37例口颊癌术后腮腺瘘的放疗效果评估

目的 评估放射治疗应用于口颊癌术后腮腺瘘的疗效以及不良反应.方法 回顾性分析2010年1月-2020年1月湖南省肿瘤医院头颈外科收治的因口颊癌术后出现腮腺瘘且接受放射治疗的患者37例,所有患者均采用6-MeV电子线照射,每次2 Gy,每天1次,每周5次,照射总剂量为8～18 Gy(平均剂量9.7 Gy),照射野包括整个...     

A Double-Clear Variant of Epithelial-Myoepithelial Carcinoma of the Parotid Gland

The hallmark of the histology of epithelial-myoepithelial carcinoma (EMC) is the presence of a regular repetitive mixture of bilayered duct-like structures with an outer layer of myoepithelial cells and inner ductal epithelial cells. Clear cell change in the myoepithelial component is common, but clearing of both cell types, giving an impression of a monocellular neoplasm, is rare. A parotid biopsy was received from an 83-year-old male and subject to routine histologic processing for conventional staining and immunohistochemistry. The encapsulated tumour was composed of sheets of PAS/diastase negative clear cells, separated by fibrous septae. The clear myoepithelial cells were positive for S-100 protein, SMA, and p63 and negative for CK19 and surrounded CK19-positive luminal cells. It is important to utilise immunohistochemistry to differentiate this tumour from others with a similar histologic pattern. Information about the behaviour of the double-clear EMC is limited since there are few cases reported.     

40例不同类型舌下腺囊肿的临床分析

目的：探讨不同类型舌下腺囊肿的临床特征、诊治方法、临床疗效及手术并发症的处理。方法：对某医院口腔颌面外科收治的40例不同类型舌下腺囊肿进行回顾性分析,其中单纯型30例,潜突型4例,哑铃型6例。结果：在40例不同类型舌下腺囊肿中。单纯型及哑铃型因其临床特征明显,易于诊断,对于潜突型舌下腺囊肿,则通过颌下区穿刺及彩色超声检查辅助诊断。手术方法均采用口内入路切除患侧舌下腺囊肿邻近囊壁及腺体。其中1例发生术后出血。通过紧急手术探查予以结扎止血处理,其余病例均未发生手术并发症。结论：局部穿刺及超声检查是值得推荐的用于舌下腺囊肿鉴别诊断的有效手段,完整摘除患侧舌下腺腺体是治疗不同类型舌下腺囊肿并预防其复发的关键。     

Bilateral internal mammary artery grafting

The superiority of the left internal mammary artery over the saphenous vein graft led many surgeons to adopt bilateral internal mammary artery (BIMA) as a good surgical option for further improving late outcome of patients undergoing myocardial revascularization. However, routine use of BIMA was limited by some potential drawbacks: the increase of deep sternal wound problems, especially in diabetic patients; the shortness of right internal mammary artery (RIMA), which limited its utilization as an in situ graft; the low patency rate if grafted to the right coronary artery; and the longer operative time. The skeletonization of the internal mammary artery along with a better glucose control in diabetic patients significantly reduced the incidence of deep sternal problems. Another problem to solve was finding the optimal target of the RIMA. The general consensus is that RIMA appears to be more efficient if grafted to the lateral wall. The Y or T configuration of double mammary arteries could be more helpful to reach the lateral target vessels. Finally, recent reports clearly demonstrate the superiority of BIMA over single internal mammary artery in terms of survival or quality of life. The latter finding has also been reported in diabetic patients.     

超声引导下mammotome微创旋切在乳腺不可扪及肿块切除中的应用

目的：探讨B超定位引导下mammotome切除乳腺不可扪及肿物的临床价值。方法：使用B超高频探头,对37位女性40个临床检查触不及的乳腺肿物作术前体表定位,按定位对40个肿物行麦默通切除术。结果：40个肿物皆被准确切除,病理结果为导管内癌3例,多发性乳头状瘤3例,非典型增生10例,纤维瘤8例,纤维囊性乳腺病伴瘤样增生结节13例,正常乳腺组织3例。结论：B超引导麦默通对不可扪及阴性乳腺肿物切除准确,方便,美观,可用于乳腺体表不可扪及肿块早诊断和治疗。     

~(99m)锝腮腺动态显像对舍格伦综合征的诊断价值

目的 探讨＾９９ｍ锝腮腺动态显像对诊断舍格伦征的价值。方法 应用＾９９ｍ锝对临床诊断为舍格伦综合征的５２例患者进行腮腺动态显像,将所得的结果应用计算机ＲＯＩ程序进行定量分析和动态曲线分析,结果 腮腺外形较正常大者４６例（８８．４％）肿大腮腺轮廓清晰２８例（５３．８５％）轮廓模糊１８例（３４．６２％）腮腺功能正常７例（１３．４６％）轻度受损１５例（２８．８４％）中８度受损１７例（３２．６９％）,重度     

脑下垂体阻滞术的临床应用

应用脑下垂体阻滞术后于例全性顽痛及四例癌痛的治疗，获得满意效果。经Ｘ线检查了解蝶窦、蝶鞍、筛窦所见，并用鼻匀确认鼻腔有无异常，据此选定拟穿刺的鼻孔。平卧全麻后在Ｘ线电视荧光屏下，用特制的脑下垂体双重套针行经鼻脑下垂体穿刺，针尖穿过鞍低到鞍内脑下垂体后，注入造影剂并折片确认针位正确，注入无水乙醇１．８￣２．０ｍｌ。分别用于全身性顽痛、宫颈癌Ⅲ期ｂ、转移性肺癌、外阴癌、卵巢癌痛。本组５例平均疼痛记分（     

PET studies with l-[1-11C]tyrosine,l-[methyl-11C]methionine and 18F-fluorodeoxyglucose in prolactinomas in relation to bromocryptine treatment

Aspects of metabolism in prolactinomas were investigated by positron emission tomography using l-[1-¹¹C]tyrosine, l-[methyl-¹¹C]methionine and ¹⁸F-fluorodeoxyglucose (¹⁸FDG). Using l-[1-¹¹C]tyrosine, four patients were monitored prior to and 18 h after an injection of 50 mg bromocryptine. At 18 h after bromocryptine intervention, l-[1-¹¹C]tyrosine uptake into tumour was reduced with 28% (P<0.07). A correlation analysis of the bromocryptine-induced decrease in l-[1-¹¹C]tyrosine uptake and the reduction of serum prolactin levels indicated that the action of bromocryptine on prolactin synthesis and prolactin release is not coupled. In the untreated situation, the four patients were investigated with ¹⁸FDG as well, but the prolactinomas could not be visualized. Three untreated patients were studied with l-[methyl-¹¹C]methionine. The tumour-imaging potential of l-[methyl-¹¹C]methionine and l-[1-¹¹C]tyrosine appeared to be nearly equivalent for prolactinomas. Unlike prolactinoma tissue, the salivary glands showed a pronounced preference for l-[1-¹¹C]tyrosine as compared to l-[methyl-¹¹C]methionine. l-[1-¹¹C]tyrosine is a valuable tool to obtain information on the metabolism and treatment of prolactinomas.     

Impact of Psychosocial Stress on Pineal Structure of Male Gerbils (Meriones unguiculatus, Cricetidae)

Stress responses were investigated in 5-month-old male gerbils. Breeders having no pubescent litters served as controls. The first experimental group never left their parents' cage and were thereby fought by higher-ranking males; the second and third groups were stressed for a week by four daily 1-minute encounters with trained fighters, the second group during daytime, the third during the dark period. The first and second groups developed signs of gonadal regression, the third did not. The adrenals of the first group weighed the same as those of controls; the adrenals of both other groups were increased in weight. In the adrenal medulla of all experimental groups, a large number of cells were densely packed with noradrenaline-containing vesicles. In each experimental group the pineal changes included a remarkable decrease in nuclear size of pinealocytes, an increased number of colloidal cysts, and a reduction of that portion of the plasmalemma that is lined by subsurface cisterns. All these changes are interpreted in terms of pineal activation, as are the increased number of membrane whirls found in the first group. The third group exhibited an additional decrease in the size of mitochondria and in the number of "synaptic" structures. This finding and the day-night differences in the gonadal response indicate that stress interferes with the metabolic cyclicity of the pineal gland. However, it remains indiscernible whether the pineal stress reaction signals a general activation of the gland or a change in it's temporal activity patterns.