Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences最新文献

Frozen section diagnosis rendered in 549 consecutive breast biopsies performed in 5 years in a single pathology laboratory was correlated with the final pathological diagnosis. There were no false positive reports among the 220 (40.1%) biopsies interpreted as benign lesions in paraffin sections. Among 329 (59.9%) malignant biopsies on paraffin sections, 3 cases were interpreted as benign lesions on frozen sections. Three false negatives included 2 ductal carcinoma in situ and one infiltrating ductal carcinoma associated with papillomatosis. The tumors were small and confined to the breast without any evidence of metastasis. There was a very good correspondence between the frozen section diagnosis and the paraffin section diagnosis (K = 0.98). The sensitivity of frozen section diagnosis was 99.1% and the clinical diagnostic specificity was 100%. Our results suggest that frozen section diagnosis is a highly reliable procedure, but small lesions (less than 1 cm in diameter, or non-palpable) should not be subjected to frozen section examination to avoid unnecessary loss of neoplastic tissue during the frozen section. The careful investigation of paraffin-embedded tissue is recommended for small breast lesions in breast conserving lumpectomy.

Primary intracranial yolk sac tumor (Endodermal sinus tumor, YST) is quite rare, and most usually involves the pineal gland. This report concerns a rare case of unknown origin of yolk sac tumor with intracranial and spinal metastases. The 6-year-old boy initially manifested symptoms of acute urinary retension and paraparesis. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an intrathecal tumor spreading below the third lumbar segment, and tumors also appeared in the left temporal area and right cerebellar hemisphere. The pineal region was free of neoplastic involvement and the gonads were normal. The patients underwent operation to remove intracranial and spinal tumors, and postoperative radiotherapy was administered. The histological findings showed metastatic yolk sac tumor. Multiple intracranial and spinal seeding were noticed postoperatively. The patient died of recurrent YST and pneumonia three months after operation. The origin of secondary YST can always be found in specific midline sites. This is a rare case since the primary lesion is unknown.

Raised intraocualr pressure has been suggested to be a contributing factor in NAION occurrence. Thus, there should be a high NAION incidence rate in glaucoma patients when compared with that of the general population. From June 1990 to December 1991, we retrospectively surveyed 180 glaucoma patients to find the incidence of NAION, but no NAION cases were found. We concluded that the increase in intraocular pressure is not a major factor to cause NAION.

Diaphragmatic elevation after cardiac surgery may result in compromized post operative respiratory function, prolonged ventilator use, longer intensive care unit (ICU) stays, poor quality of life and even mortality. 200 patients receiving open-heart surgery during the two years from October 1990 to October 1992 were studied retrospectively. 26 patients developed postoperative diaphragmatic elevation (Group 2). On the other hand, 174 patients did not (Group 1). The mean age of Group 1 (37.3 +/- 20.0 years) was younger than that of Group 2 (57.4 +/- 9.1 years), P < 0.0001. The mean aortic cross-clamp time was 70.1 +/- 38.1 minutes in Group 1. On the other hand, Group 2 had a longer crossclamp time (84.5 +/- 31.3 Minutes), p < 0.03. Our study revealed that the patients who suffered post operative diaphragmatic dysfunction were older and had a longer aortic crossclamp time than the patients who did not.

This study aimed to assess the possibility of a direct effect of betel-nut alkaloids arecoline and arecaidine on cell proliferation and interleukin-6 (IL-6) production by cultured fibroblasts from human normal gingiva, buccal mucosa and oral submucous fibrosis (OSF) buccal mucosa in vitro. Confluent monolayers of fibroblasts were incubated with or without alkaloids in the presence of 10% fetal calf serum for 48 h at 37 degree C in 5% CO2 and air. At the end of the culture period, supernatants were collected and assayed for IL-6 level. The cell proliferation was monitored by determining 5-bromo-2'-deoxy-uridine (BrdU) incorporated into cellular DNA. Except for the fact that arecoline inhibited cell growth at 100 micrograms/ml, arecoline and arecaidine had similar dose-dependent stimulant effects on the proliferation of these three groups fibroblasts. Concentrations of IL-6 in the control culture supernatants were greatest in healthy gingival fibroblasts, followed by normal buccal mucosa and OSF. Also, the presence of fetal calf serum could stimulate IL-6 release. Except for arecoline at the 100 microgram/mg, there were no significant differences in IL-6 levels between treated and control cultures of the same group when the data were expressed with mean +/- S.D.. However, two of six individuals' normal buccal mucosa fibroblasts significantly released less IL-6, and some cases of OSF and healthy gingiva exhibited slightly higher levels of IL-6 when cells were exposed to arecoline or arecaidine in cultures. Such findings suggests that arecoline and arecaidine can enhance cell proliferation and affect fibroblasts to synthesize IL-6. Furthermore, IL-6 may be a contributing molecular factor in the pathological features noted in OSF.