CROSS-SECTIONAL ECHOCARDIOGRAPHIC FINDINGS IN VEGETATIVE AORTIC VALVE ENDOCARDITIS

M-mode echocardiograms of two patients with bacterial endocarditis of approximately 4 months' duration showed dense echoes in the area of the aortic valve. In one patient, who had no prior abnormal cardiac findings, the echoes were clearly suggestive of valvular vegetations. The second patient, however, was known to have had aortic valve disease and a systolic murmur for more than a decade; therefore, dense echoes arising from the aortic valve also could have resulted from valvular calcification. In both patients, cross-sectional echocardiography provided important information. In the first patient, retrograde cardiac catheterization was prevented by large and highly mobile masses attached to the aortic cusps that prolapsed into the left ventricular outflow tract during diastole. Aortic valve replacement without further hemodynamic evaluation was recommended. In the second patient, whose blood cultures remained negative after the acute phase of his illness had been treated, cross-sectional echocardiography showed large vegetations on the aortic valve. Intraoperative findings confirmed the echocardiographic interpretation in each case.     

End organ changes associated with the self-regulatory treatment of mild essential hypertension?

M-mode echocardiograms were obtained on unmedicated males with mild hypertension before and after treatment with thermal biofeedback, autogenic training, or self-relaxation. Although patients for whom diastolic blood pressure (DBP) was successfully reduced showed trends toward reduction in left ventricular parameters while unsuccessful patients showed no changes, the results were not significant. For the four patients with borderline left ventricular hypertrophy, there was a strong trend (p = .06) for successful treatment to lead to a reduction in left ventricular mass. Moreover, across the whole sample, reduction in left ventricular mass was related (r = .30) to decrease in DBP.     

End organ changes associated with the self-regulatory treatment of mild essential hypertension?

M-mode echocardiograms were obtained on unmedicated males with mild hypertension before and after treatment with thermal biofeedback, autogenic training, or self-relaxation. Although patients for whom diastolic blood pressure (DBP) was successfully reduced showed trends toward reduction in left ventricular parameters while unsuccessful patients showed no changes, the results were not significant. For the four patients with borderline left ventricular hypertrophy, there was a strong trend (p=.06) for successful treatment to lead to a reduction in left ventricular mass. Moreover, across the whole sample, reduction in left ventricular mass was related (r=.30) to decrease in DBP.This research was supported by a grant from the NHLBI, HL-31189.     

人工饲养和野生草鱼幼鱼耳石微结构的比较研究

分别检测了人工饲养和野生草鱼幼鱼的耳石微结构特征,根据耳石透明性的差异。可将微耳石划分出中央暗区和外部亮区两部分,饲养种群的耳石暗区大小和生长轮数目均大于野生种群,暗区和亮区的特征比较稳定。生长轮清晰,对比度好,宽度比较均匀;野生种群的耳石暗区和亮区表现形式多变。暗区的生长轮清晰或不清晰,亮区的生长轮清晰,但宽度波动较大,依据耳石微结构特征。可以对饲养和野生草鱼种群进行识别。     

IDENTIFICATION OF LARGE LEFT ATRIAL THROMBUS BY CROSS-SECTIONAL AND M-MODE ECHOCARDIOGRAPHY

In addition to a typical pattern indicative of mitral stenosis, the M-mode echo-cardiogram of a patient with mitral valve disease revealed a broad band of dense echoes within an enlarged left atrial cavity that was suggestive of an intraatrial thrombus. Subsequent cross-sectional echocardiography demonstrated a globular cluster of echoes inside the left atrial cavity, thus corroborating our interpretation of the M-mode recording. When open mitral commissurotomy was performed, a large, partially calcified thrombus was found protruding from the posterior wall and left atrial appendage into the atrial cavity. Postoperative M-mode and cross-sectional echocardiography did not show the previously noted abnormal echoes within the left atrium.     

子宫内膜息肉研究进展

子宫内膜息肉(endometrial polyps,EMP)由子宫内膜腺体和含有厚壁血管的纤维化内膜间质构成,是局部子宫内膜过度增生形成的有蒂或无蒂的赘生物。子宫内膜息肉是最常见的子宫内膜病变之一,临床表现为子宫不规则出血,或月经量增多、不孕、绝经后出血等,也可无明显临床症状。子宫内膜息肉多数属良性病变,但其可恶变性已经被证实。子宫内膜息肉的发病机制目前尚不明确,传统观点认为其与慢性子宫内膜炎症有关,属慢性炎症范畴,即为生物致炎因子及长期反复机械性刺激所致的反应性增生物;近年来随着分子生物学研究的深入,发现子宫内膜息肉的发生与可能与激素调控下增殖与凋亡失衡相关。近来随着宫腔镜检查技术的推广及激素补充治疗人数的增多,子宫内膜息肉的发病率及检出率逐渐增加,加之经刮宫或电切治疗后复发率非常高,因此,子宫内膜息肉越来越受到临床医生的重视,现将子宫内膜息肉的研究进展作一综述。     

Electron microscopic study of subcapsular cell hyperplasia in the adrenal glands of IQI/Jic mice.

Hyperplastic cells in subcapsular cell hyperplasia (SCH) lesion in adrenal glands of female IQI/Jic mice were examined by electron microscopy. These cells were small and polygonal, and had irregular nuclei, elongated mitochondria with lamellar cristae and dense lipid droplets. While these cells showed different features, some of them had desmosomes and basement membranes, and a few round mitochondria with tubular cristae as endocrine cells. These findings suggest that hyperplastic cells in SCH lesions might originate from endocrine blastemic cells.     

Bacterial endocarditis of the mitral valve associated with annual calcification.

Bacterial endocarditis, caused mainly by Staphylococcus aureus, was found at autopsy in five patients who had a calcified posterior mitral valve annulus. Clincopathologic correlation indicates that the infection should be suspected in elderly patients with a calcified mitral annulus, the murmur of mitral insufficiency, fever, anemia, polymorphonuclear leukocytosis and a positive blood culture, regardless of evidence of peripheral embolism or of another disease that could cause the last four features. Pertinent pathologic findings are a calcified mitral valve annulus, vegetations of bacterial endocarditis towards the base of the posterior leaflet associated with leaflet perforation and an annulus abscess, and no other valvular disease. The infection may develop on the atrial aspect of a leaflet ulcerated by the calcium mass or may begin on its ventricular aspect, subsequently perforating the leaflet and infecting its atrial surface.     

The Routine Use of Echoencephalography in the Diagnosis of Intracranial Masses

Ultrasonic echoes can be detected from interfaces within the body. This principle has been applied to the examination of the cranial contents by the procedure of echoencephalography. The presence of a unilateral intracranial mass was correctly predicted by this technique in 30 out of 33 cases. The method of examination is simple, harmless, painless and rapid. Its general adoption as an aid in diagnosis of intracranial lesions, particularly in acute head injuries, is recommended.     

Noncontrast computed tomography in the diagnosis of tumors of the major salivary glands

Non-contrast computed tomography (CT) of the major salivary glands was made in 127 patients, which revealed 95 space-occupying lesions (88 intraglandular and 7 extraglandular ones). Pleomorphic tumors of the parotid glands are solitary, round, high-density (29.6 +/- 4.2 HU) masses with well-defined, smooth margins. Salivary cysts were characterized by the presence of a dense capsule; the density of cyst contents was 8.0 +/- 2.0 HU. Salivary lipomas had a characteristic tomographic pattern due to the presence of adipose tissue; the lipoma density was -108.3 +/- 7.8 HU. Malignant parotid tumors were characterized by the presence of higher-density masses with irregular shapes and ill-defined, indistinct margins. Benign submandibular gland tumors had no well-defined margins that separated the tumor from the gland; the density of a tumor matched that of the parenchyma; the mean tumor size was 3.6 +/- 1.3 cm; there was an increase in the sizes of the gland as compared to those of the contralateral gland, as well as a displacement of the adjacent soft tissues. Malignant submandibular gland neoplasms tumors were characterized by the presence of inhomogenous lower-density masses with irregular shapes. Enlarged paraglandular lymph nodes were observed. The sensitivity, specificity, and accuracy of native CT in diagnosing space-occupying lesions of the salivary glands were 97.6, 96.4, and 97.6%, respectively.     

Development and fine structure of the yolk nucleus of previtellogenic oocytes in the medaka Oryzias latipes

The development and fine structure of yolk nuclei in the cytoplasm of previtellogenic oocytes were examined by electron microscopy during several stages of oogenesis in the medaka, Oryzias latipes. Shortly after oogenesis starts, oocytes 20-30 microm in diameter have much electron-dense (basophilic) cytoplasm, within which a continuous or discontinuous, irregular ring-shaped lower electron-dense area of flocculent appearance (LF) begins to emerge around the nucleus. The yolk nucleus is first recognized within an LF area as a few fragments of dense granular thread measuring 20-25 nm in width. The threads consist of two rows of very dense granules resembling ribosomes or ribonucleoprotein (RNP)-like particles in size and electron density. These thread-like fragments gradually increase in number and length until they assemble into a compact, spherical mass of complicated networks. Analysis of serial sections suggests that the yolk nucleus is a complicated mass of numerous, small deformed vacuoles composed of a single lamella with double layers of ribosomes or RNP-like granules, rather than a mass of granular threads. When oocytes develop to greater than 100 microm in diameter, the yolk nucleus begins to fragment before dispersing throughout the surrounding cytoplasm, concomitantly with the disappearance of LF areas. At this stage of oogenesis, a restricted region of the granulosa cell layer adjacent to the yolk nucleus becomes somewhat columnar in morphology, fixing the vegetal pole region of the oocyte.     

Left Ventricular Wall Movement in Heart Failure

Of 34 patients admitted to hospital with left ventricular failure seven died before echocardiograms could be repeated after treatment and in three no echocardiograms could be obtained owing to chronic obstructive lung disease. In the remaining 24 patients echocardiograms were taken soon after admission and compared with echocardiograms taken later, after clinical improvement. The results show that in most patients both anterior and posterior motion of the posterior left ventricular wall increased. The rate of backward diastolic motion was appreciably less before and after treatment of heart failure compared with that in a small group of normal younger healthy men. This technique is a quick and apparently reliable way to assess ventricular function. The rate of diastolic motion is probably a reflection of left ventricular wall compliance.     

Echographic findings and histological feature of the thyroid: a reverse relationship between the level of echo-amplitude and lymphocytic infiltration

In 43 patients with Graves' disease, 5 patients with painless thyroiditis and 30 patients with Hashimoto-thyroiditis ultrasonographical observations and histological examinations by needle biopsy of the thyroid were carried out simultaneously. In all cases the level of echo-amplitude was well correlated with the rate of lymphocytic infiltrations and fibrosis. In cases which exhibited marked lymphocytic infiltrations in the thyroidal biopsy specimen, no apparent echoes or very low amplitude echoes were observed in the whole thyroid and in cases in which replacement with lymphocytic infiltration was observed in almost a half part of the thyroid, several sonolucent regions were observed in the thyroid and in cases in which lymphocytic infiltration or fibrosis was observed sporadically, low-amplitude and uniform echoes were observed in the whole or several regions of the thyroid. In cases with no lymphocytic infiltration in the histological specimen, diffuse high-amplitude and uniform echoes were observed throughout the whole lobe of the thyroid. In patients with painless thyroiditis, the amplitude of echo was low when the level of lymphocytic infiltration was high and the echo-amplitude showed a tendency to increase along with the decrease in the rate of lymphocytic infiltration. From these observations it is concluded that echo-amplitude is well correlated with lymphocytic infiltration and fibrosis in patients with Hashimoto-thyroiditis, Hashitoxicosis and painless thyroiditis.     

Two-dimensional echocardiography in the diagnosis of unusual left atrial myxomas

In two patients with atypical myxomas of the left atrium, two-dimensional echocardiography furnished valuable diagnostic information. In one patient, who had previously developed an embolism at the right brachial artery, M-mode echocardiography revealed an abnormal band of echoes within the left atrium. Two-dimensional echocardiography showed a globular cluster of echoes that remained within the left atrial cavity throughout the cardiac cycle; left ventricular angiography confirmed the ultrasonic findings of an intraatrial mass. At surgery, a calcified, nonprolapsing myxoma was excised from the interatrial septum. The second patient had clinical as well as M-mode echographic features of mitral stenosis. Cardiac catheterization showed a significant gradient across the mitral valve, but the left ventriculogram was normal except for an unusual pattern of mitral regurgitation. Subsequent two-dimensional echocardiography revealed a mass of echoes that prolapsed through the mitral valve during diastole. At surgery, a left atrial myxoma was found attached to the posterior mitral annulus. Our experience indicates that two-dimensional ultrasound is superior to conventional echocardiography for detecting unusual cardiac masses.     

血清肿瘤标志物联合多层螺旋CT和核磁共振对胆管癌的诊断价值及其与组织侵袭分子的关系分析

目的:探讨血清癌抗原19-9(CA19-9)、糖类抗原125(CA125)、多层螺旋CT和核磁共振(MRI)联合检测对胆管癌的诊断价值,并分析肿瘤标志物与组织侵袭分子的相关性。方法:选择2017年1月至2018年8月赤峰学院附属医院收治的胆管癌患者62例作为胆管癌组,另选择同期我院收治的胆管良性病变患者55例作为胆管良性病变组。比较两组血清CA19-9、CA125水平以及组织侵袭分子含量,观察胆管癌患者和胆管良性病变患者的多层螺旋CT和MRI影像学征象,分析血清CA19-9、CA125、多层螺旋CT和MRI对胆管癌的诊断价值,并分析血清CA19-9、CA125水平与组织侵袭分子含量的相关性。结果:胆管癌组血清CA19-9、CA125水平高于胆总管良性病变组,胆管癌组织赖氨酰氧化酶样蛋白-2(LOXL2)、瞬时受体电位阳离子通道7(TRPM7)含量高于胆总管良性病变组,组织E钙黏素(E-cadherin)含量低于胆总管良性病变组(P0.05)。多层螺旋CT影像学征象:胆管癌可见胆总管、肝管内圆形或类圆形高密度影伴有管壁浸润,胆管内出现不规则结节,肿块与周围组织界限模糊,胆囊管及胆囊颈部浸润,肝叶萎缩,淋巴结肿大等;胆管良性病变则多为圆形或类圆形高密度影,管壁浸润、淋巴结肿大并不多见。MRI影像学征象:胆管癌肝内胆管与肝组织分界不清,肿块呈不规则或分叶状,胆囊增大,肝内外胆管不同程度扩张,胰管扩张,肝叶萎缩,淋巴结肿大;胆管良性病变胆管则多为"杯口状"低信号充盈缺损,胆管梗阻上方出现"鸟嘴样"改变等。血清CA19-9、CA125、多层螺旋CT和MRI联合检测对胆管癌诊断的灵敏度、特异度、准确度均高于CA19-9、CA 125、多层螺旋CT、MRI单独诊断。胆管癌患者血清CA19-9、CA125水平与组织LOXL2、TRPM7含量呈正相关,与组织E-cadherin含量呈负相关(P0.05)。结论:血清CA19-9、CA125、多层螺旋CT和MRI联合检测对胆管癌诊断具有较好的价值,患者血清CA19-9、CA125水平与组织侵袭分子存在相关性,可以为胆管癌恶性程度的评估提供依据。     

Echocardiographic features of an unusual case of aortic valve endocarditis.

In a patient with aortic valve endocarditis a myocardial abscess, complete heart block and acute aortic regurgitation developed. Echocardiography gave evidence of large aortic valve vegetations, and at operation vegetations were found to have destroyed the right coronary cusp and part of the noncoronary cusp. Following surgery the patient recovered. Echocardiography may prove to be a useful noninvasive technique to aid in the timing of surgical therapy in patients with valvular vegetations.     

Demonstration by light and electron microscopy of capsules on gonococci recently grown in vivo.

A study by light microscopy, using Leishman's stain alone or Leishman's stain followed by nigrosin, showed the presence of capsules on gonococci of two strains subcultured from subcutaneous chambers in guinea pigs. With the Alcian blue method of preparation for electron microscopy, gonococci of both strains recently grown in vivo showed densely stained capsules on some cells, while others in the same preparation showed only irregular masses of dense material on their surfaces with strands connecting adjacent bacteria. Treatment with antiserum, complement and conglutinin revealed irregular masses and strands of extracellular material with fixatives that did not contain Alcian blue.     

The validity of burrow counting in estimating the densities of Chiromantes dehaani and Ilyoplax deschampsi in tidal flat at Yangtze Estuary

It has been confirmed that the crabs play significant roles in the structure and function of coastal wetland ecosystems, such as mangroves and salt marshes. However it is not easy to estimate the abundance and density of burrowing crabs effectively, thus a further understanding of roles of crabs in these ecosystems has been lagged. Some studies have discussed the suitability of several census techniques, such as burrow counting method in estimating crab density in mangroves. The validities of burrow counting method and other census techniques in estimating crab density, however, has not been tested in salt marshes, especially where vegetation are dense. In this study, we tested the validity of burrow counting method in estimating the densities of Chiromantes dehaani and Ilyoplax deschampsi in tidal flat with dense vegetation of Phragmites australis and Zizania aquatica at Yangtze Estuary through comparing densities estimated by the burrow counting method and the excavation. Burrow counting averagely underestimated the density of C. dehaani by 15% and the degree of underestimation varied among vegetations and habitats (from an overestimate by 23% to underestimate by 41%). Burrow counting averagely overestimated the density of I. deschampsi by 43% and the degree of overestimate varied from 0% to 133% depending on the vegetations and habitats. The percentage of occupied burrows and the number of crabs sharing one burrow were important factors influencing the validity of estimating crab density through burrow counting method.     

On the ultrastructure of the ovary of the liver fluke (Fasciola hepatica L.)

Summary The ovary of the liver fluke has been studied with light and electron microscopy. The organ consisted of germ cells and a layer of peripheral cells suggested to be nurse cells, and was surrounded by a capsule containing muscular tissue. The peripheral cells rested on a thick basement membrane and were irregular in outline. Their nuclei were of irregular shape, the mitochondria were dark with few cristae and the endoplasmic reticulum was tubular or vesicular and partly studded with ribosomes. The germ cells were rounded or polyhedral except in the outer part of the ovary where some of them showed irregular processes. The germ cells of the outer region (oogonia) were relatively small and in close contact with the cells suggested to be nurse cells. The inner germ cells (oocytes) were large and loosely packed. Their nuclei were irregular and contained round distinct nucleoli. The nuclear envelopes showed numerous pores. The endoplasmic reticulum was very sparse, but free ribosomes were abundant in the cytoplasm. This corresponded with a strong basophilia removable with RNase. In addition round basophilic bodies formed by densely packed ribosomes and membraneous material occurred in close spatial relation to mitochondria. The latter contained dense granules and few cristae. Groups of vesicles and membraneous lamellae were found in the cytoplasm, but they were considerably smaller than vertebrate Golgi complexes. Numerous dense spherical granules were found mainly in the periphery of the large germ cells. The granules were strongly osmiophilic except in the terminal part of the ovary. They were PAS-positive, but negative to Sudan dyes.Supported by a grant from Jordbrukets Forskningsråd, Stockholm.     

Variation in plasma glucose and pancreatic β cells in the turtle, Lissemys punctata (order: Chelonia; family: Trionychidae)

The present study relates to the determination of the plasma glucose level and volumetric analysis of β cells in pancreatic islets of the soft‐shelled turtle Lissemys punctata during different phases of its reproductive cycle. Reproductive events play a vital role in influencing the plasma glucose level and β‐cell behaviour in the pancreatic islets. The colour of the pancreas is either yellowish or pinkish, depending on endocrine activity. Islets are present throughout the gland and range from individual cells to small or large clumps, depending on the seasonal cycle. Splenic islets are dense with more blood capillaries and nerve innervations irrespective of sex and season. The endocrine cell mass forms irregular patches without connective tissue capsule. β cells occupy the inner region of the islets, being surrounded by other cell types. Lissemys punctata exhibits higher β‐cell activity during hibernation. Most insulin‐secreting cells acquire a larger size during the regressive period. An analysis indicates that β cells outnumber the non‐β endocrine cell mass in both number and per cent volume. There is negative correlation between islet mass and animal weight. Between the periods of reproductive cycles, a difference exists with respect to fasting plasma glucose and β‐cell volume.