20例食管粘液表皮样癌组织化学和免疫组织化学观察──组织发生学探讨

本文通过对２３９例食管原发性腺癌（ＰＡＥ）中的２０例粘液表皮样癌进行４种粘液组织化学、４种免疫组织化学的综合观察，以探讨食管粘液表皮样癌的组织起源及其生物学特征。认为：粘液表皮样癌可能是食管固有腺的腺导管上皮和腺泡细胞同时发生癌变而成；并指出它是一种分化低、预后差的原发性食管腺癌类型。     

Medical Emergencies and Cardiopulmonary Arrests in Interventional Radiology

PurposeTo evaluate the circumstances and determine the outcomes of medical emergencies (MEs) and cardiopulmonary arrests (CPAs) in patients undergoing interventional radiology (IR) procedures.Materials and MethodsRetrospective review of all MEs and CPAs that occurred between July 2006 and December 2011 was performed. Procedure type, technical outcome, complications, etiology and location of ME/CPA, event outcome, and postevent mortality were collected.ResultsA total of 58 events occurred during 38,927 procedures (0.15%). Complete records were available for 55 events (43 MEs, 12 CPAs) in 53 patients (mean age, 63 y; 58.5% male) during 37 inpatient (27 MEs, 10 CPAs) and 18 outpatient (16 MEs, two CPAs) encounters. Seven events (13%; six MEs, one CPA) occurred before the start of the procedure, and 18 (33%; 16 MEs, two CPAs) occurred in the periprocedural holding area. Thirty-five procedures (64%) were completed successfully. Forty-two patients (76%) were alive at discharge, 37 (67%) at 1 month, 26 (47%) at 3 months, and 23 (42%) at 1 year. Procedural complications were attributed as the main cause of 22 MEs (51%) and one CPA (8%; P = .018). The relative risk (RR) of an ME or CPA occurring during a hemodialysis access case versus all other cases was 5.2 (95% confidence interval = 3.02–8.95; P < .0001).ConclusionsAlthough the incidence of MEs/CPAs in patients undergoing IR procedures is low, the 1-year mortality rate following these events is high. MEs are significantly more likely than CPAs to be directly attributed to a procedural complication. The RR of MEs/CPAs is significantly higher in hemodialysis access interventions.     

Impact of 5-Alpha-Reductase Inhibitors Use at the Time of Prostatic Artery Embolization for Treatment of Benign Prostatic Obstruction

Purpose

To compare the 12-month post-prostatic artery embolization (PAE) clinical outcomes of patients who were and were not taking 5-alpha-reductase inhibitors (5ARIs) at the time of PAE.

Duplicated Prostate Artery Central Gland Blood Supply: A Retrospective Analysis and Classification System

Angiograms and cone-beam computed tomography scans of 36 consecutive prostate artery embolization patients (72 hemipelves) between October 2014 and February 2018 were reviewed. The hemipelves were classified according to the presence of dual central gland (CG) blood supply and the pattern of vascularization: Type 1 with a single CG blood supply (83.3%; n = 60); Type 2 with 2 independent CG arteries with overlapping territories (9.7%; n = 7); and Type 3 with 2 independent CG arteries with isolated territories (7%; n = 5). Up to 20% of pelvic sides may have more than 1 independent CG prostate artery that should be searched for during prostate artery embolization.     

Prostate Artery Embolization for Giant Prostatic Enlargement: Short-Term Efficacy and Safety

Eight patients with giant prostatic enlargement > 200 mL and lower urinary tract symptoms who underwent bilateral prostatic artery embolization (PAE) were reviewed. Mean prostate volume decreased from 318.2 mL to 212.2 mL (P < .01). At 5-month mean follow-up, International Prostate Symptom Score decreased by 16.7 points (P < .05), and urinary quality of life improved by 3.0 points (P < .01). Three of 4 catheter-dependent patients no longer needed catheterization after the procedure. No major complications were encountered. Preliminary results suggest PAE is safe and effective in patients with giant prostatic enlargement > 200 mL.     

氟罗沙星体内外抗菌活性及抗生素后效应研究

 目的：对比研究氟罗沙星(FLRX)与其它氟喹诺酮类药物对临床分离致病菌的体内外抗菌活性及抗生素后效应(PAE)。方法：应用琼脂平板稀释法测定最低抑菌浓度(MIC)，微量稀释法测定血清杀菌效价(SBA)，吸光度法测定PAE。结果：FlRX对金葡菌、大肠埃希菌、肺炎克雷伯菌、绿脓假单胞菌均具很强的体内外抗菌活性，与氧氟沙星(OFLX)相似，而强于洛美沙星(LFLX)；FLRX对上述受试菌的峰时SBA与OFLX和LFLX相似，但谷时SBA多在1:1以上，高于OFLX和LFLX。FLRX无论对革兰阳性或阴性菌均具较长的PAE，呈显著的浓度依赖性，除金葡菌外，对其它受试菌的PAE均长于OFLX。结论：FLRX抗菌谱广，体内外抗菌活性强，具有较长时间的PAE，临床可采取每日1次给药方案治疗各类细菌感染。     

夫西地酸对葡萄球菌的抗生素后效应的研究

目的 研究夫西地酸对临床分离的葡萄球菌的体外抗菌作用,为夫西地酸的临床合理应用提供依据.方法 采用琼脂二倍稀释法测定夫西地酸的最低抑菌浓度（MIC）,以夫西地酸的MIC为基础,根据抗生素后效应理论,应用光密度法测定了夫西地酸对1株ATCC 29213、2株表面葡萄球菌和4株金黄色葡萄球菌（包括2株耐甲氧西林的金黄色葡萄球菌和2株甲氧西林敏感的金黄色葡萄球菌）的体外PAE.结果 87.7%的葡萄球菌对夫西地酸敏感,耐药菌主要为耐甲氧西林的凝固酶阴性葡萄球菌;夫西地酸对上述7株葡萄球菌的抗生素后效应（PAE）的范围为0.14~1.54 h.结论 夫西地酸对各种葡萄球菌,包括耐甲氧西林的金葡菌具有良好的抗菌作用;夫西地酸对葡萄球菌具有较短的PAE,且随药物浓度的不同,PAE也不一样.     

Prostatic Arterial Embolization for Control of Hematuria in Patients with Advanced Prostate Cancer

Nine patients with advanced prostate cancer (stage T4) underwent prostatic arterial embolization (PAE) for refractory prostatic hematuria. Angiograms showed prostatic neovascularity in all cases, and complete PAE was achieved in 8 cases (89% technical success rate). Gross hematuria ceased after PAE in 6 cases, translating to a 67% clinical success rate. There were no PAE-related complications. At 3-month follow-up, 2 cases showed recurrent hematuria, 4 patients had died from PAE-unrelated etiologies, and only 3 patients survived and were without gross hematuria. PAE could represent an alternative option for patients with advanced prostate cancer to control hematuria.     

The Role of Accessory Obturator Arteries in Prostatic Arterial Embolization

In 9 of 491 patients (1.8%) who underwent prostatic arterial embolization (PAE) for benign prostatic hyperplasia from March 2009–November 2013, prostatic arteries arose from the external iliac artery via an accessory obturator artery (AOA). Computed tomography angiography performed before the procedure identified the variant and allowed planning before the procedure. The nine AOAs were catheterized from a contralateral femoral approach. Bilateral PAE was technically successful in the nine patients. There was a mean decrease in international prostate symptom score of 6.5 points and a mean prostate volume reduction of 15.1% (mean follow-up, 4.8 mo) in the nine patients.