Medicine
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We aim to quantitatively investigate the difference between benign and malignant solid pulmonary nodules that appeared on dual-energy spectral computed tomography, and assess the diagnostic accuracy of several parameters derived from computed tomography in differentiating malignant from benign pulmonary nodules. Between September 2021 and December 2022, spectral images of 71 patients (male:female = 44:27, mean age = 71.0 years) confirmed by pathology were retrospectively analyzed in the venous phase. Patients were classified into the malignant group and the benign group. ⋯ The malignant pulmonary nodules have higher iodine density and slope of the spectral curve than the benign lesions. The combined model of iodine density and curve slope with an optimal cutoff of 0.39 (area under the curve = 0.82) yielded a sensitivity of 95% and a specificity of 63%. Contrast-enhanced dual-energy spectral computed tomography allows promising capability of distinguishing malignant from benign lesions, potential for avoiding unnecessary invasive procedure or surgery.
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The present study aimed to evaluate the elbow flexor force induced by perineural intramuscular stimulation compared with surface electrical stimulation (ES) and maximal voluntary contraction. Thirty nondominant arms of healthy volunteers were evaluated. Isometric elbow flexion force was evaluated using a surface electrode stimulation at the biceps brachii muscle, a perineural intramuscular stimulation around the musculocutaneous nerve, and maximum voluntary contraction. ⋯ The mean elbow flexion force by ES was 2.9 ± 2.0 kgf, stimulation intensity was 24.8 ± 5.5 mA, and the numeric rating scale was 5.0 ± 2.5 via surface electrode stimulation and 3.1 ± 2.0 kgf, 5.0 mA, and 3.8 ± 1.9 via perineural stimulation, respectively. ES provides 16% to 18% of the maximal voluntary contraction force in elbow flexion, which corresponds to a fair grade of muscle force. Perineural intramuscular stimulation can generate an equivocal contraction force with less discomfort in elbow flexion than surface electrode stimulation.
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Accumulating evidence supports the notion that S100A16 exhibits differential expression in many human cancers, affecting cellular functions associated with tumorigenesis through various signaling pathways. While extensive research has been conducted on S100A16 in specific cancer types, a comprehensive evaluation of its role across diverse cancers remains lacking. To explore the prognostic significance, drug sensitivity, and immunomodulatory roles of S100A16, a thorough analysis was conducted at a pan-cancer level using multiple databases. ⋯ Furthermore, our study demonstrated a significant association between S100A16 expression and the infiltrating levels of diverse cell types in the tumor microenvironment (TME), suggesting its potential as a prognosis predictor for immunotherapy. Novel collections of miRNAs, such as has-miR-423-5p, has-miR-769-5p, has-miR-151a-3p, and has-miR-550a-5p, targeting S100A16 at a pan-cancer level were predicted through various databases. These findings contribute to a comprehensive understanding the role of S100A16 in prognosis prediction, chemotherapy, and immunotherapy, providing valuable insights for identifying novel targets in cancer treatment.
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Observational Study
The nexus between appendicitis and chronic inflammatory bowel diseases: Unraveling an intriguing association.
Appendicitis is 1 of the most frequent diseases worldwide. In general, it is treated with appendectomy, which, in almost all cases, leads to the healing of the disease and averts acute complications. However, only limited data regarding long-term sequalae, including inflammatory bowel diseases following appendicitis are available. ⋯ In contrast, no statistically significant link was observed between appendicitis and the subsequent development of UC (Hazard ratio: 1.24; 95% CI: 0.90-1.71). The present study presents novel data from a large cohort of outpatients in Germany, providing strong evidence for an association between appendicitis and the development of CD (but not UC). These findings contribute to the existing body of literature and may facilitate the recognition of appendicitis as a risk factor for the development of chronic inflammatory bowel diseases.
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Case Reports
Carbon dioxide narcosis following cesarean section in a patient with severe pulmonary hypertension: A case report.
Managing anesthesia in patients with severe pulmonary conditions involves complex considerations, especially when dealing with high baseline CO2 levels. We present a case that demonstrates the challenges and complexities of anesthesia and postoperative analgesia in a patient with severe pulmonary hypertension and a history of lung disease exacerbated by the interactions of protein-bound drugs. ⋯ The clinical course highlighted the need for careful monitoring and prompt intervention in anesthesia in patients with severe pulmonary hypertension, particularly when administering multiple protein-bound drugs. Drug interactions can exacerbate the underlying condition, necessitating diligent oversight to prevent severe complications such as carbon dioxide narcosis.