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Objective To investigate the clinicopathologic features of Chinese patients with early gastric cancer (EGC) according to the World Health Organization(WHO) diagnostic criteria,and to explore the risk factors of lymph node metastasis (LNM) in EGC.Methods From 2002 to 2017,at the Second Affiliated Hospital of Nantong University,and from 2014 to 2017,at the People's Hospital of Qidong City,the People's Hospital of Haimen City and the People's Hospital of Rugao City,315 EGC patients with complete clinicopathological data were enrolled.The clinicopathologic features were analyzed including gender,age,tumor location,tumor size,macroscopic type,histological type (WHO),differentiation degree,depth of tumor invasion,Lauren subtype,infiltration pattern,ulceration,lymphoid follicles,lymphovascular invasion and perineural invasion.Chi-square test and Fisher's exact test were performed for univariate analysis and the logistic regression was used for multivariate analysis.Results The ratio of EGC was 10.0% (315/3 140) of patients with gastric cancer and received surgery during the same period.Among the 315 EGC,the ratio of well-differentiated tubular adenocarcinoma was 11.7% (37/315),which was lower than 24.8%(2 752/11 104) in Japan and 19.9%(41/206) in South Korea,and the differences were statistically significant (x2 =28.208,P<0.01;x2 =6.51 0,P =0.011),however there was no statistically significant difference when compared with Western countries (11.9 %,8/67;x2 =0.002,P=0.964).Among the 276 patients who underwent radical gastrectomy,49 (17.8 %) patients had with LNM.The results of univariate analysis showed that tumor size,macroscopic type,differentiation degree,depth of invasion,infiltration pattern,ulceration and lymphovascular invasion were related with LNM(x2=9.327,6.038,6.381,34.983,19.309,52.297 and 5.058;all P<0.05).The results of multivariate analysis revealed that lymphovascular invasion and ulceration were the independent risk factors of LNM (odd ratio (OR)=7.028 and 2.566,both P<0.05).Conclusions There is obvious difference in pathological diagnostic standard of well-differentiated tubular adenocarcinoma between China,Japan and South Korea,which may influence the therapeutic strategy of EGC.Lymphovascular invasion and ulceration are independent risk factors of LNM in EGC.
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Objective To discuss MRI and pathological features of intracranial hemangioblastoma.Methods MRIdata of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively.Results There were 22 cases with single lesion and multiple lesions in 4 eases.And a total of 31 lesions located in the posterior cranial fossa,including 14 lesions in right cerebellar hemispheres,9 lesions in left cerebellar hemispheres,2 lesions in cerebellar inferior vermis,4 lesions in medulla oblongata,and 2 lesions in fourth ventricle.Ninteen lesions showed cystic nodular type,1 lesion was cystic type,11 lesions showed parenchymal type or partial parenchyma type.Cystic lesions showed long T1 and long T2 signal,T1WI of solid area showed slightly long T1 and slightly long T2 signal,of which 12 lesions were slightly shorter T1 signal.Solid areas significantly enhanced,cystic area had no enhancement,but cystic wall of 3 cystic nodular lesions were slightly enhanced.DWI of solid areas showed low signal.MRS showed the peak of Cho obviously increased,and the peaks of Cr and NAA obviously decreased or nearly disappeared,and the high peak of lipids and lactate were observed.Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics,MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.
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Objective To discuss MRI and pathological features of intracranial hemangioblastoma.Methods MRIdata of 26 cases of hemangioblastoma confirmed with operation and pathology were analyzed retrospectively.Results There were 22 cases with single lesion and multiple lesions in 4 eases.And a total of 31 lesions located in the posterior cranial fossa,including 14 lesions in right cerebellar hemispheres,9 lesions in left cerebellar hemispheres,2 lesions in cerebellar inferior vermis,4 lesions in medulla oblongata,and 2 lesions in fourth ventricle.Ninteen lesions showed cystic nodular type,1 lesion was cystic type,11 lesions showed parenchymal type or partial parenchyma type.Cystic lesions showed long T1 and long T2 signal,T1WI of solid area showed slightly long T1 and slightly long T2 signal,of which 12 lesions were slightly shorter T1 signal.Solid areas significantly enhanced,cystic area had no enhancement,but cystic wall of 3 cystic nodular lesions were slightly enhanced.DWI of solid areas showed low signal.MRS showed the peak of Cho obviously increased,and the peaks of Cr and NAA obviously decreased or nearly disappeared,and the high peak of lipids and lactate were observed.Conclusion The conventional and functional MRI of intracranial hemangioblastoma have some characteristics,MRI has a great value in the diagnosis and localization of intracranial hemangioblastoma.
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Objective To explore the application value of paraffin embedding cell blocks from hydrothorax and ascite in diagnosis of tumors in the chest.Methods Of all clinical inspection for hydrothorax samples of thin-layer cytology,suspicious made paraffin embedding sediments of the tumor cells,immunohistochemical staining,identified the benign and malignant cells,determined the types of tumor cells and tissue origin.Results For liquid thin-layer cytology diagnosis of heterocyst,suspicious cases of malignant tumor,69 cases made the cell block combined with immunohistochemical staining,determined the malignant 51 cases,17 cases were benign,difficult to diagnose in 1 case,malignant determined the source of 46 cases,adenocarcinoma did not determine the source of 6 cases.Conclusion The technique of the embedding of paraffin embedding cells is of great value to the organization of the malignant and malignant tumors of the cells from hydrothorax and ascite.
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Objective To investigate the possible pathway of FITC-dextran to the cochlea after post-aural injection.Methods The FITC-dextran(weight between 3 000~5 000) was chosen as a tracer in this study.A total of 200 suckling mice were randomly divided into four groups, with 50 in each group.Each animal was then administered with FITC-dextran or dextran via either post-auricular or intra-muscular injection, to a total dose of 20 μl (5 mg/ml).Samples were obtained at 0, 1/12, 1/4, 1/2, 1, 3, 5, 7, 12, and 24 hours after adminstmiceion, and the confocal technique was used to observe the distribution of the tracer.Taking into consideration the influence of spontaneous fluorescence, the fluorescence intensity ratio of the experimental and control groups was used as the final statistical data.Results FITC-dextran injected intramuscularly group: The fluorescence signal can be detected in the sigmoid sinus(SS) 3h after management, while in endolymphatic sac and cochlea at 12 h.FITC-dextran injected post-aurally group: After administration, an obvious fluorescence signal could be observed in the sigmoid sinus and endolymphatic sac immediately, cochlea at 30 min.The signal of the sigmoid sinus, endolymphatic sac and cochlea gradually increased successively, peaked at 5~15 min, 30 min and 60 min, and then decreased gradually.At 12 h, another small increases appeared, and the signal could not be detected at 24 h.Conclusion Compared with intramuscularly application, post-auricular injection can allow the drug to directly reach the endolymph.It is possible that the tracer first gathered in the SS via local blood circulation or infiltration, then entered the ES via micro-circulation around, and eventually arrived at the cochlea.
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Purpose Central nervous system (CNS) hemangiopericytoma (HPC) is rare in clinic and prone to misdiagnosis. This paper aims to improve the diagnostic accuracy of CNS HPC by analyzing the MRI and CT features. Materials and Methods CT and MRI appearances and pathologic features of 14 cases with surgery and pathology proved CNS HPC were analyzed retrospectively. Results There were intracranial and intraspinal lesions in 12 and 2 cases respectively. 5 cases were lobular, 4 cases irregular, and 5 cases were round or oval in shapes. On CT scan, 2 intracranial lesions showed slight hyperdensity and were avidly enhanced following contrast injection. On T1WI, 11 cases showed isointensity compared with brain white matter;on T2WI, 10 cases showed isointensity compared with brain gray matter. Marked heterogeneous enhancement was shown in 7 cases. Necrosis and cystic changes were seen in 6 cases. Flow-void sign was seen in 9 cases;9 cases were attached to meninges through narrow base. Dural tail sign was observed in 4 cases. Bone erosion was seen in 4 cases. In 5 cases with DWI scan, isointensity was shown in 4 cases and slight hyperintensity in 1 case. The density and signals in 2 cervical spine lesions were uniform with homogenous enhancement;expansive bone swelling in 1 case. Conclusion CNS HPC shows hyperdensity on CT. They present equal signal compared with white matter on T1WI and equal signal compared with grey matter on T2WI, with some void signal of vessel, and isointense on diffusion weighted images. Tumor invades adjacent skull with rare dural tail sign.
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OBJECTIVE@#To compare the vertigo controlling situation between the endolymphatic sac decompression(ELSD) and semicircular canal occlusion (SCO) in stage 4 Ménière disease.@*METHOD@#Fourteen patients who underwent endolymphatic sac decompression and 9 patients who underwent semicircular canal occlusion from 2009 to 2013 were followed. All patients has complete preoperative examination and postoperative follow-up.@*RESULT@#The vetigo control of the patients underwent endolymphatic sac decompression: completely control 35.7%; basic control 28.6%; partly control 14.3%; the vetigo control of the patients underwent semicircular canal occlusion: completely control 88.9%; basic control 11.1%.@*CONCLUSION@#ELSD and SCO are alternative methods for the patients of stage 4. SCO has a much highter complete vertigo control rate. For the patients without practical listening, SCO is a better choice.
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Humans , Endolymphatic Sac , General Surgery , Meniere Disease , General Surgery , Otologic Surgical Procedures , Methods , Semicircular Canals , General Surgery , Vertigo , General SurgeryABSTRACT
Objective To investigate CT appearances of abdominal primary malignant fibrous histiocytoma(MFH).Methods The CT characteristics,clinical features and pathological data of 1 7 patients with MFH proved pathologically were analyzed retrospectively. Results The lesions located in retroperitoneum were 6,in liver were 5,in kidney were 2,in superior mesentery was 1,in greater omentum was 1,in stomach was 1,in ileum was 1.The lesions are oval shape,lobulated,nodule shape,and the size of these lesions were large. 2 cases of MFH located in gastrointestinal tract were slightly low density,and the remaining were uneven high density due to necro-sis.In CT contrast enhanced scan,the solid portion and internal divisions showed progressive or continuous enhancement,and the nec-rosis were not enhanced in MFH located in the retroperitoneum,the greater omentum,the superior mesentery and the liver.MFH in kidney was poorly circumscribed and showed mild progressive enhancement lower than normal renal parenchyma.The stomach and ileum lesions showed uniform and continuous enhancement with normal gastrointestinal mucosa in corresponding parts.Conclusion Imaging features of retroperitoneal MFH were the same as those of interstitial tumors,and most tumors showed features of progres-sive and persistent enhancement,but have different imaging appearances with the malignant lesions in corresponding parts.
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OBJECTIVE@#To investigate the effecacy of cochlear implantation (CI) improving hearing of Lermoyez's syndrome, we retrospectively analyzed a case of Lermoyez's syndrome whose left ear was extremely severe sensorineural deafness and right ear was severe sensorineural deafness.@*METHOD@#The patient had completed preoperative audiological examination , vestibular function and imaging examination, then was carried out bilateral endolymphatic sac decompression and left side CI. Follow up after the surgery.@*RESULT@#The vertigo could be controlled very well after the bilateral endolymphatic sac decompression surgery, but the hearing loss couldn't be control, so CI was carried out to improve hearing and speech recognition rate. The contralateral hearing also improved significantly after the operation.@*CONCLUSION@#Endolymphatic sac decompression can effectively control. Ménière's disease in patients with vertigo attacks. CI can improve patients' hearing, and speech recognition rate and, also could improve the quality of life. CI was the first choice for the patient of 4 stage Ménière's disease.
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Humans , Cochlear Implantation , Deafness , Decompression, Surgical , Ear, Inner , Endolymphatic Sac , Hearing , Hearing Loss , Hearing Loss, Sensorineural , Meniere Disease , Therapeutics , Quality of Life , Retrospective Studies , VertigoABSTRACT
Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.
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Objectives To study the value of CT and MRI in diagnosing focal nodular hyperplasia (FNH).Methods The CT and MRI findings of 16 patients with FNH confirmed histopathologically were analyzed retrospectively.Both plain and dynamic enhanced CT scannings were performed in all the patients.Plain and dynamic enhanced MRI were carried out in 9 patients.Results (1) There were 16 patients with 19 lesions,and 8 lesions were in the left lobe,5 lesions in the right lobe,4 lesions between the left/right lobes and 2 lesions in the caudate lobe.The morphology of the lesions showed 15 lesions to have clear boundaries and 4 lesions to have fuzzy boundaries.The tumor diameters varied from 2.2 to 9.6 cm,(average 4.3 cm).(2) Sixteen patients underwent CT examination.On plain CT,the lesions were isotonic (n= 5),or slightly low-density (n=11).In 7 lesions,there was a slit-like,stellate-shaped low density central scar.Nine patients underwent MRI examination.On T2WI,6 lesions showed slightly higher signal while the remaining 3 lesions showed iso-signal.On T1WI,4 lesions showed slightly lower signal,3 lesions showed iso-signal and 2 lesions showed slightly higher signal while in 1 lesion the local signal showed reduction in anti-phase 1.A central scar was seen in 6 lesions which showed high signal on T2WI,and low signal on T1WI.(3) Enhanced CT: 15 lesions were significantly enhanced and 1 lesion showed mild enhancement at the arterial phase.For the patients with mild enhancement,the scar in the center of the lesion showed no enhancement.In all lesions,the central scar did not enhance.In 5 lesions,enhancements of thickened and torturous arteries were seen.In all the lesions with enhancement,the enhancement was reduced at the portal venous phase,with 12 lesions showing slightly higher density,3 lesions isodensity and 1 lesion low-density.Three lesions showed mild enhancement of the central scar.All the substantial parts of the lesions with enhancement declined at the delay phase,with 3 lesions showing slightly higher density,9 lesions of isodensity and 4 lesions slightly low density.In 7 lesions with central scar delayed enhancement,they showed slightly higher density.Nine patients underwent MRI enhancement and the enhancement characteristics were similar to CT,but the arterial phase magnitude was higher than that of CT.In 4 lesions,the central scar began to enhance at the portal venous phase,while 6 lesions continued to enhance,thus showing slightly higher signal at the delay phase.In a large lesion,there was persistent delayed enhancement in the capsule.(4) On DWI,6 lesions showed inhomogeneous,slightly hyperintensity with the center showing a slit-like low signal area.Three lesions showed iso-signal.The ADC values of the lesions were (1.31±0.08)× 10-3 mm2/s,and the normal liver parenchyma were (1.22± 0.14)× 10-3 mm2/s,(difference not statistically significant).Conclusions CT and MRI using plain and dynamic enhanced scans could show fully and accurately the pathological features and the characteristics of blood supply of FNH.The characteristic signs on both CT and MRI make an accurate diagnosis of FNH.MRI when compared with CT was slightly better.A combined use of both CT and MRI has an important value in the diagnosis of FNH.
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OBJECTIVE To analyze 1000 Hz probe tone tympanometry of middle ear with different volume of fluid, and to evaluate the role of 1000 Hz probe tone tympanometry in the diagnosis of presence of fluid in tympanic cavity. METHODS Tympanometries with 1000 Hz or 226 Hz probe tone were obtained from all the guinea pigs with different volume of fluid in tympanic cavity using GSI33 analyzer and tympanometry curves were analyzed. RESULTS There was a significant difference of the peak pressure of 1000 Hz tympanometry among all test groups and control group. The peak pressure decreased with the increasing of fluid volume in tympanic cavity. CONCLUSION Tympanometry with 1000 Hz probe tone can be used in the diagnosis of fluid in tympanic cavity, and it can be an indicator of volume of fluid in tympanic cavity.
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OBJECTIVE To study the effect of laryngopharyngeal and gastroesophageal reflux on the development of the laryngeal precancerous lesion and cancer.METHODS Twelve patients with vocal fold precancerous lesions and one patient with laryngeal cancer proved pathologically underwent 24-hour dual probe pH monitoring.All patients had been operated on and follow-up.RESULTS Seven of 13 patients(53.85%)showed positive pH monitoring in laryngopharynx,8 of 13(61.53%)patients showed positive pH monitoring in esophagus.Positive pH monitoring in both sites was found in 6 patients(46.15%).Among 7 patients with laryngopharyngeal reflux and 8 patients with gastroesophageal reflux,positive RSI was found in 5 cases and positive RFS was found in 6 cases.CONCLUSION The laryngopharyngeal reflux may be a risk factor in the development of the laryngeal precancerous lesion laryngeal cancer.
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Objective To explore the value of brainstem auditory evoked potentials (BAEP) in the evaluation of spastic cerebral palsy (CP). Methods Forty five cases of CP children were recruited and divided, according to the diagnosis standards, into three groups: diplegia, hemiplegia and tetraplegia groups. Twenty three healthy children served as control. BAEP was recorded from all the subjects and comparisons were done among the various groups. Results The abnormality rate of BAEP in the hemiplegia and tetraplegia groups was significantly higher than that in the diplegia group ( P
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<p><b>BACKGROUND</b>To study the relationship between the expression of E-cadherin and MVD in lung cancer and its significance.</p><p><b>METHODS</b>The expressions of E-cadherin and factor VIII were detected in 104 lung cancer tissues by immunohistochemical method, and MVD was calculated by image analysis system.</p><p><b>RESULTS</b>The expression of E-cadherin was significantly related to the differentiation of lung cancer (P < 0.05). A negative correlation was observed between E-cadherin expression and MVD in lung cancer tissues (P= 0.047).</p><p><b>CONCLUSIONS</b>Downexpression of E-cadherin and increase of MVD may play an important role in the invasion and metastasis of lung cancer, and may also be used as a useful marker for tumor prognosis.</p>
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<p><b>BACKGROUND</b>To determine the expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in lung cancer specimens, and to find out the possible roles of MMPs and TIMPs in the infiltration and metastasis of lung cancer.</p><p><b>METHODS</b>The expression of MMP-1, MMP-2, MMP-9, MMP-13, TIMP-1, TIMP-2 were detected in 104 lung cancer tissues by immunohistochemical method.</p><p><b>RESULTS</b>The expressions of MMPs and TIMPs were up-regulated in lung cancer tissues. The expression of MMP-2 was related to differentiated degree of tumor cells. MMP-9 correlated with lymph node metastasis of lung cancer. The positive rate of TIMP-1 was related to TNM stage and lymph node metastasis. In lung cancer tissues, there was positive correlation between MMP-2 and TIMP-2, and between MMP-9 and TIMP-2.</p><p><b>CONCLUSIONS</b>MMPs and TIMPs may play the important roles in the development of lung cancer. MMP-9 and TIMP-1 might promote the infiltration and metastasis of lung cancer.</p>
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0.05).Conclusion The maximal slow-phase velocity induced by bithermal caloric test failed to decline with aging,implying that the functions of the horizontal semicircular didn't decline with aging.
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Objective The application value of CTA for BA in interventional theray of lung cancer.Methods 15 patients with lung cancers including central type(13 cases)and peripheral type(2 cases) proven by pathology were analyzed prospectively.They were all examined with contrast enhanced.MDCT and the data were sent to the workstation and reconstructed with thin section multi-planar reformation(MPR),maximum intensity projection(MIP)and volume rendering(VR).Results All cases of central type lung cancer were supplied by the bronchial artery including two by the bronchial artery and intercostal artery,clearly demonstrated on the scans with the origin,branches and routes.One case of peripheral lung cancer was supplied by the bronchial artery and the other could not find the definite supplying artery.Conclusions CTA of BA for lung cancer can provide the accurate localization and other reference data for interventional therapy.