应用准分子激光鞘技术拔除电极导线的单中心经验

目的:探讨准分子激光鞘拔除电极导线的安全性和有效性.方法:回顾性分析2014年5月至2020年11月于北京大学人民医院应用准分子激光鞘拔除电极导线的157例患者的临床资料.结果:共纳入应用准分子激光鞘拔除电极导线的患者157例,平均年龄(65.28±15.38)岁,其中男性94例(59.87％);共拔除导线288根,其...     

Early Triple Carcinomas Metachronously Involving the Sigmoid Colon,Stomach and GallbladderReport of a Case

We present a case of early triple carcinomas metachronously involving the sigmoid colon, stomach and gallbladder in order to emphasize that a mass screening is useful in the detection of early cancer of the alimentary tract.A 61-year-old male was admitted to the hospital for investigation of a flat elevated lesion of the sigmoid colon. The patient received partial resection of the sigmoid colon with the diagnosis of carcinoma.Pathologic findings showed adenocarcinoma confined to the mucosa. Sixteen months after surgery, a depressed stomach lesion was found through a mass screening. Distal gastrectomy was performed because of carcinoma, which was histologically confined to the mucosa. Sixty-five months later, he underwent cholecystectomy because of a polypoid lesion of the gallbladder. Pathologic findings disclosed adenocarcinoma infiltrated into the muscular layer of the gallbladder. The patient is currently in good health about 4 years after undergoing cholecystectomy.     

Rare Case of Internal Hernia with a New Type of Hepatodiaphragmatic Interposition of the Stomach and Colon

We report a new type of retroperitoneal internal hernia with hepatodiaphragmatic interposition of the stomach and colon. The hernia neck was formed in the lesser omentum, and the hernia sac consisted of the lesser omentum and retroperitoneum. The herniated organs (the stomach and colon) were incarcerated in the right extraperitoneal subphrenic space from the left dorsal side of the sulcus vena cava. This is the first reported case of this type.     

Use of a Long Preshaped Sheath to Facilitate Cannulation of the Coronary Sinus at Electrophysiologic Study

INTRODUCTION: Catheterization of the coronary sinus (CS) from the femoral vein can be challenging. We tested whether use of a long preshaped sheath facilitates CS cannulation. METHODS AND RESULTS: One hundred four patients were randomized into two phases. In phase 1, consecutive patients were allocated to CS catheterization using the long sheath (n = 26) or standard 7-French 15-cm sheath (n = 25). If unsuccessful within 10 minutes, the alternative technique was used. Phase 2 assessed the utility of the long sheath in difficult cases. All patients initially were approached using the standard sheath. If cannulation failed after 10 minutes, patients were randomly allocated to the standard or long sheath approach. In phase 1, the standard approach failed in 4 (16%) of 25 cases. In each case, a long sheath proved successful (mean 3.2 min). The long sheath approach was successful within 10 minutes in all 26 cases. Catheter deployment was significantly quicker with the long sheath, but this was offset by the time required for sheath insertion. In phase 2, the standard approach was successful in 46 (87%) of 53 cases. Of 7 "failures," 3 were randomized to continue the standard approach, which was successful in 1; 4 were randomized to the long sheath approach, and success was achieved in all (mean 4.4+/-1.5 min). Overall, the CS could not be promptly catheterized in 15% of cases within 10 minutes using the standard sheath, and no failures were seen using the long sheath. No complications arose from the use of either technique. CONCLUSION: The long sheath was uniformly successful in permitting catheterization of the CS from the femoral approach in both unselected and difficult cases.     

Solketal Removal from Aqueous Solutions Using Activated Carbon and a Metal–Organic Framework as Adsorbents

The worldwide rise in biodiesel production has generated an excess of glycerol, a byproduct of the process. One of the most interesting alternative uses of glycerol is the production of solketal, a bioadditive that can improve the properties of both diesel and gasoline fuels. Even with its promising future, not much research has been performed on its toxicity in aqueous environments. In this work, solketal adsorption has been tested with two different commercial adsorbents: an activated carbon (Hydrodarco 3000) and a metal–organic framework (MIL-53). Diclofenac and caffeine were also chosen as emerging contaminants for comparison purposes. The effect of various parameters, such as the adsorbent mass or initial concentration of pollutants, has been studied. Adsorption kinetics with a better fit to a pseudo-second-order model, intraparticle diffusion, and effective diffusion coefficient were studied as well. Various isotherm equation models were employed to study the equilibrium process. The results obtained indicate that activated carbon is more effective in removing solketal from aqueous solutions than the metal–organic framework.     

Metastatic Hepatoma in the Stomach Masquerading as a Leiomyoma

Metastatic hepatoma in the stomach is rare. A case is described in which a gastric tumour appeared to be a leiomyoma, but after laparotomy proved to be an isolated secondary deposit from a hepatoma.     

Fine-needle Aspiration Biopsy of a Submucosal Tumor of the Stomach Using Endoscopic Ultrasonography

Abstract: We report here on the use of the new fine-needle aspiration biopsy under endoscopic ultrasonography (EUS), developed in the course of our research into an EUS-guided puncture. From a specimen obtained using this method, a submucosal tumor of the stomach was identified as a leiomyosarcoma by histologic examination. As our equipment for aspiration biopsy was confirmed to be useful, we hope to establish a new system of EUS diagnosis by collecting more clinical data and improving the technique and instruments further.     

Laparoscopic-Assisted Rectal Foreign Body Removal: Report of a Case

PURPOSE Rectal foreign bodies are not an uncommon presentation to the emergency department. Frequently they can be removed in the department through the transanal approach. However, this often is not well tolerated by the patient or can force the foreign body more proximal. We present a case of a difficult rectal foreign body in an obese patient that was successfully removed transanally in the operating room with laparoscopic assistance. METHODS Under general anesthesia, with the patient in Trendelenburg position, laparoscopy was used to push the rectal foreign body from above while it was removed transanally from below. This was performed with one 10-mm and two 5-mm incisions. RESULTS The foreign body was successfully removed transanally with laparoscopic assistance, and the patient was discharged within 12 hours from the operation. CONCLUSIONS The laparoscopic approach to assist in rectal foreign body removal is a good treatment choice for difficult cases. It allows for easy removal, detection of rectal injury, and early discharge.     

Risk Factors of Mortality from Foreign Bodies in the Respiratory Tract: The Japan Collaborative Cohort Study

Objective This study assessed the risk factors of mortality from foreign bodies in the respiratory tract using the Japan Collaborative Cohort Study for the Evaluation of Cancer Risk data. Methods Data of 110,585 participants 40-79 years old living in 45 areas in Japan were collected between 1988 and 2009. Mortality from foreign bodies in the respiratory tract was assessed in a multivariable-adjusted analysis using a Cox proportional hazard regression model. Results Among all participants, 202 deaths occurred from foreign bodies in the respiratory tract. In the multivariable-adjusted model, older age [50-59 (hazard ratio, 4.93; 95% confidence interval, 1.91-12.74), 60-69 (hazard ratio, 14.96, 6.01-37.25) and 70-79 (hazard ratio, 53.81; 95% confidence interval, 21.44-135.02) years old compared to 40-49 years old], male sex (hazard ratio, 2.34; 95% confidence interval, 1.54-3.54), a history of apoplexy (hazard ratio, 7.04; 95% confidence interval, 4.24-11.67) and the absence of a spouse (hazard ratio, 1.56; 95% confidence interval, 1.05-2.32) were associated with an increased risk of mortality from foreign bodies in the respiratory tract. Conclusions Older age, male sex, medical history of apoplexy and the absence of a spouse were potential risk factors of mortality from foreign bodies in the respiratory tract. Especially in elderly men, social connections, such as cohabitation or relationships, may be important for ensuring the early detection of asphyxia and preventing death due to foreign bodies in the respiratory tract.     

Cancer of the Colon as a Late Sequel of Pelvic Irradiation

A patient, who developed carcinoma of the rectum nine years following therapeutic radiation for pelvic malignancy is presented. The relationship of radiation to carcinoma of the colon is reviewed. This relationship makes rigorous follow-up of patients with radiation induced chronic proctocolitis essential.     

Metastatic Hepatocellular Carcinoma of the Stomach Presenting as a Bleeding Polypoid Lesion

Abstract: This is a report of a case of hepatocellular carcinoma (HCC) with gastric metastasis and a review of 20 cases of gastric metastasis of HCC in Japan. A 67-year-old man was diagnosed as having HCC in May 1991, and underwent transcatheter arterial embolization in June 1991 and February 1992. He came to us with hematemesis in November 1992. An endoscopic examination revealed a semipedun-culated polypoid lesion with bleeding spots at the fornix of the stomach. The polypoid lesion was resected by endoscopic snare polypectomy to prevent rebleeding and in order to make a definitive diagnosis. Histological examination of the resected specimen, 15X10X6 mm in size, revealed well-differentiated HCC with bile production.