OBJECTIVETo evaluate the missing diagnosis of neck metastases by routine detecting method (palpation combined with one pathological slide) in laryngeal carcinomas.

METHODSSixty-six specimens of neck dissections were collected and observed by routine method, transparent method, and continuous sliding method.

RESULTSTotally, 1153 lymph nodes were detected by palpation method and another 1204 lymph nodes were detected by transparent method. The lymph nodes detected by transparent method account for 51.1% of the total, and among them 10 metastases were found, which account for 15.6% (10/64) of metastatic lymph nodes. For those with no metastasis detected by routine method, 50 microm interval continuous sliding method was performed, and 14 tiny metastases were found, which account for 21.9% (14/64) of metastatic lymph nodes. Detecting by routine method, most lymph nodes (95%) were in tumor growth and tumor suffusion stage. The missing diagnosis rate of routine method was 37.5% (24/64).

CONCLUSIONSWhen routine method was used to detect lymph nodes in neck specimens, missing diagnosis should be considered to select best therapy. Through transparent method small lymph nodes could be found and it is a valuable method to observe pathological changes of small nodes. Continuous sliding method could find micrometastasis precisely, but the work burden is heavy and it is difficult to be widely used.

Carcinoma, Squamous Cell ; secondary ; surgery ; Diagnostic Errors ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Staging ; Specimen Handling ; methods

OBJECTIVETo evaluate the impact of extracapsular lymph node spread (ECS) in the ipsilateral neck on the contralateral neck metastasis and prognosis of laryngeal cancer.

METHODSThe data of 184 laryngeal cancer patients who underwent laryngectomy and simultaneous radical or modified radical neck lymph node dissection between Jan. 1994 and Dec. 1997 were retrospectively analyzed. Of these 184 patients, 144 underwent unilateral neck lymph node dissection and 40 bilateral; 159 had supraglottic lesion and 25 transglottic. All had squamous cell carcinoma. The clinical T stage was T1 in 3, T2 63, T3 77, T4 41; N stage: NO in 123, N1 38, N2a 5, N2b 11, N2c 7. Transparent lymph node detection and continuous sectioning method were applied to all dissected neck lymph nodes. Statistical analysis was carried out using SPSS software package ( version 11.5). Survival curves were calculated through the Kaplan-Meier model. Impact of extracapsular lymph node spread in the ipsilateral neck on prognosis was assessed using the Log rank test.

RESULTSOf these 184 patients, neck lymph node metastasis was pathologically proven in 80, 26 had ECS in the ipsilateral neck with a ECS rate of 32.5% (26/80). The ECS incidence was positively correlated with advanced pathological N stage and metastatic lymph nodes (P < 0.01). The incidence of the contralateral neck metastasis and ipsilateral neck recurrence with ECS were higher than those without ECS, which was 46.2% versus 24.1%, and 34.6% versus 7.4%, respectively (P < 0.05). The 3- and 5-year survival rates of patients with ECS were significantly lower than those of patients without ECS, which was 53.9% versus 70.4%, and 23.1% versus 57.4%, respectively (P = 0.0125).

CONCLUSIONExtracapsular lymph node spread is found to be an important prognostic factor in the laryngeal cancer. Bilateral neck dissection may be mandatory due to patients with ECS have a higher incidence of contralateral neck metastasis. The capsule of metastatic lymph nodes should be pathologically checked and reported in order to determine the extra-capsular spread status.

Adult ; Aged ; Carcinoma, Squamous Cell ; secondary ; surgery ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; secondary ; surgery ; Humans ; Kaplan-Meier Estimate ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; methods ; Lung Neoplasms ; secondary ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; methods ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Retrospective Studies

An investigation on the chemical constituents of the 90% EtOH extract of Perovskia atriplicifolia led to the isolation of fifteen compounds from the EtOAc fraction. Based on the detailed spectral analysis (MS, 1D and 2D NMR), as well as comparison with the literatures, the structures of compounds 1-15 were determined as cirsimaritin (1), salvigenin (2), syringaldehyde (3), vinyl caffeate (4), 2α, 3α-dihydroxyolean-12-en-28-oicacid (5), 2α, 3α-dihydroxyurs-12-en-28-oicacid (6), niga-ichigoside F1 (2α, 3β, 19α, 23- tetrahydroxyurs - 12-en-28-oicacid- O-β-D- glucopyranoside, 7), sericoside (8), 4-epi-niga-ichigoside F1 (2α, 3β, 19α, 24-tetrahydroxyurs-12-en-28-oicacid O-β-D-glucopyranoside, 9), 2α, 3β, 24-trihydroxyolean-12-en-28-oicacid O-β-D-glucopyranosyl-(1 --> 2) - β-D-glucopyranoside (10), pruvuloside A (11), asteryunnanoside A [2α, 3β, 23-trihydroxyolean-12-en-28-oicacid O-β-D-glucopyranosyl-(1 --> 2)-β- D- glucopyranoside,12], rosmarinic acid methyl ester (13), β-sitosterol (14), and daucosterol (15), respectively. Compounds 1-13 were isolated from the Perovskia genus for the first time. All the compounds were obtained from P. atriplicifolia for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Lamiaceae ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo study the prognostic factors of 1018 patients with laryngeal cancer treated surgically.

METHODSAll patients were treated surgically for laryngeal cancer from 1984 to 1996. A total of 16 clinical factors was studied by univariate analysis and Cox multivariate model.

RESULTSThe follow-up rate was 93.5% over 5 years. The overall cumulative survival rate was 79.1% at 3 years, 70.2% at 5 years. The 5-year survival rate of T1N0 is the highest, followed by T1N+, T2N0, T3N0, T4N0, T2N+, T4N+, and T3N+. In univariate analysis, the survival was related to patient age, mobility of vocal cords, preoperative T status, preoperative N status, preoperative UICC stage, postoperative T status, postoperative N status, postoperative UICC stage, topographic location of the tumor and tumor size. In Cox multivariate modal, only postoperative N status, mobility of vocal cords and tumor size were independent prognostic factors.

CONCLUSIONIndependent prognostic factors for patients with laryngeal cancer after curative resection are postoperative N stage, mobility of vocal cords as well as tumor size. Postoperative follow-up and salvage surgery in time should be attached with importance to improve the survival of patients with laryngeal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; mortality ; pathology ; surgery ; Laryngectomy ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Salvage Therapy ; Survival Rate ; Vocal Cords ; physiopathology

OBJECTIVETo evaluate the impact of extracapsular spread (ECS) in ipsilateral neck metastasis on prognosis and its related factors in laryngeal cancer.

METHODSThe study included 184 patients who underwent laryngectomy and simultaneous radical or modified radical neck dissection between January 1994 and December 1997 for laryngeal cancer. All of them had a complete 5-year follow-up. We used transparent lymph node detection and continuous slicing method on all neck dissection specimens. Kaplan-Meier model was used for survival analysis and the log-rank test was used to assess significance.

RESULTSWe found pathological neck metastases in 80 patients. Among them, 26 cases (32.5%) had ECS in ipsilateral neck. ECS incidence increased with advanced pathological N (pN) stages (pN1 3.7%, pN2a 25.0%, pN2b 50.0%, and pN2c 55.6%; P = 0.001). ECS incidence also increased with number of positive nodes (1 positive node 8.6%, 2 positive nodes 33.3%, 3 and more positive nodes 66.7%; P < 0.001). Incidences of contralateral neck metastases and ipsilateral neck recurrence in patients with ECS were higher than those in patients without ECS (46.2% vs. 24.1%, P = 0.046; 34.6% vs. 7.4%, P = 0.002). The 5-year survival rate of patients with ECS was significantly lower than that of patients without ECS (23.1% vs. 57.4%, P = 0.013).

CONCLUSIONECS is an important prognostic factor in laryngeal cancer. Patients with ECS have a higher incidence of contralateral neck metastasis, so bilateral neck dissection should be selected.

Adult ; Aged ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Neck ; Neck Dissection ; Prognosis ; Survival Analysis

OBJECTIVEThe purpose of this study was to determine the effects of local delivery of vascular endothelial growth factor( VEGF) transferred with adenovirus-mediated gene on the survival of ischemic random skin flap in rats.

METHODSThe animals were divided into three groups randomly (n = 10) . A 2 cm x 8 cm dorsal skin flap was designed with the pedicle at the level of the iliac crest. In group A (AdCMV-VEGF), each animal received 10(12) PR replication-deficient recombinant adenovirus (AdCMV-VEGF) in the distal two-thirds of the proposed flap by means of the subdermal injection at ten different locations. In group B (AdCMV-GaI), each received 1012 PR AdCMV-Gal. In Group C (Saline), each received 1 ml saline. Three days after the treatment, the flap was elevated as planed way and re-sutured back to its donor site. All the animals were evaluated 7 days after the operation.

RESULTSThe mean percentage of surviving flap area was (85.91 +/- 2.54)% in group A, (59.56 +/- l.18)% in group B, and (61.48 +/- l.09)% in group C. There was a significant increase in the percentage of the survival area in the flaps of the group A, compared with the group B and group C (Group B vs. Group A, P < 0.01; Group C vs.Group A, P < 0.01, Group B vs. Group C, P >0.05). Hybridization in the situ, the immunohistochemical stain showed that the VEGF was expressed in the survival tissue of the flap treated with the AdCMV-VEGF, but it was not found in the control groups. Histological analysis demonstrated qualitatively greater amount of granulation tissue and angiogenesis was found in the group treated with the AdCMV-VEGF than the controls.

CONCLUSIONSThe results may indicate that Ad vector carrying VEGF cDNA could be useful in enhancing the survival of the skin flap due to the effect of the local delivery of the VEGF.

Adenoviridae ; genetics ; Animals ; DNA, Complementary ; Genetic Therapy ; Genetic Vectors ; Graft Survival ; Humans ; Male ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; genetics ; Surgical Flaps ; Vascular Endothelial Growth Factor A ; genetics

Adult ; Anemia, Aplastic ; drug therapy ; Antilymphocyte Serum ; administration & dosage ; Bone Marrow Transplantation ; Cyclosporins ; administration & dosage ; Drug Therapy, Combination ; Dyskeratosis Congenita ; complications ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppressive Agents ; administration & dosage ; Male

BACKGROUNDNucleophosmin plays a critical role in embryonic development. This study aimed to examine the expression pattern of nucleophosmin in glandular epithelium of human endometrium during the menstrual cycle.

METHODSEndometrial tissues used for this study were obtained from 46 non-pregnant patients who underwent hysterectomy which had been performed to treat benign diseases. Nucleophosmin expression was assessed by in situ hybridization and immunohistochemistry.

RESULTSAt the early-, mid- and late-proliferative phase, nucleophosmin mRNA was highly expressed in glandular epithelium of human endometrium. At the secretory phase, the expression of nucleophosmin mRNA was reduced in glandular epithelium in early-secretory phase, and the expression in mid- and late-secretory phases was not detected. Similarly, nucleophosmin protein was strongly expressed in endometrial glands throughout the proliferative phase, but was gradually reduced during secretory phase.

CONCLUSIONNucleophosmin mRNA and protein are expressed in glandular epithelium of human endometrium throughout the menstrual cycle.

Adult ; Endometrium ; metabolism ; Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; In Vitro Techniques ; Menstrual Cycle ; genetics ; metabolism ; Middle Aged ; Nuclear Proteins ; genetics ; metabolism

Repeated acute intermittent hypoxia promotes the expression of growth factors and neurotrophic factors, as well as the key molecules for neural protection and plasticity. Hypoxic preconditioning may improve the survival rate of transplant-ed stem cells and protect the neural function. Meanwhile, acute intermittent hypoxia can be an approach to improve re-spiratory function after spinal cord injury. Hyperbaric oxygen may improve the neural tolerance to hypoxia and isch-emia, to protect the structure of cells and tissues, and promote the neuranagenesis. It is important to study the role of hy-poxic and hyperoxic preconditioning in spinal cord injury.

Objective To identify the clinical characteristics and prognostic factors of young patients with sporadic rectal cancer liver metastasis(RCLM).Methods The clinical data of young RCLM patients at 45 years or under(n=40,as younger patient group)in Peking University First Hospital from January 2016 to January 2021 were reviewed,meanwhile,elder RCLM patient group were comprised of 82 patients older than 45-year-old in a 1:2 ratio.Proportions of categorical variables were compared between young patients and old patients.The clinicopathologic parameters were analyzed with univariate and multivariate Cox regression models and Kaplan-Meier method for demonstrating survival differences between the maximum diameter of liver metastasis and local therapy.Results One hundred and twenty-two RCLM patients were identified,the 1-,3-and 5-year survival rates of young patient group were 97.5%,47.5%,15.0%,those of elder patient group were 84.1%,26.8%,9.8%,respectively.The differences in BMI(P=0.008),primary tumor with obstruction and bleeding(P=0.006),synchronous rectal cancer liver metastases(P=0.005),the maximum diameter of liver metastasis>3 cm(P=0.019)were statistically significant between the two groups.And univariate and multivariate analyses showed that age(P=0.003),N stage(P=0.007),local therapy for liver metastases(P=0.047)and the maximum diameter of liver metastasis(P=0.030)were independent risk factors for influencing the prognosis of RCLM patients;curative resection or not of primary tumor(P=0.035)and the maximum diameter of liver metastasis(P=0.041)were independent risk factors for influencing the prognosis of young RCLM patients.Kaplan-Maier curve demonstrated survival differences between the maximum diameter of liver metastasis and local therapy for liver metastasis in RCLM patients(log-rank P=0.000).Conclusions Although with later staging of initial tumor station,young RCLM patients may obtain better survival benefit compared with old patients.Higher degree of lymph node metastasis,local therapy for liver metastases and the maximum diameter of liver metastasis>3 cm indicates poor prognosis in RCLM patients,and without curative resection of primary tumor and maximum diameter of liver metastasis are also considered as the independent poor prognostic factors of young RCLM patients.Local therapy for liver metastases appears to play an important role in the treatment strategy of RCLM patients.