Comparative study of low power neodymium-YAG laser interstitial hyperthermia versus ethanol injection for controlled hepatic tissue destruction

A solitary hepatic metastasis is amenable to surgery. However, if surgery is contraindicated or if multiple lesions are present in both liver lobes, other treatment modalities have to be considered. We compared the effect of interstitial laser hyperthermia with damage caused by alcoholization. Six anaesthetized beagle dogs were studied. Three animals were treated with laser hyperthermia. A bare laser fibre (400m diameter) was introduced through a 17-gauge needle, length 170 mm, positioned into the liver under real time ultrasonographic guidance. Lesions were produced by continuous 500-s exposure of 1W YAG laser (Medilas MBB 40N) power. Three dogs were subjected to an injection of 4 ml of 98% pure ethanol into the liver through the same needle system. Two days after the procedure the animals were killed and the livers examined. The surface of the livers treated with the YAG laser were entirely normal; superficial lesions were, however, clearly visible. Laserinduced lesions were well reproducible, clearly demarcated, roughly spherical with a mean diameter of 1.01±0.23 cm (n=16). In contrast, the dogs treated with alcohol had free intraperitoneal serohaemorrhagic fluid and the surface of the liver was diffusely abnormal. The lesions had a more or less cylindrical shape, 1.22±0.43 cm on 0.40±0.10 cm (n=12) although exact measurement was often difficult. The border of the lesions was irregular and there was a clear necrotic zone along the puncture track. On microscopic examination the laser-induced lesions consisted of a central evaporation area, a zone of carbonized material and an outer zone of coagulation necrosis. The alcohol-induced lesions were characterized by both fixation necrosis and coagulative necrosis but surprisingly, there was also necrosis present at a distance of the lesions extending along the centrilobular and even portal veins. These data show that laser-induced interstitial necrosis in the liver is better controlled and more reproducible than necrosis induced by injection of pure ethanol. Moreover, pure ethanol may cause damage to the liver surface and even at a distance of the injection site.     

Antinociceptive action of quipazine: Relation to central serotonergic receptor stimulation

Quipazine, a serotonin receptor stimulant, inhibited the response of rats to painful stimuli in two methods currently used to measure antinociception in these animals: the hot plate and tail compression test. The antinociceptive action was observed with doses ranging from 5 to 20 mg/kg i.p. according to the test situation.The effect was significantly antagonized by a pretreatment with methergoline, a potent serotonin antagonist. An electrolytic lesion placed in the nucleus raphe medianus, which produced a marked decrease of serotonin in the forebrain did not, or only slightly, affected the effect of quipazine, depending on the method used to measure antinociception.It is suggested that quipazine can produce antinociceptive action in rats by interacting with a serotonergic mechanism. The action appears to be due mainly to a direct action on postsynaptic serotonin receptors, although a presynaptic component can also contribute to the effect of quipazine.Visiting scientist from Clinica Neurologica, UniversitàVisiting scientist from Clinica Neurologica, Università     

Phonomicrosurgery for benign vocal Fold lesions - our experience

Benign lesions of glottis creates stiffness of the vocal fold and inefficient glottal valve, aerodynamically effecting the vocal quality by preventing smooth vocal edge closure. Introduction of phonomicrosurgical techniques based on Hirano ’s principle of vocal fold epithelium have revolutionized results of voice surgery. Our experience in the management of benign vocal fold lesions by phonomicrosurgical techniques with pre and post operative stroboscopic, perceptual and computerized acoustic voice analysis is described.     

高频电波刀行电圈切除治疗宫颈病变的临床应用探讨

目的　评价高频电波刀行电圈切除 (LEEP)治疗宫颈病变中的临床应用价值。方法　回顾性分析我院 2 71例LEEP治疗宫颈病变的临床资料 ,所有病例均行阴道镜下多点活检和LEEP术后病理诊断 ,在炎症和赘生物病变外缘 3mm进出电极 ,对于CINI与HPV感染患者 ,电极在病变边缘外 5mm进出。结果　阴道镜下多点活检与LEEP术标本的病理诊断差别有显著性 (P <0 0 5 )。 2 71例患者术后随访 2 4 3例 ,术后复查宫颈细胞学 ,仅 9 0 5 %出现细胞核肥大和核异质。结论　LEEP对包括炎症、损伤、癌前病变、HPV感染等宫颈病变是一种非常理想的诊断、治疗手段。宫颈细胞学检查、阴道镜下多点活检、LEEP术后病理诊断构成了宫颈病变系统的诊断模式。LEEP可以广泛地应用于治疗CIN各级病变 (原位癌除外 ) ,LEEP也适用于CINI的治疗 ,LEEP治疗的范围可以在病变边缘外 5mm处进出电极     

超声治疗外阴白色病变30例临床分析

目的 :探讨超声治疗外阴白色病变的临床疗效。方法 :收治外阴白色病变 6 0例 ,随机分为 :超声治疗组 30例 ,微波治疗对照组 30例。观察其临床症状、体征和组织学变化。结果 :超声治疗组 30例患者的外阴瘙痒症状基本消失 ,患处上皮不同程度地恢复正常 ,显效率达 90 %。不同的病理类型间疗效的比较 ,差异无显著性 (P >0 .0 5 )。结论 :用超声治疗外阴白色病变效果明显     

323例乳腺肿块针吸细胞学诊断分析(英文)

目的探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果本组 FNAC 诊断敏感性为97.1%,特异性为97.3%,假阳性率为2.7%,假阴性率为2.9%,诊断符合为97.2%。结论乳腺肿块 FNAC 检查是一种实用价值很高的诊断方法。文中对影响 FNAC 诊断的因素进行了讨论。     

高频电波刀行电圈切除治疗宫颈病变的效果观察

目的　探讨高频电波刀行电圈切除 (LEEP)治疗宫颈病变的临床效果及应用价值。方法　对2 32例 (其中 12 5例为CIN)LEEP治疗的宫颈病变患者进行回顾性分析。所有病例均行阴道镜下多点活检和LEEP术后病理诊断 ,在炎症和赘生物病变外缘 3mm进出电极 ,对于CIN和HPV感染患者 ,电极在病变边缘外 5mm进出。结果　LEEP治疗的宫颈病变治愈率为 96 98% ,CIN残留率和复发率低 ,分别为 2 4 0 %( 3/12 5 )和 1 6 0 % ( 2 /12 5 )。阴道镜下多点活检和LEEP术标本的病理诊断比较 ,差异有显著意义 (P <0 0 5 )。结论　LEEP对炎症、损伤、癌前病变、HPV感染等宫颈病变是一种非常理想的诊断、治疗手段     

Cytogenetics of benign breast lesions

This review summarizes the cytogenetic information on benign breast lesions of various histologies, i.e., fibrocystic lesions from women with and without a known hereditary predisposition to breast cancer, fibroadenomas, phyllodes tumors, and papillomas, and relate the chromosomal features with those in breast carcinoma. In general, the frequency of chromosome abnormalities is lower in benign lesions than in breast cancer, and seems to correlate with the histologic features of the tissue, and the corresponding risk of developing invasive mammary carcinoma; aberrations are more common in proliferative than in nonproliferative lesions. The karyotypes are generally less complex than those detected in invasive carcinoma, and more often involve balanced rearrangements. No lesion-specific aberration has so far been detected; on the contrary, changes repeatedly encountered in breast cancer samples can be found in benign lesions as well, e.g., gain of 1q, interstitial deletion of 3p, and trisomies 7, 18, and 20. Especially intriguing is the prevalence of rearrangements of the short arm of chromosome 3, with the minimally deleted bands 3p13–14, in proliferative lesions from prophylactic mastectomies in breast cancer families. The potential tumor suppressor gene(s) in this region remains, however, to be identified.     

MNNG诱发大鼠腺胃癌模型的建立及p53,ras基因表达的研究

目的建立N一甲基一N’一硝基一N一亚硝基胍（N－methy1－N’－nitro－N－nitrosoguanidine，MNNG）诱发大鼠腺胃癌模型并观察p53，ras基因的表达。方法给Wistar大鼠饮用MNNG水溶液（终浓度为80μg／ml），用ABC法检测P53和P21蛋白的表达。结果MNNG成功地诱发出了胃癌、胃腺瘤、胃息肉、胃粘膜不典型增生和历上皮化生等病变。胃癌肝转移2例，淋巴结转移1例。P53蛋白在肠化及不典型增生皆阴性，胃癌阳性率为50％；P21蛋白在肠化及不典型增生中阳性率为44％，在癌组织中为23％。结论MNNG能诱发大鼠脾胃癌等病变，P53基因突变在胃癌发生发展过程中起一定作用，而ras基因激活是一个早期现象。     

Ultrasound variables and their prognostic value in a population of 1103 patients with 272 breast cancers

In a prospective two-centre study targeted US was performed as an adjunct to mammography in a population of 1103 patients with 272 breast cancers, 517 benign lesions and no abnormalities in 314 patients. The purpose of the study was to analyse the distribution of the different US variables among the breast lesions and to determine the prognostic value of these variables with respect to the diagnosis of malignancy. The following variables were analysed: border; contour; orientation; structure; echogenicity; sound transmission; and size. These variables were correlated with the definitive diagnosis and univariate analysis was performed. A statistically significant association with breast cancer (p < 0.001) was present for irregular border; ill-defined contour; indeterminate or vertical orientation; homogeneous, complex or heterogeneous structure; hypoechogenicity; and unchanged or decreased sound transmission. Multivariate analysis showed a high independent prognostic value for malignancy for irregular border, followed by ill-defined contour and unchanged or decreased sound transmission. However, their discriminative power was not absolute: in 38 cancers none of the malignant US variables were present, and in 11 benign lesions all variables were present. There were hardly any benign-looking lesions that proved to be malignant. Received: 6 October 1999; Revised: 3 March 2000; Accepted: 26 June 2000