ABSTRACT
Children with pediatric tumors have better prognosis and longer survival than adults, suggesting that attention should be paid to the long-term complications induced by radiotherapy. In this article, the data from more than 40 clinical studies of pediatric tumor radiotherapy published in the recent decade were retrospectively analyzed. Long-term complications of nervous system, cardio-cerebrovascular system, respiratory system, endocrine system, urinary system, reproductive system, skeletal development, long-term secondary tumors were considered and the corresponding radiation dose-volume parameters were summarized, aiming to guide radiation oncology physicians and physicists to optimize radiotherapy plans for children with pediatric tumors.
ABSTRACT
Objective@#To discuss the feasibility and effectiveness of using micro-CT in bone-implant contact (BIC) evaluation in dogs, and to provide reference for clinical and scientific research.@*Methods@#Bilateral mandibular second premolar and first molar of six male Beagle dogs were extracted. After 3 months′ healing, eight implants were placed in bilateral mandible of each dog, four on each side. Dogs were sacrificed at 2 weeks, 4 weeks and 8 weeks after implant placement, two on each time point. Samples were scanned with micro-CT and digitally reconstructed. Bone-implant interface was analyzed at different analysis regions (25, 50 and 100 μm from implants′ surface), different detection range models were obtained (each time point consists 48 models), and BIC was evaluated, and the results were counted as micro-CT25, micro-CT50, and micro-CT100 groups. Then undecalcified slides were made (three slides for each sample) and stained with toluidine blue for observation and analysis of BIC using an optical microscope, and the results were counted as optical microscope groups. The advantages and disadvantages, evaluation efficiency and BIC of different methods were analyzed.@*Results@#To evaluate BIC of single sample, it took about 90 minutes by micro-CT, which was much lower than the time of 14 days by optical microscope. The success rates of modeling of micro-CT25, micro-CT50, and micro-CT100 groups all were 100.0% (48/48), and total success rate of micro-CT group was 100.0% (144/144). For optical microscope groups, the success rates of making slides 2, 4, 8 weeks were 89.6% (43/48), 93.8% (45/48) and 93.8% (45/48), respectively, and total success rates of optical microscope group was 92.4% (133/144). At 2, 4,8 weeks after implantation, BIC in micro-CT25 group was significantly smaller than that in optical microscope group at the same time point (P<0.05). However, at 2, 4,8 weeks after implantation, BIC of the micro-CT50 and micro-CT100 groups showed no significant difference with optical microscope groups at the same time point (P>0.05). A significant correlation (P<0.001, each) was seen between slides and micro-CT (25, 50, 100 μm groups) concerning BIC (r=0.680, r=0.892, r=0.713), and error bias was -19.4%, -0.9%, 3.0%, respectively. The probability within the 95% limits of agreement were 97.9%.@*Conclusions@#Micro-CT is a faster, simpler and more efficient way to analyze BIC at the implant-bone interface than optical microscope observation. BIC analysis by selecting 50 μm from implants′ surface as analysis region using micro-CT is in consistent with that using the optical microscope.
ABSTRACT
Objective: To evaluate the effects of surgical navigation technique in the reconstruction of traumatic orbital wall defect.Methods: 20 patients underwent the operation with the aid of navigation for repairing traumatic orbital wall defect as the test group. 20 patients were treated without navigation as the control group. Treatment outcome was evaluated by correction of exophthalmos, orbital volumes and patient's self-satisfaction. Results: The mean difference of eyeball protrusion between the reconstructed and the unaffected orbit cavity in the navigation group and control group was (0. 81 ± 0. 35) mm and (1. 65 ± 0. 37) mm (P ＜ 0. 05), that of the orbital volume (0. 68 ± 0. 29) ml and (0. 98 ± 0. 22) ml (P ＜ 0. 05), respectively. The patient's satisfaction value of the navigation group was higher than in the control group (P ＜ 0. 05) . The operation duration in the navigation group was less than in the control group (P ＜0. 05) . Conclusion: Surgical navigation can improve the accuracy and the effects of operation for orbital defect reconstruction.
ABSTRACT
Objective: To establish and verify the validity of a finite element(FE) model of fragment injury in swine mandibular composite tissue. Methods: Swine facial composite tissue digital information was obtained by 3D CT,the 3D model and the cylinder fragment with the diameter and height of 5. 5 mm were reconstructed and designed in mimics15. 0. The right mandibular angle region was impacted by the fragment with velocities in finite element analysis software. A two stage light gas gun was used to launch the same shape 30CrMnSi alloy fragment with the speed of 831,1 120 and 1 536 m/s respectively to impact swine mandibular angle area. The actual damage area and acceleration at jaw were measured and compared with the digital simulation results. Results: Compared with the data of digital simulation the fragment with the speed of 831,1 120 and 1 536 m/s resulted in the larger mandibular damage area of entry in the in vivo experiment by 13. 4％,23. 6％ and 22. 3％; that of exit by 18. 7％,23. 0％ and 26. 5％; the smallar accelaration peak by 16. 7％,15. 3％ and 14. 6％,respectively. Conclusion: A digital model of the swine mandible composite tissue fragment injury model is established. The simulation results of the FE model are consistent similar to those of the in vivo test data.
ABSTRACT
Objective:To summarize the clinical features of clear cell sarcoma of the kidney (CCSK) in children and to evaluate the effica-cy and safety of the WT-2009 chemotherapy protocol. Methods:Clinical data of children with CCSK recorded between January 2009 and December 2014 were retrospectively analyzed. Follow-ups were conducted to monitor the postoperative conditions of the pa-tients. Results:Nine cases of CCSK were recruited, and another three cases were excluded for the analysis because of incomplete clini-cal data. All patients achieved complete remission when the treatment was finished. The estimated 3-year overall survival rate was 100％, and the estimated 3-year event-free survival rate was 83.3％. No report is available on the significant side effects associated with this treatment. Conclusion:CCSK is rare in children and is easily misdiagnosed. The chemotherapy based on the WT-2009 proto-col can produce a favorable prognosis and a high tolerance for patients with CCSK. However, the treatment for high-risk patient needs to be further explored, and follow-ups must be intensified.
ABSTRACT
Objective To evaluate the clinical outcome of NB09 (China Pediatric Neuroblastoma cooperative group 09) protocol on children with high-risk and ultra-high risk neuroblastoma. Methods The clinical and follow-up data of pa?tients who suffered from high-risk (n=7) and ultra-high risk (n=31) neuroblastomas and admitted in Tumor hospital of Tian?jin Medical University between January 2009 to January 2013 were retrospectively reviewed (27 boys and 11 girls). The age at diagnosis was 19-160 months (median age was 36.5 months). In the high risk group, patients were evaluated and operated after 4 to 6 circles of neoadjuvant chemotherapy. In ultra-high risk group, patient received chemotherapy before and after op?eration, then autologous stem cell transplantation and tumor bed radiotherapy. After chemotherapy, retinoic acid treatment was given to patients in ultra high risk group as in high risk group. Results At the end of treatment, 25 patients achieved complete remission; 5 patients achieved partial remission; 3 patients were in stable disease;5 patients were deteriorating in their conditions which lead to 2 deaths. In total, the response rate reaches upto 86.8%. By the end of follow up, 15 patients had a disease-free-survival, 9 patients survived with tumor, 7 died from recurrence and 7 died from deteriorating conditions. Survival time ranged from 6 to 52 months (median survival 25.5 months). The 1-, 2- and 3-year overall survival were 91.7%, 64.5%and 57.3%respectively. Kaplan-Meier curve and Log-rank test showed no statistical significance between high risk and ultra-high risk neuroblastomas. Conclusion The outcome of NB09 protocol for high risk and ultra-high risk neuroblastoma was preliminary affirmed. It is worthy of further clinical verification.
ABSTRACT
Objective To investigate the effect of vascular inner diameter and artery flow velocity on the flow of internal arteriovenous fistula. Methods Sixty-two patients received the operation of internal fistula were enrolled. According to the inner diameter (Group A: d ≤ 1.5 mm, Group B: 1.5 mm 3.0 mm), the patients were divided into four groups in terms of artery flow velocity (Group a: v ≤ 20 cm/s, Group b:20 cm/s 100 cm/s), the differences of fistula and dialysis flow for two months were analyzed among various groups. Results Compared with Group B/b, patients in Group A/a had higher risk of operation failure, with lowered inner fistula flow and dialysis flow. In terms of inner venous diameter , there were significant differences between Group B and C. Conclusions It is not recommended to carry out the inner vascular fistula operation. Followed with the thickening and increasing of inner artery diameter and artery flow , the inner fistula flow and the dialysis flow increase. The inner venous diameter has no significant impact on the inner fistula flow.
ABSTRACT
Objective To discuss the surgical method of resection of petroclival tumors used temporal base transtentorial approach.Methods Analyzed 26 cases of petroclival tumors.All of them were surgically treated under intraoperative neurophysiological monitoring by temporal base transtentorial approach.Firstly the supratentorial part of tumors were resected by pieces,and then the tentorium was cut open,in order to resect residue of the subtentorial part of tumors.This surgical maneuver was applied to reduce the retraction to surrounding vessels,nerves and brain stem,as well to protect important structures and to finally achieve radical removal of the tumors.The efficacy and complications were observed.Results Among 26 cases,19 cases (73.1％,19/26) achieved total removal,5 cases (19.2 ％,5/26) achieved subtotal removal and 2 cases (7.7％,2/26) achieved great partial removal.There was no surgery-related death.Eleven cases suffered from partial neurological deficit.All cases were followed up for 3 months to 4 years,3 cases underwent complete recovery,4 cases underwent partial recovery,and 4 cases underwent permanent deficit.Conclusions Using temporal base transtentorial approach to resect petroclival tumors is convenient,applicable,safe and with minimal injury and with high proportionality of total resection.Under intraoperative neurophysiological monitoring,this approach may be an ideal choice for surgical treatment of these tumors.