The coronary arteries diseases are one of the most causes of mortality and morbidity worldwide, particularly in the developing countries. Coronary obstructions are generally described by location and severity of steno...The coronary arteries diseases are one of the most causes of mortality and morbidity worldwide, particularly in the developing countries. Coronary obstructions are generally described by location and severity of stenosis. Manual tracing and measurement of the stenosis vessel in comparison to reference location of stenosis can be helpful to classify whether a lesion is significant or not. The aim of this study is to identify the dominant type of circulation carried out in patients presented in heart institute and associated with degree of stenosis in RCA and LAD artery. Materials and Methods: This was a retrospective study carried out on patients reporting to Heart Institute from June 2013 to August 2013 (311 patients records as a total coverage were collected as sample) whose coronary artery angiography revealed pathology in coronary arteries. Result: The findings were 71.7% right dominant, 23.5% left dominant and 4.8% co-dominant;LAD tends to be stricture with right dominant circulation type. LAD artery tends to be stenosis at proximal and mid segment while in the RCA tends to be stenosis in mid and distal segments. The right dominant artery is popular type of circulation in Sudanese people reported in Sudan Heart Institute;there is no significance association between gender and arterial type of circulation and also degree stenosis in LAD degree of stenosis in RCA. I observed that the site of stenosis in LAD artery was proximal and mid (P value < 0.05 significance association). Conclusion: Patients present at the heart institute are right dominant mostly coming with proximal and middle LAD stenosis unlike RCA which commonly presents with distal and middle stenosis, so the middle segment of coronary artery is stenosis in both situations. There are wild variations in dominance artery in relation to reduction of diameter in deferent ethic group. There are no significant associations between the gender and dominant artery.展开更多
BACKGROUND Radical D2 lymphadenectomy for advanced gastric cancer as a standard procedure has gained global consensus. Mounting studies have shown that the number of lymph nodes dissection directly affects the prognos...BACKGROUND Radical D2 lymphadenectomy for advanced gastric cancer as a standard procedure has gained global consensus. Mounting studies have shown that the number of lymph nodes dissection directly affects the prognosis and recurrence of gastric cancer. Our previous study showed that there was no obvious lymph node around the abnormal hepatic artery derived from the superior mesenteric artery. AIM To investigate the relationship between celiac artery variation and the number of lymph nodes dissection in gastric cancer surgery. METHODS The clinicopathological data of 421 patients treated with radical D2 lymphadenectomy were analyzed retrospectively. The difference of the number of lymph nodes dissection between the celiac artery variation group and the normal vessels group and the relationship with prognosis were analyzed. RESULTS Celiac artery variation was found in 110 patients, with a variation rate of 26.13%. Celiac artery variation, tumor staging, and Borrmann typing were factors that affected lymph node clearance in gastric cancer, and the number of lymph nodes dissection in patients with celiac artery variation was significantly less than that of non-variant groups (P < 0.05). Univariate analysis showed that there was no significant difference in survival time between the two groups (P > 0.05). Univariate and multiple Cox regression analysis showed that celiac artery variation was not a prognostic factor for gastric cancer (P > 0.05). Tumor staging, intraoperative bleeding, and positive lymph node ratio were prognostic factors for gastric cancer patients (all P < 0.05). CONCLUSION The number of lymph nodes dissection in patients with celiac artery variation was reduced, but there was no obvious effect on prognosis. Therefore, lymph nodes around the abnormal hepatic artery may not need to be dissected in radical D2 lymphadenectomy.展开更多
AIM： To determine the distance between the branching point of the left colic artery （LCA） and the inferior mesenteric artery （IMA） by computed tomography （CT） scanning, for preoperative evaluation before laparo...AIM： To determine the distance between the branching point of the left colic artery （LCA） and the inferior mesenteric artery （IMA） by computed tomography （CT） scanning, for preoperative evaluation before laparoscopic colorectal operation. METHODS： From February 2004 to May 2005, 100 patients （63 men, 37 women） underwent angiography performed with a 16-scanner multi-detector row CT unit （Toshiba, Aquilion 16）. All images were analyzed on a workstation （AZE Ltd, Virtual Place Advance 300）. The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation. RESULTS： The IMA could be visualized in all the cases, but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm （range, 23.2-75.0 mm）. There were no differences in gender, arterial branching types, body weight, height, and body mass index. CONCLUSION： Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.展开更多
The objective of the work is to study the topographic and anatomical characteristics of the atrioventricular node’s artery in complex congenital heart defects.The material for the work was the following:44 specimens ...The objective of the work is to study the topographic and anatomical characteristics of the atrioventricular node’s artery in complex congenital heart defects.The material for the work was the following:44 specimens including hearts of fetuses and children of the first three years having congenital defects and 50 specimens of the hearts of a similar age with normal development as the control.A complex of generally accepted morphological methods was used to identify the conductive system of the heart,its blood supply.According to the data obtained given congenital heart defects,the artery of the atrioventricular node arises from an artery,that determines the type of blood supply to the heart.With the full form of the common atrioventricular canal,the presence of the“U”-shaped bend of the coronary artery at the point of departure of the atrioventricular artery from it is inconstant,which is apparently due to the localization of the atrioventricular node in the embryonic position.The intensity of the lateral branches from the artery of the atrioventricular node to the heart partitions is determined by the hemodynamic features with congenital heart defects.展开更多
BACKGROUND Controversy over the issue that No.12a lymph node involvement is distant or regional metastasis remains,and the possible inclusion of 12a lymph nodes in D2 lymphadenectomy is unclear.As reported,gastric can...BACKGROUND Controversy over the issue that No.12a lymph node involvement is distant or regional metastasis remains,and the possible inclusion of 12a lymph nodes in D2 lymphadenectomy is unclear.As reported,gastric cancer(GC)located in the lower third is highly related to the metastasis of station 12a lymph nodes.AIM To investigate whether the clinicopathological factors and metastasis status of other perigastric nodes can predict station 12a lymph node metastasis and evaluate the prognostic significance of station 12a lymph node dissection in patients with lower-third GC.METHODS A total of 147 patients with lower-third GC who underwent D2 or D2+lymphadenectomy,including station 12a lymph node dissection,were included in this retrospective study from June 2003 to March 2011.Survival prognoses were compared between patients with or without station 12a lymph node metastasis.Logistic regression analyses were used to clarify the association between station 12a lymph node metastasis and clinicopathological factors or metastasis status of other perigastric nodes.The metastasis status of each regional lymph node was evaluated to identify the possible predictors of station 12a lymph node metastasis.RESULTS Metastasis to station 12a lymph nodes was observed in 18 patients with lowerthird GC,but not in 129 patients.The incidence of station 12a lymph node involvement was reported as 12.2%in patients with lower-third GC.The overall survival of patients without station 12a lymph node metastasis was significantly better than that of patients with station 12a metastasis(P<0.001),which could also be seen in patients with or without extranodal soft tissue invasion.Station 12a lymph node metastasis and extranodal soft tissue invasion were identified as independent predictors of poor prognosis in patients with lower-third GC.Advanced pN stage was defined as independent risk factor significantly correlated with station 12a lymph node positivity.Station 3 lymph node staus was also proven to be significantly correlated with station 12a lymph node involvement.CONCLUSION Metastasis of station 12a lymph nodes could be considered an independent prognosis factor for patients with lower-third GC.The dissection of station 12a lymph nodes may not be ignored in D2 or D2+lymphadenectomy due to difficulties in predicting station 12a lymph node metastasis.展开更多
BACKGROUND Advanced rectal cancer with submesenteric lymph node metastasis is a common complication of advanced rectal cancer,which has an important impact on the treatment and prognosis of patients.AIM To investigate...BACKGROUND Advanced rectal cancer with submesenteric lymph node metastasis is a common complication of advanced rectal cancer,which has an important impact on the treatment and prognosis of patients.AIM To investigate the clinical and pathological characteristics of inferior mesenteric artery(IMA)root lymph node metastases in patients with rectal cancer.The findings of this study provided us with fresh medical information that assisted us in determining the appropriate treatment for these patients.METHODS Our study searched PubMed,Google Scholar,and other databases and searched the relevant studies and reports on the risk factors of IMA root lymph node metastasis of rectal cancer published in the self-built database until December 31,2023.After data extraction,the Newcastle-Ottawa scale was used to evaluate the quality of the included literature,and RevMan5.3 software was used for meta-analysis and heterogeneity testing.The fixed effect modules without heterogeneity were selected to combine the effect size,and the random effect modules with heterogeneity were selected to combine the effect size.The cause of heterogeneity was found through sensitivity analysis,and the data of various risk factors were combined to obtain the final effect size,odds ratio(OR)value,and 95%confidence interval(CI).Publication bias was tested by drawing funnel plots.RESULTS A total of seven literature were included in this study.By combining the OR value of logistic multivariate regression and the 95%CI of various risk factors,we concluded that the risk factors for lymph node metastasis in the IMA region of rectal cancer were as follows:Preoperative carcinoembryonic antigen(CEA)>5 ng/mL(OR=0.32,95%CI:0.18-0.55,P<0.05),tumor located above peritoneal reflexive(OR=3.10,95%CI:1.78-5.42,P<0.05),tumor size≥5 cm(OR=0.36,95%CI:0.22-0.57,P<0.05),pathological type(mucinous adenocarcinoma/sig-ring cell carcinoma)(OR=0.23,95%CI:0.13-0.41,P<0.05),degree of tumor differentiation(low differentiation)(OR=0.17,95%CI:0.10-0.31,P<0.05),tumor stage(T3-4 stage)(OR=0.11,95%CI:0.04-0.26,P<0.05),gender and age were not risk factors for IMA root lymph node metastasis in rectal cancer(P>0.05).CONCLUSION Preoperative CEA level,tumor location,tumor size,tumor pathologic type,tumor differentiation,and T stage were correlated with IMA root lymph node metastasis.展开更多
Kawasaki disease (muco-cutaneous lymph node syndrome, MCLS) was first reported by Kawasaki in 1967. It was characteried by nonvascular polymorphous rash, fever, ulcer in oral mucosa, edema of hands of feet, cervix lym...Kawasaki disease (muco-cutaneous lymph node syndrome, MCLS) was first reported by Kawasaki in 1967. It was characteried by nonvascular polymorphous rash, fever, ulcer in oral mucosa, edema of hands of feet, cervix lymphadenopathy and desquamations in peripheral extremities. Because of unknown pathogens, no lab examination was available as a single easily recognized diagnostic marker; the diagnosis is展开更多
文摘The coronary arteries diseases are one of the most causes of mortality and morbidity worldwide, particularly in the developing countries. Coronary obstructions are generally described by location and severity of stenosis. Manual tracing and measurement of the stenosis vessel in comparison to reference location of stenosis can be helpful to classify whether a lesion is significant or not. The aim of this study is to identify the dominant type of circulation carried out in patients presented in heart institute and associated with degree of stenosis in RCA and LAD artery. Materials and Methods: This was a retrospective study carried out on patients reporting to Heart Institute from June 2013 to August 2013 (311 patients records as a total coverage were collected as sample) whose coronary artery angiography revealed pathology in coronary arteries. Result: The findings were 71.7% right dominant, 23.5% left dominant and 4.8% co-dominant;LAD tends to be stricture with right dominant circulation type. LAD artery tends to be stenosis at proximal and mid segment while in the RCA tends to be stenosis in mid and distal segments. The right dominant artery is popular type of circulation in Sudanese people reported in Sudan Heart Institute;there is no significance association between gender and arterial type of circulation and also degree stenosis in LAD degree of stenosis in RCA. I observed that the site of stenosis in LAD artery was proximal and mid (P value < 0.05 significance association). Conclusion: Patients present at the heart institute are right dominant mostly coming with proximal and middle LAD stenosis unlike RCA which commonly presents with distal and middle stenosis, so the middle segment of coronary artery is stenosis in both situations. There are wild variations in dominance artery in relation to reduction of diameter in deferent ethic group. There are no significant associations between the gender and dominant artery.
文摘BACKGROUND Radical D2 lymphadenectomy for advanced gastric cancer as a standard procedure has gained global consensus. Mounting studies have shown that the number of lymph nodes dissection directly affects the prognosis and recurrence of gastric cancer. Our previous study showed that there was no obvious lymph node around the abnormal hepatic artery derived from the superior mesenteric artery. AIM To investigate the relationship between celiac artery variation and the number of lymph nodes dissection in gastric cancer surgery. METHODS The clinicopathological data of 421 patients treated with radical D2 lymphadenectomy were analyzed retrospectively. The difference of the number of lymph nodes dissection between the celiac artery variation group and the normal vessels group and the relationship with prognosis were analyzed. RESULTS Celiac artery variation was found in 110 patients, with a variation rate of 26.13%. Celiac artery variation, tumor staging, and Borrmann typing were factors that affected lymph node clearance in gastric cancer, and the number of lymph nodes dissection in patients with celiac artery variation was significantly less than that of non-variant groups (P < 0.05). Univariate analysis showed that there was no significant difference in survival time between the two groups (P > 0.05). Univariate and multiple Cox regression analysis showed that celiac artery variation was not a prognostic factor for gastric cancer (P > 0.05). Tumor staging, intraoperative bleeding, and positive lymph node ratio were prognostic factors for gastric cancer patients (all P < 0.05). CONCLUSION The number of lymph nodes dissection in patients with celiac artery variation was reduced, but there was no obvious effect on prognosis. Therefore, lymph nodes around the abnormal hepatic artery may not need to be dissected in radical D2 lymphadenectomy.
基金Supported by Kobayashi Magobe Memorial Medical Foundation
文摘AIM： To determine the distance between the branching point of the left colic artery （LCA） and the inferior mesenteric artery （IMA） by computed tomography （CT） scanning, for preoperative evaluation before laparoscopic colorectal operation. METHODS： From February 2004 to May 2005, 100 patients （63 men, 37 women） underwent angiography performed with a 16-scanner multi-detector row CT unit （Toshiba, Aquilion 16）. All images were analyzed on a workstation （AZE Ltd, Virtual Place Advance 300）. The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation. RESULTS： The IMA could be visualized in all the cases, but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm （range, 23.2-75.0 mm）. There were no differences in gender, arterial branching types, body weight, height, and body mass index. CONCLUSION： Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.
文摘The objective of the work is to study the topographic and anatomical characteristics of the atrioventricular node’s artery in complex congenital heart defects.The material for the work was the following:44 specimens including hearts of fetuses and children of the first three years having congenital defects and 50 specimens of the hearts of a similar age with normal development as the control.A complex of generally accepted morphological methods was used to identify the conductive system of the heart,its blood supply.According to the data obtained given congenital heart defects,the artery of the atrioventricular node arises from an artery,that determines the type of blood supply to the heart.With the full form of the common atrioventricular canal,the presence of the“U”-shaped bend of the coronary artery at the point of departure of the atrioventricular artery from it is inconstant,which is apparently due to the localization of the atrioventricular node in the embryonic position.The intensity of the lateral branches from the artery of the atrioventricular node to the heart partitions is determined by the hemodynamic features with congenital heart defects.
文摘BACKGROUND Controversy over the issue that No.12a lymph node involvement is distant or regional metastasis remains,and the possible inclusion of 12a lymph nodes in D2 lymphadenectomy is unclear.As reported,gastric cancer(GC)located in the lower third is highly related to the metastasis of station 12a lymph nodes.AIM To investigate whether the clinicopathological factors and metastasis status of other perigastric nodes can predict station 12a lymph node metastasis and evaluate the prognostic significance of station 12a lymph node dissection in patients with lower-third GC.METHODS A total of 147 patients with lower-third GC who underwent D2 or D2+lymphadenectomy,including station 12a lymph node dissection,were included in this retrospective study from June 2003 to March 2011.Survival prognoses were compared between patients with or without station 12a lymph node metastasis.Logistic regression analyses were used to clarify the association between station 12a lymph node metastasis and clinicopathological factors or metastasis status of other perigastric nodes.The metastasis status of each regional lymph node was evaluated to identify the possible predictors of station 12a lymph node metastasis.RESULTS Metastasis to station 12a lymph nodes was observed in 18 patients with lowerthird GC,but not in 129 patients.The incidence of station 12a lymph node involvement was reported as 12.2%in patients with lower-third GC.The overall survival of patients without station 12a lymph node metastasis was significantly better than that of patients with station 12a metastasis(P<0.001),which could also be seen in patients with or without extranodal soft tissue invasion.Station 12a lymph node metastasis and extranodal soft tissue invasion were identified as independent predictors of poor prognosis in patients with lower-third GC.Advanced pN stage was defined as independent risk factor significantly correlated with station 12a lymph node positivity.Station 3 lymph node staus was also proven to be significantly correlated with station 12a lymph node involvement.CONCLUSION Metastasis of station 12a lymph nodes could be considered an independent prognosis factor for patients with lower-third GC.The dissection of station 12a lymph nodes may not be ignored in D2 or D2+lymphadenectomy due to difficulties in predicting station 12a lymph node metastasis.
文摘BACKGROUND Advanced rectal cancer with submesenteric lymph node metastasis is a common complication of advanced rectal cancer,which has an important impact on the treatment and prognosis of patients.AIM To investigate the clinical and pathological characteristics of inferior mesenteric artery(IMA)root lymph node metastases in patients with rectal cancer.The findings of this study provided us with fresh medical information that assisted us in determining the appropriate treatment for these patients.METHODS Our study searched PubMed,Google Scholar,and other databases and searched the relevant studies and reports on the risk factors of IMA root lymph node metastasis of rectal cancer published in the self-built database until December 31,2023.After data extraction,the Newcastle-Ottawa scale was used to evaluate the quality of the included literature,and RevMan5.3 software was used for meta-analysis and heterogeneity testing.The fixed effect modules without heterogeneity were selected to combine the effect size,and the random effect modules with heterogeneity were selected to combine the effect size.The cause of heterogeneity was found through sensitivity analysis,and the data of various risk factors were combined to obtain the final effect size,odds ratio(OR)value,and 95%confidence interval(CI).Publication bias was tested by drawing funnel plots.RESULTS A total of seven literature were included in this study.By combining the OR value of logistic multivariate regression and the 95%CI of various risk factors,we concluded that the risk factors for lymph node metastasis in the IMA region of rectal cancer were as follows:Preoperative carcinoembryonic antigen(CEA)>5 ng/mL(OR=0.32,95%CI:0.18-0.55,P<0.05),tumor located above peritoneal reflexive(OR=3.10,95%CI:1.78-5.42,P<0.05),tumor size≥5 cm(OR=0.36,95%CI:0.22-0.57,P<0.05),pathological type(mucinous adenocarcinoma/sig-ring cell carcinoma)(OR=0.23,95%CI:0.13-0.41,P<0.05),degree of tumor differentiation(low differentiation)(OR=0.17,95%CI:0.10-0.31,P<0.05),tumor stage(T3-4 stage)(OR=0.11,95%CI:0.04-0.26,P<0.05),gender and age were not risk factors for IMA root lymph node metastasis in rectal cancer(P>0.05).CONCLUSION Preoperative CEA level,tumor location,tumor size,tumor pathologic type,tumor differentiation,and T stage were correlated with IMA root lymph node metastasis.
文摘Kawasaki disease (muco-cutaneous lymph node syndrome, MCLS) was first reported by Kawasaki in 1967. It was characteried by nonvascular polymorphous rash, fever, ulcer in oral mucosa, edema of hands of feet, cervix lymphadenopathy and desquamations in peripheral extremities. Because of unknown pathogens, no lab examination was available as a single easily recognized diagnostic marker; the diagnosis is
基金江苏省卫生与健康委员会重点科研项目(编号:K2023027)苏州大学“医学+X”科研项目(编号:grant number ML12203423)+2 种基金江苏省研究型医院学会感染与炎症放射学专委会科研基金资助项目(编号:GY202301)江苏省科教能力提升工程(江苏省医学重点学科建设)项目(编号:JSDW202242)苏州市影像医学重点实验室(编号:SZS2024032)。
