Objective To analyze the MRI findings and study the correlations between pathologic, clinical and MRI findings of demyelinating pseudotumor in brain. Methods Pathologic,clinical and MRI findings in 8 cases proved pathologically with demyelinating pseudotumor in brain were retrospectively analyzed. Results The clinical manifestations comprised mostly dyskinesia and/or limb sensory disability, as well as epilepsy in few cases. MRI showed a single focal lesion mainly invading subcortical white matter in every case, and most lesions were showed round or nearly round with clear boundary, homogenous low signal on T1WI and high signal on T2WI, and marked enhancement. Pathological examination showed demyelinating, perivascular inflammatory infiltration consisting predominantly of lymphocytes, and glial cell proliferation. Conclusions MRI can well mirror the pathological and clinical changes of demyelinating pseudotumor in brain, so MRI plays an important role in its diagnosis. It is easy to make a differential diagnosis between glioma and supratentorial demyelinating pseudotumor, but it is difficult for those lesions in cerebellum. For such cases, both clinical and MRI diagnosis are necessary. Trial treatment of corticoids or even biopsy is available for those cases that are difficult to diagnose by clinical and MRI methods.

Objective To investigate the clinical, pathological and dynamic imaging characteristics of patients with mitochondrial myopathy,encephalopathy,lactic acidosis and stroke-like episodes (MELAS). Methods A retrospective analysis was performed on the clinical,pathological and dynamic imaging data of 10 patients with MELAS confirmed by muscle biopsy. Results The clinical manifestations included headache,seizures,nausea,vomiting,nystagrnus and visual disturbances.CT showed less lesions,and MRI could clearly show multiple lesions which mainly located in the temporal,parietal,occipital cortex and sub-cortex,having multifocal,asymmetric,migratory characterstics and not following the distribution of blood vessels.MRA showed no significant stenosis,and the lesion showed hyperperfusion and vasogenic edema,and Lae peak was visible.Muscle biopsy showed ragged red fiber optical microscope (RRF) and strongly SDH-reactive vessel (SSV),and electron microscope showed increased mitochondria number, and abnormal size and shape. Conclusion MELAS has certain clinical and imaging characteristics; by combining the muscle biopsy,we can diagnose the disease early and make differential diagnosis.

OBJECTIVETo summarize the methods, safety and efficiency of surgical resection for hilar cholangiocarcinoma.

METHODSThe clinical and follow-up data of 48 patients with hilar cholangiocarcinoma underwent surgical resection from January 2003 to December 2007 were analyzed retrospectively. There were 26 male and 22 female, aged from 38 to 72 years old with a mean of 63.6 years old.

RESULTSPerioperative management including percutaneous transhepatic biliary drainage applied in 19 cases and portal vein embolization applied in 2 cases. Eight patients were treated with extrahepatic bile duct resection with or without parital hepatic segment II resection, 10 cases with perihilar hepatic resection (segment IVB, partial V, partial VIII, I), 28 cases with extended hemihepatectomy and 2 cases with central hepatic resection (segment IVB, V, VIII, I). R0 resection rate was 89.5% and the operative mortality was 2.1%. The 1-, 3- and 5-year survival rate were 93.5%, 51.8% and 36.5%, respectively. Patients undergoing extended hepatic resection survived significantly longer than those undergoing partial hepatic resection (P = 0.034).

CONCLUSIONSExtended hepatic resection for hilar cholangiocarcinoma offers good outcomes with an acceptable mortality rate.

Adult ; Aged ; Bile Duct Neoplasms ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo find a procedure for facial rejuvenation which is simple, safe with lasting aesthetic results based on facial anatomic study.

METHODSAnatomy study was performed on 12 sides from 6 head specimens. Observe the range and thickness of fat lateral to the nasolabial grooves. Observed the location of the skin retaining ligaments and reappraised their functions combining with clinical observations.

RESULTSSkin and subcutis and SMAS (including mimic muscles) become slackening with aging, but the loosening degrees are different, especially in the region lateral to the nasolabial groove. So they should be handled respectively. The fat lateral to the nasolabial groove is thick and is mobile with aging . So the subcutaneous detachment need not beyond the anterior border of the masseter. In the past two years, we performed rhytidectomy on 100 patients by limited subcutaneous detachment and SMAS double-plication. Satisfactory results were obtained. There are no serious complications observed.

CONCLUSIONSRhytidectomy by limited subcutaneous detachment and SMAS double-plication is a simple and safe procedure with lasting aesthetic results.

Face ; anatomy & histology ; Head ; anatomy & histology ; Humans ; Male ; Middle Aged ; Neck ; anatomy & histology ; Rhytidoplasty ; methods

OBJECTIVETo study the prevalence of asthma and its correlated factors in Zaozhuang area in 2003, to provide a basic consideration for prevention/treatment and control policy.

METHODS6 points were selected by stratified-clusterd-random sampling with a total of 16,725 persons expected, but only 10,610 subjects investigated.

RESULTSIn this survey, 128 asthma cases were identified with a overall prevalence of 1.21%. The prevalence for children was 2.02%, and for adult was 0.90% with the former significantly higher then the latter (chi(2) = 21.39, P < 0.01). Rates for male and female were 1.08%, 1.32% with a ratio of 1:1.22. For 77.97% of children with asthma. The initiative age of asthma was before 7 years old among children while among 36.23% of the adults, it was before 15 years of age. Correlation analysis showed that upper respiratory tract infection (OR = 17.81, 95% CI: 12.25-25.89), cold air exposure (OR = 3.43, 95% CI: 2.41-4.90), stimulation through cooking and by harmful gases (OR = 2.56, 95% CI: 1.80-3.63), allergic materials (OR = 2.74, 95% CI: 1.80-4.17) were main inducing factors. 65.63% of the asthma cases having had history of allergic disease while 25.78% having had family history with the OR of allergic history and family history as 21.69 vs. 73.96.

CONCLUSIONThe epidemic status of bronchial asthma was serious, with an assumption that asthma cases might have reached the number of 43 thousand in Zaozhuang area.

Adolescent ; Adult ; Aged ; Asthma ; epidemiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Risk Factors

OBJECTIVEAdhesive or too highly located folds upper eyelid and even blepharoptosis are common complications of double eyelid operation. To correct such deformities.

METHODWe shifted down the double eyelid line, removed adhesion thoroughly, relieved orbital fat and restarted the volume with infraorbicularis oculi fat flap.

RESULTWe had treated 32 case in past two years. The results were satisfying.

CONCLUSIONThe method are acted easy and gained fine result, so behaving to extend application.

Adipose Tissue ; transplantation ; Adult ; Blepharoplasty ; methods ; Eye Abnormalities ; etiology ; surgery ; Eyelids ; abnormalities ; pathology ; Female ; Humans ; Oculomotor Muscles ; surgery ; Postoperative Complications ; surgery ; Tissue Adhesions ; Young Adult

OBJECTIVETo analyze operative and perioperative factors associated with hepatectomy.

METHODS2008 consecutive patients undergoing hepatectomy from January 1986 to December 2005 at Chinese People's Liberation Army General Hospital were investigated retrospectively according to their medical documentation. Diagnoses were made on basis of pathological results.

RESULTSMalignant and benign liver diseases accounted for 58.5% and 41.2%, respectively. In the former, primary liver cancer accounted for 76.1% and hilar cholangiocarcinoma for 6.7%. Hemangioma (41.7%) and hepatolithiasis (29.6%) were listed in the first two in the latter group with relatively more patient ratios. Isolated caudate lobe resection was performed in 25 patients and micro-wave inline coagulation was induced in 236 cases of liver resection. In all cases, those with blood loss less than 200 ml accounted for 50.5% (1015/2008), whereas those with more than 400 ml accounted for 28.4% (570/2008). In patients performed micro-wave inline coagulation liver resection, those with blood loss less than 200 ml and more than 400 ml accounted for 60.6% (143/236) and 19.9% (47/236), respectively, which differed significantly from the average level (P < 0.05). The postoperative complication incidence was 14.44% for all cases, 12.54% for primary liver cancer, 16.40% for secondary liver cancer, and 16.32% for hepatolithiasis. Complication incidence of primary liver cancer with tumor size smaller than 5 cm was 11.65% and that with tumor larger than 10 cm was 14.69%. There was no significant difference between the two groups. All-case hospital mortality was 0.55% and that for liver malignant disease was 0.60%, hilar cholangiocarcinoma 2.53%.

CONCLUSIONHepatectomy can be performed safely with low mortality and low complication incidence, provided that it is carried out with optimized perioperative management and innovative surgical technique.

Blood Loss, Surgical ; statistics & numerical data ; Female ; Hepatectomy ; methods ; mortality ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; epidemiology ; Retrospective Studies

BACKGROUNDHepatectomy is a standard hepatic surgical technique. The safety of hepatectomy has been improved in line with improvements in surgical techniques. This study analyzed the operative and perioperative factors associated with hepatectomy.

METHODSA total of 2008 patients who underwent consecutive hepatectomies between January 1986 and December 2005 were investigated retrospectively. Diagnoses were made based on pathological findings.

RESULTSMalignant and benign liver diseases accounted for 58.5% and 41.2%, respectively, of the conditions requiring resections. Primary liver cancers accounted for 76.1% of the malignant tumors, while hilar cholangiocarcinomas accounted for 6.7%. Hemangiomas (41.7%) and hepatolithiasis (29.6%) were the most common of the benign conditions. Microwave in-line coagulation was used in 236 of our liver resection cases. The overall postoperative complication rate was 14.44%, of which 12.54% of resections were performed for primary liver cancer, 16.40% for secondary liver cancer, and 16.32% for hepatolithiasis. The overall hospital mortality was 0.55%, and that for malignant liver disease was 0.51%. A high mortality (2.53%) was associated with extensive liver resections for hilar cholangiocarcinomas (two deaths in 79 cases). Microwave in-line pre-coagulation resection, Child-Pugh grading, operating time, postoperative length of stay, and preoperative serum albumin level were independent predictors of morbidity. Blood loss, Child-Pugh grading, operating time and preoperative serum albumin level were independent predictors of mortality.

CONCLUSIONSHepatectomy can be performed safely with low morbidity and mortality, provided that it is carried out with optimal perioperative management and innovative surgical techniques.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Hepatectomy ; adverse effects ; mortality ; Humans ; Liver ; physiopathology ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Morbidity ; Postoperative Complications ; etiology

OBJECTIVETo evaluate the early results of precise liver resection.

METHODSBetween May 2006 and June 2009, 65 patients with complicated liver space-occupying lesions were included in the study. Fifty-one patients underwent curative liver resection. Liver resections performed included 16 trisectionectomies, 11 hemihepatectomy, 5 meso hepatectomies, 3 combined segmentectomies, 5 caudate lobectomies and 11 irregular local resections.

RESULTSPatients undergoing resection had no mortality with a major morbidity of 9.8%. Nineteen vascular repairs and reconstructions were patent at last follow-up. The postoperative 1-year survival rate was 100% in 10 patients with benign lesions and 92.7% in 41 patients with malignant tumors. The 1-year survival rate was zero in patients with malignant tumors, who underwent no liver resection.

CONCLUSIONSPrecise liver resection, as an aggressive surgical approach, offers hope for these patients, who would otherwise have a dismal prognosis.

Adult ; Aged ; Female ; Hepatectomy ; methods ; Humans ; Liver ; surgery ; Liver Diseases ; surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

OBJECTIVETo report clinical experience of percutaneous endoscopic gastrostomy, duodenostomy, jejunostomy in 120 patients, focusing on its technique and indications.

METHODSOne hundred and twenty patients received percutaneous endoscopic gastrostomy, duodenostomy, jejunostomy from May 2001 to April 2004, including 75 percutaneous endoscopic gastrostomy (PEG), 42 percutaneous endoscopic jejunostomy (PEJ), 2 percutaneous endoscopic duodenostomy (PED), 1 direct percutaneous endoscopic jejunostomy (DPEJ). All tubes established by traditional pull technique.

RESULTSThe average duration of PEG was (9 +/- 4) min, PEJ (17 +/- 6) min, DPEJ 20 min, and PED was 10 and 12 min for 2 patients, respectively. Success rate of the technique was 98.4% (120/122). Major complication rate was 0.8% (1/120), and minor complication rate was 7.5% (9/120). Clinical indications: PEG, PED and PEJ were applied for long-term enteral nutritional support in 88 patients, gastrointestinal decompression in 25 patients, and transfusing external drainage bile to gastrointestinal tract in 5 patients. Two radiation enteritis patients used PEG for gastrointestinal decompression preoperatively and long-term enteral nutritional support postoperatively.

CONCLUSIONPEG, PED PEJ and DPEJ are easily handled, effective and safe, and may be widely used in clinical practice.

Adult ; Aged ; Duodenostomy ; methods ; Endoscopy, Gastrointestinal ; Enteral Nutrition ; Female ; Gastrostomy ; methods ; Humans ; Jejunostomy ; methods ; Male ; Middle Aged