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Objective To analyze the clinical manifestations and imaging characteristics of pulmonary and extra pulmonary paragonimiasis westermani. Methods A retrospective analysis was performed of 30 patients diagnosed by clinical features, laboratory serological tests and surgical pathology. Results The symptoms of the lung included mainly chest distress, fever, chest pain, cough and expectoration, and dyspnea. The extra pulmonary symptoms included abdominal pain, vomiting, diarrhea, poor appetite, emaciation, both lower extremities asthenia, headache, dizziness, epileptic seizures, and subcutaneous migratory masses. The laboratory examination showed that the eosinophil numbers of serum and pleural effusion of all the thirty patients were increased, and the eggs of Paragonimus westermani were found by the stool tests in four cases. The chest CT tests found abnormal nodules, ground glass changes, insect damages, pleural effusion, "tunnel" signs, and "halo" signs. Cranial CT and MRI showed intracranial hemorrhage foci, and extensive "finger-like" edema. Abdominal CT showed serpentine deformation and “tunnel” signs in the hepatic and spleen capsules. Conclusions Paragonimiasis westermani is a multiple organ system involved infection, and it has complex and varied clinical manifestations. The "tunnel" sign and serpentine deformations in the intracranial part, lung, liver and spleen are important imaging manifestations of the disease.
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Objective To analyze the clinical manifestations and imaging characteristics of pulmonary and extra pulmonary paragonimiasis westermani. Methods A retrospective analysis was performed of 30 patients diagnosed by clinical features, laboratory serological tests and surgical pathology. Results The symptoms of the lung included mainly chest distress, fever, chest pain, cough and expectoration, and dyspnea. The extra pulmonary symptoms included abdominal pain, vomiting, diarrhea, poor appetite, emaciation, both lower extremities asthenia, headache, dizziness, epileptic seizures, and subcutaneous migratory masses. The laboratory examination showed that the eosinophil numbers of serum and pleural effusion of all the thirty patients were increased, and the eggs of Paragonimus westermani were found by the stool tests in four cases. The chest CT tests found abnormal nodules, ground glass changes, insect damages, pleural effusion, "tunnel" signs, and "halo" signs. Cranial CT and MRI showed intracranial hemorrhage foci, and extensive "finger-like" edema. Abdominal CT showed serpentine deformation and “tunnel” signs in the hepatic and spleen capsules. Conclusions Paragonimiasis westermani is a multiple organ system involved infection, and it has complex and varied clinical manifestations. The "tunnel" sign and serpentine deformations in the intracranial part, lung, liver and spleen are important imaging manifestations of the disease.
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<p><b>OBJECTIVE</b>To identify factors that can effectively predict the efficacy of laparoscopic splenectomy (LS) in the treatment of immune thrombocytopenic purpura (ITP).</p><p><b>METHODS</b>From January 2007 to September 2012, 78 patients with ITP underwent laparoscopic splenectomy were retrospectively analyzed. According to the postoperative platelet (PLT) count and haemorrhagic manifestations, they were divided into effective group and ineffective group. Nine influencing factors were univariate analyzed and multivariate analyzed.</p><p><b>RESULTS</b>In effective group (65 cases) and ineffective group (13 cases), average PLT count of 1 day before surgery was 47×10(9)/L vs. 21×10(9)/L, average operative time was (166 ± 46) minutes vs. (139 ± 29) minutes. Univariate analysis result: PLT count of 1 day before surgery (Z = -2.776, P = 0.005) and operative time (t = 2.723, P = 0.011) was statistically significant in 2 groups, the rest factors did not significantly influence the result. Multivariate analysis revealed that only PLT count of 1 day before surgery was statistically significant (OR = 0.964, 95%CI: 0.932-0.997, P = 0.031) in 2 groups, but operative time (P = 0.051) was not statistically significant.</p><p><b>CONCLUSIONS</b>PLT count of 1 day before surgery is a predict factor in LS for ITP. Because of the limited sample number, further multi-center prospective study with large sample is warrant.</p>