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2008 Year 1 Issue
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SPECTRUM OF FUNCTIONING ISLET CELL TUMOR ON MULTISLICE COMPUTED TOMOGRAPHY:EXPERIENCE ON 70 PATIENTS
Abstract：Objective To review experience in preoperative detection of islet cell tumors using multislice computed tomography （MSCT） and summarize various imaging features of functioning islet cell tumors on enhanced MSCT.Methods Seventy patients with clinical or pathological diagnosis of functioning pancreatic islet cell tumor between October 2003 and February 2007 were included in this retrospective study. Seventy-four enhanced MSCT scans in these patients were identified. All MSCT scans were interpreted by two experienced radiologists by consensus interpretation. Surgery and pathology reports were used to confirm the diagnosis, localization, and size of tumors.Results Totally, 73 functioning islet cell tumors including 65 benign insulinomas, 2 benign glucagonomas, 3 malignant insulinomas, and 3 malignant glucagonomas were pathologically diagnosed. Tumors in only two cases were not found by MSCT. In 67 benign lesions, 32 showed typical enhancement style, 21 showed prolonged enhancement in portal venous phase, 4 showed delayed enhancement, 4 had iso-dense enhancement with normal pancreatic parenchyma, 2 had no enhancement at all in arterial phase and portal venous phase, and 4 had inhomogeneous enhancement with necrosis or cyst-formation. Patchy or spotty calcifications were found in 3 of the 67 tumors. In 6 malignant islet cell tumors, vessel invasion （2/6） and bowel invasion （1/6） were seen. Different enhancement patterns were shown. All hepatic metastases showed hyper-enhancement during their arterial phase. ConclusionsPancreatic islet cell tumor may display a wide spectrum of presentations in MSCT. Tumors with unusual appearances often present as diagnostic challenges. Non-contrast and post-contrast multiphase scans are recommended for the localization of functioning islet cell tumors.4|24|2Updated：2024-04-10 - Abstract：Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy（CSP）.Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007,including age,interval from the last cesarean delivery to diagnosis,clinical presentation,location of the lesion,process of diagnosis and treatment,outcome,and follow-up,were retrospectively analyzed.Results CSP constituted 1.05% of all ectopic pregnancies,and the ratio of CSP to pregnancy was 1∶1221.The mean age of the group was 31.4 years.Twenty-six women had only one prior cesarean delivery.The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years.The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding.Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor.The other 9 were diagnosed definitely before treatment.The diagnosis was made based on cesarean delivery history,gynecologic examination,ultrasound,and magnetic resonance imaging（MRI）.The treatment of CSP included systemic or local methotrexate administration,conservative surgery,and hysterectomy.The conservative treatment was successful in 24 cases.All of the 28 women were cured through individual therapies.Conclusions CSP is rare and usually misdiagnosed as other diseases.Ultrasound is valuable for diagnosing CSP,and MRI can be used as an adjunct to ultrasound scan.Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients.Individual therapy is strongly recommended.4|148|82Updated：2024-04-10
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INTRATHECAL GLYCINE SIGNIFICANTLY DECREASES THE MINIMUM ALVEOLAR CONCENTRATION OF ISOFLURANE IN RATS
Abstract：Objective To evaluate the effect of intrathecal administration of glycine on the minimum alveolar concentration（MAC）of isoflurane in rats.Methods Intrathecal catheters were implanted in 40 adult male rats anesthetized with isoflurane.Baseline MAC of isoflurane was measured during the infusion of artificial cerebrospinal fluid（CSF）alone.Subsequently,10,40,80,160,and 300 mmol/L of glycine dissolved in artificial CSF were infused for two hours at the same rate as under control conditions,and MAC for isoflurane was re-determined.Results Intrathecal administration of glycine produced a significant,dose-dependent decrease in MAC for isoflurane（up to-65.2%±16.2%）.Conclusions Intrathecal administration of glycine decreases anesthetic requirement.This result supports the idea that glycine receptors may be important to the immobilizing effect of anesthetics that enhance glycine receptor function such as isoflurane.4|24|0Updated：2024-04-10 - Abstract：Objective To summarize the clinical characteristics,treatment,and prognosis of brain metastasis in patients with epithelial ovarian carcinoma.Methods Retrospective analysis was conducted in 7 cases of brain metastases of epithelial ovarian carcinoma from January 1986 to March 2007 in Peking Union Medical College Hospital for summarizing therapy results and prognosis-affecting factors.Results Incidence of brain metastases of epithelial ovarian carcinoma was about 0.66%（7/1055）.Serous adenocarcinoma was the predominant pathological type in 4 cases and the subsequent was adenocarcinoma in 3 cases.All the patients were diagnosed at late stage,6 cases with the International Federation of Gynecology and Obstetrics（FIGO）stage IIIc and 1 with FIGO stage IV.The mean duration from diagnosis of ovarian carcinoma to brain metastasis was 32.7±20.0 months（range,23-73 months）.Single metastasis focus occurred in 43% of cases and multiple metastases in 57% of cases.Fifty-seven percent of patients presented extracranial metastasis.Serum CA125 played a role in monitoring reoccurrence and brain metastases.The average survival time was about 12 months.Better treatment with prolonged survival could be achieved by combination of operation and chemotherapy or combination of radiotherapy with chemotherapy.Conclusions As a rare condition,brain metastasis of epithelial ovarian carcinoma is rising in incidence with improved treatment of ovarian carcinoma and prolonged survival.However,brain metastasis indicates bad prognosis which can be improved by combined therapy.4|17|4Updated：2024-04-10
- Abstract：Objective To investigate the variability of human cytomegalovirus（HCMV）UL140 open reading frame（ORF）in clinical strains,and to explore the relationship between the variability of UL140 ORF and different symptoms of HCMV infection.Methods HCMV UL140 ORF was amplified by polymerase chain reaction and sequenced selectedly in 30 clinical strains.Results UL140 ORF of all clinical strains was amplified successfully.Compared with that of Toledo strain,the nucleotide and amino acid sequence identities among all strains were 96.5%-100.0% and 95.2%-100.0%,respectively.All of the nucleotide changes were substitutions.The post-translational modification sites were conserved.The result of phylogenetic tree showed that the strains did not cluster according to different clinical symptoms.Conclusion HCMV UL140 ORF in clinical strains is highly conserved,which may play an important role in HCMV infection.4|16|1Updated：2024-04-10
- Abstract：Objective To evaluate the effects of retinoic acid（RA）on expression of bone morphogenetic protein 7（BMP-7）in rat fetus with cleft palate,and the effects of RA on proliferation and apoptosis of osteoblasts.Methods All-trans RA（ATRA）was used to induce congenital cleft palate in Wistar rat.BMP-7 mRNA expression in maxillary bone tissue of fetal rats was measured by Northern blotting analysis.Flow cytometry and MTT assay were used to measure the apoptosis and proliferation of ATRA-treated MC-3T3-E1 cells.BMP-7 mRNA and protein expressions in ATRA-treated MC-3T3-E1 cells were detected by RT-PCR and Western blotting analysis.Results ATRA could induce cleft palate of rat fetus.The incidence rate of cleft palate induced by 100 mg/kg ATRA（45.5%）was significantly higher than 50 mg/kg ATRA（12.5%,P<0.05）.BMP-7 mRNA expression decreased in maxillary bone tissue of rat fetus with cleft palate.MC-3T3-E1 cells proliferation treated with 1×10-6 mol/LATRA decreased by 60%,the cell apoptosis increased by 2 times.BMP-7 mRNA and protein levels in MC-3T3-E1 cells treated with 1×10-6 mol/L ATRA decreased by 60% and 80%,respectively,compared with ATRA-untreated cells（P<0.05）.Conclusions BMP-7 may play an important role in embryonic palate development.RA may possess the ability to down-regulate cell proliferation through regulation of BMP-7 gene expression.4|28|7Updated：2024-04-10
- Abstract：Objective To explore the potential mechanism of breakthrough bleeding associated with progestin with in vitro methods.Methods The isolation and culture of human endometrial endothelial cells（HEECs）was performed with the method established in our laboratory.The content and activity of urokinase-type plasminogen activator（uPA）and the content of plasminogen activator inhibitor-1（PAI-1）in cell supernatants after incubated with different concentrations of progesterone（0-5 μmol/L）and 17β-estradiol（0,0.1,or 1 nmol/L）were measured by method of ELISA.Apoptosis rate of HEECs was measured by flow cytometry.Viable cell count was measured by MTT.Results The increased level of progesterone（0.5-5 μmol/L）combined with 17β-estradiol elevated content and activity of uPA while the production of PAI-1 remained unchanged.The apoptosis of HEECs was inhibited along with the increment of total viable cell counts at higher concentrations of progesterone with 17β-estradiol.Conclusion The inhibition of apoptosis and increased content and activity of uPA may contribute to the occurrence of irregular bleeding associated with progestin use to some extent.4|29|0Updated：2024-04-10
- Abstract：Objective To investigate the frequency of GAG deletion in the DYT1 gene among early onset primary dystonia patients in China.Methods Thirteen patients with early onset primary torsion dystonia were screened for mutation in exon 5 of the DYT1 gene using denaturing high-performance liquid chromatography（DHPLC）and DNA sequencing,and the results were confirmed with polymerase chain reaction-restriction fragment length polymorphism（PCR-RFLP）.Results The GAG deletion mutation which results in Glu302del in exon 5 of the DYT1 gene was found in 5 patients.The detecting results were consistent between with DHPLC and PCR-RFLP.We did not find any other mutations in the DYT1 gene.Conclusions The GAG deletion in the DYT1 gene is common amongst early onset primary torsion dystonia patients in China.The frequency of DYT1 mutation is not significantly different between European and Asian patients with early onset primary dystonia.4|22|1Updated：2024-04-10
- Abstract：Objective To evaluate magnetic resonance imaging（MRI）characteristics and surgical results of adrenocorticotropin（ACTH）-secreting pituitary adenomas.Methods MRI characteristics and relationship between MRI positive rate and surgical results of 266 patients with pathologically confirmed Cushing’s disease were analyzed retrospectively.All patients underwent thin-section sagittal and coronal scans of the pituitary gland before and after administration of gadolinium-diethylene triamine pentaacetic acid（Gd-DTPA）on a 1.5 Tesla MRI scanner,and dynamic enhanced MRI was performed in 39 patients.All patients underwent transsphenoidal adenomectomy.Endocrinological examinations and assessments were performed.Results Preoperative MRI revealed normal results in 41（15.4%）cases,microadenoma in 179（67.3%）,macroadenoma in 42（15.8%）,and huge adenoma in 4（1.5%）.Pituitary apoplexy was found in 13（4.9%）cases.Positive rate of ACTH-secreting adenomas was 84.6%（225/266）on MRI scans,and that of small microadenomas was 87.2%（34/39）on dynamic enhanced MRI scans.Preoperative endocrinological tests of 199 cases supported the diagnosis of typical Cushing’s disease,while the other 67 cases had atypical endocrinological results.The endocrinological cure rate,remission rate,and inefficacy rate were 85.7%,7.9%,and 6.4%,respectively.There was no difference in the initial endocrinological cure rate between the patients with positive and normal MRI results（90% vs.87.8%,P=0.904）.Conclusions Enhanced coronal pituitary MRI is helpful for preoperative localization of ACTH-secreting pituitary microadenoma.Dynamic enhanced MRI may improve detection rate of microadenoma.There is no marked difference in the surgical results for patients with preoperative MRI results indicating presence or absence of microadenoma.4|34|13Updated：2024-04-10
- Abstract：Objective To explore the effect of genistein on proliferation of human endometrial endothelial cells（HEECs）and glandular epithelium.Methods In vitro HEECs and human endometrial cancer-1B cell（HEC-1B）were cultured with 0,1,10,50,100,and 200 μmol/L of genistein alone or indicated concentrations of genistein combined with 0.2 or 1 nmol/L 17β-estradiol（17β-E2）.Cell proliferation was determined by[3H]-thymidine incorporation and cell cycle was measured by flow cytometry.Results After 96 hours of treatment,genistein inhibited the proliferation of HEECs in a dose-dependent manner.The stimulation index reduced from 100%（without genistein treatment）to about 1%（200 μmol/L genistein）.HEECs were arrested at G1/0 and G2/M phase when treated with genistein for 96 hours.When the concentration of genistein was 200 μmol/L,the percentages of HEECs at G1/0,G2/M,and S phase were 96.0%,2.1%,and 1.9%,respectively.However,when HEECs were treated without genistein,the percentages of HEECs at G1/0,G2/M,and S phase were 76.7%,8.5%,and 14.7%,respectively.17β-E2 could not influence the effects of genistein on the proliferation of HEECs.Meanwhile,genistein could suppress the proliferation of HEC-1B.If the stimulation index of HEC-1B was defined as 100% when HEC-1B was treated with different doses of 17β-E2（without genistein）,it was 67%,19%,as well as 32% when cell was supplemented with 200 μmol/L genistein combined with 0,0.2,or 1 nmol/L 17β-E2,respectively.Conclusion Genistein at the concentration of 200 μmol/L can sufficiently inhibit the proliferation of HEECs and endometrial glandular epithelium simultaneously in vitro.4|36|8Updated：2024-04-10
- Abstract：Objective To investigate and compare the biological characteristics and sensitivity to chemotherapy and radiotherapy of intrahepatic and extrahepatic cholangiocarcinoma cells in vitro.Methods The intrahepatic and extrahepatic cholangiocarcinoma cell lines were established,and cells with steady passage were chosen to study the biological characteristics including morphology,growth dynamics,chromosome,and levels of cancer antigen（CA）125,CA19-9,alpha-fetoprotein（AFP）,and carcino-embryonic antigen（CEA）.Meanwhile,MTT assay was used to determine the sensitivity of both kinds of cells to 6 chemotherapeutic drugs,including cisplatin,paclitaxel,harringtonine,5-fluorouracil,vincristine,and aclacimomycin,and the inhibitory rate of cells under the irradiation of 10 Gy ray was also measured.Results The intrahepatic cholangiocarcinoma cells were mostly fusiform in shape,and extrahepatic cholangiocarcinoma cells were mostly round or polygon in shape.Their doubling time was 26.3 hours and 23.1 hours,respectively.Their average number of chromosomes was 59（range,38-84）and 67（range,49-103）,respectively.The chromosome karyotypes of most intrahepatic cholangiocarcinoma cells were hyperdiploid and hypotriploid,while hypertriploid was predominant in extrahepatic cholangiocarcinoma cells.The level of CA 125 in supernatant of extrahepatic cholangiocarcinoma cells increased obviously,while levels of other determined tumor markers in both kinds of cells were all within normal range.The intrahepatic cholangiocarcinoma cells were low sensitive to cisplatin and paclitaxel,but not sensitive to the other 4 chemotherapeutic drugs.The extrahepatic cholangiocarcinoma cells were high sensitive to cisplatin,but not sensitive to the other 5 drugs.Both kinds of cells had poor sensitivity to radiotherapy.Conclusions Intrahepatic and extrahepatic cholangiocarcinoma cells show differences in shape,doubling time,chromosome karyotype,tumor marker level,and chemosensitivity,whereas they both have poor radiosensitivity.Though they are similar in histopathology,they have different growth characteristics and have discrepancy in treatment and prognosis.4|17|10Updated：2024-04-10
- Abstract：<正>MANY cases of pure red cell aplasia（PRCA）were mediated by over-function of immune cells,and responded well to immunosuppressive therapy.1 Sometimes refractory cases also arose.Fludarabine is an analogue of adenosine resistant to deamination which is widely used for B-chronic lymphocytic leukemia（CLL）and other hematological malignancies.2 As a strong immunosuppressive agent,4|14|3Updated：2024-04-10
- Abstract：<正>China is one of the countries with the highest risk of gastric cancer over the past century,which is still the leading cause of death worldwide.Because metastatic disease of gastric cancer is the most critical impediment to patient survival,it is necessary to further understand the molecular mechanisms of its metastasis.Kiss-1,mapping to chromosome 1q32,is one of these genes regulated at chromosome 6.Kiss-1 expression was discovered to inhibit metastasis in both in vivo melanoma and breast carcinoma models.4|22|12Updated：2024-04-10
- Abstract：<正>Chinese Medical Sciences Journal（Chin Med Sci J）is a peer-reviewed,general medical journal published by the Chinese Academy of Medical Sciences.Chin Med Sci/reports on all aspects of basic and clinical medicine and pharmacology in China,while contributions from abroad are welcomed as well.4|1623|0Updated：2024-04-10
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