Focused helical appendiceal computed tomography: Technique and interpretation

This article reviews a focused helical appendiceal computed tomographic technique and discusses an approach to appendiceal computed tomographic interpretation.     

用阑尾作输出道的可控回肠膀胱术（附三例报告）

目的：探讨带血管蒂游离阑尾倒置与脐吻合作输出道的可控回肠膀胱术在膀胱癌手术中的应用效果。方法：3例膀胱移行上皮癌，均为多发、浸润肿瘤。男2例，女1例。年龄52－64岁，平均58岁。行根治性全膀胱切除术后，采用带血管蒂游离阑尾倒置与脐吻合作输出道，行可控回肠膀胱术。结果：全部患者手术顺利，3例均获随访，时间分别为8个月、15个月、26个月，效果满意，脐部造口隐蔽，导尿管插管排尿通畅，无尿外溢，1例有轻度双肾积水，血肌酐、尿素氮均正常。结论：带血管蒂游离阑尾倒置与脐吻合作输出道的可控回肠膀胱术是一种治疗中、晚期膀胱癌的较理想的手术方法。     

147例阑尾肿物的临床病理分析

对１４７例阑尾肿物进行临床病理分析，原发性的１３２例，继发性的１５例。提出了有关阑尾肿物分类的一些意见，讨论了单纯性粘液囊肿的病理与阑尾标本的取材规范。     

人胎阑尾IAPP-、SS-及5-HT免疫反应性细胞的免疫组织化学研究

为了探讨胰岛淀粉样多肽，在胎阑尾中的个体发及其与其他生物活性物质的关系，用免疫组织ＰＡＰ法，对３６例１２－３８周人胎阑尾中ＩＡＰＰ免疫反应性细胞，生称抑素ＩＲ细胞５－羟色胺－ＩＲ细胞进行定位研究。结果表明，肥１２周，阑尾上皮中已可见到ＳＳ－ＩＲ细胞，而ＩＡＰＰ－及５－ＨＴ－ＩＲ细胞于１４周才见到。在整个胎期，阑尾中的ＩＡＰＰ－及ＳＳ－ＩＲ细胞始络分散存在，数量较少，而５－ＨＴ－ＩＲ细胞数量随胎龄增     

Immunohistochemical expressions of cytokeratins, mucin core proteins, p53, and neuroendocrine cell markers in epithelial neoplasm of appendix

Epithelial neoplasms of appendix are infrequent, and their pathological features are not fully characterized. We collected 33 cases of appendiceal tumors and examined immunohistochemically the expression of cytokeratins (CK, CK7, and CK20), mucin core protein (MUC1, MUC2, MUC5AC, and MUC6), E-cadherin, chromogranin A, and p53 protein. Gene analysis of TP53 was also conducted on exons 5 to 8. Clinically, mucinous tumors were predominant in females. Immunohistochemically, all the tumors expressed CK20, whereas CK7 was positive in one third of the cases. Similarly, MUC2 was expressed in all the tumors, whereas MUC1 and MUC5AC were detected in about a half of the cases. Although chromogranin A-positive cells are generally sparse in normal appendix, they were more common in mucinous tumors than in nonmucinous tumors. Contrary to the previous data reported (Mod Pathol 2002;15:599-605), mucinous carcinoma exhibited a higher frequency of p53-positive cells (mean 29%) compared with mucinous adenoma (2.8%) (P < .001), whereas nonmucinous tumors showed high levels of p53-positive cells to similar extent (51%-67%) in both adenoma and carcinoma. The high expression of p53 protein coincided with the presence of mutations in multiple sites of TP53 gene in mucinous tumors. This is the first report that characterized the immunophenotypic profile of appendiceal epithelial neoplasms with an emphasis of a higher frequency of p53 positivity in mucinous carcinoma cases compared with mucinous adenoma in the appendix.     

家兔阑尾淋巴管铸型的扫描电镜研究

用淋巴管铸型、冰冻断裂样品及半薄切片样品观察了家兔阑尾巴管及泡周围淋巴窦的立体构筑，可见在阑尾粘膜浅层存在一层毛细淋巴管网，粘膜深层有致密的毛细淋巴管丛，从毛细淋巴管丛发出许多短树枝样毛细淋巴管伸向胸腺依赖区。从粘膜浅层毛细淋忱网及粘膜深层毛细淋巴管丛都发出与腔面垂直的毛细淋巴管，与滤泡周围淋巴窦相连，滤泡周围淋巴窦位于淋巴滤泡的外面和底面从腔面观察，滤泡财要巴窦与粘膜深层的毛细淋巴管丛共同形成茶     

Valoración de parámetros clínicos y analíticos preoperatorios en apendicitis aguda complicada. Score para predecir apendicitis complicada

BackgroundTo analyze whether clinical and analytical parameters differ according to histopathology in cases of acute appendicitis (AA).MethodsThis is a retrospective, observational study including patients (>14 years of age) admitted for suspicion of AA from 1 April 2014 to 31 July 2016. Histopathology was divided into complicated (including perforated and gangrenous AA) and uncomplicated appendicitis (phlegmonous). Sex, age, temperature of patients on admission to the Emergency Department, symptom duration, preoperative white blood cell (WBC) count, neutrophil percentage, mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP) and hospital stay were compared in the two groups.ResultsThree hundred and thirty-five patients were analyzed, and 284 were included. Appendicitis was uncomplicated in 194 (68.3%) and complicated in 90 (31.7%). Age, symptom duration, neutrophil percentage, CRP and hospital stay were higher in the complicated AA group (P < .05). The mean differences between uncomplicated and complicated AA were: age 13.2 years (95% CI: 8.2-18.2), symptom duration 14.1 hours (95% CI: 6.3-21.9), neutrophil percentage 5.0% (95% CI: 3.2-6.8), CRP 73.6 mg/l (95% CI: 50.0-97.2) and hospital stay 2.2 days (95% CI: 1.4-3.0), with p<0.05 for all these variables. A model based on the preoperative parameters (age, symptom duration, neutrophil percentage and CRP) was calculated to predict the likelihood of complicated AA. The receiver operating characteristic (ROC) of the model had an area under the curve of 0.80 (95% CI 0.75-0.85).ConclusionThis model is able to diagnose complicated AA without the need for imaging techniques, although it must be validated with prospective analysis.