Ovarian and omental ependymomas in peritoneal washings: cytologic and immunocytochemical features

The cytologic findings in peritoneal washings of two women, one of whom had an ovarian ependymoma and the other a primary omental ependymoma, are reported. The ependymomas were characterized by the presence of numerous, isolated, spindle and stellate cells as well as groups of cells forming true rosettes. The tumor cells displayed slightly pleomorphic, round-to-oval eccentric nuclei and abundant fibrillary cytoplasm with tapering cytoplasmic processes. In addition, one of the patients had numerous papillae and cell clusters with associated psammoma bodies indistinguishable from those found in low-grade serous carcinoma. The demonstration of glial fibrillary acidic protein (GFAP) in both cases by immunocytochemical procedures indicates the usefulness of this method in cytologic preparations to confirm the diagnosis of these uncommon neoplasms.     

狗脊髓截除自体隐神经大网膜移植的初步观察

实验用6只狗于T13处切除脊髓8mm，局部用隐神经、大网膜移植。对照组6只狗单纯切除脊髓8mm。术后3个月、6个月实验组动物全部恢复到C／Ⅲ级功能，组织学切片见移植神经有不同程度存活，可记录到股四头肌、胫前肌电位。对照组动物仅达到0／0～A／I织功能，组织学切片见脊髓缺损处为结缔组织，诱电位波形消失。分析了影响脊髓神经功能恢复的原因。     

大网膜包裹人工神经移植体再血管化及神经再生的研究

目的 探讨大网膜包裹人工神经移植体的早期再血管化，以及增强移植体血供对神经再生的影响。方法 75只大耳白兔制作成左前肢正中神经2．0cm缺损，随机分成3组：A组，带蒂大网膜包裹人工神经移植体移植；B组，人工神经移植体桥接神经缺损；C组，自体神经桥接神经缺损，作为对照组。术后3、7和14d应用伊凡思蓝（evans blue bound to albumin，EBA）毛细血管造影，检测各组移植体的再血管化；术后12周通过电生理、光镜、透射电镜等检测评估神经再生的效果。结果 A、C组术后3d移植神经出现再血管化，7d和14d再血管化程度逐渐增强；B组7d出现再血管化，与A、C组比较，再血管化延迟。术后12周，A组和C组运动神经传导速度、有髓神经纤维密度、神经内纤维组织面积及面积比、髓鞘厚度、髓鞘直径等差异无统计学意义（P〉0．05），但均优于B组，差异有统计学意义（P〈0．05）。结论 大网膜包裹人工神经移植体可促进移植体早期再血管化，增强移植体血供，促进神经再生。     

头皮缺损颅骨外露的修复

我科1980～1991年收治外伤性或颅面部肿瘤切除后头皮缺损颅骨外露9例,分别应用吻合血管的游离大网膜结合中厚皮片移植、游离皮瓣或轴型皮瓣转位结合皮片移植修复。讨论了修复时机、修复方法以及手术注意事项。认为双侧股前外侧游离皮瓣是修复全头皮缺损颅骨外露的可取方法,而吻合血管的游离大网膜移植修复颅骨外露的方法应尽量避免。     

Laparoscopic repair of a diaphragmatic hernia through the foramen of Morgagni

A 78-year-old woman is described who presented with a diaphragmatic hernia through the foramen of Morgagni. A definitive diagnosis was confirmed by a sagittal view on magnetic resonance imaging prior to surgery. The hernia was repaired laparoscopically under an abdominal wall lifting technique without pneumoperitoneum, and her symptoms completely resolved postoperatively with no evidence of recurrence. The laparoscopic repair was considered a suitable and safe procedure for the treatment of a Morgagni hernia. Received: 3 April 1996/Accepted: 3 May 1996     

游离大网膜移植修复严重手外伤

目的 通过临床实践,探索一种比较简单和相对有效的治疗严重手外伤的方法,以求最大限度地恢复手功能.方法 选用部分大网膜游离移植和网膜上同时中厚植皮术修复严重手外伤伴有大面积软组织缺损.结果 1997年起应用此方法共治疗6例病人7只手,创面一期愈合.并且供区组织充足,厚薄适度,不造成供区严重损伤,随访2～8年病人没有肠粘连症状出现.结论 选用此方法修复严重手外伤术后外形不臃肿,组织柔软,并能保留部分损伤的骨关节结构,瘢痕增生不明显,有利于手内关节活动和手功能恢复.     

Post-capillary venules in the “milky spots” of the greater omentum are the major site of plasma protein and leukocyte extravasation in rodent models of peritonitis

Intraperitoneal injection of inflammatory agents in the mouse and rat causes plasma protein and leukocyte extravasation into the peritoneal cavity. Following an intraperitoneal injection of zymosan A, the milky spots of the omentum were the only abdominal sites detected where intravenously administered Monastral Blue labeled interendothelial cell gaps responsible for plasma extravasation. In addition, when colored microspheres were intraventricularly administered to quantify blood flow, the omentum was the only abdominal organ which showed an increase in blood flow during zymosan A peritonitis. A combination of light and electron microscopy, plus measurement of myeloperoxidase activity (a marker of neutrophil accumulation) demonstrated that the omental milky spots are the major route through which leukocytes migrate into the peritoneal cavity. Identical structures in the pleura likewise are the sites of protein leakage into the pleural cavity. In contrast, selective sites of protein and cellular extravasation could not be detected in the synovial lining of the inflamed knee joint.     

延髓血管压迫致高血压的犬模型

为制备延髓血管压迫致高血压模型,将１２只杂种犬随机均分为模型组和对照组,采用带蒂大网膜移植法,将裁剪好的大网膜经皮下隧道移植至左侧延髓腹外侧及Ⅸ、Ⅹ颅神经入脑干区（ＲＥＺ）,利用大网膜与延髓表面蛛网膜及软脑膜间形成的血管吻合,造成延髓血管压迫;对照组犬的大网膜移植于其小脑表面。结果,模型组术后血压较术前明显升高（Ｐ＜０．０１）,对照组血压无明显改变,提示原发性高血压与左侧延髓腹外侧受血管压迫有关。     

Infarction of omentum and epiploic appendage: Diagnosis, epidemiology and natural history

Epiploic appendagitis and segmental omentum infarction are considered to be rare conditions, which may mimic an abdominal surgical emergency. The purpose of our study was to describe clinical findings, US and CT appearance of infarction of an epiploic appendage and omentum, and to determine their epidemiological characteristics and natural history. We retrospectively studied clinical, US and CT findings at hospital admission and follow-up of all patients who were diagnosed at our institution with epiploic appendagitis or omentum infarction between June 1988 and November 1997. We found a relatively high incidence of 40 cases: 20 patients with epiploic appendagitis, 11 with omentum infarction, and 9 in whom it was not possible to discriminate between the both. All 40 patients recovered under conservative treatment without complications. We conclude that US and CT features allow a reliable diagnosis, thereby obviating unnecessary surgery. Discriminating between both conditions is of no practical relevance since treatment and prognosis are identical. Received: 30 November 1998; Revised: 30 March 1999; Accepted: 6 September 1999     

人卵巢癌裸鼠腹腔及网膜移植的研究

目的：建立既符合卵巢癌临床特征，又便于实验观察和分析的人卵巢癌裸鼠异种移植模型。方法：将体外培养的卵巢癌Ａｏ细胞接种于裸鼠皮下和腹腔内，并切取皮下移植瘤；在麻醉状态下对裸鼠进行网膜局部手术移植。结果：腹腔种植成瘤率为７０％（７／１０），肿瘤结节大小不一，分布广泛，其中２只腹水形成；网膜移植全部成瘤，移植瘤呈单一生长，易分离和切除，肿瘤重量一致性较好。结论：人卵巢癌裸鼠网膜异种移植模型直接反映肿瘤生物学行为，便于观察和分析实验结果，适于在卵巢癌实验研究中应用。