ABSTRACT
Primary cardiac fibroelastoma is a relatively rare tumor and is often detected incidentally by echocardiography. We report a case of multiple fibroelastomas that were found incidentally by follow-up echocardiography for hypertrophic cardiomyopathy and were treated with valve-sparing excision. The patient was a 71-year-old man, in whom a 10-mm tumor on the ventricular septum below the right coronary cusp and 3-mm tumors on the left ventricular side of the left and right coronary cusps were detected. Although he had no symptoms, because the tumors were mobile, surgery was performed for preventing embolization and making a definitive diagnosis. The tumor on the ventricular septum was excised together with the surrounding endocardium and part of the myocardium. The tumors on the valve leaflets were excised with the aortic valve cusps spared. Histopathologically, all the tumors were fibroelastomas. The postoperative course was uneventful.
ABSTRACT
Objective To evaluate the effectiveness and safety of multimodal postoperative analgesia of thoracotomy for malignant tumor excision.Method Sixty patients undergoing thoracotomy for malignant tumor excision were recuited.They were randomized into four groups:group A receiving single flurbiprofen axetil injection,group B using electronic analgesia pump for sufentanil PCIA,group C using electronic analgesia pump for dezocine PCIA and group D receiving sufentanil controlled by PCA-TCI system.Vital signs,artery lood gas analysis,PrinceHenry score,Ramsay score,remedial measure and untoward reactions were recorded.Results The falling down degree of Prince-Henry score of Group D was higher than those of Groups A,B and C (P ＜ 0.05).Reduction of Ramsay score of Group D was higher than those of Groups A,B and C (P ＜ 0.05).The number of the patients in Group D not undergoing Bolus remedial measure was larger than that of those in Groups B and C (P ＜ 0.05).Conclusion When referring to the effectiveness and safety of the models administrated the thoracotomy for malignant tumors excision,the analgesia model of PC A-TCI sufentanil (plasma target concentration:0.12～ 0.14 ng/ mL) used in Group D is superior to other models used in Groups A,B and C.Moreover,individual analgesia can be reached by the PCA-TCI sufentanil model.
ABSTRACT
Objective To study the influence factors and prevention measures of complication of laparoscopic uter?ine surgery. Methods Patient who underwent laparoscopic uterine surgery were collected (n=415) and divided into hyster?ectomy group (n=310) and myomectomy group (n=105). Intraoperative and postoperative complications such as gastrointesti?nal injury, urinary injury and bleeding were recorded and compared between these two groups. Base on their uterine size, pa?tients were divided into Group A (uterine volume ≤300 cm3), Group B (300 cm3 0.05). The inci?dence of intraoperative or postoperative bleeding was 1.93%(8/415) and incidence of gastrointestinal damage or urinary inju?ry rate was 0.96%(8/415). The incidence of complications in group C was 20.0%(8/40) which is higher than that in group A (2.8%;5/179) and group B (5.1%;10/196). P0.05). The incidence in pelvic adhesions group is higher than that in the group without pelvic adhesions [8.3%(15/180) vs 3.4%(8/235), P<0.05]. Conclusion The incidence of complications in laparoscopic myomectomy was higher than that in laparoscopic hysterectomy. When patients were without pelvic adhesions or with uterine volume< 600 cm3, laparo?scopic surgery present least complication.
ABSTRACT
Primitive neuroectodermal tumors(PNETs) may be a term established recently for a tumor group(?) which is composed of prominent undifferentiated cells with variable foci of differentiation along glial and neuronal lines. The authors experienced a case of 'primitive glioma' regarded as a subclass of PNETs, in a 14 year old boy who had suffered from headache and vomiting for about 40 days prior to admission. Brain CT and angiographic studies reveal a huge hypovascular mass lesion with multiple cysts in the left frontal lobe. The patient was satisfactorily treated by total tumor excision and following irradiation, and is now in follow up. We present the case with review of the literatures.