Adolescent ; Adult ; Aged ; Endoscopy ; Epistaxis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; Young Adult

Endoscopic sinus surgery is effective to nasal sinus mucocele with eye symptoms as main manifestation. It is very importment to raise the awareness of the disease and to prompt imaging examination. Three cases were reviewed. One mucocele was found in the frontal sinus ethmoid sinus,1 in the fronto-ethmoid sinus and 1 in the spheno-ethmoid sinus. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. Nasal sinus mucocele with eye symptoms as main manifestation should be early diagnosed. Endoscopic sinus surgery is a safe and effective method for the treatment of nasal sinus mucocele,and could be the primary choice for it. All cases were treated by nasal endoscopic sinus surgery. The majority of symptoms, such as exophthalmos, epiphora and diplopia, disappeared in all patients. However, vision recovery was observed only in some patients.
Diplopia ; complications ; Endoscopy ; Ethmoid Sinus ; pathology ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Lacrimal Apparatus Diseases ; complications ; Magnetic Resonance Imaging ; Mucocele ; complications ; diagnosis ; Paranasal Sinus Diseases ; complications ; diagnosis

Objective To investigate the feasibility and safety of autologous tumor tissue lysate loading den-dritic cells(DC) for the treatment of hepatocellular carcinoma (HCC). Methods The monocytes-derived DC were induced and antigen loaded with tumor tissue lysate to produce DC vaccine. Vaccination and clinical observation were conducted in 12 HCC patients for 41 times. Results The average output of DC was 1.69×107(1.69×107±9.44×106>) from 90 ml peripheral blood. 63.41% (26/41)patients appeared to develop delayed-type hypersensitivity after intradermal injection. After an average of 9 months follow up, 1 patient out of 4 recurrence and metastasis pa- tients survived for 17 months. The other three patients progressed. Out of 8 patients undergoing immunotherapy post- operatively,6 patients had no signs of recurrence and the others were found to have liver rceurrence and progression. Conclusion DC based immunotherapy is safe and feasible,with no side effects,which can be applied in the immu- notherapy strategy of HCC patients.

Objective:To investigate the most effective strategy for mature induction of dendritic cells.Methods:Human monocyte-derived dendritic cells were induced in the presence of cytokines GM-CSF and IL-4. On day 6, the immature DCs were pulsed with each of CD40L, LPS, TNF-? or a cocktail of cytokines(TNF-?, IL-6, IL-1?, PGE2). DCs were harvested after 24 h induction. The surface markers for maturation CD80,CD83,CD86 and HLA-DR were detected by FCM. FITC-Dextra endocytic activity was measured by FCM. IL-12 production was detected by ELISA. The capacity of DCs for T cell activation was detected by MTT assay.Results:CD40L,LPS,TNF-? and the cocktail of cytokines all could induce DCs’ maturation. The most effective scheme for induction of maturation was the cocktail of cytokines, and the expression rate of CD83 was up to 66.91%(P

OBJECTIVE: To investigate the diagnosis and treatment of esophageal perforation and neck abscess induced by esophageal foreign body and to make a better solution for the disease. METHOD: Twenty-four cases with esophageal perforation and neck abscess induced by esophageal foreign body treated in our department were surgery under general anesthesia. The foreign bodies were removed via esophagoscope in 14 cases, thorocomy in 3 eral neck incision in 5; and no foreign bodies were found in 2 cases. RESULT: There were 16 cases complicated by abscess. Among these complications,there were 10 cases of periesophageal abscess,4 cases of neck abscess and 1 case of mediastinal abscess. In 24 patients, 21 cases cured and one died. One case was sent to the department of endocrinology because of hyperglycaemia and two cases were sent to the department of thoracic surgery for further treatment. CONCLUSION Early diagnosis and treatment is the key to the management of esophageal perforation induced by esophageal foreign body. Thin-section CT has a high value for the diagnosis and differential diagnosis in such patients. Once deep neck abscess is diagnosed, an early abscess surgical drainage, an appropriate antibiotics and a nutrition supporting treatment are effective for the patients.
Abscess ; etiology ; surgery ; Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Drainage ; Esophageal Perforation ; etiology ; surgery ; Esophagus ; Female ; Foreign Bodies ; complications ; surgery ; Humans ; Male ; Middle Aged ; Neck ; pathology ; Young Adult

OBJECTIVE: To investigate the efficacy of endoscopic nasal cavity expansion surgery on obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal obstruction. METHOD: Clinical data of 48 OSAHS patients with structural abnormality in nasal cavity treated in our department were retrospectively analysed. These patients received endoscopic nasal cavity expansion surgery and were observed for the relief of both subjective and objective symptoms. RESULT: PSG was reexamined 12 months postoperatively. Of all the patients, 29 cases (60.4%) showed complete recovery, 10 cases (20.8%) showed remarkable improvement of the symptoms, 4 cases (8.3%) exhibited curative effect and 5 cases (10.4%) were of no effect, respectively. The symptoms of apnea, hypopnea, LSaO2 and somnolence were significantly improved in all patients,and nasal congestion was obviously relieved. The improvement of snore was not evident. CONCLUSION Endoscopic nasal cavity expansion surgery is effective and safe for the treatment of OSAHS mainly due to nasal obstruction. Operation should be performed to correct structural abnormality in nasal cavity and adjust symmetric distribution of nasal airflow on both sides in order to maintain normal ventilation function. The procedure is applicable to OSAHS patients accompanied by nasal congestion and upper airway resistance syndrome and personalized adjustment is beneficial for better clinical efficacy according to the condition of different patients.
Adult ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Nasal Obstruction ; complications ; pathology ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; etiology ; surgery ; Treatment Outcome ; Young Adult

BACKGROUND: Both aperture and porosity are mainly evaluating markers for three-dimensional poly materials. The higher the porosity is, the easier the growth and proliferation of cartilage cells are. However, with the successive increasing of porosity, compressive strength of scaffolds decreases and utility of aperture also decreases. Therefore, it is extremely significant for tracheal cartilage tissue engineering to establish three-dimensional poly scaffolds which have suitable aperture and porosity.OBJECTIVE: To establish tube foam scaffolds by using solvent casting/particulate leaching method so as to find out practical and ideal scaffolds for tracheal cartilage tissue engineering.DESIGN: Observational study.SETTING: Department of Otolaryngology, Taihe Hospital, Yunyang Medical College; Department of Otolaryngology, West China Hospital, Sichuan University.MATERIALS: The experiment was carried out in Chemical Institute, Chengdu Sub-college of Chinese Academy of Sciences from March to May 2002. Poly-D, L-lactic acid (PDLLA, Mr= 4.23×104) and sodium chloride granules (50-200 μm in diameter) were used as porogenic agent.METHODS: PDLLA was dissolved in chloroform in spherical-shape glass container to dispend 100 g/L solution and then add with sodium chloride granules (50-200 μm) based on various mass fractions of 800, 850, 900, 920, 940 and 960 g/L. Sodium chloride granules were regarded as porogenic agent (scaffolds numbered from 1 to 6) to stir and make paste suspension. Continuously, suspension was cast into tube models, heated at 90 ℃, compressed,and maintained in ventilation cabinet for 48 hours for solvent volatilization. And the resting solvent was drawn out.Form-fitting drying tube foam scaffolds were taken out and dipped in double distilled water for 48 hours so as to remove sodium chloride. The double distilled water was changed every 8 hours. Then, all tube materials were dried in vacuum drying oven for 24-48 hours. While, three-dimensional PDLLA scaffolds were successfully established.Form and intensity of scaffolds were observed with gross and scanning electron microscope; meanwhile, pore parameter was measured and analyzed.MAIN OUTCOME MEASURES: ①Gross observation of tube foam scaffolds;② measurement of pore parameters.RESULTS: ①Scaffolds were appeared as white tube foam with 8 mm in internal diameter and 12 mm in outside diameter.Scaffolds with 80-250 μm in bore and 90.6% in porosity had defined strength and ductility. ②Scanning electron microscope demonstrated that there were many holes distributed in PDLLA scaffolds in various sizes. Otherwise, hole of scaffolds was connected to each other, while big hole also contained numerous small holes. ③Porosity of scaffolds increased with the increasing mass fraction of sodium chloride; but effective porosity did not increase with the increasing mass fraction of sodium chloride. There were different effective porosities of bore (80-250 μm). Effective bore of number 4 sample was 76% and relative porosity was 90.6%. Therefore, number 4 sample was an ideal scaffold for tracheal cartilage tissue engineering.CONCLUSION: Tube foam scaffold fabricated by solvent casting/particulate leaching method is suitable for tracheal cartilage tissue engineering.

OBJECTIVE: To investigate the clinopathological characteristics, differential diagnosis, therapy and prognosis of sinonasal mucosal malignant melanoma. METHOD: Clinopathological data of 18 cases which were diagnosed by pathology and immmunohistochemistry were analyzed retrospectively. All cases were proved by pathology and immmunohistochemistry. All cases were performed operations. 5 underwent single surgery. 4 underwent surgery plus adjuvant radiotherapy. 4 underwent surgery plus adjuvant radiotherapy chemotherapy. 5 underwent surgery plus adjuvant chemoradiation. RESULT: All cases were followed up for a period of 1 to 7 years after operation. Twelve patients died of tumor until the last follow-up, meanwhile 6 patients stayed alive. In Six cases recurrence occurred. In five casescervical lymph node metastasis occurred, of which 3 cases received neck dissection and 2 cases received chemotherapy and radiotherapy due to no surgical indications. In three cases distant metastasis oc- curred. CONCLUSION Sinonasal mucosal malignant melanoma is rare and highly heterogenous. Current diagnosis depends on clinical characteristics and immunohistochemical examination. It still should be differentially diagnosed from other tumors. CT and MRI image examination can provide some helpful information to understand the extent and nature of lesions. The treatment of nasal endoscopic or the surgery under endoscopy has become to be a safe, viable and reasonable alternative to open resection. Appropriate indication must be carefully selected for these lesions.
Chemotherapy, Adjuvant ; Endoscopy ; Humans ; Lymphatic Metastasis ; Melanoma ; drug therapy ; pathology ; surgery ; Mucous Membrane ; Neck Dissection ; Neoplasm Recurrence, Local ; Nose Neoplasms ; Paranasal Sinus Neoplasms ; drug therapy ; pathology ; surgery ; Prognosis ; Radiotherapy, Adjuvant ; Retrospective Studies

OBJECTIVE: To explore and discuss the characteristics of benign fibro-osseous lesion of naso-sinuses and the features and indications of different surgical choice with endoscope. METHOD: Fourteen patients with benign fibro-osseous lesion of naso-sinuses were treated through endoscopic surgery, of which 9 cases underwent endonasal endoscopic surgery simply, 2 cases were operated with a superciliary arch incision through endoscope, 1 case underwent endoscopic caldwell-luc' surgery, 1 case was operated with endoscopic surgery through frontal recess of tears, and 1 case was operated with Draf II surgery under endoscope. RESULT: In all of patients, 2 cases relapsed, 2 cases had residual lesions, 4 cases had complications including numbness and scar of incision, no relapse and no complications in other 6 cases. CONCLUSION Endoscopic resection of benign fibro-osseous lesion of naso-sinuses with different surgical choice was of special advantages, but the exactly indications, relapse rate and complications should be observed and reckoned deeply.
Cicatrix ; Endoscopes ; Endoscopy ; Frontal Bone ; Frontal Sinus ; Humans ; Neoplasm Recurrence, Local ; Paranasal Sinus Neoplasms ; surgery

OBJECTIVE: To investigate the efficacy of CO2 laser treatment for patients with precancerous laryngeal lesions under phonomicrosurgery and to explore the points for attention in operation. METHOD: They were all treated with phonomicrosurgery techniques as mucosal epitheliumablation or mucosal stripping by using CO2 laser. Eight patients with laryngeal papilloma were excised by CO2 laser. RESULT: All patients were treated with CO2 laser surgery successfully. During follow-up of 6 to 39 months, all patients survived. Local recurrence or canceration were detected in 3 cases, of which 2 cases with laryngeal papilloma underwent CO2 laser treatment in one year post-operatively, while the other case with severe dysplasia underwent laryngeal vertical partial laryngectomy and post-operative radiotherapy one and half year postoperatively due to canceration. No local recurrence occurred until the last follow up. No severe complications such as dyspnea and hemorrhage occured. CONCLUSION CO2 laser surgery is an effective and minimally invasive treatment for precancerous laryngeal lesions. Through selecting the appropriate patient and paying attention to the operation during surgery, the adhesion of vocal cord can be reduced or even be avoided after CO2 laser surgery.
Adult ; Aged ; Carbon Dioxide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Laser Therapy ; Lasers, Gas ; therapeutic use ; Male ; Microsurgery ; Middle Aged ; Precancerous Conditions ; surgery ; Treatment Outcome