔽区的病灶。定位准确。并能有效显示肺包虫囊肿的特征及并发症的表现,提高对本病诊断的准确性。正确指导临床治疗。     

Traumatic epidural hematomas of the posterior cranial fossa

BACKGROUND: Traumatic EDHs of the posterior cranial fossa are rare and have a higher mortality than supratentorial localizations. Early diagnosis of TEHPCF and prompt surgical evacuation provide excellent recovery. Active use of cranial CT scanning has taken a major role in the diagnosis, surgical indication, close observation, and strategy planning. As a result, better prognosis is achieved. In this study, we represent our results and experiences in the management of TEHPCF. METHODS: Between 1993 and 2006, 65 patients with TEHPCF were treated in Istanbul University Faculty Of Medicine, Neurosurgery and Emergency Surgery Departments. The hospital records of these patients were analyzed retrospectively. RESULTS: Of 65 patients, whose diagnosis and management decisions were determined by cranial CT scans, 53 were treated through surgery and 12 by conservative methods. Of the 53 surgically treated patients, 2 (3%) patients died, and 2 (3%) other patients remained moderately disabled during their discharge. As a result, 61 (94%) of 65 patients had excellent recovery. CONCLUSION: When compared with the literature, our mortality rate was superior to other previously reported studies. In our opinion, this is a result of extensive use of the cranial CT scan together with aggressive surgery. Patients with occipital trauma should be evaluated using cranial CT scans, and those showing mass effect should be immediately treated surgically. The patients that have no mass effect on CT scans can be closely observed by planned serial control CT scans.     

Potentialities of the cytological method in diagnosing adenocarcinoma of the lung

Parallel cytological and histological studies were performed for 87 patients with pulmonary adenocarcinoma. Sputum, impression smears of the bronchial mucosa, aspirates from the bronchi, punctates of the tumor obtained transbronchially, pieces of tumor obtained at bronchoscopy, and operation material were examined. Considerable difficulties wre found in cytological diagnosis of adenocarcinomas due to degenerative changes in tumor cells, the presence of cells of the metaplastic columnar epithelium and marked anaplasia of tumor cells in adenocarcinoma with low differentiation. The frequency of diagnostic errors was 20.0--50.6% depending on the histological form of adenocarcinoma and the accompanying processes in bronchi. The cytological criteria improving the differential diagnosis of adenocarcinoma are presented. The validity of cytological diagnosis of adenocarcinoma does not depend on the nature of the material examined.     

Localization of Helicobacter pylori gastritis and the relation of existing histopathological features with reflux esophagitis

Abstract

Background/aims: Interactions between Helicobacter pylori (Hp) and gastroesophageal reflux disease (GERD), which are common diseases worldwide, are confusing. In this study, the aim was to compare and evaluate the relationship between reflux esophagitis (RE) and Hp infection in adult patients with both the gastric localization of Hp and its histopathologic features.

Materials and methods: 248 patients with RE were compared with 249 age and sex matched control groups. Biopsy specimens obtained from the gastric antrum and corpus were histologically evaluated.

Findings: The incidence of Hp infection was significantly lower in patients with RE than in the control group (Ratio 1.53, 95% CI 1.07–2.20; p?=?.02, p?<?.05). Corpus Hp colonization and corpus gastritis scores were notably lower in the study group (p?=?.01, p?<?.05), whereas there was no significant difference in Hp colonization and antrum gastritis scores in the antrum. Corpus Hp colonization and gastritis scores were found to be negatively correlated with esophagitis development (r?=??0.11; p?=?.01; (r?=??0.14; p?=?.00 respectively, p?<?.05). There was no difference between the groups in terms of atrophy development (p?>?.05).

Conclusion: This study showed that the presence of Hp infection in the corpus and corpus gastritis score was significantly lower in patients with erosive reflux esophagitis than in the control group. It also showed that Hp colonization and corpus gastritis scores were negatively correlated with esophagitis development. This inverse relationship was independent of atrophy.     

新疆阿拉套山发现鼠疫自然疫源地

目的查清阿拉套山是否存在鼠疫自然疫源地,以及相关的动物和昆虫区系.方法应用流行病学、医学动物昆虫学、血清学和细菌学等方法.结果调查区内共采集啮齿动物10种,优势动物为灰旱獭(Marmota baibacina),次为长尾黄鼠(Citellus undulatus)与灰旱獭在同一生境;灰旱獭定点观察密度为2.5～5.5只/hm2;旱獭路线密度最高2.36只/hm2,最低仅为0.01只/hm2.旱獭洞干蚤染蚤率0.36%、灰旱獭体蚤染蚤率为6.2%.采集小型鼠类的蚤类18种,蜱2种,虱1种.灰旱獭体蚤主要为谢氏山蚤和似升额蚤及草原硬蜱.检查鼠类血清标本180份,其中灰旱獭阳性血清2份;牧狗血清114份,阳性1份.从自毙旱獭中,分离出4株鼠疫菌.结论首次判定新疆阿拉套山存在鼠疫自然疫源地.     

Effects of membrane potential on Na+ -dependent Mg2+ extrusion from rat ventricular myocytes

To study Mg2+ transport across the cell membrane, the cytoplasmic concentration of Mg2+ ([Mg2+](i)) in rat ventricular myocytes was measured with the fluorescent indicator furaptra (mag-fura-2) under Ca2+ -free conditions (0.1 mM EGTA) at 25 degrees C. The fluorescence ratio signal of furaptra was converted to [Mg2+](i) using calibration parameters previously estimated in myocytes (Watanabe and Konishi, Pflügers Arch 442: 35-40, 2001). After [Mg2+](i) was raised by loading the cells with Mg2+ in a solution containing 93 mM Mg(2+), the cells were voltage-clamped at a holding potential of -80 mV using the perforated patch-clamp technique with amphotericin B. At the holding potential of -80 mV, the reduction of extracellular Mg2+ to 1.0 mM caused a rapid decrease in [Mg2+](i) only in the presence of extracellular Na(+). The rate of the net Mg2+ efflux appeared to be dependent on the initial level of [Mg2+](i); the decrease in [Mg2+](i) was significantly faster in the myocytes markedly loaded with Mg2+. The rate of decrease in [Mg2+](i) was influenced little by membrane depolarization from -80 to -40 mV, but the [Mg2+](i) decrease accelerated significantly at 0 mV by, on average, approximately 40%. Hyperpolarization from -80 to -120 mV slightly but significantly slowed the decrease in [Mg2+](i) by approximately 20%. The results clearly demonstrate an extracellular Na(+)- and intracellular Mg2+ -dependent Mg2+ efflux activity, which is consistent with the Na(+)-Mg2+ exchange, in rat ventricular myocytes. We found that the apparent rate of Mg2+ transport depends slightly on the membrane potential: facilitation by depolarization and inhibition by hyperpolarization with no sign of reversal between -120 and 0 mV.     

A malignant mixed gonadal stromal tumour of the testis with heterologous components

We report a case of malignant mixed gonadal stromal tumour in the testis, which consisted of epithelial heterologous components and metastasized to the retroperitoneal lymph nodes. The primary lesion and biopsy of the retroperitoneal metastases showed predominance of the Sertoli cell component. The patient was put on chemotherapy.