Aging increases, and duodenal ulcer reduces the risk for intestinal metaplasia of the gastric corpus in Japanese patients with dyspepsia

BACKGROUND AND AIMS: The classification of gastritis by using the revised Sydney system suggests that there are two types of Helicobacter pylori-related gastritis. The aim of the present study was to examine the risk factors that might be involved in the presence of either atrophic gastritis or intestinal metaplasia of the gastric corpus of Japanese patients. METHODS: Biopsy samples were obtained from the gastric corpus in 154 patients with dyspepsia, and the degree of atrophy or intestinal metaplasia was determined histologically. The correlation between several variables and presence of atrophy or intestinal metaplasia was evaluated by using multivariate analysis. RESULTS: Among the 11 variables, which included age, peptic ulcer diseases and H. pylori infection, H. pylori infection was the major risk factor associated with the presence of atrophic gastritis or intestinal metaplasia of the gastric corpus. In contrast, duodenal ulcer (DU) disease reduced the risk of contracting both conditions. Age was an independent risk factor only for intestinal metaplasia of the gastric corpus. When 128 H. pylori-positive subjects were analyzed, DU and age were similarly associated with the presence of both conditions. CONCLUSIONS: These results suggest that DU reduces the risk for contracting atrophic gastritis and intestinal metaplasia, and age is an independent risk factor for intestinal metaplasia of the gastric corpus in dyspeptic Japanese patients.     

Nonconvulsive status epilepticus manifesting as rapidly progressive dementia and infarction in the splenium of the corpus callosum: A case report

Rationale:Nonconvulsive status epilepticus (NCSE) is a heterogeneous disease with multiple subtypes. NCSE poses great diagnostic and therapeutic challenges due to the lack of typical symptoms. Here, we report a case of NCSE manifesting as rapidly progressive dementia (RPD) and infarction in the splenium of the corpus callosum. Additionally, the relevant literature was reviewed.Patient concerns:A 63-year-old man presented with RPD. Electroencephalogram (EEG) revealed NCSE, and brain magnetic resonance imaging (MRI) showed an isolated infarction in the splenium of the corpus callosum. Mini-mental state examination showed moderate cognitive impairment (14/30 points).Diagnosis:A diagnosis of NCSE with RPD and infarction in the splenium of the corpus callosum was made.Interventions:The patient was treated with intravenous diazepam (10 mg), oral levetiracetam (1.0g twice daily), oral sodium valproate (0.2g twice daily), and intramuscular phenobarbital sodium (0.2g once daily).Outcomes:After the treatment, the symptoms were improved. The patient could answer questions. Repeated EEG showed that the background a rhythm was slightly overdeveloped, and no clinical or electrical seizures were observed. After discharge, the patient was treated with oral levetiracetam (1.0g twice daily) and oral sodium valproate (0.2g twice daily) for 6 months. At the last follow-up, the patient had clear consciousness, sensitive response, and fluent answering ability. Repeated mini-mental state examination showed that his cognitive function was significantly improved (28/30 points); nevertheless, the lesion in the splenium of corpus callosum remained unchanged on MRI.Lessons:NCSE manifesting as RPD and infarction in the splenium of the corpus callosum is extremely rare. Epileptic events and focal infarction are usually overlooked in patients with dementia, and the diagnostic value of MRI and EEG should be highlighted     

White Matter Injuries Induced by MK‐801 in a Mouse Model of Schizophrenia Based on NMDA Antagonism

The etiology of schizophrenia (SZ) is complex and largely unknown. Neuroimaging and postmortem studies have suggested white matter disturbances in SZ. In the present study, we tested the white matter deficits hypothesis of SZ using a mouse model of SZ induced by NMDA receptor antagonist MK‐801. We found that mice with repeated chronic MK‐801 administration showed increased locomotor activity in the open field test, less exploration of a novel environment in the hole‐board test, and increased anxiety in the elevated plus maze but no impairments were observed in coordination or motor function on accelerating rota‐rod. The total white matter volume and corpus callosum volume in mice treated with MK‐801 were significantly decreased compared to control mice treated with saline. Myelin basic protein and 2′, 3′‐cyclic nucleotide 3′‐phosphodiesterase were also significantly decreased in the mouse model of SZ. Furthermore, we observed degenerative changes of myelin sheaths in the mouse model of SZ. These results provide further evidence of white matter deficits in SZ and indicate that the animal model of SZ induced by MK‐801 is a useful model to investigate mechanisms underlying white matter abnormalities in SZ. Anat Rec, 297:1498–1507, 2014. © 2014 Wiley Periodicals, Inc.     

内源性一氧化氮合酶抑制物在糖尿病大鼠勃起功能障碍中的作用

目的:探讨内源性一氧化氮合酶(NOS)抑制物非对称性二甲基精氨酸(ADMA)在糖尿病大鼠勃起功能障碍中的作用及其机制。方法:采用高脂饲养加小剂量链脲佐菌素腹腔注射诱导8周病程的2型糖尿病大鼠模型;麻醉下分离大鼠阴茎海绵体,用器官浴槽方法检测海绵体对乙酰胆碱的内皮依赖性舒张反应以反映其勃起功能;检测血清ADMA含量;检测海绵体组织NOS活性及一氧化氮(NO)和环磷酸鸟苷(c GMP)含量;用Western blot检测海绵体ADMA信号通路蛋白和磷酸二酯酶5(PDE5)的表达;检测超氧化物歧化酶活性和脂质过氧化产物丙二醛含量以评价氧化应激。结果:糖尿病大鼠血糖升高,胰岛素敏感性降低,表明糖尿病大鼠模型建立成功;与正常对照组比较,糖尿病大鼠海绵体舒张功能明显降低,血清ADMA浓度升高,海绵体组织NOS活性及NO和c GMP含量降低,ADMA生成酶蛋白精氨酸甲基转移酶1表达上调,ADMA代谢酶二甲基精氨酸二甲胺水解酶1、2及ADMA靶酶内皮型NOS和神经元型NOS表达下调,PDE5蛋白表达上调,氧化应激增加;体外用ADMA孵育正常大鼠离体海绵体,亦可产生与糖尿病大鼠海绵体相似的舒张功能障碍及NO和c GMP含量减少。结论:内源性NOS抑制物ADMA蓄积是导致糖尿病大鼠勃起功能障碍的重要原因,其机制可能与减少NO生成、增加氧化应激有关。     

Genital verrucous carcinoma is associated with lichen sclerosus: a retrospective study and review of the literature

Background The association of lichen sclerosus (LS) with genital squamous cell carcinoma is well recognized. However, the relationship between LS and verrucous carcinoma remains unclear. Objective To evaluate the associations of genital and perianal verrucous carcinomas with LS. Methods We conducted a retrospective study on patients with a genital or perianal verrucous carcinoma and reviewed their histopathology specimens and clinical notes. We also conducted a literature review. Results We identified a total of 13 patients (including 6 women and 7 men) with a genital or perianal verrucous carcinoma. All 5 women with vulval verrucous carcinoma had coexisting LS (5/5), and 1 man with penile verrucous carcinoma had coexisting LS (1/3). In contrast, no coexisting LS was found in all 5 cases of perianal verrucous carcinoma (0/5). Half of the cases of verrucous carcinoma with coexisting LS had recurrences (3/6), while no recurrences were found in those without coexisting LS (0/7). Conclusions Our study and review of the literature demonstrate that vulval verrucous carcinoma is strongly associated with LS. In contrast, perianal verrucous carcinoma is not associated with LS. When genital verrucous carcinoma is diagnosed, it is important to consider LS as a potential concomitant diagnosis and offer appropriate treatments and close follow‐up to detect recurrence of verrucous carcinoma.     

儿童隐匿阴茎改良Devine术后常见并发症及处理

目的:探讨改良Devine术治疗儿童隐匿型阴茎的术后常见并发症及处理方法,为儿童隐匿型阴茎治疗后得到更好的预后提供依据。方法:选取2014年12月至2015年12月前往我院接受治疗的82例儿童隐匿阴茎患者作为研究对象,在征得所有患者家属知情同意下均对其实施改良Devine术治疗,观察其并发症的发生率,以及采用相关手段进行并发症的处理,观察其效果。结果:82例患儿手术均获得成功,平均长度增加(2.7±0.6)cm;术后近期并发症15例,发生率为18.29%,分别为伤口渗血血肿、勃起疼痛以及包皮水肿等,未出现皮瓣坏死和尿瘘等并发症;术后远期并发症共18例,发生率为21.95%,分别为包皮赘生、阴茎皮肤分布不均、系带残留过多、阴茎周围皮肤瘢痕赘生以及复发等。结论:改良Devine术治疗儿童隐匿型阴茎效果显著,术后最常见的并发症为阴茎包皮顽固性水肿,临床医师需要严格掌握手术的适应症,选择恰当的手术,且需要经验丰富。     

阴茎完全离断显微再植的急诊手术治疗

目的:探讨阴茎完全离断显微再植的急诊手术治疗方法及效果。方法:回顾性分析我院2007年1月至2016年1月收治的7例行显微再植急诊手术治疗的阴茎完全离断患者的临床资料,观察其术后排尿、皮肤感觉、性生活恢复情况。结果:7例患者末次随访切口均甲级愈合,阴茎血运良好,排尿正常,平均尿流率为(18.5±1.7)m/s,平均勃起硬度达到(3.6±0.5),夜间自发阴茎勃起存在,性生活可正常完成。随访中未见尿道狭窄、尿瘘等并发症。结论:急诊显微手术治疗阴茎完全离断有着良好的效果及安全性。术前做好离断阴茎的保护,术中成功吻合血管及神经,术后实施镇痛、抗感染治疗均是提高阴茎成活率、降低并发症风险的重要手段。     

78例隐匿性阴茎患儿运用“V”形切口改良Brisson手术治疗的效果分析

目的:分析和探讨78例隐匿性阴茎患儿运用"V"形切口改良Brisson手术治疗的效果。方法:回顾性分析从2014年1月至2015年6月在我院接受阴茎腹侧"V"形切口改良Brisson手术治疗的78例隐匿性阴茎患儿的临床资料,介绍手术方法,总结应用效果。结果:术后12例患儿阴茎皮肤有不同程度水肿,但均在2周内消退,均无皮瓣坏死,切口均Ⅰ期愈合。随访6~12个月,患儿阴茎均发育及伸直良好,外观良好,家长均较满意。结论:在隐匿性阴茎的治疗中"V"形切口改良Brisson手术效果好、外观好,具有较高的应用价值。