Background: We investigated relationships between the Pediatric Appendicitis Score (PAS) and pathological progression and disease severity in pediatric acute appendicitis. Methods: We retrospectively evaluated 72 children who underwent surgery for acute appendicitis. We divided them into groups: simple appendicitis (n = 28) or complicated appendicitis (n = 44). We compared the influence of age, body temperature, blood test findings, hospitalization period, number of complications, and PAS between the groups. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the PAS for diagnosing complicated appendicitis. A receiver operating characteristic curve was constructed to evaluate the cut-off value for diagnosing complicated appendicitis. To assess the severity of acute appendicitis, we divided the patients into groups according to that cut-off value. Results: There were statistically significant differences in the PAS between simple appendicitis and complicated appendicitis (5.8 versus 7.9). The receiver operating characteristic curve indicated a PAS cut-off value of 8. A PAS ≥ 8 had a sensitivity of 73%, a specificity of 89%, a positive predictive value of 91%, and a negative predictive value of 68%. A PAS ≥ 8 was associated with significantly longer hospitalization and more complications than a PAS < 8. Conclusions: The PAS may be associated with pathological progression and disease severity in appendicitis.
Patients with cancer are considered at high risk of acquiring coronavirus disease (COVID-19). To identify patients who are likely to be diagnosed with severe COVID-19, we analyzed the risk factors for mortality in patients admitted to the hematology department at our institute. The mortality rate of all patients was as high as 62% (21 of the 34 patients), and most of these patients had malignant malignancies. Patients before an achievement of remission had a 10.8-fold higher risk of death than those in remission. The group receiving chemotherapy with steroids had a shorter survival time and had an 8.3-fold higher risk of death than that receiving chemotherapy without steroids. During the COVID-19 pandemic, it is necessary to carefully monitor or follow-up patients with active diseases and patients receiving steroid-containing chemotherapy.
To investigate the correlation between mineral formation and enhanced expressions of some proteins using undecalcified frozen bone sections. Histological studies have revealed that some proteins, such as BMP2, BMPR1A, and Connexin 43, are expressed in and around sites of ectopic ossification. However, the relationship between the expressed proteins considered to be associated with the ossification and mineral formation in vivo is not clear. Ectonucleotide pyrophosphatase phosphodiesterase 1 (ENPP1)-mutant spinal hyperostotic TWY mice and ICR mice as controls were euthanized after calcein labeling, and undecalcified frozen sections were obtained from the middle thoracic spine. Intervertebral disc areas were examined histologically and by measuring calcein-labeled areas and areas showing immunoreactivity for BMP2, BMPR1A, and Connexin 43. Calcein-labeled areas, indicating mineralization in the ectopic mineralization sites, were significantly larger in the mutant mice than in controls. The expression of Connexin 43 was elevated in the annulus fibrosus. Increases in the calcein-labeled areas was not correlated with increases in the areas showing immunoreactivity for Connexin 43 in the annulus fibrosus. There was no statistical correlation between enhanced immunohistochemical expression and elevated calcein-labeled areas. By applying the morphometrical analysis method using undecalcified frozen sections to ENPP1-mutant mice, quantitative evaluation of the mineralization and proteins expressed in the surrounding area in the same animal became possible. K E Y W O R D S BMP2, BMPR1A, Connexin 43, ENPP1, histomorphometry, mineralization, ossification of the posterior longitudinal ligament, undecalcified frozen section
The authors developed a new method of endoscopic varix ligation (EVL) using a detachable snare and a transparent cap with rim (EVLsc). The advantages of EVLsc are as follows ; 1 ) no need for an overtube, 2) multiple varix ligation can be achieved in a relatively short time after an easy preparation, and 3) the procedure is associated with less discomfort for the patient. Between August 1995 and December 1996, 31 patients with esophageal varices were treated in Sakura National Hospital by EVL, and were randomized into two groups ; 16 with EVLsc and 15 with conventional EVL. Each patient was treated only by the randomly chosen method for the purpose of achieving complete hemostasis and/ or eradicating esophageal varices at risk for bleeding. The only major complication was pharyngeal injury due to overtube insertion in the EVL group. There were no complications in the EVLsc group. Eradication was achieved in 14 of 16 cases (87.5%) in the EVLsc group, and 13 of 15 (86.7%) in the EVL group, there being no statistically significant difference between the two groups. The EVLsc was not associated with discomfort, required no complex techniques, and satisfactory results were obtained. (Dig Endosc 1997 ; 9 : 183-1 88)
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