Carcinoma tipo-linfoepitelioma pulmonar con expresión de virus de Epstein-Barr y PD-L1 / Pulmonary lymphoepithelioma-like carcinoma with ex pression of Epstein-Barr virus and PD-L1

Resumen El carcinoma tipo-linfoepitelioma pulmonar es una variante rara de carcinoma de células no pequeñas de pulmón, representa aproximadamente 0.7% de todos los casos. Está usualmente asociado con la infección por el virus de Epstein-Barr y es más prevalente en el Sureste de Asia; sin embargo, es extremadamente raro en Améri ca Latina. Informamos el caso de un hombre de 65 años de edad con un carcinoma tipo-linfoepitelioma pulmo nar, que se presentó con tos, disnea y pérdida de peso. La TAC de tórax mostró nódulo mal definido localizado en el pulmón derecho. Se realizó biopsia transtorácica de la lesión, y el estudio microscópico reveló células gran des poligonales dispuestas en mantos, infiltrados por abundantes linfocitos y células plasmáticas, alrededor del intersticio. Las células neoplásicas fueron positivas para citoqueratina 5/6 y p63, y negativas para Napsina A y el factor de transcripción tiroideo 1 (TTF-1). La expre sión de PD-L1 fue positivo (aproximadamente 100%) por inmunohistoquímica; así como el núcleo de las células neoplásicas mediante hibridación in situ para el RNA codificado por el virus de Epstein-Barr (EBER-ISH). El paciente recibió seis ciclos de un esquema combinado de quimioterapia basado en platino (gencitabina/cisplatino) más durvalumab. Presentó progresión de la enfermedad y finalmente murió 9 meses después del diagnóstico.

Abstract Pulmonary lymphoepithelioma-like carcinoma is a rare type of non-small cell lung cancer, it accounts for approximately 0.7% of all cases. It is usually associated with Epstein-Barr virus infection and is more prevalent in Southeast Asia; however, it is extremely rare in Latin America. We present a 65-year-old man with a primary pulmonary lymphoepithelioma-like carcinoma, who presented with cough, dyspnoea and weight loss. Com puter tomographic scan of the thorax showed a nodule localized in the right lung. A transthoracic biopsy of the lung lesion was made and the microscopic obser vation revealed large polygonal cells that proliferated in a nest pattern with infiltration by lymphocytes and plasma cells around the interstitium. The tumour cells were positive for citokeratin 5/6 and p63, and negative for Napsin A and thyroid transcription factor 1 (TTF-1). PD-L1 expression was positive (approximately 100%) in the immunohistochemical study, and the nuclei of the tumour cells were positive for EBV-encoded small RNA in-situ hybridization (EBER-ISH). The patient underwent six cycles of platinum-based combination (gencitabine/ carboplatin) chemotherapy plus durvalumab. He pre sented progression of the disease and finally he died 9 months after diagnosis.

Clinico-pathological analysis of osteomyelitis in cancrum ois (Noma) patients seen in Noma children hospital, Northwest Nigeria

Background: Cancrum oris is a rapid and devastating infectious disease of the orofacial region, which can be life threatening in its fulminant stage. Infection of bone (osteomyelitis) is a possible sequelae of Noma (cancrum oris) and is more likely due to late presentation especially in our environment. A literature search revealed scanty research describing osteomyelitis in Noma patients. Objective: To analyze the clinico­pathology of osteomyelitis in Noma patients diagnosed and treated at Noma Children Hospital, Sokoto.Methods: The design was a 2-year retrospective study of records of Thirty­two patients who had sequestrectomy secondary to osteomyelitis in Noma (Cancrum oris). Age, gender, jaws affected and side of involvement were analyzed Results: The age ranged from 2­11 years with mean ±standard deviation 5.47 ± 2.68 years was recorded. Osteomyelitis in Noma patients was found among 17 (53.10%) males compared to 15 (46.90%) females. In 20 (62. 50%) of the cases, anterior maxillary involvement was observed and the remaining 12 (37. 50%) was found at the mandibular posterior region and it is more common on the left side. Result of histopathology showed both acute and chronic inflammatory cells. Necrosis and bone hyperactivity was observed in most of the slides. Conclusion: Osteomyelitis is a common complication of Noma and its treatment is of paramount importance for adequate management of Noma patients.

Effects of two kinds of vertical partial laryngectomy on laryngeal function,postoperative extubation rate and survival rate of patients with glottic laryngeal carcinoma / 中国基层医药

Objective To study the effects of two kinds of vertical partial laryngectomy on laryngeal function,postoperative extubation rate and survival rate of patients with glottic laryngeal carcinoma.Methods From January 2013 to January 2014,one hundred and fifty patients with glottic carcinoma who treated in Huzhou Gospel Hospital were selected.The patients were divided into observation group and control group by random number table method,with 75 cases in each group.The control group used the traditional vertical partial laryngectomy,the observation group was treated with modified vertical partial laryngectomy.The postoperative survival rate,extubation rate,extubation time and complications were observed in the two groups.Results The extubation rate was 100.00% (75/75) in the observation group and 97.33% (73/75) in the control group,the difference was statistically significant between the two groups(χ2 =2.027,P>0.05).The extubation time in the observation group was (11.85 ± 0.49)d,which in the control group was (14.55 ± 0.56) d,the difference was statistically significant between the two groups( t=31.424, P<0.05).There were 67 cases(89.33% ) with grade 0 and 8 cases(10.67% ) with grade 1 in the observation group.The swallowing function of the observation group was stronger than that of the control group( Z=5.238,P<0.05).The 1-year and 2-year survival rates of the two groups were similar(all P>0.05).The 3-year survival rate of the observation group was 97.33% (73/75),which of the control group was only 88.00% (66/75),the differ-ence was statistically significant between the two groups (χ2 =4.807,P<0.05).There was no pharyngeal fistula in both two groups. There were 5 incision infections in the control group, and 1 incision infection in the observation group.There was no statistically significant difference in the incidence rate of complications between the two groups (χ2 =2.778,P>0.05).Conclusion Improved vertical hemilaryngectomy therapy for patients with glottic laryngeal carcinoma can effectively shorten the time of extubation,better preserve swallowing function,improve the long-term survival rate,and the extubation rate and complication rate are similar with the traditional vertical partial laryngectomy.

Mechanism and clinical significance of TGF-β1 signal transduction pathway regulated by VEGF gene in nasopharyngeal carcinoma metastasis / 实用医学杂志

Objective To explore the relationship between the expression of VEGF and TGF-β1 in naso-pharyngeal carcinoma and the clinical characteristics and prognosis of nasopharyngeal carcinoma patients. Meth-ods The expression of VEGF and TGF-β1 in the local middle-late nasopharyngeal carcinoma tissue of 96 patients was detected using immunohistochemistry.The correlation and the prognosis analysis were analyzed in combination with their clinical characteristics and prognosis. Results Expression rate of VEGF was 66.7% and that of TGF-β 1 53.1%.The expression of VEGF and TGF-β1 were positively correlated in the advanced nasopharyngeal carcino-ma.Both VEGF and TGF-β1 had significant correlation with lymphatic metastasis.The effects of VEGF and TGF-β1 on MFS were analyzed by Cox single factor and the results showed that VEGF positive was an adverse prognostic factor(P<0.05).The effects of age,sex,lymphatic metastasis,local invasion,VEGF and TGF-β1 on MFS were analyzed with Cox multifactor analysis and the results showed that VEGF positive was an adverse prognostic factor (P < 0.01). Conclusion The detection of VEGF and TGF-β1 protein in nasopharyngeal carcinoma may help to predict the metastasis of nasopharyngeal carcinoma.

Restoration of an Upper Lip Affected by Necrotizing Ulcerative Stomatitis Using Bilateral Cheek Advancement with a Crescentic Perialar Excision

Necrotizing ulcerative stomatitis (NUS) refers to ulceration of the oral mucosa that precedes rapid orofacial soft- and hard-tissue destruction. NUS on the upper lip is considered a reconstructive challenge because of the functional importance and complex multidimensional structure of the facial units that are involved, and is most commonly found in developing countries. Therefore, few studies have been conducted on NUS. Moreover, reconstruction options vary from local regional flaps to free-tissue transfers. We report a very interesting case in which we performed regional flap surgery using bilateral cheek advancement in a patient with NUS. A 75-year-old woman with a history of diabetes mellitus and hypertension, but no other immunological diseases, presented with skin necrosis on the upper lip. At presentation, necrotic tissue covered the upper lip and philtrum, but it had not invaded the nose or lower lip. After debridement of the necrotic tissue, approximately 70% of the upper lip was missing. We therefore designed a bilateral cheek advancement and rotation flap, in which the flap was sutured in 3 layers. There was no need to perform additional procedures, as the flap healed well and showed no other complications or recurrence. The patient exhibited good voluntary muscle control and oral competence while eating and drinking, and she was also very satisfied with the cosmetic results. Thus, regional flap surgery using a simple advancement flap may result in good recovery of both functional and aesthetic units in patients with NUS.

DSF-Cu induces apoptosis of human nasopharyngeal carcinoma CNE-2 Z cells by affecting function of mitochondria and cytoskeleton / 中国药理学通报

Aim To study the mechanism of DSF-Cu induced apoptosis of human nasopharyngeal carcinoma CNE-2 Z cells by affecting the function of mitochondria and cytoskeleton. Methods The cell cycle,the rate of apotosis,the levels of intracellular ROS and MMP in CNE-2 Z cells were tested by flow cytometry after trea-ted with different concentration of DSF-Cu. The chan-ges of the cell surface morphology, ultrastructure, cell height, width and roughness were detected by AFM. The distribution and reorganization of cytoskeleton F-actin were observed by Laser scanning confocal micro-scope. Results Cells were incubated with different concentration of DSF-Cu ( 0 ~200 nmol · L-1 ) for 24 h, the apoptotic ratio increased significantly and the treatment of DSF-Cu resulted in a concentration-de-pendent accumulation of CNE-2Z cells in G2/M phase. Furthermore,the treatment of DSF-Cu was able to in-crease the production of intracellular ROS and decrease the MMP in CNE-2Z cells. In addition,AFM imaging showed that compared to the control group,with the in-crease of DSF-Cu concentration,the CNE-2Z cells be-came smaller, cytoplasm condensed, the height in-creased,and the surface roughness reduced. Moreover, the filopodia became shorter, shrinked and even com-pletely destroyed after treated with different concentra-tion of DSF-Cu. At last,the LSCM image showed that the fluorescence intensity of F-actin networks was de-creased, then the structure was rearranged and de-stroyed obviously by treated with DSF-Cu. Conclusion DSF-Cu can induce apoptosis and arrest cell cycle at G2/M phase in CNE-2Z cell through a mitochondria-dependent pathway. Above findings highlight the appli-cations of AFM at the single cell level for the investiga-tion of antineoplastic drug in nasopharyngeal carcinoma therapy.

Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.

Clinical Observation of TACE Combined with HIFU in the Treatment of Middle and Advanced Primary He-patocellular Carcinoma / 中国药房

OBJECTIVE To observe therapeutic efficacy and safety of transcatheter arterial chemoembolization (TACE) com-bined with high intensity focused ultrasound (HIFU) in the treatment of middle and advanced primary hepatocellular carcinoma (HCC). METHODS:76 patients with middle and advanced primary HCC were randomly divided into treatment group(36 cases) and control group(40 cases). Control group was given TACE alone,and treatment group was additionally given HIFU 2-3 weeks after TACE. Clinical efficacy,the content of alpha-fetoprotein(AFP)before and after operation,survival rate,survival period and ADR were compared between 2 groups. RESULTS:The efficiency rate and total effective rate of treatment group were 61.1% and 94.4%,which were significantly higher than those of control group(35.0%,77.5%),with statistical significance(P0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Com-pared with TACE alone,TACE combined with HIFU in the treatment of middle and advanced primary HCC can improve long-term survival rate and the short-term efficacy,with good safety.

Benzaldehyde levofloxacin schiff base induces apoptosis of human hepatocarcinoma cells / 中国药理学通报

Aim To study the effect of (S) -1, 8-(2-methyl phosphate ethoxy )-6-fluorine-7-( 4-methyl- pi-perazine-1-base )-3-[ S-benzyls-based-4-( for nitroben-zene methylene group amino )-1 , 2 , 4-all triazole-3 base]-quinoline ( 1-H )-4-ketone ( M18 ) on apoptosis of hepatocarcinoma SMMC-7721 cells in vitro. Meth-ods With different concentrations of M18 at different time used to treat SMMC-7721 cells, human breast cancer MB-231cells, human colon cancer HCT-116 cells, human hepatocarcinoma HEPG-2 cells, mouse bone marrow mesenchymal stem cells ( BMSCs ) in vitro,the inhibition effects of M18 on cell proliferation were examined by MTT assay. Cell apoptosis was de-termined using Hoechst 33258 fluorescence staining and TUNEL method. Mitochondrial membrane poten-tial (△ψm ) was measured using a high content screening image system. Protein expression of caspase-3 , p53 and cytochrome C was detected with Western blot analysis. Results Treatment with M18 ( 4 ~32μmol·L-1 ) potently inhibited the proliferation of the cancer cells in time-and dose-dependent manners ( the IC50 value at 24 h in SMMC-7721 cells, MB-231cells, HCT-116 cells and HEPG-2 cells was 8. 65 μmol · L-1 , 9. 37 μmol · L-1 , 12. 74 μmol · L-1 and 9. 40μmol · L-1 , respectively ) . In contrast, M18 had weak cytotoxicity against BMSCs with IC50 value of 38. 96 μmol·L-1 . Levofloxacin had weak cytotoxicity against SMMC-7721 cells with IC50 value of 735. 10μmol·L-1 . Treatment of SMMC-7721cells with differ-ent concentrations of M18 for 24 h increased the per-centage of the apoptosis cells ( P <0. 05 ) and de-creased the mitochondrial membrane potential. In ad-dition, M18 increased protein expression of p53, caspase-3 and the cleaved activated forms of caspase-3 in SMMC-7721 cells. Treatment of SMMC-7721 cells with M18 significantly increased cytochrome C in the cytosol, and decreased cytochrome C in the mitochon-drial compartment. Conclusion The mitochondrial-dependent pathways are involved in M18 induction of apoptosis of SMMC-7721 cells.

Construction of shSet7/9 vector and its function in HepG2 / 西安交通大学学报(医学版)

Objective To silence human gene Set7/9 and screen out stable transfection cell line in hepatocellular carcinoma cell line HepG2 so as to investigate the impact of down-regulation of Set7/9 in cell line HepG2 and provide experimental foundation for studies on the effect of set7/9 in HepG2.Methods The target oligo was designed and synthesized;shRNA interference vector and the control vector were constructed and transfected into HepG2 cells;the stable transfection cells were screened out.Then Real-time PCR and Western blot were performed to detect the silence of Set7/9 according to both gene expression and protein expression level. Results The shRNA interference vector was constructed and transfected into HepG2 cells successfully.Compared with that in the negative control group,the expression of Set7/9 was dramatically downregulated (P < 0.05 ). Meanwhile,the expression of related protein Sirt1 and Suv39h1 was upregulated 8.4 folds and 1.1 fold, respectively.Conclusion Downregulation of Set7/9 expression can upregulate Sirt1 and Suv39h1,suggesting that Set7/9 may affect the activity of HepG2 cell lines.

A Review of Fusobacterium necrophorum Infections in Humans.

The incidence of human infections caused by Fusobacterium necrophorum is recently on the increase and this is attributed largely to alteration in antibiotic usage pattern, malnutrition and poor oral hygiene. These infections are usually acquired exogenously from animals such as dogs, livestock or humans and ranges from mild sore throat to severe infections like Lemierre’s syndrome and Cancrum oris (NOMA). Fusobacterium necrophorum species produce characteristic toxins and virulent factors which are responsible for the severity of infections. Confirming the presence of these species is recommended during suspected infections. It would help in providing information on the antimicrobial sensitivity pattern so as to guide treatment and control of these severe infections as well as for epidemiological purposes. This review summarizes human infections associated with F. necrophorum providing information on their epidemiology, risk factors, pathogenicity, diagnosis and treatment.

Être soi-même: Approche phénoménologique de l'authenticité et de l'inauthenticité / Ser si-mesmo: uma abordagem fenomenológica à autenticidade e inautenticidade / Be yourself: a phenomenological approach to the authenticity and inauthenticity

Nous prendrons pour point de départ la célèbre distinction de Winnicott entre un vrai soi (true self) et un faux soi (false self) ou, en d'autres termes, empruntés à la phénoménologie, entre un soi authentique (eigentlich) et un soi inauthentique (uneigentlich). Mais le soi est une notion qui ne va pas sans soulever bien des difficultés, y compris aux yeux des spécialistes de l'œuvre de Winnicott, ne serait-ce que dans son rapport au moi. Il nous semble cependant possible d'élucider certaines d'entre elles grâce à l'élaboration par la phénoménologie heideggérienne puis sartrienne des concepts de soi, d'authenticité et d'inauthenticité. En effet, pour Heidegger, le Dasein ne saurait être un moi au sens d'un ego substantiel mais le Dasein est un soi (Selbst), un être dont le mode d'être est irréductible à celui d'un objet subsistant (vorhanden) et qui peut se "choisir" lui-même, se gagner (sich gewinnen) ou bien se perdre (sich verlieren). De ce point de vue, l'authenticité est tout d'abord une manière possible d'exister, et si le Dasein peut être soi sur le mode de l'authenticité, il peut l'être également sur le mode privatif de la fuite et de l'inauthenticité. Reprenant le concept heideggérien d'authenticité, Sartre l'enrichit, nous semble-t-il, en insistant sur l'impossibilité pour l'existant d'être ce qu'il est. Ainsi, contrairement au soi inauthentique qui ne cesse de se fuir dans ce qu'on peut appeler un faux soi, le soi authentique ou vrai soi assume son existence et, par conséquent, aussi bien la contingence de son être que sa liberté. Nous essayerons ainsi de montrer qu'il est possible de reprendre et d'approfondir phénoménologiquement la conception winnicottienne du vrai et du faux soi.

Partiremos da célebre distinção de Winnicott entre um verdadeiro si-mesmo (true self) e um falso si-mesmo (false self) ou, em outros termos, emprestados da fenomenologia, entre um si-mesmo autêntico (eigentlich) e um si-mesmo inautêntico (uneingentlich). Todavia, o si-mesmo é uma noção que levanta muitas dificuldades, também para os especialistas da obra de Winnicott, mesmo que seja somente em sua relação com eu [moi]. Parece-nos possível, entretanto, elucidar algumas dentre essas noções por meio da elaboração da fenomenologia heideggeriana e, em seguida, por meio da sartriana, dos conceitos de si mesmo, de autenticidade e de inautenticidade. Com efeito, para Heidegger, o Dasein não seria um ser, um eu (moi), no sentido de um ego substancial, mas o Dasein é um si-mesmo (Selbst), um ser cujo modo de ser é irredutível àquele de um objeto subsistente (vorhanden) e que pode "escolher" a si mesmo, se ganhar (sich gewinnen) ou mesmo se perder (sich verlieren). Desse ponto de vista, a autenticidade é, primeiramente, uma maneira possível de existir, e se o Dasein pode ser si mesmo no modo da autenticidade, ele o pode ser igualmente no modo privativo da fuga e da inautenticidade. Retomando o conceito heideggeriano de autenticidade, Sartre o enriquece, parece-nos, insistindo sobre a impossibilidade para o existente de ser isto que ele é. Assim, contrariamente ao si-mesmo inautêntico que não cessa de fugir para isto que poder-se-ia chamar de falso si-mesmo, o si-mesmo autêntico ou verdadeiro si-mesmo assume sua existência e, por consequência, tanto a contingência de seu ser como sua liberdade. Desse modo, nós tentaremos mostrar que é possível retomar e aprofundar fenomenologicamente a concepção winnicottiana de verdadeiro e falso si-mesmo.

We begin with Winnicott's well-known distinction between a true and a false self, or, in terms borrowed from phenomenology, between an authentic (eigentlich) and an unauthentic (uneigentlich) self. Self, however, is a notion that raises many difficulties also for Winnicott scholars, even if only in its relation with the I [me]. Yet it seems possible to elucidate some of those notions by way of a Heideggerian phenomenology followed by a Sartrean phenomenology of the concepts of self, authenticity and unauthenticity. In fact, for Heidegger the Dasein is not a being, an I (me), in the sense of a substantial ego, but rather a self (Selbst), a being whose mode of being is irreducible to that of a subsisting object (vorhanden) and that can "choose" itself, gain itself (sich gewinnen), and even loose itself (sich verlieren). From this point of view, authenticity is above all a possible mode of existing, and if the Dasein can be itself in the authentic way, it can likewise be in the deprived mode of fleeing and of unauthenticity. Returning to the Heideggerian concept of authenticity, Sartre enriches - it seem to us - by underlining the impossibility for the existent of being what it is. Thus, unlike the unauthentic self that cannot but flee towards that which we might call a false self, the authentic or true self takes on its existence, and therefore also takes on both the contingency of its being and its freedom. Hence, we will try to show that it is possible phenomenologically to resume and go deeper into the Winnicottian conception of the true and false self.

Noma in Cambodia: scars from the past

Background: Noma is an orofacial gangrene that tends to afflict starving and malnourished children. It has a high mortality rate, and even if the child survives, a lifelong deformity of the face occurs. There is a worldwide incidence of Noma in areas of mass poverty and famines, but it is rare in South East Asia. In Cambodia, the Children’s Surgical Centre (CSC) has seen and treated 20 patients with facial deformity secondary to Noma occuring in the 1970s (during the “Pol Pot period”). Objective: A review and case report.

Immunohistochemical Stainning for Ber EP4and EMA in the Diagnosis Basal Cell Carcinoma and Squamous Cell Carcinoma of the Skin / 中华皮肤科杂志

Objective To investigate the significance of immunostainning for Ber EP4and EMA in the diagnosis of basal cell carcinoma and squamous cell carcinoma of the skin.Methods Immunohisto-chemical stainning for Ber EP4and EMA was performed on115cases of basal cell carcinoma,squamous cell carcinoma,Bowen' s disease,actinic keratosis,basosquamous cell carcinoma,seborrheic keratosis,and verruca vulgaris.Specimens were taken from neoplastic tissues as well as the surrounding skin and ap-pendages.Results Ber EP4was positively stained in all cases of basal cell carcinoma and basosquamous cell carcinoma,but negatively stained in squamous cell carcinoma,Bowen's disease,actinic keratosis,sebor-rheic keratosis and verruca vulgaris.Expression of EMA was found in most cases of squamous cell carcinoma and Bowen' s disease,and a few cases of actinic keratosis,and in none of basal cell carcinoma,basosqua-mous cell carcinoma,seborrheic keratosis and verruca vulgaris.Conclusions Routine immunohistochemical staining with both Ber EP4and EMA is helpful for distinction of skin basal cell carcinoma,squamous cell carcinoma,precancerosis and benign hyperplastic dermatoses.

Clinical Study of Internal Radiotherapy with Hepatic Intra-ar te rial Iodine-131 Labeled Material for Hepatocellular Carcinoma / 中国普外基础与临床杂志

Objective To discuss the clinical val ue of internal radiation therapy with hepatic intra-arterial iodine-131 labele d material for the treatment of hepatocellular carcinoma (HCC). Methods This summarized paper was made on literatu re review. Results Iodine-131-lipiodol and several reported iodine-131-labeled antibodies to HCC associated antigens were concentrated in the foci of HCC with a high tumor-to-normal-tissue absorbed dose ratios. No s evere side effects occurred. It was used in various kinds of HCC patients, and m ostly showed a significant tumor response. Survival rate of HCC patients was rai sed in several clinical trials.Conclusion Internal radiotherapy with hepatic intr a-arterial iodine-131 labeled material may be considered as an effective metho d to treat HCC.

Surgical Correction of Macrostomia

Congenital macrostomia is a result of defective union between the mandibular and maxillary processes and it is a rare deformity seen in every 100 to 300 facial clefts. Ohnizuka1`classified macrostomia into two groups as congenital and posttraumatic. We experienced two cases of acquired macrostomia due to NOMA sequelae(58/F:Lt & 51/F:Rt) and one case of congenital macrostomia (3 months/M:Rt). Many plastic surgeons have developed surgical procedures for repair of this congenital macrostomia. Among them, McCarthy6,11 described the classic commissuroplasty. We could repaired 1 case of congenital macrostomia and two cases of acquired macrostomia due to NOMA sequelae using modified technique of McCarthy,s classic commissuroplasty. McCarthy described new oral commissure 2-3mm laterally for prevention of postoperative contraction, orbicularis oris muscle transposition to restore labial function and a z- plasty cutaneous closure. But some author raise an objection to new oral commissure 2-3mm laterally, and they made new oral commissure at same distance of opposite side normal commissure. And so, we designed the new oral commissure moved 1mm laterally comparing to original commissuroplasty in a congenital case for the prevention of displacement. In cases of acquired macrostomia due to NOMA sequelae, we reconstructed new oral commissure like congenital case, moved 1mm laterally. Orbicularis oris muscle transposition could not be possible because of destruction of muscle, adhesion and atrophy. And so we dissected muscle and just sutured side by side. Acquired macrostomia following NOMA sequelae manifsted facial deformity variably, and reconstruction of the facial deformity is difficult by using simple approach. Other variable reconstructive procedures were needed with commissuroplasty as like Washio flap, rotation advancement flap, bone graft and free radial forarm flap, etc. Postoperative results were relatively good. We propose that macrostomia due to NOMA sequelae must add to Ohnizuka classification of acquired macrostomia.

Surgical Treatment of Primary Bronchogenic Carcinoma in 3568 Cases / 中华胸心血管外科杂志

This paper summerized the surgical treatment of primary bronchogenic carcinoma in 3568 cases between 1957-1991. The resectability rate was 90. 3%, postoperative morbidity rate 8.32% and operative mortality 0. 89%. Pathological diagnoses of the resected specimens included squa-mous cell carcinoma for 48.7%, adenocarcinoma 22.9%, small cell cancer 15. 4%, large cell cancer 1. 3% and squa-mous-adenocarcinoma in 10.1%. The follow-up rate was 93%. The 5-and 10-year survival rates were 34.6% and 22.79% respectively. Analyses of the data demonstratad that the histologic type, pathological stage and metastasis of mediastinal lymph node are the important factors affecting the prognosis. According to UICC P-TNM,42. 6% of the patients in this group were in stage III. The 5 year survival rate was 19% in IIIa patients and 6% in IIIb. According to authors experience, it is recommended that in IIIa patients with nonsmall cell cardinoma, active surgical treatment should be adopted; in patients with small cell carcinoma, chemotherapy and radiotherapy should be given pre-and postoperatively, in IIIb patients with small cell carcinoma, surgical treatment is generally not indicated.