Object Intracranial aneurysms are rare in children and have different epidemiological, clinical, and morphological characteristics
and outcome from those in adults.
Materials and methods We analyzed demographic, clinical, radiologic features, treatment, and outcome in 55 patients <18 years of age, treated from
Jan 1995 through December 2005.
Results Intracranial aneurysms in children below 18 years constituted 4% of all intracranial aneurysms. Internal Carotid artery (ICA)
bifurcation was the commonest location. About half of the aneurysms were complex. Three-fourth of the patients required surgical
treatment. Two patients died, constituting 5% mortality. Two patients (5%) had poor outcome, whereas the majority (90%) had
a favorable outcome.
Conclusions Pediatric aneurysms have male predominance, higher incidence of clinical features of mass effect or seizures, high incidence
of large, traumatic/mycotic aneurysms, associated illnesses and ICH/IVH and hydrocephalus, better Hunt and Hess grades at
presentation, ICA bifurcation as the commonest site, and better outcome than their adult counterparts. 相似文献
The effect of established infection with penicillin-resistant staphylococcus aureus on m'icrbarterial anastomosis was studied in an experimental model. The infection was treated with wound debridement and systemic antibiotics before the surgical procedure. It was found that the anastomotic patency rate of microarte-rial repair was 95.1%. The presence of established infection, if properly treated, should not be a contraindication to microarterial surgery. 相似文献
We describe herein the rare case of a hydatid cyst found in the breast of a 26-year-old woman. Clinically, the mass was at
first suspected of being a fibroadenoma, but fine needle aspiration cytology (FNAC) yielded clear fluid only. Histopathologic
examination of the resected speciman confirmed that it was a hydatid cyst. 相似文献
Background: Angiogenesis is essential for tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is the most potent angiogenic
factor identified to date. TGFβ-1 acts as an indirect angiogenic agent.
Methods: VEGF and TGFβ-1 were measured in the serum of breast cancer patients and agematched controls and in tumor tissue of cancer
patients by ELISA. VEGF protein and mRNA expression by breast tumor cell lines were examined, and the effect of TGFβ-1 on
VEGF production in these cells was assessed.
Results: VEGF levels were significantly higher (P=.03) in the serum of patients with breast cancer compared to age-matched controls. A positive correlation was found between
serum (r=0.539) and tumor tissue (r=0.688) levels of VEGF and TGFβ-1. Metastatic MDA-MB-231 breast cancer cells produce more
VEGF than do the primary BT474 cells. TGFβ-1 significantly (P<.05) increased production of VEGF.
Conclusions: Breast cancer cells constitutively produce VEGF protein and mRNA. There is a relationship between VEGF and TGFβ-1 levels
in breast cancer patients, and TGFβ-1 regulates VEGF expression by breast cancer cells.
Presented at the 50th Annual Cancer Symposium of the Society of Surgical Oncology, Chicago, Illinois, March 20–23, 1997. 相似文献
Background. Heparin bonding of the cardiopulmonary bypass (CPB) circuit may be associated with a reduced inflammatory response and improved clinical outcome. The relative contribution of a heparin-bonded oxygenator (ie, >80% of circuit surface area) to these effects was assessed in a group of pediatric patients.
Methods. Twenty-one pediatric patients undergoing CPB operations were assigned randomly to receive either a heparin-bonded oxygenator (group H, n = 11) or a nonbonded oxygenator (group C, n = 10) in otherwise nonbonded circuits. The two groups were similar in pathology, age, weight, CPB time, and cross-clamp time. Plasma levels of the cytokines tumor necrosis factor-, interleukin-6, and interleukin-8, as well as terminal complement complex, neutrophils, and elastase, were analyzed before, during, and after CPB.
Results. Significant levels of tumor necrosis factor- were not detected in either group. Plasma levels of all other markers increased during and after CPB compared with baseline. Plasma levels of interleukin-6 peaked in both groups 2 hours after the administration of protamine but remained significantly higher in group C 24 hours after operation. Plasma concentrations of interleukin-8 peaked at similar levels in both groups 30 minutes after protamine administration and returned to baseline thereafter. Levels of terminal complement complex and elastase peaked in both groups 30 minutes after protamine administration. Plasma levels of terminal complement complex were significantly higher at the end of CPB and after protamine administration in group C. Elastase levels were significantly higher 2 and 24 hours after CPB in group C. The ventilation time of patients in group H was significantly lower than that of patients in group C: 10 (range, 3 to 24) versus 22 (range, 7 to 24) hours, respectively (p < 0.01).
Conclusions. The present study confirms the proinflammatory nature of pediatric operations and demonstrates a lessened systemic inflammatory response with the use of heparin-bonded oxygenators. This is achieved without bonding of the entire circuit, which could have significant cost-benefit implications by negating the need for custom-built heparin-bonded circuitry. 相似文献
A primary cardiac osteogenic sarcoma is described in a patient presenting with a left atrial obstructive lesion. Wide surgical excision was possible with left atrial reconstruction and mitral valve replacement. The patient survived the operation and was symptom free for 1 year, finally dying at 18 months of cerebral metastases. 相似文献
The choice of a surgical approach for multi-level cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) is still a controversial issue. While most of the surgeons are still performing decompression by laminectomy some are doing multi-level anterior decompression. Few neurosurgeons are performing decompression by corpectomy. We have treated 26 patients by median cervical corpectomy during the last 4 years. These patients were followed up for a mean period of 25 months. Twenty one (80%) patients had a good outcome, 2 patients remained unchanged and 3 expired. Review of the literature and our experience indicates that patients with CSM and OPLL should be operated by median cervical corpectomy (anterior approach). 相似文献
We report the case of an 8-year-old boy with a parotid mass diagnosed to be a leiomyosarcoma. Considering the unresectable extent of the mass, the patient was subjected to radiotherapy. The patient developed distant metastasis following the course of radiotherapy and was put on chemotherapy. The child was lost to further follow up. To our knowledge, this is the first reported case in the English-language literature of such an entity in the pediatric age group. 相似文献