卵巢未成熟畸胎瘤43例综合治疗疗效分析

为探讨不同手术方式及化疗方法对卵巢未成熟畸胎瘤的疗效及相关影响因素，对43例卵巢未成熟畸胎瘤患者进行回顾性分析。手术方式分为：保守性手术（患侧附件、大网膜切除术＋盆、腹腔腹膜结节切除术＋盆腔淋巴结清扫术）及根治性手术（全子宫、双附件及大网膜切除术＿肿瘤细胞减灭术＋盆腔淋巴结清扫术）。术后采用VAC（长春新碱，阿霉素，环磷酰胺）方案、BEP（博莱霉素或平阳霉素，足叶乙叉甙，顺铂或卡铂）方案或VBP（长春新碱，博莱霉素或平阳霉素，顺铂或卡铂）方案进行联合化疗。患者5年生存率根治性手术为44．4％，保守性手术为64．0％，差异无显著性。VAC方案与BEP（或VBP）方案的5年生存率分别为33．3％和77．3％（P＜0．01）。疗程数≥4患者的5年生存率为73．9％，明显高于疗程数＜4患者的38．9％（P＜0．05）。认为对于有生育要求的卵巢未成熟畸胎瘤患者，可仅行保守性手术，术后辅以联合化疗。BEP（或VBP）方案对患者长期生存率的改善明显优于VAC方案。术后化疗的疗程数与疗效有关，对长期生存率的影响较明显。     

Teratoma tongue: Case report and review of literature

Teratomas are true neoplasms composed of tissues from all three germinal layers and may exhibit variable levels of maturity. They have an unknown origin and eccentric microscopic appearance. Teratomas arising from the oral cavity are rare in the newborn; only 22 cases have been reported in the literature. We describe a female neonate with an oral teratoma originating from the tongue that was successfully treated with surgery.     

Neuroimaging in Pineal Tumors

BACKGROUND AND PURPOSE: The authors report radiological findings in 11 tumors in the pineal region, which were histologically diagnosed as germinomas, pineocytomas pineoblastomas, ependymomas, teratomas, and astrocytomas. METHODS: Computed tomography (CT) was performed in seven patients and magnetic resonance imaging (MRI) was performed in all patients. RESULTS: CT showed a solid or solid/cystic mass with variable contrast enhancement. MRI showed a heterogeneous mass, with hypointense signal on T1 and iso/hyperintense signal on T2-weighted images (WI) and gadolinium enhancement. Extension to adjacent structures occurred in five patients and spread through the cerebral spinal fluid (CSF) in two. CONCLUSIONS: Pineal region tumors have no pathognomonic imaging pattern. MRI and CT are complementary in diagnosis and are important to determine localization, extension, and meningeal spread.     

足月新生儿缺氧缺血性脑病的CT临床应用与预后评估

目的:提高对足月新生儿窒息缺氧缺血性脑病(简称HIE)头颅CT的临床应用。方法:时80例有明确围产期窒息史和临床症状的患儿进行头颅CT扫描,其中72例进行复查扫描。作治疗前后CT对照并分析预后。结果:80例均有按CT诊断分度标准的轻(33例、占41.2％)、中(28例、占35.0％)、重度(19例、占23.8％)。CT表现,CT诊断阳性率为100％。结论:头颅CT检查能早期、直观、清楚地对足月新生儿窒息反映出脑缺氧缺血性损害及程度和变化。对指导治疗。评估预后有重要意义。     

The universal algorithm of maturation for secretory and excretory protein precursors.

During maturation, most proteins undergo different posttranslational modifications. In most simple cases, signal peptidases remove the signal or leader peptide from the precursors of the secretory proteins during their translocation across the ER membrane. For biologically active proteins, such as enzymes, regulatory and defense proteins, toxins, etc., additional maturation-regulating mechanisms were shown to proceed with limited proteolysis of inactive precursors by specific enzymes. A number of specific enzymes from different cell types selectively cleave proproteins at specific processing sites. In this work, we analyzed the sequences of protein precursors synthesized in the excretory glands of different animals and identified new, non-traditional processing sites. They differ from the motifs previously identified in secreted proteins' precursors and enabled us to reconstruct the sequence of events leading to the conversion of protein precursors into the final products (mature proteins). We also found that in animals, the maturation mechanism of secretory and excretory proteins and the set of enzymes involved are species specific. The processing sites identified in protein precursors in this study are useful for a more detailed genome analysis and more accurate mature protein sequence prediction.     

Virilizing mature ovarian cystic teratomas

 Three further cases of mature benign cystic teratomas of the ovary associated with virilization are added to the three previously reported in the literature. They were found in postmenopausal, obese, diabetic women aged 52, 61, and 67 years. The patients presented with hirsutism and voice changes and clitoromegaly was present in one. Testosterone and androstenedione levels were elevated but promptly regressed after removal of the tumours. Histologically, sheets of stromal luteinized cells were found peripherally at the interface between the neoplasm and ovarian tissue. Luteinization of ovarian stroma induced by an unknown factor related to diabetes mellitus is the origin of the virilization. Received: 8 January 1997 / Accepted: 28 February 1997     

Malignant transformation of mature cystic teratoma to squamous cell carcinoma involves altered expression of p53‐ and p16/Rb‐dependent cell cycle regulator proteins

Ovarian mature cystic teratomas (MCT) uncommonly undergo malignant transformation to squamous cell carcinoma (SCC). While alterations in the p53 tumor suppressor gene and protein have been shown, few studies have analyzed other molecular changes leading to this malignant conversion. The purpose of the present study was to investigate 21 samples of SCC arising in MCT for altered expression in known p53‐ and p16/Rb‐dependent cell cycle regulatory proteins, and the association between their expression and cellular proliferation and histological features. Overexpression of the p53 protein was observed in 14 SCC (67%), while four (19%) had point mutations in the p53 gene. Reduced expression of the p16 protein was observed in 18 SCC (86%), while p16 gene alterations (hypermethylation (29%) and point mutation (33%)) were found in 11 (52%). Furthermore, a statistically significant correlation was observed between p53 and Rb overexpression (P = 0.0010), and the overexpression of both p53 and Rb was respectively significantly correlated with increased cellular proliferation. The results indicate that alterations in both the p53 and p16‐Rb pathways are associated with SCC arising in MCT.     

Intrarenal mature cystic teratoma associated with renal dysplasia: case report and literature review

We report a case of intrarenal teratoma in a 6-year-old boy. Two years before his operation, multicystic masses had been found in the left side of his abdomen. In the operation, three main cystic masses were located in the upper and lower poles of the left kidney, which were removed in pieces. Histologically, the cyst wall was lined mainly with keratinizing squamous epithelium with hair follicles, shafts and sebaceous glands. The adjacent renal parenchyma showed atrophy, with partially dysplastic and angiomyolipoma-like lesions. Based on these findings, the lesion was diagnosed as mature cystic teratoma of dermoid cyst type. Extragonadal teratoma occurs predominantly along the median line of the body. Intrarenal teratoma is extremely rare; however, it should be distinguished from teratoid Wilms' tumor and other renal cystic lesions.     

不同胎龄母婴间血清前白蛋白与锌、钙、镁水平测定

目的　为检测不同孕周母婴间血清前白蛋白 (PA)与锌、钙、镁的水平及它们之间的关系。方法　采用免疫单项扩散法及原子吸收分光光度计火焰法检测了 4 0对早产与 14 8对健康足月母婴血清前白蛋白及锌钙镁的含量。结果　 4 0对早产与 14 8对健康足月母亲血清PA均显著高于新生儿脐血PA(P <0 0 0 1) ,血清锌显著低于新生儿 (P <0 0 0 1) ,血清钙早产母亲显著高于早产儿 ,足月母亲则显著低于足月儿。血清镁早产及足月母亲均略低于新生儿 (P >0 0 5 )。各孕周母婴间PA、镁无相关性 ,锌、钙呈正相关。 (相关系数分别为早产 0 39、0 33,足月 0 4 1、0 35 ,(P <0 0 1) ,早产儿脐血血清PA显著低于足月儿 (P <0 0 0 1) ,脐血血清锌低于足月儿 (P <0 0 1) ,脐血血清钙低于足月儿 (P >0 0 5 )。各孕周新生儿脐血PA与自身锌、钙、镁相关分析无相关性。结论　检测各孕周母婴PA、锌、钙、镁的含量 ,可以综合评价早产儿、足月儿的营养状况。