Renal Cell Carcinoma in a Horseshoe Kidney and Preoperative Superselective Renal Artery Embolization: A Case Report

Only rarely is renal cell carcinoma encountered in a horseshoe kidney. This is a case report on renal cell carcinoma in a horseshoe kidney, in which superselective renal artery embolization was performed preoperatively. CT and digital subtraction angiography revealed a horseshoe kidney with a 3-cm tumor in the left side. Superselective renal artery embolization of the tumor was performed as a prerequisite procedure for the organ-preserving surgery of simple enucleation. Preoperative superselective renal artery embolization can be an effective tool to facilitate organ-preserving surgery in a horseshoe kidney.     

深圳市公务员先天性白内障现状及发病因素探讨

目的　通过普查深圳市公务员先天性白内障的现状 ,分析影响先天性白内障患病因素 ,探讨有效的防治措施。　方法　在 2 0 0 3年参加深圳市保健中心健康人群体检 ,2 0岁以上的约 3万名公务员中 ,按 3 :1比例随机抽取93 40人调查。按照先天性白内障诊断及分类标准 ,分析年龄、性别、职业的相关性 ,并进行显著性检验。　结果　深圳市公务员先天性白内障总发病率为 0 86% (80 /93 40 ) ,其中男性为 0 87% (4 0 /5 0 40 ) ,女性为 0 84% (3 6/4 3 0 0 ) ,男性高于女性 (P <0 0 5 ) ,职业无明显差异 (P <0 0 5 )与家族史有关。　结论　先天性白内障病发展缓慢 ,发现困难 ,应作为常规体检项目 ,减少遗传病儿出生。     

Management of congenital tracheal stenosis

Objectives: Congenital tracheal stenosis is a rare disease. Various methods for treatment exist but there is still much debate as to the appropriate surgical procedure. We present our surgical experiences of patch tracheoplasty and slide tracheoplasty as viable methods for the treatment of congenital tracheal stenosis. Methods: From 1994 to 2002, 13 patients were diagnosed with congenital tracheal stenosis. Eight patients (7 symptomatic and 1 asymptomatic) had their stenosis corrected, three by means of pericardial patch tracheoplasty, four by slide tracheoplasty, and one by resection and anastomosis. Concomitant operations were performed on six patients to treat congenital cardiovascular disease. Five patients showing no significant symptoms did not undergo tracheal surgery and received only cardiac procedures. A retrospective review of the hospital course, complications, and long-term results was conducted. Results: Among the patch tracheoplasty group, every patient suffered from granulation tissue formation. One patient died of respiratory acidosis and one was hospitalized due to recurrent granulation tissue, which required frequent bronchoscopy. The third patient from this group is free of all symptoms. Among the slide tracheoplasty group, one patient died of anastomosis disruption. The three remaining patients are alive and well. The one patient who received resection and anastomosis is alive without symptoms. Conclusions: Surgical repair of long-segment congenital tracheal stenosis exhibited high mortality and morbidity rates. Every patient that underwent pericardial patch tracheoplasty suffered from troublesome granulation tissue. As slide tracheoplasty provided relatively good results in the short and mid-term follow-up periods, it seems to be a preferred method for the treatment of long-segment congenital tracheal stenosis.     

低体重先天性心脏病婴幼儿术后监护体会

目的 探讨低体重婴幼儿先天性心脏病的术后监护方法，以提高手术成功率。方法对142例15kg以下的先天性心脏病低体重婴幼儿（3岁以下）术后根据其生理特点，严密做好循环系统、呼吸系统、引流管、感染等监护措施，防止相关并发症的发生。结果 全组术后住院死亡6例，死亡率4．2％；术后并发症15例，发生率为10．6％，包括低心排出量综合征、呼吸衰竭、心律失常、肺部感染、出血等。结论 婴幼儿先天性心脏病术后根据其生理特点进行循环系统、呼吸系统、引流管、感染等监护，可有效降低术后并发症的发生，是提高手术成功率和治愈率的关键。     

Evaluating the impact of human papillomavirus vaccines

While two prophylactic HPV vaccines have been proven notably efficacious in clinical trials, the effectiveness of these vaccines at the population level remains to be evaluated. To lay the foundation for understanding the strengths and limitations of different endpoints for future effectiveness research, we present a comprehensive review of HPV-related clinical outcomes, including: (i) HPV type-specific positivity and persistence, (ii) Pap diagnoses (ASC-US, LSIL, and HSIL), (iii) histologic cervical cancer precursor lesions (i.e., CIN1, CIN2, and CIN3), (iv) invasive cervical cancer (ICC), (v) anogenital warts, (vi) recurrent respiratory papillomatosis (RRP), and (vii) other HPV-associated cancers (vulvar, vaginal, anal, penile, and oropharyngeal). While research on the vaccines’ effects on these HPV clinical outcomes in the general population is presently limited, numerous large trials will soon be completed, making a priori discussion of these potential outcomes especially urgent. Furthermore, population level systems to track HPV-associated clinical outcomes may need to be developed for HPV vaccine effectiveness evaluation.     

颅盖畸形形成机制的研究进展

目的为深入了解颅盖畸形目前在国内外研究中的进展情况,探讨颅缝早闭过程中相关生长因子的作用,为今后的研究工作奠定基础。方法应用计算机检索PubMed数据库,检索英文相关文章,同时检索中国期刊全文数据库的相关中文文章,并查阅相关书籍。对资料进行初审,并查看文献后的引文。纳入与颅盖畸形形成机制有关的内容,排除不相关及重复文章。结果经对收集文章的整理,共纳入23篇文献。对纳入的颅盖畸形形成机制的文献,结合目前国内外研究状况进行综述。结论进一步研究颅缝过早闭合及相关生长因子的作用,将有助于阐明颅盖畸形形成机制,并更好地指导临床治疗。     

Results of the Ross operation in a pediatric population

Objective: To analyse the results of the mid-term clinical and echocardiographic follow-up of the pediatric Ross operation. Methods: Echo-Doppler follow-up of 53 consecutive pediatric Ross procedures performed between 1994 and 2003. Median age was 9.7 years at time of operation (2 weeks–17.7 years). Six patients were younger than 3 months. Median age at follow-up was 15.6 years. Aortic valve/left ventricular outflow tract (LVOT) anomalies were congenital in 49 (92%). Seventy percent had previous surgery or balloon valvuloplasty. Root replacement was used in all. Thirteen patients (25%) had LVOT enlargement. Mean cross-clamp time was 113 (69–189) minutes. Results: Early mortality occurred in 3 patients after emergency surgery following balloon failure (n=1) and extended Ross following interrupted arch/VSD repair (n=2). Late mortality was due to LV fibroelastosis in 2 patients and complicated pulmonary artery stenting in another. RVOT reoperations were required because of late homograft obstruction in 2 patients and because of pulmonary artery stenosis in another. Five patients (9.4%) were reoperated for pulmonary autograft dilatation (n=3) and for leaflet fibrosis or perforation (n=2). Autografts were repaired in two patients, while a mechanical valve was inserted in 3 cases. At 9 years the actuarial survival and event free survival were 89 and 74%, respectively. At last follow-up 90% of autograft diameters indexed to body surface area was above the 90th percentile of normal aortic root diameters. LVOT and RVOT gradients were low and autograft insufficiency was trivial to mild in 84% and mild to moderate in 16%. Autograft stenosis was not noticed. Conclusions: The pediatric Ross procedure remains an important tool but autograft dilatation also occurs in the pediatric population. The significance of this finding has yet to be determined.     

Teratoma tongue: Case report and review of literature

Teratomas are true neoplasms composed of tissues from all three germinal layers and may exhibit variable levels of maturity. They have an unknown origin and eccentric microscopic appearance. Teratomas arising from the oral cavity are rare in the newborn; only 22 cases have been reported in the literature. We describe a female neonate with an oral teratoma originating from the tongue that was successfully treated with surgery.