BACKGROUND Paraduodenal pancreatitis(PP)is a rare form of chronic pancreatitis presenting with symptoms of duodenal obstruction.Conservative treatment is often unsuccessful and pancreaticoduodenectomy is the preferred...BACKGROUND Paraduodenal pancreatitis(PP)is a rare form of chronic pancreatitis presenting with symptoms of duodenal obstruction.Conservative treatment is often unsuccessful and pancreaticoduodenectomy is the preferred surgical approach.A mini review of the outcomes of surgical therapy for PP shows that the results of pancreaticoduodenectomy are predominantly favorable.CASE SUMMARY In our case report of PP,we describe an unusual course first presenting with the symptoms of chronic pancreatitis and a pseudocyst of the pancreatic tail.A pseudocystojejunostomy was performed and the late postoperative course was complicated with the symptoms of duodenal obstruction.At laparotomy,PP was found and the patient was treated with a total pancreatectomy.The postoperative course was uneventful and good weight gain with resolution of pain was demonstrated at follow up visits.CONCLUSION Surgery is currently the optimal treatment option for PP.It is also the best diagnostic tool in distinguishing between pancreatitis and pancreatic adenocarcinoma.展开更多
BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. ...BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. CASE SUMMARY We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present. CONCLUSION Open reduction should be performed for closed TTDs unless closed reduction is successful.展开更多
<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cros...<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. <strong>Results:</strong> All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. <strong>Conclusions:</strong> The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.展开更多
BACKGROUND A recurrent valgus deformity was a common complication after total knee arthroplasty(TKA)in patients with valgus deformity.However,re-revision surgery for re-recurrent valgus deformity after revision TKA in...BACKGROUND A recurrent valgus deformity was a common complication after total knee arthroplasty(TKA)in patients with valgus deformity.However,re-revision surgery for re-recurrent valgus deformity after revision TKA in patients with valgus deformity before primary TKA was uncommon.CASE SUMMARY We reported a 72-year-old female patient with two recurrent valgus deformities after TKA for a valgus knee deformity who underwent two revision surgeries to rectify the deformity.In the re-revision surgery,bone defects were successfully reconstructed by the augments and cement in combination with screws and a sleeve.An appropriate neutral alignment of the lower limb was restored by the perfect femoral entry point and the long diaphyseal cementless stem.Adequate fixation of the metaphysis and diaphysis of the femur was obtained by the sleeve and long diaphyseal cementless stem.The patient was pain-free and deformityfree for 2.5 years.CONCLUSION The management of bone defects,the choice of the stem and the femoral entry point were of vital importance in the revision or re-revision TKA for a recurrent valgus deformity.展开更多
BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thrombo...BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and obesity.Here we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated polycythemia.CASE SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous uterus.She suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several months.Laboratory analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of polycythemia.Arterial blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 mmHg.Abdominal computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 cm.To reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic hysterectomy.The uterus weighed 5400 g and the histology confirmed a diagnosis of leiomyoma.We did not find increased erythropoietin levels in the supernatant of the myomatous uterine tissue.There were no complications.On postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,respectively.Arterial blood gas analysis after surgery showed a pO2 of 144.7 mmHg.These results suggested the diagnosis of myomatous erythrocytosis syndrome.The patient was discharged on the second postoperative day in very good condition with no symptoms.CONCLUSION We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and obesity.Multiple VTE risk factors warranted a laparoscopic approach.展开更多
BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the ...BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the cervical stump.We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy.Gynecologists should choose the most suitable surgical method based on both the patient’s condition and wishes.If the cervix is retained,patients require a close follow-up.CASE SUMMARY A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass.Her chief complaint was abdominal distention for two months.She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior.Abdominal ultrasonography detected a 9.1 cm×8.5 cm×8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53(HPV53)was positive.The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump.We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion.The pelvic mass was removed,and a bilateral adnexectomy was implemented.Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion.After successful intervention,the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo.CONCLUSION When addressing benign uterine diseases,gynecologists should pay adequate attention to retaining the cervix.If the cervix is retained,patients require a close follow-up.展开更多
BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA see...BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA seems impossible. CASE SUMMARY We presented a case of a 54-year-old woman with a mass in the deep lobe of the right parotid gland involving the ipsilateral skull base and mastoid. The patient exhibited gradual right facial swelling but no other obvious symptoms. Combined resection of the total right parotid gland and partial skull base excision were performed. The biopsy conducted before the surgery and sections cut from intraoperatively obtained tissues were not definitive for identifying the character of the neoplasm. A final diagnosis of tubular BCA without malignant elements was established based on postoperative pathology results and immunohistochemical analysis. The tumour did not recur during the 12-mo follow-up period. CONCLUSION A diagnosis of BCA can only be established based on a histopathological examination after an excisional biopsy, and tubular BCA should carefully be considered as a destructive type.展开更多
Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic e...Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic endometrial tissue in the umbilicus, which overtly presents as a painful, discoloured swelling in the umbilicus. However, in our case the presentation wasn’t as obvious. The endometrial tissue was embedded within an umbilical hernia. Case Summary: Our patient was a 37-year-old female with a past medical/surgical history of a subtotal colectomy for ulcerative colitis in 2001 followed by an ileo-rectal anastomosis. 17 years later, she was referred to the surgical outpatient clinic from GP practice with a painful umbilical/incisional hernia surrounding the previous scar and just above the umbilicus, this pain, particularly worsening during her menstrual cycle. Multiple blood tests and ultrasound scans of her abdomen failed to diagnose a cause for her agony which mandated an elective excision of the swelling. This successfully resolved her symptoms. Conclusion: Umbilical endometriosis is a potential diagnosis in females with a painful umbilical swelling, imaging has no diagnostic role and excision is the definitive treatment.展开更多
AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who ...AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.展开更多
BACKGROUND Severe total colonic necrosis,septic shock and venous thromboembolism secondary to ulcerative colitis (UC) are rare and life-threatening.No such severe complications have been reported in the literature.CAS...BACKGROUND Severe total colonic necrosis,septic shock and venous thromboembolism secondary to ulcerative colitis (UC) are rare and life-threatening.No such severe complications have been reported in the literature.CASE SUMMARY We report a 36-year-old woman who developed total colonic necrosis and septic shock secondary to UC.The patient was treated with emergency surgery because computed tomography showed suspicious perforations.Persistent massive ascites occurred after operation and computed tomography angiography demonstrated portal vein,mesenteric vein and splenic vein thrombosis.The patient was discharged from hospital after active treatment.CONCLUSION Clinicians should pay attention to venous thrombosis,colonic necrosis and septic shock in UC patients.Close observation of surgical indications and timely surgical intervention are the key to reduce mortality and complications in UC.展开更多
Teratomas have been reported to occur in multiple organ regions, and are less common in non-gonadal regions, such as the neck and chest, than in gonadal and midline regions of the body, such as ovaries and testis. Cas...Teratomas have been reported to occur in multiple organ regions, and are less common in non-gonadal regions, such as the neck and chest, than in gonadal and midline regions of the body, such as ovaries and testis. Cases have been reported of a large teratoma of the anterior mediastinum extending to the neck, causing symptoms such as dyspnea, which can be quickly detected by Ultrasound, and patients can be quickly treated. In adults, primary teratoma at the suprasternal foss that not accumulate thyroid gland upward and not invade the mediastinum are rare, usually have no obvious clinical symptoms and are found in most patients by chance. In this literature, we report a rare case of mature cystic teratoma in the suprasternal fossa of a 33-year-old male. Preoperative ultrasonography showed a superior sternal fossa tumor with less calcification and more adipose tissue. The final pathologic diagnosis was mature cystic teratoma through open surgery of the suprasternal neck incision. The patient was followed up for 9 months and there was no recurrence. We believe that the suprasternal notch approach is a safe and effective method for the treatment of mature teratoma without protruding into the superior mediastinum.展开更多
文摘BACKGROUND Paraduodenal pancreatitis(PP)is a rare form of chronic pancreatitis presenting with symptoms of duodenal obstruction.Conservative treatment is often unsuccessful and pancreaticoduodenectomy is the preferred surgical approach.A mini review of the outcomes of surgical therapy for PP shows that the results of pancreaticoduodenectomy are predominantly favorable.CASE SUMMARY In our case report of PP,we describe an unusual course first presenting with the symptoms of chronic pancreatitis and a pseudocyst of the pancreatic tail.A pseudocystojejunostomy was performed and the late postoperative course was complicated with the symptoms of duodenal obstruction.At laparotomy,PP was found and the patient was treated with a total pancreatectomy.The postoperative course was uneventful and good weight gain with resolution of pain was demonstrated at follow up visits.CONCLUSION Surgery is currently the optimal treatment option for PP.It is also the best diagnostic tool in distinguishing between pancreatitis and pancreatic adenocarcinoma.
文摘BACKGROUND Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury. CASE SUMMARY We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present. CONCLUSION Open reduction should be performed for closed TTDs unless closed reduction is successful.
文摘<strong>Background:</strong> The main purpose of the present study was to assess the short term performance of a cementless femoral stem in total hip replacement. <strong>Methods:</strong> Cross-sectional observational study of a 48-patient cohort with Phenom? femoral stems implanted between June 1, 2014 and September 1, 2018, to determine clinical performance, stability, and radiographic osseointegration. Patients were followed-up from 13 to 76 months (mean: 44.5 months) and assessed using the Harris Hip Score-HHS, the Hip Disability and Osteoarthritis Outcome Score-HOOS and radiographs. <strong>Results:</strong> All stems were radiologically stable. Mean Harris Hip Score was 89.8 and the HOOS was 80.4. No statistical differences were observed among patients with different diagnoses. <strong>Conclusions:</strong> The short-term results revealed satisfactory clinical outcomes and radiological signs of implant stability in all cases. Using two functional scores was useful in detecting biases and a low to moderate agreement was found between the scores.
基金Supported by National Key Research and Development Program of China,No.2017YFB1104104
文摘BACKGROUND A recurrent valgus deformity was a common complication after total knee arthroplasty(TKA)in patients with valgus deformity.However,re-revision surgery for re-recurrent valgus deformity after revision TKA in patients with valgus deformity before primary TKA was uncommon.CASE SUMMARY We reported a 72-year-old female patient with two recurrent valgus deformities after TKA for a valgus knee deformity who underwent two revision surgeries to rectify the deformity.In the re-revision surgery,bone defects were successfully reconstructed by the augments and cement in combination with screws and a sleeve.An appropriate neutral alignment of the lower limb was restored by the perfect femoral entry point and the long diaphyseal cementless stem.Adequate fixation of the metaphysis and diaphysis of the femur was obtained by the sleeve and long diaphyseal cementless stem.The patient was pain-free and deformityfree for 2.5 years.CONCLUSION The management of bone defects,the choice of the stem and the femoral entry point were of vital importance in the revision or re-revision TKA for a recurrent valgus deformity.
文摘BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and obesity.Here we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated polycythemia.CASE SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous uterus.She suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several months.Laboratory analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of polycythemia.Arterial blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 mmHg.Abdominal computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 cm.To reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic hysterectomy.The uterus weighed 5400 g and the histology confirmed a diagnosis of leiomyoma.We did not find increased erythropoietin levels in the supernatant of the myomatous uterine tissue.There were no complications.On postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,respectively.Arterial blood gas analysis after surgery showed a pO2 of 144.7 mmHg.These results suggested the diagnosis of myomatous erythrocytosis syndrome.The patient was discharged on the second postoperative day in very good condition with no symptoms.CONCLUSION We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and obesity.Multiple VTE risk factors warranted a laparoscopic approach.
基金Supported by National Natural Science Foundation of China,No.81772790 and No.81602293Postgraduate Innovation Fund of 13th Five-year Comprehensive Investment,Tianjin Medical University,No.YJSCX201812
文摘BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the cervical stump.We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy.Gynecologists should choose the most suitable surgical method based on both the patient’s condition and wishes.If the cervix is retained,patients require a close follow-up.CASE SUMMARY A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass.Her chief complaint was abdominal distention for two months.She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior.Abdominal ultrasonography detected a 9.1 cm×8.5 cm×8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53(HPV53)was positive.The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump.We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion.The pelvic mass was removed,and a bilateral adnexectomy was implemented.Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion.After successful intervention,the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo.CONCLUSION When addressing benign uterine diseases,gynecologists should pay adequate attention to retaining the cervix.If the cervix is retained,patients require a close follow-up.
文摘BACKGROUND Basal cell adenoma (BCA) is a rare benign tumour that has unique histological characteristics and primarily arises in the parotid glands. According to published reports, nearby tissue destruction by BCA seems impossible. CASE SUMMARY We presented a case of a 54-year-old woman with a mass in the deep lobe of the right parotid gland involving the ipsilateral skull base and mastoid. The patient exhibited gradual right facial swelling but no other obvious symptoms. Combined resection of the total right parotid gland and partial skull base excision were performed. The biopsy conducted before the surgery and sections cut from intraoperatively obtained tissues were not definitive for identifying the character of the neoplasm. A final diagnosis of tubular BCA without malignant elements was established based on postoperative pathology results and immunohistochemical analysis. The tumour did not recur during the 12-mo follow-up period. CONCLUSION A diagnosis of BCA can only be established based on a histopathological examination after an excisional biopsy, and tubular BCA should carefully be considered as a destructive type.
文摘Background: Umbilical endometriosis, a rare benign condition, is clinically difficult to differentiate from other diseases that result in the formation of an umbilical nodule. It is caused by the presence of ectopic endometrial tissue in the umbilicus, which overtly presents as a painful, discoloured swelling in the umbilicus. However, in our case the presentation wasn’t as obvious. The endometrial tissue was embedded within an umbilical hernia. Case Summary: Our patient was a 37-year-old female with a past medical/surgical history of a subtotal colectomy for ulcerative colitis in 2001 followed by an ileo-rectal anastomosis. 17 years later, she was referred to the surgical outpatient clinic from GP practice with a painful umbilical/incisional hernia surrounding the previous scar and just above the umbilicus, this pain, particularly worsening during her menstrual cycle. Multiple blood tests and ultrasound scans of her abdomen failed to diagnose a cause for her agony which mandated an elective excision of the swelling. This successfully resolved her symptoms. Conclusion: Umbilical endometriosis is a potential diagnosis in females with a painful umbilical swelling, imaging has no diagnostic role and excision is the definitive treatment.
文摘AIM: To investigate knee awareness and functional outcomes in patients treated with simultaneous bilateral vs unilateral total knee arthroplasty(TKA).METHODS: Through a database search, we identified 210 patients who had undergone unilateral TKA(UTKA) and 65 patients who had undergone simultaneous bilateral TKA(SBTKA) at our institution between 2010 and 2012. All TKAs were cemented and cruciate retaining. The mean follow-up period was 3.2(2 to 4) years. All the patients had symptomatic and debilitating unilateral or bilateral osteoarthritis for which all conservative and non-surgical treatments were failed, thus preoperatively the patients had poor functionality. All patients were asked to complete Forgotten Joint Score(FJS) and Oxford Knee Score(OKS) questionnaires. The patients were matched according to age, gender, year of surgery, Kellgren-Lawrence score and pre- andpostoperative overall knee alignment. The FJS and OKS questionnaire results of the two groups were then compared. RESULTS: A mixed-effects model was used to analyze differences between SBTKA and UTKA. OKS: The mean difference in the OKS between the patients who had undergone SBTKA and those who had undergone UTKA was 1.5, which was not statistically significant(CI =-0.9:4.0, P-value = 0.228). The mean OKS of the SBTKA patients was 37.6(SD = 9.0), and the mean OKS of the UTKA patients was 36.1(SD = 9.9). FJS: The mean difference in the FJS between the patients who had undergone SBTKA and those who had undergone UTKA was 2.3, which was not statistically significant(CI =-6.2:10.8, P-value = 0.593). The mean FJS of the SBTKA patients was 59.9(SD = 27.5), and the mean FJS of the UTKA patients was 57.5(SD = 28.8). CONCLUSION: SBTKA and UTKA patients exhibited similar joint functionality and knee awareness. Our results support the use of SBTKA in selected patients suffering from clinically symptomatic bilateral osteoarthritis.
文摘BACKGROUND Severe total colonic necrosis,septic shock and venous thromboembolism secondary to ulcerative colitis (UC) are rare and life-threatening.No such severe complications have been reported in the literature.CASE SUMMARY We report a 36-year-old woman who developed total colonic necrosis and septic shock secondary to UC.The patient was treated with emergency surgery because computed tomography showed suspicious perforations.Persistent massive ascites occurred after operation and computed tomography angiography demonstrated portal vein,mesenteric vein and splenic vein thrombosis.The patient was discharged from hospital after active treatment.CONCLUSION Clinicians should pay attention to venous thrombosis,colonic necrosis and septic shock in UC patients.Close observation of surgical indications and timely surgical intervention are the key to reduce mortality and complications in UC.
文摘Teratomas have been reported to occur in multiple organ regions, and are less common in non-gonadal regions, such as the neck and chest, than in gonadal and midline regions of the body, such as ovaries and testis. Cases have been reported of a large teratoma of the anterior mediastinum extending to the neck, causing symptoms such as dyspnea, which can be quickly detected by Ultrasound, and patients can be quickly treated. In adults, primary teratoma at the suprasternal foss that not accumulate thyroid gland upward and not invade the mediastinum are rare, usually have no obvious clinical symptoms and are found in most patients by chance. In this literature, we report a rare case of mature cystic teratoma in the suprasternal fossa of a 33-year-old male. Preoperative ultrasonography showed a superior sternal fossa tumor with less calcification and more adipose tissue. The final pathologic diagnosis was mature cystic teratoma through open surgery of the suprasternal neck incision. The patient was followed up for 9 months and there was no recurrence. We believe that the suprasternal notch approach is a safe and effective method for the treatment of mature teratoma without protruding into the superior mediastinum.
