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Recurrent gastric neuroendocrine tumors treated with total gastrectomy

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World Journal of gastroenterology 2015年第46期21卷 13195-13200页

作者： Myounghwa Jung Jung-Wook Kim Jae-Young Jang Young Woon Chang Sun Hee Park Yong Ho Kim Youn Wha Kim Department of internal medicine College of MedicineKyung Hee University Department of Surgery College of MedicineKyung Hee University Department of Pathology College of MedicineKyung Hee University

Gastric neuroendocrine tumors are rare; however,the incidence has recently increased due to the increasing use of upper endoscopy. Neuroendocrine tumors arise from the excess proliferation of enterochromaffinlike(ECL) cells. The proliferative changes of enterochromaffin cells evolve through a hyperplasiadysplasia-neoplasia sequence that is believed to underlie the pathogenesis of gastric neuroendocrine tumors. Endoscopic resection is recommended as the initial treatment if the tumor is not in an advanced stage. However,there is no definite guideline for the treatment of recurrent gastric neuroendocrine tumors following endoscopic resection. Here,we report a rare case of gastric neuroendocrine tumors in a 56-yearold male who experienced two recurrences within 11 years after endoscopic resection. The patient finally underwent a total gastrectomy. The pathological features of the resected stomach exhibited the full hyperplasia-dysplasia-neoplasia sequence of the ECL cells in a single specimen.

关键词： Neuroendocrine tumor Hyperplasia of neuroendocrine

Cancer prevention in patients with human immunodeficiency virus infection

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World Journal of Clinical Oncology 2018年第5期9卷 71-73页

作者： Evripidis Valanikas Konstantinos Dinas Konstantinos Tziomalos First Propedeutic Department of internal medicine Medical School Aristotle University of Thessaloniki AHEPA Hospital Second Department of Obstetrics and Gynecology Medical School Aristotle University of Thessaloniki Hippokration Hospital

Cancer is a leading cause of death in patients with human immunodeficiency virus(HIV) infection. With the advent of antiretroviral treatment, the risk of AIDS-defining cancers declined but the ageing of this population resulted in the emergence of other common cancers, particularly lung and hepatocellular cancer. Accordingly, screening programs similar to the general population should be implemented in patients with HIV infection. Vaccination against common oncogenic viruses is also essential. However, rates of cancer screening and vaccination against HPV and HBV are considerably low in this population, highlighting a pressing need to educate patients and healthcare professionals about the importance of cancer preventive measures in these vulnerable patients.

关键词： Antiretroviral treatment Prevention Human immunodeficiency virus infection Cancer Vaccination

Hospitalizations for alcoholic liver disease during the COVID-19 pandemic increased more for women,especially young women,compared to men

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World Journal of Hepatology 2023年第2期15卷 282-288页

作者： John Patterson Campbell Vinay Jahagirdar Adel Muhanna Kevin F Kennedy John H Helzberg Department of internal medicine Division of Gastroenterology and HepatologySaint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States Department of internal medicine Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States Division of Cardiology Saint Luke’s Health System of Kansas CityKansas CityMO 64111United States Department of internal medicine Division of Gastroenterology and HepatologyLiver Disease Management UnitSaint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States

BACKGROUND Alcoholic liver disease(ALD)remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare *** is evidence of increased alcohol consumption during the coronavirus disease 2019(COVID-19)pandemic,and the effect of this on the already burdened health systems remains *** To assess the trends for ALD admissions during the COVID-19 pandemic,and compare it to a similar pre-pandemic *** This retrospective study analyzed all admissions at a tertiary health care system,which includes four regional *** admissions were identified by querying a multi-hospital health system’s electronic database using ICD-10 *** admissions were compared for two one-year periods;pre-COVID-19 from April 2019 to March 2020,and during-COVID-19 from April 2020 to March *** were analyzed using a Poisson regression model and admission rates were compared using the annual quarterly average for the two time periods,with stratification by age and *** increase or decrease in admissions from the Poisson regression model were reported as incident rate *** One thousand three hundred and seventy-eight admissions for ALD were included.80.7%were Caucasian,and 34.3%were *** increase in the number of admissions for ALD during the COVID-19 pandemic was *** women,a sharp rise(33%)was noted in those below the age of 50 years,and an increase of 22%in those above 50 *** men,an increase of 24%was seen for those below 50 years,and a 24%decrease in those above 50 *** The COVID-19 pandemic has had widespread implications,and an increase in ALD admissions is just one of ***,given that women are often prone to rapid progression of ALD,this finding has important preventive health implications.

关键词： Alcoholic liver disease COVID-19 Alcoholic hepatitis Alcoholic liver cirrhosis Alcoholism Pandemic Young women Alcohol-related disorders

Comorbidity negatively influences prognosis in patients with extrahepatic cholangiocarcinoma

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World Journal of gastroenterology 2009年第42期15卷 5279-5286页

作者： Mario Fernández-Ruiz Juan-Manuel Guerra-Vales Francisco Colina-Ruizdelgado Department of internal medicine University Hospital "12 de Octubre"Avenue Córdobas/nUniversidad ComplutenseMadrid 28041Spain Hospital Tumor Registry University Hospital "12 de Octubre"Avenue Córdobas/nUniversidad ComplutenseMadrid 28041Spain

AIM:To study the outcome and prognostic factors in a series of patients with extrahepatic cholangiocarcinoma and determine the impact of comorbidity on ***:A retrospective analysis of 68 patients with extrahepatic cholangiocarcinoma(perihilar,n = 37;distal,n = 31) seen at a single tertiary-care institution during the period 1999-2003 was *** on presentation,management,and outcome were assessed by chart *** confirmation was obtained in 37 cases(54.4%) .Comorbidity was evaluated by using the Charlson comorbidity index(CCI) .RESULTS:Mean age at diagnosis was 73.4 ± 11.5 *** was the most common symptom presented(86.8%) .Median CCI score was 1(range,0 to 4) .Nineteen patients(27.9%) underwent tumor *** biliary drainage was performed in 39 patients(57.4%) ,and 6 patients(8.8%) received only best supportive ***-free margin status(R0) was achieved in 15 cases(78.9% of resection group) .Baseline serum carbohydrate antigen 19-9(CA 19-9) level was revealed to be an independent predictor of surgical treatment(P = 0.026) .Overall median survival was 3.1 ± 0.9 mo,with 1-and 2-year survival rates of 21% and 7%,*** the univariate analysis,tumor resection,CCI score,and serum CA 19-9 levels correlated significantly with *** the multivariate analysis,only resection(HR 0.10;95% CI,0.02-0.51,P = 0.005) and a CCI score ≥ 2(HR 3.36;95% CI,1.0-10.9,P = 0.045) were found to independently predict ***:Tumor resection and comorbidity emerged as significant prognostic variables in extrahepatic *** evaluation instruments should be applied in the clinical management of such patients.

关键词： Charlson index Cholangiocarcinoma Comorbidity Prognosis Survival

Association of CagA and VacA presence with ulcer and non-ulcer dyspepsia in a Turkish population

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World Journal of gastroenterology 2003年第7期9卷 1580-1583页

作者： Kantarceken Bulent Aladag Murat Atik Esin Koksal Fatih Harputluoglu MMMurat Harputluoglu Hakan Karincaoglu Melih Ares Mehmet Yildirim Bulent Hilmioglu Fatih Division of gastroenterology Medical FacultyInonu UniversityMalatyaTurkey Mustafa Kemal University Department of PathologyMedical FacultyHatayTurkey Department of Microbiology Medical Faculty Cukurova UniversityAdanaTurkey Department of internal medicine Medical FacultyInonu UniversityMalatyaTurkey

AIM:The mostly known genotypic virulence features,of *** are cytotoxin associated gene A (cagA) and Vacuolating cytotoxin gene A (VacA).We investigated the association of these major virulence factors with ulcer and non-ulcer dyspepsia in our region. METHODS:One hundred and forty two dyspeptic patients were studied (average age 44.8±15.9 years,range 15-87 years,64 males and 78 females).Antral and corpus biopsies were taken for detecting and genotyping of ***.107 patients who were *** positive by histological assessment were divided into three groups according to endoscopic findings:Duodenal ulcer (DU),gastric ulcer (GU) and non-ulcer dyspepsia (NUD).The polymerase chain reaction (PCR) was used to detect CagA and VacA genes of *** using specific primers. RESULTS:*** isolated from 75.4% (107/142) of the *** the 107 patients,66 (61.7%) were cagA- positive and 82 (76.6%) were *** gene was positively associated with DU and GU (P0.05).Although VacA positivity in ulcer patients was higher than that in NUD group,the difference was not statistically significant (P>0.05). CONCLUSION:There is a significantly positive association between CagA genes and DU and *** presence of VacA is not a predictive marker for DU,GU,and NUD in our patients.

关键词： Adolescent Adult Aged Aged, 80 and over Antigens, Bacterial Bacterial Proteins Biopsy Dyspepsia Female Genotype Helicobacter Infections Helicobacter pylori Humans Male Middle Aged Predictive Value of Tests Prevalence Stomach Ulcer Turkey Virulence

Bystander resuscitation of a near-drowning child in a rural south China township

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Family medicine and Community Health 2013年第4期1卷 45-47页

作者： Zhixin Wu Mingfeng He Qihong guo Minhua Kuang mergency Department Foshan Hospital of Traditional Chinese MedicineFoshanChina Department of internal medicine Foshan Hospital of Traditional Chinese MedicineFoshanChina

We report resuscitation of a near-drowning child by a bystander in a rural south China *** was performed on a 6-year-old,otherwise healthy boy who was witnessed drowning in a river,with submersion for approximately 12 *** several resuscitation attempts,spontaneous breathing was established at the scene and the boy was transferred to a nearby *** developed pneumonia but recovered completely on the ward and was discharged without any neurologic *** case shows that early bystander resuscitation is an important factor for survival after *** search for an ideal approach to resuscitation must continue,and all members of society must work together towards this goal.

关键词： Resuscitation Drowning Bystander cardiopulmonary resuscitation

Gastric polyps: Association with Helicobacter pylori status and the pathology of the surrounding mucosa, a cross sectional study

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World Journal of gastrointestinal Endoscopy 2015年第10期7卷 995-1002页

作者： Sherif Elhanafi Mohammed Saadi Wynee Lou Indika Mallawaarachchi Alok Dwivedi Marc Zuckerman Mohamed O Othman Division of gastroenterology Department of Internal Medicine Paul L.Foster School of Medicine Texas Tech University Health Sciences Center Division of Biostatistics and Epidemiology Department of Biomedical Sciences Paul L.Foster School of Medicine Texas Tech University Health Sciences Center gastroenterology and Hepatology Section Department of Internal Medicine Baylor College of Medicine

aim:To assess the endoscopic characteristics of gastric polyps and their association with Helicobacter pylori(***)status in a predominantly Hispanic population.m ETHODS:We conducted a retrospective study of all esophagogastroduodenoscopies performed at our ***,endoscopic and histopathological data were *** of patients into Hispanic and Non-Hispanic was based on *** without resection/biopsy were not included in the *** of polyps type was based on histological *** way analysis of variance was used to compare continuousvariables among different polyp types and Fisher’s exact test was used compare categorical variables among polyp *** and adjusted comparisons of demographic and clinical characteristics were performed according to the *** status and polyp type using logistic ***:Of 7090 patients who had upper endoscopy,335 patients had gastric polyps(4.7%).Resection or biopsy of gastric polyps was performed in 296 patients(88.4%)with a total of 442 polyps removed or *** 296 patients,87(29%)had hyperplastic polyps,82(28%)had fundic gland polyps and 5(1.7%)had adenomatous *** polyps were significantly associated with positive *** status compared with fundic gland polyps(OR=4.621;95%CI:1.92-11.13,P=0.001).Hyperplastic polyps were also found to be significantly associated with portal hypertensive gastropathy compared with fundic gland polyps(OR=6.903;95%CI:1.41-33.93,P=0.0174).Out of 296 patients,30(10.1%)had a followup endoscopy with a mean duration of 26±16.3 *** development of cancer was not noted in any of the patients during follow up *** ON:Gastric hyperplastic polyps were significantly associated with positive *** status and portal hypertensive gastropathy as compared with fundic gland polyps.

关键词： Gastric polyps Fundic gland polyp Hyperplasticpolyp Adenomatous polyps Chronic gastritis Helicobacter pylori

MicroRNA-31 expression in colorectal serrated pathway progression

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World Journal of gastroenterology 2014年第34期20卷 12346-12349页

作者： Hironori Aoki Katsuhiko Nosho Hisayoshi Igarashi Miki Ito Kei Mitsuhashi Takafumi Naito Eiichiro Yamamoto Tokuma Tanuma Masafumi Nomura Hiroyuki Maguchi Toshiya Shinohara Hiromu Suzuki Hiroyuki Yamamoto Yasuhisa Shinomura Center for gastroenterology Teine-Keijinkai HospitalSapporo 006-0811Japan Department of gastroenterology Rheumatology and Clinical ImmunologySapporo Medical University School of MedicineSapporo 060-8543Japan Department of gastroenterology Rheumatology andClinical ImmunologySapporo Medical University School of MedicineSapporo 060-8543Japan Department of Pathology Teine-KeijinkaiHospitalSapporo 006-0811Japan Department of Molecular Biology SapporoMedical University School of MedicineSapporo 060-8543Japan Division of gastroenterology and Hepatology Department of Internal MedicineSt. Marianna University School of MedicineKawasaki 216-8511Japan

MicroRNAs have been increasingly recognized as useful biomarkers for colorectal cancers(CRC).We have recently observed that microRNA-31(miR-31)expression is associated with BRAF mutation and prognosis in ***,high miR-31 expression is frequently detected in sessile serrated adenomas compared with hyperplastic polyps(HPs).These results suggest that miR-31 may contribute to the progression of serrated *** a follow-up colonoscopy,we observed the case of a 75-year-old man with a 7-mm flat-elevated lesion in the cecum and diagnosed the lesion as an early invasive carcinoma with serrated *** specimens were obtained from the representative areas to compare the molecular alterations in the carcinoma component with those in the HP *** miR-31 expression was observed in the carcinoma component(57-fold increase)and the HP component(8-fold increase)compared with the paired normal mucosa,suggesting that miR-31 may be one of the key molecules in serrated pathway progression.

关键词： BRAF Colorectal carcinoma MicroRNA-31 MLH1 microsatellite instability Serrated pathway

Disparities in employment outcomes among critical care graduates with different training backgrounds

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Emergency and Critical Care medicine 2023年第4期3卷 163-170页

作者： Greg J.Eisinger Patrick J.Sylvester Dheeraj Duggineni David P.Way Jing Peng Jiang Ma Jennifer W.McCallister Matthew C.Exline Division of Pulmonary Critical Care and Sleep medicine Department of Internal MedicineThe Ohio State University Wexner Medical CenterColumbusOHUSA Team Health KnoxvilleTNUSA Department of Emergency medicine The Ohio State University Wexner Medical CenterColumbusOHUSA Department of Biomedical Informatics The Ohio State UniversityColumbusOHUSA

Background:We sought to characterize the impact of critical care training pathways on subsequent employment ***:A survey assessing the postfellowship work environment and barriers to employment in a preferred setting was electronically distributed on September 16,2019,to program directors and coordinators at all US adult critical care fellowships with instructions to for-ward it to the prior year’s ***:Data collection was interrupted by the coronavirus disease 2019 ***-nine participants were included,reflecting a low rate of *** worked in urban areas(76.6%)at academic hospitals(81.7%).Graduates of internal medicine critical care(IMCC)were more likely than pulmonary critical care(PCC)to report their fellowship as a barrier to employment(50%vs 0%;Pmedicine graduates were more likely than internal medicine to report their residency as a barrier to employment(83.3%vs 4.6%;Pmedicine and fellowship in IMCC were associated with in-creased barriers to finding desired employment.

关键词： Bias Critical care Critical care workforce Employment medicine Employment barriers Employment opportunities Fellowship training Job market Residency training