1.The mechanism of neurovascular decompression for essential hypertension
Journal of Medical Postgraduates 2001;14(3):255-256,259
Essential hypertension, which is common in population, has an unclear etioligy and the medical therapy is predominantly used. In the last few years, some studies found that the blood pressure could be elevated with the pulsatile compression at the root entry zone(REZ) of the Ⅸ、Ⅹcranial nerve, which may considered to be one of the causes of essential hypertension. Neurovascular decompression moderates the pulsatile compression, and is to be a new method for the treatment of essential hypertension, especially for refractory hypertension. This article summarized the mechanism of neurovascular decompression for essential hypertension and the operative courses.
2.Treatment of brain deep lesions by stereotaxy
Kangjian SUN ; Qifu TAN ; Kehua SUN
Journal of Medical Postgraduates 2001;14(3):221-223
Objectives:To discuss the effects of stereotactic techniques in treating brain deep lesions. Methods: Eighty-two patients with deep brain lesions were treated by fisher stereotactic apparatus and ASA-601S. Among these, stereotactic biopsy was performed in 22, clearance of haematoma in 5 (2 located in brain stem), aspiration of brain abscess in 2 and placement of Ommaya tube into cystic craniopharyngioma in 53. Results: All of the 22 biopsies were pathologically diagnosed, which included 10 cases of glioma, 4 cases of germ cell tumor, 3 cases of brain parasite, 4 cases of metastatic lung tumor and one case of hyperplasia of colloid cells at rear end of third ventricle, which turned to be glioma in follow-up period. Tumor resection was performed in 4 patients with glioma and radiation therapy for other tumors. After the treatment, 6 patients were fully recovered ( 4 with germ cell tumor and 2 with metastatec tumor). All brain parasite, brain abscess and brain haematoma were cured. Three patients with craniopharyngioma were cured after the placement of Ommaya tube (with radiation therapy inside the cyst), and others were improved. Conclusions:Stereotaxy has the advantages of precise location, less damage, easy manipulation and on the safe side. It is worth advocating.
3.Diagnosis and treatment of craniocerebral firearm wounds in peacetime
Kehua SUN ; Yicheng LU ; Jian ZHOU
Chinese Journal of Trauma 2003;0(11):-
Objective To review the features of diagnosis and treatment of craniocerebral firearm wounds in peacetime. Methods A total of 86 cases with various kinds of firearm wounds were retrospectively analyzed for discussing the characteristics of diagnoses and treatment of firearm wounds so as to provide the best treatment methods for firearm wounds of the brain. Results Of all, 80 cases (93%) won full recovery and four (5%) partial recovery but two (2%) were died of massive vascular damage and severe cerebral injuries within 24 hours after operation. Conclusions Craniocerebral firearm wounds are among the most devastating causes for morbidity and mortality in the civilian population. It is important to remove all foreign bodies, especially broken bones and necrotic tissues, and turn the open injury to the close injury. Stereotactic technique, localization of foreign bodies, culture of foreign body bacteria, drug allergy test and correct use of antibiotic and antiepileptic drugs are also critical for eliminating mortality and complications of craniocerebral firearm wounds.
4.Comparison of maximum slope and deconvolution algorithms in multi-slice CT hepatic perfusion measurement
Kehua PAN ; Guoquan CAO ; Houzhang SUN ; Aimin WANG ; Xianzhong GUO ; Xiufen JIA
Chinese Journal of Radiology 2016;50(7):537-541
Objective To evaluate the reliability of CT perfusion parameter values of the normal hepatic segments and neoplasms, obtained with deconvolution (DC) and maximum slope (MS) algorithms. Methods Perfusion parameter values of 111 ROIs in 62 normal hepatic segments and 49 neoplasms derived from 62 CT perfusion studies performed with 320 multi-slice CT, were retrospectively analyzed by two experienced radiologists. BF,BV and PI according to DC and MS algorithms were compared with t paired test, Pearson correlation and Bland-Altman agreement analysis. Interobserver agreement for all perfusion parameters was calculated using intraclass correlation coefficients (ICC). Results Interobserver agreement measured with ICC was very good for all perfusion parameters (≥0.95). BFdc and BVdc exceeded the BFms and BVms in normal hepatic segments and neoplasms (P<0.05); PIdc significantly exceeded the PIms in normal hepatic segments(P<0.05) ,while no difference were found in hepatic neoplasms(P>0.05). Both pairs of perfusion measurements significantly correlated with each other(r>0.9, P<0.01),but the agreement of BF, BV and PI according to DC and MS algorithms was not good. Conclusions CT perfusion values such as BF,BV and PI obtained by DC and MS algorithms correlated significantly with each other, but with poor agreement.
5.Surgical treatment of gliomatosis cerebri
Kangjian SUN ; Jixin SHI ; Handong WANG ; Kehua SUN ; Youwu FAN ; Chunhua HANG ; Huilin CHENG ; Wei XIE ; Yunxi PAN ; Hongxia YIN ; Jie LI ; Changchun HUA ; Liang QIAO
Journal of Medical Postgraduates 2004;0(01):-
Objective:To discuss the diagnosis, treatment and outcome of patients with gliomatosis cerebri (GC). Methods:Retrospectively reviewed the clinical manifestations and radiological appearances of 6 patients with GC, which were diagnosed in our hospital between 1993 and 2003. We employed surgical treatment in three patients, stereotactic biopsy in two, and the other one received both biopsy and surgery. Results: The lesions of GC infiltrated more than two lobes in brain. CT studies showed diffuse hypodensity changes and enhancement was absent in four patients. MRI examinations revealed isointense or hypointense regions on T1WI, and uniformly high signal on T2WI. MRI also disclosed structural enlargement. All patients received radiotherapy after surgery and three patients underwent chemotherapy additionally. Five patients died during follow up with average course of 16.4 months. Conclusion:MRI examination is valuable in the diagnosis and the prognosis of GC is poor.
7.A case report of primary Ewing’s sarcoma of penis
Xianxian QIU ; Yinyin ZHAO ; Kehua JIANG ; Xiaohu TANG ; Fa SUN
Chinese Journal of Urology 2020;41(9):707-708
Ewing sarcoma is a member of the Ewing sarcoma family tumor(ESFT), which is commonly from bones and soft tissues, while it is rare for penis. In this thesis, a case of 21-year-old Ewing sarcomas on the left side of the penis was reported. After the penis mass excision, the pathological diagnosis was Ewing sarcoma and positive margin, then he underwent penis total hysterectomy. After the surgery, he received chemotherapy for 14 cycles without radiation. With 8 months’ reexamination and follow-up, there was no local recurrence or metastasis.