OBJECTIVETo explore a new method for body surface orientation of the puncture site, determination of the direction of the needling and puncture depth for caudal block.

METHODSThree-dimensional reconstruction of the pelvis was performed in 8 cases for measuring the distances between the sacral hiatus and the planned site of anesthetic delivery and the size of the sacral hiatus. After image processing with the technique of shaded surface display (SSD), the shapes of sacral hiatus and sacral tube were evaluated.

RESULTSThree-dimensional reconstruction of the pelvis in the 8 cases allowed clear view from any directions of the sacral hiatus and sacral tube and accurate measurement of the size of the sacral hiatus. After simulated cutting of half of the rumpbone, the distances between the sacral hiatus and the drug injection site were accurately measured. With these measurements, accurate preoperative localization of the puncture site on the skin was achieved and the anesthesia was successful in all the cases.

CONCLUSIONSThis technique can provide accurate data for localization of the puncture site on the skin and determination of the direction of the needling and the puncture depth for caudal block to increase the successful rate of anesthesia, lower the operative risks and allow simulated operative training.

Adolescent ; Adult ; Aged ; Anesthesia, Caudal ; methods ; Anthropometry ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Reproducibility of Results ; Sacrum ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVETo observe the efficacy of biological dressing containing calcium and magnesia (sheep dermis absorbing calcium and magnesia and cross-link with glutaraldehyde) on the management of hydrofluoric acid burns in rats and patients.

METHODSWistar rats were randomly divided into A ( n = 24, normal control, with isotonic saline dressing after burns), B ( n = 32, with isotonic saline dressing treatment after hydrofluoric acid burns), C ( n = 32, with wet-dressing treatment after hydrofluoric acid burns), and D ( n = 32, with biological dressing treatment after hydrofluoric acid burns) groups. The rats in the latter 3 groups were inflicted with 3 cm x 3 cm TBSA full-thickness burns, and mortality, concentration of blood calcium , histopathological observation were carried out at 4,8,24 and 72 postburn hours (PBH), with 8 rats at each time-points. In addition, 46 patients with hydrofluoric acid burns were divided into E (with wet-dressing treatment) and F (with biological dressing treatment) groups to compare the curative effect.

RESULTSThe mortality in A,B,C,D groups were 0,31.2% ,15. 6% ,6. 2% , respectively. The wound in B group was deepened gradually after burns, but that in D group was slighter when compared with that in C group. The concentration of blood calcium in A group was higher than that in B, C and D groups at each time-points, and that in D groups was higher than that in B and C groups. The concentration of blood calcium in D group at 8 and 24 PBH were [(2.215 +/-0.008) ,(2.216 +/-0.008) mmol/L], which were obviously higher than those in B [(1.813 +/-0.017),(1.912 +/-0.013)mmol/L l] and C [(2.015 +/-0.006), (2.018 +/-0. 010)mmol/L] groups, (P <0. 01). The clinical outcome in E group was much better than that in F group.

CONCLUSIONBiological dressing containing calcium and magnesium can be applied in the emergency management and following treatment after hydrofluoric acid burns.

Adult ; Animals ; Biological Dressings ; Burns, Chemical ; therapy ; Calcium ; therapeutic use ; Disease Models, Animal ; Female ; Humans ; Hydrofluoric Acid ; Magnesium ; therapeutic use ; Male ; Middle Aged ; Rats

OBJECTIVETo investigate an ideal method for finger reconstruction with extended the second toe flap transfer.

METHODSThe second toe free flap was created, combined with an pedicled skin flap from the fibular side of the great toe inlaid in the ventral side of the second toe, a double-wing flap and the distal part of the metatarsal bone. The composite free flap was transferred by vascular anastomosis for finger reconstruction.

RESULTSThe reconstructed finger exhibited nice looking and better function. The procedure had little influence to the appearance and function of the donor foot.

CONCLUSIONThis method is effective in ameliorating the appearance and function of the reconstructed finger with the second toe transfer.

Adult ; Female ; Fingers ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply ; Toes ; surgery ; Treatment Outcome

OBJECTIVETo analyze the CT and magnetic resonance imaging (MRI) findings of craniopharygioma and explore the correlation between the pathological findings and clinical features of the disease.

METHODSThe CT and MRI findings of 123 pathologically confirmed craniopharygioma cases were reviewed retrospectively in conjunction with the pathological findings and surgical data.

RESULTSThis patient cohort consisted of 70 male and 53 female patients with their age ranging from 1 to 72 years (mean 23.82 years). Of the 123 craniopharyngioma patients, 59 were found to have adamantinous craniopharyngiomas, 41 had papillary squamous craniopharyngiomas, and 23 had mixed tumors. Solid tumor was found in 18 cases, cystic tumor in 38 cases, and calcification in 78 cases; in 23 cases, the posterior of the tumor did not exhibit clear boundary from the wall of the three cerebral ventricles, and in 11 cases CT and MRI displayed hypophysial stalk, which was found intraoperatively in 53 cases.

CONCLUSIONSMRI allows clear vision of the range of craniopharyngioma involvement and the anatomical structures surrounding the tumor. CT, on the other hand, shows better performance in displaying the calcification foci. Accurate identification of the site, dimension, calcification patterns and relation between the hypophysial stalk and hypothalamus by the imaging modalities significantly benefits the optimization of the surgical plan for the tumor.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Cohort Studies ; Craniopharyngioma ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo analyze the magnetic resonance imaging (MRI) features of supratentorial primitive neuroectodermal tumors (sPNET) and improve the diagnosis of this disease.

METHODSMRI manifestations of 14 cases of PNET were retrospectively analyzed and compared with their pathological features.

RESULTSThe supratentorial lesions involved the occipital lobe in 4, frontal lobe in 3, fronto-occipital lobe in 2, temporo-occipital lobe in 3, lateral ventricle in 1 case and the saddle region in 1. All the lesions were large in volume and most of them presented heterogeneous signals in MRI. Of the 14 cases, 12 showed cystic degeneration and necrosis, 2 had hemorrhage and 6 showed signs of emptied small blood vessels. Twelve cases had heterogeneous enhancement and 2 had moderate enhancement. Pathologically, 10 cases of neuroblastomas were identified, along with 3 ganglioneuroblastomas and 1 atypical rhabdoid tumor.

CONCLUSIONMRI findings of PNET are rather characteristic to assist in the diagnosis and treatment of the disease, but a final definite diagnosis still relies on pathological examination.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neuroectodermal Tumors, Primitive ; diagnosis ; diagnostic imaging ; pathology ; Radiography ; Retrospective Studies ; Sensitivity and Specificity ; Supratentorial Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Young Adult

OBJECTIVETo study the value of ultrasound, abdominal X-ray, and dual-source CT (DSCT) in the diagnosis of colon tumor obstruction.

METHODSA retrospective analysis was conducted among 45 patients who were admitted to our department between October 2010 and August 2011 for abdominal pain. All the patients underwent ultrasound, abdominal X-ray and DSCT examinations and subsequent surgical interventions, which confirmed the diagnosis of colon tumor obstruction.

RESULTSDSCT diagnosis was obviously more efficient than ultrasound and X-ray in detecting colon obstruction by neoplasms, and could better predict the position of the obstruction. Complete information of the vessels in the surgical field could be obtained by DSCT imaging three-dimensional reconstruction.

CONCLUSIONSCompared with ultrasound and X-ray, DSCT is more effective in the diagnosis of colon tumor obstruction by acquiring more thorough information by imaging reconstruction and should be considered for a rapid and accurate diagnosis.

Adult ; Aged ; Colonic Neoplasms ; complications ; Female ; Humans ; Intestinal Obstruction ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVETo evaluate the efficacy and safety of weekly paclitaxel combined with S-1 or fluorouracil in the first line treatment of advanced gastric carcinoma.

METHODSTwo hundred and forty patients with untreated advanced gastric carcinoma were randomized into two arms, patients in the experimental arm were given paclitaxel and S-1, while those in the control arm received paclitaxel and fluorouracil. The regimen of experimental arm was paclitaxel 60 mg/m(2) by intravenous infusion, day 1, 8, 15; S-1 80 - 120 mg/day given by oral administration, day 1 - 14. The regimen of control arm was fluorouracil 500 mg/m(2) by intravenous infusion continuously, day 1 - 5; CF 20 mg/m(2) by intravenous infusion, day 1 - 5. The regimens in both arms were repeated every 28 days. The efficacy and safety of both arms were assessed.

RESULTSTwo hundred and twenty-eight patients were analyzed in the full analysis set, and 192 patients were analyzed in per-protocol set (experimental arm 100 patients, control arm 92 patients). The overall response rates of experimental and control arms were 50.0% and 28.3% (P = 0.002), and the disease control rates were 82.0% and 70.7% (P = 0.064), respectively. The primary endpoints of experimental arm were non-inferior to that of the control arm. The secondary endpoint of experimental arm in terms of median progression free survival was significantly better than that of control arm (5 months versus 4 months, P = 0.006). The experimental arm had a higher incidence of grade III-IV bone marrow suppression than the control arm, but the incidence of fever in both arms was not significantly different.

CONCLUSIONSOral administration of S-1 is an alternative option of venous infusional fluorouracil. Weekly paclitaxel combined with S-1 is a safe regimen and has a promising efficacy.

Adenocarcinoma ; drug therapy ; pathology ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Squamous Cell ; drug therapy ; pathology ; Diarrhea ; chemically induced ; Disease-Free Survival ; Drug Combinations ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; Follow-Up Studies ; Humans ; Leukopenia ; chemically induced ; Male ; Middle Aged ; Neoplasm Staging ; Oxonic Acid ; administration & dosage ; adverse effects ; Paclitaxel ; administration & dosage ; adverse effects ; Prospective Studies ; Remission Induction ; Stomach Neoplasms ; drug therapy ; pathology ; Survival Rate ; Tegafur ; administration & dosage ; adverse effects