Psammoma bodies and optically clear nuclei in bronchiolo-alveolar cell carcinoma. Diagnosis by fine needle aspiration biopsy with histologic and ultrastructural confirmation

The fine needle aspiration cytology of two cases of bronchiolo-alveolar cell carcinoma of the lung having unusual features is reported. One case demonstrated numerous psammoma bodies in the cytologic smears, whereas the other case showed an abundance of cells with optically clear nuclei. Both peripherally located tumors were resected and confirmed as primary bronchiolo-alveolar cell carcinoma by histologic and ultrastructural examination. We believe this to be the first report describing these unusual features of bronchiolo-alveolar cell carcinoma diagnosed by fine needle aspiration cytology. Presented is a discussion of psammoma bodies and optically clear nuclei seen in primary and metastatic tumors of the lung. This will aid in the diagnosis of these cases.     

急性后颅窝血肿的微创穿刺术治疗

目的：探讨应用IL－2型特种针进行微创穿刺术治疗后颅窝血肿的可行性及临床应用。材料及方法：回顾性分析我们自1995年9月至1999年9月对28例后颅窝高血压性或外伤性脑内血肿及硬膜外血肿进行微创穿刺引流治疗的病例。结果：28例病例中除1例于穿刺成功后死于脑干功能衰竭外,其余病例均获成功,病人无后遗症,痊愈出院,其中1例伴发再出血,经血肿腔内止血药冲洗引流治疗再出血停止,结论：此穿刺针特点为针钻一体,解决了针在颅骨上固定问题,也解决了立体定向不能留置针管问题,微创穿刺方法治疗后颅窝血肿可避免传统后颅窝开颅手术,安全性高,疗效良好,操做简便,费用较低,易于在各级医院普遍开展,具有较大推广使用价值。     

Pancreatic solid pseudopapillary neoplasm

Pancreatic solid pseudopapillary neoplasm (SPN) is a rare low grade malignant tumour. Distinguishing this entity from other pancreatic neoplasms is critical for therapeutic decision making and prognostication. It predominantly affects young female patients <40 years of age, with excellent clinical outcome following surgical removal. The gold standard diagnostic test is cytopathological or histopathological assessment of fine needle aspirate. There are two main difficulties with this. First, SPN can present with morphological and immunohistochemical appearances that can closely mimic other pancreatic tumours, in particular, pancreatic neuroendocrine tumour (NET). Second, the amount of diagnostic material from fine needle aspiration can be limited. Here, we present a cytopathological case with both challenges during the pre-operative investigation of SPN. The case exemplifies the importance of combining morphological features with a targeted panel of immunohistochemistry to arrive at the diagnosis.     

Transurethral microwave needle ablation for bladder cancer

Ｔｏｉｎｖｅｓｔｉｇａｔｅｔｈｅｒｏｌｅｏｆｔｒａｎｓｕｒｅｔｈｒａｌｍｉｃｒｏｗａｖｅｎｅｅｄｌｅａｂｌａｔｉｏｎ (ＴＵＭＷＮＡ)ｉｎｔｈｅｍａｎａｇｅｍｅｎｔｏｆｂｌａｄｄｅｒｃａｎｃｅｒ ,ＴＵＭＷＮＡｗａｓｃａｒｒｉｅｄｏｕｔｉｎ 2 4ｐａｔｉｅｎｔｓｗｉｔｈｂｌａｄｄｅｒｃａｎｃｅｒｓｉｎｃｅ 1989 ＦｒｏｍＪａｎｕａｒｙ 1989ｔｏＤｅｃｅｍｂｅｒ 1997,2 4ｐａｔｉｅｎｔｓｗｉｔｈｂｌａｄｄｅｒｃａｎｃｅｒｗｅｒｅｔｒｅａｔｅｄｗｉｔｈＴＵＭＷＮＡ Ｔｈｅ 15ｍｅｎａｎｄ 9ｗｏｍｅｎｗｅｒｅ 4 2…     

静脉输液拔针后按压血管时间的临床探讨

目的静脉输液拔针后,按压血管多长时间较为合适,目前尚无定论。旨在探讨按压血管的最佳时间,以便最大限度地减少皮下瘀血,减轻病人痛苦,保护静脉血管。方法对200例静脉输液病人拔针后不同按压血管时间的效果进行了观察,并根据统计处理结果进行分析、比较。结果拔针后4min左右较为合适,能够有效地防止瘀血,时间过长,多数病人难以坚持;过短则皮下瘀血率高。结论这种做法,克服了过去静脉输液拔针后,按压血管时间随意性较大的缺陷,应大力推广。     

细针吸取活检细胞学在乳腺癌诊断中的应用

目的：探讨细针吸取活检细胞学对乳腺癌的诊断价值。方法：以术后病理诊断为对照（１３４例）,光镜下观察５２１例乳腺肿瘤的针吸涂片。结果：在５４例乳腺癌中,细胞学诊断正确者４９例（９０．７％）,可疑者４例（７．４％）,假阴性者１例。同期细胞学诊断为乳腺癌者未见假阳性。结论：细针吸取活检对乳腺癌的定性和分级诊断均准确可靠。     

Pulmonary Failure After Norwood Procedure: Indication for Extracorporeal Membrane Oxygenation? A Case Report

Today some authors consider univentricular repair a contraindication for postoperative cardiac extracorporeal membrane oxygenation (ECMO). The question is whether or not ECMO is indicated as pulmonary support in case of an overwhelming pulmonary infection during the postoperative course after a Norwood procedure. During the prolonged weaning period after a Norwood procedure using a 4 mm aortopulmonary shunt, proven respiratory syncytial virus (RSV) bronchiolitis occurred at the time of expected weaning from artificial ventilation. Venovenous ECMO was able to improve oxygenation, but when pulmonary opacification failed to resolve, ECMO was terminated after 12 days.     

Use of ultrasound-guided percutaneous needle biopsy in the diagnosis of mediastinal tumors

We herein report the usefulness of ultrasoundguided percutaneous needle biopsy for histological diagnosis in 18 patients with mediastinal tumors. Computed tomography revealed these tumors to be in contact with the chest wall. The preoperative diagnosis was thymoma in 7 patients, germinoma in 5, neurogenic tumor in 3, and other in 3. The most commonly encountered indication for an ultrasound-guided percutaneous needle biopsy was an anterior mediastinal lesion (78%; 14 of 18 patients). In 16 (89%) of the 18 patients, the biopsy diagnosis corresponded to the post-operative diagnosis. No complications were encountered in any of the patients. This new technique of ultrasound-guided percutaneous needle biopsy is both relatively simple and highly accurate and may thus be useful for outpatients. Preoperative ultrasound-guided percutaneous needle biopsy is thus considered to be a safe and reliable method for the histological diagnosis of mediastinal tumors, and a good alternative to traditional biopsy techniques such as mediastinoscopy or thoracotomy.Presented at the 11th Biennial Asian Congress on Thoracic and Cardiovascular Surgery, Kuala Lumpur, Malaysia, November, 21–25, 1993.     

Peritonsillar abscess – critical analysis of abscess tonsillectomy

The risk of secondary haemorrhage following abscess tonsillectomy is reported in the literature with differing rates. A retro‐ and prospective analysis of complication rates following abscess tonsillectomy was conducted in 142 patients (54 females, 88 males; mean age: 35 years). In 22% of patients, a secondary haemorrhage occurred. In half of these (11% of total), the haemorrhage had to be treated surgically. Secondary haemorrhage occurred most commonly on the 6th and 8th postoperative days. Reports in the literature are not in unison about the risk of secondary haemorrhage following abscess tonsillectomy and therefore allow no final judgement about an objective risk of this complication. This report strengthens the results of the ‘Comparative Audit Service’ analysis from 1997, which did show a high risk of secondary haemorrhage following tonsillectomy, as well as following abscess tonsillectomy.     

张家维教授针灸治疗小儿多动症380例临床研究

目的　探讨针灸治疗小儿多动症的临床疗效、对异常脑电图的改变情况、疗效与证型的关系、疗效与年龄的关系等。方法　将 5 92例患者分为针灸组及中药组。结果　针灸组总有效率为 84 .4 % ,中药组为 78.77% ,前者疗效优于后者 (P<0 .0 5 ) ;针灸组对异常脑电图的改变率优于中药组 (P<0 .0 5 ) ;针灸组中肝肾不足型、肝郁气滞型两型间的疗效有显著性差异(P<0 .0 1) ;肝郁气滞型较佳。疗效与年龄之间有非常显著性关系 (P<0 .0 1) ,年龄小者针刺疗效较佳。结论　针灸治疗小儿多动症可取得较好疗效 ,其总有效率及对异常脑电图的改善优于内服中药 ,肝郁气滞型及年龄小者疗效较好