In 1984, according to the criteria of the classifieation for congenital hand deformity which wasput out by the International Hand Surgery Committee, we had made an investigation for congenitalhand deformity among 318066 newborns in Shanghai. It was found that the inctdence of a congenitalhand malformation was 0. 0808 percent among the total newborns. The congenital malformation ofthe thumb was 37. 74 percent of all deformities of the hand. According to the statistical analysis, we ...
摘要:目的: 評估手術、栓塞及γ刀綜合治療腦動靜脈畸形的療效。 方法 :回顧性分析了我科自2002年3月至2009年7月期間綜合治療的43例腦AVM患者,分析評估這43例腦AVM的臨床特點及治療效果,隨訪患者并對其進行GOS評分。 結果 :本組病例采取栓塞＋手術治療3例、栓塞＋γ刀治療26例、手術＋γ刀治療11例、栓塞+手術＋γ刀治療3例。術后隨訪28例,隨訪時間4月至7年6月,GOS評分5分者25例,患者均能重新回到工作或學校;GOS評分4分者2例,患者生活能夠自理;GOS評分1分者1例,患者死亡。 結論 :對大型、功能區、有深部靜脈引流的腦AVM綜合治療有一定的優越性,它不僅使腦AVM治愈率明顯提高,而且與治療相關的各種并發癥和病死率也明顯降低。Abstract: Objective: To evaluate the efficacy of multimodality treatment of cerebral arteriovenous malformations(AVMs) with surgery, embolization and γknife radiation. Methods : A retrospective analysis of 43 cases of cerebral AVMs applied with multimodality treatment in our department From March 2002 to July 2009 has been made, meanwhile we have analyzed and assessed the clinical characteristics and treatment outcome of these 43 patients with cerebral AVMs. Results : Patients received multimodality treatment with embolization followed by surgery(n=3), embolization followed by γknife radiation(n=26), surgery followed by γknife radiation(n=11), or embolization, surgery, and γknife radiation(n=3). Postoperative followup of 28 cases, the followup time is 4 months to 7 years and 6 months. GOS score 5 in 25 cases, who can be able to return to work or school. GOS score 4 in 2 cases, who can be able to live independently. GOS score 1 in 1 case, who is dead. Conclusion : In the cerebral AVMs which are large, or located within or immediately adjacent to eloquent regions of the brain, or have deep venous drainage, multimodality treatment has some superiority. It can not only improve the cure rate of cerebral AVMs significantly, but also reduce the treatmentrelated complications and mortality.
From Jan. 1991 to Jan. 1994, 11 cases ofdifferent hip lesions with flexon contracture deformity were treated by combination of SmithPeterson and WatsonJones incisions in replacement of hip joint. All of them were followed-up for 1 to 3 years (an average of 1.9 years). According to pain, joint function, the excellent and good results were rated at 90.9%. This showed that from using the combined incisions, the hip joint was very well exposed, and release of hip flexion contracture could be acomplished in the same time. Bleeding fromoperation was reduced and the procedure was simple.
Objective To detect the operative technique and aesthetic problem of reconstruction to deformity of bilateral cleft lip． Methods From March 2003 to December 2004, 26 patients with bilateral cleft lip were treated, aged 10 months to 11 years. Of 26 patients, there were 13 bilateral complete cleft lip and palate, 9 bilateral incomplete cleft lip and 4 mixed cleft lip with unilateral complete cleft palate. The chief design principle was keeping the length of prolabium. During operation, sufficient dissociation was made in the base of the ala base and orbicularis oris muscle to reconstruct these structures．The circle suture was made for the bilateral orbicularis oris muscle. The shape of vermilion was achieved by lateral red lip muscle flap and simultaneous simple rhinoplasty was performed. Results Primary healing of the incisions was achieved in all cases. After the 10 days-3 months follow-up, the results were satisfactory in thewidth and chubbiness of the nose bottom,the shapes of nostril and Cupid’s bow were good without whistle deformity. Theapperance of upper lip was good in either dynamic or static state． Conclusion Excellent shapes and function of the nose and lip， and opportunity for twostage repair could be obtained with this method，which being believed important methods for the primary repair of bilateral cleft lip．
Objective
To investigate the clinicopathologic features of congenital cystic adenomatoid malformation (CCAM) of lung in adults.
Methods
The clinical and pathological characteristics of two cases of CCAM of lung in adults from November 19, 2012 to February 12, 2014 were analyzed, and relevant literatures were reviewed.
Results
Both of the two patients were males who were 59 years and 60 years old respectively. Both of them presented with respiratory symptoms such as productive cough, hemoptysis and fever. The lesions in the two cases were about 4.0 cm×3.0 cm×1.5 cm and 5.0 cm×5.0 cm×3.0 cm in size respectively. Both had a cystic appearance and involved unilateral lobes of the lung. Histologically, normal pulmonary alveoli were replaced by different size of cysts composed of adenomatoid hyperplastic bronchioles. The inner cystic wall was lined by pseudostratified ciliated columnar epithelium, and the cystic wall contained smooth muscle and elastic tissue, but no cartilage. In one of our cases, mucous cells could be seen in part of the inner cystic wall, with focal atypical hyperplasia.
Conclusions
CCAM of the lung is a rare congenital developmental anomaly, which typically manifests in neonates and infants, but extremely rare in adults. The diagnosis of CCAM in adults depends on clinical features, imaging changes and histopathological characteristics.
ObjectiveTo sum up the diagnosis and treatment of adult ileal duplication with clinical cases from Peking Union Medical College Hospital (PUMCH). MethodsSix cases of adult ileal duplication admitted in our hospital from February 1996 to December 2010 were analyzed. Different assistant investigations were supposed to different patients due to the chief complaints including gastroscope, colonoscopy, abdominal CT scan, arteriography, 99Tcm radionuclide imaging, and double-balloon intestinal endoscope. None was made a definite diagnosis before operation with only one uncertain case. All cases received operation and pathological examination. Results All cases admitted were male. The chief complaints included intestinal bleeding, abdominalgia, intestinal obstruction, and abdominal mass. Five out of six patients received gastroscope, colonoscopy, and abdominal CT scan while three received mesenteric arteriography, but none was found any suggestion for ileal duplication. Even 99Tcm radionuclide imaging pointed out only two with abnormal abdominal bleeding. Three received doubleballoon intestinal endoscope, paying attention that only one discovered with ileal duplication. In a concluding, none was made a definite diagnosis before operation with only one uncertain case. All the cases received operation. The duplications of ileum in the length of 6-25 cm were found at the site of 11-100 cm proximal to ileocecum during the operation. Pathological report confirmed the clinical diagnosis of all cases with adult ileal duplications． Two cases were found with ectopic gastric mucosa, another two with diverticulum, and one with ectopic pancreas， in addition the remaining with inflammatory fibrous pseudotumor. Prognosis were good for all after operation. ConclusionsIleal duplications are rarely seen in adults, gender prefer male． Without specific clinical symptoms and inspections, definite diagnosis before operation is hard to make. But maybe doubleballoon intestinal endoscope and 99Tcm radionuclide imaging can give out positive result. Surgeons should be aware of this condition when performing abdominal exploration. Once discovered, resection is necessary.
