乳腺导管扩张症研究进展

乳腺导管扩张症是临床上较常见的一种良性乳腺疾病,但由于该病临床及病理表现复杂,疾病命名多样,治疗手段也千变万化,若认识不清,极易造成误诊误治。对近年来国内外关于乳腺导管扩张症的病因、临床表现、诊断及治疗方面的进展做一系统综述。     

浆细胞性乳腺炎21例分析

本文报告浆细胞性乳腺炎21例，好发于中年妇女，病程长，临床表现复杂多样。认为术前针吸细胞学检查及术中冰冻活组织检查能明确诊断。治疗原则以附带少量正常乳腺组织的乳腺区段切除术为宜。     

原发性乳腺恶性淋巴瘤诊疗新进展

乳腺恶性淋巴瘤是指发生于乳腺内淋巴组织的恶性肿瘤.乳腺恶性淋巴瘤属于结外淋巴组织恶性肿瘤,可分为两类:一类是继发性乳腺恶性淋巴瘤,另一类是原发性乳腺恶性淋巴瘤.由于原发性乳腺恶性淋巴瘤率发病低、术前诊断困难、病情发展快、恶性程度高,所以应提高临床医师的高度重视.本文在探讨原发性乳腺淋巴瘤病理改变、组织分型、临床表现的基础上,着重讲述了原发性乳腺恶性淋巴瘤的诊断方法和治疗模式的进展.     

乳腺导管扩张病40例分析

本文报告乳腺导管扩张病40例,年龄23～60岁,平均38.7岁.占同期收治所有乳房疾病的5.36%,右侧多于左侧.本文对乳腺导管扩张病的病因病理、临床表现和诊断、治疗,尤其是与乳癌的鉴别诊断问题进行了讨论.     

副乳腺在整形美容外科中的研究及治疗进展

副乳腺又称异位乳腺、多乳腺症，也可伴有多乳头症。副乳是一类较常见疾病，是胎儿时期原 始乳腺未退化或退化不全所致的先天性乳腺发育异常疾病；大部分患者常因有碍美观或难以忍受相应症状 而寻求治疗。因不同年龄阶段和不同位置的副乳表现不同决定了不同的治疗方案。因此本文结合国内外文 献对副乳形成的机制、分类、临床表现、诊断和治疗作一综述，以期为副乳腺的诊断及治疗提供参考。     

复杂乳腺纤维腺瘤的诊断及治疗

我国乳腺癌发病率呈快速上升趋势,在引起乳腺癌的众多危险因素中,乳腺纤维腺瘤与乳腺癌有无相关一直是争论的焦点,尤其是复杂乳腺纤维腺瘤。本研究主要围绕复杂乳腺纤维腺瘤的癌变率、诊断和治疗做一综述,为临床医师正确处理乳腺纤维腺瘤提供证据。     

乳腺结核的诊断与治疗

乳腺结核又称为结核性乳腺炎,由结核杆菌感染所致的慢性特异性感染性疾病,由Astley Cooper于1829年首次报道,是罕见的乳腺疾病,分为原发性和继发性两种类型.这种疾病多见于欠发达地区,20 ～ 40岁的育龄期女性是本病的好发年龄阶段[1].在世界范围内,乳腺结核的发病率约占乳腺外科疾病的0.1％～3％[2].乳腺结核的发病率与年龄、多产、哺乳期、乳腺外伤及既往患有化脓性乳腺炎等多种因素密切相关[3].近年来,随着耐药结核菌蔓延、肺结核发病率的回升、HIV感染及AIDS全球蔓延,乳腺结核发病率有上升趋势[4].但因其临床表现复杂多样,临床报道病例较少,工作实践中极易误诊为乳腺癌、乳腺炎症及其他乳腺疾病,乳腺结核的诊断与治疗显得尤为重要.现结合文献对其相关问题进行探讨.     

乳腺派杰病临床研究进展

乳腺派杰氏病(Paget disease of the breast,MPD)是一种罕见的皮肤上皮性肿瘤,又称Paget癌,临床医生对该病认识不足,常造成延迟诊断和治疗,为提高对其认识,争取早期诊断,及时治疗,现就其发病机制、病理、肿瘤特性、临床表现、诊断、治疗及影响预后因素等方面的研究进展综述如下.     

乳腺叶状囊肉瘤10例诊治体会

乳腺叶状囊肉瘤是发生于女性的一种少见疾病,虽名为“肉瘤”,但主要表现为良性肿瘤的特点。临床表现出乳腺巨大肿块,穿刺细胞学或其它辅助检查对诊断帮助不大,易与其它乳腺良、恶性肿瘤混淆,给诊断和治疗带来困难。我科从１９９１～１９９６年共收治该病１０例,报告...     

乳腺叶状肿瘤诊疗现状与研究进展

乳腺叶状肿瘤（PTB）是一种临床发病率低的乳腺肿瘤,多表现为进行性增大的无痛性肿块,易与乳腺纤维腺瘤、乳腺化生性癌等疾病混淆,术前穿刺病理较难做出精确诊断,确诊有赖于肿块完整切除后的分子病理学诊断。PTB的治疗以外科手术为主,目前公认肿瘤扩大切除确保足够的阴性切缘是标准术式。放疗可进一步降低部分交界性或恶性PTB患者局部复发风险。化疗等全身治疗相关研究甚少,临床获益有限且具有一定争议。现笔者综述国内外对PTB流行病学、临床表现、影像学诊断、病理学诊断的最新研究进展,并对临床治疗的新观点进行疏理。     

牙体牙弓颌骨阻力中心及其临床意义

牙体、牙弓及颌骨的阻力中心在正畸矫治力系统中具有重要的意义,也是正畸学领域争论较多的一个问题。Dermaut等研究表明,当力作用于物体阻力中心时,物体将发生平动,否则将发生平动和转动的复合运动。目前,国内外多数学者认为牙体、牙弓及颌骨存在阻力中心,但其位置存在争议。本文就牙体、牙弓及颌骨的阻力中心及其临床意义作一综述。     

Hazards and complications of endoscopic transurethral ureterolithotripsy and lithoextraction and means of prevention

Complications related to ureterolithotomy and ultrasonic ureterolithotripsy performed under the control of visual endoscope were analyzed in 86 ureterolithiasis patients, methods of their prevention discussed. All the aforementioned complications were distributed into three groups: inapplicability of surgery due to anatomic and functional defects of lower and upper urinary tracts, intraoperative, and postoperative complications. The commonest ones were ureteral abruption and perforation, acute pyelonephritis, temporary vesicoureteral reflux. Their control measures were considered as relative methods of treatment: immediate surgical intervention in case of ureteral abruption, renal catheterization in patients with insignificant ureteral perforation or acute pyelonephritis. Adequate ureteroscopy, careful consideration of pro- and contraindications, catheterization of renal pelvis and urinary bladder performed within 2-3 days after the surgery and adequate antibacterial therapy are the most decisive steps in the control of aforementioned complications.     

Characterisation and differentiation of chondroblastomas and chondromyxoidfibromas - presence and expression of collagen types I and II

AIM: Chondroblastomas and chondromyxoidfiibromas are rare benign skeletal neoplasms with reported overlapping histology. Aim of this study was to analyse the biochemical composition of the matrix of these tumour entities in order to further characterise the cellular phenotypes of these neoplasms using typical cell biological marker genes. METHODS: The matrix compositions of chondroblastomas and chondromyxoidfibromas were analyzed by HE-histology, histochemistry, and immunolocalization techniques. Cellular gene expression patterns were detected by mRNA in situ hybridization. RESULTS: Chondroblastomas are rich in collagen type I and show foci of an osteoid-like matrix, whereas collagen type II as a typical marker of chondrocytic differentiation was not detected in any of the specimens. Chondromyxoidfiibromas had foci of chondroid appearance with chondroblastic cellular differentiation characterised by collagen type II expression. CONCLUSION: These results characterise chondroblastomas and chondromyxoidfiibromas as skeletal neoplasms that have a different biology and which can be distinguished by matrix protein expression products: collagen type II, the typical marker of chondroblast differentiation, could only be detected in chondromyxoidfibromas, but not in chondroblastomas. Thus, both neoplasms are clearly different on the cell biological level.     

Histochemical and contractile properties of striated muscles of urethra and levator ani of dogs and sheep

AIMS: To understand their possible importance in long- and short-term control of continence, some properties of the striated muscles of the urethra and pelvic floor (levator ani) of dogs and sheep were investigated, especially fiber types and contractile characteristics. MATERIALS AND METHODS: Striated muscles of urethra and levator ani of 29 male and 6 female dogs and 11 male and 6 female sheep were removed and cut into strips. Some strips were frozen and stained for ATPase at pH 9.4 and 4.3 for fiber typing; others were set up in an organ bath to study contractile responses to nerve stimulation. RESULTS: All muscles contained both type I (slow) and type II fibers, ranging from 97% type II in female greyhound urethra to 60% in female sheep levator ani. For each muscle, there were fewer type II muscles in sheep than in dog. The diameters of the urethral fibers were about 60% of the levator ani in dogs and 34% in sheep. Contraction of the urethral muscle was faster than for levator ani and declined to about 80% of the peak, 500 msec after the beginning of stimulation at 20 Hz. The levator ani contraction rose to a steady level as long as stimulation continued. CONCLUSIONS: Both the levator ani and urethral striated muscles contain slow and fast fiber types. The levator ani muscles are capable of sustained contraction with rapid onset which will produce long-term closure of the urethra. The circular urethral muscle contraction was faster but less well maintained.     

Effect of smoking and abstention on oxidative burst and reactivity of neutrophils and monocytes

BACKGROUND: Smoking is associated with surgical wound infections, impaired wound healing, and tissue-destructive disorders. The mechanisms are largely unknown, but changes in the function and activity of inflammatory cells may be involved. METHODS: Seventy healthy volunteers (54 smokers and 16 never smokers) were included. The smokers were studied while they smoked and after 20 days of abstinence. After the first 10 days of abstinence, they were randomized to double-blind treatment with transdermal nicotine patch 25 mg per day or placebo. Venous blood neutrophils and monocytes were sampled and isolated. In 22 randomly selected smokers and in all never smokers, the oxidative burst and chemotaxis were determined by a chemiluminescence response assay and a modified Boyden chamber technique, respectively. Stimulants were opsonized zymosan, formyl-Met-Leu-Phe, and zymosan-activated serum. RESULTS: The neutrophil and monocyte oxidative burst was 50% and 68% lower, respectively, in smokers compared to never smokers (P < .05). Neutrophil chemotaxis was 93% higher in smokers (P < .05). Monocyte chemotaxis was lower in smokers compared to never smokers (P < .05). After 20 days of abstinence, neutrophil oxidative burst increased to the level of never smokers (P < .05); monocyte oxidative burst increased by 50% (P < .05). Chemotaxis was only marginally affected. The changes induced by abstinence were less pronounced in the transdermal nicotine patch group compared to the placebo group. CONCLUSIONS: Smoking attenuates the oxidative burst of inflammatory cells and increases chemotaxis. Three weeks of abstinence normalize the oxidative burst, but affect chemotaxis only marginally.