Is Preservation of the Adrenal Vein Mandatory in Laparoscopic Adrenal-Sparing Surgery?

BACKGROUND AND OBJECTIVE: Adrenal tissue-sparing or partial adrenalectomy evolved initially for patients with bilateral synchronous adrenal surgical pathology to preserve vital adrenal volume. In the laparoscopic era, the exact criteria for performing such procedures laparoscopically have yet to be defined. Controversy exists regarding the importance of preserving the adrenal vein, main or accessory. The aim of this retrospective study was to present our short series of laparoscopic tissue-sparing adrenalectomies with vein preservation. Our main goal is not to support partial adrenalectomy as an alternative to total (this is already advocated by many surgeons) but to emphasize the vein-preserving technique. METHODS: Seven patients with peripherally located either aldosterone-producing adenomas (4 cases) or myelolipomas (4 cases) underwent laparoscopic lateral partial adrenalectomy. One patient harbored an aldosterone-producing adenoma and a myelolipoma as well. The main adrenal vein was identified and preserved in 6 patients and the accessory vein in one. RESULTS: No conversion to open adrenalectomy was necessary, and no perioperative morbidity or mortality occurred. Three adenoma patients are normotensive 44, 23, and 20 months postoperatively, while the fourth one's pressure is refractory. CONCLUSIONS: Surprisingly, total adrenalectomies preceded the partial ones, which is controversial compared with other procedures. Laparoscopic lateral partial adrenalectomy is a technically challenging tissue-sparing operation. Meticulous dissection allows preservation of the middle artery and main or accessory vein resulting in a functioning adrenal stump.     

125I-抑制素在大鼠垂体和下丘脑的放射自显影研究

目的研究抑制素（INH）在体条件下能否通过大鼠的血脑屏障及在垂体或下丘脑的分布。方法采用颈静脉灌流和放射自显影技术，将20只SD大鼠分为4组，每组5只，第1～3组（实验组）颈静脉注射^125 I-INH50μl，第4（对照）组注射等量的生理盐水。第1，2，3组分别于注射后30，60和120min断头处死，取出垂体、下丘脑，以生理盐水洗涤，测量放射性计数，取放射性最大组的垂体与下丘脑组织行放射自显影分析。结果第1组垂体的放射性最高[（1008．00±5．78）Bq]，而第2和3组分别为（723．00±4．95）和（491．00±4．90）Bq；1～3组的下丘脑放射性分别为（20．00±1．01），（22．00±0．95）与（19．00±0．73）Bq。第4组垂体与下丘脑的放射性分别为（16．00±1．40），（15．00±0．98）Bq。各实验组大鼠垂体的放射性与对照组差异有统计学意义（P〈0．01），且在注射后30min放射性最大（第1组），60和120min后逐渐降低；而实验组与对照组大鼠的下丘脑放射性差异无统计学意义（P〉0．05）；放射自显影结果示，实验组大鼠的垂体组织上有明显的银颗粒，而对照组没有；实验组和对照组大鼠的下丘脑组织上均未见明显的银颗粒。结论^125I-INH能通过大鼠血脑屏障，垂体在注射后30min放射性最大，在大鼠垂体上有INH结合位点或受体，而在其下丘脑没有。     

Pleomorphic adenoma of the nasal septum

Despite the common occurrence of pleomorphic adenoma of major salivary glands, intranasal pleomorphic adenoma are rare. We present a ease of pleomorphic adenoma of the nasal septum along with a brief review of literature. The histological nature of this lesion in comparison to other salivary gland tumours and the importance of an accurate diagnosis has been stressed.     

Mucous Gland Adenoma Simulating Bronchial Asthma: Case Report and Literature Review

We report a case of mucous gland adenoma arising in the left main bronchus which was initially misdiagnosed as asthma and review the previous reported cases of this rare tumor published in the available literature.     

Primary leiomyosarcoma of the thyroid gland

Primary leiomyosarcoma of the thyroid gland is extremely rare, and to the best of our knowledge only five well-documented cases have been reported in the world literature. We herein report a 58-year-old female patient with primary leiomyosarcoma of the thyroid who was successfully treated by total thyroidectomy with a modified neck dissection. Immunohistochemically, the tumor cells showed positive reactivity to α-smooth muscle actin and vimentin. Radical surgery was thus considered to be essential in the treatment of this rare but rather aggressive malignancy.     

Comparison of salivary calmodulin binding proteins in Sjögren''s syndrome and healthy individuals

Background: Reduction in salivary secretion is the hallmark of Sjögren's syndrome (SS). Calmodulin (CaM) and calmodulin binding proteins (CaMBPs) play a key role in the secretory process of saliva. Recent studies have suggested that SS‐B, an autoantibody associated with SS, is a CaMBP. This finding suggests that CaMBP may contribute to the loss of saliva in SS. To better understand the role(s) of these proteins in SS, the purpose of this study was to compare salivary CaMBPs in Sjögren's patients and controls. Methods: Saliva samples were collected from 20 patients and 20 age‐, race‐, and gender‐matched controls. CaM overlay was used to identify CaMBPs in saliva of patients and controls. Results: Higher number of salivary CaMBPs was observed among patients than controls. Conclusions: The increased number of salivary CaMBPs in SS may suggest a potential role for these proteins in the pathogenesis of the disease.     

维丁胶性钙预防关节腔内注射皮质类固醇引起骨关节的损害

目的：采用维丁胶性钙预防关节内注射皮质类固醇对骨关节的损害。方法：４５只健康新西兰白兔，随机分为三组，每组１５只。Ａ组：右膝关节内注射醋酸强的松龙７．５ｍｇ／ｋｇ。Ｂ组：用药同Ａ组，同时每周肌注维丁胶性钙三次，每次１ｍｌ。Ｃ组：右膝关节内注射生理盐水０．３７５ｍｌ／ｋｇ，作为对照。于实验的第３、５、７、９、１１周的第１天，每组取３只动物作髋关节和膝关节Ｘ光照片，并取膝关节及股骨头标本作病理组织学和超微结构检查。结果：Ａ组。用药２次后，Ｘ线照片、病理组织学检查和超微结构观察均有骨关节损害的表现，并随给药次数的增加而加重。Ｂ组。用药６次后才出现轻度病理组织学和超微结构改变。Ｃ组。各项指标均正常。从而证实维丁胶性钙有预防或减轻皮质类固醇所致骨关节损害的作用。结论：在疼痛治疗中，关节内注射皮质类固醇应尽量减少注射次数和延长间隔时间，并同时应用维丁胶性钙肌注有一定预防骨质损害作用。     

数字化曲面全景X线系统造影在腮腺非肿瘤类疾病诊断中的应用

目的　本文报告普通X线机腮腺造影与数字化曲面X线机腮腺造影结果及其对比应用。方法　用3种不同的X线机对 3组腮腺非肿瘤类疾病患者进行腮腺造影 ,第 1组患者 10人应用普通 30 0mAX线机 ,第 2组患者 10人应用普通曲面全景X线机 ,第 3组患者 36人应用数字化曲面全景X线系统一套 ,分别行造影检查。结果腮腺造影侧位投照第 2组与第 1组末梢导管及腺泡有显著差异 (P <0 .0 5 ) ,第 3组与第 1组末梢导管及腺泡无显著差异 (P >0 .0 5 ) ,腮腺造影后前位投照第 2组与第 1、3组之间有显著差异 (P <0 .0 5 )。结论　本研究对比了 3种X线投照技术在腮腺非肿瘤性疾病造影诊断中的效果 ,用数字化曲面全景X线系统造影在诊断此类疾病中显示出较好的效果。     

沃辛瘤35例临床分析

目的：探讨沃辛瘤的发病及临床诊治特点。方法：对近10年来收治的35例经病理证实的沃辛瘤患者的临床资料进行统计分析。结景：肿瘤全部发生在腮腺。多见于50～70岁的男性，平均年龄56．9岁，男女之比为10．7：1。肿瘤位于腮腺后下极31例，占88．5％。同侧多灶性或双侧发生4例，占11．4％。吸烟者占全部病例71．4％(25例)。治疗采用全腮腺或浅叶 肿物切除术，无复发病例。诘论：腮腺后下部淋巴结与其中的迷走涎腺组织是肿瘤发生的组织学基础，吸烟和高龄免疫功能改变可能是肿瘤发生的主要刺激因素，采用肿瘤与不同范围腮腺组织切除术可达治愈效果。