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1.
Anticancer Res ; 40(4): 2185-2190, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32234913

RESUMEN

BACKGROUND/AIM: The study aimed at investigating the correlation between ductoscopic and histopathological findings and clarify whether the former allow for accurate prediction of malignancy. PATIENTS AND METHODS: The prospective national multi-center study covered a sample of 224 patients with pathologic nipple discharge. A total of 214 patients underwent ductoscopy with subsequent extirpation of the mammary duct. The ductoscopic findings were categorized according to shape, number, color and surface structure of lesions and vascularity and compared to the histological results and analyses. RESULTS: Ductoscopy revealed lesions in 134 of 214 patients (62.2%). The criteria "multiple versus solitary lesion" differed significantly between malignant and benign lesions. All other criteria were not statistically significant. Malignant tumors were more frequently presented as multiple lesions, benign lesions or masses as solitary lesions (80% vs. 24.8%; p=0.018). CONCLUSION: The ductoscopic criterion "solitary vs. multiple lesion" appears to have a low diagnostic prediction of malignancy or benignity.


Asunto(s)
Enfermedades de la Mama/diagnóstico , Neoplasias de la Mama/diagnóstico , Carcinoma Intraductal no Infiltrante/diagnóstico , Endoscopía/métodos , Secreción del Pezón , Pezones/patología , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de la Mama/metabolismo , Enfermedades de la Mama/patología , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Carcinoma Intraductal no Infiltrante/metabolismo , Carcinoma Intraductal no Infiltrante/patología , Diagnóstico Diferencial , Femenino , Alemania , Humanos , Persona de Mediana Edad , Pezones/metabolismo , Estudios Prospectivos , Adulto Joven
2.
Medicine (Baltimore) ; 99(15): e19670, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32282719

RESUMEN

INTRODUCTION: Percutaneous endoscopic lumbar disectomy (PELD) is one of the most popular minimally invasive techniques of spinal surgery in recent years. At present, there are 2 main surgical approaches in PELD: foraminal approach and interlaminar approach. What's more, foraminoplasty is a necessary step for both approaches. However, there are few biomechanical studies on the formation of different parts of the intervertebral foramen. The aim of this study is to explore the effects of different foraminoplasty methods on the biomechanics of the corresponding and adjacent segments of the lumbar through a 3-dimensional finite element model analysis. METHODS: We established a normal 3-dimensional finite element mode of L3 to L5, simulated lumbar percutaneous endoscopy by doing cylindrical excision of bone whose diameter was 7.5 mm on the L5 superior articular process and the L4 inferior articular process, respectively, so that we obtained 3 models: the first one was normal lumbar model, the second one was the L4 inferior articular process shaped model, and the third one was the L5 superior articular process shaped model. We compared the biomechanics of the intervertebral disc of L3/4 and L4/5 when they were in the states of forward flexion, backward extension, left and right flexion, and left and right rotation on specific loading condition. DISCUSSION: If the outcomes indicate the trial is feasible and there is evidence that one of the foraminoplasty technique may make few differences in biomechanics of corresponding lumbar intervertebral disc, we will proceed to a definitive trial to test the best way to foraminplasty, which could make biomechanical influence as little as possible. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900026973. Registered on September 27, 2019.


Asunto(s)
Discectomía Percutánea/métodos , Análisis de Elementos Finitos/normas , Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Adulto , Fenómenos Biomecánicos , Endoscopía/métodos , Femenino , Foraminotomía/métodos , Fracturas por Estrés/complicaciones , Humanos , Disco Intervertebral/patología , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Rango del Movimiento Articular/fisiología , Esguinces y Distensiones/complicaciones
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(4): 327-331, 2020 Apr 25.
Artículo en Chino | MEDLINE | ID: mdl-32306597

RESUMEN

Objective: To explore the necessity and safety of selective endoscopy to detect gastrointestinal (GI) malignancy during the outbreak of coronavirus disease 2019 (COVID-19). Methods: A retrospective cohort study was carried out to analyze the clinical data of selective endoscopy performed at the Endoscopic Center, Zhongshan Hospital of Fudan University from February 20 to March 6, 2020. Clinical data included epidemiological questionnaire, chief complaints, endoscopic findings and biopsy pathology results, etc. All medical staff had blood test for IgM/IgG antibodies of COVID-19. Patients and their families were followed up by phone to determine whether they were infected with COVID-19. Meanwhile, the clinical data of selective endoscopy during the same period from February 20 to March 6, 2019 were collected as the control group to compare the overall results of endoscopy examinations during the epidemic and the detection rate of GI malignancy. Results: A total of 911 patients underwent endoscopy in the epidemic period group, and a total of 5746 cases in the control group, which was 6.3 times over the epidemic period group. In the epidemic period group, 544 cases received gastroscopy and 367 cases received colonoscopy, while 3433 cases received gastroscopy and 2313 cases received colonoscopy in the control group, which were both 6.3 times of epidemic period group. Gastroscopy revealed that 39 patients (7.2%) were diagnosed with upper GI malignancies in the epidemic period group and 77 patients (2.2%) in the control group with significant difference (χ(2)=40.243, P<0.001). The detection rate of gastric cancer in these two groups was 3.3% (n=18) and 1.7% (n=59) respectively with significant difference (χ(2)=6.254,P=0.012). The detection rate of esophageal cancer was 3.7% (n=20) and 0.5% (n=18) respectively with significant difference (χ(2)=49.303,P<0.001). Colonoscopy revealed that colorectal cancer was found in 32 cases (8.7%) of the epidemic period group and 88 cases (3.8%) of the control group with significant difference (χ(2)=17.888, P<0.001). During the epidemic period, no infection of medical staff was found through the blood test of IgM/IgG antibodies on COVID-19. No patient and family members were infected with COVID-19 by phone follow-up. Conclusion: Compared with the same period in 2019, the number of selective endoscopy decreases sharply during the epidemic period, while the detection rate of various GI malignant tumors increases significantly, which indicates that patients with high-risk symptoms of GI malignancies should still receive endoscopy as soon as possible. Provided strict adherence to the epidemic prevention standards formulated by the state and professional societies, it is necessary to carry out clinical diagnosis and treatment as soon as possible.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Endoscopía/estadística & datos numéricos , Neumonía Viral/epidemiología , Neoplasias Gástricas/diagnóstico por imagen , Anticuerpos Antivirales/sangre , Betacoronavirus , China , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Humanos , Cuerpo Médico , Pandemias/prevención & control , Neumonía Viral/prevención & control , Estudios Retrospectivos
5.
Chin J Dent Res ; 23(1): 27-32, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32232226

RESUMEN

Skull base surgery is an interdisciplinary subject. The anatomical structures in the skull base related to oral and maxillofacial surgery include the parapharyngeal space, the pterygopalatine fossa and the infratemporal space. This operative area is one of the most challenging surgical areas in oral and maxillofacial surgery due to its deep site, complex anatomy and high risk. Obtaining pathological information of the tumour preoperatively may help surgeons optimise their treatment plan. Needle biopsy is one of the major minimally invasive techniques that allows preoperative pathological results to be obtained. The navigation technology, which is developing rapidly nowadays, provides a reliable assistance for deep tissue biopsy surgery. Experts from the Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association formulated an expert consensus on the procedures and operations of navigation-guided needle biopsy techniques for skull base tumours, so as to standardise and promote the application and operation of navigation-guided needle biopsy for skull base tumours.


Asunto(s)
Neoplasias de la Base del Cráneo , Biopsia con Aguja , Consenso , Endoscopía , Humanos , Base del Cráneo
6.
Chin J Dent Res ; 23(1): 71-76, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32232232

RESUMEN

Endoscopic techniques have been applied to oral and maxillofacial surgeries. Previous studies have proved their practicability in the treatment of osteomyelitis of the mandible and displaced residual roots in the maxillary sinus. In this report, two patients with dentigerous cysts in the maxillary sinus underwent endoscope-assisted curettage. Both patients were successfully cured without recurrent lesions or any complications. The follow-up found that the bone cavities had shrunk. An endoscope-assisted Caldwell-Luc operation provided clear visibility of the surgical field and preserved the mucosa of the maxillary sinus.


Asunto(s)
Quiste Dentígero , Seno Maxilar , Endoscopía , Humanos
7.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(4): 249-252, 2020 Apr 09.
Artículo en Chino | MEDLINE | ID: mdl-32268624

RESUMEN

Objective: To evaluate the changes of nasalance when cleft palate patients examined using nasometer and nasopharyngeal fiberscopy simultaneously. Methods: A total of 33 cleft palate patients from August 2004 to August 2010 were examined by nasopharyngeal fiber endoscopy and nasometer simultaneously. The nasalance of 33 voice samples was compared under two situations only nasometer and nasometer with nasopharyngeal fiberscopy. Results: The statistics showed that the nasalance value of 33 voice samples of 33 participants under different situations were no significant difference through paired t-test (P>0.05). Conclusions: Nasopharyn fiber endoscopy had no influence to the results of the nasalance value under simultaneous condition. The nasometer and nasopharyn fiber endoscopy can be applied to evaluate the velopharyngeal function of cleft palate patients simultaneously.


Asunto(s)
Fisura del Paladar , Endoscopía/métodos , Tecnología de Fibra Óptica , Insuficiencia Velofaríngea , Fisura del Paladar/diagnóstico , Fisura del Paladar/patología , Endoscopía/instrumentación , Humanos , Nariz/patología
8.
Med Sci Monit ; 26: e921119, 2020 Apr 03.
Artículo en Inglés | MEDLINE | ID: mdl-32243427

RESUMEN

BACKGROUND Percutaneous transforaminal endoscopic surgery has been used as a surgical measure for lumbar lateral recess stenosis. However, the necessary decompressive range has never been clearly documented in detail. Here, we discuss the effectiveness of a percutaneous transforaminal endoscopic procedure with clearly defined decompressive range. MATERIAL AND METHODS The relevant data were retrospectively collected from a series of degenerative lateral recess stenosis patients who acquired a prospectively designed percutaneous transforaminal endoscopic procedure in our department. The decompressive procedure mainly included undercutting of superior articular process and intervertebral disk annuloplasty. Leg pain and back pain was evaluated using visual analogue scale (VAS). The functional status was assessed using Oswestry disability index (ODI). The clinical results were also evaluated using MacNab criteria. RESULTS From May 2014 to October 2018, a total of 33 patients who met our inclusion criteria were included for analysis. There were no perioperative complications. Leg pain VAS decreased from preoperative score of 6.18±2.38 to final follow-up score of 0.45±1.00 (P<0.01). Back pain VAS decreased from preoperative score of 1.88±2.19 to final follow-up score of 0.64±1.02 (P<0.01). ODI (%) decreased from preoperative score of 47.86±18.15 to final follow-up score of 6.29±6.75 (P<0.01). At the final follow-up, the results of MacNab criteria were excellent in 18 cases (54.55%), good in 14 cases (42.42%), fair in 1 case (3.03%) and poor in 0 cases. None of the patients complained of recurrence of the symptoms during follow-up. CONCLUSIONS Undercutting of "superior articular process neck" plus intervertebral disk annuloplasty is sufficient for lumbar lateral recess decompression in a transforaminal approach.


Asunto(s)
Descompresión Quirúrgica/métodos , Disco Intervertebral/cirugía , Estenosis Espinal/cirugía , Adulto , Anciano , Endoscopía/métodos , Femenino , Humanos , Región Lumbosacra/cirugía , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos , Dolor/epidemiología , Dolor/patología , Estudios Retrospectivos , Resultado del Tratamiento , Escala Visual Analógica
9.
J Korean Med Sci ; 35(12): e90, 2020 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-32233159

RESUMEN

BACKGROUND: Virtual environments have brought the use of realistic training closer to many different fields of education. In medical education, several visualization methods for studying inside the human body have been introduced as a way to verify the structure of internal organs. However, these methods are insufficient for realistic training simulators because they do not provide photorealistic scenes or offer an intuitive perception to the user. In addition, they are used in limited environments within a classroom setting. METHODS: We have developed a virtual dissection exploration system that provides realistic three-dimensional images and a virtual endoscopic experience. This system enables the user to manipulate a virtual camera through a human organ, using gesture-sensing technology. We can make a virtual dissection image of the human body using a virtual dissection simulator and then navigate inside an organ using a virtual endoscope. To improve the navigation performance during virtual endoscopy, our system warns the user about any potential collisions that may occur against the organ's wall by taking the virtual control sphere at the virtual camera position into consideration. RESULTS: Experimental results show that our system efficiently provides high-quality anatomical visualization. We can simulate anatomic training using virtual dissection and endoscopic images. CONCLUSION: Our training simulator would be helpful in training medical students because it provides an immersive environment.


Asunto(s)
Simulación por Computador , Educación Médica , Endoscopía , Interfaz Usuario-Computador , Competencia Clínica , Endoscopía/educación , Endoscopía/métodos , Cuerpo Humano , Humanos , Estudiantes de Medicina
10.
Zhonghua Wai Ke Za Zhi ; 58(4): 257-260, 2020 Apr 01.
Artículo en Chino | MEDLINE | ID: mdl-32241054

RESUMEN

Endoscopic surgery is a major achievement in breast surgery during the past 20 years. It is a long process of introduction, inheritance, innovation and development. Endoscopic surgery overcomes the technical bottleneck that how to apply endoscopic surgery in organs without cavities, and improves surgical safety in an academic and technical basis. However, compared with other surgical disciplines, breast endoscopic surgery is not widely applied in clinic. In order to standardize the clinical application of endoscopic surgery for breast cancer, the experts of Chinese Society of Breast Surgery, Chinese Surgical Society of Chinese Medical Association reiterate the indications and contraindications of endoscopic surgery for breast cancer, and give some practice suggestions.


Asunto(s)
Neoplasias de la Mama/cirugía , Endoscopía , China , Consenso , Humanos
12.
N Engl J Med ; 382(14): 1376, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-32242371
13.
N Engl J Med ; 382(14): 1376-1377, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-32242372
14.
N Engl J Med ; 382(14): 1377, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-32242373
15.
N Engl J Med ; 382(14): 1377-1378, 2020 04 02.
Artículo en Inglés | MEDLINE | ID: mdl-32242374
17.
J Laryngol Otol ; 134(4): 332-337, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32238199

RESUMEN

OBJECTIVE: To evaluate the colour values of nasal mucosa for the purpose of presenting an objective parameter of allergic rhinitis. METHODS: Seventy-three patients with allergic rhinitis (allergy group) and 73 normal healthy individuals (control group) were included in the study. Endoscopic examinations were conducted, and endoscopic photographs of the septum and both inferior turbinates were taken. The Adobe Photoshop Elements 7.0 software program was used to measure the numerical values of red-green-blue (RGB) colour components in the endoscopic photographs of nasal mucosa. RESULTS: The G and B values were significantly higher in the allergy group compared to the control group (both p < 0.05). Cumulative R, G and B values of all measurement points were significantly higher in the allergy group compared to the control group (p < 0.05). CONCLUSION: Nasal mucosa discolouration can be measured objectively with RGB analysis to aid the diagnosis of allergic rhinitis.


Asunto(s)
Color/normas , Endoscopía/métodos , Mucosa Nasal/anatomía & histología , Fotograbar/instrumentación , Rinitis Alérgica/diagnóstico , Adulto , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mucosa Nasal/patología , Tabique Nasal/diagnóstico por imagen , Rinitis Alérgica/epidemiología , Rinitis Alérgica/patología , Sensibilidad y Especificidad , Programas Informáticos , Cornetes Nasales/diagnóstico por imagen
18.
J Laryngol Otol ; 134(4): 344-349, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32238214

RESUMEN

OBJECTIVE: The aim of this study was to evaluate contact endoscopy in detecting local treatment failures post-radiotherapy in squamous cell carcinoma of the upper aerodigestive tract. METHOD: A total of 135 consecutive patients with suspected residual or recurrent cancer after definitive radiotherapy underwent contact endoscopy before biopsy. Contact endoscopy findings were compared with histopathological examination findings. Contact endoscopy could not be completed in 7 patients (5.9 per cent) and histopathological examination was inconclusive in 5 patients (3.7 per cent). The findings of the remaining 123 patients were compared. RESULTS: The sensitivity, specificity and accuracy of contact endoscopy were 88.75, 88.72 and 86.99 per cent, respectively, with similar results across various sites of upper aerodigestive tract. Inter-observer kappa value was 0.86 (95 per cent confidence interval: 0.79-0.93). The intra-observer kappa value was 0.93 (95 per cent confidence interval: 0.87-1.00) for the first observer and 0.95 (95 per cent confidence interval: 0.90-1.00) for second and third observers. CONCLUSION: Contact endoscopy showed the same high sensitivity and specificity with low inter- and intra-observer variability in detecting post-radiotherapy failures in cancer of the upper aerodigestive tract as has been shown in non-irradiated tissues in earlier studies.


Asunto(s)
Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/radioterapia , Endoscopía/métodos , Neoplasias de Cabeza y Cuello/patología , Adulto , Anciano , Biopsia/métodos , Progresión de la Enfermedad , Femenino , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Variaciones Dependientes del Observador , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Insuficiencia del Tratamiento
19.
Medicine (Baltimore) ; 99(17): e19847, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32332639

RESUMEN

BACKGROUND: We set out to evaluate the biomechanical influence of foraminoplasty on intervertebral discs in different areas under lumber percutaneous endoscopy through the use of a three-dimensional finite element. METHODS: We established a normal 3D finite element mode of L3-5, using simulate lumbar percutaneous endoscopy by carrying out cylindrical excision of a bone whose diameter was 7.5 mm on the L5 superior articular process and the L4 inferior articular process, respectively. We therefore obtained 3 models. The first was the normal lumbar model, the second the L4 inferior articular process shaped model, while the third was the L5 superior articular process shaped model. We compared the biomechanics of discs of L3/4 and L4/5 in states of forward flexion, backward extension, left and right flexion as well as left and right rotation. RESULTS: When the L4 inferior articular process shaped model was in backward extension, left rotation, and right rotation, the stress of the L4/5 disc was greater than in the normal model, especially in the state of extension. When the L5 superior articular process shaped model was in left and right rotation, the biggest stress of the L4/5 disc increased slightly. However, no matter which way the L5 superior articular process or the L4 inferior articular process of model was shaped, the stress impact of the L3/4 disc was small. CONCLUSIONS: There is more biomechanical influence on the L4/5 disc when carrying out a foraminoplasty on L4 inferior articular process under a lumber percutaneous endoscopy. In addition, the influence of both types of surgery on the stress of L3/4 disc is small.


Asunto(s)
Endoscopía/métodos , Análisis de Elementos Finitos , Disco Intervertebral/fisiología , Disco Intervertebral/cirugía , Vértebras Lumbares/fisiología , Vértebras Lumbares/cirugía , Procedimientos Ortopédicos/métodos , Adulto , Fenómenos Biomecánicos , Humanos , Degeneración del Disco Intervertebral/cirugía , Masculino , Estrés Mecánico
20.
Arq Gastroenterol ; 57(1): 13-18, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32294730

RESUMEN

BACKGROUND: Intragastric balloon (IGB) use is indicated for patients whose BMI precludes the option of bariatric surgery or who need to lose weight prior to undergoing surgery. It is a minimally invasive procedure and currently there are two main models of IGBs in use, the non-adjustable intragastric balloon (NIB), implanted for six months, and the adjustable intragastric balloon (AIB), implanted for up to 12 months. OBJECTIVE: Analyze clinical characteristics between patients receiving non-adjustable gastric balloon and the adjustable (prolonged implantation) intragastric balloon. METHODS: This was a cross-sectional study of 470 patients diagnosed as obese or overweight who had balloon implantation from October 2011 to July 2018. The associations between percentage excess weight loss versus clinical and demographic variables were calculated using the chi-squared test. Independent samples were submitted to the Student's t test to determine the quantitative variables, with a confidence interval of 95%. Calculation of excess weight was based on an estimated ideal weight that would correspond to a BMI of 24.99 kg/m2. RESULTS: A total of 414 patients completed the treatment achieving an average total body weight loss (%TBWL) of 15.4±7 with the NIB and 15.5±9.6 with the AIB. Overweight patients achieved higher excess weight loss (%EWL) values using AIBs (157.2±82.5) and obese patients did so with NIB use (56±29.7). Women achieved higher %EWL values (65.6±62.2) than men (48±27.1). Individuals who attended >4 consultations with a nutritionist (60.8%) achieved TBWL >18%. All of those P-values were <0.001. CONCLUSION: Obese individuals and women registered the greatest weight losses. Overweight patients achieved greater losses using AIB and obese patients did so using NIBs. NIB use was associated with higher EWL percentages. Nutritional accompaniment had a positive impact on the %TBWL.


Asunto(s)
Bariatria/métodos , Endoscopía/métodos , Balón Gástrico , Obesidad/cirugía , Adolescente , Adulto , Anciano , Bariatria/efectos adversos , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Resultado del Tratamiento , Pérdida de Peso , Adulto Joven
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