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Fenton TR, Barr SM, Elmrayed S, Alshaikh B. Expected and Desirable Preterm and Small Infant Growth Patterns. Adv Nutr 2024:100220. [PMID: 38670164 DOI: 10.1016/j.advnut.2024.100220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Adequate nutrition is necessary for achieving optimal growth and neurodevelopment. Growth is a natural and expected process that happens concomitantly with rapid advancements in neurodevelopment. Serial weight, length, and head circumference growth measures are essential for monitoring development, although identifying pathological deviations from normal growth can pose challenges. Appropriate growth assessments require considerations that a range of sizes for length, head circumference, and weight are expected and appropriate. Because of genetic differences and morbidities, there is a considerable overlap between the growth of healthy infants and those with growth alterations. Parents tend to be over-concerned about children who plot low on growth charts and often need reassurance. Thus, the use of terms such as "poor" growth or growth "failure" are discouraged when growth is approximately parallel to growth chart curves even if their size is smaller than specific percentiles. No specific percentile should be set as a growth goal; individual variability should be expected. An infant's size at birth is important information that goes beyond the common use of prognostic predictions of appropriate compared with small or large for gestational age. The lower the birthweight, the lower the nutrient stores and the more important the need for nutrition support. Compared to term infants, preterm infants at term-equivalent age have a higher percentage of body fat, but this diminishes over the next months. Current research findings support expert recommendations that preterm infants should grow, after early postnatal weight loss, similar to the fetus and then term-born infants, which translates to growth approximately parallel to growth chart curves. There is no need for a trade-off between optimum cognition and optimum future health. Each high-risk infant needs individualized nutrition and growth assessments. This review aims to examine infant growth expectations and messaging for parents of preterm and term-born infants within the broader causal framework.
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Affiliation(s)
- Tanis R Fenton
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | | | - Seham Elmrayed
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Institute of Global Health and Human Ecology, American University in Cairo, Egypt
| | - Belal Alshaikh
- Community Health Sciences, O'Brien Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
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2
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Chen L, Chu D, Li W, Zhang H. Non- small cell lung cancer patient with a rare UGP2-ALK fusion protein responded well to alectinib: a case report. Anticancer Drugs 2024; 35:97-100. [PMID: 37450292 PMCID: PMC10720821 DOI: 10.1097/cad.0000000000001531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/14/2023] [Indexed: 07/18/2023]
Abstract
Several rare anaplastic lymphoma kinase (ALK) fusions have been identified in patients with non-small cell lung cancer (NSCLC); however, their treatment is not currently uniform. alectinib has been commonly used to treat rare ALK fusions in patients with NSCLC. This is the first study to report the occurrence of a uridine diphosphate-glucose pyrophosphorylase 2 (UGP2)-ALK fusion in a patient with NSCLC. The patient, who was hospitalized because of shortness of breath lasting 20 days, showed hydrothorax of the left lung under a computerized tomography chest scan. Pathological histology revealed lung adenocarcinoma in the patient. The UGP2-ALK mutation was found by next-generation sequencing. Subsequently, the patient was administered alectinib, and thereafter, the tumor lesion was observed to gradually shrink over the follow-up period. Progression-free survival reached 10 months as of the follow-up date, with no adverse events detected. This case report provides valuable insights into the clinical management of NSCLC patients with UGP2-ALK fusions. Moreover, alectinib is confirmed to be an appropriate therapeutic agent for such patients.
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Affiliation(s)
- Liulin Chen
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi’an, China
| | - Daifang Chu
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi’an, China
| | - Wangping Li
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi’an, China
| | - Haitao Zhang
- Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Military Medical University, Xi’an, China
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Iida K, Matsumoto Y, Nabeshima A, Fujiwara T, Setsu N, Endo M, Nakashima Y. The Difference in Clinical Features between Small-Sized Soft Tissue Sarcomas and Benign Tumors. Kurume Med J 2023; 69:65-73. [PMID: 37793890 DOI: 10.2739/kurumemedj.ms69120015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Small-sized tumors tend to be resected without thorough assessment and are often managed in a sarcoma center after a malignancy is diagnosed. The lack of knowledge about the features of smallsized sarcomas may lead to unplanned resection. The features of small-sized soft tissue sarcomas were investigated by comparing them with those of small benign soft tissue tumors. METHODS We included 17 soft tissue sarcoma cases (7 on the hands and feet and 10 on the limbs and trunk) with a diameter of under 2 cm. The features of small-sized sarcomas were compared to those of 39 benign soft tissue tumors with a diameter of under 2 cm and non-specific imaging findings (30 on the hands and feet and 9 on the limbs and trunk). The investigated features were age, sex, presence of pain, subjective increasing tumor size, and duration of observation. RESULTS When we compared the tumors in the hands and feet, those <40 years of age (5/7 [71%] vs. 8/30 [27%], p=0.03) experiencing pain (7/7 [100%] vs. 13/30 [43%], p=0.007) were more common in patients with sarcomas than in patients with benign tumors. When we compared the tumors in the limbs and trunk, there was no significant difference in all investigated features. CONCLUSION Although clinical features were ineffective in distinguishing malignancy in most small-sized soft tissue tumors, we should pay attention to painful tumors of the hands and feet in younger patients.
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Affiliation(s)
- Keiichiro Iida
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
| | - Akira Nabeshima
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
| | - Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
| | - Nokitaka Setsu
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
| | - Makoto Endo
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Faculty of Medical Sciences, Kyushu University
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Maniwa T, Okami J, Miyoshi T, Wakabayashi M, Yoshioka H, Mimae T, Endo M, Hattori A, Nakagawa K, Isaka T, Isaka M, Kita R, Sekino Y, Mitome N, Aokage K, Saji H, Nakajima R, Okada M, Tsuboi M, Asamura H, Fukuda H, Watanabe SI. Lymph node dissection in small peripheral lung cancer: Supplemental analysis of JCOG0802/WJOG4607L. J Thorac Cardiovasc Surg 2023:S0022-5223(23)01099-1. [PMID: 38000629 DOI: 10.1016/j.jtcvs.2023.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/30/2023] [Accepted: 11/12/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVE The optimal region of lymph node dissection (LND) during segmentectomy in patients with small peripheral non-small cell lung cancer requires clarification. Through a supplemental analysis of the Japan Clinical Oncology Group (JCOG) 0802/West Japan Oncology Group (WJOG) 4607L, we investigated the associated factors, distribution, and recurrence pattern of lymph node metastases (LNMs) and proposed the optimal LND region. METHODS Of the 1106 patients included in the JCOG0802/WJOG4607L, 1056 patients with LNDs were included in this supplemental analysis. We investigated the distribution and recurrence pattern of LNMs along with the radiologic findings (with ground-glass opacity, part-solid tumor; without ground-grass opacity component, pure-solid tumor). RESULTS The radiologic findings were the only significant factor for LNMs. Of 533 patients with part-solid tumors, 8 (1.5%) had LNMs. Further, only 3 (0.5%) patients had pN2 disease, and no patients had interlobar LNMs from nonadjacent segments. Of the 523 patients with pure-solid tumors, 55 (10.5%) had LNMs, and 28 (5.4%) had pN2 disease. Five patients had metastases to nonadjacent interlobar lymph nodes (LNs). Two (2.0%) patients with S6 tumors had upper mediastinal LNMs. In addition, the incidence of mediastinal LN recurrence in patients with S6 lung cancer was greater in those who underwent selective LND than those who underwent systematic LND (P = .0455). CONCLUSIONS Nonadjacent interlobar and mediastinal LND have little impact on pathologic nodal staging in patients with part-solid tumors. In contrast, selective LND is recommended at least for patients with pure-solid tumors.
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Affiliation(s)
- Tomohiro Maniwa
- Department of Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Jiro Okami
- Department of Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan.
| | - Tomohiro Miyoshi
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Masashi Wakabayashi
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Osaka, Japan
| | - Takahiro Mimae
- Department of Surgical Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Makoto Endo
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Aritoshi Hattori
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuo Nakagawa
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Isaka
- Department of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mitsuhiro Isaka
- Department of Thoracic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Ryosuke Kita
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yuta Sekino
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Mitome
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Keiju Aokage
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Hisashi Saji
- Department of Chest Surgery, St Marianna University School of Medicine, Kawasaki, Japan
| | - Ryu Nakajima
- Department of General Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Morihito Okada
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Masahiro Tsuboi
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Haruhiko Fukuda
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
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Begley SL, White TG, Khilji H, Katz J, Dehdashti AR. Disappearance of a small unruptured intracranial aneurysm: A case report and brief literature review. Neuroradiol J 2023; 36:621-624. [PMID: 36647339 PMCID: PMC10569197 DOI: 10.1177/19714009221150861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Disappearing intracranial aneurysms are rare and have not been extensively reported in the literature. They are often small or partially thrombosed and carry a significant risk of recurrence. We discuss a unique case of a 65-year-old woman who presented in 2006 with a subarachnoid hemorrhage and was found to have a ruptured posterior communicating artery and an unruptured P1 aneurysm. Follow-up angiography and imaging showed no changes in the size of a left P1 aneurysm for 11 years (2006-2017). However, in 2021, 15 years after initial presentation, no aneurysm was seen on magnetic resonance angiography, and subsequent digital subtraction angiography in 2022 showed almost complete disappearance of the unruptured P1 aneurysm. Literature review reveals only six reported cases during which a small, unruptured anterior circulation aneurysm disappeared, or regressed on follow-up imaging and no reported cases in the posterior circulation.
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Affiliation(s)
- Sabrina L Begley
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Timothy G White
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Hamza Khilji
- Department of Neurosurgery, Lenox Hill Hospital, Manhattan, NY, USA
| | - Jeffrey Katz
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Amir R Dehdashti
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
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Dessinioti C, Plaka M, Kypreou K, Stergiopoulou A, Kostaki M, Soura E, Chasapi V, Befon A, Stratigos AJ. A retrospective study of small-diameter invasive melanomas: Metastasis at diagnosis and 9-year follow-up. J Am Acad Dermatol 2023; 89:152-154. [PMID: 36822351 DOI: 10.1016/j.jaad.2023.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/18/2023] [Accepted: 02/09/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Clio Dessinioti
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece.
| | - Michaella Plaka
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece
| | - Katerina Kypreou
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece
| | - Aravella Stergiopoulou
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece
| | - Maria Kostaki
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece
| | - Efthymia Soura
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece
| | - Vasiliki Chasapi
- State Department of Dermatology-Venereology, 'A. Sygros' Hospital, Athens, Greece
| | - Angelliki Befon
- State Department of Dermatology-Venereology, 'A. Sygros' Hospital, Athens, Greece
| | - Alexander J Stratigos
- 1st Department of Dermatology, 'A. Sygros' Hospital, University of Athens, Athens, Greece
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Djekic S, Vekic J, Zeljkovic A, Kotur-Stevuljevic J, Kafedzic S, Zdravkovic M, Ilic I, Hinic S, Cerovic M, Stefanovic M, Mihajlovic M, Neskovic A, Bogavac-Stanojevic N. HDL Subclasses and the Distribution of Paraoxonase-1 Activity in Patients with ST-Segment Elevation Acute Myocardial Infarction. Int J Mol Sci 2023; 24:ijms24119384. [PMID: 37298334 DOI: 10.3390/ijms24119384] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/14/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
The aim of this multicentric study was to assess the impacts of oxidative stress, inflammation, and the presence of small, dense, low-density lipoproteins (sdLDL) on the antioxidative function of high-density lipoprotein (HDL) subclasses and the distribution of paraoxonase-1 (PON1) activity within HDL in patients with ST-segment elevation acute myocardial infarction (STEMI). In 69 STEMI patients and 67 healthy control subjects, the lipoproteins' subclasses were separated using polyacrylamide gradient (3-31%) gel electrophoresis. The relative proportion of sdLDL and each HDL subclass was evaluated by measuring the areas under the peaks of densitometric scans. The distribution of the relative proportion of PON1 activity within the HDL subclasses (pPON1 within HDL) was estimated using the zymogram method. The STEMI patients had significantly lower proportions of HDL2a and HDL3a subclasses (p = 0.001 and p < 0.001, respectively) and lower pPON1 within HDL3b (p = 0.006), as well as higher proportions of HDL3b and HDL3c subclasses (p = 0.013 and p < 0.001, respectively) and higher pPON1 within HDL2 than the controls. Independent positive associations between sdLDL and pPON1 within HDL3a and between malondialdehyde (MDA) and pPON1 within HDL2b were shown in the STEMI group. The increased oxidative stress and increased proportion of sdLDL in STEMI are closely related to the compromised antioxidative function of small HDL3 particles and the altered pPON1 within HDL.
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Affiliation(s)
- Saska Djekic
- Department of Laboratory Diagnostics Public Health Institution "Health Center", 74000 Doboj, Bosnia and Herzegovina
| | - Jelena Vekic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksandra Zeljkovic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Jelena Kotur-Stevuljevic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Srdjan Kafedzic
- Clinical Hospital Center "Zemun", 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Marija Zdravkovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Clinical Hospital Center "Bezanijska Kosa", 11000 Belgrade, Serbia
| | - Ivan Ilic
- Clinical Hospital Center "Zemun", 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Sasa Hinic
- Clinical Hospital Center "Bezanijska Kosa", 11000 Belgrade, Serbia
| | | | | | - Marija Mihajlovic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksandar Neskovic
- Clinical Hospital Center "Zemun", 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Natasa Bogavac-Stanojevic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
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Murphy G, Naughton A, Durand R, Heron E, McCaughey C, Murphy RT, Pearson I. Long-term Outcomes for Drug-eluting Balloons versus Drug-eluting Stents in the Treatment of Small Vessel Coronary Artery Disease: A Systematic Review and Meta-analysis. Interv Cardiol 2023; 18:e14. [PMID: 37398872 PMCID: PMC10311399 DOI: 10.15420/icr.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/27/2022] [Indexed: 07/04/2023] Open
Abstract
Background: This systematic review and meta-analysis compares long-term outcomes follow-up data comparing drug-eluting balloons (DEBs) and drug-eluting stents (DESs) in interventional treatment of small coronary artery disease (<3 mm). Methods: A systematic review was undertaken along with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome was 1-3-year performance of DEB versus DES in major adverse cardiac events. Secondary outcomes include all-cause mortality, MI, cardiac death, vessel thrombosis, major bleeding, target vessel revascularisation and target lesion revascularisation. Two independent reviewers extracted data. All outcomes used the Mantel-Haenszel and random effects models. ORs are presented with a 95% CI. Results: Of 4,661 articles, four randomised control trials were included (1,414 patients). DEBs demonstrated reduced rates of non-fatal MI at 1 year (OR 0.44; 95% CI [0.2-0.94]), and BASKET-SMALL 2 reported a significant reduction in 2-year bleeding rates (OR 0.3; 95% CI [0.1-0.91]). There was no significant difference in all other outcomes. Conclusion: Long-term follow-up of DEB and DES use in small coronary arteries demonstrates DEBs be comparable with DESs in all outcomes at 1, 2 and 3 years of follow-up. A significant reduction was found in rates of non-fatal MI at 1 year in the DEB arm, and a reduction in major bleeding episodes at 2 years in the BASKET-SMALL 2 trial. These data highlight the potential long-term utility of novel DEBs in small coronary artery disease revascularisation.
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Affiliation(s)
- Greg Murphy
- Cardiology Department, St James' Hospital Dublin, Ireland
| | | | - Rory Durand
- Cardiology Department, St James' Hospital Dublin, Ireland
| | | | | | - Ross T Murphy
- Cardiology Department, St James' Hospital Dublin, Ireland
| | - Ian Pearson
- Cardiology Department, St James' Hospital Dublin, Ireland
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Tree K, Kotecha K, Reeves J, Aitchison L, Noeline Chui J, Gill AJ, Mittal A, Samra JS. Meckel's diverticulectomy: a multi-centre 19-year retrospective study. ANZ J Surg 2023; 93:1280-1286. [PMID: 36821518 DOI: 10.1111/ans.18351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Meckels diverticulum (MD) causes a number of acute surgical pathologies and can contain ectopic tissue with the surgical aim to resect all ectopic mucosa. This has traditionally implied a small bowel resection (BR); though contemporary literature has demonstrated Meckel's diverticulectomy to be safe. The aim of this study was to determine optimal resection strategy, and assess MD histopathological features and their relationship to outcomes. METHODS A 19-year retrospective review of patient medical records across seven hospitals was conducted with demographic, clinical and pathological data collected. Analysis was conducted using a student's t-test for continuous variables and chi-squared test for categorical variables. Univariate regression was performed to identify risk factors. P < 0.05 was considered statistically significant. RESULTS One hundred and sixty patients underwent resection of MD, 70 (44%) had Meckel's diverticulectomy and 90 (56%) had BR. No significant difference in length (P = 0.486), width (P = 0.238), or ratio (P = 0.188) of diverticulectomy compared to BR, with fewer complications in diverticulectomy. In all, 24 (15.3%) MD were perforated, of whom 5 had gastric mucosa, 2 had mixed ectopic mucosa and 1 carcinoid tissue. There were no cases of ectopic mucosa in the resection margin requiring re-operation, or causing base perforation. MD specimen with greater length: width ratio was a risk factor for perforation OR 1.437 P = 0.042 but not for malignancy P = 0.813 or ectopic tissue P = 0.185. CONCLUSION Meckel's diverticulectomy is safe via laparoscopic or open approach compared with BR. Despite higher perforation rates in MD with greater length: width ratio, no malignancy or ectopic risk was identified, supporting diverticulectomy as a safe operative approach.
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Affiliation(s)
- Kevin Tree
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Krishna Kotecha
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jenna Reeves
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Lucy Aitchison
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Juanita Noeline Chui
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Anubhav Mittal
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.,School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Jaswinder S Samra
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia
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10
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Abstract
Acute mesenteric ischemia (AMI) is an uncommon yet highly lethal cause of acute abdomen in the emergency setting. Computed tomography (CT) imaging, in particular a biphasic protocol consisting of angiographic and venous phase scans, is widely used to corroborate non-specific clinical findings when suspicions of AMI are high. Techniques such as low kilovoltage peak scanning, dual energy acquisition, or a combined arterial/enteric phase can improve iodine conspicuity and evaluation of bowel enhancement. Biphasic CT with CT angiography is mandatory to directly assess for the 3 primary etiologies of AMI-arterial, venous, and non-occlusive mesenteric ischemia (NOMI), and the CT angiographic findings may be the first visible in the disease. In addition, numerous non-vascular CT findings have also been reported. Bowel wall thickening, mesenteric stranding, and ascites are common but non-specific findings that correlate poorly with disease severity. Pneumatosis intestinalis and portomesenteric venous gas, while not pathognomonic for ischemia, are highly specific in cases of high clinical suspicion. Bowel wall hypoenhancement is an early and specific sign but requires a protocol optimizing iodine conspicuity to confidently identify. Finally, intraperitoneal free air and solid organ infarcts are also highly specific ancillary findings in AMI. AMI occurs as a complication in 10% of small bowel obstruction (SBO) patients, and understanding imaging findings of ischemia in the context of SBO is necessary to aid in treatment planning and reduce over- and under-diagnosis of strangulation. Familiarity with the imaging features of ischemia by radiologists is vital to establish an early diagnosis before irreversible necrosis occurs.
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Affiliation(s)
- Hang Yu
- Department of Diagnostic Radiology, 8664University of Manitoba, Winnipeg, MB, Canada
| | - Iain D C Kirkpatrick
- Department of Diagnostic Radiology, 8664University of Manitoba, Winnipeg, MB, Canada
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11
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Paik WH, Lee KJ. Management of Small Nonfunctioning Pancreatic Neuroendocrine Neoplasms: Current Opinion and Controversies. J Clin Med 2022; 12. [PMID: 36615051 DOI: 10.3390/jcm12010251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
The incidence of small and asymptomatic pancreatic neuroendocrine neoplasms (PNENs) has increased due to the widespread use of high-resolution diagnostic imaging in screening programs. Most PNENs are slow-growing indolent neoplasms. However, a local invasion or metastasis can sometimes occur with PNENs, leading to a poor prognosis. The management of small, nonfunctioning PNENs remains under debate. The National Comprehensive Cancer Network guidelines recommend observation in selected cases of small PNENs less than 2 cm. Pancreatic surgery remains a high-risk operation with a 28-30% morbidity and 1% mortality. Therefore, the decision on how to manage small PNENs is challenging. This review focuses on the management of small nonfunctioning PNENs. We also highlight the malignant potential of small PNENs according to tumor size, tumor grade, and tumor biomarker. Endoscopic-ultrasound-guided biopsy is recommended to evaluate the potential risk of malignancy. Furthermore, we discuss the current guidelines and future directions for the management of small PNENs.
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Li L, Gao BL, Shao QJ, Zhang GL, Wang ZL, Li TX, Zhu LF. Small Unruptured Intracranial Aneurysms Can Be Effectively Treated With Flow-Diverting Devices. Front Neurol 2022; 13:913653. [PMID: 35707031 PMCID: PMC9190436 DOI: 10.3389/fneur.2022.913653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the effect and safety of flow diverters in the management of small (<10 mm in diameter) unruptured intracranial aneurysms. Materials and Methods One hundred and ten patients with 145 small intracranial aneurysms treated with flow diverters were retrospectively enrolled. The clinical, endovascular, and follow-up data were analyzed. Results One hundred twenty-one flow diverters were deployed for the treatment of 145 small intracranial aneurysms in 110 patients, and the stenting success rate was 99.1%. In 133 (91.7%) aneurysms, only flow-diverting devices were deployed, and in the rest 12 (8.3%) of aneurysms, coils were used to loosely pack the aneurysm after deployment of a flow-diverting device. Five patients (4.5%) experienced ischemic complications, but no hemorrhagic complications were occurred. All patients had clinical follow-up 6-18 (median 12) after the procedure, with the modified Rankin scale score (mRS) 0 in 101 patients, 1 in four patients, 2 in three patients, 4 in one patient, and 5 in one patient. Digital subtraction angiography was performed at follow-up in 90 (81.8%) patients with 118 (81.4%) aneurysms 6-18 months (median 12) after the procedure, with the Raymond grade I in 90 (76.2%) aneurysms and Raymond grade III in 28 (23.7%). Eighteen patients with 22 partially occluded aneurysms at the first angiographic follow-up experienced the second digital subtraction angiography 12-36 months (median 26) after the procedure, and 21 (95.5%) aneurysms were completely occluded. Two patients had asymptomatic in-stent stenosis. Conclusion Treatment of small unruptured intracranial aneurysms with flow diverters can be performed safely and effectively with satisfactory outcomes.
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Affiliation(s)
- Li Li
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Bu-Lang Gao
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Qiu-Ji Shao
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Guang-Lin Zhang
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Zi-Liang Wang
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Tian-Xiao Li
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
| | - Liang-Fu Zhu
- Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, China
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Abstract
INTRODUCTION Hidradenitis suppurativa (HS) is a chronic, debilitating inflammatory skin disorder characterized by painful nodules, abscesses, fistulae, and scarring with a predilection for flexural regions. Several biologics and small molecule inhibitors are being evaluated in clinical trials for treatment. AREAS COVERED The authors discuss the data available from clinical trials and smaller, high-quality studies for existing and emerging biologic and small molecule inhibitor therapies for treatment of HS. Biologics discussed include TNFα, IL-17, IL-23, IL-12/23, and IL-1 inhibitors. Small molecule inhibitors discussed include PDE4, JAK, TYK, IFX-1, and complement cascade inhibitors. Pharmacokinetics and pharmacodynamics for these drugs are also described. EXPERT OPINION Trial data and our own experience have shown that about half of HS patients experience improvement with adalimumab. However, there is a significant need for pharmacotherapies with higher efficacy goals as in those used for psoriasis. Many biologics and small molecule inhibitors are being tested in clinical trials. The landscape of upcoming therapies for hidradenitis suppurativa appears promising.
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Affiliation(s)
- Stella X Chen
- Department of Dermatology, Massachusetts General Hospital, Harvard Combined Dermatology Residency Program, Boston, MA, USA
| | - Charlotte Greif
- Clinical Laboratory for Epidemiology and Applied Research in Skin (CLEARS), Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Ruby S Gibson
- Clinical Laboratory for Epidemiology and Applied Research in Skin (CLEARS), Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Martina L Porter
- Clinical Laboratory for Epidemiology and Applied Research in Skin (CLEARS), Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Dermatology, Harvard Medical School, Boston, MA, USA
| | - Alexa B Kimball
- Clinical Laboratory for Epidemiology and Applied Research in Skin (CLEARS), Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Dermatology, Harvard Medical School, Boston, MA, USA
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Johnson KC, Quiroga D, Sudheendra P, Wesolowski R. Treatment of small (T1mic, T1a, and T1b) node-negative HER2+ breast cancer - a review of current evidence for and against the use of anti-HER2 treatment regimens. Expert Rev Anticancer Ther 2022; 22:505-522. [PMID: 35389302 PMCID: PMC9156575 DOI: 10.1080/14737140.2022.2063844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Since the advent of anti-HER2 therapies, evidence surrounding adjuvant treatment of small (T1mic, T1a, and T1b), node-negative, HER2-positive breast cancer (HER2+BC) has remained limited. Practices vary widely between institutions with little known regarding the added benefit of systemic therapy, including cytotoxic chemotherapy and HER2-directed treatments. Our group has set out to perform an extensive review of available literature on this topic. AREAS COVERED In this review, we examined HER2 biology, anti-HER therapies, outcome definitions, and available prospective and retrospective data surrounding the use of adjuvant therapy in those with small, node-negative, HER2+BC. For outcomes, we primarily explored breast cancer-specific survival (BCSS), invasive disease-free survival (iDFS), and overall survival (OS). We also investigated the incidence of adverse events with a particular focus on symptomatic and asymptomatic declines in left ventricular ejection fraction. EXPERT OPINION Retrospective data will likely be the main driver for future treatment decisions. Given what we know, high risk T1b and T1c subgroups derive measurable added benefit from HER2-guided combination therapies but it's not clear whether these benefits outweigh known risks associated with this combination therapy. For tumors ≤0.5cm (T1mic and T1a), treatment remains highly controversial with limited evidence available through retrospective analysis that suggest over-treatment may be occurring.
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Affiliation(s)
- Kai Cc Johnson
- Stefanie Spielman Comprehensive Breast Center, Columbus, OH, USA
| | - Dionisia Quiroga
- Stefanie Spielman Comprehensive Breast Center, Columbus, OH, USA.,Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | | | - Robert Wesolowski
- Stefanie Spielman Comprehensive Breast Center, Columbus, OH, USA.,Pelotonia Institute for Immuno-Oncology, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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15
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Ferrara J, Theron A, Porto A, Morera P, Luporsi P, Jaussaud N, Gariboldi V, Collart F, Cuisset T, Deharo P. Prosthesis-Patient Mismatch in Small Aortic Annuli: Self-Expandable vs. Balloon-Expandable Transcatheter Aortic Valve Replacement. J Clin Med 2022; 11. [PMID: 35407567 DOI: 10.3390/jcm11071959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/15/2022] [Accepted: 03/29/2022] [Indexed: 11/19/2022] Open
Abstract
Prosthesis−patient mismatch (PPM) is associated with worse outcomes following surgical aortic valve replacement (SAVR). PPM has been identified in a significant proportion of TAVR, particularly in patients with small aortic annuli. Our objective was to evaluate the hemodynamic performances of balloon-expandable (BE) (Sapiens 3TM) versus two different self-expandable (SE) (Evolut ProTM, Accurate NeoTM) TAVR devices in patients with small aortic annulus defined by a computed tomography aortic annulus area (AAA) between 330 and 440 mm2. We enrolled 131 consecutive patients corresponding to 76 Sapiens 3 23 mm (58.0%), 26 Evolut Pro (19.9%) and 29 Accurate Neo (22.1%). Mean age was 82.5 ± 7.06 years, 22.9% of patients were male and mean Euroscore was 4.0%. Mean AAA was 374 ± 27 mm2 for Sapiens 3, 383 ± 29 mm2 for Corevalve Evolut Pro and 389 ± 25 mm2 for Accurate Neo. BE devices were associated with significantly higher rates of PPM (39.5%) as compared to SE devices (15.4% for Corevalve Evolut Pro and 6.9% for Accurate Neo) (p < 0.0001). Paravalvular leaks ≥ 2/4 were more often observed in SE devices (15.4% for Corevalve Evolut Pro and 17.2% for Accurate Neo) than in BE devices (2.6%) (p = 0.007). In conclusion, SE TAVR devices did achieve better hemodynamic results despite higher rates of paravalvular leaks. Therefore, SE TAVI devices could be considered as first choice in small aortic anatomy.
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16
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Shah NR, Hughes BD, Garza-Serna U, Walker JP. Jejunal duplication cyst in an adult: a rare small bowel complication. Trauma Surg Acute Care Open 2022; 7:e000884. [PMID: 35309266 PMCID: PMC8883281 DOI: 10.1136/tsaco-2022-000884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Nikhil R Shah
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Byron D Hughes
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | | | - John P Walker
- Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USA
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17
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Kim JH, Choi JI, Lim DJ. Radiologic assessment of rupture risk in small (<5 mm) posterior communicating artery aneurysms. Medicine (Baltimore) 2022; 101:e28696. [PMID: 35089225 PMCID: PMC8797568 DOI: 10.1097/md.0000000000028696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/05/2022] [Indexed: 01/05/2023] Open
Abstract
Although previous studies have investigated the predictors of posterior communicating artery (PCoA) aneurysm rupture with clinical and radiologic parameters, the accessibility of "small PCoA aneurysms (<5 mm)" has rarely been reported. Here, we designed a study to identify the factors which are thought to be risky and prone to rupture in small PCoA aneurysms (<5 mm).A total of 114 patients diagnosed with PCoA aneurysm under 5 mm in size on digital subtraction angiography were retrospectively enrolled and divided into ruptured (n = 51) and unruptured (n = 63) groups. Clinical variables were reviewed, and 10 radiologic parameters were obtained, including maximum diameter, height, width, neck width, aspect ratio, dome-to-neck ratio, bleb formation, size ratio, presence of fetal-type PCoA, and inflow angle. Statistical analyses were conducted to compare the groups (ruptured vs unruptured) and identify the risk factors for rupture.High rupture rate of small PCoA aneurysm is noted (51/114, 44.7%). In the comparison analysis, parameters of size ratio (P = .045), aspect ratio (P = .001), and bleb formation (P = .015) were significantly different between the 2 groups. In the regression model, the aspect ratio (P = .045) and bleb formation (P = .004) were significantly associated with the rupture of aneurysm.In respect of small (<5 mm) PCoA aneurysms of our cohort, morphologic parameters of "bleb formation" and "a high aspect ratio" are present more often in ruptured aneurysms as compared to unruptured aneurysms.
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Affiliation(s)
- Jang Hun Kim
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jong-Il Choi
- Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea
| | - Dong-Jun Lim
- Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea
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18
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Sadler EM, Gawad N, Bradley NL. Incidental Meckel's diverticulum at time of laparotomy for perforated diverticulitis. Trauma Surg Acute Care Open 2021; 6:e000840. [PMID: 34790881 PMCID: PMC8565539 DOI: 10.1136/tsaco-2021-000840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Erin M Sadler
- General Surgery, St Joseph's Health Centre, Toronto, Ontario, Canada
| | - Nada Gawad
- General Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Nori L Bradley
- General Surgery, University of Alberta, Edmonton, Alberta, Canada
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19
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Rizvi AA, Stoian AP, Janez A, Rizzo M. Lipoproteins and Cardiovascular Disease: An Update on the Clinical Significance of Atherogenic Small, Dense LDL and New Therapeutical Options. Biomedicines 2021; 9:1579. [PMID: 34829807 DOI: 10.3390/biomedicines9111579] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/15/2022] Open
Abstract
Dyslipidemia is a potent risk factor for the genesis and progression of cardiovascular disease (CVD), and both the concentration and type of low-density lipoproteins (LDL) augment this association. The small, dense LDL (sdLDL) subfraction is the subtype which is most strongly predictive of atherosclerosis and cardiovascular events. In addition to the traditionally available lipid-lowering treatment options, certain novel therapies have been shown to favorably impact sdLDL, among them the antidiabetic class of agents known as glucagon-like peptide 1 receptor agonists (GLP1-RAs). These drugs seem to alter the pathophysiologic mechanisms responsible for the formation and accumulation of atherogenic lipoprotein particles, thus potentially reducing cardiovascular outcomes. They represent a uniquely targeted therapeutic approach to reduce cardiometabolic risk and warrant further study for their beneficial nonglycemic actions.
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20
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Pantoja DA, Vega‐Álvarez NA, Gasca‐Ortiz T. Trophic state in a tropical lake based on Chlorophyll-a profiler data and Sentinel-2 images: The onset of an algal bloom event. Water Environ Res 2021; 93:2185-2197. [PMID: 34018272 PMCID: PMC8596837 DOI: 10.1002/wer.1590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/17/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023]
Abstract
The condition of Lake Zirahuén was evaluated before and after a significant algal bloom took place. The state of the lake was tracked using measurements of chlorophyll-a concentration from a fluorometer attached to a conductivity, temperature, and depth (CTD) profiler and complemented with the use of satellite images from Sentinel-2. It was found that the current state of the lake is in transition from an oligotrophic to a mesotrophic level with some evidence of deterioration, but still being considered as a clear lake. With the use of empirical algorithms to retrieve chlorophyll-a from satellite data it was found that the images presented an acceptable feasibility (R2 = 0.64). The observed algal bloom was detected one month before the algae reached its major extent, being the reflectiveness of the green band a good indicator of the onset of the algal bloom event. Favorable conditions for the algal bloom were also recorded two months before its major extend through a chain of thermistors. PRACTITIONER POINTS: The trophic state of Lake Zirahuén was evaluated before and after a significant algal bloom took place. The lake is classified as being in transition from oligotrophic to mesotrophic. Nonetheless, it continues to have good clarity. Satellite images improve in the description of the spatial-temporal variability of the lake. In particular, the green band reflectiveness.
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Affiliation(s)
- Diego A. Pantoja
- Department of PhysicsUniversidad de GuadalajaraGuadalajaraMexico
| | | | - Tzitlali Gasca‐Ortiz
- Faculty of Physics and MathematicsUniversidad Michoacana de San Nicolás de HidalgoMoreliaMexico
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21
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Lee HA, Kim SE, Jung DW, Byeon JR, Choe AR, Tae CH, Moon CM, Jung HK, Shim KN, Jung SA. Small Bowel Necrosis Associated with Catastrophic Antiphospholipid Syndrome: A Case Report. Korean J Gastroenterol 2021; 77:294-299. [PMID: 34158449 DOI: 10.4166/kjg.2021.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/17/2021] [Accepted: 04/12/2021] [Indexed: 11/03/2022]
Abstract
Catastrophic antiphospholipid syndrome is a highly fatal condition characterized by widespread thromboembolism subsequent to a triggering factor (e.g., infection, trauma, and neoplasia) in antiphospholipid antibody-positive patients. This paper reports a case of a 29-year-old male without the underlying disease who developed extensive mesenteric thromboembolism and jejunal necrosis during the treatment for acute enteritis. The patient's condition was improved with low-molecular-weight heparin and an intravenous Ig treatment with emergency surgery. The serum antiphospholipid (anticardiolipin IgM) and lupus anticoagulant antibody tests showed positive results. Acute infectious enterocolitis is generally considered a mild disease. On the other hand, aggressive evaluation and treatment should be considered if the clinical conditions do not improve and deteriorate rapidly despite appropriate antibiotic treatment because of the possibility of acute immunological complications, such as catastrophic antiphospholipid syndrome.
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Affiliation(s)
- Hyun Ae Lee
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Seong-Eun Kim
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Do Woung Jung
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Ju Ran Byeon
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - A Reum Choe
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Chung Hyun Tae
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Chang Mo Moon
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Hye Kyung Jung
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Ki Nam Shim
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Sung Ae Jung
- Department of Internal Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
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22
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An X, Lei X, Huang R, Luo R, Li H, Xu F, Yuan Z, Wang S, de Nonneville A, Gonçalves A, Houvenaeghel G, Li J, Xue C, Shi Y. Adjuvant chemotherapy for small, lymph node-negative, triple-negative breast cancer: A single-center study and a meta-analysis of the published literature. Cancer 2021; 126 Suppl 16:3837-3846. [PMID: 32710666 DOI: 10.1002/cncr.32878] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Current guidelines recommend adjuvant chemotherapy for patients with small, lymph node-negative, triple-negative breast cancer (TNBC) measuring >5 mm (T1b disease), but clinical evidence to support this recommendation is lacking. Thus, the current study aimed to evaluate the survival benefit of adjuvant chemotherapy in patients with T1N0M0 (measuring ≤2 cm) TNBC with different tumor sizes. METHODS The authors retrospectively evaluated consecutive patients with pT1N0M0 TNBC who were diagnosed between 2000 and 2016 at Sun Yat-Sen University Cancer Center. For the meta-analysis, electronic medical databases were searched for all relevant studies regarding the effect of adjuvant chemotherapy on the target population. RESULTS Of the 351 enrolled patients, 309 (88%) received adjuvant chemotherapy and 42 patients (12%) did not. The distribution by T classification was T1a in 19 patients (5.4%), T1b in 67 patients (19.1%), and T1c in 265 patients (75.5%). Adjuvant chemotherapy significantly improved recurrence-free survival (RFS) in the patients with T1c disease, but not those with T1b and T1a disease. Meanwhile, there was no difference in RFS noted according to the chemotherapy regimen among patients with T1c disease. Seven eligible studies comprising 1525 patients with T1N0M0 (941 with T1a/bN0M0) were included in the meta-analysis. The meta-analysis demonstrated that adjuvant chemotherapy significantly reduced the rate of disease recurrence for patients with T1a/b disease as a group, but the population driving that was only patients with T1b disease, not those with T1a disease. CONCLUSIONS Although the retrospective analysis demonstrated a survival benefit of adjuvant chemotherapy only for patients with T1cN0 TNBC, the meta-analysis showed it also is beneficial for individuals with T1bN0 TNBC. For patients with T1cN0M0 TNBC, less intensive chemotherapy regimens achieve an excellent survival outcome similar to that of intensive anthracycline and taxane combination chemotherapy.
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Affiliation(s)
- Xin An
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xuefen Lei
- Department of Medical Oncology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Riqing Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Rongzhen Luo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Haifeng Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Fei Xu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhongyu Yuan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shusen Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Alexandre de Nonneville
- Department of Medical Oncology, Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Anthony Gonçalves
- Department of Medical Oncology, Aix-Marseille University, CNRS, INSERM, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Gilles Houvenaeghel
- Department of Surgical Oncology, Aix-Marseille University, CNRS, INSERM, Institute Paoli-Calmettes, CRCM, Marseille, France
| | - JiBin Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Cong Xue
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yanxia Shi
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.,Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
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23
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Dutta R, Iqbal A, Das P, Palanichamy JK, Singh A, Mehtab W, Chauhan A, Aggarwal A, Sreenivas V, Ahuja V, Datta Gupta S, Makharia GK. Liver involvement in patients with coeliac disease: proof of causality using IgA/anti-TG2 colocalisation techniques. J Clin Pathol 2021; 74:766-773. [PMID: 33789921 DOI: 10.1136/jclinpath-2020-206735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/09/2020] [Accepted: 09/07/2020] [Indexed: 12/20/2022]
Abstract
AIMS Despite clinical evidence of liver involvement in patients with coeliac disease (CeD), there is a lack of a method to prove this association. METHODS Of 146 treatment-naive patients with CeD, 26 had liver dysfunction. Liver biopsies and corresponding small intestinal biopsies were obtained from these 26 patients. Multicolour immunohistochemical and immunofluorescence confocal microscopic studies were performed on paraffin-embedded tissue to detect the IgA/anti-TG2 deposits. Follow-up liver biopsies were taken after a gluten-free diet. RESULTS Twenty-six out of the 146 patients (17.8%) with suspected coeliac-associated liver disease on histological examination revealed irregular sinusoidal dilatation in 15 (57.6%), steatohepatitis in 4 (15.3%), non-specific chronic hepatitis in 3 (11.5%), autoimmune hepatitis in 2 (7.6%) biopsies, including cirrhosis in one of them, irregular perisinusoidal fibrosis and changes of non-cirrhotic portal fibrosis in one biopsy each (3.8%). IgA/anti-tTG deposits were observed in 22 (84.6%) liver biopsies by dual immunohistochemistry technique, and in 24 (92.3%) by confocal immunofluorescence technique and in all corresponding duodenal biopsies (100%). Overall, IgA/anti-tTG deposits showed 100% sensitivity, 77% specificity and 85% positive predictive value for establishing an association of extraintestinal pathology and CeD using archived tissues. Follow-up liver biopsies could be obtained in five patients; four of them showed not only resolution of the histological lesions but disappearance of IgA/anti-tTG co-localisation. CONCLUSIONS Data of the present study adds to the body of evidence that liver lesions in patients with CeD are disease related and may have been caused by a similar pathogenic mechanism that causes intestinal changes.
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Affiliation(s)
- Rimlee Dutta
- Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Asif Iqbal
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Prasenjit Das
- Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | | | - Alka Singh
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Wajiha Mehtab
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ashish Chauhan
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ashish Aggarwal
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | | | - Vineet Ahuja
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | | | - Govind K Makharia
- Gastroenetrology & Human Nutritions, All India Institute of Medical Sciences, New Delhi, Delhi, India
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24
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Cho JY, Choi TW, Kim SH, Ahnn J, Lee SK. Morphological Characterization of small, dumpy, and long Phenotypes in Caenorhabditis elegans. Mol Cells 2021; 44:160-167. [PMID: 33692220 PMCID: PMC8019597 DOI: 10.14348/molcells.2021.2236] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 11/27/2022] Open
Abstract
The determinant factors of an organism's size during animal development have been explored from various angles but remain partially understood. In Caenorhabditis elegans, many genes affecting cuticle structure, cell growth, and proliferation have been identified to regulate the worm's overall morphology, including body size. While various mutations in those genes directly result in changes in the morphological phenotypes, there is still a need for established, clear, and distinct standards to determine the apparent abnormality in a worm's size and shape. In this study, we measured the body length, body width, terminal bulb length, and head size of mutant worms with reported Dumpy (Dpy), Small (Sma) or Long (Lon) phenotypes by plotting and comparing their respective ratios of various parameters. These results show that the Sma phenotypes are proportionally smaller overall with mild stoutness, and Dpy phenotypes are significantly stouter and have disproportionally small head size. This study provides a standard platform for determining morphological phenotypes designating and annotating mutants that exhibit body shape variations, defining the morphological phenotype of previously unexamined mutants.
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Affiliation(s)
- Joshua Young Cho
- Department of Life Science, School of Natural Sciences, Hanyang University, Seoul 04763, Korea
- BK21 PLUS Life Science for BDR Team, Hanyang University, Seoul 04763, Korea
- Research Institute for Natural Sciences, Hanyang University, Seoul 04763, Korea
- Present address: Doctor of Dental Surgery Program, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA 94103, USA
| | - Tae-Woo Choi
- Department of Life Science, School of Natural Sciences, Hanyang University, Seoul 04763, Korea
- BK21 PLUS Life Science for BDR Team, Hanyang University, Seoul 04763, Korea
- Research Institute for Natural Sciences, Hanyang University, Seoul 04763, Korea
- Present address: Macrogen Inc., Seoul 08511, Korea
| | - Seung Hyun Kim
- Department of Life Science, School of Natural Sciences, Hanyang University, Seoul 04763, Korea
- Research Institute for Natural Sciences, Hanyang University, Seoul 04763, Korea
| | - Joohong Ahnn
- Department of Life Science, School of Natural Sciences, Hanyang University, Seoul 04763, Korea
- BK21 PLUS Life Science for BDR Team, Hanyang University, Seoul 04763, Korea
- Research Institute for Natural Sciences, Hanyang University, Seoul 04763, Korea
| | - Sun-Kyung Lee
- Department of Life Science, School of Natural Sciences, Hanyang University, Seoul 04763, Korea
- BK21 PLUS Life Science for BDR Team, Hanyang University, Seoul 04763, Korea
- Research Institute for Natural Sciences, Hanyang University, Seoul 04763, Korea
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25
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Wong NACS, Suortamo S, George E, Beavers S. Paraduodenal/pancreatic Ewing sarcoma is very rare and therefore may be mistaken for neuroendocrine carcinoma. J Clin Pathol 2021; 75:71-72. [PMID: 33619219 DOI: 10.1136/jclinpath-2021-207452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/03/2022]
Affiliation(s)
| | - Sari Suortamo
- Cellular and Anatomical Pathology, Derriford Hospital, Plymouth, UK
| | - Elinor George
- Cellular Pathology, Royal Devon and Exeter Hospital, Exeter, Devon, UK
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26
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Liu YA, Finn AJ, Subtil A. Primary cutaneous lymphomas in patients with chronic lymphocytic leukemia/ small lymphocytic lymphoma (CLL/SLL): A series of 12 cases. J Cutan Pathol 2021; 48:617-624. [PMID: 33415780 DOI: 10.1111/cup.13956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/03/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is associated with an increased risk of a second malignancy. METHODS We conducted a retrospective clinicopathologic review of 12 patients with CLL/SLL who developed a second lymphoma in the skin. Demographic data, clinical information, and histopathology from 31 biopsies were recorded. Cases of secondary cutaneous involvement by CLL/SLL (leukemia cutis) and non-primary cutaneous lymphomas were excluded. RESULTS A wide variety of primary cutaneous lymphomas was identified, including classic mycosis fungoides (3), cutaneous marginal zone lymphoma (2), primary cutaneous peripheral T-cell lymphoma unspecified (2), folliculotropic mycosis fungoides (1), Sézary syndrome (1), cutaneous gamma-delta T-cell lymphoma (1), cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma (1), and cutaneous anaplastic large cell lymphoma (1). A male predominance was observed, and the average age was 74.1 years. In all patients, CLL/SLL predated the development of the second lymphoma, which was aggressive in the majority of cases (58%). Aggressive cytotoxic T-cell lymphomas, generally rare neoplasms, were relatively common (30%). CONCLUSIONS CLL/SLL patients may develop a second lymphoma in the skin, which may be aggressive. Atypical cutaneous lymphoid infiltrates in this patient population should not be assumed to represent secondary CLL/SLL involvement and require thorough immunohistochemical analysis.
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Affiliation(s)
- Yi Ariel Liu
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander J Finn
- Department of Laboratory Medicine, Island Health, Victoria, British Columbia, Canada.,Department of Laboratory Medicine and Pathology, University of British Columbia, Vancouver, British Columbia, Canada
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27
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Yılmaz S, Yalçın S, Yılmaz M, Açıkgöz O, Aybal HÇ, Gazel E, Kaya E, Tunç L. Comparison of outcomes of Holmium enucleation of the prostate for small- and moderate-sized prostates. Andrologia 2021; 53:e13970. [PMID: 33432683 DOI: 10.1111/and.13970] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 12/16/2022] Open
Abstract
There is an ongoing discussion in the literature on the surgical treatment option for small prostate size benign prostate hyperplasia (BPH) patients. This study aimed to evaluate the efficacy of Holmium laser enucleation of the prostate (HoLEP) surgery in small (<30 ml) and moderate (30-80 ml) prostate size as accepted in European Association of Urology guideline. We retrospectively analysed our database between May 2016 and May 2019 and patients who underwent HoLEP surgery. Patients who have prostate size <80 ml were included the study. These patients were divided into two group: group 1 with prostate size <30 ml (n: 64) and group 2 with prostate size 30-80 ml (n: 101). Enucleation time (ET), morcellation time (MT), total operation time (OT), enucleation efficiency (EE), morcellation efficiency (ME), intra- and post-operative complications were analysed. While EE and Hb drop were better in favour of group 2; PSA drop, ET, MT, OT and ME were superior in favour of group 1. In group 1, intra-operative complications were higher (6 vs. 2; p < .05) and post-operative complications did not differ statistically between groups (p = .14). No statistically significant finding was found between groups regarding incontinence. In conclusion, HoLEP is a reliable method in terms of its results in patients with small prostates.
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Affiliation(s)
- Sercan Yılmaz
- Department of Urology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Serdar Yalçın
- Department of Urology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Mehmet Yılmaz
- Department of Urology, Zile State Hospital, Tokat, Turkey
| | - Onur Açıkgöz
- Department of Urology, Pendik State Hospital, Istanbul, Turkey
| | - Halil Çağrı Aybal
- Department of Urology, Kahramankazan Hamdi Eris State Hospital, Ankara, Turkey
| | - Eymen Gazel
- Department of Urology, Acıbadem University Ankara Hospital, Ankara, Turkey
| | - Engin Kaya
- Department of Urology, Health Sciences University, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Lütfi Tunç
- Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey
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28
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Suerink M, Kilinç G, Terlouw D, Hristova H, Sensuk L, van Egmond D, Farina Sarasqueta A, Langers AMJ, van Wezel T, Morreau H, Nielsen M. Prevalence of mismatch repair deficiency and Lynch syndrome in a cohort of unselected small bowel adenocarcinomas. J Clin Pathol 2020; 74:724-729. [PMID: 33046565 PMCID: PMC8543220 DOI: 10.1136/jclinpath-2020-207040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/11/2022]
Abstract
AIMS Previous estimates of the prevalence of mismatch repair (MMR) deficiency and Lynch syndrome in small bowel cancer have varied widely. The aim of this study was to establish the prevalence of MMR deficiency and Lynch syndrome in a large group of small bowel adenocarcinomas. METHODS To this end, a total of 400 small bowel adenocarcinomas (332 resections, 68 biopsies) were collected through the Dutch nationwide registry of histopathology and cytopathology (Pathologisch-Anatomisch Landelijk Geautomatiseerd Archief (PALGA)). No preselection criteria, such as family history, were applied, thus avoiding (ascertainment) bias. MMR deficiency status was determined by immunohistochemical staining of MMR proteins, supplemented by MLH1 promoter hypermethylation analysis and next generation sequencing of the MMR genes. RESULTS MMR deficiency was observed in 22.3% of resected and 4.4% of biopsied small bowel carcinomas. Prevalence of Lynch syndrome was 6.2% in resections and 0.0% in biopsy samples. Patients with Lynch syndrome-associated small bowel cancer were significantly younger at the time of diagnosis than patients with MMR-proficient and sporadic MMR-deficient cancers (mean age of 54.6 years vs 66.6 years and 68.8 years, respectively, p<0.000). CONCLUSIONS The prevalence of MMR deficiency and Lynch syndrome in resected small bowel adenocarcinomas is at least comparable to prevalence in colorectal cancers, a finding relevant both for treatment (immunotherapy) and family management. We recommend that all small bowel adenocarcinomas should be screened for MMR deficiency.
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Affiliation(s)
| | - Gül Kilinç
- Clinical Genetics, LUMC, Leiden, The Netherlands
| | - Diantha Terlouw
- Clinical Genetics, LUMC, Leiden, The Netherlands.,Pathology, LUMC, Leiden, The Netherlands
| | | | - Lily Sensuk
- Clinical Genetics, LUMC, Leiden, The Netherlands
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29
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Bessoff KE, Choi J, Bereknyei Merrell S, Nassar AK, Spain D, Knowlton LM. Creation and implementation of a novel clinical workflow based on the AAST uniform anatomic severity grading system for emergency general surgery conditions. Trauma Surg Acute Care Open 2020; 5:e000552. [PMID: 32953998 PMCID: PMC7481073 DOI: 10.1136/tsaco-2020-000552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/01/2020] [Accepted: 08/16/2020] [Indexed: 01/04/2023] Open
Abstract
Objective Emergency general surgery (EGS) conditions encompass a variety of diseases treated by acute care surgeons. The heterogeneity of these diseases limits infrastructure to facilitate EGS-specific quality improvement (QI) and research. A uniform anatomic severity grading system for EGS conditions was recently developed to fill this need. We integrated this system into our clinical workflow and examined its impact on research, surgical training, communication, and patient care. Methods The grading system was integrated into our clinical workflow in a phased fashion through formal education and a written handbook. A documentation template was also deployed in our electronic medical record to prospectively assign severity scores at the time of patient evaluation. Mixed methods including a quantitative survey and qualitative interviews of trainees and attending surgeons were used to evaluate the impact of the new workflow and to identify obstacles to its adoption. Results We identified 2291 patients presenting with EGS conditions during our study period. The most common diagnoses were small bowel obstruction (n=470, 20.5%), acute cholecystitis (n=384, 16.8%), and appendicitis (n=370, 16.1%). A total of 21 qualitative interviews were conducted. Twenty interviewees (95.2%) had a positive impression of the clinical workflow, citing enhanced patient care and research opportunities. Fifteen interviewees (75.0%) reported the severity grading system was a useful framework for clinical management, with five participants (25.0%) indicating the system was useful to facilitate clinical communication. Participants identified solutions to overcome barriers to adoption of the clinical workflow. Conclusions The uniform anatomic severity grading system can be readily integrated into a clinical workflow to facilitate prospective data collection for QI and research. The system is perceived as valuable by users. Educational initiatives that focus on increasing familiarity with the system and its benefits will likely improve adoption of the classification system and the clinical workflow that uses it. Level of evidence Level III.
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Affiliation(s)
- Kovi E Bessoff
- General Surgery, Stanford University, Stanford, California, USA
- Students and Surgeons writing About Trauma, Department of Surgery, Stanford University, Stanford, CA, USA
| | - Jeff Choi
- General Surgery, Stanford University, Stanford, California, USA
- Students and Surgeons writing About Trauma, Department of Surgery, Stanford University, Stanford, CA, USA
| | | | - Aussama Khalaf Nassar
- Students and Surgeons writing About Trauma, Department of Surgery, Stanford University, Stanford, CA, USA
- Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - David Spain
- Students and Surgeons writing About Trauma, Department of Surgery, Stanford University, Stanford, CA, USA
- Department of Surgery, Stanford University, Stanford, California, USA
| | - Lisa Marie Knowlton
- General Surgery, Stanford University, Stanford, California, USA
- Students and Surgeons writing About Trauma, Department of Surgery, Stanford University, Stanford, CA, USA
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30
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Booth AL, Gonzalez RS. Helicobacter pylori colonisation of duodenal foveolar metaplasia requires concurrent gastric infection. J Clin Pathol 2020; 74:537-539. [PMID: 32934104 DOI: 10.1136/jclinpath-2020-206844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 11/04/2022]
Abstract
AIMS Evaluate the rate and significance of Helicobacter pylori (H. pylori) involving duodenal foveolar metaplasia of chronic peptic duodenitis (CPD). METHODS We identified 100 biopsy cases of CPD with synchronous stomach biopsies. All 200 were reviewed for histological changes (eg, chronic gastritis, acute inflammation) and underwent immunohistochemical staining for H. pylori. Results were correlated with patient age, sex, endoscopy indication and findings on stomach biopsy. RESULTS Cases included 49 men and 51 women, with a median age of 56 years. Reflux or dysphagia was the most common symptom. Chronic gastritis was present in 46 stomach biopsies, with 54 within normal limits. Twelve stomach biopsies showed H. pylori, all of which showed gastritis. Two duodenal biopsies (2%) demonstrated H. pylori organisms on immunohistochemistry, both from patients with H. pylori gastritis. CONCLUSIONS Routine examination of CPD samples for H. pylori appears unnecessary if a stomach biopsy is available for review.
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Affiliation(s)
- Adam L Booth
- Pathology, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Raul S Gonzalez
- Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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31
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Abstract
In the field of nano- and microscale science and technology, Small has become one of the worldwide leading journals since its initiation 15 years ago. Among all the topics covered in Small, "nanosafety" has received growing interest over the years, which accounts for a large proportion of the total publications of Small. Herein, inspired by its coming Special Issue "Rethinking Nanosafety," a general bibliometric overview of the nanosafety studies that have been published in Small is presented. Using the data derived from the Web of Science Core Collection, the annual publication growth, most influential countries/institutions as well as the visualized collaborations between different countries and institutions based on CiteSpace software are presented. A special emphasis on the impact of the previous Special Issue from Small that is related to nanosafety research is given and the research trend from the most highly cited papers during last 15 years is analyzed. Lastly, future research directions are also proposed.
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Affiliation(s)
- Shuang Zhu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing, 100049, China
| | - Lele Li
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Chinese Academy of Science, Beijing, 100190, China
| | - Zhanjun Gu
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, Institute of High Energy Physics and National Center for Nanoscience and Technology, Chinese Academy of Sciences, Beijing, 100049, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chunying Chen
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Chinese Academy of Science, Beijing, 100190, China
| | - Yuliang Zhao
- CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Chinese Academy of Science, Beijing, 100190, China
- College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
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Park KB, Jeon SW. Endoscopic Treatment of a Twisted Small Bowel Obstruction after Laparoscopic Proximal Gastrectomy with Double Tract Reconstruction. Korean J Gastroenterol 2020; 75:296-299. [PMID: 32448860 DOI: 10.4166/kjg.2020.75.5.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/25/2020] [Accepted: 04/06/2020] [Indexed: 11/03/2022]
Abstract
This paper reports a case of a twisted small bowel obstruction in a 74-year-old man that occurred after a double tract reconstruction (DTR) in a laparoscopic proximal gastrectomy (PG) for early gastric cancer. The patient had inadequate oral intake and reflux symptoms for 10 days after discharge. Imaging analysis revealed a narrowed small bowel with twists between the esophagojejunostomy and gastrojejunostomy sites. A fully covered stent was placed in the narrowed small bowel for 2 weeks. The patient was then discharged after stent removal without any dietary problems. The authors' experience shows that twisted small bowel after a DTR in PG can be treated by endoscopy.
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Affiliation(s)
- Ki Bum Park
- Department of Surgery, Kyungpook National University, Daegu, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, Kyungpook National University, Daegu, Korea
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33
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Li Q, Li X, Zhao C. Strategies to Obtain Encapsulation and Controlled Release of Small Hydrophilic Molecules. Front Bioeng Biotechnol 2020; 8:437. [PMID: 32478055 PMCID: PMC7237580 DOI: 10.3389/fbioe.2020.00437] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/16/2020] [Indexed: 12/03/2022] Open
Abstract
The therapeutic effect of small hydrophilic molecules is limited by the rapid clearance from the systemic circulation or a local site of administration. The unsuitable pharmacokinetics and biodistribution can be improved by encapsulating them in drug delivery systems. However, the high-water solubility, very hydrophilic nature, and low molecular weight make it difficult to encapsulate small hydrophilic molecules in many drug delivery systems. In this mini-review, we highlight three strategies to efficiently encapsulate small hydrophilic molecules and achieve controlled release: physical encapsulation in micro/nanocapsules, physical adsorption via electronic interactions, and covalent conjugation. The principles, advantages, and disadvantages of each strategy are discussed. This review paper could be a guide for scientists, engineers, and medical doctors who want to improve the therapeutic efficacy of small hydrophilic drugs.
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Affiliation(s)
| | | | - Chao Zhao
- Department of Chemical and Biological Engineering, The University of Alabama, Tuscaloosa, AL, United States
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王 骁, 李 兆, 范 焕, 魏 莉, 郭 旭, 郭 娜, 王 彤. [A rare case of cystadenoma in the small intestine]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:382-384. [PMID: 32306027 PMCID: PMC7433445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Indexed: 09/20/2023]
Abstract
In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.
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Affiliation(s)
- 骁 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 兆星 李
- 河北医科大学附属河北省肿瘤医院外三科, 石家庄 050011The Third Surgery Department, Hebei Tumor Hospital Affiliated to Hebei Medical University, Shijiazhuang 050011, China
| | - 焕芳 范
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 莉瑛 魏
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 旭瑾 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 娜 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 彤 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
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35
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王 骁, 李 兆, 范 焕, 魏 莉, 郭 旭, 郭 娜, 王 彤. [A rare case of cystadenoma in the small intestine]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:382-384. [PMID: 32306027 PMCID: PMC7433445 DOI: 10.19723/j.issn.1671-167x.2020.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Indexed: 06/11/2023]
Abstract
In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.
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Affiliation(s)
- 骁 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 兆星 李
- 河北医科大学附属河北省肿瘤医院外三科, 石家庄 050011The Third Surgery Department, Hebei Tumor Hospital Affiliated to Hebei Medical University, Shijiazhuang 050011, China
| | - 焕芳 范
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 莉瑛 魏
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 旭瑾 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 娜 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 彤 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
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Pampena R, Piana S, Manfreda V, Bianchi L, Pellacani G, Longo C. Too small to be true! Skin Res Technol 2019; 26:438-439. [PMID: 31535390 DOI: 10.1111/srt.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 09/05/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Simonetta Piana
- Pathology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valeria Manfreda
- Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome "Tor Vergata", Rome, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Tai J, Liu J, Lv J, Huibin K, Hou Z, Yang J, Zhang H, Huang Q. Risk factors predicting a higher grade of subarachnoid haemorrhage in small ruptured intracranial aneurysm (< 5 mm). Neurol Neurochir Pol 2019; 53:296-303. [PMID: 31397878 DOI: 10.5603/pjnns.a2019.0029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/18/2019] [Accepted: 06/21/2019] [Indexed: 11/25/2022]
Abstract
AIM To identify the risk factors for clinical and radiographic grades of subarachnoid haemorrhage (SAH) in small (< 5 mm) intracranial aneurysms (SIAs). MATERIAL AND METHODS We retrospectively analysed patients with SIAs treated in our centre between February 2009 and June 2018. The clinical status was graded using the Hunt and Hess (H&H) score and the radiological severity of SAH was graded by Fisher grades (FG). The risk factors were determined using multivariate logistic regression analysis. RESULTS A total of 160 patients with ruptured SIAs (< 5 mm) were included. In univariate analysis, smoking (P = 0.007), alcohol use (P = 0.048), aspirin use (P = 0.001), and higher size ratio (SR) (P = 0.001) were significantly associated with a higher H&H grade (3-5) in SIAs; and smoking (P = 0.019), aspirin use (P = 0.031), inflow angle < 90 degrees (P = 0.011), and aneurysm size (P = 0.039) were significantly associated with a higher FG score (3-4). In the adjusted multivariate analysis, previous SAH (OR, 12.245, 95% CI, 2.261-66.334, P = 0.004), aspirin use (OR, 4.677, 95% CI, 1.392-15.718, P = 0.013), alcohol use (OR, 3.392, 95% CI, 1.146-10.045, P = 0.027), inflow angle < 90 (OR, 3.881, 95% CI, 1.273-11.831, P = 0.017), and higher SR (OR, 6.611, 95% CI, 2.235-19.560, P = 0.001) were independent risk factors for a higher H&H grade in ruptured SIAs; smoking (OR, 2.157, 95% CI, 1.061-4.384, P = 0.034), and inflow angle < 90 degrees (OR, 2.603, 95% CI, 1.324-5.115, P = 0.006) were independent risk factors for a higher FG (3-4). CONCLUSIONS This study revealed that inflow angle < 90 degrees and size ratio, but not absolute size, may highly predict poorer grade of SAH in SRA. Aspirin use, previous SAH, and alcohol use were significantly associated with a higher H&H grade in ruptured SIAs, and smoking was a significant predictor of poorer FG.
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Affiliation(s)
- Junli Tai
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China.
| | - Jianxin Liu
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
| | - Jianhua Lv
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
| | - Kang Huibin
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
| | - Zhe Hou
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
| | - Jun Yang
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
| | - Hongbing Zhang
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
| | - Qing Huang
- Department of Neurosurgery in Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 100076 beijing, China
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Abstract
Small copper sulfide nanoparticles (s-Cu2-xS NPs, 0 < x < 1) with a core size of less than 5.5 nm have unique physicochemical characteristics and pharmacokinetic properties and have attracted substantial attention from researchers in the field of biomedicine in recent years. After exposure to near-infrared (NIR) light, s-Cu2-xS NPs can rapidly convert light energy into heat for photoacoustic imaging (PAI) and photothermal therapy (PTT). In addition, the potential for magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging, along with the low toxicity and low cost, makes s-Cu2-xS NPs a promising multifunctional diagnostic reagent. This Review outlines recent advances in s-Cu2-xS NPs for molecular imaging and tumor therapy and discusses the challenges associated with successful clinical translation.
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Affiliation(s)
- Yang Liu
- School of Biological Science & Medical Engineering , Southeast University , Nanjing 210096 , China
| | - Min Ji
- School of Biological Science & Medical Engineering , Southeast University , Nanjing 210096 , China
| | - Peng Wang
- School of Engineering , China Pharmaceutical University , Nanjing 211198 , China
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Yuan W, Yang MJ, Xu J, Yan ZP, Liu R, Qu XD, Wang JH, Qian S. Radiofrequency Ablation Combined With Transarterial Chemoembolization for Specially Located Small Hepatocellular Carcinoma. Technol Cancer Res Treat 2018; 17:1533033818788529. [PMID: 30045673 PMCID: PMC6071156 DOI: 10.1177/1533033818788529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To investigate the safety and efficacy of radiofrequency ablation combined with transarterial chemoembolization in patients with specially located small hepatocellular carcinoma. MATERIALS AND METHODS Between March 2014 and March 2017, a total of 26 patients with 26 lesions (10 perivascular, 6 subdiaphragmatic, 5 subcapsular, 5 perivascular, and subdiaphragmatic location; mean diameter 2.12 (0.62) cm), who received radiofrequency ablation-transarterial chemoembolization treatment, were retrospectively analyzed. Local tumor response was assessed by computed tomography/magnetic resonance imaging 1 month after the procedure. Tumor-free survival was also assessed according to the modified Response Evaluation Criteria in Solid Tumors. Complications were evaluated according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (version 4.0). RESULTS Complete response was achieved in all patients 1 month after the procedure. During a median follow-up duration of 16.76 months (95% confidence interval: 7.78-25.73 months), local tumor recurrence occurred in 2 patients and new intrahepatic lesions developed in 7 patients. The 1-, 2-, and 3-year cumulative local tumor progression rates were 3.84%, 7.69%, and 7.69%, respectively. The median tumor-free survival duration was 21.96 months (95% confidence interval: 17.58-26.34 months). The 1-, 2-, and 3-year tumor-free survival rates were 67.4%, 46.1%, and 39.3%, respectively. CONCLUSION The radiofrequency ablation-transarterial chemoembolization combination therapy appears to be safe and effective and might be a treatment option for specially located small hepatocellular carcinoma lesions that have a risk of incomplete ablation or major complications.
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Affiliation(s)
- Wei Yuan
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
| | - Min-Jie Yang
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
| | - Jiang Xu
- 3 Department of Rehabilitation, Huai'an Second People's Hospital, The Affiliated Hospital of Xuzhou Medical University, Huai'an, China
| | - Zhi-Ping Yan
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
| | - Rong Liu
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
| | - Xu-Dong Qu
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
| | - Jian-Hua Wang
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
| | - Sheng Qian
- 1 Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.,2 Shanghai Institution of Medical Imaging, Shanghai, China
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Abstract
The goal of this study is to determine the feasibility, diagnostic accuracy, and risk factor of complications of computed tomography (CT)-guided percutaneous cutting needle biopsy (PCNB) for small lung nodules.From January 2014 to May 2015, 141 patients with small lung nodule were performed with CT-guided PCNB procedure. Data on technical success, diagnostic accuracy, and complication were collected and analyzed.Technical success of CT-guided PCNB for small lung nodules was 100%. A total of 141 nodules were punctured. The mean time of the procedure was 15.7 ± 4.3 minutes. The PCNB results included malignancy (n = 79), suspected malignancy (n = 6), specific benign lesion (n = 8), nonspecific benign lesion (n = 47), and invalid diagnosis (n = 1). The final diagnosis of the 141 nodules included malignancy (n = 90), benign (n = 37), and nondiagnostic lesion (n = 14). The nondiagnostic nodules were not included for calculating the diagnostic accuracy. The sensitivity, specificity, and overall diagnostic accuracy of CT-guided PCNB for small lung nodule were 94.4% (85/90), 100% (37/37), and 96.1% (122/127), respectively. Pneumothorax and lung hemorrhage (≥ grade 2) occurred in 17 (12.1%) and 22 (15.6%) patients, respectively. Based on the univariate and multivariate logistic analyses, the risk factors of pneumothorax included nonprone position (P = .019) and longer procedure time (P = .018). The independent risk factor of lung hemorrhage (≥ grade 2) was deeper lesion distance from pleura along needle path (P = .024).This study demonstrates that CT-guided PCNB can provide a high diagnostic accuracy for small lung nodule with acceptable complications.
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D'Orio V, Demondion P, Lebreton G, Coutance G, Varnous S, Leprince P. Acquired transdiaphragmatic hernia: an unusual cause of cardiac tamponade. Asian Cardiovasc Thorac Ann 2017; 25:233-236. [PMID: 28325075 DOI: 10.1177/0218492317698326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transdiaphragmatic peritoneopericardial hernia is a rare complication after peritoneopericardial window formation, coronary artery bypass grafting using the gastroepiploic artery, or subxiphoid epicardial pacemaker insertion. We describe two different clinical presentations of transdiaphragmatic peritoneopericardial hernia in patients who had undergone recent heart transplantation. One was an exceptional case of cardiac tamponade caused by small bowel strangulation through a diaphragmatic defect.
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Affiliation(s)
- Virginie D'Orio
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Pierre Demondion
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Guillaume Lebreton
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Guillaume Coutance
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Sheida Varnous
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Pascal Leprince
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
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Abstract
OBJECTIVE We analyzed contrast-enhanced ultrasound (CEUS) features of histologically proved small (≤20 mm) liver metastases, in comparison to small (≤20 mm) hepatocellular carcinomas (HCC), to define the differentiate diagnoses value of CEUS in clinical practice. MATERIAL AND METHODS Eighty-two cases of small (≤20 mm) liver metastases and 84 cases of small (≤20 mm) HCC were retrospectively reviewed. All patients had CEUS images. Two radiologists assessed CEUS enhancement pattern and time of enhancement in consensus. Statistical analyses were performed using SPSS v.19.0 (SPSS Inc., Chicago, IL). The χ2 test and the independent sample t-test were used to compare the differences. RESULTS Comparing to small HCCs, rapid rim-like hyper-enhancement in arterial phase (56.1% in liver metastases vs. 2.3% in HCCs, p < .01), rapid wash-out and become hypo-enhancement in late arterial phase or early portal venous phase (96.4% in liver metastases vs. 22.6% in HCCs, p < .01) with central non-enhanced area in late phase were characteristic CEUS features of small metastases. CONCLUSIONS CEUS imaging enhancement findings reliably offer typical signs of small liver metastases, differentiate effectively with small HCCs. CEUS can help to improve the diagnostic confidence of small liver metastases.
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Affiliation(s)
- Yi Dong
- a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China
| | - Xiao-Long Zhang
- b Department of Ultrasound , Shanghai Institute of Imaging , Shanghai , China
| | - Feng Mao
- b Department of Ultrasound , Shanghai Institute of Imaging , Shanghai , China
| | - Bei-Jian Huang
- a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China
| | - Qin Si
- c Department of Ultrasound , 81st Hospital of Chinese PLA , Nanjing Jiangsu , China
| | - Wen-Ping Wang
- a Department of Ultrasound , Zhongshan Hospital, Fudan University , Shanghai , China
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Lachhab I, Traoré BZ, Saoud O, Khedid YZAA, Zouaidia F, Echarrab M, Chkoff MR. Small bowel volvulus with intussusception: an unusual revelation of neuroendocrine tumor. Pan Afr Med J 2015; 22:6. [PMID: 26600906 PMCID: PMC4643153 DOI: 10.11604/pamj.2015.22.6.7132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 06/07/2015] [Indexed: 11/20/2022] Open
Abstract
The primary malignant tumors of the small bowel are rare, representing 1 to 1.4% of all gastrointestinal tumors. We report a case of a 33 year-old women, admitted to our emergency department of visceral surgery for acute abdomen. The clinical examination revealed diffuse abdominal distension, defenseless, the hernia orifices were free and the rectal examination was normal. The biological test showed no hydro electrolytic disorders with normal hemoglobin and normal renal function. The abdominal CT-Scan showed signs of bowel obstruction due to a volvulus with intussusception without ischemia. The patient was operated urgently; the exploration has revealed a small bowel obstruction in the ileum with volvulus, an intussusceptum associated with a retractile mesenteritis, and the hepatic exploration found no metastases. The patient underwent a bowel resection taking away the intussusceptum with the infiltrated mesentery. The postoperative course was uneventful. The pathological result has proved a well-differentiated neuroendocrine tumor with five free nodes. Through this observation, we aim to highlight that an obstruction of small bowel with volvulus and intussusception could be exceptionally due to a neuroendocrine tumor, this complication has enabled a relatively early diagnosis in the absence of metastases and a 6-month follow-up without recurrence is a demonstration.
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Affiliation(s)
- Imad Lachhab
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | - Boubacar Zan Traoré
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | - Omar Saoud
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | | | - Fouad Zouaidia
- Department of Pathology, IBN Sina University Hospital, Rabat, Morocco
| | - Mahjoub Echarrab
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
| | - Mohamed Rachid Chkoff
- Departement of Visceral Surgical Emergency, IBN Sina University Hospital, Rabat, Morocco
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Chou TH, Delmar JA, Wright CC, Kumar N, Radhakrishnan A, Doh JK, Licon MH, Bolla JR, Lei HT, Rajashankar KR, Su CC, Purdy GE, Yu EW. Crystal structure of the Mycobacterium tuberculosis transcriptional regulator Rv0302. Protein Sci 2015; 24:1942-55. [PMID: 26362239 DOI: 10.1002/pro.2802] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/08/2015] [Accepted: 09/11/2015] [Indexed: 11/10/2022]
Abstract
Mycobacterium tuberculosis is a pathogenic bacterial species, which is neither Gram positive nor Gram negative. It has a unique cell wall, making it difficult to kill and conferring resistance to antibiotics that disrupt cell wall biosynthesis. Thus, the mycobacterial cell wall is critical to the virulence of these pathogens. Recent work shows that the mycobacterial membrane protein large (MmpL) family of transporters contributes to cell wall biosynthesis by exporting fatty acids and lipidic elements of the cell wall. The expression of the Mycobacterium tuberculosis MmpL proteins is controlled by a complicated regulatory network system. Here we report crystallographic structures of two forms of the TetR-family transcriptional regulator Rv0302, which participates in regulating the expression of MmpL proteins. The structures reveal a dimeric, two-domain molecule with architecture consistent with the TetR family of regulators. Comparison of the two Rv0302 crystal structures suggests that the conformational changes leading to derepression may be due to a rigid body rotational motion within the dimer interface of the regulator. Using fluorescence polarization and electrophoretic mobility shift assays, we demonstrate the recognition of promoter and intragenic regions of multiple mmpL genes by this protein. In addition, our isothermal titration calorimetry and electrophoretic mobility shift experiments indicate that fatty acids may be the natural ligand of this regulator. Taken together, these experiments provide new perspectives on the regulation of the MmpL family of transporters.
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Affiliation(s)
- Tsung-Han Chou
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa, 50011
| | - Jared A Delmar
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa, 50011
| | - Catherine C Wright
- Department of Molecular Microbiology and Immunology, Oregon Health and Sciences University, Portland, Oregon, 97239
| | - Nitin Kumar
- Department of Chemistry, Iowa State University, Ames, Iowa, 50011
| | | | - Julia K Doh
- Department of Molecular Microbiology and Immunology, Oregon Health and Sciences University, Portland, Oregon, 97239
| | - Meredith H Licon
- Department of Molecular Microbiology and Immunology, Oregon Health and Sciences University, Portland, Oregon, 97239
| | - Jani Reddy Bolla
- Department of Chemistry, Iowa State University, Ames, Iowa, 50011
| | - Hsiang-Ting Lei
- Department of Chemistry, Iowa State University, Ames, Iowa, 50011
| | - Kanagalaghatta R Rajashankar
- NE-CAT and Department of Chemistry and Chemical Biology, Argonne National Laboratory, Cornell University, Argonne, Illinois, 60439
| | - Chih-Chia Su
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa, 50011
| | - Georgiana E Purdy
- Department of Molecular Microbiology and Immunology, Oregon Health and Sciences University, Portland, Oregon, 97239
| | - Edward W Yu
- Department of Physics and Astronomy, Iowa State University, Ames, Iowa, 50011.,Department of Chemistry, Iowa State University, Ames, Iowa, 50011
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Hobkirk JP, King RF, Davies I, Harman N, Gately P, Pemberton P, Smith A, Barth JH, Carroll S. The metabolic inter-relationships between changes in waist circumference, triglycerides, insulin sensitivity and small, dense low-density lipoprotein particles with acute weight loss in clinically obese children and adolescents. Pediatr Obes 2014; 9:209-17. [PMID: 23616363 DOI: 10.1111/j.2047-6310.2013.00165.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 01/10/2013] [Accepted: 02/11/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Small, dense low-density lipoprotein (LDL) particles are highly atherogenic and strongly associated with obesity-related dyslipidemia. The metabolic inter-relationships between weight loss induced changes in waist circumference, triglycerides, insulin sensitivity and small-dense LDL particles in clinically obese children and adolescents have not been studied. METHODS Seventy-five clinically obese boys and girls (standardized body mass index 3.07 ± 0.59, aged 8-18 years) were recruited. Anthropometric, body composition and cardiometabolic risk factors were measured pre- and post-weight loss. RESULTS There were highly significant reductions in anthropometric, body composition and cardiometabolic risk factors. Triglyceride change was positively correlated with LDL peak particle density and percentage LDL pattern B changes (relative abundance of small, dense LDL particles). Multiple regression analyses showed that changes in triglyceride concentration accounted for between 24 and 18% of the variance in LDL peak particle density and percentage LDL pattern B change, respectively. Changes in waist circumference and insulin sensitivity did not predict these changes in LDL characteristics. CONCLUSION Acute and highly significant weight loss significantly decreased LDL peak particle density and percentage LDL pattern B. The change in triglycerides was a strong predictor of LDL peak particle density and percentage LDL pattern B change.
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Affiliation(s)
- J P Hobkirk
- Department of Academic Endocrinology, Diabetes and Metabolism, University of Hull, Hull, UK
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Nikeghbalian S, Aliakbarian M, Kazemi K, Shamsaeefar AR, Mehdi SH, Bahreini A, Malek-Hosseini SA. Ex-vivo Resection and Small-Bowel Auto-transplantation for the Treatment of Tumors at the Root of the Mesentery. Int J Organ Transplant Med 2014; 5:120-4. [PMID: 25184032 PMCID: PMC4149739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Tumors involving the root of the mesentery are generally regarded as "unresectable" with conventional surgical techniques. Resection with conventional surgery may end in life-threatening complications in these patients. Ex-vivo resection and auto-transplantation avoids excessive bleeding and prevents ischemic related damage to the small intestine and other organs. OBJECTIVE To share our experience of ex-vivo resection of the tumors with involvement of small bowel mesentery followed by small bowel auto-transplantation. METHODS In this study, medical records of all the patients who underwent ex-vivo resection and auto-transplantation at our center were retrospectively analyzed. RESULTS The most common indication for the procedure in our series was locally advanced pancreatic carcinoma. Our survival rate was 50% with a mean±SD follow-up of 10.1±9.8 (range: 0-26) months. Causes of early in-hospital mortality were multi-organ failure, sepsis, and cerebrovascular accident. Recurrence of disease was noted in one patient while one patient developed hepatic metastasis after 20 months of surgery. CONCLUSION Ex-vivo resection of the tumor and auto-transplantation is the surgical treatment of choice for the locally advanced abdominal tumors involving the root of the mesentery.
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Affiliation(s)
- S. Nikeghbalian
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. Aliakbarian
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Correspondence: Mohsen Aliakbarian, MD, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Tel: +98-51-3802-2677, Fax: +98-51-3852-5255, E-mail:
| | - K. Kazemi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A. R. Shamsaeefar
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S. H. Mehdi
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A. Bahreini
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S. A. Malek-Hosseini
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Roayaie S, Obeidat K, Sposito C, Mariani L, Bhoori S, Pellegrinelli A, Labow D, Llovet JM, Schwartz M, Mazzaferro V. Resection of hepatocellular cancer ≤2 cm: results from two Western centers. Hepatology 2013; 57:1426-35. [PMID: 22576353 PMCID: PMC3442120 DOI: 10.1002/hep.25832] [Citation(s) in RCA: 271] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Accepted: 05/03/2012] [Indexed: 12/17/2022]
Abstract
UNLABELLED Asian series have shown a 5-year survival rate of ≈70% after resection of hepatocellular carcinoma (HCC) ≤2 cm. Western outcomes with resection have not been as good. In addition, ablation of HCC ≤2 cm has been shown to achieve competitive results, leaving the role of resection in these patients unclear. Records of patients undergoing resection at two Western centers between January 1990 and December 2009 were reviewed. Patients with a single HCC ≤2 cm on pathologic analysis were included. Thirty clinical variables including demographics, liver function, tumor characteristics, nature of the surgery, and the surrounding liver were examined. An exploratory statistical analysis was conducted to determine variables associated with recurrence and survival. The study included 132 patients with a median follow-up of 37.5 months. There was one (<1%) 90-day mortality. There were 32 deaths with a median survival of 74.5 months and a 5-year survival rate of 70% (63% in patients with cirrhosis). The median time to recurrence was 31.6 months and the 5-year recurrence rate was 68%. Presence of satellites (hazard ratio [HR], 2.46; P = 0.031) and platelet count <150,000/μL (HR, 2.37; P = 0.026) were independently associated with survival. Presence of satellites (HR, 2.79; P = 0.003), cirrhosis (HR, 2.3; P = 0.010), and nonanatomic resection (HR, 1.79; P = 0.031) were independently associated with recurrence. Patients with a single HCC ≤2 cm and platelet count ≥150,000/μL achieved a median survival of 138 months and a 5-year survival rate of 8%, respectively. CONCLUSION Resection of HCC ≤2 cm is safe and achieves excellent results in Western centers. Recurrence continues to be a significant problem. Presence of satellites, platelet count, anatomic resection, and cirrhosis are associated with outcomes after resection, even among such early tumors. Resection should continue to be considered a primary treatment modality in patients with small HCC and well-preserved liver function.
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Affiliation(s)
- Sasan Roayaie
- Liver Cancer Program, Mount Sinai Medical Center, New York, NY 10029, USA.
| | - Khaled Obeidat
- Liver Cancer Program, Mount Sinai Medical Center, New York, NY, United States
| | - Carlo Sposito
- Hepato-Oncology Group, Surgery, Gastroenterology, Pathology, and Biostatistics, National Cancer Institute - Istituto Nazionale dei Tumori, Milan, Italy
| | - Luigi Mariani
- Hepato-Oncology Group, Surgery, Gastroenterology, Pathology, and Biostatistics, National Cancer Institute - Istituto Nazionale dei Tumori, Milan, Italy
| | - Sherrie Bhoori
- Hepato-Oncology Group, Surgery, Gastroenterology, Pathology, and Biostatistics, National Cancer Institute - Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Pellegrinelli
- Hepato-Oncology Group, Surgery, Gastroenterology, Pathology, and Biostatistics, National Cancer Institute - Istituto Nazionale dei Tumori, Milan, Italy
| | - Daniel Labow
- Liver Cancer Program, Mount Sinai Medical Center, New York, NY, United States
| | - Josep M. Llovet
- Liver Cancer Program, Mount Sinai Medical Center, New York, NY, United States,BCLC Group, Liver Unit, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain,Institució Catalana d'Estudis Avancats (ICREA), Barcelona, Catalonia, Spain
| | - Myron Schwartz
- Liver Cancer Program, Mount Sinai Medical Center, New York, NY, United States
| | - Vincenzo Mazzaferro
- Hepato-Oncology Group, Surgery, Gastroenterology, Pathology, and Biostatistics, National Cancer Institute - Istituto Nazionale dei Tumori, Milan, Italy
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Kalra N, Kang M, Bhatia A, Duseja AK, Dhiman RK, Arya VK, Rajwanshi A, Chawla YK, Khandelwal N. Role of radiofrequency ablation in unresectable hepatocellular carcinoma: An Indian experience. Indian J Radiol Imaging 2013; 23:139-44. [PMID: 24082478 PMCID: PMC3777323 DOI: 10.4103/0971-3026.116569] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIMS To evaluate the role of radiofrequency ablation (RFA) as an ablative technique in patients with unresectable hepatocellular carcinoma (HCC). SETTINGS AND DESIGN A tertiary care center, prospective study. MATERIALS AND METHODS The subjects comprised 31 patients (30 males, one female; age range 32-75 years) with HCC (41 lesions) who were treated with image-guided RFA. The follow-up period ranged from 3 months to 6 years, and included a multiphasic computed tomography (CT) at 1, 3 and 6 months post-RFA, and every 6 months thereafter. Patient outcome was evaluated and the tumor recurrence, survival and complications were assessed. STATISTICAL ANALYSIS USED Discrete categorical data were presented as n (%) and continuous data as mean ± SD. Pearson correlation coefficient was used to determine the relationship between the different variables. Kaplan-Meier survival curve and Log-rank test were used to test the significance of difference between the survival time of the different groups. RESULTS The ablation success rate was 80.5% (33/41 HCC lesions). 12.2% (5/41) of the lesions were managed with repeat RFA due to tumor residue. 4.9% (2/41) of the lesions were managed with repeated RFA and transarterial chemoembolization. Eight patients had tumor recurrence (five patients (16.1%) had local recurrence and three patients (9.6%) had distant recurrence). Eleven patients died within 3.5-20 months post-RFA. The survival rate at 1 year in patients who completed at least 1 year of follow-up was 63.3%. There was one major complication (1/31, 3.2%) in a patient with a subcapsular lesion and ascites. This patient developed hemoperitoneum in the immediate postprocedure period and was managed with endovascular treatment. She, however, had hepatic decompensation and died 48 h post-RFA. CONCLUSION RFA is an effective and safe treatment for small unresectable HCC.
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Affiliation(s)
- Naveen Kalra
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Mandeep Kang
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Anmol Bhatia
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Ajay K Duseja
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Radha K Dhiman
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Virendra K Arya
- Department of Anaesthesia, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynaecology Pathology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Yogesh K Chawla
- Department of Hepatology, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
| | - Niranjan Khandelwal
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, India
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Yu J, Wu C, Zhang X, Ye F, Gallina ME, Rong Y, Wu Y, Sun W, Chan YH, Chiu DT. Stable functionalization of small semiconducting polymer dots via covalent cross-linking and their application for specific cellular imaging. Adv Mater 2012; 24:3498-504. [PMID: 22684783 PMCID: PMC3433747 DOI: 10.1002/adma.201201245] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Indexed: 05/05/2023]
Abstract
A facile cross-linking strategy covalently links functional molecules to semiconducting polymer dots (Pdots) while simultaneously providing functional groups for biomolecular conjugation. In addition to greatly enhanced stability, the formed Pdots are small (<10 nm), which can be difficult to achieve with current methods but is highly desirable for most biological applications. These characteristics are significant for improving labeling efficiency and sensitivity in cellular assays that employ Pdots.
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Affiliation(s)
| | | | - Xuanjun Zhang
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
| | - Fangmao Ye
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
| | - Maria Elena Gallina
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
| | - Yu Rong
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
| | - Yizhe Wu
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
| | - Wei Sun
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
| | - Yang-Hsiang Chan
- Department of Chemistry, University of Washington Seattle, Washington 98195, United States
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Abstract
Small, dense low-density lipoproteins (LDLs) are more susceptible to oxidation than their larger, more buoyant counterparts and therefore the biological modification of these LDL particles may, in part, be responsible for their atherogenic properties. Kotani et al. found that at multiple regression analysis there was an independent and significant inverse correlation between the mean LDL particle size and the oxidative stress status; notably, the authors adjusted not only for the traditional cardiovascular risk factors, but also for drug treatments. Higher levels of small, dense LDL concentrations significantly contribute to atherosclerosis, and lipoprotein size and subfractions may refine cardiovascular disease risk assessment.
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Affiliation(s)
- Ali A Rizvi
- a Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Giuseppe Montalto
- b Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Angelo Maria Patti
- b Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Manfredi Rizzo
- a Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA
- b Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
- c Euro-Mediterranean Institute of Science and Technology, Palermo, Italy.
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