The impact of lower urinary tract symptoms on general health status and on the use of prostatectomy

Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to the decision to undergo surgery. A cross-sectional population survey using postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing prostatectomy (North West Thames and Oxford regions). The subjects in the first survey were 221 men aged 55 and over with previously reported mild, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy. Main outcome measures were selfreported symptom severity, bothersomeness and general health status (Nottingham Health Profilie, Part 1). The response rate among eligible responders in the population survey was 85.7%. Increasing symptom severity was associated with worsening NHP scores for energy, emotional reactions, sleep and physical mobility (p<0.01). Increasing bother-someness of symptoms was associated with emotional reactions, sleep and pain (p<0.05). Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards emotional reactions, energy and pain. For a given level of symptom severity, the impact of those symptoms on aspects of a man's general health status may be the determinant of seeking and undergoing surgery. Greater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept treatment.     

Metastatic thyroid carcinoma presenting as an expansile intraluminal esophageal mass

We report a patient with metastatic thyroid carcinoma invading the esophagus in whom barium and MR examinations revealed an expansile intraluminal mass indistinguishable from that of a primary esophageal malignancy. Metastatic thyroid carcinoma should therefore be included in the differential diagnosis of an expansile esophageal mass. As in our patient, MR imaging may be useful for showing that the mass originates in the thyroid gland.     

特殊型前列腺增生症的诊治

收治特殊型前列腺增生症１１０例，分别伴有逼尿肌无力、不稳定性膀胱、前列腺结石、膀胱结石、前列腺炎或糖尿病。认为：治疗前认真检查发现特殊前列腺增生症，是提高治愈率、减少并发症的关键步骤之一。     

Laryngeal pleomorphic rhabdomyosarcoma

A case of an extremely unusual tumor of the larynx, pleomorphic rhabdomyosarcoma, is presented with a review of literature. This is the fifth case of this malignancy described in the larynx in the English language literature. A histopathological diagnosis was made with immunohistochemistry and electron microscopy. In contrast to other reported cases, the tumor in the present case had a very aggressive behavior. Despite radical surgery involving total laryngectomy and neck dissection followed by radiation therapy, the patient died of disease 8 months following treatment. Received: 14 March 1997 / Accepted: 23 January 1998     

长程低剂量口服Vp-16治疗晚期肺癌17例近期效疗观察

应用长程低剂量口服足叶乙甙（Ｖｐ－１６）治疗晚期肺癌１７例，ＰＲ为２３．５２％（４／１７），ＮＣ３５．２９％（６／１７）；毒副作用主要为骨髓抑制、恶心、呕吐和脱发，但均为轻度及可逆性反应。长程低剂量口服Ｖｐ－１６对失去手术机会或术后复发、转移而不能耐受正规静脉化疗的晚期肺癌患者是较理想的治疗方法。     

Rapid decrease of urinary pyridinoline excretion in growth hormone deficient children following discontinuation of growth hormone therapy

In order to examine the effect of growth hormone on urinary pyridinoline excretion, 32 patients with complete or partial growth hormone deficiency had their urinary pyridinoline excretion measured while receiving growth hormone and for 14 days after it was discontinued. There was a significant positive correlation between increases in growth velocities during the first year of growth hormone administration compared to before it, and the ratio of the urinary pyridinoline excretion levels while receiving growth hormone to those after discontinuation. Therefore, urinary pyridinoline excretion rapidly decreased in patients with growth hormone deficiency when the administration of growth hormone was stopped. Exogenous growth hormone appears to stimulate bone resorption in these patients.     

异体胸腺的解剖、组织学及吻合血管移植治疗晚期恶性骨肿瘤的研究

本文对20例20～36周引产死胎胸腺进行了解剖学,组织学观察,并应用吻合血管胎儿胸腺移植治疗晚期恶性原发及继发骨肿瘤12例。结果表明,胎儿胸腺的血供主要来自胸廓内动脉,其次为甲状腺下动脉和心包膈动脉胸腺支,7～8个月胎儿胸腺静脉血管壁较厚,适合作血管吻合,胸腺细胞发育成熟,组织结构正常,已有分泌胸腺素及转化免疫细胞的功能,在解剖学,组织学,免疫学方面均具备了良好的移植条件。12例接受吻合血管胎儿胸腺移植的晚期恶性骨肿瘤患者,其临床症状、体征、X线、免疫指数均有明显改善,患者生存6个月至37个月以上。     

隆突性皮纤维肉瘤23例临床分析

本文报告了我科1978～1990年间收治的降突性皮纤维肉瘤23例,均经组织学证实.治疗以手术切除为主,术后局部复发率为65.2%.无一例发生转移.切除不彻底是复发的主要原因.作者指出广泛切除是防止复发的主要措施,手术前后的放疗有可能减少复发.