4501
|
Zhang XY, Wang ZM. Relevance on the diagnosis of malignant lymphoma of the salivary gland. World J Clin Cases 2020; 8:2717-2726. [PMID: 32742982 PMCID: PMC7360714 DOI: 10.12998/wjcc.v8.i13.2717] [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: 02/20/2020] [Revised: 04/13/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
Malignant lymphoma originates from the lymphohematopoietic system. It can occur in any lymphoid tissue. Malignant lymphoma of the salivary gland is rare, but its incidence has increased in recent years. Its clinical- presentations are non-specific, and it is often manifested as a painless mass in a salivary gland, which can be accompanied by multiple swollen cervical lymph nodes. Confirmation of the diagnosis before an invasive procedure is difficult. Clinically, malignant lymphoma of the salivary gland tends to be misdiagnosed, leading to an inappropriate treatment plan and the ultimate delay in the optimal treatment of the disease. This article reviews the pathogenesis, clinical features, imaging findings, diagnosis, treatment and prognosis of malignant lymphoma of the salivary gland.
Collapse
Affiliation(s)
- Xin-Yue Zhang
- 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
| |
Collapse
|
4502
|
Dong YP, Deng JY. Advances in para-aortic nodal dissection in gastric cancer surgery: A review of research progress over the last decade. World J Clin Cases 2020; 8:2703-2716. [PMID: 32742981 PMCID: PMC7360716 DOI: 10.12998/wjcc.v8.i13.2703] [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: 03/04/2020] [Revised: 04/30/2020] [Accepted: 06/07/2020] [Indexed: 02/05/2023] Open
Abstract
Approximately 17%-40% of para-aortic lymph node (PAN) metastasis occurs in patients with advanced gastric cancer. As the third tier of lymphatic drainage of the stomach and the final station in front of the systemic circulation, PAN infiltration is defined as distant metastasis and plays a key role in the evaluation of the prognosis of advanced gastric cancer. Many clinical factors including tumor size ≥ 5 cm, pT3 or pT4 depth of tumor invasion, pN2 and pN3 stages, the macroscopic type of Borrmann III/IV, and the diffuse/mixed Lauren classification are indicators of PAN metastasis. Whether PAN dissection (PAND) should be performed on patients with or without the macroscopic PAN invasion remains unascertained, regardless of the numerous retrospective comparative studies reported on the improved prognosis over D2 alone. Another paradoxical result from many other studies showed no significant difference in the overall survival between these two lymphadenectomies. A phase II trial launched by the Japan Clinical Oncology Group indicated that two or three courses of S-1 and cisplatin preoperatively followed by radical surgery with D2 + PAND and postoperative S-1 is the current standard strategy for the treatment of patients with extensive lymph node metastasis, and this regimen could be substituted by a promising strategy with effective combination chemotherapy or suitable chemotherapy duration. This review focuses on the advances in radical gastrectomy plus PAND with or without chemotherapy for patients with advanced gastric cancer.
Collapse
Affiliation(s)
- Yin-Ping Dong
- Department of Gastroenterology, Tianjin Medical University Cancer Hospital, City Key Laboratory of Tianjin Cancer Center and National Clinical Research Center for Cancer, Tianjin 300060, China
| | - Jing-Yu Deng
- Department of Gastroenterology, Tianjin Medical University Cancer Hospital, City Key Laboratory of Tianjin Cancer Center and National Clinical Research Center for Cancer, Tianjin 300060, China
| |
Collapse
|
4503
|
Kim HB, Park SG, Hong R, Kang SH, Na YS. Acute myelomonocytic leukemia during pembrolizumab treatment for non-small cell lung cancer: A case report. World J Clin Cases 2020; 8:2833-2840. [PMID: 32742992 PMCID: PMC7360697 DOI: 10.12998/wjcc.v8.i13.2833] [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: 02/14/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pembrolizumab is a highly selective IgG4 kappa isotype monoclonal antibody against the programmed cell death-1 (PD-1) molecule. In the treatment of non-small cell lung cancer (NSCLC), pembrolizumab has demonstrated significant efficacy, significant survival outcomes, long-lasting responses, and a good safety profile compared with cytotoxic chemotherapy.
CASE SUMMARY A 79-year-old Korean male presented with a left side palpable neck mass. An ultrasound-guided core-needle biopsy of the largest neck mass was performed, and squamous cell carcinoma was confirmed based on the histological and immunohistochemical findings. He was diagnosed with squamous cell carcinoma of the lung with multiple lymph nodes and rib metastases (T1N3M1b, Stage IVA) using enhanced chest computed tomography and 18F-fluorodeoxyglucose positron emission/computed tomography. After 4 cycles of gemcitabine and carboplatin, we clinically judged the disease as progressive. Owing to the high PD-1 expression demonstrated by the patient, pembrolizumab was initiated (200 mg every 3 wk). After 3 cycles of pembrolizumab, a complete response was achieved. At the 4th cycle of pembrolizumab, the white blood cell count was markedly elevated. Peripheral blood smear analysis and bone marrow biopsy were performed. The patient was diagnosed with acute myelomonocytic leukemia.
CONCLUSION We present the first report of acute myelomonocytic leukemia during pembrolizumab treatment in an NSCLC patient; the mechanism remains unknown.
Collapse
Affiliation(s)
- Hong-Beum Kim
- Department of Premedical Course, Chosun University School of Medicine, Gwangju 61452, South Korea
| | - Sang-Gon Park
- Department of Hemato-oncology, Chosun University Hospital, Gwangju 61453, South Korea
| | - Ran Hong
- Department of Pathology, Chosun University Hospital, Gwangju 61453, South Korea
| | - Seong-Ho Kang
- Department of Laboratory Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| | - Yong Sub Na
- Department of Pulmonology and Critical Care Medicine, Chosun University Hospital, Gwangju 61453, South Korea
| |
Collapse
|
4504
|
Wu CW, Lan CC, Hsieh PC, Tzeng IS, Wu YK. Role of peripheral eosinophilia in acute exacerbation of chronic obstructive pulmonary disease. World J Clin Cases 2020; 8:2727-2737. [PMID: 32742983 PMCID: PMC7360705 DOI: 10.12998/wjcc.v8.i13.2727] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/26/2020] [Accepted: 06/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Eosinophil counts are a promising guide to systemic steroid administration for chronic obstructive pulmonary disease (COPD).
AIM To study the role of peripheral eosinophilia in hospitalized patients with acute exacerbation of COPD (AECOPD).
METHODS From January 2014 to May 2017, patients with AECOPD hospitalized in Taipei Tzu Chi Hospital were retrospectively stratified into two groups according to their peripheral eosinophil count: The EOS group (eosinophil count ≥ 2%) and the non-EOS group (eosinophil count < 2%). Demographics, comorbidities, laboratory data, steroid use, length of hospital stay, and COPD-related readmissions were compared between the groups.
RESULTS A total of 625 patients were recruited, with 176 patients (28.2%) in the EOS group. The EOS group showed a lower prevalence of infection, lower cumulative doses of prednisolone equivalents, shorter length of hospital stay, and higher number of COPD-related readmissions than the non-EOS group. There were significantly linear correlations between eosinophil percentage and number of readmissions and between eosinophil percentage and length of hospital stay (P < 0.001, Pearson's r = 0.147; P = 0.031, Pearson's r = -0.086, respectively). The EOS group and a lower percent-predicted value of forced expiratory volume in one second (FEV1) were associated with shorter time to first COPD-related readmission [adjusted hazard ratio (adj. HR) = 1.488, P < 0.001; adj. HR = 0.985, P < 0.001, respectively].
CONCLUSION The study findings suggest that the EOS group had the features of a shorter length of hospital stay, and lower doses of systemic steroids, but more frequent readmissions. The EOS group and lower percent-predicted FEV1 values were risk factors for shorter time to first COPD-related readmission.
Collapse
Affiliation(s)
- Chih-Wei Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
| | - Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
| | - Po-Chun Hsieh
- Department of Chinese Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
| | - I-Shiang Tzeng
- Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
| | - Yao-Kuang Wu
- Division of Pulmonary Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
| |
Collapse
|
4505
|
Lin L, Jiao Y, Luo XG, Zhang JZ, Yin HL, Ma L, Chen BR, Kelly DM, Gu WK, Chen H. Modified technique of advanced core decompression for treatment of femoral head osteonecrosis. World J Clin Cases 2020; 8:2749-2757. [PMID: 32742985 PMCID: PMC7360713 DOI: 10.12998/wjcc.v8.i13.2749] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/14/2020] [Accepted: 05/29/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Osteonecrosis of the femoral head (ONFH) is a destructive condition most commonly affecting young and middle-aged patients. The leading consequence of ONFH is often a significant articular disability. Effective joint-preserving surgical treatments are urgently needed for patients with early stage ONFH when outcomes of treatment are in general better than the advanced stage disease.
AIM To introduce a new surgery procedure called percutaneous expanded core decompression and mixed bone graft technique, which is a new way of joint-preserving surgical treatments.
METHODS The clinical data of 6 patients with ONFH diagnosed and treated with the procedure called percutaneous expanded core decompression and mixed bone graft technique at The First Hospital of Qiqihar from March 2013 to August 2019 were retrospectively analyzed; the follow-up ended in December 2019.
RESULTS There were 6 male patients with an average age of 43 years in our study. Gratifying results have been obtained from the comparison of Harris hip score, visual analogue scale, and imaging examination before and after operation.
CONCLUSION This new modified technique is simple, safe, and reliable. No serious perioperative complications were observed in our cases. Advantages of the single blade expandable reamer are obvious. The adjuvant substance is inexpensive and easy to obtain. Thus, this technique is an effective joint-preserving surgical treatment for patients with early stage of ONFH.
Collapse
Affiliation(s)
- Lin Lin
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, United States
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
- The Precision Treatment Institute of Jinzhu Osteoarthrosis in Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
| | - Yan Jiao
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Xian-Guo Luo
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
- The Precision Treatment Institute of Jinzhu Osteoarthrosis in Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
| | - Jin-Zhu Zhang
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
- The Precision Treatment Institute of Jinzhu Osteoarthrosis in Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
| | - He-Liang Yin
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, United States
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
| | - Li Ma
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, United States
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
| | - Bo-Ran Chen
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
| | - Derek M Kelly
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Wei-Kuan Gu
- Department of Orthopedic Surgery and BME-Campbell Clinic, University of Tennessee Health Science Center, Memphis, TN 38163, United States
- Research Service 151, VA Medical Center, Memphis, TN 38112, United States
| | - Hong Chen
- Center of Integrative Research, The First Hospital of Qiqihar, Qiqihaer 161005, Heilongjiang Province, China
- Affiliated Qiqihar Hospital, Southern Medical University, Qiqihaer 161005, Heilongjiang Province, China
| |
Collapse
|
4506
|
Au KP, Chiang CL, Chan ACY, Cheung TT, Lo CM, Chok KSH. Initial experience with stereotactic body radiotherapy for intrahepatic hepatocellular carcinoma recurrence after liver transplantation. World J Clin Cases 2020; 8:2758-2768. [PMID: 32742986 PMCID: PMC7360706 DOI: 10.12998/wjcc.v8.i13.2758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Graft hepatocellular carcinoma (HCC) recurrence after liver transplant is more frequently encountered. Graft hepatectomy is technically challenging and is associated with high morbidity. Stereotactic body radiation therapy (SBRT) has been shown to be safe and effective for the treatment of primary HCC. However, its role in HCC recurrence in a liver graft remains unclear.
AIM To evaluate the safety and efficacy of SBRT for the treatment of graft HCC recurrence after liver transplantation.
METHODS A retrospective study was conducted. From 2012 to 2018, 6 patients with intrahepatic HCC recurrence after liver transplant were treated with SBRT at Queen Mary Hospital, the University of Hong Kong. The primary outcome was time to overall disease progression and secondary outcomes were time to local progression and best local response, as assessed with the Modified response Evaluation Criteria for Solid Tumours criteria. Patients were monitored for treatment related toxicities and graft dysfunction.
RESULTS A total of 9 treatment courses were given for 13 tumours. The median tumour size was 2.3 cm (range 0.7-3.6 cm). Two (22%) patients had inferior vena cava tumour thrombus. The best local treatment response was: 5 (55%) complete response, 1 (11%) partial response and 3 (33%) stable disease. After a median follow up duration of 15.5 mo, no local progression or mortality was yet observed. The median time to overall disease progression was 6.5 mo. There were 6 regional progression in the liver graft (67%) and 2 distant progression in the lung (22%). There was no grade 3 or above toxicity and there was no graft dysfunction after SBRT.
CONCLUSION SBRT appears to be safe in this context. Regional progression is the mode of failure.
Collapse
Affiliation(s)
- Kin Pan Au
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong 999077, China
| | - Chi Leung Chiang
- Department of Clinical Oncology, Queen Mary Hospital, the University of Hong Kong, Hong Kong 999077, China
| | - Albert Chi Yan Chan
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong 999077, China
| | - Tan To Cheung
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong 999077, China
| | - Chung Mau Lo
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong 999077, China
| | - Kenneth Siu Ho Chok
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong 999077, China
| |
Collapse
|
4507
|
Liu JF, Shen T, Zhang YT. Posterior reversible encephalopathy syndrome and heart failure tacrolimus-induced after liver transplantation: A case report. World J Clin Cases 2020; 8:2870-2875. [PMID: 32742997 PMCID: PMC7360704 DOI: 10.12998/wjcc.v8.i13.2870] [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: 03/01/2020] [Revised: 05/07/2020] [Accepted: 06/13/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients undergoing liver transplantation can develop posterior reversible encephalopathy syndrome (PRES) and acute heart failure (HF) in the post-operative period. But PRES with HF caused by tacrolimus has rarely been described.
CASE SUMMAR A 40-year-old female patient who had a normal preoperative cardiac and neural evaluation developed PRES with acute heart failure tacrolimus-induced after liver transplantation. The challenges associated with both diagnosis and management in the setting of a newly implanted graft are discussed.
CONCLUSION Tacrolimus can induce neurotoxicity and then cardiac toxicity. Magnetic resonance imaging, echocardiography, and increased brain natriuretic peptide may be predictive of post-operative PRES with acute heart failure. Further investigations are necessary to verify this finding.
Collapse
Affiliation(s)
- Jun-Fang Liu
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Tian Shen
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Yun-Tao Zhang
- Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| |
Collapse
|
4508
|
Chen P, Yu M, Zhang JL, Chen WY, Zhu L, Song Y, Jiang CY, Zhang S. Significant benefits of pembrolizumab in treating refractory advanced pulmonary sarcomatoid carcinoma: A case report. World J Clin Cases 2020; 8:2876-2884. [PMID: 32742998 PMCID: PMC7360715 DOI: 10.12998/wjcc.v8.i13.2876] [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: 01/26/2020] [Revised: 03/26/2020] [Accepted: 06/07/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pulmonary sarcomatoid carcinoma (PSC), a rare subtype of non-small cell lung cancer (NSCLC), is poorly differentiated and highly aggressive. Treatment is limited, and the prognosis is poor. Pembrolizumab is an anti-programmed death (PD)-1 antibody with good efficacy in NSCLC. Recent studies have demonstrated that PD-ligand 1 (PD-L1) overexpression is common in PSCs, which suggests that anti-PD-L1 treatment is an ideal option. However, the response to pembrolizumab in PSC has not been studied.
CASE SUMMARY We present a PSC case with PD-L1 overexpression that significantly benefited from pembrolizumab. A 73-year-old Chinese male was detected with a right lung lesion. Pathological analysis of the right upper lobectomy confirmed PSC. The PD-L1 test revealed overexpression (TPS: 90%). Multiple metastases occurred 1 mo after surgery, representing stage IV PSC. Neither first-line chemotherapy nor second-line antiangiogenic agents showed any benefit. Radiotherapy (1200 cGy) was administered to relieve chest wall pain. The patient received the PD-1 inhibitor pembrolizumab (100 mg) as third-line therapy; however, because of fever and severe infection, he refused to receive immunotherapy any longer. Thus, only one dose of pembrolizumab was administered. Deep sustained remission of most of the metastases was achieved except for lesions in the right adrenal gland, which first shrank and then progressed. The patient died because of disease progression in the right adrenal gland. He achieved a progression-free survival time of 8 mo and an overall survival time of 9 mo with third-line pembrolizumab.
CONCLUSION Our findings highlight and offer direct evidence of the efficacy of pembrolizumab in PD-L1-overexpressing PSCs. Combined radiotherapy and immunotherapy may enhance treatment efficacy.
Collapse
Affiliation(s)
- Ping Chen
- Department of Oncology, Chengdu Seventh People’s Hospital, Chengdu Tumor Hospital, Chengdu 610041, Sichuan Province, China
| | - Min Yu
- Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ji-Liang Zhang
- Department of Oncology, Chengdu Seventh People’s Hospital, Chengdu Tumor Hospital, Chengdu 610041, Sichuan Province, China
| | - Wei-Yong Chen
- Department of Oncology, Chengdu Seventh People’s Hospital, Chengdu Tumor Hospital, Chengdu 610041, Sichuan Province, China
| | - Li Zhu
- Department of Oncology, Chengdu Seventh People’s Hospital, Chengdu Tumor Hospital, Chengdu 610041, Sichuan Province, China
| | - Yue Song
- Department of Oncology, Chengdu Seventh People’s Hospital, Chengdu Tumor Hospital, Chengdu 610041, Sichuan Province, China
| | - Cheng-Yi Jiang
- Department of Oncology, Chengdu Seventh People’s Hospital, Chengdu Tumor Hospital, Chengdu 610041, Sichuan Province, China
| | - Shuang Zhang
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| |
Collapse
|
4509
|
Wang S, Gao JY, Li X, Wu Y, Huo XX, Han CX, Kang MJ, Sun H, Ge BL, Liu Y, Liu YQ, Zhou JP, Wang Z. Correlation between crowdedness in emergency departments and anxiety in Chinese patients. World J Clin Cases 2020; 8:2802-2816. [PMID: 32742990 PMCID: PMC7360700 DOI: 10.12998/wjcc.v8.i13.2802] [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: 05/13/2020] [Accepted: 06/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Emergency department (ED) overcrowding is a severe health care concern, while anxiety and depression rates among ED patients have been reported to be substantially higher compared to the general population. We hypothesized that anxiety due to over crowdedness may lead to adverse events in EDs.
AIM To investigate correlations between crowdedness in EDs and anxiety of patients and nurses, and to identify factors affecting their anxiety.
METHODS In this prospective observational study, a total 43 nurses and 389 emergency patients from two tier III hospitals located in Beijing were included from January 2016 to August 2017. Patients were grouped into inpatients when they were hospitalized after diagnoses, or into outpatients when they were discharged after treatments. The State Trait Anxiety Inventory (STAI Form Y) questionnaire was used to investigate patient and nurse anxieties, while crowdedness of EDs was evaluated with the National Emergency Department Over Crowding Score.
RESULTS The present results revealed that state anxiety scores (49.50 ± 6.00 vs 50.80 ± 2.80, P = 0.005) and trait anxiety scores (45.40 ± 5.70 vs 46.80 ± 2.70, P = 0.002) between inpatients (n = 173) and outpatients (n = 216) were significantly different, while the state anxiety of nurses (44.70 ± 5.80) was different from those of both patient groups. Generalized linear regression analysis demonstrated that multiple factors, including crowdedness in the ED, were associated with state and trait anxieties for both inpatients and outpatients. In addition, there was an interaction between state anxiety and trait anxieties. However, multivariable regression analysis showed that while overcrowding in the ED did not directly correlate with patients’ and nurses’ anxiety levels, the factors that did correlate with state and trait anxieties of inpatients were related to crowdedness. These factors included waiting time in the ED, the number of patients treated, and the number of nurses in the ED, whereas for nurses, only state and trait anxieties correlated significantly with each other.
CONCLUSION Waiting time, the number of patients treated, and the number of nurses present in the ED correlate with patient anxiety in EDs, but crowdedness has no effect on nurse or patient anxiety.
Collapse
Affiliation(s)
- Shuang Wang
- Department of Emergency Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Jun-Yi Gao
- Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xiang Li
- Emergency Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Yu Wu
- Department of Orthopedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xiao-Xia Huo
- Department of Emergency Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Chao-Xia Han
- Department of Emergency Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Meng-Jie Kang
- Emergency Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Hong Sun
- Department of Emergency Medicine, Peking University People’s Hospital, Beijing 100044, China
| | - Bao-Lan Ge
- Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Yu Liu
- Department of Emergency Medicine, Chinese PLA General Hospital, Beijing 100853, China
| | - Ying-Qing Liu
- Department of Emergency Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
| | - Jian-Ping Zhou
- Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhen Wang
- Department of Emergency Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| |
Collapse
|
4510
|
Bi YC, Gong L. Headache and sick sinus syndrome: A case report. World J Clin Cases 2020; 8:2629-2633. [PMID: 32607342 PMCID: PMC7322413 DOI: 10.12998/wjcc.v8.i12.2629] [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: 03/16/2020] [Revised: 05/12/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sick sinus syndrome is a common disease in cardiology. Typical symptoms include palpitations, dizziness, shortness of breath, chest tightness, and amaurosis. However, to date, there are no known reports of sick sinus syndrome presenting with headache. Whether there is a correlation between headache and sick sinus syndrome merits further research. In this report, we describe a case of headache induced by sick sinus syndrome.
CASE SUMMARY A 73-year-old female patient presented to our department with the chief complaint of recurrent paroxysmal headache for more than 7 years. The patient described paroxysmal palpations, usually headache occurring after palpitation. Her blood pressure was normal when the most recent headache occurred. A magnetic resonance imaging study and magnetic resonance angiography of the head at another center were normal. A clinical neurological examination was negative. A 24-h Holter electrocardiogram monitoring study showed sick sinus syndrome. The patient received dual chamber pacing implantation and was administered drug therapy to control ventricular rate. The patient’s paroxysmal headaches and palpitations had resolved within 1 year, confirmed via a follow-up telephone call.
CONCLUSION After dual-chamber pacing implantation and drug therapy administration to control the ventricular rate, the patient’s paroxysmal headaches and palpitations had resolved within 1 year, confirmed via a follow-up telephone call. We believe that the headaches were related to the patient’s sick sinus syndrome.
Collapse
Affiliation(s)
- You-Cai Bi
- Department of Neurology, Zigong Fourth People’s Hospital, Zigong 643000, Sichuan Province, China
| | - Liang Gong
- Department of Neurology, Chengdu Second People’s Hospital, Chengdu 650017, Sichuan Province, China
| |
Collapse
|
4511
|
Wu SW, Pan Q, Chen T. Research on diagnosis-related group grouping of inpatient medical expenditure in colorectal cancer patients based on a decision tree model. World J Clin Cases 2020; 8:2484-2493. [PMID: 32607325 PMCID: PMC7322429 DOI: 10.12998/wjcc.v8.i12.2484] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In 2018, the diagnosis-related groups prospective payment system (DRGs-PPS) was introduced in a trial operation in Beijing according to the requirements of medical and health reform. The implementation of the system requires that more than 300 disease types pay through the DRGs-PPS for medical insurance. Colorectal cancer (CRC), as a common malignant tumor with high prevalence in recent years, was among the 300 disease types.
AIM To investigate the composition and factors related to inpatient medical expenditure in CRC patients based on disease DRGs, and to provide a basis for the rational economic control of hospitalization expenses for the diagnosis and treatment of CRC.
METHODS The basic material and cost data for 1026 CRC inpatients in a Grade-A tertiary hospital in Beijing during 2014-2018 were collected using the medical record system. A variance analysis of the composition of medical expenditure was carried out, and a multivariate linear regression model was used to select influencing factors with the greatest statistical significance. A decision tree model based on the exhaustive χ2 automatic interaction detector (E-CHAID) algorithm for DRG grouping was built by setting chosen factors as separation nodes, and the payment standard of each diagnostic group and upper limit cost were calculated. The correctness and rationality of the data were re-evaluated and verified by clinical practice.
RESULTS The average hospital stay of the 1026 CRC patients investigated was 18.5 d, and the average hospitalization cost was 57872.4 RMB yuan. Factors including age, gender, length of hospital stay, diagnosis and treatment, as well as clinical operations had significant influence on inpatient expenditure (P < 0.05). By adopting age, diagnosis, treatment, and surgery as the grouping nodes, a decision tree model based on the E-CHAID algorithm was established, and the CRC patients were divided into 12 DRG cost groups. Among these 12 groups, the number of patients aged ≤ 67 years, and underwent surgery and chemotherapy or radiotherapy was largest; while patients aged > 67 years, and underwent surgery and chemotherapy or radiotherapy had the highest medical cost. In addition, the standard cost and upper limit cost in the 12 groups were calculated and re-evaluated.
CONCLUSION It is important to strengthen the control over the use of drugs and management of the hospitalization process, surgery, diagnosis and treatment to reduce the economic burden on patients. Tailored adjustments to medical payment standards should be made according to the characteristics and treatment of disease types to improve the comprehensiveness and practicability of the DRGs-PPS.
Collapse
Affiliation(s)
- Suo-Wei Wu
- Department of Medical Administration, Beijing Hospital, Beijing 100730, China
| | - Qi Pan
- Department of Medical Administration, Beijing Hospital, Beijing 100730, China
| | - Tong Chen
- Department of Medical Administration, Beijing Hospital, Beijing 100730, China
| |
Collapse
|
4512
|
Xie J, Zhao YY, Liu J, Nong GM. Diffuse alveolar hemorrhage with histopathologic manifestations of pulmonary capillaritis: Three case reports. World J Clin Cases 2020; 8:2662-2666. [PMID: 32607347 PMCID: PMC7322415 DOI: 10.12998/wjcc.v8.i12.2662] [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: 02/26/2020] [Revised: 04/28/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diffuse alveolar hemorrhage (DAH) is a multicause pulmonary capillary hemorrhage or pulmonary vascular small vessel injury (mainly capillaries, including arteries and veins), causing pulmonary microcirculation blood to accumulate in the alveolar space. DAH is classified by the histological absence or presence of pulmonary capillaritis (PC) and is rarely reported in the literature.
CASE SUMMARY This is a report of three girls aged 6-11 years with DAH and PC. Two patients had decreased hemoglobin and one had increased erythrocyte sedimentation rate. High-resolution computed tomography showed bilateral diffuse pulmonary infiltrate, and diagnosis of PC was confirmed by lung biopsy. Immunofluorescence test in one case showed granular IgG and a small amount of granular IgA deposit on the alveolar walls, and was negative in the other two cases, describing isolated pauci-immune PC. Treatment was with glucocorticoid alone or combination with immunosuppressants, and the symptoms resolved in all patients.
CONCLUSION PC is classified as isolated and immune-mediated PC associated with systemic disease. It can be controlled in most children with glucocorticoid alone or combined with immunosuppressants.
Collapse
Affiliation(s)
- Jun Xie
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Ying-Yue Zhao
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Jing Liu
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| | - Guang-Min Nong
- Department of Pediatrics, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
| |
Collapse
|
4513
|
Chen J, Jin JX, Xu XF, Zhang XX, Ye XN, Huang J. Successful treatment of plasma exchange-refractory thrombotic thrombocytopenic purpura with rituximab: A case report. World J Clin Cases 2020; 8:2617-2622. [PMID: 32607340 PMCID: PMC7322435 DOI: 10.12998/wjcc.v8.i12.2617] [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: 04/13/2020] [Revised: 05/05/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Thrombotic thrombocytopenic purpura (TTP), a subtype of thrombotic microangiopathy, has a very high fatality rate if there is no timely diagnosis or treatment. Here, we report a case of TTP refractory to high displacement plasma exchange, which was later successfully treated with rituximab.
CASE SUMMARY Here we report a case of refractory TTP in a 63-year-old woman with a low platelet count and decreased ADAMTS13 activity. Her platelet count was 9 × 109/L, hemoglobin level was 81 g/L, and ADAMTS13 was < 5%. She was diagnosed with thrombotic thrombocytopenic purpura. After 8 d of daily plasma exchange (PEX), her platelet levels were still low. However, after 6 d of treatment with rituximab, her platelet count increased and ADAMTS13 activity returned to normal.
CONCLUSION PEX can cure most patients, but the relapse rate can be up to 50%-60%. This case suggested that rituximab can improve the curative efficiency of PEX and prevent disease relapse in TTP.
Collapse
Affiliation(s)
- Jian Chen
- Department of Ultrasonography, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Jing-Xia Jin
- Department of Hematology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Xiao-Fei Xu
- Department of Hematology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Xuan-Xuan Zhang
- Department of Ultrasonography, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Xing-Nong Ye
- Department of Hematology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| | - Jian Huang
- Department of Hematology, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu 322000, Zhejiang Province, China
| |
Collapse
|
4514
|
Wu SH, Zhang BZ, Han L. Collision tumor of squamous cell carcinoma and neuroendocrine carcinoma in the head and neck: A case report. World J Clin Cases 2020; 8:2610-2616. [PMID: 32607339 PMCID: PMC7322427 DOI: 10.12998/wjcc.v8.i12.2610] [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: 01/20/2020] [Revised: 04/24/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There are many disputes about the definition, diagnosis, therapy, and prognosis of collision tumors.
CASE SUMMARY We describe a rare patient with a collision tumor consisting of neuroendocrine carcinoma (NEC) and squamous cell carcinoma (SCC) in the nasal cavity and paranasal sinus. She received operation, concurrent chemoradiotherapy, and then two cycles of palliative chemotherapy. Follow-up at 12 mo after diagnosis showed that this patient experienced a complete response with no signs of recurrence or metastasis. A literature review of previous 26 cases diagnosed with collision tumor of NEC and SCC in the head and neck was also undertaken.
CONCLUSION It is challenging to manage collision tumors because there are two morphologically and etiologically distinct tumors. Well-designed multimodality therapy including surgery and chemoradiotherapy might lead to a long survival in these patients.
Collapse
Affiliation(s)
- Shi-Hai Wu
- Department of Radiation Oncology, the Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen 518020, Guangdong Province, China
| | - Bao-Zhu Zhang
- Department of Oncology, The People’s Hospital of Baoan, Shenzhen, The Affiliated Baoan Hospital of Southern Medical University, Shenzhen 518020, Guangdong Province, China
| | - Ling Han
- Department of Otorhinolaryngology, the Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen 518020, Guangdong Province, China
| |
Collapse
|
4515
|
Liu Y, Sun LY, Zhu ZJ, Qu W. Novel approach for the diagnosis of occult cytomegalovirus cholangitis after pediatric liver transplantation: A case report. World J Clin Cases 2020; 8:2597-2602. [PMID: 32607337 PMCID: PMC7322438 DOI: 10.12998/wjcc.v8.i12.2597] [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: 03/01/2020] [Revised: 05/09/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) infection is a common infection in liver transplant recipients, which is related to chronic rejection and biliary complications. It is often diagnosed based on serum CMV-DNA or CMV pp65. To our knowledge, this is the first report of the successful treatment of occult CMV cholangitis in a pediatric liver transplantation (LT) recipient.
CASE SUMMARY A 7-mo-old baby girl received LT due to biliary atresia and cholestasis cirrhosis. At 1 mo following LT, the patient suffered from aggravated jaundice with no apparent cause. As imaging results showed intrahepatic and extrahepatic bile duct dilatation, the patient was diagnosed with biliary complications and percutaneous cholangiography and biliary drainage was performed. However, there was little biliary drainage and her liver function deteriorated. CMV-DNA was isolated from the bile with the surprising outcome that 3 × 106 copies/mL were present, whereas the CMV-DNA in serum was negative. Following antiviral therapy with ganciclovir, she gradually recovered and bilirubin decreased to normal levels. During the 4-year follow-up period, her liver function remained normal.
CONCLUSION Bile CMV sampling can be used for the diagnosis of occult CMV infection, especially in patients with negative serum CMV-DNA and CMV pp65. Testing for CMV in the biliary tract may serve as a novel approach for the diagnosis of cholestasis post-LT. Timely diagnosis and treatment will decrease the risk of graft loss.
Collapse
Affiliation(s)
- Ying Liu
- Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Li-Ying Sun
- Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhi-Jun Zhu
- Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Wei Qu
- Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| |
Collapse
|
4516
|
Chai JS, Wang X, Li XZ, Yao P, Yan ZZ, Zhang HJ, Ning JY, Cao YB. Presentation of gallbladder torsion at an abnormal position: A case report. World J Clin Cases 2020; 8:2667-2673. [PMID: 32607348 PMCID: PMC7322416 DOI: 10.12998/wjcc.v8.i12.2667] [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: 02/22/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Gallbladder torsion is a rare acute abdominal condition that requires emergency surgery. It occurs more commonly in elderly people and in women in the adult population. Diagnosis is a challenge as non-specific symptoms and signs have been reported on ultrasonography, computed tomography and magnetic resonance imaging. Prompt cholecystectomy can decrease the mortality and morbidity of perforation due to gallbladder torsion.
CASE SUMMARY An 82-year-old woman with upper-right quadrant pain and associated nausea and vomiting was diagnosed with ectopic acute calculus cholecystitis. Magnetic resonance cholangiopancreatography (MRCP) showed a V-shaped distortion of the extrahepatic bile ducts and a particularly extended twisted cystic duct, which indicated the presence of gallbladder torsion. Emergency laparoscopic cholecystectomy confirmed the diagnosis and the patient recovered without incident.
CONCLUSION Gallbladder torsion can be diagnosed pre-operatively by MRCP. The specific signs are a V-shaped distortion of the extrahepatic bile ducts and a particularly extended twisted cystic duct which can be called twisting signs.
Collapse
Affiliation(s)
- Jia-Sui Chai
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| | - Xu Wang
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| | - Xiao-Zheng Li
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| | - Peng Yao
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| | - Zheng-Zheng Yan
- Department of General Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
| | - Hong-Jie Zhang
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| | - Jia-Yong Ning
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| | - Yan-Bing Cao
- Department of Hepatobiliary Surgery, Yuncheng Central Hospital, the Eighth Clinical College of Shanxi Medical University, Yuncheng 044031, Shanxi Province, China
| |
Collapse
|
4517
|
Zhou F, Niu L, Zhao M, Ni WX, Liu J. Real-time three-dimensional echocardiography predicts cardiotoxicity induced by postoperative chemotherapy in breast cancer patients. World J Clin Cases 2020; 8:2542-2553. [PMID: 32607331 PMCID: PMC7322441 DOI: 10.12998/wjcc.v8.i12.2542] [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: 02/24/2020] [Revised: 04/01/2020] [Accepted: 06/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The anthracycline chemotherapeutic drugs are cardiotoxic. Studies have found some indicators related to cardiotoxicity. However, there is currently no accurate indicator that can predict cardiac toxicity early.
AIM To explore the diagnostic value of real-time three-dimensional echocardiography (RT3DE) in predicting cardiac toxicity in breast cancer patients undergoing chemotherapy.
METHODS Female breast cancer patients who underwent radical mastectomy and postoperative chemotherapy at the Affiliated Hanzhou First People’s Hospital, Zhejiang University School of Medicine were recruited. All patients were routinely administered with chemotherapy for four cycles (T1-T4) after surgery. Two-dimensional (2D) echocardiography, RT3DE, and serological examinations were performed after each cycle of chemotherapy. Patients were divided into a toxic group and a non-toxic group based on whether patients had Δ left ventricular ejection fraction > 10% after one year of chemotherapy. Repeated measurement analysis of variance was used to compare the changes in 2D echocardiographic indicators, serological indicators, and RT3DE indicators before and after chemotherapy. Multivariate logistic regression was used to identify independent predictive indicators for cardiac toxicity in postoperative chemotherapy patients. Receiver operating characteristics (ROC) curve analysis was performed to analyze the diagnostic value of potential indicators in the diagnosis of cardiotoxicity.
RESULTS A total of 107 female breast cancer patients were included in the study. T4 maximum peak velocity in early diastole (E peak)/mitral annulus lateral tissue Doppler (e' peak) (E/e'), serological indicators [T4 cardiac troponin I (cTnI) and T4 pro-brain natriuretic peptide (Pro-BNP)], T3 minimum left atrial volume (LAV), T4 LAVmin, T3 LAV before the start of the P wave (LAVprep), and T4 LAVprep in the toxicity group were significantly higher than those in the non-toxic group. Multivariate logistic regression found that T4 cTnI, T4 Pro-BNP, T3 LAVmin, T4 LAVmin, T3 LAVprep, and T4 LAVprep had potential predictive value for cardiac toxicity (P < 0.05). ROC results showed that T4 LAVmin had the highest accuracy for diagnosing cardiac toxicity [area under the curve (AUC) = 0.947; sensitivity = 78.57%; specificity = 94.62%], followed by T4 LAVprep (AUC = 0.899; sensitivity = 100%; specificity = 66.67%). The accuracies of LAVprep and LAVprep in predicting cardiac toxicity were higher than those of T3 LAVmin and T3 LAVprep.
CONCLUSION RT3DE of left atrial volume can be used to predict the cardiotoxicity caused by chemotherapy, and it is expected to guide the clinical adjustment of dose and schedule in time.
Collapse
Affiliation(s)
- Fang Zhou
- Department of Breast Surgery, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Lin Niu
- Department of Ultrasound, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Min Zhao
- Department of Ultrasound, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Wei-Xing Ni
- Department of Ultrasound, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| | - Jian Liu
- Department of Breast Surgery, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
| |
Collapse
|
4518
|
Boussuges A, Rives S, Finance J, Brégeon F. Assessment of diaphragmatic function by ultrasonography: Current approach and perspectives. World J Clin Cases 2020; 8:2408-2424. [PMID: 32607319 PMCID: PMC7322428 DOI: 10.12998/wjcc.v8.i12.2408] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [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: 02/17/2020] [Revised: 05/19/2020] [Accepted: 06/02/2020] [Indexed: 02/05/2023] Open
Abstract
This article reports the various methods used to assess diaphragmatic function by ultrasonography. The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography, during respiratory maneuvers such as quiet breathing, voluntary sniffing and deep inspiration. On the zone of apposition to the rib cage for both hemidiaphragms, it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration. These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction. These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases. Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.
Collapse
Affiliation(s)
- Alain Boussuges
- Institut de Recherche Biomédicale des Armées, ERRSO, Toulon 83800, France
- Center for Cardiovascular and Nutrition Research (C2VN), Aix Marseille Université, INSERM (1260), INRAE (1263), Toulon 83800, France
| | - Sarah Rives
- Institut de Recherche Biomédicale des Armées, ERRSO, Toulon 83800, France
| | - Julie Finance
- Service d’Explorations Fonctionnelles Respiratoires, CHU Nord, Assistance Publique des Hôpitaux de Marseille et Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille 13015, France
| | - Fabienne Brégeon
- Service d’Explorations Fonctionnelles Respiratoires, CHU Nord, Assistance Publique des Hôpitaux de Marseille et Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille 13015, France
| |
Collapse
|
4519
|
Wang JJ, Ni JD, Song DY, Ding ML, Huang J, He GX, Li WZ. Modified pararectus approach for treatment of atypical acetabular anterior wall fracture: A case report. World J Clin Cases 2020; 8:2634-2640. [PMID: 32607343 PMCID: PMC7322424 DOI: 10.12998/wjcc.v8.i12.2634] [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: 03/07/2020] [Revised: 05/14/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acetabular anterior wall fracture with preservation of the pelvic brim is extremely rare. It is different from anterior wall fracture classified by Judet and Letournel. Few studies have reported cases treated by open reduction and internal fixation via the Smith-Petersen or iliofemoral approach.
CASE SUMMARY We report a 48-year-old Chinese woman who had difficulty moving her right hip from abduction and external rotation after falling from 3 m. Pelvic radiograph and three-dimensional reconstruction of computed tomography revealed acetabular anterior wall fractures combined with fractures of the anterior inferior iliac spine and the iliac wing but not involving the pelvic brim. First, the patient underwent interim management by closed reduction of the hip dislocation and skin traction for 6 d. Then, we used a modified pararectus approach for treatment to fix the acetabular fractures with a reconstruction plate and nonlocking T-shape plate. At the 9-mo follow-up, the patient could walk painlessly without necrosis of the femoral head or heterotopic ossification, and the X-rays and computed tomography scan reconstructions showed good bone union.
CONCLUSION The modified pararectus approach described here can facilitate exposure, reduction, and osteosynthesis for atypical acetabular fracture with less invasiveness.
Collapse
Affiliation(s)
- Jun-Jie Wang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Jiang-Dong Ni
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - De-Ye Song
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Mu-Liang Ding
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Jun Huang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Guang-Xu He
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| | - Wen-Zhao Li
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China
| |
Collapse
|
4520
|
Xu P, Wu M, Yang M, Xiao J, Ruan ZM, Wu LY. Evaluation of internal and shell stiffness in the differential diagnosis of breast non-mass lesions by shear wave elastography. World J Clin Cases 2020; 8:2510-2519. [PMID: 32607328 PMCID: PMC7322423 DOI: 10.12998/wjcc.v8.i12.2510] [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: 02/24/2020] [Revised: 04/09/2020] [Accepted: 04/24/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The diagnostic specificity of conventional ultrasound for breast non-mass lesions (NMLs) is low at approximately 21%-43%. Shear wave elastography (SWE) can distinguish benign from malignant lesions by evaluating the internal and peripheral stiffness. SWE has good reproducibility and high diagnostic efficacy. However, there are very few independent studies on the diagnostic value of SWE in breast NMLs.
AIM To determine the value of SWE in the differential diagnosis of breast NMLs.
METHODS This study enrolled a total of 118 patients with breast NMLs who underwent SWE examinations in the Beijing Shijitan Hospital Affiliated to Capital Medical University and The Second Hospital of Shandong University from January 2019 to January 2020. The internal elastic parameters of the lesions were recorded, including maximum (Emax), mean (Emean) and minimum elastic values and the standard deviation. The following peripheral parameters were noted: Presence of a “stiff rim” sign; Emax, and Emean elasticity values within 1 mm, 1.5 mm, 2 mm, 2.5 mm and 3 mm from the edge of NMLs. The receiver operating characteristic curve of each parameter was drawn, and the areas under the curve were calculated.
RESULTS Emax, Emean and elastic values, and the standard deviation of the internal elastic values in malignant NMLs were significantly higher than those in benign NMLs (P < 0.05). The percentage with the “stiff rim” sign in malignant NMLs was significantly higher than that in the benign group (P < 0.05), and Emax and Emean at the shell of 1 mm, 1.5 mm, 2 mm, 2.5 mm and 3 mm in the malignant group were all higher than those in the benign group (P < 0.05). Of the surrounding elasticity values, Emax of the shell at 2.5 mm in malignant NMLs had maximum areas under the curve of 0.900, and the corresponding sensitivity and specificity were 94.57% and 85.86%, respectively.
CONCLUSION The “stiff rim” sign and multiple quantitative elastic values within and around the lesion had good diagnostic performance in the differential diagnosis of breast NMLs. Emax in peripheral tissue had better diagnostic efficiency than other parameters.
Collapse
Affiliation(s)
- Ping Xu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Mei Wu
- Department of Ultrasound, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
| | - Min Yang
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| | - Juan Xiao
- Evidence-based Medicine Center, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
| | - Zheng-Min Ruan
- Department of Ultrasound, The Second Hospital of Shandong University, Jinan 250033, Shandong Province, China
| | - Lan-Ying Wu
- Department of Ultrasound, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing 100038, China
| |
Collapse
|
4521
|
Yu T, Cheng XL, Qu Y, Dong RP, Kang MY, Zhao JW. Computer navigation-assisted minimally invasive percutaneous screw placement for pelvic fractures. World J Clin Cases 2020; 8:2464-2472. [PMID: 32607323 PMCID: PMC7322419 DOI: 10.12998/wjcc.v8.i12.2464] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
Pelvic fractures are often caused by high-energy injuries and accompanied by hemodynamic instability. Traditional open surgery has a large amount of bleeding, which is not suitable for patients with acute pelvic fracture. Navigation-guided, percutaneous puncture-screw implantation has gradually become a preferred procedure due to its advantages, which include less trauma, faster recovery times, and less bleeding. However, due to the complexity of pelvic anatomy, doctors often encounter some problems when using navigation to treat pelvic fractures. This article reviews the indications, contraindications, surgical procedures, and related complications of this procedure for the treatment of sacral fractures, sacroiliac joint injuries, pelvic ring injuries, and acetabular fractures. We also analyze the causes of inaccurate screw placement. Percutaneous screw placement under navigational guidance has the advantages of high accuracy, low incidence of complications and small soft-tissue damage, minimal blood loss, short hospital stays, and quick recovery. There is no difference in the incidence of complications between surgeries performed by new doctors and experienced ones. However, computer navigation technology requires extensive training, and attention should be given to avoid complications such as screw misplacement, intestinal injury, and serious blood vessel and nerve injuries caused by navigational drift.
Collapse
Affiliation(s)
- Tong Yu
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
| | - Xue-Liang Cheng
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
| | - Yang Qu
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
| | - Rong-Peng Dong
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
| | - Ming-Yang Kang
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
| | - Jian-Wu Zhao
- Department of Orthopedics, the Second Hospital of Jilin University, Changchun 130014, Jilin Province, China
| |
Collapse
|
4522
|
Chen WG, Li R, Zhang Y, Hao JH, Du JB, Guo AS, Song WQ. Recovery from prolonged disorders of consciousness: A dual-center prospective cohort study in China. World J Clin Cases 2020; 8:2520-2529. [PMID: 32607329 PMCID: PMC7322439 DOI: 10.12998/wjcc.v8.i12.2520] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 04/24/2020] [Accepted: 05/20/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness (DoC). Data are lacking regarding the long-term outcomes of those patients in China. It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.
AIM To present the preliminary results of a DoC cohort.
METHODS This was a two-center prospective cohort study of inpatients with vegetative state (VS)/unresponsive wakefulness syndrome (UWS). The study outcomes were the recovery from VS/UWS to minimally conscious state (MCS) and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years. The patients were evaluated using the Glasgow coma scale, coma recovery scale-revised, and Glasgow outcome scale. The endpoint of follow-up was recovery of full consciousness or death. The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.
RESULTS The study population included 93 patients (62 VS/UWS and 31 MCS). The post-injury interval range was 28-634 d. Median follow-up was 20 mo (interquartile range, 12-37 mo). At the endpoint, 33 transitioned to an emergence from MCS or full consciousness, eight had a locked-in syndrome, and there were 35 patients remaining in a VS/UWS and 11 in an MCS. Seven (including one locked-in syndrome) patients (7.5%) died within 12 mo of injury. Compared with the unresponsive group (n = 52) at 12 mo, the responsive group (n = 41) had a higher proportion of males (87.8% vs 63.5%, P = 0.008), shorter time from injury (median, 40.0 d vs 65.5 d, P = 0.006), higher frequency of vascular etiology (68.3% vs 38.5%, P = 0.007), higher Glasgow coma scale score at admission (median, 9 vs 6, P < 0.001), higher coma recovery scale-revised score at admission (median, 9 vs 2.5, P < 0.001), at 1 mo (median, 14 vs 5, P < 0.001), and at 3 mo (median, 20 vs 6, P < 0.001), lower frequency of VS/UWS (36.6% vs 90.0%, P < 0.001), and more favorable Glasgow outcome scale outcome (P < 0.001).
CONCLUSION Patients with severe DoC, despite having strong predictors of poor prognosis, might recover consciousness after a prolonged time of rehabilitation. An accurate initial diagnosis of patients with DoC is critical for predicting outcome and a long-term regular follow-up is also important.
Collapse
Affiliation(s)
- Wei-Guan Chen
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Ran Li
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
| | - Ye Zhang
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
| | - Jian-Hui Hao
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
| | - Ju-Bao Du
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
| | - Ai-Song Guo
- Department of Rehabilitation Medicine, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Wei-Qun Song
- Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing 100053, China
| |
Collapse
|
4523
|
Xin Q, Sun Q, Zhang CS, Zhang Q, Li CJ. Functions and mechanisms of chemokine receptor 7 in tumors of the digestive system. World J Clin Cases 2020; 8:2448-2463. [PMID: 32607322 PMCID: PMC7322425 DOI: 10.12998/wjcc.v8.i12.2448] [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: 02/02/2020] [Revised: 05/12/2020] [Accepted: 06/02/2020] [Indexed: 02/05/2023] Open
Abstract
Chemokine (C-X-C motif) receptor 7 (CXCR7), recently termed ACKR3, belongs to the G protein-coupled cell surface receptor family, binds to stromal cell-derived factor-1 [SDF-1, or chemokine (C-X-C motif) ligand 12] or chemokine (C-X-C motif) ligand 11, and is the most common chemokine receptor expressed in a variety of cancer cells. SDF-1 binds to its receptor chemokine (C-X-C motif) receptor 4 (CXCR4) and regulates cell proliferation, survival, angiogenesis and migration. In recent years, another new receptor for SDF-1, CXCR7, has been discovered, and CXCR7 has also been found to be expressed in a variety of tumor cells and tumor-related vascular endothelial cells. Many studies have shown that CXCR7 can promote the growth and metastasis of a variety of malignant tumor cells. Unlike CXCR4, CXCR7 exhibits a slight modification in the DRYLAIV motif and does not induce intracellular Ca2+ release following ligand binding, which is essential for recruiting and activating G proteins. CXCR7 is generally thought to work in three ways: (1) Recruiting β-arrestin 2; (2) Heterodimerizing with CXCR4; and (3) Acting as a “scavenger” of SDF-1, thus lowering the level of SDF-1 to weaken the activity of CXCR4. In the present review, the expression and role of CXCR7, as well as its prognosis in cancers of the digestive system, were investigated.
Collapse
Affiliation(s)
- Qi Xin
- Department of Pathology, Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China
| | - Quan Sun
- Department of Hepatobiliary Surgery, Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
| | - Chuan-Shan Zhang
- Department of Pathology, Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
| | - Qin Zhang
- Department of Pathology, Tianjin Third Central Hospital, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China
| | - Chun-Jun Li
- Department of Endocrinology, Health Management Center, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin 300121, China
| |
Collapse
|
4524
|
Rozłucka L, Semik-Grabarczyk E, Pietrukaniec M, Żak-Gołąb A, Grabarczyk M, Grosicki S, Holecki M. Demyelinating polyneuropathy and lymphoplasmacytic lymphoma coexisting in 36-year-old man: A case report. World J Clin Cases 2020; 8:2566-2573. [PMID: 32607333 PMCID: PMC7322434 DOI: 10.12998/wjcc.v8.i12.2566] [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: 02/24/2020] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lymphoplasmacytic lymphoma is a rare non-Hodgkin’s lymphoma, occurring mostly in the elderly. It develops slowly and leads to malignant proliferation of lymphoid line cells in the bone marrow, lymph nodes and spleen. It may also affect nerve roots and meninges; some patients develop sensorimotor polyneuropathy which may precede general symptoms of lymphoma.
CASE SUMMARY We present a case of a 36-year-old man diagnosed in 2012 with chronic inflammatory demyelinating polyneuropathy (CIDP), then he was hospitalized in 2019 due to progressive symptoms of heart failure and significant weight loss over the previous four months. Based on clinical and laboratory findings a diagnosis of lymphoplasmacytic lymphoma was suspected and confirmed by bone marrow flow cytometry. There was no improvement in the results of laboratory tests and the patient's condition after immediate implementation of chemotherapy. Patient died on the fifth day of treatment.
CONCLUSION While CIDP and malignant disease co-occurrence is rare, it should be suspected and investigated in patients with atypical neuropathy symptoms.
Collapse
Affiliation(s)
- Lesia Rozłucka
- Department of Internal Medicine, Allergology and Clinical Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice 40-752, Poland
| | - Elżbieta Semik-Grabarczyk
- Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Marta Pietrukaniec
- Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Agnieszka Żak-Gołąb
- Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Małgorzata Grabarczyk
- Student Scientific Society at the Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, Bytom, 41-902, Poland
| | - Michał Holecki
- Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice 40-752, Poland
| |
Collapse
|
4525
|
Komiyama S, Numata K, Moriya S, Fukuda H, Chuma M, Maeda S. Lenvatinib for large hepatocellular carcinomas with portal trunk invasion: Two case reports. World J Clin Cases 2020; 8:2574-2584. [PMID: 32607334 PMCID: PMC7322437 DOI: 10.12998/wjcc.v8.i12.2574] [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: 04/24/2020] [Accepted: 06/03/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In a phase III trial of lenvatinib as first-line treatment for advanced unresectable hepatocellular carcinoma (uHCC), the drug proved non-inferior to sorafenib in terms of the overall survival, but offered better progression-free survival. However, the effects of lenvatinib in uHCC patients with a tumor thrombus in the main portal vein and/or a high tumor burden (tumor occupancy more than 50% of the total liver volume), remain unclear, because these were set as exclusion criteria in the aforementioned trial.
CASE SUMMARY A 53-year-old man (case 1) and 66-year-old woman (case 2) with uHCC presented to us with a tumor thrombus in both the main portal vein and inferior vena cava, a high tumor burden accompanied by a tumor diameter greater than > 100 mm, and distant metastasis, with the residual liver function classified as grade 2A according to the modified Albumin–Bilirubin grading. We started both patients on lenvatinib. The therapeutic effect, as evaluated by the modified Response Evaluation Criteria in Solid Tumors, was rated as partial response in both case 1 and case 2 (at 8 wk and 4 wk after the start of lenvatinib administration, respectively). The therapeutic effect was sustained for 6 mo in case 1 and 20 mo in case 2. Fever occurred as an adverse event in both case 1 and 2, and hyperthyroidism and thrombocytopenia in only case 2, neither of which, however, necessitated treatment discontinuation.
CONCLUSION Even in hepatocellular carcinoma patients with poor prognostic factors, if the liver function is well-preserved, lenvatinib is effective and safe.
Collapse
Affiliation(s)
- Satoshi Komiyama
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 2320024, Japan
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 2320024, Japan
| | - Satoshi Moriya
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 2320024, Japan
| | - Hiroyuki Fukuda
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 2320024, Japan
| | - Makoto Chuma
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 2320024, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 2360004, Japan
| |
Collapse
|
4526
|
Zhong ZF, Huang J, Yang X, Peng JL, Zhang XY, Hu Y, Fu N, Lin HL, Jiang B, Tian YY, Yao HY, Deng LP, Tang XQ, Zhou JC, Tang J, Xie X, Liu Q, Liu J, Dou CY, Dai RJ, Yan B, Yang XF. Epidemiological and clinical characteristics of COVID-19 patients in Hengyang, Hunan Province, China. World J Clin Cases 2020; 8:2554-2565. [PMID: 32607332 PMCID: PMC7322431 DOI: 10.12998/wjcc.v8.i12.2554] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 03/13/2020] [Revised: 05/15/2020] [Accepted: 06/02/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In December 2019, an ongoing outbreak of coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China. The characteristics of COVID-19 patients treated in local hospitals in Wuhan are not fully representative of patients outside Wuhan. Therefore, it is highly essential to analyze the epidemiological and clinical characteristics of COVID-19 in areas outside Wuhan or Hubei Province. To date, a limited number of studies have concentrated on the epidemiological and clinical characteristics of COVID-19 patients with different genders, clinical classification, and with or without basic diseases.
AIM To study the epidemiological and clinical characteristics of COVID-19 patients in Hengyang (China) and provide a reliable reference for the prevention and control of COVID-19.
METHODS From January 16 to March 2, 2020, a total of 48 confirmed cases of COVID-19 were reported in Hengyang, and those cases were included in this study. The diagnostic criteria, clinical classification, and discharge standard related to COVID-19 were in line with the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (Trial Version 7) released by National Health Commission and National Administration of Traditional Chinese Medicine. The presence of SARS-CoV-2 in pharyngeal swab specimens was detected by quantitative reverse transcription polymerase chain reaction. All the data were imported into the excel worksheet and statistically analyzed by using SPSS 25.0 software.
RESULTS A total of 48 cases of COVID-19 were collected, of which 1 was mild, 38 were moderate, and 9 were severe. It was unveiled that there were 31 (64.6%) male patients and 17 (35.4%) female patients, with a female-to-male ratio of 1.82:1. The range of age of patients with COVID-19 was dominantly 30-49 years old [25 (52.1%) of 48], followed by those aged over 60 years old [11 (22.9%)]. Besides, 29.2% (14 of 48) of patients had basic diseases, and 57.2% (8 of 14) of patients with basic diseases were aged over 60 years old. The occupations of 48 COVID-19 patients were mainly farmers working in agricultural production [15 (31.5%) of 48], rural migrant workers from Hengyang to Wuhan [15 (31.5%)], and service workers operating in the service sector [8 (16.7%)]. The mean latent period was 6.86 ± 3.57 d, and the median was 7 [interquartile range (IQR): 4-9] d. The mean time from onset of symptoms to the first physician visit was 3.38 ± 2.98 (95%CI: 2.58-9.18) d, with a median of 2 (IQR: 1-5) d, and the mean time from hospital admission to confirmed diagnosis was 2.29 ± 2.11 (95%CI: 1.18-6.42) d, with a median of 2 (IQR: 1-3) d. The main symptoms were fever [43 (89.6%) of 48], cough and expectoration [41 (85.4%)], fatigue [22 (45.8%)], and chills [22 (45.8%)]. Other symptoms included poor appetite [13 (27.1%)], sore throat [9 (18.8%)], dyspnea [9 (18.8%)], diarrhea [7 (14.6%)], dizziness [5 (10.4%)], headache [5 (10.4%)], muscle pain [5 (10.4%)], nausea and vomiting [4 (8.3%)], hemoptysis [4 (8.3%)], and runny nose [1 (2.1%)]. The numbers of peripheral blood leukocytes, lymphocytes, and eosinophils were significantly reduced in the majority of the patients. The levels of C-reactive protein, fibrinogen, blood glucose, lactate dehydrogenase, D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GT), myoglobin (MB), and creatine kinase (CK) were increased in 64.6%, 44.7%, 43.2%, 37.0%, 29.5%, 22.9%,20.8%, 21.6%, 13.6%, and 12.8% of patients, respectively. The incidence of ALT elevation in male patients was remarkably higher than that in females (P < 0.01), while the incidences of AST, CK, and blood glucose elevations in severe patients were remarkably higher than those in moderate patients (P < 0.05, respectively). Except for the mild patients, chest computed tomography showed characteristic pulmonary lesions. All the patients received antiviral drugs, 38 (79.2%) accepted traditional Chinese medicine, and 2 (4.2%) received treatment of human umbilical-cord mesenchymal stem cells. On March 2, 2020, 48 patients with COVID-19 were all cured and discharged.
CONCLUSION Based on our results, patients with COVID-19 often have multiple organ dysfunction or damage. The incidences of ALT elevation in males, and AST, CK, and blood glucose elevations in severe patients are remarkably higher.
Collapse
Affiliation(s)
- Zhe-Feng Zhong
- Department of Infectious Diseases, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Jia Huang
- Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Xia Yang
- Department of General Practice, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Jin-Ling Peng
- Department of General Practice, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Xiao-Yan Zhang
- Department of General Practice, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Yang Hu
- Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Nian Fu
- Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Hai-Lian Lin
- Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Bo Jiang
- Department of Infectious Diseases, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Ya-Ying Tian
- Department of Infectious Diseases, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Hong-Yi Yao
- Department of Intensive Medicine, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Li-Pu Deng
- Department of Intensive Medicine, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| | - Xiao-Qing Tang
- Institute of Clinical Medicine, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Jie-Can Zhou
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Jian Tang
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Xia Xie
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Qiong Liu
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Jing Liu
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Cheng-Yun Dou
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Rong-Juan Dai
- Department of Infectious Diseases, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Bo Yan
- Department of Cardiology, the First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
| | - Xue-Feng Yang
- Department of Gastroenterology, the Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
| |
Collapse
|
4527
|
Li XY, Shi ZH, Guan YL, Ji Y. Anti-N-methyl-D-aspartate-receptor antibody encephalitis combined with syphilis: A case report. World J Clin Cases 2020; 8:2603-2609. [PMID: 32607338 PMCID: PMC7322422 DOI: 10.12998/wjcc.v8.i12.2603] [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: 03/08/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis is a common type of autoimmune encephalitis characterized by complex clinical signs and variable imaging manifestations. The pathogenesis of the disease is unclear. Syphilis is an infectious disease caused by Treponema pallidum that can invade the nervous and immune systems and cause systemic symptoms. There are few reports of anti-NMDAR encephalitis with syphilis, and the association between them is unknown; both diseases are related to immune system damage. We report a case of anti-NMDAR encephalitis with syphilis.
CASE SUMMARY A 32-year-old man was admitted to our hospital with complaints of cognitive decline, diplopia, and walking instability during the previous 6 mo. He developed dysarthria, difficulty swallowing, and involuntary shaking of his head, neck, and limbs during the month prior to presentation. Cranial magnetic resonance imaging showed symmetrical abnormal signals in the pons, midbrain, and bilateral basal ganglia, and inflammatory demyelination was considered. The diagnosis of syphilis was confirmed based on the syphilis diagnosis test and the syphilis rapid test. He was given anti-syphilis treatment, but the above symptoms gradually worsened. Anti-NMDAR antibody was positive in cerebrospinal fluid but was negative in serum. Due to the cerebrospinal fluid findings, anti-NMDAR encephalitis was a consideration. According to the patient’s weight, he was treated with intravenous methylprednisolone 1 g QD for 5 d, with the dose gradually decreased for 6 mo, and immunoglobulin 25 g QD for 5 d; his symptoms improved after treatment.
CONCLUSION This case shows that anti-NMDAR encephalitis may be combined with syphilis, which should be recognized to avoid misdiagnosis and treatment delay.
Collapse
Affiliation(s)
- Xi-Yu Li
- Graduate School, Tianjin Medical College, Tianjin 300070, China
| | - Zhi-Hong Shi
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Ya-Lin Guan
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
| | - Yong Ji
- Tianjin Key Laboratory of Cerebrovascular and Neurodegenerative Diseases, Tianjin Dementia Institute, Department of Neurology, Tianjin Huanhu Hospital, Tianjin 300350, China
- China National Clinical Research Center for Neurological Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| |
Collapse
|
4528
|
Sun HS, Yang QR, Bai YY, Hu NW, Liu DX, Qin CY. Gene testing for osteonecrosis of the femoral head in systemic lupus erythematosus using targeted next-generation sequencing: A pilot study. World J Clin Cases 2020; 8:2530-2541. [PMID: 32607330 PMCID: PMC7322418 DOI: 10.12998/wjcc.v8.i12.2530] [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: 02/24/2020] [Revised: 05/09/2020] [Accepted: 05/18/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Previous publications indicated that genetic predisposition might play important roles in the onset of osteonecrosis of the femoral head (ONFH) in systemic lupus erythematosus (SLE). Some gene loci such as complement C3d receptor 2 (CR2), nitric oxide synthase 3 (NOS3), collagen type II alpha 1 chain (COL2A1), protein tyrosine phosphatase non-receptor type 22 (PTPN22), and transient receptor potential cation channel subfamily V member 4 (TRPV4) were reported to be involved in this process.
AIM To investigate whether the risk of ONFH in SLE is associated with single nucleotide variations (SNVs) in these five genes.
METHODS SNVs in the CR2, NOS3, COL2A1, PTPN22, and TRPV4 genes were examined by using FastTarget and Illumina Miseq sequencing technologies in 49 cases of SLE with ONFH. Burrows–wheeler aligner was used to align the sequencing reads to hg19, and GATK and Varscan programs were used to perform SNV calling. PolyPhen-2, SIFT, and MutationTaster were used to assess the functional effects of non-synonymous SNVs.
RESULTS Six of the 49 patients were confirmed to have low frequency SNVs, including one patient with SNVs in NOS3 (exon 6: c.814G>A: p.E272K and exon 7: c.814G>A: p.E272K.), four in COL2A1 (rs41263847: exon 29: c.1913C>T: p.T638I, exon 28: c.1706C>T: p.T569I, and rs371445823: exon 8: c.580G>A: p.A194T, exon 7: c.373G>A: p.A125T), and one in CR2 (rs45573035: exon 2: c.200C>G: p.T67S).
CONCLUSION The onset of ONFH in SLE might be associated with the identified SNVs in NOS3, COL2A1, and CR2.
Collapse
Affiliation(s)
- Hong-Sheng Sun
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Qing-Rui Yang
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Yan-Yan Bai
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Nai-Wen Hu
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Dong-Xia Liu
- Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| | - Cheng-Yong Qin
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China
| |
Collapse
|
4529
|
Li XL, Shi LX, Du QC, Wang W, Shao LW, Wang YW. Magnetic resonance imaging features of minimal-fat angiomyolipoma and causes of preoperative misdiagnosis. World J Clin Cases 2020; 8:2502-2509. [PMID: 32607327 PMCID: PMC7322440 DOI: 10.12998/wjcc.v8.i12.2502] [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: 02/24/2020] [Revised: 04/10/2020] [Accepted: 05/18/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Minimal-fat angiomyolipoma (mf-AML) is often misdiagnosed as renal cell carcinoma before surgery.
AIM To analyze the magnetic resonance imaging (MRI) features of mf-AML and the causes of misdiagnosis by MRI before operation.
METHODS A retrospective analysis was performed on ten patients with mf-AML confirmed by surgical pathology, all of whom underwent preoperative MRI examination to analyze the morphological characteristics and MRI signals of the tumor.
RESULTS MRI revealed a circular-like mass in 4/10 (40%) patients, an oval mass in 6/10 patients (60%), a mass with a capsule in 9/10 patients (90%), and a mass with a lipid component in 7/10 patients (70%). The diameter of the masses in all ten patients was from 11 to 47 mm; the diameter was between 11 mm and 40 mm in 8/10 (80%) patients and between 40 mm and 47 mm in 2/10 (20%) patients.
CONCLUSION An oval morphological characteristic is strong evidence for the diagnosis of mf-AML, while a capsule and lipids are atypical manifestations of mf-AML.
Collapse
Affiliation(s)
- Xiao-Long Li
- Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Li-Xin Shi
- Department of Urology Surgery, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Qi-Cong Du
- Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Wei Wang
- Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Li-Wei Shao
- Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| | - Ying-Wei Wang
- Department of Radiology, First Medical Center of Chinese People’s Liberation Army General Hospital, Beijing 100853, China
| |
Collapse
|
4530
|
Wei XX, He YM, Jiang W, Li L. Ovarian endometrioid carcinoma resembling sex cord-stromal tumor: A case report. World J Clin Cases 2020; 8:2623-2628. [PMID: 32607341 PMCID: PMC7322421 DOI: 10.12998/wjcc.v8.i12.2623] [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: 05/06/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Ovarian endometrioid carcinoma resembling sex cord-stromal tumor (ECSCSs) is rare.
CASE SUMMARY We present a rare case of primary ECSCSs in the left ovary. A 39-year-old female patient had persistent dull pain in the lower abdomen for more than 1 mo, and she was initially diagnosed with pelvic inflammatory disease at a hospital. The patient received transabdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymph node dissection at our hospital and finally diagnosed with ECSCSs. After the operation, the patient received eight courses of cisplatinum + etoposide + bleomycin chemotherapy treatment and no evidence of tumor recurrence or metastasis was found in a 2-year follow-up period.
CONCLUSION Ovarian endometrioid carcinoma is similar to the ovary sex cord-stromal tumor, especially when the cord-like structure is obvious. The clinical diagnosis for this tumor is difficult before surgery and pathology examination. The necessary immunohistochemical markers are of positive significance for assisting diagnosis and differential diagnosis.
Collapse
Affiliation(s)
- Xiao-Xia Wei
- Department of Pathology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu 610041, Sichuan Province, China
| | - Yan-Mei He
- Department of Pathology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu 610041, Sichuan Province, China
| | - Wei Jiang
- Department of Pathology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu 610041, Sichuan Province, China
| | - Lei Li
- Department of Pathology, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu 610041, Sichuan Province, China
| |
Collapse
|
4531
|
Wang LY, Zhao S, Lv GJ, Ma XJ, Zhang JB. Mechanisms of resveratrol in the prevention and treatment of gastrointestinal cancer. World J Clin Cases 2020; 8:2425-2437. [PMID: 32607320 PMCID: PMC7322414 DOI: 10.12998/wjcc.v8.i12.2425] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 12/31/2019] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023] Open
Abstract
Gastrointestinal (GI) cancer is one of the leading causes of cancer-related deaths worldwide. According to the Global Cancer Statistics, colorectal cancer is the second leading cause of cancer-related mortality, closely followed by gastric cancer (GC). Environmental, dietary, and lifestyle factors including cigarette smoking, alcohol intake, and genetics are the most important risk factors for GI cancer. Furthermore, infections caused by Helicobacter pylori are a major cause of GC initiation. Despite improvements in conventional therapies, including surgery, chemotherapy, and radiotherapy, the length or quality of life of patients with advanced GI cancer is still poor because of delayed diagnosis, recurrence and side effect. Resveratrol (3, 4, 5-trihydroxy-trans-stilbene; Res), a natural polyphenolic compound, reportedly has various pharmacologic functions including anti-oxidant, anti-inflammatory, anti-cancer, and cardioprotective functions. Many studies have demonstrated that Res also exerts a chemopreventive effect on GI cancer. Research investigating the anti-cancer mechanism of Res for the prevention and treatment of GI cancer has implicated multiple pathways including oxidative stress, cell proliferation, and apoptosis. Therefore, this paper provides a review of the function and molecular mechanisms of Res in the prevention and treatment of GI cancer.
Collapse
Affiliation(s)
- Li-Yan Wang
- Department of Pharmacy, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
| | - Shan Zhao
- Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, Liaoning Province, China
| | - Guo-Jun Lv
- Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, Liaoning Province, China
| | - Xiao-Jun Ma
- Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, Liaoning Province, China
| | - Jian-Bin Zhang
- College of Pharmacy, Dalian Medical University, Dalian 116044, Liaoning Province, China
| |
Collapse
|
4532
|
Chen X, Zou C, Yang C, Gao L, Bi LK, Xie DD, Yu DX. Pleomorphic rhabdomyosarcoma of the spermatic cord and a secondary hydrocele testis: A case report. World J Clin Cases 2020; 8:2641-2646. [PMID: 32607344 PMCID: PMC7322420 DOI: 10.12998/wjcc.v8.i12.2641] [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: 03/09/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pleomorphic rhabdomyosarcoma (RMS) of the spermatic cord is a group of rare neoplasms, and a secondary hydrocele testis occasionally occurs. The misdiagnosis of paratesticular mass may lead to a therapeutic delay.
CASE SUMMARY A 79-year-old man presented to our clinic complaining of a 1-mo history of painless scrotal swelling. Physical examination revealed approximately a 15 cm × 10 cm × 5 cm inguinal mass with limited mobility. Contrast-enhanced magnetic resonance imaging showed a hydrocele testis, several enlarged inguinal lymph nodes, and a heterogeneously enhanced lesion with a relatively well-defined margin in the left inguinal region. Due to the imaging findings, he was diagnosed with pleomorphic RMS and received a wide resection of the mass, an inguinal incision with a high section of the left spermatic cord, and a left radical orchiectomy. He experienced local relapse 1 mo postoperatively and received radiotherapy and anlotinib hydrochloride-based immunotherapy as adjuvant therapy. The patient died 3 mo after the surgery.
CONCLUSION The optimal interventions for advanced-stage pleomorphic RMS patients should be investigated by more preclinical studies and clinical trials. Physicians need to be aware of the occurrence of pleomorphic RMS in unusual locations, especially when accompanied by a hydrocele testis.
Collapse
Affiliation(s)
- Xin Chen
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Ci Zou
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Chao Yang
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Liang Gao
- Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg 66421, Germany
| | - Liang-Kuan Bi
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Dong-Dong Xie
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
| | - De-Xin Yu
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei 230032, Anhui Province, China
| |
Collapse
|
4533
|
Medina-Liabres KRP, Kim BM, Kim S. Biopsy-proven acute phosphate nephropathy: A case report. World J Clin Cases 2020; 8:2585-2589. [PMID: 32607335 PMCID: PMC7322417 DOI: 10.12998/wjcc.v8.i12.2585] [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: 03/28/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Acute phosphate nephropathy (APN) is a disease that can occur when exposed to high doses of phosphate. The most common cause of APN is the use of oral sodium phosphate for bowel cleansing preparations. However, there are other less commonly known sources of phosphate that are equally important. To date, our literature search did not identify any report of excessive dietary phosphate as a cause of APN.
CASE SUMMARY We report an unusual case of a 39-year-old diabetic male who presented with epigastric pain and oliguria. Work-up showed elevated serum creatinine, potassium, and calcium-phosphate product, and metabolic acidosis. The patient was admitted in the intensive care unit and received emergent renal replacement therapy. Kidney biopsy revealed tubular cell injury with transparent crystal casts positive for Von Kossa staining, which established the diagnosis of APN.
CONCLUSION This case confirmed that APN may occur with other sources of phosphorus, highlighting the importance of good history taking and kidney biopsy in patients with predisposing factors for APN. Raising awareness on the possibility of APN and its timely recognition and management is imperative so that appropriate measures can be instituted to prevent or delay its progression to end stage renal disease.
Collapse
Affiliation(s)
| | - Bo Mi Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, South Korea
| | - Sejoong Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, South Korea
| |
Collapse
|
4534
|
Ma CH, Guo HB, Pan XY, Zhang WX. Comprehensive treatment of rare multiple endocrine neoplasia type 1: A case report. World J Clin Cases 2020; 8:2647-2654. [PMID: 32607345 PMCID: PMC7322426 DOI: 10.12998/wjcc.v8.i12.2647] [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: 01/14/2020] [Revised: 04/25/2020] [Accepted: 05/28/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multiple endocrine neoplasia type 1 (MEN1) is a rare hereditary disorder caused by mutations of the MEN1 gene. It is characterized by hyperparathyroidism and involves the pancreas, anterior pituitary, duodenum, and adrenal gland. Here, we report a 40-year-old male patient with MEN1 who first manifested as thymic carcinoid, then primary hyperparathyroidism and prolactinoma, and a decade later pancreatic neuroendocrine tumor.
CASE SUMMARY The patient underwent a thymectomy because of the thymic carcinoid 10 years prior and a prolactinoma resection 2 years prior. His sister suffered from prolactinoma. His parents displayed a typical triad of amenorrhea, galactorrhea, and infertility. Computed tomography revealed a strong signal in the upper portion of the left lobes and posterior portion of the right lobes of the thyroid and irregular soft tissue densities of the pancreatic body. Positron emission tomography/computed tomography imaging further showed strong 18F-flurodeoxyglucose uptake in the tail of the pancreatic body and segment IV of the liver. The patient underwent pancreatic body tail resection, pancreatic head mass enucleation, and ultrasound-guided radio-frequency ablation for liver cancer. Pathology results reported neuroendocrine tumor grade 2. Whole exome sequencing revealed a verified pathogenic mutation c.378G>A (p.Trp126*) in the MEN1 gene. The diagnosis of MEN1 was confirmed. At the 1.5-year follow-up, the patient appeared healthy without any sign of reoccurrence.
CONCLUSION The present case may add some insight into the diagnosis and treatment of patients with MEN1.
Collapse
Affiliation(s)
- Chen-Hui Ma
- Department of Hepatobiliary, Hebei General Hospital, Shijiazhuang 050017, Hebei Province, China
- Graduate School of North China University of Science and Technology, Tangshan 050051, Hebei Province, China
| | - Huai-Bin Guo
- Department of Hepatobiliary, Hebei General Hospital, Shijiazhuang 050017, Hebei Province, China
| | - Xin-Yan Pan
- Department of Hepatobiliary, Hebei General Hospital, Shijiazhuang 050017, Hebei Province, China
| | - Wan-Xing Zhang
- Department of Hepatobiliary, Hebei General Hospital, Shijiazhuang 050017, Hebei Province, China
| |
Collapse
|
4535
|
Meng LF, Zhang W, Wang JY, Zhang YG, Zhang P, Liao LM, Lv JW, Ling Q, Wei ZQ, Zhong T, Xu ZH, Wen W, Li JY, Luo DY. Clinical outcomes of sacral neuromodulation in non-neurogenic, non-obstructive dysuria: A 5-year retrospective, multicentre study in China. World J Clin Cases 2020; 8:2494-2501. [PMID: 32607326 PMCID: PMC7322430 DOI: 10.12998/wjcc.v8.i12.2494] [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: 02/05/2020] [Revised: 05/08/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Management of non-neurogenic, non-obstructive dysuria represents one of the most challenging dilemmas in urological practice. The main clinical symptom is the increase in residual urine. Voiding dysfunction is the main cause of dysuria or urinary retention, mainly due to the decrease in bladder contraction (the decrease in contraction amplitude or duration) or the increase in outflow tract resistance. Sacral neuromodulation (SNM) has been used for > 10 years to treat many kinds of lower urinary tract dysfunction. It has become increasingly popular in China in recent years. Consequently, studies focusing on non-neurogenic, non-obstructive dysuria patients treated by SNM are highly desirable.
AIM To assess the outcome of two-stage SNM in non-neurogenic, non-obstructive dysuria.
METHODS Clinical data of 54 patients (26 men, 28 women) with non-neurogenic, non-obstructive dysuria treated by SNM from January 2012 to December 2016 in ten medical centers in China were retrospectively analyzed. All patients received two or more conservative treatments. The voiding diary, urgency score, and quality of life score before operation, after implantation of tined lead in stage I (test period), and during short-term follow-up (latest follow-up) after implantation of the implanted pulse generator in stage II were compared to observe symptom improvements.
RESULTS Among the 54 study patients, eight refused to implant an implanted pulse generator because of the unsatisfactory effect, and 46 chose to embed the implanted pulse generator at the end of stage I. The conversion rate of stage I to stage II was 85.2%. The average follow-up time was 18.6 mo. There were significant differences between baseline (before stage I) and the test period (after stage I) in residual urine, voiding frequency, average voiding amount, maximum voiding amount, nocturia, urgency score, and quality of life score. The residual urine and urgency score between the test period and the latest follow-up time (after stage II) were also significantly different. No significant differences were observed for other parameters. No wound infection, electrode breakage, or other irreversible adverse events occurred.
CONCLUSION SNM is effective for patients with non-neurogenic, non-obstructive dysuria showing a poor response to traditional treatment. The duration of continuous stimulation may be positively correlated with the improvement of residual urine.
Collapse
Affiliation(s)
- Ling-Feng Meng
- Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Wei Zhang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Jian-Ye Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Yao-Guang Zhang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
| | - Peng Zhang
- Department of Urology, Beijing Chaoyang Hospital, Institute of Urology, Capital Medical University, Beijing 100000, China
| | - Li-Min Liao
- Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing 100000, China
| | - Jian-Wei Lv
- Department of Urology, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
| | - Qing Ling
- Department of Urology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
| | - Zhong-Qing Wei
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
| | - Tie Zhong
- Department of Urology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, Shaanxi Province, China
| | - Zhi-Hui Xu
- Department of Urology, Zhejiang Provincial People’s Hospital, Hangzhou 310000, Zhejiang Province, China
| | - Wei Wen
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
| | - Jia-Yi Li
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
| | - De-Yi Luo
- Department of Urology, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
| |
Collapse
|
4536
|
Yue T, Lu H, Yao XM, Du X, Wang LL, Guo DD, Liu YM. Elevated serum growth differentiation factor 15 in multiple system atrophy patients: A case control study. World J Clin Cases 2020; 8:2473-2483. [PMID: 32607324 PMCID: PMC7322433 DOI: 10.12998/wjcc.v8.i12.2473] [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: 01/30/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multiple system atrophy (MSA) is a serious progressive neurodegenerative disease. Early diagnosis of MSA is very difficult, and diagnostic biomarkers are limited. Growth differentiation factor 15 (GDF15) is involved in the differentiation and progression of the central nervous system, and is widely distributed in peripheral blood, which may be a novel biomarker for MSA.
AIM To determine serum GDF15 levels, related factors and their potential diagnostic value in MSA patients, compared with Parkinson’s disease (PD) patients and healthy controls.
METHODS A case-control study was conducted, including 49 MSA patients, 50 PD patients and 50 healthy controls. Serum GDF15 levels were measured by human enzyme-linked immunosorbent assay, and the differences between the MSA, PD and control groups were analyzed. Further investigations were performed in different MSA subgroups according to age of onset, sex, clinical subtypes, diagnostic criteria, and disease duration. Receiver-operating characteristic curve analysis was used to evaluate the diagnostic value of GDF15, especially for the differential diagnosis between MSA and PD.
RESULTS Serum GDF15 levels were significantly higher in MSA patients than in PD patients and healthy controls (P = 0.000). Males and those with a disease duration of more than three years showed higher serum GDF15 levels (P = 0.043 and 0.000; respectively). Serum GDF15 levels may be a potential diagnostic biomarker for MSA patients compared with healthy controls and PD patients (cutoff: 470.42 pg/mL, sensitivity: 85.7%, specificity: 88.0%; cutoff: 1075.91 pg/mL, sensitivity: 51.0%, specificity: 96.0%; respectively).
CONCLUSION Serum GDF15 levels are significantly higher in MSA patients and provide suggestions on the etiology of MSA.
Collapse
Affiliation(s)
- Tao Yue
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
- Department of Gerontology, Zibo Central Hospital, Zibo 255036, Shandong Province, China
| | - Hui Lu
- Department of Ophthalmology, Zibo Central Hospital, Zibo 255036, Shandong Province, China
| | - Xiao-Mei Yao
- Department of Gerontology, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250013, Shandong Province, China
| | - Xia Du
- Department of Neurology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong Province, China
| | - Ling-Ling Wang
- Department of Neurology, Yantaishan Hospital, Yantai 264001, Shandong Province, China
| | - Dan-Dan Guo
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| | - Yi-Ming Liu
- Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
| |
Collapse
|
4537
|
Zhuang SF, Hu J, Qiao N, Lan ZH, Lai JY, Wu JG, Wu XY. Low-grade fever during COVID-19 convalescence: A report of 3 cases. World J Clin Cases 2020; 8:2655-2661. [PMID: 32607346 PMCID: PMC7322412 DOI: 10.12998/wjcc.v8.i12.2655] [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: 03/21/2020] [Revised: 05/05/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019 (COVID-19). Reports of such cases are rare, and the mechanism and outcome of low-grade fever during COVID-19 convalescence are not completely clear. We report 3 cases with low-grade fever during COVID-19 convalescence and highlight the main clinical, radiographic, and laboratory characteristics, thereby increasing the level of expertise in the clinical management of COVID-19 during convalescence and facilitating individualized decision-making.
CASE SUMMARY We describe 3 patients with COVID-19, two females aged 62 and 66 years and a male 55 years, who had low-grade fever during COVID-19 convalescence. All 3 patients had no other discomfort or comorbidities during low-grade process. Lesions on computed tomography in all 3 patients had resolved during this period. Two patients tested negative on two consecutive severe acute respiratory syndrome coronavirus 2 tests with an interval of at least 24 h between tests. Body temperature in all 3 patients returned to normal after several days without treatment, and fever recurrence was not observed.
CONCLUSION Enhancing the knowledge of low-grade fever during COVID-19 convalescence may increase the expertise in the delivery of optimal healthcare services.
Collapse
Affiliation(s)
- Shu-Fan Zhuang
- Department of Gastroenterology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China
| | - Jia Hu
- Department of Gastroenterology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China
| | - Nan Qiao
- Department of Student Affairs, Jiangxi Institute of Economic Administrators, Nanchang 330088, Jiangxi Province, China
| | - Zhi-Hui Lan
- Department of Respiration, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China
| | - Jun-Yu Lai
- Department of Cardiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China
| | - Jian-Guang Wu
- Department of Cardiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China
| | - Xiao-Yong Wu
- Department of Radiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, Jiangxi Province, China
| |
Collapse
|
4538
|
Zhang ZH, Yao HL, Zhang Y, Wang X. Endodontic management of the maxillary first molar with special root canals: A case report and review of the literature. World J Clin Cases 2020; 8:2590-2596. [PMID: 32607336 PMCID: PMC7322432 DOI: 10.12998/wjcc.v8.i12.2590] [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: 03/08/2020] [Revised: 05/02/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As the complex anatomy of maxillary first molars is one of the major challenges in endodontic therapy, knowledge of the complicated root canal anatomy and configuration is crucial to ensure the success of endodontic treatment and prognosis. This article presents an endodontically managed left maxillary first molar with an unusual palatal root morphology. The available literature on the anatomic variation of maxillary first molars is also reviewed.
CASE SUMMARY A 36-year-old man with no medical history presented to the Stomatology Department of Peking University Third Hospital complaining of a toothache during mastication in the maxillary left posterior region for approximately 3 mo. He had a spontaneous and intermittent toothache that had worsened, particularly at night. The diagnosis based on clinical examination, X-ray imaging, and cone beam computed tomography (CBCT) was symptomatic irreversible pulpitis. Nonsurgical endodontic therapy was performed for the left maxillary first molar. Five root canals revealed by CBCT included a special palatal root canal (1-2-1-shaped), two mesiobuccal root canals, and one distobuccal root canal. Evaluation of the CBCT images confirmed the root canal morphology and the clinician performed more effective cleaning, obturation, and therapy. Finally, the tooth was restored using composite resin, and the patient was satisfied with the result.
CONCLUSION CBCT and a complete review of the literature may be beneficial for investigating the root canal system to achieve a biological and functional therapeutic effect.
Collapse
Affiliation(s)
- Zhi-Hui Zhang
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| | - Hai-Lin Yao
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| | - Yan Zhang
- Department of Stomatology, Peking University Third Hospital Yanqing Hospital, Beijing 102100, China
| | - Xiao Wang
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| |
Collapse
|
4539
|
Onuigbo LN, Onyishi CN, Eseadi C. Clinical benefits of rational-emotive stress management therapy for job burnout and dysfunctional distress of special education teachers. World J Clin Cases 2020; 8:2438-2447. [PMID: 32607321 PMCID: PMC7322436 DOI: 10.12998/wjcc.v8.i12.2438] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 05/20/2020] [Accepted: 06/10/2020] [Indexed: 02/05/2023] Open
Abstract
It has been observed that managing job burnout and dysfunctional distress constitute part of the major challenges among special educators, and that empirical data on the management of burnout and dysfunctional distress associated with the job of special education teachers are lacking in the literature. The current article discusses the clinical benefits of a rational-emotive stress-management therapy program in reducing the level of job burnout symptoms and dysfunctional distress in special education teachers, using evidence from a 2018 clinical trial study that reported the efficacy of this intervention. Results show the clinical benefits and implications of conducting a rational-emotive stress management intervention, and recommendations are made for future research.
Collapse
Affiliation(s)
- Liziana N Onuigbo
- Department of Educational Foundations, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
| | - Charity N Onyishi
- Department of Educational Foundations, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
- Department of Educational Psychology, Faculty of Education, University of Johannesburg, Gauteng 2006, South Africa
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
| |
Collapse
|
4540
|
Su QH, Zhu K, Li YC, Chen T, Zhang Y, Tan J, Guo S. Choice and management of negative pressure drainage in anterior cervical surgery. World J Clin Cases 2020; 8:2201-2209. [PMID: 32548150 PMCID: PMC7281064 DOI: 10.12998/wjcc.v8.i11.2201] [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: 01/05/2020] [Revised: 04/09/2020] [Accepted: 04/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Postoperative unobstructed drainage is an important measure for avoiding hematoma formation and preventing complications from anterior cervical surgery.
AIM To discuss the characteristics and key points of clinical management of two types of commonly used negative pressure drainage systems in clinical settings.
METHODS Two types of commonly used silica gel negative pressure drainage balls and a type of gastrointestinal decompression apparatus were fully emptied and then injected with different amounts of water and air. Following this, the negative pressure values of the three devices were measured. Meanwhile, we undertook a retrospective analysis of the clinical data of 1328 patients who had been treated with different negative pressure drainage apparatuses during their anterior cervical surgery in our department between January 2007 and January 2018.
RESULTS As the amount of injected air or water increased, the negative pressure of the silica gel negative pressure drainage ball decreased rapidly, dropping to zero when 150 mL of water or air was injected. In contrast, the negative pressure of gastrointestinal decompression apparatus decreased slowly, maintaining an ideal value even when 300 mL of water or air was injected. And statistical analysis demonstrated that patients who had been treated with the gastrointestinal decompression apparatus were less likely to develop severe complications than those who had been treated with the silica gel negative pressure drainage ball (P < 0.05).
CONCLUSION This study showed that the gastrointestinal decompression apparatus has the advantages of large suction capacity, long duration of continuous negative pressure, and good drainage effect, all of which are the favorable factors for the use of this apparatus for negative pressure drainage in anterior cervical surgery.
Collapse
Affiliation(s)
- Qi-Hang Su
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Kai Zhu
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Yong-Chao Li
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Tao Chen
- Department of Orthopedics, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai 200092, China
| | - Yan Zhang
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Jun Tan
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Song Guo
- Department of Orthopedics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| |
Collapse
|
4541
|
Zhu DX, Qiao JJ, Fang H. Macrophage activation syndrome as a complication of dermatomyositis: A case report. World J Clin Cases 2020; 8:2339-2344. [PMID: 32548165 PMCID: PMC7281037 DOI: 10.12998/wjcc.v8.i11.2339] [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: 03/09/2020] [Revised: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Macrophage activation syndrome (MAS) can be a fatal complication of rheumatic disorders, which occurs most commonly in patients with systemic juvenile idiopathic arthritis or systemic lupus erythematosus. It has rarely been reported in patients with dermatomyositis. Here, we describe a fatal case of MAS that developed in an adult patient with dermatomyositis.
CASE SUMMARY A 44-year-old woman was admitted to our hospital with fever, generalized rash and muscle weakness. Fifteen days later, the fever persisted after the use of antibiotics, and repeat blood culture was negative. The patient then exhibited a typical Gottron sign and diffuse erythema on the face and neck, which were consistent with a diagnosis of dermatomyositis. The patient exhibited limb muscle strength of 2, and electromyography was suggestive of muscle-derived damage, which also supported a diagnosis of dermatomyositis. In addition, the patient exhibited high serum ferritin level, cytopenia, liver dysfunction, coagulopathy, enlarged spleen and hypertriglyceridemia, all of which are typical manifestations of MAS. The patient was diagnosed with dermatomyositis complicated by MAS. Although a high dose of methylprednisolone was administered for 15 d, the patient’s condition continued to deteriorate and central nervous system symptoms developed. Eventually, treatment was discontinued, and the patient died.
CONCLUSION MAS is an important, potentially fatal, complication of dermatomyositis. Although MAS is rare in dermatomyositis, it should be considered in the differential diagnosis of an unexplained change of hemoglobin, platelet, fibrinogen, ferritin and triglyceride, which may complicate dermatomyositis.
Collapse
Affiliation(s)
- Ding-Xian Zhu
- Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Jian-Jun Qiao
- Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Hong Fang
- Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| |
Collapse
|
4542
|
Chen X, Zou XJ, Xu Z. Serial computed tomographic findings and specific clinical features of pediatric COVID-19 pneumonia: A case report. World J Clin Cases 2020; 8:2345-2349. [PMID: 32548166 PMCID: PMC7281042 DOI: 10.12998/wjcc.v8.i11.2345] [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: 04/06/2020] [Revised: 04/26/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A series of recent cases of pneumonia in Wuhan, Hubei Province, China, was caused by the 2019 novel coronavirus [2019-nCoV, also called severe acute respiratory syndrome (SARS)-CoV-2]. The World Health Organization officially named the disease as coronavirus disease 2019 (COVID-19). With the global spread of COVID-19, similar cases have appeared in other areas of China, and there are a few reports of pediatric patients with COVID-19 pneumonia.
CASE SUMMARY A 7-year-old girl was diagnosed with COVID-19 and presented with irregular fever, sore throat and diarrhea. Chest computed tomography revealed patchy consolidation and ground-glass opacities in multiple areas. The lesions were mainly distributed in the bronchial bundles or subpleural areas of both lungs, particularly in the right lower lobe. The patient also presented with diarrhea, mild kidney injury, and live coronavirus was found in her feces. She was given antiviral agents (lopinavir and ritonavir), and follow-up detection showed that these abnormalities were markedly decreased within 3 d.
CONCLUSION The clinical symptoms and prognosis of COVID-19 in pediatric patients may be different from those in adult patients, and the fecal–oral transmission of SARS-CoV-2 should be considered.
Collapse
Affiliation(s)
- Xing Chen
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Cent Hospital HuZhou University, Huzhou 313000, Zhejiang Province, China
| | - Xiao-Jie Zou
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Cent Hospital HuZhou University, Huzhou 313000, Zhejiang Province, China
| | - Zhen Xu
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Cent Hospital HuZhou University, Huzhou 313000, Zhejiang Province, China
| |
Collapse
|
4543
|
Tominaga K, Kamimura K, Sato H, Ko M, Kawata Y, Mizusawa T, Yokoyama J, Terai S. Cytapheresis for pyoderma gangrenosum associated with inflammatory bowel disease: A review of current status. World J Clin Cases 2020; 8:2092-2101. [PMID: 32548138 PMCID: PMC7281039 DOI: 10.12998/wjcc.v8.i11.2092] [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: 02/06/2020] [Revised: 02/27/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023] Open
Abstract
Pyoderma gangrenosum (PG) is a neutrophilic dermatosis clinically characterized by the presence of painful skin ulcerations with erythematous. As it is frequently associated with inflammatory bowel diseases, including ulcerative colitis, gastroenterologists should be familiar with the disease including therapeutic options. Therefore, we have conducted a review focusing on the cytapheresis for PG in cases of inflammatory bowel diseases. A literature search was conducted to extract studies published in the last 20 years, with information on demographics, clinical symptoms, treatment, and the clinical course from a total of 22 cases reported and our recent case. In most patients, cytapheresis was associated with improvement or resolution of PG after failure of conventional therapeutic options such as corticosteroids, antibiotics, immunosuppressive agents and immunoglobulin. Based on the information summarized, cytapheresis is helpful in the majority of patients with PG refractory to medical treatment associated with inflammatory bowel diseases and could be further studied in a multicenter, randomized trial.
Collapse
Affiliation(s)
- Kentaro Tominaga
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Hiroki Sato
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Masayoshi Ko
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Yuzo Kawata
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Takeshi Mizusawa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan
| |
Collapse
|
4544
|
Wechkunanukul K, Parajuli DR, Hamiduzzaman M. Utilising digital health to improve medication-related quality of care for hypertensive patients: An integrative literature review. World J Clin Cases 2020; 8:2266-2279. [PMID: 32548157 PMCID: PMC7281038 DOI: 10.12998/wjcc.v8.i11.2266] [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: 01/15/2020] [Revised: 04/01/2020] [Accepted: 05/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hypertension or high blood pressure is considered as a significant contributor and risk factor to many serious conditions, approximately 1.13 billion people have hypertension globally. However, the integrated technologies can upscale health provisions and improve the effectiveness of the healthcare system. WHO has recommended that the digital health interventions (DHIs) and the Health System Challenges should be used in tandem in addressing health.
AIM To summarise the outcomes from a range of research which investigated the use of DHI to improve the medication-related quality of care (MRQOC) for hypertensive patients.
METHODS An integrative literature review was undertaken in October 2019 using the Medline, Cumulative Index of Nursing and Allied Health Literature, and Scopus databases for publications in English with no date limit.
RESULTS In total, 18433 participants were included in this review from 28 studies meeting the eligibility criteria. There were 19 DHI identified within eight countries: Australia, Canada, India, South Korea, Lebanon, Pakistan, the United Kingdom, and the United States of America. The DHI were provided as community-based, clinical-based and home-based program through mobile phone, mobile health system, short message service, and telehealth, digital medicine, and online healthcare (web-based). The mean age of participants was 59 ranging from 42 to 81 years with an average mean systolic blood pressure of 143.3 mmHg at baseline, ranging from 129.0 mmHg to 159.0 mmHg. The proportion of male participants ranged from 13.9% to 92.0%. Eighteen interventions showed evidence of reduction in blood pressure and improvement of self-management in relation to medication adherence and blood pressure control. The reduction of systolic blood pressure ranged between 1.9 mmHg and 26.0 mmHg, with a mean of 10.8 mmHg. The digital health was found positively associated with the MRQOC for hypertensive patients such as improvement in medication adherence and medication management; better blood pressure control; maintaining follow-ups appointment and self-management; increasing access to healthcare particularly among patients living in rural area; and reducing adverse events. However, some interventions found no significant effect on hypertensive care. The follow up duration varied between 2 mo and 18 mo with an average attrition rate of 10.1%, ranging from 0.0% to 17.4%.
CONCLUSION Utilising digital health innovation for hypertensive care in different settings with tailored interventions positively impacted on MRQOC leading to an improvement of patient outcomes and their quality of life. Nevertheless, inconclusive findings were found in some interventions, and inconsistent outcomes between DHI were noted. A future research and evidence-based DHI for hypertension or chronic diseases should be developed through the evidence-to-decision framework and guidelines.
Collapse
Affiliation(s)
- Kannikar Wechkunanukul
- College of Nursing and Health Sciences, Flinders University, Bedford Park 5042, Australia
| | - Daya Ram Parajuli
- Flinders University Rural Health SA, College of Medicine and Public Health, Flinders University, Renmark 5341, Australia
| | - Mohammad Hamiduzzaman
- Flinders University Rural Health SA, College of Medicine and Public Health, Flinders University, Renmark 5341, Australia
| |
Collapse
|
4545
|
Ko DS, Kim YH, Goh TS, Lee JS. Altered physiology of mesenchymal stem cells in the pathogenesis of adolescent idiopathic scoliosis. World J Clin Cases 2020; 8:2102-2110. [PMID: 32548139 PMCID: PMC7281031 DOI: 10.12998/wjcc.v8.i11.2102] [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: 02/27/2020] [Revised: 05/13/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023] Open
Abstract
Adolescent idiopathic scoliosis is the most common spinal deformity during puberty, especially in females. It is characterized by aberrant skeletal growth and generalized reduced bone density, which is associated with impaired bone mineral metabolism. Despite recent progress in multidisciplinary research to support various hypotheses, the pathogenesis of Adolescent idiopathic scoliosis is still not clearly understood. One of the hypothesis is to study the role of mesenchymal stem cells due to its involvement in the above-mentioned bone metabolic abnormalities. In this review, we will summarize reported literatures on the role of mesenchymal stem cells, particularly in the pathogenesis of Adolescent idiopathic scoliosis. In addition, we will describe the research on mesenchymal stem cells of Adolescent idiopathic scoliosis performed using bioinformatics tools.
Collapse
Affiliation(s)
- Dai Sik Ko
- Division of Vascular Surgery, Department of Surgery, Gachon University Gil Medical Center, Incheoz 21565, South Korea
| | - Yun Hak Kim
- Department of Anatomy and Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan 50612, South Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| | - Jung Sub Lee
- Department of Orthopaedic Surgery and Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea
| |
Collapse
|
4546
|
Chen H, Teng X, Hu XH, Cheng L, Du WL, Shen YM. Application of a pre-filled tissue expander for preventing soft tissue incarceration during tibial distraction osteogenesis. World J Clin Cases 2020; 8:2181-2189. [PMID: 32548148 PMCID: PMC7281070 DOI: 10.12998/wjcc.v8.i11.2181] [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: 03/14/2020] [Revised: 04/19/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Bone transport and distraction osteogenesis has been widely used to treat bone defects after traumatic surgery, but, skin and soft tissue incarceration can be as high as 27.6%.
AIM To investigate the efficacy of inserting a tissue expander to prevent soft tissue incarceration.
METHODS Between January 2016 and December 2018, 12 patients underwent implantation of a tissue expander in the subcutaneous layer in the vicinity of a tibial defect to maintain the soft tissue in position. A certain amount of normal saline was injected into the tissue expander during surgery and was then gradually extracted to shrink the expander during the course of transport distraction osteogenesis. The tissue expander was removed when the two ends of the tibial defect were close enough.
RESULTS In all 12 patients, the expanders remained intact in the subcutaneous layer of the bone defect area during the course of transport distraction osteogenesis. When bone transport was adequate, the expander was removed and the bone transport process was completed. During the whole process, there was no incarceration of skin and soft tissue in the bone defect area. Complications occurred in one patient, who experienced poor wound healing.
CONCLUSION The pre-filled expander technique can effectively avoid soft tissue incarceration. The authors’ primary success with this method indicates that it may be a valuable tool in the management of incarcerated soft tissue.
Collapse
Affiliation(s)
- Hui Chen
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xing Teng
- Department of Traumatic Orthopedics, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Xiao-Hua Hu
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Lin Cheng
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Wei-Li Du
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yu-Ming Shen
- Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| |
Collapse
|
4547
|
Zhang Y, Ma NY, Pang XA. Uterine incision dehiscence 3 mo after cesarean section causing massive bleeding: A case report. World J Clin Cases 2020; 8:2392-2398. [PMID: 32548173 PMCID: PMC7281066 DOI: 10.12998/wjcc.v8.i11.2392] [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: 01/09/2020] [Revised: 04/26/2020] [Accepted: 05/18/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The traditional definition of late postpartum hemorrhage is a massive uterine hemorrhage from 24 h after delivery to the puerperal period. Here, we report a case of late postpartum hemorrhage that occurred 3 mo after cesarean section and endangered the patient's life. The cause of the case we are reporting was poor incision healing. By reporting this case, we hope to make doctors aware that late postpartum hemorrhage due to poor incision healing may happen as late as 3 mo after cesarean section.
CASE SUMMARY A 31-year-old woman complained of acute, severe vaginal bleeding for 1 h; the patient had a history of cesarean section 3 mo prior. After receiving anti-inflammatory treatment, fluid supplementation, blood transfusion, oxytocin administration, and hemostatic treatment, the vaginal bleeding ceased, and the patient’s clinical status improved. Unfortunately, she experienced recurrent massive vaginal bleeding, and uterine contractile agents did not decrease the persistent bleeding. To save the patient’s life, she was admitted for emergency laparotomy. At exploratory laparotomy, dehiscence and necrosis of the previous cesarean section scar were noted; the dehiscence penetrated through the entire thickness of the uterine muscle wall and extended to the left uterine artery. Ultimately, we performed a total hysterectomy.
CONCLUSION Late postpartum hemorrhage due to poor incision healing after cesarean section may occur in the 3 mo after cesarean section or even later. Therefore, obstetricians-gynecologists should monitor for this potential complication in all patients post–cesarean section. Such hemorrhages can be severe enough to endanger the patient's life.
Collapse
Affiliation(s)
- Yao Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Ning-Ye Ma
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| | - Xiao-Ao Pang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
| |
Collapse
|
4548
|
Yang HY, Liu YZ, Zhou XD, Huang Y, Xu NW. Role of IL-17 gene polymorphisms in osteoarthritis: A meta-analysis based on observational studies. World J Clin Cases 2020; 8:2280-2293. [PMID: 32548158 PMCID: PMC7281068 DOI: 10.12998/wjcc.v8.i11.2280] [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: 12/11/2019] [Revised: 03/06/2020] [Accepted: 04/24/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic complex multifactorial joint disease, and a major degenerative form of arthritis. Existing studies on the association between polymorphisms of the IL-17 gene and the risk of OA in different populations have yielded conflicting findings. AIM To investigate the association between polymorphisms of the IL-17 gene and the risk of OA. METHODS We conducted a meta-analysis by systematically searching databases, including PubMed, EMBASE, MEDLINE, Cochrane Library, and Google Scholar to evaluate this association by calculating pooled odds ratios with 95% confidence intervals. Moreover, subgroup analyses stratified by ethnicity and OA type were also conducted. RESULTS In a total of 6 citations involving 8 studies (2131 cases and 2299 controls), 4 single nucleotide polymorphisms were identified. Of these 4 polymorphisms, 2 (rs2275913, rs763780) were common in five case-control studies. Together, the pooled results revealed that the A allele and genotype AA/GA of the rs2275913 polymorphism, and the C allele and genotype CC of the rs763780 polymorphism in the IL-17 gene increased the risk of OA. Furthermore, stratification analyses by ethnicity and OA type showed that the rs2275913 polymorphism increased the risk of OA among Asians and in knee/hip OA, respectively. In addition, stratification analyses also revealed that the rs763780 polymorphism increased OA risk among both Asians and Caucasians in knee/hip OA. CONCLUSION The rs763780 polymorphism of the IL-17F gene increased the risk of OA, whereas the rs2275913 polymorphism of the IL-17A gene increased the risk of OA only among Asians. Due to the limitations of this study, these findings should be validated in future studies.
Collapse
Affiliation(s)
- Hao-Yu Yang
- Department of Orthopedics, Wuxi 9th People’s Hospital affiliated to Soochow University, Wuxi 214000, Jiangsu Province, China
| | - Yu-Zhou Liu
- Department of Orthopedics, Wuxi 9th People’s Hospital affiliated to Soochow University, Wuxi 214000, Jiangsu Province, China
| | - Xin-Die Zhou
- Department of Orthopedics, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu Province, China
| | - Yong Huang
- Department of Orthopedics, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu Province, China
| | - Nan-Wei Xu
- Department of Orthopedics, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou 213003, Jiangsu Province, China
| |
Collapse
|
4549
|
Feng Z, Liu ZM, Yuan XL, Ye LS, Wu CC, Tan QH, Hu B. Peroral endoscopic myotomy for management of gastrointestinal motility disorder. World J Clin Cases 2020; 8:2116-2126. [PMID: 32548141 PMCID: PMC7281049 DOI: 10.12998/wjcc.v8.i11.2116] [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: 01/07/2020] [Revised: 03/27/2020] [Accepted: 04/27/2020] [Indexed: 02/05/2023] Open
Abstract
Achalasia is a type of esophageal motility disorder, consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis. Related clinical symptoms include dysphagia, regurgitation, chest pain, and weight loss. Traditional treatment options include endoscopic botulinum toxin injection, endoscopic pneumatic dilation, and laparoscopic Heller’s myotomy. These therapies mainly relieve symptoms by reducing the pressure on the lower esophageal sphincter and reducing blood flow resistance at the esophagogastric junction. Based on endoscopic submucosal dissection and natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) is a purely endoscopic method of myotomy with minimal invasiveness and a low rate of adverse events when performed by experienced operators. Since then, numerous studies have shown the significant clinical efficacy and safety of POEM. The purpose of this article is to introduce different modified POEMs, special indications for different POEMs, and their advantages as well as disadvantages.
Collapse
Affiliation(s)
- Zhe Feng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zi-Ming Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qing-Hua Tan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| |
Collapse
|
4550
|
Akbulut S, Ozer A, Gokce A, Demyati K, Saritas H, Yilmaz S. Attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation: Study of a nationwide survey. World J Clin Cases 2020; 8:2235-2245. [PMID: 32548154 PMCID: PMC7281036 DOI: 10.12998/wjcc.v8.i11.2235] [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: 03/12/2020] [Revised: 05/04/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many countries. AIM To evaluate the attitudes, awareness, and knowledge levels of the Turkish adult population toward organ donation. METHODS This nationwide study surveyed 3000 adults (≥ 18 years) in Turkey. To ensure a representative sample, the Nomenclature of Territorial Units for Statistics-II (modified for Turkey) was used. Turkey was divided into 26 regions based on social, economic, and geographic criteria as identified by the Turkish Statistical Institute. A stratified sampling method was used with an even distribution of adults across cities and towns based on population data. Data were collected by the PRP Research and Consultancy Company using computer-assisted personal interviews. RESULTS Out of 3000 individuals represented in the study population, 1465 (48.8%) were male and 1535 (51.2%) female. The results showed that most participants were under 45 years (59.0%) and married (72.1%), some had a bachelor's degree or higher (21.9%), and very few (1.5%) had any direct experience with organ transplantation - whether in the family, or a family member on a transplantation waiting list. Most of the study population (88.3%) had not considered donating an organ, however, most (87.9%) said that they would accept an organ from a donor if they needed one. Among the individuals surveyed, 67% were willing to donate an organ to a close relative, while 26.8% would donate an organ to an unrelated person. Only 47.2% said they had adequate information about brain death, and 85.2% refused to consent to donating organs of family members declared brain dead. Only 33.9% thought they had adequate information about organ donation. The main source of information was the television. The two main reasons for refusing organ donation were that it was too soon to think about organ donation and the importance of retaining the integrity of the dead person's body. CONCLUSION This study showed that Turkey's adult population has inadequate knowledge about organ donation. The study advocates for public education programs to increase awareness among the general population about legislation related to organ donation.
Collapse
Affiliation(s)
- Sami Akbulut
- Department of Public Health, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Liver Transplant Institute, Inonu University, Malatya 44280, Turkey
| | - Ali Ozer
- Department of Public Health, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Ayse Gokce
- Department of Public Health, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Khaled Demyati
- Liver Transplant Institute, Inonu University, Malatya 44280, Turkey
- Department of Surgery, An-Najah National University Hospital, An-Najah National University, Nablus 11941, Palestine
| | - Hasan Saritas
- Department of Surgical Nursing, Inonu University Faculty of Nursing, Malatya 44280, Turkey
| | - Sezai Yilmaz
- Liver Transplant Institute, Inonu University, Malatya 44280, Turkey
| |
Collapse
|