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Transthoracic echo: A sensitive tool for detecting cardiac extension of renal cell carcinoma?

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World Journal of Clinical Cases 2014年第8期2卷 377-379页

作者： michelle Bejarano Yara L Cameron Theodore C Koutlas Assad Movahed Department of Cardiovascular Sciences East Carolina Heart Institute and Brody School of MedicineGreenvilleNC 27834United States

Renal cell carcinoma is a common urological malignancy with the unique ability to invade the inferior vena cava(IVC) and to extend into the right atrium of the heart. Of those with Renal cell carcinoma only 4%-25% are found to have IVC invasion and of those only 2%-10% extend into the right atrium. If treated surgically, extension of tumor thrombus is not a determinant of survival; therefore it is imperative to determine the presence and extent of tumor thrombus in order to determine surgical approach and tumor resection. To date this has been primarily accomplished by magnetic resonance imaging and computed tomography. We present a case of 61 years old African American woman in which transthoracic echocardiography provided a more accurate determination/characterization of the presence and degree of tumor thrombus and extension.

关键词： Renal cell carcinoma Tumor thrombus Cardiac extension Right atrial mass

Ultrastructural changes and asthenozoospermia in murine spermatozoa lacking the ribosomal protein L29/HIP gene

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Asian Journal of Andrology 2014年第6期16卷 925-926页

作者： Rolands G Aravindan Catherine B Kirn-Safran michelle A Smith Patricia A Martin-DeLeon Department of Biological Sciences University of Delaware NewarkDE 19716 USA.

Dear Editor, We present here the first report linking a specific gene, ribosomal protein L29 （Rp129）, also known as Hip （heparin/heparan sulfate interacting protein）, to the mammalian sperm flagellar morphological anomaly termed the ＂dag＂ defect. In addition, we show that loss of Rp/29 invariably results in low sperm motility with infertility accompanying this abnormality.

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An exploratory pilot of factors associated with premenstrual syndrome in minority women

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International Journal of Nursing Sciences 2015年第2期2卷 118-122页

作者： Mallory Perry michelle Judge Danielle Millar Deborah McDonald University of Connecticut School of Nursing StorrsCT 06269-4026USA

Purpose:This investigation explored factors associated with premenstrual syndrome(PMS)in minority women,and compared the response of minority and non-minority women supplemented with omega-3 fatty acids(FA)in the form of fish ***:This descriptive,correlational,retrospective pilot was a secondary data *** consuming 2 g of fish oil/d(n=15)in the larger study were *** Moos Menstrual Distress Questionnaire(MMDQ)was assessed monthly for two months to acquire a mean baseline MMDQ *** total sample was stratified to evaluate racial variations in PMS symptoms(non-minority,n=7;minority,n=8).MMDQ score at 5 months was compared to the mean baseline score within each ***:Fish oil supplementation significantly reduced PMS symptoms in both groups(nonminority p=0.002;minority p=0.046)with a large effect of 1.4 for both *** MMDQ total scores were not significantly different between groups at 5 ***:This pilot evidence of improved PMS symptoms in minority and non-minority groups related to fish oil supplementation supports a universal treatment approach and highlights need for a larger-scale investigation.

关键词： Omega-3 fatty acids Fish oil Premenstrual syndrome Minority

Ocular prosthesis incorporating IPS e-max press scleral veneer and a literature review on non-integrated ocular prosthesis

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International Journal of Ophthalmology(English edition) 2017年第1期10卷 148-156页

作者： Godwin Clovis Da Costa Meena Ajay Aras Paul Chalakkal michelle Clovis Da Costa Department of Prosthodontics Goa Dental College and HospitalBambolimGoa 403202India Department of Pedodontics and Preventive Dentistry Goa Dental College and HospitalBambolimGoa 403202India Primary DNB(Ophthalmology) West Lion's Super Specialty Eye HospitalBangaloreKarnataka 560002India

The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a “cut-back” on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses.

关键词： IPS e-max press ceramic eye prosthesis ocular prosthesis

Novel approaches to combat chemoresistance against glioblastomas

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Cancer Drug Resistance 2020年第4期3卷 686-698页

作者： Rheal A.Towner michelle Zalles Debra Saunders Nataliya Smith Advanced Magnetic Resonance Center Oklahoma Medical Research FoundationOklahoma CityOK 73104USA Oklahoma Center for Neuroscience University of Oklahoma Health Sciences CenterOklahoma CityOK 73104USA

The poor prognosis of glioblastoma multiforme(GBM)patients is in part due to resistance to current standard-of-care treatments including chemotherapy[predominantly temozolomide(TMZ;Temodar)],radiation therapy and an anti-angiogenic therapy[an antibody against the vascular endothelial growth factor(bevacizumab;Avastin)],resulting in recurrent *** recurrent GBM tumors are commonly resistant to either TMZ,radiation or bevacizumab,which contributes to the low survival rate for GBM *** review will focus on novel targets and therapeutic approaches that are currently being considered to combat GBM *** of these therapeutic options is a small molecule called OKlahoma Nitrone 007(OKN-007),which was discovered to inhibit the transforming growth factor β1 pathway,reduce TMZ-resistance and enhance ***-007 is currently an investigational new drug in clinical trials for both newly-diagnosed and recurrent GBM *** novel target is ELTD1(epidermal growth factor,latrophilin and seven transmembrane domain-containing protein 1;alternatively known as ADGRL4,Adhesion G protein-coupled receptor L4),which we used a monoclonal antibody against,where a therapy against it was found to inhibit Notch 1 in a pre-clinical GBM xenograft *** 1 is known to be associated with chemoresistance in *** potential therapeutic targets to combat GBM chemoresistance include the phosphoinositide 3-kinase pathway,nuclear factor-κB,the hepatocyte/scatter factor(c-MET),the epidermal growth factor receptor,and the tumor microenvironment.

关键词： Glioblastoma pre-clinical models OKlahoma Nitrone 007 transforming growth factor-β1 ELTD1 magnetic resonance imaging

Retrospective chart review of skin cancer presence in the wide excisions

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World Journal of Clinical Cases 2014年第3期2卷 52-56页

作者： Ye Yuan michelle L Duff Dawn L Sammons Shiyong Wu Edison Biotechnology Institute and Department of Chemistry and Biochemistry Ohio University Athens OH 45701 United States Department of Specialty Medicine Heritage College of Osteopathic Medicine Ohio University Athens OH 45701 United States

AIM: To investigate cancer cell absence or presence in wide excision after biopsy of squamous cell carcinoma(SCC) and basal cell carcinoma(BCC) ***: 200 patients(100 BCC and 100 SCC) from the same dermatology clinic, who had positive margin upon biopsy, were selected from a computer generated randomized report. All selected patients had wide excision following biopsy. To determine the correlation of gender, age distribution and cancer absence, BCC and SCC cases were separated based on excision-cancer absent or present after wide excision. χ2 tests, Fisher's exact tests were used to analyze the ratio of male to female between excision-cancer absent and excision-cancer present patients, while Mann-Whitney U test were used to compare the age distribution in the two groups. Statistical analyses were performed using SPSS version 16.0 for ***: Our retrospective chart review of the patients showed that cancer cells were absent in 49% of BCC patients(n = 100) and 64% of SCC patients(n = 100) who had previously had positive margins upon biopsy. Gender analysis showed the ratio of male to female(M/F) in the BCC arm was significantly higher compared with the SCC arm in those with excision-cancer absent(2.06 vs 0.66; P = 0.004; χ2 test). But M/F of excision-cancer absent and excision-cancer present in neither BCC nor SCC patients was statistically significant. Age adjustment showed no significant difference between excision-cancer absent and excision-cancer present in BCC and SCC patients. Nevertheless, in excision-cancer absent cases, the age distribution showed that the BCC patients were younger than SCC patients(average age 67 vs 74; P < 0.001; Mann-Whitney U test). In addition, our data also indicated that in the patient group of 71-80 years old, there were more SCC patients who showed excision-cancer absence(67.6% vs 39.4%; P = 0.02; χ2 test).CONCLUSION: Our study indicates that approximately 50% or more of BCC and SCC patients with positive margin

关键词： Biopsy Histology Positive margin Skin cancer Wide excision

Asymptomatic early acute appendicitis initiated and diagnosed during colonoscopy: A case report

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World Journal of Gastroenterology 2005年第34期11卷 5398-5400页

作者： michelle Petro Anil Minocha Division of Digestive Diseases University of Mississippi Medical Center Jackson MS 39216 USA

Colonoscopic diagnosis of asymptomatic early acute appendicitis is exceedingly rare. Although obstruction of common physiologic mechanism of acute appendicitis, all of the previously documented cases in the literature have only shown a patent appendiceal lumen with pus flowing into the cecum. We present the case of a patient undergoing colonoscopy for colorectal cancer evaluation with no abdominal symptoms. An obstructed, swollen appendix was seen. The process was probably initiated during the colonoscopy, documenting perhaps the earliest stage of acute appendicitis for the first time. Endoscopic, CT and microsCOpic documentation of the case is also presented.

关键词： Colonoscopy Appendicitis Complications Endoscopy

Advances in the treatment of cervical rheumatoid: Less surgery and less morbidity

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World Journal of Orthopedics 2014年第3期5卷 292-303页

作者： Grant W Mallory Sasha R Halasz michelle J Clarke Department of Neurologic Surgery Mayo ClinicRochesterMN 55905United States

Rheumatoid arthritis is a chronic systemic inflammatory disease that often affects the cervical *** it was initially thought that cervical involvement was innocuous,natural history studies have substantiated the progressive nature of untreated *** the past 50 years,there has been further elucidation in the pathophysiology of the disease,as well as significant advancements in medical and surgical *** introduction of disease modifying drugs and biologic agents has reduced the amount of patients with advanced stages of the disease needing *** in instrumentation techniques has improved patient outcomes and fusion *** introduction of endoscopic approaches for ventral decompression may further lower surgical *** this review,we give a brief overview of the pertinent positives of the disease.A discussion of historical techniques and the evolution of surgical therapy into the modern era is *** improved medical therapies and lessinvasive approaches,we will likely continue to see less advanced cases of disease and less surgical ***,a thorough understanding of the disease is crucial,as its systemic involvement and need for continued medical therapy have tremendous impact on overall complications and outcomes even in patients being seen for standard degenerative disease with comorbid rheumatoid.

关键词： Atlantoaxial instability Cranial settling Subaxial subluxation Cervical Surgery Morbidity Rheumatoid arthritis

Hyperammonemia-induced encephalopathy: A rare devastating complication of bariatric surgery

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World Journal of Hepatology 2015年第7期7卷 1007-1011页

作者： michelle L Kromas Omar Y Mousa Savio John Department of Anesthesiology SUNY Upstate Medical University Department of Medicine SUNY Upstate Medical University

The clinical manifestations of hyperammonemia are usually easily identifiable to the clinician when associated with liver disease and lead to prompt diagnosis and treatment. However, hyperammonemia-induced encephalopathy is rare in adults in the absence of overt liver disease, thus diagnosis is often delayed or missed leading to potentially life threatening complications. Without proper treatment, such patients can decompensate rapidly with poor outcomes including seizures, coma, and death. Early assessment of plasma ammonia levels in patients with normal hepatic function and characteristic symptoms of encephalopathy can lead to early intervention while investigating the underlying etiology. We describe a patient who presented with a 2-year progression of waxing and waning acute mental status changes after a Roux-en-Y gastric bypass surgery. He was found to have elevated ammonia level as well as orotic aciduria; results consistent with a urea cycle disorder. After consulting neurology as well as toxicology, he ultimately improved after dietary protein restriction, sodium benzoate and lactulose therapy. While rare, clinicians should have a high index of suspicion for late onset urea cycle disorders in symptomatic patients presenting with encephalopathy secondary to hyperammonemia.

关键词： Hyperammonemia Urea cycle Bariatricsurgery Encephalopathy Hepatic