Experimental model of chronic tonsillar herniation associated with early stage syringomyelia

This report describes an experimental model of chronic tonsillar herniation and its effects on the spinal cord. In ten rats, a small piece of chemically induced mammary cancer was transplanted to the supraoccipital bone. In all cases, the transplanted cancers grew into the posterior fossa, destroying the supraoccipital bone and compressing the cerebellum extradurally. In six of the ten rats, tonsillar herniation was observed at 8–14 weeks after transplantation. Transdural infiltration of the tumor cells was not apparent in any animal. In those rats with tonsillar herniation (n=6), the spinal cord from the C5 to the T8 segments showed enlargement of the central canal without exception. Histological examination revealed the following changes: stretching and thinning of the ependymal cells; swelling of the astrocytic processes; and extracellular edema, predominantly in the dorsal gray matter, but also in the ventral inner portion of the dorsal column. In the control group (n=4) and those rats without tonsillar herniation (n=4), such histological changes of the spinal cord were not observed. Although the lesions can not be regarded as representing mature syringomyelia, they most likely constitute an earlier evolutionary stage.     

62例扁桃体癌临床疗效分析

目的探讨不同治疗方法对扁桃体癌的疗效及预后因素。方法62例扁桃体癌根据1997年国际抗癌联盟分期标准，Ⅰ期3例，Ⅱ期7例，Ⅲ期17例，Ⅳ期35例。根据不同治疗方法，将62例患者分为3个组，外照射 腔内治疗组(15例)，单纯外照射治疗组(31例)，外照射 化疗组(16例)。结果62例肿瘤患者的3、5、10年总生存率分别为61．3％(38／62)，35．5％(22／62)，17．0％(9／53)。外照射 腔内治疗组，单纯外照射组及外照射 化疗组肿瘤局部控制率分别为86．7％(13／15)，54．8％(17／31)，50．0％(8／16)，外照射 腔内治疗组肿瘤局部控制率分别与单纯外照射组和外照射 化疗组相比，均有显著性差异；3个组3、5、10年生存率相比较，均无显著性差异。结论腔内治疗作为原发灶推量方法，能提高肿瘤局部控制率，但不能提高患者生存率。     

小脑扁桃体下疝合并脊髓空洞症治疗分析

目的 探讨小脑扁桃体下疝合并脊髓空洞症的治疗.方法 回顾性分析1995年8月至2010年8月经治的29例小脑扁桃体下疝合并脊髓空洞症患者,均采用手术干预治疗,单纯行枕大孔减压术16例,行枕大孔减压加空洞-蛛网膜下腔分流术13例.术后随访6个月～3年观察治疗效果.结果 随访6个月～3年,单纯行后颅窝减压组中显效8例,有效6例,无效2例,恶化0例,总有效率为87.5％;后颅窝减压空洞-蛛网膜下腔分流组中显效6例,有效4例,无效2例,恶化1例,总有效率为76.9％,2组总有效率比较差异无统计学意义（P＞0.05）.结论 手术是小脑扁桃体下疝合并脊髓空洞症的首选治疗,因下疝和空洞致脊髓受损轻者减压术后恢复较好,而脊髓受损明显者则手术效果差.     

Reactive Tonsillar Enlargement Showing Strong 18F-Fdg Uptake During the Follow-Up of Follicular Lymphoma

The ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has become a standard procedure for the diagnosis, staging, and restaging in lymphoma patients. However, a relative high rate of false-positive results has been reported. We report a case of a 40-year-old man with a previous history of a nodal follicular lymphoma, stage IVA, treated with R-CHOP, which showed strong ¹⁸F-FDG uptake in the Waldeyer’s tonsillar ring during his follow-up, being considered highly suspicious of relapsed lymphoma. A surgical removal of the palatine tonsils and adenoids was performed, which showed reactive follicular hyperplasia. Furthermore, bone marrow biopsy revealed absence of neoplasia. The patient is still in follow-up with no signs of recurrent lymphoma. This case illustrates that, despite the high sensitivity for the detection of recurrent lymphoma, ¹⁸F-FDG uptake should be interpreted with great caution and confirmatory studies should be performed before any therapy.     

等离子射频消融与传统结扎止血术在治疗舌扁桃体肥大中的临床效果分析

目的探讨等离子消融联合传统结扎术在治疗扁桃体肥大中的疗效。方法选取舌扁桃体三度肥大合并睡眠通气障碍患者300例,记录术前低通气指数后分为等离子消融止血术组（A组,130例）和传统结扎止血术组（B组,170例）。比较两组术中出血量、术后第1天患者疼痛视觉（VAS）评分、术后30天手术并发症。结果术中出血量B组比A组多[（28±1．23）ml vs．（10±1．55）ml],VAS评分B组比A组低[（3±0．60） vs．（5±0．52）],两组1个月后随访低通气指数（AHI）都较前改善,术后5天内再出血A组有10例、B组2例。结论等离子射频术具有操作简单,出血少,手术时间短,视野清晰的临床优势。等离子射频消融切除扁桃体联合传统结扎止血术出血并发症发生率低,患者术后疼痛减轻。     

The influence of tonsillectomy on cell-mediated immune response

Summary In order to ascertain the influence of a possible immunoregulatory effect of tonsils on the organism, phytohaemagglutinin (PHA) and concanavalin A (Con A) stimulation and the suppressor index in peripheral blood lymphocytes were determined in the pre-operative and postoperative course. Consistent statements on a possible effect of the tonsil can not be made from the results obtained.     

108例扁桃体鳞癌治疗效果的回顾性分析

背景与目的:扁桃体鳞癌的治疗,是选择根治性放疗加外科挽救手术,还是计划性术前放疗加手术,目前尚无一致观点。在Ⅲ～Ⅳ期扁桃体鳞癌患者中,仅以肿瘤大小和淋巴结转移来判断预后显然不足。为此,本研究旨在总结我院扁桃体鳞癌的治疗效果,并探讨上述两种治疗方法的适应证及影响预后的因素。方法:回顾性总结1984年～2000年我院收治的108例扁桃体鳞癌患者的临床资料,其中根治性放疗加外科挽救手术83例(A组),计划性术前放疗加手术25例(B组)。总结两组的治疗效果及口腔功能损害情况,分析肿瘤的放疗反应与生存率的关系。结果:联合根治术导致不同程度的口腔功能损害,其发生率在A组为24.1%(20/83),在B组达88.0%(22/25)。A组患者的5年生存率为59.3%,B组为55.4%(P=0.706)。放疗后转移淋巴结消失及手术标本有重度放疗反应者,A、B两组的5年生存率分别为73.0%和76.9%(P>0.05)。结论:根治性放疗加挽救性手术使部分扁桃体鳞癌患者避免了联合根治术,在一定程度上保留了口腔功能。放疗后淋巴结的消失情况及组织放疗反应程度可以作为晚期扁桃体鳞癌的预后参考指标。     

71例扁桃体癌放射治疗分析

目的：探讨扁桃体癌放射治疗方法、疗效和影响预后的因素。方法：回顾性分析我科1971年8月至1995年10月收治的经病检证实的扁桃体癌71例，外照射＋腔内治疗组15例，单纯外照射组39例，外照射＋化疗组17例。结果：外照射＋腔内治疗组局部控制率为82．1％，单纯外照射组局部控制率为68．4％，外照射＋化疗组局部控制率为64．2％。外照射＋腔内治疗组局部控制率与单纯外照射和外照射＋化疗组相比，差异有显著性意义（χ^2=4.65,P=0.030;χ^2=5.65,P=0.018)。外照射＋腔内治疗组3、5、10年生存率分别为76．3％、53．2％和31．2％，单纯外照射组3、5、10年生存率分别为74．0％、45．2％和33．5％，外照射＋化疗组3、5、10年生存率分别为75．2％、47．1％和25．3％，3个组3、5、10年生存率相互比较，差异均无显著性意义（P＞0．05）。结论：腔内治疗作为原发灶推量手段，能提高局部控制率，但不能提高生存率。