Objective To introduce the donor heart preservation techniques and study the clini- cal results in 26 patients undergoing orthotopic heart transplantations with long donor ischemia time (DIT) in our center.Methods From Sept.2004 to Aug.2006,26 patients underwent orthotopic heart transplantation at our center with DIT longer than 360 min.Crystalloid cardioplegia was infused through aortic root after aorta was cross clamped.UW solution was used when donor heart was removed.All patients underwent bicaval anastomotic cardiac transplantation.NO was inhaled through ventilator during and after operation in patients with pulmonary hypertension.Results DIT was 360- 560 (mean 401?43) min.There was no operative death in this group.Echocardiography and X-ray examinations in one month were normal.One case of abnormal coronary orifice was subjected to re- anastomosis of aorta.One case of renal failure post-operation was subjected to blood dialysis.Conclu- sion With proper donor heart procurement and preservation,recipient selection,anastomotic technique,efficient postoperative surveillance and pulmonary hypertension treatment,transplanted patients with long DIT can obtain the satisfactory short-term outcome.

The breakage of component is rare in TKA and usually restricted to hinges and linked design. Occasionally fracture of metal tibial component has been noted, but fracture of the femoral component has been rarely reported and occurred to be a significaot problem in TKA. This study reports 2 cases of femoral component fracture using Whiteside Ortholoc total knee system and analyzes the cause of this phenomenon. One pahent, a 67 years old female who weighed 74kg, was performed 1ke left TKA using Whiteside Ortholoc g system with cement. The size of feraoral component was small plus, and small tibial component, 14mm tibial insert and 28mm pateBa were used, The medial site of femoeal component fractured at 38 months postoperatively. A second female patient, who weighed 68kg and was 64 years old at the time of surgery, had also the left TKA using a medium sized femoral component of Whiteside Ortholoc modular system with cement. The small-Ex large tibial component, 8rrun tibial insert were used, but did not replace the pateBa. Also at 37 mainths postaperatively the medial site of femoral compcnent fractured, Ail cases were revised with using a cemented P,F.C. Modular Total Knee System (Johnson k Johnson). All two cases were kactured at the junction between the posterior bevel md distal surface of the medial femoral condyle. The thickness and length of Whiteside Ortholoc femoral component are thinner and shorter at posterior bevel surface compared with other TKA systems. So it is encouraging that a minor design modification of Whiteside Ortholoe femoral component and also should be edueated for the prohibihon of excessive flexion of the knee joint after TKA.
Aged ; Female ; Humans ; Knee Joint ; Knee* ; Middle Aged

Aim To study the expression of caspase-12 mRNA and protein following focal cerebral ischemia-reperfusion in rats,and explore the effect of endoplasmic reticulum pathway on neuronal apoptosis.Methods 60 male Wistar rats were randomly divided into sham-operated group and ischemic group.The middle cerebral artery occlusion(MCAO)models were established by using the intraluminal suture occlusion method,neuronal apoptosis was detected by TUNEL staining,the expression of caspase-12 protein was detected by immunohistochemical staining,the expression of caspase-12 mRNA was detected by RT-PCR method.Results In ischemic group,the number of apoptotic cells and the expression of caspase-12 mRNA and protein were gradually increased following prolonged cerebral reperfusion,reached the peak at 24 h.The number of apoptotic cells and the expression of caspase-12 mRNA and protein in ischemic group were significantly less than those of sham-operated group at all times(P

Candida albicans endophthalmitis following cataract surgery is fortunately rare complication, but once the infection is established, its course is unrelenting and the prognosis for a good visual result is usually very guarded. The authors experienced a case of culture-proved Candida albicans endophthalmitis following intracapsular cataract extraction in a 74-year old man. Endophthalmitis was resolved after treatment with intravitreal injection of amphotericin B, intravenous amphotericin B, oral Ketoconazole and 2% of topical Ketoconazole.
Aged ; Amphotericin B ; Candida albicans ; Candida* ; Cataract Extraction* ; Cataract* ; Endophthalmitis* ; Humans ; Intravitreal Injections ; Ketoconazole ; Prognosis

Contrary to being an idle bystander,the surrounding tumor microenvironment or stroma,actively participates in,and contributes to tumor progression directly or indirectly.It is evident that tumor stromal cells exhibit specific tumor-suppressive and tumor-promoting abilities that serve to regulate neoplastic growth of the epithelium.Due to the mounting evidence demonstrating the far-reaching effects of stroma during the process of malignant transformation,the involvement of stroma in cancer progression has become an area of intense investigations in recent years.

Lipid cell tumors of the ovary are among the rarest of the functional ovarian neoplasms. Recently, authors experienced a case of lipid cell tumor of the left ovary in a 19 year old female, who presented with amenorrhea and hirsutism for 4 years. Grossly, the ovary was well encapsulated, and measured 6.5x6x4.5 cm. Cut surface show homogenous yellowish bulging neoplastic tissue and peritheral displaced normal ovarian tissue. Microscopically, neoplastic cells were composed of rounded and polyhedral cells, arranged in nests seperated by rich vascular networks. On the basis of the author's findings and the evidence available in the literature, we determined this case as ovarian lipid cell tumor.
Female ; Humans

A 55 year old male complain right shoulder pain and right upper quadrant pain about three months. He was a heavy alcoholism. Highly selective angiography, CT scan and operation findings suggest primary malignant neoplasm of the liver. Right hepatic lobectomy and partial diaphragmectomy was done under impression of heaptocellular carcinoma. The specimen measured 15x11x9 cm and disclose relatively hard and nodular mass devoid of cirrhotic changes. Cut surface show unilobar large mass measuring 11x8x6 cm and bearing brightly yellow discoloration and multifocal hemorrhagic necrosis. Histological characteristics were diffuse proliferation of large neoplastic cells with ample cytoplasm, containing granular materials, erythrophagocytosis, neutrophagocytosis and hemosiderin pigments. Atypical and bizarre mitosis and multinucleated giant cells bearing abundant erythro and neutrophagocytosis were frequently seen. The large or vesicular nuclei were irregular, with occasional deep indentations and revealed sharply defined nuclear membrane, coarse chromatin and conspicious nucleoli. Ultrastructurally the cytoplasm of neoplasltic cells had lysosomal granule, phagolysosome, phagocytized material and residual bodies. Immunohistochemical stains for alpha 1-antitrypsin, alpha 1-antichymotrypsin, vimentin and lysozyme showed positive reactions, but, alpha fetoprotein, cytokeratin, S-100 protein, factor VIII, complement 3 receptor and carcinoembryonic antigen were negative. Alpha-naphtyl acetate esterase activity in paraffin embedded tissue ribbon showed negative reaction. These findings show compatible with primary malignant lymphoma, true histiocytic type, (histiocytic sarcoma, Kupffer cell carcinoma) of the liver.
Male ; Humans

Anterior mediastinal teratoma was removed from the right hemithorax of a 15-year-old male patient presenting initially with right chest discomfort and hemoptysis. He was died following precipitous clinical deterioration, 2 months after open thoracotomy. The true malignant nature of this tumor, that there are endodermal sinus tumor and squamous cell carcinoma, was apparent on resection specimen. The former had metastasized to right supraclavicular lymph node. A similar case has not been reported previously on the review of the pertinent literature on malignant mediastinal teratoma.
Male ; Humans

OBJECTIVES: To investigate the correlation of the initial Computerized Tomography(CT) findings of the brain and the functional outcome, and to suggest the initial CT findings as a functional outcome predictor in the traumatic brain injured(TBI) patients. METHODS: Thirty-nine TBI patients were included in this study. Subjects were divided into groups of non-focal or focal TBI, and with or without a depressed skull fracture according to their initial brain CT findings. RESULTS: The non-focal TBI patients were not significantly different from focal TBI patients in the days from onset to rehabilitation, rehabilitation stay, and initial FIM score. However their outcome in FIM gain and FIM efficiency significantly worse than focal TBI patients. The TBI patients with a depressed skull fracture were not significantly different from the patients without a depressed skull fracture in the days from onset to rehabilitation, rehabilitation stay, and intial FIM score. However their outcomes were significantly worse than patients without a depressed skull fractrue in FIM efficiency. CONCLUSION: The initial brain CT findings were generally useful for the prediction of functional outcomes in TBI patients.
Brain Injuries ; Brain* ; Humans ; Rehabilitation ; Skull ; Skull Fracture, Depressed

OBJECTIVETo observe the changes of electrocardiogram (ECG) and pregnancy outcome of the late pregnancy women.

METHODSLate pregnancy women were divided into two groups by age: over 35 group and under 35 group. The incidence of abnormal electrocardiogram was recorded when the patients were subjected to routine ECG examination. Then the pregnancy, delivery outcome and if there's low birth weight newborn were recorded later.

RESULTSThe incidence of abnormal ECG in over 35 group was significantly higher than that in under 35 group (P < 0.05). And the incidence of ST segment changes, arrhythmia in the group of former was higher than that in the group of latter (P < 0.05). Among the different type of arrhythmia, the incidence of sinus bradycardia and ventricular premature beat in the group of former were higher than those in the group of latter (P < 0.05). But the incidence of sinus tachycardia in the former group was obviously lower than that in the latter group (P < 0.05). The incidence of pregnancy loss in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal or abnormal ECG groups (P < 0.05). The incidence of premature birth in over 35 with abnormal ECG group was significantly higher than that in over 35 with normal ECG group (P < 0.05). The incidence of low body weight in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal ECG group (P < 0.05).

CONCLUSIONThe late pregnancy women with the age of over 35 are more likely to have ECG abnormalities, such as arrhythmia, myocardial ischemia and so on. The older pregnant women with abnormal ECG easily suffer from pregnancy losing, premature birth and having a low birth weight baby.

Adult ; Age Factors ; Arrhythmias, Cardiac ; epidemiology ; Electrocardiography ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; epidemiology