A Case of Pulmonary Cryptococcosis Mimicking Bronchogenic Lung Cancer in an Immunocompetent Patient: A Review of the Literature / 대한의진균학회지

We experienced a 59-year-old immunocompetent female patient who complained progressive cough. A bronchoscopic examination revealed an endobronchial mass protruding from the left lower lobe and occluding anterior-basal segment bronchus. Bronchial biopsy and endobronchial ultrasound guided transbronchial needle aspiration were consistent with cryptococcal infection. However, the response of medical therapy was an unsuccessful. Finally, the patient underwent left lower lobectomy with lymph node dissection. We report a case of pulmonary cryptococcosis mimicking bronchogenic lung cancer, and surgical therapy with antifungal treatment resulted in successful resolution of the pneumonia.

Diagnosis and treatment of blunt liver injury ( a report of 135 cases) / 国际外科学杂志

Objective To study the effective method of improving the diagnosis and treatment of blunt liver injury.Methods The clinical data of 135 cases with blunt liver injury hospitalized in Daxing District People' s Hospital from January 2000 to October 2010 were reviewed retrospectively.Results By standard grading of American Society of Trauma Surgery (AAST) in 1994,36 cases were grade Ⅰ,42 cases gradeⅡ,33 cases gradeⅢ,14 cases grade Ⅳ,10 cases gradeⅤ.Fifty-one cases were treated by non-operative therapy,among which 42 cases were crued,9 cases underwent operative surgery.Ninety-three cases were treated by operative therapy,seven cases died.The morbidity related to blunt liver injury was 5.19％.Conclusions Non-operative therapy may be used firstly in patients with stable hemodynamics,but close monitoring should be done for changes of the life signs.Timely and reasonable choice of time and the way of surgery is important to avoid complications and reduce the mortality rate.

Primary Aortocaval Fistua Associated with Abdominal Aortic Aneurysm

Primary aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm (AAA), occurring in only 4% of ruptured cases and less than 1% of all AAAs. The hemodynamic changes resulting from the major shunt caused by the ACF include a sudden increase in inferior vena caval pressure and volume with renal venous hypertension and a decrease in total peripheral resistance. So, if untreated, it leads to irreversible high output heart failure. Preoperative diagnosis is crucial, as adequate preparation should be made for massive bleeding expected at operation. Successful treatment depends on management of perioperative hemodynamics, control of bleeding from fistula and prevention of thromboembolism. We report two cases of successfully treated spontaneous ACF with a review of the literature.

Treatment of Acute Mesenteric Venous Thrombosis:12 Cases Report / 中国康复理论与实践

@#Objective To detect the effect of the operative and non-operative therapy on acute mesenteric venous thrombosis (AMVT).Methods The documents of 18 AMVT patients from Jan 1990 to May 2006 were reviewed retrospectively.Results In 18 patients, 12 cases with intestinal necrosis received operation, among them, 2 cases received the operation only and 10 cases added with anti-coagulation therapy further. The rest 6 patients received non-operative therapy. All of 18 patients recovered well.Conclusion Non-operative therapy is safe and effective for the patients without intestinal necrosis. Post-operative anti-coagulation therapy is very important for the patients received the operative therapy.

Ten Trigger Fingers in an Adult Man: A Case Report

Trigger finger is a common disease particularly in the middle aged women. A very rare case in which an adult man had 10 trigger fingers was experienced. He was treated with local steroid injections in both thumbs, but trigger finger disease has been aggravated in every digit of both hands. We performed an early operative treatment. Three months after the operation, the patient could perform his work without discomfort in his hands and showed normal range of motion in all fingers.

Application of Pemberton's osteotomy in the treatment of congenital hip dislocation of chidren / 中国矫形外科杂志

[Objective]To summarize clinical experience of Pemberton's ilium osteotomy in developing hip dislocation and emphasize the combined and individual principles in the clinical practice. [Methods]From February 1996 to April 2007,26 patients(aged 3 to 10 years) with 28 hips were operated on together with soft tissue solution,a pericapsular osteotomy of the ilium (Pemberton) and an optional femoral rotational,shortening or varus osteotomy of the proximal femur. Pre-and post-operative indexes including those of AI angle,CE angle and deep of acetabulum were compared. According to Severin's classification and McKay clinical curative effect evaluation critera,these indexes were evaluated.[Results]According to the Severin's classification,the results were rated as 64.3% excellent,28.6% good and 7.1% fair.On the McKay's critera ,the functional results were graded as 50.0% excellent,35.8% good,7.1% fair and 7.1% poor. On the whole,the radiographic evaluation was superior to that of the functional results.[Conclusion]The Pemberton's osteotomy is safe and effective.The combined surgical treatment can improve the success rate and decrease complications.

Incidence and the factors of postoperative residual numbness in lumbar canal stenosis / 中国矫形外科杂志

[Objective]To evaluate the incidence of postoperative residual numbness and the factors that influenced numbness in lumbar canal stenosis(LCS).[Method]Eighty patients with LCS including 24 males and 32 females,who were 27～78 years of age with an average age of 61.3,were operated by posterior decompression,and followed 10 days,1 month,3 months,1 year and 2 years after operation.All patients were examined by neurological findings and residual symptoms.[Result]In LCS,there were 82.1% of patients who complained numbness preoperativety.The incidence of residual numbness was 43.6%,39.1%,36.6%,35.3% and 35.7% after 10 days,1 month,3 months,12 months and 24 months,respectively.The factors that influenced residual numbness were related to stenosis types;JOA score before operation and the type of spinal canal stenosis were independent of age and nerve root diameter.[Conclusion]The lower limbs numbness recovered within 1 month postoperatlvely.The incidence of postoperative residual numbness was 35.3% and 35.7% in LCS after 1 year and 2 years.It is speculated that the potential of recovery of neural tissue is important for lower limbs residual numbness.

Anterior approach microendoscopic discectomy for cervical spondylosis:A report of 21 cases / 中国微创外科杂志

Objective To evaluate the clinical application of anterior approach microendoscopic discectomy for cervical spondylosis. Methods Clinical data of 21 cases of cervical spondylosis from October 2001 to June 2002 treated by anterior approach decompression with bone allograft or autograft for cervical fusion by means of microendoscopic discectomy system were reviewed. Results The mean intraoperative blood loss was 150 ml. The drainage was removed 48 hours and the stitches taken out 5 days after the operations. The mean hospital stay was 10 days. All the patients got out of bed for motion wearing a cervical collar 2 days after the operations. Follow-up ranged 6～12 months with a mean of 9 months.The outcome was determined using Odom grading. Of the 21 cases, 16 were classified as excellent results, 4 as good, 1 as poor, the rate of excellent or good results being 95%.Complications were found in 3 cases:rupture of threaded fusion cage in 1 case;hoarseness in 1 case;and multiple infarction of brain stem in 1 case. Conclusions Anterior approach microendoscopic discectomy in the treatment of cervical spondylosis has the advantages of minimal invasion and rapid recovery. It offers a clear surgical vision for vertebral posterior margin and effective protection for blood vessels and nerves, conforming to the standards of minimally invasive surgery.

Anal cushions-preserving ligation resection for the treatment of circumferential mixed hemorrhoids / 中国微创外科杂志

Ojective To evaluate a new operation procedure for the treatment of circumferential mixed hemorrhoids. Methods 187 cases were treated by anal pad-preserving ligation resection, while 77 cases by routine procedures of stripping off the varicose masses of the external hemorrhoids and ligation the internal one as the control. Results Healing time of the operative wound were (17?4)d in the the study group and (24?4)d in the controls respectively( t =9.24, P 0.05). Postoperative urinary dysfunction: 14.4% of cases developed in the study group and 27.3% in the controls(? 2=8.42, P

Papillary carcinoma in a thyroglossal duct remnant / 中国癌症杂志

Purpose: To report 2 cases of papillary thyroid carcinoma occurring in a thyroglossal duct remnant, and to discuss the diagnostic and therapeutic methods by reviewing the literature. Methods: An asymptomatic midline mass occurring in the upper neck was the sole presenting complaint in 2 cases. The preoperative evaluation included a complete head and neck examination, B-ultra sound examination and FNAB. The Sistrunk procedure was done. A lobectomy( case 1) and a lumpectomy ( case 2) were performed respectively, because of the abnormality found in their thyroid gland. A modified neck dissection was performed in case 2 because of regional lymphadenopathy. The following histologic studies were carried out on tissues with HE stain. Results: Diagnoses of thyroglossal duct carcinoma were made by several pathologists. Tissues from thyroid were first diagnosed as nodular goiter in case 1 and thyroid adenoma in case 2. In case 2, one positive lymph node and invasion to the hyoid bone was found. Conclusions: Malignant lesions are rare in the thyroglossal duct remnant. The diagnostic criteria is acknowledged. Resection of the thyroglossal duct carcinoma by the Sistrunk procedure is an adequate surgical approach. But the controversy about further treatment will continue because of the lack of large series of patients and the 10 to 20 year follow-up.

CLINICAL OBSERVATION OF EFFECTS OF TRACTION AND MANIPULATION IN PATIENTS WITH VERTEBROARTERIAL TYPE OF CERVICAL SPONDYLOPATHY / 中国运动医学杂志

Clinical observation was undertaken on patients with vertebroarterial type ofcervical spondylopathy who were treated with necktraction and manipulation, of110 patients, there were 82 men and 28 women. The average age was 56.29 yearsold. 102 of 110 patients had vertigo. In 91 patients with which vertigo wasassociated with body position, most of them also had abnormal hearing and visionand headche and hoarseness, etc. Examination: The positive rate of Jackson Test and Rotating-head Test was83.33%. The degenerative changes could be seen on the X-ray films of the cer-vical vertebrae. 55.95% of them suffered from eyeground arteriosclerosis, 40.78%hyperlipemia, 42.16%. hypertension, 36.17% ECG abnormality. Treatment: of 110 patients, 97 were treated with neck traction and manipu-lation. The average times of neck-traction of whom were 44.13, the averagetimes of manipulation 33.92. In addition, we compared one group which usedtraction and manipulation with another one that used traction and manipulationtogether with drip transfusion of dextran. Chi-spuare Test showed no signifi-cant difference between the two groups. Conclusion 1. The information in the paper indicated close relationship between verte-broarterial type of cervical spondylopathy and atherosclerosis. 2. Diagnosis of the disease could be done after excluding a few diseasessuch as Meniere's disease and hemicranie and sympathetic type of cervicalvertebrae, etc. 3. After vertebroarterial angiography, the patients suffering from the diseasetreated with surgery if conservative therapy had no effect. 4. The paper also studied the mechanism of neck-traction and manipulation on vertebroarterial type of cervical spondylopathy.