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Objective@#To assess the efficacy of supraclavicular artery island flap (SCAIF) for the reconstruction of hypopharynx and upper esophagus.@*Methods@#The SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in (4-8) cm×(5-12) cm. Clinical indexes such as harvesting time and survival were recorded.@*Results@#Harvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications.@*Conclusions@#SCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.
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Purpose Papillary thyroid microcarcinoma (PTMC) is difficult to diagnose its nature before surgery, thus results in misdiagnosis. This paper aims to determine the best diagnostic cutoff value using anteroposterior and transverse diameter ratio (A/L) and longitudinal and transverse diameter ration (L/T) in PTMC. Materials and Methods The CT data of 154 pathology proven benign and malignant thyroid nodules ≤ 1.0 cm in diameter in 78 cases were reviewed, including 75 PTMC in 47 patients and 79 benign nodule in 31 patients. The anteroposterior and transverse diameter ratio (A/T) on axial view, A/L on sagittal view, and L/T on coronal view were measured and calculated. A non-parametric method was used to draw the receiver operating curve of A/T, A/L and L/T. The mean and standard deviation of CT diameters in benign and malignant nodules were calculated. The area under the curve, sensitivity, specificity and diagnostic accuracy, positive predictive value and negative predictive value were determined. CT manifestations of small benign and malignant thyroid nodules were also analyzed. Results The A/T and A/L ratio were significantly larger for PTMC than benign nodules (P<0.01), while L/T diameters were significantly smaller than the benign nodules (P<0.01). The area under ROC was 0.8841, 0.7676 and 0.4052 for A/T, A/L and L/T respectively. The best diagnostic cutoff value of A/T and A/L were 1.05 and 1.0. With A/T ≥ 1.05, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.00%, 84.81%, 86.36%, 84.62% and 88.12%, respectively. With A/L ≥ 1.0, the sensitivity, specificity, accuracy, positive predictive value and negative predictive values were 66.67%, 82.28%, 74.68%, 78.13% and 72.22%, respectively. CT characteristics of PTMC included superficial location, oval low density, blurry boundary, microcalcification and progressive enhancement with accuracy of 71.43%, 50.00%, 79.22%, 68.83% and 90.91%, respectively. Conclusion The cutoff values of A/T ≥ 1.05 and A/L ≥ 1.0 can be used to diagnose PTMC with high accuracy.
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<p><b>OBJECTIVE</b>To investigate the relation of plasma vascular endothelial growth factor(VEGF) and tumor necrosis factor-α (TNF-α) with obstructive sleep apnea-hypopnea syndrome(OSAHS) in children.</p><p><b>METHODS</b>Eighty children were recruited from October 2008 to March 2009, including 60 children with snoring and 20 healthy children without snoring as control. Plasma VEGF or TNF-α concentration was measured by enzyme-linked immunosorbent assay (ELISA) respectively. Sixty children with snoring underwent an overnight polysomnography test their PSG data, including whole night mean saturation (MSaO2), lowest oxygen saturation (LSaO2), desaturation cumulate time/total sleep time (DCT/TST), oxygen desaturation index 3 (ODI3), apnea-hypopnea index (AHI), obstructive apnea index (OAI), were collected and analysed. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>The levels of plasma VEGF and TNF-α in children with OSAHS(540.45 pg/ml and 311.94 pg/ml) were higher than those in children with snoring alone (234.45 pg/ml and 97.55 pg/ml) or those in healthy children (259.80 pg/ml and 120.70 pg/ml), with statistically significant differences(HC value:14.176 and 15.571, P < 0.05, respectively), but with no statistical difference between children with snoring alone and healthy children (P > 0.05). The differences in plasma VEGF or TNF-α levels between children with moderate and severe hypoxemia and children with mild hypoxemia were not statistically significant (P > 0.05). Spearman rank correlation analysis showed no significant correlation between plasma level of VEGF or TNF-α and LSaO2, MSaO2, ODI3, DCT/TST, OAI, AHI or BMI (r values were <0.5, P > 0.05).</p><p><b>CONCLUSION</b>Plasma levels of VEGF and TNF-α increase in children with OSAHS.</p>
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Child , Child, Preschool , Female , Humans , Male , Case-Control Studies , Sleep Apnea, Obstructive , Blood , Tumor Necrosis Factor-alpha , Blood , Vascular Endothelial Growth Factor A , BloodABSTRACT
0.05). CONCLUSION Obesity was an influential factor of snoring. The PS and OSAHS have the same effect on children growth and their clinical features.
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OBJECTIVE To summarize the clinical experience of endoscopic thyroidectomy via suprasternal approach. METHODS Endoscopic thyroidectomy via suprasternal approach was performed in 35 patients with ultrasonic scalpel. RESULTS Operations were successfully performed in 35 patients. The mean operation times were 130 (105～190) minutes in 24 cases with subtotal lobectomy and 4 case with total lobectomy, 60 (50~70) minutes in 2 cases with isthmectomy, 228 (185～270) minutes in 2 case with bilateral subtotal lobectomy, 163 (140～215) minutes in 3 case with subtotal lobectomy and the contralateral ademona resection. The bleeding during operation was 5 to 40ml and the average hospital stay time was 4 (3～5) days. CONCLUSION Endoscopic thyroidectomy via suprasternal approach is a safe way with good cosmetic value.
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0.05),but there was a significant difference in the lowest SaO2,average SaO2 and AHI between the 2 groups(P