Soft tissue expander has been improved to perfection in recent ten years. Many excellent works have been accomplished for the patients who suffered from either soft tissue malformation or defects following traumatism, infection or benign tumors. But the reconstruction of soft tissue defects cause by malignant tumor hasbeen less studied.Four patients suffering from malignant tumour localized in the scalp and face, 1women and 3 men ranging from 65 to 75 years of age, have been operated on since1986. Their major deficits have been reconstructed with radican tissue expander, by the flap of the same colour and texture and also, similar thickness and sensation. There is no relapse in all the patients operated on reported until today.The surgical technique was discribed. The clinical results and the indication of tissue expander in the surgical treatment of malignant tumour are discussed.
After freatment of prosthesis replacement for 12 malignant tumer of the proximal humoral werereported. The operation were performed after the indications and methods of treatment had beendefined. All of the 12 cases were followed-up, in the average of 8 yeare. On functional evaluation , 8cases had satisfactory result , but per in 1 cases and 3 cases died from recurrence or metastasis withinfive years. The indieation of the procthetic replantation, the complications, and revision weredisecused.
Objective To evaluate the methods of the pedicle screw-rod fixationsystem combined with allograft bone or polymethylmethacrylate (PMMA) for the reconstruction of pelvic girdle after the complete resections of primary malignantbone tumor and the metastatic lesion of ilium. Methods From July 1999 to July2004, 16 patients with iliac malignant bone tumor were treated with the techniques of the complete resection and reconstruction. There were 9 males and 7 females at the age of 16 to 80 years. The 10 patients with primary malignant bone tumor included 4 cases of chondrosarcomas, 3 cases of osteosarcomas, 2 cases of Ewing sarcomas, and 1 case of malignant giant cell tumor of bone. The 6 patients with the metastatic lesion consisted of 2 cases of breast carcinoma, 1 case of lung carcinoma, 1 case of kidney carcinoma, 1 case of thyroid carcinoma and 1 case of prostate carcinoma. A solitary skeletal metastatic lesion was demonstrated in all metastases. There were 2 cases of stage ⅠA and 8 cases of stage ⅡB in primary malignant bone tumor according to the Enneking classification. The pedicle screwrod fixationsystem combined with allograft bone was used to reconstruct the pelvic girdle in primary malignant tumor. The patients with metastases underwent the pedicle screwrod system fixation with PMMA or without PMMA. The postoperative complication of reconstruction, local recurrence and bone healing were investigated. The postoperative function was analyzed according to the method reported by Enneking. Results The average followup was 35.6 months (5 to 65 months). Of all patients, 2had suspected deep infection, 2 had internal fixation loosening and 1 had nonunion of allograft bone. The mean healing time of the osteotomy site was 5.8 months (4.2 to 8.4 months). No immune rejection was seen. There were 2 patients with local recurrences, 3 patients with pulmonary metastases and 2 deaths due to metastases. The average functional score was 24.8(82.7%) in 8 survival. The functional results also were classified as excellent in 4, good in 3 and fair in 1. The median survival was 11.8 months (4.6 to 48.5 months) in metastases. Four patientshad lived for 1 year or longer after surgical intervention. The internal fixation loosening occurred in 2 patients, new destruction in 3 patients and no infectionoccurred. All patients immediately alleviated the pain and could walk with or without support after operation. At follow-up after 1 year, the average functional score was 21.7(72.3%). The functional results also were classified as excellent in 2 and good in 2. Conclusion Because of less complication and good function, the pedicle screwrod fixation system combined with allograft bone orPMMA are advisable for the reconstructions of pelvic stability after the complete iliac resections of primary malignant bone tumor and the metastatic lesion.
T ree cases of sarcomas of theJ we femur were treated by region-a?ir? ation with overdosage of me-chlorethamine for 3 weeks and there-after a high amputation was done,and the distal leg was replantedwith the length that the anklewould act as a knee joint and thefoot pointing backword. Follow-upfor 1 -5 years discovered no me-tastasie of the tumor and the artifi-cial limb showed a better function.
目的探讨肢体淋巴水肿疾病中相关恶性肿瘤的诊断与治疗。方法对我院 1988年10月至2000年12月收治的332例肢体淋巴水肿患者，根据临床表现，用B超、淋巴管造影、静脉造影或CT等手段作为病因诊断检查，对可疑恶性肿瘤病例用穿刺、局部切除或局部探查的方法共活检20例。结果检出由恶性肿瘤引发的淋巴水肿18例,其中原发淋巴系统恶性肿瘤4例，均为下肢； 继发性淋巴结转移癌14例，上、下肢各7例，并予相应治疗。结论重视本病临床表现，可使患者获得及早诊断，及时治疗。
Objective To summarize the CT, MRI, and positron emission computed tomography (PET) imaging findings of hematologic malignancies of the pancreas, so as to improve the capacity of its diagnosis. Methods After searching articles concerning radiological research about hematologic malignancies of the pancreas, summarizing its imaging characteristics. Results Hematologic malignancies of the pancreas include pancreatic lymphoma, pancreatic multiple myeloma, myeloid sarcoma, posttransplantation lymphoproliferative disorder, and giant lymph node hyperplasia. ① Pancreatic lymphoma: imaging features of pancreatic lymphoma are segmental or diffuse homogeneous enlargement of the pancreas, diameter of mass >5 cm, adenopathy below the level of renal veins, and lack of pancreatic duct dilation. Blurred margins of pancreas by lymphadenopathy is highly suggestive of lymphoma. ② Pancreatic multiple myeloma: pancreatic multiple myeloma are hyperintense on both T1- and T2-weighted images. ③ Pancreatic granulocytic sarcoma: pancreatic granulocytic sarcoma present as homogeneous hypoenhancing mass on CT, usually without pancreatic duct dilation. On MRI, the lesions are isointense and mildly hyperintense on T1- and T2-weighted images respectively. ④ Posttransplantation lymphoproliferative disorder: diameter of leison of posttransplantation lymphoproliferative disorder usually is >5 cm with poor enhancement. Lesions are mildly hyperintense on T2-weighted images and extremely hypermetabolic on PET images. ⑤ Giant lymph node hyperplasia: it mainly appear as solitary noninvasive masses. Punctate calcification and surrounding supply vessels are observed in hyaline vascular type. Plasma cell type demonstrate unapparent enhancement and less calcification. Conclusions Hematologic malignancies of the pancreas manifest different imaging features on CT, MRI, and PET. Familiarity with such characteristics helps to early recognize diseases and determine next-step measures.
ObjectiveTo analyze the causes of death of patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). MethodsA total of 493 patients admitted between January 2006 and Octomber 2015 were respectively analyzed, including 348 asthma patients and 145 ACOS patients. The patients was divided into a survival group and a death group based on the outcome. The ACOS patients were divided into three subgroups based on FEV1% pred level (≥80%, 50%-80%, and < 50%, respectively). The basic characteristics and causes of death were analyzed using χ2-test, t-test and Fish-test based on data type. ResultsThe age (t=3.457, P < 0.001), male proportion (χ2=15.394, P < 0.001) and smoking history (χ2=12.418, P=0.002) had significant differences between the survival group and the death group. The proportion of ACOS patients was higher in the death group (42% vs. 27%, χ2=7.033, P=0.008), and the mortality was also higher in the ACOS patients (21% vs. 12%). The proportion of male patients was higher in the ACOS patients than that in the asthma patients (86% vs. 38%, P < 0.001). The leading three causes of death in the ACOS patients were malignant diseases (45%), pneumonia (26%), and cardiovascular diseases (16%). Malignant diseases were the main cause of death in the ACOS patients with FEV1% pred≥50%, while pneumonia was the main cause of death in those with FEV1% pred≥50%. There was no significant difference in cause of death distribution between three subgroups with different FEV1% pred (P=0.318). ConclusionThe main cause of death of ACOS patients is malignant diseases, the followed are pneumonia and cardiovascular diseases.