MDR1-mRNA在原发性大肠癌中定量测定及临床意义

探讨大肠癌ｍｄｒ１基因与肿瘤生物学行为的关系及ｍｄｒｌ基因表达分级标准制定的临床意义。方法采用ＲＴ－ＰＣＲ方法检测了６５例大肠腺癌患者肿瘤组织中ｍｄｒｌ基因表达水平并进行程度分级。结果ｍｄｒｌ基因表达水平与大肠腺癌分化程度相关，但与肿瘤侵袭程度、淋巴结转移程度及远处转移与否无关。     

Meningoencephalocele of the temporal bone: Pictorial essay on transmastoid extradural-intracranial repair

Purpose

A spontaneous meningoencephalocele of the temporal bone may present with effusion in the middle ear, a cerebrospinal fluid leak, hearing loss, or rarely otitic meningitis. Repair of spontaneous encephaloceles in the temporal bone has been performed using transmastoid and transcranial middle fossa approaches or a combination of the two with varied results. The authors present a technical paper on the transmastoid extradural intracranial approach for the management of temporal lobe encephaloceles.

Materials/Methods

Case reports and cadaver dissections are used to provide a pictorial essay on the technique. Advantages and disadvantages compared with alternative surgical approaches are discussed.

Results

Traditional transmastoid approaches are less morbid compared with a transcranial repair as they avoid brain retraction. However, in the past, there has been a higher risk of graft failure and hearing loss due to downward graft migration and a potential need for ossicular disarticulation. For the appropriate lesion, the transmastoid extradural intracranial approach lesion offers a stable meningoencephalocele repair without the comorbidity of brain retraction.

Conclusion

The authors describe a transmastoid extradural intracranial technique via case reports and cadaver dissections for the repair of spontaneous meningoencephalocele defects larger than 2 cm. This approach provides more support to the graft compared to the conventional transmastoid repair.     

Knowledge,attitude, and skills regarding sports medicine among football players and team doctors in the football super league in Malawi

A study was conducted among football players and team doctors in the football super league in Malawi to determine the level of knowledge, skills and attitude in sports medicine. One hundred football players and thirteen team doctors were involved in the study. Standardised questionnaires were used to collect data in an interview format. Among the players 37% had completed tertiary education and 60% had finished secondary school education. Most players had poor knowledge on prevention of injuries; had poor advice on diet; used illicit drugs or knew of fellow players using illicit drugs and believed in the role of magic in sports. All 13 team ‘doctors’ worked full-time in paramedical fields: 3 were orthopaedic clinical officers, 2 were physiotherapists and the rest were in various fields, such as dental technician, pharmacy assistant, medical assistant and dermatology technician, where trauma is not part of their basic training. Most team “doctors” were aware of the impact of HIV/AIDS on sports but few had good knowledge of the role of nutrition in sports and the effect of performance enhancing drugs in sports. Most believed in the role of magic in sports. Recommendations are made on the basis of these findings.     

Autologous bone marrow transplantation using marrow incubated with Asta Z 7557 in adult acute leukemia

The sensitivity of human myeloblastic leukemic (CFU-L) and normal hemopoietic stem cells (CFU-GM and BFU-e) to Asta Z 7557 (INN Mafosfamide) was studied with regard to autologous bone marrow transplantation (ABMT) with cleansed marrow for consolidation therapy in adult patients with acute leukemia (AL) in remission. Establishment of the dose-response curves for CFU-GM (n = 37), BFUe (n = 11), and myeloblastic CFU-L (n = 9) demonstrated a wide range of sensitivity from patient to patient for all three progenitors. Whereas CFU-L, CFU- GM, and BFU-e grown in semisolid cultures disclosed similar sensitivities to Asta Z 7557, long-term culture (LTC) studies (n = 41) indicated a higher resistance of early progenitors. In an effort to achieve a maximum tumor cell kill and yet spare a sufficient amount of normal stem cells to ensure consistent engraftment, we defined the optimal dose for marrow cleansing as the dose sparing 5% CFU-GM (LD95). This dose was established from a preincubation test (PIT) realized on a 10-mL marrow aspirate taken 15 days before marrow collection in each individual patient. Twenty-four adult patients while in remission of AL (20 in complete remission, four in partial remission) were consolidated by cyclophosphamide 60 mg/kg X 2 and total body irradiation at 10 Gy followed by ABMT with marrow cleansed by Asta Z 7557 according to the specification described above. Patients were divided in two groups: group 1, unfavorable prognosis (11 patients); group 2, standard prognosis [13 patients in first complete remission (CR)]. All patients engrafted on leukocytes (median day for recovery to 10(9)/L: day 30), patients with ALL recovered faster than patients with ANL (median day 19 v 34). Similarly, recovery of platelets to 50.10(9)/L occurred sooner in patients with ALL (median day 67, range day 23 through 90) whereas three patients with acute nonlymphoblastic leukemia (ANLL) in group 2 had to be supported with platelet transfusions for more than one year. In group 1, six patients had recurrent tumor within six months; three patients died from toxicity with no evidence of tumor. Two patients are still disease-free with a short follow-up (nine and ten months). In group 2, two patients died from toxicity with no evidence of leukemia three and 16 months post-ABMT. One patient with a M5 ANLL and one patient with ALL relapsed at six and 15 months, respectively. Nine patients have remained in CR or are disease-free with a median follow-up of 22 months.(ABSTRACT TRUNCATED AT 400 WORDS)