ABSTRACT
OBJECTIVE@#To determine the clinical, imaging, and histological features, and surgical resection modalities and outcomes of adult sacrococcygeal teratoma (SCT).@*METHODS@#Adult patients with histopathologically diagnosed SCT were enrolled in our hospital between August 2010 and August 2018. Each patient's characteristics and clinical information were reviewed.@*RESULTS@#There were 8 patients in the study (2 males, 6 females) with a median age of 34 years (range, 18-67 years). The time to clinical symptoms was 14 d to 35 years, with a median time of 4 years. Six patients presented with symptoms of sacrococcygeal pain, and four with signs of sacrococcygeal mass and ulceration in the sacrococcygeal region. Six patients were evaluated using a combination of computed tomography (CT) and magnetic resonance imaging (MRI). All patients showed a presacral tumor with heterogeneous intensity on CT images. All patients underwent surgical treatment, including 6 parasacral, 1 transabdominal, and 1 combined anterior-posterior surgery cases. Seven patients were histopathologically diagnosed with benign mature SCT, and have shown no recurrence. One patient had malignant SCT, with recurrence at 84 months after surgery. After a second surgery, the patient had no recurrence within 6 months follow-up after re-resection.@*CONCLUSIONS@#Our retrospective study demonstrated: (1) adult SCT is difficult to diagnose because of a lack of typical clinical symptoms and signs; (2) a combination of CT and MRI examination is beneficial for preoperative diagnosis; (3) the choice of surgical approach and surgical resection modality depends on the size, location, and components of the tumor, which can be defined from preoperative CT and MRI evaluation; (4) most adult SCTs are benign; the surgical outcome for the malignant SCT patient was good after complete resection. Even for the patient with recurrent malignant SCT, the surgical outcome was good after re-resection.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Magnetic Resonance Imaging , Margins of Excision , Neoplasm Recurrence, Local , Pain Measurement , Retrospective Studies , Sacrococcygeal Region/surgery , Teratoma/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Objective To explore the treatment efficacy and safty of donepezil hydrochloride combined with comprehensive rehabilitation in memory impairment of patients after traumatic brain injury(TBI).Methods Seventy-six patients with TBI,admitted to our hospital from May 2008 to October 2010,were randomly divided into control group(n=38)and treatment group(n=38)using a case-control study method; patients from control group were given memory training,cognitive training and other comprehensive rehabilitation therapy while those from treatment group were given donepezil hydrochloride combined with comprehensive rehabilitation therapy for 3 months.Wechsler memory scale (WMS)was used to evaluate the efficacy and the drug adverse reactions were observed.Results As compared with those before treatment,the scores of forward counting in the long-term memory,scores of recall and recognition in short-term memory,scores of counting without looking in immediate memory and total scores of WMS were significantly higher in the cnntrol group after treatment(P＜0.05); as compared with those before treatment,the scores of long term memory(forvard counting,backward counting and adding),and scores of recall,recognition and logic memory in short-term memory,scores of counting without looking in immediate memory,and total scores of W-MS were significantly higher in the treatment group after treatment(P＜0.05); as compared with those in the control group after treatment,the scores of adding in long term memory,scores of logic memory in short-term memory and total scores of WMS were significantly higher in the treatment group after treatment(P＜0.05); oral administration of donepezil hydrochloride showed no significant adverse reactions.Conclusion Donepezil hydrochloride therapy combined with memory training,cognitive training and other comprehensive rehabilitation program is more effective than comprehensive rehabilitation therapy alone for memory impairment of patients after TBI.