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Blood metal concentrations and cardiac structure and function in total joint arthroplasty patients

World Journal of Orthopedics 2024年第8期15卷 773-782页

作者： Peter C Brennan Stephanie M Peterson Thomas J O'Byrne Mariana L Laporta Cody C Wyles Paul J Jannetto Garvan C Kane Maria Vassilaki Hilal Maradit Kremers Department of Orthopedic Surgery Mayo ClinicRochesterMN 55905United States Department of Quantitative Health Sciences Mayo ClinicRochesterMN 55905United States Department of Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States Department of Laboratory Medicine and pathology Mayo ClinicRochesterMN 55905United States Department of Cardiovascular Diseases Mayo ClinicRochesterMN 55905United States

BACKGROUND There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty(TJA)*** To determine the association of commonly used implant metals with echocardiographic measures in TJA *** The study comprised 110 TJA patients who had a recent history of high chromium,cobalt or titanium *** underwent two-dimensional,three-dimensional,Doppler and speckle-strain transthoracic echocardiography and a blood draw to measure metal *** and sex-adjusted linear and logistic regression models were used to examine the association of metal concentrations(exposure)with echocardiographic measures(outcome).RESULTS Higher cobalt concentrations were associated with increased left ventricular end-diastolic volume(estimate 5.09;95%CI:0.02-10.17)as well as left atrial and right ventricular dilation,particularly in men but no changes in cardiac *** titanium concentrations were associated with a reduction in left ventricle global longitudinal strain(estimate 0.38;95%CI:0.70 to 0.06)and cardiac index(estimate 0.08;95%CI,-0.15 to-0.01).CONCLUSION Elevated cobalt and titanium concentrations may be associated with structural and functional cardiac changes in some *** studies are warranted to better understand the systemic effects of metals in TJA patients.

关键词： Total joint arthroplasty Metal-on-metal Cardiotoxicity Heart failure Echocardiography Cobalt

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Unique presentation of neonatal liver failure:A case report

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World Journal of clinical Pediatrics 2024年第2期13卷 221-226页

作者： Eman Al Atrash Amer Azaz Samar Said Mohammad Miqdady Department of Pediatrics Division of Pediatric GastroenterologySheikh Khalifa Medical CityAbu Dhabi 971United Arab Emirates Department of pathology Mayo ClinicRochesterMN 55905United States

BACKGROUND Acute fulminant liver failure rarely occurs in the neonatal *** etiologies include viral infection(15%),metabolic/genetic disease(10%),hematologic disorders(15%),and ischemic injury(5%).Gestational alloimmune liver disease usually manifests as severe neonatal liver failure,with extensive hepatic and extrahepatic iron overload,sparing the reticuloendothelial *** liver failure is a rare cause of liver failure where a patient presents with liver failure in the neonatal period with no hepatocytes in liver *** SUMMARY A 5-week-old male presented with *** examination revealed an alert but deeply icteric *** data demonstrated direct hyperbilirubinemia,a severely deranged coagulation profile,normal transaminase,and normal *** resonance imaging of the abdomen was suggestive of perinatal *** biopsy showed histiocytic infiltration with an absence of *** hemosiderin deposition was identified in a buccal mucosa *** Neonatal liver failure in the absence of hepatocellular regeneration potentially reflects an acquired or inborn defect in the regulation of hepatic regeneration.

关键词： Liver Hyperbilirubinemia Le foie vide Neonatal hemochromatosis Case report

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Mucinous neoplasm of the appendix:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 944-954页

作者： Hao-Cheng Chang Jung-Cheng Kang Ta-Wei Pu Ruei-Yu Su Chao-Yang Chen Je-Ming Hu Department of Surgery Tri-Service General HospitalTaipei 114TaiwanChina Division of Colon and Rectal Surgery Department of SurgeryTaiwanChina Adventist HospitalTaipei 105TaiwanChina Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105TaiwanChina Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114TaiwanChina Department of pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 105TaiwanChina Department of pathology and Laboratory Medicine Taoyuan Armed Forces General HospitalTaoyuan 325TaiwanChina

BACKGROUND Appendiceal mucinous neoplasms(AMNs),although not classified as rare,are relatively uncommon tumors most often discovered incidentally during colorectal *** identification of AMNs is difficult due to non-specific sym-ptoms,overlapping tumor markers with other conditions,and the potential for *** underscores the urgent need for precision in diagnosis to pre-vent severe *** SUMMARY This case report describes the unexpected discovery and treatment of a low-grade AMN(LAMN)in a 74-year-old man undergoing laparoscopic hemicolectomy for transverse colon adenocarcinoma(AC).Preoperatively,non-specific gastroin-testinal symptoms and elevated tumor markers masked the presence of *** tumor,presumed to be an AMN peritoneal cyst intraoperatively,was con-firmed as LAMN through histopathological *** neoplasm exhibited mucin accumulation and a distinct immunohistochemical profile:Positive for Ho-meobox protein CDX-2,Cytokeratin 20,special AT-rich sequence-binding protein 2,and Mucin 2 but negative for cytokeratin 7 and Paired box gene *** profile aids in distinguishing appendiceal and ovarian mucinous *** recovery was uncomplicated,and the patient initiated adjuvant chemotherapy for the colon *** This case highlights the diagnostic complexity of AMNs,emphasizing the need for vigilant identification to avert potential complications,such as pseudomyxoma peritonei.

关键词： Adenocarcinoma Appendiceal neoplasms Low-grade appendiceal mucinous neoplasm Peritoneal neoplasms Pseudomyxoma peritonei Case report

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Cellular angiofibroma arising from the rectocutaneous fistula in an adult: A case report

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World Journal of clinical Cases 2024年第10期12卷 1778-1784页

作者： Hao-En Chen Yu-Yang Lu Ruei-Yu Su Hong-Hau Wang Chao-Yang Chen Je-Ming Hu Jung-Cheng Kang Kuan-Hsun Lin Ta-Wei Pu Department of Surgery Taichung Armed Forces General HospitalTaichung 411Taiwan Department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of Pediatrics Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan Department of pathology and Laboratory Medicine Taoyuan Armed Forces General HospitalTaoyuan 32551Taiwan Department of Radiology Tri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND Rectocutaneous fistulae are *** infection originates within the anal glands and subsequently extends into adjacent regions,ultimately resulting in fistula *** angiofibroma(CAF),also known as an angiomy ofibroblastoma-like tumor,is a rare benign soft tissue neoplasm predominantly observed in the scrotum,perineum,and inguinal area in males and in the vulva in *** describe the first documented case CAF that developed within a rectocutaneous fistula and manifested as a perineal *** SUMMARY In the outpatient setting,a 52-year-old male patient presented with a 2-year history of a growing perineal mass,accompanied by throbbing pain and minor scrotal *** examination revealed a soft,well-defined,non-tender mass at the left buttock that extended towards the perineum,without a visible *** initial assessment identified a soft tissue tumor,and the laboratory data were within normal *** and pelvic computed tomography(CT)revealed swelling of the abscess cavity that was linked to a rectal cutaneous fistula,with a track-like lesion measuring 6 cm×0.7 cm in the left perineal region and attached to the left *** examination found no significant inner orifices.A left medial gluteal incision revealed a thick-walled mass,which was excised along with the extending tract,and curettage was *** examination confirmed CAF *** patient achieved total resolution during follow-up assessments and did not require additional *** CT imaging supports perineal lesion diagnosis and *** angiofibromas,even with a cutaneous fistula,can be excised transperineally.

关键词： Angiofibroma Perineal mass Rectocutaneous fistula Anorectal fistula Anal fistula Case report

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Stercoral perforation of the cecum:A case report

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1189-1194页

作者： Hung-Chun Yu Ta-Wei Pu Jung-Cheng Kang Chao-Yang Chen Je-Ming Hu Ruei-Yu Su Department of Surgery Taichung Armed Forces General HospitalTaichung 411228Taiwan Department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General Hospital Songshan BranchNational Defense Medical CenterTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Department of pathology Tri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan Department of pathology and Laboratory Medicine Taoyuan Armed Forces General HospitalTaoyuan 325Taiwan

BACKGROUND With less than 90 reported cases to date,stercoral perforation of the colon is a rare *** ulceration is thought to occur due to ischemic pressure necrosis of the bowel wall,which is caused by the presence of a stercoraceous *** underscore this urgent surgical situation concerning clinical presentation,surgical treatment,and results,we present the case of a 66-year-old man with a stercoral *** SUMMARY A 66-year-old man with a history of hypertension,hyperlipidemia,and gout presented at the emergency department with lower abdominal pain and a low-grade fever lasting for a few *** computed tomography indicated a suspected bezoar(approximately 7.6 cm)in the dilated cecum,accompanied by pericolic fat stranding,mild proximal dilatation of the ileum,pneumoperitoneum,and minimal ***,feculent peritonitis with isolated cecal perforation were ***,a right hemicolectomy with peritoneal lavage was performed.A histopathological examination supported the intraoperative *** In stercoral perforations,a diagnosis should be diligently pursued,especially in older adults,and prompt surgical intervention should be implemented.

关键词： Acute abdomen Colectomy Peritoneal lavage Pneumoperitoneum Bezoars Case report

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Transient receptor potential channels as predictive marker and potential indicator of chemoresistance in colon cancer

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Oncology Research 2024年第1期32卷 227-239页

作者： WEI HU THOMAS WARTMANN MARCO STRECKER ARISTOTELIS PERRAKIS ROLAND CRONER ARPAD SZALLASI WENJIE SHI ULF D.KAHLERT The Fourth clinical Medical College of Yangzhou University Nantong Rich HospitalNantongChina Molecular and Experimental Surgery Clinic for General-Visceral-Vascular and Transplant SurgeryFaculty of Medicine and University Hospital MagdeburgOtto-von-Guericke UniversityMagdeburgGermany Department of pathology and Experimental Cancer Research Semmelweis UniversityBudapestHungary

Transient receptor potential(TRP)channels are strongly associated with colon cancer development and *** study leveraged a multivariate Cox regression model on publicly available datasets to construct a TRP channels-associated gene signature,with further validation of signature in real world samples from our hospital treated patient ***-Meier(K-M)survival analysis and receiver operating characteristic(ROC)curves were employed to evaluate this gene signature’s predictive accuracy and robustness in both training and testing cohorts,***,the study utilized the CIBERSORT algorithm and single-sample gene set enrichment analysis to explore the signature’s immune infiltration landscape and underlying functional *** support vector machine algorithm was applied to evaluate the signature’s potential in predicting chemotherapy *** findings unveiled a novel three TRP channels-related gene signature(MCOLN1,TRPM5,and TRPV4)in colon adenocarcinoma(COAD).The ROC and K-M survival curves in the training dataset(AUC=0.761;p=1.58e-05)and testing dataset(AUC=0.699;p=0.004)showed the signature’s robust predictive capability for the overall survival of COAD *** of the immune infiltration landscape associated with the signature revealed higher immune infiltration,especially an increased presence of M2 macrophages,in high-risk group patients compared to their low-risk ***-risk score patients also exhibited potential responsiveness to immune checkpoint inhibitor therapy,evident through increased CD86 and PD-1 expression ***,the TRPM5 gene within the signature was highly expressed in the chemoresistance group(p=0.00095)and associated with poor prognosis(p=0.036)in COAD patients,highlighting its role as a hub gene of ***,this signature emerged as an independent prognosis factor for COAD patients(p=6.48e-06)and expression of model gene are validated by public data a

关键词： Colon cancer Transient receptor potential channels Prognostic signature Chemotherapy efficiency TRPM5

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Update in lean metabolic dysfunction-associated steatotic liver disease

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World Journal of Hepatology 2024年第3期16卷 452-464页

作者： Karina Sato-Espinoza Perapa Chotiprasidhi Mariella R Huaman Javier Díaz-Ferrer Division of Gastroenterology and Hepatology Department of MedicineMayo ClinicRochesterMN 55902United States Obesity and Metabolic Center for Obesity and Metabolic HealthLima 02002LimaPeru Hepatology service Department of Digestive DiseasesHospital Nacional Edgardo Rebagliati MartinsLima 02002LimaPeru Medicine Faculty Universidad San Martin de PorresLima 02002LimaPeru Gastroenterology service Clinica InternacionalLima 02002LimaPeru

BACKGROUND A new nomenclature consensus has emerged for liver diseases that were previously known as non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated fatty liver disease(MAFLD).They are now defined as metabolic dysfunction-associated steatotic liver disease(MASLD),which includes cardiometabolic criteria in *** condition,extensively studied in obese or overweight patients,constitutes around 30%of the population,with a steady increase *** patients account for approximately 10%-15%of the MASLD ***,the pathogenesis is complex and is not well *** To systematically review the literature on the diagnosis,pathogenesis,characteristics,and prognosis in lean MASLD patients and provide an interpretation of these new *** We conducted a comprehensive database search on PubMed and Google Scholar between January 2012 and September 2023,specifically focusing on lean NAFLD,MAFLD,or MASLD *** include original articles with patients aged 18 years or older,with a lean body mass index categorized according to the World Health Organization criteria,using a cutoff of 25 kg/m2 for the general population and 23 kg/m2 for the Asian *** We include 85 studies in our *** findings revealed that,for lean NAFLD patients,the prevalence rate varied widely,ranging from 3.8%to 34.1%.The precise pathogenesis mechanism remained elusive,with associations found in genetic variants,epigenetic modifications,and adaptative metabolic *** risk factors included metabolic syndrome,hypertension,and type 2 diabetes mellitus,but their prevalence varied based on the comparison group involving lean *** non-invasive tools,Fibrosis-4 index outperformed the NAFLD fibrosis score in lean *** modifications aided in reducing hepatic steatosis and improving cardiometabolic profiles,with some medications showing efficacy to a lesser ***,lean NAFLD patients ex

关键词： Lean Non-obese Non-alcoholic fatty liver disease Metabolic dysfunction-associated fatty liver disease Metabolic dysfunction-associated steatotic liver disease Guidelines Diagnosis Management Pathogenesis Treatment

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Parametric analysis of craniocerebral injury mechanism in pedestrian trafficaccidents based on finite element methods

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Chinese Journal of Traumatology 2024年第4期27卷 187-199页

作者： Jin-Ming Wang Zheng-Dong Li Chang-Sheng Cai Ying Fan Xin-Biao Liao Fu Zhang Jian-Hua Zhang Dong-Hua Zou Academy of Forensic Science Shanghai Key Laboratory of Forensic MedicineKey Laboratory of Forensic ScienceMinistry of JusticeShanghai Forensic Service PlatformShanghai200063China School of Forensic Medicine Guizhou Medical UniversityGuiyang550004China Key Laboratory of Forensic pathology Ministry of Public Security PR ChinaGuangzhou510050China

Purpose:The toughest challenge in pedestrian traffic accident identification lies in ascertaining *** study aimed to systematically simulate and parameterize 3 types of craniocerebral injuryincluding impact injury,fall injury,and run-over injury,to compare the injury response outcomes ofdifferent injury ***:Based on the total human model for safety(THUMS)and its enhanced human model THUMShollow structures,a total of 84 simulations with 3 injury manners,different loading directions,andloading velocities were *** Mises stress,intracranial pressure,maximum principal strain,cumulative strain damage measure,shear stress,and cranial strain were employed to analyze the injuryresponse of all areas of the *** examine the association between injury conditions and injuryconsequences,correlation analysis,principal component analysis,linear regression,and stepwise linearregression were ***:There is a significant correlation observed between each criterion of skull and brain injury(p40 km/h),the Von Mises stress on the skull waswith a high possibility exceed the threshold for skull fracture(100 MPa).When falling and makingtemporal and occipital contact with the ground,the opposite side of the impacted area experienceshigher frequency stress concentration than contact at other ***-over injuries tend to have amore comprehensive craniocerebral injury,with greater overall deformation due to more adequate kinetic energy *** mean value of maximum principal strain of brain and Von Mises stress ofcranium at run-over condition are 1.39 and 403.8 MPa,while they were 1.31,94.11 MPa and 0.64,120.5 MPa for the impact and fall conditions,*** impact velocity also plays a significant rolein craniocerebral injury in impact and fall loading conditions(the p

关键词： Craniocerebral injury Finite element Injury mechanism Traffic accident Biomechanism Forensic practice

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Bridging the divide: Harmonizing polarized clinical laboratory medicine practices

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iLABMED 2024年第2期2卷 67-69页

作者： Yi-Wei Tang Joseph D.Yao Medical Affairs Danaher Corporation/CepheidNew YorkNew YorkUSA Division of clinical Microbiology Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA

In today's healthcare,clinical laboratory medicine stands as a cornerstone of patient care,providing vital diagnostic insights that inform decisions in disease ***,within this crucial field,a dichotomy persists between two predominant models of laboratory testing to support clinical practice:point-of-care testing(PoCT)and central laboratory testing[1].This schism,while born of practical necessity and evolving technology,presents both opportunities and challenges that warrant closer examination.

关键词： central laboratory testing clinical microbiology point-of-care testing

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Congophilic fibrils in the glomeruli with polyclonal immunoglobulin gamma staining-another cause for diagnostic overlap:A case report

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World Journal of clinical Cases 2024年第17期12卷 3200-3205页

作者： Maria Bernadette Che-Ying Chow Lucas Bushrow Irmeen Siddiqui April Chiu Mirza Hamirani Anjali A Satoskar Department of pathology The Ohio State University Medical CenterColumbusOH 43210United States Department of pathology North District HospitalSheung ShuiHong KongChina Department of Laboratory Medicine and pathology Mayo ClinicRochesterMN 55905United States Department of Internal Medicine S.Joseph's HospitalParkersburgWV 26101United States

BACKGROUND Glomerulopathy with fibrillary deposits is not uncommon in routine nephropathology practice,with amyloidosis and fibrillary glomerulonephritis being the two most frequently encountered *** amyloid heavy and light chain(AHL)is relatively uncommon and its biopsy diagnosis is usually limited to cases that show strong equivalent staining for a single immunoglobulin(Ig)heavy chain and a single light chain,further supported by mass spectrometry(MS)and serum studies for monoclonal *** polyclonal light chain staining can pose a *** SUMMARY Herein we present a challenging case of renal AHL with polyclonal and polytypic Ig gamma(IgG)staining pattern by *** patient is a 62-yearold Caucasian male who presented to an outside institution with a serum creatinine of up to 8.1 mg/dL and nephrotic range *** the finding of a polyclonal and polytypic staining pattern on immunofluorescence,ultrastructural study of the renal biopsy demonstrated the presence of fibrils with a mean diameter of 10 *** red was positive while DNAJB9 was *** suggested a diagnosis of amyloid AHL type with IgG and lambda,but kappa light chains were also present supporting the immunofluorescence staining *** immunofixation studies demonstrated IgG lambda monoclonal *** patient was started on *** chronic renal injury however was quite advanced and he ended up needing dialysis shortly *** Tissue diagnosis of AHL amyloid can be *** confirmation using other available diagnostic techniques is recommended in such cases.

关键词： Heavy and light chain amyloid Fibrillary glomerulonephritis DNAJB9 Serum immunofixation Protein electrophoresis Mass spectrometry Congo red Case report

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