Carcinoma arising from an epiphrenic diverticulum: a frequently misdiagnosed disease.

Epiphrenic diverticulum is rare, comprising of about 10% of all esophageal diverticula. Carcinoma arising within such a diverticulum is even less common. We report on two patients with squamous cell carcinoma arising from an epiphrenic diverticulum. Some features of malignant change related to the epiphrenic diverticula were misdiagnosed or missed in our cases and other reports due to lack of clinical experience. It is important to exclude the possibility of malignancy as this is vital for surgical planning. Although the prognosis for patients with malignancy arising from an epiphrenic diverticulum is generally poor, a high index of suspicion may increase the chance of cure.     

咬肌与颅面形态的关系

目的探讨咬肌与颅面形态之间的关系，了解咬肌体积与邻近骨骼结构的大小及形态的相关性。方法对40例要求改变脸型者进行磁共振成像（MRI）测量，人体测量，头部正位、侧位和下颌骨曲面断层X线检查，测量并计算咬肌体积（MsV），测量头长（HL）、头宽（HB）、面长（FL）、面宽（FB）、下颌角间宽（IB）、下颌骨体长（CL）、下颌角切线长（MAL）、下颌角角度（JA），计算颜面形态指数FI（FL／FB）、头颅指数C（IHB／HL）。用SPSS11．5软件统计分析MsV与HI。HB、FL、FB、IB、CL、MAL、JA、FI、CI之间的相关性。结果MsV与JA呈明显负相关，与CL、MAL、IB、FB、HL呈明显正相关，与CL、FI、HB无明显相关性。结论咬肌肥大可能是方脸面型的成因之一，是影响面型的重要因素。     

Sonographic diagnosis of early recurrence after inguinal herniorrhaphy: Potential pitfalls

Three patients who presented with scrotal swelling within a few days of inguinal herniorrhaphy are reported. Ultrasonography scans performed in these patients all demonstrated features suspicious of recurrence of hernia. One patient underwent surgical exploration, which revealed only a scrotal haematoma without evidence of recurrent hernia. The other two patients were managed conservatively because clinically the swellings were regarded to be more compatible with haematoma. Both patients had subsequent resolution of the scrotal swelling with no clinical evidence of recurrence of hernia on follow‐up. It is concluded that sonographic diagnosis of recurrence of hernia shortly after inguinal herniorrhaphy can occasionally be misleading.     

Early indices of warm ischemic damage in autotransplanted canine kidneys preserved by simple hypothermic storage

After measurement of normal renal function, dog kidneys (n = 52) were subjected to 3, 15, or 30 min of normothermic warm ischemia (WI). After 24 hr of preservation by simple hypothermic storage (SHS) in a modified Collins solution, autotransplant was done and renal function was again measured beginning at 1 hr. Compared with preharvest values, kidneys with minimal (3 min) WI had significantly decreased clearances of creatinine (Cr) and para-aminohippuric acid (PAH), PAH extraction, absolute and fractional Na reabsorption, Na excretion, and urinary Na concentration; no change in urine flow rate or K excretion; and significantly increased fractional excretion of Na, K, and H2O. Compared with minimal WI, 30-min WI produced further significant decreases in clearances of Cr, PAH, and PAH extraction; and further increases in fractional excretion of Na, K, and H2O. Urine flow was also decreased by about half and urine Na concentration rose significantly. Several parameters were very significantly correlated with the length of WI, but the most reliable index was the fractional reabsorption of Na. When several functional parameters were used together, kidneys with significant (30 min) WI prior to preservation could be identified with a high degree of statistical reliability.     

Ultrasound Biomicroscopic Dark Room Provocative Test

Purpose : To compare the clinical application value of Ultrasound biomicrsocpic dark room provocative test with the traditional dark room test in screening primary angle closure glaucoma (PACG).Methods: 22 eyes with PACG in prodromal stage and 30 eyes with deep anterior chamber and wide angle of 15 normal persons were observed in this trail. All 52 eyes were performed traditional dark room provocative test and ultrasound biomicorosopic darkroom test respectively. With different positive diagnostic criteria, the sensitivity of the two methods were compared using chi-squared analysis.Results : After staying in the dark room for 2 hours, In case group, IOP in 10 of 22 eyes rose more than 1. 07kPa(1kPa = 7.5mmHg), in 12 eyes less than 1.07kPa or had no changes; appositional angle closure were found by Goldmann gonioscopy in 8 eyes : 3 eyes in two quadrants, 5 eyes in more than two quadrants; the appositional angle closure was found by UBM in 15 eyes; 3 eyes in one quadrants, 5 eyes in two quadrants, 7 eyes     

Arachidonic acid metabolites in CSF in hypoxic-ischaemic encephalopathy of newborn infants

The aim of this study was to evaluate the cerebral synthesis of eicosanoids in the asphyctic newborn and to investigate the relation between the prostanoid profiles in cerebrospinal fluid (CSF) and the appearance and severity of hypoxic-ischaemic encephalopathy (HIE). Levels of 6-keto-PGF _1-α, TXB₂, PGE₂ and PGF_2-α in CSF were measured in 40 full term newborns during the first day of life. Thirty of these newborns had birth asphyxia and were divided into three groups: 10 without HIE, 12 with mild HIE and 8 with moderate-severe HIE. They were compared to a control group of 10 non-hypoxic newborns. Determinations of the metabolites in CSF were performed by RIA and expressed as pg/ml (mean ± SD). The CSF TXB₂ (thromboxane A₂ metabolite) in asphyxiated newborns was always higher than in the control group (28.12 ± 10.6), and related to the severity of HIE ( p = 0:005): without HIE (50.84 ± 16.4; p = 0:02), mild HIE (80.65 ± 12.64; p ± 0:01) and moderate-severe HIE (178.14 ± 20.5; p < 0:01). The CSF 6-keto-PGF _1-α (prostacyclin metabolite) in asphyxiated newborns was always higher than in the control group (80.55 ± 12.56), but indirectly related to the severity of HIE: without HIE (240.95 ± 28.12; p < 0:01), mild HIE (183.65 ± 30.1; p < 0:01) and moderate-severe HIE (140.55 ± 25.12; p < 0:01). In the moderate-severe HIE group, the increase in TXB₂ was higher than the rise in 6-keto-PGF _1-α.     

脐血LAK细胞生物学特性影响因素的研究

采集２３名产妇的脐带血和８名正常成人的外周血制备ＬＡＫ细胞，随机分为４组，在培养第３，５，７，１４天，分别利用ＭＴＴ法和＾１２５Ｉ－ＵｄＲ释放法对４组ＬＡＫ细胞的增殖力和杀伤活性进行了测定，同时用细胞毒方法测定培养７天的ＬＡＫ细胞的免疫表型。结果发现，在不同培养时间，脐血来源的ＬＡＫ细胞增殖力显著高于成人血ＬＡＫ细胞（Ｐ〈０．０５或Ｐ〈０．０１），成人血清组，脐血血清组，红细胞组ＬＡＫ细胞增殖力有     

A study of the relationship between ambient lead and blood lead among lead battery workers

 Objective: To examine the relationship between ambient lead levels and blood lead levels and to explore the modifiers of the relationship between ambient lead and blood lead. Method: A cross-sectional study was conducted in two lead battery factories. Blood lead level and ambient lead concentration were measured for each participant concurrently. A structured questionnaire was administered to collect sociodemographic characteristics and occupational history. Design: Biological and personal environmental measurements of 219 lead-exposed workers were analyzed by both simple and multiple linear regression. A regression model was selected for interpretation. Results: A high correlation (r=0.62) between ambient lead (PbA) and blood lead (PbB) was observed. In addition, numerous factors, including age, sex, alcohol consumption, personal hygiene practice and type of lead exposure, were also found to influence blood lead levels. Although PbB was highly correlated with PbA, blood lead level may not be effectively lowered by reducing ambient lead level. Based on the regression coefficients, improvement of hygienic practice was more effective at lowering PbB than reducing ambient lead level. Good hygienic practice may be the preferential way to reduce lead exposure in current conditions. Conclusion: Education of correct work practice may be more important than engineering control in the developing countries to lower blood lead levels in lead battery factories. Received: 28 May 1996/Accepted: 30 August 1996