Thyroid Embolization for Nonsurgical Treatment of Nodular Goiter: A Single-Center Experience in 56 Consecutive Patients

PurposeTo investigate the safety and efficacy of thyroid artery embolization (TAE) in the treatment of nodular goiter (NG).MethodsDuring a 5.5-year period, 56 consecutive patients with a NG underwent TAE. In Group A, there were 20 patients with a solitary/dominant 5–11-cm nodule, and in Group B, there were 36 patients with numerous nodules. Of the 56 patients, 47 (84%) had a retrosternal goiter and 25 had hyperthyroidism. In all patients, clinical and radiological evaluations were made at baseline and 6 months after TAE, and these parameters were statistically compared.ResultsIn 56 patients, 145 of the 146 thyroid arteries were successfully embolized. The 30-day mortality rate was 1.8%. Minor and major complications occurred in 25 and 2 patients, respectively. Six months after the TAE, the mean nodule volume was reduced from 80.2 mL to 25.0 mL, the mean thyroid volume was reduced from 147.0 mL to 62.6 mL, and the mean intrathoracic extension was reduced from 31.7 mm to 15.9 mm (P < .001). Of the 22 patients with non–Graves hyperthyroidism, 19 (86%) became euthyroid. The mean thyroid-related patient-reported outcome scores improved from 155.4 to 70.4 (P < .001). Of the 51 patients, 50 (98%) declared that they would recommend TAE to other patients with NG.ConclusionsTAE is safe and effective for the treatment of NG, with a significant volume reduction of the nodule(s) and thyroid gland.     

The Transmission of Trauma from Mother to Infant: Radioactive Residues and Counter-Transference in the Case of a Haitian Mother and Her Two-Year-Old Son*

ABSTRACT

Close observation of the interactions between a traumatised mother and her infant son provides information on the modes of transmission of psychic trauma in the mother–infant dyad. Following the presentation of a current literature review on the theme, the subject of “radioactive residue” and counter-transference in the transmission of psychic trauma from mother to infant will be illustrated through a clinical case study that focuses on a Haitian mother and her two-year-old infant son who has been referred to a “transitional care nursery” in urban Paris. The encounter with this mother–infant dyad is analysed through observing the quality of the interactions that take place between the mother and infant in order to determine how a particularly traumatic narrative impacts the mother–infant relationship, in addition to relations with the clinician. Mother and infant respond to one another through the emission and reception of “radioactive residues” as hypothesized by Gampel. This clinical case study shows that there is a need to consider transcultural factors and collective experience and history when analysing traumatic events. Additionally, the case study shows that counter-transference can be an effective clinical tool for gaining access to an infant's experience as the recipient of a traumatic narrative.     

Evodiamine-inspired dual inhibitors of histone deacetylase 1 (HDAC1) and topoisomerase 2 (TOP2) with potent antitumor activity

A great challenge in multi-targeting drug discovery is to identify drug-like lead compounds with therapeutic advantages over single target inhibitors and drug combinations. Inspired by our previous efforts in designing antitumor evodiamine derivatives, herein selective histone deacetylase 1 (HDAC1) and topoisomerase 2 (TOP2) dual inhibitors were successfully identified, which showed potent in vitro and in vivo antitumor potency. Particularly, compound 30a was orally active and possessed excellent in vivo antitumor activity in the HCT116 xenograft model (TGI = 75.2%, 150 mg/kg, p.o.) without significant toxicity, which was more potent than HDAC inhibitor vorinostat, TOP inhibitor evodiamine and their combination. Taken together, this study highlights the therapeutic advantages of evodiamine-based HDAC1/TOP2 dual inhibitors and provides valuable leads for the development of novel multi-targeting antitumor agents.     

甲状腺机能亢进危象：附14例临床分析

本文报道14例甲亢危象,其发病率为4.5％,其发病与感染、劳累、情绪激动及同位素治疗有关。指出同位素治疗甲亢初期应服用抗甲状腺药物,讨论了淡漠型危象的有关问题。     

LHRH-PE40识别结肠癌细胞膜表面蛋白的研究

目的探讨人结肠癌细胞系Lovo及人白血病细胞系Jurket细胞膜表面蛋白能否识别LHRH-PE40及是否存在竞争性抑制。方法将结肠癌细胞系Lovo及白血病细胞系Jurket制备成细胞膜,利用125I标记的LHRH-PE40与两种细胞膜进行放射性配基分析,与LHRH进行竞争结合分析。结果人结肠癌细胞系Lovo的结合竞争符合特异性配基-受体结合、竞争;而白血病细胞系Jurket未见配基-受体特异性结合。其中LHRH-PE40与Lovo细胞的亲和力:Kd=10·6±2·33nmol/L,容量Bmax=345±7·59pmol/mg。结论LHRH是结肠癌免疫治疗的有效靶点,LHRH-PE40对过度表达LHRH受体的结肠癌具有特异性杀伤作用,而对无LHRH表达的肿瘤无杀伤作用,对于药物的临床应用有着指导意义。     

Positive autoradiographic findings in brains of four MS patients

Autoradiography of brain slices from 4 multiple sclerosis (MS) and 9 control patients was performed. After 6 weeks of exposure the exact picture of the white matter appeared on the X-ray films in all cases with MS, but only in one of the controls. The high level of autoradiographic signal from MS white matter suggests that an abnormal accumulation of radioactive trace elements takes place within the brains of MS victims.     

后装机出源阻力大故障分析及维修

从机械和电路两方面分析了 KLHZ-001型后装机出源阻力大的原因 ,并分别阐述了维修办法.     

血液胆碱酯酶活力测定方法的进一步研究Ⅰ．红细胞／全血胆碱酯酶活力比例及红细胞计数校正酶活力值的研究

应用硫代乙酰胆碱－联硫代双硝基苯甲酸（ＡＳＣｈ－ＤＴＮＢ）比色测定法，测定了４０名健康者及５名贫血者血样的全血胆碱酯酶（ｂｌ－ＣｈＥ）活力值、红细胞胆碱酯酶（ｅ－ＣｈＥ）活力值及血浆胆碱酯酶（ｐ－ＣｈＥ）活力值，探讨它们之间的比例关系并用红细胞计数值（ＲＢＣ）校正酶活力。结果表明：ｅ－ＣｈＥ与ｂ１－ＣｈＥ之间关系密切（ｒ＝０．９４８，Ｐ＜０．００１），ｅ－ＣｈＥ稳定地占ｂｌ－ＣｈＥ的８４．９７％，在质和量两方面验证了以ｂｌ－ＣｈＥ值表示ｅ－ＣｈＥ值的可靠性和可信程度，血液胆碱酯酶（ｂ１ＣｈＥ）活力主要取决于ｅ－ＣｈＥ活力，ＲＢＣ值的离散对ｅ－ＣｈＥ值有极大影响，故用ＲＢＣ值校正ｅ－ＣｈＥ活力，这样可缩小人群测定值的变异度，得到较难确的群体均值；消除男女之间测定值的差异，建立更合理和通用的临界参比值，极大地方便了使用，使血液胆碱酯酶（ＣＨＥ）活力测定法在防治有机磷农药中毒中的应用，更为敏感和特异。     

Radium-228 determination of natural waters via concentration on manganese dioxide and separation using Diphonix ion exchange resin

The objective of this work was to establish a new procedure for ²²⁸Ra determination of natural waters via preconcentration of radium on MnO₂ and separation of its daughter, ²²⁸Ac, using Diphonix ion exchange resin. Following removal of potential interferences via passage through an initial Diphonix Resin column, the first daughter of ²²⁸Ra, ²²⁸Ac, is isolated by chromatographic separation via a second Diphonix column. A holding time of >30 h for ²²⁸Ac ingrowth in between the two column separations ensures secular equilibrium. Barium-133 is used as a yield tracer. Actinium-228 is eluted from the second Diphonix Resin with 5 ml 1 M 1-Hydroxyethane-1,1-diphosphonic acid (HEDPA) and quantified by addition of scintillation cocktail and LSC counting. Radium (and ¹³³Ba) from the load and rinse solutions from the 2nd Diphonix column may be prepared for alpha spectrometry (for determination of ²²³Ra, ²²⁴Ra, and ²²⁶Ra) by BaSO₄ microprecipitation and filtration. Decontamination tests indicate that U, Th, and Ra series nuclides do not interfere with these measurements, although high contents of ⁹⁰Sr (⁹⁰Y) require additional treatment for accurate measurement of ²²⁸Ra. Addition of stable Sr as a “hold back” carrier during the initial MnO₂ preconcentration step was shown to remove most ⁹⁰Sr interference.     

肺癌与感染──附28例肺癌患者下呼吸道细菌检查结果

肺癌常继发肺内感染，且使其预后恶化。２８例肺癌患者中，９例下呼吸道分泌物培养生长细菌，多为大肠杆菌，流感杆菌和金黄色葡萄球菌。