Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein(SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for c...Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein(SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. However, the optimum surgical method for venous management is controversial. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. Here we present the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No venous reconstruction was performed during surgery. No ischemic changes occurred in the bowel. The presence of several welldeveloped collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. This case indicated that the main trunk of the SMV can be resected without venous reconstruction if adequate collateralization has formed.展开更多
Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are es...Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are especially considered as the risk factor for fatal cardiac events. Surgical indication remains controversial because many patients are asymptomatic. A 52-year-old man with anomalous origin of the right coronary artery with an interarterial?course concomitant with the left main trunk disease was resuscitated from cardiopulmonary arrest. It was likely to be attributed to the left main trunk disease, but anatomical structure of the right coronary artery suggests its possible involvement. Prophylactic bypass grafting for the right coronary artery was performed using saphenous vein graft without ligating native vessel to prevent future cardiac events, as well as revascularization of the left main trunk disease. All grafts were patent in one-year follow-up coronary angiography. Any cardiac event has not occurred.展开更多
目的 探讨 u PA、u PAR基因表达和肝癌转移、肝细胞癌门静脉主干癌栓 (Tum or thrombosid of the m ain trunkof the portal vein,PVTT)形成的关系。方法 采用原位杂交等技术检测 u PA、u PAR表达。结果 癌栓 (A1组 )和其原发癌(A2组...目的 探讨 u PA、u PAR基因表达和肝癌转移、肝细胞癌门静脉主干癌栓 (Tum or thrombosid of the m ain trunkof the portal vein,PVTT)形成的关系。方法 采用原位杂交等技术检测 u PA、u PAR表达。结果 癌栓 (A1组 )和其原发癌(A2组 ) u PA、u PAR m RNA阳性表达率均高于无转移肝癌 (B组 ) (P均 <0 .0 1) ;A 1组表达强度均高于 A2组 (P<0 .0 1)。 A 2组小血管内可见癌细胞群落 ,A 1组多见 ,B组无此现象。 A1组、A 2组 u PAR和 u PA蛋白质阳性表达率均高于 B组 (P均 <0 .0 1) ,A1组表达强度均高于 A2组 (P<0 .0 1)。 u PA、u PAR m RNA和其蛋白质表达存在良好相关性 (P均 <0 .0 1)。结论 u PA、u PAR在肝癌的侵袭和转移中起重要作用 ,其过度表达是展开更多
文摘Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein(SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. However, the optimum surgical method for venous management is controversial. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. Here we present the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No venous reconstruction was performed during surgery. No ischemic changes occurred in the bowel. The presence of several welldeveloped collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. This case indicated that the main trunk of the SMV can be resected without venous reconstruction if adequate collateralization has formed.
文摘Anomalous origin of the right coronary artery is a rare congenital anomaly, but is associated with sudden death. Originating from the opposite sinus of Valsalva, an interarterial?course and an intramural course are especially considered as the risk factor for fatal cardiac events. Surgical indication remains controversial because many patients are asymptomatic. A 52-year-old man with anomalous origin of the right coronary artery with an interarterial?course concomitant with the left main trunk disease was resuscitated from cardiopulmonary arrest. It was likely to be attributed to the left main trunk disease, but anatomical structure of the right coronary artery suggests its possible involvement. Prophylactic bypass grafting for the right coronary artery was performed using saphenous vein graft without ligating native vessel to prevent future cardiac events, as well as revascularization of the left main trunk disease. All grafts were patent in one-year follow-up coronary angiography. Any cardiac event has not occurred.
文摘目的 探讨 u PA、u PAR基因表达和肝癌转移、肝细胞癌门静脉主干癌栓 (Tum or thrombosid of the m ain trunkof the portal vein,PVTT)形成的关系。方法 采用原位杂交等技术检测 u PA、u PAR表达。结果 癌栓 (A1组 )和其原发癌(A2组 ) u PA、u PAR m RNA阳性表达率均高于无转移肝癌 (B组 ) (P均 <0 .0 1) ;A 1组表达强度均高于 A2组 (P<0 .0 1)。 A 2组小血管内可见癌细胞群落 ,A 1组多见 ,B组无此现象。 A1组、A 2组 u PAR和 u PA蛋白质阳性表达率均高于 B组 (P均 <0 .0 1) ,A1组表达强度均高于 A2组 (P<0 .0 1)。 u PA、u PAR m RNA和其蛋白质表达存在良好相关性 (P均 <0 .0 1)。结论 u PA、u PAR在肝癌的侵袭和转移中起重要作用 ,其过度表达是
