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World Journal of pediatric Surgery 2022年第2期5卷 29-33页

作者： Mohammad Ashkan Moslehi pediatric interventional pulmonology division Medical SchoolShiraz University of Medical SciencesShirazIran

Background Several children are affected by airway foreign body aspiration(FBA)resulting from life-threatening *** has been considered the major symptom and is defined as airway blockage by a foreign body(FB),leading to marked morbidity or *** retrospective study indicates the possibility of misdiagnosis or rigid bronchoscope(RB)failure,which is the standard gold method for extracting FB in the *** Six children with airway FBA who failed treatment using RB between 2018 and 2019 were retrospectively *** inclusion criterion was a history of failure to extract FB using RB followed by flexible fiberoptic bronchoscopy(FFB).Results In the present study,among 63 patients who had undergone rigid bronchoscopy,airway FBs were successfully removed in 57(90.48%).Rigid bronchoscopy failed in 6(9.52%)*** age of cases at the time of bronchoscopy ranged from 11 months to 13 *** was performed to extract missing or remaining FBs and was done successfully in all *** patients made an uneventful recovery following FB extraction using the FFB *** It is not easy to diagnose and treat airway FB in *** bronchoscopy has been approved as a method to manage airway FB,but a negative bronchoscopy result must usually be interpreted *** is applicable as a proper and relatively safe diagnostic and therapeutic tool in managing airway FBs among the pediatric population,especially in cases where rigid bronchoscopy was performed but missed or failed to extract the FB.

关键词： airway rigid removed

Stubborn Hypoxia in Neonates with D-Transposition of the Great Arteries after Arterial Switch Operation: Central Sleep Apnea as the Cause and Potential Indicator of Brain Immaturity

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Congenital Heart Disease 2024年第2期19卷 185-195页

作者： Camden L.Hebson Kyle Bliton Amr Y.Hammouda Kaitlyn Barr W.Hampton Gray Mohini Gunnett Waldemar F.Carlo Department of pediatrics Division of Pediatric CardiologyUniversity of Alabama BirminghamBirmingham35233USA Department of pediatrics Division of Pediatric PulmonologyUniversity of Alabama BirminghamBirmingham35233USA Department of pediatrics University of Alabama BirminghamBirmingham35233USA Department of Surgery Division of Cardiothoracic SurgeryUniversity of Alabama BirminghamBirmingham35233USA

D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive *** significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic *** report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal *** this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.

关键词： Transposition congenital heart disease sleep apnea polysomnography

Pulmonary lymphomatoid granulomatosis in a 4-year-old girl:A case report

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World Journal of Clinical Cases 2022年第16期10卷 5380-5386页

作者： Jia-Wei Yao Li Qiu Ping Liang Han-Min Liu Li-Na Chen division of pediatric pulmonology Chengdu Women's and Children's Central HospitalSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610091Sichuan ProvinceChina division of pediatric pulmonology and Immunology Key Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationWest China Second University Hospital of Sichuan UniversityNHC Key Laboratory of ChronobiologyChengdu 610041Sichuan ProvinceChina

BACKGROUND Pulmonary lymphomatoid granulomatosis(PLG)is a lymphoproliferative disease associated with Epstein-Barr viral infection occurring mainly in adults and rarely in *** is characterized by multiple pulmonary *** diagnosis depends on lung biopsy *** patients are immunodeficient,and it commonly presents in children undergoing chemotherapy for *** report the case of a child with PLG caused by a mutation in the macrophageexpressed gene 1(MPEG1),suggesting possible PLG occurrence in children undergoing treatment for pulmonary nodular *** SUMMARY This study reports a case of PLG without apparent immunodeficiency,suggesting the possibility of this disease occurrence during the treatment of pulmonary nodular lesions in ***,the cause was assumed to be an atypical *** conventional anti-infective treatment,chest computed tomography findings revealed that there were still multiple nodules in the ***,the patient was found to be infected with the Epstein-Barr *** examination of the resected lung revealed lymphoproliferative lesions with *** lymphocytes,plasma cells,and histiocytes were observed in the background,although Reed-Sternberg cells were *** staining[CD20(+),CD30(+),and CD3(+)]and EBV-encoded small RNA1/2 in situ hybridization of small lymphocytes revealed approximately 200 cells/high-power *** exon sequencing of the patient revealed a mutation in the *** patient was eventually diagnosed with PLG and transferred to the Department of pediatric Oncology for bone marrow *** As PLG is rare and fatal,it should be suspected in clinical settings when treatment of initial diagnosis is ineffective.

关键词： Pulmonary lymphomatoid granulomatosis Child Epstein-Barr virus Lymphoproliferative disease Leukemia Case report

Making the case for multidisciplinary pediatric aerodigestive programs

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World Journal of Gastroenterology 2022年第28期28卷 3620-3626页

作者： Sohit P Kanotra Rebecca Weiner Riad Rahhal Department of Otolaryngology-Head and Neck Surgery University of IowaIowa CityIA 52242United States Department of pediatrics Division of Pediatric PulmonologyUniversity of IowaIowa CityIA 52242United States Department of pediatrics Division of Pediatric GastroenterologyUniversity of IowaIowa CityIA 52242United States

Multidisciplinary pediatric aerodigestive centers have been proposed to address the needs of children with complex multi-system problems affecting the respiratory and upper gastrointestinal *** setup of a multidisciplinary service allows for the complex coordination needed between different *** allows for rapid communication and family-centered decision making and agreement on further diagnostic and/or therapeutic next steps such as offering triple endoscopy when *** endoscopy entails performing rigid upper airway assessment,flexible bronchoscopy and upper gastrointestinal endoscopy and has been linked to reduced time to diagnosis/treatment,reduced costs and anesthesia *** review summarizes the available literature on the structure and benefits of multidisciplinary pediatric aerodigestive services.

关键词： Aerodigestive Multidisciplinary pediatric Triple endoscopy

Transjugular intrahepatic portosystemic shunt vs conservative treatment for recurrent ascites:A propensity score matched comparison

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World Journal of Gastroenterology 2022年第41期28卷 5944-5956页

作者： Martin Philipp Theresia Blattmann Jörn Bienert Kristian Fischer Luisa Hausberg Jens-Christian Kröger Thomas Heller Marc-AndréWeber Georg Lamprecht Department of Medicine Division of Gastroenterology and EndocrinologyRostock University Medical CenterRostock 18057Germany Institute of Diagnostic and interventional Radiology Pediatric Radiology and NeuroradiologyRostock University Medical CentreRostock 18057Germany

BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) placement is an effective intervention for recurrent tense ascites. Some studies show an increased risk of acute on chronic liver failure(ACLF) associated with TIPS placement. It is not clear whether ACLF in this context is a consequence of TIPS or of the pre-existing liver *** To better understand the risks of TIPS in this challenging setting and to compare them with those of conservative *** Two hundred and fourteen patients undergoing their first TIPS placement for recurrent tense ascites at our tertiary-care center between 2007 and 2017 were identified(TIPS group). Three hundred and ninety-eight patients of the same time interval with liver cirrhosis and recurrent tense ascites not undergoing TIPS placement(No TIPS group) were analyzed as a control group. TIPS indication,diagnosis of recurrent ascites, further diagnoses and clinical findings were obtained from a database search and patient records. The in-hospital mortality and ACLF incidence of both groups were compared using 1:1 propensity score matching and multivariate logistic *** After propensity score matching, the TIPS and No TIPS groups were comparable in terms of laboratory values and ACLF incidence at hospital admission. There was no detectable difference in mortality(TIPS: 11/214, No TIPS 13/214). During the hospital stay, ACLF occurred more frequently in the TIPS group than in the No TIPS group(TIPS: 70/214, No TIPS: 57/214, P = 0.04). This effect was confined to patients with severely impaired liver function at hospital admission as indicated by a significant interaction term of Child score and TIPS placement in multivariate logistic regression. The TIPS group had a lower ACLF incidence at Child scores < 8 points and a higher ACLF incidence at ≥ 11 points. No significant difference was found between groups in patients with Child scores of 8 to 10 *** TIPS placement for recurrent tense as

关键词： Liver cirrhosis Ascites Transjugular intrahepatic portosystemic shunt Acute on chronic liver failure Mortality Propensity score

Radiological response and inflammation scores predict tumour recurrence in patients treated with transarterial chemoembolization before liver transplantation

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World Journal of Gastroenterology 2017年第20期23卷 3690-3701页

作者： Daniele Nicolini Andrea Agostini Roberto Montalti Federico Mocchegiani Cinzia Mincarelli Alessandra Mandolesi Nicola L Robertson Roberto Candelari Andrea Giovagnoni Marco Vivarelli division of Hepatobiliary and Transplant Surgery Department of Experimental and Clinical MedicinePolytechnic University of Marche division of General and pediatric Radiology Department of Radiological SciencesPolytechnic University of Marche division of interventional Radiology Department of Radiological SciencesPolytechnic University of Marche division of Pathology Department of PathologyPolytechnic University of Marche division of Radiology Department of RadiologyMemorial Sloan Kettering Cancer Center

To investigate the prognostic value of the radiological response after transarterial chemoembolization (TACE) and inflammatory markers in patients affected by hepatocellular carcinoma (HCC) awaiting liver transplantation (LT).METHODSWe retrospectively evaluated the preoperative predictors of HCC recurrence in 70 patients treated with conventional (n = 16) or doxorubicin-eluting bead TACE (n = 54) before LT. The patient and tumour characteristics, including the static and dynamic alpha-fetoprotein, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (PLR) measurements, were recorded. Treatment response was classified according to the modified Response Evaluation Criteria in Solid Tumours (mRECIST) and the European Association for the Study of the Liver (EASL) criteria as complete response (CR), partial response (PR), stable disease or progressive disease. After examination of the explanted livers, histological necrosis was classified as complete (100% of the cumulative tumour area), partial (50%-99%) or minimal (< 50%) and was correlated with the preoperative radiological *** to the pre-TACE radiological evaluation, 22/70 (31.4%) and 12/70 (17.1%) patients were beyond Milan and University of San Francisco (UCSF) criteria, respectively. After TACE procedures, the objective response (CR + PR) rates were 71.4% and 70.0% according to mRECIST and EASL criteria, respectively. The agreement between the two guidelines in defining the radiological response was rated as very good both for the overall and target lesion response (weighted k-value: 0.98 and 0.93, respectively). Complete and partial histological necrosis were achieved in 14/70 (20.0%) and 28/70 (40.0%) patients, respectively. Using histopathology as the reference standard, mRECIST criteria correctly classified necrosis in 72.9% (51/70) of patients and EASL criteria in 68.6% (48/70) of cases. The mRECIST non-response to TACE [Exp(b) = 9.2, p = 0.012], exceeding UCSF criteria before

关键词： Liver transplantation Recurrence-free survival Hepatocellular carcinoma Radiological response Locoregional therapies Inflammatory markers Selection criteria

Endoscopic identification of endoluminal esophageal landmarks for radial and longitudinal orientation and lesion location

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World Journal of Gastroenterology 2019年第4期25卷 498-508页

作者： Fabian Emura Rene Gomez-Esquivel Carlos Rodriguez-Reyes Petros Benias Javier Preciado Michael Wallace Luis Giraldo-Cadavid division of Gastroenterology Universidad de La Sabana Advanced Gastrointestinal Endoscopy EmuraCenter LatinoAmerica Emura Foundation for the Promotion of Cancer Research Unidad de Endoscopia Digestiva Clínica Pediátrica Colsanitas division of Digestive Diseases and Nutrition Morsani College of Medicine University of South Florida division of Gastroenterology North Shore-Long Island Jewish Medical Center Unidad de Exploraciones Digestivas Clinica Universitaria Colombia Department of Gastroenterology and Hepatology Mayo Clinic Department of Internal Medicine. Universidad de La Sabana division of interventional pulmonology Fundacion Neumologica Colombiana

AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion *** Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination. A sub-study was also performed using white light followed by endoscopic ultrasound(EUS) in 25 consecutive patients to confirm the *** scope orientation throughout the exam was maintained at the natural axis,where the left esophageal quadrant corresponds to the area between 6 and 9 o'clock. When an anatomical landmark was identified, it was recorded with a photograph and its quadrant orientation and distance from the incisors were determined. The reference points to obtain the distances and radial orientation were as follows: the midpoint of the left main bronchus and the most intense pulsatile zone of the left atrium. With the video processor system set to moderate insufflation, measurements were obtained at the end of the patients' air *** The left main bronchus and left atrium esophageal landmarks were identified using white light in 99% and 100% of subjects at a mean distance of 25.8 cm(SD2.3), and 31.4 cm(SD 2.4) from the incisors, respectively. The left main bronchus landmark was found to be a tubular, concave, non-pulsatile, esophageal external compression, occupying approximately 1/4 of the circumference. The left atrium landmark was identified as a round, convex, pulsatile, esophageal external compression, occupying approximately 1/4 of the circumference. Both landmarks were identified using white light on the anterior esophageal quadrant. In the substudy, the left main bronchus was identified in 24(92%) patients at 25.4 cm(SD2.1) and 26.7 cm(SD 1.9) from the incisors, by white light and EUS, *** left atrium was recognized in all patients at 30.5 cm(SD 1.9), and 31.6 cm(SD2.3) from the incisors, by b

关键词： Esophagus Natural landmark Radial orientation Longitudinal orientation Four-quadrants Left main bronchus Left atrium

Ablative therapies for intrahepatic cholangiocarcinoma

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Hepatobiliary Surgery and Nutrition 2018年第3期7卷 192-194页

作者： Antonio Giorgio Pietro Gatti Paolo Matteucci Valentina Giorgio interventional Ultrasound Unit Tortorella Clinical HospitalSalernoItaly Internal Medicine division Ostuni HospitalOstuni BRItaly Radiation Oncology Institute Campus Biomedico UniversityRomeItaly pediatric Gastroenterology Unit Sacred Heart UniversityPoliclinico GemelliRomeItaly

Among the 3 sub-types of cholangiocarcinoma (CH), [intrahepatic CH, hylar (CH) and extrahepatic (CH)], intrahepatic cholangiocarcinoma (ICC) accounts for up 8–10% of cholangiocarcinomas and 10–20% of all primary liv... 详细信息

关键词： carcinoma liver for

Segmental intrahepatic cholestasis as a technical complication of the transjugular intrahepatic porto-systemic shunt

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World Journal of Gastroenterology 2019年第43期25卷 6430-6439页

作者： Julian Nikolaus Bucher Marcus Hollenbach Steffen Strocka Gereon Gaebelein Michael Moche Thorsten Kaiser Michael Bartels Albrecht Hoffmeister Department of Surgery Munich University Hospital at GroβhadernBavariaMunich 81377Germany Medical Department Ⅱ-Gastroenterology HepatologyInfectious DiseasesPulmonologyUniversity of Leipzig Medical CenterSaxonyLeipzig 04103Germany Department of Diagnostic and interventional Radiology University of Leipzig Medical CenterSaxonyLeipzig 04103Germany Department of General VisceralVascular and Pediatric SurgeryUniversity of SaarlandSaarlandHomburg 66421Germany Department of Diagnostic and interventional Radiology BavariaNuernberg 90411Germany Institute of Laboratory Medicine Clinical Chemistry and Molecular DiagnosticsUniversity of Leipzig Medical CenterSaxonyLeipzig 04310Germany Department for General and Visceral Surgery Helios Park-Klinikum LeipzigSaxonyLeipzig 04289Germany Medical Department Ⅱ-Gastroenterology HepatologyInfectious DiseasesPulmonologyUniversity of Leipzig Medical CenterLeipzig 04103SaxonyGermany

BACKGROUND Segmental intrahepatic cholestasis caused by transjugular intrahepatic portosystemic shunt(TIPS)(SIC-T),is a rare complication of this technique and only referred by case ***,we conducted a systematic,retrospective analysis to provide evidence regarding prevalence and consequences of this TIPS-induced bile duct *** To assess prevalence and outcome of SIC-T in a large *** In this retrospective cohort study,we screened the institutional databases for all consecutive patients that were treated by TIPS-placement or TIPS-revision between January 2005 and August *** analyzed radiologic images for signs of biliary *** that were indicative of SIC-T were reviewed by two independent radiologists and additional patient data was *** statistics of patient demographics,indications for TIPS and procedural details were *** regression analysis was performed to identify predictors for the development of *** We analyzed 135 cirrhotic patients who underwent TIPS(mean age 55 years,79%male gender).Etiology of cirrhosis was alcohol in most cases and indications for TIPS were mainly refractory ascites and recurrent variceal *** revision was necessary in 31 *** identified 4 cases(2.9%)of SIC-T in direct proximity of the *** was confirmed by CT-scan,MRI or endoscopic retrograde cholangio pancreaticography(ERCP).In two patients TIPS was implanted via the right and in one through the medial hepatic *** patient received TIPS-prolongation by multiple *** patients were asymptomatic but one cholangitic abscess necessitated a transhepatic *** regression analysis identified TIPS-placement other than from medial hepatic vein to right portal vein as risk factor(OR 21.0)for *** SIC-T ads to(mostly late)complications in the interventional treatment of cirrhotic portal hypertensions and can lead to cholangitic ***

关键词： Transjugular intrahepatic portosystemic shunt Cirrhosis Ascites Bleeding Cholestasis Biliary congestion

Bronchial thermoplasty

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Chinese Medical Journal 2013年第17期126卷 3375-3378页

作者： Javier Diaz-Mendoza ] BAI Chong HUANG Hai-dong Michael J. Simoff interventional pulmonology Division of Pulmonary and Critical Care Medicine Henry Ford Health System Detroit Michigan United States of America Department of Respiratory Diseases Changhai Hospital Second Military Medical University Shanghai 200433 China

Asthma is a chronic inflammatory disease that affects 300 million people worldwide. Its prevalence rangesfrom 1% to 18% of the population in different countries. The World Health Organization has estimated that 15 million disability-adjusted life years are lost annually due to asthma. Worldwide deaths from asthma are estimated at 250 000 per year. Furthermore, asthma is a major cause of absence from work in many countries, including United States .

关键词： asthma bronchial thermoplasty airway smooth muscle