Primary Transitional Cell Carcinoma of the Fallopian Tube: A Case Report and Review of the Literature

Primary carcinoma of the fallopian tube is extremely rare and the preoperative diagnosis is often misdiagnosed as an ovarian carcinoma. We report a patient with primary carcinoma of the fallopian tube, strongly suspected preoperatively on the basis of characteristic clinical symptoms, elevated CA125 levels, and transvaginal sonography, computed tomography, and magnetic resonance imaging findings. The histology of fallopian tube carcinoma was demonstrated as transitional cell carcinoma. Extensive review of the literature showed that our case seemed to be the 14th case of primary transitional cell carcinoma of the fallopian tube.     

Inhaled nitric oxide therapy via nasopharyngeal tube in an infant with end-stage pulmonary hypertension

Abstract The delivery of nitric oxide (NO) via a nasopharyngeal tube is an alternative to endotracheal intubation. A male infant with end-stage pulmonary hypertension (PH) due to a severe hypoplastic lung developed a PH crisis on day 145 and received NO inhalation via a nasopharyngeal tube. Clinical improvement was maintained for 7 days with18–22ppm NO inhalation. The patient remained in close physical contact with his parents without the use of sedation. Blood methemoglobin levels remained below 1%. The environmental NO levels were less than 0.06 ppm and NO₂ less than 0.3 ppm throughout the treatment, well within the safety margin. On day 152, the patient succumbed to hypoxemia and heart failure. The use of a nasopharyngeal NO delivery system without sedation, as an alternative to endotracheal intubation with sedation, was a practical method in treating a patient with PH while maintaining a certain quality of life for the patient and the family.     

面神经管裂缺处面神经组织学观察

目的探讨先天性面神经管裂处神经外膜缺陷可能引起的病理学改变。方法采用光学显微镜对美国明尼苏达大学颞骨病理实验室１５２６具颞骨连续切片的面神经颞骨全程进行组织病理学观察。结果发现先天性面神经管裂者８８５耳，其中４８耳在管裂处神经外膜缺损，其中４０耳面神经从管裂处疝出，有１３耳在管裂处形成外生性面神经鞘瘤。３耳在管裂处面神经受炎性细胞浸润。而管裂处有神经外膜覆盖的８３７耳均未见此类病变。结论面神经管裂处神经外膜的缺损是此处面神经疝出、外生性神经鞘瘤形成和面神经易于受炎症浸润的组织解剖学原因。     

颞骨内微型面神经鞘瘤病理研究

目的探讨颞骨内微型面神经鞘瘤的原发部位和病理行为。方法用光镜对８１５人（１５２６侧）颞骨连续切片进行面神经颞骨内全程组织病理学观察。结果发现未诊断的无症状微型ＡｎｔｏｎｉＡ型面神经鞘瘤１５人（１７耳），占１．８４％。依其病理行为特征分为外生性（１３耳，起自面神经管裂处神经束膜，并向管外生长）和内生性（４耳，起自面神经主干）两种类型。肿瘤起自迷路段者２耳，水平段１２耳，第二膝段１耳，垂直段２耳。结论将颞骨内面神经鞘瘤分为内生性和外生性两种类型有重要的病理和临床意义，有助于手术目的的确定和手术方法的设计     

Evaluation of the MTHFR C677T allele and the MTHFR gene locus in a German spina bifida population

A number of recent studies have demonstrated that the occurrence and recurrence risk of neural tube defects (NTD) is reduced by folic acid supplementation before and during pregnancy. Epidemiological studies have shown low plasma folate and raised plasma homocysteine in women with spina bifida aperta (SB) children suggesting an abnormal folate metabolism. The 5,10-methylenetetrahydrofolate reductase (MTHFR) variant C677T, resulting in a decreased activity of the enzyme, has been associated with the development of NTD. Several studies demonstrated that homozygosity for the C677T mutation occurs at a higher frequency in patients with SB phenotype than in control individuals. The SB risk is strongest if both the mother and her child have the mutation in the homozygous state. In the present study we compared the frequency of the C- and T-alleles in healthy German individuals (n=153) with German SB patients (n=137). Our study groups reveal no significant difference in C/T-allele frequencies and genotype distributions. A family based association study, the transmission disequilibrium test, confirms the absence of an association between T-allele and SB. In 9 of 40 families we were able to exclude linkage to the MTHFR locus (1p36.3) employing different inheritance models. Conclusion Our data show no evidence for an association between the C677T mutation and the occurrence of the SB phenotype. Therefore we cannot support the hypothesis that the MTHFR variant does account for a significant genetic predisposition to the SB phenotype in the studied German patients. Received: 11 June 1997 / Accepted in revised form: 3 November 1997     

大鼠小肠粘膜淋巴管的图像分析

大鼠腹主动脉注入１％墨汁硝酸银溶液，可同时显示小肠淋巴管和微血管，浆膜下注入１０％ＡＢＳ丁酮溶液可制成小肠粘膜淋巴管的铸型标本，用光镜和ＳＥＭ观察，利用图像分析仪测量了肠粘膜淋巴管的数量、管径、长度等。小肠粘膜初始淋巴管数为２７５±５２／ｍｍ２，管径为３４９±４０μｍ，长度为２０８５μｍ，初始后淋巴管管径为３４９＋４０μｍ，长度１０７４μｍ，提出了区分初始淋巴管和初始后淋巴管的依据，获得了有关汇合淋巴管、粘膜下层淋巴管网数、园形因子等数据，小肠不同区段如十二指肠、空肠、回肠、淋巴管的上述数据有某些差别。我们的研究结果加深了对大鼠小肠淋巴管的分布、走行和形态等的认识     

胸腔置管引流并腔内鸦胆子油乳注射治疗癌性胸水疗效分析

目的：观察ARROW管胸腔留置引流胸水后胸腔内注射鸦胆子油乳注射液治疗癌性胸水的疗效。方法：对24例行胸腔内留置ARROW管引流胸水后腔内注射鸦胆子油乳注射液治疗。结果：胸水消失或减少总有效率为79．17％。结论：该方法不但能有效地控制癌性胸水，改善患者生存质量，延长其生存时间，而且方便安全。     

一次性输液连接管和输液针对硝酸甘油的吸附作用研究

目的:研究微泵维持静脉注射时一次性输液连接管和输液针对硝酸甘油的吸附作用。方法:模拟临床微泵维持静脉注射,用高效液相色谱法、紫外分光光度法定量分析硝酸甘油在注射过程中的浓度变化。结果:一次性输液连接管和输液针对硝酸甘油具有显著的吸附作用,8h内平均吸附率为(73 .88±2. 05) %。结论:硝酸甘油经微泵维持静脉注射时,不宜使用对硝酸甘油具有吸附作用的一次性输液连接管和输液针     

Total versus tube-related additional work of breathing in ventilator-dependent patients

BACKGROUND: In tracheally intubated or tracheostomized spontaneously breathing patients, tube resistance can highly increase the patient's work of breathing. In this study we focused upon the relationship between total (WOBtot) and tube-related additional inspiratory work of breathing (WOBadd) and compared different ventilatory modalities for proper tube compensation. METHODS: In ten tracheostomized spontaneously breathing patients we measured WOBtot and WOBadd in the continuous positive airway pressure (CPAP) mode, under inspiratory pressure support of 5, 10, and 15 cmH2O in the pressure support ventilation (PSV) mode, and under flow-adjusted pressure support in the automatic tube compensation (ATC) mode. WOBadd and WOBtot were calculated on the basis of measured tracheal pressure and esophageal pressure, respectively. Inspiratory peak tracheal pressure above PEEP was taken as an estimate of pressure support beyond mere tube compensation (i.e., overcompensation). RESULTS: The percentage of the tube-related WOBadd on WOBtot in the CPAP mode was 52%. It decreased with increasing pressure support in the PSV mode from 32% (PSV 5 cmH2O) to 17% (PSV 15 cmH2O). WOBadd was only 15% of WOBtot in the ATC mode. In contrast to the other ventilatory modes, reduction of WOBadd in the ATC mode was achieved with the smallest amount of overcompensation, i.e. with minimal pressure assist beyond mere tube compensation. CONCLUSION: In tracheally intubated or tracheostomized spontaneously breathing patients, adequate compensation of tube resistance (i.e. with minimal overcompensation and minimal undercompensation) is best done by the ATC mode.     

气管导管位置检测仪的研制

利用Hall传感器设计了一个气管导管位置检测仪来快速检测气管导管的位置.气管插管时,Hall传感器探头固定在病人颈部皮肤上,顶端带有小磁铁的管芯随气管导管一起进入气管中,根据检测到的磁场强度的大小,测量出探头与磁铁间的距离,从而判断出气管导管的位置.经临床测试,该检测仪性能可靠,测量准确,可以用于教学及临床气管插管时气管导管的定位.