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1.
Article in Chinese | WPRIM | ID: wpr-927909

ABSTRACT

Panax quinquefolium, as a common precious medicinal plant, has complex chemical components and unique pharmacological activities, which can play a healthcare role in the human body. With the deepening of research, the application of P. quinquefolium has become increasingly extensive. This paper summarized the research progress of the saponins isolated and identified from diffe-rent parts of P. quinquefolium, the structural classification and pharmacological activities of the saponins, and the quality control of Panacis Quinquefolii Radix. Further, this paper put forward the urgent problems to be solved in the development of P. quinquefolium. It is hoped to lay a foundation for the further study and provide reference for the research direction of P. quinquefolium.


Subject(s)
Ginsenosides , Humans , Panax/chemistry , Plants, Medicinal/chemistry , Quality Control , Saponins/pharmacology
2.
Article in English | WPRIM | ID: wpr-925118

ABSTRACT

Purpose@#Controversy exists regarding the role preoperative urodynamic study for asymptomatic closed spinal dysraphism as it has failed to reveal the benefit in surgical decision and expectation of urological outcomes. We explore the relationship between preoperative videourodynamic study and postoperative urological outcomes after toilet training completed, focusing on their capability of spontaneous voiding. @*Methods@#We retrospectively reviewed the data of 181 patients who underwent preventive spinal cord untethering and followed at least till the completion of toilet training. Before untethering, patients underwent preoperative videourodynamic study. Postoperative voiding function was evaluated in 3 phases: (1) till postoperative 6 months, (2) till the completion of toilet training, and (3) 2 years after toilet training. Changing distribution of emptying pattern at each period was described. Also, relevance to preoperative urodynamic parameters on spontaneous voiding and urinary continence after toilet training was assessed. @*Results@#Spinal lipoma and low lying conus were found in 145 (80%) and 128 patients (70.7%), respectively. Spontaneous voiding was found in 125 (69.1%), 164 (90.6%), and 162 patients (89.5%) at postoperative 6 months, till the toilet training, and 2 years after toilet training, respectively. Videourodynamics helped to clarify the presence of vesicourethral synergy. This was correlated with spontaneous voiding at postoperative 6 months and better urinary continence after 2 years of toilet training. @*Conclusions@#Eventual spontaneous voiding was achieved till toilet training in 90% patients following preventive untethering. Those showing preoperative vesicourethral synergy was associated with faster achievement of spontaneous voiding and better urinary continence when they enter elementary school.

3.
Article in English | WPRIM | ID: wpr-892417

ABSTRACT

During the last two decades, there have been remarkable advances in knowledge regarding secondary neurulation. An increased number of cases of occult spinal dysraphism and progress in basic embryology research have provoked the continuous discovery of new disease entities and the reclassification of occult spinal dysraphic lesions. Examples of such changes are described. The characteristics of secondary neurulation compared with those of primary neurulation are listed and discussed. Our fundamental questions include what the evolutionary significance of secondary neurulation is and what the advantages of having secondary neurulation are. However, our current data and speculations are insufficient to support scientific inference. The direction of future progress of research in this field is predicted. The role of clinicians in this progress is emphasized.

4.
Article in English | WPRIM | ID: wpr-892411

ABSTRACT

Caudal agenesis refers to the congenital malformation with the essential feature of the agenesis of the sacrococcygeal bone. It is associated with various types of spinal cord anomaly as well as with complex anomalies of genitourinary or gastrointestinal system. The wide spectrum of the disease can be attributed to its pathoembryological origin, the secondary neurulation. This review presents the definition, etiology, classification, and clinical features of the disease.

5.
Article in English | WPRIM | ID: wpr-892410

ABSTRACT

Recent advancements in basic research on the process of secondary neurulation and increased clinical experience with caudal spinal anomalies with associated abnormalities in the surrounding and distal structures shed light on further understanding of the pathoembryogenesis of the lesions and led to the new classification of these dysraphic entities. We summarized the changing concepts of lesions developed from the disordered secondary neurulation shown during the last decade. In addition, we suggested our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Disordered secondary neurulation at each phase of development may cause corresponding lesions, such as failed junction with the primary neural tube (junctional neural tube defect and segmental spinal dysgenesis), dysgenesis or duplication of the caudal cell mass associated with disturbed activity of caudal mesenchymal tissue (caudal agenesis and caudal duplication syndrome), failed ingression of the primitive streak to the caudal cell mass (myelomeningocele), focal limited dorsal neuro-cutaneous nondisjunction (limited dorsal myeloschisis and congenital dermal sinus), neuro-mesenchymal adhesion (lumbosacral lipomatous malformation), and regression failure spectrum of the medullary cord (thickened filum and filar cyst, low-lying conus, retained medullary cord, terminal myelocele and terminal myelocystocele). It seems that almost every anomalous entity of the primary neural tube may occur in the area of secondary neurulation. Furthermore, the close association with the activity of caudal mesenchymal tissue in secondary neurulation involves a wider range of surrounding structures than in primary neurulation. Although the majority of the data are from animals, not from humans and many theories are still conjectural, these changing concepts of normal and disordered secondary neurulation will provoke further advancements in our management strategies as well as in the pathoembryogenetic understanding of anomalous lesions in this area.

6.
Article in English | WPRIM | ID: wpr-892404

ABSTRACT

Objective@#: Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. @*Methods@#: Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. @*Results@#: The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). @*Conclusion@#: Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

7.
Article in Chinese | WPRIM | ID: wpr-907929

ABSTRACT

Objective:To explore the clinical characteristics of children with severe tuberculosis (TB) in pediatric intensive care unit (PICU) and the diagnostic viability of metagenomic next-generation sequencing (mNGS).Methods:The clinical data and mNGS results of 3 children with severe TB admitted to PICU of Anhui Provincial Children′s Hospital from January 2018 to December 2020 were retrospectively analyzed.The literature reporting children with TB diagnosed by applying mNGS were searched in China National Knowledge Infrastructure, Wanfang data, VIP and PubMed data bases, all of which were searched from the establishment of the database to March 2021, and the relevant literature was reviewed.Results:(1)All of 3 cases, including 2 males and 1 female, all had fever.One case was diagnosed with X-linked severe combined immunodeficiency (X-SCID). Acid-fast stain tests of body fluid, purified protein derivative (PPD) tests and T-cell spot tests of tuberculosis infection (T-SPOT.TB) were conducted in 3 cases, with the test results being negative, and the early diagnosis was confirmed with mNGS.Two cases were discharged from the hospital after being switched to special anti-TB treatment.(2)A total of 3 articles were retrieved, in which 7 children were reported.One male with X-SCID combined with bacillus Calmette-Guérin-associated hemophagocytic syndrome and 6 children with tuberculous meningitis were subject to early diagnosis with mNGS (detection of Mycobacterium tuberculosis complex).Conclusions:It is promising for the application of mNGS in rapid pathogen diagnosis of children with severe TB, especially in children with immunodeficiency.It could optimize early diagnosis and treatment to improve prognosis.

8.
International Journal of Surgery ; (12): 519-526, 2021.
Article in Chinese | WPRIM | ID: wpr-907474

ABSTRACT

Objective:To evaluate the efficacy and safety of primary tumor resection for asymptomatic metastatic colorectal cancer with unresectable metastases.Methods:A literature search was conducted in PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure and WanFang databases to identify studies comparing primary tumor resection and systemic treatment for asymptomatic metastatic colorectal cancer with unresectable metastases until March 31, 2021 (inchuding RCTs and non-RCTs) . The search strategy was: (((colorectal cancer) OR (colorectal neoplasms) OR (colon cancer) OR (colon neoplasms) OR (rectal cancer) OR (rectal neoplasms)) AND ((metastatic) OR (stage Ⅳ)) AND (asymptomatic) AND (primary tumor resection)). Review manager (RevMan) (Version 5.3.0, Cochrane Collaboration, Oxford, UK) was used to perform the statistical analysis.Results:A total of 14 original studies (RCT: 1; cohort study: 13) were included in this analysis with a total of 2123 patients (primary tumor resection: 1162 cases, systemic treatment: 961 cases). The results of this Meta-analysis showed that PTR group had a significantly improved overall survival in 1-year overall survival ( HR=0.80, 95% CI: 0.67~0.95, P=0.01), 2-year overall survival ( HR=0.81, 95% CI: 0.71~0.93, P=0.002), 3-year overall survival ( HR=0.82, 95% CI: 0.72~0.92, P=0.001), 4-year overall survival ( HR=0.86, 95% CI: 0.75~0.98, P=0.02) and 5-year overall survival ( HR=0.85, 95% CI: 0.74~0.97, P=0.02). The median survival time of PTR group was 4.35 months longer than that of systemic treatment group ( MD=4.35, 95% CI: 0.99~7.72, P=0.015). Conclusions:The current evidence suggests that primary tumor resection may be a potentially safe and feasible treatment strategy for asymptomatic metastatic colorectal cancer with unresectable metastases. Large sample size prospective randomized controlled trials are needed to validate our findings in the future.

9.
Article in English | WPRIM | ID: wpr-900121

ABSTRACT

During the last two decades, there have been remarkable advances in knowledge regarding secondary neurulation. An increased number of cases of occult spinal dysraphism and progress in basic embryology research have provoked the continuous discovery of new disease entities and the reclassification of occult spinal dysraphic lesions. Examples of such changes are described. The characteristics of secondary neurulation compared with those of primary neurulation are listed and discussed. Our fundamental questions include what the evolutionary significance of secondary neurulation is and what the advantages of having secondary neurulation are. However, our current data and speculations are insufficient to support scientific inference. The direction of future progress of research in this field is predicted. The role of clinicians in this progress is emphasized.

10.
Article in English | WPRIM | ID: wpr-900115

ABSTRACT

Caudal agenesis refers to the congenital malformation with the essential feature of the agenesis of the sacrococcygeal bone. It is associated with various types of spinal cord anomaly as well as with complex anomalies of genitourinary or gastrointestinal system. The wide spectrum of the disease can be attributed to its pathoembryological origin, the secondary neurulation. This review presents the definition, etiology, classification, and clinical features of the disease.

11.
Article in English | WPRIM | ID: wpr-900114

ABSTRACT

Recent advancements in basic research on the process of secondary neurulation and increased clinical experience with caudal spinal anomalies with associated abnormalities in the surrounding and distal structures shed light on further understanding of the pathoembryogenesis of the lesions and led to the new classification of these dysraphic entities. We summarized the changing concepts of lesions developed from the disordered secondary neurulation shown during the last decade. In addition, we suggested our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Disordered secondary neurulation at each phase of development may cause corresponding lesions, such as failed junction with the primary neural tube (junctional neural tube defect and segmental spinal dysgenesis), dysgenesis or duplication of the caudal cell mass associated with disturbed activity of caudal mesenchymal tissue (caudal agenesis and caudal duplication syndrome), failed ingression of the primitive streak to the caudal cell mass (myelomeningocele), focal limited dorsal neuro-cutaneous nondisjunction (limited dorsal myeloschisis and congenital dermal sinus), neuro-mesenchymal adhesion (lumbosacral lipomatous malformation), and regression failure spectrum of the medullary cord (thickened filum and filar cyst, low-lying conus, retained medullary cord, terminal myelocele and terminal myelocystocele). It seems that almost every anomalous entity of the primary neural tube may occur in the area of secondary neurulation. Furthermore, the close association with the activity of caudal mesenchymal tissue in secondary neurulation involves a wider range of surrounding structures than in primary neurulation. Although the majority of the data are from animals, not from humans and many theories are still conjectural, these changing concepts of normal and disordered secondary neurulation will provoke further advancements in our management strategies as well as in the pathoembryogenetic understanding of anomalous lesions in this area.

12.
Article in English | WPRIM | ID: wpr-900108

ABSTRACT

Objective@#: Few studies exist on primary spinal cord tumors (PSCTs) in pediatric patients. The purpose of this study was to perform descriptive analysis and detailed survival analysis for PSCTs. @*Methods@#: Between 1985 and 2017, 126 pediatric patients (male : female, 56 : 70) with PSCTs underwent surgery in a single institution. We retrospectively analyzed data regarding demographics, tumor characteristics, outcomes, and survival statistics. Subgroup analysis was performed for the intramedullary (IM) tumors and extradural (ED) tumors separately. @*Results@#: The mean age of the participants was 6.4±5.04 years, and the mean follow-up time was 69.5±46.30 months. The most common compartment was the ED compartment (n=57, 45.2%), followed by the IM (n=43, 34.1%) and intradural extramedullary (IDEM; n=16, 12.7%) compartments. Approximately half of PSCTs were malignant (n=69, 54.8%). The most common pathologies were schwannomas (n=14) and neuroblastomas (n=14). Twenty-two patients (17.5%) died from the disease, with a mean disease duration of 15.8±15.85 months. Thirty-six patients (28.6%) suffered from progression, with a mean period of 22.6±30.81 months. The 10-year overall survival (OS) rates and progression-free survival (PFS) rates were 81% and 66%, respectively. Regarding IM tumors, the 10-year OS rates and PFS rates were 79% and 57%, respectively. In ED tumors, the 10-year OS rates and PFS rates were 80% and 81%, respectively. Pathology and the extent of resection showed beneficial effects on OS for total PSCTs, IM tumors, and ED tumors. PFS was affected by both the extent of removal and pathology in total PSCTs and ED tumors; however, pathology was a main determinant of PFS rather than the extent of removal in IM tumors. The degree of improvement in the modified McCormick scale showed a trend towards improvement in patients with IM tumors who achieved gross total removal (p=0.447). @*Conclusion@#: Approximately half of PSCTs were malignant, and ED tumors were most common. The most common pathologies were schwannomas and neuroblastomas. Both the pathology and extent of resection had a decisive effect on OS. For IM tumors, pathology was a main determinant of PFS rather than the extent of removal. Radical excision of IM tumors could be a viable option for better survival without an increased risk of worse functional outcomes.

13.
Article in Chinese | WPRIM | ID: wpr-922000

ABSTRACT

OBJECTIVE@#To explore the clinical features and genetic basis of two children with glycogen storage disease type III (GSD III).@*METHODS@#The probands and their parents were subjected to genetic testing, and the pathogenity of candidate variants was analyzed by using bioinformatic tools.@*RESULTS@#Sequencing has identified compound heterozygous variants of the AGL gene in both children, namely c.1423+1G>A and c.3701-2A>G in case 1, and c.4213_c.4214insA (p.Glu1405Glufs*17) and c.3589-3C>G in case 2. Both children were diagnosed with GSD III. Literature review suggested that the main type variant among Chinese patients with GSD III involve splice sites of the AGL gene, with c.1735+1G>T being the most common. Based on the American College of Medical Genetics and Genomics standards and guidelines,c.1423+1G>A, c.3701-2A>G and c.4213_c.4214insA variants of AGL gene were predicted to be of pathogenic (PVS1+PM2+PM3, PVS1+PM2+PM3, PVS1+PM2+PP5), and c.3589-3C>G variant was predicted to be of uncertain significance (PM2+PM3+PP3).@*CONCLUSION@#The compound heterozygous variants of the AGL gene probably underlay the GSD III in both children. Above findings have enriched the spectrum of genetic variants underlying this disease.


Subject(s)
Child , Genetic Testing , Genomics , Glycogen Storage Disease Type III/genetics , Humans , Mutation
14.
Article in English | WPRIM | ID: wpr-913812

ABSTRACT

Purpose@#We aimed to refine the radiotherapy (RT) volume and dose for intracranial germinoma considering recurrences and long-term toxicities. @*Materials and Methods@#Total 189 patients with intracranial germinoma were treated with RT alone (n=50) and RT with upfront chemotherapy (CRT) (n=139). All cases were confirmed histologically. RT fields comprised the extended-field and involved-field only for primary site. The extended-field, including craniospinal, whole brain (WB), and whole ventricle (WV) for cranial field, is followed by involved-field boost. The median follow-up duration was 115 months. @*Results@#The relapses developed in 13 patients (6.9%). For the extended-field, cranial RT dose down to 18 Gy exhibited no cranial recurrence in 34 patients. In CRT, 74 patients (56.5%) showed complete response to chemotherapy and no involved-field recurrence with low-dose RT of 30 Gy. WV RT with chemotherapy for the basal ganglia or thalamus germinoma showed no recurrence. Secondary malignancy developed in 10 patients (5.3%) with a latency of 20 years (range, 4 to 26 years) and caused mortalities in six. WB or craniospinal field rather than WV or involved-field significantly increased the rate of hormone deficiencies, and secondary malignancy. RT dose for extended-field correlated significantly with the rate of hormone deficiencies, secondary malignancy, and neurocognitive dysfunction. @*Conclusion@#De-intensifying extended-field rather than involved-field or total scheme of RT will be critical to decrease the late toxicities. Upfront chemotherapy could be beneficial for the patients with complete response to minimize the RT dose down to 30 Gy. Prospective trials focused on de-intensification of the extended-field RT are warranted.

15.
Article in Chinese | WPRIM | ID: wpr-880139

ABSTRACT

OBJECTIVE@#To investigate the predictive value of methyltransferase EZH2 expression level on the clinical efficacy and long-term prognosis of patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL).@*METHODS@#161 patients with newly treated PGI-DLBCL in our hospital from August 2013 to July 2019 were selected. The expression level of EZH2 protein was detected by immunohistochemistry, and the short-term efficacy and long-term survival differences of patients with different levels of EZH2 were compared. The predictive values of EZH2 expression level on the short-term efficacy and long-term prognosis of PGI-DLBCL patients were analyzed by Log-rank test and COX risk proportional regression model. Chi-square test and Logistic regression analysis were used to analyze the influencing factors of EZH2 expression level.@*RESULTS@#The complete response (CR) and overal response(OR) rates of those with high EZH2 expression were significantly lower than those with low EZH2 expression (P<0.001). The median OS and PFS of EZH2 high-level and low-level expression group was 37, 31 months and 49, 42 months, respectively. The cumulative OS and PFS rates of the high-level expression group were significantly lower than those of the low-level expression group, and the differences were statistically significant (P<0.05). The high expression levels of H3K27me3, EZH2, BCL-2, BCL-6, c-MYC were closely related to the shortening of OS and PFS, while the high expression level of Ki-67 was closely related to the shortening of OS (P<0.05), of which the high expression levels of H3K27me3, EZH2, BCL-2, and BCL-6 were independent risk factors for shortening of OS and PFS. The expression level of EZH2 was positively correlated with the expression level of H3K27me3, BCL-6, c-MYC and Ki-67 (r=0.741, r=0.837, r=0.809, r=0.772), and the high expression levels of H3K27me3, BCL-6 and Ki-67 were independent factors influencing the high expression of EZH2.@*CONCLUSION@#In patients with PGI-DLBCL, the high expression of EZH2 significantly reduces the short-term CR and OR rates, which is an independent risk factor for the shortening of long-term OS and PFS rates, and it is independently related to the high expression of H3K27me3 and BCL6.


Subject(s)
Enhancer of Zeste Homolog 2 Protein , Humans , Immunohistochemistry , Lymphoma, Large B-Cell, Diffuse , Prognosis , Remission Induction , Retrospective Studies , Treatment Outcome
16.
Article in English | WPRIM | ID: wpr-878317

ABSTRACT

Objective@#In the present study, the ABCA1 was used as a label to capture specific exosomes, the level of ABCA1-labeled exosomal microRNA-135a (miR-135a) was evaluated for the diagnosis of Alzheimer's disease (AD), especially in patients with early stages of AD.@*Methods@#This is a preliminary research focused on the levels of ABCA1 in WBCs, RBCs, HT-22 cells, and neuron cells. The diagnostic value of ABCA1-labeled exosomal miR-135a was examined using the CSF and serum of APP/PS1 double transgenic mice, and 152 patients with SCD, 131 patients with MCI, 198 patients with DAT, and 30 control subjects.@*Results@#The level of ABCA1 exosomes harvested from HT-22 cells and neuron culture medium was significantly higher compared to that of RBCs and WBCs ( @*Conclusion@#This study outlines a method to capture specific exosomes and detect them using immunological methods, which is more efficient for early diagnosis of AD.


Subject(s)
ATP Binding Cassette Transporter 1/cerebrospinal fluid , Aged , Aged, 80 and over , Alzheimer Disease/cerebrospinal fluid , Animals , Biomarkers/cerebrospinal fluid , Cell Line , Cognitive Dysfunction/cerebrospinal fluid , Erythrocytes/metabolism , Exosomes , Female , Humans , Leukocytes/metabolism , Male , Mice, Transgenic , MicroRNAs/blood , Neurons/metabolism
17.
Article | IMSEAR | ID: sea-200952

ABSTRACT

Background:Malnutrition is common in patients with cancer, whichadversely affectsthesurvival and quality of life ofcancer patients.However, there is no national data on the prevalence of malnutrition inChinese cancer patients. Thisstudy aims to evaluate the prevalenceof malnutrition and quality of life(QOL)ofChinese patients with localregional, recurrentor metastatic cancer,to address the prognostic value of nutritional status and QOLon the survival of cancer patients in China and to validate the patient-generated subjective global assessment (PG-SGA) questionnaire in Chinese cancer patients.Methods:Thisisanobservational,multi-centered,and hospital-based prospective cohort study.We aimed to recruit 50,000 cancer patients (age 18and above)overan 8-year period.Data collection will occur within 48hrafter patientsare admitted to hospital, 30-days after hospital admission, and the follow-up will be conducted1-8years after enrolment. The primary outcomeisoverall survival, and secondaryoutcomes arelength of hospital stay and hospital costs. Factors measured are demographic characteristics, tumor characteristics, anthropometry measurements,hematological measurement, body composition, PG-SGAscores,Karnofsky performance status scores,and QLQ C30 scores. This protocol wasapproved by local ethical committees of all the participant hospitals.Conclusions: This multi-centered, large-scale, long-time follow-up prospective study will help diagnose malnutrition in cancer patients in China, and identify the related risk factors associated with the negative outcomes. The anticipated results will highlight the need for a truly scientific appraisal of nutrition therapy, and help to improve outcomes among cancer patients in China.Trial Registration: The trial has been registered with the Chinese Clinical Trial Registry, ChiCTR1800020329. Registered on 19 December 2018

18.
Cancer Research and Clinic ; (6): 213-216, 2020.
Article in Chinese | WPRIM | ID: wpr-872480

ABSTRACT

Microsatellite instability (MSI) is caused by the deficiency of DNA mismatch repair (MMR) protein, which is closely related to the occurrence, development, prognosis and efficacy prediction of various tumors. MSI-high (MSI-H) and mismatch repair protein deficiency (dMMR) might be a predictor factor for the good prognosis of patients with gastric cancer, and a negative predictor factor for the chemotherapy efficacy of resectable gastric cancer. MSI-H/dMMR can be used as a marker for predicting the effective treatment outcome of immune checkpoint inhibitors in advanced gastric cancer, however, the predictive role in palliative chemotherapy of advanced gastric cancer is still unclear. This paper reviews the progress of the association of MSI/MMR with prognosis and efficacy prediction in gastric cancer.

19.
Article | WPRIM | ID: wpr-833463

ABSTRACT

Compared to any other decade, the last two decades have been the most dynamic period in terms of advances in the knowledge on spinal dysraphism. Among the several factors of rapid advancement, such as embryology during secondary neurulation and intraoperative neurophysiological monitoring, there is no doubt that Professor Dachling Pang stood high amidst the period. I review here the last two decades from my personal point of view on what has been achieved in the field of spinal dysraphism, focusing on occult tethered cord syndrome, lumbosacral lipomatous malformation, terminal myelocystocele, retained medullary cord, limited dorsal myeloschisis and junctional neural tube defect. There are still many issues to revise, add and extend. Profound knowledge of basic science is critical, as well as refined clinical analysis. I expect that young scholars who follow the footsteps of precedent giants will shed bright light on this topic in the future.

20.
Article | WPRIM | ID: wpr-833462

ABSTRACT

Retained medullary cord (RMC) is a relatively recent term. Pang et al. newly defined the RMC as a late arrest of secondary neurulation leaving a non-functional vestigial portion at the tip of the conus medullaris. RMC, which belongs to the category of closed spinal dysraphism, is a cord-like structure that is elongated from the conus toward the cul-de-sac. Because intraoperative electrophysiological confirmation of a non-functional conus is essential for the diagnosis of RMC, only a tentative or an assumptive diagnosis is possible before surgery or in cases of limited surgical exposure. We suggest the term ‘possible RMC’ for these cases. An RMC may cause tethered cord syndrome and thus requires surgery. This article reviews the literature to elucidate the pathoembryogenesis, clinical significance and treatment of RMCs.

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