BACKGROUND Monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL)is an uncom-mon and highly aggressive form of lymphoma that represents less than 1%of all non-Hodgkin’s lymphomas.At present,few reports have fo...BACKGROUND Monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL)is an uncom-mon and highly aggressive form of lymphoma that represents less than 1%of all non-Hodgkin’s lymphomas.At present,few reports have focused on the imaging findings of MEITL,which poses significant challenges for clinical diagnosis.A 78-year-old female with recurrent vomiting and abdominal distension was admitted to our hospital.Magnetic resonance and^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)examinations revealed multiple segmental malignant tumors in the small intestine with me-senteric lymph node metastasis.An endoscopic biopsy revealed MEITL.After three cycles of reduced-dose cyclophosphamide,vinorelbine,and prednisone che-motherapy,follow-up^(18)F-FDG PET/CT demonstrated a partial response to treatment.The patient was still alive after 6 months of follow-up.CONCLUSION Magnetic resonance imaging serves as a valuable tool in detecting malignant tumor lesions of MEITL,whereas^(18)F-FDG PET/CT offers additional assistance in tumor staging and assessing treatment efficacy.展开更多
BACKGROUND Crohn’s disease(CD)patients with intestinal involvement often require surgical intervention due to resistance to medical therapy.Postoperative recurrence remains a significant challenge,with the Rutgeerts ...BACKGROUND Crohn’s disease(CD)patients with intestinal involvement often require surgical intervention due to resistance to medical therapy.Postoperative recurrence remains a significant challenge,with the Rutgeerts score commonly used to predict endoscopic recurrence.AIM To evaluate the relationship between microscopic and macroscopic pathological findings in resected intestinal specimens and the Rutgeerts score to predict endoscopic recurrence in CD patients.METHODS This retrospective cohort study included 32 patients over 18 years of age with intestinal CD who underwent surgery at General Surgery Clinic of Ankara Bilkent City Hospital between November 2019 and October 2023.Resection specimens were histopathologically re-examined,and postoperative colonoscopy reports were classified according to the Rutgeerts score.The association between pathological findings and endoscopic recurrence was analyzed statistically.RESULTS No significant association was found between macroscopic findings and Rutgeerts scores or endoscopic recurrence(P>0.05).However,the presence and severity of neutrophilic cryptitis(P=0.035)and crypt abscesses(P=0.010)in microscopic findings were significantly associated with higher Rutgeerts scores,indicating a parallel increase with endoscopic recurrence.Other microscopic findings showed no significant correlation with Rutgeerts scores or endoscopic recurrence(P>0.05).CONCLUSION The presence of neutrophilic cryptitis and crypt abscesses in resected intestinal specimens of CD patients increases the likelihood of endoscopic recurrence.Early postoperative medical treatment and close endoscopic follow-up may benefit high-risk patients to prevent recurrence,with treatment decisions made by a weekly multidisciplinary council involving General Surgery,Gastroenterology,and Radiology.展开更多
AIM:To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency(CLD),an extremely rare condition.METHODS:A prospective,cross-sectional comparative study was perf...AIM:To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency(CLD),an extremely rare condition.METHODS:A prospective,cross-sectional comparative study was performed on six patients with CLD and 13 healthy age-and sex-matched controls.The central corneal thickness(CCT),anterior chamber depth(ACD),axial length(AL),keratometry(K1,K2),optical coherence tomography(OCT),and OCT angiography parameters were compared between the leptin and control groups at the baseline visit.The change in these measurements in leptin patients over a two-year period was analyzed.RESULTS:CLD patients had lower mean AL,ACD,and CCT(P≤0.012 for all).Mean K1,K2(P≤0.047 for both),choroidal thickness(P≤0.001),and central ganglion cell layer(GCL)thickness(P=0.029)were higher in the leptin group.Perifoveal superficial capillary plexus(SCP)density was decreased in all quadrants except the temporal region(P<0.05),and parafoveal deep capillary plexus(DCP)density was decreased in the superior hemisphere,temporal quadrant(P≤0.036 for both)and nasal quadrant(P=0.048)in the leptin group.During the two-year follow-up,no changes in anterior and posterior segment measurements were observed in the leptin patients,except for subfoveal choroidal thickness(P<0.001).CONCLUSION:CLD patients exhibit structural alterations in both the anterior and posterior segments of the eye,including notable changes in retinal and choroidal vasculature.However,there is limited evidence concerning the influence of leptin therapy on the eye.展开更多
BACKGROUND Immunoglobulin A(IgA)vasculitis,formerly known as Henoch-Schönlein purpura,is a small vessel vasculitis predominantly affecting children.It commonly presents with a triad of purpuric rash,arthralgia,an...BACKGROUND Immunoglobulin A(IgA)vasculitis,formerly known as Henoch-Schönlein purpura,is a small vessel vasculitis predominantly affecting children.It commonly presents with a triad of purpuric rash,arthralgia,and abdominal pain.However,dermatologic manifestations of IgA vasculitis in black-skinned individuals are poorly documented in literature.CASE SUMMARY This case report describes an 11-year-old black girl with acute onset of rash,joint pain,and abdominal pain,subsequently diagnosed with IgA vasculitis.CONCLUSION The case highlights the importance of early recognition and supportive management in ensuring a favorable outcome,particularly in dark-skinned populations.展开更多
AIM:To validate the usefulness of screening endoscopy findings for predictingHelicobacter pylori (H. pylori) infection status. METHODS:H. pylori infection status was determined by histology, serology, and the urea bre...AIM:To validate the usefulness of screening endoscopy findings for predictingHelicobacter pylori (H. pylori) infection status. METHODS:H. pylori infection status was determined by histology, serology, and the urea breast test in 77 consecutive patients who underwent upper endoscopy. Based on the findings, patients were categorized as H. pylori -uninfected, -infected, or -eradicated cases. Using six photos of certain sites in the stomach per case, we determined the presence or absence of the following endoscopic findings:regular arrangement of collecting venules (RAC), linear erythema, hemorrhage, fundic gland polyp (FGP), atrophic change, rugal hyperplasia, edema, spotty erythema, exudate, xanthoma, and mottled patchy erythema (MPE). The diagnostic odds ratio (DOR) and inter-observer agreement (Kappa value) for these 11 endoscopic findings used in the determination of H. pylori infection status were calculated. RESULTS:Of the 77 patients [32 men and 45 women; mean age (SD), 39.7 (13.4) years] assessed, 28 were H. pylori uninfected, 28 were infected, and 21 were eradicated. DOR values were significantly high (< 0.05) for the following H. pylori cases:uninfected cases with RAC (11.5), linear erythema (24.5), hemorrhage (4.1), and FGP (34.5); for infected cases with atrophic change (8.67), rugal hyperplasia (15.8), edema (14.2), spotty erythema (11.5), and exudate (3.52); and for eradicated cases with atrophic change (32.4) and MPE (103.0). Kappa values were excellent for FGP (0.93), good for RAC (0.63), hemorrhage (0.79), atrophic change (0.74), and MPE (0.75), moderate for linear erythema (0.51), rugal hyperplasia (0.49), edema (0.58), spotty erythema (0.47), and exudate (0.46), and poor for xanthoma (0.19). CONCLUSION:The endoscopic findings of RAC, hemorrhage, FGP, atrophic change, and MPE will be useful for predicting H. pylori infection status.展开更多
AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data ...AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gan- grenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.展开更多
Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 U...Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 UC patients in Adnan Menderes University,Training and Research Hospital were examined by direct microscopy and cultivated in Jones medium.Blastocystis positive cultures were subjected to DNA isolation and subtypes were identified by sequencing of barcode region.A retrospective analysis was conducted on C reactive protein(CRP),leukocyte counts(WBC),neutrophil counts,and sedimentation rates.Results:The overall positive rate of Blastocystis was 8%(12 patients) and the most abundant subtype was ST3(eight isolates,66.7%),followed by ST1,ST2 and ST7.Laboratory findings between Blastocystis infected and non-infected UC patients were not significantly different.Blastocystisfrequency was 3.8% among the patients in active stage,while it was 11.8% among the patients in remission stage.Conclusions:The present study confirms previous findings that have indicated the predominance of Blastocystis ST3 in humans and contributes additional evidence that suggests the low colonization of Blastocystis infection in ulcerative colitis patients during active stage.展开更多
AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinic...AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH.Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records.The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist.Patients were divided into two groups according to age(belowand above 55 years).Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.RESULTS:A total number of 77 NASH patients,consisting of 58 males(75.3%)and 19(24.7%)females with a mean age of 41.99±11.80 years(range,18-70 years),were enrolled.The mean age(48.72±13.99 years vs 39.74±10.16 years,P=0.004)and aspartate aminotransferase level(75.11±29.68 U/L vs 52.78± 25.00 U/L,P=0.002)was significantly higher in female patients.Mean quantitative grade of hepatosteatosis was significantly higher in females(2.00±0.82 vs 1.59 ±0.68,P=0.031)compared to males.Fifty four percent(34/65)of young patients had mild hepatosteatosis (GradeⅠ)while only one patient(11.2%)in the older group had gradeⅠhepatosteatosis.Patients aged≥55 had significantly more severe hepatosteatosis(GradeⅢ) (44.4%vs 9.5%,P=0.007)and the mean quantitative grade of hepatosteatosis was significantly higher among them(2.33±0.71 vs 1.56±0.67,P=0.002).Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients(P=0.010).CONCLUSION:These findings point toward the possible influence of age in the severity of steatohepatitis,portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.展开更多
Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the resul...Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the results of a two-sample Mendelian randomisation2(MR)study examining associations between blood pressure traits(systolic,diastolic,hypertension and pulse pressure)and psychological traits(anxiety,depression,neuroticism and subjective well-being).After correction for multiple testing.展开更多
A 39-year-old patient with Crohn's disease (CD) was referred to our hospital for maintenance treatment of CD.He was diagnosed as having CD of the small and large intestines at 32 years old.He underwent partial res...A 39-year-old patient with Crohn's disease (CD) was referred to our hospital for maintenance treatment of CD.He was diagnosed as having CD of the small and large intestines at 32 years old.He underwent partial resection of the ileum at 35 years old because of ileal perforation.He had received enteral nutritional supplement (1200 kcal/d) and metronidazole preparation (500 mg/d),and was in remission Crohn's disease activity index 73.We performed a routine gastroduodenal endoscopic examination,which revealed the representative endoscopic findings of gastroduodenal lesions in CD,namely,bamboo-joint-like appearance of the gastric body and cardia and a notched sign in the duodenum.These findings were clearly observed by using indigo carmine dye spraying.In our patient,typical gastroduodenal findings were observed even in the remission stage,suggesting that these findings would contribute to the early diagnosis of CD not only in the active stage but also during remission.展开更多
AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects w...AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects with CLSS and 48 control subjects were retrospectively evaluated. In each examination, the five lumbar levels were assessed for the presence or absence of circumferential or shallow annular bulges, annular tears, anterior or posterior disc herniations, epidural lipomatosis, Schmorl's nodes,spondylolisthesis, pars defects, and stress reactions of the posterior vertebral elements. RESULTS: Compared to control individuals, subjects with CLSS exhibited increased incidence of circumferential and shallow annular bulges, annular tears, discherniations and spondylolisthesis(P < 0.05). CONCLUSION: CLSS is associated with increased incidence of degenerative changes in specific osseous and soft-tissue elements of the lumbar spine.展开更多
Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of ...Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.展开更多
Objective: Primary lymphoma of bone (PLB) is a rare malignant bone tumor often presenting in the fifth-sixth decades involving appendicular long bones. Published radiological findings indicate that PLB typically prese...Objective: Primary lymphoma of bone (PLB) is a rare malignant bone tumor often presenting in the fifth-sixth decades involving appendicular long bones. Published radiological findings indicate that PLB typically presents as a moth-eaten osteolytic lesion with periosteal reaction, while MRI commonly demonstrates marrow infiltration with extraosseous extension. Given rarity and variable appearances, PLB may not be primarily considered prior to biopsy. Our objective was to evaluate preoperative imaging findings in effort to increase awareness and improve a perceived deficiency in preoperative diagnosis. Materials and Methods: Following IRB approval, retrospective review identified 60 patients with newly diagnosed bone lesions proven to represent PLB in accordance with WHO definition. Preoperative radiographs (n = 46), MRI (n = 33) and PET (n = 37) were independently reviewed by two radiologists. At radiography, lesions were classified: purely lytic, mixed, purely sclerotic, or occult;lytic lesions were graded utilizing Lodwick’s classification. At MRI, lesions were defined as focal or infiltrative and the presence or absence of extraosseous disease was recorded. Extraosseous masses were defined as small (1 cm) and subjectively correlated with degree of cortical destruction. At PET, lesions were recorded as FDG-avid or not. Primary radiograph reports when available (n = 33) were reviewed and exact wording of differential considerations was recorded. Results: Radiographs demonstrated mixed (n = 22), lytic (n = 15), and sclerotic (n = 8) appearances;one radiographically occult lesion was seen by MRI. Lytic lesions were graded: IB (n = 3), IC (n = 5), II (n = 4), and III (n = 3);none were IA. At MRI, 30 lesions were infiltrative and 3 were focal;11 were not associated with extraosseous extension, while 22 showed bony disease with small (n = 7) or large (n = 15) soft tissue mass. Of large masses, 13 demonstrated minimal cortical destruction. At PET, 36 demonstrated FDG uptake;one study was technically limited. Review of reports found that only 5 included “lymphoma” as a diagnostic consideration. Conclusion: Contrary to most published data, we suggest that PLB typically demonstrates some degree of osteosclerosis, often a mixed pattern of sclerosis and lucency;purely lytic lesions may be less common. Similar to existing reports, MRI commonly demonstrates marrow infiltration with extraosseous extension of disease, typically a large soft tissue mass with disproportionate (minimal) cortical destruction. Familiarity with these findings should improve preoperative consideration of PLB in the appropriate clinical scenario when a new osteoblastic lesion is identified.展开更多
AIM: To document unusual findings in appendectomy specimens. METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were r...AIM: To document unusual findings in appendectomy specimens. METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies performed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English language studies published between 2000 and 2010 on unusual findings in appendectomy specimens. RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltrations, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two patients who were diagnosed with tuberculous appendicitis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed. CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appendectomy specimens should be sent for routine histopathological examination.展开更多
AIM:To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging(MRI)-enterography in patients with suspected or known Crohn's disease(CD). METHODS:Incidental find...AIM:To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging(MRI)-enterography in patients with suspected or known Crohn's disease(CD). METHODS:Incidental findings were defined as unexpected lesions outside the small intestine,not previously known or suspected at the time of referral, and not related to inflammatory bowel disease.Through a systematic review of medical charts we analyzed the clinical impact of incidental findings,and compared the MRI findings with subsequent diagnostic procedures. RESULTS:A total of 283 patients were included in the analysis,and MRI detected active CD in 31%,fistula in 1.4%and abscess in 0.7%.Extra-intestinal findings notrelated to CD were recorded in 72 patients(25%),of which 58 patients(20%)had 74 previously unknown lesions.Important or incompletely characterized findings were detected in 17 patients(6.0%).Incidental findings led to 12 further interventions in 9 patients(3.2%) revealing previously unknown pathological conditions in 5(1.8%).One patient(0.4%)underwent surgery and one patient was diagnosed with a malignant disease. MRI detected incidental colonic lesions in 16 patients of which additional work-up in 4 revealed normal anatomy. Two patients(0.7%)benefitted from the additional examinations,whereas incidental findings led to unnecessary examinations in 9(3.2%). CONCLUSION:In a minority of patients with suspected or known CD,important incidental findings are diagnosed at MRI-enterography.However,a substantial number of patients experience unnecessary morbidity because of additional examinations of benign or normal conditions.展开更多
AIM: To investigate ophthalmologic findings in children with thalassemia major(TM) and compare the findings with healthy controls. ·METHODS: In a cross-sectional study,43 children with thalassemia major from pedi...AIM: To investigate ophthalmologic findings in children with thalassemia major(TM) and compare the findings with healthy controls. ·METHODS: In a cross-sectional study,43 children with thalassemia major from pediatric hematology outpatient clinics from two university hospitals and age/sex matched 47 healthy children were included in the study. After a complete ophthalmic examination,tear function tests including the Schirmer test,fluorescein tear breakup time(BUT),ultrasound pachymetry,and axial length measurement were performed. Obtained data was recorded for statistical analysis and the values of right eyes were compared between groups. ·RESULTS: The mean best corrected visual acuity was 1.34 ±0.75 in TM and 1.08 ±0.28 in controls. It was found lower than 0.1 logMAR unit in 10(23.2%) children with TM and 2(4.2%) in controls,and the difference was statistically significant(P 【0.05). The mean central corneal thickness was 540±26.95 in children with TM and 536.98± 20.45μm in controls(P 】0.05). The mean axial length was 22.53±0.50 in TM and 22.57±0.43mm in the control group. The mean Schirmer test score was 19.94±6.91 in TM and 24.22±3.95mm in the control group(P 【0.01). The mean BUT score was 9.62 ±1.28 in TM and 9.73 ±0.6s in the control group(P 】0.05). ·CONCLUSION: In TM,while corneal thickness,axial length,and BUT are close to controls,the Schirmer scores are less than normal. The study revealed that TM may be affected by the tear function and visual acuity.展开更多
Background Post-traumatic stress disorder(PTSD)has considerable and persistent effects on survivors of war,particularly in postconflict areas.Yet,evidence on what keeps survivors on the path of PTSD remains scarce.Aim...Background Post-traumatic stress disorder(PTSD)has considerable and persistent effects on survivors of war,particularly in postconflict areas.Yet,evidence on what keeps survivors on the path of PTSD remains scarce.Aims The current study aimed to assess the prevalence and correlates of PTSD symptoms among the war-affected population in northern Uganda.Methods Data from 476 war-affected youths(aged 20–27 years)who had participated in a longitudinal cohort study were analysed to describe the enduring associations of background and postwar environmental risk factors with PTSD symptoms.The Impact of Event Scale-Revised was used to evaluate symptoms of PTSD.Descriptive statistics were used to compute background and postwar environmental correlates.Binary logistic regression analyses were fitted to assess the magnitude of the effects of the correlates on PTSD symptoms.Results Background and postwar environmental factors(eg,sexual abuse and injury in captivity)were significantly associated with PTSD symptoms.Postwar environmental factors associated with PTSD symptoms included postwar hardships,stigma/discrimination,chronic illness,community relations,family acceptance and general functioning,among others.The odds ratios(ORs)for postwar hardships were 2.41(95%confidence interval(CI):1.63 to 3.56)and 2.90(95%CI:2.03 to 4.14)for high and severe PTSD,respectively.For stigma/discrimination,compared with higher scores,the ORs were 3.38(95%CI:2.22 to 5.17)and 4.12(95%CI:2.69 to 6.30)for high and severe PTSD symptoms,respectively.Conclusions Background and postwar environmental stressors exacerbate the severity of PTSD symptoms in survivors of war and should form the basis for interventions to alleviate the toxic effects of war on survivors.展开更多
AIM:To investigate the therapeutic usefulness of leukocytapheresis (LCAP; Cellsoba) in steroid-naive patients with moderately active ulcerative colitis (UC). METHODS: Eighteen steroid-naive patients with moderately ac...AIM:To investigate the therapeutic usefulness of leukocytapheresis (LCAP; Cellsoba) in steroid-naive patients with moderately active ulcerative colitis (UC). METHODS: Eighteen steroid-naive patients with moderately active UC received one LCAP session every week for fi ve consecutive weeks. RESULTS: The remission rate 8 weeks after the last LCAP session was 61.1% (11/18). All three patients with deep ulcers showed worsening after LCAP. For the remaining 15 patients, who had erosions or geographic ulcers, the average clinical activity index (CAI) score dropped significantly from 9.4 to 3.8 eight weeks after the last LCAP session (t = 4.89, P = 0.001). The average C-reactive protein (CRP) levels before and after LCAP were 1.2 mg/dL and 1.0 mg/dL, respectively. Of the patients with erosions, geographic ulcers, and deep ulcers, 100% (9/9), 33.3% (2/6), and 0% (0/3) were in remission 8 weeks after the last LCAP session, respectively (χ2 = 7.65, P < 0.005). Forty- eight weeks after the last LCAP session, the remission rates for patients with erosions and geographic ulcers were 44.4% (4/9) and 16.7% (1/6), respectively. Only one patient suffered a mild adverse event after LCAP (nausea). CONCLUSION: LCAP is a useful and safe therapyfor steroid-naive UC patients with moderate disease activity. Moreover, the effi cacy of the treatment can be predicted on the basis of endoscopic fi ndings.展开更多
To the Editor:Schwannoma is an infrequent tumor originating from Schwann cells of the peripheral nerve sheath and was first reported as a true neoplasm originating from Schwann cells in 1910 [1] . The ma- jority of sc...To the Editor:Schwannoma is an infrequent tumor originating from Schwann cells of the peripheral nerve sheath and was first reported as a true neoplasm originating from Schwann cells in 1910 [1] . The ma- jority of schwannomas are detected as a solitary tumor from the peripheral nerves of the face, neck, trunk, extremities, or retroperi- toneal region. Based on a previous study [2] , merely 3% of schwan- nomas are retroperitoneal, accounting for approximately 4% of all retroperitoneal tumors. Furthermore, pancreatic schwannomas that stem from either parasympathetic or sympathetic fibers of the pancreas are especially rare. Schwannomas are generally encapsu- lated, and over 90% are benign [3] . Considering its benign biolog- ical behavior, it is essential to accurately diagnose schwannomas in order to apply reasonable surgical methods and postoperative surveillance. Herein, we report four cases of pancreatic schwan- noma in our center to update the data on the clinicopathological traits about this type of tumor.展开更多
Background:?High resolution chest computed tomography (HRCT) is an established imaging modality that accurately assesses disease processes that are non-specific on conventional chest radiography. Chest Computed Tomogr...Background:?High resolution chest computed tomography (HRCT) is an established imaging modality that accurately assesses disease processes that are non-specific on conventional chest radiography. Chest Computed Tomography (CT) has proven invaluable in the evaluation of various diseases of the chest providing precise diagnosis that have great impact on the course of management. In this study, our aim is to evaluate the spectrum of radiological findings in all patients that had chest CTs at a tertiary health Institution in a developing Country. Method: This is a 6-year retrospective study of all patients that had Chest CT from 2009 till 2015. All patient data were retrieved and their Chest CT images reviewed and radiological findings and diagnosis documented. Results: Age range of patients was 1 - 84 years with a mean of 52.36 ± 22.9 years. Ten patients were children (12%). There were more males 53 (63.1%) than females 31 (36.9%) in the study. Referral for imaging was predominantly from internal medicine 33 (47.1%) and Surgery 27 (38.6%) departments. Most of the patients, 53 (63.1%) did not have previous chest radiographs. Consolidative changes were the most common parenchymal finding (77.4%). Few mediastinal masses were found in the study population. CT angiography constituted only 10.7% of all chest CTs done in adults. Conclusion: Few chest CT evaluations are performed compared to CTs of other parts of the body done in the same period. Chest CT is generally under-utilized even in a tertiary institution. There is a need to educate chest physicians on the role and advantages of CT use for the management of their patients.展开更多
基金Supported by the National Natural Science Foundation of China,No.82160330the Science and Technology Program of the Health Commission of Jiangxi Province,No.2025110045+1 种基金the Ganzhou Science and Technology Planning Project,No.GZ2024YLJ016,No.GZ2024YLJ026,and No.GZ2024ZSF064the Ganzhou Health Commission Scientific Research Planning Project,No.GZWJW202402108.
文摘BACKGROUND Monomorphic epitheliotropic intestinal T-cell lymphoma(MEITL)is an uncom-mon and highly aggressive form of lymphoma that represents less than 1%of all non-Hodgkin’s lymphomas.At present,few reports have focused on the imaging findings of MEITL,which poses significant challenges for clinical diagnosis.A 78-year-old female with recurrent vomiting and abdominal distension was admitted to our hospital.Magnetic resonance and^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)examinations revealed multiple segmental malignant tumors in the small intestine with me-senteric lymph node metastasis.An endoscopic biopsy revealed MEITL.After three cycles of reduced-dose cyclophosphamide,vinorelbine,and prednisone che-motherapy,follow-up^(18)F-FDG PET/CT demonstrated a partial response to treatment.The patient was still alive after 6 months of follow-up.CONCLUSION Magnetic resonance imaging serves as a valuable tool in detecting malignant tumor lesions of MEITL,whereas^(18)F-FDG PET/CT offers additional assistance in tumor staging and assessing treatment efficacy.
文摘BACKGROUND Crohn’s disease(CD)patients with intestinal involvement often require surgical intervention due to resistance to medical therapy.Postoperative recurrence remains a significant challenge,with the Rutgeerts score commonly used to predict endoscopic recurrence.AIM To evaluate the relationship between microscopic and macroscopic pathological findings in resected intestinal specimens and the Rutgeerts score to predict endoscopic recurrence in CD patients.METHODS This retrospective cohort study included 32 patients over 18 years of age with intestinal CD who underwent surgery at General Surgery Clinic of Ankara Bilkent City Hospital between November 2019 and October 2023.Resection specimens were histopathologically re-examined,and postoperative colonoscopy reports were classified according to the Rutgeerts score.The association between pathological findings and endoscopic recurrence was analyzed statistically.RESULTS No significant association was found between macroscopic findings and Rutgeerts scores or endoscopic recurrence(P>0.05).However,the presence and severity of neutrophilic cryptitis(P=0.035)and crypt abscesses(P=0.010)in microscopic findings were significantly associated with higher Rutgeerts scores,indicating a parallel increase with endoscopic recurrence.Other microscopic findings showed no significant correlation with Rutgeerts scores or endoscopic recurrence(P>0.05).CONCLUSION The presence of neutrophilic cryptitis and crypt abscesses in resected intestinal specimens of CD patients increases the likelihood of endoscopic recurrence.Early postoperative medical treatment and close endoscopic follow-up may benefit high-risk patients to prevent recurrence,with treatment decisions made by a weekly multidisciplinary council involving General Surgery,Gastroenterology,and Radiology.
文摘AIM:To analyze the ocular findings of patients who received lifelong leptin therapy due to congenital leptin deficiency(CLD),an extremely rare condition.METHODS:A prospective,cross-sectional comparative study was performed on six patients with CLD and 13 healthy age-and sex-matched controls.The central corneal thickness(CCT),anterior chamber depth(ACD),axial length(AL),keratometry(K1,K2),optical coherence tomography(OCT),and OCT angiography parameters were compared between the leptin and control groups at the baseline visit.The change in these measurements in leptin patients over a two-year period was analyzed.RESULTS:CLD patients had lower mean AL,ACD,and CCT(P≤0.012 for all).Mean K1,K2(P≤0.047 for both),choroidal thickness(P≤0.001),and central ganglion cell layer(GCL)thickness(P=0.029)were higher in the leptin group.Perifoveal superficial capillary plexus(SCP)density was decreased in all quadrants except the temporal region(P<0.05),and parafoveal deep capillary plexus(DCP)density was decreased in the superior hemisphere,temporal quadrant(P≤0.036 for both)and nasal quadrant(P=0.048)in the leptin group.During the two-year follow-up,no changes in anterior and posterior segment measurements were observed in the leptin patients,except for subfoveal choroidal thickness(P<0.001).CONCLUSION:CLD patients exhibit structural alterations in both the anterior and posterior segments of the eye,including notable changes in retinal and choroidal vasculature.However,there is limited evidence concerning the influence of leptin therapy on the eye.
文摘BACKGROUND Immunoglobulin A(IgA)vasculitis,formerly known as Henoch-Schönlein purpura,is a small vessel vasculitis predominantly affecting children.It commonly presents with a triad of purpuric rash,arthralgia,and abdominal pain.However,dermatologic manifestations of IgA vasculitis in black-skinned individuals are poorly documented in literature.CASE SUMMARY This case report describes an 11-year-old black girl with acute onset of rash,joint pain,and abdominal pain,subsequently diagnosed with IgA vasculitis.CONCLUSION The case highlights the importance of early recognition and supportive management in ensuring a favorable outcome,particularly in dark-skinned populations.
基金Supported by A Grant from the National Center for Global Health and Medicine
文摘AIM:To validate the usefulness of screening endoscopy findings for predictingHelicobacter pylori (H. pylori) infection status. METHODS:H. pylori infection status was determined by histology, serology, and the urea breast test in 77 consecutive patients who underwent upper endoscopy. Based on the findings, patients were categorized as H. pylori -uninfected, -infected, or -eradicated cases. Using six photos of certain sites in the stomach per case, we determined the presence or absence of the following endoscopic findings:regular arrangement of collecting venules (RAC), linear erythema, hemorrhage, fundic gland polyp (FGP), atrophic change, rugal hyperplasia, edema, spotty erythema, exudate, xanthoma, and mottled patchy erythema (MPE). The diagnostic odds ratio (DOR) and inter-observer agreement (Kappa value) for these 11 endoscopic findings used in the determination of H. pylori infection status were calculated. RESULTS:Of the 77 patients [32 men and 45 women; mean age (SD), 39.7 (13.4) years] assessed, 28 were H. pylori uninfected, 28 were infected, and 21 were eradicated. DOR values were significantly high (< 0.05) for the following H. pylori cases:uninfected cases with RAC (11.5), linear erythema (24.5), hemorrhage (4.1), and FGP (34.5); for infected cases with atrophic change (8.67), rugal hyperplasia (15.8), edema (14.2), spotty erythema (11.5), and exudate (3.52); and for eradicated cases with atrophic change (32.4) and MPE (103.0). Kappa values were excellent for FGP (0.93), good for RAC (0.63), hemorrhage (0.79), atrophic change (0.74), and MPE (0.75), moderate for linear erythema (0.51), rugal hyperplasia (0.49), edema (0.58), spotty erythema (0.47), and exudate (0.46), and poor for xanthoma (0.19). CONCLUSION:The endoscopic findings of RAC, hemorrhage, FGP, atrophic change, and MPE will be useful for predicting H. pylori infection status.
文摘AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gan- grenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.
文摘Objective:To determine Blastocystis frequency and subtypes(ST) in ulcerative colitis(UC) patients and analyse some laboratory findings between Blastocystis positive and negative cases.Methods:Faecal samples from 150 UC patients in Adnan Menderes University,Training and Research Hospital were examined by direct microscopy and cultivated in Jones medium.Blastocystis positive cultures were subjected to DNA isolation and subtypes were identified by sequencing of barcode region.A retrospective analysis was conducted on C reactive protein(CRP),leukocyte counts(WBC),neutrophil counts,and sedimentation rates.Results:The overall positive rate of Blastocystis was 8%(12 patients) and the most abundant subtype was ST3(eight isolates,66.7%),followed by ST1,ST2 and ST7.Laboratory findings between Blastocystis infected and non-infected UC patients were not significantly different.Blastocystisfrequency was 3.8% among the patients in active stage,while it was 11.8% among the patients in remission stage.Conclusions:The present study confirms previous findings that have indicated the predominance of Blastocystis ST3 in humans and contributes additional evidence that suggests the low colonization of Blastocystis infection in ulcerative colitis patients during active stage.
文摘AIM:To characterize the histopathologic specifications of non-alcoholic steatohepatitis(NASH)according to age and gender.METHODS:An analytical cross-sectional study was conducted in two private gastroenterology clinics on biopsy proven patients suffering from NASH.Biopsy histopathologic findings as well as demographic and laboratory data of the patients at the time of biopsy were gathered retrospectively from clinical records.The grading and staging of histopathologic findings were performed according to the Brunt method after reevaluation of the slides by a pathologist.Patients were divided into two groups according to age(belowand above 55 years).Mean quantitative grade of all pathologic findings were also calculated according to Brunt scoring values.RESULTS:A total number of 77 NASH patients,consisting of 58 males(75.3%)and 19(24.7%)females with a mean age of 41.99±11.80 years(range,18-70 years),were enrolled.The mean age(48.72±13.99 years vs 39.74±10.16 years,P=0.004)and aspartate aminotransferase level(75.11±29.68 U/L vs 52.78± 25.00 U/L,P=0.002)was significantly higher in female patients.Mean quantitative grade of hepatosteatosis was significantly higher in females(2.00±0.82 vs 1.59 ±0.68,P=0.031)compared to males.Fifty four percent(34/65)of young patients had mild hepatosteatosis (GradeⅠ)while only one patient(11.2%)in the older group had gradeⅠhepatosteatosis.Patients aged≥55 had significantly more severe hepatosteatosis(GradeⅢ) (44.4%vs 9.5%,P=0.007)and the mean quantitative grade of hepatosteatosis was significantly higher among them(2.33±0.71 vs 1.56±0.67,P=0.002).Multivariate analysis after omitting the confounding role of age revealed a higher grade of hepatosteatosis in female patients(P=0.010).CONCLUSION:These findings point toward the possible influence of age in the severity of steatohepatitis,portal and lobar inflammation in patients suffering from NASH while gender independently might contribute to the level of steatohepatitis.
基金This study was funded by the Medical Research Council(MC_UU_00011/6,MC_UU_00011/1).
文摘Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the results of a two-sample Mendelian randomisation2(MR)study examining associations between blood pressure traits(systolic,diastolic,hypertension and pulse pressure)and psychological traits(anxiety,depression,neuroticism and subjective well-being).After correction for multiple testing.
基金Supported by Health and Labour Sciences Research Grants for research on intractable diseases from Ministry of Health,Labour and Welfare of Japan,in part
文摘A 39-year-old patient with Crohn's disease (CD) was referred to our hospital for maintenance treatment of CD.He was diagnosed as having CD of the small and large intestines at 32 years old.He underwent partial resection of the ileum at 35 years old because of ileal perforation.He had received enteral nutritional supplement (1200 kcal/d) and metronidazole preparation (500 mg/d),and was in remission Crohn's disease activity index 73.We performed a routine gastroduodenal endoscopic examination,which revealed the representative endoscopic findings of gastroduodenal lesions in CD,namely,bamboo-joint-like appearance of the gastric body and cardia and a notched sign in the duodenum.These findings were clearly observed by using indigo carmine dye spraying.In our patient,typical gastroduodenal findings were observed even in the remission stage,suggesting that these findings would contribute to the early diagnosis of CD not only in the active stage but also during remission.
文摘AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects with CLSS and 48 control subjects were retrospectively evaluated. In each examination, the five lumbar levels were assessed for the presence or absence of circumferential or shallow annular bulges, annular tears, anterior or posterior disc herniations, epidural lipomatosis, Schmorl's nodes,spondylolisthesis, pars defects, and stress reactions of the posterior vertebral elements. RESULTS: Compared to control individuals, subjects with CLSS exhibited increased incidence of circumferential and shallow annular bulges, annular tears, discherniations and spondylolisthesis(P < 0.05). CONCLUSION: CLSS is associated with increased incidence of degenerative changes in specific osseous and soft-tissue elements of the lumbar spine.
文摘Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.
文摘Objective: Primary lymphoma of bone (PLB) is a rare malignant bone tumor often presenting in the fifth-sixth decades involving appendicular long bones. Published radiological findings indicate that PLB typically presents as a moth-eaten osteolytic lesion with periosteal reaction, while MRI commonly demonstrates marrow infiltration with extraosseous extension. Given rarity and variable appearances, PLB may not be primarily considered prior to biopsy. Our objective was to evaluate preoperative imaging findings in effort to increase awareness and improve a perceived deficiency in preoperative diagnosis. Materials and Methods: Following IRB approval, retrospective review identified 60 patients with newly diagnosed bone lesions proven to represent PLB in accordance with WHO definition. Preoperative radiographs (n = 46), MRI (n = 33) and PET (n = 37) were independently reviewed by two radiologists. At radiography, lesions were classified: purely lytic, mixed, purely sclerotic, or occult;lytic lesions were graded utilizing Lodwick’s classification. At MRI, lesions were defined as focal or infiltrative and the presence or absence of extraosseous disease was recorded. Extraosseous masses were defined as small (1 cm) and subjectively correlated with degree of cortical destruction. At PET, lesions were recorded as FDG-avid or not. Primary radiograph reports when available (n = 33) were reviewed and exact wording of differential considerations was recorded. Results: Radiographs demonstrated mixed (n = 22), lytic (n = 15), and sclerotic (n = 8) appearances;one radiographically occult lesion was seen by MRI. Lytic lesions were graded: IB (n = 3), IC (n = 5), II (n = 4), and III (n = 3);none were IA. At MRI, 30 lesions were infiltrative and 3 were focal;11 were not associated with extraosseous extension, while 22 showed bony disease with small (n = 7) or large (n = 15) soft tissue mass. Of large masses, 13 demonstrated minimal cortical destruction. At PET, 36 demonstrated FDG uptake;one study was technically limited. Review of reports found that only 5 included “lymphoma” as a diagnostic consideration. Conclusion: Contrary to most published data, we suggest that PLB typically demonstrates some degree of osteosclerosis, often a mixed pattern of sclerosis and lucency;purely lytic lesions may be less common. Similar to existing reports, MRI commonly demonstrates marrow infiltration with extraosseous extension of disease, typically a large soft tissue mass with disproportionate (minimal) cortical destruction. Familiarity with these findings should improve preoperative consideration of PLB in the appropriate clinical scenario when a new osteoblastic lesion is identified.
文摘AIM: To document unusual findings in appendectomy specimens. METHODS: The clinicopathological data of 5262 patients who underwent appendectomies for presumed acute appendicitis from January 2006 to October 2010 were reviewed retrospectively. Appendectomies performed as incidental procedures during some other operation were excluded. We focused on 54 patients who had unusual findings in their appendectomy specimens. We conducted a literature review via the PubMed and Google Scholar databases of English language studies published between 2000 and 2010 on unusual findings in appendectomy specimens. RESULTS: Unusual findings were determined in 54 (1%) cases by histopathology. Thirty were male and 24 were female with ages ranging from 15 to 84 years (median, 32.2 ± 15.1 years). Final pathology revealed 37 cases of enterobiasis, five cases of carcinoids, four mucinous cystadenomas, two eosinophilic infiltrations, two mucoceles, two tuberculosis, one goblet-cell carcinoid, and one neurogenic hyperplasia. While 52 patients underwent a standard appendectomy, two patients who were diagnosed with tuberculous appendicitis underwent a right hemicolectomy. All tumors were located at the distal part of the appendix with a mean diameter of 6.8 mm (range, 4-10 mm). All patients with tumors were alive and disease-free during a mean follow-up of 17.8 mo. A review of 1366 cases reported in the English literature is also discussed. CONCLUSION: Although unusual pathological findings are seldom seen during an appendectomy, all appendectomy specimens should be sent for routine histopathological examination.
文摘AIM:To determine the frequency and clinical impact of incidental findings detected with magnetic resonance imaging(MRI)-enterography in patients with suspected or known Crohn's disease(CD). METHODS:Incidental findings were defined as unexpected lesions outside the small intestine,not previously known or suspected at the time of referral, and not related to inflammatory bowel disease.Through a systematic review of medical charts we analyzed the clinical impact of incidental findings,and compared the MRI findings with subsequent diagnostic procedures. RESULTS:A total of 283 patients were included in the analysis,and MRI detected active CD in 31%,fistula in 1.4%and abscess in 0.7%.Extra-intestinal findings notrelated to CD were recorded in 72 patients(25%),of which 58 patients(20%)had 74 previously unknown lesions.Important or incompletely characterized findings were detected in 17 patients(6.0%).Incidental findings led to 12 further interventions in 9 patients(3.2%) revealing previously unknown pathological conditions in 5(1.8%).One patient(0.4%)underwent surgery and one patient was diagnosed with a malignant disease. MRI detected incidental colonic lesions in 16 patients of which additional work-up in 4 revealed normal anatomy. Two patients(0.7%)benefitted from the additional examinations,whereas incidental findings led to unnecessary examinations in 9(3.2%). CONCLUSION:In a minority of patients with suspected or known CD,important incidental findings are diagnosed at MRI-enterography.However,a substantial number of patients experience unnecessary morbidity because of additional examinations of benign or normal conditions.
文摘AIM: To investigate ophthalmologic findings in children with thalassemia major(TM) and compare the findings with healthy controls. ·METHODS: In a cross-sectional study,43 children with thalassemia major from pediatric hematology outpatient clinics from two university hospitals and age/sex matched 47 healthy children were included in the study. After a complete ophthalmic examination,tear function tests including the Schirmer test,fluorescein tear breakup time(BUT),ultrasound pachymetry,and axial length measurement were performed. Obtained data was recorded for statistical analysis and the values of right eyes were compared between groups. ·RESULTS: The mean best corrected visual acuity was 1.34 ±0.75 in TM and 1.08 ±0.28 in controls. It was found lower than 0.1 logMAR unit in 10(23.2%) children with TM and 2(4.2%) in controls,and the difference was statistically significant(P 【0.05). The mean central corneal thickness was 540±26.95 in children with TM and 536.98± 20.45μm in controls(P 】0.05). The mean axial length was 22.53±0.50 in TM and 22.57±0.43mm in the control group. The mean Schirmer test score was 19.94±6.91 in TM and 24.22±3.95mm in the control group(P 【0.01). The mean BUT score was 9.62 ±1.28 in TM and 9.73 ±0.6s in the control group(P 】0.05). ·CONCLUSION: In TM,while corneal thickness,axial length,and BUT are close to controls,the Schirmer scores are less than normal. The study revealed that TM may be affected by the tear function and visual acuity.
基金the Welcome Trust(grant number:087540/Z/08/Z)as part of the African institutional initiative for the project Training Health Researchers in Vocational Excellence(THRiVE)in East Africa.
文摘Background Post-traumatic stress disorder(PTSD)has considerable and persistent effects on survivors of war,particularly in postconflict areas.Yet,evidence on what keeps survivors on the path of PTSD remains scarce.Aims The current study aimed to assess the prevalence and correlates of PTSD symptoms among the war-affected population in northern Uganda.Methods Data from 476 war-affected youths(aged 20–27 years)who had participated in a longitudinal cohort study were analysed to describe the enduring associations of background and postwar environmental risk factors with PTSD symptoms.The Impact of Event Scale-Revised was used to evaluate symptoms of PTSD.Descriptive statistics were used to compute background and postwar environmental correlates.Binary logistic regression analyses were fitted to assess the magnitude of the effects of the correlates on PTSD symptoms.Results Background and postwar environmental factors(eg,sexual abuse and injury in captivity)were significantly associated with PTSD symptoms.Postwar environmental factors associated with PTSD symptoms included postwar hardships,stigma/discrimination,chronic illness,community relations,family acceptance and general functioning,among others.The odds ratios(ORs)for postwar hardships were 2.41(95%confidence interval(CI):1.63 to 3.56)and 2.90(95%CI:2.03 to 4.14)for high and severe PTSD,respectively.For stigma/discrimination,compared with higher scores,the ORs were 3.38(95%CI:2.22 to 5.17)and 4.12(95%CI:2.69 to 6.30)for high and severe PTSD symptoms,respectively.Conclusions Background and postwar environmental stressors exacerbate the severity of PTSD symptoms in survivors of war and should form the basis for interventions to alleviate the toxic effects of war on survivors.
文摘AIM:To investigate the therapeutic usefulness of leukocytapheresis (LCAP; Cellsoba) in steroid-naive patients with moderately active ulcerative colitis (UC). METHODS: Eighteen steroid-naive patients with moderately active UC received one LCAP session every week for fi ve consecutive weeks. RESULTS: The remission rate 8 weeks after the last LCAP session was 61.1% (11/18). All three patients with deep ulcers showed worsening after LCAP. For the remaining 15 patients, who had erosions or geographic ulcers, the average clinical activity index (CAI) score dropped significantly from 9.4 to 3.8 eight weeks after the last LCAP session (t = 4.89, P = 0.001). The average C-reactive protein (CRP) levels before and after LCAP were 1.2 mg/dL and 1.0 mg/dL, respectively. Of the patients with erosions, geographic ulcers, and deep ulcers, 100% (9/9), 33.3% (2/6), and 0% (0/3) were in remission 8 weeks after the last LCAP session, respectively (χ2 = 7.65, P < 0.005). Forty- eight weeks after the last LCAP session, the remission rates for patients with erosions and geographic ulcers were 44.4% (4/9) and 16.7% (1/6), respectively. Only one patient suffered a mild adverse event after LCAP (nausea). CONCLUSION: LCAP is a useful and safe therapyfor steroid-naive UC patients with moderate disease activity. Moreover, the effi cacy of the treatment can be predicted on the basis of endoscopic fi ndings.
基金supported by a grant from the Youth Start-up Fund Project of Changhai Hospital(CH201823).
文摘To the Editor:Schwannoma is an infrequent tumor originating from Schwann cells of the peripheral nerve sheath and was first reported as a true neoplasm originating from Schwann cells in 1910 [1] . The ma- jority of schwannomas are detected as a solitary tumor from the peripheral nerves of the face, neck, trunk, extremities, or retroperi- toneal region. Based on a previous study [2] , merely 3% of schwan- nomas are retroperitoneal, accounting for approximately 4% of all retroperitoneal tumors. Furthermore, pancreatic schwannomas that stem from either parasympathetic or sympathetic fibers of the pancreas are especially rare. Schwannomas are generally encapsu- lated, and over 90% are benign [3] . Considering its benign biolog- ical behavior, it is essential to accurately diagnose schwannomas in order to apply reasonable surgical methods and postoperative surveillance. Herein, we report four cases of pancreatic schwan- noma in our center to update the data on the clinicopathological traits about this type of tumor.
文摘Background:?High resolution chest computed tomography (HRCT) is an established imaging modality that accurately assesses disease processes that are non-specific on conventional chest radiography. Chest Computed Tomography (CT) has proven invaluable in the evaluation of various diseases of the chest providing precise diagnosis that have great impact on the course of management. In this study, our aim is to evaluate the spectrum of radiological findings in all patients that had chest CTs at a tertiary health Institution in a developing Country. Method: This is a 6-year retrospective study of all patients that had Chest CT from 2009 till 2015. All patient data were retrieved and their Chest CT images reviewed and radiological findings and diagnosis documented. Results: Age range of patients was 1 - 84 years with a mean of 52.36 ± 22.9 years. Ten patients were children (12%). There were more males 53 (63.1%) than females 31 (36.9%) in the study. Referral for imaging was predominantly from internal medicine 33 (47.1%) and Surgery 27 (38.6%) departments. Most of the patients, 53 (63.1%) did not have previous chest radiographs. Consolidative changes were the most common parenchymal finding (77.4%). Few mediastinal masses were found in the study population. CT angiography constituted only 10.7% of all chest CTs done in adults. Conclusion: Few chest CT evaluations are performed compared to CTs of other parts of the body done in the same period. Chest CT is generally under-utilized even in a tertiary institution. There is a need to educate chest physicians on the role and advantages of CT use for the management of their patients.
