[Endoscopic CO2 laser treatment for the decannulation difficulty after vertical laryngectomy]

Sixteen patients with the decannulation difficulty after vertical laryngectomy were treated by endoscopic CO2 laser. The rate of decannulation was 87.5% (14/16). The curative effect was stable after 1-3 years. The causes of the decannulation difficulty included the over growth of granulation tissue, scar formation and bulky of the muscle flap. The result showed that endoscopic CO2 laser is an effective modality in the treatment of the decannulation difficulty after vertical laryngectomy.

Intergenerational relations in urban China: proximity, contact, and help to parents

Although most older Chinese parents live with an adult son or daughter, most adult offspring do not live with parents. We examine the relations of these noncoresident offspring with parents in terms of proximity, frequency of contact, and exchange of help. Based on a 1993 random sample survey conducted in two major Chinese cities, we find that although rates of coresidence are high, noncoresident sons and daughters live close to parents, have frequent contact with their parents, and provide regular help to parents. Relationships with noncoresident sons and daughters are unaffected by whether parents coreside with another child. There is some evidence of closer relationships with sons than with daughters, but parents without a son receive as much help from all children as do parents with sons. The effects of these and other predictors are estimated in multivariate analyses, and results are interpreted in terms of the persistence or change of traditional family norms.

Molecularly cloned mammalian glucosamine-6-phosphate deaminase localizes to transporting epithelium and lacks oscillin activity

Glucosamine-6-phosphate deaminase (GNPDA) catalyzes the conversion of glucosamine-6-phosphate to fructose-6-phosphate, a reaction that under physiological conditions proceeds to the formation of fructose-6-phosphate. Though first identified in mammalian tissues in 1956, the enzyme has not previously been molecularly characterized in mammalian tissues, although a bacterial GNPDA has been cloned. Recently, a protein displaying similarity to bacterial GNPDA was purified and cloned from sperm extract. It was proposed that this protein was the factor, found in sperm extracts, that causes calcium oscillations in cells; thus, the protein was named 'oscillin.' We demonstrate that oscillin is the mammalian form of glucosamine 6-phosphate deaminase by showing that cloned oscillin has a robust GNPDA activity and can account for all such activity in mammalian tissues extracts. In situ hybridization and immunohistochemistry localize GNPDA selectively to tissues with high energy requirements such as the apical zone of transporting epithelia in the proximal convoluted tubules of the kidney and the small intestine; to neurons (but not glia) and especially to nerve terminals in the brain; and to motile sperm. Recombinant GNPDA and GNPDA purified to homogeneity from hamster sperm fail to elevate intracellular calcium when injected into mouse eggs over a wide range of concentrations under conditions in which sperm extracts elicit pronounced calcium oscillations. Thus, the calcium-releasing or oscillin activity of sperm extracts is due to a substance other than GNPDA. Since GNPDA is the sole enzyme linking hexosamine systems with glycolytic pathways, we propose that it provides a source of energy in the form of phosphosugar derived from the catabolism of hexosamines found in glycoproteins, glycolipids, and sialic acid-containing macromolecules. Evidence that GNPDA can regulate hexosamine stores comes from our observation that transfection of GNPDA into HEK-293 cells reduces cellular levels of sialic acid.

[The cellular immunologic status of the laryngeal cancer patients]

To observe the cellular immunologic status of the laryngeal cancer patients 70 laryngeal cancer patients were examined with immunohistochemical method. The peripheral blood T lymphocyte subsets were detected and local tumor infiltrative T lymphocytes were observed. The results showed that the cellular immunologic function of laryngeal cancer patients was lower than that of the healthy persons and the function of late staged patients was lower than that of the early staged patients. The pattern of changes of these two observations was of the same trend. The clinical significance of the examinations was discussed.

[Scanning electron microscopic observation of the three-dimensional structure of laryngeal carcinoma using freeze-cracking method]

OBJECTIVE

To investigate the relation between the morphology and the biological characteristics of laryngeal carcinoma.

METHODS

The freeze-cracking method was used to examine 126 specimens of the larynx under scanning electron microscope (SEM). The specimens were obtained from 12 patients suffering from laryngeal cancer and 4 patients with normal larynx.

RESULTS

(1) In the normal larynx, the squamous-cell epithelium showed marked keratinization and the intracellular bridges were clear and regular. (2) In areas adjacent to cancer, the structure of the squamous-cell epithlium could be identified, but the cells were deranged and paramorphic. (3) There were two types in the marginal area of the carcinoma. Along the areas adjacent to cancer, infiltrating lymphocytes were usually observed and the surface of the lymphocytes had many leading lamella.

CONCLUSION

The results indicate that the three-dimensional observation with SEM using the freeze-cracking technique is helpful for studying the relation between morphology and biologic characteristics of laryngeal carcinoma.

Cytologic diagnosis of upper urinary tract neoplasms by ureteroscopic sampling

During a three-year period, 160 cytologic specimens from the upper urinary tract (UUT) were collected from 62 patients. The specimens were obtained during ureteroscopy using various sampling techniques, including washing, brushing, aspiration and minute biopsies. The patients ranged from 17 to 84 years of age and consisted of 32 men and 30 women. For each patient one diagnosis that indicated the highest degree of abnormality was selected. These consisted of 23 "malignant," 9 "suspicious for malignant," 19 "atypical," 8 "negative for malignancy" and 3 "unsatisfactory" diagnoses. Of 30 patients with a malignant or suspicious diagnosis for whom adequate clinical and follow-up information was available, 18 had histologic confirmation of malignancy, and the other 12 had clinical and endoscopic evidence of neoplasms. Of 15 patients with an atypical diagnosis and adequate follow-up, 2 proved to have low grade transitional cell carcinoma, 1 had a fibroepithelial polyp, and 12 had clinical, endoscopic and follow-up evidence of nonneoplastic conditions. None of the 11 cases with negative or unsatisfactory diagnoses was found to have a malignant neoplasm. Because of the difficulty in obtaining adequate biopsies from UUT lesions, cytologic examination is the most practical method of diagnosis. This study indicated that highly accurate results are achieved, with close correlation between endoscopic and cytologic findings.

Effusion cytology of desmoplastic small round cell tumor of the pleura. A case report

Desmoplastic small round cell tumor is a recently described neoplasm with multidirectional differentiation. Although it occurs predominantly in adolescent males as an intraabdominal mass with multiple peritoneal implants, we report a case with primary pleural involvement. The cytologic features correspond to previously reported histologic findings and include tightly cohesive clusters of small round poorly differentiated malignant cells with accompanying desmoplastic stromal cells. Immunohistochemical studies revealed characteristic reactivity to epithelial markers, desmin and one neuroendocrine marker (chromogranin). We believe that together with clinical and immunohistochemical data, desmoplastic small round cell tumor can be diagnosed in effusion or aspiration cytology specimens.