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991.
Li-xin Yu Jun-sheng Ye Jian Xu Wen-feng Deng Cong-xiang Han Gui-rong Ye Shao-jie Fu Chuan-fu Du Jun-jie Ma Yi-bin Wang Xiao-you Liu Chuan-jiang Li 《第一军医大学学报》2003,23(12):1332-3, 1337
OBJECTIVE: To study the effect of combined transplantation of the liver and the pancreas in diabetic patients with end-stage liver disease, and explore the optimal surgical procedure. METHODS: Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis, hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506), mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, and C-peptide were monitored after transplantation. RESULTS: Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections. CONCLUSION: End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreas transplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitute the optimal surgical approaches as the primary choice. 相似文献
992.
993.
Takehiko Shimoyama Katsuo Yoshiya Yasushi Yamato Teruaki Koike Keiichi Honma 《General thoracic and cardiovascular surgery》2009,57(6):310-314
Malignant peripheral nerve sheath tumors (MPNSTs; malignant schwannomas) rarely occur in the anterior mediastinum, and their
prognosis is poor. A 75-year-old man was referred to our hospital for examination of an anterior mediastinal tumor. A computed
tomography-guided percutaneous needle biopsy revealed only fibrosis. The tumor was completely excised via a median sternotomy
with partial resection of the pericardium and right upper lobe of the lung. Thereafter, the tumor was diagnosed as a storiform-pleomorphic
type of malignant fibrous histiocytoma. At 1 year after the surgery, a distant metastasis was found in the interlobular space
between the right middle and lower lobes. The tumor was completely excised via a right posterolateral thoracotomy. Reexamination
of the primary and secondary tumors revealed an MPNST. No recurrence was found up to 5 years after the second surgery without
adjuvant chemotherapy or radiation therapy. However, he died from multiple lung metastases after 6 years. 相似文献
994.
Malignant peripheral nerve sheath tumors (MPNST) are defined as any tumor arising from a peripheral nerve or showing nerve
sheath differentiation. The majority of these tumors arise on the trunk, extremities, or head and neck region. The literature
to date has fewer than 14 cases of MPNST arising in the gastrointestinal tract, and only two cases were ever reported in the
small intestine, one of which was a recurrent disease. In this paper, we report the first US case of an MPNST arising in the
small intestine and presenting as intussusception. 相似文献
995.
996.
A mature cystic teratoma in pineal region mimicking parietal encephalocele in a newborn 总被引:1,自引:0,他引:1
M. Kemali Baykaner Ertan Ergun Berker Cemil Pelin Bayik Hakan Emmez 《Child's nervous system》2007,23(5):573-576
Objective Teratoma is the most frequently encountered intracranial tumor at birth and constitutes 18–20% of all germ cell tumors. They
are usually located in pineal and suprasellar regions. The authors aim to report an extremely unusual presentation, location,
and appearance of a teratoma in a newborn.
Case report A soft tissue swelling in the vertex was detected in a 1-month-old girl. Neurological examination was normal. A big, cystic–solid
lesion beginning from pineal region and extending to the scalp was detected in magnetic resonance imaging. It is interesting
to note that cerebral venous angiography showed that the superior sagittal sinus (SSS) was divided into three branches at
the level of the lesion and they joined together distally. The tumor was excised totally. Histopathological examination revealed
the diagnosis of a mature cystic teratoma.
Conclusion A mature cystic teratoma mimicking parietal encephalocele is extremely rare. Germ cell tumors should be kept in mind in the
differential diagnosis of all midline lesions with unusual radiographic appearance. Cerebral venous angiography or MR angiography
must be performed for the diagnosis and the surgical planning in lesions located near SSS. 相似文献
997.
Erkki Lotspeich Markus Schoene Heinz Gerngroß Roland Schmidt Reinhard Steinmann Marco Ramadani Susanne Gansauge 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):559-566
Introduction Postoperative treatment for colorectal cancer depends on tumor stage as defined by the International Union Against Cancer
(UICC). Adjuvant chemotherapy is not recommended in patients without lymph node involvement (UICC stages I and II). As many
as 20–30% of these patients, however, will develop recurrence.
Aims and objectives We conducted this study to determine the presence of disseminated tumor cells in the lymph nodes by quantitative real-time
polymerase chain reaction (QRT-PCR) for cytokeratin 20 (CK20) in an attempt to provide supplementary information compared
to histopathological findings.
Materials and methods Using a standard QRT-PCR assay, we examined primary tumors and 391 lymph nodes from 31 patients with completely resected colorectal
cancer.
Results Of the 31 primary tumors, 29 were positive for CK20 by QRT-PCR.
Discussion An examination of the lymph nodes from the 29 patients with CK20-positive primary tumors revealed that 35 (92.1% sensitivity)
of the 38 histopathologically positive lymph nodes and 54 (16.7%) of the 324 histopathologically negative lymph nodes were
positive by molecular analysis. CK20 expression was detected in 10 (100%) of 10 patients with a histopathologically positive
lymph node status (pN1). In 9 (47.4%) of 19 patients with negative histopathological results (pN0), we detected a CK20 mRNA
signal in at least one lymph node. Whereas eight patients with histopathologically negative lymph nodes could be upstaged
on the basis of the molecular findings, no patient would be downstaged.
Conclusion Our results suggest that QRT-PCR for CK20 is a useful tool for the quantitative detection of micrometastases in the regional
lymph nodes. We introduce a standardized procedure that integrates a molecular diagnostic technique in the clinical staging. 相似文献
998.
Mahmut Koç Ömer Yoldaş Yusuf Alper Kılıç Erdal Göçmen Tamer Ertan Hayrettin Dizen Mesut Tez 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):581-585
Background and aims The aim of this study is to evaluate the predictive accuracy of different scoring systems on surgery for perforated peptic
ulcer referred to an academic department of general surgery in a tertiary reference center.
Patients and methods Seventy-five consecutive patients (Male/female ratio = 64:11; mean age, 44 years; range, 16–85) with perforated peptic ulcer
disease were investigated. Disease severity scores and mortality predictions were calculated using the collected data during
admission. Discrimination and calibration characteristics of each system, namely, the acute physiology and chronic health
evaluation II and III, the simplified acute physiology score II, and the mortality probability models (MPM) II, were determined
by using the area under receiver operating characteristics curve and the Hosmer–Lemeshow goodness-of-fit test, respectively.
Results Among the 75 patients included, there were eight (10.6%) mortalities. All systems had a reliable power of discrimination and
calibration. Among the systems tested, MPM II was the best performing as far as discrimination and calibration characteristics
were considered. The parameters of MPM II system that were related to systemic perfusion of the patient were significantly
positive in patients who died compared to those who survived.
Conclusions MPM II that predicted mortality at admission is better than the other systems in predicting mortality. Results also indicate
the importance of maintenance of systemic perfusion of the patient at the early phases of peptic ulcer perforation. 相似文献
999.
1000.
Chia-Hung Lu MD Ming Yao MD Hon-Man Liu MD Ya-Fang Chen MD 《Journal of neuroimaging》2007,17(2):184-187
We report the findings of spinal magnetic resonance imaging (MRI) in 2 patients who had undergone intrathecal chemotherapy and presented with the subacute onset of ascending numbness and weakness. MRI revealed a symmetric hyperintensity at the posterior columns of the spinal cord from the lower cervical region down to the conus medullaris level on T2-weighted images, and no abnormal enhancement. The imaging findings are similar to those seen in subacute combined degeneration (SCD), but the serum vitamin B(12) levels were normal in these 2 cases. 相似文献