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CA19-9 antigen levels can distinguish between benign and malignant pancreaticobiliary disease

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Hepatobiliary & Pancreatic Diseases International 2009年第6期8卷 620-626页

作者： gareth Morris-Stiff Mary Teli Nicky Jardine Malcolm CA Puntis department of surgery University Hospital of Wales

BACKgROUND:CA19-9 is a carbohydrate tumor-associated antigen which is frequently upregulated in pancreatobiliary ***,it may also be elevated in patients with jaundice in the absence of a tumor due to biliary obstruction,and in other non-hepato-pancreatico-biliary *** study aimed to evaluate whether CA19-9 levels could accurately differentiate between benign and malignant pancreatobiliary ***:All patients referred to a single surgeon for investigation of pancreaticobiliary disease in 2003 in whom a firm diagnosis had been established were *** malignant disease,a histological diagnosis was required but for benign disease a firm radiological diagnosis was deemed *** patients were divided into 4 categories:pancreatic adenocarcinoma(PCa);cholangiocarcinoma(CCa);chronic pancreatitis(CP)and biliary calculous disease(Calc).Bilirubin and alkaline phosphatase levels corresponding to the point of assessment of CA19-9 were also ***:Final diagnoses were made of pancreatic adenocarcinoma(PCa,n=73),cholangiocarcinoma(CCa,n=19),ampullary carcinoma(Amp,n=7),neuroendocrine carcinoma(Neu,n=4),duodenal carcinoma(Duo,n=3),chronic pancreatitis(CP,n=115),and biliary calculous disease(Calc,n=27).Median CA19-9 levels(U/ml)were:PCa,653;CCa,408;Duo,403;Calc,27;CP,19;Neu,10.5;Amp,8(reference range:0-37).The CA19-9 levels were significantly greater for malignant than for benign disease,could differentiate PCa from CCa/Duo,and were significantly higher in unresectable than in resectable *** sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)for CA19-9 were 84.9%,69.7%,67.7%and 86.1%,respectively.A ROC analysis provided an area under the curve for CA19-9 of 0.871(0.820-0.922),giving an optimal CA19-9 of 70.5 U/ml for differentiating benign from malignant *** this cut-off,the sensitivity was 82.1%,while specificity,PPV and NPV improved to 85.9%,81.3%and 86.5%,*** sta

关键词： CA19-9 antigen pancreatic disease biliary tract disease malignant benign

Are multidisciplinary consultation meetings for prenatal diagnosis achievable in a low-income country? A descriptive cross-sectional survey in Benin

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World Journal of Pediatric surgery 2023年第4期6卷 270-275页

作者： Monsoia gildas Yassegoungbe Beaudelaire Romulus Assan Amoussou Sedjro Clotaire Romeo Houegban Codjo Serge Metchihoungbe Jean-Francois Lecompte Christine Tschabu Aguemon Sidoine Bitho gbetey Jean Breaud Antoine Seraphin gbenou Pediatric surgery department Mother and Child Teaching Hospital LaguneUniversity of Abomey-CalaviCotonouBenin Pediatric surgery department National Teaching Hospital Hubert Koutoukou MagaUniversity of Abomey-CalaviCotonouBenin Pediatric surgery department CHU-LENVAL Paediatric Hospitals of NiceNiceFrance University Clinic of gynecological Obstetrics National Teaching Hospital Hubert Koutoukou MagaUniversity of Abomey-CalaviCotonouBenin Intellectual Production department Center of Expertise in Applied Social SciencesCotonouBenin

Objective The multidisciplinary antenatal diagnosis staff bring together practitioners who are involved in the management of the antenatal period at *** project was designed following the French experience to institute multidisciplinary consultation meetings for prenatal diagnosis(MCMPD)in *** This is a descriptive cross-sectional study examining the knowledge,attitudes,and practices of Beninese practitioners in the field of MCMPD to develop the pilot phase of the *** We collected 108 participants from different *** and pediatric surgeons were in the majority at 23.9% and 16.5%,***-seven percent of participants were from the public sector(n=75).One practitioner felt that it was not a good idea to implement these *** all staff(96.2%)agreed that this meeting would have a positive impact on reducing neonatal ***(58.5%),spina bifida aperta(43.6%),and gastroschisis(34%)were the most commonly diagnosed antenatal conditions in *** neonatal pathology required medical termination of the pregnancy according to 35.6% of the *** The objective of reducing infant mortality due to medical and surgical pathologies is a noble one and deserves to be *** innovative project,developed through this study,the first of its kind in the subregion,will contribute inexorably to the achievement of the third goal Sustainable Development.

关键词： diagnosis sectional income

Massive presacral bleeding during rectal surgery: From anatomy to clinical practice

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World Journal of gastroenterology 2013年第25期19卷 4039-4044页

作者： Zheng Lou Wei Zhang Rong-gui Meng Chuan-gang Fu department of Colorectal surgery Changhai Hospital

AIM: To investigate control of two different types of massive presacral bleeding according to the anatomy of the presacral venous system. METHODS: A retrospective review was performed in 1628 patients with middle or low rectal carcinoma who were treated surgically in the department of Colorectal surgery, Changhai hospital, Shanghai, China from January 2008 to December 2012. In four of these patients, the presacral venous plexus (n = 2) or basivertebral veins (n = 2) were injured with massive presacral bleeding during mobilization of the rectum. The first two patients with low rectal carcinoma were operated upon by a junior associate professor and the source of bleeding was the presacral venous plexus. The other two patients with recurrent rectal carcinoma were both women and the source of bleeding was the basivertebral ***: Two different techniques were used to con-trol the bleeding. In the first two patients with massive bleeding from the presacral venous plexus, we used suture ligation around the venous plexus in the area with intact presacral fascia that communicated with the site of bleeding (surrounding suture ligation). In the second two patients with massive bleeding from the basivertebral veins, the pelvis was packed with gauze, which resulted in recurrent bleeding as soon as it was removed. Following this, we used electrocautery applied through one epiploic appendix pressed with a long Kelly clamp over the bleeding sacral neural foramen where was felt like a pit Electrocautery adjusted to the highest setting was then applied to the clamp to "weld" closed the bleeding point. Postoperatively, the blood loss was minimal and the drain tube was removed on days 4-7. CONCLUSION: Surrounding suture ligation and epiploic appendices welding are effective techniques for controlling massive presacral bleeding from presacral venous plexus and sacral neural foramen, respectively.

关键词： Massive presacral bleeding Rectal surgery Suture ligation Welding

Application of digital positioning guide plates for the surgical extraction of multiple impacted supernumerary teeth:A case report and review of literature

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World Journal of Clinical Cases 2022年第27期10卷 9886-9896页

作者： Zhi Wang Shu-Yi Zhao Wu-Shu He Fan Yu Shao-Jie Shi Xue-Ling Xia Xin-Xiao Luo Yu-Hong Xiao department of Oral and Maxillofacial surgery 920th Hospital of Joint Logistics Support ForcePLATeaching Hospital of Kunming Medical UniversityKunming 650032Yunnan ProvinceChina

BACKgROUND An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth(SNT).Due to the large variation in location and morphology,the extraction of impacted SNTs is an extensive and complex procedure with high risks of several *** report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide *** SUMMARY In January 2022,a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth#*** examination showed a deep carious lesion with pulpal involvement in tooth#36 and lingual swelling of the bilateral mandibular posterior *** examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third *** on these findings,the patient was diagnosed with bilateral,multiple impacted SNTs and tooth#36 chronic pulpitis.A root canal treatment and an all-ceramic crown restoration for tooth#36 were *** individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted *** the operation,the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical *** 3-month follow-up,regeneration of bone and soft tissues was *** The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.

关键词： Supernumerary teeth Computer aided design/computer aided manufacturing Digital Surgical guide Minimal invasion Case report

Mutations in the p16 gene in DMBA-induced pancreatic intraepithelial neoplasia and pancreatic cancer in rats

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Hepatobiliary & Pancreatic Diseases International 2015年第2期14卷 208-214页

作者： Zhu Zhu Tao Liu Fei Han Su-Dong Zhan Chun-You Wang department of Pancreatic surgery Union HospitalHuazhong University of Science and Technology department of general surgery First Affiliated HospitalUniversity of South China

BACKgROUND：7,12-dimethylbenzanthracene（DMBA）-induced pancreatic intraepithelial neoplasia（PanIN）and pancreatic cancer in rats provide a classic model for uncovering the molecular mechanisms underlying pancreatic ***,this model has not been characterized genetically,and in particular,the major genetic alterations in the p16 gene are ***： Lesions of PanlN and pancreatic cancer were induced with DMBA implantation in 40 rats, and control pancreatic tissue was obtained from 10 age-matched rats without exposure to DMBA. Pancreatic tissue was harvested three months after DMBA implantation and DNA was extracted. Homozy- gous deletions and point mutations of the pl6 （exons 1 and 2） gene were detected by PCR amplification and direct sequencing. RESULTS： DMBA implantation in the 40 rats induced 26 Pan- INs and 9 carcinomas. The overall frequency of p 16 alterations in the pancreatic tissue of these rats was 42.86% （15/35）, and the changes were point mutations, not homozygous deletions. p16 mutations were present in 30.77% （8/26） of the rats with PanIN and 77.78% （7/9） of the rats with carcinoma （P〈0.05）. The increasing incidence of p16 alterations was detected in 20.00% （1/5） of PanIN-1, 28.57% （2/7） of PanIN-2 and 35.71% （5/14） of PanIN-3 lesions. CONCLUSION： Our findings indicated that p16 alteration is a common event in the carcinogenesis of this model and that the mutation pattern is analogous to that of human lesions.

关键词： homozygous deletion point mutation p16 pancreatic intraepithelial neoplasia pancreatic carcinoma

Vascularized lymph node transfer with efferent lymphatico-lymphatic anastomosis for treatment of upper extremity lymphedema

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Plastic and Aesthetic Research 2023年第1期10卷 736-743页

作者： Kento Hosomi Chihena H.Banda Makoto Shiraishi Kohei Mitsui Ryohei Ishiura Kanako Danno Mitsunaga Narushima department of Plastic and Reconstructive surgery Mie universityTsu 514-8507Japan Plastic and Reconstructive surgery Unit Department of SurgeryThe University Teaching HospitalLusaka 50110Zambia department of Plastic and Reconstructive surgery The University of Tokyo HospitalTokyo 113-8655Japan

Vascularized lymph node transfers(VLNT)are useful options for the surgical treatment of *** VLNT does not include the reconstruction of physiological lymphatic outflow,which may pose a risk of postoperative lymphatic vessel obstruction and lymph node *** report a case of lymph flow bypass reconstruction using a superficial circumflex Iliac artery perforator(SCIP)flap,including VLNT with efferent lymphatico-lymphatic anastomosis.A 63-year-old female with severe right upper extremity lymphedema after mastectomy was reconstructed using a SCIP free flap,which included a vascularized lymph node elevated from the left groin area and transferred to the right axilla *** SCIP vessels were anastomosed to the medial intercostal artery perforator vessels and the efferent lymphatic vessel from the vascularized lymph node was anastomosed to the internal mammary lymphatic vessels using supermicrosurgical *** green lymphography showed the reconstructed lymphatic flow from the right hand to the right internal mammary lymphatics through the transferred ***,lymphedema improved and there was no lymphedema at the donor site with a 2-year *** flow bypass reconstruction using VLNT with efferent lymphatico-lymphatic anastomosis may provide a useful option for the treatment of severe lymphedema.

关键词： Lymph tissue transplantation upper extremity lymphedema vascularized lymph node transplantation

Same impact momentum causes different degrees of spinal cord injury

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Chinese Science Bulletin 2014年第32期59卷 4298-4303页

作者： Le Ji Xiaoqian Dang Binshang Lan Qichun Song Dapeng Duan Zhe Ji Yongtao Zhang Lisong Heng department of Orthopedic surgery The Second Affiliated Hospital School of Medicine Xi’an Jiaotong University department of Orthopedic surgery Shaanxi Provincial People’s Hospital department of Orthopedic surgery Xi’an Honghui Hospital

The weight-drop impact is widely used in making animal model of spinal cord injury(SCI).But there has not yet been an appropriate unit for the quantification of the *** this study,we compared the degrees of the spinal cord injury caused by weight-drop impact with the same momentum but different combinations of drop weight and drop height,in order to test whether‘‘momentum’’is capable of being the unit for the quantification of weightdrop *** adult rats were randomly allocated to three groups and were injured with 5 g–10 cm(group A),10 g–2.5 cm(group B)and 15 g–1.11 cm(group C)impacts with the same momentum to the spinal cord,***-field locomotor function was evaluated using the Basso–Beattie–Bresnahan(BBB)locomotor rating *** percentage of spared tissue area(STA)at the epicenter,and 500,1000 and 1500 lm from the epicenter was calculated using serial sections stained by hematoxylin and *** a result,the behavioral recovery(BBB scores)and the STA percentage were similar in group B and group ***,the BBB score in group A was significantly lower than that in groups B and C at the same time point post *** STA percentage was significantly less and the lesion/cavity length was significantlygreater in group A than in groups B and *** suggested that the 5 g–10 cm weight-drop impact,compared with the other two impacts with different weights and heights,caused a greater damage of the spinal cord when the momentum was the ***,these impacts with the same momentum but different weights and drop heights cause different degrees of spinal cord *** alone is inadequate to be the unit for the qualification of weightdrop impact and to be used to predict the extent of injury.

关键词：脊髓损伤运动功能 HE染色 STA 动物模型成年大鼠连续切片跌落高度

Prognosis of Pregnancy and Childbirth in Heart Operated Patients: Experience in a 3 Referral hospital in Mali, Case of the gabriel University hospital in Bamako

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Open Journal of Obstetrics and gynecology 2021年第12期11卷 1875-1887页

作者： Fané Seydou Sanogo Siaka Amara Bocoum Amadou Sylla Checkna Kante Ibrahima Traore Youssouf Tegueté Ibrahima M. Traoré Mounkoro Niani A. Dolo UTH gabriel Toure Bamako Mali point g hospital teaching Bamako Mali

Introduction: In sub-Saharan Africa and Mali, young women who have had heart surgery want to become pregnant. The occurrence of pregnancy in these women who have had heart surgery is becoming more and more frequent in... 详细信息

g>Introduction:g> In sub-Saharan Africa and Mali, young women who have had heart surgery want to become pregnant. The occurrence of pregnancy in these women who have had heart surgery is becoming more and more frequent in our country because of the persistence of acute rheumatoid arthritis (RAA) and especially the increasingly easy access to heart surgery. General Objective: To study the evolution of pregnancy and the prognosis of childbirth in women who have undergone heart surgery. Methodology: This was a retrospective and descriptive study that took place over a period of five (5) years in the gynecology-obstetrics department of University Teaching Hospital (UTH) Gabriel Touré and the cardiology department of UTH Luxembourg. Was included in the study any pregnant woman admitted to the gynecology-obstetrics department of UTH Gabriel Touré and having a history of heart surgery. The variables studied were the socio-demographic characteristics, the type of heart disease, the management, the evolution of the pregnancy and the prognosis. Data was typed on word processor, Excel and analyzed on Epi info and SPSS. The Chi square or Fisher exact test (for the number

关键词： Cardiac surgery Pregnancy Prognosis

Scleroderma and HIV Infection: A Case Report with Literature Review

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Open Journal of Internal Medicine 2018年第4期8卷 255-260页

作者： I. A. Dembélé N. R. Nyanke D. Traore A. K. Souckho D. Sy M. Cissoko A. Sanogo B. B. Sangaré O. A. Cisse K. Dao K. T. Tighankpa M. Malle M. Togo A. Keita A. Traore M. Saliou Y. Fofana D. Sangaré N. Tolo N. Doumbia A. Doumbia B. B. Berthé B. D. Camara S. A. Coulibaly N. Sawadogo M. Dembélé A. K. Traore H. A. Traore Internal Medicine department Point G Teaching Hospital Bamako Mali department of Internal Medicine Kaya Regional Hospital Kaya Burkina Faso

Introduction: Acquired immunodeficiency syndrome (AIDS) linked to HIV infection is accompanied by auto-immune phenomena. Autoimmune diseases can develop in people living with HIV, most in a context of good immunological control (vasculitis, anti-phospholipid syndrome). Since the advent of antiretroviral therapy, an increasing number of autoimmune connective tissue diseases such as systemic lupus erythematosus, dermatomyositis, and syndromes of Sj?gren and scleroderma have been reported. Purpose: To describe this association’s not very common scleroderma and HIV infection. Observation: We report the case of a 56-year-old lady admitted into the service for functional impotence that would have been evolving for a week. Prior to her hospitalization, she presented edemas of the lower limbs associated with anesthesia of the lower limbs for 5 months. The painting is accompanied by a productive cough and an intermittent fever. At the physical examination a weight loss (BMI = 13.74 Kg/m2), fever (38.7°C): Oral candidiasis, lower lip ulceration, perlicking, undernutrition folds, sclerodactyly and homogeneous hepatomegaly was noted. The diagnosis of immunosuppression to HIV Stage 3 with TB co-morbidity and positive hepatitis B Serology was retained while diffuse Scleroderma was selected from the ACR/EULAR criteria of 2012 with a score of 10 (sclerodactyly = 4 point;Raynaud’s phenomenon = 3 point and Ac Anti Scl 70 positive = 3 point). Conclusion: These associations of chronic pathology must be described to improve the future treatment of our patients.

关键词： Scleroderma HIV Internal Medicine