Large gangliocytic paraganglioma of the duodenum: A rare entity

Gangliocytic paragangliomas are rare tumors that almost exclusively occur within the second portion of the duodenum. Although these tumors generally have a benign clinical course, they have the potential to recur or metastasize to regional lymph nodes. The case report presented here describes a 57-year-old female patient with melena, progressive asthenia, anemia, and a mass in the second-third portion of the duodenum that was treated by local excision. The patient was diagnosed with a friable bleeding tumor. The histologic analysis showed that the tumor was a 4 cm gangliocytic paraganglioma without a malignant cell pattern. In the absence of local invasion or distant metastasis, endoscopic resection represents a feasible, curative therapy. Although endoscopic polypectomy is currently considered the treatment of choice, it is not recommended if the size of the tumor is > 3 cm and/or there is active or recent bleeding. Patients diagnosed with a gangliocytic paraganglioma should be closely followed-up for possible local recurrence.     

完全性胸腹腔内脏反位合并十二指肠壶腹周围癌一例报告与文献复习

目的总结完全性胸腹腔内脏反位合并十二指肠壶腹周围癌的临床诊治方法。方法报道2006年3月收治的1例极为罕见的完全性胸腹腔内脏反位合并十二指肠壶腹周围癌行胰十二指肠切除术的病例,并复习国内外相关文献。结果本例患者病理诊断为十二指肠乳头及壶腹部腺癌Ⅰ-Ⅱ级。术后1周胆红素降至正常;但2周后出现胃-空肠吻合输出袢粘连性不完全性梗阻,经内镜下置管、鼻饲、营养支持、针灸等处理,40d后痊愈出院。经检索,全球自1936-2006年间报道的全胸腹腔内脏反位合并恶性肿瘤的患者仅15例;其中只有5例全胸腹腔内脏反位合并胰头与壶腹周围癌的报道。结论完全性胸腹腔内脏反位合并肿瘤时,若无明显禁忌证,应同样予以积极的外科治疗,术中操作应注意完全相反的解剖学结构。     

数字减影子宫输卵管造影术

目的:介绍和评价数字减影与自动高压注射器联合应用于子宫输卵管造影(HSG)。方法:自行设计造影用硅胶管使之能与自动高压注射器相联接,用40%泛影葡胺和数字减影方法作造影;随机抽取常规透视点片碘油造影片44份,数字减影泛影葡胺造影片50份进行对照分析。结果:两组比较:清晰度宫腔无显著性差异(P>0.05),输卵管有显著性差异(P<0.05);输卵管通畅率、血管或(和)淋巴管回流率有显著性差异(P<0.05)。盆腔涂布无显著性差异(P>0.05)。结论:采用数字减影与高压注射器行子宫输卵管造影能提高造影质量。     

新式非脱垂子宫阴式全子宫切除术45例报告

目的探讨非脱垂子宫经阴道改良切除的可行性及方法。方法将103例子宫肌瘤、子宫腺肌瘤、功能性子宫出血等需行全子宫切除术的患者随机分为两组，常规经腹式全子宫切除术(腹式组)58例，经阴道全子宫切除术(阴式组)45例，比较两种手术方法的优劣。结果阴式组较腹式组手术时间短，术中出血少，术后痛苦少；48h内肛门排气阴式组40例(88．9％)，腹式组31例(53．4％)；平均住院天数阴式组5．1d，腹式组7．1d。结论新式非脱垂子宫的阴式全子宫切除术相对于经腹式全子宫切除术有一定的优势，但要严格选择其手术适应证。     

Case report: CT of a duodenal paraganglioma

Paraganglioma is a neoplasm of neuroectodermal origin that occurs rarely in the bowel. This case report illustrates the previously undescribed CT appearance of a duodenal paraganglioma. An intensely enhancing mass in the region of the pancreatic head was found. The intense enhancement ruled out adenocarcinoma and focal pancreatitis. An islet cell tumor of the pancreas was the major differential diagnostic consideration.     

Developmental changes in intracellular pH buffering power in smooth muscle

 Intracellular pH (pH_i) is known to modulate contraction. Neonatal tissues can differ from adult tissue in contractile response to stimuli known to alter pH_i e.g. hypoxia. Changes of pH are attenuated by buffering, thus any difference in buffering power (β) between tissues could affect their functional response to pH_i perturbation. Similarly the extent to which any extracellular pH (pH_o) alteration is transmitted into a pH_i change will also influence function. We have therefore determined the intrinsic β and effect of pH_o change on pH_i in neonatal and adult ureteric, uterine and gastric smooth muscles using the pH-sensitive fluorophore carboxy-SNARF. β was found to be similar in the three adult tissues, but there were significant differences between neonatal tissues. In contrast, we found little difference in the amount of pH_i change produced by pH_o change between neonatal and adult tissues from the same smooth muscle, but a difference between smooth muscles. These data highlight significant differences between smooth muscles and their developmental state, which may contribute to different degrees of protection when pH is perturbed. Received: 17 October 1997 / Received after revision: 27 November 1997 / Accepted: 28 November 1997     

十二指肠溃疡生活事件及社会支持的对照研究

目的 探讨十二指肠溃疡与生活事件及社会支持的关系。方法 采用生活事件量表（LES），社会支持评定量表（SSRS）对十二指肠溃疡患者（58例）与健康对照（67例）进行问卷测试与评价分析。结果 十二指肠溃疡患者在生活事件里正性刺激量，负性刺激量和总刺激量都明显高于健康对照组，十二指肠溃疡患者受到的主观支持比一般人群多；而客观支持比一般人群少，但十二指肠溃疡患者受到的总支持量并不比一般人多，而且，十二指肠溃疡患者对支持的利用度也不比一般人高。结论 十二指肠溃疡患者有明显的生活事件和不足的社会支持，对生活事件的刺激尤为敏感。     

应用单宁酸-氯化铁法观察大鼠子宫血管构筑

目的:光镜下观察大鼠子宫不同部位微血管构筑。方法:应用单宁酸-氯化铁法(TA-Fe法)灌流固定大鼠,取子宫前、中、后段做冰冻切片,氯化铁显色,显微摄影。结果:子宫前、中段粘膜固有层中子宫腺间穿行着小血管和毛细血管,在上皮下形成毛细血管网,肌层近外膜处的动脉较粗大,边走行边分支,有些分支反向走行,与其它动脉分支互相吻合成血管网。后段中央部位动脉增粗,蜿蜒走行,分支不规则,近外膜的动脉向内分支,发出更多小动脉和毛细血管,形成致密的血管网。结论:TA-Fe 法可清晰显示子宫微血管,子宫壁的动脉明显弯曲,可见反向分支,内膜中未见螺旋动脉。     

大鼠子宫内膜抗菌成分的初步分析

作者以１％乙酸冲洗ＳＤ大鼠子宫内膜，获得子宫内膜酸溶性提取物。利用琼脂糖弥散法和电泳凝胶琼脂糖弥散法抗菌试验发现，子宫内膜提取物有三条主蛋白带对致病性大肠杆菌ＭＬ－３５Ｐ耐药株有强抗菌活性，这三条抗菌蛋白带命名为ＲａｔＵＰ－１，ＲａｔＵＰ－２和ＲａｔＵＰ－３，分别占子宫内膜提取物总蛋白量的４．５％，５．７％和６．６％。虽然提取物存在溶菌的活性，但其含量甚微，在ＡＵ一ＰＡＧＥ图谱上亦未能显现溶菌酶条带。本实验的结果提示子宫内膜合成一类抗菌多肽，可能在子宫抗菌机制中发挥重要作用。