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Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 107-110页

作者： Soumil Vyas james RA Skipworth Dimitrios Lytras Claire Smyth Anthony Mee Adrian Hatfield charles Imber George Webster Department of Hepatobiliary & Pancreatic Surgery University College London Hospital NHS Trust Department of Gastroenterology University College London Hospital NHS Trust Department of Gastroenterology Royal Berkshire Hospital NHS Trust

BACKGROUND:Brunner's gland adenoma (BGA) is an unusual benign neoplasm arising from Brunner's glands in the *** symptomatic it presents either with duodenal obstruction or ***,pancreatitis secondary to ampullary obstruction from a BGA is very ***:A 23-year-old female presented with recurrent episodes of 'idiopathic' *** was extensively investigated and was found to have a large polypoid BGA,intermittently obstructing the *** created a ball-valve effect causing secondary intermittent obstruction of the pancreatic duct resulting in *** condition was cured surgically,through transduodenal excision of the *** reviewed the surgical literature pertaining to these unusual and similar causes of obstructive pancreatitis,not related to ***:BGA of the duodenum is a rare cause of *** investigations should be carried out in all cases of unexplained pancreatitis before classifying the condition as 'idiopathic'.Discovery of a lesion of this nature gives an opportunity to provide a permanent surgical ***:BGA adds an unusual etiology for *** patients with pancreatitis should undergo extensive investigations before being termed 'idiopathic'.Surgical excision of the BGA provides a definitive curative treatment for the adenoma and pancreatitis.

关键词： ampullary polyp Brunner's gland adenoma pancreatitis excision

Predictors of sperm recovery after cryopreservation n testicular cancer

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Asian Journal of Andrology 2016年第1期18卷 35-38页

作者： james M Hotaling Darshan P Patel Christopher Vendryes Natalya A Lopushnyan Angela P Presson Chong Zhang charles H Muller Thomas J Walsh Division of Urology Department of Surgery University of Utah Salt Lake City UT 84132 USA Department of Urology University of Illinois-Chicago Chicago IL 60612 USA Department of Urology University of Washington Seattle WA 98195 USA Division of Epidemiology Department of Internal Medicine University of Utah Salt Lake City UT 84132 USA

Our objective was to identify predictors of improved postthaw semen quality in men with testicular cancer banking sperm for fertility preservation. We reviewed 173 individual semen samples provided by 67 men with testicular germ cell tumor （TGCT） who cryopreserved sperm before gonadotoxic treatment between 1994 and 2010 at our tertiary university medical center. Our main outcomes measures were independent predictors for the greater postthaw total motile count （TMC） in men with TGCT. Men with NSGCT were more likely to be younger （P 〈 0.01） and had high cancer stage （Ⅱ or Ⅲ, P 〈 0.01） compared with men with seminoma. In our multiple regression model, NSGCT histology, use of density gradient purification, and fresh TMC 〉 median fresh TMC each had increased odds of a postthaw TMC greater than median postthaw TMC. Interestingly, age, advanced cancer stage （11 or III）, rapid freezing protocol, and motility enhancer did not show increased odds of improved postthaw TMC in our models. In conclusion, men with TGCT or poor fresh TMC should consider preserving additional vials （at least 15 vials） before oncologic treatment. Density gradient purification should be routinely used to optimize postthaw TMC in men with TGCT. Larger, randomized studies evaluating cancer stage and various cryopreservation techniques are needed to assist in counseling men with TGCT regarding fertility preservation and optimizing cryosurvival.

关键词： cryopreservation fertility preservation seminoma testicular neoplasms

Evaluating Contractors’ Safety Record and Its Influence on Performance of Road Infrastructural Projects

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World Journal of Engineering and Technology 2021年第2期9卷 203-228页

作者： james Mushori charles Mallans Rambo charles Misiko Wafula Johnson Matu Project Planning and Management University of Nairobi Nairobi City Kenya School of Open and Distance Learning University of Nairobi Nairobi City Kenya

A number of studies conducted in Kenya and internationally indicated that most of the construction firms and contractors do not seem to strictly observe safety administration in construction industry, hence compromised performance at implementation stage of projects and even later in the post implementation or post-delivery stage. The study aimed to examine the influence of contractors’ safety record on road performance. This is to create better understanding of how the safety record of contractors could either positively or negatively influence performance of roads during post-delivery stage. The study used both descriptive survey research design and correlation design based on a pragmatic mixed method approach. Through stratified sampling and proportionate sampling, a sample of 210 was drawn from a population of 460 comprising of registered contractors and Public Service Vehicles (PSV) drivers within Nairobi County in Kenya. Questionnaires were distributed using simple random sampling. The questionnaires returned were 153 in total representing 72.8% of all questionnaires distributed to the respondents. Data was descriptively analyzed using percentages, frequencies, means and standard deviations for measuring central tendency and variability. Inferential analysis was done by use of correlation and regression. The descriptive analysis revealed that safety policy management system, insurance policy, and adequacy of standards in addressing safety outcome are to some extent practiced and adhered to. However, compliance behavior to safety procedures is still weak and requires improvement. The null hypothesis was tested and the results obtained from a simple linear regression indicated that, R = 0.657, R2

关键词： Contractors’ Safety Record Road Performance Road Safety Infrastructural Projects

Inguinal Neuritis in Open Recurrent Hernia Repair

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International Journal of Clinical Medicine 2014年第13期5卷 790-798页

作者： Robert charles Wright Robert james Wright Cascade Hernia & Heartburn Institute Meridian Surgical Center Puyallup USA

PURPOSE: To investigate the pattern of occurrence of inguinal neuritis in recurrent inguinal hernia. We hypothesize that neuritis will occur in more nerves with a wider distribution than in primary repair. METHODS: Retrospective chart review of thirty consecutive recurrent inguinal hernia repairs concentrating on the occurrence of inguinal neuritis. These are not chronic pain patients. Nerves suspected of containing inguinal neuritis were sent for histologic examination. Ilioinguinal nerves were routinely resected. Operative parameters and nerve pathology reports were reviewed. These data were compared with a recent series of one hundred consecutive primary inguinal hernia repairs with a 34% incidence of inguinal neuritis. An independent statistician from Whitman University reviewed the data. RESULTS: Twenty patients were found to have inguinal neuritis among thirty recurrent open inguinal hernia repairs (66%). This compares to 34% among primary repairs, but it is a similar rate (P > 0.42) assuming that the damaged nerve was left intact in 34% of these recurrences during the primary repair. In recurrent inguinal hernia 69% of neuritis occurred in the ilioinguinal nerve compared to 88% of damaged ilioinguinal nerves in the primary hernia. A test for the difference in proportions gives P > 0.10. The most common site of neuritis occurrence in recurrent hernias with nerve damage to the ilioinguinal nerve was at the external oblique neuroperforatum among 70% of patients compared to 83% in primary cases. A test for difference in proportions gives P > 0.36. Two separate nerves were found to exhibit neuritis in six patients (20%) significantly higher than 1% among primary hernias (P < 0.01). CONCLUSION: The overall incidence of inguinal neuritis was 66% in recurrent inguinal hernia repairs. The ilioinguinal nerve was most commonly affected in these recurrent hernias. Inguinal neuritis occurs more commonly in recurrent hernia compared with primary inguinal hernia;however, it

关键词： Hernias Recurrent Nerve Inflammation Neuritis

Impact of gender and race on expectations and outcomes in total knee arthroplasty

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World Journal of Orthopedics 2020年第5期11卷 265-277页

作者： Brian A Perez james Slover Emmanuel Edusei Annamarie Horan Afshin Anoushiravani Atul F Kamath charles L Nelson Department of Orthopedics University of PennsylvaniaPhiladelphiaPA 19104United States Department of Orthopedic Surgery New York University Langone HealthNew YorkNY 10016United States Department of Orthopaedic Surgery Cleveland ClinicClevelandOH 44195United States

BACKGROUND Total joint arthroplasty is one of the most common surgeries performed in the United States with total knee arthroplasty(TKA)being one of the most successful surgeries for restoring function and diminishing *** with the demonstrated success of TKA and a higher prevalence of arthritis and arthritis related disability among minorities,racial and gender disparity remains a constant issue in providing care for the adult reconstruction *** To assess the role of demographics and expectations on differences in perioperative patient reported outcomes(PRO)following *** One hundred and thirty-three patients scheduled for primary unilateral TKA secondary to moderate to severe osteoarthritis were enrolled in this twoinstitution prospective *** PRO questionnaires were collected at four time *** analysis was conducted to determine the impact of gender,ethnic background and expectation surveys responses to assess PRO at these time *** Females were associated with worse preoperative Knee Injury and Osteoarthritis Outcome Scores(KOOS)for symptoms,pain,and activities of daily *** Americans were associated with worse KOOS for pain,activities of daily living,and quality of *** worse preoperative scores,no difference was noted in these categories between the groups ***,all pre-operative psychometric scales were equivalent across groups except Geriatric Depression scale,which was significantly different between groups within the Race and Age Group(P<0.05).Conversely,Pain Catastrophizing Scale,was significantly different for all subscales and total score within Age Group(P<0.05),and the Magnification,Helplessness subscales as well as the Total score were significantly different between groups for Race and Relationship Status(P<0.01).CONCLUSION We conclude that female and African American patients have lower preoperative KOOS scores compared to white male *** postoper

关键词： Knee Joints Arthroplasty Osteoarthritis Race Gender Postoperative Outcomes

Anti-tumour necrosis factor agent and liver injury:literature review,recommendations for management

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World Journal of Gastroenterology 2014年第46期20卷 17352-17359页

作者： Roberta Elisa Rossi Ioanna Parisi Edward John Despott Andrew Kenneth Burroughs james O'Beirne Dario Conte Mark Ian Hamilton charles Daniel Murray Centre for Gastroenterology Royal Free HospitalLondon NW3 2QGUnited Kingdom Department of Pathophysiology and Organ Transplant Universita’ degli Studi di Milano20122 MilanoItaly Division of Gastroenterology and Endoscopy Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico20122 MilanoItaly Sheila Sherlock Liver Centre Royal Free Hospital and Institute of Liver and Digestive HealthLondon NW3 2PFUnited Kingdom

Abnormalities in liver function tests,including transient and self-limiting hypertransaminasemia,cholestatic disease and hepatitis,can develop during treatment with anti-tumour-necrosis-factor(TNF)*** optimal management of liver injury related to antiTNF therapy is still a matter of *** some authors recommend discontinuing treatment in case of both a rise of alanine aminotransferase more than5 times the upper limit of normal,or the occurrence of jaundice,there are no standard guidelines for the management of anti-TNF-related liver *** searches were performed in Pub Med,using the following key words:inflammatory bowel disease(IBD);TNF inhibitors;hypertransaminasemia;drugrelated liver injury;*** to published data,elevation of transaminases in patients with IBD treated with anti-TNF is a common finding,but resolution appears to be the usual ***-TNF agents seem to be safe with a low risk of causing severe drugrelated liver *** to our centre experience,we found that hypertransaminasemia was a common,mainly self-limiting finding in our IBD cohort and was not correlated to infliximab treatment on both univariate and multivariate *** algorithm for the management of liver impairment occurring during antiTNF treatment is also proposed and this highlights the need of a multidisciplinary approach and suggests liver biopsy as a key-point in the management decision in case of severe rise of ***,hepatic injury is generally self-limiting and drug withdrawal seems to be an exception.

关键词： Inflammatory bowel disease Tumour necrosis factor inhibitors Hypertransaminasemia Drug-related liver injury Infliximab

The fine arts reduced to a single principle

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The fine arts reduced to a single principle

Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level： what to expect in the Chinese population？

作者： (author..1713-1780 )Batteux charles (editor .1957-)Young james O.

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Asian Journal of Andrology 2015年第5期17卷 821-825,I0010页

作者： Jeremy YC Teoh Steffi KK Yuen james HL Tsu charles KW Wong Brian SH Ho Ada TL Ng Wai-Kit Ma Kwan-Lun Ho Ming-Kwong Yiu Department of Surgery Division of Urology Queen Mary Hospital University of Hong Kong Hong Kong China

We investigated the prostate cancer detection rates upon transrectal ultrasound （TRUS）-guided biopsy in relation to digital rectal examination （DRE） and prostate-specific antigen （PSA）, and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of 〈 4, 4-10, 10.1-20, 20.1-50 and 〉 50 ng ml^-1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA 〈 4, 4-10, 10.1-20, 20.1-50 and 〉 50 ng ml^-1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA 〈 4, 4-10, 10.1-20, 20.1-50 and 〉 50 ng m1-1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses （P 〈 0.001）. Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.

关键词： Chinese digital rectal examination prostate biopsy prostate cancer prostate-specific antigen

Genre Fiction; Science Fiction; The Quest for Utopia

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外国文学研究 2005年第6期27卷 36-40页

作者： charles N. Brown founder and editor-in-chief of Locus Publications USA 23-time Hugo winner

This paper will discuss the difference between genre fiction and mainstream fiction, the difference between science fiction and other fields of genre fiction, and in particular, the philosophical use of science fiction in our search for a better world. All genres used to be called ″romance″ to distinguish them from ″true″ novels. There were arguments about it in Hawthorne’s The House of Seven Gables and in a heated exchange between H.G. Wells and Henry james. I will talk about this difference. All genre fiction pays attention to the external world, but science fiction is the only one of them that looks forward by being grounded in the present. Is science fiction really a genre? There are some doubts. Science fiction is not about science per se, but about the philosophy of science:the study of the external world and its relation to man. It is ideal for ″thought experiments.″ By exploring possible futures, we cannot only examine our present world, but can see ways in which it can be improved. Hence, science fiction is the search for, if not utopia, then at least a better world. This paper will also discuss the ideas of Kim Stanley Robinson, Ursula K. Le Guin, and others in their search for a better future.

关键词：美国文学研究虚构小说科学小说

The performance characteristics of prostate-specific antigen and prostate-specific antigen density in Chinese men

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Asian Journal of Andrology 2017年第1期19卷 113-116页

作者： Jeremv YC Teoh Steffi KK Yuen james HL Tsu charles KW Wong Brian SH Ho Ada TL Ng Wai-Kit Ma Kwan-Lun Ho Ming-Kwong Yiu Division of Urology Department of Surgery Queen Mary Hospital University of Hong Kong Hong Kong China

We investigated the performance characteristics of prostate-specific antigen （PSA） and PSA density （PSAD） in Chinese men. All Chinese men who underwent transrectal ultrasound-guided prostate biopsy （TRUS-PB） from year 2000 to 2013 were included. The receiver operating characteristic （ROC） curves for both PSA and PSAD were analyzed. The sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） at different cut-off levels were calculated. A total of 2606 Chinese men were included. For the ROC, the area under curve was 0.770 for PSA （P〈 0.001） and 0.823 for PSAD （P〈 0.001）. PSA of 4.5 ng ml^-1 had sensitivity of 94.4%, specificity of 14.1%, PPV of 29.5%, and NPV of 86.9%; PSAD of 0.12 ng ml^-1cc^-1 had sensitivity of 94.5%, specificity of 26.6%, PPV of 32.8%, and NPV of 92.7%. On multivariate logistic regression analyses, PSA cut-off at 4.5 ng ml^-1 （OR 1.61, 95% CI 1.05-2.45, P = 0.029） and PSAD cut-off at 0.12 ng ml^-1 cc^-1 （OR 6.22, 95% CI 4.20-9.22, P 〈 0.001） were significant predictors for prostate cancer detection on TRUS-PB. In conclusion, the performances of PSA and PSAD at different cut-off levels in Chinese men were very different from those in Caucasians. PSA of 4.5 ng ml^-1 and PSAD of O. 12 ng ml^-1 cc^-1 had near 95% sensitivity and were significant predictors of prostate cancer detection in Chinese men.

关键词： Chinese prostate cancer transrectal ultrasound-guided prostate biopsy prostate-specific antigen prostate-specific antigen density