Aspirex mechanical thrombectomy system in the treatment of acute iliofemoral deep vein thrombosis / 中华普通外科杂志

Objective:To evaluate percutaneous mechanical thrombectomy (PMT) using Aspirex device for treating acute iliofemoral deep vein thrombosis (IFDVT).Methods:The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results:Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis (CDT) were included into group A, and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%, and the clinical efficacy of thrombolysis was achieved. Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant. Hospitalization costs in group A were more than group B. At one year follow-up, there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome (PTS) and the Villalta score and primary patency (92.0% vs. 90.0% , χ2=0.059, P=0.807). Conclusions:The application of PMT using the Aspirex device for acute IFDVT was safe and effective, which could accelerate the clearance of thrombus, and reduce UK dosage, lysis duration, hospital days. However, it increased the hospitalization costs.

The Effects of Vascular Endothelial Growth Factor on Capsule Formation around Silicone Implant in Rats

BACKGROUND: The purpose of this study was to examine the effects of a single administration of vascular endothelial growth factor (VEGF) in promoting the angiogenesis and thereby reducing the formation of capsular contracture. METHODS: We treated 24 female Sprague-Dawley rats with (1) 5 mM Tris Buffer and 150 mM NaCl 0.1 cc, (2) VEGF 15 µg/0.1 cc, (3) VEGF 150 µg/0.1 cc during placement of the implant, or (4) VEGF 150 µg/0.1 cc and VEGF 300 µg/0.2 cc. We histopathologically measured the thickness of the capsule and the number of blood vessels. RESULTS: All experimental groups had a significant difference in the thickness of the capsule compared to the control group (P<0.001). There was no significant difference between experimental group 2 and experimental group 3. The number of blood vessels formed around the capsule was significantly greater in all the experimental groups compared with the control group (P<0.05). There was no significant difference between the experimental groups. There was a significant negative correlation between the thickness of the capsule and the number of blood vessels (Spearman's correlation coefficient, 0.2732; P<0.0001). CONCLUSIONS: A single administration of VEGF reduced formation of the capsule and increased the vascularity around the implant, supporting the hypothesis that prevention of tissue ischemia can be a treatment strategy for capsular contracture.

Prognosis of patients with early enteral nutrition after gastrointestinal operation: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To systematically assess the effect of early enteral nutrition support after gastrointestinal operation on prognosis.</p><p><b>METHODS</b>The Cochrane Library, PubMed, CBM, CNKI, Wanfang, and VIP databases were retrieved via computer system for randomized controlled trails(RCTs) with early enteral nutrition support to patients undergoing gastrointestinal operation. Quality of studies was evaluated by the Cochrane Jadad rating scale. Nutrition indexes, bowel function indices, postoperative complications, health-economics indices were collected. Meta-analysis was conducted with RevMan 5.2.</p><p><b>RESULTS</b>Eleven relevant RCTs studies with 1087 cases were enrolled, including 541 patients in the study group(early enteral nutrition) and 546 in the control group. Meta-analysis showed that patients in the study group had significantly higher levels of plasma albumin and prealbumin than those in the control group(WMD=2.87, 95%CI:1.03-4.71; WMD=0.04, 95%CI:0.02-0.05). The time of postoperative bowel ventilation in the study group was significantly shorter than that in the control group(WMD=4.10, 95%CI:-5.38--2.82). The postoperative complication rate in the study group was significantly lower as compared to the control group(RR=0.64, 95%CI:0.44-0.93).</p><p><b>CONCLUSION</b>Early enteral nutrition support after gastrointestinal operation is safe and effective, which can improve the nutritional status, promote bowel function return, and reduce postoperative complication rate.</p>

Inflammatory Myofibroblastic Tumor of the Parotid Gland / 대한이비인후과학회지

Inflammatory myofibroblastic tumor (IMT), which is composed of spindle shaped myofibroblasts accompanied by an inflammatory infiltrate, is an uncommon neoplasm. Herein we present a rare case of an IMT of the parotid gland. The patient was a 56-year-old woman with parotid mass, which developed a tingling sensation around the mouth angle when the mass was palpated. Ultrasound and CT scan showed a parotid mass with an ill-defined margin. Preoperative gun biopsy showed spindle shaped cell proliferation without cytological atypia. Surgery revealed that the mass was adhesive to buccal branch of facial nerve without encapsulation. The adhesive part of the facial nerve was excised with mass due to the possibility of malignancy. The final pathological report confirming IMT became available following the surgery. We stress that confirmation of IMT should be included in the differential diagnosis of parotid mass which shows spindle shaped cells in histology.

Effect of Gastroesophageal Reflux on the Symptoms and Treatment Result of Obstructive Sleep Apnea Syndrome

BACKGROUND: Gastroesophageal reflux (GER) is characterized by the retrograde movement of gastric contents into the esophagus and laryngopharynx. Recent studies have described a relationship between GER and obstructive sleep apnea (OSA). The aim of this study was to determine whether the presence of GER affects the symptoms and treatment results of OSA. METHODS: One hundred twenty-seven OSA patients were enrolled in this study. All subjects underwent overnight polysomnography. Objective symptoms were evaluated using the Epworth Sleepiness Scale (ESS), the Stanford Sleepiness Scale (SSS), the Pittsburgh Sleep Quality Index (PSQI) and Korean version of the World Health Organization Quality of Life Assessment Instrument-BREF (WHOQOL). Diagnosis of GER was based on the Korean version of GER questionnaires. Post-operative subjective symptoms were evaluated 3 months after uvulopalatopharyngoplasty. RESULTS: Body mass index, ESS, and SSS were significantly higher in the GER group, but polysomnographic parameters were not different between two groups. In the GER group, post-operative overall health quality was significantly improved, but the subjective symptoms were not different between the two groups. CONCLUSIONS: Although the prevalence of GER was higher in OSA patients, GER did not significantly influence OSA symptoms and post-operative results.

Relationship between Taste Genotype and Smoking and Alcohol Intake / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Genetic variations of bitter taste receptors (TAS2R) have shown different responses to bitter taste compounds and the frequencies of these variations were different within and between populations. Recently, single nucleotide polymorphisms (SNPs) in the TAS2R38 and TAS2R16 genes demonstrated a significant association with smoking and alcohol consumption in several studies. The aim of this study was to determine the relationship between bitter taste gene polymorphism and cigarette smoking and alcohol intake in Korean. SUBJECTS AND METHOD: One hundred seventy four healthy normal volunteers were asked to fill in a questionnaire regarding demographic information, smoking history, frequency of alcohol intake. Peripheral blood samples were obtained for DNA extraction and genotyping. Single nucleotide polymorphisms were identified on the TAS2R38 and TAS2R16 genes. RESULTS: Haplotype analyses of the three SNPs inside the TAS2R38 gene allowed identifying of only two haplotypes that were associated with the non-taster phenotype (AVI homozygous) and the taster phenotype (PAV homozygous and PAV/AVI heterozygous). Common SNP within TAS2R16, which results in aminoacid change in the protein (K172N), is not demonstrated in this study. Smokers and frequent drinkers were more prevalent among non-tasters than tasters in male. CONCLUSION: Functional variants in TAS2R38 correlated with cigarette smoking in the Korean male. Our findings suggest that taster status plays a role in governing the development of nicotine dependence.

Flank Reconstruction of Large Soft Tissue Defect with Reverse Pedicled Latissimus Dorsi Myocutaneous Flap: A Case Report

PURPOSE: Coverage of full-thickness large flank defect is a challenging procedure for plastic surgeons. Some authors have reported external oblique turnover muscle flap with skin grafting, inferiorly based rectus abdominis musculocutaneous flap, and two independent pedicled perforator flaps for flank reconstruction. But these flaps can cover only certain portions of the flank and may not be helpful for larger or more lateral defects. We report a case of large flank defect after resection of extraskeletal Ewing's sarcoma which is successfully reconstructed with reverse latissimus dorsi myocutaneous flap. METHODS: A 24-year-old male patient had 13.0x7.0x14.0cm sized Ewing's sarcoma on his right flank area. Department of chest surgery and general surgery operation team resected the mass with 5.0cm safety margin. Tenth, eleventh and twelfth ribs, latissimus dorsi muscle, internal and external oblique muscles and peritoneum were partially resected. The peritoneal defect was repaired with double layer of Prolene mesh by general surgeons. 24x25cm sized soft tissue defect was noted and the authors designed reverse latissimus dorsi myocutaneous flap with 2110cm sized skin island on right back area. To achieve sufficient arc of rotation, the cephalic border of the origin of latissimus dorsi muscle was divided, and during this procedure, ninth intercostal vessels were also divided. The thoracodorsal vessels were ligated for 15 minutes before divided to validate sufficient vascular supply of the flap by intercostal arteries. RESULTS: Mild congestion was found on distal portion of the skin island on the next day of operation but improved in two days with conservative management. Stitches were removed in postoperative 3 weeks. The flap was totally viable. CONCLUSION: The authors reconstructed large soft tissue defect on right flank area successfully with reverse latissimus dorsi myocutaneous flap even though ninth intercostal vessel that partially nourishes the flap was divided. The reverse latissimus dorsi myocutaneous flap can be used for coverage of large soft tissue defects on flank area as well as lower back area.

The Effects of Fungi on the Activation of Monocyte Derived Dendritic Cells and Its Impact on Priming Th Polarization

BACKGROUND AND OBJECTIVES: The mucosal immune response depends on the surveillance network established by dendritic cells (DC) localized within the respiratory epithelium. Fungi have been increasingly recognized as important pathogens in respiratory diseases. We hypothesized that DCs play a central role in the immune response against airborne fungi. MATERIALS AND METHODS: Monocyte-derived DCs were developed by incubating monocytes with interleukin-4 (IL-4) and granulocyte-macrophage colony-stimulating factor. DCs were stimulated with Alternaria alternata and Aspergillus nigra for 24 hours and then co-cultured with CD4-positive lymphocytes for 6 days. Levels of IL-6 and tumor necrosis factor-alpha (TNF-alpha) were measured to determine activation of the DCs, and levels of TNF-alpha, IL-5, and interferon-gamma (INF-gamma) were measured to determine Th polarization. DC migration was induced with conditioned media from nasal polyp epithelial cells stimulated with fungi. RESULTS: Alternaria and Aspergillus activated DCs with enhanced production of cytokines. When activated DCs were co-cultured with CD4-positive lymphocytes, Th2 cytokine and IL-5 production was significantly increased by Alternaria. DC migration was significantly increased by conditioned media from cells that were activated with Alternaria. CONCLUSION: Airborne fungi induced different immune responses depending on the fungi. Alternaria strongly induced DC migration and a Th2 immune response.

Magnetic Resonance Guided Focused Ultrasound Induced Dermal Burn, Case Report

PURPOSE: Authors experienced a case of burn induced by magnetic resonance guided focused ultrasound (MRgFUS) which is performed for treatment of uterine myoma. The patient presented unusual progress from that of usual burns and did not cured by conservative treatment. At last the patient underwent surgical treatment. Authors report this rare case of burn induced by focused ultrasound. METHODS: A 26-year-old woman visited the department of gynecology with a abdominal mass. A 9.0x7.9x8.4 cm sized uterine myoma was found after evaluation. The patient was treated with MRgFUS after hormone therapy. Burn was noted on her lower abdomen immediately after MRgFUS and the patient was send to our department. Authors found 3.7x3.3 cm sized superficial second degree burn on her lower abdomen. The wound was treated with conservative methods but the depth extended to subcutaneous layer. 35 days after burn, debridement and primary repair was performed. RESULTS: The wound was healed clearly without any complication. There was no specific complaints or long-term complications during 6 months of follow-up. CONCLUSION: MRgFUS is known as a safe and reliable method for treatment of soft tissue tumors. Ultrasound is concentrated at inner body and generates high thermal energy. It might induce burn. The burn induced by ultrasound seems to have different progress and traits from usual burn wound. It is hard to make a precise diagnosis with external wound only.

Simultaneous control of microorganisms and disinfection by-products by sequential chlorination / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To introduce a new sequential chlorination disinfection process in which short-term free chlorine and chloramine are sequentially added.</p><p><b>METHODS</b>Pilot tests of this sequential chlorination were carried out in a drinking water plant.</p><p><b>RESULTS</b>The sequential chlorination disinfection process had the same or better efficiency on microbe (including virus) inactivation compared with the free chlorine disinfection process. There seemed to be some synergetic disinfection effect between free chlorine and monochloramine because they attacked different targets. The sequential chlorination disinfection process resulted in 35.7%-77.0% TTHM formation and 36.6%-54.8% THAA5 formation less than the free chlorination process. The poorer the water quality was, the more advantage the sequential chlorination disinfection had over the free chlorination.</p><p><b>CONCLUSION</b>This process takes advantages of free chlorine's quick inactivation of microorganisms and chloramine's low disinfection by-product (DBP) yield and long-term residual effect, allowing simultaneous control of microbes and DBPs in an effective and economic way.</p>