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1.
Amr Abdelhamid AbouZeid Sherif Elhussiny Ibrahim Shaimaa Abdelsattar Mohammad Ahmed Bassiouny Radwan Mohamed Eldebeiky Ahmed Medhat Zaki 《Journal of pediatric surgery》2019,54(3):471-478
Purpose
To identify anatomical aberrations following PSARP procedure by using MRI, while correlating MRI findings to clinical outcome.Patients and methods
Between January 2014 and December 2017, we conducted our study on male patients with rectourethral fistula who underwent PSARP. Postoperative pelvic MRI studies were performed and correlated to their clinical continence scores (Rintala, and Krickenbeck classification).Results
The study included 31 patients. Fourteen patients were retrieved from the hospital records and accepted to participate in the study; while the remaining 17 were collected from the fecal incontinence clinic. Their age ranged from 40 to 156?months (mean 83) We divided patients in the study into two groups according to their Rintala continence scores: (Group A) 15 patients with low scores (10 or less); and (Group B) 16 patients with higher scores (more than 10). We detected wider pelvic hiatus (hiatus/PC ratio) and more obtuse anorectal angle in group A than B.Conclusion
Several anatomical alterations can be detected by MRI following the PSARP procedure that include abnormalities in the striated muscle sphincter (attenuation/deficiency), deviated neorectum, and presence of excessive perirectal fat. A widened pelvic hiatus and/or obtuse anorectal angle may correlate with poor fecal continence in these patients.Level of Evidence
This is a case control study (level III evidence). 相似文献2.
Janet Crane Jackie Manfredo Elisa Boscolo Mara Coyan Clifford Takemoto Maxim Itkin Denise M. Adams Timothy D. Le Cras 《Pediatric blood & cancer》2020,67(9)
Kaposiform lymphangiomatosis (KLA) is a rare, life‐threatening congenital lymphatic malformation. Diagnosis is often delayed due to complex indistinct symptoms. Blood angiopoietin‐2 (ANG2) levels are elevated in KLA and may be useful as a biomarker to monitor disease status. We report a 7‐year‐old male child with easy bruising, inguinal swelling, and consumptive coagulopathy, diagnosed with KLA. A multimodal treatment regimen of prednisone, sirolimus, vincristine, and adjunctive zoledronate was used. Plasma ANG2 levels were highly elevated at diagnosis but decreased during treatment. The patient showed significant clinical improvement over a 38‐month period and normalization of ANG2 levels correlated with resolution of the coagulopathy. 相似文献
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Wladimir Wertelecki 《Congenital anomalies》2021,61(1):9-13
We report population prevalence rates of neural tube defects (NDT) and microcephaly (MIC) as well as levels of incorporated Cs137 by pregnant women in two areas of the Rivne Province of Ukraine, a northern half (Polissia) polluted by Chornobyl radiation and not‐Polissia areas. Monitoring of congenital malformations was conducted with adherence to methods adopted by a European surveillance network (EUROCAT). Incorporated Cs137 (Bq/kg) by pregnant women residing in the Polissia and not‐Polissia areas were obtained concurrently with prenatal ultrasound examinations. In Polissia, the incorporated Cs137 levels by pregnant women as well as the prevalence rates of NDTs and MIC are significantly higher than in not‐Polissia. In Polissia, the prevalence rates of NDTs and MIC are among the highest in Europe. The debate concerning the teratogenic impact of chronic exposures to low levels of ionizing radiation was re‐ignited by our 2010 report. Health agencies uphold the notion that exposure to Chornobyl radiation levels are too low to be teratogenic, which is inconsistent with our observations. Further investigations in Rivne by international teams can, we believe, contribute facts to the ongoing debate. Our monitoring system, experience and data can facilitate concurrent investigations of teratogenic risks from exposures to other sources of ionizing radiation, alcohol, folate, and zinc deficiencies, among other risk factors. Study of genomic impacts can likewise be undertaken. 相似文献
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目的 探讨脑干海绵状血管瘤的手术适应证、手术时机、手术入路及手术技巧。方法 回顾性分析2013年3月至2018年12月神经导航及术中电生理监测辅助下显微手术治疗的60例脑干海绵状血管瘤的临床资料。结果 肿瘤全切除57例;次全切除3例,术后辅助伽玛刀治疗。出院时神经功能障碍改善34例,无变化21例,加重8例。无手术死亡病例,无颅内感染及脑脊液漏。术后随访3~60个月,平均(27.1±13.5)个月,术后症状加重8例中,2例好转,3例恢复至术前,3例无明显变化。肿瘤全切除病例未见肿瘤复发。伽玛刀治疗3例中,1例再出血。结论 脑干海绵状血管瘤手术需严格掌握适应证,选择合理手术时机,根据病灶位置采取个体化入路,联合神经导航及电生理监测等辅助技术,可以完整切除肿瘤、减少并发症,改善病人预后。 相似文献