1.Clinical and imaging characteristics of bilateral medial medullary infarction in elderly patients
Xuemei WANG ; Yanling WANG ; Yijie SHI ; Hongpeng ZHANG ; Qiling JI ; Xiaokun GENG ; Huishan DU
Chinese Journal of Geriatrics 2019;38(3):255-259
Objective To investigate the clinical features of bilateral medial medullary infarction (BMMI)in elderly patients.Methods Clinical and imaging data of 8 elderly BMMI patients with different morphology on diffusion-weighted magnetic resonance imaging (DWI-MR) were retrospectively analyzed.All patients were diagnosed by MRI,while 4 patients received CTA and vascular ultrasound testing,and the other 4 patients received vascular ultrasound testing.Results All 8 cases(100.0%) had acute-onset BMMI.Patients showed varying degrees of acroparalysis(7/8,87.5 %),dizziness (5/8,62.5 %),dysarthria(6/8,80.0 %),dysphagia(3/8,37.5 %),deep or superficial sensory dysfunction(5/8,62.5 %),consciousness disorders (2/8,25.0 %),dyspnea (2/8,25.0 %),and tinnitus(1/8,12.5 %).Lesions in most patients were located in the upper part of medulla oblongata(7/8,87.5 %).In the transverse direction of DWI,the lesions as the inverted V shape were seen in 3 cases (37.5%),the V shape(12.5%)in 1 case,the Y shape(37.5%)in 3 cases,and the heart shape(12.5%) in 1 case.All 8 patients were complicated with posterior cerebral artery stenosis or occlusion,of whom patients with heart-or Y-shaped lesions showed progressive exacerbation.After treatment,4 cases (50.0 %) recovered,3 cases (37.5 %) improved,and 1 case (12.5 %) unrecovered before discharge from the hospital.Conclusions Most elderly BMMI patients have concurrent posterior circulation artery stenosis,and patients with heart-or Y-shaped lesions on MR-DWI show rapid progression and have a poor prognosis.Cranial examination with MR-DWI is helpful for early clinical diagnosis of BMMI,prediction of disease progression and effective prevention of complications.
2. Analysis and comparison of the clinical features and prognosis between extra - gastrointestinal stromal tumors and duodenal gastrointestinal stromal tumors
Hongpeng SHI ; Zhenqiang WANG ; Zhiyuan FAN ; Mingde ZANG ; Jiaomeng PAN ; Qingqiang DAI ; Yanan ZHENG ; Zhenglun ZHU ; BirendraKumar SAH ; Wentao LIU ; Zhongyin YANG ; Runhua FENG ; Xuexin YAO ; Mingmin CHEN ; Chao YAN ; Min YAN ; Zhenggang ZHU ; Chen LI
Chinese Journal of Gastrointestinal Surgery 2019;22(9):856-860
Objective:
To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra-gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST).
Methods:
A retrospective case - control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra - gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann-Whitney