喉不典型增生和喉癌的P_(53)基因PCR-SSCP的研究及临床应用

目的：探求Ｐ５３基因突变在喉癌发生中的作用及石蜡包埋组织在分子生物学研究中的价值。方法：应用ＰＣＲ－ＳＳＣＰ方法对１９例喉癌和３４例不典型增生的石蜡包埋组织进行Ｐ５３基因的研究，应用４种方法从石蜡组织中提取ＤＮＡ，通过银染方法显示ＤＮＡ突变带。结果：１９例喉癌中有５例发生突变（Ｅ４－０，Ｅ５－１，Ｅ６－２，Ｅ７－１，Ｅ８，９－１），其突变率为７．０％；在３４例不典型增生中有３例发生突变（Ｅ４－０，Ｅ５－１，Ｅ６－１，Ｅ７－０，Ｅ８，９－１）其突变率为４．０％。结论：表明Ｐ５３基因突变可能是喉癌发生的始动因素。ＰＣＲ－ＳＳＣＰ方法可以做为喉不典型增生定性诊断和喉癌早期诊断的指标。     

Cementless hemispheric acetabular components: 2–4-year results

A retrospective clinical and radiographic analysis was performed on 99 patients (106 hips) undergoing total hip arthroplasty with noncemented Harris-Galante (Zimmer, Warsaw, IN) or Optifix (Smith Nephew Richards, Memphis, TN) acetabular components. There were 94 primary and 12 revision procedures with a minimum follow-up period of 24 months (range, 24–52 months). The cups were evaluated for evidence of vertical and horizontal migration, as well as the presence of radiolucencies at the bone-implant interface. Age, sex, component inclination and medialization, cup coverage, and number of fixation screws used were examined to determine the influence of these factors on the incidence of cup migration or radiolucent line formation. A radiolucent line was present in at least one zone in 60% of the Harris-Galante and 45% of the Optifix cups. Progressive radiolucent lines were noted in two of the Optifix and three of the Harris-Galante components. Two Harris-Galante cups (1.9%) were revised. There were no Optifix cup migrations or evidence of instability in the Optifix or remaining Harris-Galante cups. Although there was a trend toward an increased incidence of radiolucencies in those cups lacking complete coverage, no statistically significant radiographic predictors for failure or impending failure could be determined from this short-term follow-up study. With the exception of the two revisions, all acetabular components performed well clinically over the study period.     

幽门螺杆菌感染与胃粘膜良恶性病变的关系

目的：揭示幽门螺杆菌（Ｈｐ）引起胃粘膜病变的可能机制。方法：对胃粘膜良恶性病变的ＨＥ切片，用油镜检测Ｈｐ；并对Ｈｐ阳性病例随机抽样，用聚合酶链反应（ＰＣＲ）法鉴定Ｈｐ。同时用免疫组化（ＬＳＡＢ）法检测增殖细胞核抗原（ＰＣＮＡ）的表达。结果：Ｈｐ在慢性浅表性胃炎活动性（ＣＳＧ）组最高（６５％），且与各组间均有差异（Ｐ＜０．０５）；ＰＣＮＡ在正常胃粘膜阳性率最低（３５％），与各组间均有差异（Ｐ＜０．０００５）。且随病变加重，阳性率呈递增趋势。结论：Ｈｐ在ＣＳＧ的发生中，具有病因学价值；Ｈｐ感染导致胃粘膜过度增生，为发展成癌前病变提供条件     

Cell proliferation in dysplasia of the prostate: Analysis by PCNA immunostaining

Patterns of cell proliferation in the prostate were compared between benign epithelium and dysplasia. Proliferating cell nuclear antigen (PCNA) immunostaining was used to quantitate proliferation, and basal cells were tallied separately from secretory cells with the aid of keratin immunostaining. Using a novel technique, absolute cell densities (cells/mm) were determined and used to calculate growth fractions. In benign epithelium, 83% of PCNA⁺ cells were basal cells, while only 7% of PCNA⁺ cells in dysplasia were basal cells and there was a clear separation between groups. This dramatic shift of the proliferative compartment to the secretory cells in dysplasia was accompanied only by a moderate increase in overall secretory cell density and moderate reduction in basal cell density, but these ranges overlapped those of benign epithelium. The median PCNA⁺ secretory cell “growth fraction” was 0.12% in benign epithelium and 1.06% in dysplasia. The findings presented give further support to the concept that dysplasia represents an evolutionary stage in the malignant transformation of prostatic epithelium. The patterns of change in PCNA immunostaining may reflect certain aspects of the biologic nature of malignant transformation. © 1995 Wiley-Liss, Inc.     

Phenotype of cranioectodermal dysplasia with different hair and bone abnormalities

We report on a 3-year-old boy with hair abnormalities and a generalized bone dysplasia. He had very short, sparse hair and craniosynotosis. His stature, growth, and limb lengths were normal, as was his neurological development. While this phenotype has some resemblance to cranioectodermal dysplasia, the radiographic and hair abnormalities are different. Histological studies showed abnormalities in the internal root sheath of the hair follicle and the hair shaft. These findings define a new ectodermal dysplasia syndrome of unknown cause. © 1993 Wiley-Liss, Inc.     

Severe dysplastic lesions in the colon – how aggressive should we be?

Introduction Biopsies of colonic lesions are often reported as showing dysplasia, though in reality some lesions may harbour invasive malignancy. Aim To assess the risk of underlying invasive malignancy in sessile polyps where biopsies had shown severe dysplasia and also to attempt to define a management strategy in such patients. Methods Between 1997 and 2001, 30 patients were diagnosed as having severe dysplasia using Morson's criteria in colonic lesions not amenable for endoscopic polypectomy. Severely dysplastic lesions were completely excised by appropriate surgical measures. Results Out of 30 patients, 15 had invasive cancers. Surgical intervention involved anterior resections, endoanal excisions, sigmoid colectomies, or abdomino‐perineal excisions as deemed appropriate. The lesions ranged in size from 0.5 cm to 13 cm (mean 3.4 cm). There were nine T₁ lesions (one of which was T₁N₁) and two each of T₂, T₃, T₄ lesions (10 Dukes' A, 3 Dukes' B, 2 Dukes' C). Complete resection was confirmed histologically in all cases. One patient had a leak following endoanal excision, which required intervention. There was no mortality. Discussion This study demonstrates that endoscopic sampling can be misleading and severely dysplastic sessile lesions should be managed along the same principles as followed for invasive cancers, rather than adopting a ‘wait and watch’ policy with repeated endoscopies, biopsies or piece‐meal polypectomies.     

颞骨骨纤维异常增殖症HRCT研究

目的 探讨颞骨骨纤维异常增殖症HRCT表现，评价HRCT 的诊断价值。资料与方法回顾性分析资料完整的16例颞骨骨纤维异常增殖症的HRCT扫描图像。结果 颞骨单侧发病lO例，双侧发病6例。腿cT示受累颞骨弥漫性膨大，骨皮质变薄。根据病变的密度分为3种类型：硬化型9例(56．25％)，表现为均匀一致的高密度；变形性骨炎型6例(37．5％)，表现为高密度病灶中散在点或片状低密度区；囊型1例(6．25％)，病变明显膨胀，表现为多个球形或卵圆形透亮区，有薄的骨壳包绕。骨纤维异常增殖症可导致颞骨的自然腔隙、孔道狭窄，如外耳道、鼓室腔、内听道、前庭导水管、耳蜗导水管及面神经乳突段骨管；一般不破坏听小骨和内耳骨迷路；常见并发症为炎症、胆脂瘤，3例(18．75％)继发胆脂瘤分别位于外耳道、乳突及上鼓室，乳突窦，其中上鼓室，乳突窦胆脂瘤破坏邻近听小骨、上半规管。此外，还可引起岩段颈内动脉管、颈静脉孔、茎乳孔和颞下颌关节形态的改变。结论HRCT可清楚显示颞骨骨纤维异常增殖症骨质改变、病变范围及并发症，在本病的诊断、治疗及随访中起重要作用。     

Fibrocartilaginous dysplasia

 We present the case of a 53-year-old patient with fibrocartilagenous dysplasia. The area involved was in the proximal femur and presented a lytic lesion with extensive calcifications which radiologically mimicked chondrosarcoma. The radiopathological pattern of this rare entity is discussed in detail and the literature reviewed.