RESUMEN
We described a patient with adenocarcinoma of the stomach combined with choriocarcinoma and neuroendocrine cell carcinoma. An 85-year-old man visited our hospital because of appetite loss. Gastric fiberscopy revealed a large tumor occupying the cardial region and anterior wall of the gastric body. The patient underwent total gastrectomy with lymphnode dissection and partial resection of the liver. Choriocarcinoma, small cell carcinoma and tubular adenocarcinoma existed in the gastric tumor. The choriocarcinomatous foci contained cells positive for beta-subunit of human chorionic gonadotropin (B-hCG) and human placental lactogen mainly in syncytiotrophoblastic cells. The small cell carcinomatous foci contained cells positive for synaptophysin, neuron-specific enolase (NSE), and chromogranin A. The prognosis for gastric adenocarcinoma with choriocarcinoma and neuroendocrine cell carcinoma is exceedingly poor. This patient died about 2 mo after the first complaint from hepatic failure. This is the first reported case of gastric cancer with these three pathological features.
Asunto(s)
Adenocarcinoma/patología , Carcinoma Neuroendocrino/patología , Coriocarcinoma/patología , Neoplasias Hepáticas/secundario , Neoplasias Gástricas/patología , Adenocarcinoma/cirugía , Anciano de 80 o más Años , Carcinoma Neuroendocrino/cirugía , Coriocarcinoma/cirugía , Resultado Fatal , Gastrectomía , Hepatectomía , Humanos , Inmunohistoquímica , Fallo Hepático/etiología , Neoplasias Hepáticas/complicaciones , Escisión del Ganglio Linfático , Masculino , Neoplasias Gástricas/cirugíaRESUMEN
The bean aphid, Megoura crassicauda Mordvilko, feeds selectively on plants belonging to the genus Vicia (Fabaceae). However, it never infests the tiny vetch, V. hirsuta (L.) Gray. The aphid appeared to discriminate between host and non-host plants by tasting specific chemicals during penetration of its stylet into the plant tissues. The aphid, after being stimulated by specific probing stimulants, deposited characteristic proteinous stylet sheaths through a parafilm membrane, which has one side in contact with an extract solution of Vicia angustifolia. However, an addition of a V. hirsuta extract to the medium strongly inhibited the salivary sheath formation. A specific probing deterrent was isolated from a V. hirsuta extract by monitoring the inhibitory effect, and identified as (E)-2-methyl-2-butene-1,4-diol 4-O-beta-d-glucopyranoside. A mixture of the glycoside and the stimulatory V. angustifolia fraction in the same equivalency found in plants significantly decreased the probing activity in M. crassicauda. Since the stylet insertion process is a crucial step for the aphid's settlement on a plant, the glycoside seems to act as an effective chemical barrier for V. hirsuta.
Asunto(s)
Áfidos/efectos de los fármacos , Áfidos/fisiología , Glucósidos/farmacología , Terpenos/farmacología , Vicia/química , Vicia/parasitología , Animales , Conducta Alimentaria/efectos de los fármacos , Conducta Alimentaria/fisiología , Preferencias Alimentarias/efectos de los fármacos , Glucósidos/química , Interacciones Huésped-Parásitos , Espectroscopía de Resonancia Magnética , Estructura Molecular , Extractos Vegetales/química , Terpenos/químicaRESUMEN
BACKGROUND: Thymidylate synthase (TS) and methylenetetrahydrofolate reductase (MTHFR) play important roles in folate metabolism. Previous studies have suggested that TS expression is a prognostic factor in non-small cell lung cancer (NSCLC). The TS gene has a variable number of tandem repeats (VNTR) and single nucleotide polymorphism (SNP) in the 5'-untranslated region, which are associated with TS expression. This association suggests that the TS polymorphism is a novel prognostic factor in NSCLC. In the present study, multiple genetic polymorphisms, TS VNTR, TS SNP and MTHFR C677T, were analyzed in NSCLC and compared with clinicopathological features and patients' prognoses. MATERIALS AND METHODS: Genomic DNA was isolated from 294 surgically resected NSCLC tissues. The genotypes were determined by PCR and PCR-RFLP. The TS VNTR and SNP were combined, followed by functional stratification of H/H (3G/3G), H/L (2R/3G, 3G/3C) and L/L (2R/2R, 2R/3C, 3C/3C). Patients' prognoses were compared with TS and/or MTHFR genotype groups. TS was divided into the H- (H/H, H/L) and L-groups (L/L) according to functional stratification and MTHFR C677T was divided into C- (C/C) and T-groups (C/T, T/T). RESULTS: TS VNTR, the SNP and the TS functional type, along with MTHFR C677T, showed no significant association with clinicopathological factors. There were no differences in prognosis between each genotype or functional group when the TS and MTHFR groups were considered separately. However, we found a unique association between prognosis and the TS functional group in stage I NSCLC, taking both TS and MTHFR groups into consideration. The patients in the TS L-group survived longer than those in the H-group when limited to stage I and MTHFR C-group (p = 0.086). This relationship between the TS genotype group and prognosis was statistically significant in the subgroup of stage IB and MTHFR C-group (p = 0.030). In contrast, the patients in the TS H-group survived longer than those in the L-group when limited to stage I and MTHFR T-group (p = 0.052). CONCLUSION: The TS and MTHFR genotypes can be prognostic factors in NSCLC, where gene-gene interactions between the genotypes may occur. Further validation and investigation of the involvement of genotypes of folate metabolizing enzymes in the prognosis of NSCLC patients are required.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/enzimología , Neoplasias Pulmonares/enzimología , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Timidilato Sintasa/genética , Anciano , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/patología , ADN de Neoplasias/genética , Femenino , Genotipo , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Polimorfismo Genético , Polimorfismo de Nucleótido Simple , PronósticoRESUMEN
PURPOSE: Checking bowel viability is difficult but important during surgery for ischemic bowel disease or jejunal autotransplantation. We investigated the effectiveness of two-wavelength near-infrared spectroscopy (NIRS) to quantify tissue oxygen saturation (StO(2)), which can affect bowel viability during reconstruction of the cervical esophagus using a free jejunal graft. METHODS: Free jejunal autotransplantation was performed after resection of the hypopharynx, larynx, and cervical esophagus in 12 pigs. The arterial blood flow and StO(2) of the graft were measured before harvesting the graft and after reperfusion. We analyzed the measurement site of the graft and the anastomotic method as possible factors influencing StO(2). We also examined the relationship between the blood flow and StO(2) of the autograft. RESULTS: The StO(2) at the distal site of the graft was significantly lower than that at the midpoint of the graft (P < 0.05). There was a correlation between the blood flow of the graft artery, measured by the transonic volume flowmeter, and the StO(2) of the graft, measured by NIRS. CONCLUSIONS: Tissue oxygen saturation of the free jejunal graft can be safely and reliably measured with two-wavelength NIRS. Therefore, NIRS is a promising new method for evaluating the viability of the gastrointestinal tract.
Asunto(s)
Yeyuno/irrigación sanguínea , Yeyuno/trasplante , Consumo de Oxígeno/fisiología , Procedimientos de Cirugía Plástica/métodos , Espectroscopía Infrarroja Corta , Animales , Modelos Animales de Enfermedad , Esofagectomía/efectos adversos , Esofagectomía/métodos , Femenino , Hemodinámica/fisiología , Cuidados Posoperatorios/métodos , Probabilidad , Análisis de Regresión , Sensibilidad y Especificidad , Porcinos , Trasplante AutólogoRESUMEN
This report presents a case of lung carcinoid tumor that showed a growth pattern similar to that of a superior sulcus tumor (SST). A 63-year-old man was referred to our hospital and was diagnosed to have a stage IV (T3N2M1) SST on his right side. After three cycles of induction therapy with MVP (methotrexate/vinblastine/prednisolone) and a total dose of 45 Gy radiation given to the chest lesion, the clinical stage was restaged down to IIB (T3N0M0). A salvage operation was performed (upper lobectomy plus chest wall combined resection including the first to fourth ribs) followed by targeting adjuvant brachytherapy. The results of a histologic examination of the resected specimen revealed the tumor to be an atypical carcinoid tumor.
Asunto(s)
Tumor Carcinoide/patología , Neoplasias Pulmonares/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Braquiterapia , Tumor Carcinoide/tratamiento farmacológico , Tumor Carcinoide/radioterapia , Terapia Combinada , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/radioterapia , Masculino , Persona de Mediana Edad , Neumonectomía , Radioterapia Adyuvante , Terapia RecuperativaRESUMEN
STUDY OBJECTIVE: We evaluated the expression of vascular endothelial growth factor (VEGF) in airways in patients with lung cancer. METHODS: BAL fluid (BALF) and plasma samples were obtained from 41 patients with primary lung carcinomas and 7 patients with noncancerous diseases, and were analyzed for VEGF by an enzyme-linked immunosorbent assay. After standardization with the albumin protein levels, the relative intensity (VEGF index) was determined as the ratio of VEGF expression on the disease side to that on the healthy side. RESULTS: In all cases, VEGF concentrations in BALF were greater than those in plasma samples. On the healthy side, the mean value of VEGF in BALF was significantly greater in lung cancer patients than in patients with noncancerous diseases (p = 0.0470). While age, gender, location of cancer (right vs left), histology (adenocarcinoma vs squamous cell carcinoma), and T factor (T1/2 vs T3/4) did not affect the VEGF levels in BALF, the VEGF index was inversely associated with distant metastasis and nodal involvement. The VEGF index of patients in stage I was significantly greater than that of patients in stage IV (p = 0.0308). CONCLUSIONS: The VEGF expression in airways is likely to reflect the response to tumor angiogenesis on the host side. Of direct clinical relevance is that the assessment of VEGF concentrations in airways may provide information concerning the dependency of tumor angiogenesis on VEGF, which is variable according to tumor progression.