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Younger age of onset and multiple primary lesions associated with esophageal squamous cell carcinoma cases with a positive family history of the cancer suggests genetic predisposition

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Chinese Medical Journal 2014年第15期127卷 2779-2783页

作者： Jia Nan Wen Xiaoduo Zhang Nan YangYi Zhang Liwei Wang Xiaoling Wang Na Wen Denggui Department of surgery Hebei Tumor Hospital and theFourth Hospital of Hebei Medical University Shijiazhuang Hebei050011 China Department of Tumor Image Hebei Tumor Hospital and theFourth Hospital of Hebei Medical University Shijiazhuang Hebei050011 China Department of Medical Information Hebei Tumor Hospital and theFourth Hospital of Hebei Medical University Shijiazhuang Hebei050011 China Department of Pathology Hebei Tumor Hospital and theFourth Hospital of Hebei Medical University Shijiazhuang Hebei050011 China Department of Oncology Hebei Tumor Hospital and theFourth Hospital of Hebei Medical University Shijiazhuang Hebei050011 China

Background Previous epidemiological studies have consistently found a positive family history of esophageal cancer is associated with a significantly increased risk of the ***,whether the elevated risk could be attributed to common household exposure or inherited susceptibility is *** study aimed to highlight the effect of genetic predisposition by noting the significant differences in onset age and multiple primary cancers between esophageal squamous cell carcinoma （ESCC） cases with or without a positive family history of the *** Age at onset and the percentage of multiple primary cancers were compared between ESCCs with （n=766） or without （n=1 776） a positive family history of the cancer in a consecutive surgery cohort at the Department of thoracic surgery of Hebei Tumor Hospital and the Fourth Hospital of Hebei Medical *** Overall,ESCCs with a positive family history of the cancer featured both a significantly younger age of onset and significantly more multiple primary cancers than those with a negative family history （onset age 51.83 vs.53.49 years old,P 〈0.01; percent of multiple primary cancers 5.50% vs.1.70%,x2=25.42,P 〈0.01）.Both the differences were evident in subgroup analyses,but did not *** age at onset differed significantly by family history among the male,smoking,and drinking groups,the difference of multiple primary cancers was significant among the otherwise nonsmoking,nondrinking,and younger onset age *** Younger age of onset and multiple primary cancers associated with ESCCs with a positive,as opposed to a negative family history of the cancer,suggest a genetic *** results of subgroup analyses indicate a younger age of ESCC development results from the interaction of environmental and genetic risk factors,but multiple primary cancers may be related only to genetic predisposition.

关键词： esophageal squamous cell carcinoma gastric cardia adenocarcinoma a positive family history of cancer genetic predisposition onset age multiple primary cancer

基质金属蛋白酶9基因(-8202A/G)中单核苷酸多态性与胸主动脉瘤和胸主动脉夹层形成相关

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 57-57页

作者： Carter S.A. S.A. LeMaire 张步升 Cardiovascular surgery Service The Texas Heart Institute at St Luke's Episcopal Hospital The Division of Cardiothoracic Surgery Houston TX United States Dr.

Objective: Matrix metalloproteinase 9 plays an important role in the maintenance of the aortic extracellular matrix. Genetic variations that affect protease expression or activity might contribute to thoracic aortic disease. The purpose of this study was to determine whether 3 single nucleotide polymorphisms in the matrix metalloproteinase 9 gene are associated with thoracic aortic aneurysms and dissection. Methods: Genomic DNA was isolated from blood or aortic tissue from 28 patients with degenerative thoracic aortic aneurysms, 60 patients with thoracic aortic dissection, and 111 control patients. The frequency distributions of 3 matrix metalloproteinase 9 single nucleotide polymorphisms(-8202A/G, IVS4+3G/T, and 2003A/G[Q668R]) were determined by using genotyping accomplished with a real-time detection system. Associations between polymorphisms and disease were estimated with odds ratios and their 95%confidence intervals. Results: The frequency of the-8202G allele was significantly higher in patients with thoracic aortic aneurysms and aortic dissection(0.52 and 0.56, respectively) than in control subjects(0.36, Pthoracic aortic aneurysms or dissection were nearly 5 times more likely than control subjects to have the G allele(adjusted odds ratio, 4.87; 95%confidence interval, 2.04-11.64). There were no significant associations between the IVS4+3G/T or 2003A/G polymorphisms and thoracic aortic disease. Conclusions: The matrix metalloproteinase 9-8202A/G polymorphism is associated with thoracic aortic aneurysms and dissection. Further studies are warranted to elucidate the functional role of the-8202A/G variant in matrix metalloproteinase 9 expression.

关键词：胸主动脉夹层 A/G 基质金属蛋白酶胸主动脉瘤单核苷酸多态性细胞外基质主动脉组织等位基因频

胰胸膜腔瘘:一种罕见的胰管破裂的胸部并发症

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世界核心医学期刊文摘（儿科学分册） 2006年第9期2卷 30-30页

作者： Duncan N.D. Ramphal P.S. Dundas S.E. 李丹 Department of surgery University Hospital of the West IndiesKingstonJamaica

Pancreaticopleural fistula resulting in a chronic pleural effusion is a rare complication of pancreatic duct disruption. We describe the presentation and management of 2 children with pancreaticopleural fistulas. Pleural fluid amylase concentration and contrast computed tomography were sufficient to establish the diagnosis in both cases. The initial management of these fistulas should be conser vative,by tube thoracostomy and suppression of pancreatic secretion. Operative treatment is necessary for those who fail to resolve. Complete diversion of the pancreatic juice into the gastrointestinal tract by longitudinal pancreaticojejunostomy has been an effective surgical option leading to fistula closure.

关键词：胸膜腔胸廓造口术慢性胸腔积液空肠吻合术浓度测定计算机断层扫描管破裂

Esophageal Perforation in Children: Experience in Kurdistan Center for Gastroenterology and Hepatology/Iraq

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Open Journal of Gastroenterology 2014年第5期4卷 221-227页

作者： Adnan M. H. Hamawandi Aram Baram Ali A. G. Ramadhan Taha A. Karboli Abdulsalam Y. Taha Ako Anwar Department of Anasthesia Sulaimani Teaching Hospital Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Duhok Kurdistan Center for Gastroenterology and Hepatology Duhok Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Pediatrics School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of surgery School of Medicine Faculty of Medical Sciences University of Sulaimani Sulaimani Teaching Hospital Sulaymaniyah Iraq

Background: Esophageal perforation is a rare, but potentially life threatening injury. The etiology and management of this condition have changed overtime. Iatrogenic causes are increasingly recognized and management is evolving towards more conservative approaches. Objective: To review our experience in the management of esophageal perforation in pediatric patients. Patients and methods: This retrospective study was conducted in the Kurdistan center for gastroenterology and hepatology in Sulaimani city. Review of records for cases of esophageal perforation during the period from January 2006 to October 2013 was performed. Results: Ten cases were found to have esophageal perforation. The causes of esophageal perforation were complications of endoscopic dilation for esophageal stricture (n = 7), button battery ingestion (n = 2), complication of esophagoscopy for corrosive injury (n = 1). The mean age was 42 months (range, 18 - 75 months). The diagnosis was made during the procedure in 6 cases, within 12 hours in 2 cases and late in the two cases of battery ingestion. Subcutaneous emphysema and respiratory distress were the main presenting features. The location of perforation was thoracic in 9 cases and cervical in 1 case. Conservative management was successful in 7 patients and surgical closure was done in two patients. One death has been reported. Conclusion: Iatrogenic causes were the most common causes of esophageal perforation. Conservative management with interventions guided by clinical response can have a favorable outcome and may become the best initial treatment strategy in the future. Further larger scale studies are recommended to establish the best protocol for conservative management.

关键词： Dilatation Esophageal Perforation Children Conservative Management Sulaimani

带血管蒂肋软骨移植治疗声门下及高位气管狭窄

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世界核心医学期刊文摘（儿科学分册） 2005年第5期1卷 51-51页

作者： Hashizume K. Kanamori Y. Sugiyama M. 宁亮 Department of Pediatric surgery The University of Tokyo Hospital Tokyo JapanDr.

Background/purpose Free costal cartilage graft for the treatment of subglottic and tracheal stenosis is widely used, but postoperative granulation formation i s a problem. To reduce the risk of granulation formation after free costal graft , a new operation of costal cartilage graft with vascular pedicle was introduced . Methods A vascular pedicled fifth costal cartilage graft is prepared using int ernal thoracic artery and vein and intercostal artery and vein as a vascular ped icle. The prepared graft is brought to the upper trachea. The anterior wall of c ricoid is split, and the costal cartilage graft is implanted to the split part a nd tracheostomy. Extubation on the next day is possible if the general condition of the patient permits. Results In 3 cases of subglottic or upper tracheal sten osis, this operation was performed. All the patients had tracheostomy made durin g early infancy. The postoperative course was uneventful, and all the patients w ere extubated soon after the operation. No granulation tissue was obserbed by po stoperative bronchoscopic examinations. Conclusions Costal cartilage graft with vascular pedicle is a safe and useful new operation for the treatment of subglot tic and upper tracheal stenosis. There also is a possibility of using this proce dure for the treatment of long segment tracheal stenosis.

关键词：气管狭窄带血管蒂肋软骨移植物气管造口术颗粒形成动静脉带蒂移植拔管支气管镜检查

Comparison of ultrasonography and radiography in diagnosis of rib fractures

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Chinese Journal of Traumatology 2017年第4期20卷 226-228页

作者： Elham Pishbin Koorosh Ahmadi Molood Foogardi Maryam Salehi Farrokh Seilanian Toosi Vafa Rahimi-Movaghar Department of Emergency Medicine. Imam Reza Hospital Mashhad University of Medical Sciences. Mashhad Iran Department of Emergency Medicine. Alborz University of Medical Sciences Karaj Iran Department of Emergency Medicine. Birjand University of Medical Sciences. Birjand. Iran Department of Community Medicine. Mashhad University of Medical Sciences. Mashhad Iran Department of Radiology. Mashhad University of Medical Sciences Mashhad. Iran Sina Trauma and surgery Research Center Tehran University of Medical Sciences TehranIran

Purpose： Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography （USG） has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. Methods： In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior （PA） chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Results： Sixty-one suspected patients were assessed. The male to female ratio was 2.4：1 （43 men and 18 women） with a mean ± SD age of （44.3 ± 19.7） years. There were totally 59 rib fractures in 38 （62.3%） patients based on radiography and USG, while 23 （37.7%） patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 （54.1%） of 61 suspected patients and radiographs revealed 32 rib fractures in 20 （32.8%） of 61 patients. A total of 58 （98.3%） rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 （45.8%） and 24 （40.7%） rib fractures, respectively. The average duration of USG was （12 ± 3） min （range 7e17 min）, whereas the duration of radiography was （27 ± 6） min （range 15-37 min）. The kappa coefficient showed a low level of agreement between both USG and PA chest radiography （kappa coefficient=0.28）, and between USG and oblique rib view （kappa coefficient=0.32）. Conclusion： USG discloses more fractures than radi

关键词： Rib fractures Radiography Ultrasonography

大面积胸部外伤后第1肋骨骨折引起的霍纳综合征

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世界核心医学期刊文摘（儿科学分册） 2006年第4期2卷 38-38页

作者： Ozel S.K. Kazez A. 王一飞 Department of Pediatric surgery Firat University Faculty of Medicine 23119 Elazi■ Turkey

A case of Horner syndrome diagnosed during the follow-up after major thoracic trauma is presented in this report. A 10- year-old boy was admitted to the emergency service with severe thoracic trauma with left clavicular and first rib fracture after a traffic accident. During the follow-up, myosis and ptosis were recognized in his left eye. Cranial tomography and neurological examination were all normal. The symptoms were thought to be caused by compression of the local hematoma to the cervical ganglia. After 30 days of conservative treatment with tube thoracostomies, he was discharged with his Horner syndrome. After 6 months of follow-up, the findings of Horner syndrome were found to be partially resolved. First rib fracture associated with Horner syndrome is very rarely seen in children, and only 2 cases were found in English-language literature. Our case seems to be the third reported case. Horner syndrome should be kept in mind in cases of first rib fractures. When head trauma is considered, as it can be mistaken with anisocoria, this knowledge may help the surgeon in differential diagnosis.

关键词：霍纳综合征胸部外伤肋骨骨折血肿压迫上睑下垂颈部交感神经节瞳孔缩小外科医生左侧锁骨紧

严重胸部外伤后第1肋骨骨折引发的Horner综合征

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世界核心医学期刊文摘（眼科学分册） 2006年第3期2卷 9-9页

作者： Ozel S.K Kazez A. 张磊 Department of Pediatric surgery Firat University Faculty of Medicine 23119 Elazig Turkey

A case of Horner syndrome diagnosed during the follow-up after major thoracic trauma is presented in this report. A 10-year-old boy was admitted to the emergency service with severe thoracic trauma with left clavicular and first rib fracture after a traffic accident. During the follow-up, myosis and ptosis were recognized in his left eye. Cranial tomography and neurological examination were all normal. The symptoms were thought to be caused by compression of the local hematoma to the cervical ganglia. After 30 days of conservative treatment with tube thoracostomies, he was discharged with his Horner syndrome. After 6 months of follow-up, the findings of Horner syndrome were found to be partially resolved. First rib fracture associated with Horner syndrome is very rarely seen in children, and only 2 cases were found in English-language literature. Our case seems to be the third reported case. Horner syndrome should be kept in mind in cases of first rib fractures. When head trauma is considered, as it can be mistaken with anisocoria, this knowledge may help the surgeon in differential diagnosis.

关键词： Horner综合征胸部外伤肋骨骨折外伤后神经系统检查随访过程急诊治疗瞳孔缩小上睑下垂头颅CT

对肺挫伤患者进行CT单独诊断与其患病率的升高无关

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世界核心医学期刊文摘（儿科学分册） 2006年第5期2卷 37-37页

作者： Kwon A. Sorrells Jr. D.L. Kurkchubasche A.G. F.I. Luks 刘凯 Division of Pediatric surgery Brown Medical School ProvidenceRI 02905United States

Background: Increased utilization of computed tomography (CT) has led to a rise in the diagnosis of pulmonary contusion. Its clinical significance, in the absence of findings on chest radiograph (CXR), has not been defined. This study examines the clinical course of patients with CT-only diagnosis of pulmonary contusion and compares it with that of patients with CXR-proven pulmonary contusion. Methods: The trauma database identified all children undergoing chest CT for blunt thoracic trauma during a 3-year period. Records were reviewed for age,mechanism of injury, Injury Severity Score (ISS), length of hospital stay (LOS), need for intensive care unit admission, and need for endotracheal intubation. A pedi atric radiologist reviewed all films in a blinded fashion. Statistical analysis was performed using analysis of variance and Fisher’s Exact test for 2 ×3 tables. Results: Eighty-two patients were identified. There were no CXR-positive, CT-negative cases. A CT diagnosis of pulmonary contusion was made in 46 patients. Of these, 31 had a contusion on CXR as well (CXR+group) and 15 had a normal CXR (CT+only group). Mean ISS score did not differ significantly between the two groups (27±12.3 and 22±10.3, respectively). Thirty-six patients had a normal CT (control). Mean LOS was significantly longer in the CXR+group (13±12.0 days) than in the CT+only and control groups (5±3.6 and 9±9.5 days, respectively; P < .01). The percentages of children requiring intensive care unit admission and intubation were also significantly higher in the CXR+group. Conclusion: The finding of pulmonary contusion by CT alone does not increase patient morbidity and appears to be of limited clinical significance.

关键词：胸部CT检查肺挫伤伤患者诊断患病率胸部X线照片创伤严重度评分重症监护室