Anesthetic management of conjoined twins undergoing one-stage surgical separation: a single center experience

Objective: To summarize our experience in the anesthetic management of conjoined twins undergoing one-stage surgical separation

Methodology: Medical records of conjoined twins admitted to our hospital for treatment and considered for surgical separation from 1996 to present were retrospectively reviewed. Four cases of conjoined twins underwent one-stage surgical separation under general anesthesia. Preoperative evaluation was performed to determine the extent of anatomical conjunction and associated anomalies. Anesthesia was simultaneously induced in all conjoined twins. The intubation procedure was successfully performed with the head slightly rotated to each baby's side, followed by the administration of vecuronium. Anesthetic agents were administered according to the estimated weight of each baby. One case of conjoined twins underwent surgical separation with cardiopulmonary bypass due to shared hearts

Results: All conjoined twins were successfully separated. No significant respiratory or cardiac events occurred during surgery except for one twin, which died after separation because of complicated congenital heart disease

Conclusions: Accurate preoperative evaluation, respiratory and circulatory management, and close cooperation of the multidisciplinary team are important aspects of anesthetic management of conjoined twins surgery

Imaging diagnosis of the vertebral injury in earthquake / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical value of imaging diagnosis of the vertebral injury in earthquake.</p><p><b>METHODS</b>Twenty-two cases of the vertebral injury in earthquake with clinical and imaging data were analyzed retrospectively. All of the cases were performed X-ray plain film examination, CT in 20 cases and MRI in 15 cases.</p><p><b>RESULTS</b>Imaging examination can establish definitive diagnosis in all cases. In the 22 cases, the vertebral compression fracture was found in 20 cases, and vertebral bursting fracture in 2 cases,single-level vertebral fracture in 12 case,and multiple-level vertebral fracture in 10 case. Among the 31 vertebral bodies of fracture, the fracture of cervical vertebra, thoracic vertebra, lumbar vertebra and sacral vertebra was found in 3, 12, 14, 2 vertebral bodies, respectively.</p><p><b>CONCLUSION</b>Imaging examination is the most valuable examination method in diagnosis of the vertebral injury in earthquake. It can not only make definitive diagnosis, but also play an important role in selection of therapeutic method.</p>

Hepatic VX2 tumor after portal vein occlusion in rabbits:evaluation with DSA / 介入放射学杂志

Objective To study the value of DSA for hepatic vascular anatomy,and to evaluate the efficacy of portal vein occlusion in rabbits with hepatic VX2 tumor.Methods Twenty New Zealand white rabbits were randomly divided into two groups with 10 in each group,including test group A and positive control group B of ham operation.For the test group A,portal branch ligation(PBL)was performed for the left external branch after 3 weeks of the tumor implantation to the left external lobe.Two weeks later,the DSA of hepatic artery and portal vein were performed in all of the rabbits.Results The total displaying effectiveness of the branches of hepatic artery by DSA was better than that by vascular perfusion.There was hypovascular blood supply to hepatic artery implantation of the tumor in the test group A,comparing with that of the group B.Conclusion DSA can clearly display spacial details of the hepatic vascular anatomy in rabbits,and play an important role in post-procedual evaluation of the portal vein occlusion in rabbits.