Single-dose oral omeprazole for reduction of gastric residual acidity in adults for outpatient surgery

Omeprazole is a substituted benzimidazole that causes dose-dependent intracellular inhibition of gastric acid secretion in humans. This double-blind study examined the effect of omeprazole in decreasing gastric acidity and gastric residual volume in outpatient adults. Unpremedicated outpatients, ASA I-III, 18 years or older (n = 17), were randomly assigned to receive omeprazole 80 mg, or placebo by mouth the night before scheduled elective outpatient surgery. The patients were fasted for 8 h prior to surgery. After the patient was anesthetized, an orogastric tube was inserted with proper placement verified by auscultation for gastric sounds. Gastric residual contents were withdrawn into a Luken's trap, and pH was then determined and gastric volume indexed to weight (ml.kg-1). Data were analyzed by a t-test, with P less than 0.05 considered statistically significant. Patient characteristics of both groups were similar. There was a statistically significant difference between the two groups for pH (P = 0.02), but not between the two groups for gastric volume indexed to weight (P = 0.07).     

New monoclonal antibodies reacting with bile ducts: further insights into the pathogenesis of bile ductular proliferation in biliary diseases.

We have produced a range of monoclonal antibodies which stain human intrahepatic bile ducts of different sizes. Amongst 26 monoclonal antibodies produced, five clones reacted specifically with bile ducts of different sizes, of which three have been maintained in culture and their viability following freezing and thawing confirmed. Staining patterns varied between normal adult liver tissue, normal fetal liver tissue and a variety of hepatobiliary diseases. The antibodies provide further evidence of the immunological heterogeneity of the human intrahepatic biliary tree and support the hypothesis that proliferating bile ductules are derived from periseptal hepatocytes. The preparation of the antibodies, their staining reactions in normal adult, normal fetal and a variety of liver diseases are described.     

P53基因突变、人乳头瘤病毒16，18型感染与肺鳞癌发病的关系

应用单链构象多态性分析多聚酶链反应ＥＢ染色法（ＰＣＲ－ＳＳＣＰ－ＥＢ）对４０例肺癌组织标本的Ｐ５３基因序列５～８外显子突变进行分析，同时应用ＰＣＲ方法检测上述标本及１８例肺良性疾病组织标本中ＨＰＶ１６、１８型ＤＮＡ相关序列，旨在分析二者在肺鳞癌发病中的作用及相互关系，并就肺鳞癌与Ｐ５３基因结构和功能异常的关系进行初步探讨。     

妇科盆腔肿块超声误诊漏诊原因分析

本文报道经手术病理证实的１６７例妇科盆腔肿块超声检查结果，超声诊断总的符合率为９０．４２％（１５１／１６７）。其中子宫肌瘤、畸胎瘤、卵巢囊肿、卵巢囊腺瘤以及卵巢交响癌符合率较高，对于其它疾病引起的盆腔肿块也有参考价值，本文着重分析误诊漏诊原因，以吸取教训，供超声诊断借鉴。     

Granular cell tumors of the breast: A report of two cases

Granular cell tumors (GCT) are rare neoplasms, and only 173 cases of benign GCT of the breast have been documented. We report herein the cases of two patients with this tumor and discuss the methods of diagnosis and treatment. The first patient was a 60-year-old woman who presented with a firm ill-defined mass in her left breast. Mammography showed a dense shadow with spicula and skin thickness, and ultrasonography revealed a hypoechoic mass with an irregular border. Radical mastectomy was performed under the wrong preoperative diagnosis of breast cancer. The second patient was a 31-year-old woman who presented with an elastic-hard mass in her left breast. Mammography showed a well-demarcated dense mass, and ultrasonography revealed a well-defined hypoechoic mass with a large depth-width ratio. Fine-needle aspiration cytology (FNAC) showed a large number of histiocytic cells with abundant granular cytoplasm. An excisional biopsy was performed, and histological examination confirmed a diagnosis of GCT. GCT is benign, but often misdiagnosed as breast cancer both clinically and radiologically. Therefore, histological examination is essential for making a correct diagnosis, while FNAC is also useful. Local resection is still the treatment of choice, and surgeons should do their utmost to avoid performing needless radical mastectomy.     

肺内小病灶CT表现及其病理基础的研究：附76例分析

本文对７６例肺内小病灶（直径≤３ｃｍ）病例进行了ＣＴ－病理对照研究。结果表明，短毛刺征，深分叶征、棘状突起征、空泡征、血管集束征，胸膜凹陷征等对于诊断周围型小肺癌有重要临床价值；而尖角征、局限性胸膜肥厚粘连对诊断良性病灶有意义。本文重点讨论了血管集束征的定义，ＣＴ表现及病理基础；并就有争议的胸膜凹陷征提出一些粗浅的看法。旨在提高肺内小病灶良恶性诊断的准确率     

MRI同层动态增强对垂体微腺瘤的诊断价值

目的：分析垂体微腺瘤的MPd同层动态增强特征。方法：对40例临床怀疑为垂体微腺瘤的病人行同层动态增强MPd扫描，并绘出时间一信号强度曲线图。结果：40例病人中共检出垂体微腺瘤26例。同层动态增强后垂体微腺瘤的MPd表现为圆或椭圆形的低或稍低信号，似“充盈缺损”；垂体微腺瘤的最大信号强度多出现在注入造影剂后32～96s，以64s最明显。结论：同层MPd动态增强对垂体微腺瘤的诊断有较高价值。     

肺癌组织端粒酶活性测定

①目的　探讨端粒酶作为肺癌诊断标记物的可行性及临床意义。②方法　用TRAP法检测 2 9例肺癌组织、2 7例癌旁组织和 35例正常组织标本中端粒酶活性表达。③结果　 2 9例肺癌组织中 2 1例 (72 .4 % )端粒酶活性表达阳性 ,2 7例癌旁组织中 6例 (2 2 .2 % )端粒酶活性表达阳性 ,35例正常组织均不表达端粒酶活性。癌组织、癌旁组织与正常组织标本端粒酶活性比较有显著差异 (χ2 =34.0 13、3.937,P <0 .0 1、0 .0 5 )。④结论　端粒酶表达与肿瘤发生有关 ,其癌旁组织中端粒酶活性有可能成为判定肿瘤复发和预后的指标。     

System for prostate brachytherapy and biopsy in a standard 1.5 T MRI scanner.

A technique for transperineal high-dose-rate (HDR) prostate brachytherapy and needle biopsy in a standard 1.5 T MRI scanner is demonstrated. In each of eight procedures (in four patients with intermediate to high risk localized prostate cancer), four MRI-guided transperineal prostate biopsies were obtained followed by placement of 14-15 hollow transperineal catheters for HDR brachytherapy. Mean needle-placement accuracy was 2.1 mm, 95% of needle-placement errors were less than 4.0 mm, and the maximum needle-placement error was 4.4 mm. In addition to guiding the placement of biopsy needles and brachytherapy catheters, MR images were also used for brachytherapy treatment planning and optimization. Because 1.5 T MR images are directly acquired during the interventional procedure, dependence on deformable registration is reduced and online image quality is maximized.     

老年人尸检中前列腺腺癌的发生情况

目的　探讨老年人尸检前列腺腺癌的发生情况。　方法　采用光镜和免疫组化方法 ,观察 150例老年人 (62～ 10 2岁 )尸检前列腺标本的组织病理形态。　结果　 150例标本中原发前列腺腺癌 3 2例 (2 1.3 % ) ,其中前列腺临床癌 4例 (2 .7% ) ;前列腺潜伏癌 2 8例 (18.7% ) ,高分化 16例(57.1% ) ,中分化 10例 (3 5.7% ) ,低分化 2例 (7.1% )。潜伏癌中有高级别前列腺上皮内瘤 (HGPIN )者 9例 ,在高分化癌中占 3 1.2 % (5/ 16) ,中分化癌中占 40 .0 % (4/ 10 ) ,低分化癌中未发现 ;潜伏癌中发现有非典型腺瘤性增生 (AAH)者 2例。　结论　 60岁以上前列腺潜伏癌的发生率是欧美国家的1/ 2左右 ,绝大多数潜伏癌分化程度为高 中分化 ,HGPIN与前列腺癌有密切关系