Objective To evaluate the surgical treatment for patients with malignant colorectal mesenchymoma, and to analyze the clinical data, pathological features and the common presenting symptoms and its immunohistochemical staining property. Methods The clinical data and the pathological findings, including immunohistochemical staining, of 17 patients with malignant colorectal mesenchymoma admitted from Jan 1990 to Mar 2005 were retrospectively analyeed. All the patients were followed up carefully. Results All the patients underwent operation, and all the tumors were proved malignant pathologically. In 6 cases left hemicolectomy was done, in 3 cases right hemicolectomy was done, in 2 cases the treatment was local resection from the rectum, and 6 patients received Mile's resection. The 1, 3 and 5-year overall survival rates for 17 patients with the total resection of tumor were 100%, 70.6% and 47.1%, respectively. The median survival time for 17 patients was 52 months. The final diagnosis of malignant GIST depended on the pathological examination, but the most worthwhile diagnostic criterion was the presence of CD117 and CD34 cells. Conclusion Since the prognosis is very poor, radical hemicolectomy is the principal treatment, and comprehensive treatment is necessary to improve clinical result.

Objective The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course,but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates.Methods Coronary angiographies of 3368 patients were selected to assess thrombolysis in myocardial infarction (TIMI) frame count (TFC) values.Seventy eight of them had CSFP,and their demographic and laboratory findings were compared with 61 patients with normal coronary flow.Results Patients'demographic characteristics were similar in both two groups.Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (P ＜ 0.001).Furthermore,hematocrit and hemoglobin values,and eosinophil and basophil counts of the CSFP patients were significantly elevated compared with the values obtained in the control group (P =0.005,P =0.047,P =0.001 and P =0.002).The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r =0.288 and r =0.217).Conclusion Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow.The increases inhematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow.

Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .

Objective To evaluate the imaging characteristics of chondromalacia patellae(CMP)in low-field MR and the value of MR in diagnosis.Methods 37 cases with CMP proved by arthroscopy and/or operation were carefully examined by 0.3 Tesla permanent magnet MR unit.The results of MRI were retrospectively analyzed according to that of arthroscopy and operation to search for the MR imaging manifestations of different degrees of patellae cartilage injuries in CMP.Results According to the golden-standard by arthroscopy and operation as for CMP,the overall diagnostic accuracy of MRI was 79.4%,with 28.6% accuracy in the early phase,92.6% in the late phase of CMP.Conclusion Low-field MR imaging is accurate in diagnosing CMP in the late phase and should be suggested as a useful nontraumatic imaging modality in the assessment of CMP before arthroscopy and operation.

BACKGROUND: Cardiac problems are common and are a major cause of death in both Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). Early diagnosis and proper management are very important for prolonging life expectancy, improving mobility and the quality of life in dystrophinopathic patients. The object of this study was to assess the cardiac dysfunction in dystrophinopathic patients. METHODS: We reviewed the clinical and laboratory findings of 53 male patients with DMD/BMD. The diagnosis was based on clinical criteria suggested by the European neuromuscular center, dystrophin gene analysis and immunohistochemistry of dystrophinopathic patients. We investigated 12-lead electrocardiography (EKG) findings, cardiac echocardiography findings and exon deletion analysis of dystrophin by multiplex polymerase chain reaction. RESULTS: The mean age of 53 patients was 20.98+/-7.85 years old. On EKG findings of DMD/BMD patients, 50 patients (94.3%) revealed abnormal findings (DMD 36 [94.7%]/BMD 14 [93.3%]). Of the forty nine patients investigated by cardiac echocardiography, 25 patients (51.1%) showed abnormal echocardiographic findings (DMD 18 [51.4%]/BMD 7 [50.0%]), 18 patients (36.7%) had dilated cardiomyopathy, and 7 (14.3%) patients had cardiac symptoms (DMD 4 [11.4%] /BMD 3 [21.4%] numbers). There was no difference in the neurological disability score between normal echocardiographic finding patients and abnormal patients. On DNA analysis by multiplex PCR, the proximal exon deletion of dystrophin genes (exon 1-30) has a significant association with cardiac involvement compared to those of distal exon deletion (exon 31-60) (p=0.034). CONCLUSIONS: Because DMD/BMD patients mostly have affected cardiac dysfunctions without clinical symptoms, early diagnosis and appropriate management of asymptomatic cardiac dysfunctions is very important.
Cardiomyopathy, Dilated ; Cause of Death ; Diagnosis ; DNA ; Dystrophin ; Early Diagnosis ; Echocardiography ; Electrocardiography ; Exons ; Humans ; Immunohistochemistry ; Life Expectancy ; Male ; Multiplex Polymerase Chain Reaction ; Muscular Dystrophies* ; Muscular Dystrophy, Duchenne ; Quality of Life

Objective To evaluate the clinical results of Willis covered stent implantation and coil embolization in the treatment of cranial internal carotid artery (CICA) aneurysm. Methods Eighty-nine patients with CICA aneurysms were selected for treatment with Willis covered stents (n = 43, group A) or coil embolization (n =46, group B) according to the patients'will. Data on the technical success, initial procedure time and in-hospital interval, initial and final angiographic results, mortality, morbidity, and final clinical outcomes were collected and analyzed for the two groups at 6 months post-procedure. Results Endovascular covered stent placement and coil embolization were technically successful in all patients,except for one patient in group A. The initial angiographic results showed complete occlusion in 34 patients of group A (81%, 95% CI: 69%, 93% ) and 24 patients of group B (52%, 95% CI: 37%, 67% ) ( P ＜0. 05). The final angiographic results indicated complete occlusion in 39 patients of group A (39/41,95%,95% CI: 88%, 102% ) and 22 patients of group B (22/45,49%, 95% CI: 34%, 64% ,P ＜0. 01 ). The average procedure time was(103 ± 13)min in group A and (143 + 39) min in group B (P＜0. 01). No significant differences were seen between the two groups in technique success, mortality, morbidity, or final clinical outcomes. Conclusion In this nonrandomized, prospective trial, CICA aneurysm treatment with covered stents yielded midterm angiographic results that were superior to those of coil embolization.

Heparin-induced thrombocytopenia (HIT) is usually caused by anti-platelet factor 4 (PF4)/heparin antibodies, leading to intravascular platelet activation. Circulating anti-PF4/heaprin antibody (IgG, IgA and IgM) was detected by ELISA (Asserachrom HPIA, Diagnostia Stago, Asnieres, France) in a 61-yearold man with coronary artery disease and dyspnea on exercise. He had undergone a coronoary angiography using 2,000 unit of heparin before a procedure. On admission, laboratory testing revealed a platelet count of 296x10(9)/L and aPTT (activated partial thromboplastin time) of 38.1 sec. The fall in the platelet count was progressive, resulting in 42% and 53% of platelet counts on the 6th and 12th days after intravenous heparin administration, respectively. He was discharged after coronary artery bypass graft. On discharge, platelet count was normalized to be 212x10(9)/L. On the 7th day after dischage, anti-PF4/heaprin antibody was detected by ELISA (Asserachrom HPIA, Diagnostia Stago, Asnieres, France).
Angiography ; Antibodies ; Coronary Artery Bypass ; Coronary Artery Disease ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Heparin* ; Immunoglobulin A ; Platelet Activation ; Platelet Count ; Thrombocytopenia* ; Thromboplastin ; Transplants

The gray platelet syndrome (GPS) is a rare platelet storage pool deficiency with variable degrees of reduction in the numbers and contents of alpha granules. We report a case of GPS in a two month-old male patient who was admitted to the hospital because of congenital biliary atresia and hip dislocation under the impression of ARC (arthroglyposis, renal tubular dysfunction, and cholestasis) syndrome. Bleeding time was not prolonged and platelet count was normal. The peripheral smear demonstrated abnormal platelet morphology with many agranular and large forms. A platelet aggregation study was abnormal in response to adenosine diphosphate and collagen. Electron microscopy of platelets revealed marked decrease in alpha granules and increase in vacuoles. The patient underwent Kasai operation with mild complication of postoperative bleeding.
Male ; Humans

Sudden Unexpected Death in Epilepsy (SUDEP) is defined as sudden, unexpected, non-traumatic, and non-drowning death in epilepsy. Postmortem examination must not reveal any anatomical or toxicological causes for SUDEP. The most commonly suggested mechanisms for SUDEP are cardiac abnormalities and apnea, although the cause of SUDEP is still unknown. We experienced a 36 years old male patient with epilepsy who was admitted to emergency room for cardiopulmonary arrest and the death was compatible with SUDEP because of unexpected death without reasonable explanation of cause of death except seizure. There is a possibility of an irreversible cardiac arrest or respiratory arrest by a seizure, which led to death in this case.
Adult ; Apnea ; Autopsy ; Cause of Death ; Emergency Service, Hospital ; Epilepsy* ; Heart Arrest ; Humans ; Male ; Seizures