Patterns of cancer distribution in a medical center among adolescents 14 to 17 years of age for the period 1995 to 2001.

BACKGROUND AND PURPOSE: There are limited data on the pattern of cancer distribution among adolescents in Taiwan. This study evaluated the characteristics of these rare cancers in a medical center. METHODS: Analyses of the characteristics of malignant neoplasms for patients aged 14 to 17 years at diagnosis were performed for all cases recorded in the tumor registry of Chang Gung Memorial Hospital (CGMH) at Linkou for the period 1995 to 2001. All eligible tumors were categorized in 1 of 12 diagnostic groups according to the scheme of the International Classification of Childhood Cancer (ICCC). Relative frequencies, age, and gender variations and the characteristics of tumor types were analyzed. RESULTS: Cancer was diagnosed in 320 adolescents during the study period. The male/female ratio was 1.17. Leukemia was the leading diagnostic group. The frequency of carcinomas increased with age and was highest among 17-year-olds. In this age group, non-rhabdomyosarcoma soft tissue sarcoma/primitive neuroectodermal tumor (non-RMS STS/PNET), thyroid carcinoma (CA) and ovarian germ cell tumor (GCT) were the 3 most common solid tumors; the embryonal malignancies were rare. Tumors with the greatest male predominance were intracranial GCT (91%), nasopharyngeal CA (87.5%), osteosarcoma (84.6%), and colorectal CA (75%). Tumors with the greatest female predominance were thyroid CA (78.3%), gonadal GCT (75%), and non-RMS/PNET (56.5%). Hepatocellular CA comprised 9.4% of all carcinomas. CONCLUSIONS: The relative frequency and the distribution of histology subtypes among adolescents were between those of childhood and adult cancers. There were marked variations in tumor occurrence between genders and among different ages.     

Functional correlates of Doppler flow study of the female urethral vasculature.

OBJECTIVES: To examine the effect of individual patient factors (age, parity, body mass index, menstrual cycle, menopause, hormone replacement therapy, bladder neck position and urethral mobility) on the appearance of Doppler flow in urethral vessels, to investigate the association between the Doppler flow parameters and intrinsic urethral function, storage and voiding, and to explore differences in the urethral vasculature between subjects with and without urodynamic stress incontinence (USI). METHODS: Over a 4-year period we prospectively performed imaging studies in 355 women, including 244 who denied any lower urinary tract symptoms within the previous 3 months (Group A) and 111 who had had lower urinary tract symptoms (Group B). Studies included morphologic assessment and Doppler flow investigation of the lower urinary tract. Vascular flow velocity and vessel density in the urethral vasculature were measured. For women in Group B, multichannel urodynamic studies were also performed. RESULTS: The urethral vasculature has five main branches of vessels. Their appearance was not affected by the menstrual cycle or menopause except for those of the anterior vaginal vessel and anterior branch of the middle urethral vessel. Other than that of the posterior urethral vessel, in which there was a correlation with parity, the resistance index (RI) was not affected by individual patient factors. However, there was a correlation between the vascular index (VI) and individual factors such as age (r = -0.336, P = 0.002), body mass index (r = -0.287, P = 0.028), menopause (r = -0.402, P < 0.001), and hormone replacement therapy (r = 0.392, P = 0.027). Only the VI and RI of the posterior urethral vessel correlated significantly with the urethral pressure profile. In subjects with lower urinary tract symptoms, the appearance of the urethral vasculature on power Doppler imaging and the corresponding RI and VI values were not correlated with objective evidence of USI. CONCLUSION: Patient factors may affect specific Doppler flow parameters of the urethral vasculature, which are related to intrinsic resting urethral closure. There is no difference in the appearance of the urethral vasculature in subjects with or without USI.     

兔视网膜方向选择性神经节细胞树突的独特分枝模式及其生理意义

本实验研究了兔视网膜中的方向选择性神经节细胞 (direction selective retinal ganglion cells,DS cells)树突野的分枝模式。测量了视网膜中方向选择性神经节细胞和作为经典分枝模式神经元代表的α神经节细胞的树突直径。发现 ,方向选择性神经节细胞的树突在分枝后直径达到 0 .5 μm,进一步分枝树突直径仍保持在 0 .5 μm左右 ,这样 ,在方向选择性神经节细胞树突野中大多数树突直径在 0 .5μm左右。而作为经典分枝模式神经元代表的α神经元的树突每次分枝后都逐级变细 ,最终直径达到 0 .5μm左右 ,这样 ,α神经节细胞的树突直径大部分都大于 0 .5μm。我们应用程序“NEU RON”对在两种神经元模型中 ,抑制点落于兴奋点与胞体之间 (proximal)和抑制点不落于兴奋点与胞体之间 (distal)这两种情况进行模拟。我们发现 ,当抑制点不落于兴奋点与胞体之间时 ,在方向选择性神经节细胞的树突分枝模型中 ,抑制效果更强。那么 ,将使得方向选择性神经节细胞对抑制点落于兴奋点和胞体之间的要求变得不是那么迫切。所以 ,方向选择性神经节细胞的这种独特分枝模式 ,也许可以避免或至少减轻其在发育中可能会产生的连线的复杂性。并且 ,我们对得出的结论进行了电路分析 ,对方向选择性神经节细胞这种独特的分枝模式具有的?     

自体腹白线片修补十二指肠溃疡穿孔(附13例报告)

目的探讨用游离自体腹白线片修补急性十二指肠溃疡穿孔的应用价值。方法从2006年1月至2006年7月对13例用自体腹白线片修补急性十二指肠溃疡穿孔的病人的临床资料和随访情况进行回顾性分析,其中2例穿孔大于2cm2,平均手术时间60分钟,平均失血量20ml,平均住院天数9±1天。结果游离自体腹白线片修补急性十二指肠溃疡穿孔13例均痊愈出院。随访15天至6个月,无手术并发症。结论本方法操作较简单、安全、效果好,其适应症广,是一种可行的新方法。     

动态增强MR灌注成像在脑胶质瘤诊断中的价值

目的　探讨动态增强T2 WMR灌注成像在脑胶质瘤术前分级预测及鉴别诊断中的价值。资料与方法　有病理或追踪结果的 4 8例脑病变患者 ,其中胶质瘤 2 5例 (高、低级别胶质瘤分别为 16例和 9例 ) ,非胶质瘤病变 2 3例。全部病例均行常规T1WI、T2 WI和EPI SE序列动态增强MR灌注成像。计算每个病灶的最大相对脑血容量 (rCBV)比值 (病灶最大rCBV/对侧正常脑白质rCBV)。分析胶质瘤的最大rCBV比值与其组织学级别的关系 ,并比较胶质瘤与非胶质瘤的灌注异常及常规MRI强化表现。结果　高级别胶质瘤 ( 16例 )的最大rCBV比值为4 .6 0± 1.98( 2 .5 5～ 9.2 2 ) ,低级别胶质瘤 ( 9例 )的最大rCBV比值为 1.86± 1.5 2 ( 0 .85～ 5 .72 ) ,经t检验 ,两组之间有显著统计学差异 (P <0 .0 1)。脑膜瘤、转移瘤、血管母细胞瘤、淋巴瘤均显示有局部高灌注 ,最大rCBV比值为5 .35± 2 .39( 3.15～ 12 .39) ,而有强化表现的脑梗死、脑炎性灶及放射性脑损伤表现为低、等灌注 ,最大rCBV比值为1.2 7± 0 .36 ( 0 .85～ 1.72 )。结论　MR灌注成像在胶质瘤的术前影像学分级预测上有重要价值 ,在脑胶质瘤的某些鉴别诊断上亦具有一定的参考价值     

99TCm-RBC显像在下消化道出血诊断中的应用

目的　研究 99TCm-RBC显像诊断下消化道出血的临床价值。方法　对 2 5例下消化道出血患者行 99TCm-RBC显像 ,并与手术及病理检查结果作比较。结果　99TCm-RBC显像诊断下消化道出血阳性率为 80 .0 %,定位诊断率为 68.0 %,特异性为 85 .0 %。结论99TCm-RBC显像可作为下消化道出血诊断及定位的一种有效方法。     

Foley尿管气囊压迫治疗骶前静脉丛大出血的评价(附6例报告)

目的:评价直肠癌根治术中用Foley尿管气囊压迫治疗骶前静脉丛大出血(MPVP)的临床价值。方法:分析1995~2005年用Foley尿管气囊压迫治疗骶前静脉丛大出血6例的临床资料。结果:6例骶前大出血中全部用Foley尿管气囊压迫控制出血,术中出血量为800~1700mL,Foley尿管于术后4d拔除3例,5d1例,6d2例,均无再出血,会阴切口均一期愈合。结论:Foley尿管气囊压迫治疗骶前静脉丛大出血是一种简单安全有效的治疗方法。