Objectice:To study the relationship of surgical trteatment, pathological stages and prognosis of soft tissue sarcoma In extremities. Methods:31 cases of soft tissue sarcoma in extremities in different pathological stages were reviewed. 22 cases were treated with wide excision and 9 cases were treated with amputation. Results:Among 22 cases treated with wide excision,16 cases were in gradeⅠ,11 cases had survived for 5 to 15 years without relapse and 3 cases had local recurrence. In 9 cases treated with amputation,3 cases died of lung metastasis within 18 months,6 cases survived for 4 to 15 years without relapse. Conclusion:The prognosis of soft tissue sarcoma in extremities in gradeⅠwith wide excision is better than that in grade Ⅲ or Ⅳ, if the local wide excision for patients with grade Ⅲ or Ⅳ is not good,the amputation or disarticulation is recommended.The extent of local resection should be wide enough or radical,and adjuvant radiotherapy is advisable.
Objective
To analyze the value of MRI in the diagnosis of anteromedial bundle(AMB) and posterolateral bundle (PLB) tears in patients undergoing anterior cruciate ligament (ACL) reconstruction.
Methods
MRI of 141 knees undergoing ACL reconstruction were retrospectively reviewed with using arthroscopy as golden standard to evaluate diagnostic accuracy of MRI to predict AMB and PLB injury conditions. The interval time between MRI and arthroscopic ACL reconstruction was 4 days to 29 days. The median time was 11 days. The injury patterns of AMB and PLB was observed on MRI and classified into normal type, partial tear and complete tear. Using the arthroscopic findings as the golden standard, MRI diagnostic accuracy of AMB and PLB tears was compared with Chi-square test.
Results
Thirteen cases(9.2%, 13/141) with isolated bundle injury were identified in the arthroscopic assessments among 141 patients, including 11 cases with isolated AMB injury and 2 cases with isolated PLB injury. Combined AMB and PLB injury were all identified in the remaining 128 knees (90.8%, 128/141). There was statistical difference between the incidence rate of isolated bundle injury and double-bundles injury (χ2=6.532, P=0.011). Partial tear was defined as partially torn or interrupted fiber bundles with remaining normal fiber bundles. Complete tear was defined as the fiber bundles in the expected region of the ligament were completely discontinuous. The diagnostic accuracy of MRI in prediction of AMB injury was better than PLB [85.8% (121/141) versus 72.3% (102/141); χ2=7.737, P=0.005]. There was no statistical difference between the accuracy rate of MRI in diagnosis of partial AMB and PLB tear [77.8% (14/18) versus 50.0% (15/30); χ2=3.630, P=0.057]. There was no statistical difference between the accuracy rate of MRI in diagnosis of complete AMB and PLB tear[87.6% (106/121) versus 84.0% (84/100); χ2=0.589, P=0.443]. There was no statistical difference between the accuracy rate of MRI in diagnosis of partial and complete AMB tear (χ2=1.282, P=0.258). There was statistical difference between the accuracy rate of MRI in diagnosis of partial and complete PLB tear (χ2= 14.690, P=0.001).
Conclusions
Complete AMB and PLB tear are the common injury patterns among patients undergoing ACL reconstruction, while an isolated AMB or PLB tear is uncommon. MRI is of value in the diagnosis of ACL injury. MRI can accurately diagnose complete AMB tear, complete PLB tear and partial AMB tear, but the diagnostic accuracy of MRI in assessing partial PLB tear needs to be improved.
Key words:
Anterior cruciate ligament; Wounds and injury; Magnetic resonance imaging
Objective Summary laparoscopic biliary mirror the clinical experience of treatment of common bile duct stones.Methods Retrospective analysis from January 2008 to September 2009 in our hospital combined with minimally invasive laparoscopic Choledochofiberscope bile duct stones treated 78 cases of clinical data.Results Operative time was 50 ～ 80 min,an average of 65 min,bile duct I suture 78 cases,1 case occurred a few postoperative bile leakage,intra-abdominal drainage conservative treatment.72h removal of intra-abdominal drainage tube.78 cases were cured and discharged without serious complications.Conclusions Laparoscopic treatment of common bile duct stones with biliary mirror trauma,incision infection rate is low,rapid postoperative recovery,short hospital stay,intra-abdominal organs adhesion of light,practical common bile duct a suture,and many other advantages.With good clinical effects,safety and reliability.
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