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May 2023 DOI 10.14302/issn.2691-5014.jphn-23-4555
Kathryn DohertyCorresponding author
Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.
Nov 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3612
Sah BikashCorresponding author
Associate Professor, Department of Forensic Medicine and Toxicology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. The depressant effect of alcohol further complicates the diagnosis. We report a case of a young male who was unable to seek medical support and was found dead within 12 hours of the onset of abdominal discomfort following acute alcohol intoxication. At autopsy, rupture of the urinary bladder with blood and blood clots was found in the pelvic cavity with no any corresponding external injury. Spontaneous rupture of the urinary bladder is a rare cause of death in acute alcohol intoxication. In order to further understand this rare condition, the review of related literature has been done.
Mar 2020 DOI 10.14302/issn.2575-1212.jvhc-20-3256
di Virgilio FabrizioCorresponding author
DVM, Clinique Vétérinaire Vet24 – 59700 – Marcq en Baroeul, France
This pilot study aims to compare cardiorespiratory parameters in female dogs that underwent either laparoscopic or open elective gonadectomy with spontaneous ventilation anaesthesia. Records of 77 client-owned female dogs were reviewed. Patients were divided into two groups: laparoscopic surgery (L group, n 47) and open abdominal surgery (O group, n 30). The end-tidal carbon dioxide, respiratory rate, oxygen saturation, heart rate, non-invasive arterial blood pressure and length of procedure were recorded and statistically evaluated. Once normality of the sample data has been assessed, equality between the groups was analysed with two-sample Student’s or Welch’s t-test, whether the hypothesis of variance equality, through an F-test, was verified or not. A value of p <0.05 was considered statistically significant. No statistically significant difference was found between groups regarding the end-tidal carbon dioxide, oxygen saturation, respiratory rate, heart rate, systolic and medium arterial pressure values. Mean diastolic pressure was lower in the L group. The procedure length between the two groups was statistically different: laparoscopy was shorter than open surgery. In spontaneously ventilating female dogs, the cardiorespiratory parameters evaluated seem not to be affected by the presence of pneumoperitoneum when intrabdominal pressure is kept between 8 and 10 mmHg. The pilot nature of the study and the shorter laparoscopic surgery length could bias these results. However, in the author’s opinion, these findings confirm the interest of laparoscopy and the small impact of this mini-invasive technique in healthy patients.
Oct 2016 DOI 10.14302/issn.2576-182X.jbsc-16-1261
BOON SENG LIEWCorresponding author
Department of Neurosurgery, Hospital Sungai Buloh, Malaysia.
Background: Spontaneous primary intracranial hemorrhage or known as intracerebral hypertensive hemorrhage consist of 15 to 20% of all stroke, is one of the major health problems among healthy and productive workforce in any countries. Methods: A retrospective study was conducted in a dedicated Neurosurgical Centre at the Hospital Sungai Buloh, Malaysia. The study was conducted for admission within a year period, in the year 2013 with 6 months follow-up. A total of 35 patients were studied. Results: The mean age was 52.8 years old (31-77 years old). A total of 29 patients (82.9%) were presented with basal ganglia hemorrhage, 4 with cerebral lobar hemorrhage (11.4%) and 2 with cerebellar hemorrhage (5.7%). The surgical mortality rate was 40%. For the 6 months follow-up, 31.4% patients improved to Glasgow Outcome score (GOS) of 4, while 22.9% and 5.7% patients improved to only GOS of 3 and 2 respectively. There were several factors identified in the study to be important predictors of survival. There were statistically significance of higher mortality rate among patients with pre-operative GCS of 5 and below (p=0.015), pre-operative CT scan brain showing acute hydrocephalus (p=0.046) and residual post-operative hematoma above 5% of pre-operative clots volume (p=0.006). Other factors such as age, sex, size of pre-operative hematomas, presence of intraventricular hemorrhage, underlying medical illness were not statistically significant in predicting the surgical outcome of those patients. Conclusions: Outcome predictors such as pre-operative GCS and CT scan brain findings helps treating neurosurgeons to determine the prognosis of patients presented with spontaneous intracranial hemorrhage.
Oct 2016 DOI 10.14302/issn.2470-5020.jnrt-16-1279
Damelan KombateCorresponding author
University of Lomé , Teaching Hospital CAMPUS – Lomé , Neurology Department, 03Bp 30284
Carotid-cavernous fistula (CCF) is a rare neurological condition with risk of death in case of inappropriate management. The outcome of this pathology is very bad in developing countries with inadequate technical Platform. We underlined the main difficulties of the management of CCF in a 43 years-old Togolese woman with a fatal outcome.
May 2025 DOI 10.14302/issn.2641-5518.jcci-25-5522
Qureshi AbidCorresponding author
Background In adult males, non-communicating hydroceles are non fluctuant scrotal swellings that are formed when there is an imbalance of fluid secretion and absorption between the parietal and visceral layers of the tunica vaginalis. Giant hydroceles are a rare manifestation and have previously been classified as hydroceles that drain more than 1000 mL of fluid. In this report, we describe a case of a giant hydrocele requiring surgical management and highlight a review of the literature. Case Presentation A 34-year-old male presented with complaints of large right-sided scrotal swelling, accompanied by scrotal discomfort. Ultrasound of the right testicle revealed a large hypoechoic space with a complex collection and posterior displacement of the testicle, indicating a possible hydrocele. The patient was taken to the operating room for a right hydrocelectomy. Approximately 2 liters of fluid were drained from the sac. Discussion Hydroceles are defined as straw-colored fluid collections within the parietal and visceral layers of the tunica vaginalis. Giant hydroceles, defined as fluid collections within the tunica vaginalis exceeding 1000 mL, are rare and the management of such cases is sparsely documented in the literature. While most asymptomatic fluid collections resolve spontaneously, larger collections with inflammatory changes within the testicular wall may require surgical intervention, either laparoscopic or open.
Dec 2024 DOI 10.14302/issn.2641-4538.jphi-24-5358
Kar SonaliCorresponding author
Background Injuries, particularly unintentional ones, are a neglected public health concern and are preventable or avoidable. Children in urban slums are especially vulnerable due to hazardous living conditions, inadequate supervision, and lack of safe sojourns or play areas. Since these injuries result in seeming spontaneous recovery, appropriate care being initiated by the primary care giver is questionable. Objective To assess the burden of unintentional injuries of unintentional injuries in pre-school going children aged 2-6 years in urban slums of Bhubaneswar, Odisha. To compare the knowledge of the 1st level care post-injury among the primary care givers against standardized prescribed care. Methods A cross-sectional descriptive observational study was conducted for over 2 years in urban slums under the Bhubaneswar Municipal Corporation (BMC), the capital city of Odisha. A total of 285 children aged 2-6 years, whose mothers consented to participate, were included in the study. Data regarding the type of injury and its management, as well as, associated socio-demographic factors, were collected using a pre-designed, pre-tested questionnaire. Descriptive statistics was used to derive the burden of unintentional injuries in children. The knowledge of the 1st level of care to be given after the common injuries was assessed among all the primary caregivers to detect the treatment and care gap. Results The majority of primary respondents were mothers aged 21-30 years (82.1%), The frequency of an episode of unintentional injury (occurrence in last 3 months) in the study population was found to be 58%. The most common type of injury reported was skin lacerations or tears, common site being in the upper and lower limbs. Males were more affected as compared to females (54.64 %) The reporting of unintentional injuries among the children was found to have significant association with the occupation of the father. Fathers who were unemployed or working as unskilled labor, their child’s probability of reporting an unintentional injury was found to be high, with p value coming to be statistically significant. Conclusion The study highlights the complex interplay of sociodemographic factors influencing unintentional injuries among children in urban slums and the need to create awareness among the primary caregivers, about the immediate management, so that chronic complications may be averted. It is difficult to avert injury as this age group is agile and nowadays supervision is challenging. Still, the knowledge of management would not just empower the caregiver, but also the growing child, who can attend to their younger siblings or themselves, whenever they get injured next. Further research with larger sample sizes is warranted to validate these findings and develop effective prevention strategies.
Apr 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5036
Saeki TamieCorresponding author
According to the Japan’s National Health and Nutrition Survey, trends in the intake of vegetables and fruits (1999-2018), which are considered effective in preventing lifestyle-related diseases, are far below the target value; In the under-50 age group, less than 30% achieved the target vegetable intake of 350g, and less than 15% achieved the target fruit intake of 200g 53. Against such background, it has become a challenge to nurture children's ‘self-management ability’ that leads to spontaneous and healthy dietary habits 16. Until now, almost all research on ‘Dietary education’ has been conducted in the field of nutrition, focusing on accumulating nutritional knowledge by explaining each nutritional component and its function. However, it is difficult to nurture spontaneous and healthy dietary habits simply through repeated nutrition-based education. It can be said that the pedagogical approach of this paper has made it possible to pursue from a broader perspective that influences food choices. Research on ‘nutrition transition’ points out “worldwide obesity dynamics and their determinants” based on “a shift in the broader patterns of dietary habits (Western-style diet) and corresponding nutrition-related diseases” 42. Nutrition transition research 5040 has a broad and holistic perspective on food and health, making it easy to understand nutrition. The purpose of this paper is to pursue how to nurture the ‘self-management ability’ for spontaneous and healthy dietary habits, based on these latest nutritional knowledges. Because nutrition transition is a global phenomenon, the author choses to use broader methods of international comparative research. Comparisons lead to discoveries and value creation. This can be said to have the greatest significance in comparative research.
Jan 2023 DOI 10.14302/issn.2329-9487.jhc-22-4362
PIO MachihudeCorresponding author
Objective To describe the epidemiological, clinical and arterial Doppler ultrasound aspects of abdominal aortic aneurysm (AAA). Material and Methods This is a prospective study with descriptive and analytical aims carried out from January 2019 to March 2022 (3 years) at the cardiovascular exploration center (CEC) "Saint-Esprit" of the association of the people's doctors for the research on cardiovascular diseases (AMP-MCV), at the clinic "Le Printemps" and at the University Hospital of Kara. All patients who underwent arterial Doppler ultrasound of the lower limbs for any reason in these centers during the study period were included. Ultrasound scans were performed or confirmed by a physician with a diploma specializing in vascular Doppler ultrasound. Results We retained 32 Doppler ultrasound scans out of 739 performed for AAA with a frequency of 4.38%. The mean age was 73.5± 9.07 years. The sex ratio M/F was 1.4. The cardiovascular medical history (84.38%) found was: hypertension (33.33%), diabetes (18.52%), dyslipidemia (33.33%) and a combination of diabetes and hypertension (14.81%). The circumstances of discovery were: downstream MI ischemia (72%), incidental finding on abdominal ultrasound (15.63%) and De bakey sign (6.25%). The location of the aneurysms was subrenal (84.4%), suprarenal (9.4%) and both (6.2%). AAAs were fusiform (71.9%) and saccular (28.1%). The size of the aneurysms was greater than 5 cm in 78.17% of patients. High blood pressure increases the probability of the occurrence of subrenal AAA while dyslipidemia increases the occurrence of fusiform AAA. Diabetes increases the probability of occurrence of AAA larger than 7cm. AAAs were thrombosed in 75% of patients. There were extensions of the aneurysms to the iliac arteries in 70.59%. Downstream embolic complications represented 46.88%, in the form of occlusions and tight stenoses. Spontaneous mortality was 81.24%. Conclusion Arterial Doppler ultrasonography is a very important tool in the screening, positive and lesion diagnosis of AAA. The risk factors for AAA are: age over 60 years, male gender, hypertension, diabetes and dyslipidemia. Early detection remains essential, because the spontaneous prognosis is poor.
Feb 2022 DOI 10.14302/issn.2470-5020.jnrt-22-4092
AGBA LéhlengCorresponding author
Neurology Department, Intercommunal Hospital of Poissy/Saint-Germain-En-Laye, Poissy – France
Acute disseminated encephalomyelitis (ADEM) is a monophasic, multifocal, demyelinating, autoimmune disease that affects the central nervous system (CNS). It usually occurs after a systemic infection, usually viral, including certain coronavirus infections. A 27-year-old girl presented with complaints of left interscapular pain, paresthesias and weakness in the ipsilateral upper limb. These symptoms followed paresthesias on the fingertips of her right hand the day before her admission. she was treated two weeks earlier for pneumonia with COVID-19. Her clinical pattern resulted in a moderate weakness of the left limbs associated with tactil and algic hypoesthesia in the lower left limb ascending until the C4 level in the left side. Magnetic resonance imaging (MRI) of the brain and spinal cord showed diffuse spontaneous hypersignals on fluid-attenuated inversion recovery (FLAIR) images at the cerebral level and on T2-weighted images at the spinal level. These imaging lesions coupled with the medical history of a recent COVID-19 infection led to the diagnosis of acute disseminated encephalomyelitis (ADEM) post covid-19. The clinical condition improved rapidly with intravenous (IV) corticosteroid therapy and IV immunoglobulin combined with physiotherapy. ADEM is a demyelinating autoimmune disease which is increasingly reported during this current corona virus pandemic.
Aug 2021 DOI 10.14302/issn.2372-6601.jhor-21-3903
B Katakkar SureshCorresponding author
Arizona Hematology Oncology, Tucson Arizona USA
A 61 years female patient with known diagnosis of the breast cancer in remission for more than 10 years has Renaud’s disease. During her work up for lupus and lupus anticoagulant which both were negative a prolonged thrombin time was noted which was done by mistake. She has no history of bleeding or thrombosis and last recent surgery was 5 years ago for spinal stenosis and was uncomplicated. Her clinical examination is normal without evidence of any spontaneous bruises but colder hands. The thrombin time was greater than 125 seconds on two different occasions and correction of it by addition of normal plasma was down to 56 seconds and was thus incomplete. Her prothrombin time and PTT were normal and there was no evidence of FDP or D-Dimers. There was no evidence of circulating heparins. The fibrinogen level was normal. The para proteinmia was excluded by normal serum protein electrophoresis and by immunofixation . Thus it is felt that this patient has dysfibrinogenemia or hypo dysfibrinogenemia without bleeding or thrombotic complication. The literature review shows approximately 55% of dysfibrinogenemia patients do not have bleeding or thrombotic complications.
Jan 2021
Ramalingam ManickamCorresponding author
Urology Clinic, Coimbatore
Small extra-peritoneal bladder injury is commonly treated conservatively as it heals spontaneously. However if there is an impinging bony spicule in the rent, the bladder wound does not heal and it is preferable to repair the rent primarily. We present a case of non healing extra-peritoneal bladder injury initially managed conservatively in a trauma center with supra-pubic catheter (SPC). Cystogram was done after 7 weeks showed persistent leakage of contrast. Hence patient was managed by laparoscopic repair of persistent extra-peritoneal bladder rent.
Sep 2019 DOI 10.14302/issn.2689-4602.jes-19-2990
Shkliarevsky GennadyCorresponding author
Bard College
There is hardly anything more central to our universe than conservation. Many scientific fields and disciplines view the law of conservation as one of the most fundamental universal laws. The Darwinian model pivots the process of evolution on variability, reproduction, and natural selection. Conservation plays a marginal role in this model and is not really universal, as the model allows exceptions to conservation, i.e. non-conservation, to play an equally important role in evolution. This anomalous role of conservation in the Darwinian model raises questions: What is the reason for this anomaly? Is conservation really universal, as we tend to believe or is it not, as the Darwinian model suggests? This contribution proposes a new model of evolution that focuses on levels of organization, rather than of species, organisms, or populations. It argues that conservation is central to evolution. Not only does this new model restores the universal status of conservation but it also makes possible to resolve some outstanding problems and controversies that continue to plague the Darwinian model. The article tries to advance the broad Darwinian project that seeks to explain the process of evolution as a product of the spontaneous processes in nature.
Aug 2019 DOI 10.14302/issn.2372-6601.jhor-19-2982
Padaro EssohanaCorresponding author
Hematology Department, Campus Teaching Hospital, University of Lome.
Objective Rosenthal's disease (RD) is a rare constitutional hemorrhagic disorder defined by factor XI deficiency. It is clinically characterized by the presence of minimal haemorrhage. We report the first observation of RD in Togo. Observation Mrs. G. A., 45 years old with no particular pathological antecedents, was referred for anemia in a context of chronic epistaxis. It was a spontaneous anterior exteriorization epistaxis often of great abundance, rocking and which evolved episodically. The patient received several transfusions for anemia. The ear-nose-throat examination was normal and a sinus CT scan found only an inflammatory process of the right maxillary sinus. The blood count showed microcytic severe anemia (2,2g/dl). Hemostasis tests showed a prolonged aPTT (57,9 seconds). Clinical examination documented an anemic syndrome with dry skin. Iron deficiency was found. The hemostasis balance confirmed aPTT elongation. Coagulation factors activity showed normal VIII and IX level, but moderate decrease of factor XI (32%). The family survey was not possible (orphan patient). It is recommended the setting under fresh frozen plasma (FFP) in case of a new episode. Follow-up is in progress. Conclusion In the event of any hemorrhagic syndrome, the isolated elongation of the aPTT must lead to a systematic analysis of intrinsic pathway factors
Sep 2018 DOI 10.14302/issn.2576-2818.jfb-18-2298
E. Meyer AnneCorresponding author
Faculty of the Department of Oral Diagnostic Sciences, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY 14214
The currently reported study employed the curiously named (but simple) quantitative, nondestructive technique of Multiple Attenuated Internal Reflection InfraRed (MAIR-IR) spectroscopy to assess daily variations of both saliva and vaginal secretions from a panel of consenting volunteers. The project goal was to determine whether the protein-to-carbohydrate (starch) ratio, determined by MAIR-IR analysis of salivary and vaginal secretions is an objective measure of the co-variation of mucinous secretions with daily menstrual cycle. Overall, the spectral data were found to provide valid signatures of vaginal mucus chemical changes that also correlated with cyclic periods of presumed fertility, such periods exhibiting repeat times of 14-16 days and 27-29 days in the thoroughly analyzed records. At mid-cycle, associated with ovulatory events, the protein-to-carbohydrate ratio of vaginal mucin maximizes. Higher carbohydrate ratios are associated with stiffer cervical mucus plug formation, which usually prevents infection, spontaneous abortion, and pre-term birth, but may also be responsible for infertility. Mucin relaxation compounds, such as the FDA-approved oral rinse, delmopinol, may induce fertility in such cases.
Dec 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1869
de Cassia Stocco RitaCorresponding author
Genetics Laboratory, Butantan Institute, São Paulo-SP, Brazil
Introduction Bovine papillomavirus (BPV) is the etiological agent of bovine papillomatosis, infectious and neoplastic disease, characterized by the presence of multiple papillomas that can regress spontaneously or to persist and progress to malignancies when in association with environmental cofactors. Although recognized that the BPV can induce DNA damages, the viral role following cancer initiation remains unresolved. Based on this, we stablished cell lines derived from cutaneous papilloma, fibropapilloma and esophageal carcinoma to study the BPV action on epithelial-mesenchymal transition (EMT). Our results showed strong evidences that the virus action can contribute to EMT and, therefore, metastasis. Aim In this study, we analyzed the expression levels of the EMT markers (cytokeratin 10, STAT3 Y705, Oct-3/4 and vimentin) in paraffin-embed samples, using the same tissues that originated the cell lines previous studied, aiming to validate the results observed using cell lines. Material and Methods Expression levels of these markers was analyzed by immunohistochemistry and the collagen composision by Picrosirius red staining. Results We verified an overexpression of these markers in fibroblastoid cells present into the epidermis and ketarinocyte-like cells into the dermis present in dermo-epidermal junction. These data reinforce our previous results using cell cultures, validating both systems (cell culture and paraffin-embed tissues) as useful models to study the natural history of BPV-infected lesions. Conclusion Altogether, the results from these systems indicate that the BPV promote the cancer progression and metastasis through the transdifferentiation of an epithelial to mesenchymal cells (EMT).
Sep 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1733
Inoue NobuhiroCorresponding author
Division of Neurosurgery Kumamoto Neurosurgical Hospital
Spontaneous dissection of the cervical segment of the internal carotid artery (CS-ICA) is uncommon but not rare. A 43-year-old man suddenly developed complete right hemiparesis with motor aphasia. 3 weeks after the initial symptom onset. Magnetic resonance imaging showed enlargement of an intramural hematoma at the cervical carotid artery; it severely compressed and completely occluded the arterial lumen. Diffuse ischemia was observed in the area of the left middle cerebral artery (MCA) immediately after onset and he underwent emergency left superficial temporal artery-MCA double bypass within 6 hours. There was no fatal deterioration and his neurological deficit was resolved. We discuss our treatment of spontaneous dissection of the CS-ICA to prevent ischemic damage.
Sep 2017 DOI 10.14302/issn.2328-0182.japst-17-1714
Najmul Hejaz Azmi SyedCorresponding author
Department of Applied Sciences, Chemistry Section, Higher College of Technology, P. O. Box 74, Al-Khuwair-133, Muscat, Sultanate of Oman
A spectrofluorimetric method has been developed for the determination of imipramine HCl in bulk and commercial dosage forms. The method was based on measuring the fluorescence emission intensity of imipramine-eosin Y ion pair complex (λem = 558 and λex = 319) in dichloroethane at buffer solution (sodium acetate and acetic acid) of pH 4.8. The stoichiometric ratio between imipramine and eosin Y was studied by Job's method of continuous variations and found to be 2:1. Formation constant (Kf) and Gibb’s free energy change (ΔG) were calculated and pointed towards the spontaneous nature of the reaction. A series of variables were studied to optimize the reaction conditions. The proposed method was validated as per ICH guidelines and successfully applied for the determination of active imipramine HCl in commercial dosage forms with high degree of accuracy and precision.
Aug 2017 DOI 10.14302/issn.2688-5328.ijp-17-1581
Gustorff B.Corresponding author
Department of Anesthesia, Intensive Care and Pain Medicine & Vienna Human Pain Research Group, Wilhelminenspital, Vienna, Austria, teaching hospital of the Medical University of Vienna
Background Capsaicin 8% patch reduces peripheral neuropathic pain. Based on the concept of neuropathic pain (NeP) in mixed low back pain (LBP) it is hypothesized, that an exclusively lumbar capsaicin 8% patch is an effective treatment of mixed LBP. The aim is a proof of this concept and to identify predictors of responsiveness. Methods This prospective stratified study included 54 chronic, mixed, LBP patients with spontaneous pain >3/10 on the NRS (0-10) and a painDETECT Questionnaire (PDQ) score >12 meaning possible or likely (>18) NeP. Pain intensity, PDQ, and quantitative sensory testing (QST) were assessed at baseline. After a one-hour capsaicin 8% treatment on the low back, follow-up was carried out regularly over three months. Response was determined at one month (≥30% pain reduction) and predictors were compared accordingly. Results The average change in pain intensity at week four was -1.1 (-0.50;-1.71, 95%CI, p < 0.001). Twenty-one (39%) patients responded at one month with a mean pain reduction of -3.1 (-4.0;-2.3, 95%CI) and even 10 of the 21 responders showed a ≥ 50% pain reduction. No pain reduction was seen in 33 (61%) patients (p = 0.42). Responders and non-responders did not differ at any baseline parameter: NRS (p = 0.85), PDQ score (p = 0.47), duration of pain (median of 48 and 36 months) nor QST profiles. Conclusions Lumbar capsaicin 8% patch is an effective treatment in about 40% of chronic patients with mixed neuropathic LBP. However, predictors for response could not be identified.
Jan 2017 DOI 10.14302/issn.2574-4518.jsdr-16-1333
Hakim T.S.Corresponding author
Sleep Apnea Treatment Unit, Phoenix, AZ and University of South Florida, Department of Anesthesiology, Tampa, FL.
Expiratory Positive airway pressure (EPAP) devices such as prevent have been used for treatment of obstructive sleep apnea without discussing their limitations. In this short review we discuss the physiological limitations of EPAP devices during inspiration and during expiration. During spontaneous breathing, when EPAP is excessive, the patient would have difficulty breathing in because lung compliance decreases at higher volumes. Furthermore excessive EPAP could lead to progressive trapping of air in the lungs. An ideal EPAP device should allow the patient to adjust the resistance to a comfortable level that would provide EPAP without a progressive buildup in pressure, without compromising tidal volume, without causing CO2 retention, and without disturbing sleep. The use of EPAP devices with adjustable resistance is essential for best results in treatment of obstructive sleep apnea and snoring.
Jan 2017 DOI 10.14302/issn.2575-7881.jdrr-16-1375
Góth LászlóCorresponding author
Department of Medical Laboratory and Diagnostic Imaging, University of Debrecen, Debrecen POBox 55, Hungary H-4012
We checked our simple screening technique for detection of the known polymorphism of rs769217, and the two acatalasemic mutations in exon 9 of the catalase gene. This fast and inexpensive method yielded better resolution than those of the standard SSCP. We suppose that the method detects the spontaneously formed single stranded DNAs.
Oct 2016 DOI 10.14302/issn.2572-3030.jcgb-16-1276
Hayashi TakumaCorresponding author
Dept. of Obstetrics and Gynecology, Shinshu University School of Medicine, Japan,
Human uterine leiomyosarcoma (LMS) is neoplastic malignancy that typically arises in tissues of mesenchymal origin. The identification of novel molecular mechanism leading to human uterine LMS formation and the establishment of new therapies has been hampered by several critical points. We earlier reported that mice with a homozygous deficiency for proteasome beta subunit 9 (PSMB9)/b1i, an interferon (IFN)-g inducible factor, spontaneously develop uterine LMS. The use of research findings of the experiment with mouse model has been successful in increasing our knowledge and understanding of how alterations, in relevant oncogenic, tumour suppressive, and signaling pathways directly impact sarcomagenesis. The IFN-g pathway is important for control of tumour growth and invasion and, has been implicated in several malignant tumours. In this study, experiments with human tissues revealed a defective PSMB9/b1i expression in human uterine LMS that was traced to the IFN-g pathway and the specific effect of somatic mutations of Janus kinase (JAK1) molecule or promoter region on the transcriptional activation of PSMB9/b1i gene. Understanding the molecular mechanisms of human uterine LMS may lead to identification of new diagnostic candidates or therapeutic targets in human uterine LMS.
Apr 2016 DOI 10.14302/issn.2470-5020.jnrt-16-980
Stein MarcoCorresponding author
Department of Neurosurgery, Justus Liebig University Giessen, Germany
Spontaneous intracerebral hemorrhage (ICH) is one of the leading causes of death worldwide. In randomized trials on surgical therapy inclusion of the very old was limited by the recruitment process. This study was performed to evaluate the age limits in published surgical trials on ICH, and to determine how upper age limits effect the inclusion of men and women in these and future trials on the basis of a large cohort of ICH patients in central Europe. The Hessian stroke registry, a state-wide prospective stroke databank, was used to analyze upper age limits and sex differences for patients with the diagnosis of ICH (ICD-10: I61.0 to I61.9) who were admitted between January 2010 and December 2012. Sex differences were calculated at different age cutoffs, and the proportions of potentially excluded sex-specific patients from surgical trials on ICH were calculated. Overall, 5184 patients with the diagnosis of spontaneous ICH were identified. A total of 2457 (47.4%) patients were female and 2727 (52.6%) patients were male. Mean age was 72.3 ± 13.6 years. Female patients were significantly older compared to male patients (74.9 ± 13.5 years vs. 69.9 ± 13.2 years; p<0.001). With an upper age limit of 70, 75, and 80 years, 3437 patients (66.3%), 2664 patients (51.4%), and 1765 patients (34.0%) were excluded, respectively. Upper age limits in surgical trials on ICH could lead to the exclusion of a significant portion of patients from studies. This should be noted when transferring conclusions from these trials into clinical practice.
Jun 2014 DOI 10.14302/issn.2372-6601.jhor-13-379
Hayashi TakumaCorresponding author
Dept. of Immunology and Infectious Disease, Shinshu University, School of Medicine, Matsumoto, Nagano 390-8621, Japan
Sarcomas are neoplastic malignancies that typically arise in tissues of mesenchymal origin. The identification of novel molecular mechanisms leading to sarcoma formation and the establishment of new therapies has been hampered by several critical factors. Human uterine leiomyosarcoma (Ut-LMS) develops more frequently in the muscle tissue layer of the uterine body than in the uterine cervix. Although the development of gynecologic tumors is often correlated with the secretion of female hormones; that of human Ut-LMS does not and its risk factors remain unknown. Importantly, a diagnostic biomarker that can distinguish malignant Ut-LMS from benign tumor uterine leiomyoma (LMA) has yet to be established. Therefore the risk factor(s) associated with human Ut-LMS to establish a diagnosis and novel therapeutic method. Proteasome b-ring subunit LMP2/b1i-deficient mice spontaneously develop Ut-LMS, with a disease prevalence of ~40% by 14 months of age. We shown that LMP2/b1i expression was absent in human Ut-LMS, but present in other human uterine mesenchymal tumors including uterine LMA. Therefore, defective-LMP2/b1i expression may be one of the risk factors for human Ut-LMS. LMP2/b1i is a potential diagnostic biomarker for human Ut-LMS, and may be a targeted-molecule for a new therapeutic approach.