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Long-term safety of laser in situ keratomileusis in eyes with thin corneas： 5-year follow-up

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International Journal of Ophthalmology(English edition) 2018年第7期11卷 1227-1233页

作者： Yao-Wen Song Rui He Jack X.Ma douglas D.Koch Li Wang Beijing Tongren Eye Center Beijing Tongren HospitalCapital Medical University Beijing Ophthalmology and VisualScience Key Laboratory Beijing 100730 China Shanxi Eye hospital Taiyuan 030002 Shanxi ProvinceChina Mc Govern Medical School University of Texas Health Science Center at Houston TX 75835 USA Cullen Eye Institute Department of Ophthalmology Baylor College of Medicine Houston TX 75844 USA

AIM： To investigate the long term（≥5 y） efficacy, predictability, and safety of laser in situ keratomileusis（LASIK） in eyes with thin corneas [central corneal thickness（CCT）〈500 μm]. METHODS： A total of 339 patients met the criteria of this study. Finally, 175 eyes of 89 patients who had thin corneas and underwent LASIK≥5 y ago returned to our clinic and included in this study. Preoperative parameters recorded included uncorrected visual acuity（UCVA）, corrected distance visual acuity（CDVA）, manifest refraction, CCT and corneal topography. At returning visits, in addition to visual acuity and manifest refraction, ultrasound CCT and corneal topography were performed. Optical coherence tomography was used to measure the CCT, LASIK flap thickness, and residual stromal bed thickness（RSBT）. Safety index, efficacy index, percentage of eyes within ±0.5 D and ±1.0 D of refraction, percent tissue altered（PTA）, and percentage stromal bed thickness（PSBT） were calculated. RESULTS： The safety index was 1.09 and efficacy index was 0.99. The percentages of eyes within ±0.5 D and ±1.0 D were 71.2% and 87.7%, respectively. The mean PTA was 40%±6%（range 20% to 55%）; 76 eyes（43.4%） had PTA 〈40% and 99 eyes（56.6%） had PTA≥40%. The mean RSBT was 303±27 μm（range 240 to 390 μm）, and 2 eyes had RSBT〈250 μm. The mean PSBT was 61%±9%（range 51% to 85%）. No eyes developed ectasia. CONCLUSION： In this cohort with the PSBT of 50% or more, LASIK is safe with follow-up for at least 5 y.

关键词： LASIK thin cornea long-term safety percent tissue altered percentage stromal bed thickness

Gastric Perforation in a 28-Month-Old Child: Complicated by Peritonitis Admitted to the Surgical Emergency Room after a Case

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Open Journal of Emergency Medicine 2020年第4期8卷 118-124页

作者： Abdoulaye Touré Fofana Naby Amadou Yalla Camara Joseph Donamou Boubacar Atigou Dramé Oularé Ibrahima Camara M’mah Lamine Bangoura Almamy Camara Mariama Mohamed Emile Camara Godwe Justin Naibe Anesthesia-Intensive Care Unit at the National Ignace Deen hospital Conakry Guinea General Surgery Department of the National Ignace Deen hospital Conakry Guinea Anesthesia-Intensive Care Unit at the Donka National hospital Conakry Guinea

We report the case of a 28-month-old male child with no particular history who was admitted to the emergency room for severe abdominal pain associated with vomiting, asthenia and fever at 39.1˚C that had progressed for 4 days. He was conscious, polypneic at 32 cycles/min on admission. On palpation the abdomen was distended, painful as a whole, more pronounced in the epigastrium. There was abdominal contracture, generalized defense, a cry with sudden decompression of the umbilicus. On abdominal auscultation, there was a disappearance of prehepatic dullness, a decrease in the dullness of the flanks and absence of hydro-aeric noises. On the digital rectal examination, douglas’s cul de sac was bulging and sensitive. An unprepared X-ray of the abdomen revealed diffuse grayness, lateral gas crescent pneumoperitoneum under diaphragm. The preoperative resuscitation consisted of the placement of a nasogastric tube, a urinary catheter, a peripheral venous route and the fluid electrolyte rebalancing adapted according to the blood ionogram, early antibiotic therapy with broad aero and anaerobic spectrum. Surgical management under general anesthesia found at laparotomy a perforation of the anterior surface of the duodenal bulb which we estimate to be 1 cm in diameter with fibrin deposits. The gesture was the toilet of the peritoneal cavity;suture of the bank and the operative consequences were simple.

关键词： Resuscitation Gastric Perforation Child Peritonitis Ignace Deen

An exploration of the relationship between wastewater viral signals and COVID-19 hospitalizations in Ottawa,Canada

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Infectious Disease Modelling 2023年第3期8卷 617-631页

作者： K.Ken Peng Elizabeth M.Renouf Charmaine B.Dean X.Joan Hu Robert Delatolla douglas G.Manuel Department of Statistics and Actuarial Science Simon Fraser University8888 University DrBurnabyV5A 1S6BCCanada Department of Statistics and Actuarial Science University of Waterloo200 University Ave WWaterlooN2L 3G1ONCanada Department of Civil Engineering University of Ottawa75 Laurier Ave.EOttawaK1N 6N5ONCanada The Ottawa hospital research Institute 1053 Carling AveOttawaK1Y 4E9ONCanada Department of Family Medicine University of Ottawa75 Laurier Ave.EOttawaK1N 6N5ONCanada School of Epidemiology and Public Health University of Ottawa75 Laurier Ave.EOttawaK1N 6N5ONCanada

Monitoring of viral signal in wastewater is considered a useful tool for monitoring the burden of COVID-19,especially during times of limited availability in *** have shown that COVID-19 hospitalizations are highly correlated with wastewater viral signals and the increases in wastewater viral signals can provide an early warning for increasing hospital *** association is likely nonlinear and *** project employs a distributed lag nonlinear model(DLNM)(Gasparrini et al.,2010)to study the nonlinear exposure-response delayed association of the COVID-19 hospitalizations and SARS-CoV-2 wastewater viral signals using relevant data from Ottawa,*** consider up to a 15-day time lag from the average of SARS-CoV N1 and N2 gene concen-trations to COVID-19 *** expected reduction in hospitalization is adjusted for vaccination efforts.A correlation analysis of the data verifies that COVID-19 hospital-izations are highly correlated with wastewater viral signals with a time-varying *** DLNM based analysis yields a reasonable estimate of COVID-19 hospitalizations and enhances our understanding of the association of COVID-19 hospi-talizations with wastewater viral signals.

关键词： Wastewater surveillance COVID-19 vaccination effectiveness Distributed lag nonlinear model Time varying correlation

Multiparameteric PET-MR Assessment of Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer: PET, MR, PET-MR and Tumor Texture Analysis: A Pilot Study

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Advances in Molecular Imaging 2015年第3期5卷 49-60页

作者： Ur Metser Kartik S. Jhaveri Grainne Murphy Jaydeep Halankar douglas Hussey Paul Dufort Erin Kennedy Joint Department of Medical Imaging University Health Network Mount Sinai Hospital and Women’s College Hospital University of Toronto Toronto Canada Division of General Surgery University Health Network & Mount Sinai Hospital University of Toronto Toronto Canada

Purpose: Patients with locally advanced rectal cancer (LARC) achieving pathologic complete response (pCR) to neoadjuvant chemoradiotherapy (CRT) have significantly improved long term survival. Preoperative detection of pCR may enable a conservative therapeutic approach in some patients. The purpose of the current prospective pilot study was to assess multiparametric qualitative and quantitative MR, PET, PET-MR and tumor texture features in predicting pCR to CRT in patients with LARC. Material and Methods: Eighteen LARC patients underwent staging with FDG-PET and MR-rectum and 15 had post-CRT restaging. Response was assessed qualitatively and quantitatively. SUV (tumor/background), SUV/ADC, and tumor texture parameters derived via machine learning algorithms (MLA) from PET and multiple MR sequences and were correlated with histopathology. Results: A third of patients had pCR. Sensitivity, specificity & accuracy of PET, MR and combined PET-MR were 90, 60, & 80;90, 20 & 66.7;90, 80 & 86.7, respectively. Differences did not reach statistical significance. Quantitatively, only tumor-muscle (SUV/ADC) ratio improved prediction of pCR. Of all texture features assessed using MLA, only the classifier trained on pre-treatment PET was significant (p = 0.034;accuracy, 92.8%). Combined PET and MR texture features did not improve performance. Conclusion: Combined PET-MR may improve specificity compared with PET or MR alone, although this needs to be validated in a larger cohort. Tumor to muscle SUV/ADC ratios post-therapy and texture features on baseline PET show promise in improving prediction of pCR post-CRT in LARC.

关键词： FDG PET-MR Therapy Response Rectal Cancer Radiomics

Foreign body granulomas mimic peritoneal dissemination caused by incarcerated femoral hernia perforation:A case report

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World Journal of Clinical Oncology 2021年第11期12卷 1083-1088页

作者： Shinpei Ogino Tatsuya Matsumoto Yosuke Kamada Noriaki Koizumi Hiroshi Fujiki Kenji Nakamura Takeshi Yamano Chouhei Sakakura Department of Surgery Akashi City HospitalAkashi 673-8501HyogoJapan Department of Pathology Akashi City HospitalAkashi 673-8501HyogoJapan

BACKGROUND Foreign body granuloma(FBG)is a well-known type of granulomatous formation,and intraabdominal FBG(IFBG)is primarily caused by surgical *** IFBGs caused by gastrointestinal perforation is an extremely rare and interesting clinicopathological condition that resembles peritoneal ***,we present a case of IFBGs mimicking peritoneal dissemination caused by bowel perforation and describe the value of intraoperative pathological examinations for rapid IFBG *** SUMMARY An 86-year-old woman with an incarcerated femoral hernia was admitted to the hospital and underwent *** the operation,the incarcerated ileum was perforated during repair due to hemorrhage necrosis,and a small volume of enteric fluid leaked from the *** incarcerated ileum was resected,and the femoral hernia was repaired without *** months later,a second operation was performed for an umbilical incisional *** the second operation,multiple small,white nodules were observed throughout the abdominal cavity,resembling peritoneal *** results of peritoneal washing cytology in douglas’pouch and the examination of frozen nodule sections were compatible with IFBG diagnosis,and incisional hernia repair was *** IFBGs can mimic *** pathological examinations and operation history are valuable for the rapid diagnosis to avoid excessive treatments.

关键词： Foreign body granuloma Peritoneal dissemination Peritoneal seeding Perforation Operation Case report

A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome

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Asian Journal of Andrology 2017年第1期19卷 80-90页

作者： Luke Simon Armand Zini Alina Dyachenko Antonio Ciampi douglas T Carrell Department of Surgery (Urology) University of Utah School of Medicine Salt Lake City UT USA Division of Urology Department of Surgery St. Mary's Hospital Center St. Mary's Hospital 3830 Lacombe Avenue Montreal Quebec H3T 1M5 Canada Department of Human Genetics University of Utah School of Medicine Salt Lake City UT USA Department of Obstetrics and Gynecology University of Utah School of Medicine Salt Lake City UT USA.

Sperm DNA damage is prevalent among infertile men and is known to influence natural reproduction. However, the impact of sperm DNA damage on assisted reproduction outcomes remains controversial. Here, we conducted a meta-analysis of studies on sperm DNA damage （assessed by SCSA, TUNEL, SCD, or Comet assay） and clinical pregnancy after IVF and/or ICSI treatment from MEDLINE, EMBASE, and PUBMED database searches for this analysis. We identified 41 articles （with a total of 56 studies） including 16 IVF studies, 24 ICSI studies, and 16 mixed （IVF ＋ ICSI） studies. These studies measured DNA damage （by one of four assays： 23 SCSA, 18 TUNEL, 8 SCD, and 7 Comet） and included a total of 8068 treatment cycles （3734 IVF, 2282 ICSI, and 2052 mixed IVF ＋ ICSI）. The combined OR of 1.68 （95% Ch 1.49-1.89; P 〈 0.0001） indicates that sperm DNA damage affects clinical pregnancy following IVF and/or ICSI treatment. In addition, the combined OR estimates of IVF （16 estimates, OR = 1.65; 95% CI： 1.34-2.04; P 〈 0.0001）, ICSI （24 estimates, OR = 1.31; 95% Ch 1.08-1.59; P = 0.0068）, and mixed IVF ＋ ICSI studies （16 estimates, OR = 2.37; 95% Ch 1.89-2.97; P〈 0.0001） were also statistically significant. There is sufficient evidence in the existing literature suggesting that sperm DNA damage has a negative effect on clinical pregnancy following IVF and/or ICSI treatment.

关键词： assisted reproductive technology outcomes clinical pregnancy meta-analysis sperm DNA damage systematic review

Targeted Ptpn11 deletion in mice reveals the essential role of SHP2 in osteoblast differentiation and skeletal homeostasis

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Bone research 2021年第1期9卷 75-85页

作者： Lijun Wang Huiliang Yang Jiahui Huang Shaopeng Pei Liyun Wang Jian Q.Feng Dian Jing Hu Zhao Henry M.Kronenberg douglas C.Moore Wentian Yang Department of Orthopedic Surgery Brown University Alpert Medical School and Rhode Island HospitalProvidenceRI 02903USA Department of Mechanical Engineering University of DelawareNewarkDE DE19716USA Department of Biomedical Sciences Texas A&M College of Dentistry3302 Gaston AveDallasTX 75246USA Department of Comprehensive Dentistry Texas A&M College of Dentistry3302 Gaston AveDallasTX 75246USA Endocrine Unit Massachusetts General Hospital and Harvard Medical SchoolBostonMA 02114USA

The maturation and function of osteoblasts(OBs)rely heavily on the reversible phosphorylation of signaling *** date,most of the work in OBs has focused on phosphorylation by tyrosyl kinases,but little has been revealed about dephosphorylation by protein tyrosine phosphatases(PTPases).SHP2(encoded by PTPN11)is a ubiquitously expressed ***11 mutations are associated with both bone and cartilage manifestations in patients with Noonan syndrome(NS)and metachondromatosis(MC),although the underlying mechanisms remain ***,we report that SHP2 deletion in bone gamma-carboxyglutamate protein-expressing(Bglap+)bone cells leads to massive osteopenia in both trabecular and cortical bones due to the failure of bone cell maturation and enhanced osteoclast activity,and its deletion in Bglap+chondrocytes results in the onset of enchondroma and osteochondroma in aged mice with increased tubular bone ***,SHP2 was found to be required for osteoblastic differentiation by promoting RUNX2/OSTERIX signaling and for the suppression of osteoclastogenesis by inhibiting STAT3-mediated RANKL production by osteoblasts and *** findings are likely to explain the compromised skeletal system in NS and MC patients and to inform the development of novel therapeutics to combat skeletal disorders.

关键词： skeletal homeostasis SHP2

Ameta-analysis on efficacy and safety:single-balloon ***-balloon enteroscopy

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Gastroenterology Report 2015年第2期3卷 148-155页

作者： Vaibhav Wadhwa Saurabh Sethi Sumeet Tewani Sushil Kumar Garg douglas K.Pleskow Ram Chuttani Tyler M.Berzin Nidhi Sethi Mandeep S.Sawhney Department of Internal Medicine Fairview HospitalCleveland ClinicClevelandOHUSA Division of Gastroenterology Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMAUSA Division of Basic and Translational research Department of SurgeryUniversity of MinnesotaMinneapolisMNUSA

Background and aim:Double-balloon enteroscopy(DBE)and single-balloon enteroscopy(SBE)are new techniques capable of providing deep *** of individual studies comparing these techniques have not been able to identify a superior *** aim was to systematically pool all available studies to compare the efficacy and safety of DBE with SBE for evaluation of the small ***:Databases were searched,including PubMed,Embase,and the Cochrane Central Register of Controlled *** main outcome measures were complete small-bowel visualization,diagnostic yield,therapeutic yield,and complication *** analysis was performed using Review Manager(RevMan version 5.2).Meta-analysis was performed using fixed-effect or random-effect methods,depending on the absence or presence of significant *** used the v2 and I2 test to assess heterogeneity between *** were expressed as risk ratios(RR)or mean differences with 95%confidence intervals(CI).Results:Four prospective,randomized,controlled trials with a total of 375 patients were *** was superior to SBE for visualization of the entire small bowel[pooled RR=0.37(95%CI:0.19–0.73;P=0.004)].DBE and SBE were similar in ability to provide diagnosis[pooled RR=0.95(95%CI:0.77–1.17;P=0.62)].There was no significant difference between DBE and SBE in therapeutic yield[pooled RR=0.78(95%CI:0.59–1.04;P=0.09)]and complication rate[pooled RR=1.08(95%CI:0.28–4.22);P=0.91].Conclusions:DBE was superior to SBE with regard to complete small bowel *** was similar to SBE with regard to diagnostic yield,ability to provide treatment and complication rate,but these results should be interpreted with caution as they is based on very few studies and the overall quality of the evidence was rated as low tomoderate,due to the small sample size.

关键词： small bowel enteroscopy single-balloon enteroscopy double-balloon enteroscopy meta-analysis outcomes

Safety and effectiveness of robot-assisted radical prostatectomy by retzius sparing approach: a systematic review and meta-analysis

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Safety and effectiveness of robot-assisted radical prostatec...