Comparison of the efficacy and characteristics of metallic foreign body extraction by incision surgery and x-ray guided forceps after body-surface projection positioning: A STROBE-compliant article.

A foreign body retained in soft tissue may give rise to infection and dysfunction, which may pose a potential threat to patient health. Our study is to compare the efficacy and characteristics of metallic foreign body (MFB) extraction from soft tissue by incision surgery and x-ray-guided forceps after body surface projection positioning.This study enrolled 775 patients who underwent percutaneous MFB extraction between January 2011 and December 2016. A total of 257 cases underwent extraction by incision surgery and 518 cases underwent x-ray-guided forceps extraction after body surface projection positioning.All patients were diagnosed by x-ray and the diagnostic accuracy rate was 100%. In the incision surgery group, MFB extraction was successful in 193 of 257 cases. All cases in the forceps extraction group were successful, and the success rate was significantly higher than that of the incision surgery group (100% vs.75.1%, P < .01). Sixty-four patients in the incision surgery group who failed treatment were subsequently treated with x-ray-guided forceps extraction and all MFBs were extracted. The symptoms in all patients were relieved, wound healing was good, and there were no major bleeding, incision infection, or other complications.Compared with incision surgery, x-ray-guided foreign body forceps extraction after body surface projection positioning is a less invasive, safer, and more effective treatment for MFB extraction.

First Direct Evidence of Pan-African Orogeny Associated with Gondwana Assembly in the Cathaysia Block of Southern China.

Metamorphic zircon from a hornblendite in the South China Block (SCB) yield U-Pb age of 533 ± 7 Ma and Hf model ages from 900 to 1200 Ma. Geochemical and isotopic characteristics indicate that primary magma of the hornblendites was probably derived from an enriched asthenospheric mantle source. This Late Neoproterozoic-Cambrian (Pan-African) metamorphic event provides the first direct evidence that the SCB was an integral part of the Gondwana assembly. Combined with available geological data which show that the SCB has great affinity with India or Australia, the Pan-African metamorphic event most likely belongs to the eastern Kuunga orogeny. We propose that the SCB was located at the nexus between India, Antarctica and Australia along the northern margin of East Gondwana, with the Cathaysia Block connecting western Australia whereas the Yangtze Block facing northern India at ca. 533 Ma.

Clinical application of surface projection in the localization of metal foreign bodies using computed tomography scan.

OBJECTIVE: To analyse the clinical efficacy of surface projection in the localization and removal of metal foreign bodies using CT scan. METHODS: Total 795 cases with 1008 metal foreign bodies were treated at our hospital in 2012. Pre-operative surface projection was performed to localize foreign bodies in patients under the guidance of CT scan. The removal path from the skin surface to foreign body and puncture site were then determined. Finally, the foreign bodies were extracted using proper foreign body forceps which were chosen according to the size, depth and position of the foreign bodies in different parts of the human body. The incision length, operative time and intraoperative blood loss were recorded. Additionally, outpatient follow-up was scheduled post-operatively for 1 week. RESULTS: The accurate localization rate under the guidance of CT scan was 100%, and 1008 pieces of metal foreign bodies were all successfully removed with a removal rate of 100%. The mean incision length was 0.4 ± 0.1 cm, the mean operative time was 4.1 ± 2.0 min and the intraoperative blood loss was 1.1 ± 0.5 ml. These results showed minimal invasiveness, shorter operative time and minimal blood loss, respectively. Additionally, the results of outpatient follow-up showed that the wound healed spontaneously. Moreover, there were no significant bleeding, incision infections or complications. CONCLUSION: Surface projection may be an accurate and effective method for the pre-operative localization and extraction of metal foreign bodies. ADVANCES IN KNOWLEDGE: (1) Surface projection was applied for localization of metal foreign bodies in our study. (2) The accurate localization rate of surface projection under the guidance of CT scan was 100%. (3) All foreign bodies were successfully removed with a removal rate of 100%. (4) Surface projection technique has advantages in the removal of foreign bodies.

Percutaneous Retrieval of Foreign Bodies Around Vital Vessels Aided with Vascular Intervention: A Technical Note.

OBJECTIVE: To describe a new interventional technique to remove foreign bodies (FBs) embedded in soft tissues around vital vessels. METHODS: Under fluoroscopic guidance and using local anesthesia, percutaneous removal of FBs was performed using forceps in nine patients. All patients suffered from a metallic soft tissue FB located in close proximity to important vessels and one also had a small traumatic pseudoaneurysm adjacent to the FB. Prior to removal of the FB, the position of the nearest vessel was identified using a guide wire or catheter placed into the vessel. Balloon catheter was also simultaneously used to temporarily stop the blood flow of the nearest artery during the FB removal in three of the nine patients. RESULTS: All of the nine FBs with 0-2 mm interval to the nearest vessel were successfully removed in the nine patients without any serious complications. The removed FBs measured 3-12 mm in length and 1-3 mm in width. The total fluoroscopic time of retrieval of each FB was 5-9 min (mean, 6.4 min). The volume of intraoperative bleeding ranged from 5 to 12 ml (mean, 7.5 ml). The length of hospital stay for each patient ranged from 4 to 8 days (mean, 5.5 days). CONCLUSION: Vascular intervention-aided percutaneous FB removal is minimally invasive and an effective method for removal of FBs around vital vessels.

Diversity in early crustal evolution: 4100 Ma zircons in the Cathaysia Block of southern China.

Zircons are crucial to understanding the first 500 Myr of crustal evolution of Earth. Very few zircons of this age (>4050 Ma) have been found other than from a ~300 km diameter domain of the Yilgarn Craton, Western Australia. Here we report SIMS U-Pb and O isotope ratios and trace element analyses for two ~4100 Ma detrital zircons from a Paleozoic quartzite at the Longquan area of the Cathaysia Block. One zircon ((207)Pb/(206)Pb age of 4127 ± 4 Ma) shows normal oscillatory zonation and constant oxygen isotope ratios (δ(18)O = 5.8 to 6.0‰). The other zircon grain has a ~4100 Ma magmatic core surrounded by a ~4070 Ma metamorphic mantle. The magmatic core has elevated δ(18)O (7.2 ± 0.2‰), high titanium concentration (53 ± 3.4 ppm) and a positive cerium anomaly, yielding anomalously high calculated oxygen fugacity (FMQ + 5) and a high crystallization temperature (910°C). These results are unique among Hadean zircons and suggest a granitoid source generated from dry remelting of partly oxidizing supracrustal sediments altered by surface waters. The ~4100 Ma dry melting and subsequent ~4070 Ma metamorphism provide new evidence for the diversity of the Earth's earliest crust.

Value of 3-dimensional CT virtual anatomy imaging in complex foreign body retrieval from soft tissues.

OBJECTIVE: To investigate the value of 3-dimensional (3D) CT virtual anatomy imaging (VAI) in the complex foreign body (FB) retrieval of the soft tissues. MATERIALS AND METHODS: Four hundred and seventy-five patients with radiopaque FB(s) diagnosed by radiograph underwent contrast-enhanced 3D CT examination. VAI was reconstructed by volume-rendering opacity software, by sliding down the lowest threshold from -600 to 100 HU. The imaging was grouped into three groups: A (axial and multi-planar reformation [MPR] images), B (standard 3D imaging with axial and MPR images), and C (VAI with axial and MPR images). They were analyzed to reveal the type, size, number, location, complications, and the interventional removability of the object, with the comparisons in the management and clinical outcomes on the patient follow-up studies. The data were subjected to chi-square tests, with p value < 0.05 indicating significant statistical difference. RESULTS: The FB shape, size, number, site distribution and vessels around FB, as well as the FB-associated vascular complications and the FB interventional removability were assessed more accurately in Group C than in Group B or Group A (p < 0.005). There was no significant difference in disclosing the type and depth of the FB among the three groups (p > 0.75). On the basis of the 3D CT, especially the enhanced 3D CT VAI, the followings were processed: the recommendation of interventional removal in 286 (60.47%) and non-intervention in 187 (39.53%) of the 473 patients with soft-tissue FB(s); in 352 (56.50%) of the 623 radiopaque FBs patients, 258 (54.55%) patients accurately detected on 3D CT and the successful removal by intervention (343 FBs) or surgery (9 FBs) without any sequela; and 215 (45.45%) patients with 271 FBs lost in the follow-up, with their departure from the hospital. CONCLUSION: The 3D CT, especially 3D enhanced CT VAI, has great incremental value in further diagnosis and management of complex FB extraction from soft tissues.

Novel methods of removing metallic foreign body from human soft tissue: a report of 7390 cases.

BACKGROUND: We studied methods of locating metallic foreign bodies in soft tissue of the human body. METHODS: Using a three-dimensional (3D) locator, we removed metallic foreign bodies precisely from soft tissue of 7390 patients through magnetic forceps between June 1999 and June 2009. RESULTS: In 7390 patients, we successfully removed 99.5% of all metallic foreign bodies by 3D locator and forceps. Average operation time was 5 min. CONCLUSIONS: Metallic foreign bodies can be located precisely and removed simply with few complications using our 3D location method. The method may lead to minor trauma, less suffering, and a high success rate.