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A hiperplasia hemimandibular é responsável por prejuízos estéticos, funcionais, motores e psicossociais. Com etiologia incerta, ocorre frente ao desequilíbrio de fatores regulatórios de crescimento presentes na camada cartilaginosa do côndilo. O relato objetiva descrever a tomada de decisões baseada em exames complementares específicos aliados à adequada intervenção cirúrgica da lesão. Paciente gênero feminino, 33 anos de idade, compareceu à clínica particular com queixa principal de "face assimétrica", foi requerido uma avaliação cintilográfica objetivando e confirmando a interrupção do crescimento condilar, descartando a hipótese de Osteocondroma e condilectomia. Após preparo ortodôntico prévio, os exames tomográficos foram utilizados na criação de um protótipo que foi impresso após a realização dos movimentos ósseos planejados. Mediante à reconstrução, foi concluído que a assimetria presente não seria totalmente corrigida somente através da intervenção ortognática, sendo necessária também uma osteotomia removendo parte da base do corpo e ângulo mandibular, através da confecção de um guia de corte, promovendo à reanatomização sem a necessidade de acesso extra oral submandibular, evitando uma cicatriz em face feminina. Paciente encontra-se em pós-operatório de 60 meses, sem queixas e satisfeita. Portanto, é evidenciado cada vez mais a influência positiva que o planejamento virtual pode trazer aos profissionais na otimização dos resultados cirúrgicos.
Hemimandibular hyperplasia is responsible for aesthetic, functional, motor, and psychosocial impairments. With an uncertain etiology, it occurs due to the imbalance of regulatory growth factors present in the cartilaginous layer of the condyle. The report aims to describe decision-making based on specific complementary exams combined with the appropriate surgical intervention for the condition. A 33-year-old female patient presented at a private clinic with the main complaint of "asymmetric face." A scintigraphic evaluation was requested to objectively confirm the interruption of condylar growth, ruling out the hypothesis of Osteochondroma and condylectomy. After prior orthodontic preparation, tomographic exams were used to create a prototype that was printed after planned bone movements. Through the reconstruction, it was concluded that the existing asymmetry would not be entirely corrected through orthognathic intervention alone, necessitating also an osteotomy to remove part of the base of the body and mandibular angle. This was done through the creation of a cutting guide, allowing for reanatomization without the need for submandibular extraoral access, thus avoiding a scar on the female face. The patient is 60 months postoperative, with no complaints and satisfied. Therefore, the increasingly positive influence of virtual planning on optimizing surgical outcomes for professionals is evident.
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Humans , Female , Adult , Surgical Procedures, Operative , Radionuclide Imaging , Planning , Facial Asymmetry , Clinical Decision-Making , Hyperplasia , Mandibular CondyleABSTRACT
Background: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms among older males. Transurethral resection of the prostate (TURP) still remains the gold standard in the treatment of benign prostatic hyperplasia. However, its availability is not widespread in most public healthcare facilities across sub-Saharan Africa. This study was designed to describe and share our experience of TURP in a single centre. Methods: This is a retrospective evaluation of 64 patients who had TURP for bladder outlet obstruction secondary to enlarged prostate. The records of men who had TURP over a period of one year (January 2022-December 2022) were retrieved and reviewed. The pre-operative prostate specific antigen (PSA), pre-operative ultrasound measured size of prostate, resected weight of prostate, duration of surgery, duration of hospital stay, indication for TURP and complications were analysed. Results: Sixty-four patients had TURP done during the period under review. The age range was 50-90 years (mean 68.33), the pre-operative prostate gland weight was 76.78gm. The mean resected weight was 53.9gm. The pre-operative serum prostate specific antigen PSA had a minimum value of 1.5ng/ml and the maximum was 50.8ng/ml with mean value of 13.8ng/ml. The mean duration of surgery was 55.73 minutes and the mean duration of hospital stay was 3 days. The most common indication for TURP was lower urinary tract symptoms. We recorded four complications; capsule perforation, clot retention, hypotension and stress incontinence, 60 patients had no complications. Conclusions: Transurethral resection of the prostate is an effective surgical treatment for benign prostatic hyperplasia, it is associated notable improvement in the patient抯 quality of life and minimal complications.
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Prolactinomas are the most common functional tumour of pituitary gland arising from lactotrophs. Microadenomas constitute 90% and the rest are macroadenomas. Females are more prone to develop macroadenomas. High estrogen levels during pregnancy leads to increase in the size of prolactinomas thereby leading to compression of optic chiasma. This eventually manifests as visual symptoms and headache. Pharmacotherapy with dopamine agonists is the treatment of choice. We present here a case of prolactinoma in a pregnant woman whose symptoms worsened due to increase in size of the tumor. Multidisciplinary management resulted in successful outcome.
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Objetivo: La gingivitis espongiótica es una patología benigna poco común y una entidad clínica patológica poco frecuente que los odontólogos pueden observar durante la atención odontológica. Es importante conocer la misma para poder diagnosticarla adecuadamente, describir sus características clínicas y elaborar un plan para su tratamiento. El objetivo de este artículo es presentar un caso clínico de esta patología poco conocida, describir sus características y su manejo clínico. Caso clínico: Un niño de 7 años que ingresó derivado por su odontólogo a la cátedra de Estomatología de la Facultad de Odontología de la Universidad Nacional de Córdoba, Argentina, presentaba en la encía libre e insertada del maxilar superior una lesión con ausencia de sintomatología y evolución crónica, benigna y con cambios estéticos notorios. Se deriva a la cátedra de Periodoncia para realizar un tratamiento interdisciplinario. Tuvo una respuesta favorable al tratamiento de la lesión, y se realizó un seguimiento periódico de la misma evitando la técnica quirúrgica convencional para su tratamiento.(AU)
Aim: Spongiotic gingivitis is a rare benign pathology and a rare clinical pathological entity that dentists can observe during dental care. It is important to know it to be able to properly diagnose it, describe its clinical characteristics and develop a plan for its treatment. The aim of this article is to present a clinical case of this little-known pathology and describe its characteristics as well as its clinical management. Clinical case: A 7-yeard-old child who was referred by his dentist to the Department of Stomatology of the Faculty of Dentistry of the National University of Córdoba, Argentina, presented a lesion in the free and inserted gingiva of the upper jaw, with absence of symptoms and chronic, benign evolution with notable aesthetic changes. He is referred to the Periodontics department to perform interdisciplinary treatment. He had a favorable response to the treatment of the lesion, and a periodic follow-up was carried out, avoiding the conventional surgical technique for its treatment.(AU)
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Background: In neurosurgical practice meningiomas are one of the commonest intracranial tumors to seek surgical intervention which is classified into 3 histological grades and 15 subtypes according to the 2016 WHO classification of tumors of the CNS. The aim of this study was to evaluate the association between radiological type of dural tail sign in contrast MRI with histopathological grading of intracranial meningiomas. Methods: This was a cross sectional interventional study carried out in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Dhaka Medical College Hospital and National Institute of Neuroscience Hospital including 35 patients of intracranial meningiomas who fulfilled the selection criteria were enrolled in this study. Results: This study included 35 cases of intracranial meningiomas. There were 22 individuals (62.9%) in the 28-47 age group. The mean±standard deviation (SD) age of the participants was 45.97±9.56 years. There were 9 male participants (25.7%) and 26 female participants (74.3%) with ratio 1:3. We see that parasagittal location (50%) and sphenoid wing (33.3%) were more prevalent in grade II. We found significant distribution of the types of DTS among the histological grades of meningioma. The nodular cases (6,100%) were all grade II type. Mixed type was the most prevalent type among grade I. Conclusions: There is association of radiological type of dural tail sign in contrast MRI with histopathological grading of intracranial meningiomas and may be used as a good tools for forecasting tumor type and prognosis.
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Postmenopausal bleeding (PMB) poses a diagnostic challenge due to the varied presentation of endometrial pathologies ranging from benign endometrial atrophy to the possibility of endometrial carcinoma. Although the incidence varies with patient characteristics, it warrants thorough evaluation. Risk factors such as obesity and hormone use should guide assessment. Bleeding may originate from various gynecological and non-gynecological sites, demanding meticulous history-taking and examination. Transvaginal sonography (TVS) is typically the initial step, yet its accuracy in excluding carcinoma remains debated. Invasive procedures like hysteroscopy and endometrial sampling offer higher accuracy but are more intrusive. The optimal diagnostic strategy remains uncertain, necessitating focused research for enhanced accuracy. TVS-guided assessment with an endometrial thickness (ET) threshold of >4 mm prompts evaluation and endometrial sampling. Progestogen therapy mitigates endometrial cancer risk associated with estrogen use, with atypia-hyperplasia necessitating vigilant monitoring and possible hysterectomy. Patient counselling on treatment options is crucial. In summary, PMB warrants a systematic approach integrating imaging, histological assessment, and tailored therapy guided by risk factors, final diagnosis and patient preferences.
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ABSTRACT Background: To evaluate the 10-year functional outcomes (primary) and frequency and predictors of BPH surgical retreatment (secondary) after ThuLEP. Materials and Methods: A single-center retrospective analysis of consecutive patients undergoing ThuLEP between 2010 and 2013 was performed. Inclusion criteria were: age ≥ 40 years, prostate volume (PV) ≥ 80 mL, International Prostate Symptom Score (IPSS)-Total score ≥ 8 points. IPSS-Total score was the primary outcome, and BPH surgical retreatment rate was the secondary outcome. Paired t-test, McNemar test, and Wilcoxon signed-rank test were used to compare variables. Logistic regression analysis was performed to evaluate predictors of surgical retreatment. Results: A total of 410 patients with a mean ±SD age of 63.9 ± 9.7 years and a PV of 115.6 ± 28.6 mL were included. Mean ±SD follow-up was 108.2 ± 29.6 months. IPSS-Total score was significantly improved at 1 year compared to baseline (23.3 ± 4.7 vs. 10.3 ± 3.8; p<0.001). It was similar after 5 years (10.5 ± 3.6 vs. 10.7 ± 5.0; p=0.161), with a significant worsening at 10 years (10.3 ±4.8 vs. 13.8 ±4.5; p=0.042) but remaining statistically and clinically better than baseline (13.8 ±4.5 vs. 22.1 ±4.3; p<0.001). After 10 years, 21 (5.9%) patients had undergone BPH reoperation. Baseline PV (adjusted OR 1.27, 95% CI 1.09-1.41; p<0.001) and time from BPH surgery (adjusted OR 1.32, 95% CI 1.15-1.43; p<0.001) were predictors of BPH surgical retreatment. Conclusions: ThuLEP is associated with optimal functional outcomes and a low frequency of BPH surgical retreatment in the long-term. Baseline PV and time from surgery were predictors of BPH reoperation.
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Background: Benign prostatic hyperplasia (BPH) is common amongst the elderly. Even after transurethral resection of prostate (TURP), retention of urine may persist in some leading to significant morbidity adversely affecting the quality of life. The role of alpha blockers in this situation as a combination is unclear. The present study was conducted to evaluate and compare the efficacy of tamsulosin versus tamsulosin and deflazacort in relieving the postoperative retention of urine following TURP. Methods: After obtaining ethics approval and written informed consent, 72 patients satisfying the eligibility criteria were included. After TURP, patients with urinary retention following catheter removal were randomized into group A (tamsulosin hydrochloride) and group B (tamsulosin hydrochloride and deflazocort). baseline international prostate symptom score (IPSS) score was done to assess quality of life and findings of radiological investigations were noted. Thereafter, medical therapy was done as per assigned group and postoperative findings were documented and analyzed. Results: Both the groups were similar in terms of demographic characteristics and baseline characteristics. The relief of symptoms was significantly more in group B along with lower IPSS score and residual volume. Conclusions: We recommend addition of deflazacort to tamsulosin hydrochloride as medical therapy for the management of postoperative retention of urine (POUR), especially following TURP.
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Background: Uroflowmetry, a non-invasive urodynamic technique, is commonly employed in evaluating patients with potential lower urinary tract dysfunction. Accurate assessment of the severity of lower urinary tract symptoms (LUTS) can be achieved through the utilization of various validated questionnaires, such as the International Prostate Symptom Score (IPSS). The objective of this study was to investigate the correlation between uroflowmetry parameters and the severity of symptoms. Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation from May 2022 to December 2023. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Significant statistical correlations were identified between the IPSS and uroflowmetry outcomes, including peak flow rate, average flow rate, and post-void residual urine. However, no correlation was observed between the IPSS and measurements of prostate volume. Conclusions: A positive correlation was observed between the measured peak flow rate through uroflowmetry and the severity of lower urinary tract symptoms.
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Background: Endometrioid endometrial carcinoma is one of the most prevalent gynecologic cancers. The epithelial-mesenchymal transition is a multistep process involved in the development of cells that results in disappearance of intercellular adhesion in the epithelium and acquiring mesenchymal properties, hence influence cancer progression and metastasis. Loss of intercellular adhesion can be activated by different mechanisms, including transcriptional repression. However, the expression of transcriptional repressors in EEC and precursor lesions remain to be investigated. In the present study, we evaluated the immunohistochemical expression of proteins of transcriptional after repression snail and slug in EEC and its precursor lesions.Methods: It was a prospective nested case-control study on women from 35 to 70 years of age. Endometrial biopsies were obtained and processed for routine histological diagnosis. Immunohistochemical expression of snail and slug were evaluated.Results: A total of 39 EEC cases, 37 Endometrial hyperplasia and 19 normal controls were included in this study. Expression of snail was positive in 77% (30/39) and slug in 82% (32/39) of EEC cases while in precancer group snail was positive in 76% (28/37) and slug in 68% (25/37). In normal control snail was positive in 32% (6/19) and SLUG in 21% (4/19).Conclusion: Up-regulation of snail & slug observed in both precancer and cancer cases, suggesting their involvement from an early stage of carcinogenesis. Therefore therapies targeted at transcriptional repressors at an early stage of carcinogenesis, i.e., at precancerous lesions, could play a valuable role in reducing cancer progression and metastasis.
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Background: Endometrial cancer significantly contributes to gynecological cancers. The aim of the study was to assess the concordance between the preoperative endometrial biopsy and histology of hysterectomy specimens in patients surgically treated for endometrial hyperplasia and endometrial cancer. Concurrent malignancy was also assessed in cases of endometrial hyperplasia with atypia.Methods: This study is a retrospective analysis of patients surgically treated for atypical hyperplasia (47 patients) and cancer (210 patients) at HHFT from January 2014 to March 2020. The preoperative histology was compared to the histological findings of hysterectomy. In cases of endometrial cancer, its histological type and grade were also assessed.Results: In the endometrial cancer group, the majority were endometrioid adenocarcinoma (204 patients) and only 6 had a non-endometrioid type. In the endometrioid and non-endometrioid group, preoperative diagnosis was confirmed in 88.7% and 100% patients respectively in postoperative specimens. Tumor grade was reported in 193 patients. The present study shows the highest accuracy in grade 3 patients (88%) followed by grade 1 (82.8%) and grade 2 (62.5%). Out of these 47 patients who underwent surgical management for atypical hyperplasia, preoperative diagnosis was confirmed in 46.8% (22 patients). Importantly, concurrent endometrial cancer in hysterectomy specimens was found in 34% patients in atypical hyperplasia group.Conclusions: High level of concordance was noticed in histology and grade in endometrial cancer patients. Only half of the patients in atypical hyperplasia group showed concordance as one-third of patients were found to have concurrent malignancy.
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Background: Benign prostate hyperplasia (BPH) results in the enlargement of the gland and ultimately obstructs the bladder and the kidney. The effect on the kidney results in the dysregulation of the electrolyte causing electrolyte imbalance. Methods: An analytical cross-sectional study conducted at a tertiary teaching hospital aimed at assessing the levels and severity of electrolyte imbalance among BPH patients. The blood samples were analyzed for electrolytes and PSA levels for both patients and control group. An Independent t-test was used to compare the means of the BPH patients and healthy control subjects. Chi-square was used to determine the association between the electrolyte imbalance and the PSA levels of the BPH patients. Results: The mean age of the BPH patients and the healthy individuals was 65.47�.55 and 64.52�.19 years respectively. Hyponatremia, and hypernatremia were observed in 26.08% (n=104) and 4.22% (n=8) of the BPH patients respectively. There was a statistical significance positive correlation between potassium (K) and sodium (Na) concentrations (r=0.350, p<0.01), as well as a notable positive association between chloride (Cl) and magnesium (Mg) levels (r=0.288, p<0.01). PSA biomarker levels varied among the patients. There was a statistical significance (<0.0001*) difference in PSA levels between the BPH patients and the control group. Conclusions: With high prevalence of electrolyte imbalance among BPH patients there is a need to monitor the electrolytes and PSA levels in the management of BPH aiming at restoration of kidney function.
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Objective:To investigate the efficacy and safety of en-bloc Holmium laser enucleation of the prostate (HoLEP) with an early apical mucosa dissection technique for the treatment of benign prostate hyperplasia (BPH).Methods:The clinical data of 215 patients treated with HoLEP for BPH from January 2020 to January 2023 in the Department of Urology, Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. According to different treatment methods, the patients were divided into study group ( n=112) and control group ( n=103). Patients in the study group were treated by the en-bloc HoLEP with an early apical mucosa dissection technique, while patients in the control group were treated by the classical two or three-lobes HoLEP. The primary endpoints included the rates of urinary incontinence at 1-month, 3-month, and 6-month after surgery in two groups of patients. The secondary endpoints included operative time, hemoglobin decrease, dissected prostate weight, postoperative indwelling catheter time, postoperative hospital stay, and international prostate symptom score (IPSS), quality of life (QoL), Qmax, and postvoid residual urine (PVR) at 3-month and 6-month after surgery. The measurement data were tested by Shapiro-Wilk normality test. The normal distribution of the measurement data were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used for comparison between two groups. Measurement data of skewness distribution were expressed as median (interquartile distance) [ M( Q1, Q3)], and Wilcoxon or Mann-Whitney U test were used for comparison between two groups. The count data in the two groups were compared by the Chi-square test. Results:The incidence of urinary incontinence in the study group was 9.0% (10/112) and 3.6% (4/112) at 1-month and 3-month after surgery, which was significantly lower than those in the control group [18.5% (19/103) and 11.7% (12/103)], and the differences were statistically significant ( P< 0.05). Urinary incontinence in two groups recovered completely 6-month after surgery. The operation time of the study group was (68.74±23.71) min, which was lower than that of the control group [(88.04±25.43) min], and the difference was statistically significant ( P<0.05). There were no significant differences in hemoglobin decrease, dissected prostate weight, postoperative indwelling catheter time, postoperative hospital stay in the two groups ( P> 0.05). The IPSS, QoL, Qmax and PVR of the two groups were significantly improved at 3-month and 6-month after surgery ( P< 0.05), but there was no significant difference between the two groups ( P> 0.05). Conclusion:En-bloc HoLEP with an early apical mucosa dissection technique is safe and reliable in treating BPH, and has advantages over classic HoLEP in terms of short-term urinary continence rates, shortening operation time.
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The incidence of parathyroid hyperfunction is high and its clinical manifestations are diverse. Some patients develop chest tightness and palpitations as the main discomfort, which may be caused by the hypocalcemia and hypercalcemia related to negative calcium balance and parathyroid hyperfunction. We report a case of 53 years old male with parathyroid hyperfunction who was diagnosed with osteoporosis before and received conventional regular supplementation of vitamin D and calcium supplements. However, his condition worsened and he developed chest tightness and palpitation. After 1 month of sufficient supplementation of calcium, the symptoms of chest tightness and palpitation disappeared completely. Then we continued to provide the patients enough vitamin D and calcium supplementation actively. After 1 year of follow-up, the patient's condition was stable. His discomfort of chest tightness and palpitation never recurred, and all the bone metabolism indicators returned to normal.
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Objective To investigate the clinicopathological characteristics of extranodal NK/T cell lymphoma(ENKTL)with B-lymphocytosis.Methods Two cases of ENKTL with B-lymphocytosis diagnosed in Shaanxi Provincial People's Hospital from June to September 2023 were collected.HE staining,immunohistochemistry,and in situ hybridisation Epstein-barr virus encoded small RNA(EBER)testing was used to observe the histological features,immunophenotypes,and results of the in situ hybridisation EBER testing.A review of the relevant literature was conducted.Results In two cases of elderly male patients,whose lesion sites were on both the right side of the nasal cavity,histological characteristics of the tumor cells were diffuse distribution.The cells were of different sizes,mainly medium and large cells,with irregular nuclei,stained or transparent cytoplasm,oval nuclei,granular chromatin and inconspicuous nucleoli.Nuclear schizophrenia was more common and coagulative necrosis and apoptosis were evident.Foci of small lymphocyte aggregates were seen in the background and lymphoid follicles were distributed in a scattered manner.Immunohistochemical CD2,CD3,CD56,TIA-1 and granzyme B(GrB)were positive.CD20,CD79a and PAX-5 were focal positive.CD21,CD23 and CD35 had residual FDC network,and CD5 was negative.Ki-67 proliferation index was approximately 30%.EBER tumor cells detected by in situ hybridisation were positive.Pathological diagnosis showed ENKTL with B-lymphocytosis.Conclusion NKTL with B-lymphocytosis was rare,especially when B-lymphocyte hyperplasia formed lymphoid follicles.Lack of experience can easily cause diagnostic difficulties,and comprehensive analysis and diagnosis should be combined with the clinical manifestations,histological morphology and immunophenotype.
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Objective:To analyze the difference and reliability of blood 17-hydroxyprogesterone (17-OHP), an indirect screening index for congenital adrenal hyperplasia (CAH), between preterm and full-term infants.Methods:In this retrospective cross-sectional study, a total of 210 285 newborns who underwent CAH screening at the Neonatal Screening Center of Shanghai Children′s Hospital from January 2019 to December 2022 were collected, including 14 312 premature infants and 195 973 full-term infants.The concentration of 17-OHP in dried blood spots on filter paper was determined by an automatic fluorescence analyzer.The distribution of 17-OHP levels in preterm and full-term infants and its statistical index were analyzed.The Kolmogorov-Smirnov test was used for normal distribution.The skewed distribution data was converted into approximately normal distribution using Box-Cox.Outliers were eliminated by the interquartile range method.The cumulative frequency distribution map was drawn by R language programming.The 99.5 th percentile value was used as the screening threshold and compared with the reference value given by the manufacturer or laboratory and with the reference change value (RCV). Results:According to the threshold provided by the laboratory, 26.76‰ of premature infants were tested positive in preliminary screening, and 4 were confirmed with an incidence of 1∶3 578, while 0.79‰ of full-term infants were tested positive in preliminary screening, and 11 were confirmed with an incidence of 1∶17 816.The thresholds for CAH screening established indirectly were 20.35 nmol/L in preterm infants and 10.78 nmol/L in full-term infants.The relative deviations between the indirect CAH screening thresholds and the manufacturer′s or laboratory′s CAH screening thresholds were higher than the RCV, respectively.According to the indirect CAH screening thresholds, the negative and positive coincidence rates of 65 samples in 13 batches from the Centers for Disease Control and Prevention interlaboratory quality assessment program in the United States reached 100%.A retrospective analysis of 210 285 neonates showed that 17-OHP concentration was higher than the screening threshold in all CAH-positive neonates.The application of this screening threshold reduced the false positive rate of preterm infants by 59.79%.Conclusions:It is feasible to establish the CAH screening thresholds for premature and full-term infants by an indirect method, which can improve the efficiency of screening and provide better diagnostic basis for clinical practice.
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Objective To evaluate the clinical value of transarterial catheterization C-arm CT perfusion scanning technique during prostatic artery embolization(PAE)for benign prostatic hyperplasia(BPH).Methods The clinical data of 46 patients with BPH received PAE were analyzed retrospectively.All patients underwent prostatic artery(PA)digital subtraction angiography(DSA)and C-arm CT perfusion scanning to identify PA and prevent non-target organ embolization.The final recognization of PA was consulted by three senior doctors.After C-arm CT confirmation,PA was embolized with 100-300 μm polyvinyl alcohol(PVA)particles or microspheres under fluoroscopy.The postoperative complications and 3-month clinical efficacy were observed.Results A total of 106 vessels were angioraphed in 46 patients,with 83 PA vessels and 23 non-PA vessels.PA was identified by DSA and C-arm CT with sensitivity of 81.9%(68/83)and 100%(83/83),respectively,which showed significance(χ2=22.3,P<0.01).Non-PA was identified by DSA and C-arm CT with specificity of 73.9%(17/23)and 100%(23/23),which showed significance(χ2=9.2,P=0.02).No serious complications were observed and 3-month clincial efficacy was 91.3%.Conclusion Transarterial catheterization C-arm CT perfusion scanning technique can accurately identify PA,reduce PA leakage and prevent non-target organ embolization.
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Objective To investigate the imaging manifestations and pathogenesis of liver focal nodular hyperplasia-like(FNH-like)lesions in patients undergoing antineoplastic chemotherapy.Methods The clinical and imaging data of focal nodular hyperplasia(FNH)and FNH-like lesions patients confirmed by pathology after antineoplastic chemotherapy were analyzed retrospectively.Results A total of 67 FNH-like nodules were detected in 15 patients after antineoplastic chemotherapy,including multiple FNH nodules in 8 cases and sin-gle nodule in 7 cases.The mean detected time of FNH-like nodules was(18.9±11.7)months.Central scarring could be observed during follow-up in 5 nodules,and the rest showed atypical FNH features.Among 45 nodules examined with hepatocyte-specific con-trast medium,36 nodules showed slightly high signal in the hepatobiliary phase and other 9 nodules showed isosignal.Conclusion FNH-like lesions in patients during antineoplastic chemotherapy have certain imaging features,such as lack of central scarring,gener-ally smaller nodules,delayed enhancement,and hyperenhancement in hepatobiliary-specific phase,which are of significant value in the diagnosis and differential diagnosis of the disease.
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BACKGROUND:How to provide sufficient skin resources for scar plastic surgery and repair of extensive deep burn patients while avoiding the re-proliferation of scar tissue in the surgical area has always been an important topic in burn and wound repair research. OBJECTIVE:To observe the clinical application effects of artificial dermis combined with autologous scar epidermis in the repair of scar after extensive burns. METHODS:Retrospective analysis was performed on 73 patients with scar hyperplasia and contracture deformity after extensive burns in Bengbu Third People's Hospital Affiliated to Bengbu Medical College from January 2021 to January 2023.The patients were divided into three groups according to the treatment method:Group A(n=21,artificial dermis combined with autologous scar epidermis transplantation was used for treatment),group B(n=27,scar epidermis was transplanted after scar release in the functional site),and group C(n=25,functional site scar release after transplantation of thick skin treatment).Skin survival and infection at the receiving site,wound healing time at the receiving site and the donor site were recorded in the three groups.The scar status and functional recovery of the recipient area and donor area were evaluated by the Vancouver Scar Scale and activities of daily living. RESULTS AND CONCLUSION:(1)The skin infection rate was lower in group B than that in groups A and C(P<0.05).The survival grade was higher in group B than that in groups A and C(P<0.05).(2)The wound healing time at the receiving site was longer in group A than that in groups B and C(P<0.05).The wound healing time at the receiving site was longer in group C than that in group B(P<0.05).The wound healing time at the donor site was longer in group C than that in groups A and B(P<0.05).(3)Vancouver Scar Scale score was higher in group B than that in groups A and C at 12 months postoperatively(P<0.05).Vancouver Scar Scale score was higher in group C than that in groups A and B at 6 and 12 months postoperatively(P<0.05).The excellent grade of activities of daily living in groups A and C was significantly higher than that of group B at 12 months postoperatively(P<0.05).(4)The results showed that the application of artificial dermis combined with autologous scar epidermis composite transplantation in the treatment of scar contracture after extensive burn could not only achieve the same effect as that of intermediate-thickness skin,but also avoid postoperative scar re-hyperplasia at the donor site and shorten the time of complete wound healing at the donor site.Compared with scar epidermal transplantation,this treatment has obvious advantages.
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The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.