MANAGEMENT OF CHONDROSARCOMA INCLUDING MODULAR CERAMIC AND ALUMINA PROSTHETIC REPLACEMENT

Forty-one cases of chondrosarcoma from varying sites throughout the body, and treated exclusively by one of the authors (R. L. H.) from 1972 to 1990 were reviewed. The symptoms, signs, location of tumours, treatment and progress are presented. Particular attention was paid to modular bone replacement techniques. Excision and reconstruction of the bone or joint were carried out in 17 femora, five tibia and six humeri. Comparison between this method of management and other techniques is discussed. Titanium and alumina prostheses for the hip, femur, tibia, shoulder and humerus have been designed by the senior author. These are both inert and modular, and have been found to be superior to other methods of treatment in both function and cosmesis. They do not possess the same potential donor infection risks and other disadvantages of allograft replacement. Immediate postoperative weight bearing and mobilization are possible with these systems. The Huckstep prostheses allow for bony in growth into their porous coated alumina sleeves, spacers and stems. In addition, the titanium alloy locking component for the femoral stems has an elasticity half that of other metal alloys and this was found to minimize stress shielding.     

24例阴道肿瘤的B超诊断

目的 通过对24例阴道肿瘤患者的B超声像图分析，总结B超诊断阴道肿瘤的方法。方法 收集24例1995～2002年，我院门诊及住院患者的病史资料及声像图，结合病理结果分析声像图特征，并与病理加以对照。结果 24例患者声像图表现为囊性、实质性、囊实性肿瘤。结论 通过对声像图的分析，探讨了B超诊断阴道肿瘤的可行性、声像图特征及该方法的局限性。     

87例肺癌患者核素骨显像结果分析

目的：通过对87例肺癌患者放射性核素全身骨显像结果进行分析，探讨肺癌骨转移的特点和规律。方法：回顾性分析了经临床病理证实的87例肺癌患者的全身骨显像表现。结果：肺癌骨转移率为63．2％，发生骨转移最常见的部位为肋骨，其次为脊椎骨、盆骨、四肢骨、肩胛骨、颅骨和胸锁骨。在不同病理类型的肺癌中，腺癌和鳞癌较其它类型更易发生骨转移。结论：肺癌骨转移比较常见，所以肺癌患者应常规作全身核素骨扫描，以帮助临床制订正确的治疗方案。     

治疗性高碳酸血症对大鼠移植肺细胞凋亡的影响

目的探讨治疗性高碳酸血症对移植肺细胞凋亡的影响及其可能的机制。方法26只Wistar大鼠,供体鼠和受体鼠各13只,肺移植成功后随机分为2组：对照组（n=6）和治疗组（n= 7）。对照组再灌注期间吸入50%N2-50%O2混合气体;治疗组再灌注期间吸入40%N2-60%O2- 100%CO2混合气体,调节吸入二氧化碳和氧气的流量,维持吸入氧浓度50%,动脉血二氧化碳分压（PaCO2）80～100 mm Hg。记录受体鼠机械通气15 min时平均动脉压（MAP）、PaCO2和动脉血氧分压（PaO2）作为基础值,再灌注期间每15分钟记录1次,直至实验结束。再灌注90 min时放血处死大鼠,采用考马斯亮蓝法测定支气管肺泡灌洗液（BALF）蛋白浓度;取左肺组织,计算湿/干重比;采用免疫组化法测定Bax、Bcl-2的表达;采用TUNEL法检测细胞凋亡情况。结果与基础值比较,再灌注期间对照组MAP和PaO2降低（P〈0.05）;与对照组比较,再灌注期间治疗组MAP、PaCO2和PaO2升高,BALF蛋白浓度、肺组织W/D、Bax表达和细胞凋亡指数降低（P〈0.05）,Bcl-2表达差异无统计学意义（P〉0.05）。结论治疗性高碳酸血症可抑制大鼠移植肺细胞凋亡,其机制与下调Bax蛋白表达有关。     

Gynandroblastoma of ovary with juvenile granulosa cell component and heterologous intestinal type glands

An ovarian gynandroblastoma in a 15-year-old girl is described. The predominant component was juvenile granulosa cell tumour. Areas of adult granulosa cell tumour and Sertoli cell elements were also present. Stromal theca and luteinised cells were identified. An additional histological finding was the presence of heterologous intestinal type glands. There was positive immunohistochemical staining of juvenile and adult granulosa cell areas with inhibin and MIC2 antibodies. Electronmicroscopy showed a close ultrastructural resemblance between tumour cells in granulosa and Sertoli cell areas, in spite of differences in architectural pattern, suggesting that both morphological components may derive from a single cell of origin. The tumour demonstrates a unique combination of elements which has not previously been described.     

Whole-Body [18F]FDG PET in the Management of Metastatic Brain Tumours

Summary Background To determine its roles in the diagnosis and the systemic evaluation of metastatic brain tumours, whole-body positron emission tomography (PET) using [¹⁸F]FDG was performed in 20 consecutive patients. Methods  All patients were thought to be suffering or needing to be differentiated from metastatic brain tumours. Nine patients had multiple brain lesions; six were older and showed a rim-enhancing lesion with surrounding oedema; seven had homogeneously enhancing periventricular lesion(s) on computed tomography (CT) and/or magnetic resonance (MR) imaging, thought to be central nervous system lymphomas. Two patients had skull mass(es) and two patients had a solid mass suspected to be, respectively, a haemorrhagic metastasis and a metastatic malignant melanoma. All of them received whole-body [¹⁸F]FDG PET and conventional systemic work-up for metastasis in order to compare the results of the two methods. Results  Metastatic brain tumours were diagnosed on whole-body [¹⁸F]FDG PET in eleven patients who had extracranial and intracranial hypermetabolic lesions. In nine of these, a conventional work-up also detected primary lesions which on whole-body [¹⁸F]FDG PET were seen to be hypermetabolic foci. Systemic lymph node metastases were detected by whole-body [¹⁸F]FDG PET only in two patients and histological diagnosis was possible by biopsy of lymph nodes rather than of brain lesions. In the remaining nine patients who had only intracranial hypermetabolic foci, histological diagnosis was made by craniotomy or stereotactic biopsy. It was confirmed that seven of nine patients were suffering from a primary brain tumour and two from metastatic carcinoma. None of the nine showed evidence of systemic cancer on conventional work-up. Histological diagnoses of the primary brain tumours were four cases of primary central nervous system lymphoma and one each of multifocal glioblastoma, Ewing's sarcoma, and cavernous angioma.  Patients felt no discomfort during the whole-body [¹⁸F]FDG PET procedure and there were no complications. The false negative rate in [¹⁸F]FDG PET and in conventional work-up was 15.4% and 30.7% respectively. There were no false positives on either [¹⁸F]FDG PET or conventional work-up. Conclusion  It is suggested that whole-body [¹⁸F]FDG PET is a safe, reliable, and convenient method for the diagnosis and systemic evaluation of patients thought to be suffering or needing to be differentiated from a metastatic brain tumour.     

核仁形成区嗜银蛋白形态定量在结肠良恶性病变鉴别诊断中的意义

应用银染技术对114例结肠癌,95例结肠腺瘤和10例正常结肠进行核仁形成区嗜银蛋白(Ag-NORs)数量、形态、大小和分布的定量研究。结肠癌的Ag-NORs均数/核(7.04 ±2.20)明显高于结肠腺瘤(3.43±0.88,P=0.0000)和正常结肠(1.25±0.09,P=0.0000)。结肠癌的异形Ag-NORs均数/100个核(61.39土22.38)明显高于结肠腺瘤(20.74土26.61,P=0.0000)和正常结肠(0,P=0.0000)。结肠癌的小型(2um)Ag-NORs均数/100个核(483.76±242·89和)78.08±23.06)明显高于结肠腺瘤(112.00±47·23和19·49±17.47 P值均=0.0000)和正常结肠(0和0.76土1.16,P值均=0.0000)。结肠癌Ag-NORs颗粒的聚合、分散、核仁内和混合型分布(23.64％、53.20％、9.30％和13.86％)明显不同于结肠腺瘤(77.72％、16.88％、5.46％和0.04％,P值均<0.05)和正常结肠(100％、0、0和0、P值均<0.05)。本研究结果提示Ag-NORs4项定量指标有助于结肠良恶性病变的鉴别诊断。     

Identification of functional GRP-preferring bombesin receptors on human melanoma cells

Bombesin was originally isolated from amphibian skin, wherease its mammalian counterpart, gastrin-releasing peptide (GRP), was first identified in the nervous system of the gastrointestinal tract. Whether GRP is present in the human skin is not known. Bombesin-like peptides are also known to modulate growth. We therefore investigated whether human melanoma cell lines express functional GRP-preferring bombesin receptors and whether they alter growth or other specific cellular functions of these tumour cells. GRP receptor mRNA was found in HBL, D-10, Me-28 and A375-6 cell lines, but only A375-6 cells express a large number of high-affinity binding sites for [¹²⁵I]-[Tyr⁴] bombesin ( K _d 0.31 ± 0.04 nmol L⁻¹, 3880 ± 429 binding sites per cell). Bombesin dose-dependently increased cytosolic calcium, but did not alter interleukin (IL) 1β-induced reduction of cell viability or IL-6 secretion, both A375-6-specific cell functions. Growth of A375-6 cells was not altered by bombesin or the specific GRP receptor antagonist BIM26226 as measured by [³H]-thymidine incorporation or methylene blue assay, whereas insulin alone or in combination with other potential growth factors dose-dependently stimulated growth of these cells. The newly characterized GRP-preferring bombesin receptors on highly malignant human melanoma cells could initiate studies of growth effects on solid tumours or in vivo scanning using radiolabelled tracers.     

三袖套管法大鼠肺移植

我们将血管套接技术用于大鼠肺移植中。在肉眼下，完成肺动静脉及支气管的吻合。在连续６例手术中，手术平均时间６１±４分钟，移植物总缺血时间１７±３分钟，手术时间缩短至国外同类手术的１／４，缺血时间缩短至同类手术的１／３。同时手术成功率达到７５％（６／８），手术后生存率１００％。行对侧肺切除术后，血气分析正常，显示了移植肺良好的气体交换功能