Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) is the least common type of gallbladder carcinoma. Here, the author presents a case of undifferentiated gallbladder carcinoma with OGCs in an 81-year-old male patient. Grossly, the tumor was a 10x7 cm sized, polypoid, lumen-filling mass with extensive hemorrhage and necrosis. Microscopically, the tumor was composed of pleomorphic ovoid to spindle cells admixed with numerous OGCs. There was a minute focus of mucosal dysplasia and carcinoma in situ. Immunohistochemically, the mononuclear cells were positive for cytokeratin, p53 and Ki-67, while the OGCs were negative for these markers but positive for CD68. These findings support an epithelial origin for the ovoid to spindle cells and the nonneoplastic reactive histiocytic lineage of the OGCs.
Aged, 80 and over ; Carcinoma ; Carcinoma in Situ ; Gallbladder* ; Giant Cells* ; Hemorrhage ; Humans ; Keratins ; Male ; Necrosis ; Osteoclasts

120 cases of nuchal ligament strain were treated with Tuina at the nape, tapping Dazhui (GV 14) with plum-blossom needle, and cupping Dazhui(GV 14). Clinical observation was made after 14-day treatments. Eighty-seven cases got cure, 28 cases improvement and 5 cases failure; the total effective rate was 95.8%.

Objective To explore the clinical effect of local prophylactic application of methotrexate(MTX) in laparoscopic linear salpingostomy. Methods The data of 102 women with confirmed unruptured tubal pregnancy and desire to conceive were collected.They were divided into two groups: the study group(local application of MTX in the operation,n=51) and the control group(without application of MTX,n=51).The demographic data,the incidence of persistent ectopic pregnancy(PEP)postoperation,and the hysterosalpingography(HSG) 3 months(postoperation) were analysed,and the side effects of the study group were observed. Results There was 1 case of PEP in the study group and 9 cases in the control group(2.0% vs 17.6%,P0.05).There were no obvious side effects such as nausea,vomit and dental ulcer in the study group. Conclusion Patients who were treated with local MTX injection during the laparoscopic linear salpingostomy present less incidence of PEP with no obvious side effects.

Objective: To analyze the correlation of carotid artery color Doppler flow imaging (CDFI) indices and transcranial Doppler ultrasound (TCD) indices. Methods: The clinical data of 118 hospitalized patients with ischemic cerebrovascular diseases were included in the present study and all of them received CDFI and TCD examination. The patients were divided into two groups according to presence of carotid plaque group; t-test was used to identify the correlation between the presence of carotid plaque and TCD indices. Meanwhile, the patients were also divided into three groups according to the quantity/distribution of plaque) one-way ANOVA(F-test) and student-Newman-Keuls were used to identify the correlation of the quantity/distribution of plaque with TCD indices. The patients with carotid plaque were divided into three groups according to the plaque texture) one-way ANOVA(F-test) and student-Newman-Keuls were used to identify the correlation of the quality of plaque with TCD indices. Meanwhile, linear correlation was used to identify the correlation of the common carotid intimal-medial thickness (CCA IMT) with TCD indices. Results: The resistance index (RI), pulsatile index (PI) and ratio of peak systolic to least diastolic flow velocity (S/D) of bilateral middle cerebral arteries and basal artery in patients with carotid plaque were significantly higher than those in patients without carotid plaque (P<0.05); other TCD indices including Vp, Vd, and Vm were not significantly different. The quantity/distribution of plaque, the quality of plaque and CCA IMT were not correlated with TCD indices. Conclusion: No CDFI indices, except for the presence of carotid plaque, are correlated with TCD indices. Combined application of CDFI and TCD indices can better reflect the structure and hemodynamic status of cerebral vessels.

The usefulness of two-dimensional echocardiography to measure the right ventricular volume was assessed in 58 normal children (mean age 5 years and 3 months). From the apical 4-chamber view (A4CV), the subcostal RV sagittal view (SCRVSV), the subcostal right anterior oblique view (SCRAOV), and the subcostal RV coronal view (SCRVCV), the dimensions and areas of the right ventricle were measured. The right ventricular volumes and ejection fractions were calculated from these data by pyramid model and single plane area/length method. We could obtain subcostal right ventricular sagittal view in 98%, apical 4-chamber view in 90%, subcostal right anterior oblique view in 79%, and subcostal right ventricular coronal view in 71% of our children. The areas and dimensions correlated with all growth indices, such as age, height, weight, and body surface area. In general the areas showed higher correlation with body surface area, and dimensions with height. correlations of parameters obtained from the subcostal right anterior oblique view and subcostal right ventricular sagittal view with the growth indices were better than those of the subcostal right ventricular coronal view. The calculated right ventricular volume and ejection fraction showed a great varibility depending on the model used. The right ventricular volume calculated by pyramid model correlated better with the growth indices than that by single plane area/length method. the right ventricular volume calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model is the model which showed the best correlation with growth indices. Right ventricular ejection fraction did not change with any growth indices. Among the right ventricular volumes and ejection fractions by single plane area/length method, the volume(59.9+/-29.9 ml/m(2)) and ejection fracton (58.7+/-10.9%) from the subcostal right anterior oblique view were similar to those (51.0+/-17.3ml/m(2), 51.3+/-10.2%) calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model. The subcostal right anterior oblique view reflects three parts of the right ventricle. Its area and dimension are well correlated with growth indices. Also the right ventricular volume and ejection fraction obtained by single plane area/length method using the subcostal right anterior oblique view correlate with the growth indices. Therefore the subcostal right anterior oblique view is the most valuable single view representing the right ventricle.
Body Surface Area ; Child* ; Echocardiography* ; Heart Ventricles ; Humans ; Stroke Volume

No abstract available.
Autopsy* ; Diagnostic Errors*

Three cases of human embryo of Carnegie stage 13 were described. The CR length of these embryos were 3.0-5.3mm. The authors made a reconstruction model using photograph, photocopy and computer. These embryos were characterized externally by 4 limb buds and 4 pairs of branchial arches, and internally closed otic pits, appearance of venous valves, septum primum and foramen primum in the heart, beginning of the right and left lung buds, appearance of lens disk.
Branchial Region ; Embryonic Structures* ; Heart ; Humans* ; Limb Buds ; Lung ; Venous Valves

Tumors of the ceruminous gland are rare. However, careful histologic evaluation and classification are necessary for the proper treatment and ultimate prognosis. We present 5 cases of ceruminous gland tumors. Case l (73/M) and case 2 (52/M) were adenoid cystic carcinoma. They presented with protuding masses in the left external auditory canal for several months. Case 3 (76/M) was a mucoepidermoid carcinoma of auditory canal, who presented with right ear swelling. The mass recurred 3 years after the surgical resection and combined radiation therapy. Case 4 (60/F) and case 5 (2l/F) were ceruminous adenoma, which showed diffuse or focal areas of glandular structures with one-or two-layer of eosinophilic columnar to cuboidal cells and sometimes with myoepithelial cells. These tumors showed non-infil-trative growth pattern and lack of mitosis, and had no capsule.

The cytologic heterogeneity of the tumor cells in gastric signet ring cell carcinoma was studied with 13 surgically early gastric carcinoma specimens by means of histochemical stainings on mucin(periodic acid Schiff-alcian blue at pH 2.5, paradoxical concanavalin A, high iron diamine) and electron microscopy. Of the 13 cases of early gastric cell carcinomas, 6 were mucosal type and 7 were submucosal type. Eleven cases consisted of mixture of gastric and intestinal type signet ring cells and the remaining 2 of the mucosal type were entirely made of gastric type. The colonic goblet cell type was found in 4 of the submucosal type. Within the mucosa the tumor cells showed a layering phenomenon; type A signet ring cells were distributed at the central zone and type B and C at the superficial or deeper zone. Each type of signet ring cell showed variable mucin histochemical stainability of gastric and/or intestinal nature. Above finding strongly suggest that the variable phenotypes of signet ring cells result from a heterogeneity of cytoplasmic mucin as well as different stages of differentiation of signet ring carcinoma cells.

The quality of traditional Chinese medicines (TCMs) has been mainly evaluated based on chemical ingredients, yet recently more attentions have been paid on biological ingredients, especially for pill-based preparations. It is a key approach to establish a fast, accurate and systematic method of biological ingredient analysis for realization of modernization, industrialization and internationalization of TCMs. The biological ingredient analysis of TCM preparations could be abstracted as the identification of multiple species from a biological mixture. The metagenomic approach based on high-throughput-sequencing (HTS) and big-data-mining has been considered as one of the most effective methods for multiple species analysis of a biological mixture, which would also be helpful for the analysis of biological ingredients in TCMs. Simultaneous identification of diverse species, including the prescribed species, adulterants, toxic species, protected species and even the biological impurities introduced through production process, could be achieved by selecting appropriate DNA biomarkers, as well as applying large-scale sequence comparison and data mining. By this approach, it is prospective to offer an evaluation basis for the effectiveness, safety and legality of TCM preparations.
Biological Products ; chemistry ; Data Mining ; High-Throughput Nucleotide Sequencing ; Medicine, Chinese Traditional ; Metagenomics ; methods