Cholecystocolic fistula secondary to gallbladder carcinoma is extremely rare and has been reported in very few studies. Most cholecystocolic fistulae are late complications of gallstone disease, but can also develop f...Cholecystocolic fistula secondary to gallbladder carcinoma is extremely rare and has been reported in very few studies. Most cholecystocolic fistulae are late complications of gallstone disease, but can also develop following carcinoma of the gallbladder when the necrotic tumor penetrates into the adjacent colon. Although no currently available imaging technique has shown great accuracy in recognizing cholecystocolic fistula, abdominopelvic computed tomography may show fistulous communication and anatomical details.Herein we report an unusual case of cholecystocolic fistula caused by gallbladder carcinoma, which was preoperatively misdiagnosed as hepatic flexure colon carcinoma.展开更多
Left-sided periappendiceal abscesses occur in association with two types of congenital anomaly: intestinal malrotation and situs inversus. It is diffi cult to obtain an accurate preoperative diagnosis of these abscess...Left-sided periappendiceal abscesses occur in association with two types of congenital anomaly: intestinal malrotation and situs inversus. It is diffi cult to obtain an accurate preoperative diagnosis of these abscesses due to the abnormal position of the appendix. We present an unusual case of a left-sided periappendiceal abscess in an adult with intestinal malrotation, the diagnosis of which was a challenge.展开更多
Angiomyolipomas(AMLs),a form of benign mesenchymal hamartoma,arise primarily in the kidneys of patients with or without tuberous sclerosis.Extra-renal AMLs are very rare and are most commonly found in the liver. AMLs ...Angiomyolipomas(AMLs),a form of benign mesenchymal hamartoma,arise primarily in the kidneys of patients with or without tuberous sclerosis.Extra-renal AMLs are very rare and are most commonly found in the liver. AMLs of the small intestine are exceedingly rare.Here, a case of a 28-year-old man,who presented with ileal intussusception caused by ileal AML is reported.The clinicopathological and immunohistochemical findings of ileal AMLs are discussed and the literature on small intestinal AMLs is reviewed.展开更多
Bone metastasis of primary colorectal cancer is uncommon.When it occurs,it is usually a late manifestation of disease and is indicative of poor prognosis.We describe a patient with multiple metachronous bone metastase...Bone metastasis of primary colorectal cancer is uncommon.When it occurs,it is usually a late manifestation of disease and is indicative of poor prognosis.We describe a patient with multiple metachronous bone metastases from lower rectal cancer who was successfully treated with multimodal treatment including surgical resections and has shown 32 mo disease-free survival.Surgical resection of metastatic bone lesion(s)from colorectal cancer may be a good treatment option in selected patients.展开更多
AIM:To study factors associated with loss of hepatitis B surface antigen (HBsAg) in patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV).METHODS:We retrospectively reviewed the medi...AIM:To study factors associated with loss of hepatitis B surface antigen (HBsAg) in patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV).METHODS:We retrospectively reviewed the medical records of 5681 patients followed up at two New York City HIV clinics from January 1999 to May 2007.Clinical and laboratory parameters including baseline and follow-up HIV viral loads,CD4 cell counts,alanine transaminase levels,demographics,presence of hepatitis C infection,and treatment with highly active antiretroviral therapy dually active against both HIV and HBV infection,were analyzed to determine factors associated with loss of HBsAg.RESULTS:Three hundred and fifty five patients (355/5681,6.84%) were co-infected with HIV and HBV and were evaluated.Of these,226 patients with more than 12 mo follow-up were included in further analysis to determine factors associated with loss of HBsAg in the long-term follow-up.In the univariate analysis,baseline CD4 cell count was associated with loss of HBsAg (P=0.052).Cox regression analysis revealed that loss of HBsAg was associated with baseline CD4 cell count > 500 cells/mm3 (P=0.016,odds ratio:76.174,95% confidence interval:2.233-2598.481).CONCLUSION:Our study showed an interesting association of loss of HBsAg in HIV-HBV co-infected patients with higher CD4 cell count,suggesting that T-cell cytolytic activity against HBV may still be effective in clearing HBV infection.展开更多
For an analysis of the oxidation behavior of UO2 nuclear fuel pellet under a loss of water coolant accident in a spent nuclear fuel pool of an LWR, thermodynamic assessments of UO2 oxidation were carried out under var...For an analysis of the oxidation behavior of UO2 nuclear fuel pellet under a loss of water coolant accident in a spent nuclear fuel pool of an LWR, thermodynamic assessments of UO2 oxidation were carried out under various atmospheric conditions. In a steam atmosphere, it was assessed that UO2 would not be fully oxidized into U3O8 due to the relatively lower oxygen partial pressure, while UO2 will be fully oxidized into U3O8 in an air atmosphere. In an air and steam mixture atmosphere, the UO2 oxidation was dominantly affected by the air volumetric fraction, because of the relatively higher oxygen partial pressure of air. In addition, the effect of H2 volumetric fraction on the oxygen partial pressure under a mixture atmosphere was calculated, and it was revealed that UO2 pellet oxidation could be reduced above the critical value of H2 volumetric fraction.展开更多
For an evaluation of a thermal conductivity of Zr + 30 vol% ZrO2 simulated inert matrix nuclear fuel pellet, a simulated fuel pellet was fabricated using a hot-pressing method at 800°C in a vacuum and at a 20 MPa...For an evaluation of a thermal conductivity of Zr + 30 vol% ZrO2 simulated inert matrix nuclear fuel pellet, a simulated fuel pellet was fabricated using a hot-pressing method at 800°C in a vacuum and at a 20 MPa load. And several thermophysical properties of the simulated inert matrix fuel pellet were measured and calculated. The thermal diffusivity and linear thermal expansion as a function of temperature of the simulated fuel pellet were measured using a laser flash method and a dilatometry, respectively. Finally, based on the experimental data, the thermal conductivity of the simulated inert matrix fuel pellet was calculated and evaluated.展开更多
Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus （HIV） co-infection. However, there is little information about factors influencing syphil...Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus （HIV） co-infection. However, there is little information about factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients. We conducted a study to evaluate factors associated with syphilis treatment failure/re-infection in HIV co-infected patients.Methods We reviewed 3542 medical records of HIV-infected patients from January 2005 to December 2007 followed up at HIV Clinic in New York City. Patients were categorized by rapid plasma regain titer （RPR） into success/serofast （4-fold decrease in RPR by 12 months after treatment, RPR conversion to nonreactive, persistently stable reactive RPR with no 4-fold increase）, and failure/re-infection （failure to decrease 4 folds in RPR by 12 months after treatment, 4-fold increase in RPR from baseline）.Results Among a total of 156 patients who met the eligibility criteria, 122 （78.2％） were under success/serofast category,and 34 （21.8％） were under failure/re-infection category. HIV viral load, CD4 cell count, and use of highly active antiretroviral therapy （HAART） were not associated with syphilis treatment failure/re-infection. However, early syphilis stage （OR：11.036, 95％ CI： 2.499-48.740, P=0.002） and high （＞1∶64） RPR titers （OR： 715.921, 95％ CI： 422.175-23 113.396, P ＜0.001） were significantly associated.Conclusions No correlations were seen with depressed immune states with syphilis treatment failure and/or re-infection. However, association with early stage syphilis suggests that risky psychological sexual behaviors may be the most important leading factor, emphasizing needs for safe sex education.展开更多
Objective Little information is available to guide treatment strategies regarding patients with unexpected positive cultures （UPC）,including Propionibacterium acnes （PA）,without overt signs of infection in revisio...Objective Little information is available to guide treatment strategies regarding patients with unexpected positive cultures （UPC）,including Propionibacterium acnes （PA）,without overt signs of infection in revision shoulder arthroplasty （RSA）.The purpose of our study was to analyze the prevalence,clinical meaning,treatment and prognosis of UPC in RSA.Data sources and study selection We performed a systematic review of the literature between 1950 and 2013 for all studies reporting on UPC for PA.Studies with the prevalence and prognosis of patients with UPC in RSA were analyzed.Results Six studies meeting our inclusion criteria yielded data for 1 402 patients who underwent a total of 1405 RSA.Based on the available data,following RSA 235 shoulders had UPCs with a pooled percentage of 16.7％ （235/1405）.The most commonly isolated bacteria from shoulders following RSA with UPCs was PA with pooled percentages of 63.4％ （149/235）.Occurrence of true infection from UPCs after RSA was seen in 24 shoulders （24/235,10.2％）.Antibiotic use did not influence the rate of the occurrence of true infection from UPCs （P=0.498）.Conclusions Our study showed a low risk of having a true infection from UPCs after RSA without clinical signs of preoperative infection at the time of the surgery.Therefore,prolonged antibiotic therapy may not be necessary in these patients.展开更多
文摘Cholecystocolic fistula secondary to gallbladder carcinoma is extremely rare and has been reported in very few studies. Most cholecystocolic fistulae are late complications of gallstone disease, but can also develop following carcinoma of the gallbladder when the necrotic tumor penetrates into the adjacent colon. Although no currently available imaging technique has shown great accuracy in recognizing cholecystocolic fistula, abdominopelvic computed tomography may show fistulous communication and anatomical details.Herein we report an unusual case of cholecystocolic fistula caused by gallbladder carcinoma, which was preoperatively misdiagnosed as hepatic flexure colon carcinoma.
文摘Left-sided periappendiceal abscesses occur in association with two types of congenital anomaly: intestinal malrotation and situs inversus. It is diffi cult to obtain an accurate preoperative diagnosis of these abscesses due to the abnormal position of the appendix. We present an unusual case of a left-sided periappendiceal abscess in an adult with intestinal malrotation, the diagnosis of which was a challenge.
文摘Angiomyolipomas(AMLs),a form of benign mesenchymal hamartoma,arise primarily in the kidneys of patients with or without tuberous sclerosis.Extra-renal AMLs are very rare and are most commonly found in the liver. AMLs of the small intestine are exceedingly rare.Here, a case of a 28-year-old man,who presented with ileal intussusception caused by ileal AML is reported.The clinicopathological and immunohistochemical findings of ileal AMLs are discussed and the literature on small intestinal AMLs is reviewed.
文摘Bone metastasis of primary colorectal cancer is uncommon.When it occurs,it is usually a late manifestation of disease and is indicative of poor prognosis.We describe a patient with multiple metachronous bone metastases from lower rectal cancer who was successfully treated with multimodal treatment including surgical resections and has shown 32 mo disease-free survival.Surgical resection of metastatic bone lesion(s)from colorectal cancer may be a good treatment option in selected patients.
文摘AIM:To study factors associated with loss of hepatitis B surface antigen (HBsAg) in patients co-infected with human immunodeficiency virus (HIV) and hepatitis B virus (HBV).METHODS:We retrospectively reviewed the medical records of 5681 patients followed up at two New York City HIV clinics from January 1999 to May 2007.Clinical and laboratory parameters including baseline and follow-up HIV viral loads,CD4 cell counts,alanine transaminase levels,demographics,presence of hepatitis C infection,and treatment with highly active antiretroviral therapy dually active against both HIV and HBV infection,were analyzed to determine factors associated with loss of HBsAg.RESULTS:Three hundred and fifty five patients (355/5681,6.84%) were co-infected with HIV and HBV and were evaluated.Of these,226 patients with more than 12 mo follow-up were included in further analysis to determine factors associated with loss of HBsAg in the long-term follow-up.In the univariate analysis,baseline CD4 cell count was associated with loss of HBsAg (P=0.052).Cox regression analysis revealed that loss of HBsAg was associated with baseline CD4 cell count > 500 cells/mm3 (P=0.016,odds ratio:76.174,95% confidence interval:2.233-2598.481).CONCLUSION:Our study showed an interesting association of loss of HBsAg in HIV-HBV co-infected patients with higher CD4 cell count,suggesting that T-cell cytolytic activity against HBV may still be effective in clearing HBV infection.
文摘For an analysis of the oxidation behavior of UO2 nuclear fuel pellet under a loss of water coolant accident in a spent nuclear fuel pool of an LWR, thermodynamic assessments of UO2 oxidation were carried out under various atmospheric conditions. In a steam atmosphere, it was assessed that UO2 would not be fully oxidized into U3O8 due to the relatively lower oxygen partial pressure, while UO2 will be fully oxidized into U3O8 in an air atmosphere. In an air and steam mixture atmosphere, the UO2 oxidation was dominantly affected by the air volumetric fraction, because of the relatively higher oxygen partial pressure of air. In addition, the effect of H2 volumetric fraction on the oxygen partial pressure under a mixture atmosphere was calculated, and it was revealed that UO2 pellet oxidation could be reduced above the critical value of H2 volumetric fraction.
文摘For an evaluation of a thermal conductivity of Zr + 30 vol% ZrO2 simulated inert matrix nuclear fuel pellet, a simulated fuel pellet was fabricated using a hot-pressing method at 800°C in a vacuum and at a 20 MPa load. And several thermophysical properties of the simulated inert matrix fuel pellet were measured and calculated. The thermal diffusivity and linear thermal expansion as a function of temperature of the simulated fuel pellet were measured using a laser flash method and a dilatometry, respectively. Finally, based on the experimental data, the thermal conductivity of the simulated inert matrix fuel pellet was calculated and evaluated.
文摘Background Recent studies have reported overall increasing rates of syphilis with a high rate of human immunodeficiency virus （HIV） co-infection. However, there is little information about factors influencing syphilis treatment failure and/or re-infection in HIV co-infected patients. We conducted a study to evaluate factors associated with syphilis treatment failure/re-infection in HIV co-infected patients.Methods We reviewed 3542 medical records of HIV-infected patients from January 2005 to December 2007 followed up at HIV Clinic in New York City. Patients were categorized by rapid plasma regain titer （RPR） into success/serofast （4-fold decrease in RPR by 12 months after treatment, RPR conversion to nonreactive, persistently stable reactive RPR with no 4-fold increase）, and failure/re-infection （failure to decrease 4 folds in RPR by 12 months after treatment, 4-fold increase in RPR from baseline）.Results Among a total of 156 patients who met the eligibility criteria, 122 （78.2％） were under success/serofast category,and 34 （21.8％） were under failure/re-infection category. HIV viral load, CD4 cell count, and use of highly active antiretroviral therapy （HAART） were not associated with syphilis treatment failure/re-infection. However, early syphilis stage （OR：11.036, 95％ CI： 2.499-48.740, P=0.002） and high （＞1∶64） RPR titers （OR： 715.921, 95％ CI： 422.175-23 113.396, P ＜0.001） were significantly associated.Conclusions No correlations were seen with depressed immune states with syphilis treatment failure and/or re-infection. However, association with early stage syphilis suggests that risky psychological sexual behaviors may be the most important leading factor, emphasizing needs for safe sex education.
文摘Objective Little information is available to guide treatment strategies regarding patients with unexpected positive cultures （UPC）,including Propionibacterium acnes （PA）,without overt signs of infection in revision shoulder arthroplasty （RSA）.The purpose of our study was to analyze the prevalence,clinical meaning,treatment and prognosis of UPC in RSA.Data sources and study selection We performed a systematic review of the literature between 1950 and 2013 for all studies reporting on UPC for PA.Studies with the prevalence and prognosis of patients with UPC in RSA were analyzed.Results Six studies meeting our inclusion criteria yielded data for 1 402 patients who underwent a total of 1405 RSA.Based on the available data,following RSA 235 shoulders had UPCs with a pooled percentage of 16.7％ （235/1405）.The most commonly isolated bacteria from shoulders following RSA with UPCs was PA with pooled percentages of 63.4％ （149/235）.Occurrence of true infection from UPCs after RSA was seen in 24 shoulders （24/235,10.2％）.Antibiotic use did not influence the rate of the occurrence of true infection from UPCs （P=0.498）.Conclusions Our study showed a low risk of having a true infection from UPCs after RSA without clinical signs of preoperative infection at the time of the surgery.Therefore,prolonged antibiotic therapy may not be necessary in these patients.
