Significance For Early Diagnosis Research Articles

纤维鼻咽镜下活检在诊断鼻咽癌中的价值

目的：探讨电视监视纤维鼻咽镜下行鼻咽部肿物活检术中的应用价值。方法：回顾分析我院应用纤维鼻咽镜直视下行鼻咽部活检所得的38例临床资料。结果：在38例患者中一次成功活检36例，成功率94.7%。结论：纤维鼻咽镜直视下行鼻咽部活检临床体会是定位准确、取材合理、并发症少，对NPC早期诊断，合理治疗，减少误诊和漏诊的发生有重要意义，值得临床推广应用。 Objective: To investigate the application value of television surveillance endoscopy nasal pharyngeal tumor biopsy. Methods: The clinical data of 38 cases in our hospital were analyzed using fibre nasopharyngoscope straight down from nasopharyngeal biopsy. Results: Of the 38 patients, 36 cases are successful biopsies at the first time. The success rate is 94.7%. Conclusion: Nasopharygo fiberscope straight down from nasopharyngeal biopsy in clinical experience is accurate positioning, reasonable materials and fewer complications. It has the important significance for early diagnosis of NPC, reasonable treatment and the reduction of the occurrence of misdiagnosis and missed diagnosis. And, it is worthy of clinical application.

The significance of ecthyma gangrenosum in early diagnosis of pseudomonas aeruginosa sepsis in chidren

Objective To summarize the characteristics of ecthyma gangrenosum and explore its significance in early diagnosis of pseudomonas aeruginosa sepsis in children.Methods We retrospectively reviewed the medical records of 11 children with ecthyma gangrenosum who were hospitalized at Guangzhou women and children's medical center between May 2008 and Apr 2011.Results Eight cases were male and 7 were less than twelve months,the oldest was 2 years old,all of them were diagnosed as Pseudomonas aeruginosa spesis.Two patients had a single lesion,and the others had multiple lesions.Ecthyma gangrenosum located on the trunks in 7 cases,on anogenital areas in 5 cases,on extremities in 5 cases and on faces in 3.The lesions appeared on day 2 to day 10.On average,they developed on day 5.Seven patients developed ecthyma gangrenosum before admission,the course of the illness before admission was 6 days.Fever and multiple organ dysfunction occurred in all the patients and their cultures grew pseudomonas aeruginosa,blood cultures were positive in 8 cases,the others were isolated psudomonas aeruginosa from tissue of the lesion,discharge,ascites,pleural effusion,respectively.The time of ecthyma gangrenosum appeared was earlier than the time of the culture results reported.All of the patients were started empiric antibiotics therapy on admission,the initial antibiotic regimen was appropriate in 9 patients,8 needed surgical intervention,4 were treated with continuous blood purification.Ten patients survived and 2 died,the hospital stay was from 1 to 63 days,the average was 30.Conclusion Ecthyma gangrenosum is a known cutaneous manifestation of pseudomonas aeruginosa sepsis,which is helpful for early diagnosis and treatment,and then the outcome will be improved. Key words: Ecthyma gangrenosum ; Pseudomonas aeruginosa; Sepsis; Children

以腹股沟淋巴结肿大为首发症状的黑色素瘤一例 One Case of Melanoma with Inguinal Lymph Node Enlargement as the First Symptom

摘 要：恶性黑色素瘤是西方国家常见的好发于皮肤或其他器官黑素细胞的恶性肿瘤，其发病率逐年上升。该病在我国相对罕见，且其临床表现和生物学行为复杂多样，因此临床上经常发生漏诊和误诊。本文通过报道一例罕见的仅以腹股沟淋巴结肿大为首发症状的发生于妊娠期的黑色素瘤来说明该病临床表现的复杂性和早期诊断的重要性。 Abstract: Malignant melanoma is a common tumor occurred in the skin or other melanocyte organs in Western coun- tries, and its incidence is increasing these years. But this disease is relatively rare in China, and its clinical manifesta- tions and biological behavior is complex and diverse, so the clinical misdiagnosis and missed diagnosis often occur. In this paper, the author report a rare melanoma case with inguinal lymph node enlargement as the first symptom occurred in pregnancy. So as to illustrate the complexity of the clinical manifestation and the significance of early diagnosis about melanoma.

DEVELOPMENT OF A GENERIC ULTRASOUND VIBRO-ACOUSTIC IMAGING PLATFORM FOR TISSUE ELASTICITY AND VISCOSITY

Tissue elasticity and viscosity are always associated with pathological changes. As a new imaging method, ultrasound vibro-acoustic imaging is developed for quantitatively measuring tissue elasticity and viscosity which have important significance in early diagnosis of cancer. This paper developed an ultrasound vibro-acoustic imaging research platform mainly consisting of excitation part and detection part. The excitation transducer was focused at one location within the medium to generate harmonic vibration and shear wave propagation, and the detection transducer was applied to detect shear wave at other locations along shear wave propagation path using pulse-echo method. The received echoes were amplified, filtered, digitized and then processed by Kalman filter to estimate the vibration phase. According to the phase changes between different propagation locations, we estimated the shear wave speed, and then used it to calculate the tissue elasticity and viscosity. Preliminary phantom experiments based on this platform show results of phantom elasticity and viscosity close to literature values. Upcoming experiments are now in progress to obtain quantitative elasticity and viscosity in vitro tissue.

Hematologic Markers of Influenza A H1N1 for Early Laboratory Diagnosis and Treatment Assessment

Background: Influenza A H1N1 has contributed to significant morbidity and mortality, yet very few studies on changes in hematologic and biochemical markers have been reported. Methods: The variable characteristics of several laboratory indices were statistically analyzed during the disease course. Results: In the incipient stage, the RBC and platelet counts in most patients were normal, while total WBC, neutrophils, and lymphocytes decreased in some cases. The hepatic and renal function indicators were mostly within the normal limits, while electrolyte imbalance occurred in some cases. T lymphocytes subgroups counts were significantly decreased in the acute stage and became extremely low a few days later, then recovered to normal limits in the convalescent stage. Conclusions: T lymphocytes subgroups could be considered as progressive markers of H1N1, which were of great clinical significance in early diagnosis, progression, and prognosis evaluation of H1N1. This work provided convenient hematologic diagnostic criteria for reference. * CDC : Centers for Disease Control TB : total bilirubin TP : total protein A : albumin ALT : alanine aminotransferase AST : aspartate aminotransferase LD : lactate dehydrogenase UN : urea CR : creatinine RT-PCR : reverse transcription polymerase chain reaction PCR : polymerase chain reaction SARS : severe acute respiratory syndrome RSV : respiratory syncytial virus

Pathogenic Spectrum of Fungal Keratitis and Specific Identification ofFusarium solani

To investigate the predominant causative pathogens and epidemiologic features of fungal keratitis and establish a rapid, specific molecular method to detect fungal keratitis caused by Fusarium solani. A total of 174 patients with presumed fungal keratitis and 174 affected eyes were examined. Isolates from corneal specimens were identified according to morphologic and physiological characteristics. The primers that were designed for F. solani were tested to confirm whether they had species specificity. Multiplex PCR with universal fungal and F. solani-specific primers was performed with fungal and bacterial strains and was used to detect microorganisms in the clinical specimens. A total of 160 patients (92.0%) were diagnosed with fungal infection by either potassium hydroxide wet-mount or microbiologic culture. Fungal cultures were positive in 128 patients (73.6%) with 139 fungal isolates. Fusarium (48.2%) was the most frequently isolated genus, in which F. solani (35.2%) was the most common species, followed by the Aspergillus (18.7%) and Candida (16.6%) genera. The PCR results showed that the designed primers were species specific and suitable for specific identification of F. solani. The multiplex PCR of 3-day broth cultures could identify and distinguish F. solani from other pathogens rapidly and specifically from clinical specimens. Fusarium species, especially F. solani, were found to be the predominant cause of fungal keratitis in northeast China. The established multiplex PCR method could have potential advantages for rapid detection of F. solani. These findings might have significance for early diagnosis and treatment of fungal keratitis.

E0652 The level changes of IL-8 and the relationship to the left ventricular aneurysm formation and cardiac performance in patients with acute myocardial infarction

ObjectiveTo investigate the changes in interleukin-8 (IL-8) and the relationship with the left ventricular aneurysm (LVA) and cardiac function in acute myocardial infarction (AMI) patients using left ventriculography (LVG).MethodsA total...

Coagulation disturbances in paediatric patients with hepatic veno-occlusive disease after stem cells transplantation

Hepatic veno-occlusive disease (VOD) is a life threatening complication after stem cells transplantation (SCT). Its prediction, precise diagnosis and treatment remain unclear. Our goals were to determine the incidence, outcome and changes in haemostatic parameters in patients with VOD. Also, we tried to determine coagulation disturbances and their practical significance in early diagnosis of such patients. We prospectively evaluated all consecutive VOD patients after SCT, aged 3 months to 17 years, from February 2004 to July 2008 treated at the Mother and Child Health Institute of Serbia "Dr Vukan Cupić" (IMD). All patients were diagnosed according to the Seattle criteria. The values of PT, aPTT, fibrinogen, FVIII, AT and vWF were measured on the day prior to the initiation of conditioning regiment and on the days 1, 7 and 14 from the moment of VOD diagnosis. Laboratory testing was performed in the IMD haemostasis laboratory and results were statistically evaluated. During the study period 74 SCT were performed at IMD. VOD developed 11 patients; 10 of 46 were autologous and 1 of 28 allogeneic SCT patients. In our group of patients the incidence of VOD was 14.8%. VOD was classified as mild in 7, moderate in 1 and severe in 3 patients. At the moment of establishing the diagnosis all patients had a significantly increased activity of vWF, FVIII and fibrinogen, and decreased AT. All of them were dependent on platelet transfusions. Platelet transfusion dependence suggests coagulation activation with great significance and indicates a possible development of VOD. Our results also suggest that monitoring coagulation parameters levels in the first five days from the establishment of diagnosis may have a significant predictive value for VOD outcome.

The expression and significance of serum AFP-IgM immune complexes in hepatocellular carcinoma

Objective To investigate the expression level of AFP-IgM in hepatocellular carcinoma (HCC).Methods The serum AFP-IgM concentrations were detected by ELISA in 79 HCC patients,20 patients affected by liver cirrhosis and 30 healthy controls.Results AFP-IgM concentrations in serum and the positive rate were significantly higher in HCC than that in liver cirrhosis and in healthy controls(P＜0.01).The positive rates of AFP-IgM in the stage Ⅰ or Ⅱ(89%,88%)were higher than that of the stage Ⅲ(30%,P＜0.05).The serum concentration of AFP-IgM is related to the stage,tumor sizes.Conclusion AFP-IgM was of significance for early diagnosis of HCC,it will hopefully be a useful biological marker for the diagnosis of HCC. Key words: Hepatocellular carcinoma; Alpha-fetoproteins; Immunoglobulin M

Clinical significance of early diagnosis in procalcitionin for neonatal severe bacterial Infection

Objective To evaluate the clinical significance of early diagnosis in procalcitionin (PCT) for neonatal severe bacterial infection. Methods The PCT were quantitative detected in 60 cases neonatal se-vere bacterial infection and 35 cases normal neonate, and the CRP and WBC were detected also. The PCT and CRP of observe group were rechecked after been treated for 72 hours. Results On admission 60 cases PCT >0.5 μg/L,the positive rate was 100%. 8 cases PCT > 10 μg/L,the WBC didn't heighten obviously. On admis-sion the CRP of 20 cases (48.0%) was abnormal. 58 cases were healing well and the PCT all decreased to nor-mal level. Conclusion In earlier period of neonatal severe bacterial infection PCT is better than CRP and WBC among the diadynamic criteria of bacterial infection. Key words: Procalcitionin; Bacterial infection; Neonat

Promoter methylation and mRNA expression of DKK-3 and WIF-1 in hepatocellular carcinoma

To investigate the promoter methylation status and mRNA expression of DKK-3 and WIF-1 gene in hepatocellular carcinoma (HCC). DKK-3 and WIF-1 acted as Wnt-antagonists and tumor suppressors, but hypermethylation of the gene promoter and low mRNA expression activated Wnt signaling aberrantly and induced the development of HCC. Methylation status of the DKK-3 and WIF-1 gene promoter was investigated using methylation specific polymerase chain reaction (PCR) in tumor and adjacent non-cancerous tissues from 33 HCC patients and 20 normal liver tissues served as control. The expression of DKK-3 and WIF-1 mRNA was also determined by real-time quantitative reverse transcriptase PCR. The relationship between methylation, mRNA expression, and clinical data, as well as methylation and mRNA expression of the two genes were analyzed. The methylation of DKK-3 and WIF-1 genes in HCC increased significantly compared with adjacent non-cancerous tissues and normal control tissues (chi(2) =7.79, P < 0.05; chi(2) = 4.89, P < 0.05), and no significant difference in methylation between adjacent non-cancerous tissues and normal control tissues was observed. In HCC tissues, significant differences in the DKK-3 promoter methylation were observed in age and cirrhosis, and significant differences of the WIF-1 promoter methylation were observed in HBsAg and cirrhosis. The average expression of DKK-3 mRNA in HCC and adjacent non-cancerous tissues was increased significantly compared with normal control tissues. The average expression of WIF-1 mRNA showed no significant difference among the three tissues. The mRNA expression of DKK-3 gene in HCC was decreased as the pathological grade increased. The aberrant promoter methylation and decreased expression of DKK-3 and WIF-1 may be an important mechanism in HCC, and may be a far-reaching significance in early diagnosis and therapy of HCC.

Construction of protein fingerprint signature in serum and its significance for early diagnosis with chronic allograft nephropathy

To construct protein fingerprints in serum and to early diagnose chronic allograft nephropathy (CAN) using surface enhanced laser ionization/desorption-time of flight-mass spectrometry (SELDI-TOF-MS). Serum protein spectra were detected by SELDI-TOF-MS and weak cation exchange (CM10), which were from long-term survival patients with well-functioning kidney allograft (LS) (n = 24) and CAN (n = 15), and then biomarkers were screened through the analysis of database with Biomarker Wizard and Biomarker Pattern softwares. 78 protein peaks of interest were generated in each sample, 18 protein spectra statistically show difference between LS and CAN (P < 0.05), 6 of which (m/z 2476.0, 3078.7, 3190.5, 4076.5, 4506.0, 6178.4) statistically show significant difference (P < 0.01), a single biomarker (m/z 3078.7) differentiated LTS and CAN (P = 0.0001), it was upregulated in the former and downregulated in the latter, its diagnostic sensitivity and specificity were 87.5% and 81.8% respectively. Its cost-effective value is 0.307. Establishment of protein fingerprint signature in serum by SELDI-TOF-MS is clinically predictive of CAN.

Spinal Epidural Abscess—From Onset to Rehabilitation: Case Study

Spinal epidural abscess (SEA) is a rare condition; consequently, the clinical significance of early diagnosis often is overlooked. The challenge with SEA is not its treatment, but achieving early diagnosis before neurological symptoms occur. Once neurological deficits are present, immediate treatment must be implemented to prevent deterioration that can result in paralysis. The common SEA signs and symptoms are fever, back pain, and radicular symptoms that can progress to weakness and paralysis. Magnetic resonance imaging is the imaging of choice for diagnosis. Treatments include antibiotics and surgical evacuation of the abscess if neurologic deficits are present. Nurses play a major role in caring for SEA patients by identifying those at risk, preventing complications, and collaborating with a multidisciplinary team to prepare patients for rehabilitation.

Hip joint structures assessment in juvenile idiopathic (chronic) arthritis with ultrasound TOC \o "1-5" \h \z examination

Sonographic (SG) examination of hip joints was performed in 100 pts with juvenile chronic arthritis (JCA) with different forms, activity and duration. SG signs of hip joint inflammation in JCA were identified. SG features in pts with different disease duration, form and activity were revealed. SG changes of clinically unchanged hip joints were noted which may be of important significance for early diagnosis of coxitis. More wide use of arthrosonography in pediatric rheumatology was proved.

Expression of IGF-II in early experimental hepatocellular carcinomas and its significance in early diagnosis.

To investigate the serum level and expression of insulin growth factor II (IGF-II) in liver tissues of rats with early experimental hepatocellular carcinomas (HCC) and its significance in early diagnosis. Early experimental hepatocellular carcinomas were induced by diethylnitrosamine (DENA) in 180 male SD rats. Another 20 male SD rats served as control. The IGF-II serum level was measured by ELISA. Immunohistochemistry and electron microscopic immunohistochemistry were used to observe the expression of IGF-II in normal and tumor liver tissues and its ultrastructural location in malignant hepatocytes. The expressions of IGF-II in human hepatoma cell lines HepG2, SMMC7721 and human embryonic liver cell line L-02 were measured by immunocytochemistry. IGF-II mRNA level was studied by in situ hybridization. IGF-II was expressed in the cytoplasm of both sinusoidal cells in paracancerous cirrhotic liver tissue and malignant hepatocytes in early experimental HCC tissues. Gold particles were seen on the rough endoplasmic reticulum and the mitochondrion in malignant hepatocytes. IGF-II was expressed in the human hepatoma cell lines. The mRNA level of IGF-II was higher in rat liver tumor tissue than in normal rat liver tissue. The serum IGF-II level of the early experimental HCC group was 34.67+/-10.53 ng.ml(-1) and that of the control group was 11.75+/-5.84 ng.ml(-1). The rank sum test was used for statistical analysis. There was a significant difference between the two groups (P<0.01). During the induction of early experimental HCC by DENA, IGF-II may promote hepatocytic proliferation via a paracrine mechanism in the pre-cancerous stage. When hepatocytes are transformed into malignant cells, they may secrete IGF-II and promote malignant cell proliferation by an autocrine mechanism. IGF-II may be a possible biological marker in the early diagnosis of HCC.

Ramsay Hunt Syndrome: An Unusual Variant After Dental Infection

Ramsay Hunt Syndrome: An Unusual Variant After Dental Infection

Epidural abscess in an infant

We report the case of a 2-year-old infant who developed a staphylococcal septicaemia that subsequently resulted in an epidural abscess and paraparesis. The significance of early diagnosis and the roles of anterior surgery to decompress the spinal cord, debride infection and correct deformity are discussed.

Visual hallucinations and macular degeneration: An example of the Charles Bonnet syndrome

Abstract Purpose: Patients with any form of visual disturbance, no matter how unusual, often present first to their ophthalmologist. An example of the Charles Bonnet syndrome as a result of bilateral macular degeneration is presented. The significance of early diagnosis is highlighted as reassurance and explanation of the condition seems to be the cornerstone of management. Methods/Results: A chronological case history, results of investigations and management are presented. Conclusions: The diagnosis of Charles Bonnet syndrome should be considered in elderly, cognitively intact patients who present with vivid, elaborate and complex visual hallucinations following ocular pathology. Although there is no universal definition of this entity and there is no specific pharmacotherapy, patients may be referred for counselling.

Blood pressure in children and adolescents with Cushing's syndrome before and after surgical care.

Approximately half of children and adolescents with Cushing's syndrome develop hypertension. To examine the role of hypercortisolism in the pathogenesis of hypertension in young patients and to establish its reversibility, we studied 31 hypertensive children and adolescents with Cushing's syndrome (systolic, diastolic, and/or mean blood pressure more than 2 SD U for age and sex) from a total of 63 patients before, and for a period of 1 yr after surgical cure. Preoperatively, 93.5%, 42%, and 45% of these patients presented with an increase of the systolic, diastolic, and mean blood pressure, respectively. The systolic blood pressure remained increased in 30.7%, 15.8%, and 5.5% of patients at 3, 6, and 12 months after surgical cure, respectively. The diastolic and mean blood pressure completely normalized by 3 months after surgical cure. A significant, positive correlation was observed between the systolic blood pressure and the duration of the disease, but no correlation was seen with the 24-h urinary free cortisol values and/or the patients' body mass indices. The lack of correlation between 24-h urinary free cortisol values and blood pressure suggests that hypercortisolism influences blood pressure through multiple pathways. The positive correlation between the systolic blood pressure and the duration of the disease points towards the deleterious effects of prolonged hypercortisolism and the significance of early diagnosis and treatment. The fact that the blood pressure normalized within a year from the correction of hypercortisolism suggests that, as a rule, young patients with hypercortisolism do not develop essential hypertension.

Treatment of Ramsay Hunt syndrome with acyclovir-prednisone: significance of early diagnosis and treatment.

Although the antiviral agent acyclovir is currently used for the treatment of Ramsay Hunt syndrome, its effects on facial nerve and hearing recovery remain controversial. We retrospectively analyzed the effects of acyclovir-prednisone treatment in 80 Ramsay Hunt patients. Of 28 patients for whom treatment was begun within 3 days of the onset of facial paralysis, the recovery from paralysis was complete in 21 (75%). By comparison, of 23 patients for whom treatment was begun more than 7 days after onset, recovery from facial paralysis was complete in only 7 (30%). A significant difference in facial nerve recovery was found between these groups. Early administration of acyclovir-prednisone was proved to reduce nerve degeneration by nerve excitability testing. Hearing recovery also tended to be better in patients with early treatment. There was no significant difference in facial nerve outcome between intravenous and oral acyclovir treatment.