头颈部恶性肿瘤患者上呼吸道分泌物和血清中α－L－岩藻糖苷酶活性的对比研究（摘要）

头颈部恶性肿瘤患者上呼吸道分泌物和血清中α－Ｌ－岩藻糖苷酶活性的对比研究（摘要）游学俊谭慎微我们采用微量比色法对２０例正常人、头颈部良性疾病和恶性肿瘤患者各２０例上呼吸道分泌物、血清中α－Ｌ－岩藻糖苷酶（ＡＦＵ）的活性进行对比研究。头颈部恶性肿瘤组包...     

β—葡萄糖苷酸酶与恶性肿瘤

近年来,β-葡萄糖苷酸酶(β-glucuronidase,β-GD)与恶性肿瘤之间的关系日益引起人们的注意。有关β-GD在恶性肿瘤早期诊断、临床分期分级以及它在恶性肿瘤转移等方面所起作用的报道日见增多。本文作者亦对头颈部恶性肿瘤患者上呼吸道分泌物及血清中β-GD的活性变化及其与肿瘤的临床分期分级、疗效评估及判断肿瘤有无复发的关系进行了研究。现综述如下。     

喉癌患者血清γ－谷氨酰转肽酶活性测定

测定喉癌术前患者３６例、喉部良性病变患者４０例和正常对照者６１名的血清γ－谷氨酰转肽酶（γ－ＧＴ）活性，结果前组与后二组间差异有极显著性（Ｐ＜０．０１）；而后二组间差异无显著性（Ｐ＞０．０５）。证明测定喉癌患者血清γ－ＧＴ活性，可作为喉癌诊断的辅助指标。通过对９例喉癌患者治疗后追踪，观察其酶活性动态变化，证明有助于观察疗效、监测肿瘤有无复发或转移。     

喉癌患者血清γ—谷氨酰转肽酶活性测定

测定喉癌术前患者３６例、喉部良性病变患者４０例和正常对照者６１名的血清γ－谷氨转肽酶活性，结果前组与后二组间差异有极显著性（Ｐ＜０．０１）；而后二组间差异无显著性（Ｐ＞０．０５）。证明测定喉癌患者血清γ－ＧＴ活性，可作为喉癌诊断的辅助指标。通过对９例喉癌患者治疗后追踪，观察期酶活性动态变化，证明有助于观察疗效、监测肿瘤有无复发或转移。     

鼻咽分泌物中β_2微球蛋白测定的临床意义

为了探讨鼻咽分泌物中β２微球蛋白（β２－ｍｉｃｒｏｇｌｏｂｕｌｉｎ，β２－ＭＧ）含量的临床意义，以放射免疫法测定了７３例鼻咽癌患者、３０例慢性鼻咽炎患者和３０例健康人鼻咽分泌物β２－ＭＧ含量，并对３１例鼻咽癌患者作了治疗前后动态观察。结果发现：鼻咽癌组为４．８７±２．５１ｍｇ／Ｌ，慢性鼻咽炎组为１．０５±０．６４ｍｇ／Ｌ，对照组为０．８５±０．３２ｍｇ／Ｌ。鼻咽癌组明显高于鼻咽炎组与对照组，差异有显著意义（Ｐ＜０．０１）。在动态观察中发现放射治疗治愈组明显降低，放射治疗失败组仍增高。提示鼻咽部也具有β２－ＭＧ分泌功能，在患鼻咽癌时其水平升高，并与肿瘤的消长有一定相关性，其作为肿瘤标志物或病程转归判断指标的意义，值得进一步探讨。     

头颈部粘膜原发性与转移性黑色素瘤的临床病理特征

[英]／BillingsKR…／／Otolaryn-golHeadNeckSurg．－1995，112（6）．－700～706恶性黑色素瘤其恶性程度之高、侵犯范围之广、累及器官之多是体内任何恶性肿瘤无法比拟的。皮肤恶性黑色素瘤最常转移的部位是区域淋巴结、肺、肝及大脑。转移至上呼吸道粘膜较少见，其发生率约为2％～9．3％。在呼吸道粘膜、鼻腔腺体、鼻中隔、下鼻甲、中鼻甲粘膜内有黑素细胞存在，可发生原发性黑色素瘤，但较少见。11例头颈部粘膜转移性黑色素瘤，5男6。女，平均年龄48岁（30～77岁），原发部位分别位于躯干（6，55％）、四肢（3，27％）及头颈部（2，1…     

头颈部恶性肿瘤患者血小板聚集性的电镜观察

目的探讨头颈部恶性肿瘤与血小板聚集性的关系。方法采用电镜方法，以血小板聚集型百分比为指标，检测了３７例头颈部恶性肿瘤患者的血小板聚集性，并以非肿瘤患者和良性肿瘤患者各１０例作为对照。随访了手术后４～６个月的２５例头颈部恶性肿瘤患者的血小板聚集性的改变值。结果①头颈部恶性肿瘤患者的血小板聚集型百分比均数显著高于非肿瘤患者和良性肿瘤患者（Ｐ值均小于０．０５）；②头颈部恶性肿瘤患者血小板聚集型百分比随临床分期进展而显著增高（Ｐ＜０．０５）；③手术后４～６月的随访患者中，１７例无转移和无复发患者的血小板聚集型百分比较手术前显著降低（Ｐ＜０．０５）；８例有转移或有复发患者的血小板聚集型百分比则较手术前显著增高（Ｐ＜０．０５）。结论①头颈部恶性肿瘤患者的血小板聚集性增加；②电镜方法测定的血小板聚集型百分比在判断头颈部恶性肿瘤的发展、疗效和预后上可能有潜在的价值。     

原发于头颈以外恶性肿瘤的颈淋巴转移临床分析

目的探讨原发于头颈以外的恶性肿瘤的颈淋巴转移规律，以期对此类疾病进一步认识，为诊断提供依据。方法回顾性分析自1989年1月至2004年6月在北京协和医院住院治疗的466例发生颈淋巴转移的恶性肿瘤患者之中的77例原发灶位于头颈以外的病例，均经病理证实为恶性肿瘤颈淋巴转移。分析其发病特点，并按照颈淋巴结LEVEL分区探讨颈淋巴转移区域的特点。结果77例原发于头颈以外的恶性肿瘤病例，原发部位包括肺、胃、食管、乳腺、结肠、纵隔、卵巢、子宫、胰腺、肝脏、肠系膜、肾上腺、直肠。81．8％（63／77）的患者发生LEVELⅤ区颈淋巴转移，其中50例为左侧LEVELⅤ区转移；11．7％（9／77）发生LEVELⅣ区转移；5．2％（4／77）发生LEVELⅢ区转移；1．3％（1／77）发生LEVELⅠ区转移。原发灶位于头颈部以外的病例占各区域全部病例的比例分别为LEVELⅠ区2．1％，LEVELⅢ区3．7％，LEVELⅣ区14．3％，LEVELⅤ区70．8％。发生颈淋巴转移的头颈外恶性肿瘤中，低分化腺癌占51．9％，中分化腺癌占15．6％，低分化鳞癌占11．7％，中分化鳞癌占10．4％，其他组织学类型占10．4％。结论头颈部以外的多个器官的恶性肿瘤均可见颈淋巴转移，其中以肺癌最为常见，胃、食管、乳腺也是常见的原发灶。头颈部以外的恶性肿瘤发生颈淋巴转移的区域集中在LEVELⅤ区，尤其是左侧LEVELⅤ区。且发生于LEVELⅤ区的肿瘤转移病例，原发肿瘤位于头颈部以外的情况多于头颈部肿瘤。发生颈淋巴转移的头颈外恶性肿瘤，分化程度以中．低分化为主。     

鼻咽癌患者单个核细胞mIL-2R表达和血清sIL-2R水平的检测及意义

目的：探讨ＩＬ－２Ｒ与鼻咽癌发生、发展的关系。方法：应用间接免疫荧光法和ＥＬＩＳＡ法对６２例鼻咽癌、２１例鼻咽良性病变和２６例健康对照者外周血单个核细胞（ＰＢＭＣ）经植物血凝素（ＰＨＡ）刺激后的ｍＩＬ－２Ｒ和血清ｓＩＬ－２Ｒ水平进行检测。结果：１）鼻咽癌患者ｍＩＬ－２Ｒ表达显著低于鼻咽良性病变和健康对照组（Ｐ＜０．０５）;２）鼻咽癌患者血清ｓＩＬ－２Ｒ水平显著高于鼻咽良性病变和健康对照组（Ｐ＜０．０１）;３）与无远处转移的鼻咽癌患者相比,有远处转移的鼻咽癌患者血清ｓＩＬ－２Ｒ显著升高（Ｐ＜０．０１）;４）鼻咽良性病变与健康对照组之间ｍＩＬ－２Ｒ表达和ｓＩＬ－２Ｒ水平无显著差异。结论：结果提示ｍＩＬ－２Ｒ表达低下和ｓＩＬ－２Ｒ异常升高在鼻咽癌患者机体免疫抑制中可能起重要作用。     

肿瘤标记物CA-50，CA-242和唾液精脒在头颈部肿瘤病人中的测定

采用三明治式固相免疫放射测定法，对头颈部恶性肿瘤病人９９人，良性疾病４２人血清中肿瘤相关抗原ＣＡ－５０和ＣＡ－２４２进行测定，此外，对上述病人还采用￣［１２５］Ｉ标记的固相放免法测定唾液精眯。发现ＣＡ－５０，ＣＡ－２４２和精脒水平在恶性肿瘤病人中增高百分比分别为２７％（２６／９８），４９％（４２／８６）和６２％（４９／７９）。在良性疾病中增高比率分别为１０％（４／４２），２８％（１１／３９）和４０％（１１／２７）。联合使用三个标记物，可以相对提高恶性组的阳性率，降低良性组的假阳性率。１４名恶性肿瘤病人的标记物作了连续测定，结果术后１０～１５天时的ＣＡ－５０值明显低于术前和术后３～４个月时的ＣＡ－５０值，而ＣＡ－２４２和唾液精脒却没有明显变化。     

Oxidants and antioxidants in tonsillar and adenoidal tissue in chronic adenotonsillitis and adenotonsillar hypertrophy in children

OBJECTIVE: The aim of the study is to determine the possible role of oxidants and antioxidants in the pathogenesis of chronic adenotonsillitis and adenotonsillar hypertrophy in children. PATIENTS AND METHODS: The children were divided into infection and hypertrophy groups, which were comparable according to age and gender distribution. The infection group was consisted of 20 children with the diagnosis of chronic adenotonsillitis and the hypertrophy group was made up of 19 children with adenotonsillar hypertrophy to whom adenotonsillectomy was performed. Preoperative blood levels of erythrocyte MDA, serum MDA, erythrocyte catalase and serum catalase, and adenoidal and tonsillar tissue levels of MDA and catalase were studied. RESULTS: There were significant increase in tonsil MDA, adenoid MDA, tonsil catalase and adenoid catalase levels in infection group (p<0.05). CONCLUSION: Oxidants and antioxidants are found to have an important role in the pathogenesis of adenotonsillar hypertrophy and chronic adenotonsillitis. These findings strengthen the hypothesis that indicates adenotonsillar hypertrophy and chronic adenotonsillitis are different diseases of the same tissues.     

Mismatch negativity in aging and in Alzheimer's and Parkinson's diseases

Mismatch negativity (MMN) is an auditory event-related potential (ERP) that reflects automatic stimulus discrimination in the human auditory system. By varying the interstimulus intervals (ISIs), the MMN can be used as an index of auditory sensory memory. This paper focuses on MMN findings in aging and in Alzheimer's (AD) and Parkinson's diseases (PD). The accumulated data suggest that MMN to duration deviance, unlike MMN to frequency deviance, is reduced in amplitude in aging at short ISIs. The attenuated MMN to frequency deviance observed at long ISIs in elderly subjects seems to be caused by age-related memory trace decay. Existing results suggest that automatic discrimination for the frequency change is not affected in the early phase of AD, whereas the memory trace seems to decay faster in AD patients. The present findings on PD are not as conclusive, although they tentatively suggest deteriorated automatic change detection. The MMN appears to offer an objective tool for studying auditory processing and memory trace decay in different neurological disorders.     

Urokinase-type plasminogen activator expression and proliferation stimulation in head and neck squamous cell carcinoma in vitro and in situ

BACKGROUND: Stimulation of proliferative activity by urokinase-type plasminogen activator (uPA) has been demonstrated in vitro for cultured primary and carcinoma cells. OBJECTIVE: To examine the effect of uPA stimulation on cultured squamous cell carcinoma cell lines of the head and neck in vitro and to compare the results with the situation in tumor tissue specimens. DESIGN: The uPA-mediated growth stimulation of 2 head and neck squamous cell carcinoma cell lines after suppression of endogenous uPA production was monitored by measuring (3)H-thymidine uptake into cellular DNA. Alternatively, applications of antibodies against the uPA-binding domain of the urokinase receptor were used to suppress autostimulation. To analyze the situation in situ we performed Western blot and zymographic studies on tissue homogenates of 25 squamous cell carcinoma specimens. We tested the expression of proliferating cell nuclear antigen (PCNA), a marker for proliferative activity, and uPA in tissue lysates and correlated uPA and PCNA expression by regression analysis. RESULTS: High-molecular-weight urokinase had a proliferation stimulative effect on both cell lines in vitro. The uPA autostimulation was decreased by blocking the uPA-binding domain of urokinase receptor with antibodies. Regression analysis of zymographic and Western blot data of tumor tissue lysates revealed no significant coherency between PCNA and uPA expression. Immunohistochemical stainings frequently showed different sublocalization of uPA and PCNA within tumors. CONCLUSION: In vitro uPA-mediated growth stimulation is not necessarily transferable to the in situ situation.     

ATP induces respiratory ciliostimulation in rat and guinea pig in vitro and in vivo.

Adenosine triphosphate (ATP) has been shown to revitalize the disturbed nasal mucociliary function in man. We investigated the effects of ATP on the ciliary beat frequency (CBF) in animals by immersing tracheal explants from rats in various concentrations of ATP, and by infusing ATP intravenously to guinea pigs. CBF was measured with a photodetector technique from the surface of the explants or from the incised trachea. ATP (from 0.01 to 1 mg/ml) in vitro increased CBF in rat tracheal explants up to 10.5% (p less than 0.05). In vivo ATP (1 mg/kg) increased the CBF by 29% (p less than 0.01) in the guinea pig trachea. As the CBF was increased by ATP, both in vitro and in vivo, it can be suggested that the improvement in mucociliary transport by exogenous ATP as shown in previous studies is caused by the ciliostimulatory effect of ATP.     

Trends and Perspectives in Minimally Invasive Surgery in Otorhinolaryngology-Head and Neck Surgery

The roots of minimally invasive surgery (MIS) in otolaryngology-head and neck surgery (ORL-HNS) can be traced to the 1950s. Today, endonasal sinus surgery and endolaryngeal surgery already fulfill the principles of MIS. To widen its spectrum of indications, however, MIS must be able to offer three advantages that conventional macrosurgery and microsurgery already have: free maneuverability for the instrument, sensory feedback, and three-dimensional imaging. Every anatomical region (e.g., paranasal sinuses, upper aerodigestive tract, cerebellopontine angle) requires specific surgical instrumentation. Here, the authors present recently developed steerable instruments that allow two additional degrees of freedom not attainable with conventional instruments. These instruments may permit access to problem zones(e.g., laterally extending frontal and ethmoidal sinus recesses) in the near future. For better control of the instrument and the operative procedure, tactile feedback can be achieved with appropriate microsensor systems. Three-dimensional vision can be realized by three-dimensional video-endoscopes and sequential image processing.     

Changes in otoacoustic emissions and high-frequency hearing thresholds in children and adolescents

With the aim of characterizing the loss of high frequency hearing sensitivity in children, hearing thresholds and otoacoustic emissions were measured in a group of 126 normal hearing children and adolescents aged from 6 to 25 years. The subjects were divided into four 5-year age groups. Hearing thresholds over a range of 125 Hz-12.5 kHz were similar in all age groups, the average hearing threshold at 16 kHz was significantly elevated in the oldest age group. The response values of transiently evoked otoacoustic emissions (TEOAEs) significantly declined with age; the decline was negatively correlated with the hearing loss at 16 kHz. Significantly larger TEOAE responses and average distortion-product otoacoustic emission (DPOAE) values at 6.3 kHz were present in the youngest group in comparison with the other three older groups. Spontaneous otoacoustic emissions (SOAEs) were present in 70.8% of the children (in either one or both ears) with the greatest prevalence in the 11-20-year-old subjects. In the 21-25-year-old group, the hearing loss at 16 kHz was significantly smaller in ears with SOAEs than in ears without SOAEs. The results demonstrate that the increase in the high frequency hearing threshold at 16 kHz, which starts at ages over 20 years, is correlated with a decrease in the TEOAE responses at middle frequencies.