卵巢子宫内膜异位症恶性变25例临床分析

目的 探讨卵巢子宫内膜异位症恶性变的临床表现、病理特征、治疗方法和预后。方法 回顾性分析２５例卵巢子宫内膜异位症恶性变患者和病量资料。结果 卵巢子宫内膜异位症恶性变患者的主要症状为盆腔包块、腹胀、腹痛、异常阴道流血和流液。病理类型为子宫内膜样癌１４例,透明细胞癌２例,腺棘癌２例,浆液性腺癌１例,混合性卵巢上皮性癌６例,镜下均可见良性的异位子宫内膜向恶性移行的证据。临床分期为Ⅰ１４例,Ⅱ期７例,Ⅲ期３例,Ⅳ期１例。治疗方法均采用肿瘤细胞减灭术＋化学治疗。患者５年生存率达７７．７％。结论 卵巢子宫内膜异位症恶性变的确切发生率难以估计,该病的治疗以肿瘤细胞减灭术＋化学治疗为主。     

Effect of lubrication of frictional properties of sutures

The results of this study have provided an insight into the behavior of sutures in the environment of fluids. It has been shown that friction could both increase or decrease with lubrication, depending upon the nature of the application. In tests on straight sutures, lubricants have generally led to an increase in friction. This was found in the present investigation as well as in another study which measured friction in sutures soaked in serum. These results are explained on the basis that higher friction is expected to arise if the lubricant formed a multilayer film between the sliding surfaces. In this instance, the resistance to shear flow by the lubricant becomes the governing factor. On the other hand, if only a small amount of lubricant, such as a monolayer film, is present between surfaces, as expected within the structure of a snugged surgical knot, the lubricant may play the role of decreasing adhesion and, thus, friction.     

Cytologic findings of aspiration of tumors of the breast

Fine needle aspiration biopsy for cytologic diagnosis has been shown to be an effective adjunct to the clinical evaluation of masses of the breast by physical examination and mammography. In addition to adequately decompressing cystic masses, the procedure has been beneficial in obtaining a pathologic interpretation of any mass that is to be observed. Preoperative knowledge of the malignant nature of a mass of the breast allows the physician to investigate more selectively the possibility of metastatic disease and to consider more intelligently treatment options. Furthermore, the psychologic agony of the unknown for the patient and her family is avoided. Although histologic confirmation is always recommended before proceeding with mastectomy, a positive cytologic diagnosis can suffice when clinically advanced carcinoma is present or when there are medical contraindications to surgical treatment. Because of the false-negative rate of aspiration cytologic diagnosis, all clinically malignant or suspicious masses should have a biopsy in the face of benign cytology. This point cannot be over emphasized and is particularly pertinent to those patients in whom high risk factors of carcinoma of the breast are present. Inconclusive aspirates should be repeated or a biopsy of the mass should be done.