Objective To investigate the clinical features , diagnosis and treatment of ectopic thyroid in order to avoid misdiagnosis and mismanagement .Methods Six cases of ectopic thyroid admitted to Fuzhou Gen-eral Hospital from Jan .2000 to Oct.2011 were retrospectively analyzed and the literatures were reviewed .Re-sults Three cases of ectopic thyroid were located in the anterior cervical area , 2 cases were at the base of the tongue and 1 case in the gall bladder .Two cases of aberrant thyroid were confirmed preoperatively in patients whose gland wasn't discovered by imaging examinations at the normal position of the thyroid gland .A symptomless individual of aberrant thyroid did not need other treatment but follow-up.One case with foreign body sensation in pharynx had a good response to thyroxine therapy .Four cases with accessory thyroid were operated because of misdiagnosis .Three cases were ectopic thyroid tissue and one was nodular goiter confirmed by pathology .None of these patients developed hypothyroidism after surgery .Conclusions Ectopic thyroid gland is a rare disease fre-quently misdiagnosed and mistreated .Goiters in the commonly location of ectopic thyroid gland such as the anteri-or cervical area and the base of the tongue should be paid special attention .Hormonal therapy or surgical inter-vention should be chosen according to clinical features , type of the goiter , thyroid function and whether it is be-nign or malignant .Long term follow-up and thyroid function tests are absolutely necessary .

Objective To analyze the differences between calculated and actual volumes of regions of interest ( ROIs) in three treatment planning systems ( TPSs):PrecisePlan, Xio, and Oncentra, to transfer different ROIs and compare their calculated volume between the three TPSs, and to provide a basis for clinical application. Methods Different sizes of ROIs were delineated on 5 sets of computed tomography ( CT) images with different slice thickness. Square and round regions with different slice numbers were contoured in a homogeneous phantom. Three groups of patients ( n=5) with head and neck tumor, chest and abdomen tumor, and pelvic tumor, respectively, were enrolled as subjects. All the ROIs were independently transferred back and forth between three TPSs and different workstations with the same system in DICOM RT format. The changes in actual and calculated ROI volumes were evaluated after back and forth transfer. Results There was a significant positive linear correlation between the calculated volume, slice thickness, slice number, and actual volume of ROI in each TPS ( PrecisePlan:R2=0. 994, P<0. 01;Xio:R2=0. 997, P<0. 01;Oncentra:R2=0. 995, P<0. 01) . There were significant differences in all calculated ROI volumes of the head, chest and abdomen between the three TPS ( P<0. 05) except for the calculated ROI volumes of the chest and abdomen between Oncentra and Xio ( P=0. 114 ) . Conclusions The variations in volume calculation algorithm and slice thickness are the main causes of differences in calculated ROI volume. Particularly, small?volume ROIs have the greatest variation in calculated volume. To avoid a secondary reconstruction of ROI volume, it is recommended to transfer ROI back and forth between dose calculation workstations with the same TPS.

Objective To investigate the time of spontaneous recovery of atelectasis after removing the acute airway foreign bodies in miniature pigs.Methods Twenty-two miniature pigs were inserted into the occlusion stent in the right lower lobe bronchus by using bronchoscopy.After confirming the formation of atelectasis,the occlusion stent was removed and the imaging changes were observed for 3 weeks continuously.Results Atelectasis was formed within 1 week after the airway occlusion stent implantation in miniature pigs.Pulmonary reexpansion was observed obviously on week 3 after removal of airway occlusion stent (P ＜0.05).Conclusions The spontaneous recovery time of atelectasis,which caused by an acute foreign body airway obstruction within 1 week,may take 3 weeks at least.

OBJECTIVETo investigate the classification criterion and surgical treatment strategy of intrathoracic esophageal injury caused by foreign body.

METHODSEighty-four patients with intrathoracic esophageal injury caused by foreign body in our department from January 1980 to April 2004 were divided into 4 grade: grade I was non-penetrated injury of esophagus (18 cases); grade II was esophageal perforation with mild mediastinitis (39 cases); grade III was esophageal perforation with severe intrathoracic infection (17 cases); grade IV was aortoesophageal fistula (10 cases). Based on the degree of esophageal injury and the extension of inflammation, operative procedures were selected including esophagotomy, esophageal reparation, esophagectomy, mediastinal drainage, reparation of fistula and replacement of aorta.

RESULTSPatients in grade I and II were all cured . One death occurred in grade III (1/17), the same in Grade IV was 9 (9/10).

CONCLUSIONSClassification of esophageal injury caused by foreign body is helpful to the decision of surgical treatment strategy. The prevention of aortoesophageal fistula is the key point of reducing of mortality.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Esophageal Perforation ; classification ; etiology ; surgery ; Esophagectomy ; Esophagoscopy ; Esophagus ; injuries ; surgery ; Female ; Foreign Bodies ; complications ; Humans ; Infant ; Injury Severity Score ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo explore CT and MRI manifestations of the axial area peripheral primitive neuroectodermal tumors (pPNETs) in order to improve the knowledge of this disease.

METHODSThe clinical data of 10 patients with pPNETs underwent pathologically confirmed were retrospectively analyzed from October 2008 to May 2014. There were 7 males and 3 females, aged from 8 to 49 years old with median of 23.6 years. The preoperative multi-slice spiral CT scan was completed in 3 cases, plain CT scan and enhancement in 4 cases; MRI and enhancement scanning in 5 cases; and among them, 2 cases underwent both MRI and CT scan.

RESULTSIn-bone type was found 6 cases and out-bone type was found 4 cases. Three cases occurred in sacral vertebrae, 2 cases in lumbar vertebrae, 1 case in cervical vertebrae, 1 case in cervical spinal canal, 1 case in coccyx, 1 case in the right iliac bone, 1 case in presacral space. Cross sectional the smallest tumor maximum level was 1.1 cmx 1.2 cm in size, the biggest tumor was 8.0 cm x 9.2 cm, the median size was 4.4 cm x 5.7 cm, of them, the tumor of maximal diameter larger than 5 cm had 6 cases. Except 2 cases-without destruction of bone, the other 5 cases with osteolytic destruction, 2 cases with calcification, 1 case with mixed. Equidensite was main in CT scan, 1 case with uniform density, other 6 cases with uneven density,in which 3 cases with "floating ice" change; 1 case with moderate strengthening, other 3 cases with obviously strengthening, 2 cases with multiple small blood vessels in enhancement scanning. MRI of 5 cases showed the signal of isointensity on T1WI, the slightly high signal on T2WI and the signal was not uniform; after enhancement scan, the signal of 5 cases obviously enhanced. Two patients complicated with vertebral compression fractures, no periosteal reaction was found in all patients, and no the destruction of intervertebral disk was found in 5 patients of MRI scan.

CONCLUSIONThe axial area pPNETs is common among children and the youth, and the mass often is huge. The mass of in-bone type often envelopes the vertebral body, and main located on prevertebral space, all associated with bone destruction, osteolytic destruction is common, and primary vertebral bodies also is common, attachment primary or involvement is few found, it can involve the spinal canal and anterior wall of spinal canal is common, some cases complicate with multiple newly born small vessels. The mass of out-hone type in deep soft tissue is common, minority primary spinal canal, many complicated with vertebral bone destruction, osteolytic destruction was main. The intervertebral disk was not invaded and intervertebral space has not stenosis. CT scan offer complicate with "floating ice" sign, and in-bone type is common. Isointensity is main on MRI TlWI and slightly longer signal is main on MRI T2WI, strengthening signal is obvious.

Adolescent ; Adult ; Child ; Cross-Sectional Studies ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuroectodermal Tumors, Primitive, Peripheral ; diagnosis ; diagnostic imaging ; Radionuclide Imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo study the diagnostic value of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy.

METHODSTwenty healthy volunteers and fifty patients with cervical spondylotic myelopathy underwent DTI in the Affiliated Hospital of Medical College of Ningbo University from January 2014 to April 2015. Healthy volunteers served as controls. Fifty patients were divided into three groups (group A , B, C) according to cervical MRI scan standard. Group A (17 cases) had only the dura mater spinalis compressed; Group B (23 cases) showed the cervical spinal cord compressed, but no high signal in it; Group C (10 cases) had the cervical spinal cord compressed with high signal in the same level. The average apparent diffusion coefficients(ADC) and fractional anisotropy (FA)values in these examinee were analyzed and all subjects were performed fiber tracking.

RESULTSThere was no statistically significant differences in ADC and FA values in C2/C3, C3/C4, C4/C5, C5/C6, C6/C7 of control group (P>0.05). The average ADC and FA values in control group were (0.875 +/- 0.096) x10(3) mm2/s and 0.720 +/- 0.051, respectively; compared with group A,there was no statistically significant difference; compared with group B and C, there was significant difference; comparison among group A, B, C, there was significant differences.

CONCLUSIONDTI can early and accurately quantify the changes of microstructure in cervical spondylotic myelopathy. Fiber tracking can show the damage range of spinal cord lesions.

Adult ; Case-Control Studies ; Cervical Vertebrae ; diagnostic imaging ; Diffusion Tensor Imaging ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spondylosis ; diagnostic imaging ; Young Adult

Adult ; Aged ; Aged, 80 and over ; Fascia Lata ; surgery ; Female ; Humans ; Male ; Middle Aged ; Synovial Cyst ; surgery

OBJECTIVETo evaluate the staging criteria and surgical treatment strategy of traumatic intrathoracic esophageal perforations by foreign bone.

METHODSFifty-seven patients with intrathoracic esophageal perforations caused by foreign bone in our department from January 1980 to June 2006 were studied. Patients were divided into 4 grades: grade I was esophageal perforation without mediastinitis (n=17), grade II was esophageal perforation with severe mediastinitis (n=13), grade III was esophageal perforation with severe empyema (n=21), grade IV was esophageal perforation with tracheal or aorto-esophageal fistula (n=6). Based on the stage of esophageal perforation, operative procedures were selected including esophagotomy, esophageal repair, esophagectomy, mediastinal drainage, and esophagus reconstruction with colon.

RESULTSIn grade I, II and III, all but one patient experienced satisfactory healing of the esophagus. One patient died of multi-organ failure from septic complication. No leakage was observed. Normal swallowing function and improved weight gain was achieved in all the patients. There were 2 deaths in grade IV (2/6).

CONCLUSIONSGrading of esophageal perforation caused by foreign bone is helpful to the decision of surgical treatment strategy.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Esophageal Perforation ; classification ; surgery ; Esophagus ; pathology ; surgery ; Female ; Foreign Bodies ; classification ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Young Adult

OBJECTIVETo study the effect of tanshinone II A on the cell signal transduction system protein kinase B (Akt) in rats with hypertrophy of the myocardium induced by partial constriction of the thoracic aorta.

METHODSRat models of myocardial hypertrophy were established by the thoracic aorta partial constriction method. Forty-eight rats were randomly divided into the sham-operative group, the model group, the valsartan treatment group, and the low-, medium-, and high-dose tanshinone treatment groups. The heart mass index (HMI), left ventricular mass index (LVMI), ejection fraction (EF), left ventricular posterior wall (LVPW), and interventricular septal thickness (IVS) were detected by high-frequency ultrasonography. The myocardial fiber diameter (MFD) was detected by HE staining, and the contents of p-Akt and p-Gsk3beta in the myocardium were detected by Western blot.

RESULTSCompared with the sham-operative group, the levels of HMI, LVMI, LVPW, IVS, and MFD were increased respectively in the other groups (P<0.05); the contents of p-Akt and p-Gsk3beta were also increased in the other groups. Compared with the model group, the levels of HMI, LVMI, LVPW, IVS, and MFD were decreased respectively in all treatment groups (P<0.05); the contents of p-Akt and p-Gsk3beta were decreased in all treatment groups as well. There was no significant difference, however, among the low-, medium-, and high-dose tanshinone treatment groups and the valsartan treatment group (P>0.05).

CONCLUSIONTanshinone II A can prevent myocardial hypertrophy by its action on the protein kinase B (Akt) signaling pathway.

Animals ; Cardiomegaly ; enzymology ; prevention & control ; Diterpenes, Abietane ; Drugs, Chinese Herbal ; Phenanthrenes ; pharmacology ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Signal Transduction ; drug effects

OBJECTIVETo study the clinicopathologic features and immunophenotype of intraabdominal extranodal follicular dendritic cell sarcoma (FDCS) and the relationship with Epstein-Barr virus (EBV).

METHODSThe clinical and histologic features of 4 cases of FDCS were evaluated. Immunohistochemical study was performed using standard EnVision method for CD21, CD23, CD35, S-100 protein, CD68, HLA-DR, vimentin, epithelial membrane antigen, desmin, CD34 and CD117. In-situ hybridization for EBV-encoded RNA (EBER) was carried out in 2 cases.

RESULTSThe age of patients ranged from 28 to 63 years (mean=42 years). The male-to-female ratio was 3:1. The clinical presentation was abdominal discomfort, pain or mass. Radiologic examination revealed concurrent lesions in stomach and left lobe of liver in 1 patient, while non-specific intraabdominal masses were detected in the remaining cases (in which the tumor was later found to be located in the appendix, mesentery of jejunum and omentum). Two cases were misdiagnosed as gastrointestinal stromal tumor before operation. Grossly, the tumors appeared as large solid nodules, with a mean diameter of 10.8 cm. Three of the cases showed areas of necrosis. Histologically, there were plump spindle, ovoid to epithelioid cells associated with scattered multinucleated giant cells. The tumor cells were arranged mostly in storiform pattern, whorls, fascicles or solid sheets. Lymphocytic infiltrates with perivascular cuffing were noted in all cases, resulting in a distinctive biphasic pattern. Two tumors showed significant cytologic atypia, with mitotic figures (including atypical mitotic figures) readily demonstrated. The remaining case (occurring in liver) was composed of scattered large atypical cells embedded in a dense inflammatory background, mimicking inflammatory pseudotumor. Immunohistochemical study showed that all cases were positive for CD21, CD23 and vimentin. There was focal expression of CD35, S-100 protein, CD68, HLA-DR and epithelial membrane antigen. The staining for CD34 and CD117 was negative. In-situ hybridization for EBER was negative in 2 cases tested.

CONCLUSIONSIntraabdominal extranodal FDCS is extremely rare. Familiarity with its characteristic histologic features and immunophenotype is important in distinguishing the tumor from other intraabdominal spindle cell lesions (such as gastrointestinal stromal tumor). Hepatic FDCS may show inflammatory pseudotumor-like features, resulting in misinterpretation. Non-hepatic intraabdominal FDCS seems to have little association with EBV infection.

Abdominal Neoplasms ; metabolism ; pathology ; virology ; Adult ; Dendritic Cell Sarcoma, Follicular ; metabolism ; pathology ; virology ; Diagnosis, Differential ; Epstein-Barr Virus Infections ; Female ; Gastrointestinal Stromal Tumors ; pathology ; Granuloma, Plasma Cell ; pathology ; Humans ; Immunophenotyping ; Male ; Middle Aged ; Receptors, Complement 3d ; metabolism ; Receptors, IgE ; metabolism ; Vimentin ; metabolism