Prone versus Barts “flank-free” modified supine percutaneous nephrolithotomy: a match-pair analysis

Background/aimIn this study, we aimed to compare the results of prone and Barts “flank-free” modified supine percutaneous nephrolithotomy (PCNL) operations in our clinic.Materials and methods The data from patients that underwent Barts “flank-free” modified supine PCNL (BS-PCNL) (n = 52) between June 2018 and July 2020 and prone PCNL (P-PCNL) (n = 286) between April 2014 and June 2018 were retrospectively evaluated. Of those 286 patients, 104 patients whose sex, age, body mass index, American Society of Anesthesiology score, stone localization, stone size, and hydronephrosis matched the BS-PCNL group in a 1:2 ratio were included in the study. The groups were compared in terms of intraoperative outcome, complication rates, and stone-free rates.Results The mean age of all patients (58 females, 98 males) included in the study was 41.8 ± 15.2 years, and the mean body mass index (BMI) was 24.7 ± 2.9 kg/m2. The mean operation time was significantly shorter in the BS-PCNL group than in the P-PCNL group (80.2 ± 15.1 min vs. 92.4 ± 22.7 min and p = 0.01). There was no significant difference between the two groups in terms of fluoroscopy time, intraoperative complications, postoperative complications, and stone-free rates.Conclusion Our study shows that BS-PCNL is an effective and safe method that significantly reduces the operation time and should be considered as one of the primary treatment options for patients scheduled for PCNL.     

肝门胆管癌的临床诊断

目的：探求实用和有效的诊断肝门胆管癌的方法。方法：对61例肝门胆管癌及50例良性胆道疾病（肝门胆管结石伴肝管狭窄、肝门胆管损伤性狭窄）的临床表现,实验室和影像检查结果比较分析。结果：肝门胆管癌的主要表现为梗阻性黄疸和右上腹痛。肝门胆管癌病人血清CA19－9水平显著高于良性对照组（P＜0．01）。血清CA19－9,CEA诊断肝门胆管癌的敏感性和特异性分别是83．6％,17．4％和68％,100％。B超,电脑彩超,CT,MRI诊断肝门胆管癌的敏感性和特异性分别是70％,97％,71．9％,78．3％和95．7％,100％,90．9％,87．5％。所有46例肝门胆管癌病人行MRC均能明确显示胆管梗阻部位和扩张的肝门胆管树。结论：血清CA19－9有助于肝门胆管癌的诊断。彩超,MRI结合MRC是诊断肝门胆管癌的首选影技术。     

Ribose conversion with amino acids into pyrraline platform chemicals – expeditious synthesis of diverse pyrrole-fused alkaloid compounds

One-pot conversion of sustainable d-ribose with l-amino acid, methyl esters produced pyrrole-2-carbaldehydes 5 in reasonable yields (32–63%) under pressurized conditions of 2.5 atm at 80 °C. The value-added pyrraline compounds 5 as platform chemicals were utilized for quick installation of poly-heterocyclic cores for the development of pyrrole-motif natural and artificial therapeutic agents. A pyrrole-fused piperazin-2-one scaffold 6 was prepared by reductive amination of pyrralines 5 with benzylamine. While further cyclization of pyrralines 5 with ethane-1,2-diamine produced pyrrolo-piperazin-2-ones 7 with an extra imidazolidine ring, the reaction with 2-amino alcohols derived from natural l-amino acids, alanine, valine, and phenylalanine, respectively provided pyrrolo-piperazin-2-ones 8, 9, and 10 with oxazolidine as the third structural core. Cell viability and an anti-inflammatory effect of the synthesized compounds were briefly tested by the MTT method and the Griess assay, among which 8h and 10g exhibited significant anti-inflammatory effects with negligible cell toxicity.

One-pot conversion of sustainable d-ribose with l-amino acid, methyl esters produced pyrrole-2-carbaldehydes 5 in reasonable yields (32–63%) under pressurized conditions of 2.5 atm at 80 °C.     

低浓度二甲基亚砜冻存外周血造血干细胞的效果

目的:观察外周血造血干细胞(PBSC)用低浓度二甲基亚砜(DMSO)和羟乙基淀粉(HES)在-80℃条件下冷冻保存的效果。方法:49例次患者的PBSC在冻存后3、6个月及1年进行复苏,分别取样进行有核细胞(NC)计数、锥虫蓝拒染率测定、CD34 细胞阳性率分析和粒-巨噬细胞集落生成单位(CFU-GM)检测。结果:PB-SC在-80℃冰箱中冻存3个月和6个月的NC、CD34 细胞、CFU-GM回收率的差异均无统计学意义(均P>0.05),NC活细胞比率差异也无统计学意义(P>0.05)。PBSC冻存1年NC、CD34 细胞、CFU-GM集落回收率及活细胞比率均有显著性下降(均P<0.01)。结论:应用低浓度DMSO在-80℃冻存PBSC3个月和6个月的细胞能得到较好保存,1年后的冻存效果显著下降。     

An analysis of factors affecting the incidence of inhibitor formation in patients with congenital haemophilia in Japan

Summary. Studies conducted in European and North American countries have demonstrated that various factors including races affect the frequency of inhibitor formation in haemophilia patients. The present study was undertaken to analyse factors affecting the incidence of inhibitor formation in Japanese haemophilia A and B patients. Analytical data were retrospectively collected from haemophilia A and B patients born after 1988, the year when monoclonal antibody‐purified factor VIII products were first marketed in Japan. Various data were collected from 184 patients (153 cases of haemophilia A; 31 cases of haemophilia B). The sample size of haemophilia B cases was too small to reveal any significant differences between the inhibitor formation group and the inhibitor‐free group in any of background variables. For patients with haemophilia A, on the other hand, univariate analysis identified the severity of haemophilia and a positive family history of inhibitor development as risk factors for the formation of inhibitors. In analyses of the clotting factor products used, the incidence of inhibitor formation did not differ significantly between the group treated with plasma‐derived products (29.7%) and the group treated with recombinant products (25.0%). When background variables were compared, age was higher in the group treated with plasma‐derived products but none of the other background variables differed between the two groups. These results suggest that in Japanese haemophilia patients, the type of clotting factor preparations used for therapy has not influenced the incidence of inhibitor formation.     

Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults

Background and Aim: Differences in the prevalence of non‐alcoholic fatty liver disease (NAFLD) between Eastern and Western populations are primarily attributable to differences in definitions and biased population selection. Thus, the aim of the present study was to accurately determine the actual prevalence of NAFLD by sonography and to characterize the risk factors for NAFLD. Methods: The present cross‐sectional study was performed with data obtained from 6648 subjects, all of whom were older than 20 years of age (3530 men and 3118 women). The term ‘non‐drinker’ was applied to men who consumed less than 30 g alcohol/day and to women who consumed less than 20 g alcohol/day. Non‐alcoholic fatty liver disease was defined as a sonographically detected fatty liver in the absence of viral hepatitis in a non‐drinker. Results: Of the 1613 subjects who were diagnosed with sonographic fatty liver, 1240 were non‐drinkers and had no viral hepatitis. Overall, the unadjusted and age‐adjusted prevalences of NAFLD were 18.7% (23% in men, 13.7% in women) and 16.1% (21.6% in men, 11.2% in women), respectively. Multivariate analysis revealed that several risk factors were profoundly associated with the prevalence of NAFLD, including obesity, insulin resistance, hyperlipidemia and hyperglycemia in both genders, as well as age, menopausal status and estrogen medication in women only. Conclusions: These results demonstrate that the prevalence of NAFLD in Korean adults, according to sonographic surveys, is comparable to that seen in more developed countries. From the perspective of increasing obesity, the high prevalence rates noted in the study may herald an increased burden of chronic liver disease in the Korean population.     

Triple simultaneous primary gynecological malignancies in a 56-year-old patient

The occurrence of double simultaneous primary cancers is common. However, the occurrence of synchronous primary triple gynecological malignancies is an extremely rare event. In this report, the clinical and pathologic findings of a 56-year-old female patient with synchronous triple primary gynecological cancers including well-differentiated ovarian mucinous cystadenocarcinoma, well-differentiated endometrial endometrioid adenocarcinoma, and uterine leiomyosarcoma were presented. Synchronous primary, well-differentiated endometrial endometrioid adenocarcinoma and leiomyosarcoma of uterus without any ovarian neoplasm has only been once described in the English literature. To our knowledge, the presented patient is the first case in aspect of accompanying ovarian mucinous adenocarcinoma to endometrial endometrioid adenocarcinoma and leiomyosarcoma of uterus.     

Antibody Response of Restricted Isotype to Heat Shock Proteins in Juvenile Chronic Arthritis

Synovial fluid and peripheral blood mononuclear cells from juvenile chronic arthritis (JCA) patients have previously been shown to exhibit substantial proliferative responses to both human and mycobacterial heat shock protein (hsp) 65. We investigated the nature of the antibody response to mycobacterial and E. coli hsp 65 and human and E. coli hsp 70 in 56 JCA patients using an ELISA. Elevated levels of antibodies to both human and E. coli hsp 70 were demonstrated. With hsp 65, raised levels of antibodies to the mycobacterial but not the E. coli protein were detected. Overall, 48% of patient serum samples contained antibodies of at least one isotype to mycobacterial hsp 65. These antibodies were predominantly of IgG and IgM isotype, a finding in contrast to adult rheumatoid arthritis, where IgA and IgG isotypes are most often detected.