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Collecting Duct Carcinoma in the Kidneys: A Rare Case Report 肾集合管癌:罕见病例报告
Pub Date : 2024-04-24 DOI: 10.37275/bsm.v8i7.1023
Julpa Nurul Aini, Noza Hilbertina, Pamelia Mayorita
Background: Collecting duct carcinoma (CDC) is one of the rare pathological subtypes of renal cell carcinoma, with high malignancy and poor prognosis. Pathological examination is the gold standard in confirming the diagnosis of CDC. CDC is described as a tumor that has a tubulopapillary architecture and forms a hobnail pattern along the glandular tube. Case presentation: A 56-year-old woman with the main complaint of a lump in the right abdomen for 1.5 months before entering the hospital. The lump in the stomach is getting bigger, complaints are accompanied by intermittent pain, nausea, vomiting, body feeling weak, and decreased appetite. The patient then underwent a CT-Scan examination of the abdomen and concluded that fluid/water was found next to the right kidney, and a hypodense lesion appeared in segment 6 of the right lobe of the liver. Histopathological examination of large tissue shows pieces of kidney tissue with a connective tissue capsule on the outside containing glomeruli and tubules lined by cuboidal epithelium as well as a proliferation of tumor cells that grow infiltratively in the connective tissue stroma which is partly desmoplastic and fatty tissue between the glomeruli and tubules. Tumor cells are arranged to form tubulopapillary and tubulocystic structures. These cells with pleomorphic nuclei, some hyperchromatic, some vesicular, coarse chromatin, clear nuclei, and atypical mitoses can be found and tumor cell embolism in the blood vessels and perineural invasion can be seen. There were spots and clusters of lymphocytes and plasma cells as well as areas of bleeding and necrosis. Conclusion: The patient was diagnosed with collecting duct carcinoma (CDC).
背景:集合管癌(CDC)是肾细胞癌的罕见病理亚型之一,恶性程度高,预后差。病理检查是确诊 CDC 的金标准。CDC 被描述为一种具有管状乳头状结构并沿腺管形成滚刀型的肿瘤。病例介绍:一名 56 岁女性,入院前主诉右腹部肿块 1 个半月。胃部肿块越来越大,主诉伴有间歇性疼痛、恶心、呕吐、全身乏力、食欲减退。随后,患者接受了腹部 CT 扫描检查,结果发现右肾旁有积液/积水,肝脏右叶第 6 段出现低密度病变。大块组织的组织病理学检查显示,肾脏组织碎片外有结缔组织囊,内含肾小球和肾小管,肾小球和肾小管之间有立方体上皮衬里,结缔组织基质中有肿瘤细胞浸润性增生,结缔组织基质部分为去瘤细胞和脂肪组织。肿瘤细胞排列成肾小管乳头状结构和肾小管囊状结构。这些细胞核呈多形性,有的呈高色素性,有的呈水泡状,染色质粗糙,核清晰,有不典型有丝分裂,可见肿瘤细胞栓塞血管和侵入神经周围。可见淋巴细胞和浆细胞的斑点和集群,以及出血和坏死区域。结论患者被诊断为集合管癌(CDC)。
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引用次数: 0
Differences in Mean Anti-Pertussis Antibody Levels in Children with Acellular Pertussis Immunization and Whole Pertussis Without Booster 接种无细胞百日咳疫苗和未接种百日咳疫苗的儿童平均抗百日咳抗体水平的差异
Pub Date : 2024-04-23 DOI: 10.37275/bsm.v8i7.1022
Wenny Rahmalia Rezki, Rinang Mariko, Rizanda Machmud, Rusdi, Asrawati, Indra Ihsan
Background: The incidence of pertussis is increasing every year, especially in developing countries. Low immunization coverage and decreased immunity are some of the factors causing the re-increase in pertussis cases. The protection provided by the pertussis vaccine whole and acellular pertussis given as a baby will decrease with age. This study aims to determine the difference in mean levels of anti-pertussis antibodies in children who received acellular pertussis and whole pertussis immunization without a booster.  Methods: A cross-sectional study was carried out at the pediatric polyclinic of Dr. M. Djamil General Hospital Padang from December 2022 to December 2023. Research subjects were children aged 5-9 years with a history of whole pertussis immunization (DPwT) 3 times or acellular pertussis immunization (DPaT) 3 times. The research subjects were examined for anti-pertussis antibody titers using the ELISA technique. Results: Thirty-four children with a history of DPwT immunization 3 times and 34 children with a history of DPwT immunization 3 times were research subjects, with mean age 6.94±1.49 in the DPwT group and 6.88 ±1.61 in the DPaT group. The mean anti-pertussis antibody level in the DPwT group (9.54 IU/mL) was higher than the DPaT group (6.96 IU/mL) but was not statistically significant (p>0.05). The average antibody results showed that the antibody levels in both groups were below the antibody titer threshold that provides protection against pertussis. The results of the analysis showed that there was a significant difference in the incidence of AEFI between the DPwT and DPaT immunization groups (p<0.05). Conclusion: There was no difference in anti-pertussis antibody levels in children who received DPwT and DPaT immunization 3 times. Pertussis immunization is a required booster so that antibody levels are sufficient to provide protection against pertussis.
背景:百日咳发病率逐年上升,尤其是在发展中国家。免疫覆盖率低和免疫力下降是导致百日咳病例再次增加的部分原因。婴儿时期接种的百日咳疫苗全苗和无细胞百日咳疫苗所提供的保护会随着年龄的增长而减少。本研究旨在确定接受过无细胞百日咳和百日咳全程免疫接种但未接受加强免疫的儿童体内抗百日咳抗体平均水平的差异。 研究方法2022 年 12 月至 2023 年 12 月,在巴东 M. Djamil 医生综合医院儿科综合诊所开展了一项横断面研究。研究对象为5-9岁的儿童,他们曾接受过3次全百日咳免疫接种(DPwT)或3次无细胞百日咳免疫接种(DPaT)。研究人员用酶联免疫吸附技术检测受试者的抗百日咳抗体滴度。研究结果34名儿童有3次DPwT免疫史,34名儿童有3次DPwT免疫史,DPwT组平均年龄(6.94±1.49)岁,DPaT组平均年龄(6.88±1.61)岁。DPwT 组的平均抗百日咳抗体水平(9.54 IU/mL)高于 DPaT 组(6.96 IU/mL),但差异无统计学意义(P>0.05)。平均抗体结果显示,两组的抗体水平均低于可预防百日咳的抗体滴度阈值。分析结果显示,DPwT 组和 DPaT 组的 AEFI 发生率有显著差异(p<0.05)。结论接受 3 次 DPwT 和 DPaT 免疫接种的儿童的抗百日咳抗体水平没有差异。百日咳免疫接种是一种必要的加强免疫,以便抗体水平足以提供对百日咳的保护。
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引用次数: 0
Investigation of 3% Binahong (Anredera cordifolia) Leaf Extract Nanogel on the Alveolar Bone Healing: BMP-2 Modulation in Rat Models 3% Binahong (Anredera cordifolia) 叶提取物纳米凝胶对牙槽骨愈合的研究:大鼠模型中的 BMP-2 调节作用
Pub Date : 2024-04-18 DOI: 10.37275/bsm.v8i7.1020
Bernard Bernard, Syafruddin Ilyas, O. A. Hanafiah
Background: Alveolar bone healing relies on osteoblasts activity and differentiation, with bone morphogenetic protein-2 (BMP-2) playing a crucial regulatory role. Binahong leaf extract (BLE) has demonstrated efficacy in bone healing due to its rich phytochemical composition. Nanogel offers enhanced bioavailability and targeted release to effectively deliver therapeutic agents. This study aims to assess the impact of 3% BLE nanogel on BMP-2 expression in tooth extraction socket healing. Methods: Thirty male Wistar rat underwent anaesthesia for the extraction of their lower incisors to induce alveolar bone healing. Subjects were randomly assigned into treatment (BLE nanogel) and control (base nanogel) group. Five rats from each group were respectively sacrificed at 7, 14, and 28 days after procedures. BMP-2 expression was assessed by performing immunohistochemistry analysis using BMP antibody reagent. Data were analysed using chi-square. Results: The analysis of BMP-2 expression showed no significant difference between treatment and control groups on days 7, 14, and 28 (p>0,05). However, a subtle increase was observed in the treatment group throughout observation period. Conclusion: Application of 3% BLE nanogel may enhance the expression of BMP-2, even though it was not significantly increase. The findings underscore the complex interplay between Binahong leaf extract, nanogel and BMP-2 expression.
背景:牙槽骨愈合依赖于成骨细胞的活性和分化,其中骨形态发生蛋白-2(BMP-2)起着至关重要的调节作用。比纳红叶提取物(BLE)因其丰富的植物化学成分而被证明对骨愈合具有疗效。纳米凝胶具有更高的生物利用度和靶向释放性,可有效递送治疗药物。本研究旨在评估 3% BLE 纳米凝胶对拔牙窝愈合中 BMP-2 表达的影响。研究方法30 只雄性 Wistar 大鼠在麻醉下拔除下门牙,以诱导牙槽骨愈合。受试者被随机分为治疗组(BLE 纳米凝胶)和对照组(基底纳米凝胶)。每组各 5 只大鼠,分别于术后 7 天、14 天和 28 天处死。使用 BMP 抗体试剂进行免疫组化分析,评估 BMP-2 的表达。数据采用卡方分析。结果对 BMP-2 表达的分析表明,治疗组和对照组在术后第 7、14 和 28 天没有明显差异(P>0.05)。然而,在整个观察期间,治疗组的BMP-2表达量出现了细微的增加。结论应用 3% BLE 纳米凝胶可增强 BMP-2 的表达,尽管其增幅并不明显。这些发现强调了比纳红叶提取物、纳米凝胶和 BMP-2 表达之间复杂的相互作用。
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引用次数: 0
Management of Thrombocytopenia with Partial Splenic Embolization in Liver Cirrhosis 肝硬化患者通过部分脾栓塞治疗血小板减少症
Pub Date : 2024-04-03 DOI: 10.37275/bsm.v8i6.1015
Septia Harma Putri, Arnelis, Saptino Miro
Thrombocytopenia is a frequent complication in patients with cirrhosis. Thrombocytopenia is generally divided into mild, moderate, and severe thrombocytopenia. Thrombocytopenia in liver cirrhosis not only increases the risk of bleeding during surgery but can also have an impact on patient management, such as liver biopsy, administration of antiviral therapy, and postponement of elective surgery. The pathophysiology of thrombocytopenia in chronic liver disease can be caused by decreased platelet production, sequestration in the spleen, and increased platelet destruction. Partial splenic embolization (PSE) is one option for treating thrombocytopenia in chronic liver disease. PSE is an effective procedure in treating complications associated with hypersplenism and portal hypertension, such as esophageal varices, pancytopenia, portal hypertensive gastropathy and ascites.
血小板减少是肝硬化患者经常出现的并发症。血小板减少一般分为轻度、中度和重度血小板减少。肝硬化患者血小板减少不仅会增加手术中出血的风险,还会影响患者的治疗,如肝脏活检、抗病毒治疗和推迟择期手术。慢性肝病患者血小板减少的病理生理学原因可能是血小板生成减少、脾脏栓塞和血小板破坏增加。部分脾栓塞术(PSE)是治疗慢性肝病血小板减少症的一种选择。部分脾栓塞术是治疗与脾功能亢进和门静脉高压有关的并发症(如食管静脉曲张、全血细胞减少、门静脉高压性胃病和腹水)的有效方法。
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引用次数: 0
Spinal Anesthesia with Ultrasonography (USG) Marker in Morbidly Obese Pregnant Women Undergoing Cesarean Section Surgery: A Case Report 在接受剖腹产手术的病态肥胖孕妇中使用超声波(USG)标记的脊髓麻醉:病例报告
Pub Date : 2024-02-15 DOI: 10.37275/bsm.v8i4.977
Made Septyana Parama Adi, I Gusti Ngurah Mahaalit Aribawa, I Gusti Agung Gede Utara Hartawan, I Putu Fajar Narakusuma, Gusti Agung Made Wibisana Kurniajaya
Background: Spinal anesthesia is a regional anesthesia technique used to provide analgesia or numbness in the lower part of the body. This technique has long been employed in childbirth and cesarean section surgeries due to its numerous advantages for pregnant women. Obese pregnant patients often have increased adipose tissue in the back area, making it challenging to identify the appropriate interspinous space. Case presentation: A 26-year-old primigravida at 38 weeks of gestation with morbid obesity, standing at 158 cm tall and weighing 140 kg, with a body mass index (BMI) of 56.1 kg/m², underwent cesarean section surgery under spinal anesthesia. The identification of the spinal needle insertion site was performed using pre-procedural ultrasound (USG) marker at the L3-L4 level, with heavy bupivacaine 0.5% 12.5 mg used as the anesthetic agent. The surgery lasted for 1 hour and 20 minutes, with stable hemodynamics and a blood loss of 450 ml. A female infant was delivered, weighing 3080 grams, with a length of 50 cm and an APGAR score of 8-9-10. Conclusion: The use of USG markers can assist in determining the precise location for spinal anesthesia injection, thereby reducing complications from repeated needle insertions.
背景:脊柱麻醉是一种区域麻醉技术,用于在身体下部提供镇痛或麻木。由于该技术对孕妇有诸多好处,因此长期以来一直被用于分娩和剖腹产手术。肥胖孕妇的背部脂肪组织通常会增加,这就给确定适当的棘间间隙带来了挑战。病例介绍:一位 26 岁的初产妇在妊娠 38 周时患有病态肥胖,身高 158 厘米,体重 140 千克,体重指数(BMI)为 56.1 千克/平方米,她在脊髓麻醉下接受了剖腹产手术。手术前使用超声波(USG)标记在 L3-L4 水平确定脊柱针插入部位,使用 0.5% 12.5 毫克重型布比卡因作为麻醉剂。手术持续了 1 小时 20 分钟,血流动力学稳定,失血量为 450 毫升。娩出一名女婴,体重 3080 克,身长 50 厘米,APGAR 评分 8-9-10 分。结论:使用 USG 标记可帮助确定脊髓麻醉注射的精确位置,从而减少重复进针引起的并发症。
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引用次数: 0
Spinal Anesthesia with Ultrasonography (USG) Marker in Morbidly Obese Pregnant Women Undergoing Cesarean Section Surgery: A Case Report 在接受剖腹产手术的病态肥胖孕妇中使用超声波(USG)标记的脊髓麻醉:病例报告
Pub Date : 2024-02-15 DOI: 10.37275/bsm.v8i4.977
Made Septyana Parama Adi, I Gusti Ngurah Mahaalit Aribawa, I Gusti Agung Gede Utara Hartawan, I Putu Fajar Narakusuma, Gusti Agung Made Wibisana Kurniajaya
Background: Spinal anesthesia is a regional anesthesia technique used to provide analgesia or numbness in the lower part of the body. This technique has long been employed in childbirth and cesarean section surgeries due to its numerous advantages for pregnant women. Obese pregnant patients often have increased adipose tissue in the back area, making it challenging to identify the appropriate interspinous space. Case presentation: A 26-year-old primigravida at 38 weeks of gestation with morbid obesity, standing at 158 cm tall and weighing 140 kg, with a body mass index (BMI) of 56.1 kg/m², underwent cesarean section surgery under spinal anesthesia. The identification of the spinal needle insertion site was performed using pre-procedural ultrasound (USG) marker at the L3-L4 level, with heavy bupivacaine 0.5% 12.5 mg used as the anesthetic agent. The surgery lasted for 1 hour and 20 minutes, with stable hemodynamics and a blood loss of 450 ml. A female infant was delivered, weighing 3080 grams, with a length of 50 cm and an APGAR score of 8-9-10. Conclusion: The use of USG markers can assist in determining the precise location for spinal anesthesia injection, thereby reducing complications from repeated needle insertions.
背景:脊柱麻醉是一种区域麻醉技术,用于在身体下部提供镇痛或麻木。由于该技术对孕妇有诸多好处,因此长期以来一直被用于分娩和剖腹产手术。肥胖孕妇的背部脂肪组织通常会增加,这就给确定适当的棘间间隙带来了挑战。病例介绍:一位 26 岁的初产妇在妊娠 38 周时患有病态肥胖,身高 158 厘米,体重 140 千克,体重指数(BMI)为 56.1 千克/平方米,她在脊髓麻醉下接受了剖腹产手术。手术前使用超声波(USG)标记在 L3-L4 水平确定脊柱针插入部位,使用 0.5% 12.5 毫克重型布比卡因作为麻醉剂。手术持续了 1 小时 20 分钟,血流动力学稳定,失血量为 450 毫升。娩出一名女婴,体重 3080 克,身长 50 厘米,APGAR 评分 8-9-10 分。结论:使用 USG 标记有助于确定脊髓麻醉注射的精确位置,从而减少重复进针引起的并发症。
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引用次数: 0
The Role of Anti-PD 1 (Programmed Cell Death-1) (Pembrolizumab) in Hepatocellular Carcinoma: A Narrative Literature Review 抗 PD 1(程序性细胞死亡-1)(Pembrolizumab)在肝细胞癌中的作用:叙述性文献综述
Pub Date : 2024-02-15 DOI: 10.37275/bsm.v8i4.975
Nelila Pasmah Fitriani, Suyata
Hepatocellular carcinoma (HCC) is a malignant tumor originating from liver cells, HCC occurs in around 85% of patients diagnosed with cirrhosis. Treatment options for HCC consider liver function, extrahepatic spread, invasiveness, and the number and size of nodules. HCC therapy options include surgical resection, liver transplantation, tumor ablation, transarterial therapy and systemic chemotherapy. Pembrolizumab is a second-line systemic therapy option for the treatment of HCC after sorafenib therapy. Pembrolizumab is a class of immune checkpoint inhibitors (ICIs) and more specifically works as a programmed cell death-1 (PD-1) inhibitor.
肝细胞癌(HCC)是一种起源于肝细胞的恶性肿瘤,约 85% 的肝硬化患者会发生 HCC。HCC 的治疗方案要考虑肝功能、肝外扩散、侵袭性以及结节的数量和大小。HCC 治疗方案包括手术切除、肝移植、肿瘤消融、经动脉治疗和全身化疗。Pembrolizumab 是索拉非尼治疗后治疗 HCC 的二线系统疗法选择。Pembrolizumab 是一类免疫检查点抑制剂(ICIs),更确切地说,它是一种程序性细胞死亡-1(PD-1)抑制剂。
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引用次数: 0
The Role of Anti-PD 1 (Programmed Cell Death-1) (Pembrolizumab) in Hepatocellular Carcinoma: A Narrative Literature Review 抗 PD 1(程序性细胞死亡-1)(Pembrolizumab)在肝细胞癌中的作用:叙述性文献综述
Pub Date : 2024-02-15 DOI: 10.37275/bsm.v8i4.975
Nelila Pasmah Fitriani, Suyata
Hepatocellular carcinoma (HCC) is a malignant tumor originating from liver cells, HCC occurs in around 85% of patients diagnosed with cirrhosis. Treatment options for HCC consider liver function, extrahepatic spread, invasiveness, and the number and size of nodules. HCC therapy options include surgical resection, liver transplantation, tumor ablation, transarterial therapy and systemic chemotherapy. Pembrolizumab is a second-line systemic therapy option for the treatment of HCC after sorafenib therapy. Pembrolizumab is a class of immune checkpoint inhibitors (ICIs) and more specifically works as a programmed cell death-1 (PD-1) inhibitor.
肝细胞癌(HCC)是一种起源于肝细胞的恶性肿瘤,约 85% 的肝硬化患者会发生 HCC。HCC 的治疗方案要考虑肝功能、肝外扩散、侵袭性以及结节的数量和大小。HCC 治疗方案包括手术切除、肝移植、肿瘤消融、经动脉治疗和全身化疗。Pembrolizumab 是索拉非尼治疗后治疗 HCC 的二线系统疗法选择。Pembrolizumab 是一类免疫检查点抑制剂(ICIs),更确切地说,它是一种程序性细胞死亡-1(PD-1)抑制剂。
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引用次数: 0
Gut Microbiota in Chronic Kidney Disease: A Narrative Literature Review 慢性肾脏病中的肠道微生物群:叙述性文献综述
Pub Date : 2024-02-15 DOI: 10.37275/bsm.v8i4.976
Novandra Abdillah, Zulklhair Ali, Novadian, Ian Effendi, Suprapti, Elfiani, Rery TF Yuniarti
Chronic kidney disease (CKD) is a growing public health problem related to loss of kidney function and cardiovascular disease as the main causes of morbidity and mortality in CKD. It is known that CKD is associated with intestinal dysbiosis. There is an influence of the gut microbiota on the gut-kidney axis and it works reciprocally: on the one hand, CKD significantly changes the composition and function of the gut microbiota. On the other hand, gut microbiota is able to manipulate the processes that cause the emergence and progression of CKD through inflammatory, endocrine and neurological pathways. Understanding the complex interactions between gut and kidney microbiota may provide novel nephroprotective interventions to prevent the progression of CKD by therapeutically targeting balance of gut microbiota composition.
慢性肾脏病(CKD)是一个日益严重的公共卫生问题,肾功能丧失和心血管疾病是导致慢性肾脏病发病和死亡的主要原因。众所周知,慢性肾脏病与肠道菌群失调有关。肠道微生物群对肠道-肾轴有影响,而且是相互影响的:一方面,慢性肾功能衰竭会显著改变肠道微生物群的组成和功能。另一方面,肠道微生物群能够通过炎症、内分泌和神经途径操纵导致 CKD 出现和恶化的过程。了解肠道微生物群与肾脏微生物群之间复杂的相互作用可提供新的肾脏保护干预措施,通过治疗性靶向平衡肠道微生物群组成来预防慢性肾功能衰竭的进展。
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引用次数: 0
Gut Microbiota in Chronic Kidney Disease: A Narrative Literature Review 慢性肾脏病中的肠道微生物群:叙述性文献综述
Pub Date : 2024-02-15 DOI: 10.37275/bsm.v8i4.976
Novandra Abdillah, Zulklhair Ali, Novadian, Ian Effendi, Suprapti, Elfiani, Rery TF Yuniarti
Chronic kidney disease (CKD) is a growing public health problem related to loss of kidney function and cardiovascular disease as the main causes of morbidity and mortality in CKD. It is known that CKD is associated with intestinal dysbiosis. There is an influence of the gut microbiota on the gut-kidney axis and it works reciprocally: on the one hand, CKD significantly changes the composition and function of the gut microbiota. On the other hand, gut microbiota is able to manipulate the processes that cause the emergence and progression of CKD through inflammatory, endocrine and neurological pathways. Understanding the complex interactions between gut and kidney microbiota may provide novel nephroprotective interventions to prevent the progression of CKD by therapeutically targeting balance of gut microbiota composition.
慢性肾脏病(CKD)是一个日益严重的公共卫生问题,肾功能丧失和心血管疾病是导致慢性肾脏病发病和死亡的主要原因。众所周知,慢性肾脏病与肠道菌群失调有关。肠道微生物群对肠道-肾轴有影响,而且是相互影响的:一方面,慢性肾功能衰竭会显著改变肠道微生物群的组成和功能。另一方面,肠道微生物群能够通过炎症、内分泌和神经途径操纵导致 CKD 出现和恶化的过程。了解肠道微生物群与肾脏微生物群之间复杂的相互作用可提供新的肾脏保护干预措施,通过治疗性靶向平衡肠道微生物群组成来预防慢性肾功能衰竭的进展。
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引用次数: 0
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Bioscientia Medicina : Journal of Biomedicine and Translational Research
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