肿瘤干细胞与肝癌干细胞

肿瘤起源于干细胞的假说正在各种人类肿瘤中得到证实,肿瘤不单是一种基因病,而且是一种干细胞病,基因突变作用于干细胞,干细胞突变成为肿瘤干细胞,这是肿瘤发生、再生、转移和复发的关键。肝细胞癌是最常见的恶性肿瘤之一,其中是否存在“肝癌干细胞”的问题一直倍受人们关注。该文介绍肿瘤干细胞与肝癌干细胞的研究情况。     

Small epithelial cells in human liver cirrhosis exhibit features of hepatic stem-like cells: immunohistochemical,electron microscopic and immunoelectron microscopic findings

AIMS: To investigate whether cells with features similar to those of the oval cells of rodents and the small epithelial cells (SEC) recently described in certain human liver diseases, i.e. hepatic progenitor cells, also occur in human liver cirrhosis. METHODS AND RESULTS: Surgical specimens from 35 cases of hepatitis B virus-positive cirrhosis (30 cases containing hepatocellular carcinoma) were investigated by immunohistochemical staining for cytokeratin 7 and albumin. Electron microscopic investigations, and immunoelectron microscopic investigations using the same antibodies and a double-labelling technique were performed in 15 and seven cases, respectively. SEC were observed in proliferated bile ductules, at the margins of regenerating nodules and in the fibrous septa in all cases of cirrhosis. The SEC were morphologically similar to the SEC described previously, and to the oval cells seen in experimental hepatocarcinogenesis. They were characterized by their small size, oval shape, scanty electron-dense or electron-lucent cytoplasm, a high nucleo-cytoplasmic ratio, tonofilaments and intercellular junctions. Immunoelectron microscopy revealed that the SEC co-expressed cytokeratin 7 and albumin. Both relatively undifferentiated SEC and SEC with morphological and immunophenotypical signs of differentiation towards biliary epithelial cells and hepatocytes were found. CONCLUSIONS: SEC that exhibit morphological and immunophenotypical features of the SEC seen in certain other liver diseases are found in cirrhosis. These findings further support the hypothesis that a bipotent hepatic stem cell that may give rise to biliary epithelial cells and hepatocytes exists in the human liver.     

人肝病变组织低分子量角蛋白CK19的表达

目的 研究低分子量角蛋白CK19在人肝细胞癌、肝癌前病变、肝硬化组织中的表达状况及意义。方法 采用免疫组织化学SP法检测56例细胞癌、8例肝硬化及9例正常肝组织中CK19的表达。结果 56例肝癌旁不典型增生组中异型增生细胞及卵圆细胞的CK19表达率（51.9%)显著高于癌旁非不典型组中肝细胞的表达率（17.2%),但与肝癌组织的表达率差别不大。肝硬化组中CK19的表达率为37.5(3/8)阳性细胞均为卵圆细胞及异型增生细胞,结论 肝细胞癌和增生的卵圆细胞及异型增生肝细胞表达CK19,提示CK19可做为判断肝细胞异型增生的一个指标,肝细胞癌CK19表达与其组织学类型有密切关系。     

Radiographic studies of the ventricles in syringomyelia

Summary Radiographic investigations of 171 patients with communicating syringomyelia have been reviewed. Hydrocephalus was found in onethird of the cases and has occasionally progressed after operation on the posterior fossa, sometimes with accompanying clinical deterioration. The outlets of the fourth ventricle were usually abnormal; tonsillar descent, arachnoiditis and both together were seen. Arachnoiditis correlated strongly with a history of difficult birth. The foramen of Magendie was sometimes patent and sometimes blocked. There was no consistent level of occlusion corresponding to a persistent roof of the fourth ventricle. The cisterna magna was usually small or obliterated but some examples of large cisterns or subarachnoid pouches were found. Radiological demonstration of a communication from the fourth ventricle to the syrinx occurred in only seven patients by positive contrast material and not by air. It is suggested that a sizable communication is rare at the time when patients seek treatment.     

枕下远外侧入路解剖研究与临床应用

目的　探讨枕下远外侧入路的相关解剖研究和临床应用效果。方法　选用 2 0例成人头颅湿标本进行显微解剖测量。应用枕下远外侧入路切除枕大孔区和前外侧肿瘤 10例。结果　枕骨髁为术中重要的解剖标志 ,枕下三角为显露椎动脉的重要标志 ,枕下三角由三条肌肉形成 ,即头后大直肌、头上斜肌和头下斜肌。枕下三角内有椎动脉及肌支 ,椎静脉丛和颈 1神经。测量寰椎横突孔外缘至椎动脉入颅处距离 ,左侧 (16 .87± 2 .0 8)mm、右侧 (16 .79± 1.90 )mm。枕大孔区肿瘤 10例手术中 ,肿瘤全切 6例 ,次全切 3例 ,大部分切除 1例 ,无手术死亡。结论　枕下远外侧入路手术应了解枕大孔区的相关解剖参数和局部解剖结构 ,该入路优点能增加术野空间 ,最大程度上显露肿瘤组织 ,减少对脑干和重要血管神经牵拉。     

黄芪刺激体外培养的大鼠肝卵圆细胞生长的作用

目的探讨黄芪对体外培养的大鼠肝卵圆细胞生长的影响。方法从喂饲含0．1%乙硫氨酸的胆碱缺乏性饮食4～6周的大鼠肝脏中分离出肝卵圆细胞,用RT-PCR、免疫组化、Westem blot等方法对培养的细胞进行鉴定。MIT法观察不同浓度黄芪对肝卵圆细胞生长的影响；Giemsa染色法观察细胞表型的改变情况；碘化丙啶染色流式细胞仪测定细胞周期的变化。结果所分出的细胞既表达干细胞标志物c-kit,也表达胚胎肝细胞标志物甲胎蛋白、胆管细胞标志物OV6和CK19,此外还表达成熟肝细胞标志物白蛋白,认为它们是大鼠肝卵圆细胞。从0．125mg/ml～4mg/ml黄芪处理肝卵圆细胞48h后都有促进其生长的作用,其中2mg/ml黄芪刺激生长作用最明显(P＜0．05)。2 mg/ml黄芪处理肝卵圆细胞48h后既出现了一些增殖能力强的细胞,也出现了一些核质比低的细胞,此时细胞周期测定结果显示处G_2-S和M期的细胞比未用黄芪处理的对照细胞增多。结论黄芪具有明显的刺激体外培养的肝卵圆细胞生长的作用。     

Sudden Foot Drop Caused by Foraminal Gas Pseudocyst

A foraminal gas pseudocyst is a rare cause of lumbar radiculopathy. The association with a sudden foot drop has not been previously reported. Here, a 67-year-old woman with sudden foot drop on the left side is reported. Computed tomography and magnetic resonance imaging identified a foraminal gas containing lesion compressing the left L5 root at the L5-S1 foramen. The foraminal gas containing lesion compressing the L5 ganglion was successfully removed by the posterior approach. The histological diagnosis was a gas pseudocyst. This unique case of surgically proven gas pseudocyst indicates that it should be included in the differential diagnosis of patients presenting with sudden foot drop.     

Transthoracic Repair of Asymptomatic Morgagni Hernia in an Adult

Morgagni hernia represents a rare type of diaphragmatic hernia which usually occurs on the right side, in the anterior mediastinum. Predisposing factors of Morgagni hernia include pregnancy, obesity or other causes of increased intraabdominal pressure, and a history of trauma. Most of adults diagnosed with a foramen of Morgagni are asymptomatic. We report a case of an overweight 23-year-old asymptomatic patient with a Morgagni hernia incidentally diagnosed on chest x-ray. There was a satisfactory result after the repair by a transthoracic approach.     

Morphometric evaluation of the foramen magnum for sex determination: A study from Saudi Arabia

The present study provides a database of various morphometric dimensions of the foramen magnum region in the Saudi population. The objective of this study was to evaluate various measurements of the foramen magnum region for sex determination in the Saudi population by using computed tomography (CT) images. The various radiological measurements of the foramen magnum region were measured in a total of 200 adult subjects of Saudi origin including 100 males and 100 females. Sexual dimorphism was observed in five parameters related to the foramen magnum, namely length of the right occipital condyle (LROC), length of the left occipital condyle (LLOC), width of the foramen magnum (WFM), area of the foramen magnum (AFM) and length of the foramen magnum (LFM). The accuracy to discriminate sex ranged from 65.5% to 62.5% when LROC, LLOC, WFM, AFM, and LFM were considered as individual parameters. When multiple parameters were combined to discriminate sex, the highest accuracy of 71% was achieved.