Enucleation combined with orbital implants for malignant melanoma of the uvea

Advanced malignant melanomas of the uvea unsuited for an eye salvaging approach require enucleation of the tumor containing eye. A series of 68 patients is reported who underwent enucleation combined with insertion of a spherical dura-encased implant after 30 Gray pre-irridiation therapy of the orbit. Postoperative results with special attention to cosmetic outcome and motility of the prosthesis suggest that the insertion of an orbital implant should be preferred to the enucleation with no implant.     

Four primary malignant tumors, including malignant melanoma and malignant lymphoma, in the same adult patient

We report an 80-year-old Japanese male with four primary malignant tumors: malignant melanoma, prostatic cancer, malignant lymphoma, and renal cell carcinoma, which occurred in that respective order. The combination of malignant melanoma and malignant lymphoma is rare. The patient was treated with BCG after an operation for malignant melanoma. He was also treated with cobalt 60 irradiation after an operation for prostatic cancer. We also discuss other reports of multiple malignant tumors and suggest some possible causes of this patient's primary malignant tumors.     

丝裂霉素胸膜腔灌注治疗肺癌恶性胸膜腔积液初报

目的 观察胸膜腔内灌注丝裂霉素治疗恶性胸膜腔积液的疗效。方法 对15例恶性胸膜腔积液病人采用胸膜腔闭式引流术，1-2d排空胸膜腔积液，后注入100mL生理盐水＋20mg丝裂霉素，夹闭引流管4h后开放，间隔1d再同样方法用1次，引流无液体后拔出引流管，4wk后评价疗效。结果 病人呼吸困难明显好转，生活质量明显改善。CR10例，PR3例，NC2例，总有效率86．7％（13／15）。结论 胸膜腔内灌注丝裂霉素能有效控制恶性胸膜腔积液，对晚期肿瘤所致恶性胸水的病人有重要意义。     

SURGERY OF PERIURETERIC OBSTRUCTION IN 101 CHILDREN OVER ONE YEAR OF AGE

One hundred and one children over 1 year of age have had surgery for pelviureteric obstruction over an 11 year period. The common clinical features were abdominal pain, urinary infection or haematuria, but number presented as an incidental finding. Less commonly, the patients presented with an abdominal mass or with hypertension. The diagnosis was usually made on intravenous pyelography (IVP) but in the latter part of the series, renal nuclide scan (RNS) and ultrasonography (US) were preferred. Ninety–three patients had unilateral pyeloplasty, three had bilateral pyeloplasty and five had nephrectomy or heminephrectomy. Whereas initially nephrostomy drainage was used in the majority of patients after pyeloplasty, trend away from nephrostomy evolved in the latter part of the series. With experience, the incidence of postoperative complications was also reduced and there was reduction in the period of hospitalization. Clinical results were consistently satisfactory. Postoperative assessment after pyeloplasty was made by IVP and/or RNS and also US. A review of these investigations showed that RNS provided more factual information of the result when compared with the IVP.     

胃癌雌激素受体表达及新一代抗受体药物在胃癌治疗中的探讨

目的　探讨胃癌雌激素受体 (ER)实际表达率 ,为临床使用新一代抗ER药物 (toremifene ,TOR)治疗胃癌提供临床病理依据。方法　用免疫组化法对 349例胃癌标本进行ER的检测 ,其中 2 99例用ABC(avidinbiotinperoxidasecomplex)法 ,5 0例用葡聚糖聚合物技术二步法进行检测。在检测ER的同时也检测 p5 3及PCNA的表达。结果　两种检测方法的ER阳性率分别为 2 .3% (7/ 2 99)及 0 % (0 / 5 0 ) ,p5 3阳性率 37.1% (111/ 2 99)及 4 6 %(2 3/ 5 0 ) ,PCNA 94 .3% (2 82 / 2 99)及 96 % (48/ 5 0 )。结论　胃癌细胞可表达ER但实际表达率很低 ,而且存在质和量的变化。tamoxifen (TAM )及TOR的抗胃癌效应需要进一步研究     

表阿霉素联合化疗方案治疗29例恶性肿瘤疗效观察

目的观察以表阿霉素为主的不同化疗方案对常见恶性肿瘤的疗效及其毒副作用。方法以表阿霉素为主的CEP、CEOP、TE、IEO方案治疗肺癌、非霍奇金淋巴瘤、晚期乳腺癌和横纹肌肉瘤，其中表阿霉素60mg/m^2分2天静脉注射，其他药物都为常规剂量。21～28天为1个治疗周期，治疗2～3个周期后评价疗效。结果全组29例中CR7例，PR13例，SD5例，PD4例，总有效率68．97％。主要不良反应为骨髓抑制，其次是脱发和消化道反应。对肝肾功能和心脏影响轻微。结论以表阿霉素为主的联合化疗方案对常见恶性肿瘤疗效佳，安全性好，患者能较好地耐受。     

恶性肿瘤并发皮肤瘙痒症5例临床分析

作者认为恶性肿瘤引起的瘙痒有二种特点:(1)患者难以忍受;(2)抗组织胺药物无效。     

Acute renal failure as a result of bilateral ureteral obstruction by Candida albicans fungus balls

A 73-year-old male with a history of diabetes mellitus was admitted to our hospital for acute renal failure. An ultrasonogram revealed bilateral hydronephrosis, which worsened despite insertion of a bladder catheter. Nephrostomy catheters were positioned bilaterally, and Candida albicans was found in the urine culture. The patient was successfully treated with intermittent direct irrigation and i.v. antifungal agent therapy. Since 1977, approximately 50 cases of fungus balls or fungal bezoars in the urinary tract have been reported, but the majority of these cases have been characterized by unilateral ureteral or bladder involvement. Herein, we report a case of acute renal failure as a result of bilateral ureteral obstruction by Candida albicans fungus balls.     

Laparoscopic Local Resection Based on Sentinel Node Evaluation for Early Gastric Cancer: A Preliminary Report

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.