Showing papers by "Peking Union Medical College Hospital published in 1995"

Prevalence of primary Sjögren's syndrome in China.

Abstract: Objective To determine the prevalence rate of primary Sjogren's syndrome (SS) in a community population of 2066 adults in a Beijing suburban village, and 100 inpatients, who were not necessarily admitted for rheumatic diseases. Methods Questionnaire and serological studies of antinuclear antibodies, rheumatoid factor, and anti-SSA, anti-SSB antibodies were done. Possible positive subjects were given eye and oral examinations for objective evidence of xerostomia and keratoconjunctivitis sicca. Results According to the Copenhagen criteria, the prevalence rate of primary Sjogren's syndrome in China was 0.77%, and it was 0.33% by modified San Diego criteria. In 100 inpatients, we found 4 cases of primary Sjogren's syndrome by Copenhagen criteria, and one case by modified San Diego criteria. Conclusion Primary Sjogren's syndrome is not a rare disease in China, but most cases are overlooked or misdiagnosed.

Rheumatic diseases in China

Abstract: To determine the prevalence of rheumatic diseases in Chinese of Han nationality in the north and the south of China, samples of 4,192 adults in Beijing (north) and 5,057 in Shantou (south) area were studied. The same questionnaire was administered to each subject surveyed. Physical examinations were done in all who gave positive answers. For those who gave positive response to certain set of questions, blood antinuclear antibody and rheumatoid factor tests and radiographs of hand and/or sacroiliac joint were done. The prevalence of definite rheumatoid arthritis (RA) was 0.34% in the north (95% confidence interval 0.20-0.51) and 0.32% (0.95% CI 0.16-0.47) in the south and ankylosing spondilitis was noted in 0.26% of both samples (95% confidence interval in the north 0.11-0.42 and in the south 0.14-0.40). Only 3 cases of systemic lupus erythematosus in the north and one in the south were identified. General rheumatic pain was reported more frequently in the north. Lumbar problems were recorded on examinations 5 times more commonly in the north than in the south (men 25.0% vs 5.3%, women 38.0% vs 6.5%) and knee problems 10 times (men 24.0% vs 1.8%, women 36.0% vs 3.4%) more commonly in the north; the difference was greatest in the age of 55-64. A further study in the south is planned to assess the contribution of inter-observer error and/or difference in cultural response to the north/south difference observed in the prevalence of general rheumatic symptoms and back pain. A search for environmental risk factors such as climate, diet, degeneration or overuse would then be indicated to explain these differences.

99Tcm-MIBI mammoscintigraphy of breast masses: early and delayed imaging.

Abstract: Forty patients with breast mass and 10 female controls underwent double-phase (15 min and 3 h) 99Tcm-sestamibi (MIBI) imaging. Another four post-mastectomy patients with suspected metastases underwent total body imaging at 15 min. The 99Tcm-MIBI images of all 10 female controls showed symmetrical homogeneous radioactivity in both breasts. A focal area of increased 99Tcm-MIBI uptake in the breast tumour is considered as positive. Eleven breasts of 10 patients underwent total mastectomies with lymph node dissection, with one patient having bilateral mastectomy. These 11 breast tumours were confirmed to be infiltrating ductal carcinoma. All 11 breast carcinomas had positive early and delayed phase results with the exception of one patient who had only a focal increased uptake in early phase which happened to be the smallest size of carcinoma. Focal areas of positive MIBI uptake in the axillae in 4 of 10 patients were confirmed to be metastatic carcinoma of the breast. One patient with breast carcinoma underwent mastectomy whose 99Tcm-MIBI imaging was negative. Twelve patients undergoing excisional biopsy or lumpectomy of breast resulted in 7 fibroadenomas, 2 papillomas, 1 abscess, 1 granuloma and 1 chronic inflammation. Four of 7 fibroadenomas having hypercellularity histopathologically exhibited a focal MIBI uptake on double-phase imaging. One granulomatous disease had positive early phase but faded on the delayed image. The patients with absence of MIBI uptake included 3 fibroadenomas, 2 papillomas, 1 abscess, 1 chronic inflammation and 17 fibrous hyperplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular responses to graded doses of three catecholamines during lactic and hydrochloric acidosis in dogs

Abstract: We have studied the cardiovascular effects of incremental doses of three catecholamines in dogs subjected to lactic (LAC) and hydrochloric (HCl) acidosis. Fifty-four dogs were allocated randomly to one of three groups: control, LAC and HCl acidosis (n = 18 each group). In the acidotic models, 2 mol litre−1 of lactic acid (4 ml kg−1 h−1 or 2 mol litre−1 of HCl (1 ml kg−1 h−1) was infused i.v. until arterial pH was reduced to 7.00±0.1. Within each group, six dogs received one of three different drugs in logarithmically incremental doses: adrenaline 0.1, 0.2, 0.4, 0.8, 1.6, 3.2 μg kg−1 min−1, noradrenaline 0.1, 0.2, 0.4, 0.8, 1.6, 3.2 μg kg−1 min−1 and dobutamine 5, 10, 20, 40, 80, 160 μg kg−1 min−1 Cardiovascular variables were monitored, with periodic measurements of plasma electrolyte and lactate concentrations. The pH reduction induced by HCl or lactic acid was associated with a statistically significant increase in mean pulmonary arterial pressure (MPAP), prominent especially in the LAC group where MPAP increased from mean 18 (SD 5) to 27 (6) mm Hg. In the acidotic models, the reduction in myocardial responsiveness to adrenaline or noradrenaline was more prominent than that for the control for corresponding doses of drugs. In the LAC group mean cardiac index decreased significantly from 5.2 (1.8) to 2.2 (0.7) litre min−1 m−2 after infusion of adrenaline 3.2 μg kg−1 min−1 and decreased from 5.1 (1.1 to 2.4 (0.9) litre min−1 m−1 after infusion of noradrenaline 3.2 μg kg−1 min−1. In contrast, dobut amine showed dose-dependent increases in cardiac index and heart rate in control, as well as acidotic groups. The acute HCl acidosis induced greater hyperkalaemia than the lactic acidosis. (Br. J. Anaesth. 1995; 74: 583–590)

An epidemiological study of knee osteoarthritis

Abstract: 2,063 adult people of a Beijing suburban village were surveyed for osteoarthritis of the knees. Questionnaire was completed in all. 799 (38.7%) responded to have knee joint pain. 311 with knee joint pain and 212 without knee joint pain were selected randomly for X-ray films of the knees. In the former group, 79 showed osteoarthritic X-ray changes and were thus diagnosed as such, accounting 24.7% of those with knee pain. In the latter group, all were not diagnosed as clinical osteoarthritis, yet 54 (25.5%) showed also X-ray osteoarthritic changes. In both groups the X-ray osteoarthritic changes increased in parallel with increase of age, reaching 78% in those aged 60 and more in the former group and 67% in the latter group. 100 retired cadres were similarly surveyed but all had X-ray films of the knees taken. 51 of 100 responded knee pain, out of whom 49 (95.9%) showed X-ray osteoarthritic changes and were thus diagnosed as such. The overall prevalence rate of osteoarthritis of knee in rural population as judged by the 523 who had taken X-ray films (people with and without knee pain are not entirely proportional) is about 9.6% and that of 100 aged retired cadres is 49%. Those with X-ray knee osteoarthritic changes but without knee pain were not categorized as clinical osteoarthritic cases.

Tc-99m Antimony Sulfate Lymphoscintigraphy to Demonstrate Lymphatic Communication Between the Peritoneal Cavity and the Scrotum

Abstract: Lymphatic complications in the groin from inguinal artery surgery include lymphoceles and lymphocutaneous fistulae. Lymphatic fistula between the peritoneal cavity and the scrotum developed in a patient after excision of a cavernous lymphangioma in the inguinal region. The communication was demonstrated by Tc-99m antimony sulfate lymphoscintigraphy.

Effects of antisense epidermal growth factor and its receptor retroviral expression vectors on cell growth of human pancreatic carcinoma cell line.

Abstract: A 150 bp epidermal growth factor (EGF) cDNA fragment and a 1024 bp epidermal growth factor receptor (EGFR) cDNA fragment were inserted into 5.05 kb pBabe-puro retroviral vectors between BamH I and EcoR I sites in 3'-5' and/or 5'-3' orientation. The vectors were ligated with EGF and EGFR fragments by T-4 Ligase. The recombinant retroviral vectors were then packaged with packaging cell line PA317 through calcium phosphate mediated transfection. The viral supernatant of transfected PA317 cell lines were used to infect the human pancreatic carcinoma cell line PC-7. The resultant transformant cell lines: PC-7/AS-EGF, PC-7/S-EGFR, PC-7/AS-EGFR and PC-7/pBabe were tested for their endogenous EGF and EGFR mRNA expressions, cell growth rate, 3H-TdR incorporation rate, soft agar colony formation and tumorigenicity in nude mice. The results showed that there were noticeable inhibitions of cell growth, 3H-TdR incorporation rate, soft agar colony formation and tumorigenicity in nude mice in PC-7/AS-EGF and PC-7/AS-EGFR transformant cell lines. The endogenous EGF mRNA expression was blocked in PC-7/AS-EGF cell line and the endogenous EGFR mRNA was significantly down-regulated in PC-7/AS-EGFR cell line.

Point mutation of p53 and detection of human papillomavirus DNA in bronchogenic carcinoma

Abstract: The p53 gene has been implicated in the pathogenesis of lung cancer as a tumor suppressor gene. Aberrations of the p53 gene (exon 6-8) was examined in 34 surgical specimens of lung cancer with single-strand-conformation-polymorphism analysis of polymerase chain reaction products. Structural abnormalities of the p53 gene were observed in 30 tumor specimens (88.2%), i.e, in 10 of the 12 specimens with squamous cell carcinoma, 8 of the 10 with adenocarcinoma, all the 3 small cell carcinoma, the only one large cell carcinoma, all the 5 alveolar cell carcinoma and all the 3 adenosquamous carcinoma. The aberrations of the p53 gene were not limited to a particular histological type or clinical stage and were not associated with degree of differentiation or history of heavy smoking. It is suggested that high mutation rate of the p53 gene may participate in the genesis of lung cancer. In this study, multiple primer polymerase chain reaction method was applied to detect the human papillomavirus DNA (HPV DNA) in human lung cancer. Only 4 of these 34 specimens were HPV DNA positive, and they were all of squamous cell carcinoma, 3 of them had p53 mutation.

Characterization of lethal action of near-ultraviolet on retinal pigment epithelial cells in vitro

Abstract: The lethal effect of near ultraviolet (NUV) with low intensity on cultured RPE cells has been investigated. RPE cultures with various cell densities were exposed to NUV (peaking at 365 nm) with or without ambient oxygen in phenol-red-free Dulbecco's PBS containing Ca2+, Mg2+ and glucose (PBS+). The cell viability was determined by dye exclusion and was expressed as cell death ratio (CDR, dead cells/total cells). When RPE cells at 5×103 cells/cm2, a non-contact low density, were irradiated either at a fixed irradiance (900 μW/cm2) with different exposure times (4 to 8h) or vice versa (8 h with irradiance from 430 to 900 μW/cm2), the change of CDR represented a similar linear function. The replotted data from both the time- and the irradiance-dependent curves indicated that the killing of RPE cells is dependent on the total energy dose of NUV. When a single NUV energy (19.44 J/cm2) was used, CDR was RPE cell density dependent. At confluence, NUV at the highest dosage tested (26 J/cm2) did not show any letha...

[Overexpression of C-erbB3 in transitional cell carcinoma of the ovary]

Abstract: Objective To determine the prevalence of C-erbB3 abnormal protein expression in transitional cell carcinoma of the ovary in our hospital and to analyse the correlation between the overexpression of C-erbB3 protein and prognostic parameters of transitional cell carcinoma of the ovary. Methods Thirty-two transitional cell carcinoma of the ovary and 20 normal ovaries were studied for overexpression of C-erbB3 protein by immunohistochemical staining (IHS), using the monoclonal antibody RJT2 on paraffin sections. Results Forty seven percent of 32 samples of transitional cell carcinoma of the ovary showed positive IHS with RJT2, and 39% of 20 normal ovaries showed positive cytoplasmic and membrane staining (P > 0.05). C-erbB3 overexpression did not correlate with age, CA125 levels, histological grade and lymph node metastases, but patients with overexpression of C-erbB3 had a poorer prognosis. Conclusion Overexpression of C-erbB3 is a common event in transitional cell carcinoma of ovary. Further studies are warranted to clarify the role of C-erbB3 in transitional cell carcinoma of the ovary.

The change of gut barrier function and gene expression after surgical stress and parenteral nutrition

Abstract: Surgical stress and parenteral nutrition (PN) may cause gut mucosal atrophy and alter barrier function. Gene expression of growth factors and enzymes in small intestine may change. The effects of alanyl-glutamine dipeptide (Ala-Gln) on gut barrier and the gene expression of insulin-like factor I (IGF-I) and glutaminase in parenteral infusion rats with massive small intestine resection were investigated. Twenty Wistar rats were catheterized with 60% small bowel resectin. They were divided into two groups. Control group (n = 10) received traditional parenteral nutritional solution, and study group (n = 10) received Ala-Gln enriched nutritional solution (3% Ala-Gln). The rats were maintained with their respective diets for 7 days. The rats in the study group maintained serum glutamine concentration (844.0 +/- 13.2uMol: 640.4 +/- 17.2uMol, P < 0.05), mucosal architecture (mucosal thickness 591 +/- 12uM: 486 +/- 8uM, P < 0.05) and villus height (404 +/- 7uM: 303 +/- 5uM, P < 0.05). Bacterial translocation rate decreased in the study group (70%: 20%, P < 0.05). Ileal mucosal IGF-I mRNA and jejunal mucosal glutaminase mRNA in the study group increased twofold and threefold respectively. The results suggest that Ala-Gln may enhance gut growth and improve gut mucosa integrity and barrier function in part by means of stimulating IGF-I and glutaminase expression in surgical stress.

Surgical treatment of familial acromegaly

Abstract: The annual incidence of the acromegaly is three cases per million, and that of the familial acromegaly is even far rarer. The number of familial acromegaly reported in the medical literature of all the world is fewer than 10 cases per year, and up till now none of such a patient has been reported in China. All the three cases of familial acromegaly reported here were from the same family, and showed typical clinical manifestations. They presented the history of acral enlargement, headache, amenorrhoea, elevated serum GH level, enlargement and erosion of pituitary fossa in X-ray and CT scan, and characteristic immunohistochemical findings of GH-secreting pituitary adenoma. All of them underwent successful transsphynoidal total removal of the pituitary adenoma, and recovered well by clinical, endocrine, and pathological criteria. An extended family tree of 65 members excluded consanguinous marriage and suggested that the mode of inheritance was irregular autosomal dominant.

An empirical model of hyperopic shift with corticosteroid modulation and refractive power prediction after photorefractive keratectomy.

Abstract: Data from a selected sample of 158 patients who received excimer laser photorefractive keratectomy (PRK) in our center and obtained a desirable refractive outcome at 6-months were analyzed retrospectively to establish an empirical model of refractive power after PRK. This model, generated by a computer-assisted regression program, is presented as a multivariate non-linear quadratic equation. Since the coefficients of each variable (attempted correction and postoperative days) are statistically significant, the estimated influence of the variables on the postoperative refraction from this regression model is reliable and consistent. Therefore, this model has been used to direct the use of corticosteroids for modulating post-PRK refraction. The predictability of this model has also been corroborated by separate data from 1-year follow up of PRK recipients. The recipients whose refraction at 6 months agree with the calculation from this model have obtained an excellent outcome; while those whose refractive outcome deviates from this model have gotten undesirable results.

Significance of the Detection of Ki-ras Codon 12 Mutation in the Diagnosis and Differential Diagnosis of Pancreatic Carcinoma

Abstract: Ki-ras codon 12 mutation was detected in: (1) surgically resected formalin-fixed and paraffin-embedded specimens from 109 carcinoma cases, including 46 pancreatic, 35 ampullary, 24 extrahepatic bile duct, and 4 gallbladder carcinomas, showing prevalences of 95.7%, 5.7%, 8.3%, and 0%, respectively, by polymerase chain reaction-restriction fragment length polymorphism technique, and 89.1%, 2.9%, 8.3%, and 0%, respectively, by polymerase chain reaction-dot blot method; and (2) 35 consecutive fine-needle aspiration biopsy specimens by polymerase chain reaction-restriction fragment length polymorphism giving a positive rate of 94.7% (18/19) for pancreatic carcinoma and 0% (0/16) in the specimens from nonpancreatic carcinoma tissues or tumors. Our results demonstrate that the strikingly high prevalence of Ki-ras codon 12 mutation of pancreatic carcinoma could be used as an effective means in the diagnosis and differential diagnosis of pancreatic carcinoma.

Excimer laser photorefractive keratectomy for myopia in China. A report of 750 eyes with a 6-month follow-up.

Abstract: A total of 750 six-month follow-up records of myopia treated with excimer laser photorefractive keratectomy (PRK) were analyzed. By 6 months, in group 1 (up to -6.00D, 587 eyes), uncorrected visual acuity was improved to 20/20 or better in 86.7% of treated eyes and 95.4% fell into the range of refraction of +/- 1.00D. In group 2 (-6.25D to -11.00D, 163 eyes), 74.5% of treated eyes had uncorrected visual acuity of 20/20 or better and 89.4% of the eyes were within +/- 1.00D. The designed predictability of the two groups was the same (P > 0.1). The refractive stability from 3 to 6 months between the two groups was not statistically different, and no severe complications were observed in these two groups. The excimer laser PRK for correcting myopia up to -11.00D appears to be effective, predictable, stable and safe in this study. The ideal outcome may result from the precise ablation quality of excimer laser, its computerized surgical manipulation and an appropriate postoperative management including detection of refractive indices by corneal topography and modulation by steroid.

Screening for gestational diabetes with capillary blood glucose

Abstract: Two hundred and twenty 3rd trimester pregnant women were randomly selected to perform 50 g oral glucose tolerance screening test. Simultaneously, both capillary and venous blood samples were obtained one hour after the glucose load. A high correlation between capillary and venous glucose levels was found (r = 0.87, P or = 7.8 mmol/L, 11 were diagnosed as gestational diabetes mellitus (GDM). All of these 11 patients had capillary glucose > or = 9.1 mmol/L. This results suggest that the capillary blood glucose test may be feasible for screening of gestational diabetes.

Lactulose hydrogen breath test in small intestinal bacterial overgrowth

Abstract: Lactulose hydrogen breath test (LHBT) was evaluated in 21 patients suspected of having small intestinal bacterial overgrowth syndrome and 10 healthy volunteers as control. After dietary preparation and a 12-hour fast, subjects received 15g of lactulose mixed with 40% barium sulfate. The purpose of the barium meal was to reveal the position of lactulose in the intestines. End-expiratory samples of breath were taken at 15 minutes intervals at least for 4 hours. Breath hydrogen was measured with gas chromatography. A positive LHBT was defined as increase of hydrogen concentration in the breath more than 10 x 10(-6) above the baseline value before barium reached the sixth group of small intestine. Cultures were considered positive for bacterial overgrowth when anaerobic counts > or = 10(6) CFU/ml of aspirate. The procedure was carried out under sterile condition. Compared with the bacteriologic culture, LHBT has a sensitivity of 71.4%, specificity of 88.2% and accuracy of 80.6%. These results show that the LHBT is a simple, non-invasive and relatively reliable method for diagnosis of small intestinal bacterial overgrowth.

Gynandroblastoma of the Ovary Review of Literature and Report of a Case

Abstract: A rare case of gynandroblastoma of the right ovary with a typical morphologic appearance in a 10-year-old girl is reported. Clinically, there were both feminizing and masculinizing symptoms with elevated estradiol and testosterone levels. The pathomorphology, immunohistochemistry, and ultrastructural features of this tumor are described, and the reported cases in the literature are reviewed.

Clinical characteristics of hepatic tuberculosis

Abstract: The clinical characteristics of hepatic tuberculosis in 52 cases diagnosed pathologically were analyzed. Fever, abdominal pain and hepatomegaly were the major clinical manifestations; they were present in 96.2%, 42.3% and 88.5% of the patients respectively. The fever had no consistent pattern and the abdominal pain was usually localized to the right hypochondrium and not related to overwork. Hypergrammaglobulinaemia, elevated alkaline phosphatase level and increased ESR were noted in most of the patients (76.9%, 75.0%, 76.5% respectively). 62.5% of the 52 patients was diagnosed by percutaneous liver biopsy. Since there is no consistent clinical pattern in patients with hepatic tuberculosis, the diagnosis should be considered in patients with unexplained fever associated especially with hepatomegaly or hepatosplenomegaly, elevated alkaline phosphatase level, hypergrammaglobulinaemia and increased ESR, Liver biopsy is the most valuable method to confirm the diagnosis of hepatic tuberculosis.

The role of endoscopic ultrasonography and epidermal growth factor receptor assay in preoperative staging for gastric carcinoma

Abstract: Endoscopic ultrasonography (EUS) was performed in 36 patients with gastric carcinoma and the epidermal growth factor receptor (EGFR) of the specimen from endoscopic biopsy in 19 patients with gastric carcinoma was measured with immunoassay. Results of EUS were compared to the pathology of resected specimens according to the new (1987) TNM classification. EUS was very accurate in assessing the depth of tumor infiltration and the lymph node metastasis. Overall accuracy in T and N stage were 81% and 72% respectively. The level of EGFR in patients with infiltration into the neighbouring organs (97.7 +/- 27.9 fmol/mg pro.) were significantly higher than those without infiltration (47.7 +/- 21.3 fmol/mg pro.) (P < 0.01). The EGFR levels of those with lymph node metastasis (85 +/- 24.3 fmol/mg pro.) were significantly higher than that without lymph node metastasis (37.1 +/- 16.1 fmol/mg pro.) (P < 0.01). The results show that EUS as well as the EGFR assay could be used to determine the progress and prognosis of gastric carcinoma.

[Report of a case of glucagonoma misdiagnosed as "eczema" and "hepatic angioma" for three years and review of literature].

Abstract: Glucagonoma is a rare pancreatic tumor, necrolytic migratory erythema is its distinctive feature and it is often associated with diabetes mellitus, weight loss, anemia, hypoaminoacidemia, glossitis and stomatitis We reported a case of glucagonoma misdiagnosed as "eczema" and "benign hepatic anginoma" for 3 years His blood glucagon level was 1,758 ng/L The results of abdominal B-mode ultrasonography and CT scan were negative, but selected arteriogram showed a tumor mass between the pancreatic body and tail Before operation, treatment with octreotide and supply of amino acids were given with improvement of the skin lesion After resection of the tumor from pancreas, necrolytic migratory erythema disapeared, but his blood level of glucagon and amino acids did not improve It is suggested that any diabetic patient with chronic skin damage should be checked for blood glucagon level In suspected cases, selected arteriogram will be helpful for location of the tumor Vigorous resection of the pancreatic tumor should be done as soon as possible, even though there is already metastases

Analysis of mutations in the androgen receptor gene in complete androgen insensitivity syndrome

Abstract: bjectives:To study the androgen receptor(AR)gene mutations in Chinese patients with complete an-drogen insensitivity syndrome(CAIS ).Design:Genomic DNA in patients with CAIS were extracted from peripheral blood,the exons of AR gene were amplified by the polymerase chain reaction(PCR),mutated exons were screened by the single strand conformation polymorphism(SSCP)and directly sequenced. Patients:Four unrelated individuals with CAIS.Results:Exons two to eight were grossly intact in all study subjects using PCR-agarose electrophoresis, while SSCP revealed that three patients had a different pattern of electrophoresis in exon E and one had a change in exon H comparing to normal control.Sequencing of these four exons confirmed three different point mutations in exon E leading to formation of prematrue stop codon,the other had two nucleotides(A and T)insertion in splicing site of exon H and intron 7resulting in abnormal splicing. Conclusion:The mutations causing CAIS were divergent and complicated.The formation of premature stop codon seemed to be one of the common mechanism of CAIS.The insertion of two nucleotides in splicing site of intron-exon has not been previously identified in the human AR gene in patients with CAIS.

Overexpression of p53 in transitional cell carcinoma of the ovary

Abstract: To determine the prevalence of p53 abnormal protein expression in transitional cell carcinoma of the ovary in Peking Union Medical College hospital, and to analyse the correlation between the overexpression of p53 protein and prognostic parameters of transitional cell carcinoma of the ovary, thirty-two transitional cell carcinoma of the ovary and 20 normal ovaries were analysed. Detection of overexpression of p53 protein was carried out by immunohistochemical staining (IHS) using the monoclonal antibody DO-1 on paraffin sections. 41% of 32 samples of transitional cell carcinoma of the ovary showed positive IHS with DO-1, whereas only 5% of 20 normal ovaries showed weakly positive cytoplasmic staining (P < 0.01). p53 overexpression did not correlate with age, CA125 levels, histological grade and lymph node metastasis, but patients with overexpression of p53 had a poor prognosis. Overexpression of p53 is a more common event in transitional cell carcinoma of the ovary. Further studies are warranted to clarify the role of p53 in transitional cell carcinoma of the ovary.

[Chlamydia pneumoniae infection in patients with pneumonia, bronchitis and acute upper respiratory tract infection in Beijing].

Abstract: A prospective study for C. pneumoniae infection was conducted in 134 patients with acute respiratory disease and 134 matched patients with other medical reasons from January to May 1994 in Beijing. The positive rate of micro-IF (MIF) IgG antibodies was 93% (125/134) and 89% (119/134) respectively (0.1 < P < 0.25) and the geometric mean titers (GMT) were not found to be significant (55.9 +/- 4.2 vs 41.7 +/- 2.8, 0.1 < P < 0.20). Ten patients, four (4/30) with pneumonia and six (6/81) with bronchitis were serologically diagnosed as having recent C. pneumoniae infection. Chronic bronchitis was statistically more frequent in patients with C. pneumoniae infection than those without (0.025 < P < 0.05). Patients with chronic bronchitis (GMT, 87.1 +/- 3.9; n = 36) tended to have higher IgG titers than those without (GMT, 47.6 +/- 4.1; n = 98, 0.02 < P < 0.05). Culture of retro-pharyngeal swab specimens for C. pneumoniae was negative in the all 134 studied patients.

Experiences in clinical diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)

Abstract: Two hundred and three cases of PNH diagnosed (according to the National Unified Diagnosed Criteria, 1987) and treated from 1949 to 1992 in Peking Union Medical Hospital were analyzed retrospectively in an attempt to investigate the factors leading to delayed diagnosis. The presenting manifestation was anemia in 56.7% of the patients. Next was hemorrhage (24.6%). Hemoglobinuria was seen only in 12.8% of the cases at the onset. Ham test was persistently negative in 10.4% of the patients. Only one third of all the cases was correctly diagnosed as PNH within one year after onset. Aplastic anemia or anemia of unknown cause was first diagnosed in 60.1% of cases. The heterogeneity of the manifestations and the lack of sensitive and also specific laboratory tests were the factors leading to delayed diagnosis, but negligence of PNH in differential diagnosis seem to be a major the main cause. Constant awareness of the possibility and careful follow-up accompanied with repeated laboratory examinations in a suspected case are crucial for early diagnosis of PNH.

The transphincteric approach excision of rectal villous adenomas

Abstract: Twenty-four patients with rectal villous adenomas were operated on which posterior transphincteric approach. They had benign villous adenona in (13 patients), villous adenomas showing atypia (2), and villous adenomas developed malignancy (9). All the patients gained excellent results, except one with wounded infection after operation. No patient died at operation. No patient developed rectal fistula and incontinence of feces. The different methods of operation with excised villous adenoma of the rectum were discussed and compared. We conclude that the posterior transsphincteric approach is better than others.