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World Journal of Cardiovascular Diseases 2021年第2期11卷 99-105页

作者： Ozge Cetinarslan Aysem Kaya Alev Arat Ozkan private Incirli Ethica hospital Istanbul Turkey Institute of Cardiology University of Istanbul Cerrahpasa Turkey

Background: Most of the institutions accept the Transradial Access (TRA) as the first approach for patients undergoing Coronary Angiography (CAG) and Percutaneous Coronary Interventions (PCI). Several studies clearly revealed endothelial injury of coronary arteries triggers inflammatory response. In this study, we aimed to evaluate inflammatory respond to CAG and to compare the inflammatory response of TRA and Transfemoral Access (TFA). Methods: In this single-center prospective study 140 consecutive patients presenting with (Chronical Coronary Syndrome) CCS and underwent transradial or transfemoral CAG between December 2017 and December 2018 were included. After exclusions, left 92 patients were divided into two equal groups as TRA and TFA. The primary endpoints were 2nd hour Tumor Necrosis Factor alpha (TNFα), 48th hour high-sensitivity C-Reactive Protein (hs-CRP), complication rates, amount of contrast medium, procedure time and fluoroscopy time. Results: Basal characteristics of TRA and TFA groups were similar. A comparison of variables demonstrated that there was no statistical significance in increase in inflammatory markers (TNFα, hs-CRP), complication rates, amount of contrast media and procedure time. In contrast, TRA was associated longer fluoroscopy time and higher X-ray dosage, althou

关键词： Transradial Coronary Angiography Transfemoral Coronary Angiography Inflammation TNFα hs-CRP

Twisting of the Spermatic Cord in an Elderly Subject at the Yaounde Central hospital: About a Case

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Open Journal of Urology 2022年第7期12卷 394-400页

作者： Jean Cedrick Fouda Junior Bartthelemy Mekeme Mekeme Philip Fernandez Owon’Abessolo Marcella Derboise Christelle Biyouma Ranibel Allo Axel Stephane Nwaha Makon Frantz Guy Ngalle Epoupa Landry Oriole Mbouche Cedric Mayopa Dongmo Achille Aurèle Mbassi Medjo Hell Pierre Joseph Fouda Arthur Essomba Yaounde Central hospital Yaounde Cameroon University of Yaounde I Yaounde Cameroon University of Douala Douala Cameroon private hospital Cameroon

Introduction: Twisting of the spermatic cord is part of urological emergencies. It can occur at any age with a predilection for children and adolescents. There is no literature on spermatic cord torsion in octogenarians, probably due to its rarity. The majority of recent studies show spermatic cord torsion in patients under 55 years of age. This is why we present a case of spermatic cord torsion in an 80 years old subject. Case Presentation: We present a case of torsion of the spermatic cord in an 80-year-old subject. The diagnosis was made on anamnestic and clinical grounds. The patient presented with scrotal pain, unilateral, of sudden onset, violent intensity without urinary signs with an ascended testicle. The urine dipstick was unremarkable. Management was done surgically and as an emergency. The postoperative course was satisfactory. Conclusion: Spermatic cord torsion in octogenarians is exceptional and should be suspected in the first instance in the presence of any sudden onset, severe testicular pain without urinary signs with an ascended testicle and a negative urine dipstick.

关键词： Twisting of the Spermatic Cord 80-Year-Old Subject Diagnostic Emergency

Severe acute respiratory syndrome coronavirus 2 may cause liver injury via Na^(+)/H^(+) exchanger

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World Journal of Virology 2023年第1期12卷 12-21页

作者： Medine Cumhur Cure Erkan Cure Department of Biochemistry Private Tanfer HospitalIstanbul 34394Turkey Department of Internal Medicine Bagcilar Medilife HospitalIstanbul 34200Turkey

The liver has many significant functions,such as detoxification,the urea cycle,gluconeogenesis,and protein *** diseases,hypoxia,infections,drugs,and toxins can easily affect the liver,which is extremely sensitive to *** infection of severe acute respiratory syndrome coronavirus 2 can cause liver *** primary regulator of intracellular pH in the liver is the Na+/H+exchanger(NHE).Physiologically,NHE protects hepatocytes from apoptosis by making the intracellular pH *** acute respiratory syndrome coronavirus 2 increases local angiotensin II levels by binding to angiotensinconverting enzyme *** severe cases of coronavirus disease 2019,high angiotensin II levels may cause NHE overstimulation and lipid accumulation in the *** overstimulation can lead to hepatocyte *** overstimulation may trigger a cytokine storm by increasing proinflammatory cytokines in the *** the release of proinflammatory cytokines such as interleukin-6 increases with NHE activation,the virus may indirectly cause an increase in fibrinogen and D-dimer *** overstimulation may cause thrombotic events and systemic damage by increasing fibrinogen levels and cytokine ***,NHE overstimulation causes an increase in the urea cycle while inhibiting vitamin D synthesis and gluconeogenesis in the *** NHE3 activity leads to Na+loading,which impairs the containment and fluidity of bile *** overstimulation can change the gut microbiota composition by disrupting the structure and fluidity of bile acid,thus triggering systemic *** other tissues,tumor necrosis factor-alpha and angiotensin II decrease NHE3 activity in the ***,increased luminal Na+leads to diarrhea and cytokine *** acute respiratory syndrome coronavirus 2-induced local and systemic damage can be improved by preventing virus-induced NHE overstimulation in the liver.

关键词： Liver Hepatocyte Severe acute respiratory syndrome coronavirus 2 COVID-19 Na+/H+exchanger Sodium-proton pump

Fatal complication, rescue therapy;covered stent for coronary artery perforation

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Health 2013年第7期5卷 1-5页

作者： Abdulmelik Yildiz Ahmet Karakurt Atila Bitigen Bayram Bagirtan private Medikalpark hospital IstanbulTurkey Department of Cardiology Faculty of MedicineKafkas UniversityKarsTurkey Medikal Park Faculty of MedicineKemerburgaz UniversityIstanbulTurkey private Avrupa Safak hospital IstanbulTurkey

Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be 0.20%-0.6%. Its sudden development, the patient’s agitation and development of rapid collapse render intervention difficult. Materials and Method: The presence of perfusion balloon and covered stent in clinics is life-saving. In the present study, we retrospectively reviewed 17 cases with coronary artery perforation that were treated between 2009 and 2012. Of these patients, 10 (58.8%) were men and 7 (41.2%) were women;the median age was 62.8 ± 8.3 years. The coronary artery perforation resulted from guide wire in 23.5%, balloon dilatation in 58.8% and stent implantation in 17.6%. All the lesions were either type B or C lesions. Results: The extensiveness of perforation was Ellis grade I in 23.5%, grade II in 47.1% and grade III in 29.4% of the cases. In the treatment of the perforation, polytetrafluoroethylene-covered stent graft was implemented in 9 (52.9%) patients, whilst conventional and emergency surgical therapy was performed in 8 (47.1%) patients. Grade I perforations occurred due to the guide wire and were managed with conventional therapy (p < 0.05). Grade II and III perforations resulted from balloon and stent. The majority of these patients were inserted Graft Stent (stent graft in 52.9% and conventional therapy in 23.5% of the cases (p < 0.05). Although all the stent grafts were successfully implanted, the complete control of bleeding was achieved only in 77.7% of the patients. Mortality was not observed in grade I perforation, whilst all cases resulted in mortality had grade III perforation. Conclusion: These data indicate that there is a need for further advanced technology in the coronary artery perforation despite of currently available therapeutic options.

关键词： Percutaneous Coronary Artery Intervention Coronary Artery Perforation Covered Stent

Neutrophil-lymphocyte ratio in the management and prediction of outcomes in renal cell carcinoma

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World Journal of Clinical Urology 2018年第1期7卷 1-6页

作者： Tuck Y Yong Kareeann SF Khow Internal Medicine Flinders Private Hospital Geriatric Training Research and Aged Care Centre the University of Adelaide

Renal cell carcinoma(RCC) is one of the ten most common *** prognosis of RCC is poor when the disease is in advanced stages,with five-year survival of less than 10%.However current assessment approaches are limited in their ability to prognosticate and guide therapeutic ***-mediated inflammatory response is increasingly being recognised to have an important role in carcinogenesis of *** inflammatory markers have been found to identify patients with RCC at high risk of recurrence and predict ***-lymphocyte ratio(NLR) is a simple and inexpensive inflammatory marker that has been shown to be of value in the assessment of patients with *** elevated pretreatment NLR has been found to be associated with reduced overall survival,recurrence-free survival and progress-free survival and risk of recurrence in localized *** addition,lower pretreatment NLR has been demonstrated to be associated with better clinical response to systemic therapy including vascular endothelial growth factor inhibitors,among patients with metastatic ***,NLR has not been found to differentiate whether small renal masses of less than 40 mm are benign or *** research is needed to determine the cut-offs for NLR to predict different clinical outcomes and how post-treatment NLR can be *** addition,more work is also needed to evaluate combining NLR with other biomarkers in a model to predict patients' clinical outcome or response to treatment for RCC.

关键词： Neutrophil-lymphocyte ratio Prognosis Renal cell carcinoma Survival

Non-immune hydrops fetalis:Two case reports

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World Journal of Clinical Cases 2021年第22期9卷 6531-6537页

作者： Marianna Maranto Valentina Cigna Emanuela Orlandi Gaspare Cucinella Clelia Lo Verso Vincenzo Duca Francesco Picciotto Fetal Medicine and Prenatal Diagnosis Unit Villa Sofia Cervello HospitalsPalermo 90146Italy Health Promotion Maternal and Infant Care UnitInternal Medicine and Medical Specialties“G.D’Alessandro”University of PalermoPalermo 90100Italy Neonatology and Neonatal Intensive Care Unit Civico Di Cristina Benfratelli HospitalPalermo 90100Italy Neonatology and Neonatal Intensive Care Unit Ingrassia HospitalPalermo 90100Italy

BACKGROUND Fetal hydrops is a serious condition difficult to manage,often with a poor prognosis,and it is characterized by the collection of fluid in the extravascular *** 1968,the most frequent cause was the maternal-fetal Rh ***,90%of the cases are non-immune hydrops *** fetal anatomic and functional disorders can cause non-immune hydrops fetalis and the pathogenesis is incompletely *** varies from viral infections to heart disease,chromosomal abnormalities,hematological and autoimmune *** SUMMARY A 38-year-old pregnant woman has neck lymphoadenomegaly,fever,cough,tonsillar plaques at 14 wk of amenorrhea and a rash with widespread *** 27.5 wk a fetal ultrasound shows signs of severe anemia and *** is performed with confirmation of severe fetal anemia and subsequent fetal *** karyotype is 46,XX,array-comparative genome hybridization(CGH)negative,and infectious tests are not *** the following days there is a progressive improvement of the indirect signs of fetal *** 33.6 wk,for relapse of severe fetal anemia,further fetal transfusions are necessary and an urgent cesarean section is *** the day 12 of life,for the detection of anemia,the newborn is subjected to transfusion of concentrated red blood cells and begins treatment with *** there is a normalization of blood chemistry values and the baby does not need new transfusions.A 29-year-old pregnant woman,with Sjogren's syndrome and positive Anti-Ro/SSA antibodies,is subjected to serial fetal ecocardio for branch *** 26.5 wk there is a finding of fetal *** disease tests on amniotic fluid are negative as well as quantitative fluorescent polymerase chain reaction,Array *** cordocentesis Hb is 1.3 mmol/L,consequently fetal transfusion is *** in this case,due to continuous episodes of relapse of fetal anemia with consequent transfusions,at 2

关键词： Cordocentesis Fetal anemia Fetal transfusion Hydrops fetalis Preterm cesarean section Case report

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结肠直肠外科中的抗菌病因预防(英文)

中国临床药理学杂志 1989年第S3期5卷 1-4页

作者： B Collopy Chairman Clinical Review Committee ST. Vincent's Private Hospital Australia

抗菌病因预防对成功的外科手术是一种辅助措施,但并不能取代它.在任何研究中,评价某一抗菌方案有效性时,应考虑多种可变因素,诸如手术技能差异、护理和手术室成员的差异、患者自身的抵抗力以及疾病的严重程度等. 对研究成果之评价,以下... 详细信息

抗菌病因预防对成功的外科手术是一种辅助措施,但并不能取代它.在任何研究中,评价某一抗菌方案有效性时,应考虑多种可变因素,诸如手术技能差异、护理和手术室成员的差异、患者自身的抵抗力以及疾病的严重程度等. 对研究成果之评价,以下两点应予以重视:(1)明确并发症的定义;(2)评价应与手术者无关. Keighley 等使用头孢三嗪噻肟(一种长效头孢菌素)和灭滴灵在结肠手术中作单剂量病因预防.该项研究基本满足上述标准. 在上述研究中.“将120名施行结肠手术的患者随机分配到头孢三嗪噻肟(2g) 和灭滴灵(1.5g)组(59例)或庆大霉素(150mg)和灭滴灵(1.5g)组(61例).在手术室,通过单剂量静脉给药对他们进行抗菌病预防.接受头孢三嗪噻肟和灭滴灵治疗组的腹部伤口脓毒症发生率为8.5%,而庆大霉素加灭满灵组达23%(p<0.05).就手术而言,经过选择的(干净未被污染)与有并发疾患(不干净已被污染)者之间伤口脓毒发生率无差异”.未发生败血症,但两种方案未能阻止腹腔内脓肿形成,因此,每组有四人发生脓肿. 对入院病人进行连续序贯观察,术前静脉给予头孢三嗪噻肟(2g) 和灭满灵(0.5),未见伤口感染、腹腔脓肿或败血症等. 此种独特的病因预防表明,在结肠直肠外科手术中作单剂量病因预防是安全的.

关键词：头孢三嗪噻肟结肠直肠长效头孢菌素灭滴灵腹腔内脓肿腹腔脓肿前静脉可变因素脓毒症静脉给药

Retrospective Analysis of Treatment Results by Non-Invasive Radiofrequency (RF) Device with Standard and High Voltage RF Electrical Pulses Coupled with Suction for Fat Reduction and Cellulite Improvement

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Journal of Cosmetics, Dermatological Sciences and Applications 2021年第4期11卷 279-292页

作者： Judith Hellman R. Stephen Mulholland Mt. Sinai hospital New York USA private Plastic Surgery Practice Toronto Canada

Introduction: The growing demand for non-surgical, non-invasive procedures for fat and circumference reduction and for cellulite treatments has led to the development of various energy-based technologies. Bi-polar radiofrequency (RF) technology combined with additional technologies, such as vacuum, massage or infrared (IR) light is widely used in various body contouring treatments in the medical aesthetic market. The current study is based on a retrospective efficacy analysis of an RF device, combining two RF modalities, coupled with suction. Methods: Representative treatment outcomes, documented in photographs taken at baseline and post-treatment were gathered from several clinics. Photos of the various treatment areas were evaluated by independent evaluators for cellulite and contour improvement. Results: Before and after photographs were gathered from 31 patients treated in different clinics. Analysis was carried out on different body areas such as thighs, abdomen, back, buttocks and arms and analyzed by two independent evaluators. Scoring was performed according to the Global Aesthetic Improvement Scale (GAIS) scale and indicated an overall improvement in the contour of all treated body areas. In cellulite cases, improved appearance according to the cellulite grading scale was noted. Conclusion: This retrospective analysis supports the device’s efficacy for fat and circumferences reduction and cellulite improvement. The device’s unique specifications contribute to treatment safety and efficacy which is highly tolerable by the patients.

关键词： Noninvasive Radiofrequency RF Fat Reduction Adipocytes Apoptosis Adi-pose Tissue Fat Reduction Cellulite Improvement Electroporation

Chronic kidney disease after radical nephrectomy for suspected renal cancers

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World Journal of Clinical Urology 2017年第1期6卷 10-17页

作者： Tuck Y Yong Kareeann SF Khow Internal Medicine Flinders Private Hospital Adelaide Geriatrics Teaching and Research with Aged Care the University of Adelaide

Nephrectomy is the treatment of choice for early stage renal cell carcinoma. However,radical nephrectomy is consistently associated with higher rates of newonset chronic kidney disease(CKD) than the general population,regardless of the method used in measuring renal function. The higher rates of CKD are associated with worsened survival because of increased risk of cardiovascular diseases and mortality. Comorbidities and adjacent non-neoplastic kidney diseases are important risk factors for the development of CKD after nephrectomy. Partial nephrectomy has become the standard of care for patients with stage 1a tumours(diameter < 4 cm) and an attractive option for those with stage 1b(diameter 4-7 cm). Therefore stratifying the risk of postoperative CKD before surgery is important and ongoing monitoring of kidney function after radical nephrectomy is needed in addition to oncological surveillance. More research is needed to better understand the risk of CKD after radical nephrectomy and develop effective strategies to optimize kidney function after such surgery.

关键词： Nephrectomy Renal function Renal cell carcinoma Chronic kidney disease Prevention

Diabetic muscle infarction in end-stage renal disease: A scoping review on epidemiology, diagnosis and treatment

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World Journal of Nephrology 2018年第2期7卷 58-64页

作者： Tuck Yean Yong Kareeann Sok Fun Khow Internal Medicine Flinders Private Hospital Geriatric Training Research and Aged Care Centre The University of Adelaide

Diabetic muscle infarction(DMI) refers to spontaneous ischemic necrosis of skeletal muscle among people with diabetes mellitus, unrelated to arterial occlusion. People with DMI may have coexisting end-stage renal disease(ESRD) but little is known about its epidemiology and clinical outcomes in this setting. This scoping review seeks to investigate the characteristics, clinical features, diagnostic evaluation, management and outcomes of DMI among people with ESRD. Electronic database (Pub Med/MEDLINE, CINAHL, SCOPUS and and EMBASE) searches were conducted for ("diabetic muscle infarction" or "diabetic myonecrosis") and("chronic kidney disease" or "renal impairment" or "dialysis" or "renal replacement therapy" or "kidney transplant ") from January 1980 to June 2017. Relevant cases from reviewed bibliographies in reports retrieved were also included. Data were extracted in a standardized form. A total of 24 publications with 41 patients who have ESRD were included. The mean age at the time of presentation with DMI was 44.2 years. Type 2 diabetes was present in 53.7% of patients while type 1 in 41.5%. In this cohort, 60.1% were receiving hemodialysis, 21% on peritoneal dialysis and 12.2% had kidney transplantation. The proximal lower limb musculature was the most commonly affected site. Muscle pain and swelling were the most frequent manifestation on presentation. Magnetic resonance imaging (MRI) provided the most specific findings for DMI. Laboratory investigation findings are usually non-specific. Non-surgical therapy is usually used in the management of DMI. Short-term prognosis of DMI is good but recurrence occurred in 43.9%. DMI is an uncommon complication in patients with diabetes mellitus, including those affected by ESRD. In comparison with unselected patients with DMI, the characteristics and outcomes of those with ESRD are generally similar. DMI may also occur inkidney transplant recipients, including pancreas-kidney transplantation. MRI is the most useful dia

关键词： Diabetic muscle infarction Dialysis End-stage renal disease Kidney transplant Renal replacement therapy