Medicine
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Case Reports
Solitary vulvar metastasis from early-stage endometrial cancer: Case report and literature review.
Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. It is usually diagnosed at early-stage and presents a favorable prognosis. Conversely, advanced or recurrent disease shows poor outcome. Most recurrences occur within 2 years postoperatively, typically in pelvic and para-aortic lymph nodes, vagina, peritoneum, and lungs. Vulvar metastasis (VM) is indeed anecdotal probably because of the different regional lymphatic drainage from corpus uteri. ⋯ Vulvar metastases can show different appearance, occurring as single or diffuse lesions on healthy or injured skin. The surgical approach seems not to influence the metastatic risk, but tumor seeding and vaginal injuries should be avoided. Whether isolated or associated with recurrence in other locations, vulvar metastases imply poor prognosis despite radical treatment. Therefore, any suspected vulvar lesion arisen during EC follow-up should be biopsied and monitored closely, despite that the vulva represents an unusual metastatic site.
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Observational Study
Kinematic analysis of the human body during sit-to-stand in healthy young adults.
Sit-to-stand (STS) motion is one of the most important and energy-consuming basic motions in everyday life. Kinematic analysis provides information regarding what strategy or motion pattern is used by the healthy people, and through which, we can understand and obtain the law of the STS motion. The objective of this article is to study the law of STS motion through the experiment to determine a suitable description of STS motion in healthy adults, so as to provide a starting point and bases for future design and control of STS assistive devices. ⋯ The results suggest that when designing the sit-to-stand assistive devices, one should pay attention to the whole-body posture control in STS motion, such as the posture guidance of trunk and lower leg, and should carry out specific training according to different STS phases. Sit-to-stand assistive devices should provide the same horizontal distance between hip joint and ankle joint for different individuals during the STS motion. Transition period should be properly controlled, and the degree of freedom of the lower leg should not be limited.
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Measurement of cortisol in hair is a reliable method for determining long-term cortisol exposure reflecting chronic stress. Research using hair cortisol concentration has been limited to mainly cardiometabolic diseases. The association between hair cortisol concentration and aneurysmal rupture has not yet been studied. ⋯ High hair cortisol concentration was found to be an independent risk factor for aneurysmal rupture (odds ratio [OR]: 2.245, 95% confidence interval [CI]: 1.825-2.753; P = .013). Additionally, a history of cerebrovascular disease was significantly associated with an increased risk of aneurysmal rupture (OR: 1.577, 95% CI: 1.099-2.262; P = .040). Based on our results, we suggest that chronic stress as measured by hair cortisol concentration could be an independent risk factor for intracranial aneurysmal rupture.
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Observational Study
Pacemaker dependency after transcatheter aortic valve replacement compared to surgical aortic valve replacement.
Transcatheter aortic valve replacement (TAVR) is a standard treatment indicated for severe aortic stenosis in high-risk patients. The objective of this study was to evaluate the incidence of pacemaker dependency after permanent pacemaker implantation (PPI) following TAVR or surgical aortic valve replacement (SAVR) and the risk of mortality at a tertiary center in Korea. In this retrospective study conducted at a single tertiary center, clinical outcomes related to pacemaker dependency were evaluated for patients implanted with pacemakers after TAVR from January 2012 to November 2018 and post-SAVR from January 2005 to May 2015. ⋯ Twelve (41.4%) patients were pacemaker-dependent after 365 days post-TAVR. Pacemaker dependency did not differ at 6 months after TAVR vs SAVR. In patients undergoing post-TAVR PPI, 58.6% were not pacemaker-dependent at 1 year after the TAVR procedure.
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Observational Study
Identify the triple-negative and non-triple-negative breast cancer by using texture features of medicale ultrasonic image: A STROBE-compliant study.
The study aimed to explore the value of ultrasound (US) texture analysis in the differential diagnosis of triple-negative breast cancer (TNBC) and non-TNBC. Retrospective analysis was done on 93 patients with breast cancer (35 patients with TNBC and 38 patients with non-TNBC) who were admitted to Taizhou people's hospital from July 2015 to June 2019. All lesions were pathologically proven at surgery. ⋯ Receiver operating characteristic curve analysis indicated that at a threshold of 268.9068, GLNU in horizontal direction exhibited best diagnostic performance for differentiating TNBC from non-TNBC. Logistic regression model established based on all these parameters showed a sensitivity of 69.3%, specificity of 91.4% and area under the curve of 0.834. US texture features were significantly different between TNBC and non-TNBC, US texture analysis can be used for preliminary differentiation of TNBC from non-TNBC.