4451
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Strainiene S, Sarlauskas L, Savlan I, Liakina V, Stundiene I, Valantinas J. Multi-organ IgG4-related disease continues to mislead clinicians: A case report and literature review. World J Clin Cases 2020; 8:3267-3279. [PMID: 32874981 PMCID: PMC7441269 DOI: 10.12998/wjcc.v8.i15.3267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/07/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Immunoglobulin G4-related disease (IgG4-RD) is a multisystemic mass forming immune-mediated disease that affects almost every organ and is a diagnostic challenge for every clinician. There is a lack of adequate epidemiological data worldwide, and evidence-based treatment recommendations are not yet established. We report the first case of IgG4-RD from Lithuania and the Baltic Sea region presented with thyroiditis, orbital myositis, orbitopathy, uveitis, scleritis, sialadenitis, autoimmune pancreatitis and prostatitis.
CASE SUMMARY A 54-year-old Caucasian male was admitted to our tertiary Centre complaining of severe weight loss, diarrhoea, abdominal pain, salivary gland swelling, sicca symptoms and diplopia. On examination, bilateral palpable masses in the projection of major salivary glands, severe protrusion of the left eyeball and cachexia were noted. The patient was previously diagnosed with autoimmune thyroiditis and endocrine ophthalmopathy. The magnetic resonance imaging (MRI) of the head revealed enlarged extraocular muscles indicating orbital myositis. The biopsy from the salivary gland mass indicated sialadenitis. Abdominal MRI showed signs of autoimmune pancreatitis, and a serological test revealed the elevated serum IgG4 concentration. The patient was then diagnosed with IgG4-RD and successfully treated with prednisolone. There was a significant clinical, serological and radiological improvement after one month of treatment and no signs of relapse within twenty months. However, it took almost 18 years and the efforts of eight different medical specialists to establish the correct diagnosis.
CONCLUSION A comprehensive approach to the patient is essential to improving the recognition of rare immune system conditions, such as IgG4-RD.
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Affiliation(s)
- Sandra Strainiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Lukas Sarlauskas
- Clinic of Internal Diseases, Family Medicine and Oncology, Centre of Internal Diseases, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ilona Savlan
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Valentina Liakina
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
- Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius 10223, Lithuania
| | - Ieva Stundiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
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4452
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Fu XW, Wu LN, Shan L. Review of possible psychological impacts of COVID-19 on frontline medical staff and reduction strategies. World J Clin Cases 2020; 8:3188-3196. [PMID: 32874973 PMCID: PMC7441266 DOI: 10.12998/wjcc.v8.i15.3188] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 02/05/2023] Open
Abstract
Like soldiers, frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019. It is important to acknowledge the considerable pressure placed on frontline medical staff in the face of a new type of coronavirus that is highly infectious and for which no specific treatment is available. Here, we review the various kinds of psychological problems afflicting frontline medical staff who are combatting the severe acute respiratory syndrome epidemic. These include anxiety, insomnia, depression, interpersonal difficulties, and post-traumatic stress disorder syndrome. We further present a summary of countermeasures for alleviating these problems based on our findings. These countermeasures include ensuring the provision of adequate protective gear for frontline medical staff, developing timely and clear guidelines, strengthening social support, and providing clear criteria and additional training, focusing on the choice of frontline medical staff. An understanding of the psychological impacts of an epidemic situation and of relevant countermeasures will contribute to reducing the psychological pressures on frontline medical staff. Consequently, they will be able to cope better with outbreaks of infectious diseases in the future, to reduce the psychological pressure of the front-line medical staff, and to improve the treatment level.
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Affiliation(s)
- Xiao-Wei Fu
- Department of Nursing, Lianyungang Maternal and Child Health Hospital, Lianyungang 222000, Jiangsu Province, China
| | - Li-Na Wu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
| | - Ling Shan
- Department of Nursing, Lianyungang Maternal and Child Health Hospital, Lianyungang 222000, Jiangsu Province, China
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4453
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Yan FF, Huang BK, Chen YL, Zhuang YZ, You XY, Liu CQ, Li XJ. Coexistence of ovarian serous papillary cystadenofibroma and type A insulin resistance syndrome in a 14-year-old girl: A case report. World J Clin Cases 2020; 8:3334-3340. [PMID: 32874990 PMCID: PMC7441255 DOI: 10.12998/wjcc.v8.i15.3334] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/27/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor. Its coexistence with ovarian serous papillary cystadenofibroma is even rarer.
CASE SUMMARY A 14-year-old girl developed type A insulin resistance syndrome and showed high fasting insulin, glucose, and hemoglobin A1c (HbA1c) levels. The girl suffered from ovarian serous papillary cystadenofibroma. The laboratory results were as follows: fasting insulin was 2624.90 pmol/L and HbA1c was 8.5%. A heterozygous missense mutation on exon 20 of the insulin receptor gene (c.3601C>T, Arg1201Trp) was observed. The histopathological diagnosis was a cystic lesion that extended to the upper right uterus, indicating a right ovarian serous papillary cystadefibroma accompanied by focal interstitial hyperplasia. The patient was treated with metformin for over 6 mo. Additionally, laparoscopic resection (bilateral) of the ovarian lesion and laparoscopic intestinal adhesiolysis were performed under general anesthesia. Diet therapy combined with exercise was then initiated. The patient had an uneventful recovery. The patient also showed improved blood glucose control, with reduced levels of fasting insulin (857.84 pmol/L) and HbA1c (7.0%).
CONCLUSION Insulin resistance may play a significant role in the induction of tumors. It is important to investigate further the association between insulin resistance and tumors and the underlying mechanism.
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Affiliation(s)
- Fang-Fang Yan
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Bing-Kun Huang
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Yin-Ling Chen
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Yan-Zhen Zhuang
- Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Xue-Ye You
- Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Chang-Qin Liu
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
| | - Xue-Jun Li
- Department of Endocrinology and Diabetes, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
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4454
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Li CL, Tang DR, Ji J, Zang B, Chen C, Zhao JQ. Colorectal adenocarcinoma patients with M1a diseases gain more clinical benefits from palliative primary tumor resection than those with M1b diseases: A propensity score matching analysis. World J Clin Cases 2020; 8:3230-3239. [PMID: 32874977 PMCID: PMC7441271 DOI: 10.12998/wjcc.v8.i15.3230] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/25/2020] [Accepted: 06/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Surgical resection is regarded as the only potentially curative treatment option for patients with metastatic colorectal cancer (CRC). The National Comprehensive Cancer Network clinical practice guidelines do not recommend palliative surgery unless there is a risk of severe symptoms. However, accumulating evidence has shown that palliative surgery is associated with more favorable outcomes for patients with metastatic CRC.
AIM To investigate the separate role of palliative primary tumor resection for patients with stage IVA (M1a diseases) and stage IVB (M1b diseases) colorectal adenocarcinoma (CRA).
METHODS CRA patients diagnosed from 2010 to 2015 with definite M1a and M1b categories according to the 8th edition of American Joint Committee on Cancer staging system were selected from the Surveillance Epidemiology and End Results (SEER) database. To minimize potential selection bias, the data were adjusted by propensity score matching (PSM). Baseline characteristics, including gender, year of diagnosis, age, marital status, primary site, surgical information, race, grade, chemotherapy, and radiotherapy, were recorded and analyzed. Univariate and multivariate analyses were performed to explore the separate role of palliative surgery for patients with M1a and M1b diseases.
RESULTS A total of 19680 patients with metastatic CRA were collected from the SEER database, including 10399 cases of M1a diseases and 9281 cases of M1b diseases. Common independent prognostic factors for both M1a and M1b patients included year of diagnosis, age, race, marital status, primary site, grade, surgery, and chemotherapy. After PSM adjustment, 3732 and 3568 matched patients in the M1a and M1b groups were included, respectively. Patients receiving palliative primary tumor resection had longer survival time than those without surgery (P < 0.001). For patients with M1a diseases, palliative resection could increase the median survival time by 9 mo; for patients with M1b diseases, palliative resection could prolong the median survival time by 7 mo. For M1a diseases, patients with lung metastasis had more clinical benefit from palliative resection than those with liver metastasis (15 mo for lung metastasis vs 8 mo for liver metastasis, P < 0.001).
CONCLUSION CRA patients with M1a diseases gain more clinical benefits from palliative primary tumor resection than those with M1b diseases. Those patients with M1a (lung metastasis) have superior long-term outcomes after palliative primary tumor resection.
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Affiliation(s)
- Cheng-Lin Li
- Department of Thoracic Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China
| | - De-Rong Tang
- Department of Thoracic Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China
| | - Jian Ji
- Department of Thoracic Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China
| | - Bao Zang
- Department of Thoracic Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China
| | - Chen Chen
- Department of Thoracic Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China
| | - Jian-Qiang Zhao
- Department of Thoracic Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huaian 223300, Jiangsu Province, China
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4455
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Wang L, Guan HY, Xia HX, Chen XY, Zhang W. Dydrogesterone treatment for menstrual-cycle regularization in abnormal uterine bleeding – ovulation dysfunction patients. World J Clin Cases 2020; 8:3259-3266. [PMID: 32874980 PMCID: PMC7441273 DOI: 10.12998/wjcc.v8.i15.3259] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dydrogesterone has shown significant efficacy in treatment of irregular menstrual cycle due to abnormal uterine bleeding - ovulation dysfunction (AUB-O), but there were few relevant studies. This observational study was designed to evaluate the effectiveness of dydrogesterone for the treatment of Chinese patients with AUB-O.
AIM To evaluate the effects of dydrogesterone on menstrual-cycle (MC) regularization and metabolism in the patients with AUB-O.
METHODS A prospective, non-interventional, single-arm, post-marketing observational study was conducted. Chinese women aged 16 years or above with AUB-O who had been prescribed dydrogesterone were enrolled. The patients were treated with dydrogesterone 10 mg from day 16 to day 25 of each cycle, consecutively for at least 3 cycles. The main outcome was defined as the percentage of patients whose MCs returned to normal (defined as 21 d < menstrual cycle ≤ 35 d) after three cycles of dydrogesterone treatment.
RESULTS One hundred and fourteen women with AUB-O were enrolled in the present study. Of 89 patients who completed treatment, 72 (80.9%) achieved a regular MC at the end of the 3rd circle. The level of androgen, including testosterone and dehydroepiandrosterone sulfate, declined significantly (P = 0.01 and 0.031, respectively), whereas other hormone levels remained steady. During the treatment, 44/80 (55.0%) subjects in the per-protocol set had reported biphasic basal body temperature.
CONCLUSION Dydrogesterone therapy was effective in achieving MC regularization for Chinese patients with AUB-O.
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Affiliation(s)
- Lu Wang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Hai-Yun Guan
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - He-Xia Xia
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Xiu-Ying Chen
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Wei Zhang
- Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
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4456
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Wang KP, Jiang H, Kong C, Wang LZ, Wang GY, Mo JG, Jin C. Adult duodenal intussusception with horizontal adenoma: A rare case report. World J Clin Cases 2020; 8:3314-3319. [PMID: 32874987 PMCID: PMC7441246 DOI: 10.12998/wjcc.v8.i15.3314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/01/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Adult duodenal intussusception rarely occurs, and the majority of duodenal adenomas are located in the descending part of the duodenum. Therefore, adenomas in the horizontal part of the duodenum presenting as duodenal intussusception in adults are extremely rare.
CASE SUMMARY A 36-year-old man complained of abdominal pain for 13 d. Blood analysis showed anemia. Magnetic resonance cholangiopancreatography and computed tomography revealed a tumor in the horizontal part of the duodenum as the main finding, leading to duodeno-duodenal intussusception. No obvious abnormalities were found on endoscopy or upper gastrointestinal radiography. He was diagnosed with duodenal intussusception secondary to duodenal adenoma. Laparotomy showed duodeno-duodenal intussusception and a tumor in the horizontal part of the duodenum near the ascending part. Postoperative pathology revealed tubular-villous adenoma with low-grade glandular intraepithelial neoplasia (local high-grade intraepithelial neoplasia). He was discharged without complications.
CONCLUSION This case highlights that rational use of computed tomography, magnetic resonance cholangiopancreatography, endoscopy and upper gastrointestinal radiography for preoperative diagnosis and timely surgery is an effective strategy for the treatment of adult duodenal intussusception with duodenal masses.
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Affiliation(s)
- Kun-Peng Wang
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Hao Jiang
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Can Kong
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Lie-Zhi Wang
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Guo-Yu Wang
- Department of Radiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Jing-Gang Mo
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Chong Jin
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
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4457
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Hu L, Zhu JY, Fang L, Yu XC, Yan ZL. Isolated metachronous splenic multiple metastases after colon cancer surgery: A case report and literature review. World J Clin Cases 2020; 8:3320-3328. [PMID: 32874988 PMCID: PMC7441267 DOI: 10.12998/wjcc.v8.i15.3320] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/27/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Isolated splenic metastasis is a rare clinical entity. Multiple metastases in the spleen after radical colon resection in a patient who subsequently underwent a second local resection for isolated metachronous splenic metastasis are exceedingly rare.
CASE SUMMARY We report a colon cancer patient who underwent laparoscopic radical colon resection 14 mo previously, and subsequently underwent a second local resection due to local recurrence detected by elevated serum carcinoembryonic antigen (CEA) and positron emission tomography (PET). However, multiple metastases in the spleen were found 7 mo later by elevated serum CEA and PET-magnetic resonance imaging. Then the patient underwent total laparoscopic splenectomy. Local tumor recurrence and splenic metastasis from colorectal cancer (CRC) were found by postoperative pathology. Genetic analysis of these recurrent and metastatic tissues showed KRAS exon2, APC exon16 and TP53 exon6 missense mutations, but no mutations of NRAS, KRAF, EGFR, ERBB2, MET, MLH1, MSH2 and MSH6 were detected. Chemotherapy and target therapy were administered after multiple disciplinary team (MDT) consultation, and no tumor recurrence has been observed to date. We also reviewed the literature by conducting a search of the PubMed database using the following key words: CRC, splenic metastasis, isolated, and review. We identified 34 relevant papers, which included 28 cases of metachronous metastasis and 6 cases of simultaneous metastasis.
CONCLUSION Close monitoring of serum CEA levels is crucial for the detection of isolated splenic metastases after colon surgery. In terms of overall survival and progression-free survival, MDT plays an important role in the entire process of disease management.
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Affiliation(s)
- Li Hu
- Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, China
| | - Ji-Yun Zhu
- Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, China
| | - Lei Fang
- Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, China
| | - Xiu-Chong Yu
- Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, China
| | - Zhi-Long Yan
- Department of Gastrointestinal Surgery, Ningbo First Hospital, Ningbo 315000, Zhejiang Province, China
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4458
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Li YP, Yang Y, Wang MQ, Zhang X, Wang WJ, Li M, Wu FP, Dang SS. Facial and bilateral lower extremity edema due to drug-drug interactions in a patient with hepatitis C virus infection and benign prostate hypertrophy: A case report. World J Clin Cases 2020; 8:3372-3376. [PMID: 32874995 PMCID: PMC7441249 DOI: 10.12998/wjcc.v8.i15.3372] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/07/2020] [Accepted: 07/16/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND New direct-acting antivirals (DAAs)-based anti-hepatitis C virus (HCV) therapies are highly effective in patients with HCV infection. However, safety data are lacking regarding HCV treatment with DAAs and drugs for comorbidities.
CASE SUMMARY Herein, we reported a case of HCV-infection in a 46-year-old man with benign prostatic hypertrophy. The patient received sofosbuvir/velpatasvir as well as methadone maintenance therapy for drug abuse. The viral load became negative at week 1 post treatment. He developed facial and bilateral lower extremity edema 48 h after starting receiving tamsulosin. Edema disappeared 10 d after treatment with oral furosemide and spironolactone.
CONCLUSION In conclusion, this is the first case of an acute edema in the course of treatment with new DAAs, methadone and tamsulosin. These agents are useful in clinical management of patients with HCV infection, particularly in men with benign prostatic hypertrophy. Clinicians should be aware of potential drug-drug interactions in this subset of patients.
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Affiliation(s)
- Ya-Ping Li
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Ying Yang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Mu-Qi Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Xin Zhang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Wen-Jun Wang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Mei Li
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Feng-Ping Wu
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Shuang-Suo Dang
- Department of Infectious Diseases, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
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4459
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Sanagawa M, Kenzaka T, Kato S, Yamaoka I, Fujimoto S. Campylobacter jejuni enterocolitis presenting with testicular pain: A case report. World J Clin Cases 2020; 8:3280-3283. [PMID: 32874982 PMCID: PMC7441251 DOI: 10.12998/wjcc.v8.i15.3280] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/23/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Common symptoms of Campylobacter colitis include abdominal pain, vomiting, diarrhea, and fever, among others. However, Campylobacter colitis also has a high incidence of extraintestinal symptoms.
CASE SUMMARY We report the case of a 51-year-old man who presented with bilateral testicular pain. A scrotal examination failed to reveal any physical findings, but the patient exhibited mild tenderness in the right lower abdomen. Computed tomography revealed ileocecal wall thickening. Post-admission, the patient developed diarrhea, and a stool culture was submitted; Campylobacter jejuni infection was confirmed. Testicular pain is known to be caused by appendicitis. Consequently, we suggest that Campylobacter colitis, which causes ileocecal inflammation, caused the testicular pain in this case.
CONCLUSION In patients with testicular pain and no other objective findings, diseases such as Campylobacter colitis should be considered.
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Affiliation(s)
- Masahiro Sanagawa
- Department of Internal Medicine, Miyazaki Seikyo Hospital, Miyazaki 880-0824, Japan
| | - Tsuneaki Kenzaka
- Department of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Hyogo 669-3495, Japan
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Hyogo 652-0032, Japan
| | - Sayaka Kato
- Department of Internal Medicine, Miyazaki Seikyo Hospital, Miyazaki 880-0824, Japan
| | - Ichiko Yamaoka
- Department of General Surgery, Miyazaki Seikyo Hospital, Miyazaki 880-0824, Japan
| | - Shouichi Fujimoto
- Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan
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4460
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Sun XG, Wang RY, Xu JL, Li DG, Chen WX, Li JL, Wang J, Li AW. Surgical outcomes of bladder augmentation: A comparison of three different augmentation procedures. World J Clin Cases 2020; 8:3240-3248. [PMID: 32874978 PMCID: PMC7441248 DOI: 10.12998/wjcc.v8.i15.3240] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/01/2020] [Accepted: 07/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Augmentation cystoplasty is indispensable in many pediatric diseases, especially neurogenic bladder. Various methods and materials are used to augment the bladder, and these methods are associated with different shortcomings and complications.
AIM The present study reported the mid-term outcomes of patients undergoing various bladder augmentation procedures in a single institution, and assessed whether seromuscular cystoplasty lined with urothelium (SCLU) provided better urodynamic results than auto-augmentation (AA).
METHODS A retrospective review of 96 patients undergoing various augmentation methods between 2003 and 2018 was performed. The patients were divided into three groups according to the type of augmentation, and their outcomes were compared. All patients developed neurogenic bladder due to myelomeningocele or sacrococcygeal teratoma. The clinical data of all patients were collected.
RESULTS The mean ages at surgery in the three groups (standard cystoplasty [SC], SCLU, AA) were 10.8, 7.5, and 4.8 years, respectively, with mean follow-ups of 36, 61, and 36 mo, respectively. The mean preoperative and postoperative bladder capacities of the SC, SCLU, and AA groups were 174 ± 11.7 vs. 387 ± 13.7 (P < 0.0001), 165 ± 12.2 vs. 240 ± 14.7 (P = 0.0002), and 138 ± 16.7 vs. 181 ± 9.9 (P = 0.0360), respectively. Compared with the AA group, the SCLU procedure did not have better postoperative urodynamic parameters. Incontinence was reduced in most patients. The mean times of clean intermittent catheterization per day in the SC, SCLU, and AA groups were 5.6, 7.8, and 8.2, respectively. The main complications of the SC group were recurrent urinary tract infections (8%) and bladder calculi (6%). Re-augmentation was done in patients in the SCLU (8) and AA (3) groups.
CONCLUSION SC provided sufficient bladder capacity and improved compliance with acceptable complications. After AA and SCLU, the patients acquired limited increases in bladder capacity and compliance with a high rate of re-augmentation. Compared with AA, SCLU did not yield better postoperative urodynamic parameters.
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Affiliation(s)
- Xiao-Gang Sun
- Department of Pediatric Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
- Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
| | - Ruo-Yi Wang
- Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
| | - Jia-Long Xu
- Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
| | - Dian-Guo Li
- Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
| | - Wei-Xiu Chen
- Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
| | - Jin-Liang Li
- Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
| | - Jian Wang
- Department of Pediatric Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Ai-Wu Li
- Department of Pediatric Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
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4461
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Tao YY, Zhou Y, Wang R, Gong XQ, Zheng J, Yang C, Yang L, Zhang XM. Progress of intravoxel incoherent motion diffusion-weighted imaging in liver diseases. World J Clin Cases 2020; 8:3164-3176. [PMID: 32874971 PMCID: PMC7441263 DOI: 10.12998/wjcc.v8.i15.3164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/11/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
Traditional magnetic resonance (MR) diffusion-weighted imaging (DWI) uses a single exponential model to obtain the apparent diffusion coefficient to quantitatively reflect the diffusion motion of water molecules in living tissues, but it is affected by blood perfusion. Intravoxel incoherent motion (IVIM)-DWI utilizes a double-exponential model to obtain information on pure water molecule diffusion and microcirculatory perfusion-related diffusion, which compensates for the insufficiency of traditional DWI. In recent years, research on the application of IVIM-DWI in the diagnosis and treatment of hepatic diseases has gradually increased and has achieved considerable progress. This study mainly reviews the basic principles of IVIM-DWI and related research progress in the diagnosis and treatment of hepatic diseases.
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Affiliation(s)
- Yun-Yun Tao
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Yi Zhou
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Ran Wang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xue-Qin Gong
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Zheng
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Cui Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Lin Yang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Xiao-Ming Zhang
- Sichuan Key Laboratory of Medical Imaging, Department of Radiology and Medical Research Center of Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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4462
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Men CJ, Singh SK, Zhang GL, Wang Y, Liu CW. Acute suppurative oesophagitis with fever and cough: A case report. World J Clin Cases 2020; 8:3341-3348. [PMID: 32874991 PMCID: PMC7441257 DOI: 10.12998/wjcc.v8.i15.3341] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/28/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Suppurative oesophagitis is a diffuse inflammation of the oesophagus characterized by suppurative exudate or pus formation. Suppurative infections can affect any part of the gastrointestinal tract, most commonly the stomach, with inflammation involving the entire gastric cavity. However, cases extending beyond the cardia or pylorus and involving the oesophagus, small intestine, and colon are rare. Usually such cases are discovered during surgery or autopsy.
CASE SUMMARY We report a rare case of acute suppurative oesophagitis. A 57-year-old man presented at the Emergency Department of our hospital with fever and productive cough. The patient had a significant history of lower oesophageal mucosal frostbite. He was successfully diagnosed and treated with repeated gastroscopy, appropriate antibiotics, and innovative symptomatic treatment.
CONCLUSION Early diagnosis and appropriate treatment of acute suppurative oesophagitis are critical. Nutritional support, postural drainage, and other symptomatic treatments must be considered.
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Affiliation(s)
- Chang-Jun Men
- Department of Gastroenterology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Shashank Kumar Singh
- Department of Gastroenterology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Guo-Liang Zhang
- Department of Gastroenterology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Ye Wang
- Department of Gastroenterology, Tianjin First Central Hospital, Tianjin 300192, China
| | - Cong-Wei Liu
- Department of Gastroenterology, Tianjin First Central Hospital, Tianjin 300192, China
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4463
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Li N, Wang YZ, Zhang Y, Zhang WL, Zhou Y, Huang DS. Natural killer/T-cell lymphoma with intracranial infiltration and Epstein-Barr virus infection: A case report. World J Clin Cases 2020; 8:3284-3290. [PMID: 32874983 PMCID: PMC7441250 DOI: 10.12998/wjcc.v8.i15.3284] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 05/15/2020] [Accepted: 07/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Because of atypical clinical symptoms, lymphoma is easily confused with infectious diseases. Extranodal nasal-type natural killer/T-cell lymphoma (NKTL) is more common, and there are few cases of eyelid site onset and intracranial infiltration, which increases the difficulty of diagnosis. This disease usually has a very poor prognosis and there are few reports of recovery.
CASE SUMMARY A 3-year-old boy was admitted to our hospital due to an initial misdiagnosis of "eyelid cellulitis" and failed antibiotic treatment. He was characterized by fever, right eyeball bulging, convulsions, and abnormal liver function. His blood Epstein-Barr virus (EBV) DNA was positive (8.798 × 104 copies/mL), and remained positive for about half a year. The cranial imaging examination suggested a space-occupying lesion in the right eyelid, with the right temporal lobe and meninges involved. The boy underwent ocular mass resection. The pathological diagnosis was NKTL. He was diagnosed as having NKTL with intracranial infiltration, combined with chronic active EBV infection (CAEBV). Then he underwent systemic chemotherapy and intrathecal injection. The boy suffered from abnormal blood coagulation, oral mucositis, diarrhea, liver damage, and severe bone marrow suppression but survived. Finally, the tumor was completely relieved and his blood EBV-DNA level turned negative. The current follow-up has been more than 2 years and his condition is stable.
CONCLUSION This case suggests that chemotherapy combined with intrathecal injection may have a good effect on intracranial infiltrating lymphoma and CAEBV, which deserves further study and discussion.
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Affiliation(s)
- Nan Li
- Pediatric Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China
| | - Yi-Zhuo Wang
- Pediatric Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China
| | - Yi Zhang
- Pediatric Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China
| | - Wei-Ling Zhang
- Pediatric Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China
| | - Yan Zhou
- Pediatric Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China
| | - Dong-Sheng Huang
- Pediatric Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100176, China
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4464
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Xue H, Wang XH, Shi L, Wei Q, Zhang YM, Yang HF. Dental focal infection-induced ventricular and spinal canal empyema: A case report. World J Clin Cases 2020; 8:3114-3121. [PMID: 32775394 PMCID: PMC7385611 DOI: 10.12998/wjcc.v8.i14.3114] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 06/10/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dental focal infection-induced ventricular and spinal canal empyema is an extremely rare, severe, acute disease that is clinically associated with extremely high morbidity and mortality. Traditional cerebrospinal fluid (CSF) bacterial culture is time-consuming, with a low positive rate, which frequently results in severe irreversible consequences. The next-generation sequencing technique is an emerging pathogenic microorganism detection method that can obtain results in a short time with high accuracy, thus providing great assistance in the clinical diagnosis and treatment of this disease.
CASE SUMMARY This paper reports a rare case of dental focal infection-induced ventricular and spinal canal empyema. During the course of treatment at a local hospital, the patient had negative results from repeated CSF bacterial cultures and was empirically given vancomycin treatment. After transfer to our hospital, the next-generation sequencing technique was adopted to determine that the pathogenic microorganisms were multiple anaerobic infectious bacteria derived from the oral cavity. The antibiotic therapeutic scheme was adjusted in a timely manner, and the ventricular and spinal canal inflammation was also controlled. However, the antibiotics that had been applied at the local hospital were not able to cover all pathogenic microorganisms, which resulted in irreversible injury to the brain stem, finally leading to patient death.
CONCLUSION Dental focal infection-induced ventricular and spinal canal empyema is an extremely rare, severe, acute disease with high morbidity and mortality. Any delay in diagnosis and treatment will result in irreversible consequences. The early application of the next-generation sequencing technique can obtain results in a short time and clarify a diagnosis. Appropriate antibiotic treatment combined with suitable surgical intervention is the key to managing this disease.
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Affiliation(s)
- Hang Xue
- Department of Neurotraumatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Xiao-Hui Wang
- Department of Neurotraumatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Lin Shi
- Department of Neurosurgery, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun 130021, Jilin Province, China
| | - Qiang Wei
- Department of Neurotraumatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Yi-Ming Zhang
- Department of Neurosurgery, Dong’e Hospital Affiliated to Shandong First Medical University, Dong’e 252200, Shandong Province, China
| | - Hong-Fa Yang
- Department of Neurotraumatic Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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Abstract
BACKGROUND Intra-abdominal hemorrhage during pregnancy is a rare and dangerous complication of pregnancy. In this article, we report 4 cases of intra-abdominal hemorrhage during pregnancy, including the spontaneous rupture of uterine veins, spontaneous rupture of liver, rupture of external iliac vessel branch, and rupture of right renal hamartoma.
CASE SUMMARY The clinical manifestations of three patients lacked specificity, and the localization of the bleeding was not clear prior to surgery. All 4 pregnant women were successfully treated, while only one full-term infant survived.
CONCLUSION There are diverse causes of intra-abdominal hemorrhage during pregnancy in clinic, and it is clinically characterized by acute abdominal pain during pregnancy. Clear diagnosis before surgery is rather difficult. Early diagnosis, timely and appropriate treatment and surgery, and multidisciplinary cooperation are key to saving pregnant females’ lives and improving the outcomes of perinatal infants.
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Affiliation(s)
- Lei Yang
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China
| | - Na Liu
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China
| | - Yan Long
- Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China
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4466
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Yang F, Zhao ZC, Hu AJ, Sun PF, Zhang B, Yu MC, Wang J. Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma accompanied by a clear cell carcinoma and a cyst: A case report. World J Clin Cases 2020; 8:3064-3073. [PMID: 32775388 PMCID: PMC7385615 DOI: 10.12998/wjcc.v8.i14.3064] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/01/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Renal cell carcinomas are usually unilateral. However, they are bilateral in 2% to 4% of sporadic cases and is considerably more common in familial cases. Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma (CHRCC) with different subtypes is rare.
CASE SUMMARY In this case report, we describe a case of synchronous bilateral CHRCC with two histological variants, accompanied by a clear cell carcinoma and a cyst in a 50-year-old male. The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.
CONCLUSION We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.
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Affiliation(s)
- Fan Yang
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
| | - Zi-Chen Zhao
- Department of Urinary Surgery, Peking University Shougang Hospital, Beijing 100144, China
| | - A-Jin Hu
- Department of Pathology, Peking University Shougang Hospital, Beijing 100144, China
| | - Peng-Fei Sun
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Bin Zhang
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
| | - Ming-Chuan Yu
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
| | - Juan Wang
- Department of Radiology, Peking University Shougang Hospital, Beijing 100144, China
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4467
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Liang XH, Tang X, Luo YT, Zhang M, Feng ZP. Effects of policies and containment measures on control of COVID-19 epidemic in Chongqing. World J Clin Cases 2020; 8:2959-2976. [PMID: 32775378 PMCID: PMC7385616 DOI: 10.12998/wjcc.v8.i14.2959] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/11/2020] [Accepted: 06/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an emerging, rapidly evolving disease that spreads through the respiratory system and is highly contagious. In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. In China, the pandemic was controlled after 2 mo through effective policies and containment measures. Describing the detailed policies and containment measures used to control the epidemic in Chongqing will provide a reference for the prevention and control of COVID-19 in other areas of the world. AIM To explore the effects of different policies and containment measures on the control of the COVID-19 epidemic in Chongqing. METHODS Epidemiological data on COVID-19 in Chongqing were prospectively collected from January 21 to March 15, 2020. The policies and prevention measures implemented by the government during the epidemic period were also collected. Trend analysis was performed to explore the impact of the main policy measures on the effectiveness of the control of COVID-19 in Chongqing. RESULTS As of March 15, the cumulative incidence of COVID-19 in Chongqing was 1.84/100000 (576 cases) and the infection fatality rate was 1.04% (6/576). The spread of COVID-19 was controlled by effective policies that involved establishing a group for directing the COVID-19 epidemic control effort; strengthening guidance and supervision; ensuring the supply of daily necessities and medical supplies and equipment to residents; setting up designated hospitals; implementing legal measures; and enhancing health education. Medical techniques were implemented to improve the recovery rate and control the epidemic. Policies such as "the lockdown of Wuhan", "initiating a first-level response to major public health emergencies", and "implementing the closed management of residential communities" significantly curbed the spread of COVID-19. Optimizing the diagnosis process, shortening the diagnosis time, and constructing teams of clinical experts facilitated the provision of "one team of medical experts for each patient" treatment for severe patients, which significantly improved the recovery rate and reduced the infection fatality rate. CONCLUSION The prevention policies and containment measures implemented by the government and medical institutions are highly effective in controlling the spread of the epidemic and increasing the recovery rate of COVID-19 patients.
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Affiliation(s)
- Xiao-Hua Liang
- Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing 400014, China
| | - Xian Tang
- Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing 400014, China
| | - Ye-Tao Luo
- Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing 400014, China
| | - Min Zhang
- Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing 400014, China
| | - Ze-Pei Feng
- Clinical Epidemiology and Biostatistics Department, Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing 400014, China
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4468
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Tabak F, Wang HS, Li QP, Ge XX, Wang F, Ji GZ, Miao L. Endoscopic retrograde cholangiopancreatography in elderly patients: Difficult cannulation and adverse events. World J Clin Cases 2020; 8:2988-2999. [PMID: 32775380 PMCID: PMC7385608 DOI: 10.12998/wjcc.v8.i14.2988] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable therapeutic technique for pancreatobiliary diseases, and its application in the elderly is no longer limited. However, a higher incidence of procedure difficulty and periprocedural adverse events might be expected in elderly patients due to the presence of other medical disorders and the poor general condition of this population.
AIM To evaluate the incidence, causes, and management of difficult biliary cannulation during ERCP in elderly patients and the role of difficult cannulation as a risk factor for adverse events.
METHODS A total of 614 patients who underwent ERCP during the study period were prospectively studied and divided into two groups based on their age. One hundred and forty-six patients were aged 80 years or older and 468 patients were aged less than 80 years. The primary outcome measurements were cannulation difficulty, cannulation success rate, ERCP procedure time, and related adverse events.
RESULTS There was no difference in the incidence of difficult cannulation among the two groups (32.9% vs 34.4%, P = 0.765), as well as in the cannulation success rate (96.6% vs 96.8%, P = 0.54). The cannulation techniques were shown to be safe and efficient in achieving successful cannulation. Logistic regression analysis showed that patients aged 80 years or older were not associated with increased adverse events; however, difficult cannulation cases [adjusted odds ratio (AOR) = 3.478; 95% confidence interval (CI): 1.877-6.442; P < 0.001] and patients with Charlson Comorbidity Index ≥ 2 (AOR = 1.824; 95%CI: 0.993-3.349; P = 0.045) were more likely to develop adverse events. In contrast, other factors including age ≤ 65 (AOR = 3.460; 95%CI: 1.511-7.922; P = 0.003), female gender (AOR = 2.362; 95%CI=1.089-5.124; P = 0.030), difficult cannulation (AOR = 4.527; 95%CI: 2.078-9.860; P < 0.001), and patients with cholangitis (AOR = 3.261; 95%CI: 1.204-8.832; P = 0.020) were strongly associated with a higher rate of post-ERCP pancreatitis.
CONCLUSION Advanced age has not been proved to be a risk factor for difficult cannulation, and secondary cannulation techniques can be safely and efficaciously utilized in this group. Patients with a Charlson Comorbidity Index ≥ 2 and difficult cannulation are associated with an increased overall adverse events rate, while age ≥ 80 years is not.
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Affiliation(s)
- Fatema Tabak
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Hui-Shan Wang
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Quan-Peng Li
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Xian-Xiu Ge
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Fei Wang
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Guo-Zhong Ji
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
| | - Lin Miao
- Institute of Digestive Endoscopy and Medical Centre for Digestive Disease, Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China
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4469
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Pan HH, Zhou XX, Zhao F, Chen HY, Zhang Y. Diagnostic value of liquid-based cytology and smear cytology in pancreatic endoscopic ultrasound-guided fine needle aspiration: A meta-analysis. World J Clin Cases 2020; 8:3006-3020. [PMID: 32775382 PMCID: PMC7385618 DOI: 10.12998/wjcc.v8.i14.3006] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/25/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Smear cytology (SC) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the established and traditional choice for diagnosing pancreatic lesions. Liquid-based cytology (LBC) is a novel alternative cytological method, however, the comparative diagnostic efficacy of LBC remains inconclusive.
AIM To examine the diagnostic efficacy of LBC and SC for pancreatic specimens obtained through EUS-FNA via a systematic review and meta-analysis.
METHODS A systematic literature search was performed using PubMed, EMBASE, the Cochrane Library, and Web of Science. The numbers of true positives, false positives, true negatives, and false negatives for each cytological test (LBC and CS) were extracted from the included studies. The pooled sensitivity and specificity and the area under the summary receiver operating characteristic curve (AUC) were calculated, and the AUC was compared by Tukey's multiple comparisons test. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies II tool.
RESULTS A total of 1656 patients in eight studies were included. The pooled sensitivity and specificity and the AUC for LBC were 0.76 (95%CI: 0.72-0.79), 1.00 (95%CI: 0.98-1.00), and 0.9174, respectively, for diagnosing pancreatic lesions. The pooled estimates for SC were as follows: Sensitivity, 0.68 (95%CI: 0.64-0.71); specificity, 0.99 (95%CI: 0.96-100.00); and AUC, 0.9714. Similarly, the corresponding values for LBC combined with SC were 0.87 (95%CI: 0.84-0.90), 0.99 (95%CI: 0.96-1.00), and 0.9894. Tukey’s multiple comparisons test was used to compare the sensitivities and AUCs of the three diagnostic methods; statistically significant differences were found between the three methods, and LBC combined with SC was superior to both LBC (P < 0.05) and SC (P < 0.05). The pooled sensitivity and AUC did not change significantly in the sensitivity analysis.
CONCLUSION LBC may be sensitive than SC in the cytological diagnosis of pancreatic lesions, however, the superior diagnostic performance of their combination emphasizes their integrated usage in the clinical evaluation of pancreatic lesions.
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Affiliation(s)
- Hang-Hai Pan
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Xin-Xin Zhou
- Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Fei Zhao
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Hui-Yan Chen
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
| | - Yu Zhang
- Department of Gastroenterology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
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4470
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Wang CY, Zhou SC, Li XW, Li BH, Zhang JJ, Ge Z, Zhang Q, Hu JH. Bibliometric analysis of randomized controlled trials of colorectal cancer over the last decade. World J Clin Cases 2020; 8:3021-3030. [PMID: 32775383 PMCID: PMC7385603 DOI: 10.12998/wjcc.v8.i14.3021] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/30/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer is one of the most common cancers globally. In China, its prevalence ranks fourth and fifth among females and males, respectively. Presently, treatment of rectal cancer follows a multidisciplinary comprehensive treatment approach involving surgery, radiotherapy, chemotherapy, and targeted therapy. With deepening theoretical and molecular research on colorectal cancer, randomized controlled trials (RCTs) on colorectal cancer have made significant progress. However, many RCTs have shortfalls.
AIM To investigate the RCTs of global colorectal cancer spanning from 2008 to 2018. To provide suggestions for conducting Chinese RCTs of colorectal cancer.
METHODS PubMed and Web of Science databases were searched to obtain RCTs of colorectal cancer carried out between January 1, 2008, and January 1, 2018. The bibliometric method was used for statistical analysis of the publication years, countries/regions, authors, institutions, source journals, quoted times, key words, and authors.
RESULTS Colorectal cancer RCTs showed an upward trend between 2008 to 2018; the top 10 research institutions in the included literature were from the United States, the United Kingdom, and other countries with a high incidence of colorectal cancer. Most of the related research journals are sponsored by European and American countries. The 15 most cited studies involved international multicenter clinical research, having few participants from Chinese research institutions. Network visualization using key words showed that RCTs on colorectal cancer focus on screening, disease-free survival, drug treatment, surgical methods, clinical trials, quality of life, and prognosis. The result of the coauthorship network analysis showed that Chinese researchers are less involved in international exchanges compared to those from leading publication countries.
CONCLUSION High-quality RCTs are increasingly favored by leading international journals. However, there is still a large gap in clinical research between China and leading countries. Researchers should implement standardized and accurate clinical trials, strengthen international multicenter cooperation, and emphasize quality control.
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Affiliation(s)
- Chen-Yu Wang
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Shi-Can Zhou
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Xing-Wang Li
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Bing-Hui Li
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Jun-Jie Zhang
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Zheng Ge
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Quan Zhang
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
| | - Jun-Hong Hu
- Department of Anorectal Surgery, Huaihe Hospital, Henan University, Kaifeng 47500, Henan Province, China
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4471
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Zhang W, Tian YL, Wang QZ, Chen XW, Li QY, Han JH, Chen XD, Xu K. Restenosis after recanalization for Budd-Chiari syndrome: Management and long-term results of 60 patients. World J Clin Cases 2020; 8:2930-2941. [PMID: 32775375 PMCID: PMC7385617 DOI: 10.12998/wjcc.v8.i14.2930] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/03/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Budd-Chiari syndrome is defined as hepatic venous outflow tract obstruction. For Asian Budd-Chiari syndrome patients, the major treatment modality is recanalization (percutaneous transluminal angioplasty with or without stent implantation). The cumulative 1-, 5-, and 10-year primary patency rates and survival rates are reported to be excellent or satisfactory, but the long-term outcome of patients with restenosis (the most common complication after recanalization) is unknown.
AIM To explore the treatment strategy for restenosis in patients with Budd-Chiari syndrome after interventional therapy and to evaluate the long-term follow-up results.
METHODS The clinical data and follow-up results of 60 patients with restenosis after interventional therapy from November 1983 to December 2013 were retrospectively analyzed.
RESULTS Sixty patients with restenosis were retrospectively divided into a percutaneous transluminal angioplasty (PTA) group (40 patients) and a PTA + stent group (20 patients) according to the primary recanalization method. For the patients with restenosis in the PTA group, 13 refused treatment, and 27 received further treatment; among these patients, five had a second restenosis, two had a third restenosis, and one had a fourth restenosis. For the patients with restenosis in the PTA + stent group, nine refused treatment, ten received PTA alone, and the other received PTA + stent implantation. Among the patients who received further treatment, five had a second restenosis, three had a third restenosis, and one had a fourth restenosis. The 1-, 5-, 10-, 20-, and 25-year cumulative survival rates of the 38 patients who received further treatment after restenosis were 100%, 78.3%, 78.3%, 70.5%, and 70.5%, respectively; however, for the 22 patients who refused treatment, the survival rates were 72.7%, 45.9%, 30.6%, 10.2%, and unavailable, respectively (P < 0.001).
CONCLUSION Long-term follow-up after interventional therapy is very important. Active treatment for patients with restenosis can improve prognosis, and minimally invasive treatment strategies for restenosis allows to obtain satisfactory results.
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Affiliation(s)
- Wei Zhang
- Department of Interventional Radiology, Shenzhen People’s Hospital, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, Guangdong Province, China
| | - Yu-Long Tian
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Qiao-Zheng Wang
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Xiao-Wei Chen
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Qi-Yang Li
- Department of Interventional Radiology, Shenzhen People’s Hospital, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, Guangdong Province, China
| | - Jin-Hang Han
- Department of Interventional Radiology, Shenzhen People’s Hospital, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, Guangdong Province, China
| | - Xu-Dong Chen
- Department of Interventional Radiology, Shenzhen People’s Hospital, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, Guangdong Province, China
| | - Ke Xu
- Department of Interventional Radiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
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4472
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Wang XT, Guo W, Sun M, Han W, Du ZH, Wang XX, Du BB, Bai O. Effect of chidamide on treating hepatosplenic T-cell lymphoma: A case report. World J Clin Cases 2020; 8:3122-3129. [PMID: 32775395 PMCID: PMC7385602 DOI: 10.12998/wjcc.v8.i14.3122] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/26/2020] [Accepted: 07/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hepatosplenic T-cell lymphoma (HSTCL) is a rare subtype of non-Hodgkin’s lymphoma, which has an aggressive clinical course and an extremely poor prognosis. Chidamide is a novel, orally active, benzamide-type histone deacetylase (HDAC) inhibitor that has been used for peripheral T-cell lymphoma (PTCL) treatment. However, to date, there has been no report of the treatment and effect of the HDAC inhibitor chidamide in HSTCL, which is a special subtype of PTCL.
CASE SUMMARY A 45-year-old male patient was admitted with splenomegaly and slight bicytopenia. He was diagnosed with HSTCL via splenectomy. The patient was treated with fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine regiment as inductive therapy. Unfortunately, the disease progressed rapidly during chemotherapy before a suitable allogeneic gene transplant donor was found. The chidamide-combined chemotherapy regimen and single-drug oral maintenance regimen achieved complete remission, duration of response of 9 mo, and overall survival of 15 mo.
CONCLUSION The novel agent chidamide can be used in HSTCL to achieve deep remission and improve the duration of response and overall survival.
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Affiliation(s)
- Xing-Tong Wang
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Wei Guo
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Mo Sun
- Department of Pathology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Wei Han
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Zhong-Hua Du
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Xiu-Xiu Wang
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
| | - Bei-Bei Du
- Department of Cardiology, The Third Hospital of Jilin University, Changchun, Jilin Province 130031, China
| | - Ou Bai
- Department of Hematology, The First Hospital of Jilin University, Jilin Provincial Hematology Research Institute, National Key Discipline, Changchun 130021, Jilin Province, China
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4473
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Zheng R, Zhu HL, Hu BR, Ruan XJ, Cai HJ. Identification of APEX2 as an oncogene in liver cancer. World J Clin Cases 2020; 8:2917-2929. [PMID: 32775374 PMCID: PMC7385600 DOI: 10.12998/wjcc.v8.i14.2917] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/27/2020] [Accepted: 06/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND DNA damage is one of the critical contributors to the occurrence and development of some cancers. APEX1 and APEX2 are the most important molecules in the DNA damage, and APEX1 has been identified as a diagnostic and prognostic biomarker in liver hepatocellular carcinoma (LIHC). However, the expression of APEX2 and its functional mechanisms in LIHC are still unclear. AIM To examine the expression of APEX2 and the potential mechanism network in LIHC. METHODS We conducted a pan-cancer analysis of the expression of APEX1 and APEX2 using the interactive TIMER tool. GEO datasets, including GSE14520, GSE22058, and GSE64041, were used to compare the APEX2 expression level in tumor tissues and adjacent non-tumor tissues. Then, we calculated the 5-year survival rate according to the web-based Kaplan-Meier analysis. We included the TCGA liver cancer database in GSEA analysis based on the high and low APEX2 expression, showing the potential mechanisms of APEX2 in LIHC. After that, we conducted Pearson correlation analysis using GEPIA2. Next, we performed quantitative polymerase chain reaction (qPCR) assay to examine the APEX2 levels in normal liver cell line LO2 and several liver cancer cell lines, including HepG2, Huh7, SMMC7721, and HCCLM3. APEX2 in HCCLM3 cells was knocked down using small interfering RNA. The role of APEX2 in cell viability was confirmed using CCK-8. Dual-luciferase reporter assay was performed to examine the promoter activity of CCNB1 and MYC. RESULTS APEX1 and APEX2 are both highly expressed in the tumor tissues of BLCA, BRCA, CHOL, COAD, ESCA, HNSC, LIHC, LUAD, LUSC, READ, and STAD. APEX2 overexpression in LIHC was validated using GSE14520, GSE22058, and GSE64041 datasets. The survival analysis showed that LIHC patients with high expression of APEX2 had a lower overall survival rate, even in the AJCC T1 patients. High level of APEX2 could indicate a lower overall survival rate in patients with or without viral hepatitis. The GSEA analysis identified that kinetochore and spindle microtubules are the two main cellular components of APEX2 in GO Ontology. APEX2 was also positively associated with molecular function regulation of chromosome segregation and DNA replication. The results of KEGG analysis indicated that APEX2 expression was positively correlated with cell cycle pathway and pro-oncogenic MYC signaling. Pearson correlation analysis showed that APEX2 had a significant positive correlation with CCNB1 and MYC. APEX2 level was higher in liver cancer cell lines than in normal liver LO2 cells. Small interfering RNA could knock down the APEX2 expression in HCCLM3 cells. Knockdown of APEX2 resulted in a decrease in the viability of HCCLM3 cells as well as the expression and promoter activity of CCNB1 and MYC. CONCLUSION APEX2 is overexpressed in LIHC, and the higher APEX2 level is associated with a worse prognosis in overall survival. APEX2 is closely involved in the biological processes of chromosome segregation and DNA replication. APEX2 expression is positively correlated with the pro-oncogenic pathways. Knockdown of APEX2 could inhibit the cell viability and CCNB1 and MYC pathways, suggesting that APEX2 is an oncogene in LIHC, which could be a potential pharmaceutic target in the anti-tumor therapy.
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Affiliation(s)
- Ru Zheng
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Heng-Liang Zhu
- Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518107, Guangdong Province, China
| | - Bing-Ren Hu
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Xiao-Jiao Ruan
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
| | - Hua-Jie Cai
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
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4474
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Lu H, Liu PD, Yao X, Wang ZF, Gao LF, Wang SP. Diagnostic value of orbicularis oculi muscle electromyography in functional epiphora. World J Clin Cases 2020; 8:3000-3005. [PMID: 32775381 PMCID: PMC7385609 DOI: 10.12998/wjcc.v8.i14.3000] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/12/2020] [Accepted: 06/19/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Functional epiphora is a clinical condition which is not due to an anatomic defect. Most studies agree that it involves the action of the orbicularis oculi muscle, particularly its deeper segment (Horner’s muscle), but the exact mechanism is not clear.
AIM To evaluate the orbicularis oculi muscle in functional epiphora patients using electromyography (EMG).
METHODS A total of 8 Chinese patients (16 eyes) with functional epiphora were enrolled in this study, and ten volunteers (10 eyes) were included as normal controls. Five epiphora patients (five eyes) with facial palsy served as positive controls. Quantitative EMG was performed in the deeper segment of orbicularis oculi muscle. The average duration of each EMG waveform was measured.
RESULTS The average duration of EMG waveforms in the normal control group, the functional epiphora group, and the facial palsy group were 6.39 ± 0.73 ms, 9.39 ± 1.32 ms and 11.2 ± 1.42 ms, respectively. The duration of EMG waveforms was significantly longer in the functional epiphora group than in the normal control group (P < 0.05), and shorter than that in the facial palsy group (P < 0.05).
CONCLUSION These data indicate the presence of neurogenic orbicularis oculi muscle damage in epiphora patients, which may be the cause of functional epiphora. The etiology of neurogenic damage in the orbicularis oculi muscle requires further investigation.
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Affiliation(s)
- Hui Lu
- Department of Ophthalmology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
| | - Pei-Dong Liu
- Department of Electromyography, Zibo Central Hospital, Zibo 255000, Shandong Province, China
| | - Xue Yao
- Department of Ophthalmology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
| | - Zuo-Fen Wang
- Department of Ophthalmology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
| | - Li-Fen Gao
- Department of Ophthalmology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
| | - Shao-Peng Wang
- Department of Ophthalmology, Zibo Central Hospital, Zibo 255000, Shandong Province, China
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4475
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Taxifulati N, Yang XA, Zhang XF, Aini A, Abulizi A, Ma X, Abulati A, Wang F, Xu K, Aji T, Shao YM, Ahan A. Multiple recurrent cystic echinococcosis with abdominal aortic involvement: A case report. World J Clin Cases 2020; 8:3108-3113. [PMID: 32775393 PMCID: PMC7385612 DOI: 10.12998/wjcc.v8.i14.3108] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recurrent cystic echinococcosis (CE) with vital organ involvement is a challenge for clinicians. Herein, we report a case of aortic involvement in recurrent retroperitoneal CE lesions following primary splenic CE resection.
CASE SUMMARY A 60-year-old male was admitted due to progressive abdominal pain and poor appetite. He was diagnosed with multiple recurrent CE with abdominal aortic involvement according to preoperative evaluation. During surgical resection, major aortic bleeding accidentally occurred while dissecting the cyst, which was firmly attached to the abdominal aortic wall. Hemostasis attempts were conducted to deal with this emergency situation and maintain circulation. Post-interventional recovery was uneventful, and 2-year follow-up showed no sign of recurrence or any other complications.
CONCLUSION Radical resection of recurrent complicated CE with aortic involvement should be carefully planned and performed to prevent possible severe adverse complications, thereby improving the postoperative outcome.
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Affiliation(s)
- Nijiati Taxifulati
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Xue-An Yang
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Xin-Feng Zhang
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Abudusalamu Aini
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Abuduaini Abulizi
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Xin Ma
- Department of Pain Management, People’s Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
| | - Adilai Abulati
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Fei Wang
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Ke Xu
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Tuerganaili Aji
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Ying-Mei Shao
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
| | - Ayifuhan Ahan
- Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
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4476
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Ma LS, Zhao YL, Wei YD, Liu C. Recommendations for perinatal and neonatal surgical management during the COVID-19 pandemic. World J Clin Cases 2020; 8:2893-2901. [PMID: 32775372 PMCID: PMC7385601 DOI: 10.12998/wjcc.v8.i14.2893] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has spread rapidly around the world and is a significant threat to global health. Patients in the Neonatal Surgery Department have rapidly progressing diseases and immature immunity, which makes them vulnerable to pulmonary infection and a relatively higher mortality. This means that these patients require multidisciplinary treatment including early diagnosis, timely transport, emergency surgery and intensive critical care. The COVID-19 pandemic poses a threat to carrying out these treatments. To provide support for the health protection requirements of the medical services in the Neonatal Surgery Department, we developed recommendations focusing on patient transport, surgery selection and protection requirements with the aim of improving treatment strategies for patients and preventing infection in medical staff during the current COVID-19 pandemic.
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Affiliation(s)
- Li-Shuang Ma
- Department of Neonatal Surgery, Peking Union Medical College, Chinese Academy of Medical Sciences, Capital Institute of Pediatrics, Affiliated Children's Hospital, Beijing 100020, China.
| | - Yun-Long Zhao
- Department of Neonatal Surgery, Peking Union Medical College, Chinese Academy of Medical Sciences, Capital Institute of Pediatrics, Affiliated Children's Hospital, Beijing 100020, China
| | - Yan-Dong Wei
- Department of Neonatal Surgery, Capital Institute of Pediatrics, Affiliated Children's Hospital, Beijing 100020, China
| | - Chao Liu
- Department of Neonatal Surgery, Capital Institute of Pediatrics, Affiliated Children's Hospital, Beijing 100020, China
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4477
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Cho JH, Jeon SR, Jin SY. Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia. World J Clin Cases 2020; 8:2902-2916. [PMID: 32775373 PMCID: PMC7385595 DOI: 10.12998/wjcc.v8.i14.2902] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/01/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
Premalignant gastric lesions such as atrophic gastritis and intestinal metaplasia frequently occur in subjects with long-term Helicobacter pylori (H. pylori) infection. The regular arrangement of collecting venules (RAC) is seen in the normal gastric corpus, whereas mucosal swelling and redness without RAC are observed in H. pylori-infected mucosa. Despite successful H. pylori eradication, the presence of atrophic gastritis and/or gastric intestinal metaplasia (GIM) is a risk factor for gastric cancer. With the development of advanced imaging technologies, recent studies have reported the usefulness of narrow-band imaging (NBI) for endoscopic diagnosis of atrophic gastritis and GIM. Using NBI endoscopy with magnification (M-NBI), atrophic gastritis is presented as irregular coiled microvessels and loss of gastric pits. Typical M-NBI endoscopic findings of GIM are a light blue crest and a white opaque substance. Based on the microvascular patterns, fine network, core vascular, and unclear patterns are useful for predicting gastric dysplasia in polypoid lesions. For diagnosis of early gastric cancer (EGC), a systematic classification using M-NBI endoscopy has been proposed on the basis of the presence of a demarcation line and an irregular microvascular/microsurface pattern. Furthermore, M-NBI endoscopy has been found to be more accurate for determining the horizontal margin of EGC compared to conventional endoscopy. In this review, we present up-to-date results on the clinical usefulness of gastroscopy with NBI for the diagnosis of H. pylori gastritis, precancerous gastric lesion, and neoplasia.
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Affiliation(s)
- Jun-Hyung Cho
- Digestive Disease Center, Soonchunhyang University Hospital, Seoul 04401, South Korea
| | - Seong Ran Jeon
- Digestive Disease Center, Soonchunhyang University Hospital, Seoul 04401, South Korea
| | - So-Young Jin
- Department of Pathology, Soonchunhyang University Hospital, Seoul 04401, South Korea
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4478
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Kim DH, Park SY, Park CH, Kim HS, Choi SK. Underwater endoscopic mucosal resection for neoplasms in the pyloric ring of the stomach: Four case reports. World J Clin Cases 2020; 8:3050-3056. [PMID: 32775386 PMCID: PMC7385597 DOI: 10.12998/wjcc.v8.i14.3050] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/01/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Tumors located in the pylorus are technically more complex to resect by endoscopic resection, as the anatomical characteristics of this region can affect the adequate assessment of margins and performance of the procedure. We reported the results of underwater endoscopic mucosal resection (UEMR) of benign mucosal neoplasms located in the pyloric ring.
CASE SUMMARY This case series describes 4 patients with 4 mucosal neoplasms located in the pyloric ring. The diameter of each neoplasm was less than 15 mm. We performed UEMR for the lesions. Water immersion enabled slight floating of the lesions, resulting in easy identification. We achieved en bloc resection with a snare and electrosurgical unit. All procedure were performed within 3 min without adverse events. Pathologic examination showed low-grade dysplasia with clear resection margins in one case and hyperplastic polyps in three cases.
CONCLUSION UEMR can be an effective and safe treatment method for neoplasms in the gastric pyloric ring.
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Affiliation(s)
- Dong Hyun Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
| | - Seon-Young Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
| | - Chang Hwan Park
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
| | - Hyun Soo Kim
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
| | - Sung Kyu Choi
- Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
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4479
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Pang JY, Tan F, Chen WW, Li CH, Dou SP, Guo JR, Zhao LY. Comparison of microendoscopic discectomy and open discectomy for single-segment lumbar disc herniation. World J Clin Cases 2020; 8:2942-2949. [PMID: 32775376 PMCID: PMC7385604 DOI: 10.12998/wjcc.v8.i14.2942] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/24/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lumbar disc herniation is a common disease. Endoscopic treatment may have more advantages than traditional surgery. AIM To compare the clinical efficacy and safety of microendoscopic discectomy (MED) and open discectomy with lamina nucleus enucleation in the treatment of single-segment lumbar intervertebral disc herniation. METHODS Ninety-six patients who were operated at our hospital were selected for this study. Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group. The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy. Surgical effects were compared between the two groups. RESULTS In terms of surgical indicators, the observation group had a longer operation time, shorter postoperative bedtime and hospital stay, less intraoperative blood loss, and smaller incision length than the control group (P < 0.05). The excellent recovery rate did not differ significantly between the observation group (93.75%) and the control group (91.67%). Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d, 3 d, 1 mo, and 6 mo after surgery (P < 0.05). The incidence of complications was significantly lower in the observation group than in the control group (6.25% vs 22.92%, P < 0.05). CONCLUSION Both MED and open discectomy can effectively improve single-segment lumbar disc herniation, but MED is associated with less trauma, less bleeding, and a lower incidence of complications.
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Affiliation(s)
- Jiu-Ya Pang
- Department of Traumatology, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
| | - Fei Tan
- Intensive Care Unit, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
| | - Wei-Wei Chen
- Intensive Care Unit, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
| | - Cui-Hua Li
- Department of Nursing, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
| | - Shu-Ping Dou
- Department of Hand Surgery, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
| | - Jing-Ran Guo
- Department of Spinal Surgery, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
| | - Li-Ying Zhao
- Hospital Office, The Second Hospital of Tangshan, Tangshan 0630000, Hebei Province, China
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4480
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Zhou J, Yang DB, Wang J, Li HZ, Wang YC. Role of shear wave elastography in the evaluation of the treatment and prognosis of supraspinatus tendinitis. World J Clin Cases 2020; 8:2977-2987. [PMID: 32775379 PMCID: PMC7385596 DOI: 10.12998/wjcc.v8.i14.2977] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/24/2020] [Accepted: 07/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Supraspinatus tendinitis recurs easily after treatment. One of the main reasons is the lack of objective tools for the efficacy evaluation. Shear wave elastography (SWE) can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus (YM) value.
AIM To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis.
METHODS Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited. Another 30 healthy volunteers were enrolled as the control group. The visual analogue scale (VAS) and Constant-Murley Score (CMS) were recorded before treatment. All participants were scanned by SWE scan, and the YM value of the region of interest were recorded. Spearman correlation analysis was performed on YM values with VAS and CMS. Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS, CMS and SWE under different treatment courses. After treatment, the patients were further grouped based on who achieved significantly effective and curative treatment. The patients in the continued treatment group continued to receive treatment according to the YM value, and the remaining patients who stopped receiving treatment were included in the stopped treatment group. All patients were followed up for 1 year, and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared.
RESULTS The SWE images of supraspinatus muscle in healthy volunteers were mainly blue, while those of patients with supraspinatus tendinitis showed regional red and green areas. The average YM value of the supraspinatus muscle in healthy volunteers was 26.12 ± 4.03 kPa. The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers (average YM = 60.61 ± 11.53 kPa, t = 26.344, P < 0.001). The YM value was positively correlated with VAS (r = 0.564, P < 0.001) and negatively correlated with CMS (r = -0.411, P < 0.001). The changes of VAS and CMS were the most obvious in course 1 and then decreased gradually. The degree of change in YM values was similar in different courses. After a 1-year follow-up, the cumulative relapse-free rate in the continued treatment group was 91.43%, which was significantly higher than that in the stopped treatment group (64.71%, X2 = 7.379, P = 0.007).
CONCLUSION SWE can objectively indicate the severity of supraspinatus tendinitis. Using the YM value as a criterion for curative effect may reduce the recurrence rate.
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Affiliation(s)
- Jie Zhou
- Department of Ultrasonic Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
| | - De-Bin Yang
- Department of Ultrasonic Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
| | - Jing Wang
- Department of Ultrasonic Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
| | - Hui-Zhang Li
- Department of Orthopaedics, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
| | - Ying-Chun Wang
- Department of Ultrasonic Imaging, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai 201800, China
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4481
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Dai HY, Guo SL, Shen J, Yang L. Pulmonary benign metastasizing leiomyoma: A case report and review of the literature. World J Clin Cases 2020; 8:3082-3089. [PMID: 32775390 PMCID: PMC7385613 DOI: 10.12998/wjcc.v8.i14.3082] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/16/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pulmonary benign metastatic leiomyoma (PBML), which is very rare, is a type of benign metastatic leiomyoma (BML). Here, we report a case of PBML, finally diagnosed through multidisciplinary team (MDT) discussions, and provide a literature review of the disease.
CASE SUMMARY A 55-year old asymptomatic woman was found to have bilateral multiple lung nodules on a chest high-resolution computed tomography (HRCT) scan. Her medical history included total hysterectomy for uterine leiomyoma. The patient was diagnosed with PBML, on the basis of her clinical history, imaging manifestations, and computed tomography (CT)-guided percutaneous lung puncture biopsy, via MDT discussions. As the patient was asymptomatic, she received long-term monitoring without treatment. A follow-up of chest HRCT after 6 mo showed that the PBML lung nodules were stable and there was no progression.
CONCLUSION For patients with a medical history of hysterectomy and uterine leiomyoma with lung nodules on chest CT, PBML should be considered during diagnosis based on the clinical history, imaging manifestations, CT-guided percutaneous lung puncture biopsy, and MDT discussions.
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Affiliation(s)
- Hai-Yun Dai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Shu-Liang Guo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Jian Shen
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - Li Yang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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4482
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Zhuang JY, Zhang FF, Li QW, Chen YF. Intra-abdominal inflammatory pseudotumor-like follicular dendritic cell sarcoma associated with paraneoplastic pemphigus: A case report and review of the literature. World J Clin Cases 2020; 8:3097-3107. [PMID: 32775392 PMCID: PMC7385594 DOI: 10.12998/wjcc.v8.i14.3097] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/09/2020] [Accepted: 06/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUD Follicular dendritic cell (FDC) sarcomas are rare neoplasms that occur predominantly in the lymph nodes. They can also occur extranodally. Extranodal FDC sarcomas most commonly present as solitary masses. Inflammatory pseudotumor (IPT)-like FDC sarcomas, a subcategory of FDC sarcomas, are rarer than other sarcoma subtypes. They are composed of spindle or ovoid neoplastic cells and exhibit an admixture of plasma cells and prominent lymphoplasmacytic infiltration. Paraneoplastic pemphigus (PNP), also known as paraneoplastic autoimmune multiorgan syndrome, is a rare autoimmune bullous disease that is associated with underlying neoplasms. PNP has a high mortality, and its early diagnosis is usually difficult.
CASE SUMMARY We describe a 27-year-old woman who presented with stomatitis, conjunctivitis, and skin blisters and erosions as her first symptoms of PNP with an intra-abdominal IPT-like FDC sarcoma. The patient underwent surgical tumor resection and received tapering oral corticosteroid treatment. She showed no recurrence at the 1-year follow-up.
CONCLUSION IPT-like FDC sarcomas are rare underlying neoplasms that have an uncommon association with PNP. PNP-associated FDC sarcomas predominantly occur in intra-abdominal sites and suggest a poor prognosis. Surgical resection is an essential and effective treatment for PNP and primary and recurrent FDC sarcomas.
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Affiliation(s)
- Jia-Yi Zhuang
- Department of Dermatology, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital, Guangzhou 510091, Guangdong Province, China
| | - Fang-Fei Zhang
- Department of Dermatology, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital, Guangzhou 510091, Guangdong Province, China
| | - Qing-Wen Li
- Department of Dermatology, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital, Guangzhou 510091, Guangdong Province, China
| | - Yong-Feng Chen
- Department of Dermatology, Dermatology Hospital, Southern Medical University/Guangdong Provincial Dermatology Hospital, Guangzhou 510091, Guangdong Province, China
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4483
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Deshwal H, Ghosh S, Hogan K, Akindipe O, Lane CR, Mehta AC. Spontaneous pneumothorax in a single lung transplant recipient-a blessing in disguise: A case report. World J Clin Cases 2020; 8:3031-3038. [PMID: 32775384 PMCID: PMC7385599 DOI: 10.12998/wjcc.v8.i14.3031] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/25/2020] [Accepted: 07/16/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND End-stage chronic obstructive pulmonary disease (COPD) is one of the common lung diseases referred for lung transplantation. According to the international society of heart and lung transplantation, 30% of all lung transplantations are carried out for COPD alone. When compared to bilateral lung transplant, single-lung transplant (SLT) has similar short-term and medium-term results for COPD. For patients with severe upper lobe predominant emphysema, lung volume reduction surgery is an excellent alternative which results in improvement in functional status and long-term mortality. In 2018, endobronchial valves were approved by the Food and Drug Administration for severe upper lobe predominant emphysema as they demonstrated improvement in lung function, exercise capacity, and quality of life. However, the role of endobronchial valves in native lung emphysema in SLT patients has not been studied.
CASE SUMMARY We describe an unusual case of severe emphysema who underwent a successful SLT 15 years ago and had gradual worsening of lung function suggestive of chronic lung allograft dysfunction. However, her lung function improved significantly after a spontaneous pneumothorax of the native lung resulting in auto-deflation of large bullae.
CONCLUSION This case highlights the clinical significance of native lung hyperinflation in single lung transplant recipient and how spontaneous decompression due to pneumothorax led to clinical improvement in our patient.
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Affiliation(s)
- Himanshu Deshwal
- Division of Pulmonary, Critical Care and Sleep Medicine, New York University Grossman School of Medicine, New York, NY 10016, United States
| | - Subha Ghosh
- Imaging Institute, Section of Thoracic Imaging, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Kathleen Hogan
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, United States
| | - Olufemi Akindipe
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, United States
| | | | - Atul C Mehta
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, United States
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4484
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Munda M, Spazzapan P, Bosnjak R, Velnar T. Endoscopic third ventriculostomy in obstructive hydrocephalus: A case report and analysis of operative technique. World J Clin Cases 2020; 8:3039-3049. [PMID: 32775385 PMCID: PMC7385605 DOI: 10.12998/wjcc.v8.i14.3039] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/25/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The endoscopic third ventriculostomy (ETV) is a neuroendoscopical procedure that represents a more suitable alternative to the extracranial shunting. It consists of fenestrating the floor of the third ventricle and thus establishing a free flow of the cerebrospinal fluid from the ventricles to the site of resorption in the subarachnoid space. It offers a more physiological solution and a chance at a shunt-free life for children with hydrocephalus. The main indication for the procedure is obstructive hydrocephalus, however, it can also be useful in patients with other forms of hydrocephalus.
CASE SUMMARY We present a treatment flow of a 9-year-old patient, diagnosed with an obstructive hydrocephalus due to tectal glioma that was successfully treated with an ETV. We review the important factors influencing the success rate such as age, aetiology, shunt history, preoperative planning and visualisation of the basilar artery.
CONCLUSION Even though the ETV effectively controls obstructive hydrocephalus in more than 75% of all cases, the overall success rate of the procedure varies and could be approved by the correct preoperative patient selection.
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Affiliation(s)
- Matic Munda
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Peter Spazzapan
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Roman Bosnjak
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
| | - Tomaz Velnar
- Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
- AMEU-ECM Maribor, Ljubljana 1000, Slovenia
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4485
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Yang TY, Li YC, Wang SC, Dai QQ, Jiang XS, Zuo S, Jia L, Zheng JB, Wang HL. Clinical characteristics of patients with COVID-19 presenting with gastrointestinal symptoms as initial symptoms: Retrospective case series. World J Clin Cases 2020; 8:2950-2958. [PMID: 32775377 PMCID: PMC7385610 DOI: 10.12998/wjcc.v8.i14.2950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/14/2020] [Accepted: 07/01/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A large number of pneumonia cases due to coronavirus disease 2019 (COVID-19) have been first reported in China. Meanwhile, the virus is sweeping all around the world and has infected millions of people. Fever and pulmonary symptoms have been noticed as major and early signs of infection, whereas gastrointestinal symptoms were also observed in a significant portion of patients. The clinical investigation of disease onset was underestimated, especially due to the neglection of cases presenting with gastrointestinal symptoms.
AIM To characterize the clinical features of coronavirus-infected patients with gastrointestinal symptoms as initial symptoms.
METHODS This is a retrospective, single-center case series of the general consecutive hospitalized patients with confirmed COVID-19 at Wuhan Union Hospital from February 2, 2020 to February 13, 2020. According to their initial symptoms, these patients were classified into two groups. Patients in group one presented with pulmonary symptoms (PS) as initial symptoms, and group two presented with gastrointestinal symptoms (GS). Epidemiological, demographic, clinical, laboratory, and treatment data were collected for analysis.
RESULTS Among the 50 patients recruited, no patient has been admitted to intensive care units, and no patient died during the study. The duration of hospitalization was longer in the GS group than in the PS group (12.13 ± 2.44 vs 10.00 ± 2.13, P < 0.01). All of the 50 patients exhibited decreased lymphocytes. However, lymphocytes in the GS group were significantly lower compared to those in the PS group (0.94 ± 0.06 vs 1.04 ± 0.15, P < 0.01). Procalcitonin and hs-CRP were both significantly higher in the GS group than in the PS group. Accordingly, the duration of viral shedding was significantly longer in the GS group compared to the PS group (10.22 ± 1.93 vs 8.15 ± 1.87, P < 0.01).
CONCLUSION COVID-19 patients presenting with gastrointestinal symptoms as initial symptoms need more days of viral shedding and hospitalization than the patients presenting with pulmonary symptoms.
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Affiliation(s)
- Tuo-Yun Yang
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Yuan-Chao Li
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Si-Cong Wang
- Department of Critical Care Medicine, the Cancer Hospital of Harbin Medical University, Harbin 150081, Heilongjiang Province, China
| | - Qing-Qing Dai
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Xue-Song Jiang
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Shu Zuo
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Liu Jia
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Jun-Bo Zheng
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
| | - Hong-Liang Wang
- Department of Critical Care Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, Heilongjiang Province, China
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4486
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Zhang HY, Yang HY. Mucoepidermoid carcinoma in the infratemporal fossa: A case report. World J Clin Cases 2020; 8:3090-3096. [PMID: 32775391 PMCID: PMC7385606 DOI: 10.12998/wjcc.v8.i14.3090] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/05/2020] [Accepted: 06/25/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mucoepidermoid carcinoma is the most common primary epithelial salivary gland malignancy. It mostly occurs in the major or intraoral minor salivary glands but rarely in the infratemporal fossa. Here, we present a case of aggressive mucoepidermoid carcinoma in the infratemporal fossa with neck lymph node metastasis and also discuss diagnostic and treatment strategies.
CASE SUMMARY A 39-year-old woman with a mass located in the right submandibular area presented to our department. Physical examination revealed lymphadenopathy on the right submandibular side measuring 2.5 cm × 3 cm that was hard and had poor mobility. Results of nasal endoscopy were unremarkable. Ultrasound examination revealed an enlarged lymph node at level II of the right side. Fine needle aspiration cytology of the metastatic lymph node revealed malignant cells with infection. Contrast-enhanced computed tomography revealed an enhancing ill-defined soft tissue mass in the right infratemporal region. Positron emission tomography/computed tomography revealed hyperintensity in the right infratemporal fossa along with lymphadenopathy at level II of the right-side lymph node. The patient underwent extended resection of the primary tumor, and ipsilateral radical neck dissection was also completed. Hematoxylin-eosin staining and immunohistochemistry revealed a high-grade mucoepidermoid carcinoma. No signs and symptoms of recurrence of the neoplasm were present after 20 mo of follow-up.
CONCLUSION Positron emission tomography/computed tomography play a key role in primary tumor localization. Furthermore, histopathology and immunohistochemistry play pivotal roles in disease diagnosis.
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Affiliation(s)
- Han-Yu Zhang
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
| | - Hong-Yu Yang
- Department of Oral and Maxillofacial Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong Province, China
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4487
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Lee TG, Yoon SM, Kim MJ. Successful treatment of basaloid squamous cell carcinoma in the rectosigmoid colon: A case report and review of literature. World J Clin Cases 2020; 8:3057-3063. [PMID: 32775387 PMCID: PMC7385607 DOI: 10.12998/wjcc.v8.i14.3057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Compared with colorectal adenocarcinoma, basaloid squamous cell carcinomas (BSCCs) arising in the colorectum are rare and have very poor prognosis. To date, only nine cases have been reported. Most BSCCs are extensively involved in metastasis to the lymph node, liver, and lung at diagnosis. Despite many clinicians attempting to effectively treat BSCCs, therapeutic consensus has not been established due to lack of information.
CASE SUMMARY A 58-year-old woman presented with abdominal pain, diarrhea, fever, and hematochezia. She was referred from a department of gynecology and was diagnosed with a suspicious leiomyosarcoma of the rectum or a pedunculated myoma of the uterus. An exophytic growing mass at the right lateral wall of the rectum with an internal cystic portion and hemorrhage was observed on magnetic resonance imaging. The patient underwent low anterior resection and total hysterectomy with bilateral salphingo-oophorectomy. Histopathological findings revealed a cellular mass with a solid growth pattern and few glandular structures, many foci of intratumoral necrosis, and a palisading pattern. The pathologist diagnosed tumor as a BSCC, and the patient received chemotherapy with fluorouracil/leucovorin without radiotherapy. The patient is currently alive 8 years after the surgery with no manifestations of metastatic colon cancer.
CONCLUSION Our case suggest that curative resection and chemotherapy play important roles in improving survival, and radiotherapy may be an option to avoid radiation-associated enteritis.
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Affiliation(s)
- Taek-Gu Lee
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
| | - Myung Jo Kim
- Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea
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4488
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Zhang FH, Ding XP, Zhang JH, Miao LS, Bai LY, Ge HL, Zhou YN. Acute esophageal obstruction caused by reverse migration of gastric bezoars: A case report. World J Clin Cases 2020; 8:3130-3135. [PMID: 32775396 PMCID: PMC7385598 DOI: 10.12998/wjcc.v8.i14.3130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/04/2020] [Accepted: 07/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Bezoars can be found anywhere in the gastrointestinal tract. Esophageal bezoars are rare. Esophageal bezoars are classified as either primary or secondary. It is rarely reported that secondary esophageal bezoars caused by reverse migration from the stomach lead to acute esophageal obstruction. Guidelines recommend urgent upper endoscopy (within 24 h) for these impactions without complete esophageal obstruction and emergency endoscopy (within 6 h) for those with complete esophageal obstruction. Gastroscopy is regarded as the mainstay for the diagnosis and treatment of esophageal bezoars.
CASE SUMMARY A 59-year-old man was hospitalized due to nausea, vomiting and diarrhea for 2 d and sudden retrosternal pain and dysphagia for 10 h. He had a history of type 2 diabetes mellitus for 9 years. Computed tomography revealed dilated lower esophagus, thickening of the esophageal wall, a mass-like lesion with a flocculent high-density shadow and gas bubbles in the esophageal lumen. On gastroscopy, immovable brown bezoars were found in the lower esophagus, which led to esophageal obstruction. Endoscopic fragmentation was successful, and there were no complications. The symptoms of retrosternal pain and dysphagia disappeared after treatment. Mucosal superficial ulcers were observed in the lower esophagus. Multiple biopsy specimens from the lower esophagus revealed nonspecific findings. The patient remained asymptomatic, and follow-up gastroscopy 1 wk after endoscopic fragmentation showed no evidence of bezoars in the esophagus or the stomach.
CONCLUSION Acute esophageal obstruction caused by bezoars reversed migration from the stomach is rare. Endoscopic fragmentation is safe, effective and minimally invasive and should be considered as the first-line therapeutic modality.
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Affiliation(s)
- Fu-Hua Zhang
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Key Laboratory for Gastrointestinal Diseases, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou 730000, Gansu Province, China
| | - Xiang-Ping Ding
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou 730000, Gansu Province, China
| | - Jin-Hua Zhang
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou 730000, Gansu Province, China
| | - Lian-Sheng Miao
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou 730000, Gansu Province, China
| | - Ling-Yu Bai
- Department of Gastroenterology, Affiliated Hospital of Northwest Minzu University, Lanzhou 730000, Gansu Province, China
| | - Hai-Lan Ge
- Department of Radiology, Affiliated Hospital of Northwest Minzu University, Lanzhou 730000, Gansu Province, China
| | - Yong-Ning Zhou
- Department of Gastroenterology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
- Key Laboratory for Gastrointestinal Diseases, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
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4489
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Gao W, Ou TW, Cui X, Wu JT, Cui B. Metallic ureteral stent in restoring kidney function: Nine case reports. World J Clin Cases 2020; 8:2841-2848. [PMID: 32742993 PMCID: PMC7360699 DOI: 10.12998/wjcc.v8.i13.2841] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/12/2020] [Accepted: 06/07/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Retroperitoneal fibrosis is an exceptionally rare disease characterized by proliferation of fibrous tissue and inflammation in the retroperitoneum. It features many symptoms in the kidneys and in other organs and usually leads to ureteral obstruction.
CASE SUMMARY Here we present 9 consecutive cases of idiopathic retroperitoneal fibrosis (IRPF) in patients who presented to the Department of Nephrology or Department of Rheumatology, Xuanwu Hospital, Capital Medical University, Beijing, China, between January 2012 and June 2017 with ureteral obstruction due to external compression of the ureter that led to hydronephrosis and kidney dysfunction. Computed tomography imaging was used to identify hydronephrosis and ureteral obstruction and to evaluate kidney function. Each patient was diagnosed with IRPF based on clinical observation and computed tomography examination results. To restore kidney function, a retrograde metallic stent was placed in the ureter under X-ray guidance 2 d after each patient’s admission. No perioperative complications occurred in any patient, but postoperative complications occurred in two patients as follows: Patient 2 had stent migration and repeated metallic stent infections that resolved with treatment; and patient 4 had postoperative hematuria because he resumed normal activities too soon after stent placement (contrary to instruction). Placement of the metallic ureteral stents provided relief from ureteral obstruction and restored kidney function in all patients.
CONCLUSION Our 9-case series underscores the utility and efficacy of applying the Resonance® metallic ureteral stent to treat ureteral obstruction in patients with IRPF. For all retroperitoneal fibrosis cases in our series, ureteral stents provided effective relief and were shown to reduce the incidence rate of perioperative and postoperative complications.
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Affiliation(s)
- Wei Gao
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Tong-Wen Ou
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Xin Cui
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Jiang-Tao Wu
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Bo Cui
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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4490
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Ge J, Kong KY, Cheng XQ, Li P, Hu XX, Yang HL, Shen MJ. Missed diagnosis of femoral deep artery rupture after femoral shaft fracture: A case report. World J Clin Cases 2020; 8:2862-2869. [PMID: 32742996 PMCID: PMC7360701 DOI: 10.12998/wjcc.v8.i13.2862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/24/2020] [Accepted: 06/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vascular injury is a rare complication of femoral shaft fractures, and rupture of the deep femoral artery is more difficult to diagnose because of its anatomical location and symptoms. Despite its low incidence, deep femoral artery rupture can lead to life-threatening outcomes, such as compartment syndrome, making early identification and diagnosis critical.
CASE SUMMARY A 45-year-old male patient was admitted to our hospital due to right lower limb trauma in a car accident, with complaints of severe pain and swelling on his right thigh. X-ray demonstrated a right femoral shaft fracture. During preparation for emergency surgery, his blood pressure and blood oxygen saturation dropped, and sensorimotor function was lost. Computed tomography angiography was performed immediately to confirm the diagnosis of rupture of the deep femoral artery and compartment syndrome, so fasciotomy and vacuum-assisted closure were performed. Rhabdomyolysis took place after the operation and the patient was treated with appropriate electrolyte correction and diuretic therapy. Twenty days after the fasciotomy, treatment with the Hoffman Type II External Fixation System was planned, but it was unable to be immobilized internally based on a new esophageal cancer diagnosis. We kept the external fixation for 1 year, and 3 years of follow-up showed improvement of the patient’s overall conditions and muscle strength.
CONCLUSION For patients with thigh swelling, pain, anemia, and unstable vital signs, anterior femoral artery injury should be highly suspected. Once diagnosed, surgical treatment should be performed immediately and complications of artery rupture must be suspected and addressed in time.
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Affiliation(s)
- Jun Ge
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Ke-Yu Kong
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Xiao-Qiang Cheng
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Peng Li
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Xing-Xing Hu
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Hui-Lin Yang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
| | - Min-Jie Shen
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
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4491
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Yue YY, Fan XY, Zhang Q, Lu YP, Wu S, Wang S, Yu M, Cui CW, Sun ZR. Bibliometric analysis of subject trends and knowledge structures of gut microbiota. World J Clin Cases 2020; 8:2817-2832. [PMID: 32742991 PMCID: PMC7360702 DOI: 10.12998/wjcc.v8.i13.2817] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/05/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gut microbiota is an emerging field of research, with related research having breakthrough development in the past 15 years. Bibliometric analysis can be applied to analyze the evolutionary trends and emerging hotspots in this field.
AIM To study the subject trends and knowledge structures of gut microbiota related research fields from 2004 to 2018.
METHODS The literature data on gut microbiota were identified and downloaded from the PubMed database. Through biclustering analysis, strategic diagrams, and social network analysis diagrams, the main trend and knowledge structure of research fields concerning gut microbiota were analyzed to obtain and compare the research hotspots in each period.
RESULTS According to the strategic coordinates and social relationship network map, Clostridium Infections/microbiology, Clostridium Infections/therapy, RNA, Ribosomal, 16S/genetics, Microbiota/genetics, Microbiota/immunology, Dysbiosis/immunology, Infla-mmation/immunology, Fecal Microbiota Transplantation/methods, Fecal Microbiota Transplantation can be used as an emerging research hotspot in the past 5 years (2014-2018).
CONCLUSION Some subjects were not yet fully studied according to the strategic coordinates; and the emerging hotspots in the social network map can be considered as directions of future research.
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Affiliation(s)
- Yuan-Yi Yue
- Department of Gastroenterology Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xin-Yue Fan
- Student Affairs Department, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Qiang Zhang
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province
| | - Yi-Ping Lu
- BioBank, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Si Wu
- BioBank, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Shuang Wang
- BioBank, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Miao Yu
- BioBank, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Chang-Wan Cui
- BioBank, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zheng-Rong Sun
- BioBank, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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4492
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Jia Z, Wang BJ, Li X, Zhang X. Pheochromocytoma with delayed tumor thrombus detection in renal vein: A case report. World J Clin Cases 2020; 8:2849-2854. [PMID: 32742994 PMCID: PMC7360707 DOI: 10.12998/wjcc.v8.i13.2849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/04/2020] [Accepted: 05/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pheochromocytomas with inferior vena cava (IVC) or renal vein tumor thrombus are rare. Surgical management is the first choice.
CASE SUMMARY We presented a 42-year-old man with adrenal pheochromocytoma and delayed tumor thrombus detection in the renal vein at the entrance of the IVC three months after adrenalectomy. We performed laparoscopic adrenalectomy during the first surgery and robot-assisted laparoscopic nephrectomy and resection of tumor thrombus during the second surgery.
CONCLUSION We report the surgical management of a patient with adrenal pheochromocytoma with tumor thrombus at the entrance of the IVC. Robot-assisted laparoscopic surgery is safe and efficient.
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Affiliation(s)
- Zhuo Jia
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing 100853, China
| | - Bao-Jun Wang
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing 100853, China
| | - Xing Li
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing 100853, China
| | - Xu Zhang
- Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing 100853, China
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4493
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Lei L, Wang MJ, Zhang S, Hu DJ. Effects of prostaglandin E combined with continuous renal replacement therapy on septic acute kidney injury. World J Clin Cases 2020; 8:2738-2748. [PMID: 32742984 PMCID: PMC7360708 DOI: 10.12998/wjcc.v8.i13.2738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/25/2020] [Accepted: 06/09/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The effects of prostaglandin E (PGE) combined with continuous renal replacement therapy (CRRT) on renal function and inflammatory responses in patients with septic acute kidney injury (SAKI) remain unclear.
AIM To investigate the effects of PGE combined with CRRT on urinary augmenter of liver regeneration (ALR), urinary Na+/H+ exchanger 3 (NHE3), and serum inflammatory cytokines in patients with SAKI.
METHODS The clinical data of 114 patients with SAKI admitted to Yichang Second People's Hospital from May 2017 to January 2019 were collected. Fifty-three cases treated by CRRT alone were included in a control group, while the other 61 cases treated with PGE combined with CRRT were included in an experimental group. Their urinary ALR, urinary NHE3, serum inflammatory cytokines, renal function indices, and immune function indices were detected. Changes in disease recovery and the incidence of adverse reactions were observed. The 28-d survival curve was plotted.
RESULTS Before treatment, urinary ALR, urinary NHE3, blood urea nitrogen (BUN), serum creatinine (SCr), CD3+ T lymphocytes, CD4+ T lymphocytes, and CD4+/CD8+ T lymphocyte ratio in the control and experimental groups were approximately the same. After treatment, urinary ALR and NHE3 decreased, while BUN, SCr, CD3+ T lymphocytes, CD4+ T lymphocytes, and CD4+/CD8+ T lymphocyte ratio increased in all subjects. Urinary ALR, urinary NHE3, BUN, and SCr in the experimental group were significantly lower than those in the control group, while CD3+ T lymphocytes, CD4+ T lymphocytes, and CD4+/CD8+ T lymphocyte ratio were significantly higher than those in the control group (P < 0.05). After treatment, the levels of tumor necrosis factor-α, interleukin-18, and high sensitivity C-reactive protein in the experimental group were significantly lower than those in the control group (P < 0.05). The time for urine volume recovery and intensive care unit treatment in the experimental group was significantly shorter than that in the control group (P < 0.05), although there was no statistically significant difference in hospital stays between the two groups. The total incidence of adverse reactions did not differ statistically between the two groups. The 28-d survival rate in the experimental group (80.33%) was significantly higher than that in the control group (66.04%).
CONCLUSION PGE combined with CRRT is clinically effective for treating SAKI, and the combination therapy can significantly improve renal function and reduce inflammatory responses.
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Affiliation(s)
- Li Lei
- Department of Nephrology, the Second People's Hospital of Three Gorges University (Yichang Second People's Hospital), Yichang 443000, Hubei Province, China
- Institute of Nephrology of Integrated Chinese and Western Medicine of Three Gorges University, Yichang 443000, Hubei Province, China
| | - Ming-Jun Wang
- Department of Nephrology, the Second People's Hospital of Three Gorges University (Yichang Second People's Hospital), Yichang 443000, Hubei Province, China
- Institute of Nephrology of Integrated Chinese and Western Medicine of Three Gorges University, Yichang 443000, Hubei Province, China
| | - Sheng Zhang
- Department of Nephrology, the Second People's Hospital of Three Gorges University (Yichang Second People's Hospital), Yichang 443000, Hubei Province, China
- Institute of Nephrology of Integrated Chinese and Western Medicine of Three Gorges University, Yichang 443000, Hubei Province, China
| | - Da-Jun Hu
- Department of Nephrology, the Second People's Hospital of Three Gorges University (Yichang Second People's Hospital), Yichang 443000, Hubei Province, China
- Institute of Nephrology of Integrated Chinese and Western Medicine of Three Gorges University, Yichang 443000, Hubei Province, China
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4494
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Jin Q, Zhao ZH, Luo Q, Zhao Q, Yan L, Zhang Y, Li X, Yang T, Zeng QX, Xiong CM, Liu ZH. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: State of the art. World J Clin Cases 2020; 8:2679-2702. [PMID: 32742980 PMCID: PMC7360712 DOI: 10.12998/wjcc.v8.i13.2679] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 05/28/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a complex chronic disease in which pulmonary artery stenosis or obstruction caused by organized thrombus can lead to increased pulmonary artery pressure and pulmonary vascular resistance, ultimately triggering progressive right heart failure and death. Currently, its exact mechanism is not fully understood. Pulmonary endarterectomy (PEA) has immediate effects with low perioperative mortality and satisfactory prognosis in experienced expert centers for CTEPH patients with proximal lesions. Nevertheless, 37% of patients are deemed unsuitable for PEA surgery due to comorbidities and other factors, and nearly half of the operated patients have residual or recurrent pulmonary hypertension. Riociguat is the only approved drug for CTEPH, although its effect is limited. Balloon pulmonary angioplasty (BPA) is a promising alternative treatment for patients with CTEPH. After more than 30 years of development and refinements, emerging evidence has confirmed its role in patients with inoperable CTEPH or residual/recurrent pulmonary hypertension, with acceptable complications and comparable long-term prognosis to PEA. This review summarizes the pathophysiology of CTEPH, BPA history and development, therapeutic principles, indications and contraindications, interventional procedures, imaging modalities, efficacy and prognosis, complications and management, bridging and hybrid therapies, ongoing clinical trials and future prospects.
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Affiliation(s)
- Qi Jin
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Zhi-Hui Zhao
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qin Luo
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qing Zhao
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Lu Yan
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yi Zhang
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xin Li
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Tao Yang
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qi-Xian Zeng
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chang-Ming Xiong
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Zhi-Hong Liu
- State Key Laboratory of Cardiovascular Disease, Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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4495
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Yin ZZ, Zhao ZM, Tang WB, Jiang N, Zhang KD, Song YY, Wang Y, Li CG, Gao YX, Liu R. Adjuvant nab-paclitaxel plus gemcitabine vs gemcitabine alone for resected pancreatic ductal adenocarcinoma: A single center experience in China. World J Clin Cases 2020; 8:2778-2786. [PMID: 32742988 PMCID: PMC7360710 DOI: 10.12998/wjcc.v8.i13.2778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 05/02/2020] [Accepted: 06/07/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Nab-paclitaxel plus gemcitabine (AG) has resulted in higher tumor response and survival rates for metastatic or advanced pancreatic ductal adenocarcinoma (PDAC) compared with gemcitabine (GEM) alone.
AIM To examine the feasibility and safety of AG adjuvant chemotherapy of resectable PDAC.
METHODS We retrospectively analyzed patients with resected PDAC who received AG or GEM as postoperative adjuvant treatment between January 2013 and December 2016 at the Chinese People’s Liberation Army General Hospital, Beijing, China. The patients adopted combined nab-paclitaxel (125 mg/m2) and GEM (1 g/m2) or GEM (1 g/m2) alone treatment, on days 1 and 8 every 3 wk for six cycles, unless intolerable adverse events or disease progression occurred. The disease-free survival, overall survival (OS) and adverse events of the two groups were statistically analyzed.
RESULTS Compared with GEM, median disease-free survival (12.2 mo vs 15.8 mo, P = 0.039) and OS (20.6 mo vs 28.3 mo, P = 0.028) were significantly improved in the AG group. The 2-year OS rates were 63.3% and 43.3% in the AG and GEM groups, respectively. However, the incidence of sensory neuropathy was increased significantly in the AG than the GEM group (53.3% vs 23.3%, P < 0.001).
CONCLUSION In our initial experience, AG significantly improved disease-free survival and OS of patients with resected PDAC. AG may be a potential option for postoperative adjuvant chemotherapy of resectable PDAC.
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Affiliation(s)
- Zhu-Zeng Yin
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Zhi-Ming Zhao
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Wen-Bo Tang
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Nan Jiang
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Ke-Di Zhang
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Yu-Yao Song
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Yang Wang
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Cheng-Gang Li
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Yuan-Xing Gao
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Rong Liu
- The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
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4496
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Yang SB, Du SW, Wang JH. Correlation between age of onset and gastrointestinal stenosis in hospitalized patients with Crohn's disease. World J Clin Cases 2020; 8:2769-2777. [PMID: 32742987 PMCID: PMC7360709 DOI: 10.12998/wjcc.v8.i13.2769] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/26/2020] [Accepted: 06/13/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients affected by Crohn's disease (CD) are more likely to develop gastrointestinal stenosis and often undergo surgery during the duration of disease.
AIM To identify the risk factors for gastrointestinal stenosis in hospitalized CD patients in China.
METHODS The clinical data of CD patients hospitalized at the Seventh Medical Center, Chinese People's Liberation Army General Hospital from January 2010 to December 2018 were included. Patients with gastrointestinal stenosis were compared to those without gastrointestinal stenosis for clinical variables. The risk factors for gastrointestinal stenosis were identified using univariate and multivariable logistic regression analyses. The treatments for patients with gastrointestinal stenosis were analyzed, and the characteristics of different treatment methods were discussed.
RESULTS The incidence of gastrointestinal stenosis was 59.02% in the 122 hospitalized CD patients. Age of onset of more than 40 years (odds ratio [OR] = 3.072, 95% confidence interval [CI]: 1.298-7.272, P = 0.009) and duration of disease of more than 5 years (OR = 2.101, 95%CI: 1.002-4.406, P = 0.048) were associated with the occurrence of gastrointestinal stenosis. Fifteen (20.83%) patients did not undergo surgery and received internal medicine and nutrition treatment. Surgical treatments were performed in 72.22% (52) of cases. The rate of postoperative complications was 15.38% (8 cases), and during a median follow-up period of 46 mo, 11.54% (6 cases) underwent reoperation. A total of 29.17% (21 cases) were treated with endoscopic therapy, and during a median follow-up period of 32 mo, 76.19% (16 cases) had no surgical event, 23.81% (5 cases) failed to avoid surgical treatments, and no serious postoperative complications occurred after endoscopic therapy.
CONCLUSION Age of onset of more than 40 years and duration of disease of more than 5 years may be strongly correlated with a higher risk of gastrointestinal stenosis in hospitalized CD patients. Endoscopic therapy for gastrointestinal stenosis is relatively safe and effective, and may help to prevent or delay surgery.
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Affiliation(s)
- Shan-Bing Yang
- Department of Gastroenterology, the Seventh Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100700, China
| | - Shu-Wen Du
- Department of Gastroenterology, the Seventh Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100700, China
| | - Ji-Heng Wang
- Department of Gastroenterology, the Seventh Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100700, China
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4497
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Cai YQ, Liu W, Zhang H, He XQ, Zhang J. Laparoscopic repair of uterine rupture following successful second vaginal birth after caesarean delivery: A case report. World J Clin Cases 2020; 8:2855-2861. [PMID: 32742995 PMCID: PMC7360696 DOI: 10.12998/wjcc.v8.i13.2855] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/01/2020] [Accepted: 06/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND With the increasing trend of vaginal birth after caesarean delivery (VBAC), evaluation of the feasibility and safety of a second VBAC with grand multiparity is worth considering. Intrapartum uterine rupture is diagnosed in approximately one-fifth of all VBAC cases following successful vaginal delivery. To our knowledge, no report is available on the application of laparoscopy to repair postpartum uterine rupture after a successful second VBAC in China.
CASE SUMMARY A 31-year-old woman (gravida 5, para 2) at 39 wk and 5 d of gestation was admitted to the hospital in labour. After a successful VBAC and observation for approximately 13 h, the patient complained of progressive abdominal pain. Given the symptoms, signs, and auxiliary examination results, intraperitoneal bleeding was considered. Because the patient was stable and ultrasound imaging was the only method available to assess the possibility of rupture, we recommended laparoscopy to clarify the diagnosis and for prompt laparoscopic uterine repair or exploratory laparotomy if necessary. Operative findings included transverse uterine scar rupture at the lower uterine segment of approximately 5.0 cm in length and 800 mL of intraoperative pelvic haemoperitoneum. Finally, she successfully underwent laparoscopic repair of uterine rupture and recovered very well according to three-dimensional magnetic resonance imaging at 42 d postpartum.
CONCLUSION Routine postpartum intrauterine exploration is not beneficial to the mother and may even increase the risk of rupture. This case highlights a laparoscopic approach for repairing uterine rupture in the immediate postpartum period.
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Affiliation(s)
- Yan-Qing Cai
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China
| | - Wei Liu
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China
| | - Hong Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China
| | - Xiao-Qing He
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China
| | - Jian Zhang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
- Shanghai Municipal Key Clinical Specialty, Shanghai 200030, China
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4498
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Neidhart E, Löffler-Stastka H. Case studies in psychotherapy training using Austria as an example. World J Clin Cases 2020; 8:2787-2801. [PMID: 32742989 PMCID: PMC7360703 DOI: 10.12998/wjcc.v8.i13.2787] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/15/2020] [Accepted: 06/30/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Case studies (CS) are relevant for the development of theoretical and practical competencies in psychotherapy. Despite rapid progress in the development of methods and principles for establishing CS in the last three decades, research into the aims of CS, especially in training, or how CS are to be conducted is rare.
AIM To elucidate the form and methodology of CS, the objectives of CS used in training institutions (TI), and if/how TIs handle therapist allegiance. Also, this preliminary investigation will suggest avenues for further research and attempt to establish certain guidelines.
METHODS In order to counteract researcher bias and enlarge the question-pool, a focus group was established. The recorded and transcribed text was analyzed with Mayring’s method of qualitative content analysis, and the generated categories were formulated as questions. The resulting questionnaire with both qualitative and quantitative queries was sent out (after pre-testing) to all 39 Austrian TIs that provide professional psychotherapy training. The answers and text passages received were then also categorized with qualitative content analysis. Data analysis was discussed by a peer group consisting of three psychotherapists trained in differing schools of psychotherapeutic methods.
RESULTS 94% of Austrian institutes use CS as part of their psychotherapeutic training. Understanding of the term “case study” is inconsistent and has a wide variety of interpretations. CS serve mainly: (1) For observation of training/progress in therapeutic practice and knowledge/acquisition of the theory specific to each psychotherapeutic school; (2) To improve (self-)reflection capabilities; and (3) To expand theoretical knowledge. Most of the CS written are not accessible for students nor for the research community. More than two thirds of the CS take only the position of the author into account (the client’s position is not described). 15.5 % of the TIs do not consider researcher or therapist allegiance at all.
CONCLUSION A more precise formulation of the term case study is needed in psychotherapeutic training. The training therapists play a key function, as they exemplify and teach how to deal with distorting factors. General guidelines as to how to conduct CS in training institutions would provide more direction to students, increase scientific rigor, and enhance synergistic effects.
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Affiliation(s)
- Ela Neidhart
- Department of Psychoanalysis and Psychotherapy, and Teaching Center – Postgraduate Unit, Medical University of Vienna/General Hospital of Vienna, Vienna 1090, Austria
| | - Henriette Löffler-Stastka
- Department of Psychoanalysis and Psychotherapy, and Teaching Center – Postgraduate Unit, Medical University of Vienna/General Hospital of Vienna, Vienna 1090, Austria
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4499
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Lio CF, Cheong HH, Lei CI, Lo IL, Lam C, Leong IH. Minimizing the risk of community spread of COVID-19 via institutional quarantine of high-risk travelers with serial viral RNA testing: A successful experience from Macao SAR, China. World J Clin Cases 2020; 8:2674-2678. [PMID: 32742979 PMCID: PMC7360711 DOI: 10.12998/wjcc.v8.i13.2674] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/09/2020] [Accepted: 06/28/2020] [Indexed: 02/05/2023] Open
Abstract
Macao, a special administrative region (SAR) of the People’s Republic of China, is located in southern China and shares the border with mainland China. It is the most densely populated region in the world, with a population of 667400 and a total land area of 32.9 square kilometers in 2019. Since the first case diagnosed on January 22, 2020, there was a total of 45 laboratory-confirmed coronavirus disease 2019 (COVID-19) cases in Macao, of which 43 patients (96%) were imported cases. To date, all patients had been discharged successfully from Centro Hospitalar Conde de São Januário, a designated hospital to manage all COVID-19 patients in Macao. Eventually, no patient died, and no local community outbreak was noted. This opinion review describes the underlying factors that could have contributed to the successful experience in Macao SAR, China, which include the following: (1) Early implementation of containment measures; (2) Large-scale quarantine using hotel rooms to reduce the risk of a local outbreak; and (3) Multidisciplinary co-operation and transparency of information to the public. Although the successful experience in Macao SAR, China, may not be generalized to other regions, it should not be unreasonable to be well prepared with sufficient logistic support to conduct timely containment and early detection of episodic cases to prevent the backsliding of COVID-19 outbreak.
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Affiliation(s)
- Chon Fu Lio
- Macao Academy of Medicine, Health Bureau, Macao SAR, China
| | - Hou Hon Cheong
- Macao Academy of Medicine, Health Bureau, Macao SAR, China
| | - Chin Ion Lei
- Department of Internal Medicine, Centro Hospitalar Conde de São Januário, Health Bureau, Macao SAR, China
| | - Iek Long Lo
- Department of Respiratory Medicine, Centro Hospitalar Conde de São Januário, Health Bureau, Macao SAR, China
| | - Chong Lam
- Center for Disease Control and Prevention, Health Bureau, Macao SAR, China
| | - Iek Hou Leong
- Center for Disease Control and Prevention, Health Bureau, Macao SAR, China
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4500
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Liu NN, Zhang XY, Tang YY, Wang ZM. Two sequential surgeries in infant with multiple floor of the mouth dermoid cysts: A case report. World J Clin Cases 2020; 8:2885-2892. [PMID: 32742999 PMCID: PMC7360698 DOI: 10.12998/wjcc.v8.i13.2885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/23/2020] [Accepted: 06/03/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multiple intraoral dermoid cysts of large magnitude generally appear in the second or third decade of life. They are rare in infants and are usually solitary. In this case, a large mass was identified in utero during prenatal exams.
CASE SUMMARY We introduce a rare case on multiple dermoid cysts in the floor of the mouth of an infant who underwent two surgeries for this. Preoperative magnetic resonance imaging confirmed a large well-circumscribed cystic lesion that originated at the former midline region in the floor of the mouth in which a suspicious lesion of minute size was likely compressed by the bulkier mass and overlooked. Therefore, the infant underwent two surgeries by an intraoral approach within 9 mo. At 5 mo after the second operation, a routine follow-up ultrasound showed evidence of an additional cyst. No further surgery was planned because the tumor had no immediate effect.
CONCLUSION This report demonstrates the importance of carefully analyzing preoperative imaging to avoid multiple operations for a seemingly isolated oral cyst.
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Affiliation(s)
- Nan-Nan Liu
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Xin-Yue Zhang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Yan-Yan Tang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
| | - Zhi-Ming Wang
- Department of Stomatology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
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