Journal of International Medical Research最新文献

This case report aimed to examine the clinical pathological characteristics, immunohistochemical phenotype, and differential diagnosis of primary pulmonary meningioma (PM), which is a rare tumor. A retrospective analysis was conducted on the clinical data, imaging manifestations, histological features, immunohistochemical results, and in situ hybridization results of a 60-year-old male patient who underwent surgical resection and was diagnosed with PM by pathology. Additionally, the relevant literature was reviewed. Multiple nodules were detected in the right lung of the patient during a re-examination because of a novel coronavirus infection but there were no obvious clinical symptoms. Imaging revealed well-defined masses in the upper, middle, and lower lobes of the right lung, and the masses were surgically removed. Microscopy showed that the boundary between the tumor and surrounding lung tissue was clear, and consisted of spindle cells and epithelioid cells. The final diagnosis was multiple grade II meningiomas of the right lung. No postoperative radiotherapy or chemotherapy was performed. There was no recurrence or metastasis during a 6-month follow-up. Pulmonary metastatic meningioma is rare, while primary PM is even rarer. Surgical resection is the preferred treatment method for PM, with a generally good prognosis, but a few malignant manifestations may require close follow-up.

Background: This study aimed to elucidate the distinctions between the expression levels of angiotensin-converting enzyme (ACE) and ACE2, as well as their genetic polymorphisms, in patients with acute aortic dissection (AD) and coronary heart disease (CHD).

Methods: A cohort of 86 patients was enrolled, comprising 34 individuals with acute AD (encompassing Stanford types A and B), 18 with ascending aortic aneurysm, 21 with CHD, and 13 healthy controls. Aortic tissue samples were procured from 44 patients during surgical interventions.

Results: Statistically significant differences were observed in ACE and ACE2 expression levels among the ascending aortic aneurysm, CHD, and control groups (p < 0.05). However, the expression of ACE messenger ribonucleic acid (mRNA) in the aortic wall was significantly higher in the AD group than in the ascending aortic aneurysm and CHD groups (p < 0.05). Additionally, the expression of ACE2 mRNA and the ACE/ACE2 ratio in the aortic wall were significantly different in the AD group compared with the ascending aortic aneurysm and CHD groups (p < 0.05).

Conclusion: Plasma ACE levels, and the gene expressions of ACE and ACE2, are markedly reduced in patients with acute AD. The observed imbalance in ACE and ACE2 expressions may play a pivotal role in the pathogenesis of AD.

Objective: Non-alcoholic fatty liver disease is a risk factor for atrial fibrillation. We assessed whether liver fibrosis markers are associated with atrial remodeling indicators in patients with atrial fibrillation in whom fatty liver disease has not been identified.

Methods: In this prospective, observational study, 174 patients with atrial fibrillation without chronic liver disease who underwent catheter ablation were enrolled. Using blood collected from the right atrium, type IV collagen (COL4), type IV collagen 7S (COL4-7S), and tumor necrosis factor-α concentrations were measured as markers of liver fibrosis and inflammation. The left atrial volume and P-wave duration were used as atrial remodeling indicators.

Results: Left atrial volume was significantly positively correlated with COL4, COL4-7S, and tumor necrosis factor-α concentrations. COL4-7S concentrations were significantly positively correlated with tumor necrosis factor-α concentrations and the P-wave duration. To exclude the effect of alcohol consumption, a multiple regression analysis was performed for left atrial volume in patients with a <30-g daily alcohol intake (n = 124). Age, sex, and COL4-7S were significant explanatory variables (R = 0.44, adjusted R2 = 0.142, COL4-7S standardized β = 0.20).

Conclusion: Liver fibrosis may be involved in atrial remodeling via inflammation in patients with atrial fibrillation who do not have obvious fatty liver disease.

Heat stroke, triggered by excessive heat exposure or intense physical activity, is a medical condition characterized by a rapid rise in core body temperature, central nervous system dysfunction and multiorgan failure. A patient presented with heat stroke and was unconscious. During treatment, we identified a range of complications, including shifted flora, coagulation abnormalities, liver damage and renal failure-indicating multiorgan dysfunction. We administered antibiotic therapy, blood purification and other comprehensive treatments, leading to the patient's recovery and subsequent discharge. For cases of heat stroke in an intensive care setting, clinicians must recognize the condition early and act swiftly to reduce body temperature. Additionally, the early use of antibiotics can help prevent microbial imbalance. For eligible patients, hemodialysis should be initiated promptly to manage renal complications effectively.

Cutaneous metastasis (CM) is a rare phenomenon, occurring in only 0.6% to 10.4% of oncology patients. Breast carcinoma represents nearly one-third of all CM cases, although it manifests in a minority of patients with breast cancer (BC). Notably, CMs are detected at the time of primary tumor diagnosis in 6.3% of patients with BC and serve as the initial clinical presentation in only 3.5% of patients. We present a case involving a 53-year-old woman with a 5-month history of asymptomatic infiltrating nodules in the axillae and trunk. Skin biopsy and immunohistochemical analysis confirmed metastatic breast carcinoma with positive estrogen receptor staining. This case underscores the importance of early detection and precise diagnostic techniques in managing metastatic adenocarcinoma with cutaneous manifestations. Despite the promising outcome of the initial treatment, the disease progression in this case highlights the aggressive nature of CMs and the ongoing need for research and advanced therapeutic strategies.

Gastroduodenal intussusception is a relatively rare condition in adults and is typically caused by mobile pedunculated submucosal tumors arising from the stomach. Its clinical presentation often includes nonspecific signs of gastric outlet obstruction, such as nausea, vomiting, abdominal pain, epigastric fullness, or abdominal distention. We report a case of gastroduodenal intussusception in a 38-year-old woman who presented with severe anemia but no symptoms of gastric outlet obstruction. The preoperative diagnosis was established through esophagogastroduodenoscopy and computed tomography of the abdomen, and it was confirmed during surgery. Postoperative pathology and immunohistochemistry identified the tumor as a gastric leiomyoma.

Objective: This study aimed to evaluate the therapeutic effects of minimally invasive lateral, posterior, and posterolateral sacroiliac joint fusion for low back pain through a meta-analysis.

Methods: The PubMed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov databases were comprehensively searched for studies up to 31 August 2024. Relevant studies using lateral, posterior, and posterolateral approaches were identified. Pooled outcomes and publication bias were assessed. The study was registered with PROSPERO (registration No. CRD42023451047).

Results: A total of 48 studies were included: 32 focused on the lateral approach, 10 on the posterior approach, four on the posterolateral approach, and two compared the lateral and posterolateral approaches. The pooled effect analysis showed statistically significant improvements in the visual analog scale (VAS) scores for all three approaches at 6 and 12 months postoperatively. Although no between-approach comparisons were conducted, the pooled improvements in VAS scores at 6 and 12 months postoperatively were numerically similar across all three approaches, as were the pooled fusion rates. The pooled complication rate for the lateral approach was 9.2%, numerically higher than 1% for the posterior approach. The pooled revision rate for the lateral approach was 2.4%, also numerically higher than 0.6% for the posterior approach.

Conclusions: Although pain relief and fusion rates were similar across all approaches, the lateral approach might be associated with a higher risk of total complications and revision surgery.

Objective: To compare the efficacy of dexmedetomidine and fentanyl to reduce hemodynamic and biochemical stress markers associated with endotracheal intubation under general anesthesia.

Methods: We performed a prospective randomized controlled study of 80 patients and 20 healthy controls at Assiut University from January to June 2024. The patients were allocated to two groups: Group D received dexmedetomidine and Group F received fentanyl. Blood samples were collected at four time points: T0 (baseline), T1 (2 minutes after induction of anesthesia), T2 (1 minute after intubation), and T3 (10 minutes post-intubation), for stress marker analysis.

Results: Intubation significantly increased stress markers in both groups compared to baseline. Group D showed significantly lower cortisol, norepinephrine, and lactate concentrations at T1, T2, and T3; and hemodynamic parameters at T2; whereas Group F demonstrated earlier post-operative recovery.

Conclusions: Both drugs increased stress markers, but dexmedetomidine more effectively reduced biochemical marker concentrations, suggesting better stress control, whereas fentanyl use led to quicker recovery. Dexmedetomidine is more effective at reducing intubation-induced stress, whereas fentanyl facilitates faster post-operative recovery.

Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with intermediate biological potential. The stomach is an uncommon site for IMTs, and gastric IMTs are typically confined to the submucosal layer. This report presents a rare case of a 29-year-old woman with a gastric IMT located in the gastric fundus, exhibiting local invasion into the esophagus and spleen.