Magnetic resonance imaging in the diagnosis of gastric cancer: X-ray versus MRI anatomic findings

The paper assesses the present-day role of MRI in the diagnosis of gastric cancer. The authors consider the major prerequisites for the main aim of their study to be: 1) a dramatic incidence of diffuse (endophytic) gastric carcinoma, which requires significant correction of today's approaches to its diagnosis and 2) a rather biased and, in the authors' opinion, present-day mainly negative attitude towards MRI of the stomach as a diagnostic method for its tumor lesions. By applying the X-ray-MRI anatomic principle to the comparative study of MRI findings in 50 patients with predominantly gastric intramural carcinoma and in 25 patients without gastric tumors (controls), the authors present their methods for gastric MRI, the MRI semiotics of gastric cancer by concurrently touching upon a variety of problems that characterize the potentialities of MRI of the stomach in the diagnosis of its tumor lesions, including their differential diagnosis. As a result, the authors highly appreciate gastric MRI and consider this method to be included into the diagnostic algorithm of radiation techniques used in the diagnosis of gastric cancer, which should occupy its definite diagnostic place.     

Shear wave elastography: possibilities of the differential diagnosis of focal and diffuse changes in various organs and tissues

Ultrasound study (USS) using a shear wave elastography procedure was made in different groups of patients with morphologically verified focal and diffuse abnormalities of both superficial organs and structures and viscera. The qualitative and quantitative characteristics of the stiffness of normal and pathologic organs and tissues were estimated; there was a significance importance of differences in benign and malignant lesions. The magnitude of fibrous changes in the hepatic parenchyma was first estimated by a USS technique; there was evidence that there were significant differences in indicators in health and various liver abnormalities.     

Ultrasonic study of the brain in the diagnosis of meningoencephalitis in young children

The paper is concerned with the potentialities of ultrasonic study (USS) of the brain in 60 children of young age, suffering from meningoencephalitides of various genesis. The authors analyzed in detail the results of scanning in different sections, permitting the determination of topographic characterization of a pathological process, changes in the cerebral parenchyma and ventricular system, its spreading and complications. USS ensured the significance of final diagnosis, efficacy of therapy and detection of the effects of cerebral infection, serving a prognostic factor during a follow-up of these patients by pediatricians, neuropathologists and neurosurgeons.     

胃印戒细胞癌与非印戒细胞癌临床病理分析

目的：通过比较胃印戒细胞癌与非印戒细胞癌的临床特征与病理资料,探讨胃印戒细胞癌的临床特征,病理特点及预后。方法：回顾性分析2005年1月至2007年1月在哈尔滨医科大学附属第三医院住院治疗的1138例胃癌患者临床资料,根据组织学类型分为胃印戒细胞癌组和非印戒细胞癌扣对两组的性别、年龄、家族史、肿瘤发生部位、浸润深度、淋巴结转移、远处转移及根治术后中位进展时间、1年生存率和3年生存率进行统计分析比较。结果：胃印戒细胞癌好发于女性（P〈0．05）;年龄≤55岁的患者发病率高于非印戒细胞癌（P〈0．05）,≥56岁的患者发病率低于非印戒细胞癌（P〈0．05）;肿块生长部位以胃中下部为主（P〈0．05）,侵犯胃上部者明显少于非印戒细胞癌（P〈0．05）;胃印戒细胞癌多数在胃壁组织内呈弥漫浸润性生长,垂直浸润能力较弱,突破浆膜层者明显少于非印戒细胞癌（P〈0．05）;根治术后中位进展时间胃印戒细胞癌（10个月）较非印戒细胞癌（12个月）提前2个月,进展风险增加（P〈0．05）;胃印戒细胞癌在家族史、淋巴结转移、远处转移及根治术后1年和3年生存率方面与非印戒细胞癌比较无差异。结论：胃印戒细胞癌多发于中青年女性;好发年龄小于56岁;发病部位以胃中下部为主;多呈弥漫性浸润性生长,且较少突破浆膜层;中位进展时间短,进展风险高。     

Long-term follow-up of a patient with early diagnosis of untreated stomach cancer

A case of the patient with type IIc carcinoma of the stomach is presented. The patient was followed-up for 7 years, and did not agree to the operation. Endoscopic examination has shown that the ulcer did not change within 6 years. No data suggesting generalization of the neoplastic process were available during 7 years following the diagnosis. The authors review the literature on the kinetics of the carcinoma of the stomach proliferation in both experimental and clinical investigations.     

Comparative stability of the "Internal Fixator" and the "Universal Spine System" and the effect of crosslinking transfixating systems. A biomechanical in vitro study.

In this study, the three-dimensional stabilizing capabilities of the AO-Internal Fixator (IF) and the new Universal Spine System (USS) were investigated. Both devices were tested without and with the cross-link system (IF, IFC, USS, USSC). To determine biomechanical characteristics, a human thoracolumbar spine instability model with resection of the vertebral body Th12 was created. The vertebral body was replaced by a spacer and transpedicular posterior stabilization was performed from Th11 to L1. All devices reduced the range of motion (ROM) significantly compared to the values of the intact specimen. In flexion the IFC showed the highest reduction of ROM (85% of intact), followed by the USSC, USS and IF (79% of intact). In extension the ROM was restored again most by the IFC (52% of intact), followed by the USSC, IF and USS (44% of intact). In lateral bending stability was provided by the USSC (right 78% and left 81% of intact), followed in right lateral bending by the IF, IFC and USS and in left lateral bending by the USS, IF and IFC. In axial rotation the ROM was reduced primary by the IFC (right 51% and left 46% of intact), followed in right axial rotation by the USS, USSC and IF, in left axial rotation by the USSC, USS and IF. Additional stability by crosslinking has been provided in the IF and the USS in flexion and extension, in the USS in lateral bending and in the IF in axial rotation nonsignificantly. The neutral zone (NZ) was reduced by posterior instrumentation in flexion/extension and right/left lateral bending significantly. In axial rotation only the USSC decreased the NZ below intact levels. The study showed no statistical significant differences in the stabilizing capabilities of the USS compared to the IF. For both implants the cross-link system increased stability in the chosen instability model insignificantly only.     

Ultrasound study in the differential diagnosis of thyroid focal lesions of various origin

The present study deals with the ultrasound differential diagnosis of thyroid lesions. A hundred and ninety-two patients, including 130 patients with benign diseases (nodular colloidal goiter) (36.9%), chronic autoimmune thyroiditis (30.7%), and adenomas (32.3%) and 62 patients with malignant diseases (thyroid cancer (88%), lymphoproliferative diseases (6.4%), and recurrent thyroid cancer) (4.8%), were clinically examined. Ultrasound studies (USS) were performed in the B- and (see text symbols) modes. The diagnosis was verified from cytological and histological findings with mandatory morphological confirmation. Interdisease comparison has shown that USS is both a screening and diagnostic technique in revealing thyroid changes and determining their site, sizes, and structure. Ultrasound pathognomonic signs were detected in different morphological types of adenomas, thyroiditis, and nodular colloidal goiter, in the classical, pseudoadenomatous and pseudocystic types of thyroid cancer. At the same time there were characteristic ultrasound parameters at the stage of pronounced changes in undifferentiated thyroid cancer (pseudothyroiditis), lymphoproliferative diseases, and acute thyroiditis. The exception was the diffuse form of chronic autoimmune thyroiditis in which both thyroid lobes were always altered.     

Comparison of Ultrasonic Scalpel versus Conventional Techniques in Open Gastrectomy for Gastric Carcinoma Patients: A Systematic Review and Meta-Analysis

Objectives

To compare surgical efficacy and postoperative recovery of ultrasonic scalpel (USS) with conventional techniques for the resection of gastric carcinoma.

Methods

A systematic search of major medical databases (PubMed, Embase, CCRT and CNKI) was conducted. Both randomized and non-randomized controlled trials (RCTs and nRCTs) were considered eligible. Operation time (OT), intraoperative blood loss (BL) and postoperative complications (POC) rates as well as postoperative hospitalization days, number of dissected lymph nodes, abdominal drainage volume and time for recovery of gastrointestinal functions were synthesized and compared.

Results

Nineteen studies were included (7 RCTs and 12 nRCTs), in which 1930 patients were enrolled totally (946 in the USS group and 984 in the conventional group). Monopolar electrocautery and ligation were used as the conventional methods. Comparative meta-analysis showed perioperative outcomes were significantly improved using USS compared with conventional surgical instrumentation. OT was reduced from a weighted mean of 185.3 min in the conventional group to 151.0 min in the USS group (MD = −33.30, 95% CI [−41.75, −24.86], p<0.001) and intraoperative BL was decreased from a weighted mean of 217.9 ml in the conventional group to 111.6 ml in the USS group (MD = −113.42, 95% CI [−142.05, −84.79], p<0.001). Results from RCTs subgroup were consistent with those from nRCTs subgroup. The weighted cumulative risk of POC accounted for 8.9% (0%–25%) and 12.9% (5.5%–45%) in the USS and conventional groups, respectively. Pooled estimated results from nRCTs (OR = 0.54, 95% CI [0.27, 1.06], p = 0.07) and RCTs (RR = 0.75, 95% CI [0.44, 1.26], p = 0.27) showed no significant difference between the USS and control groups. Analysis of secondary outcomes showed the improvements of the USS group over control group regarding the number of dissected lymph nodes, postoperative hospitalization days, abdominal drainage volume and time for recovery of gastrointestinal functions.

Conclusion

Compared with conventional electrosurgery, the USS is a safe and effective technique with more short-term advantages in open surgery for gastric cancer.     

老年人萎缩性胃炎和胃癌与胃液pH及微生态环境改变的关系探讨

本实验研究了老年人萎缩性胃炎和胃癌患者的胃液ｐＨ值及胃内部分菌群数量与正常人胃液ｐＨ值及菌群数量的比较,从１５例萎缩性胃炎患者和１５例胃癌患者的胃液中发现ｐＨ值增高,随之肠杆菌、肠球菌、拟杆菌数量也明显高于正常人,而一些胃内的生理菌少于正常人,由此证明胃内微环境的改变与胃癌的发病率有关系     

Computed tomography in the diagnosis of endophytic cancer of the stomach

The authors discuss the potentialities of CT in the diagnosis of endophytic stomach cancer. They proposed a method for CT of the stomach based on a pneumatic study of its lumen via a nasogastric probe with graded inflation and repeated CT imaging. The major CT-semiotics of endophytic stomach cancer were obtained. This method should be employed in combination with the existing routine methods of stomach cancer diagnosis, and its efficacy is in direct relation to the quality of preliminary routine x-ray and endoscopic investigations.     

Algorithms of x-ray and ultrasonic diagnoses in urology]

Roentgenourologic methods and ultrasonic scanning (USS) should be combined in the radiologic diagnosis of urologic diseases. USS should be the first stage of examinations of urologic patients, and its results should be taken into account when planning and carrying out excretory urography. USS can be repeated before more sophisticated roentgenourologic examinations in order to single out the "zones of interest"; special programmes are possible for the purpose-pharmacoechography, dopplerography, etc. Development of tentative algorithms of x-ray and ultrasonic diagnosis of the major urologic diseases will help optimize the diagnostic process.     

Autoradiographic study of human scirrhous gastric carcinoma during cultivation in diffusion chambers]

The growth of the epithelial and connective tissue cells was noted in cultivation of human schirrous carcinoma of the stomach in diffuse chambers. In difference to the initial tissue of the tumour in vitro in which no incorporation of thymidine-H3 into the connective tissue cells was noted, these cells proved to be labeled under conditions of growth in the chambers. One hour after the administration of thymidine-H3 the percentage of cells with labeled nuclei averaged 25.1% this considerably exceeding the value of the label index determined under conditions of incubation in vitro of the initial tumour tissue (6.6%). Under conditions of cultivation there was revealed a rapidly proliferating subpopulation of cells with the mitotic cycle duration of 14.8 hours.     

Unsupervised Spike Sorting of extracellular electrophysiological recording in subthalamic nucleus of Parkinsonian patients

The present study demonstrates the application of the Unsupervised Spike Sorting algorithm (USS) to separation of multi-unit recordings and investigation of neuronal activity patterns in the subthalamic nucleus (STN). This nucleus is the main target for deep brain stimulation (DBS) in Parkinsonian patients. The USS comprises a fast unsupervised learning procedure and allows sorting of multiple single units, if any, out of a bioelectric signal. The algorithm was tested on a simulated signal with different levels of noise and with application of Time and Spatial Adaptation (TSA) algorithm for denoising. The results of the test showed a good quality of spike separation and allow its application to investigation of neuronal activity patterns in a medical application. One hundred twenty-four single channel multi-unit records from STN of 6 Parkinsonian patients were separated with USS into 492 single unit trains. Auto- and crosscorrellograms for each unit were analyzed in order to reveal oscillatory, bursting and synchronized activity patterns. We analyzed separately two brain hemispheres. For each hemisphere the percentage of units of each activity pattern were calculated. The results were compared for the first and the second operated hemispheres of each patient and in total.     

Current complex noninvasive diagnosis of parathyroid tumors

The diagnosis of bulky formations of the parathyroid glands (PTG) has become possible since current high-resolution techniques of visualization, such as ultrasound study (USS), computed tomography (CT), magnetic resonance imaging (MRI), were introduced into practice. The presence of clinical and/or laboratory signs of hyperparathyroidism (HPT) is a signal to initiate a goal-oriented search for abnormal PTG formations. The complex diagnosis of HPT involves the methods of detecting osteoporosis ranging from routine X-ray study of the hand and foot to more in-depth techniques: dichromatic X-ray absorptiometry (DXA) and quantitative CT (QCT). USS is an excellent method for screening if abnormal PTC changes are suspected; however, negative USS results in the presence of clinical and/or laboratory signs of HPT should not stop a diagnostic search. CT with intravenous contrast bolus specifies the site and structure of an formation, has some advantage in detecting retrosternal tumors. Due to its high tissue contrast, three-dimensional images, none ionizing radiation and osseous structural artefacts, MRI becomes a preferable tool for studying PTG when they are typically or atypically located. Needle biopsy is required when noninvasive methods cannot characterize the pattern of an abnormal PTG formation properly or their results are contradictory.     

Study of the "continuous cell antigen" and the human gastric mucosa]

The antigen common for continuous epithelial cell lines and gastric mucosa of humans described earlier was studied. This antigen was revealed in one more cell line, namely in that prepared from human mammary carcinoma MDA-MB-231, noncontaminated with HeLa cells. The antigen described can be detected in the exophytely growing adenocarcinomas of the stomach and in the mucosa of the carcinoma affected stomach at a distance of 10--12 cm from the site of affection; no such antigen was revealed in the endophytely growing carcinoma of the stomach and in mucosa areas surrounding gastric ulcer. The antigen is not a glycoprotein since glycoprotein fractions obtained by means of 1.2 M perchloric acid from the normal stomach mucosa homogenate and the E 16b extract were inactive in immunodiffusion with a sensitive serum. The electrophoretic mobility of the antigen was similar to that of globulin alpha1-beta2. This antigen is of interest since its detection or absence would possibly aid in determination of the initial type of cells from which development of carcinoma occurred, and in more precise recognition of the histological form of carcinoma of the stomach.     

Clinical and radiation diagnosis of circumscribed peritonitis complicating duodenal perforation

This paper deals with the results of ultrasound (US) and multislice computed tomography (MSCT) in patients with perforated duodenal ulcer in different periods after the onset of the disease, with varying clinical manifestations, and in the postoperative period. A comparative analysis of the results of radiation studies has indicated that X-ray study is a basic technique that defines treatment policy in the early development periods of perforation; US study (USS) reveals a change in the duodenum, fluid and infiltration outside the duodenum. As circumscribed peritonitis progresses, USS allows the diagnosis of abdominal abscesses and infiltrations. Out of the radiation techniques, MSCT is of most importance in the diagnosis of interintestinal abscesses and in the determination of syntopy of purulent cavities.     

Chemopreventive effects of minor dietary constituents in common foods on human cancer cells

Epidemiological evidence has suggested that vegetables and fruits may have a role in cancer prevention. The aim of the present study was to examine the anti-proliferative activity of ten related pure compounds from common vegetables and fruits. Studies were conducted on a series of carcinoma cells derived from eight human organs. The results show that linalool possessed the strongest activity against nine carcinoma cells, and that baicalein and luteolin also exhibited a broad spectrum of anti-proliferative activities. Among them, linalool showed the strongest activity against carcinoma of the cervix (IC50: 0.37 microg/ml), stomach (IC50: 14.1 microg/ml), skin (IC50: 14.9 microg/ml), lung (IC50: 21.5 microg/ml) and bone (IC50: 21.7 microg/ml). As for the flavonoids, luteolin exhibited the strongest activity against carcinoma of the stomach (IC50: 7.1 microg/ml), cervix (IC50: 7.7 microg/ml), lung (IC50: 11.7 microg/ml) and bladder (IC50: 19.5 microg/ml), whereas baicalein possessed the strongest anti-proliferative activity against carcinoma of the cervix (IC50: 9.8 microg/ml), stomach (IC50: 16.1 microg/ml) and skin (IC50: 19.5 microg/ml). The present study indicates that linalool possessed the strongest activity against a broad spectrum of carcinoma cells, especially cervical carcinoma cells, suggesting that linalool and flavonoids are partially responsible for the cancer prevention of common vegetables and fruits.     

Anterior vertebral body screw pullout testing with the hollow modular anchorage system--a comparative in vitro study.

Pullout of implants at the proximal and distal ends of multilevel constructs represents a common spinal surgery problem. One goal concerning the development of new spinal implants is to achieve stable fixation together with the least invasive approach to the spinal column. This biomechanical study measures the influence of different modes of implantation and different screw designs, including a new monocortical system, on the maximum pullout strength of screws inserted ventrolaterally into calf vertebrae. The force pullout of eight different groups were tested and compared. Included were three bicortical used single screws (USS, Zielke-VDS, single KASS). To further increase pullout strength either a second screw (KASS) or a pullout-resistant nut can be added (USS with pullout nut). A completely new concept of anchorage represents the Hollow Modular Anchorage System (MACS-HMA). This hollow titanium implant has an increased outside diameter and is designed for monocortical use. Additionally two screw systems suitable for bicortical use were tested in monocortical mode of anchorage (USS, single KASS). We selected seven vertebrae equal in mean size and bone mineral density for each of the eight groups. The vertebral body and implant were connected to both ends of a servohydraulic testing machine. Displacement controlled distraction was applied until failure at the metal-bone-interface occurred. The maximum axial pullout force was recorded. Mean BMD was 312 +/- 55 mg CaHA/ml in cancellous bone and 498 +/- 98 mg CaHA/ml in cortical bone. The highest resistance to pullout found, measured 4.2 kN (KASS) and 4.0 kN (USS with pullout nut). The mean pullout strength of Zielke-VDS was 2.1 kN, of single KASS 2.5 kN, of MACS-HMA 2.6 kN and of USS 3.2 kN. There was no statistically significant difference (t-test, p > 0.05) between bicortical screws and the new monocortical implant. For the strongest fixation at the proximal or distal end of long spinal constructs the addition of a second screw or a pullout-resistant nut behind the opposite cortex offers even stronger fixation.     

一种新的抑癌候选基因——NDR2在人类正常组织及相应肿瘤中的表达

为观察NDR2基因在人类正常组织及相应肿瘤组织中的表达分布特点,收集人脑与胶质瘤、肺与肺癌、胃与胃癌、结肠与结肠癌组织标本,分别进行组织石蜡切片和总RNA提取,应用免疫组化方法和RT-PCR技术检测NDR2蛋白质及mRNA表达水平,并通过DNA测序验证PCR产物的正确性.免疫组化结果表明,在上述各组织均有NDR2蛋白不同程度的表达.RT-PCR结果显示,在人脑和胶质瘤组织、肺与肺癌组织、胃与胃癌组织、结肠与结肠癌组织中均有NDR2 mRNA表达,其表达水平以脑组织为最高.NDR2 mRNA在正常脑和肺组织的表达水平分别显著高于胶质瘤与肺癌组织,而结肠与结肠癌组织,胃与胃癌组织NDR2 mRNA表达水平则无显著差别.以上结果表明,NDR2基因可能广泛表达于人体正常组织内,而在胶质瘤与肺癌中的表达较相应正常组织减低,提示该基因可能与神经系统及呼吸系统肿瘤的发生发展有关,为进一步探讨该基因功能提供了线索.