Effects of Saponins from Allium Macrostemon Bunge Bulbs on Platelet Aggregation and Interactions between Platelets and Neutrophils / 中国中医药信息杂志

Objective To investigate the effects of saponins from Allium Macrostemon Bunge Bulbs (SMBB) on platelet aggregation and platelet-neutrophil-interactions. Methods The effects of SMBB on platelet aggregation in SD rats were observed in vivo and in vitro. The adhesion of platelets to neutrophils was measured by rosette test. The effect of SMBB on activated platelet calcium levels was detected. Results Platelet aggregation induced by platelet activating factor (PAF), adenosine diphosphate (ADP) and arachidonic acid (AA) was significantly inhibited by SMBB in vitro concentration-dependent. Platelet aggregation induced by PAF, AA and ADP was significantly inhibited by 5 mg/kg of SMBB. SMBB could reduce the intracellular calcium concentration in the wash platelets. SMBB significantly reduced the adhesion between neutrophils and thrombin-activated platelets and inhibited neutrophil supernatant-induced platelet aggregation, with IC50of 2.7 μmol/L and 9.6 μmol/L, respectively. Conclusion SMBB can inhibit platelet aggregation in vitro and ex vivo, and inhibit the interactions between platelets and neutrophils.

Clinical comparison of two microinvasive surgery for giant benign prostatic hyperplasia / 中国医师进修杂志

Objective To compare the clinical effect between retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation and transurethral resection of the prostate (TURP) for giant benign prostatic hyperplasia (BPH).MethodsThe clinical data and follow-up of 128 cases of giant BPH were analyzed retrospectively.Seventy-two cases underwent TURP (TURP group) and 56 cases underwent retropubic extraperitoneal laparoscopic prostatectomy with prostatic urethra preservation ( laparoscopic group ).The operation time,blood loss,gland mass excision,bladder washing time,catheterization time,hospital stay,hospital cost,international prostate symptoms score (IPSS) and quality of life questionnaires (QOL),maximum flow rate (MFR),residual urine volume (RUV) were compared between two groups.ResultsThe bladder washing time,catheterization time,hospital stay in laparoscopic group were less than those in TURP group[0 d vs.(2.8 ± 1.2) d,(2.3 ± 0.6) d vs.(5.2 ± 1.5) d,(4.2 ± 0.5) d vs.(7.5 ±0.5) d],gland mass excision in laparoscopic group was more than that in TURP group [(100.2 ±25.4) g vs.(85.6 ± 15.5) g],there were significant differences between two groups(P＜ 0.05).There was no significant difference in the operation time,blood loss,hospital cost between two groups (P ＞ 0.05).There were significant differences in IPSS,QOL,RUV and MRF before and after 3,6 months treatment for two groups [ laparoscopic group:(9.1 ± 3.4),(7.5 ± 2.5 ) scores vs.(27.5 ± 5.8) scores,( 1.8 ± 1.1 ),( 1.6 ± 0.8)scores vs. (5.5 t0.5) scores,(26.5 ± 11.5),(22.4 ± 12.6) ml vs. (145.0 ±48.0) ml,(17.6 ±8.4),(20.2 ± 5.4) ml/s vs.(8.3 ± 3.5) ml/s;TURP group:(9.2 ± 3.8),(7.8 ± 2.2) scores vs.(28.5 ± 5.4) scores,( 1.9 ± 1.2),( 1.7 ± 0.6) scores vs.(5.0 ± 0.5 ) scores,(28.5 ± 12.9),(23.0 ± 11.7) ml vs. ( 155.0 ± 47.0) ml,( 17.8 ± 9.2),( 19.8 ± 4.5 ) ml/s vs.(7.2 ± 3.2 ) ml/s ] (P ＜ 0.01 ),but there was no significant difference between two groups (P ＞ 0.05).ConclusionsThe clinical effect of two microtrauma surgery are good.Laparoscopic technique is a feasible treatment option for patients suffered from giant BPH for which has the benefit of a quicker recovery,shorter hospital stay,less complications,no bladder washing.

Short-term clinical effects of Achillon in repair of acute Achilles tendon rupture / 中国骨伤

<p><b>OBJECTIVE</b>To study the clinical effects of Achillon for the treatment of acute Achilles tendon rupture (AATR).</p><p><b>METHODS</b>From April 2009 to April 2010, 19 patients with AATR who were treated with Achillon were retrospectively analyzed. There were 17 males and 2 females, with an average age of 40.2 years (30 to 58 years). There were 9 cases of sports injury, and 2 case of fall injury. The time from injury to surgery ranged from 0 to 8 days (2.2 days on average). The results of Thompson test and single heel rise test were positive in 19 cases. Clinical data were assessed with the patient satisfaction and the AOFAS hindfoot score during follow-up.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 12 to 28 months (19.9 months on average). The average operation time was 41 minutes. There were no wound infections, recurrent rupture, or sural nerve complications. At the latest follow-up, 18 patients were totally satisfied with the surgical result, 1 patient feel generally due to mild pain when running. None of the patients were dissatisfied with the final results the latest follow-up. At the latest follow-up, the AOFAS score was 98.42 +/- 3.29 (89 to 100). All the patients regained normal range of motion and were able to resume their previous activities at six months after operation, with a high rate of satisfaction. Average decreased of mid-calf circumference was (0.82 +/- 0.85) cm (ranged from 0 to 3 cm).</p><p><b>CONCLUSION</b>Treatment with Achillon is safe, effective for AATR with low incidence of complications and early active rehabilitation can be carried out. It is a good method to treat AATR.</p>

Surgical treatment of apical chest tumor in 27 patients / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the "hemi-clamshell" approach to the resection of the apical chest tumors, and to evaluate its advantages of operative safety and completeness.</p><p><b>METHODS</b>We conducted a retrospective review of the records of 27 patients undergoing resection of the primary apical chest tumors from January 1995 to January 2001. Tumor type included NSCLC, sarcoma, neurofibromatosis, esophageal carcinoma. Data collected included clinical presentation, tumor type and involvement, type of resection, complication, and survival.</p><p><b>RESULTS</b>A clinical operation for gross-total resection of tumors and invaded structures was performed on six patients by means of a successful anterior approach. Among other 21 patients on whom a clinical operation was performed by posterior approach, only 13 patients obtained gross-total resection. There were significant difference between the two groups (P < 0.01). The mean duration for follow-up was 29 months, and the overall median survival was 21 months. Median survival in patients undergoing gross-total resection was 29 months, and this is significantly better than in incomplete resection group (P < 0.01).</p><p><b>CONCLUSIONS</b>The anterior "hemi-clamshell" approach is a successful technique for the exposure and resection of these tumors and invaded structures. Release of symptoms and long-term survival is acceptable if complete resection can be performed.</p>

Overexpression of the promyelocytic leukemia gene suppresses growth of human bladder cancer cells by inducing G1 cell cycle arrest and apoptosis / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To examine the anti-oncogenic effects of promyelocytic leukemia (PML) on bladder cancer and to explore its molecular mechanisms of growth suppression.</p><p><b>METHODS</b>Wild-type PML was transfected into bladder cancer cells (5637 cell) and expressed in a replication-deficient adenovirus-mediated gene delivery system and introduced into human bladder cancer cells (5637 cell) in vitro and in vivo. The effect and mechanisms of the PML gene in cell growth, clonogenicity, and tumorigenicity of bladder cancer cells were studied using in vitro and in vivo growth assays, soft agar colony-forming assay, cell cycle analysis, apoptosis assay and in vivo tumorigenicity assay.</p><p><b>RESULTS</b>Overexpression of PML in 5637 cells significantly reduced their growth rate and clonogenicity on soft agar. PML suppressed bladder cancer cell growth by inducing G1 cell cycle arrest and apoptosis. Adenovirus-mediated PML (Ad-PML) significantly suppressed the tumorigenicity and growth of bladder cancer cells. Intratumoral injection of Ad-PML into tumors induced by 5637 cells dramatically suppressed their growth.</p><p><b>CONCLUSIONS</b>The results indicated that overexpression of PML protein may promote efficient growth inhibition of human bladder cancer cells by inducing G1 cell cycle arrest and apoptosis, and adenovirus-mediated PML (Ad-PML) expression efficiently suppresses human bladder cancer growth.</p>

The Fate of Untreated ACL Insufficient Knee Joint / 대한정형외과학회잡지

The purpose of this study is to access and describe the status of patients with untreated anterior cruciate ligament ruptures to determine if prediction of functional deterioration in these knees were inevitable. 29 patients with rupture of the anterior cruciate ligament verified arthroscopically were evaluated at an average of 3 years and 8 month after injury. This group of patients was selected by the retrospective review in patients who were treated with traumatic ligament injury of the knee joint. The average age at the injury time was 25.9 years ranged from 16 to 44 years and most of injuries occured during sports activities including 12 cases (4196) occured while the patients were playing football. Meniscal lesions were found in 21 cases(72.4%) of all 29 cases of which were 15 cases in the medial, 4 in the lateral and 2 in both side. Follow up functional average score using the Hospital for Special Surgery Knee was 35.8 which would be fall in the Fair range defined as moderate functional disability and depending on the condition of thigh muscle, the functional score was 38.3 in case of less than 2cm atropy of the thigh on the involved side and 32.6 in case of more than 2cm atrophy. There was statistically significant difference (p < 0.05) of the functional score. Reinjuries of the same knee joint were experienced in 22 cases (76%). Rehabilitation of thigh muscles would play an important part in recovery from the injuries.

The Significance of Postangiographic CT for Differentiation of Hepatic Masses

PURPOSE: To identify the longterm hemodynamics of various hepatic masses and to determine any differential findings by using postangiographic CT performed with increased amount of contrast media and time than conventional contrast CT. MATERIALS AND METHODS: 50 confirmed masses consisted of 22 hepatocellular carcinoma, 10 cholangiocarcinoma, 9 metastasis, and 9 cavernous hemangioma were included. The changes of the density of internal viable tumor portion relative to surrounding normal liver parenchyma in postangiographic CT from that in conventional CT were classified as 3 patterns; no specific changes, increase, or decrease. RESULTS: in 22 cases of hepatoceilular carcinoma, six cases showed no relative density change, four cases increase, and twelve cases decrease. In ten cases of cholangiocarcinoma, one case showed no change, nine cases increase. In nine cases of metastasis, four cases showed no change, five cases increase. In nine cases of hemangioma, all cases showed increase. CONCLUSION: In postangiographic CT which emphasize the significance of postequilibrium and delayed phase, other hemodynamic changes undetected in angiography could more easily be comprehended. Considering the differing amount of consumed contrast media and time duration, and with reference of other imaging modalities, differential diagnosis of hepatic masses based on longterm hemodynamics could easily be made.

Enhancement Patterns of Hepatic Metastasis from Stomach Cancer at Multi-phase Incremental Bolus Dynamic CT

PURPOSE: The purpose of our study was to characterize the enhancing patterns of hepatic metastasis from gastric adenocarinoma using multi-phase incremental bolus dynamic CT with obtained both in early and late phase contrast scan and to evaluate the its advantages. METHODS AND MATERIALS: Of 33 cases of multi-phase incremental bolus dynamic CT with proved hepatic~metastasis from gastric adenocarinoma, we classified dynamic enhancement patterns as three types according to early phase contrast enhancement, and then analized the late phase contrast enhancement, more metastasis detection, segmental abnormal arterial perfusions and correlation between pathologic type. RESULTS: Type I (totally hypodense lesion) was in 18 patients(55%), type II (peripheral high density area) was seen in 13 patients (39%), and type III (near totally hyperdense lesion) was seen in two patients(6%). But in late phase, masses showed totally hypodense area in 26 patients(79%), central high with peripheral low density area(PLDA) in six patients(18%) and totally isodense in one patient(3%). More metastatic masses were detected with early phase in 11 patients(33%) as compared with late phase contrast. Segmental arterial hyperperfusion around the lesions, which could represent intrahepatic portal branch invasion, was seen in 10 patients(30%). There was no correlation between pathologic type and enhancement pattern of lesions. CONCLUSION: Multi-phase incremental bolus dynamic CT could represent variable hemodynamic changes of hepatic metastatic masses and was useful to evaluate the qualitative and quantitative analysis of hepatic metastases.

A clinical study of core decompression for osteonecrosis of the femoral head / 대한정형외과학회잡지

No abstract available.

Superiority of IV bolus CT in evaluation of metastatic lymphadenopathy in th stomach cancer

Differentiation of lymph node from vessels or bowel wall with similar clearity is often difficult in conventional contrast-enhanced computed tomography (CCCT). For optimal differentiation of these structures, arterial-phase dominent CT images by IV bolus injection and rapid scan were obtained. The images were compared from those by CCCT in evaluation of lymphadenopathy. Seventy patients, diagnosed as stomach cancer by pathology, were selected for this study. There were 14 cases of equivocal lymphadenopathy on CCCT while IV bolus CT revealed lymphadenopathy in 9 of there and no lymphadenopathy in the rest. Among the 38 cores without lymphadenopathy on CCCT, IV bolus CT detected 4 lymphadenopathy. In 30 node dissection cases, when we decided 1cm as CT criterion for lymphatic enlargement, the sensitivity and the specificity that there were lymphatic enlargement in gross of lymphatic infiltration above one fourth in pathology even though no lymphatic enlargement in gross were 100%. On conclusion, IV bolus CT is more helpful method to evaluate lymphadenopathy than CCCT and compatible with pathologic findings when we decide 1cm as CT criterion for lymphadenopathy. In conclusion, IV bolus CT is superior to CCCT in evaluation of metastatic Lymphadenopathy when using CT Criferion of 1cm as the diameter of enlarged lymph node.

Analysis of the result and merit of computed tomography guided percutaneous needle aspiration biopsy of focal lung lesion / 영남의대학술지

Percutaneous needle biopsy of pulmonary lesion with use of fluoroscopic guidance is well estabilished as a diagnostic tool but limited by the small size and inaccessibility of certain lesions. However, percutaneous needle biopsy'has been used increasingly in relation to advance and the salty of smaller biopsy needle and new imaging modalities such as ultrasound and CT. CT, because of its characteristics of high resolution, allows tissue sampling with considerable safty from area that heretofore could not be visualized under fluoroscopy. The authors summarized 44 pulmonary lesions that underwent CT-guided transthoracic biopsy with fine-needle over a 14 month period and analyzed the sensitivity of PTNB. -CT-guided PTNB was done with 20 gauge or 22 gauge Westcott biopoy needle (Mann medical products, USA). A diagnosis was made in 27 of 44 cases (61%) including malignany in 19 of 24 cases and benignancy in 8 of 20 cases. The pulmonary mass lesions were located at the peripheral zone of the lung field in 33 cases and at the central zone in 11 cases. Complications were observed in 2 cases which were pneumothorax and hemoptysis each but specific therapy was not required The sensitivity of PTNB by one session was 61% (27/44). The sensitivity of malignancy was 79% (19/24) and benignancy was 40% (8/20). These results suggest the usefulness of PTNB using fine needles be increased in eariler diagnosis and improved staging of pulmonary nodular lesions without significant complications.

Multiple hepatic adenomatosis: a case report

We expirenced multiple hepatocellular adenomatosis, which was proved by pathology, in 38 years old man who had no prior history of predisposing factors. The radiologic findings were different by the size of tumor mass and intratumoral hemorrhage. Ultrasound demonstrated inhomogeneous hyperechoic large mass in segment 5 of right lobe and hyperechoic or isoechoic multiple small nodules in right lobe. Computed tomography demonstrated low density mass without contrast enhacement. Central high density is noted in hemorrhagic portion. Magnetic resonance T1-weighted image demonstrated high signal intensity in mass and hemorrhagic portion. T2-weighted image demonstrated slightly high signal intensity in mass portion, high signal intensity in hemorrhagic portionand double-layered peripheral rim. Gradient echo image well demonstrated inhomogenesity of mass.

Radiologic findings of mediastinal fibromatosis / 영남의대학술지

The fibromatosis is a rare timorous with local invasion, but is not metastasized distantly. This term should not be applied to nonspecific reactive fibrous proliferations that are part of an inflammatory process of are secondary to injury of hemorrhage and have no tendency toward growth or recurrence. It arises principally from the connective tissue of muscle and overlying fascia or aponeurosis (musculoaponeurotic fibromatosis), and chiefly affects the muscle of shoulder, pelvic girdle, and extremity. The term 'aggressive fibromatosis' is also employed to describe this disease, but it is impossible to predict the clinical course in the individual case. The fibromatosis arising in the mediastinum is very rare, and the report about it is nearly absent. The plain radiography shows merely mass with soft tissue density. The CT demonstrates a poorly defined homogenous or heterogeneous mass, isodense with skeletal muscle on precontrast-images, and slightly hyperdense to muscle on postcontrast-scan. Accurate delineation between the tumor & surrounding tissue is vague or frequently impossible. The authors experienced one case of the mediastinal fibromatosis recently and report the case with review of concerned literature.