Partial splenic embolization for hypersplenism concomitant with or after arterial embolization of hepatocellular carcinoma in 30 patients

Purpose To study the value of partial splenic embolization (PSE) for the treatment of hypersplenism in patients undergoing embolization of hepatocellular carcinoma (HCC). Methods Transcatheter hepatic arterial embolization (THAE) combined with PSE was performed in 30 patients with HCC complicating liver cirrhosis, portal hypertension, and hypersplenism. Gelfoam sponge was used as the embolic material for PSE and limited to 100–150 pieces. Results More than 50% of splenic parenchyma was infarcted in 27 patients. Leukopenia and thrombocytopenia were corrected by PSE in 25 of 27 patients with hypersplenism. In 26 patients with esophageal varices, including 5 patients with bleeding, no rebleeding occurred during a 6–17 month follow-up. Hypersplenism was not corrected in 2 of 3 patients whose infarcted splenic parenchyma was less than 50%. No splenic abscesses or other severe complications were observed. Of the 30 patients treated, 19 are still alive after 1 year. Conclusions THAE combined with PSE is a safe and effective measure for patients with HCC.     

Diagnostic imaging of spinal cord lesions

Magnetic resonance imaging (MRI) has greatly facilitated morphologic evaluation of spinal cord lesions. Eleven cases representative of inflammatory, demyelinating, neoplastic and vascular diseases, are presented which illustrate and summarize important abnormal features in spinal cord imaging, particularly MR findings. Recently, specialised techniques such as MR angiography, fat-inhibiting methods, dynamic MRI and functional imaging have been developed. These methods have facilitated not only lesion diagnosis but also qualitative assessment, and are being used to analyze pathophysiology. Comprehensive diagnoses based on such modalities may be important in determining indications for surgery or defining the extent of surgery or the intensity of other treatments.     

前列腺体积与前列腺特异抗原及抗原密度关系的多元回归研究

对１００例前列腺增生患者的前列腺体积，年龄，血清前列腺特异抗原，抗原密度进行多元回归与相关分析。结果；年龄和前列腺体积与血清ＰＳＡ浓度显著相关，其中，体积与ＰＳＡ之间的年龄与体积之间具有相关性、而年龄与ＰＳＡ之间无相关性，体积每增加１０ｃｍ＾３，ＰＳＡ增高０．９μｇ／Ｌ。     

HBV DNA及HBxDNA亚片段在肝癌细胞内的整合及作用

为探讨ＨＢＶＤＮＡ及其亚基因片段ＨＢｘＤＮ在肝细胞肝癌（ＨＣＣ）中整合特点用机制，制备了地高辛标记的３．２ｋｂＨＢＶＤＮＡ全基因及０．５９ｋｂＨＢＶＤＮＡ／ＢａｍＨＩ，ＢｇｌⅡＢＨｘＤＮＡ亚基因探针。点杂交、原位杂交及Ｓｏｕｔｈｅｒｎ杂交检测ＨＢＶＤＮＡ的存在情况，筛选ＨＢＶＤＮＡ纯整合标本，以ＨＢｘＤＮＡ探针检测ＨＢｘＤＮＡ在ＨＣＣ染色体的整合。结果显示ＨＢＶＤＮＡ在肝细胞内以核型为主（７０％）     

乌苯美司的药物动力学及对实验性肿瘤转移的治疗作用

目的：探讨乌苯美司对小鼠药物动力学及与实验性肿瘤转移治疗活性间的关系。方法：用放射免疫法测定小鼠在不同给药途径下的乌苯美司血清药物动力学及观察乌苯美司对黑色素瘤肺转移模型的治疗活性。结果：乌苯美司ｉｖ的Ｔ１２较短，初始血药浓度较高。ｉｖ和ｉｍ给药后的曲线下面积较大；ｐｏ及ｉｐ则较小。不同给药途径对实验性肿瘤转移均有治疗作用。结论：乌苯美司的血清Ｔ１２较短，其治疗活性取决于冲击和高剂量的给药方式。     

Solitary necrotic nodule of the liver: A riddle that is difficult to answer

Solitary necrotic nodule of the liver is an unusual lesion that is often an incidental finding on abdominal imaging, intraoperative examination, or post mortem. Most reported cases of solitary necrotic nodule have been in males, and over three quarters of these lesions have occurred in the right lobe of the liver. Pathologically, solitary necrotic nodule is a benign lesion characterized by a completely necrotic core that is often partly calcified, surrounded by a dense hyalinized fibrous capsule containing elastin fibres. The ultrasound appearance of solitary necrotic nodule is usually of a “target” lesion with a hyperechoic center, while on CT scan they appear as non-enhancing hypodense lesions that are typical of metastatic adenocarcinoma or peripheral cholangiocarcinoma. The impression of malignancy is further enforced with the finding of necrotic cellular material on biopsy and the macroscopically hard and “gritty” nature of the nodules. Currently, permanent histopathology of solitary necrotic nodules is the only accurate method of diagnosis. However, solitary necrotic nodules are usually of a bilobed or lobulated shape that is unusual for malignant liver lesions, and they often lie in close proximity to hepatic inflow structures. Solitary necrotic nodule should be suspected in liver lesions with this configuration, location, and on a biopsy showing a large amount of necrosis.     

PTEN基因在喉鳞癌中的表达及意义

目的:探讨蛋白酪氨酸磷酸酶基因(PTEN)在喉鳞癌中的表达及其临床意义.方法:应用半定量RTPCR方法检测喉癌组织中PTEN mRNA的表达.结果:淋巴结转移组喉癌较正常喉组织PTEN mRNA表达下降有统计学意义(P＜0.05).病理低分化与高分化相比,PTEN mRNA表达差异有统计学意义(P＜0.05).结论:PTEN基因表达下降在喉鳞癌演进中起重要作用.     

Ninety-one Cases of Breast Cancer and Chronic Lymphoproliferative Neoplasm: A Retrospective Review of a Population at High Risk for Multiple Malignancies

Abstract: We performed a retrospective analysis of clinical course of 91 patients who developed both breast cancer and a chronic lymphoproliferative neoplasm and were seen at the M. D. Anderson Cancer Center between January 1, 1970 and December 30, 1991. The sample included 24 individuals who developed lymphoproliferative neoplasm first (Group A), 22 individuals with concurrent diagnosis of both malignancies (Group B), and 45 individuals who developed breast cancer first (Group C). The median time to diagnosis of secondary breast cancer and lymphoproliferative neoplasm was 66 months (range, 7–459) and 65 months (range, 0–334), respectively. A higher proportion of Group B lymphomas were low-grade (77% vs. 47% [Group A] vs. 37% [Group C] p = 0.009). Prior occurrence of either one of these malignancies did not affect the disease-specific survival from the second malignancy. However, continuing mortality from the first malignancy appeared to contribute to a poor overall survival following second malignancy. Group A included 8 patients who developed breast cancer following radiation therapy for Hodgkin's disease after a mean interval of 18 (± 4.3) years. Three of these individuals had coexisting ductal and lobular histology (vs. none of the individuals in Groups B and C, p = 0.02). Another interesting finding was the high incidence of multiple additional malignancies in this patient population. A total of 29 additional neoplasms occurred in 21 (23%) of the 91 study subjects. These malignancies involved a wide variety of organ sites and could not be attributed to the therapy for either the breast cancer or the lymphoma in most cases. The data suggest that individuals who develop both breast cancer and a lymphoproliferative neoplasm are at a high risk for multiple malignancies. Close surveillance of such individuals for additional malignancies and further studies to understand the molecular basis of this predisposition are warranted.?     

Diagnosis and therapy for primary hepatic carcinoma: Transcatheter inferior phrenic arteriography and chemoembolization

Summary Transcatheter inferior phrenic arterial (IPA) and hepatic arteriography was performed on 38 patients with advanced primary hepatic carcinoma (PHC) with blood supplied by IPA and hepatic artery. 18 patients received single treatment with hepatic arterial infusion (HAI) or embolization (HAE) 20 received double treatment with IPA and hepatic arterial infusion or embolization. The results show that the double treatment is superior to the single one. The angiographic features and mechanism of parasitization of inferior phrenic arterial supply to PHC were also discussed.     

大,巨型垂体腺瘤的手术入路选择

自１９９０年以来收治直径在２－５．６ｃｍ的大、巨型垂体腺瘤３３例。依肿瘤生长形态与扩展范围将其简略分为三种类型。Ａ型：瘤体位于鞍内或侵入蝶窦；Ｂ型；瘤体呈椭圆形或哑铃向鞍上扩展，三脑室明显移位抬高；Ｃ型：瘤体巨大侵入三脑室阻塞室间孔或明显的鞍周扩展。