Objective To evaluate the application of 64-slice computed tomography (CT) and software-assisted image analysis in preoperative evaluation and surgical planning of hilar cholangiocarcinoma. Methods The clinical data of six patients with hilar cholangiocarcinoma who were admitted to The First Affiliated Hospital of Sun Yat-sen University from June to December, 2009 were retrospectively analyzed. All six patients underwent 64-slice CT scanning before the operation, and then three-dimensional (3D) reconstruction of the liver, tumor, blood vessels and bile ducts was achieved with the assistance of Myrian (R) XP-Hepatic software. The relationships of the tumor, blood vessels and bile ducts were illustrated in the 3D model. Virtual liver resection was carried out for surgical planning. Results The 3D models of the liver, tumor, blood vessels and bile ducts were successfully constructed . The 3D models were able to be rotated and magnified as necessary. Preoperative evaluation and surgical planning were in accordance with actual surgery. The relative accuracy of the software-assisted image analysis system for calculating the hepatic volume to be resected was 5%. Patients recovered well without occurrence of hepatic failure. Conclusion Sixty-four-slice CT scanning and software-assisted image analysis are important for preoperative evaluation and surgical planning of hilar cholangiocarcinoma.

China ; Disaster Medicine ; Disasters ; statistics & numerical data ; Earthquakes ; statistics & numerical data ; First Aid ; statistics & numerical data ; Humans ; Mass Casualty Incidents ; statistics & numerical data ; Rescue Work

Tuberculous aortic aneurysm (TBAA) is an extremely rare clinical event with life-threatening implication. Management for this condition is challenging and its therapeutic option has not been yet established. A few recent reports described endovascular repair rather than open surgery as the method for treatment. Although this remains controversial, endovascular exclusion has been gaining acceptance for some surgeons. We present a case of TBAA who was treated by endovascular stent grafting for a descending thoracic aortic aneurysm with simultaneous anti-tuberculous medication. The outcome was favorable.
Adult ; Aneurysm, Infected ; drug therapy ; microbiology ; surgery ; Antitubercular Agents ; therapeutic use ; Aortic Aneurysm, Thoracic ; drug therapy ; microbiology ; surgery ; Humans ; Male

OBJECTIVETo investigate the polymorphism of DXYS267 locus in China Han population and find the application and characters of its Y-specific single nucleotide substitutions.

METHODSThe locus was analyzed by PCR and PAGE in silver-staining. The Y-specific STR was amplified with newly designed primers according to the Y-specific single nucleotide substitutions.

RESULTSSix alleles were detected in Han population in Wuhan. Exact tests demonstrated that genotype frequencies did not deviate from Hardy-Weinberg equilibrium. Heterozygosity of DXYS267 was 0.6706, discrimination power (DP) was 0.8433, and the probability of paternity exclusion (PE) was 0.5957. The Y-specific STR of DXYS267 was successfully amplified with the new primer. The 4 alleles for Y-STR were detected with haplotype diversity (HD) 0.6372.

CONCLUSIONThe DXYS267 locus is appropriate for individual identification and paternity testing. The new primer is useful for individual and paternity testing involving brothers and mixed stains.

Base Sequence ; Chromosomes, Human, X ; genetics ; Chromosomes, Human, Y ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Tandem Repeat Sequences ; genetics

BACKGROUNDInflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs). In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA.

METHODSBetween 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs. The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors. All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared.

RESULTSThe two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs. 42.4%, P = 0.001) and had larger aneurysms on admission ((7.4 +/- 0.7) cm vs. (6.3 +/- 0.9) cm, P = 0.006). In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5 +/- 9.1) mm/h vs. (11.4 +/- 5.4) mm/h, P < 0.05). Surgical morbidity and mortality rates did not differ between the two groups. The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308 +/- 36) minutes vs. (224 +/- 46) minutes, P < 0.05), but the cross-clamp time was similar in both groups ((41.5 +/- 6.2) minutes vs. (41.8 +/- 6.2) minutes, P = 0.92). A five-year survival rate analysis showed no significant difference between the two groups (P = 0.711).

CONCLUSIONSDespite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause low morbidity and mortality, similar to patients with aAAA. Long term outcome of IAAA patients is of no difference from aAAA patients.

Adult ; Aged ; Aortic Aneurysm, Abdominal ; mortality ; pathology ; surgery ; Atherosclerosis ; complications ; pathology ; Case-Control Studies ; Female ; Humans ; Inflammation ; complications ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo study the effects of early high fat diet on sugar metaboliam, insulin sensibility and pancreatic β cellularity in young rats.

METHODSSixty male weaned young rats were randomly fed with high fat diet (high fat group) and normal diet (control group). The body weight, viscus fattiness and fasting plasma glucose (FPG) were measured after 3, 6 and 9 weeks. Serum insulin level was measured with radioimmunoassay. The ultrastructure of pancreas was observed under an electricmicroscope.

RESULTSThe high fat group had significantly higher body weight and visceral fat weight than the control group after 3 weeks. There were no significant differences in the FPG level between the two groups at all time points. The levels of fasting insulin and HOMAIR in the high fat group were significantly higher than those in the control group after 3, 6 and 9 weeks (P<0.01). Dilation of rough endoplasmic reticulum and mild swelling of mitochondria of islet β-cells were observed in the high fat group after 6 weeks.

CONCLUSIONSEarly high fat diet may induce a reduction in insulin sensitivity and produce insulin resistance in young rats. Endoplasmic reticulum expansion in β-cells may be an early sign of β-cell damage due to obesity.

Animals ; Blood Glucose ; analysis ; Dietary Fats ; adverse effects ; Insulin ; Insulin Resistance ; Insulin-Secreting Cells ; pathology ; ultrastructure ; Intra-Abdominal Fat ; pathology ; Male ; Rats ; Rats, Sprague-Dawley

Aneurysm ; surgery ; Aneurysm, Infected ; surgery ; Aneurysm, Ruptured ; surgery ; Carotid Arteries ; surgery ; Carotid Artery Diseases ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures

OBJECTIVETo summarize the experience of surgical resection of 103 hilar cholangiocarcinoma.

METHODSOne hundred and three consecutive cases of hilar cholangiocarcinoma who underwent surgical resection at our hospital over the past ten years were reviewed retrospectively. The clinical data and long-term outcome were analyzed.

RESULTSOut of 103 cases, 43 patients underwent radical resection (41.7%), and 60 patients underwent palliative resection. There were 34 patients developed postoperative complications and 8 patients died in hospital. For the radical resection group, the median survival time was 29.9 months and 1-year, 3-year, 5-year survival rate was 69.6%, 42.0%, 20.9%, respectively, which was significant greater than 34.1%, 10.2%, 0 of the palliative resection group (P < 0.05). Over the past five years, 42 cases underwent pre-operative drainage of bile and the rate of combined liver resection reached 53.8%. The tumor radical resection rate has increased to 45.7%, the median survival time have reached 24.7 months (P < 0.05).

CONCLUSIONSImprovement of pre-operative management, intraoperative pathology for resection margin, and combined liver resection may help in increasing the radical resection rate. Radical resection can improve postoperative survival, and produce a satisfactory outcome for patient with hepatic hilar cholangiocarcinoma.

Adult ; Aged ; Bile Duct Neoplasms ; mortality ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; mortality ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate

OBJECTIVETo investigate the feasibility of the classification of the spino-pelvic sagittal alignment in adluts according to lumbar lordosis (LL) and inflection point (IP).

METHODSWhole spine, standing radiographs of 223 adult volunteers were taken from July to August in 2011 .There were 111 cases(56 female and 55 male) enrolled in the study based on the inclusion criteria. The pelvic and spinal parameters, including thoracic kyphosis(TK), thoracolumbar kyphosis(TLK), LL, sacral slope(SS), pelvic tilt(PT), pelvic incidence(PI), intervertebral endplate angle, sagittal vertical axis (SVA), spino-sacral angle (SSA) and IP were measured. The spino-pelvic sagittal alignment were classified in to 3 types according to LL and IP. Type I: LL > -40°, IP located below L2 ∼ 3; Type II: -60° ≤ LL ≤ -40°, IP located in L1 ∼ 2 or T12 ∼ L1; Type III: LL < -60°, P located above T11 ∼ 12. Pearson correlation analysis was used to test the correlation between the variables. The parameters in each type were compared by oneway-ANOVA respectively,then additional multiple comparisons were performed.

RESULTSThe mean value of LL was -49° ± 10°, TK was 36° ± 7°, TLK was 6° ± 7°, PT was 11° ± 7°, SS was 34° ± 8°, PI was 45° ± 9°, SSA was 127° ± 9° and SVA was (-2.7 ± 22.8)mm, respectively. Only LL had significant statistical correlation with all the other parameters. Negative correlation presented between LL and TK, PI, SS, SSA (r = -0.387, -0.536, -0.858, -0.801,P < 0.05). Positive correlation presented between LL and TLK, SVA, PT (r = 0.319, 0.296, 0.262, P < 0.05). All the volunteers were classified into the 3 types: Type I1 9 cases, Type II 75 cases,Type III 17 cases. Oneway-ANOVA results showed statistical difference in LL, TK, TLK, PT, SS, PI, SSA, SVA among the 3 types, (F = 164.559, 7.431, 14.099, 4.217, 53.856, 6.252, 35.995, 8.626, P < 0.05 ). Multiple comparisons showed that LL, SS, SSA, PI had statistical difference between each two types comparison (P < 0.05).

CONCLUSIONSLL is the central parameter of the spino-pelvic sagittal balance. The patterns of the spino-pelvic sagittal alignment in adults could be classified into three types, according to LL and IP. The classification could describe the morphological differences and balance of the spino-pelvic sagittal alignment.

Adult ; Analysis of Variance ; Anthropometry ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Pelvis ; anatomy & histology ; Postural Balance ; Radiography ; Spine ; anatomy & histology

Aneurysm, Dissecting ; pathology ; surgery ; Humans ; Male ; Mesenteric Artery, Superior ; pathology ; surgery ; Middle Aged ; Tomography, X-Ray Computed