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Ultrasound Value in the Management of Parapneumonic Pleural Effusions in a Limited-Resource Setting: A Case Report

Open Journal of Radiology 2023年第3期13卷 134-138页

作者： Joseph-Francis Nwatsock Ambroise-Merci Seme Engoumou Maggy Mbede Christopher Vagoda Sinbaï Christopher Vagoda Sinbaï amos ela bela Emilienne Guegang Goujou Department of Medical Imaging and Radiotherapy Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Radiology Yaoundé General Hospital Yaoundé Cameroon Department of Thoracic and Vascular Surgery Yaoundé General Hospital Yaoundé Cameroon

Pleural effusion is a common complication of acute lung infection, with rising morbidity and mortality. If poorly treated, parapneumonic effusion evolves to the fibrino-purulent stage wherein antibiotic therapy alone becomes inadequate. Chest CT is the gold standard diagnostic imaging tool, however, in a resource-limited context, it may not be performed. Chest ultrasound can therefore be an alternative for drainage and intermittent follow-up of complicated parapneumonic pleural effusions. We report the case of a 4-year-old child who presented with cough, breathing difficulties and fever for over two weeks and in whom an initial chest X-ray revealed a left hemithorax white-out with an air-fluid level. Chest ultrasound revealed a left pleuropulmonary massive fluid collection with an encysted empyema. It also allowed ultrasound-guided pleural effusion drainage of a fibrino-purulent liquid which tested positive for Kocuria kristinae, a bacterium sensitive to gentamycin, vancomycin, norfloxacin and clindamycin. The next follow-up ultrasound checks showed improvement and the control chest X-ray performed one month later demonstrated pulmonary functional recovery. This case highlights the importance of ultrasound in the management and follow-up of this chest pathology in resource-limited settings.

关键词： Chest Ultrasound Ultrasound-Guided Pleural Puncture Parapneumonic Effusion

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Thoracoscopy in Cameroon: Indications, Technics and Short Term Results

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Surgical Science 2024年第4期15卷 278-288页

作者： Guy Aristide Bang Richard II Mbele Fabrice Stephane Arroye Betou Arlette Joelle Moukitek Banaken amos Bella ela Charles Mve Mvondo Arthur Essomba Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaound&#233 I University Yaound&#233 Cameroon Department of Surgery and Specialities Yaound&#233 Teaching Hospital Yaound&#233 Cameroon General Surgery Service Mvog-Ada District Hospital Yaound&#233 Cameroon Department of Cardiothoracic and Vascular Surgery Laquintinie Hospital Douala Cameroon Department of Cardiothoracic and Vascular Surgery Yaound&#233 General Hospital Yaound&#233 Cameroon Cardiac Center Shisong St. Elizabeth Catholic General Hospital Shisong Kumbo Cameroon

Introduction: Thoracoscopy is a video-assisted surgical approach that mirrors the techniques used in thoracotomy. Our aim is to map the current state of thoracoscopy practice in Cameroon’s hospitals. Methods: This was a descriptive study that collected both retrospective and prospective data over 57 months across four hospitals in Cameroon. It included 13 patients and focused on variables such as socio-demographic factors, clinical profiles, surgical procedures, and postoperative follow-up. Results: Thirteen patients, predominantly male (84.6%, n = 11), with a mean age of 37.5 ± 16 years, were enrolled. Alcohol use (61.5%) and smoking (38.5%) were the most common past histories. The major complaints were dyspnea (84.6%) and chest pain (58.3%). The primary surgical procedure was clot-free thoracoscopy in 30.8% of cases, mainly for persistent hemothorax (41.8%). Most surgeries were elective (76.9%) and performed under general anesthesia with selective intubation (61.5%). The most common approach was single-port thoracoscopy (U-VATS) (76.9%), with no reported difficulties;however, one intraoperative incident occurred and was successfully treated. Drainage was performed systematically in all patients, and one case required conversion to open surgery. Postoperative complications were minor (Clavien-Dindo grade I) and mainly consisted of pain, with a mortality rate of 15.4%. No significant association was found between risk factors and the occurrence of complications or postoperative mortality. Conclusion: Thoracoscopy, a novel approach in our context, primarily focuses on minor thoracic surgeries.

关键词： Thoracoscopy Single-Port Hemothorax Cameroon

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Caspase-3 expression in metastatic lymph nodes of esophageal squamous cell carcinoma is prognostic of survival

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World Journal of Gastroenterology 2014年第15期20卷 4414-4420页

作者： Xiu-Shen Wang Kong-Jia Luo amos ela Bella Shan-Shan Bu Jing Wen Shui-Shen Zhang Yi Hu Department of Radiation Oncology Cancer Hospital of Zhengzhou University State Key Laboratory of Oncology in South China Cancer CenterSun Yat-sen University Department of Thoracic Oncology Cancer CenterSun Yatsen University Guangdong Esophageal Cancer Research Institute

AIM: To assess whether differential expression of caspase-3 in paired metastatic lymph nodes (LNs) is prognostic of survival in patients with resectable esophageal squamous cell carcinoma (ESCC).

关键词： Esophageal squamous cell carcinoma Caspase-3 protein Prognosis Lymph node

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Maximum standardized uptake value on PET/CT in preoperative assessment of lymph node metastasis from thoracic esophageal squamous cell carcinoma

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Chinese Journal of Cancer 2014年第4期33卷 211-217页

作者： amos JM ela Bella Ya-Rui Zhang Wei Fan Kong-Jia Luo Tie-Hua Rong Peng Lin Hong Yang Jian-Hua Fu Department of Thoracic Surgery Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Department of Nuclear Medicine Sun Yat-sen University Cancer Center Guangdong Esophageal Cancer Institute

The presence of lymph node metastasis is an important prognostic factor for patients with esophageal *** assessment of lymph nodes in thoracic esophageal carcinoma is essential for selecting appropriate treatment and forecasting disease *** emission tomography combined with computed tomography(PET/CT)is becoming an important tool in the workup of esophageal ***,we evaluated the effectiveness of the maximum standardized uptake value(SUVmax)in assessing lymph node metastasis in esophageal squamous cell carcinoma(ESCC)prior to ***-nine surgical patients with pathologically confirmed thoracic ESCC were retrospectively *** patients underwent radical esophagectomy with pathologic evaluation of lymph *** all had18F-FDG PET/CT scans in their preoperative staging *** had a prior history of *** pathologic status and PET/CT SUVmax of lymph nodes were collected to calculate the receiver operating characteristic(ROC)curve and to determine the best cutoff value of the PET/CT SUVmax to distinguish benign from malignant lymph *** node data from 27 others were used for the validation.A total of 323 lymph nodes including 39 metastatic lymph nodes were evaluated in the training cohort,and 117lymph nodes including 32 metastatic lymph nodes were evaluated in the validation *** cutoff point of the SUVmax for lymph nodes was 4.1,as calculated by ROC curve(sensitivity,80%;specificity,92%;accuracy,90%).When this cutoff value was applied to the validation cohort,a sensitivity,a specificity,and an accuracy of 81%,88%,and 86%,respectively,were *** results suggest that the SUVmax of lymph nodes predicts ***,when an SUVmax of 4.1 was used instead of 2.5,FDG-PET/CT was more accurate in assessing nodal metastasis.

关键词：淋巴结肿大 CT扫描食管癌 PET 评估摄取标准计算机断层扫描

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Detection of PRL-2 gene expression in hepatocellular carcinoma by real-time fluorescence quantitative PCR

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The Chinese-German Journal of Clinical Oncology 2009年第4期8卷 210-213页

作者： Chao Cheng amos ela Bella Ailin Guo Guoyong Wu Weikang Wu Department of Thoracic Surgery The First Affiliated Hospital Sun Yat-sen University Guangzhou 510080 China Medical Research Center GuangDong Provincial People＇s Hospital Guangzhou 510080 China Department of Pathophysiology Sun Yat-sen University Guangzhou 510080 China

Objective:To quantitatively detect the expression level of PRL-2 in primary hepatocellular carcinoma using real-time fluorescence quantitative ***:Total RNA isolated from human HCC and liver tissue adjacent to the tumor was reversely transcribed into ***-time fluorescence quantitative PCR(Q-PCR) method was used to analyze the expres-sion level of PRL-2 ***:The Q-PCR method was performed successfully to precisely detect RNA ***-2 was expressed in all portal vein tumor thrombosis(PVTT) and HCC,but only in some paratumor *** highest expression level of PRL-2 gene was recorded in PVTT;meanwhile expression level of PRL-2 was higher than that in paratumor liver tis-sues and in HCC(P < 0.01),and it was higher in HCC than that in paratumor liver ***:The Q-PCR may be the most precise method to quantitatively detect RNA level and can be used in gene expression *** PRL-2 gene has higher expression in PVTT than that in HCC and in paratumor liver tissue cells,indicating that it plays an important role in the development and metastasis of the HCC.

关键词： carcinoma hepatocellular polymerase chain reaction PRL2 gene expression

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术前放化疗对微创食管切除术的影响

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中华胸心血管外科杂志 2013年第2期29卷 84-86,90页

作者：谢绚傅剑华张旭杨弘杨富罗孔嘉李小东 amos ela BELIA 林婷华南肿瘤学国家重点试验室中山大学肿瘤防治中心胸科广州510060

目的探讨术前放化疗对微创食管切除术（MIE）手术质量及围术期的影响。方法符合入组条件的初治胸段局部晚期食管鳞癌63例，随机分成对照组与试验组，对照组33例行单纯MIE治疗，试验组30例行术前放化疗联合MIE治疗，遵循意向性处理原则... 详细信息

目的探讨术前放化疗对微创食管切除术（MIE）手术质量及围术期的影响。方法符合入组条件的初治胸段局部晚期食管鳞癌63例，随机分成对照组与试验组，对照组33例行单纯MIE治疗，试验组30例行术前放化疗联合MIE治疗，遵循意向性处理原则，对其手术质量及围术期状况进行对比评价。结果对照组与试验组中转开胸率分别是6．1％与3．3％；R0切除率分别是97．0％与93．3％；两组间差异均无统计学意义（P〉0．05）。试验组除胸部手术时间较对照组显著延长外（P=0．018），其余各项指标包括总手术时间、失血量、正常结构的暴露与保护、清扫淋巴结数目两组比较差异均无统计学意义（P〉0．05）。试验组总体并发症发生率50．0％，较对照组（39．4％）略高，但差异无统计学意义（P〉0．05）。结论术前放化疗虽略增加了MIE的手术难度，但对原发灶及淋巴结的根治性切除影响不大，围术期并发症增加不明显，因此术前放化疗后MIE安全可行。

关键词：食管肿瘤外科手术微创性食管切除术肿瘤辅助疗法

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新型可回收全覆膜镍钛合金支架治疗难治性食管良性狭窄

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中华胃肠外科杂志 2011年第11期14卷 875-878页

作者：李小海胡祎杨弘 amos ela Bella 傅剑华华南肿瘤学国家重点实验室中山大学肿瘤防治中心胸科广州510060

目的探讨自行设计的新型可回收抗反流全覆膜镍钛合金支架治疗难治性食管良性狭窄的疗效。方法2009年11月至2011年5月间中山大学肿瘤防治中心胸科采用新型支架治疗难治性食管良性狭窄患者8例。在支架置入术后第1、7、30和60天以及拔除支... 详细信息

目的探讨自行设计的新型可回收抗反流全覆膜镍钛合金支架治疗难治性食管良性狭窄的疗效。方法2009年11月至2011年5月间中山大学肿瘤防治中心胸科采用新型支架治疗难治性食管良性狭窄患者8例。在支架置入术后第1、7、30和60天以及拔除支架术后1、2、3和6个月，进行胃镜和食管吞钡检查，评价患者吞咽功能改善及并发症发生情况。结果8例患者均成功置入新型支架．术后吞咽功能较术前明显改善（P〈0．05）。经9个月的中位随访，已拔除支架6例，其吞咽功能亦较术前明显改善（P〈0．05）：支架继续留置2例，其中1例支架置入术后已15个月，目前仍进普通饮食：另1例支架置入术后2个月吞咽功能较术前改善．但3个月后吞咽功能减退至术前水平。8例患者远期吞咽功能改善率为7／8。术后再狭窄1例：支架脱落2例：肉芽过度增生3例，其中支架覆膜破裂致肉芽向内生长2例。结论新型可回收全覆膜镍钛合金支架置入食管良性狭窄术后和拔除支架后吞咽功能明显改善．远期再狭窄发生率低：但支架脱落发生率仍较高．支架覆膜材料易破裂．仍需进一步改进。

关键词：食管良性狭窄支架吞咽功能并发症

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腔镜微创食管癌切除术的学习过程分析

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中华胃肠外科杂志 2012年第9期15卷 918-921页

作者：谢绚傅剑华王军业张旭罗孔嘉杨富 amos ela Bella 李小海华南肿瘤学国家重点实验室、中山大学肿瘤防治中心胸科广州510060

目的总结腔镜微创食管癌切除术（MIE）的学习过程。方法选取同一组医生连续完成的MIE手术100例，按手术时间顺序分为3组：第1、2组各25例行胸腔镜并常规开腹手术，第3组50例行胸腹腔镜手术．分别记录手术时间、出血量、正常结构保护及... 详细信息

目的总结腔镜微创食管癌切除术（MIE）的学习过程。方法选取同一组医生连续完成的MIE手术100例，按手术时间顺序分为3组：第1、2组各25例行胸腔镜并常规开腹手术，第3组50例行胸腹腔镜手术．分别记录手术时间、出血量、正常结构保护及并发症发生情况、术后ICU观察时间、住院时间、术后肿瘤病理及淋巴结清扫情况等临床资料，比较各组之间的差异。结果全组中96例患者顺利完成MIE，4例患者中转开胸，无中转开腹。中位手术时间310min，中位失血量200ml，中位清扫淋巴结22枚，总体并发症发生率50％。第1组与第2组比较，在保留奇静脉弓（P=0．010）、保留支气管动静脉（P=0．038）及左侧喉返神经胸段术中暴露率（P=0．048）方面的差异有统计学意义。前50例与后50例比较，在胸部手术时间（P=0．000）、失血量（P=0．025）、保留奇静脉弓（P=0．001）、保留支气管动静脉（P=0．000）、胸野淋巴结清扫（P=0．022）、左喉返神经链淋巴结清扫（P=0．000）及该神经起始部术中暴露率（P=0．002）方面的差异有统计学意义。结论MIE学习过程较长．应循序渐进。随着经验的积累和手术技巧的提升．MIE将逐渐显示其独特的优势并替代传统开胸食管癌切除术。

关键词：食管肿瘤微创外科食管切除术学习曲线

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