Evaluation and management of thyroid incidentalomas detected prior to the parathyroid surgery

Background

We investigated the management of thyroid incidentalomas associated with cases of parathyroid lesions in order to suggest a practical approach to their management from a surgical point of view.

Role of infection in the middle lobe syndrome in asthma.

Twenty one children with asthma aged 1.0-10.5 years (mean (SD) 3.3 (2.5) years) were admitted to the hospital to evaluate pulmonary right middle lobe or lingular collapse lasting one to 12 months (mean (SD) 4.4 (3.8) months). Seven children had mild asthma and were treated with inhaled beta 2 agonists as needed. Nine had moderate asthma treated with either sodium cromoglycate or slow release theophylline. Five had severe asthma treated with inhaled steroids. Each child underwent fibreoptic bronchoscopy under local anaesthesia and a bronchoalveolar lavage. Differential cell counts of the lavage fluid revealed predominance of neutrophils in 12 patients (57%). In nine of these patients cultures grew pathogenic bacteria, mainly Haemophilus influenzae and Streptococcus pneumoniae. There was no correlation between the severity of asthma and a positive bacterial culture. There was also no correlation between the duration of the right middle lobe collapse and a positive culture. We conclude that longstanding right middle lobe collapse in asthmatic children is often associated with bacterial infection.     

Characterization of the median sacral artery course at the sacral promontory using contrast-enhanced computed tomography

Introduction and hypothesis

Laparoscopic sacral colpopexy (SC) is increasingly utilized in the surgical management of apical prolapse. It involves attachment of a synthetic mesh to the sacral promontory and to the prolapsed vaginal walls. The median sacral artery (MSA) runs close to the site of mesh attachment and is therefore prone to intraoperative injury, which may lead to profound hemorrhaging. The aim of this study was to determine the location of the MSA at the level of the sacral promontory with regard to adjacent visible anatomical landmarks. Surgeons may use this information to reduce the risk for presacral bleeding.

Methods

Sixty consecutive contrast-enhanced pelvic computed tomography scans were revised, and the location of the MSA at the level of the sacral promontory was determined in relation to the ureters, iliac arteries, sacral midline, and aortic bifurcation.

Results

The MSA runs 0.2?±?3.9 mm left to the midline of the sacral promontory and 48.0?±?15.4 mm caudal to the aortic bifurcation. The ureters, internal and external iliac arteries on the right were significantly closer to the MSA than on the left (30.0?±?7.1 vs 35.2?±?8.8 mm, p?=?0.001; 21.5?±?6.8 vs 30.3?±?8.4 mm, p?<?0.0001; 32.8?±?10.2 vs 41.9?±?14.5 mm, p?=?0.005 respectively).

Conclusions

The MSA, which runs left to the midline of the sacral promontory, and its location can be determined intraoperatively in relation to adjacent visible anatomical structures. The iliac vessels and ureter on the right are significantly closer to the MSA than those on the left. This information may help surgeons performing SC to avoid MSA injury, thus reducing operative morbidity.

     

β-淀粉样多肽1-42(Aβ42)多克隆抗体的制备及其鉴定

目的：β—淀粉样多肽1—42(Amyloid β1-42，简称Aβ42)是存在于阿尔茨海默病(Alzheimer’s Disease，AD)患者脑组织中的特异病理改变之物，同时它在AD患者的脑积液及血浆中有所改变。我们制备Aβ42多克隆抗体及其建立测定方法，是希望找到—个特异性鉴定AD的生物指标。方法：将Aβ42多肽与匙孔虫戚血蓝蛋白(KLH)偶联，免疫新西兰白兔从而产生抗—Aβ啦多克隆抗体。此特异性抗体可用于ELISA、Western印迹法和免疫组织化学的方法中，并可测定AD脑组织中的特异性淀粉样沉淀物。结果：通过免疫组织化学法鉴定此抗—Aβ42多克隆抗体，结果显示在AD患者的脑组织淀粉样沉淀物中呈阳性。同时应用Western印迹法对Aβ42抗体进行了鉴定，结果显示Aβ42多肽的分子量与Aβ42多肽标准的4．5kDa分子量相一致。结论：我们所制备的Aβ42多克隆抗体能与Aβ42抗原呈特异性结合，这就为研究淀粉样前体蛋白(APP)在生理学和病理生理学上的机制提供了—个有效工具。