Lymphoid follicular hyperplasia–a distinctive feature of diversion colitis

Diversion colitis refers to the inflammatory changes that occur in the defunctioned segment of the large intesting following diversion of the faecal stream. We report the histological features in the defunctioned rectums from seven patients: one each with severe constipation and Behcet's disease, two with Crohn's disease with rectal sparing and three with ulcerative colitis. The appearances of diversion colitis in a previously normal rectum are compared with diversion colitis with superimposed inflammatory bowel disease. Lymphoid follicular hyperplasia was found in all cases. This was marked in patients with inflammatory bowel disease. with or without initial rectal involvement. Other changes comprised surface epithelial degeneration and ulceration, mucosal inflammation including crypt abscesses, and crypt branching. Inflammatory and crypt changes were mild, except in ulcerative colitis where changes were marked and resembled those of the proximal colon. Lymphoid hyperplasia is a distinctive feature in diversion colitis. The term follicular proctitis, previously used to indicate chronic ulcerative colitis exclusively, should be re-examined.     

Open surgery of giant paraclinoid aneurysms improved by intraoperative angiography and endovascular retrograde suction decompression

Summary In three consecutive cases of giant left sided paraclinoid aneurysms we employed an endovascular retrograde suction decompression technique in combination with intra-operative angiography. A double-lumen balloon catheter was placed in the left internal carotid artery by the transfemoral route. After balloon inflation and placement of a temporary clip distal to the aneurysm blood was aspirated and the aneurysm collapsed. Thus further dissection of the aneurysm could easily be achieved and clips could be placed. Afterwards real-time digital subtraction angiography was performed. Intra-operative angiography led to clip repositioning in all cases either due to a clip induced stenosis of the parent vessel, or because of incomplete aneurysm obliteration. Afterwards successful clipping could be confirmed in all cases. Outcome was excellent in one case, good in the other. The third case, extremely complicated by an accompanying craniopharyngioma, showed a satisfactory outcome, but presented new neurological deficits.     

前列腺癌患者PSA、PSAD、PSAT测定

目的：探讨前列腺特异抗原（PSA）及前列腺特异抗原密度（PSAD）、前列腺特异抗原移行区密度（PSAT）作为前列腺癌肿瘤标志物的临床价值。方法：选择前列腺癌患者30例、前列腺增生患者30例、健康志愿者20例，采用放射免疫法检测PSA并计算PSAD、PSAT，比较3组间的变化情况。结果：前列腺增生组PSA升高，与对照组相比差异有统计学意义（P＜0．05），前列腺癌组PSA、PSAD、PSAT均升高，与对照组及前列腺增生组对比差异有统计学意义（P＜0．001）。结论：PSA作为前列腺癌肿瘤标志物有重要临床价值，但单纯测定血PSA含量有时不易区分前列腺增生与前列腺癌；PSAD、PSAT在前列腺增生与前列腺癌的鉴别诊断中优于PSA。     

Long term changes in the vascular wall after laser recanalization of an artery

All-Union Surgical Research Center, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR N. N. Malinovskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 112, No. 12, pp. 653–657, December, 1991.     

哈乐在良性前列腺增生伴急性尿潴留中的应用

目的 :探讨α1A肾上腺素能受体阻滞剂哈乐 (tamsulosin)对良性前列腺增生 (BPH)伴急性尿潴留病人的治疗作用。方法 :对 72例BPH伴急性尿潴留病人采用随机、对照研究 ,分为治疗组和对照组。病人均行保留导尿 ,口服抗生素治疗。治疗组加用哈乐 0 .4mg ,1次 /d ,连续服用 3次。 72h后拔除导尿管。　结果 :拔除导尿管后 4 4 % (32 / 72 )的病人能自行排尿。有效率治疗组为 6 1% (2 2 / 36 ) ,对照组为 2 8% (10 / 36 ) ,两组比较差异有显著性 (P <0 .0 1)。　结论 :对BPH伴急性尿潴留应用哈乐治疗 ,可提高早期拔除导尿管后病人自行排尿的成功率 ,且疗效与前列腺体积大小无关。     

输精管结扎干扰前列腺增生过程的机制探讨——精浆睾酮双氢睾酮的放射免疫测定

本文应用放射免疫测定的方法检测了13例输精管结扎后(平均15.3年,平均年龄50岁)的男性精浆双氢睾酮和睾酮的浓度,另取同年龄组男性13例作为对照。结果表明,精浆睾酮在结扎组(374.54p/ml)和正常对照组(315.64Pg/ml)中没有明显差异,而结扎组精浆中双氢睾酮(46.21pg/ml)却明显低子对照组(184.27pg/ml(p<0.01)。作者认为,输精管结扎对精浆DHT有长期影响,这可能是其对前列腺增生过程产生抑制作用的原因之一。     

性激素受体及相关生长因子在前列腺基质细胞中的表达

目的：探讨前列腺基质增生的发病机制与性激素以及相关生长因子的关系。方法：应用RT－PCR的方法研究了在人前列腺不同细胞类型中Smoothelin的表达，研究了雄、雌激素受体及相关生长因子在前列腺基质细胞中的表达，以及它们在前列腺基质细胞分化中表达的变化。结果：Smoothelin是前列腺平滑肌细胞特异性的标记蛋白；雄激素受体（AR）、碱性成纤维细胞生长因子（bFGF)、角化细胞生长因子（KGF）主要在前列腺成纤维细胞中表达，而雌激素受体（ER）、转移生长因子β1（TGFβ1）主要在平滑肌细胞中表达。结论：前列腺基质增生与雌激素受体和转移生长因子β1的过度表达密切相关。     

桥小脑角区巨大肿瘤诊治的回顾分析

目的　总结桥小脑角区巨大肿瘤的诊治经验。方法　对我科 73例桥小脑角区巨大肿瘤的发病率、临床和影像学表现、定位定性诊断、手术治疗及随访心理治疗结果作回顾性分析。结果　本组 73例桥小脑角巨大肿瘤 (均≥ 4cm)中 ,神经鞘瘤 50例 (68.4% )、脑膜瘤 1 9例 (2 6 .1 % )、胆脂瘤 4例 (5 .6 % )。 73例均有颅神经损害、小脑损害的症状与体征及颅内高压征。 73例中手术全切除 60例 (82 .2 % )、次全切除 1 3例 (1 7.8% )。 56例颅神经损伤中需心理治疗者 40例 (54 .8% ) ,2例死于肺部感染。平均随访 3 - 5年 ,无复发 ,疗效满意。结论　将桥小脑角区巨大肿瘤的临床特点结合影像学检查 ,可作早期定位、定性诊断 ,并有助于手术设计。早诊断、早治疗以及娴熟的显微操作技术是减少并发症 ,提高疗效的关键。手术结合伽玛刀以及随访心理治疗可改善预后 ,提高生存质量。     

Possible Role of Streptococcus Pyogenes in Mucocutaneous Lymph Node Syndrome. XII. Variable Responses of Platelets in MCLS Seem to Be Explainable by Streptococcal Pyrogenic Exotoxin

As a model system for mucocutaneous lymph node syndrome (MCLS), we have advocated and used mice which had been rendered tolerant to Streptococcus pyogenes-associated antigens by neonatal infection with group A fteta-hemolytic streptococci, because these mice have shown a variety of peculiar bioimmunological characteristics bearing a striking resemblance to those of MCLS patients. The results of our current investigations reaffirmed the reliability of the animal model by indicating that mice subjected to neonatal infection with 5. pyogenes , or inoculation with streptococcal pyrogenic exotoxin (SPE) in Freund's adjuvant, were perfect counterparts of patients with MCLS on account of their platelet activation and hyperaggregability in response to provocative treatment, which are familiar findings in this disease.     

Lymph node metastases in the neck and parotid gland from an unknown primary melanoma

A lymph node metastasis in the neck or parotid region from an unknown primary melanoma is an uncommon occurrence. Out of a total of 300 patients with head and neck melanoma treated at the Netherlands Cancer Institute between 1976 and 1992, 17 (5.7%) presented in this way. The most common site for metastatic lymph nodes (18 nodes in 17 patients) was level V (n= 7), followed by the parotid region (n= 4), level II (n= 4), level III (n= 2), and level IV (n= 7). Two patients had local excision of the neck node metastasis only, while the remaining 15 patients underwent more extensive surgical treatment. The 5-year disease-specific survival rate in this group was 48%, with a median survival of 36 months, which is more or less similar to the prognosis of stage II melanoma of the head and neck with a known, surgically treated primary tumour. No relation was found between disease-free interval and sex, the number of positive lymph nodes or the duration of symptoms.