Objective To investigate the clinical and EEG characteristics, therapeutic response and prognosis in children with atypical absence seizures. Methods The clinical and EEG data of 43 children with atypical absence seizures in Qilu Hospital, Shandong University during January 2011 to December 2016 were analyzed, and therapeutic response and prognosis were followed up. Results Childre were 24 male and 19 female with the mean age of 5.43 y. The onset ages were from 1 years and 8 months to 10 years and 3 months. All of the 43 patients had MRI examines, and 18 children were normol. MRI abnormalities appeared in 25 children, including cerebral cortical dysplasia and cerebral atrophy (13 cases), congenital corpus callosum hypoplasia (2 cases), and abnormal signal in bilateral posterior putamen (2 cases), encephalomalacia focus(4 cases), ventricle expention (2 cases), hydrocephalus(2 cases). All the children underwent EEG more than once. All children had atypical absence seizures during daytime. Children had slowly backgrounds in retesting EEG, and spine and slow waves of 1.5 Hz to 2.8 Hz could be seen in all the atypical absence seizures. All children were followed up, and except 6 children with complete control, 19 children’ parents reported seizure- free, 18 children have poor effect. Forty Children had various degrees of psychological abnormalities and motor regression. Among them 13 cases had psychological abnormalities and motor regression before disease; cognitive ability of 27 cases were normal before onset age, however, about 75% to 95% of the children became abnormal 2 years after atypical absence seizures. The rest 3 cases had no obviously impairment. Conclusions Most of the atypical absence seizures children had small onset age and high incidence in mental damage and cognitive impairment. The course of typical absence seizures aggravate gradually, and often develops to nonspecific brain damage in this process. Antiepileptic drugs can reduce the frequency of the seizure in part of the patients, but had no effect on psychological and motor regression.
Barrett’s esophagus is considered an important risk factor for the pathogenesis of esophageal adenocarcinoma. Treatment strategies for diseases from high-grade dysplasia （HGD） to adenocarcinoma are different. The recurrence rates of endoscopic treatment and anti-reflux surgery are comparatively higher. Abnormal lesions of the esophagus can be completely resected by esophagectomy for the treatment of HGD to adenocarcinoma, and treatment outcomes are confirmed.But appropriate surgical strategies and lymph node dissection scopes should be chosen according to different cancer staging.Lymph node metastasis is a major factor in determining prognosis.
Objective To discuss the surgical indication of mammotome （MMT） operation and its auxiliary diagnosis value on breast cysts. Methods Seventy-eight patients with breast cysts from May 2010 to November 2011 in this hospital were enrolled. Excision and biopsy were performed according to the following guidelines：Single cyst with inhomogeneous interna echoes and diameter at least 1 cm；Multiple cysts associated with irregular megalgia， localized thickening of breast or ineffective drug treatment after three months；High risk of breast cancer；Hypoechoic nodules and laticifers exaggerated cysts；Ultrasonography showed disorderly echo and abundant blood supply in glandular tissues around the lesions. The result of preoperative ultrasound was compared with that of postoperative pathology diagnosis. Results In these 78 breast cysts patients with preoperative ultrasound diagnosis， 40 cases were breast multiple cysts， 38 cases were multiple cysts plus untouchable hypoecho nodules；42 cases were high risk lesions， and the other 36 cases were low risk lesions. Postoperative pathology diagnosis revealed 27 cases of cystic hyperplasia， 2 cases of atypical hyperplasia， and 1 case of breast cancer in the ultrasonic high risk lesions， and 19 cases of cystic hyperplasia in the ultrasonic low risk lesions. Ultrasound diagnostic accuracy rate was 60.26%（47/78）， sensitivity was 61.22%（30/49）， and specificity was 58.62%（17/29）. The number of resection lesions was 13.00±8.16， the time of operation was （74.25±22.68） min. The average hospital stay was 1 d after surgery. The local hematoma occurred in 2 cases and no other complications occurred during one month of follow-up. Conclusions The guidelines of MMT protocoled according to clinical manifestation of breast cyst patients and imaging of high-frequency ultrasound in author’s department are simple and utility. Minimal excision and biopsy via MMT can confirm the histological type and help for early diagnosis of breast cancer and precancerous lesion. It is important and necessary to standardize the surgical indications of MMT in the clinical work.
The expression of C-erb B-2 oncogene protein in the tissues of normal breast, atypical cystic hyperplasia of breast and breast carcinoma were determined in order to analyse the significance of the changes of C-erb B-2 oncogene in the course from atypical hyperplasia to carcinoma of breast. Results: there were no expression of C-erb B-2 protein in the tissues of normal breast and cystic hyperplasia of breast with epithelia proliferation grade Ⅰ. The positive rates of the expressions of C-erb B-2 protein in the tissues of atypical hyperplasia grades Ⅱ, Ⅲ and carcinoma of breast were 20.0%, 40.0% and 54.2% respectively. The results indicated that the abnormal changes of C-erb B-2 nocogene might occured in the carcinomatous transformation phase along with the changes from normal breast epithelial cell through atypical hyperplasia to breast cancer, those changes could be the result or promotion factor of abnormal proliferation of atypical hyperplasia of breast and was one of the markers of malignant transformation of epithelia of breast.
【Abstract】Objective To investigate the changes of myoepithelial cells in mammary atypical hyperplasia and breast cancer. MethodsSP immunohistochemistry was used to detect actin expression in normal breast tissue, grade Ⅰ, Ⅱ and Ⅲ atypical hyperplasia and breast cancer. Electromicroscopy was used to observe the changes of ultrastructure of myoepithelial cells. Results Actin was only detected in myoepithelial cells of normal breast tissue and grade Ⅰand Ⅱ atypical hyperplasia. The positive expression rates of actin in grade Ⅲ atypical hyperplasia（70%） and breast cancer（90%） were significantly higher than that in grade Ⅱ atypical hyperplasia（10%），P＜0.01. In mammary atypical hyperplasia, the number of myoepithelial cells increased with disturbed alignment and abnormal ultrastructure. The changes included that the protrusions on the cell surface diminished, myofilaments and pinosomes in the myoepithelial cells of grade Ⅱ, Ⅲ atypical hyperplasia decreased, and the irregularity of the nuclear morphosis and the increase of nuclear heterochromosome were found. ConclusionThe changes of actin expression in atypical hyperplasia are possibly correlated with carcinogenesis of breast cancer, and myoepithelial cells may play a role in carcinogenesis of breast cancer.
Objective To observe the changes of basement membrane (BM) during carcinogenic change of the atypical hyperplasia of the mammary. MethodsSP immunohistochemical method and two special stain method (Foot and PAS stain method) and the electron microscope were used to observe the changes of the BM. Results BM already changed in atypical hyperplasia grade Ⅱ, and more significantly changed in atypical hyperplasia grade Ⅲ. BM was thinner or thicker somewhere distinctively under the microscope, and some little deletions were observed under the electron microscope in atypical hyperplasia grade Ⅲ, and there was no BM in breast cancer.Conclusion The change procedure of BM was correlated with the changes of the epithelial, atypical hyperplasia. The changes of BM in the atypical hyperplasia are a part of the carcinogenic procedure from the epithelial atypical hyperplasia of the mammary.