BACKGROUND Pulmonary hypertension(PH)is a progressive disease characterized by endothelial dysfunction and vascular remodeling and is a leading cause of mortality worldwide.Although it is independently associated with...BACKGROUND Pulmonary hypertension(PH)is a progressive disease characterized by endothelial dysfunction and vascular remodeling and is a leading cause of mortality worldwide.Although it is independently associated with multiple comorbidities,the impact of diabetes mellitus(DM)on mortality in patients with PH remains uncertain.To address this issue,we conducted a systematic review and meta-analysis to investigate the effect of DM on survival in patients with pulmonary hypertension.AIM To investigate the impact of diabetes mellitus on mortality in pulmonary hypertension patients.METHODS We conducted a comprehensive search of four major electronic bibliographic databases like PubMed,Google Scholar,Scopus,and Embase,and identified 106 relevant studies,out of 1561 articles,published since the year 2000 for full-text review.Fourteen retrospective and prospective cohort studies that compared survival between patients with DM and those without DM in the context of PH were deemed eligible for inclusion in our meta-analysis.The study was registered on PROSPERO with the identifier CRD42023390232.RESULTS A total of 116455 patients with PH were included in the meta-analysis,of whom 41228 suffered from DM and 75227 did not.The results of our meta-analysis indicate an elevated mortality rate among PH patients with diabetes mellitus in comparison to those without DM[odds ratio(OR)=1.40,95%CI:1.15–1.70,P=0.0006].The metaregression analysis unveiled a statistically significant negative association between mean age and effect size(coefficient=-0.036,P value=0.018).Conversely,a statistically significant positive association was detected between female proportion and effect size(coefficient=0.000,P value<0.001).CONCLUSION Our meta-analysis,which included approximately 116500 PH patients,revealed that the presence of diabetes mellitus was associated with increased odds of mortality when compared to non-diabetic patients.The metaregression analysis indicates that studies with older participants and lower proportions of females tend to exhibit smaller effect sizes.Clinically,these findings underscore the importance of incorporating diabetes status into the risk stratification of patients with PH with more aggressive monitoring and early intervention to improve prognosis potentially.展开更多
The Monkeypox (Mpox) virus (MPXV) is endemic in Africa, and cases outside West and Central Africa were previously considered rare. However, around May 2022, outbreaks of multiple cases were reported worldwide includin...The Monkeypox (Mpox) virus (MPXV) is endemic in Africa, and cases outside West and Central Africa were previously considered rare. However, around May 2022, outbreaks of multiple cases were reported worldwide including the USA thus presenting a new public health emergency. We present a case report of MPXV infection in a 49-year-old gay male with AIDS who was admitted for management of severe perianal cellulitis. Three days into hospitalization, he developed pustules over the genitals and scattered lesions over the face, trunk and extremities. PCR testing from a pustule was positive for MPXV. He was initiated on tecovirimat as well as antiretroviral therapy. There was a worsening of his rash over the first three days of therapy, followed by a gradual but complete resolution of all the skin lesions. The perianal and gluteal lesions were the most persistent and took more than two months to resolve. A primary contact source of infection was never identified. The differential diagnoses for cutaneous lesions of MPXV infection are also discussed.展开更多
AIM:Microcirculatory disturbances are important early pathophysiological events in various organs during acute pancreatitis.The aim of the study was to evaluate changes in microperfusion of the pancreas,liver,kidney,s...AIM:Microcirculatory disturbances are important early pathophysiological events in various organs during acute pancreatitis.The aim of the study was to evaluate changes in microperfusion of the pancreas,liver,kidney,stomach, colon,skeletal muscle,and to investigate the influence of heparin on the organ microcirculation in caerulein-induced experimental acute pancreatitis. METHODS:Acute pancreatitis was induced by 4 intraperitoneal injections of caerulein(Cn)(15 μg/kg).The organ microcirculation was measured by laser Doppler flowmetry.Serum interleukin 6 and hematocrit levels were analysed. RESULTS:Acute pancreatitis resulted in a significant drop of microperfusion in all examined organs.Heparin administration(2×2.5 mg/kg)improved the microcirculation in pancreas(36.9±4% vs 75.9±10%),liver(56.6±6% vs 75.2±16%),kidney (45.1±6% vs 79.3±5%),stomach (65.2±8% vs 78.1±19%),colon(69.8±6% vs 102.5±19%), and skeletal muscle (59.2±6% vs 77.9±13%).Heparin treatment lowered IL-6(359.0±66 U/mL vs 288.5±58 U/mL) and hematocrit level(53±4% vs 46±3%). CONCLUSION:Heparin administration has a positive influence on organ microcirculatory disturbances accompanying experimental Cn-induced acute pancreatitis.展开更多
AIM: To investigate whether tissue samples processed by the rapid urease test (RUT) kit are suitable for dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) to detect Helicobacter pylori (...AIM: To investigate whether tissue samples processed by the rapid urease test (RUT) kit are suitable for dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) to detect Helicobacter pylori (H. pylori).展开更多
AIM: To describe the significant over-expression of fibroblast growth factor receptor 3 (FGFR3), which is a signal transduction and cell proliferation related gene in hepatocellular carcinoma (HCC).METHODS: Following ...AIM: To describe the significant over-expression of fibroblast growth factor receptor 3 (FGFR3), which is a signal transduction and cell proliferation related gene in hepatocellular carcinoma (HCC).METHODS: Following DNA microarray, Northern blot and quantitative real-time PCR were employed to confirm FGFR3 expression difference in HCC tissues and surrounding non-neoplastic liver tissue. FGFR3 expression levels were further determined by immunohistochemical study in 43 cases of HCC.RESULTS: Northern blot results showed the significant over-expression of FGFR3 in HCC tissues, which was consistent with that from DNA microarray. Quantitative real-time PCR demonstrated that the mean ratio of FGFR3 mRNA to glyceraldehyde-3-phosphate dehydrogenase (GADPH) mRNA in HCC tissue was 0.250, whereas the ratio in non-neoplastic liver tissue was 0.014. Statistical analyses of 43 cases of HCC revealed that HCC scored higher than the matched non-neoplastic liver tissues.Examination of clinicopathological features revealed a strong correlation of over-expression of FGFR3 with poor tumor differentiation and high nuclear grade.CONCLUSION: Over-expression of FGFR3 may play an important role in liver carcinogenesis. FGFR3 may be an ideal candidate as a molecular marker in the diagnosis of HCC and a potential therapeutic target.展开更多
Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 4...Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.展开更多
We investigated the effects of mouse recombinant IL-4 on hematopoiesis in vitro and in vivo. IL-4 alone was found to be incapable of stimulating colony formation, but it inhibited both IL-3-and GM-CSF-induced colony f...We investigated the effects of mouse recombinant IL-4 on hematopoiesis in vitro and in vivo. IL-4 alone was found to be incapable of stimulating colony formation, but it inhibited both IL-3-and GM-CSF-induced colony formation by murine hematopoietic progenitor cells. In contrast, colony formation induced by G-CSF was enhanced in the presence of IL-4. We also studied the influence of IL-4 on hematopoietic reconstiution after allogeneic bone marrow transplantation in a murine medel, and found that IL-4 had significant inhibitory effects on neutrophil recovery and that neutrophil recovery accelerated by IL-3 and G-CSF was significantly suppressed by IL-4. The combination of IL-4 and GM-SF caused a significant decrease in the absolute number of neutrophils.展开更多
Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectr...Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectral pattern, manifesting a sharp and high frequency peak occurring late in systole, often bearing a striking resemblance to the subaortic Doppler flow pattern. Methods: Murmurs found in thirty one subjects with dynamic subaortic stenosis were analyzed after having been recorded with a novel portable device capable of spectral and waveform sound displays. Results: All subjects manifested characteristic frequency patterns, consisting of high and sharp peaks occurring in late systole. With significant subaortic stenosis (resting subaortic flow velocity > 2 m/sec) this pattern was evident at rest. In the presence of little or no resting subaortic obstruction (< 2 m/sec) this pattern was produced regularly by the Valsalva maneuver. Conclusions: Dynamic subaortic stenosis produces a specific sound spectral pattern that may provide a basis for clinical evaluation, especially in early detection of this disorder and in screening situations.展开更多
AIM: To examine the refractive prediction error in high myopic eyes after phacovitrectomy.METHODS: This retrospective comparative case series included 91 eyes(18 high myopic eyes and 73 non-high myopic eyes) of 91 pat...AIM: To examine the refractive prediction error in high myopic eyes after phacovitrectomy.METHODS: This retrospective comparative case series included 91 eyes(18 high myopic eyes and 73 non-high myopic eyes) of 91 patients who underwent successful phacovitrectomy(phacoemulsification, intraocular lens implantation, and pars plana vitrectomy). The high myopic eyes were defined as the eye with more than 26.0mm of axial length. The postoperative prediction error of mean error and mean absolute error were evaluated at4 mo postoperatively. Axial length and keratometry measurement were performed preoperatively and 4mo postoperatively using the IOL Master.RESULTS: The refractive outcome after phacovitrectomy showed significantly greater myopic shift in the high myopic eyes [-1.08 ±0.87 diopters(D)] than that in the non-high myopic eyes(-0.43 ±0.63 D, P =0.004). Axial length and keratometric value in the high myopic eyes were significantly increased(P =0.043, 0.037 respectively),whereas those in the non-high myopic group were not significantly increased(P =0.135, 0.347 respectively). The change of the axial length in the myopic eye(0.46±0.28 mm)was greater than that in the non- high myopic eye(0.11 ± 0.34 mm; P 【0.001).CONCLUSION: High myopic eyes showed more myopic shift than non-high myopic eyes after phacovitrectomy.The cause of myopic shift in high myopic eyes seems tobe attributed to actual elongation of the axial length in high myopia.展开更多
AIM: To determine whether thalidomide prevents microvascular injury in acute radiation proctitis in white rats. METHODS: Fourteen female Wistar rats were used: six in the radiation group, six in the thalidomide group,...AIM: To determine whether thalidomide prevents microvascular injury in acute radiation proctitis in white rats. METHODS: Fourteen female Wistar rats were used: six in the radiation group, six in the thalidomide group, and two in normal controls. The radiation and thalidomide groups were irradiated at the pelvic area using a single 30 Gy exposure. The thalidomide (150 mg/kg) was injected into the peritoneum for 7 d from the day of irradiation. All animals were sacrificed and the rectums were removed on day 8 after irradiation. The microvessels of resected specimens were immunohistochemically stained with thrombomodulin (TM), von Willebrand Factor (vWF), and vascular endothelial growth factor (VEGF). RESULTS: The microscopic scores did not differ significantly between the radiation and thalidomide groups, but both were higher than in the control group. Expression of TM was significantly lower inthe endothelial cells (EC) of the radiation group than in the control and thalidomide groups (P < 0.001). The number of capillaries expressing vWF in the EC was higher in the radiation group (15.3 ± 6.8) than in the control group (3.7 ± 1.7), and the number of capillaries expressing vWF was attenuated by thalidomide (10.8 ± 3.5, P < 0.001). The intensity of VEGF expression in capillaries was greater in the radiation group than in the control group and was also attenuated by thalidomide (P = 0.003). CONCLUSION: The mechanisms of acute radiation- induced proctitis in the rats are related to endothelial cell injury of microvessel, which may be attenuated with thalidomide.展开更多
【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shun...【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the展开更多
Objective. This is a phase II group- wide study of liposomal doxorubicin chemotherapy in patients with advanced or recurrent uterine leiomyosarcomas. The aim was to evaluate clinical response and toxicity. Methods. Pa...Objective. This is a phase II group- wide study of liposomal doxorubicin chemotherapy in patients with advanced or recurrent uterine leiomyosarcomas. The aim was to evaluate clinical response and toxicity. Methods. Patients with histologically confirmed persistent or recurrent leiomyosarcomas of the uterus with documented disease progression after appropriate local therapy were invited to participate in this study. Bidimensionally measurable disease, GOG performance status of 0, 1, or 2 (Karnofsky 80- 100) was required; all patients must have failed local therapeutic measures and be considered incurable. Other eligibility criteria included adequate hepatic, renal, and hematologic function. Patients were ineligible if they had received previous chemotherapy or had other noncutaneous malignancies. Patients received liposomal doxorubicin 50 mg/m2 IV over 1 h. Courses were repeated every 4 weeks until disease progression or adverse side effects supervened. Results. Thirty- five patients were entered into this study between May 2000 and June 2001. Three patients were determined ineligible because of wrong pathological cell type or inadequate pathology information and one was inevaluable for lack of data. Median age was 52 years (range 36- 78 years). GOG performance status was 2 in 1 instance, 1 in 15 cases, and 0 in 15 others. Eleven patients (35.5% ) had received radiotherapy. A median of 2.0 courses was given (range 1- 8). Five patients (16.1% )- experienced grade 3 or 4 neutropenia, and seven (22.6% ) had grade 3 or 4 anemia. Two patients developed grade 3 and one patient developed grade 4 cardiovascular adverse events, not necessarily drug related. There were seven cases of grade 3 or 4 gastrointestinal toxicity and two patients developed grade 3 dermatologic toxicity. One complete (3.2% ) and four partial (12.9% ) responses were reported. Ten patients (32.3% ) had stable disease, 15 (48.4% ) had increasing disease, and response could not be assessed in 1 (3.2% ). Conclusion. The dose and schedule of liposomal doxorubicin employed in this trial showed no advantage over historical results with doxorubicin in the treatment of uterine leiomyosarcoma.展开更多
Dear Sir,Iam Jin A Choi,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.I write to present a case report of a young female treated with the diagnosis of Posner-Schlossman sy...Dear Sir,Iam Jin A Choi,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.I write to present a case report of a young female treated with the diagnosis of Posner-Schlossman syndrome for several years,in which she was ultimately proved to have iridocorneal endothelial(ICE)syndrome.Posner-Schlossman syndrome(PS syndrome)is characterized by recurrent attacks of mild anterior uveitis with marked elevation of intraocular pressure(IOP)[1].The exact etiology of this syndrome is not fully established yet.However,the possible role of herpes simplex virus(HSV)is suggested by a study that revealed DNA evidence of the virus in all aqueous specimens of patients during acute attacks in PS syndrome[1,2].ICE is a spectrum of disease that展开更多
Purpose: Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment modality for medically inoperable early-stage lung cancer patients. The aim of this paper is to calculate radiobiological paramet...Purpose: Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment modality for medically inoperable early-stage lung cancer patients. The aim of this paper is to calculate radiobiological parameters for a sample of 39 patients who underwent lung SBRT. Materials and Methods: For SBRT, a typical regimen of 50 Gy in 4 - 5 fractions results in local tumor control rates around 99.9%. We calculate dose volume histograms (DVHs) of targeted tumors and organs at risk for 39 patients. All patients received 4D imaging, and their internal treatment volumes (ITVs) were created by phase-based sorting of multiple CT datasets. Planning target volume (PTV) diameters ranged from 2.0 to 5.7 cm. The DVHs for the PTV and organs at risk were analyzed using a Biosuite algorithm to calculate the equivalent uniform dose (EUD), tumor control probability (TCP) via a Poisson model, and normal tissue complication probability (NTCP) via an LKB model. The radiobiological effects were analyzed by correlating EUD and TCP with PTV volumes. Results: The mean PTV volume was 31.60 ± 25.55 cc. The mean EUDs were 5.19 ± 2.84, 5.66 ± 4.95, 61.45 ± 29.18, 3.31 ± 5.92, 6.45 ± 5.18, and 12.22 ± 5.94 Gy for lungs, spinal cord, chest/ribs, heart, esophagus, and skin, respectively. On average, the heart had the lowest EUD and the chest/ribs had the highest (61.45 ± 29.18 Gy). The mean NTCPs were estimated at 3.75% ± 2.61%, 36.25% ± 36.42%, and 0.59% ± 1.48%, for the lungs, chest and esophagus, respectively. The NTCPs of spinal cord, heart, and skin were 0.00%. The mean TCP value was 99.72% ± 0.44%. The mean BED value for our study was 109.49 Gy. Conclusions: We have calculated radiobiological predictors based on DVHs for early-stage non-small cell lung cancer via SBRT. Our calculated predictors are compatible with previously published SBRT reports.展开更多
Objective. To determine whether neoadjuvant cisplatin and 5- fluorouracil chemotherapy can be used to preserve the anal sphincter and/or urethra in patients with advanced vulvar cancer involving these sites. Methods. ...Objective. To determine whether neoadjuvant cisplatin and 5- fluorouracil chemotherapy can be used to preserve the anal sphincter and/or urethra in patients with advanced vulvar cancer involving these sites. Methods. Fourteen patients with advanced vulvar cancer (1997- 2003) involving the anal sphincter and/or urethra were given 3- 4 cycles of neoadjuvant chemotherapy to attempt preservation of these pelvic structures rather than undergoing a primary pelvic exenteration. Following 3 cycles, a radical vulvectomy and groin lymph node dissection were planned. All patients had lesion size documented by measurement and photograph prior to and following chemotherapy. Results. The median age was 63 years (range 39- 88). Thirteen patients received a median of 3 cycles (range 2- 4) of neoadjuvant chemotherapy. Ten patients received cisplatin and 5- fluorouracil, while three received cisplatin alone. The median time from diagnosis to surgery was 77 days (range 54- 143). All patients with cisplatin and 5- fluorouracil chemotherapy underwent surgery except one patient who had a synchronous renal cell carcinoma and died prior to surgery. Patients receiving cisplatin alone showed no measurable response, while all patients receiving cisplatin and 5- fluorouracil demonstrated at least a partial response. Two patients had no residual invasive carcinoma on final pathology. All patients receiving cisplatin and 5- fluorouracil followed by surgery are disease- free, while two of three receiving cisplatin have progressive disease. The anal sphincter and urethra were conserved in all patients receiving cisplatin and 5- fluorouracil. Conclusion. Neoadjuvant cisplatin and 5- fluorouracil in advanced vulvar cancer demonstrated a response rate of 100% . The anal sphincter and urethra were conserved in all patients receiving cisplatin and 5- fluorouracil. Responders are disease- free at this time. This response rate demonstrates superior activity of 5- fluorouracil in vulvar cancer and spares these patients the morbidity of exenteration or radiation.展开更多
Aim:Eyelid contour is a key component to satisfactory lid position and appearance following ptosis repair,the components of which have been highly debated and remain difficult to objectively measure.We sought to minim...Aim:Eyelid contour is a key component to satisfactory lid position and appearance following ptosis repair,the components of which have been highly debated and remain difficult to objectively measure.We sought to minimize the number of intraoperative adjustments required and reduce reoperation rates by addressing only the central 6 mm of tarsus when reapproximating levator to the anterior surface of tarsus,thereby eliminating contour as an adjustable variable.Methods:All patients who underwent external levator resection with blepharoplasty for correction of involutional ptosis between 2012 and 2019 by a single surgeon at one center were retrospectively reviewed.Patients who underwent concomitant brow lifting surgery were excluded.The same technique was used for each eyelid with uniform suture placement.One 6-0 silk horizontal mattress suture was placed partial thickness through the superior third of tarsus 3 mm lateral to the center of tarsus;another was passed 3 mm medial to the center of tarsus.No sutures were placed outside of this central 6-mm zone.Patient fixation was used to determine lid height and symmetry.Once satisfactory,the sutures were tied down in a permanent fashion and the eyelid position again verified.In total,153 eyelids in 85 patients were evaluated.Data obtained included preoperative and postoperative margin-to-reflex distance(MRD1),intraoperative and postoperative complications,reoperation rates,and patient satisfaction with appearance of lid contour and symmetry.Results:The mean follow up time was 3.41 months.The mean preoperative MRD1 was 1.05 mm.The mean post-operative was 3.18 mm.All patients had recovery of an anatomically normal temporal peak height.Two of 153 ;eyelids(1.31%)required reoperation due to residual ptosis or overcorrection.No patients had postoperative lagophthalmos.Ninety-one percent of patients who underwent bilateral surgery had satisfactory symmetry defined as less than or equal to 1-mm difference between right and left MRD1.Eighty-two of the 85 patients were satisfied with their postoperative appearance.Conclusion:This simple and standardized technique for suture placement gives reliable and effective results for external elevator advancement for ptosis repair by eliminating contour as an adjustable variable.Addressing the central 6 mm of tarsus is not only paramount but also in and of itself satisfactory in achieving optimal contour during external levator resection,without regard to more medial or lateral lid anatomy.展开更多
文摘BACKGROUND Pulmonary hypertension(PH)is a progressive disease characterized by endothelial dysfunction and vascular remodeling and is a leading cause of mortality worldwide.Although it is independently associated with multiple comorbidities,the impact of diabetes mellitus(DM)on mortality in patients with PH remains uncertain.To address this issue,we conducted a systematic review and meta-analysis to investigate the effect of DM on survival in patients with pulmonary hypertension.AIM To investigate the impact of diabetes mellitus on mortality in pulmonary hypertension patients.METHODS We conducted a comprehensive search of four major electronic bibliographic databases like PubMed,Google Scholar,Scopus,and Embase,and identified 106 relevant studies,out of 1561 articles,published since the year 2000 for full-text review.Fourteen retrospective and prospective cohort studies that compared survival between patients with DM and those without DM in the context of PH were deemed eligible for inclusion in our meta-analysis.The study was registered on PROSPERO with the identifier CRD42023390232.RESULTS A total of 116455 patients with PH were included in the meta-analysis,of whom 41228 suffered from DM and 75227 did not.The results of our meta-analysis indicate an elevated mortality rate among PH patients with diabetes mellitus in comparison to those without DM[odds ratio(OR)=1.40,95%CI:1.15–1.70,P=0.0006].The metaregression analysis unveiled a statistically significant negative association between mean age and effect size(coefficient=-0.036,P value=0.018).Conversely,a statistically significant positive association was detected between female proportion and effect size(coefficient=0.000,P value<0.001).CONCLUSION Our meta-analysis,which included approximately 116500 PH patients,revealed that the presence of diabetes mellitus was associated with increased odds of mortality when compared to non-diabetic patients.The metaregression analysis indicates that studies with older participants and lower proportions of females tend to exhibit smaller effect sizes.Clinically,these findings underscore the importance of incorporating diabetes status into the risk stratification of patients with PH with more aggressive monitoring and early intervention to improve prognosis potentially.
文摘The Monkeypox (Mpox) virus (MPXV) is endemic in Africa, and cases outside West and Central Africa were previously considered rare. However, around May 2022, outbreaks of multiple cases were reported worldwide including the USA thus presenting a new public health emergency. We present a case report of MPXV infection in a 49-year-old gay male with AIDS who was admitted for management of severe perianal cellulitis. Three days into hospitalization, he developed pustules over the genitals and scattered lesions over the face, trunk and extremities. PCR testing from a pustule was positive for MPXV. He was initiated on tecovirimat as well as antiretroviral therapy. There was a worsening of his rash over the first three days of therapy, followed by a gradual but complete resolution of all the skin lesions. The perianal and gluteal lesions were the most persistent and took more than two months to resolve. A primary contact source of infection was never identified. The differential diagnoses for cutaneous lesions of MPXV infection are also discussed.
基金Supported by Medical University of Gda■sk,grant W-120,Poland
文摘AIM:Microcirculatory disturbances are important early pathophysiological events in various organs during acute pancreatitis.The aim of the study was to evaluate changes in microperfusion of the pancreas,liver,kidney,stomach, colon,skeletal muscle,and to investigate the influence of heparin on the organ microcirculation in caerulein-induced experimental acute pancreatitis. METHODS:Acute pancreatitis was induced by 4 intraperitoneal injections of caerulein(Cn)(15 μg/kg).The organ microcirculation was measured by laser Doppler flowmetry.Serum interleukin 6 and hematocrit levels were analysed. RESULTS:Acute pancreatitis resulted in a significant drop of microperfusion in all examined organs.Heparin administration(2×2.5 mg/kg)improved the microcirculation in pancreas(36.9±4% vs 75.9±10%),liver(56.6±6% vs 75.2±16%),kidney (45.1±6% vs 79.3±5%),stomach (65.2±8% vs 78.1±19%),colon(69.8±6% vs 102.5±19%), and skeletal muscle (59.2±6% vs 77.9±13%).Heparin treatment lowered IL-6(359.0±66 U/mL vs 288.5±58 U/mL) and hematocrit level(53±4% vs 46±3%). CONCLUSION:Heparin administration has a positive influence on organ microcirculatory disturbances accompanying experimental Cn-induced acute pancreatitis.
基金Supported by Research grant from Jeil Pharma.Co.,Seoul,South Korea
文摘AIM: To investigate whether tissue samples processed by the rapid urease test (RUT) kit are suitable for dual-priming oligonucleotide-based multiplex polymerase chain reaction (DPO-PCR) to detect Helicobacter pylori (H. pylori).
基金Supported by Ralph M. Parsons Foundation and Shanghai Educational Commission Grant, No. 04BC32, and Sino American Cancer Foundation
文摘AIM: To describe the significant over-expression of fibroblast growth factor receptor 3 (FGFR3), which is a signal transduction and cell proliferation related gene in hepatocellular carcinoma (HCC).METHODS: Following DNA microarray, Northern blot and quantitative real-time PCR were employed to confirm FGFR3 expression difference in HCC tissues and surrounding non-neoplastic liver tissue. FGFR3 expression levels were further determined by immunohistochemical study in 43 cases of HCC.RESULTS: Northern blot results showed the significant over-expression of FGFR3 in HCC tissues, which was consistent with that from DNA microarray. Quantitative real-time PCR demonstrated that the mean ratio of FGFR3 mRNA to glyceraldehyde-3-phosphate dehydrogenase (GADPH) mRNA in HCC tissue was 0.250, whereas the ratio in non-neoplastic liver tissue was 0.014. Statistical analyses of 43 cases of HCC revealed that HCC scored higher than the matched non-neoplastic liver tissues.Examination of clinicopathological features revealed a strong correlation of over-expression of FGFR3 with poor tumor differentiation and high nuclear grade.CONCLUSION: Over-expression of FGFR3 may play an important role in liver carcinogenesis. FGFR3 may be an ideal candidate as a molecular marker in the diagnosis of HCC and a potential therapeutic target.
文摘Ischemic injury to the bowel is a well known disease entity that has a wide spectrum of pathological and clinical findings. A sudden drop in the colonic blood supply is essential to its development. We encountered a 41-year-old male patient, who presented with abdominal pain and bloody diarrhea. A colonoscopy showed markedly edematous mucosa with tortuous dilatation of the veins and a deep ulceration at the rectosigmoid junction. On an abdominal computed tomography (CT) scan and CT angiography, the mesenteric and splenic veins were absent with numerous venous collaterals for drainage. The patient gradually responded to oral aminosalicylate therapy, and was in remission after nine months. In most cases, non-occlusive ischemic injury is caused by idiopathic form and occlusive ischemia is caused by abnormalities of arteries and acute venous thrombosis. However, chronic venous insufficiency due to obstruction of macrovascular mesenteric vein rarely causes ischemia of the bowel. This report describes the first case of ischemic colitis caused by obstruction of the mesenteric and splenic veins.
文摘We investigated the effects of mouse recombinant IL-4 on hematopoiesis in vitro and in vivo. IL-4 alone was found to be incapable of stimulating colony formation, but it inhibited both IL-3-and GM-CSF-induced colony formation by murine hematopoietic progenitor cells. In contrast, colony formation induced by G-CSF was enhanced in the presence of IL-4. We also studied the influence of IL-4 on hematopoietic reconstiution after allogeneic bone marrow transplantation in a murine medel, and found that IL-4 had significant inhibitory effects on neutrophil recovery and that neutrophil recovery accelerated by IL-3 and G-CSF was significantly suppressed by IL-4. The combination of IL-4 and GM-SF caused a significant decrease in the absolute number of neutrophils.
文摘Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectral pattern, manifesting a sharp and high frequency peak occurring late in systole, often bearing a striking resemblance to the subaortic Doppler flow pattern. Methods: Murmurs found in thirty one subjects with dynamic subaortic stenosis were analyzed after having been recorded with a novel portable device capable of spectral and waveform sound displays. Results: All subjects manifested characteristic frequency patterns, consisting of high and sharp peaks occurring in late systole. With significant subaortic stenosis (resting subaortic flow velocity > 2 m/sec) this pattern was evident at rest. In the presence of little or no resting subaortic obstruction (< 2 m/sec) this pattern was produced regularly by the Valsalva maneuver. Conclusions: Dynamic subaortic stenosis produces a specific sound spectral pattern that may provide a basis for clinical evaluation, especially in early detection of this disorder and in screening situations.
文摘AIM: To examine the refractive prediction error in high myopic eyes after phacovitrectomy.METHODS: This retrospective comparative case series included 91 eyes(18 high myopic eyes and 73 non-high myopic eyes) of 91 patients who underwent successful phacovitrectomy(phacoemulsification, intraocular lens implantation, and pars plana vitrectomy). The high myopic eyes were defined as the eye with more than 26.0mm of axial length. The postoperative prediction error of mean error and mean absolute error were evaluated at4 mo postoperatively. Axial length and keratometry measurement were performed preoperatively and 4mo postoperatively using the IOL Master.RESULTS: The refractive outcome after phacovitrectomy showed significantly greater myopic shift in the high myopic eyes [-1.08 ±0.87 diopters(D)] than that in the non-high myopic eyes(-0.43 ±0.63 D, P =0.004). Axial length and keratometric value in the high myopic eyes were significantly increased(P =0.043, 0.037 respectively),whereas those in the non-high myopic group were not significantly increased(P =0.135, 0.347 respectively). The change of the axial length in the myopic eye(0.46±0.28 mm)was greater than that in the non- high myopic eye(0.11 ± 0.34 mm; P 【0.001).CONCLUSION: High myopic eyes showed more myopic shift than non-high myopic eyes after phacovitrectomy.The cause of myopic shift in high myopic eyes seems tobe attributed to actual elongation of the axial length in high myopia.
文摘AIM: To determine whether thalidomide prevents microvascular injury in acute radiation proctitis in white rats. METHODS: Fourteen female Wistar rats were used: six in the radiation group, six in the thalidomide group, and two in normal controls. The radiation and thalidomide groups were irradiated at the pelvic area using a single 30 Gy exposure. The thalidomide (150 mg/kg) was injected into the peritoneum for 7 d from the day of irradiation. All animals were sacrificed and the rectums were removed on day 8 after irradiation. The microvessels of resected specimens were immunohistochemically stained with thrombomodulin (TM), von Willebrand Factor (vWF), and vascular endothelial growth factor (VEGF). RESULTS: The microscopic scores did not differ significantly between the radiation and thalidomide groups, but both were higher than in the control group. Expression of TM was significantly lower inthe endothelial cells (EC) of the radiation group than in the control and thalidomide groups (P < 0.001). The number of capillaries expressing vWF in the EC was higher in the radiation group (15.3 ± 6.8) than in the control group (3.7 ± 1.7), and the number of capillaries expressing vWF was attenuated by thalidomide (10.8 ± 3.5, P < 0.001). The intensity of VEGF expression in capillaries was greater in the radiation group than in the control group and was also attenuated by thalidomide (P = 0.003). CONCLUSION: The mechanisms of acute radiation- induced proctitis in the rats are related to endothelial cell injury of microvessel, which may be attenuated with thalidomide.
文摘【正】Dear Sir,Iam Yong-Sun Ahn,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.Cataracts are a common problem in eyes with a glaucoma drainage device(GDD),because tube shunt surgery increases the incidence and progression of cataracts[1].An Ahmed valve,the most commonly inserted GDD,is composed of a silicone tube connected to a flat plate sewn to the sclera,and aqueous humor flows from the
文摘Objective. This is a phase II group- wide study of liposomal doxorubicin chemotherapy in patients with advanced or recurrent uterine leiomyosarcomas. The aim was to evaluate clinical response and toxicity. Methods. Patients with histologically confirmed persistent or recurrent leiomyosarcomas of the uterus with documented disease progression after appropriate local therapy were invited to participate in this study. Bidimensionally measurable disease, GOG performance status of 0, 1, or 2 (Karnofsky 80- 100) was required; all patients must have failed local therapeutic measures and be considered incurable. Other eligibility criteria included adequate hepatic, renal, and hematologic function. Patients were ineligible if they had received previous chemotherapy or had other noncutaneous malignancies. Patients received liposomal doxorubicin 50 mg/m2 IV over 1 h. Courses were repeated every 4 weeks until disease progression or adverse side effects supervened. Results. Thirty- five patients were entered into this study between May 2000 and June 2001. Three patients were determined ineligible because of wrong pathological cell type or inadequate pathology information and one was inevaluable for lack of data. Median age was 52 years (range 36- 78 years). GOG performance status was 2 in 1 instance, 1 in 15 cases, and 0 in 15 others. Eleven patients (35.5% ) had received radiotherapy. A median of 2.0 courses was given (range 1- 8). Five patients (16.1% )- experienced grade 3 or 4 neutropenia, and seven (22.6% ) had grade 3 or 4 anemia. Two patients developed grade 3 and one patient developed grade 4 cardiovascular adverse events, not necessarily drug related. There were seven cases of grade 3 or 4 gastrointestinal toxicity and two patients developed grade 3 dermatologic toxicity. One complete (3.2% ) and four partial (12.9% ) responses were reported. Ten patients (32.3% ) had stable disease, 15 (48.4% ) had increasing disease, and response could not be assessed in 1 (3.2% ). Conclusion. The dose and schedule of liposomal doxorubicin employed in this trial showed no advantage over historical results with doxorubicin in the treatment of uterine leiomyosarcoma.
文摘Dear Sir,Iam Jin A Choi,from the Department of Ophthalmology of St.Vincent Hospital of Suwon,Kyungki-do,South Korea.I write to present a case report of a young female treated with the diagnosis of Posner-Schlossman syndrome for several years,in which she was ultimately proved to have iridocorneal endothelial(ICE)syndrome.Posner-Schlossman syndrome(PS syndrome)is characterized by recurrent attacks of mild anterior uveitis with marked elevation of intraocular pressure(IOP)[1].The exact etiology of this syndrome is not fully established yet.However,the possible role of herpes simplex virus(HSV)is suggested by a study that revealed DNA evidence of the virus in all aqueous specimens of patients during acute attacks in PS syndrome[1,2].ICE is a spectrum of disease that
文摘Purpose: Stereotactic body radiation therapy (SBRT) has emerged as a standard treatment modality for medically inoperable early-stage lung cancer patients. The aim of this paper is to calculate radiobiological parameters for a sample of 39 patients who underwent lung SBRT. Materials and Methods: For SBRT, a typical regimen of 50 Gy in 4 - 5 fractions results in local tumor control rates around 99.9%. We calculate dose volume histograms (DVHs) of targeted tumors and organs at risk for 39 patients. All patients received 4D imaging, and their internal treatment volumes (ITVs) were created by phase-based sorting of multiple CT datasets. Planning target volume (PTV) diameters ranged from 2.0 to 5.7 cm. The DVHs for the PTV and organs at risk were analyzed using a Biosuite algorithm to calculate the equivalent uniform dose (EUD), tumor control probability (TCP) via a Poisson model, and normal tissue complication probability (NTCP) via an LKB model. The radiobiological effects were analyzed by correlating EUD and TCP with PTV volumes. Results: The mean PTV volume was 31.60 ± 25.55 cc. The mean EUDs were 5.19 ± 2.84, 5.66 ± 4.95, 61.45 ± 29.18, 3.31 ± 5.92, 6.45 ± 5.18, and 12.22 ± 5.94 Gy for lungs, spinal cord, chest/ribs, heart, esophagus, and skin, respectively. On average, the heart had the lowest EUD and the chest/ribs had the highest (61.45 ± 29.18 Gy). The mean NTCPs were estimated at 3.75% ± 2.61%, 36.25% ± 36.42%, and 0.59% ± 1.48%, for the lungs, chest and esophagus, respectively. The NTCPs of spinal cord, heart, and skin were 0.00%. The mean TCP value was 99.72% ± 0.44%. The mean BED value for our study was 109.49 Gy. Conclusions: We have calculated radiobiological predictors based on DVHs for early-stage non-small cell lung cancer via SBRT. Our calculated predictors are compatible with previously published SBRT reports.
文摘Objective. To determine whether neoadjuvant cisplatin and 5- fluorouracil chemotherapy can be used to preserve the anal sphincter and/or urethra in patients with advanced vulvar cancer involving these sites. Methods. Fourteen patients with advanced vulvar cancer (1997- 2003) involving the anal sphincter and/or urethra were given 3- 4 cycles of neoadjuvant chemotherapy to attempt preservation of these pelvic structures rather than undergoing a primary pelvic exenteration. Following 3 cycles, a radical vulvectomy and groin lymph node dissection were planned. All patients had lesion size documented by measurement and photograph prior to and following chemotherapy. Results. The median age was 63 years (range 39- 88). Thirteen patients received a median of 3 cycles (range 2- 4) of neoadjuvant chemotherapy. Ten patients received cisplatin and 5- fluorouracil, while three received cisplatin alone. The median time from diagnosis to surgery was 77 days (range 54- 143). All patients with cisplatin and 5- fluorouracil chemotherapy underwent surgery except one patient who had a synchronous renal cell carcinoma and died prior to surgery. Patients receiving cisplatin alone showed no measurable response, while all patients receiving cisplatin and 5- fluorouracil demonstrated at least a partial response. Two patients had no residual invasive carcinoma on final pathology. All patients receiving cisplatin and 5- fluorouracil followed by surgery are disease- free, while two of three receiving cisplatin have progressive disease. The anal sphincter and urethra were conserved in all patients receiving cisplatin and 5- fluorouracil. Conclusion. Neoadjuvant cisplatin and 5- fluorouracil in advanced vulvar cancer demonstrated a response rate of 100% . The anal sphincter and urethra were conserved in all patients receiving cisplatin and 5- fluorouracil. Responders are disease- free at this time. This response rate demonstrates superior activity of 5- fluorouracil in vulvar cancer and spares these patients the morbidity of exenteration or radiation.
文摘Aim:Eyelid contour is a key component to satisfactory lid position and appearance following ptosis repair,the components of which have been highly debated and remain difficult to objectively measure.We sought to minimize the number of intraoperative adjustments required and reduce reoperation rates by addressing only the central 6 mm of tarsus when reapproximating levator to the anterior surface of tarsus,thereby eliminating contour as an adjustable variable.Methods:All patients who underwent external levator resection with blepharoplasty for correction of involutional ptosis between 2012 and 2019 by a single surgeon at one center were retrospectively reviewed.Patients who underwent concomitant brow lifting surgery were excluded.The same technique was used for each eyelid with uniform suture placement.One 6-0 silk horizontal mattress suture was placed partial thickness through the superior third of tarsus 3 mm lateral to the center of tarsus;another was passed 3 mm medial to the center of tarsus.No sutures were placed outside of this central 6-mm zone.Patient fixation was used to determine lid height and symmetry.Once satisfactory,the sutures were tied down in a permanent fashion and the eyelid position again verified.In total,153 eyelids in 85 patients were evaluated.Data obtained included preoperative and postoperative margin-to-reflex distance(MRD1),intraoperative and postoperative complications,reoperation rates,and patient satisfaction with appearance of lid contour and symmetry.Results:The mean follow up time was 3.41 months.The mean preoperative MRD1 was 1.05 mm.The mean post-operative was 3.18 mm.All patients had recovery of an anatomically normal temporal peak height.Two of 153 ;eyelids(1.31%)required reoperation due to residual ptosis or overcorrection.No patients had postoperative lagophthalmos.Ninety-one percent of patients who underwent bilateral surgery had satisfactory symmetry defined as less than or equal to 1-mm difference between right and left MRD1.Eighty-two of the 85 patients were satisfied with their postoperative appearance.Conclusion:This simple and standardized technique for suture placement gives reliable and effective results for external elevator advancement for ptosis repair by eliminating contour as an adjustable variable.Addressing the central 6 mm of tarsus is not only paramount but also in and of itself satisfactory in achieving optimal contour during external levator resection,without regard to more medial or lateral lid anatomy.
