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Background and Objectives@#There have not been any studies that compared retroauricular hairline (RAH) and V-shaped incisions for parotidectomy. In this regard, we aimed to evaluate the results of RAH and V-shaped incisions.Subjects and Method Between 2016 and 2019, 81 patients who underwent parotidectomy using RAH (n=46) and V-shaped (n=35) incisions were included in this study. Patient characteristics, tumor profiles, surgical parameters, postoperative complications, and cosmetic results were assessed. Mann-Whitney U test and the chi-squared test were used to inspect differences in continuous and categorical variables between the groups, respectively. @*Results@#In the RAH and V-shaped groups, the patient age was 52.7 and 42.1 years, respectively (p=0.002), and the tumour size was 2.7 and 1.8 cm, respectively (p<0.001). All parotidectomies were successfully completed with no incision extension or major complications. There were no significant differences in surgical parameters and postoperative complications between the two groups. The subjective scar satisfaction scores assessed at 3 months postoperatively were 9.0 and 9.3 in the RAH and V-shaped groups, respectively (p=0.191). The scores of male patients were 8.9 and 9.5 in the RAH and V-shaped groups, respectively, (p=0.026), while those of the female patients were 9.2 and 9.2, respectively (p=0.906). @*Conclusion@#The RAH and V-shaped incisions yields comparable surgical and cosmetic outcomes, with high patient satisfaction. For male patients, the use of V-shaped incision, if indicated, would provide higher scar satisfaction than the use of RAH incision.
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Tracheal granuloma, the most commonly reported sequela of pediatric tracheotomy. A variety of techniques are available for the management of tracheal granuloma. Potassium-titanyl-phosphate (KTP) laser has been previously established as an acceptable technique for removal of laryngeal surgery, which emits a green light with a wave length of 532 nm, which is well-absorbed by hemoglobin and can coagulate and vaporize tissue. The ability to deliver laser energy through a flexible glass fiber makes the technique convenient for use with a rigid bronchoscope, overcoming problems with intraluminal access encountered with earlier attempts at CO2 laser therapy for this problem. Another advantage of KTP laser is the avoidance of the risks and morbidity associated with an open procedure. We report our surgical technique KTP laser in the management of tracheal granuloma removal into the tracheostomy site. KTP laser is good tool for management of tracheal granuloma with low incidence of complications.
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Objective:To investigate the clinical management value of chitinase 3-like 1 protein(CHI3L1) in hepatocellular carcinoma (HCC) by studying the expression of CHI3L1 in peripheral blood, liver cancer and paired adjacent non-tumor tissues.Methods:Retrospective study. From 2013 to 2017, 405 patients with HCC in Third Affiliated Hospital of Naval Medical University were enrolled into the study. Meanwhile, 112 patients with liver cirrhosis (LC), 114 health subjects were included as disease and health controls. CHI3L1 in peripheral blood was detected by ELISA kit. Tissues array was made by collecting 90 pairs of tumor tissues and matched paracancer tissues, from HCC patients who were conformed by pathology. The expression of CHI3L1 in HCC tissues was analyzed by immunohistochemistry. Differences between independent groups were tested by Mann-Whitney U test or Kruskal Wallis H test, Pearson correlation analysis was used for analyzing the relationship between two subjects, and matched rank sum test was used for cancer tissue and adjacent tissue comparison. Results:The median (quartile) of CHI3L1 protein in LC group, HCC group and NC group was 195.8 (103.3,330.4) μg/L,118.2 (74.9,201.0) μg/L,46.8 (30.7,66.4) μg/L independently. The protein level of CHI3L1 in LC group was significantly higher than that in HCC group and health control group ( Z=5.186,12.928, P<0.001). HCC group was significantly higher than that in health control group ( Z=10.788, P<0.001). The level of CHI3L1 in HCC group was not related to whether liver cirrhosis was accompanied ( Z=-0.286, P=0.775). The level of serum CHI3L1 was positively correlated with noninvasive fibrosis markers (HA, PⅢNP, Ⅳ-C, FIB-4 index) ( r=0.202,0.159,0.299 and 0.221, P<0.05) and negatively correlated with ALB( r=-0.326, P<0.05) while positively correlated with AST and PT( r=0.138, 0.160, P<0.05). Positively correlation was observed between CHI3L1 and tumor size ( r=0.284, P<0.001). CNLC stage [CHI3L1 level in advanced group125.2(81.9,228.5)μg/L was higher than that in early group112.0(70.2,169.2)μg/L ( Z=-2.326, P=0.018)], but no correlation with microvascular invasion( Z=-1.531) and tumor capsule(χ 2=0.818, P>0.05). In 73 cases of HCC tissues, the positive rate of CHI3L1 was 78% (57/73) in cancer tissues and 83%(61/73) in paired adjacent non-tumor tissues. The staining intensity score of paracancer tissue 1.5(1.5,2.5) was higher than that of cancer tissue 1.5(1.5,2.0)( Z=-2.053, P=0.040). Conclusions:The tissue source of CHI3L1 protein in HCC includes cancer tissue and paracancerous tissue. The detection of serum CHI3L1 level is helpful to evaluate tumor load assessment and disease stratification management in HCC.
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Tracheal granuloma, the most commonly reported sequela of pediatric tracheotomy. A variety of techniques are available for the management of tracheal granuloma. Potassium-titanyl-phosphate (KTP) laser has been previously established as an acceptable technique for removal of laryngeal surgery, which emits a green light with a wave length of 532 nm, which is well-absorbed by hemoglobin and can coagulate and vaporize tissue. The ability to deliver laser energy through a flexible glass fiber makes the technique convenient for use with a rigid bronchoscope, overcoming problems with intraluminal access encountered with earlier attempts at CO2 laser therapy for this problem. Another advantage of KTP laser is the avoidance of the risks and morbidity associated with an open procedure. We report our surgical technique KTP laser in the management of tracheal granuloma removal into the tracheostomy site. KTP laser is good tool for management of tracheal granuloma with low incidence of complications.
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OBJECTIVE: To investigate the value of high-flow nasal cannula oxygen therapy after extubation in patients with acute respiratory failure. METHODS: A single-center, prospective, randomized, controlled pilot trial was conducted between January 2013 and December 2014. Sixty enrolled patients were randomized immediately after extubation into either a high-flow nasal cannula group (n=30) or an air entrainment mask group (n=30) at a fixed inspired oxygen fraction (40%). The success rate of oxygen therapy, respiratory and hemodynamic parameters and subjective discomfort (using a visual analogue scale) were assessed at 24h after extubation. RESULTS: The two groups were comparable at extubation. A total of 46 patients were successfully treated including 27 patients in the high-flow nasal cannula group and 19 patients in the air entrainment mask group. Compared to the air entrainment mask group, the success rate of oxygen therapy and the partial pressure of arterial oxygen were significantly higher and the respiratory rate was lower in the high-flow nasal cannula group. In addition, less discomfort related to interface displacement and airway dryness was observed in the high-flow nasal cannula group than in the air entrainment mask group. CONCLUSIONS: At a fixed inspired oxygen fraction, the application of a high-flow nasal cannula after extubation achieves a higher success rate of oxygen therapy and less discomfort at 24h than an air entrainment mask in patients with acute respiratory failure.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Oxygen Inhalation Therapy/methods , Respiratory Insufficiency/therapy , High-Frequency Ventilation/methods , Airway Extubation/methods , Cannula , Oxygen/metabolism , Oxygen Inhalation Therapy/instrumentation , Time Factors , High-Frequency Ventilation/instrumentation , Pilot Projects , Acute Disease , Prospective Studies , Reproducibility of Results , Treatment Outcome , Equipment Design , Hemodynamics , Intensive Care Units , MasksABSTRACT
The Wiskott-Aldrich Syndrome (WAS) is an X-linked immunodeficiency condition characterized by microthrombocytopenia, eczema and recurrent infections. It is caused by mutations in the Wiskott-Aldrich Syndrome protein (WASP) gene. We investigated two Malay boys who presented with congenital thrombocytopenia, eczema and recurrent infections. Here we report two cases of WASP mutation in Malaysia from two unrelated families. One had a novel missense mutation in exon 1 while the other had a nonsense mutation in exon 2. Both patients succumbed to diseaserelated complications. A differential diagnosis of WAS should be considered in any male child who present with early onset thrombocytopenia, especially when this is associated with eczema and recurrent infections.
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We installed seaweed reef for restoration of barron ground coast. We hollowed out a U-shaped groove in a cross-shaped artificial seaweed reef and covered it with a zinc sheet (U-bar) to transplant Ecklonia cava growing on Dellenia wood by hand, installing the U-bar on the artificial seaweed reef, fixing it with concrete. Thus seaweed can be attached easily, with pre-installed stainless bolts and nuts. The length of Ecklonia cava leaf transplanted to the cross-shaped reef was 7.2 cm in February 2005 reached its maximum size, 35.9 cm (n=30) by July. Thereafter, it decreased to 18.9 cm in October due to shedding. The leaf weight after the experiment was 24.8 from the initial 0.4 cm (n=30). Regression analysis showed Y=0.7875X-4.6488 (R2=0.7225) for blade length and Y=0.0025X2.6733 (R2=0.8711) for leaf weight. The high values of the R2 values for the two measurements were highly reliable, with the reliability of the linear regression function higher than that of the functions of 2 variables. The artificial seaweed forest constructed in the barren ground was highly comparable with natural seaweed forest in terms of growth, indicating that the artificial seaweed construction can be done in an easy, efficient and economically viable way. This further indicates that the technology developed by the present study can be extensively used for the project for artificial seaweed forest construction.
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The nodal stage of colorectal cancer is based on the number of positive nodes. It is inevitably affected by the number of removed lymph nodes, but lymph node ratio can be unaffected. We investigated the value of lymph node ratio in stage III colorectal cancer in this study. The clinicopathologic factors and follow-up data of 145 cases of stage III colorectal cancer between January 1998 and December 2008 were analyzed retrospectively. The Pearson and Spearman correlation analyses were used to determine the correlation coefficient, the Kaplan-Meier method was used to analyze survival, and the Cox proportional hazard regression model was used for multivariate analysis in forward stepwise regression. We found that lymph node ratio was not correlated with the number of removed lymph nodes (r = -0.154, P = 0.065), but it was positively correlated with the number of positive lymph nodes (r = 0.739, P < 0.001) and N stage (r = 0.695, P < 0.001). Kaplan-Meier survival analysis revealed that tumor configuration, intestinal obstruction, serum carcinoembryonic antigen (CEA) concentration, T stage, N stage, and lymph node ratio were associated with disease-free survival of patients with stage III colorectal cancer (P < 0.05). Multivariate analysis showed that serum CEA concentration, T stage, and lymph node ratio were prognostic factors for disease-free survival (P < 0.05), whereas N stage failed to achieve significance (P = 0.664). We confirmed that lymph node ratio was a prognostic factor in stage III colorectal cancer and had a better prognostic value than did N stage.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Carcinoembryonic Antigen , Blood , Chemotherapy, Adjuvant , Colectomy , Colorectal Neoplasms , Blood , Drug Therapy , Pathology , General Surgery , Disease-Free Survival , Follow-Up Studies , Lymph Node Excision , Lymph Nodes , Pathology , General Surgery , Lymphatic Metastasis , Neoplasm Staging , Prognosis , Proportional Hazards Models , Rectum , General Surgery , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To study a kind of surgical instrument for the treatment of ankle fractures in elderly patients.</p><p><b>METHODS</b>From October 2007 to May 2009, 14 patients (9 males and 5 females,ranging in age from 58 to 81 years, averaged 69.3 years) with ankle joint fractures of type A and B were treated with modified 1/3 tubular plate combined with lag screws. According to the Danis-Weber classification, 6 patients were type A and 8 patients were type B. The AOFAS criteria was used to evaluate clinical effects.</p><p><b>RESULTS</b>All the patients were followed up ranged from 12 to 18 months and healed. The time of union of fractures ranged from 10 to 16 weeks. According to the clinical assess standard of AOFAS, the average score was 88.0 +/- 2.1.</p><p><b>CONCLUSION</b>It is one of good choices to use modified 1/3 tubular plate and lag screws to treat ankle joint fractures in elder patients.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Ankle Injuries , General Surgery , Bone Plates , Bone Screws , Fracture Fixation, Internal , Fractures, Bone , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To propose a new computer software-based medical image processing technique with high resolution digital scanner for radiotherapy verification.</p><p><b>METHODS</b>Under the platform of Windows 2000, the software, programmed with Visual C++.NET, was developed according to modular design. All data of the films and the treatment planning system could be processed as images or dose curves for a robust result.</p><p><b>RESULTS</b>Many functions such as data acquisition, automatic analysis and computation and image processing were integrated in the system. Both geometric and dosimetric errors could be calculated at the same time to verify the radiotherapy accuracy.</p><p><b>CONCLUSION</b>This system has good accuracy and stability for cost-effective radiotherapy verification.</p>
Subject(s)
Humans , Film Dosimetry , Image Processing, Computer-Assisted , Radiotherapy Dosage , Reference Standards , Radiotherapy Planning, Computer-Assisted , Methods , Reproducibility of Results , SoftwareABSTRACT
The crude toxin was extracted from hypha and culture solution of Phyllosticta commelimecola through three different polarity solvent: benzinum, puncificatum ethyl acetate and chloroform. The result indicated that the toxin secreted by Phyllosticta commelimecola not only was in hypha but also in culture solution and the extracting effect of ethyl acetate was the best. The soybean median and PSK media can be respectively used as solid and liquid culture media to produce toxin and grow mycelium. The optimal cultural conditions for producing toxin were temperature 32℃,cultured period 14d, cultured ways shaking of 150r/min.