P53与ras癌基因产物对直肠癌的诊断价值

目的提高直肠癌术前活检的诊断率。方法5年来手术治疗的168例直肠癌病人中,有20例（11．9％）第一次手术前活检不能明确诊断。对其中17例患者的活检组织石蜡标本（实验组）和10例正常肠粘膜活检标本（对照组）进行常规病理、P53与ras癌基因产物检测。结果实验组中P53与ras基因表达阳性率分别为71％与47％,阳性率均高于常规病理,有显著性差异。17例标本中,11例为不典型增生,5例仅有慢性炎症。不典型增生的P53与ras基因表达分别为11例和7例,而慢性炎症则全部为阴性。二者之间,两种基因表达阳性率均有显著差异。实验结果还显示P53与ras基因表达有较好的一致性。对照组的10例正常肠粘膜的活检标本P53与ras基因检测结果均阴性,与实验组比较,P53阳性率有显著差异。结论P53与ras基因表达检测,可以作为常规病理的补充,提高直肠良恶性病变的鉴别力。     

Fungal corneal ulcers of onion harvesters in southern Taiwan

Fungal corneal ulcers related to agriculture has been reported throughout the world, especially in tropical areas. Most of them were sporadic and had histories of ocular trauma or use of topical corticosteroids and topical antibiotics. Five onion harvesters had fungal corneal ulcers during the same harvest period in Southern Taiwan. The authors think that this is the first report of a group occurrence relating to agricultural workers. Although all of the patients improved after medical and surgical management, their vision was greatly decreased. It is suggested that the tropical climate, the harvest procedure, the characteristic monsoon, and lack of eye protection were involved. Therefore, the importance of the eye protection, hygiene education, and improving medical care to reduce the occurrence of fungal corneal ulcer in agriculture workers must be emphasised.

 

     

The effect of allergen immunotherapy on in vitro IL-4 and IFN-gamma production by peripheral mononuclear cells in house dust-sensitive Chinese patients with bronchial asthma

The IFN-gamma produced by Th1 cells and IL-4 produced by Th2 cells are two most important cytokines in the regulation of IgE production. House dust immunotherapy has been tried in the treatment of house dust-sensitive Chinese asthmatic patients with good results. We examined the influence of such treatment on in vitro IL-4 and IFN-gamma production by peripheral blood mononuclear cells in house dust-sensitive asthmatic patients. Allergen immunotherapy in house-dust sensitive asthmatic patients can significantly decrease IL-4 production from peripheral mononuclear cells (p<0.05). The production levels of IL-4 in patients without treatment had higher levels than those in patients with hyposensitization (p<0.01). Such therapy also have some effect on promotion of IFN-gamma production in asthmatic patients. In conclusion, immunotherapy with house dust may have the potential ability to shift the Th1/Th2 balance of immune response to allergens and to create a favorable cytokine microenvironment to suppress the allergic reaction in the asthmatic airway.     

Laparoscopically assisted full thickness skin graft for reconstruction in congenital agenesis of vagina and uterine cervix

In patients with agenesis of the vagina and cervix but with a functional endometrium, the traditional treatment is hysterectomy with construction of a neovagina. We report successful treatment by laparoscopically assisted full thickness skin graft for reconstruction in a patient with congenital agenesis of the vagina and uterine cervix concomitant with haematometra and ovarian endometrioma in a 12 year old girl. Postoperatively, the vaginal skin graft healed well, and menstruation first appeared 4 weeks later. In our opinion, a combined laparoscopic and vaginal procedure with full thickness skin graft is an efficacious alternative in managing such genital defects.