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Spontaneous Perforation of Colon: A Case Report and Review of Literature

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Case Reports in Clinical Medicine 2014年第7期3卷 392-397页

作者： Ahmed M. Makki Soha Hejazi Nisar Haider Zaidi Adel Johari Abdulmalik Altaf department of Surgery King Abdulaziz University Jeddah KSA

Objective: To present a case of spontaneous perforation of colon. Introduction: Spontaneous perforation of colon (SPC) is defined as sudden perforation of apparently healthy colon in absence of diseases or injury. SPC is an uncommon clinical entity which is seldom reported in literature, less than 100 cases were reported. Case report: A 82-year-old gentleman presented to emergency room (ER) with acute abdominal pain, for few hours duration. Pain started paraumbilically with sudden onset and then with increasing intensity became generalized. It was associated with nausea and vomiting. On general examination, he was conscious, alert. His vital signs: afebrile, pulse: 106/m, B.P: 140/100, local examination showed generalized abdominal tenderness & guarding with absent intestinal sounds. P.R. exam showed remnants of stool with blood stain on gloves, no masses. Computerized tomography (CT) abdomen showed perforation of cecum. He was taken to operation room (OR) and right hemicolectomy was done. Post operative period was uneventful and he was discharged in good health. Conclusion: SPC is a serious condition with high morbidity and mortality due to delay in diagnosis and management so, every effort should be made to make diagnosis especially in elderly and prompt surgical intervention should be done.

关键词： SPC-Spontaneous Colon Perforation Cecal Perforation Colon Perforation

Practice of Pediatric Spinal Anesthesia in a Country with Limited Means: Example of Togo

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Open Journal of Anesthesiology 2023年第2期13卷 32-45页

作者： Essohanam Tabana Mouzou Sarakawabalo Assenouwe Pikabalo Tchetike Eyram Yoan Makafui Amekoudi Tchaa Hodabalo Towoezim Resuscitation Anesthesia department at the Kara-CHU Kara Togo CHU-Sylvanus Olympio Anesthesia Resuscitation department in Lome Lome Togo Medical Resuscitation and Nephrology Service of the CHU-Kara Kara Togo CHU-Kara Traumatology department Kara Togo

Introduction: The practice of spinal anesthesia in pediatric surgery is declining, especially in countries with limited means. What about in our context? Objective: To evaluate the practice of spinal anesthesia in pediatric surgery in Togo. Framework and method of study: This was a prospective study from November 2017 to May 2018 in pediatric surgery at CHU SO de Lomé, in the operating room and hospital ward of CHU Kara. The surgical, anesthesiological and evolutionary aspects of the patients were analyzed. Results: Sixty children were selected for the study who had an indication for sub-umbilical surgery. The male sex was predominant (73.3%). 47 (78.30%) patients were operated on for scheduled surgery. Hernia repair was the most performed surgical intervention (43.30%). The mean duration of the surgery was 78 ± 35.9 minutes. Most of the patients were ASA 1 (98.30%). The local anesthetic used was 0.5% isobaric Bupivacaine. Fentanyl was the predominant adjuvant (55%). The most widely used lumbar puncture needle was 25 Gauge with 75 millimeters in length (63.30%). Diazepam was the most widely used sedative (50%). The predominant spinal anesthesia protocol was spinal anesthesia alone (60%). Only one patient had hypotension (1.70%). Conclusion: The fairly satisfactory pediatric spinal anesthesia in Togo remains poorly performed. Its promotion involves the training of anesthesia practitioners and the strengthening of the technical platform.

关键词： Pediatric Surgery Spinal Anesthesia Togo

Acute mesenteric ischemia secondary to oral contraceptive-induced portomesenteric and splenic vein thrombosis:A case report

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World Journal of Clinical Cases 2022年第29期10卷 10629-10637页

作者： Jin-Wei Zhao Xin-Hua Cui Wei-Yi Zhao Lei Wang Lin Xing Xue-Yuan Jiang Xue Gong Lu Yu department of Hepatopancreatobiliary Surgery of Second Hospital of Jilin University State Key Laboratory for Zoonotic DiseasesKey Laboratory for Zoonosis Research of The Ministry of EducationInstitute of Zoonosisand College of Veterinary MedicineJilin UniversityChangchun 130000Jilin ProvinceChina Medical College of Yanbian University Yanbian 133002Jilin ProvinceChina department of Imaging Surgery of Second Hospital of Jilin University Jilin UniversityChangchun 130000Jilin ProvinceChina

BACKGROUND Mesenteric ischemia represents an uncommon complication of splanchnic vein thrombosis,and it is less infrequently seen in young women using oral *** is often delayed in the emergency room;thus,surgical intervention may be inevitable and the absence of thrombus regression or collateral circulation may lead to further postoperative ischemia and a fatal *** SUMMARY We report a 28-year-old female patient on oral contraceptives who presented with acute abdominal *** physical examination findings were not consistent with her symptoms of severe pain and abdominal *** findings and her abnormal blood tests raised suspicion of acute mesenteric ischemia(AMI)induced by splanchnic vein ***-enhanced abdominal computed tomography revealed ischemia of the small intestine with portomesenteric and splenic vein thrombosis(PMSVT).We treated the case promptly by anticoagulation after *** then performed delayed segmental bowel resection after thrombus regression and established collateral circulation guided by collaboration with a multidisciplinary *** patient had an uneventful postoperative course and was discharged 14 d after surgery and took rivaroxaban orally for 6 *** subsequent follow-up to date,the patient has not complained of any other *** AMI induced by PMSVT should be considered in young women who are taking oral contraceptives and have acute abdominal *** anticoagulation followed by surgery is an effective treatment strategy.

关键词： Oral contraceptive Portomesenteric and splenic vein thrombosis Acute mensenteric ischemia Anticoagulation Resection Case report

Imaging investigation of pancreatic cystic lesions and proposal for therapeutic guidelines

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World Journal of radiology 2012年第8期4卷 372-378页

作者： Atanas D Hilendarov Georgi Petrov Deenichin Kichka Georgieva Velkova department of Diagnostic Imaging Medical University Faculty of Medicne4001 PlovdivBulgaria department of Sergery III Medical University66 Pestersko Shose str.Plovdiv 4001Bulgaria department of Diagnostic Imaging Medical UniversityPlovdiv 4001Bulgaria

AIM:To propose a diagnostic algorithm for preoperatively predicting the need for surgical ***:The study included 56 patients(27 men and 29 women) with a final diagnosis of cystic pancreatic *** following materials were used:ultrasonic equipment with 3.5 and 7 MHz linear,convex and biopsical *** computed tomography(MDCT) investigations were performed using a 16-slice *** were obtained following the oral administration of 200 mL water and 100 mL intravenous iopamidol(300 mg/mL) administered by pump injector at a rate of 3 mL/s(40 and 60 s post-injection,respectively) using 0.5 mm detectors,reconstructed at 1 mm(pancreatic phase) or 2 mm(portal venous phase) *** table feed was 10 mm per *** were acquired in the pancreatic and portal venous phases of contrast *** 'Chiba' needles 18,20,22,23 G and an automatic aspiration system were used in conjunction with the followingmethods of guiding the interventional procedures:(1) 'free-hand' biopsy and puncture method under ultrasound(US) or computed tomography(CT) control;(2) guiding method using biopsical ***:All 56 patients in this study underwent at least two cuts imaging survey methods,such as US,CT or magnetic resonance imaging(MRI).The most common preoperative diagnostic examination was US scan-56 patients(100%).MDCT studies were conducted in 49(87.50%) and MRI in 13(23.21%).More than half of patients surveyed(37) underwent some type of interventional procedure:25-fine-needle aspiration and 29-fine needle aspiration biopsy(FNAB),as part of the ***-four patients of all 56 patients underwent surgery because of histological evidence of malignancy after the FNAB for cystic lesions of the *** pancreatectomy with splenectomy was the most common operative approach in 13 patients,followed by Whipple resection in 11 and distal pancreatectomy without splenectomy in *** patients were treated with

关键词： Pancreatic cystic neoplasm Diagnostic intervention Fine-needle biopsy

Usefulness of the Guglielmi detachable coil for embolization of a systemic venous collateral after Fontan operation:A case report

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World Journal of radiology 2012年第9期4卷 418-420页

作者： Tetsuo Sonomura Akira Ikoma Nobuyuki Kawai Tomohiro Suenaga Takashi Takeuchi Hiroki Minamiguchi Shunji Uchita Motoki Nakai Hiroyuki Suzuki Kazushi Kishi Morio Sato department of radiology Wakayama Medical University811-1 KimiideraWakayama 641-8510Japan department of Pediatrics Wakayama Medical University811-1 KimiideraWakayama 641-8510Japan department of Thoracic and Cardiovascular Surgery Wakayama Medical University811-1 KimiideraWakayama 641-8510Japan

Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical failure and coil migration due to inflexibility of the *** safely and successfully solve this problem,Guglielmi detachable coils(GDC) can be used for *** flexibility allows for easy navigation in tortuous veins,low risk of unintended coil release or coil migration,and safe deployment.A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan *** symp-toms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein,forming a right-to-left *** collateral,which had a large diameter and high flow,and therefore a high risk of coil migration,was successfully embolized with 8 *** were no complications such as coil migration or cerebral *** embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%,and increased her ability to *** embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.

关键词： Pediatric intervention Embolization Systemic venous collateral Fontan operation Guglielmi detachable coil

Comparison of price, volume and composition of services provided to inpatients for two procedures between a US and a Japanese academic hospital

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Health 2013年第4期5卷 703-711页

作者： Tsuyoshi Inokuchi Naoki Ikegami Vikash Gupta Sandesh Rao Gerard F. Anderson department of Health Policy and Management and department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore USA department of Health Policy and Management School of Medicine Keio University Tokyo Japan School of Medicine Johns Hopkins University Baltimore USA

Background: To drill down into why per capita health expenditures vary between the US and Japan, this exploratory study compares the price, volume and composition of services provided to inpatients for two procedures in an academic hospital in the US, and one in Japan. Methods: Detailed analysis of the amount reimbursed and services delivered was made from claims data for 449 acute myocardial infarction treated with coronary stents placed by percutaneous coronary intervention (PCI) and 115 heart valve dysfunction with heart valve replacement (HVR) cases in Johns Hopkins Hospital (JHH) Baltimore, Maryland, and 34 PCI and 21 HVR cases in Keio University Hospital (KUH), Tokyo. Results: After making appropriate adjustments, the reimbursed amount per discharge at JHH was significantly higher (Wilcoxon ranksum test, p room and board costs showed that the higher staffing level and wages of nurses at JHH was compensated by its shorter average length of stay for PCI, but not for HVR. Conclusion: Detailed analysis of the reimbursed amount and the utilization of services are needed to understand international variations in healthcare spending.

关键词： Health Expenditures United States Japan Percutaneous Coronary intervention Heart Valve Replacement

Measurement of the Effective Dose Radiation at radiology departments of Some Hospitals in Duhok Governorate

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Journal of Modern Physics 2015年第5期6卷 566-572页

作者： Dindar S. Bari Pshtiwan M. Amin Nawzad A. Abdulkareem department of Physics Faculty of Science University of Zakho Zakho Iraq

During operating of the X-ray machines, if the protection of X-ray rooms is insufficient, not only the patient but also clinical staffs as well as public are exposed to high X-ray dosage and they are affected from X-ray related to the dose level. In the present survey, by testing the radiological leakage and scatter from X-rays machines in radiology departments of 7 randomly selected hospitals in Duhok governorate, the effects dose of X-ray to the both control panel area and the patients waiting or visiting area who are located near the radiography room, were measured. The dose was recorded for a range of peak kilovoltage (kVp) and mAs values to find efficiency of shielding materials (barriers) of radiography rooms for different X-rays level. The measurements were performed at one meter above the ground surface which was the same height of X-rays tube by using Gamma Scout dosimeter. From the measurement results, it was seen that the most hospitals barriers (doors and walls) were not appropriate to the standards except 2 hospitals. The maximum effective doses were measured in uncontrolled area of Khazer hospital which was 82.48 ± 0.73 mSv·yr-1 that was much more than the reference dose limits and in controlled area of Haval Banda Zaroka hospital which was 12.98 ± 0.16 mSv·yr-1. In result, the knowledge about the radiation dose affecting the radiologists and public in the selected hospitals was obtained, and by informing the radiologists and the hospitals managements, the necessary regulations would be planned.

关键词： Radiation Dose Leakage Radiation Radiation Protection Diagnostic X-Ray X-Ray room Duhok Hospitals Controlled and Uncontrolled Areas

interventional Therapy for Cerebral Aneurysms Under the Guidance of 3D Printing Technology

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Proceedings of Anticancer Research 2020年第4期4卷 42-46页

作者： Xiangkong Song Xinguo Sun Hualong Wang Jie Qi Guoqing Wang department of Neurology Binzhou People’s HospitalBinzhou 256600Shandong ProvinceChina department of Neurosurgery Binzhou People’s HospitalBinzhou 256600Shandong ProvinceChina department of radiology Binzhou People’s HospitalBinzhou 256600Shandong ProvinceChina department of Gerontology Binzhou Medical University HospitalBinzhou 256603Shandong ProvinceChina

Objective:To explore the clinical method and effect of 3D printing in the treatment of cerebral ***:The authors research work on the hospital,work time in February 2019-February 2020,this study selected patients of cerebral aneurysms,this period are selected for treatment of 100 cases of patients,randomly divided into two groups,a group to give simple intervention,named as the control group,another group for the interventional therapy under the guidance of 3 D printing,named as experimental group,analyze the effect of two groups of patients with clinical ***:The length of hospital stay in the experimental group was shorter than that in the control ***,the incidence of complications and adverse reactions in the experimental group and the control group were 6.00%and 18.00%,the experimental group was better(Pinterventional surgical *** has significant effect,can reduce the incidence complications in patients,has significant clinical effect,and can be popularized.

关键词： 3D printing technology interventional therapy Cerebral aneurysms intervention effect

The DIRECT consortium and the REST-meta-MDD project:towards neuroimaging biomarkers of major depressive disorder

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Psychoradiology 2022年第1期2卷 32-42页

作者： Xiao Chen Bin Lu Hui-Xian Li Xue-Ying Li Yu-Wei Wang Francisco Xavier Castellanos Li-Ping Cao Ning-Xuan Chen Wei Chen Yu-Qi Cheng Shi-Xian Cui Zhao-Yu Deng Yi-Ru Fang Qi-Yong Gong Wen-Bin Guo Zheng-Jia-Yi Hu Li Kuang Bao-Juan Li Le Li Tao Li Tao Lian Yi-Fan Liao Yan-Song Liu Zhe-Ning Liu Jian-Ping Lu Qing-Hua Luo Hua-Qing Meng Dai-Hui Peng Jiang Qiu Yue-Di Shen Tian-Mei Si Yan-Qing Tang Chuan-Yue Wang Fei Wang Hua-Ning Wang Kai Wang Xiang Wang Ying Wang Zi-Han Wang Xiao-Ping Wu Chun-Ming Xie Guang-Rong Xie Peng Xie Xiu-Feng Xu Hong Yang Jian Yang Shu-Qiao Yao Yong-Qiang Yu Yong-Gui Yuan Ke-Rang Zhang Wei Zhang Zhi-Jun Zhang Jun-Juan Zhu Xi-Nian Zuo Jing-Ping Zhao Yu-Feng Zang the DIRECT consortium Chao-Gan Yan CAS Key Laboratory of Behavioral Science Institute of PsychologyChinese Academy of SciencesBeijing 100101China International Big-Data Center for Depression Research Chinese Academy of SciencesBeijing 100101China Magnetic Resonance Imaging Research Center Institute of PsychologyChinese Academy of SciencesBeijing 100101China department of Psychology University of Chinese Academy of SciencesBeijing 100049China Sino-Danish College University of Chinese Academy of SciencesBeijing 101408China Sino-Danish Center for Education and Research Graduate University of Chinese Academy of SciencesBeijing 101408China department of Child and Adolescent Psychiatry NYU Grossman School of MedicineNew YorkNY 10016USA Nathan Kline Institute for Psychiatric Research OrangeburgNew YorkNY 10962USA 9Affiliated Brain Hospital of Guangzhou Medical UniversityGuangzhou 510370China Capital Normal University Beijing 100089China department of Psychiatry Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310020ZhejiangChina department of Psychiatry First Affiliated Hospital of Kunming Medical UniversityKunmingYunnan 650032China Shanghai Mental Health Center Shanghai Jiao Tong University School of MedicineShanghai 200030China Huaxi MR Research Center(HMRRC) Department of RadiologyWest China Hospital of Sichuan UniversityChengduSichuan 610044China Research Unit of Psychoradiology Chinese Academy of Medical SciencesChengduSichuan 610052China department of Psychiatry and National Clinical Research Center for Mental DisordersThe Second Xiangya Hospital of Central South UniversityChangsha 410011HunanChina department of Psychiatry The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400042China Xijing Hospital of Air Force Military Medical University Xi’anShaanxi 710032China Center for Cognitive Science of Language Beijing Language and Culture UniversityBeijing 100083China Affiliated Mental Health Center&Hangzhou Seventh People’s Hospital Zhejiang University School of

Despite a growing neuroimaging literature on the pathophysiology of major depressive disorder(MDD),repro-ducible findings are lacking,probably reflecting mostly small sample sizes and heterogeneity in analytic *** address these issues,the Depression Imaging REsearch ConsorTium(DIRECT)was *** REST-meta-MDD project,pooling 2428 functional brain images processed with a standardized pipeline across all participating sites,has been the first effort from *** this review,we present an overview of the moti-vations,rationale,and principal findings of the studies so far from the REST-meta-MDD *** from the first round of analyses of the pooled repository have included alterations in functional connectivity within the default mode network,in whole-brain topological properties,in dynamic features,and in functional *** well-powered exploratory observations have also provided the basis for future longitudinal hypothesis-driven *** these fruitful explorations,DIRECT has proceeded to its second stage of data sharing that seeks to examine ethnicity in brain alterations in MDD by extending the exclusive Chinese original sample to other ethnic groups through international collaborations.A state-of-the-art,surface-based preprocessing pipeline has also been introduced to improve *** images from patients with bipolar disorder and schizophrenia will be included to identify shared and unique abnormalities across diag-nosis *** addition,large-scale longitudinal studies targeting brain network alterations following antidepressant treatment,aggregation of diffusion tensor images,and the development of functional magnetic resonance imaging-guided neuromodulation approaches are *** these endeavours,we hope to accelerate the translation of functional neuroimaging findings to clinical use,such as evaluating longitudinal effects of antidepressant medications and developing individualized

关键词： major depressive disorder DIRECT R-fMRI database neuroimaging