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Liu QM, Tian Y, Yu JJ, He QQ, Peng L, Guo XQ, Li DY, Chen T, Wang F. [Hearing assessment and follow-up study of aeonatal deafness gene screening homozygous mutation infants]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 33:1089-1092. [PMID: 31914302 DOI: 10.13201/j.issn.1001-1781.2019.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Indexed: 11/12/2022]
Abstract
Objective:To analyze the hearing assessment characteristics and follow-up of some deafness gene screening homozygous infants in Zhuhai. Method:The clinical data of 28 newborns with homozygous mutations transferred to Zhuhai Maternal and Child Health Hospital from Feb. 1, 2015 to Oct. 25, 2018 in hospitals of Zhuhai City were retrospectively analyzed. All the children were screened for hearing. The hearing characteristics and long-term follow-up results of homozygous mutations at different gene sites were analyzed by auditory diagnosis and behavioral follow-up from 1 to 3 years. Result:Fourteen cases of GJB2 c.109G>A with a homozygous mutation, 11 cases passed the hearing screening, the audiological diagnosis was normal, and the behavior test and follow-up were normal from 1 to 3 years. Hearing screening was not passed in 3 newborns, mild to moderate abnormalities of single or bilateral ears were diagnosed by audiology, 1 000 Hz without positive, and middle ear lesions were diagnosed. Eight cases of GJB2 c.235del C homozygous mutation were followed up by behavioral audiometry and follow-up from 1 to 3 years after cure. Among them, 5 cases were diagnosed as severe hearing impairment of bilateral ears and 3 cases as mild and moderate hearing impairment. One case of GJB3 547G>A homozygous mutation was followed up for 1-3 years, and all of them failed to pass the follow-up of behavioral audiometry and follow-up. Four cases of SLC26A4 IVS7-2A>G, 1 case of SLC26A4 1229C>T homozygous mutation, all of them failed to pass the neonatal hearing screening. All the patients were diagnosed as severe hearing impairment of binaural hearing, and the follow-up of 1-3 years' follow-up did not pass the follow-up tests. Conclusion:GJB2 C.235del C, SLC26A4 IVS7-2A>G locus homozygous mutation infant hearing impairment was mainly severe hearing impairment in bilateral ears, and there was no change in 1-3 years follow-up. GJB2 C.109G A homozygous mutant infants had normal hearing, and it was suggested that they should be followed up closely. It is very important to give correct and reasonable genetic counseling to parents with GJB2 C.109G A homozygous mutation without unnecessary panic.
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Liu QM, Tian Y, Yu JJ, He QQ, Peng L, Guo XQ, Li DY, Chen T. [A follow-up study of abnormal mutation in neonatal deafness gene screening]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2019; 54:881-887. [PMID: 31887812 DOI: 10.3760/cma.j.issn.1673-0860.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To screen, diagnose and follow up the abnormal mutation in the gene screening of neonatal deafness. Methods: A total of 24161 newborns born in Zhuhai Maternal and Child Health Hospital from February 1, 2015 to January 31, 2008 were screened for hearing and deafness genes, and audiological screening, diagnosis and 1-3 years follow-up were carried out for the newborns with positive gene screening. Results: There were 991 cases of deafness gene mutation (533 males and 458 females), and the rate of abnormal mutation was 4.10%(991/24 161). Among them, 921 cases were single heterozygous mutation, 130 cases were failed in primary hearing screening, 11 cases were failed in secondary hearing screening, 8 cases were abnormal in audiological diagnosis finally. In these 8 cases, 3 were diagnosed as otitis media and passed audiological follow-up after cure, 2 cases of single ear sensorineural injury caused by high-risk factors, passed after close audiological follow-up, and the other 3 cases were closely audiological follow-up while none of them were successfully sequenced. All of them were moderate to severe sensorineural deafness, 1 case was heterozygous mutation at 3 loci of GJB2(c.235delC,c.408C>A,c.134G>A), 1 case was heterozygous mutation at 2 loci of GJB2(c.235delC, c.109G>A), and 1 case was single heterozygous mutation of GJB2(c.235delC). The remaining 913 cases who passed the primary screening, secondary screening or hearing diagnosis were followed up for 1 to 3 years. Three cases of multiple heterozygous mutation were found in gene screening(2 cases were SLC26A4 2168A>G, IVS7-2A>G, 1 case was GJB2 c.176_191del 16bp, c.299_300del AT), all of them passed both primary and secondary hearing screening. In these 3 cases, the final audiological diagnosis was moderate sensorineural deafness in both ears, with no improvement in the follow-up of 1-3 years. There were 9 monogenic homozygous mutations, 7 failed in primary hearing screening, 3 failed in secondary hearing screening and also failed in audiological diagnosis and 1-3 years' audiological follow-up, all of whom were GJB2 c.235 del C homozygous mutations, and one of whom had a definite family history of deafness. The remaining 6 cases of homozygous mutation diagnosed by primary screening, secondary screening or hearing diagnosis were GJB2 c109G>A homozygous mutation, and passed the 1-3 years' hearing follow-up. 58 children with mtDNA mutations, including 2 with 12S rRNA 1494C>T homozygous mutation, 47 with 1555A>G homozygous mutation, and 9 with 1555A>G heterozygous mutation, all passed the primary or secondary hearing screening, and were instructed to ban ototoxic drugs for the whole life, and passed the 1-3 years' hearing follow-up. Conclusions: The audiological follow-up of children with monogenic heterozygous mutations in deafness gene screening is generally normal. In case of abnormality, the influencing factors such as otitis media should be excluded at first. In case of unexplained moderate to severe sensorineural deafness, the whole-gene sequencing should be performed to find possible pathogenic factors. The children with homozygous mutation or compound heterozygous mutation in gene screening, most of whom show different degrees of hearing loss, should be followed up for a long time, and provide parents with scientific and reasonable genetic counseling according to the mutation genes and loci,. The hearing of drug-induced deafness gene carriers is normal after birth. Parents should be advised to strengthen prevention and follow-up is generally enough.
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Gao SC, Tian H, Yu JJ, Chen X, Zuo L, Cai X, Shi L, Song B, Zhou X. [Evaluation of CT angiography vascular localization combined with refined three-dimensional printing in guiding the resection and reconstruction of complex oral cancer]. ZHONGHUA ZHONG LIU ZA ZHI [CHINESE JOURNAL OF ONCOLOGY] 2019; 41:496-500. [PMID: 31357835 DOI: 10.3760/cma.j.issn.0253-3766.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the effect of vascular localization using computerized tomography angiography (CTA) combined with refined three dimensional (3D) printing in guiding the resection and reconstruction of complex oral cancer. Methods: From December 2013 to July 2017, the clinical data of 30 patients with complex oral cancer enrolled in the Hunan Cancer Hospital were retrospectively analyzed. 15 patients received CTA+ 3D assisted surgery, while the other 15 patients underwent traditional surgery. In CTA+ 3D assisted surgery group, CT and Magnetic Resonance Imaging (MRI) data were combined with CTA to print refined solid 3D model and surgical guide plate. The preoperative and intraoperative virtual surgical system and the operative experience were combined for preoperative evaluation and surgery. In traditional surgery group, preoperative evaluation and surgery were performed according to imaging data and surgeons' clinical experience. Operative time, intraoperative blood loss, hospital stay and local recurrence rate were compared between the two groups. Results: In CTA+ 3D assisted surgery group, one patient gave up surgical treatment after intuitively watching the lesion through the 3D model, and the remaining 14 patients underwent surgery as planned. All the 15 patients in traditional surgery group received surgery. But the preoperative plans of three patients were temporarily and passively modified due to insufficient preoperative evaluation. The average intraoperative blood loss was(320.1±27.2)ml in CTA+ 3D assisted surgery group and(430.2±30.3)ml in traditional surgery group. Mean operation time was(440.3±19.2)min and(552.2±23.3)min, respectively. Mean hospitalization time was (20.4±3.2)d and (25.1±3.7)d, respectively. The differences were all statistically significant (all P<0.05). 1 year and 3 years local recurrence rates were 9.1% and 28.6% in CTA+ 3D assisted surgery group, as well as 14.3% and 50.4% in traditional surgery group with statistical significance (P<0.05). Conclusion: For complex oral cancer patients with difficulty in opening the mouth or postoperative recurrence, CTA vascular localization combined with fine 3D printing technology has significant advantages in the surgical process, surgical effect and postoperative evaluation index compared with traditional method using imaging data and clinical experience.
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Zhu CX, Li WZ, Guo YL, Chen L, Li GH, Yu JJ, Shu B, Peng S. Tumor suppressor RKIP inhibits prostate cancer cell metastasis and sensitizes prostate cancer cells to docetaxel treatment. Neoplasma 2019. [PMID: 29534584 DOI: 10.4149/neo_2018_170203n72] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Raf kinase inhibitory protein (RKIP) is a well-established metastasis suppressor that is frequently down-regulated in aggressive cancers. However, the impact of RKIP on cancer cell invasion and metastasis in prostate cancer is still elusive. To this end, we overexpressed RKIP in two prostate cancer cell lines. We found that overexpression of RKIP inhibited prostate cancer cells proliferation, migration and invasion. Mechanistically, we found that RKIP overexpression led to down-regula- tion of the NF-kB signaling pathway and inhibition of the epithelial-to-mesenchymal transition, which is important step for cancer metastasis. In addition, overexpression of RKIP can promote drug effects of docetaxel on prostate cancer cell lines. In conclusion, overexpression of RKIP significantly inhibits prostate cancer cell migration and metastasis, and overexpression of RKIP could aid prostate cancer treatment and therapy.
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Kwon YC, Kim JJ, Yun SW, Yu JJ, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Hong YM, Jang GY, Lee JK. BCL2L11 Is Associated With Kawasaki Disease in Intravenous Immunoglobulin Responder Patients. CIRCULATION-GENOMIC AND PRECISION MEDICINE 2019; 11:e002020. [PMID: 29453247 DOI: 10.1161/circgen.117.002020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Park YS, Baek JS, Yu JJ, Kim YH, Ko JK, Lee JH. B-Type Natriuretic Peptide Levels and Cardiac Dysfunction in Children on Peritoneal Dialysis. Perit Dial Int 2019; 39:210-219. [DOI: 10.3747/pdi.2018.00150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/04/2018] [Indexed: 01/19/2023] Open
Abstract
Background Abnormalities in left ventricular (LV) structure and function are prevalent in patients on peritoneal dialysis (PD). The risk of cardiovascular mortality is also 10 – 20 times higher in PD patients than in age- and gender-matched healthy control subjects. Methods Echocardiography was performed annually or every 6 months for children on PD; the frequency was increased if the patient had hypertension or any heart problem. We retrospectively reviewed echocardiographic findings of these children (since February 2005) by chart review. The linear regression analysis of log(B-type natriuretic peptide, BNP) was performed to evaluate the association between serum BNP and cardiac parameters on echocardiography. Results We enrolled 52 patients and evaluated 169 echocardiographic findings in association with serum BNP levels. Systolic blood pressure (adjusted R2 = 0.321), diastolic blood pressure (adjusted R2 = 0.292), LV posterior wall thickness at diastole (0.058), LV posterior wall thickness at systole (0.038), LV internal diameter at diastole (0.177), LV internal diameter at systole (0.132), LV mass index (0.122), thickness of interventricular septum at diastole (0.035), the left atrial (LA) diameter (0.201), LA/aorta diameter ratio (0.113), lateral E/E’ (0.229), and lateral A'/E’ (0.149) showed positive correlation with log(BNP); conversely, LV fractional shortening (FS) (0.065), LV ejection fraction (0.082), right ventricular internal diameter at diastole (0.184), right ventricular fractional shortening (0.754), lateral S’ (0.179), and lateral E’ (0.161) showed negative correlation with log(BNP). Conclusions Routine measurement of serum BNP is recommended in children on PD to evaluate the risk of morphological and functional cardiac problems.
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Kwon YC, Kim JJ, Yu JJ, Yun SW, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Hong YM, Jang GY, Lee JK. Identification of the TIFAB Gene as a Susceptibility Locus for Coronary Artery Aneurysm in Patients with Kawasaki Disease. Pediatr Cardiol 2019; 40:483-488. [PMID: 30267110 DOI: 10.1007/s00246-018-1992-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/25/2018] [Indexed: 12/17/2022]
Abstract
Kawasaki disease (KD) is a self-limiting systemic vasculitis of unknown etiology. KD is often complicated by coronary artery aneurysms (CAAs), which develop in about 20-25% of untreated children and 3-5% of children treated with intravenous immunoglobulin therapy. To identify the risk loci for CAA susceptibility in patients with KD, we performed a genome-wide association study (GWAS) using our previous Illumina HumanOmni1-Quad BeadChip data (296 KD patients) and a new replication study in an independent sample set (713 KD patients) by grouping KD patients without CAA (control) versus KD patients with extremely large aneurysms (diameter ≥ 5 mm) (case). Among 44 candidate single -nucleotide polymorphisms (SNPs) selected from the initial GWAS data (33 cases vs. 215 controls), a SNP (rs899162) located 7 kb upstream of the TIFAB gene on chromosome five was replicated in an independent sample (12 cases vs. 532 controls). In the combined analysis (45 cases vs. 747 controls), the SNP (rs899162) showed a highly significant association with CAA formation (diameter ≥ 5 mm) in patients with KD (odds ratio = 3.20, 95% confidence interval = 2.02-5.05, Pcombined = 1.95 × 10-7). These results indicate that the TIFAB gene may act as a CAA susceptibility locus in patients with KD.
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Tian Y, Wang F, Yu JJ, He QQ, Guo XQ, Li DY, Peng L, Chen T, Liu QM. [Congenital ear deformity screening and non-invasive correction effect analysis]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2019; 33:259-261. [PMID: 30813698 DOI: 10.13201/j.issn.1001-1781.2019.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Indexed: 06/09/2023]
Abstract
Objective:To synchronously perform external auricle examination during neonatal hearing screening, follow up auricle deformity with neonatal disease screening system, and calculate the incidence of auricle deformity, self-healing rate, correction rate, incidence of complications and the relationship with hearing loss in Zhuhai area. Method:According to the diagnostic criteria of auricle deformity, the newborns in Zhuhai Maternal and Child Health Hospital were examined on the spot within 2 months. The deformity auricle was registered and uploaded into the newborn hearing screening system. The newborns were followed up by short message notification 7 days after birth, and then compared with the photo uploading system again. At 14 days, the ears of those who could not self-heal were went on non-invasive correction, and collect of relevant data for summary analysis. Result:Among the 1 073 newborns(2 146 ears), 26(37 ears) with malformed ears were treated with auricular pattern correction.The corrective rates of newborns less than 14 days, 14-30 days and 31-60 days were 95%, 90% and 87% respectively, and the incidence of complications were 50%, 58% and 69%, respectively. Conclusion:The incidence of auricular deformities in neonates is high. The earlier correction the better. The ear deformity can be detected at the earliest stage and missed diagnosis can be avoided by simultaneous hearing screening and ear deformity screening. During the window period of 7-14 d, by monitoring the self-healing rate of the affected ear excessive medical correction can be avoided. By hearing screening system statistics, ear shape malformation is not directly related to hearing loss.
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Baek JS, Yu JJ, Kim MJ, You J, Jun HO, Kim YH, Ko JK. Coronary artery status of patients with transient fever 24-36 h after first IVIG infusion did not differ from that seen in responsive patients. Pediatr Rheumatol Online J 2018; 16:83. [PMID: 30594188 PMCID: PMC6311065 DOI: 10.1186/s12969-018-0301-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/12/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Current management guidelines for patients with Kawasaki disease (KD) differ in their recommendations for fever observation times when determining resistance to initial intravenous immunoglobulin (IVIG). This retrospective study assessed coronary artery status in patients with transient fever 24-36 h after the completion of a first IVIG infusion. METHODS Children with KD treated with IVIG between January 2006 and February 2017 were included. Subjects were divided into three groups according to response following the completion of initial IVIG treatment (Group 1, no fever after 24 h; Group 2, transient fever at 24-36 h; Group 3, others). RESULTS A total of 879 children were evaluated (Group 1, n = 663; Group 2, n = 54; Group 3, n = 162). During the subacute phase, the left main coronary artery (LMCA) diameter z score in both groups was significantly lower than that in Group 3 (Group 1: 1.02, Group 2: 0.87, Group 3: 1.24; Group 1 vs 2, P = 0.298; Group 1 vs 3, P = 0.025; Group 2 vs 3, P = 0.042); similar results were seen with the left anterior descending coronary artery (LAD) diameter z score (Group 1: 0.64, Group 2: 0.38, Group 3: 0.98; Group 1 vs 2, P = 0.083; Group 1 vs 3, P = 0.001; Group 2 vs 3, P = 0.004). The coronary artery (CA) status also did not differ between Groups 1 and 2 during the convalescent phase (z score of LMCA was 0.70 in Group 1 and 0.74 in Group 2, P = 0.790; z score of LAD was 0.42 and 0.46 respectively, P = 0.796; z score of right CA was 0.07 and 0.00 respectively, P = 0.630). A multivariate logistic regression analysis identified total bilirubin level (OR, 2.472; 95% CI, 1.284-4.762; P = 0.007) as the only significant predictor of persisting fever over 36 h in patients with fever 24 h after the completion of initial IVIG. CONCLUSIONS The CA status of patients with transient fever 24-36 h after the first IVIG infusion did not differ from that seen in responsive patients.
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Sim BK, Park H, Kim JJ, Yun SW, Yu JJ, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Hong YM, Jang GY, Lee JK. Assessment of the Clinical Heterogeneity of Kawasaki Disease Using Genetic Variants of BLK and FCGR2A. Korean Circ J 2018; 49:99-108. [PMID: 30468029 PMCID: PMC6331319 DOI: 10.4070/kcj.2018.0224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/16/2018] [Accepted: 09/11/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Patients with Kawasaki disease (KD) are clinically heterogeneous because its diagnosis is based solely on clinical observation and there are no definitive biomarkers. We dissected the clinical heterogeneity of KD patients using the KD-associated genetic variants. METHODS We performed a genetic association analysis in several KD subgroups categorized by clinical characteristics using the KD-associated variants of the B lymphoid tyrosine kinase (BLK; rs6993775) and Fc gamma receptor II a (FCGR2A; rs1801274) in a large number of case (n=1,011) and control (n=4,533) samples. RESULTS BLK and FCGR2A were very significantly associated with KD in Korean KD patients (odds ratio [OR],1.48; p=4.63×10⁻¹¹ for BLK, and OR, 1.26; p=1.42×10⁻⁴ for FCGR2A). However, in KD subgroup analysis, we found that neither BLK nor FCGR2A were associated with either incomplete Kawasaki disease (iKD) type patients or those older than 5 years of age (p>0.2), suggesting that patients with iKD or those older than 5 years of age are a unique subgroup of KD. In genetic association analysis after excluding iKD patients and those older than 5 years old, we found that BLK was associated with all KD subgroups, whereas FCGR2A was specifically associated with male KD patients younger than 1 year of age (OR, 2.22; p=2.35×10⁻⁵). CONCLUSIONS KD is a clinically and genetically heterogeneous disease. These findings will provide new insights into the clinical and genetic heterogeneity of KD.
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Yu JJ, Shen F, Chen TH, Liang L, Han J, Xing H, Zhou YH, Wang H, Gu WM, Lau WY, Yang T. Multicentre study of the prognostic impact of preoperative bodyweight on long-term prognosis of hepatocellular carcinoma. Br J Surg 2018; 106:276-285. [PMID: 30199100 DOI: 10.1002/bjs.10981] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/09/2018] [Accepted: 07/20/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Whether preoperative bodyweight is associated with long-term prognosis in patients after liver resection for hepatocellular carcinoma (HCC) is controversial. This study aimed to investigate the relationship of patient weight with long-term recurrence and overall survival (OS) after curative liver resection for HCC. METHODS Data for patients with HCC who underwent curative liver resection between 2000 and 2015 in five centres in China were analysed retrospectively in three groups according to their preoperative BMI: underweight (BMI 18·4 kg/m2 or less), normal weight (BMI 18·5-24·9 kg/m2 ) and overweight (BMI 25·0 kg/m2 or above). Patients' baseline characteristics, operative variables and long-term survival outcomes were compared. Univariable and multivariable Cox regression analyses were performed to identify risk factors for OS and recurrence-free survival (RFS) after resection. RESULTS Of 1524 patients, 107 (7·0 per cent) were underweight, 891 (58·5 per cent) were of normal weight and 526 (34·5 per cent) were overweight. Univariable analyses showed that underweight and overweight patients had poorer OS (both P < 0·001) and RFS (both P < 0·001) than patients of normal weight. Multivariable Cox regression analysis also identified both underweight and overweight to be independent risk factors for OS (hazard ratio (HR) 1·22, 95 per cent c.i. 1·19 to 1·56, P = 0·019; and HR 1·57, 1·36 to 1·81, P < 0·001, respectively) and RFS (HR 1·28, 1·16 to 1·53, P = 0·028; and HR 1·34, 1·17 to 1·54, P < 0·001). CONCLUSION Underweight and overweight patients appear to have a worse prognosis than those of normal weight following liver resection for HCC.
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Pan ZZ, Song YN, Zhang Q, Yu JJ, Zhang KN, Liang N, Zhang N, Ma X, Zhu JL, Zhe XY, Xia HDT, Zheng WN, Li HT, Cao DD, Pan ZM. [Screening different HPV genotypes infection and type-specific in cervical exfoliated cells of women in Yili area of Xinjiang Uygur Autonomous Region, China]. ZHONGHUA YU FANG YI XUE ZA ZHI [CHINESE JOURNAL OF PREVENTIVE MEDICINE] 2018; 52:946-950. [PMID: 30196644 DOI: 10.3760/cma.j.issn.0253-9624.2018.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the infection status and genotype distribution of cervical human papillomavirus (HPV) in women of different ethnic groups and different ages in Yili, Xinjiang Uygur Autonomous Region (Xinjiang). Methods: By using the convenient sampling method, 54 760 women from November 2015 to May 2017 seeking for service in gynecological clinics in a general hospital in Yili, Xinjiang, were selected as the research subjects, and 3 445 samples of cervical mucous exfoliative cells were collected, and the social information of their ethnic and age was collected at the same time. The inclusion criteria were those with sexual life, cervical integrity, and ethnic groups for Han or Uygur or Kazak. PCR-reverse dot blot hybridization was used to detect HPV genotyping in exfoliated cells, and chi-square test was used to compare the difference of HPV positive rate among different ethnic groups. Then, according to ethnicity and age, the differences in positive rates of different ages and ethnic groups were compared in each layer. Results: The positive rate of HPV was 25.6% (882 cases), of which the Han, Uygur and Kazakh were 27.9% (564 cases), 22.9% (196 cases) and 21.6% (122 cases), and the difference was statistically significant (χ(2)=13.80, P=0.001). The most prevalent high-risk genotypes of Han women were HPV16/52/58, accounting for 24.8% (140 cases), 17.7% (100 cases) and 9.8% (55 cases), respectively. The most prevalent high-risk genotypes of Uygur women were HPV16/52/53, accounting for 34.2% (67 cases), 12.8% (25 cases), 9.2% (18 cases), respectively. The most prevalent high-risk genotypes of Kazak were HPV16/52/53, accounting for 37.7% (46 cases), 17.2% (21 cases), 12.3% (15 cases), respectively. The highest rate of HPV in Uygur patients aged ≥61 years was 41.5% (22 cases), and the lowest in group 36-40 years old, 15.9% (21 cases), the difference between different age groups was statistically significant (χ(2)=35.01, P<0.001). Conclusion: The positive rate of HPV infection among Han, Uygur and Kazak in Yili Prefecture of Xinjiang was different, and the HPV positive genotype differs among different ethnic groups.
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Zhao M, Wang AX, Zhu X, Yu JJ, Wang W, Zhang DH, He XL, He HY, Teng XD. [Clinicopathologic features of glomus tumor of the kidney]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2018; 47:580-584. [PMID: 30107661 DOI: 10.3760/cma.j.issn.0529-5807.2018.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinicopathologic and differential diagnostic features of glomus tumor of the kidney. Methods: Four cases of glomus tumor of the kidney were collected from the archives of Peking University Third Hospital, the Second Hospital of Tianjin Medical University, Ningbo Yinzhou Second Hospital and Zhejiang Provincial People's Hospital between January 2012 to June 2017; the clinical and radiologic features, histomorphology, immunohistochemistry, ultrastucture and prognosis were analyzed and the relevant literature was reviewed. Results: Patients consisted of 2 men and 2 women with ages ranging from 37 years to 66 years (mean 55 years). Three patients had history of hypertensive disease (grade Ⅱ, 3 to 10 years). The tumors measured in maximum diameter from 3.0 cm to 4.0 cm (mean 3.6 cm) and showed gray-white to yellow and tan on cut surface. Macroscopical examinations showed all tumors were circumscribed but non-encapsulated. Histologically, 1 tumor presented as glomus tumor with extensive myxoid change, 1 as cellular and solid pattern glomus tumor, 1 as glomangioma with focal myopericytoma-like pattern and 1 as symplastic glomus tumor with areas resembling myopericytoma. The tumor cells in two cases showed scant cytoplasm and uniform, bland-appearing nuclei without mitoses. In one case, the tumor cells were epithelioid with abundant eosinophilic cytoplasm and relatively well-defined cell borders. There was an increased mitosis of 4/50 HPF; however, no evidence of atypical mitosis or nuclear atypia was noted. In the symplastic glomus tumor the tumor cells showed frequently nuclear pleomorphism without mitoses. By immunohistochemistry, all tumors showed strong and diffuse reactivities to at least 3 of the 4 muscle-associated markers (SMA, h-Caldesmon, MSA and Calponin), 3 tumors strongly and diffusely expressed collagen Ⅳ, 2 expressed CD34 and 1 focally expressed desmin; whereas markers including epithelial, neuroendocrine, nephrogenic, melanoma-associated, STAT6, S-100 protein, CD117 and β-catenin all were negative in all the 4 tumors. Ultrastuctural analysis was done in 2 cases and showed prominent cytoplasmic actin bundles and pericellular basement membrane, and lacking of rhomboid renin crystals in both tumors. The hypertension persisted after surgical resection for all the 3 patients with this medical history. Follow-up information (range: 6-64 months, mean: 44 months)showed that no evidence of local recurrence or distant metastasis was identified in all 4 patients. Conclusions: Glomus tumor rarely occurs in the kidney and usually has a good prognosis. Careful attention to its morphology with the judicious use of immunohistochemistry and ultrastuctural analysis can be helpful for its diagnosis and differential diagnosis.
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Kim HJ, Yun SW, Yu JJ, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Ebata R, Hamada H, Suzuki H, Kamatani Y, Kubo M, Ito K, Onouchi Y, Hong YM, Jang GY, Lee JK. Identification of LEF1 as a Susceptibility Locus for Kawasaki Disease in Patients Younger than 6 Months of Age. Genomics Inform 2018; 16:36-41. [PMID: 30304924 PMCID: PMC6187808 DOI: 10.5808/gi.2018.16.2.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/11/2018] [Indexed: 01/25/2023] Open
Abstract
Kawasaki disease (KD) is an acute febrile vasculitis predominately affecting infants and children. The dominant incidence age of KD is from 6 months to 5 years of age, and the incidence is unusual in those younger than 6 months and older than 5 years of age. We tried to identify genetic variants specifically associated with KD in patients younger than 6 months or older than 5 years of age. We performed an age-stratified genome-wide association study using the Illumina HumanOmni1-Quad BeadChip data (296 cases vs. 1,000 controls) and a replication study (1,360 cases vs. 3,553 controls) in the Korean population. Among 26 candidate single nucleotide polymorphisms (SNPs) tested in replication study, only a rare nonsynonymous SNP (rs4365796: c.1106C>T, p.Thr369Met) in the lymphoid enhancer binding factor 1 (LEF1) gene was very significantly associated with KD in patients younger than 6 months of age (odds ratio [OR], 3.07; pcombined = 1.10 × 10-5), whereas no association of the same SNP was observed in any other age group of KD patients. The same SNP (rs4365796) in the LEF1 gene showed the same direction of risk effect in Japanese KD patients younger than 6 months of age, although the effect was not statistically significant (OR, 1.42; p = 0.397). This result indicates that the LEF1 gene may play an important role as a susceptibility gene specifically affecting KD patients younger than 6 months of age.
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Zhao M, He HY, Yu JJ, Zhang X, He XL, Teng XD. [Clinicopathologic analysis of primary smooth muscle tumors of kidney]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2018; 47:291-292. [PMID: 29690670 DOI: 10.3760/cma.j.issn.0529-5807.2018.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Yu JJ, Jun HO, Shin EJ, Baek JS, Lee JH, Kim YH, Park YS, Ko JK. Factors associated with reduction of left ventricular mass in children on peritoneal dialysis. Nephrology (Carlton) 2018; 23:338-344. [PMID: 28199756 DOI: 10.1111/nep.13033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 02/04/2017] [Accepted: 02/07/2017] [Indexed: 01/20/2023]
Abstract
AIM This study aimed to investigate sensitive factors involved in left ventricular mass reduction in children with end-stage renal disease (ESRD) undergoing peritoneal dialysis. METHODS Thirty-five subjects on peritoneal dialysis were enrolled. Two successive echocardiographic and clinical data for each subject were obtained. Blood pressure and left ventricular mass index (LVMI) were indexed through a division with the normal 95th percentile value. Differences in numeric data between two datasets were calculated. RESULTS The mean age was 12.9 ± 4.6 years. Predictors of left ventricular hypertrophy and its persistence were systolic blood pressure index (P = 0.019 and P = 0.046) and E' velocity (P = 0.035 and P = 0.031) in univariate analysis. However, differences in these predictors between the datasets were not related to the change in indexed LVMI. Reduction in indexed LVMI was correlated to a reduction of indexed left atrial volume (R = 0.638, P = 0.001), trans-mitral A velocity (R = 0.443, P = 0.011), and serum blood urea nitrogen level (R = 0.372, P = 0.028) and an elevation of haemoglobin level (R = -0.374, P = 0.027). CONCLUSION The extent of circulating volume expansion is potentially the main predictive factor for change of LVMI, because the volume dependent diastolic functional variables correlate to the change of LVMI. Further study with a large number of ESRD children including a group under fluid volume control is needed to investigate the role of volume expansion on the change of LVMI.
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Ryu K, Yu JJ, Jun HO, Shin EJ, Heo YH, Baek JS, Kim YH, Ko JK. A comparative study of established z score models for coronary artery diameters in 181 healthy Korean children. KOREAN JOURNAL OF PEDIATRICS 2017; 60:373-378. [PMID: 29234361 PMCID: PMC5725343 DOI: 10.3345/kjp.2017.60.11.373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/21/2017] [Accepted: 09/21/2017] [Indexed: 12/18/2022]
Abstract
Purpose The aim of this study was to investigate the statistical properties of four previously developed pediatric coronary artery z score models in healthy Korean children. Methods The study subjects were 181 healthy Korean children, whose age ranged from 1 month to 15 years. The diameter of each coronary artery was measured using 2-dimensional echocardiography and converted to the z score in the four models (McCrindle, Olivieri, Dallaire, and Japanese model). Descriptive statistical analyses and 1-sample t tests were performed. Results All calculated z scores had P values of ≥0.050 using the Kolmogorov-Smirnov test. The one sample t test showed that the mean z scores did not converge to zero except in 1 model, and the mean right coronary artery (RCA) z score was less than zero in all 4 models. The smaller RCA diameter in this study could be associated with the more distal measuring point used to avoid the conal branch. The percentage of subjects with extreme z score values (≥2.0 and ≥2.5) for the left main coronary artery (LMCA) seems to be higher in the Dallaire (4.9% and 3.3%) and Japanese models (7.1% and 3.8%). Conclusion All 4 models showed statistical feasibility of normal distribution. More precise instructions would be needed for the measurement of the RCA. The higher percentage of extreme z scores for the LMCA is compatible with the basic understanding of anatomic variation in the LMCA.
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Kwon YC, Kim JJ, Yun SW, Yu JJ, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Ebata R, Hamada H, Suzuki H, Ito K, Onouchi Y, Hong YM, Jang GY, Lee JK. Male-specific association of the FCGR2A His167Arg polymorphism with Kawasaki disease. PLoS One 2017; 12:e0184248. [PMID: 28886140 PMCID: PMC5590908 DOI: 10.1371/journal.pone.0184248] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/17/2017] [Indexed: 01/18/2023] Open
Abstract
Kawasaki disease (KD) is an acute systemic vasculitis that can potentially cause coronary artery aneurysms in some children. KD occurs approximately 1.5 times more frequently in males than in females. To identify sex-specific genetic variants that are involved in KD pathogenesis in children, we performed a sex-stratified genome-wide association study (GWAS), using the Illumina HumanOmni1-Quad BeadChip data (249 cases and 1,000 controls) and a replication study for the 34 sex-specific candidate SNPs in an independent sample set (671 cases and 3,553 controls). Male-specific associations were detected in three common variants: rs1801274 in FCGR2A [odds ratio (OR) = 1.40, P = 9.31 × 10-5], rs12516652 in SEMA6A (OR = 1.87, P = 3.12 × 10-4), and rs5771303 near IL17REL (OR = 1.57, P = 2.53 × 10-5). The male-specific association of FCGR2A, but not SEMA6A and IL17REL, was also replicated in a Japanese population (OR = 1.74, P = 1.04 × 10-4 in males vs. OR = 1.22, P = 0.191 in females). In a meta-analysis with 1,461 cases and 5,302 controls, a very strong association of KD with the nonsynonymous SNP rs1801274 (p.His167Arg, previously assigned as p.His131Arg) in FCGR2A was confirmed in males (OR = 1.48, P = 1.43 × 10-7), but not in the females (OR = 1.17, P = 0.055). The present study demonstrates that p.His167Arg, a KD-associated FCGR2A variant, acts as a susceptibility gene in males only. Overall, the gender differences associated with FCGR2A in KD provide a new insight into KD susceptibility.
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Kim JJ, Yun SW, Yu JJ, Yoon KL, Lee KY, Kil HR, Kim GB, Han MK, Song MS, Lee HD, Ha KS, Sohn S, Johnson TA, Takahashi A, Kubo M, Tsunoda T, Ito K, Onouchi Y, Hong YM, Jang GY, Lee JK. A genome-wide association analysis identifies NMNAT2 and HCP5 as susceptibility loci for Kawasaki disease. J Hum Genet 2017; 62:1023-1029. [PMID: 28855716 DOI: 10.1038/jhg.2017.87] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/11/2017] [Accepted: 07/31/2017] [Indexed: 02/07/2023]
Abstract
Kawasaki disease (KD), a systemic vasculitis of infants and children, manifests as fever and mucocutaneous inflammation. Although its etiology is largely unknown, the epidemiological data suggest that genetic factors are important in KD susceptibility. To identify genetic variants influencing KD susceptibility, we performed a genome-wide association study (GWAS) and replication study using a total of 915 children with KD and 4553 controls in the Korean population. Six single-nucleotide polymorphisms (SNPs) in three loci were associated significantly with KD susceptibility (P<1.0 × 10-5), including the previously reported BLK locus (rs6993775, odds ratio (OR)=1.52, P=2.52 × 10-11). The other two loci were newly identified: NMNAT2 on chromosome 1q25.3 (rs2078087, OR=1.33, P=1.15 × 10-6) and the human leukocyte antigen (HLA) region on chromosome 6p21.3 (HLA-C, HLA-B, MICA and HCP5) (rs9380242, rs9378199, rs9266669 and rs6938467; OR=1.33-1.51, P=8.93 × 10-6 to 5.24 × 10-8). Additionally, SNP rs17280682 in NLRP14 was associated significantly with KD with a family history (18 cases vs 4553 controls, OR=6.76, P=5.46 × 10-6). These results provide new insights into the pathogenesis and pathophysiology of KD.
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Yu JJ, Park SJ. Predictors and the distal outcome of general Internet use: The identification of children's developmental trajectories. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2017; 35:483-497. [PMID: 28513971 DOI: 10.1111/bjdp.12188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 04/18/2017] [Indexed: 12/30/2022]
Abstract
This study examined the predictors and distal outcome in relation to the frequency of online activities and investigated the presence of prototypical trajectories following different patterns of general Internet use over 5 years. The data set consisted of a nationally representative sample of 2,840 fourth graders (Mage = 9.86 years) in South Korea at baseline. Analyses revealed rank-order stability in general Internet use with four latent classes: high stable (5.8%), high quadratic (20.3%), moderate stable (32.7%), and low stable (41.2%). Youth with higher levels of perceived parental monitoring knowledge, friendship closeness, and depressed mood at baseline were more likely to belong to the high stable class, while girls were more likely to be in the high quadratic or moderate stable classes relative to the low stable class. The high stable class had the greatest odds of reporting alcohol use at grade eight, whereas the low stable class had the lowest odds. Statement of contribution What is already known on this subject? Internet usage increases as children progress through to early adolescence and then levels off Longitudinal data have shown that adolescents' greater Internet use is predictive of their higher levels of drinking What does this study add? To explore different developmental pathways of Internet use in relation to its antecedents and distal outcome Early adolescents who spend more time on the Internet have a greater chance of starting to drink The interindividual rank-order stability of general Internet usage exists at least before late childhood.
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Kim GB, Yu JJ, Yoon KL, Jeong SI, Song YH, Han JW, Hong YM, Joo CU. Medium- or Higher-Dose Acetylsalicylic Acid for Acute Kawasaki Disease and Patient Outcomes. J Pediatr 2017; 184:125-129.e1. [PMID: 28043685 DOI: 10.1016/j.jpeds.2016.12.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/10/2016] [Accepted: 12/05/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the effect of medium- or higher-dose acetylsalicylic acid (ASA) for treating acute-phase Kawasaki disease to prevent coronary artery aneurysm (CAA). STUDY DESIGN Among the children with acute Kawasaki disease investigated in the eighth nationwide survey in the Republic of Korea, 8456 children with adequate data were included in this study. The subjects were divided into 2 groups according to the use of medium- or higher-dose ASA (≥30 mg/kg/day), or-low dose ASA (3-5 mg/kg/day) during the acute febrile phase. Both z- score-based criteria and Japanese criteria for CAA were used. RESULTS The prevalence of CAA based on z-score (24.8% vs 18.3%; P = .001) and on the Japanese criteria (19.0% vs 10.4%; P < .001) was higher in the 7947 patients who received medium- or higher-dose ASA compared with the 509 patients who received low-dose ASA. The use of medium- or higher-dose ASA was a significant predictor of CAA based on both sets of criteria by univariate analysis (based on z-score: OR, 1.472, 95% CI, 1.169-1.854, P = .001; based on Japanese criteria: OR, 2.013, 95% CI, 1.507-2.690, P < .001) and multivariate logistic regression analysis (OR, 1.527, 95% CI, 1.166-2.0, P = .003 and OR, 2.198, 95% CI, 1.563-3.092, P < .001, respectively). CONCLUSIONS The use of medium- or higher-dose ASA in acute Kawasaki disease did not prevent CAA. A future randomized controlled trial is needed to determine the optimum dose of ASA.
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Yoon KL, Lee HY, Yu JJ, Lee JY, Han MY, Kim KY, Huh J. Multicenter, Single-Arm, Phase IV Study of Combined Aspirin and High-Dose "IVIG-SN" Therapy for Pediatric Patients with Kawasaki Disease. Korean Circ J 2017; 47:209-214. [PMID: 28382076 PMCID: PMC5378027 DOI: 10.4070/kcj.2016.0139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/14/2016] [Accepted: 11/22/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Intravenous immunoglobulin-SN (IVIG-SN) is a new human immunoglobulin product. Its safety is ensured by pathogen-elimination steps comprising solvent/detergent treatment and a nanofiltration process. This multicenter clinical study was designed to evaluate the efficacy and safety of combined aspirin and high-dose IVIG-SN therapy in pediatric patients with Kawasaki disease (KD). SUBJECTS AND METHODS We evaluated coronary artery lesions (CALs) at 2 and 7 weeks after administering IVIG-SN; total fever duration; and variations in erythrocyte sedimentation rate, N-terminal pro B-type natriuretic peptide or B-type natriuretic peptide, and creatine kinase-myocardial band level before and after treatment with IVIG-SN (2 g/kg). Adverse events were monitored. RESULTS Forty-five patients were enrolled, three of whom were excluded according to the exclusion criteria; the other 42 completed the study. The male:female ratio was 0.91:1, and the mean age was 29.11±17.23 months. The mean fever duration before IVIG-SN treatment was 6.45±1.30 days. Although most patients had complete KD (40 patients, 90.91%), four had atypical KD (9.09%). After IVIG-SN treatment, one patient (2.38%) had CALs, which was significantly lower than the incidence reported previously (15%) (p=0.022), but not significantly different from recent data (5%). There were no serious adverse events, though 28 patients (63.64%) had mild adverse events. Three adverse drug reactions occurred in 2 patients (eczema, anemia, and increased eosinophil count), all of which were transient. CONCLUSION IVIG-SN treatment in patients with KD was safe and effective.
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Song DJ, Zhang YX, Li Z, Yu JJ, Zhou X, Chen J, Peng XW, Zhou B, Lyu CL, Yang LC, Peng W, Wang X. [Modified pedicled thoracoacromial artery perforator flap for the repair of complex pharyngocutaneous fistula: a retrospective review of 9 cases]. ZHONGHUA ER BI YAN HOU TOU JING WAI KE ZA ZHI = CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY 2016; 51:918-922. [PMID: 27978882 DOI: 10.3760/cma.j.issn.1673-0860.2016.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To report our experience in the application of modified pedicled thoracoacromial artery perforator (TAAP) flap for the repair of complex pharyngocutaneous fistula. Methods: Between December 2011 and September 2015, modified pedicled TAAP flaps were used to repair pharyngocutaneous fistulas in 9 patients. All patients were males, and ranged in age from 28 to 72 years old. Fistula size ranged from 4.5 cm×2.5 cm to 6.5 cm×4.5 cm, and the TAAP skin paddle size ranged from 7.0 cm×4.0 cm to 8.0 cm×5.0 cm. Neck defect size ranged from 4.0 cm×3.0 cm to 6.0 cm×4.0 cm, and the TAAP skin paddle size ranged from 5.5 cm×3.5 cm to 7.0 cm×5.0 cm. Results: All 9 flaps survived smoothly and all the donor sites were closed directly, with no flap vascular crisis and necrosis. The mean hospitalization of patients was 10.4 days. Postoperative barium swallow showed no hypopharyngeal stenosis or fistula recurrence. The follow-up time ranged from 8 to 32 months. The appearance of neck was good and all patients accepted oral diet. Only linear scar was left on the donor site, with no significant impairment of the function of pectoralis major muscle. Conclusion: Modified pedicled TAAP flap is suitable for the repair of complex pharyngocutaneous fistula.
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Seo E, Yu JJ, Jun HO, Shin EJ, Baek JS, Kim YH, Ko JK. Prediction of unresponsiveness to second intravenous immunoglobulin treatment in patients with Kawasaki disease refractory to initial treatment. KOREAN JOURNAL OF PEDIATRICS 2016; 59:408-413. [PMID: 27826327 PMCID: PMC5099288 DOI: 10.3345/kjp.2016.59.10.408] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/26/2016] [Accepted: 08/29/2016] [Indexed: 12/18/2022]
Abstract
Purpose This study investigated predictors of unresponsiveness to second-line intravenous immunoglobulin (IVIG) treatment for Kawasaki disease (KD). Methods This was a single-center analysis of the medical records of 588 patients with KD who had been admitted to Asan Medical Center between 2006 and 2014. Related clinical and laboratory data were analyzed by univariate and multivariate logistic regression analyses. Results Eighty (13.6%) of the 588 patients with KD were unresponsive to the initial IVIG treatment and received a second dose. For these 80 patients, univariate analysis of the laboratory results obtained before administering the second-line IVIG treatment showed that white blood cell count, neutrophil percent, hemoglobin level, platelet count, serum protein level, albumin level, potassium level, and C-reactive protein level were significant predictors. The addition of methyl prednisolone to the second-line regimen was not associated with treatment response (odds ratio [OR], 0.871; 95% confidence interval [CI], 0.216–3.512; P=0.846). Multivariate analysis revealed serum protein level to be the only predictor of unresponsiveness to the second-line treatment (OR, 0.160; 95% CI, 0.028–0.911; P=0.039). Receiver operating characteristic curve analysis to determine predictors of unresponsiveness to the second dose of IVIG showed a sensitivity of 100% and specificity of 72% at a serum protein cutoff level of <7.15 g/dL. Conclusion The serum protein level of the patient prior to the second dose of IVIG is a significant predictor of unresponsiveness. The addition of methyl prednisolone to the second-line regimen produces no treatment benefit.
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Zhao M, Kong M, Yu JJ, He XL, Zhang DH, Teng XD. [Clinicopathologic analysis of anastomosing hemangioma of the kidney and adrenal gland]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2016; 45:698-702. [PMID: 27760611 DOI: 10.3760/cma.j.issn.0529-5807.2016.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical and histopathologic characteristics, diagnosis, differential diagnosis and prognostic features of anastomosing hemangioma. Methods: Five cases of anastomosing hemangioma of the kidney and adrenal gland were collected, the clinical and radiologic features, histomorphology, immunophenotype and prognosis were analyzed with review of literature. Results: Three patients were male and two were female with ages ranging from 47 to 77 years; three were located in adrenal gland and 2 originated from the kidney. Clinically, 4 tumors were incidentally identified, 1 presented as edema of lower extremity. By radiography, all presented as a well-demarcated, oval, solid and low-density mass. Grossly, the tumors ranged in maximum diameter from 1.6 to 2.5 cm (mean 2.1 cm). Microscopically, the tumors consisted of anastomosing sinusoidal capillary-sized vessels lined by a single layer of flattened, cubical to hobnail endothelial cells, setting in an pauci-cellular stroma of edematous and hyaline changes. Other commonly seen features included vaguely lobular growth pattern (3/5), hemorrhage and thrombosis (5/5), intravascular growth pattern (5/5), eosinophilic intracytoplasmic hyaline globules (1/5) and extramedullary hematopoiesis (3/5). The tumor cells were typically bland-appearing and mitoses were scarce, with 1 case demonstrating cellular foci of tumor with slight pleomorphism and increased mitoses (2/50 HPF). Immunohistochemical studies showed the tumor cells expressed endothelial cells markers. Follow-up information was available for all 5 patients and showed no evidence of tumor recurrence or metastasis within 6 to 52 months (mean 30 months). Conclusions: Anastomosing hemangioma is a rare, benign subtype of capillary hemangioma that predominantly affects the urologic organs and adrenal glands; it is needed to distinguish it histologically from a series of benign or malignant tumors that feature a richly vascular stroma. Careful attentions to its characteristic morphology with the judicious use of immunohistochemistry can help distinguish this tumor from its many mimickers.
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