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Characteristics, management, and outcome of squamous carcinoma of the conjunctiva in a single tertiary cancer center in Jordan

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International Journal of Ophthalmology(English edition) 2018年第7期11卷 1132-1138页

作者： Ata Rajeh Fareed Barakat Samer Khurma Khaleel Al Rawashdeh Osama H.Ababneh Ibrahim AlNawaiseh Mustafa Mehyar Ghadeer Abdeen Imad Jaradat Mona Mohammad Yacoub A.Yousef Department of Surgery (Ophthalmology) King Hussein Cancer Centre (KHCC) Department of Pathology King Hussein Cancer Centre (KHCC) Department of Ophthalmology The University of Jordan and Jordan University Hospital Department of Medical Oncology King Hussein Cancer Centre (KHCC) Department of Radiation Oncology King Hussein Cancer Centre (KHCC)

AIM： To evaluate the features and outcome of management of malignant conjunctival squamous tumors in king Hussein Cancer Center（a referral tertiary cancer center in the Middle East）. METHODS： Retrospective case series of 31 eyes for 31 patients with conjunctival squamous neoplasia. Main outcome measures included： age, gender, laterality, tumor location, pathological features, tumor stage, treatment modality, and outcome. RESULTS： Twenty（65%） patients were males and median age was 58 y. Twenty-two（71%） eyes had the tumor in the nasal quadrant. Tumor invasion to nearby structures was seen in 19（61%） eyes, including the cornea, fornix, eyelid, and orbit in 17（55%）, 1（3%）, 2（6%）, and 3（10%） eyes, respectively. Eye salvage was achieved by surgical excision with cryotherapy followed by topical chemotherapy in 28（90%） eyes, and orbital exenteration was necessary in 3（10%） eyes due to orbital tumor invasion. Tumor recurrence was seen in 7（23%） eyes, and the significant predictive factors for recurrence were tumor extension onto the nearby structures（P=0.04）, tumor invasiveness（P=0.038）, and tumor TNM stage（P=0.031）. No significant change in visual acuity was seen, and disease related mortality was 6%（2 patients, both had orbital invasion by invasive squamous carcinoma）. CONCLUSION： Conjunctival squamous carcinoma is more common in males. Advanced American Joint Committee on Cancer（AJCC） T-stage, tumor local invasion, more pathologically aggressive tumors, and surgical treatment alone（without adjuvant therapy） are associated with higher risk for recurrence, and orbital invasion is the most important poor prognostic factor for metastasis and death. Treatment strategies should be affected by tumor characteristics at presentation.

关键词： conjunctiva squamous cell carcinoma metastasis

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Aberrant bile duct communicating with the cystic duct:From early detection to management of late surgical complications

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 412-416页

作者： Phonthep Angsuwatcharakon Pradermchai Kongkam Wiriyaporn Ridtitid Panida Piyachaturawat Phuphat Vongwattanakit Prooksa Ananchuensook Natee Faknak Kunvadee Vanduangden Rungsun Rerknimitr Department of Anatomy Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand Division of Gastroenterology Department of MedicineFaculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand Department of Surgery Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkokThailand Center of Excellence for Innovation and Endoscopy in Gastrointestinal Oncology Faculty of MedicineChulalongkorn UniversityBangkokThailand

The aberrant hepatic duct is classified by Huang et al.[1]into type A(right intrahepatic duct variant)and type B(left intrahepatic duct variant).Type A and B are further classified into 5(A1-5)and 6(B1-6)subtypes,*** variation of cystic duct involves only in type *** A1 or classic arrangement refers to the formation of the common hepatic duct(CHD)by the left hepatic duct(LHD)and the right hepatic duct(RHD).The RHD has two tributaries composed of the right anterior hepatic duct(RAHD)and the right posterior hepatic duct(RPHD).Then,the common bile duct(CBD)is formed when the cystic duct joins with the CHD(Fig.1).Type A2 refers to the RAHD and RPHD joining with LHD at hepatic hilum,and the absence of the *** A3 refers to the RAHD or RPHD directly draining to the *** A4 refers to the RAHD or RPHD directly draining to the *** A5 refers to the RAHD,RPHD or RHD directly draining to the cystic duct(or aberrant bile duct communicating with the cystic duct,ACC)(Fig.1)[1].

关键词： bile hepatic RPH

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Probe based confocal laser endomicroscopy of the pancreatobiliary system

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World Journal of Gastroenterology 2015年第44期21卷 12696-12708页

作者： Majid A Almadi Helmut Neumann Division of Gastroenterology Department of Medicine King Saud University Medical City King Saud University Division of Gastroenterology The Mc Gill University Health Center Montreal General Hospital Mc Gill University Department of Medicine I University of Erlangen-Nuremberg

AIM:To review applications of confocal laser endomicroscopy(CLE) in pancreatobiliary lesions and studies that assessed training and interpretation of images. METHODS: A computerized literature search was performed using OVID MEDLINE, EMBASE, Cochrane library, and the ISI Web of Knowledge from 1980 to October 2014. We also searched abstracts from major meetings that included the Digestive Disease Week, Canadian Digestive Disease Week and the United European Gastroenterology Week using a combination of controlled vocabulary and text words related to p CLE, confocal, endomicroscopy, probe-based confocal laser endomicroscopy, and bile duct to identify reports of trials. In addition, recursive searches and crossreferencing was performed, and manual searches of articles identified after the initial search was also completed. We included fully published articles and those in abstract form. Given the relatively recent introduction of CLE we included randomized trials and cohort studies.R E S U LT S : In the evaluation of indeterminate pancreatobiliary strictures CLE with ERCP compared to ERCP alone can increase the detection of cancerous strictures with a sensitivity of(98% vs 45%) andhas a negative predictive value(97% vs 69%), but decreased the specificity(67% vs 100%) and the positive predictive value(71% vs 100%) when compared to index pathology. Modifications in the classification systems in indeterminate biliary strictures have increased the specificity of p CLE from 67% to 73%. In pancreatic cystic lesions there is a need to develop similar systems to interpret and characterize lesions based on CLE images obtained. The presence of superficial vascular network predicts serous cystadenomas accurately. Also training in acquiring and interpretation of images is feasible in those without any prior knowledge in CLE in a relatively simple manner and computer-aided diagnosis software is a promising innovation. CONCLUSION: The role of p CLE in the evaluation of pancreatobilia

关键词： Probe based confocal laser endomicroscopy Confocal

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Autoimmune hepatitis in human immunodeficiency virus-infected patients: A case series and review of the literature

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World Journal of Gastroenterology 2019年第35期25卷 5388-5402页

作者： Roongruedee Chaiteerakij Anapat Sanpawat Anchalee Avihingsanon Sombat Treeprasertsuk Department of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok 10330 Thailand Department of Pathology Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok 10330 Thailand Medical Department The HIV Netherlands Australia Thailand Research Collaboration Bangkok 10330 Thailand

BACKGROUND Abnormal liver chemistry is a common problem in human immunodeficiency virus (HIV)-infected patients. Common causes of abnormal liver enzymes in this population include viral hepatitis B/C or opportunistic infection, drug toxicity, and neoplasm. Autoimmune hepatitis is a rare cause of hepatitis in HIV-infected individuals;however, this condition has been increasingly reported over the past few years. CASE SUMMARY We present 13 HIV-infected patients (5 males and 8 females) who developed autoimmune hepatitis (AIH) after their immune status was restored, i.e. all patients had stable viral suppression with undetectable HIV viral loads, and median CD4+ counts of 557 cells/× 106 L. Eleven patients presented with chronic persistent elevation of aminotransferase enzyme levels. One patient presented with acute hepatitis and the other patient presented with jaundice. The median levels of aspartate aminotransferase and alanine aminotransferase enzymes were 178 and 177 U/mL, respectively. Elevation of immunoglobulin G levels was present in 11 (85%) patients. Antinuclear antibody and anti-smooth muscle antibody were positive in 11 (85%) and 5 (38%) patients. Liver biopsy was performed in all patients. They had histopathological findings compatible with AIH. The patients were started on prednisolone for remission induction, with good response. After improvement of the liver chemistry, the dose of prednisolone was tapered, and azathioprine was added as life-long maintenance therapy. At the last follow-up visit, all were doing well, without HIV viral rebound or infectious complications. CONCLUSION This report underscores the emergence of autoimmune hepatitis in the context of HIV infection.

关键词： Autoimmune hepatitis Human immunodeficiency virus Liver biopsy Immunosuppression Autoimmunity Antiretroviral therapy Case report

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Pigmented well-differentiated hepatocellular neoplasm with β-catenin mutation

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Hepatobiliary & Pancreatic Diseases International 2015年第6期14卷 660-664页

作者： Lara Neves Souza Rodrigo Bronze de Martino Richard Thompson Sandra Strautnieks Nigel D Heaton Alberto Quaglia Institute of Liver Studies King's College Hospital Department of Gastroenterology Discipline of Liver and Gastrointestinal TransplantationHospital das ClínicasUniversity of S?o Paulo

ABSTRACT： According to the most recent WHO classification of hepatocellular adenomas, a small percentage of inflammatory hepatocellular adenomas presents with mutation in the β-catenin gene and are at higher risk of malignant transformation. It has been recognized that adenoma-like hepatocellular neoplasms with focal atypia, or in unusual clinical context present with similar cytogenetic and immunohistochemistry characteristics to well-differentiated hepatocellular carcino- mas.

关键词： hepatocellular adenoma hepatocellular carcinoma β-catenin glutamine synthetase diethylstilbestrol

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Giant cavernous liver hemangiomas： is it the time to change the size categories？

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Hepatobiliary & Pancreatic Diseases International 2016年第1期15卷 21-29页

作者： isidoro di carlo renol koshy saif al mudares annalisa ardiri gaetano bertino adriana toro departments of general surgery hamad general hospitalDohaQatar department of surgical sciences and advanced technologies"g.f.ingrassia" university of cataniaCataniaItaly hepatology unit department of medical and pediatric scienceuniversity of cataniaCataniaItaly department of surgery patti hospitalMessinaItaly

BACKGROUND： Four different sizes （4, 5, 8 and 10 cm in diameter） can be found in the literature to categorize a liver hemangioma as giant. The present review aims to clarify the appropriateness of the size category ＂giant＂ for liver heman- gioma. DATA SOURCES： We reviewed the reports on the categoriza- tion of hemangioma published between 1970 and 2014. The number of hemangiomas, size criteria, mean and range of hemangioma sizes, and number of asymptomatic and symp- tomatic patients were investigated in patients aged over 18 years. Liver hemangiomas were divided into four groups：〈5.0 cm, 5.0-9.9 cm, 10.0-14.9 cm and 〉15.0 cm in diameter. Inclu- sion criteria were noted in 34 articles involving 1972 （43.0%） hemangiomas （〉4.0 cm）. RESULTS： The patients were divided into the following groups： 154 patients （30.0%） with hemangiomas less than 5.0 cm in diameter （small）, 182 （35.5%） between 5.0 cm and 9.9 cm （large）, 75 （14.6%） between 10.0 and 14.9 cm （giant）, and 102 （19.9%） more than 15.0 cm （enormous）. There were 786 （39.9%） asymptomatic patients and 791 （40.1%） symptomatic patients. Indications for surgery related to symptoms were reported in only 75 （3.8%） patients. Operations including 137 non-anatomical resection （12.9%） and 469 enudeation （44.1%） were undearly related to size and ***： The term ＂giant＂ seems to be justified for liver hemangiomas with a diameter of 10 cm. Hemangiomas categorized as ＂giant＂ are not indicated for surgery. Surgery should be performed only when other symptoms are apparent.

关键词： giant hemangioma cavernous hemangioma liver hemangioma

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Resistin is not an appropriate biochemical marker to predict severity of acute pancreatitis:A case-controlled study

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World Journal of Gastroenterology 2014年第41期20卷 15351-15357页

作者： Hamdi Al-Maramhy Abdelrahman I Abdelrahman Samer Sawalhi Department of Surgery College of MedicineTaibah University Department of Radiology King Fahd Hospital Department of Surgery College of Medicine-Dalhousie University

AIM: To assess levels of serum resistin upon hospital admission as a predictor of acute pancreatitis (AP) severity.

关键词： Acute pancreatitis Resistin Body mass index Waist circumference

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Forward-viewing radial-array echoendoscope for staging of colon cancer beyond the rectum

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World Journal of Gastroenterology 2014年第10期20卷 2681-2687页

作者： Pradermchai Kongkam Sittikorn Linlawan Satimai Aniwan Narisorn Lakananurak Suparat Khemnark Chucheep Sahakitrungruang Jirawat Pattanaarun Supakij Khomvilai Naruemon Wisedopas Wiriyaporn Ridtitid Manoop S Bhutani Pinit Kullavanijaya Rungsun Rerknimitr Gastrointestinal Endoscopy Excellent Center Department of Medicine King Chulalongkorn Memorial Hospital Chulalongkorn University Bangkok 10330 Thailand Department of Surgery King Chulalongkorn Memorial Hospital Chulalongkorn University Bangkok 10330Thailand Department of Pathology King Chulalongkorn Memorial Hospital Chulalongkorn UniversityBangkok 10330 Thailand Department of Gastroenterology Hepatology and Nutrition-Unit UT MD Anderson Cancer Center Houston TX 77030 United States

AIM: To evaluate feasibility of the novel forward-viewing radial-array echoendoscope for staging of colon cancer beyond rectum as the first series.

关键词： Colon cancer Neoplasm Colon Endoscopic ultrasound Neoadjuvan therapy Staging Forward-viewing Colonoscopy

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Intestinal carriage of methicillin resistant Staphylococcus aureus and extended-spectrum β-Lactamase-producing Enterobacteriacae in hospitalized and nonhospitalized patients and their clinical implications

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Asian Pacific Journal of Tropical Medicine 2009年第3期2卷 41-45页

作者： Hanan Ahmed Habib Babay Ali Mohammed Somily Department of Pathology Microbiology Unit King Khalid University HospitalRiyadhSaudi Arabia

Objective:To determine the clinical implication of and intestinal carriage with methicillin resistant Staphylococcus aureus(MRSA) and extended spectrumβ-lactamase(ESBL)-producing ***: A total of 180 stool specimens were screened for MRSA and ESBL-producing *** of ESBL- producing Enterobacteriacae was done by MicroScan Walk Away 96 system(Dade Behring Inc.,West Sacramento,CA 95691,USA ) and confirmation by double-disc synergy *** was identified by disc diffusion using 30μg cefoxitin disc and the ***:The rate of fecal MRSA carriage was 7.8% (14/180),35.7%(5 /14) were recovered from surgical *** patients(21,4%) had MRSA recovered from other body sites,and 2(14.2%) had in addition ESBL -producing Escherichia coli(***) and Klebsiella pneumoniae(***) ***(28.5%) patients with MRSA fical carriage died. MRSA fecal carriage was recovered from both inpatients and ***(2.2%) cases carried ESBL-producing Enterobacteriacae in ***(75%) were from intensive care unit(ICU).One patient had both ESBL-producing *** and *** from stool as well as *** from tracheal *** ICU patients with fecal ESBL ***:Fecal screening for MRSA and ESBL of all patients at high risk admitted to different hospital wards and ICUs and implementing infection control measures were recommended.

关键词： Intestinal carriage Methicillin resistant Staphylococcus aureus Extended spectrumβ-lactamase Enterobacteriacae

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Urinary neutrophil gelatinase-associated lipocalin(NGAL)and serum cystatin C measurements for early diagnosis of acute kidney injury in children admitted to PICU

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World Journal of Pediatrics 2018年第2期14卷 134-142页

作者： Jameela Abdulaziz Kari Mohamed Ahmed Shalaby Kholoud Sofyani Ahmad Saleh Sanad Albaraa Fuad Ossra Rayan Smeer Halabi Maha Hassan Aljuhani Wael Mohammad Toffaha Feras Aymen Moria Samar Sabry Hanan AbdelAziz Ahmed Khalid Abdulaziz Alhasan Sara Sharief Osama Safdar Pediatric Nephrology Center of Excellence and Department of Pediatrics King Abdulaziz University80215Jeddah 21589Kingdom of Saudi Arabia Pediatric Intensive Care Unit Department of PediatricsKing Abdulaziz UniversityJeddahKingdom of Saudi Arabia Pediatric Department Cairo UniversityGizaEgypt Department of Pediatrics College of MedicineKing Khalid University HospitalKing Saud UniversityRiyadhKingdom of Saudi Arabia

Background Acute kidney injury(AKI)is common in critically ill children with significant mortality and *** creatinine is an insensitive and late biomarker compared to newly proposed AKI *** Prospective study in pediatric intensive care unit(PICU)over three months to compare between serum cystatin-C(s-Cys-C)and urinary neutrophil gelatinase-associated lipocalin(uNGAL)as AKI biomarkers at multiple time points with pediatric risk,injury,failure,loss,end-stage renal disease(pRIFLE)classification in diagnosing *** Forty children were *** these 40 children,22 developed AKI according to pRIFLE *** was no significant difference between AKI and non-AKI in age(P=0.29).Post cardiac surgery,renal insult was the main cause of AKI(27.3%).There was a twofold increased risk of incident AKI in those patients with high baseline uNGAL at PICU admission and almost a fourfold increased risk in patients with high baseline s-Cys-C at PICU *** levels were highly predictive of AKI during the follow-up period[area under the curve(AUC)=0.76,95%confidence interval(CI)0.61-0.92].The cutoff point with the highest correctly classified proportion was 223 ng/mL(≥12 centiles)which correctly predict 80.0%patients with AKI,with a corresponding sensitivity of 72.7%and a specificity of 89.9%.AUC for s-Cys-C was 0.86(95%CI 0.75-0.97),and the highest correctly classified proportion was 1009μg/L(≥13 centiles);75%of patients with AKI,with a corresponding sensitivity of 63.6%and a specificity of 88.9%.Conclusion uNGAL and s-Cys-C predicts AKI early in critically ill children.

关键词： Acute kidney injury Neutrophil gelatinase-associated lipocalin Serum cystatin C

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