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04 April 2006, Volume 26 Issue 04 Previous Issue    Next Issue
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High risk factors of intramammary lymphatic metastasis in breast cancer patients received extended radical mastectomy:an analysis of 1679 cases. Huang Ou,Ling Hong,Shen Kunwei,et al. 2006, 26(04): 1-256.  Abstract ( )   PDF (690KB) ( )   Objective:To study the high risk factors of intramammary lymphatic metastasis in breast cancer patients received extended radical mastectomy. Methods:The clinical data of 1679 breast cancer patients received extended radical mastectomy between 1956 and 2003 in the Cancer Hospital of Fudan University was analyzed retrospectively.Four individual variables, such as patient age, tumor size, tumor site and axillary nodes metastasis status,were selected to investigate high risk factors of the intramammary lymphatic metastasis in different conditions. Results:Tumor size was not a independent predictor of intramammary lymphatic metastasis. Axillary node status was an important predictor of intramammary lymphatic metastasis.Tumor site and age had different effects on intramammary lymphatic metastasis in different conditions.The incidence of intramammary lymphatic metastasis is 4.4%,18.8%,28.1%,41.5% for patients with negative axillary nodes,1 to 3 positive axillary nodes,4-6 positive axillary nodes,7 or more positive axillary nodes,respectively. Conclusion:Four or more positive axillary nodes, internal tumor and positive axillary nodes,young patients with tumor greater than 5.0cm were high risk factors of intramammary lymphatic metastasis.

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Correlation between the diseases of latex fill up and intraductal papillary epithelioma. Xing Hua,Xu Zheli,Luo Xiao,et al. 2006, 26(04): 1-256.  Abstract ( )   PDF (308KB) ( )   Objective:To study the correlation between the diseases of latex fill up and intraductal papillary epithelioma. Methods:From January 2004 to November 2005,316 patients with latex fill up and serosity,uprightness polyrrhea were examined by fiberoptic ductoscopy (FDS).Estrogen receptor (ER),progesterone receptor (PR) in galactophore douche and prolactin (PRL) in serum were detected in some patients. Results:By FDS,316 patients were diagnosed as latex fill up.Among them,16,2 and 3 patients were complicated with intracanalicular papilloma,multiple papillary epithelioma and papillomatosis.Twentyone patients were performed operation.Among them,14,3,3 and 1 patients were diagnosed as papillary epithelioma,papillomatosis,galactophoritis complicated with phlegmasia granuloma and breast adenosis complicated with comedomastitis in pathology respectively.ER and PR of 93 patients were detected. Seventynine cases were positive.Serum PRL of 32 patients was detected.Among them,serum PRL of 21 patients was higher than the normal level.Seven of 21 patients were diagnosed as pituitary anomaly by MRI. Conclusion:Using FDS to diagnosing the diseases of latex fill up is directviewing and accuratissime.FDS can also find and cure the intraductal occupying lesions.There are internal relationships between galactorrhea and papillomatosis based on the significant correlation between the ER,PR in galactophore douche and serum PRL.Diseases of latex fill up should be treated actively to decrease the incidence of intraductal lesions.

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Endovascular repair for infrarenal abdominal aortic aneurysms:an analysis of 42 cases. Chang Guangqi，Li Xiaoxi,Hu Zuojun,et al． 2006, 26(04): 1-269.  Abstract ( )   PDF (321KB) ( )   Objective:To evaluate the effect of endovascular repair for infrarenal abdominal aortic aneurysms(AAA). Methods:From December 2001 to April 2005,42 cases of infrarenal AAA were treated with endovascular repair in the First Affiliated Hospital of Sun Yat-Sen University.Endovascular repair was done for infrarenal AAA through single or bilateral femoral artery. Results:Fortytwo cases of infrarenal AAA were performed endovascular repair successfully.Two cases died within 3 days after the operation.One of them died of acute insufficiency of kidney function,and the other case died of bleeding in the brain.Forty cases were followed up from 1 month to 40 months with good health condition. Conclusion:Endovascular repair is a safe and effective method for the treatment of infrarenal AAA.The longterm efficacy still should be confirmed.

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Sentinel lymph node biopsy after neoadjuvant chemotherapy for breast cancer. Long Fei,Zhang Bin,Li Shuang. 2006, 26(04): 1-294.  Abstract ( )   PDF (279KB) ( )   Objective:To study the feasibility of sentinel lymph node biopsy (SLNB) after neoadjuvant chemotherapy for breast cancer. Methods:From November 2003 to October 2004,SLNB was performed in 57 patients with stage Ⅱor Ⅲ breast carcinoma and negative axillary node after neoadjuvant chemotherapy. Results:Identification rate(IR) of SLNB after neoadjuvant chemotherapy was 93.0%(53/57).The sensitivity,specificity,accuracy,positive predictive value,negative predictive value and false negative rate were 89.7%,100%,94.3%,100%,88.9% and 5.7% respectively.IR of SLNB in patients with CR,PR and S after neoadjuvant chemotherapy were 100%,96.7% and 70%,respectively (P<0.01).The number of metastatic lymph nodes in the 3 cases of the false negative SLNs was more than 4. Conclusion:It can be found that SLNB in the patients with stageⅡor Ⅲ breast cancer after neoadjuvant chemotherapy can get a similar effect as SLNB in patients with early breast cancer.

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Severe hepatitis treated with ABOincompatible liver transplantation. Wang Jiandong,Quan Zhiwei,Shen Dingfeng,et al. 2006, 26(04): 1-269.  Abstract ( )   PDF (411KB) ( )   Objective:To explore the value of ABOincompatible liver transplantation in the treatment of severe hepatitis. Methods:In July 2004,1 case of severe hepatitis with blood type O received a blood type B donor in an emergency liver transplantation in Xinhua Hospital of Medical School of Shanghai Jiao Tong University.The clinical data was analyzed retrospectively.The immunosuppressive protocol included a quadruple drug therapy.The dose of steroid was reduced slowly. Results:The patient didn’t have rejection and survived more than 17 months with good health status. Conclusion:ABOincompatible liver transplantation can be used in the treatment of severe hepatitis,especially for O recipients.

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Relationship between extensive intraductal component(EIC) in breast cancer and expression of cathepsin D,Ki-67,single stranded DNA. Zhao Haiying*,Tian Zhong,Tadaoki Morimoto,et al. 2006, 26(04): 1-294.  Abstract ( )   PDF (402KB) ( )   Objective:To study the relationship between extensive intraductal component(EIC),comedo necrosis,histological grade in breast cancer and the expression of cathepsin D,Ki-67,single stranded DNA（ssDNA）,c-erbB-2. Methods:Expression of cathepsin D,Ki-67,single stranded DNA（ssDNA）and c-erbB-2 were measured immunohistochemically in 59 cases of breast invasive ductal carcinoma admitted in Medical School of Tokushima University between January 1996 and April 1997. Results:In EIC positive group,there was higher expression of cathepsin D in tumor epithelial cell（P=0.021）.No significant expression difference was found on cathepsin D in tumor stromal cell.Positive comedo necrosis was related with c-erbB-2，cathepsin D in tumor epithelial cell and proliferation index(P value was 0.042，0.006 and 0.013 respectively）. Conclusion:Cathepsin D in tumor epithelial cell may be involved in the formation of EIC and comedo necrosis.The evaluation of EIC and comedo necrosis is useful in clinical work.

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Pathogenesis and staged treatment of KlippelTrenaunayWeber syndrome. Liu Quanfang*，Wang Weizhong,Du Jialin,et al. 2006, 26(04): 1-269.  Abstract ( )   PDF (494KB) ( )   Objective:To explore the pathogenesis of KlippelTrenaunayWeber syndrome(KTWS) and the feasibility of staged treatment. Methods:From July 1999 to September 2004,14 cases of KTWS were performed arteriography and treated by stage Ⅰendovascular intervention with bleomycin(A5) and extraliquid lipiodol,PVA,NBCA,steel coil respectively according to the different vascular lesions in Guangdong Provincial People’s Hospital and General Hospital of Guangdong Military Command.Four weeks later,all the cases were performed stage Ⅱsurgical procedure.The therapeutic effect were observed. Results:Symptoms in 13 patients among 14 patients treated by staged treatment almost subsided after surgical procedure.The other body signs except for the uncured previously lengthened and thicken limbs also disappearred.Twelve cases were followed up.The average followup period was (26.5±9.3) months.No evident recurrent signs were observed. Conclusion:Staged treatment based on the pathogenesis in 14 cases of KTWS achieved significant effect.

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Application of laparoscopy combined with endoscopy in the treatment of gallbladder calculi complicated with bile duct calculi. Chen Yajin,Shang Changzhen,Xu Guoquan,et al. 2006, 26(04): 1-263.  Abstract ( )   PDF (454KB) ( )   Objective:To explore the application of laparoscopy combined with endoscopy in the treatment of gallbladder calculi complicated with bile duct calculi. Methods:Laparoscopy combined with duodenoscopy and cholangioscopy were used in the treatment of 118 cases of gallbladder calculi complicated with bile duct calculi,including 102 cases of cholecystolithiasis combined with choledocholithiasis,16 cases of cholecystolithiasis combined with choledocholithiasis and left intrahepatic duct calculi between 2000 and 2005.The main surgical procedures included:LC combined with EST (49 cases),LC combined with cholangioscopic exploration (62 cases),LC combined with cholangioscopic exploration and laparoscopic left hepatic lobectomy (7 cases). Results:Regular reexamination and follow up after operation showed that all the calculi were removed completely.And no serious complication occurred.Four out of 62 cases accepted LC with cholangioscopic exploration were converted to open operation after laparoscopic exploration,because of high bile duct stricture,or severe portal adhesion,or bleeding. Conclusion:Laparoscopic combined with endoscopic technology is feasible,safe and effective in the treatment of gallbladder calculi and bile duct calculi.It should be used widely in biliary surgery.

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Excision and reconstruction of abdominal aorta and inferior vena cava in the treatment of retroperitoneal tumors. Du Xiaohui，Li Rong，Song Shaobai,et al. 2006, 26(04): 1-311.  Abstract ( )   PDF (304KB) ( )   Objective:To explore the surgical manipulation of abdominal aorta (AO) and inferior vena cava (IVC) invaded by retroperitoneal tumors (RPT) in order to raise the resection rate and improve the operative safety. Methods:From January 1990 to June 2003,33 cases of AO and IVC invaded by retroperitoneal tumors were performed excision and reconstruction of affected AO and IVC in the General Hospital of PLA.The clinical data of 33 cases was analyzed retrospectively. Results:All the cases were performed excision of tumors en bloc including the excision and reconstruction of affect blood vessels.No one was died in the operation.Twentynine cases were followed up.The 3year and 5year survival rate were 60.1% and 40.6% respectively.The average survival time was 53.9 months. Conclusion:RPT involving AO and IVC is not contraindication for surgical resection. The tumor and the affected vessel can be removed en bloc followed by vascular reconstruction.It can decrease the local recurrence rate and prolong survival time.

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Diagnosis and treatment of acute arterial embolism of extremities：a report of 26 cases. Xing Zhuangjie,Yang Jiwu,Zhao Hui,et al. 2006, 26(04): 1-294.  Abstract ( )   PDF (314KB) ( )   Objective:To study the diagnosis, treatment and prognosis of acute arterial embolism of extremities. Methods:The data of 26 patients with acute arterial embolism of extremities admitted in Zhong Shan Hospital of Dalian University between May 2002 and July 2005 were analyzed retrospectively.Twentysix cases were treated by arteriotomy of femoral or brachial artery and embolectomy with Fogarty catheter,together with pharmacotherapy. Results:There was no mortality in the group.Twentysix embolized limbs were saved and warmed up postoperatively.The pulsation of distal arteries was recovered in twentyfour cases after successful embolectomy.But two cases were not recovered． Conclusion:Early diagnosis,timely arteriotomy and embolectomy with Fogarty catheter is a key for saving ischemia limbs.