A rare massive presentation of catamenial hemothorax

Catamenial hemothorax is a rare manifestation of thoracic endometriosis syndrome. It is commonly seen associated with pelvic endometriosis in nulliparous reproductive-age women. Most cases are minor and self-limiting. We present a case of a 32-year-old woman who presented with prolonged worsening dyspnea and was found to have a massive hemothorax on evaluation.     

A study for evaluating the effect of the deltoid-flap repair in massive rotator cuff defects

The repair of massive cuff defects by direct suture often is impossible. In these cases, a repair by musculo–tendineous flaps (latissimus-dorsi, pectoralis or deltoideus) is required. It was the goal of this study to evaluate the result of delta-flap repair in case of massive cuff defects with a diameter of 5 cm or more. Between 1998 and 2000 for all patients who were suffering from a massive rotator cuff tear more than 5 cm a deltoid transfer was performed. A total of 20 patients (14 male, 6 female; age: 60.9 ± 8.7 years) were available for a follow-up after 47.2 ± 8.0 (range, 36 to 60) month. The operation included an arthroscopic evaluation, acromioplasty with resection of the lateral clavicular end, and biceps tenodesis. The cuff defect was repaired by transfer a muscular flap from the anterior part of the deltoid (about 2×6 cm) into the defect. The patients subjectively rated their result—10 excellent, 9 good, and 1 poor. Preoperatively, the Constant amounted 26.3 ± 5.1 points. At follow-up, the score significantly increased to 74.5 ± 8.5 points. The acromiohumeral distance increased from 4.9 ± 1.1 to 9.2 ± 1.7 mm. In MRI examination of 11 patients all had an intact flap. Two complications (a wound hematoma and a deep infection) did not influence the result. The repair of massive rotator cuff tears by a deltoid transfer produces acceptable clinical and radiological results.     

大咯血的急诊外科治疗

目的　总结 4 4a急诊手术治疗大咯血经验。方法　回顾性研究 195 8～ 2 0 0 1年在本院急诊手术的 89例大咯血患者 ,收集临床表现、诊断方法、原发病因、治疗和结果等相关资料。结果　 85 4 %病例的X线表现与出血部位一致 ,其它诊断方法 (支气管镜、CT、血管造影术等 )作为重要补充。由于 1982年后的早期外科干预 ,术前咯血总量、咯血平均量和低血压、休克发生比例较前明显减少 ,术后并发症从 1982年前的 2 2 2 %降至 17 1% ,围手术期死亡率从 9 3%降至 0。急诊全肺切除术并发症 ( 2 3 3% )高于肺叶切除术 ( 15 2 % )。在过去 4 4a肺结核一直是大咯血的主要原发病因。结论　符合新的外科治疗标准的患者应及早手术 ;选择切除范围要保守 ,首选叶切     

Foley尿管气囊压迫治疗骶前静脉丛大出血的评价(附6例报告)

目的:评价直肠癌根治术中用Foley尿管气囊压迫治疗骶前静脉丛大出血(MPVP)的临床价值。方法:分析1995~2005年用Foley尿管气囊压迫治疗骶前静脉丛大出血6例的临床资料。结果:6例骶前大出血中全部用Foley尿管气囊压迫控制出血,术中出血量为800~1700mL,Foley尿管于术后4d拔除3例,5d1例,6d2例,均无再出血,会阴切口均一期愈合。结论:Foley尿管气囊压迫治疗骶前静脉丛大出血是一种简单安全有效的治疗方法。     

善宁治疗顽固性大咯血疗效观察

目的 评价善宁对顽固性大咯血的疗效。方法 将55例传统药物抢救无效或有禁忌的大咯血分为治疗组（善宁）与对照组（立止血组），观察24—72h的止血效果。结果 治疗组总有效率为92％，对照组为70％，两组比较有显著差异p〈0．05（x^2=4．125）。结论 善宁治疗大咯血疗效显著，使用安全，不良反应少，值得临床推广应用。     

小肠广泛切除术后高胃泌素血症与结肠代偿性变化的关系

观察大鼠小肠广泛切除术后血清胃泌素和结肠粘膜代偿性改变的动态变化规律,发现术后14天内血清胃泌素稍低于正常组,从第14天开始血清胃泌素升高加快,至21天时差异有显著性意义(P<0.05),第28天时差异有非常显著性意义(P<0.01).血清胃泌素变化与术后结肠粘膜DNA、RNA变化呈正相关关系(P<0.001),提示高胃泌素血症可能是引起小肠广泛切除术后结肠粘膜代偿性变化的主要因素之一.     

海南省琼中县高疟区应用磷酸萘酚喹控制疟疾的效果

目的 评估在较大的范围内使用磷酸萘酚喹控制疟疾的效果,为今后该药用于控制疟疾提供依据。方法 在季节性抗疟控制传染源的用药上,对春季和秋季抗疟的集体服药村庄,一律使用磷酸萘酚喹一天疗法,代替哌喹 防Ⅱ 伯喹两天疗法,从首次服药的第七天起,由卫生院防保人员和村医,每隔七天到各村巡诊,发现“四热”病人采血送检,掌握用药前后的疫情动态。结果 据疫情报告统计,2000年全年“四热”血检率达10％以上,血检阳性率0．62％、居民带虫率0．05％、年带虫发病率(API)1．5‰,与1999年对比,分别下降55．83％、93．93％、33．78％,发病村(队)由1999年的180个减至109个,减少39．44％,且无明显副反应。结论 琼中县高疟区居民集体服药使用磷酸萘酚喹控制疟疾流行效果较为显,值得继续应用作进一步的评估。     

支气管动脉栓塞术治疗大咯血

总结支气管动脉栓塞(BAE)治疗大咯血 84例,即时止血 78例,5例咯血明显减少,有效率 98.8％(83/84),1例止血无效。无严重并发症发生。认为(BAE)是目前治疗大咯血安全有效的治疗方法。     

BREUS' MOLE: DNA SHOWS MASSIVE SUBCHORIONIC HEMATOMA IS MATERNAL IN ORIGIN

Breus' mole, a massive subchorionic placental hematoma, is associated with intrauterine growth retardation and second trimester stillbirth. It is relatively rare and, hence, is poorly understood. Initially, Breus' mole was thought to be a consequence of fetal demise, but subsequent observations in placentas of live - born infants as well as identification in prenatal ultrasounds prior to fetal demise discredited this tenet. A number of theories have been proposed to explain the etiology of Breus' mole; some suggest that it is a fetal hemorrhage, others claim a maternal thombosis. However, these theories are based entirely on speculation, and it is unclear from the literature whether the source of the hematoma is maternal or fetal. A macerated female fetus was delivered of a 31 - year - old G1 P0 woman at 24 weeks' gestation; the autopsy showed only marked intrauterine growth retardation while placental examination showed a massive subchorionic hematoma. DNAs extracted from portions of the fresh hematoma, placental villi (i.e., fetal tissue), and maternal blood were compared using molecular analyses. Polymerase chain reaction using primers that identify highly polymorphic loci distinguished fetal from maternal DNAs. This is the first case of Breus' mole analyzed using molecular methods; the source in this case is definitively maternal, suggesting the etiology is maternal thrombosis.