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世界核心医学期刊文摘（皮肤病学分册） 2005年第3期1卷 16-17页

作者： Ortega K.L. de Araú jo N.S. de Souza F.B. Magalh.aes M.H.C.G. 刘超 Faculdade de Odontologia Departamento de Patologia Bucal Cidade Un iversitá ria Lineu Prestes 2227 05508- 900 S.ao Paulo SP BrazilDr.

A 43-year-old white man was referred to the Special Care Dentistr y Center of the School of Dentistry,University of Sao Paulo, Brazil, for the diagnosis o f an extensive nodular lesion of the maxillary gingiva. The patient complained t hat his left maxilla had swollen over the last 4 months, with some exudation fro m the gingival crevice, sporadic bleeding, and slight tooth mobility, but no pai n. An extra-oral examination confirmed expressive swelling of the left side of the face (Fig. 1A). Palpation disclosed bilateral enlargement of the submandibu lar lymph nodes. An intra-oral examination showed an extensive, reddish, nodul ar mass (around 11 cm in diameter) that extended from the last left maxillary mo lar to the right maxillary incisor, covered by a mucosa that was ulcerated in so me areas (Fig. 1B,C). Palpation revealed a painless, soft, bleeding tissue that seemed to arise in the periodontal ligaments, extending to the palate and vestibular area. A small pigmented spot was found in the palat al mass. Histopathologically, the biopsy revealed a proliferation of neoplastic cells that exhibited a wide variety of shapes, including spindle, plasmacytoid, and epithelioid forms. The atypical cells showed enlarged and pleomorphic nuclei . Mitotic activity and pigmented areas were observed (Fig. 2A,B). Immunohistoche mistry was used to establish the final diagnosis. The tumor cells strongly expre ssed S100 protein, gp100 (HMB- 45), melan A, and tyrosine antibodies (Fig. 2C,D ). With the diagnosis of malignant melanoma, the patient was referred to an onco logist for treatment. As computed tomography revealed that the lesion was deeply inserted into the skull surface (Fig. 1D), surgical intervention was not possib le. The patient underwent radiotherapy, but died 14 months later.

关键词：恶性黑色素瘤牙龈裂多形性核分裂前庭区病理检查血组织肿大淋巴结免疫组化检查瘤细胞

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遗传和环境因素对症状性胆石症的影响:一项瑞典43141例双胞胎的研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第9期1卷 47-48页

作者： Katsika D. Grjibovski A. Einarsson C. H.-U. Marschall 王铮 Dept. of Medicine Div. of Gastroenterol. and Hepatol. Karolinska Univ. Hosp. Huddinge K63 S-14186 Stockholm Sweden Dr.

The contribution of hereditary and environmental factors to the pathogenesis of symptomatic gallstone disease is still unclear. We estimated the relative importance of genetic and environmental factors by analyzing a large population of twins. For this purpose, the Swedish Twin Registry was linked with the Swedish inpatient-discharge and causes of death registries for symptomatic gallstone disease and gallstone surgery-related diagnoses in 43,141 twin pairs born between 1900 and 1958. Concordance rates, correlations, and odds ratios were calculated for males, females, monozygotic, and dizygotic twins, respectively, as well as for twin pairs of opposite sex. Structural equation modeling techniques were used to estimate the contributions of genetic effects aswell as shared and non-shared environmental factors to the development of symptomatic gallstone disease. We found that concordances and correlations were higher in monozygotic compared with dizygotic twins, both for males and females. Of note, there were no significant sex differences in heritability. In the full model, genetic effects accounted for 25%(95%CI, 9%-40%), shared environmental effects for 13%(95%CI, 1%-25%), and unique environmental effects for 62%(95%CI, 56%-68%) of the phenotypic variance among twins. In conclusion, our results show heritability to be a major susceptibility factor for symptomatic gallstone disease, consistent with results from previous, much smaller studies.

关键词：环境因素结构方程环境效应死亡登记手术诊断模型技术作用机制性别差异优势比

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概率弥散成像:用以评估肌萎缩侧索硬化症病程进展率的潜在工具

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世界核心医学期刊文摘(神经病学分册) 2006年第11期 20-21页

作者： Ciccarelli O Behrens T.E Altmann D.R 张平 Department of Headache Brain Injury and Neurorehabilitation Institute of Neurology University College London Queen Square London WC1N 3BG United Kingdom Dr.

The goal of probabilistic tractography is to obtain a connectivity index along a white matter pathway that reflects fibre organization and is sensitive to pathological abnormalities contributing to disability. Here, we present the development of voxel-based connectivity measures along the tractography-derived corticospinal tract (CST). We investigated whether these connectivity measures are different in patients with amyotrophic lateral sclerosis (ALS) and correlate with the rate of disease progression. We also investigated whether fractional anisotropy (FA), which reflects directional coherence of fibre tracts, is reduced in the CST of ALS patients and relates to disease progression rate. Thirteen patients with probable or definite ALS and 19 healthy subjects were studied. The probabilistic tractography algorithm segmented the bilateral CST, along which FA and connectivity values were obtained. To take into account the asymmetric distribution of connectivity values, two summary statistic measures that focused on voxels with higher connectivity values were selected and then used in the analysis, together with the mean connectivity and the mean FA. To complete the analysis, the same summary measures for FA were included. Differences in all these indices between patients with moderate or rapid disease progression rate and controls were investigated using linear regression, adjusted for age and white matter fraction. The association between FA or connectivity in the CST and the disease progression rate was assessed using linear regression. Patients with a rapid disease progression rate had significantly lower summary connectivity measures than controls in the left CST, but there was only a borderline statistical difference in mean connectivity. Patients with rapid progression had a significantly lower mean FA, and any other FA measure, in both CSTs than controls. When only patients were considered, strong associations between the rate of disease progression and all the

关键词：肌萎缩侧索硬化 CST 疾病 FA 进展率连接性概率

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口服和局部雌激素对子宫切除后绝经后妇女下尿路治疗效果的一项随机比较研究

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世界核心医学期刊文摘（妇产科学分册） 2006年第4期2卷 31-32页

作者： Hsu S.-C. E.-M. Tsai 张旸 Kaohsiung Municipal Hsiao Kang Hospital Department of Obstetrics and Gynecology 482 Shan-Ming Rd. H.-Kang Dist. 812 Kaohsiung Taiwan China Dr.

Objective: To compare the effects of oral and vaginal estrogen therapy (ET) on the lower urinary tract in postmenopausal women with prior hysterectomy. Design: Randomized, prospective study. Setting: Tertiary teaching hospital. Patient( s): Fifty-seven hysterectomized, postmenopausal women. Intervention(s): Patients were randomized to receive either oral (0.625 mg of conjugated equine E per tablet; n = 27)-or topical (0.625 mg conjugated equine E per 1 g vaginal cream; n = 30) E, administered once daily. Main Outcome Measure(s): All subjects had E2 measurements, urinalysis, pelvic examination, introital color Doppler ultrasonographies, and personal interviews with the Bristol Female Lower Urinary Tract Symptoms Questionnaires before and 3 months after ET. Result(s): A higher serum level of E2 was noted in the oral group compared with the topical group after ET. The post-ET pulsatility index of periurethral vessels and bladder neck revealed statistically significant decreases in both groups. The incidences of urinary frequency and nocturia were significantly decreased after 3 months of ET in both groups. Changes in the incidence of other symptoms, including stress incontinence and urge incontinence, were not statistically significant. However, subjective improvement of stress incontinence was found in 72.7%of the oral group and 60%of the topical group. Conclusion(s) : The results suggest that ET alone, by an oral or vaginal route, could increase the blood flow around the bladder neck and mid-urethra and relieve the symptoms of overactive bladder and stress incontinence in postmenopausal women with prior hysterectomy. In addition, vaginal preparations are as effective as systemic therapy at the lower serum level of E2.

关键词：子宫切除下尿路雌激素治疗盆腔检查压力性尿失禁口服用药膀胱过度活动症膀胱颈教学医院急

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1项子宫动脉栓塞与子宫肌瘤切除术的多中心对比性研究

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世界核心医学期刊文摘（妇产科学分册） 2006年第4期2卷 22-23页

作者： Goodwin S.C. Bradley L.D. Lipman J.C. 李跃萍 Imaging Services Veterans Administration Greater Los Angeles Health Care System Mail Code 114 11301 Wilshire Boulevard Los Angeles CA 90073 United States Dr.

Objective: To determine whether there is significant quality of life score improvement after uterine artery embolization (UAE)-and to compare UAE and myomectomy outcomes. Design: Prospective cohort controlled study. Setting: Sixteen medical centers in the United States. Patient(s): One hundr.d forty-nine UAE patients and 60 myomectomy patients. Patients were assigned to myomectomy or UAE on the basis of a best treatment decision made by the patient and her physician. All patients were observed for 6 months. The UAE patients also had follow up examinations at 1 year. Intervention(s): Myomectomy or *** Outcome Measure(s): Quality of life score changes, menstrual bleeding score changes, uterine size differences, time off, and adverse events. Result(s): Both groups experienced statistically significant improvements in the uterine fibroid quality of life score, menstrual bleeding, uterine volume, and overall postoperative quality of life. The mean hospital stay was 1 day for the UAE patients, compared with 2.5 days for the myomectomy patients. The UAE and myomectomy patients returned to their normal activities in 15 days and 44 days, respectively, and returned to work in 10 days and 37 days, respectively. At least one adverse event occurred in 40.1%of the myomectomy patients, compared with 22.1%in the UAE group. Conclusion(s): The uterine fibroid quality of life score was significantly improved in both groups. No significant differences were observed in bleeding improvement, uterine volume reduction, uterine fibroid quality of life score improvement, and overall quality of life score improvement between groups. Patients receiving UAE required fewer days off work, fewer hospital days, and experienced fewer adverse events.

关键词：子宫肌瘤切除术子宫动脉栓塞对比性研究生活质量术后生活患者群观察时间无显著性差异恢复时

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Apert综合征的听力检查

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 17-18页

作者： Rajenderkumar D. Bamiou D.-E. Sirimanna T. 郭战宏 Department of Audiological Medicine Royal National Throat Nose and Ear Hospital Grays Inn Road London WC1X 8DA United Kingdom Dr.

Apert syndr.me is one of the craniosynostosis syndr.mes and is commonly associ ated with conductive hearing loss, but there are contradicting reports regarding the cause. Retrospective analysis of case notes of Apert syndr.me patients seen between 1970 and 2003 was therefore undertaken. Seventy case notes were obtaine d; 59%were males. The incidence of congenital hearing impairment was 3.0%. Alm ost all had otitismedia with effusion, which tends to persist into adulthood. Mo re than 56%developed permanent low frequency conductive hearing loss by 10-20 years of age.

关键词：听力检查 Apert综合征传导性听力丧失听力损害病例记录颅骨骨折

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甲状腺功能减退妇女妊娠期增加左旋甲状腺素的时机和剂量

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 6-7页

作者： Alexander E.K. Marqusee E. Lawrence J. 石磊 Department o f Medicine Brighamand Women’s Hospital Harvard Medical School 221Longwood Av e. Boston MA 02115 United States Dr.

BACKGROUND: Hypothyroidism during pregnancy has been associated with im paired cognitive development and increased fetal mortality. During pregnancy, maternal thyroid hormone requirements increase. Although it is known that women with hypo thyroidism should increase their levothyroxine dose during pregnancy, biochemica l hypothyroidism occurs in many. In this prospective study we attempted to ident ify precisely the timing and amount of levothyroxine adjustment required during ***: Women with hypothyroidism who were planning pregnancy were ob served prospectively before and throughout their pregnancies. Thyroid function, human chorionic gonadotropin, and estradiol were measured before conception, app roximately every two weeks during the first trimester, and monthly thereafter. T he dose of levothyroxine was increased to maintain the thyrotropin concentration at preconception values throughout pregnancy. RESULTS: Twenty pregnancies occur red in 19 women and resulted in 17 full-term births. An increase in the levothy roxine dose was necessary during 17 pregnancies. The mean levothyroxine requirem ent increased 47 percent during the first half of pregnancy(median onset of incr ease, eight weeks of gestation) and plateaued by week 16. This increased dose wa s required until delivery. CONCLUSIONS: Levothyroxine requirements increase as e arly as the fifth week of *** the importance of maternal euthyroidis m for normal fetal cognitive development, we propose that women with hypothyroid ism increase their levothyroxine dose by approximately 30 percent as soon as pre gnancy is confirmed. Thereafter, serum thyrotropin levels should be monitored an d the levothyroxine dose adjusted accordingly.

关键词：甲状腺功能减退左旋甲状腺素妇女妊娠期妊娠早期足月产儿血清甲状腺素平台期预期值

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A validated stability-indicating LC method for the separation of enantiomer and potential impurities of Linezolid using polar organic mode

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Journal of Pharmaceutical Analysis 2012年第4期2卷 272-278页

作者： T.Satyanarayana Raju O.Vishweshwari Kutty V.Ganesh P.Yadagiri Swamy dr.Reddy's Laboratories Ltd.Active Pharmaceutical Ingredients IPDOBachupallyHyderabad 500072A.PIndia Department of Chemistry University College of EngineeringOsmania University

Although a number of methods are available for evaluating Linezolid and its possible impurities, a common method for separation if its potential impurities, degradants and enantiomer in a single method with good efficiency remain unavailable. With the objective of developing an advanced method with shorter runtimes, a simple, precise, accurate stability-indicating LC method was developed for the determination of purity of Linezolid dr.g substance and dr.g products in bulk samples and pharmaceutical dosage forms in the presence of its impurities and degradation products. This method is capable of separating all the related substances of Linezolid along with the chiral impurity. This method can also be used for the estimation of assay of Linezolid in dr.g substance as well as in dr.g product. The method was developed using Chiralpak IA (250 mm 4.6 mm, 5 mm) column. A mixture of acetonitrile, ethanol, n-butyl amine and trifluoro acetic acid in 96:4:0.10:0.16 (v/v/v/v) ratio was used as a mobile phase. The eluted compounds were monitored at 254 nm. Linezolid was subjected to the stress conditions of oxidative, acid, base, hydr.lytic, thermal and photolytic degradation. The degradation products were well resolved from main peak and its impurities, proving the stability-indicating power of the method. The developed method was validated as per International Conference on Harmonization (ICH) guidelines with respect to specificity, limit of detection, limit of quantification, precision, linearity, accuracy, robustness and system suitability.

关键词： HPLC Linezolid Validation Polar organic mode Stability-indicating

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多发性皮肤和子宫平滑肌瘤的临床特征:尚无系统性诊断标准的肿瘤综合征

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世界核心医学期刊文摘（皮肤病学分册） 2005年第7期1卷 34-35页

作者： Alam N.A. Barclay E. Rowan A.J. I.P.M.Tomlinson 刘燕 Molec. and Pop. Genetics Laboratory Cancer Research UK Lincoln' s Inn Fields London WC2A 3PX United Kingdom Dr.

Objective: To investigate the clinical features of the multiple cutaneous and uterine leiomyomatosis (MCUL) syndr.me, including the hereditary leiomyomatosis and renal cell cancer syndr.me. Design: A case series of patients with multiple skin leiomyomas solicited via a circular letter to dermatologists. Setting: Research institute. Patients: A total of 108 affected individuals, including 46 probands and 62 affected relatives. Main Outcome Measures: The proportion of probands with underlying fumarate hydr.tase (FH) mutations, the penetrance of FH mutations, and clinicopathologic features of MCUL. Results: Forty-one (89% ) of 46 probands with multiple skin leiomyomas had evidence of germline FH mutations, which were highly penetrant. All 26 male mutation carriers had skin leiomyomas. Of 67 women with FH mutations, 46 (69% ) had both skin and uterine leiomyomas; 10 (15% ) had only skin leiomyomas;5(7% )had only uterine leiomyomas;and 6(9% )were clinically unaffected. Patients presented with skin leiomyomas at a mean age of 24 years and had a mean of 25 lesions. Forty-one individuals (89% ) reported painful lesions, particularly in response to cold or trauma. Fibroids were histologically unremarkable, highly symptomatic, and associated with a high risk of early hysterectomy. One individual had a very aggressive collecting duct renal cancer. The G354R FH mutation predisposed patients to uterine fibroids without skin leiomyomas (P=.03). Many patients with skin leiomyomas had not previously presented for medical attention. Fibroids were rarely recognized as cases of MCUL. Conclusions: Highly penetrant FH mutations underlie MCUL. Increased clinical awareness is important because of the associated risk of severe uterine fibroids and, in some cases, aggressive renal cancer.

关键词：子宫平滑肌瘤诊断标准子宫纤维瘤种系突变外显率组织学检查肾细胞癌延胡索酸水合酶先证者发病年龄

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新生儿脑病的发病率、病因及在2岁时的转归:基于人群的研究

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世界核心医学期刊文摘（儿科学分册） 2005年第10期1卷 26-27页

作者： Pierrat V. Haouari N. Liska A. 郭战宏 Serv. de Med. Neonatale CHRU de Lille Hpital Jeanne de Flandre 2 av O Lambret 59037 Lille Cedex France Dr.

Objectives: To ascertain the prevalence of newborn encephalopathy in term live births, and also the underlying diagnoses, timing, and outcome at 2 years of su rviving infants. Design: Population based observational study. Setting: North Pa s-de-Calais area of France, January to December 2000. Patients: All 90 neonate s with moderate or severe newborn encephalopathy. Results: The prevalence of mod erate or severe newborn encephalopathy was 1.64 per 1000 term live births (95%c onfidence interval (CI) 1.30 to 1.98). The prevalence of birth asphyxia was 0.86 per 1000 term live births (95%CI 0.61 to 1.10). The main cause of newborn ence phalopathy was birth asphyxia, diagnosed in 47 (52%) infants. It was associated with another diagnosis in 11/47 cases (23%). The timing was intrapartum in 56 %of cases, antepartum in 13%, ante-intrapartum in 10%, and postpartum in 2% . In 19%of cases, no underlying cause was identified during the neonatal course . Twenty four infants died in the neonatal period, giving a fatality rate of 27%(95%CI 17%to 36%). Three infants died after the neonatal period. At 2 years of age, 38 infants had a poor outcome, de fined by death or severe disability, a prevalence of 0.69 per 1000 term live bir ths (95%CI 0.47 to 0.91). In infants with isolated birth asphyxia, this prevale nce was 0.36 per 1000 term live births (95%CI 0.20 to 0.52). Conclusions: The c auses of newborn encephalopathy were heterogeneous but the main one was birth as phyxia. The prevalence was low, but the outcome was poor, emphasising the need f or prevention programmes and new the rapeutic approaches.

关键词：脑病活产产时程中

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