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Sep 2023
Suzuki HiroyukiCorresponding author
Objectives The number of cases of cyanoacrylate closure (CAC) system for varicose veins has been increasing worldwide. However, as this is a new treatment method, the potential adverse effects and other details remain unclear. In particular, the cause of inflammation in embolized veins is still under debate. Methods We performed a drug-induced lymphocyte stimulation test (DLST) on a patient with allergic-like symptoms after CAC. Results The DLST was strongly positive in this case, and the patient underwent total removal of the CAC-filled vein due to difficulty controlling the symptoms with medication. After that the state was recovered and no medication was continued. Conclusion We encountered a case that a delayed allergy by CA after CAC treatment developed in, eventually leading to the total removal of the CA-filled vein. It was suggested that with doubting allergic-like symptom after CAC, DLST for CA could show not only the diagnosis of the delayed allergy to CA, but also the later treatment policy with stimulation index (S.I.) in the positive cases.
Jan 2022 DOI 10.14302/issn.2641-5518.jcci-21-3959
EKMEZ MuratCorresponding author
Sultangazi Haseki Training and Research Hospital, Department of Gynecology and Obstetrics, Istanbul, Turkey
COVID-19 epidemic, described as a community health emergency by the World Health Organization, began in December 2019. COVID-19 is a source of deep vein thrombosis (DVT) because of hypercoagulation, blood stasis, and endothelium injury complications. This study reports a 26-year-old pregnant woman with coronavirus hospitalized with a left ovarian vein (LOV) thrombosis at Sultangazi- Haseki Training and Research Hospital in Istanbul. Risk classification for DVT disease is of crucial importance for the forecast of coronavirus.
Sep 2020 DOI 10.14302/issn.2470-0436.jos-20-3400
Abo Taleb EmanCorresponding author
Regional hospital for vitreo. Retina and eye care at Sana'a, Yemen
Aim To compare the efficacy of combined anti-VGEF (IVB) with steroids versus pure anti-VEGF for the treatment of macular edema secondary to retinal vein occlusion (RVO). Methods In this prospective study, 51 eyes were randomized into 2 groups according to treatment of clinically identified macular edema secondary to retinal vein occlusion within 4 weeks of onset: Group 1 (19 eyes) was given intravitreal Bevacizumab (IVB) (1.25mg/.05ml) + Triamcinolone (IVTA) (2mg/.05ml); Group 2 (22 eyes) was given pure intravitreal Bevacizumab (IVB) (1.25mg/.05ml) at baseline, at month 1, and at month 2. The outcome of the study represented the EDRTS letters gain, IOP change and (CRT) by using Spectral domain optical coherence tomography (OCT) at month 1, 2, 3 and 6 in each group. Both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) patients with at least 6 months FU were enrolled in the study. Results EDRTS letters gain was (20.37±15.28, 28.05±16.68, 35.16±17.12, 36.47±18.17) in group1 and (14.50±14.56, 18.41±14.56, 20.59±16.13, 21.06±15.72) in group2 at month 2,3 and 6 p value (0.18, .04, 0.004, 0.002). Mean IOP pre-injection (14.00±2.67) in group 1 and (13.5±5.89) in group 2. Group 1 has transient increase in IOP at month 1 and then return to baseline over 6 months. CRT from baseline to final FU decrease by 264.82 (µm) ±147.66 in group 1 and 308.42(µm) ±226.78 in group 2 with no significant difference between two group p value 0.57. There was no significant difference in EDRTS letters gain between CRVO patients and BRVO patients at month 1, 2, 3 and 6 p values (0.83, 0.23, 0.29, 0.13). Conclusion Early treatment macular edema in RVO patients by combined anti-VGEF+ steroid effectively improve functional outcome better than pure anti-VGEF injection.
Nov 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1748
Nair AjayCorresponding author
Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Research Program, Oklahoma City, Oklahoma 73104, USA
Neo-Darwinian natural selection theory indicates that sudden, drastic changes in the environment place selective pressure on genetic variants in a population. As time progresses, this pressure sculpts individuals to better fit this new environment. Waddington’s classic experiment was repeated using white-eyed (the w1118strains) flies which produced the crossveinless (cve; disturbed wing crossveins) trait from the parent generation. The F1 generation was split into two selection lines: an Upward Selection Line, that produced more cve in successive generations, and a Downward Selection Line that responded with a consistent but non-linear decline in the percentage of crossveinless. This article will introduce and enlarge observations made on flies with cve; especially the manner in which the Waddington experiment impacts the population. It seems that Waddington evaluated crossveinless just by what it is good for, but not by the price of using it. That is to say, there is an inevitable cost that needs to be paid in order to acquire crossveinless-ness (cve and the associated phenotypes).
Apr 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1425
Damelan KombateCorresponding author
University of Lome (Togo)
Lemierre’s syndrome is rare jugular thrombosis associated with an oropharyngeal infection. The jugular thrombosis is from septic origin. This often happens in young males subjects. We described Lemierre’s syndrome in a 46 year-old man with a chronic ethmoidal sinusitis associated to the left jugular thrombosis extended to the transverse sinus with a partial recanalisation after three months of oral anticoagulant therapy.
Oct 2016 DOI 10.14302/issn.2574-4526.jddd-16-1153
Umair MasoodCorresponding author
A 69 year old female with a history of pancreatic mucinous cystadenoma (treated with Whipple procedure) and recently presumed liver cirrhosis presented to the hospital with melanotic stools. The source of the bleeding was initially thought to be secondary to upper gastrointestinal (GI) varices due to portal hypertension from the liver disease. Upper endoscopy found no active bleeding and confirmed grade 2 gastric varices with gastric wall edema. Due to persistent symptoms and inability to locate the exact source, she went to the operating room for possible transjugular intrahepatic portosystemic shunt (TIPS) but was not found to have any porto-systemic gradient. Instead, she was found to have an isolated stenosis of the left gastric vein, which was treated with balloon angioplasty and eventual splenectomy. Upper GI varices usually occur due to portal hypertension from liver disease. Extra hepatic causes are much rarer. We report a case of upper GI bleed from gastric varices secondary to left gastric vein stenosis rather than portal hypertension. The stenosis was due to a rare complication of a Whipple procedure. The case is unique as there are no reported cases of gastric varices secondary to left gastric vein stenosis.
Jun 2015 DOI 10.14302/issn.2470-0436.jos-14-528
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A previously healthy 25 year old Chinese male presented with left eye blurring of vision and was diagnosed to have left eye branch retinal vein occlusion. Initial blood investigations and thrombophilia screen were negative. The patient subsequently improved with observation and conservative management, with no further events over a 2 year follow up period. The blood investigations were repeated 2 years later as part of a health check-up and he was then tested to be heterozygous for the factor V leiden mutation. This was confirmed by sequencing of his genome that identified the mutation. The laboratory was contacted to provide details regarding the testing methods and was noted to have performed the two tests via different methods. While false negative rates in genetic testing are low, we believe that there is greater need to standardize testing methods as ascertaining genetic conditions play a great role in clinical diagnosis, treatment and prognosis. Clinicians should be aware of the limitations of these tests. When clinical suspicion is high, there may be a role for repeat tests with different methods or in different laboratories.
May 2015 DOI 10.14302/issn.2470-0436.jos-14-527
Sanjay SrinivasanCorresponding author
Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
A 66 year old Chinese male with a medical history of hypertension, diabetes mellitus and hepatitis B carrier was diagnosed with hepatocellular carcinoma in 2009. He underwent treatment with selective internal radiation spheres and sorafenib, and multiple cycles of chemotherapeutic agents such as bevacizumab, erlotinib, OXAFI ( intravenous oxaliplatin and doxorubicin given on days 1, 8 and 15 in a 28-day cycle, a daily continuous infusion of fluorouracil and subcutaneous interferon alfa-2b 5 million units administered thrice weekly), thalidomide, capecitabine, and rapamycin over the course of four years. Along the course of treatment, he developed pulmonary embolism and was initially started on anti-coagulation. Two months later, he developed hemoptysis and the anti-coagulants were stopped. During his routine ophthalmology visit for diabetic eye evaluation, he complained of blurring of vision of his left eye for the past four to five weeks. He was found to have central retinal vein occlusion (CRVO) of the left eye, associated with macular edema. Visual acuity was 6/15 for the right eye and 6/60 for the left eye. Eyelids, conjunctiva, cornea, anterior chamber, pupils, lens and ocular motility were normal. Humphrey visual field testing showed a superior arcuate and basal defect. This is the first reported case of CRVO in hepatocellular carcinoma. The etiology of CRVO is multifactorial, withhepatic malignancy, previous major surgery, multiple cycles of chemotherapy and cessation of anticoagulant therapyas possible aetiological factors. His background medical problems of diabetes and hypertension are further contributors.
Oct 2024 DOI 10.14302/issn.2691-5014.jphn-24-5310
Alsaeed GihadCorresponding author
Cystic neck masses are uncommon in children, and a minority of them are soft. Internal jugular vein phlebectasia (IJVP) is a rare cause of soft neck cysts. It presents usually as a unilateral soft neck mass of changing size. In most cases it is unilateral, right sided and predominantly in males. Imaging study modalities are diagnostic and helpful for observation and follow up. In the vast majority of cases, it decreases in size with time requiring only conservative treatment. However, surgery might be necessary in large or complicated phlebectasia. IJVP is underdiagnosed or misdiagnosed especially in pediatrics, with few cases documented in medical literature. To improve awareness of presentation and management-plan of this rare case, the authors present an extremely rare case of huge left internal jugular phlebectasia in a 14 year-old boy worsened and complicated over years of wait and see approach that needed surgical treatment.
Jan 2024 DOI 10.14302/issn.2328-0182.japst-23-4771
Tariku Belay YilkalCorresponding author
Background Immunoglobulins are bio-receptors found embedded in the cell membrane with a biological role that detects the harmful molecules of a test compound. These bio-receptors interface between a biological system and its external environment that transduce information to the effector via intermediate messengers in which its response efficiency usually exhausts at high doses of exposure to external stimuli. The purpose of this review article is, therefore, to elaborate on the computational method for systemic biology which was designed to convert qualitative pharmacological data into the quantitative one that might help to determine the toxicity of a test compound. Methods First, acute toxicity studies using different levels of doses prepared from each test compound have been conducted on Balb c mice. Then, blood specimens from the tail and facial veins of each sampled Balb c mouse were collected 3 days before dosing as a reference test and 4 hr after dosing for comparison. The changes in the efficiency of immunoglobulins immune response (ΔIg) after dosing were determined using quantitative immunoassay and the body’s response against the dose as the toxic reaction rate (r) and the toxic severity (s) were finally determined using computational methods as r=d/t-ΔIg mg/sec and (s=r/w×100) %/sec respectively, where (w) represents the body weight of a study animal, (t) represents the period of time at which undesirable bio-physiological responses manifested on treated study animals and (ΔIg) represents the changes in the concentration of immunoglobulins in blood serum after dosing. Results The results of different studies revealed that the dose has never limited the toxic property of a test compound but the length of time at which the undesirable side effect was manifested on study animals. The period of time at which adverse effects manifested on treated Balb c mice was inversely related to the amount of dose administered in the oral route. The higher the dose of the administered test compound, the shorter the period of time at which the undesirable side effect was manifested on treated Balb c mice. This means that the adverse effect of test compounds was not because of the dose but rather due to its toxic reaction rate which ultimately determined the toxic severity in the natural process of treated Balb c mice. Balb c mice treated with a dose whose toxic reaction rate was ≤ 0 survived from death whereas Balb c mice treated with a dose that had a toxic reaction rate of > 0 died at different lengths of time after dosing depending on the toxic severity of a test compound. It could be a scientific fact to declare that a test compound is safe when the toxic reaction rate (r) and toxic severity (s) of a dose is ≤ 0 and toxic when it is > 0 in the natural processes of a study animal.
Aug 2023 DOI 10.14302/issn.2692-1537.ijcv-23-4679
Ryu TomikoCorresponding author
Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-Co V-2) has contributed to control of the coronavirus disease 2019 (COVID-19). On the other side, vaccination of SARS-CoV-2 could trigger autoimmune or inflammatory diseases. We present a 50-year-old female with well-controlled optic neuromyelitis with prednisolone (PSL) maintained at a dose of 2.5 mg/day. She ran a fever and liver injury was indicated 5 weeks after a second COVID-19 vaccination (BNT162b2 mRNA/Pfizer ). Liver biopsy showed accumulation of macrophages around the central veins, identified using anti-CD68 antibodies. As the treatment, cyclosporine A improved liver injury. COVID- 19 vaccination may have triggered liver inflammation due to cytokine storm via macrophage activation in the liver.
Nov 2020
Vladimir Leonidovich MartynovCorresponding author
(doctor of medical sciences, professor of the department of physiology and anatomy of the Nizhny Novgorod State University named after N.I. Lobachevsky) Kazarina Natalya Vladimirovna, resident doctor
Currently, there is a paradoxical situation where the dominant opinion in medicine recognizes the harmfulness of dysfunction of such barrier structures as the cardia, pylorus, sphincter of Oddi, heart valves, valves of the veins of the lower extremities, etc., but ignores the failure of the ileocecal obturator (bauginium damper) or its absence as a possible cause of the pathology of the digestive system, as well as various extraintestinal diseases 1. But also I.I. Grekov (1952) expressed his position 2, which remained relevant: “Despite a number of works devoted to the proximal part of the large intestines, the pathology of this department is still insufficiently explained because the role of the Bauginium damper was completely ignored in these works.
Sep 2020 DOI 10.14302/issn.2471-2175.jdrt-20-3511
Bajaj AnubhaCorresponding author
MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road, Rajouri Garden, New Delhi, 110027, India.
Intravascular papillary endothelial hyperplasia is an exceptional, benign, inflammatory, vascular neoplasm delineating papillary configuration engendered from reactive proliferation of damaged endothelial cells, while being confined to a thrombus. Initially scripted by Pierre Mason in 1923, the tumefaction was denominated as an intra-luminal lesion within an ulcerated, haemorrhoidal vein and designated as “hemangio-endotheliome’ vegetant’ intravasculaire”(1). The neoplasm is additionally nomenclated as Masson’s tumour, Masson’s pseudo-angiosarcoma, endovascularite proliferante thrombopoietique, intravenous atypical vascular proliferation, intravascular angiomatosis, vascular angiomatosis, intravascular endothelial proliferation, reactive papillary endothelial hyperplasia or intravascular papillary endothelial hyperplasia. The papillary neoplasm is associated with deposition of fibrin and thrombotic substances within a painful, ulcerated.
Oct 2018 DOI 10.14302/issn.2577-2279.ijha-18-2384
A. Hegazy AbdelmonemCorresponding author
Human Anatomy and Embryology department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
Background: Oral ingestion of zinc oxide nanoparticles (ZnONPs) may lead to serious liver injury. Vitamin E (VE) is an important antioxidant factor that can reduce such damage. Aim: This study aimed to evaluate the possible changes that could take place in the liver of adult male albino rats after oral ingestion of ZnONPs and elucidate the potential protective role of VE against such damage. Material and Methods: Forty eight male albino rats were divided into four groups of 12 animals each. Group (1) served as control group and received normal saline. Group (2) “VE-treated” received 100 mg/kg/day of VE dissolved in normal saline by oral gavage for 21 days. Group (3) “ZnONPs-treated” received a daily dose of ZnONPs dispersed in the fresh sterilized physiological saline solution 1mg/kg for 5 constitutive days. Group (4) “concomitant ZnONPs and VE-treated” was pretreated with VE 100 mg/kg/day for 14 days followed by the same dose of ZnONPs as in group (3) for 5 days. The extent of hepatic damage was evaluated by histological and immunohistochemical examination of liver samples and serological analysis of liver enzymes. Results: Body weights and liver weights showed very highly significant decrease (P <0.001) in the ZnONPs-treated group. The histological results in ZnONPs-treated group revealed congested dilated central veins and blood sinusoids, loss of normal arrangement of hepatocytes and most of hepatocytes showed marked vacuolated cytoplasm with darkly stained nuclei. Portal area affection was in the form of congested dilated portal veins with bile duct hyperplasia and cellular infiltration. There was an increase in the mount of blue stained collagen fibers around central veins together with strong positive reaction for Caspase 3 in ZnONPs-treated group. Similarly biochemical analysis indicated that the levels of serum aminotransferase (AST &ALT) significantly increased in ZnONPs-treated group when compared with other groups. Rats pretreated with VE showed improvement of the histological findings and biochemical parameters. Conclusion: Ingestion of ZnONPs could be associated with serious liver affection and pretreatment with VE is suggested to induce some improvement of such deleterious changes.
Aug 2017 DOI 10.14302/issn.2379-8572.joa-17-1672
Ozcan Kara PelinCorresponding author
Mersin University, Faculty of Medicine, Department of Nuclear Medicine, Mersin, Turkey
Accurate diagnosis of tumor thrombus and distinguishing benign thrombus from tumor thrombus avoid unnecessary anticoagulant treatment of oncological patients and it is important for patient management. In this case report, the role of FDG PET/CT in the presentation of a suspicious tumor thrombus in the left brachiocephalic vein of a patient with known laryngeal carcinoma and leiomyosarcoma diagnosis is presented.
Jul 2017 DOI 10.14302/issn.2474-7785.jarh-16-1067
Nanavati NikhilCorresponding author
Specialist Registrar Orthopedics, Sheffield Teaching Hospitals, Sheffield, UK
Aim Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in hospital with orthopaedic surgery already an established risk factor. This study aims to establish the length of time that a patient is at risk of sustaining a VTE post orthopaedic surgery. Method A retrospective case series of all patients who underwent orthopaedic surgery between 2010 and 2014 whom re-presented with a VTE within one year of their initial operation. Demographic, operative and clinical information was obtained in order to identify potential risk factors. Results 53 patients were identified as having a VTE within one year of discharge. The majority (63.4%) underwent lower limb arthroplasty. 29% of the cohort had either a family or personal history of VTE, 79% had ischaemic heart disease (IHD), hypertension or both. The average body mass index (BMI) of the cohort was 31.4; above the UK national average. 56.6% of the cohort developed a pulmonary embolism (PE) and 49% developed a deep vein thrombosis (DVT). Co-occurring DVT and PE was diagnosed in 5.6% of patients. The average length of time for readmission for patients to re-present at hospital with a PE was 122 days (range 4-361) and 107 days (range 7 – 360) with a DVT. Conclusion This study confirms the existence of pre-established risk factors for developing VTE including obesity, personal and family history of DVT, cardiovascular disease and lower limb arthroplasty. These risk factors are recognised despite patients receiving post-operative thromboprophylaxis. The findings of this study extend the current research by suggesting that patients presenting with known risk factors of developing VTE may be at risk for longer than the current guidelines cover for the administration of thromboprophylaxis. We propose further studies are needed to identify any potential requirements for more extensive VTE prophylaxis in this population.