Light and electron microscopic and autoradiographic studies onN-methyl-N-amylnitrosamine-induced rat esophageal carcinogenesis

The purpose of this study was to investigate the histogenesis of experimental tumors in the rat esophagus. Thirty rats received 0.0015% N-methyl-N-amylnitrosamine (MNAN) in the drinking water for 12 weeks. Another 30 rats received tap water. All rats then received tap water until sacrifice. Rats from each group were sacrificed immediately after MNAN administration, four weeks after, and eight weeks after. One hour before sacrifice, [³H]TdR was injected by tail vein to label proliferating cells. The entire esophagus and stomach were removed and processed for light and electron microscopy and autoradiography. The overall frequency of esophageal tumors after MNAN was 83% and did not differ significantly among the three experimental groups. Tumors were primarily papillomas and squamous cell carcinomas and occurred with equal frequency in the upper, middle, and lower thirds of the esophagus. No tumors were found in the squamous-lined forestomach. Electron microscopy revealed abundant tonofilaments, free ribosomes, and mitochondria accompanied by vacuoles. By autoradiography, esophageal epithelial proliferation was markedly stimulated in nontumorous mucosa from all three experimental groups. We conclude that MNAN ingestion for 12 weeks reliably produces papillomas and squamous cell carcinomas throughout the rat esophagus, but not in the squamouslined forestomach, and that MNAN stimulated marked epithelial proliferation which is accompanied by thickening of the epithelium in nontumorus esophageal mucosa.     

食管内翻拔脱术治疗食管癌贲门癌19例分析

目的　探讨食管内翻拔脱术在食管癌、贲门癌外科治疗中的地位。方法　 19例食管癌、贲门癌病人接受了食管内翻拔脱术 ,其中食管鳞癌 15例 ,颈段 3例 ,胸中段 6例 ,胸下段 6例 ;贲门腺癌 4例。 0期 1例 ;Ⅰ期 4例 ;Ⅱa期 4例 ;Ⅱb期 1例 ;Ⅲ期 9例。 3例因有上消化道手术史行结肠代食管。结果　 19例均获切除 ,食管切缘阴性 ,无手术死亡。术后声音嘶哑 1例 ,心律失常1例 ,双侧胸腔积液 1例 ,左侧气胸伴左膈下脓肿 1例 ,5例出现小的颈部吻合口瘘。结论　食管内翻拔脱术扩大了食管癌、贲门癌的手术适应证 ,使某些常规手术高危患者重新获得手术机会。     

USEFULNESS OF EUS IN PORTAL HYPERTENSION WITH ESOPHAGEAL VARICES

We investigated the relationship between esophageal varices and the collaterals by endoscopy and endoscopic ultrasound (20 MHz ultrasonic miniprobe; UMP). Moreover, we investigated the correlation between the collaterals around the esophagus and recurrence of esophageal varices in patients with portal hypertension who had undergone EIS. The collaterals were divided into two groups: peri‐esophageal collateral veins (peri‐ECVs) and para‐esophageal collateral veins (para‐ECVs). These were scored as mild or severe according to the stage of development. According to endoscopy, the varix form was significantly larger in severe the peri‐ECVs group than in mild the peri‐ECVs group. The prevalence of perforating veins increased according to the varix form. With regard to variceal recurrence, in patients with variceal recurrences, UMP findings included a significantly higher incidence of severe peri‐ECVs, a significantly larger diameter of perforating veins compared with patients without recurrence. In conclusion, the presence of severe peri‐ECVs and large perforating veins in the esophageal wall strongly correlates with occurrence and recurrence of esophageal varices in patients with portal hypertension. An understanding of these UMP abnormalities on the basis of hemodynamics around the esophagus is thought to be important for management of esophageal varices in patients with portal hypertension.     

TH胶胃冠状静脉栓塞术治疗门脉高压症

11例TH胶胃冠状静脉栓塞术临床治疗结果表明:(1)11例中的4例急性上消化道大出血患者均在12h左右出血基本停止,随访近一年未再发生出血现象。(2)10例半年后复查肝功能均有不同程度改善。(3)一年后复查食道钡餐透视X线平片发现8例患者食道静脉曲张有不同程度减轻。(4)11例中1例因术中急性肝功能衰竭死亡。因此我们认为此术式操作简便,手术创伤小、较易推广,是治疗门脉高压症合并食管胃底静脉曲张出血的一种有效方法。     

Validation of esophageal pressure occlusion test after paralysis

Measurements of respiratory mechanics are frequently made in ventilated infants and children. Esophageal pressure measurements (P_es using a balloon on a catheter have been used to partition the respiratory mechanics into lung and chest wall components. Appropriate positioning of this balloon is crucial to obtain accurate estimates of pleural pressure. Traditionally, in spontaneously breathing subjects the balloon position is assessed with an occlusion test. In ventilated subjects, it is not always possible to perform an occlusion test prior to paralysis, and even if such a test is performed it may not be relevant under conditions of positive pressure ventilation. We have assessed a positive pressure occlusion test that is suitable for paralyzed subjects. By occluding the airway opening and applying gentle pressure to the abdomen or rib cage, positive swings in pressure can be measured by both P_es and airway opening pressure (P_ao). We compared traditional occlusion tests measured in 16 spontaneously breathing puppies to the positive pressure occlusion test performed after paralysis. In 2 pups we were unable to obtain a reasonable traditional occlusion test (>15% difference between P_es and P_ao) but we obtained 10 traditional occlusion tests in each of the remaining 14 pups (2.1–14 kg). In 11 of these animals Ape, was within 10% of P_ao. This compared well to positive pressure occlusion test using abdominal pressure performed after paralysis, where Apes was within 10% of ΔP_ao in 10 animals. In 9 of these pups occlusion tests were also performed by applying pressure on the rib cage, where ΔP_es was within 10% of ΔP_ao in 6 animals. These results suggest that it is possible to perform accurate occlusion tests in paralyzed subjects by abdominal or rib cage compression with the airway occluded. Pediatr Pulmonol. 1994; 17:56–62. © 1994 Wiley-Liss, Inc.     

食管癌切除术并发胸导管损伤的早期诊断及治疗

我院1990年至1993年共施行食管癌切除术160例，术中胸导管损伤5例，发生率为2．1％，5例中3例于术中发现并及时处理，未发生乳糜胸，另2例于术后并发乳糜胸才诊断，经早期剖胸手术治愈,本文介绍了食管癌切除术并发胸导管损伤的早期诊治体会。     

三七皂甙对心肌腺苷三磷酸酶的影响(英文)

三七总皂甙(PNS)能抑制心肌总ATP酶活力,但对Na~( )-K~( )-ATP酶无明显影响。三七皂甙单体Rb_1及Rg_1对心肌总ATP酶活力均有抑制作用,但Rb_1的抑制效力显著大于Rg_1·Rb_1能抑制豚鼠离体心房肌的自律性和收缩性,Rg_1也能抑制豚鼠离体心房肌的自律性,但对心房肌的收缩性却无明显影响。提示PNS抑制心肌收缩力这一作用的主要有效成份是Rb_1·     

Lähmung des N. hypoglossus nach operativem Eingriff – Behandlung mit Akupunktur

Acupuncture is able to accelerate the process of healing significantly when employed in cases of nerve paresis as shown in the following analysis. The patient's constant condition of speech and swallowing impediment before treatment changed relatively fast after starting acupuncture treatment. It is self evident that we took into account the primary disease (AIDS) and its problems. The simplicity of a complementary treatment with acupuncture according to the possible results should make us consider the use of acupuncture as an important way to treat paresis in the early subacute phase and if possible during clinical stay.     

食管癌3p24等位基因LOH及其扩增产物克隆的研究

目的；研究3p24EAβMD位点与食管癌的关系。为寻找该位点附近可能存在的抑癌基因奠定基础。方法：采用PCR—RFLP法检测45例食管癌患者3p24位点杂合缺失情况。并对该片段进行克隆。结果：在22例食管癌信息个体中共检出9例杂合缺失。并通过序列分析可知变化为点突变。结论：3p24EAβMD较高的杂合缺失率显示该位点附近可能存在潜在的抑癌基因。