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OBJECTIVE: Eosinophilic esophagitis (EoE) is diagnosed with the presence of characteristic esophageal symptoms and eosinophilic infiltration of the esophageal mucosa after other causes of eosinophilia are excluded. EoE has been reported to co-occur with some allergic diseases. In this study, we evaluated the co-existence of EoE in Ear-Nose-Throat (ENT) outpatient clinic patients with allergic rhinitis (AR). PATIENTS AND METHODS: The study group consists of 67 AR patients (AR group) and the control group (CG) was formed with 53 cases with dyspepsia symptoms. Symptoms of AR and CG groups were compared in terms of endoscopic and histological findings. Moreover, in AR group, accompanying symptoms, immunoglobulin E (IgE), skin prick test (SPT) positivity, Helicobacter pylori (H. pylori) presence, endoscopic findings and biopsy results were compared between patients with EoE and those without. RESULTS: Seven of the cases with AR were diagnosed with EoE. Reflux symptoms were more common in patients with EoE (71.4%). The presence of H. pylori was similar between groups. Blood IgE levels were significantly higher among EoE patients compared to those without EoE (p = 0.003). SPT positivity was present in the 85.7% of patients with EoE and 50% of the patients without EoE (p = 0.113). Allergens were more likely to be mites Dermatophagoides farinae and Dermatophagoides pteronyssinus in patients with EoE (p = 0.042 and p = 0.034 respectively). CONCLUSIONS: The most common symptom among patients with EoE is reflux. In AR patients with EoE, serum IgE levels were higher compared to those without EoE. In AR patients with reflux symptoms, high serum IgE levels, and especially in patients whose tests are positive for allergy to mites, referral to a gastroenterologist for EoE evaluation may be recommended.
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Esofagitis Eosinofílica , Inmunoglobulina E/sangre , Rinitis Alérgica , Alérgenos , Animales , Humanos , Pruebas CutáneasRESUMEN
AIM: Rigid bronchoscopy (RB) is an invasive procedure and has its own risks. The place of virtual bronchoscopy (VB) in the treatment of patients with a clinical and radiological suspicion of foreign body aspiration was evaluated to see whether its usage can prevent rigid bronchoscopy. PATIENTS AND METHODS: The study was performed between December 2005 and May 2007 in 60 patients (35 M and 25 F) aged between 4 months and 7 years with clinical and radiographical suspicion of foreign body aspiration. Patients with radio-opaque foreign body aspiration were excluded from the study and treated directly by RB. VB was performed using 16 detector multislice computerized tomography (MDCT). If VB or clinical follow-up supported the diagnosis of foreign body, RB was performed for diagnosis and treatment. The results of RB were compared with the results of VB. RESULTS: All patients underwent VB. In 40 patients there was a suspicion of foreign body with VB. Two patients improved without RB: one had spontaneous discharge of the foreign body with coughing, and one experienced spontaneous clinical improvement. The remaining 38 patients underwent RB and a foreign body was found in the reported localization in 33. No foreign body was found with RB in 5 patients showing foreign body in VB. But we found bronchial vegetations in 2, obstructing mucus plug in 2 and external bronchial compression by neuroenteric cyst in one. In 20 patients there was no suspicion of foreign body with VB. Of these, 7 patients with presenting symptoms for more than one month underwent RB, but no foreign body was found. The 13 remaining patients were followed up clinically with improvement of symptoms. CONCLUSION: MDCT devices still require further investigation when used in pediatric surgical pathologies. Reconstructed images of VB can reveal images close to the real anatomy. In patients with a suspicion of foreign body ingestion, initial VB may help to determine the presence and exact localization of the foreign body and if negative, may reduce the number of unnecessary rigid bronchoscopies. None of the patients with negative VB had foreign bodies. Positive VB may help to shorten the operative time by providing information about the localization and size of the foreign body.
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Broncoscopía/métodos , Cuerpos Extraños/diagnóstico , Pulmón , Tomografía Computarizada por Rayos X , Obstrucción de las Vías Aéreas/diagnóstico por imagen , Obstrucción de las Vías Aéreas/etiología , Niño , Preescolar , Femenino , Cuerpos Extraños/cirugía , Humanos , Imagenología Tridimensional , Lactante , Masculino , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Post-hepatectomy liver insufficiency is one of the most serious postoperative problems and its prevention is important after major hepatic resection, especially in the cirrhotic liver. Some growth factors and cytokines appear to play important roles in liver regeneration. In the present study we have investigated the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on hepatic regeneration after 70% partial hepatectomy (PH) in cirrhotic and non-cirrhotic rats. METHODS: A rat model of liver cirrhosis was prepared using thioacetamide (TAA) (a dose of 20 mg/100 g body w, intra-peritoneally) on three days a week for 12 weeks. Adult male rats were divided into four groups:Group 1 (n=10) no cirrhosis and no GM-CSF; Group 2 (n=10) no cirrhosis and GM-CSF; Group 3 (n=10) cirrhosis and no GM-CSF; and Group 4 (n=10) cirrhosis and GM-CSF. All the rats underwent a 70% hepatectomy, and GM-CSF was administrated immediately after operation in Groups 2 and 4. On postoperative days 2 and 7, fresh samples from the remnant liver were obtained to evaluate its regenerative capacity.The liver regenerative process was estimated by DNA synthesis, using flow cytometry. RESULTS: Proliferation index (PI) of hepatocytes at 48 h was higher in Group 4 rats than Group 3 rats (p<0.05). On postoperative day 7, PI was elevated in Group 3 rats compared with Group 4 rats, but this difference was not statistically significant. In non-cirrhotic rats given GM-CSF, PI was increased compared with Group 1 rats at day 2 (p<0.05), but not at day 7. CONCLUSIONS: The findings suggest that the proliferative capacity of liver cells is impaired and delayed after 70% PH in cirrhotic rat liver. GM-CSF administration might enhance the liver PI in both normal and TAA-induced cirrhotic rats.
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Hemangiopericytoma is an uncommon mesenchymal tumor originating from pericytes. We describe the clinical and morphologic features in a case of intrathoracic extrapulmonary giant hemangiopericytoma. The tumor was radically removed, and the microscopy report was benign hemangiopericytoma. Because of the high risk of local recurrence, long-term follow-up is important in such patients.
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Hemangiopericitoma/diagnóstico por imagen , Hemangiopericitoma/cirugía , Neoplasias Torácicas/diagnóstico por imagen , Neoplasias Torácicas/cirugía , Adulto , Hemangiopericitoma/patología , Humanos , Masculino , Radiografía , Neoplasias Torácicas/patología , ToracotomíaRESUMEN
Most of the foreign bodies swallowed by children pass the entire gastrointestinal tract without any complication. Neonatal intestinal foreign bodies are extremely rare. A newborn with a small bowel obstruction caused by a fresh grape is reported.
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Cuerpos Extraños/complicaciones , Íleon , Obstrucción Intestinal/etiología , Rosales , Humanos , Recién Nacido , MasculinoRESUMEN
Among the chromosomal regions commonly undergoing deletions in breast tumors is 11q23.1. The genes that are targets for loss of heterozygosity (LOH) in this region is not yet established. One of the candidate genes located in this region is ATM, responsible for the rare autosomal recessive disorder ataxia-telangiectasia (A-T). Interestingly, A-T heterozygotes may have an increased risk of cancer, in particular breast cancer, although this is still controversial. A common assumption has been that the target for the LOH at 11q23.1 in breast carcinoma is the ATM gene, but the area studied has been too large, the density of markers too low, and the number of tumors studied has been too small to draw any firm conclusions. The present study is a multicenter study including 918 breast cancer patients with clinical information and survival data available for most of them. Primary breast tumors were investigated for LOH using a high density of microsatellite markers spanning approximately 6 Mb around the ATM gene. Survival analyses showed that there are most likely one or more candidate genes in a 3-4 Mb region between the markers D11S1819 and D11S927 including the ATM gene. Cancer-specific survival was significantly reduced in patients whose tumors exhibited LOH of markers D11S2179 (within the ATM gene), D11S1778, D11S1294, and D11S1818. The highest survival hazard ratios were 1.8(C11.2-2.8, P = 0.010) and 2.1 (C11.4-3.0, P = 0.0004) for markers D11S2179 and D11S1818, respectively. One or more of these markers are therefore most likely to be located close to or within genes associated with breast cancer survival.
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Neoplasias de la Mama/genética , Neoplasias de la Mama/mortalidad , Cromosomas Humanos Par 11/genética , Pérdida de Heterocigocidad/genética , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/genética , Carcinoma Ductal de Mama/mortalidad , Carcinoma Ductal de Mama/patología , Mapeo Cromosómico , Femenino , Marcadores Genéticos , Humanos , Persona de Mediana Edad , Tasa de Supervivencia , Translocación GenéticaRESUMEN
We presented a case of neonatal hypopharyngeal perforation resulting from extraction of a breech presentation, with symptoms of regurgitation at all feedings and excessive salivation. Inability to pass a nasogastric tube suggested the diagnosis of esophageal atresia. The diagnosis and treatment of this condition is discussed, and the literature is reviewed.