RESUMO
THE RISK FACTORS, clinical manifestation, and preventive measures of Horner syndrome (HS) caused by internal jugular vein (IJV) catheterization were explored. Electronic databases were searched to identify all case reports of HS caused by IJV catheterization. Two authors independently extracted literature characteristics, IJV catheterization method, clinical manifestations, and prognosis data. Twenty case reports (22 patients in total) were included, 18 of which were written in English and the other 2 in Chinese. Patients were between 19 months to 65 years old, and clinical manifestations included ptosis (nâ¯=â¯22), miosis (nâ¯=â¯21), anhidrosis (nâ¯=â¯8), enophthalmos (nâ¯=â¯3), and hoarseness (nâ¯=â¯1). Onset of HS manifestation ranged from a few hours to 19 days after the procedure. Eight patients with ptosis, 6 patients with miosis, and 1 patient with hoarseness recovered during follow-up. Of the 22 patients, 8 underwent more than 1 attempt of IJV catheterization. Six patients experienced accidental carotid artery puncture or hematoma formation during or after IJV catheterization. Ultrasound guidance was applied in 4 patients and anatomic landmark technique was used in the other 18 patients. The left IJV was catheterized in 3 patients, and the right IJV was catheterized in 19 patients. Repeated attempts of puncture, anatomic landmark technique, accidental carotid artery puncture, or hematoma formation may increase the possibility of HS. Ptosis and miosis are the most common manifestations of HS caused by IJV catheterization.
Assuntos
Cateterismo Venoso Central , Síndrome de Horner , Artérias Carótidas/diagnóstico por imagem , Cateterismo Venoso Central/efeitos adversos , Síndrome de Horner/diagnóstico , Síndrome de Horner/etiologia , Humanos , Veias Jugulares/diagnóstico por imagem , UltrassonografiaRESUMO
The present study aimed to explore the genetic changes involved in the liver hepatocellular carcinoma (HCC) development. The RNA-Seq data of 212 HCC tissue samples and 50 normal tissue samples were downloaded using TCGA-Assembler. A total of 4 subgroups were obtained, and 4167, 6279, 5379, and 2548 DEGs were screened in group 1, group 2, group 3, and group 4, respectively. Enrichment analysis found that cell cycle, metabolism, and translation related terms were the most significantly changed functions and pathways. There were 454 genes (1114 pairs), 803 genes (722 pairs), and 788 genes (724 pairs), separately interacted in the condition specific PPI network of group 1, 2, 3, and 4, with MMP2, ATNXN1, F2, and HDAC1 as the hub genes. What's more, using these genes, total 7, 20, 198, and 1 subtype related miRNAs; 35, 50, 47, and 17 subtype related TFs; 1, 1, 0, and 2 subtype related drugs were screened in group 1, 2, 3, and 4, respectively. The integrated biological analysis on RNA-Seq data provided substantial of bio-molecular related to the HCC development. miR-147b, SP1, and Riboflavin were the subtype-related regulator/drug for HCC. The study about the big data of HCC RNA-Seq data reveals the intrinsic gene expression pattern of the tumor, which provides a novel perspective to understand the heterogeneity of pathogenesis in HCC tumorigenesis.
Assuntos
Carcinoma Hepatocelular/genética , Neoplasias Hepáticas/genética , RNA Neoplásico/genética , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Humanos , Análise de Sequência de RNARESUMO
OBJECTIVE: To investigate the long-term therapeutic effect of autologous hematopoietic stem cell transplantation in patients with End-stage Liver Disease (ESLD). PATIENTS AND METHODS: Forty-eight ESLD patients underwent autologous CD34+ stem cell transplantation were retrospectively reviewed. Changes in clinical and biochemical data, complications, and quality of life were monitored at 3, 6, 12, 36, and 60 months following the stem cell transplantation. Liver biopsies were obtained for histopathological analysis using Ishak system. RESULTS: Marked improvement in clinical and biochemical data was observed during the long-term follow-up. Serum albumin was significantly increased (p<0.001), while total serum bilirubin, prothrombin time (PT), and international normalized ratio (INR) were all significantly decreased (p<0.001). Ishak inflammation and fibrosis scores were significantly decreased with the increased time (p<0.001). The number of patients with ascites, model of end-stage liver disease (MELD) score, Child-Pugh class, and indocyanine green (ICG) score were all markedly reduced with increased time. Meanwhile, the quality of life score of the patients was significantly increased (p<0.001). Six patients died during the 5-years follow-up, and complications occurred in 17 patients. The incidence of complications was significantly associated with mortality of the patients (p<0.05). CONCLUSIONS: The study provided the evidence that autologous CD34+ stem cell transplantation could offer a long-term therapeutic benefit to patients with ESLD. The complications occurred during the process was significantly associated with survival of the patients. Future studies on a large cohort of patients are needed to confirm the long-term effect of stem cell therapy on ESLD.
Assuntos
Doença Hepática Terminal/terapia , Transplante de Células-Tronco Hematopoéticas , Doença Hepática Terminal/fisiopatologia , Doença Hepática Terminal/psicologia , Seguimentos , Humanos , Testes de Função Hepática , Transplante de Fígado , Qualidade de Vida , Estudos RetrospectivosRESUMO
Noradrenaline and adrenaline are neurotransmitters of the sympathetic nervous system that interact with various adrenergic receptor (ADR) subtypes, and this regulates the basal metabolic rate, thermogenesis and efficiency of energy utilization. We examined a possible role of the gene coding for ADRA1A receptor in weight gain in schizophrenia subjects exposed to antipsychotics. A total of 401 schizophrenia in-patients treated with antipsychotics for >2 years were recruited and a final 394 DNA samples were genotyped. Their body mass indexes (BMIs) were recorded for 12 months and parameterized to be correlated in regression. Among the 58 single-nucleotide polymorphisms (SNPs) genotyped, 44 valid SNPs, which had minor allele frequency > or =0.03, were analyzed in statistics. Linear regression model with age, gender, diabetes, use of typical antipsychotics and use of atypical antipsychotics as covariates, with or without gender interaction, showed evidence of associations between the ADRA1A gene and BMI. Most of the SNPs associated with BMI are located in the promoter and intron regions, and being female appeared to enhance the gene effect. Our study suggests that the ADRA1A gene is involved in weight gain among schizophrenia patients treated with antipsychotics. Further molecular dissection of the ADRA1A gene warrants better understanding on weight gain mechanisms in schizophrenia.
Assuntos
Antipsicóticos/uso terapêutico , Índice de Massa Corporal , Receptores Adrenérgicos alfa 1/genética , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Sequência de Bases , Feminino , Humanos , Desequilíbrio de Ligação , Masculino , Pessoa de Meia-Idade , Obesidade/etiologia , Polimorfismo de Nucleotídeo Único , Estudos Prospectivos , Esquizofrenia/complicações , Aumento de Peso/genéticaRESUMO
AIMS: To investigate the in situ expression profile of glucocorticoid receptor (GR) in normal and carcinomatous tissues of the human digestive system. METHODS AND RESULTS: Specimens from 306 carcinomas of the human digestive tract were assayed for the expression of GR by immunohistochemistry. GR expression was strong in oesophageal squamous epithelia, pancreatic islet cells and hepatocytes, but generally weak or negative in non-squamous epithelia. Consistently, GR expression was found in a high percentage of oesophageal squamous cell carcinomas (SCC) (98.1%) and hepatocellular carcinomas (HCC) (92.9%), but rarely in gastric adenocarcinomas (7.4%) and not at all in colorectal adenocarcinomas (0%). Dexamethasone (DEX) was found to confer chemoresistance in oesophageal SCC and HCC cells, suggesting that GR expression may be biologically important in some GR-expressing carcinomas. CONCLUSIONS: Distribution of GR expression is markedly diverse among tissues of the human digestive system. The general lack of GR in adenocarcinomas contrasts with the high percentage of SCCs and HCCs expressing GR, and, along with the generation of chemoresistance by DEX, warrants prospective study of the effects of steroids on these cancers.
Assuntos
Adenocarcinoma/metabolismo , Biomarcadores Tumorais/metabolismo , Carcinoma Basoescamoso/metabolismo , Carcinoma de Células Escamosas/metabolismo , Neoplasias do Sistema Digestório/metabolismo , Receptores de Glucocorticoides/metabolismo , Adenocarcinoma/mortalidade , Adenocarcinoma/patologia , Ampola Hepatopancreática/metabolismo , Ampola Hepatopancreática/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Ductos Biliares Intra-Hepáticos/metabolismo , Ductos Biliares Intra-Hepáticos/patologia , Biomarcadores Tumorais/genética , Carcinoma Basoescamoso/mortalidade , Carcinoma Basoescamoso/patologia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Colangiocarcinoma/metabolismo , Colangiocarcinoma/mortalidade , Colangiocarcinoma/patologia , Neoplasias do Ducto Colédoco/metabolismo , Neoplasias do Ducto Colédoco/mortalidade , Neoplasias do Ducto Colédoco/patologia , DNA de Neoplasias/análise , Dexametasona/farmacologia , Neoplasias do Sistema Digestório/mortalidade , Neoplasias do Sistema Digestório/patologia , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Humanos , Técnicas Imunoenzimáticas , Receptores de Glucocorticoides/genética , Análise de Sequência de DNA , Taxa de SobrevidaRESUMO
Metaplastic carcinoma of the breast (MCB) is a poorly understood subtype of breast cancer. It is generally characterized by the coexistence of ductal carcinomatous and transdifferentiated sarcomatous components, but the underlying molecular alterations, possibly related to epithelial-mesenchymal transition (EMT), remain elusive. We performed transcriptional profiling using half-a-genome oligonucleotide microarrays to elucidate genetic profiles of MCBs and their differences to those of ductal carcinoma of breasts (DCBs) using discarded specimens of four MCBs and 34 DCBs. Unsupervised clustering disclosed distinctive expression profiles between MCBs and DCBs. Supervised analysis identified gene signatures discriminating MCBs from DCBs and between MCB subclasses. Notably, many of the discriminator genes were associated with downregulation of epithelial phenotypes and with synthesis, remodeling and adhesion of extracellular matrix, with some of them have known or inferred roles related to EMT. Importantly, several of the discriminator genes were upregulated in a mutant Snail-transfected MCF7 cell known to exhibit features of EMT, thereby indicating a crucial role for EMT in the pathogenesis of MCBs. Finally, the identification of SPARC and vimentin as poor prognostic factors reinforced the role of EMT in cancer progression. These data advance our understanding of MCB and offer clues to the molecular alterations underlying EMT.
Assuntos
Neoplasias da Mama/genética , Carcinoma Ductal de Mama/genética , Transformação Celular Neoplásica , Epitélio/patologia , Perfilação da Expressão Gênica , Mesoderma/patologia , Sarcoma/genética , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Linhagem Celular Tumoral , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Família Multigênica , Análise de Sequência com Séries de Oligonucleotídeos , Prognóstico , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Sarcoma/patologia , Fatores de Transcrição da Família Snail , Fatores de Transcrição/fisiologiaRESUMO
Glucocorticoid receptor (GR) is a steroid hormone receptor that has been shown to play important roles in mammary development and differentiation, and has been implicated in breast tumourigenesis, but its precise biological significance in mammary pathophysiology remains unclear. In order to generate a comprehensive expression profile for GR in normal versus neoplastic breast tissues, GR expression was investigated in situ in 400 human breast tissue samples, comprising normal tissue and a range of benign, pre-invasive, and invasive lesions, using immunohistochemical assays. The novel expression of GR in myoepithelium, not observed in luminal epithelium, not only demonstrates expression patterns exclusive to the alpha form of oestrogen receptor and progesterone receptor and suggests distinctive functions between GR and these two important steroid hormone receptors in the breast, but may also indicate unique physiological and perhaps pathological roles for the myoepithelium in mediating the effects of glucocorticoid hormones in the breast. The strong expression of GR in metaplastic carcinomas (94.4%) and malignant phyllodes tumours (92.3%) suggests a pathogenetic role for GR, and implies that targeting GR in these tumours may have potential therapeutic application. However, studies on the roles of GR in mammary carcinogenesis should be interpreted with great caution, based on the lack of GR expression in cancer cells in the great majority (98.2%) of non-metaplastic carcinomas, which has gone unnoticed in previous studies. This marked discrepancy warrants a re-examination of the biological roles of GR in the pathophysiology of breast malignancy. The lack of methylation in the promoter region of the GR gene in all 118 non-metaplastic carcinomas, as demonstrated by methylation-specific PCR and bisulphite DNA sequencing analysis, indicates that methylation is less likely to play a role in the reduction of GR expression in non-metaplastic carcinoma of the breast.
Assuntos
Neoplasias da Mama/metabolismo , Mama/metabolismo , Receptores de Glucocorticoides/metabolismo , Sequência de Bases , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/genética , Carcinoma Intraductal não Infiltrante/metabolismo , Carcinoma Lobular/genética , Carcinoma Lobular/metabolismo , Metilação de DNA , DNA de Neoplasias/genética , Células Epiteliais/metabolismo , Feminino , Expressão Gênica , Humanos , Técnicas Imunoenzimáticas , Dados de Sequência Molecular , Invasividade Neoplásica , Tumor Filoide/genética , Tumor Filoide/metabolismo , Regiões Promotoras Genéticas/genéticaRESUMO
An 82-year-old man developed progressive weakness of both legs 1 month prior to admission. He reported no previous history of trauma. Spine radiography revealed marked thoracic and lumbar spondylosis. Magnetic resonance imaging of the spine disclosed segmental stenosis with cord compression at T10-11 due to an extradural soft tissue lesion. Based on a diagnosis of thoracic spondylosis with cord compression, decompression laminectomy was performed. During the operation, fragile chalky-white material was noted over the epidural space, compressing the thoracic cord. The granular lesion was meticulously removed until the dura was identified and the cord was decompressed. Histologic examination of the surgical specimen revealed deposits of needle-like crystals that were consistent with monosodium urate, demonstrating that a gouty lesion of the thoracic spine had caused the cord compression. The patient had previously experienced several attacks of gouty arthritis of his feet. The postoperative serum uric acid concentration was 8.5 mg/dL. After surgery, he was treated with benzbromarone 100 mg per day. He was able to walk 3 months after the operation. A high index of suspicion of gouty involvement of the spine is necessary in patients with gout. Surgical decompression followed by regular administration of antigout drugs can provide satisfactory results.
Assuntos
Gota/complicações , Compressão da Medula Espinal/etiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Compressão da Medula Espinal/diagnóstico , Compressão da Medula Espinal/cirurgia , Vértebras TorácicasAssuntos
Neoplasias Mandibulares/cirurgia , Osteossarcoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , PrognósticoRESUMO
Osteosarcoma generally has a poor prognosis. Osteosarcoma of the mandible is rare and may have a less aggressive course. Three patients with osteosarcoma of the mandible were treated during the past 19 years at National Taiwan University Hospital. All were women, with an average age of 49 years. The patients were treated with radical excision of the tumor, with either pre- or postoperative radiotherapy. None of the patients received chemotherapy. Reconstruction with iliac osteocutaneous free flap, fibular osteoseptocutaneous free flap, or Leibinger reconstruction plate was performed to repair the facial defects resulting from tumor resection or radiation-induced necrosis. The three patients were alive and without evidence of recurrence at the time of writing, with follow-up periods ranging from 7 to 18 years. All had acceptable facial contour and satisfactory oromandibular function after reconstruction. These results support the effectiveness of wide resection with radiotherapy for treatment of mandibular osteosarcoma. With the availability of microsurgical reconstruction and biocompatible reconstruction plates, we advocate extensive ablation of this tumor. Long-term survival, good functional recovery, and acceptable facial contour can be expected.
Assuntos
Neoplasias Mandibulares/cirurgia , Osteossarcoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Mandibulares/diagnóstico , Osteossarcoma/diagnóstico , SobreviventesRESUMO
A four month-old male infant was noted to have had severe corneal opacity since birth. Buphthalmos, increased intraocular pressure and corneal opacity with neovascularization were noted during physical examination. There was neither dysmorphic face nor hirsutism and the liver and spleen were impalpable. In addition, hypotonia, poor head control, and absence of Moro and grasping reflexes were also noted. There was no evidence of congenital infection by TORCH study. Tests of both urine and plasma amino acids were within normal limits. However, excessive urinary excretion of heparan sulfate was detected by thin-layer chromatography. Corneal transplantation was performed at 6 months old. Histopathological examination of the corneal button showed homogeneous thickening of Bowmen's membrane and intracytoplasmic pinkish substances in corneal stroma. The Alcian blue stain was positive, which was consistent with mucopolysaccharidosis of cornea. The manifestation of this case may be a clinical variant of Sanfilippo's syndrome (Mucopolysaccharidosis type III).
Assuntos
Opacidade da Córnea/etiologia , Glaucoma/congênito , Heparitina Sulfato/urina , Humanos , Lactente , Masculino , Mucopolissacaridose III/complicaçõesRESUMO
Since 1994 an endemic of chronic obstructive pulmonary disease (COPD) has developed in Taiwan after a prevalent use of a body-weight-reducing vegetable, Sauropus androgynus (SA). All conventional treatments for COPD, including steroids and bronchodilators, had been ineffective. Studies of limited lung biopsy specimens from these patients revealed bronchiolitis obliterans. A few patients died, but many developed protracted chronic respiratory failure. Because of the chronic debilitation and ineffective conventional treatments, single lung transplants were performed as the last resort in four patients. The excised lungs revealed focal fibromuscular sclerosis and obliteration of bronchial arteries in the wall of large bronchi 4 to 5 mm in diameter with segmental necrosis of bronchi 2 to 4 mm in diameter. Bronchi immediately proximal to the necrotic zone showed fibrosis and atrophy of cartilage, bronchial glands, and smooth muscle cells; bronchioles immediately distal showed obstruction or dilatation. Most bronchi larger than 5 mm, pulmonary vessels, small bronchioles, and alveoli were little altered. The pathologic changes were most consistent with segmental ischemic necrosis of bronchi at the water-shed zone of bronchial and pulmonary circulation. The specific etiologic agent and detail of pathogenesis of this SA-related COPD needs further investigation.
Assuntos
Brônquios/efeitos dos fármacos , Brônquios/patologia , Extratos Vegetais/intoxicação , Verduras/química , Redução de Peso , Adulto , Feminino , Humanos , Pneumopatias Obstrutivas/induzido quimicamente , Pneumopatias Obstrutivas/patologia , Pessoa de Meia-Idade , Necrose , Intoxicação por Plantas/complicações , Taiwan , Fatores de Tempo , Verduras/intoxicaçãoRESUMO
Seven relapsed and/or refractory acute promyelocytic leukaemia patients were treated by arsenic trioxide (As2O3). Four patients (4/7, 57%) achieved complete remission after one to three cycles of treatment and the most common acute side-effect was fluid retention (in six patients, 86%), including weight gains and pleuro-pericardial effusions. Evident polyneuropathy compatible with chronic arsenic toxicity was noted in two of the three patients who received As2O3 maintenance therapy and one of them had marked distal muscular atrophy. We suggest that As2O3 may be a useful salvage therapy for relapsed and refractory APL patients, but the acute or chronic arsenic toxicity should be carefully monitored.
Assuntos
Antineoplásicos/efeitos adversos , Arsenicais/efeitos adversos , Leucemia Promielocítica Aguda/tratamento farmacológico , Óxidos/efeitos adversos , Doença Aguda , Trióxido de Arsênio , Doença Crônica , Humanos , RecidivaRESUMO
At National Taiwan University Hospital, from 1986 to 1996, autopsies were performed on 16 patients with acquired immunodeficiency syndrome. There were 15 men and 1 woman. Fourteen of these male patients had contracted the disease as a result of sexual practice, among which 9 were homosexual, 1 was bisexual and 4 were heterosexual. One of the patients had become infected by sharing a syringe during intravenous drug use. The female was a sex worker. Among these patients, only 2 had been tested for HIV before developing AIDS. On autopsy, lymphoid depletion and thymus atrophy were found in all patients. Testicular atrophy was noted in all the male patients. Three patients died of malignant lymphoma. Twelve patients died of opportunistic infections and 1 committed suicide. The initial opportunistic infection was usually oral candidiasis. Pneumocystis carinii pneumonia (PCP) was the most common opportunistic infection developed in the early stage while cytomegalovirus (CMV) infection was the most common one found in the late stage. Mycobacterium infection had developed in 8 patients. Six patients had disseminated Kaposi's sarcoma (KS) and 4 of them were homosexual. In 4 patients, biopsy specimens were proved to have KS associated viral (HHV-8) genome. Malignant lymphoma was found in 4 cases, all were of high grade B cell type. Epstein-Barr virus (EBV) encoding small RNA (EBER1) was demonstrated in all the lymphomas. In conclusion, (1) the prevalence of tuberculosis (38%) in patients with AIDS in Taiwan is high; (2) the most common opportunistic infections in this series are candidiasis, PCP and CMV infections; (3) the incidence of AIDS related non-Hodgkin's lymphoma in Taiwan has increased since 1995.
Assuntos
Síndrome da Imunodeficiência Adquirida/patologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Adulto , Autopsia , Candidíase/patologia , Infecções por Citomegalovirus/patologia , Feminino , Humanos , Linfoma Relacionado a AIDS/patologia , Masculino , Pessoa de Meia-Idade , Pneumonia por Pneumocystis/patologia , Sarcoma de Kaposi/patologia , TaiwanRESUMO
We report two cases where high-resolution computed tomography (HRCT) assisted in the diagnosis of a patient with lymphangioleiomyomatosis and a patient with pulmonary tuberous sclerosis. HRCT was used in both cases where the chest radiographs and conventional computed tomographic scans appeared relatively normal but the conditions were strongly suspected.
Assuntos
Leiomiomatose/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Linfangioleiomiomatose/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Esclerose Tuberosa/diagnóstico por imagem , Adulto , Feminino , Humanos , Aumento da Imagem/métodos , Leiomiomatose/complicações , Leiomiomatose/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Linfangioleiomiomatose/complicações , Linfangioleiomiomatose/patologia , Esclerose Tuberosa/complicações , Esclerose Tuberosa/patologiaRESUMO
A 25-year-old man suffered from a sudden severe headache followed by loss of consciousness on 29 March 1993. Cranial computed tomography was performed at a local hospital and arteriovenous malformation was suspected. An open biopsy was performed on 7 July 1993 and malignant melanoma was discovered. Radiotherapy was given in August 1993. The patient's condition continued to deteriorate and he died of bronchopneumonia about 7 months after the initial diagnosis. Autopsy confirmed primary leptomeningeal melanoma.
Assuntos
Melanoma/patologia , Neoplasias Meníngeas/patologia , Adulto , Humanos , Masculino , Meninges/patologiaRESUMO
This study investigated the clinico-pathologic correlation of tumor angiogenesis in non-small-cell lung cancers. Formalin-fixed, paraffin-embedded surgical specimens of 55 consecutive patients with primary non-small-cell lung cancers were examined. Included were 26 squamous cell carcinomas and 29 adenocarcinomas. Twenty-five patients had stage I disease, eight patients had stage II disease, and 22 patients had stage IIIA or IIIB disease. Among them, 28 had nodal metastasis and 27 did not. The microvessel was demonstrated by immunocytochemical staining for factor VIII and platelet endothelial cell adhesion molecules (PECAM-1). The microvessels in the areas of highest neovascularization were counted under light microscopy in 200x field by two independent observers without knowledge of clinical information. At least three separate fields were counted for each specimen. The Mann-Whitney U test was used for statistical analysis. The microvessel counts in adenocarcinoma were significantly higher than in the squamous cell carcinoma (54.4 +/- 35.65 versus 26.16 +/- 20.46 in factor VIII staining and 80.52 +/- 48.42 versus 40.04 +/- 32.33 in PECAM-1 staining; p < 0.001). The microvessel counts in patients with Stages I-II disease were significantly lower than that of stages IIIA-IIIB disease (23.63 +/- 16.21 versus 65.36 +/- 31.92 in factor VIII staining and 41.85 +/- 36.76 versus 93.00 +/- 43.08 in PECAM-1; p < 0.001). Patients with nodal metastasis had higher microvessel density than those without nodal metastasis (56.67 +/- 35.55 versus 23.44 +/- 15.77 in factor VIII staining and 86.89 +/- 46.46 versus 36.30 +/- 25.83 in PECAM-1 staining; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/patologia , Adenocarcinoma/irrigação sanguínea , Adenocarcinoma/patologia , Antígenos de Diferenciação Mielomonocítica/análise , Carcinoma Pulmonar de Células não Pequenas/irrigação sanguínea , Carcinoma Pulmonar de Células não Pequenas/secundário , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/patologia , Moléculas de Adesão Celular/análise , Endotélio Vascular/patologia , Fator VIII/análise , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/irrigação sanguínea , Masculino , Microcirculação/química , Microcirculação/patologia , Pessoa de Meia-Idade , Neovascularização Patológica , Molécula-1 de Adesão Celular Endotelial a PlaquetasRESUMO
Two patients with fulminant amebic colitis with colon perforation and concomitant liver abscess were collected over the last 5 years. One patient underwent emergency laparotomy to treat amebic cecal perforation. Diverted ileostomy saved his life. The ileostomy was successfully reversed 6 months later. The other patient underwent 4 laparotomies with more invasive procedures in less than 1 month due to sequential complications of amebiasis. Colon resection with enterostomy miraculously allowed him to survive. In comparison with the latter, who underwent more aggressive surgery and experienced more catastrophic complications, the former with conservative surgery had a smoother clinical result. Thus, conservative operation for colon perforation due to amebiasis is recommended. Besides, thanks to the alertness of doctors, the favorable age of the patients, the advent of new antiamebic and antimicrobial agents, excellent hyperalimentation, the great improvement in medical facilities and postoperative care, the two critical patients eventually survived after several operations, and had a better outcome as compared with the high mortality rate of 87.5% in our hospital 2 decades earlier.
Assuntos
Disenteria Amebiana/complicações , Adulto , Animais , Antibacterianos/uso terapêutico , Antiprotozoários/uso terapêutico , Doenças do Colo/etiologia , Doenças do Colo/cirurgia , Terapia Combinada , Disenteria Amebiana/diagnóstico , Disenteria Amebiana/tratamento farmacológico , Disenteria Amebiana/cirurgia , Humanos , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Abscesso Hepático Amebiano/complicações , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Hemimegalencephaly is a rare congenital anomaly of the brain characterized by unilateral hypertrophy, usually with an abnormal gyri pattern and derangement of the cortical architecture. We report 2 patients with hemimegalencephaly who presented with early-onset seizures, hemiparesis and developmental delay. An electroencephalogram showed hemispheric continuous spikes and spike-and-waves in one patient and repetitive spike-and-waves in the other. Magnetic resonance imaging showed left hemimegalencephaly in both cases and in case 1 pachygyria and heterotopia. A functional hemispherectomy was done on case 1 at the age of 33 months and on case 2 at 7 months due to difficulty in seizure control with antiepileptic drugs. The frequency of seizure dramatically decreased and there was an obvious improvement in neurologic development after surgical intervention. Pathology revealed disorganized lamination of the cortical layers with increased neuron size and bizarre-shaped neurons in both cases. Heterotopia of neurons and glia in the subarachnoid space was noted in case 1. Hemispherectomy should be performed as soon as possible when medical treatment fails to control seizures.
Assuntos
Encéfalo/anormalidades , Córtex Cerebral/cirurgia , Encéfalo/cirurgia , Feminino , Humanos , Recém-Nascido , MasculinoRESUMO
A total of 615 cases of meningioma operated on from 1959 to 1992 at National Taiwan University Hospital were reviewed. Factors influencing tumor recurrence were also evaluated. Of the 566 patients with intracranial meningioma, 350 were females and 216 were males (F:M = 1.6:1). The mean age was 47.5 years. The distribution of histologic type was: 232 meningothelial (41%), 141 transitional (24.9%), 106 fibroblastic (18.7%), 42 atypical (7.4%), 16 anaplastic (2.8%), and 29 angioblastic [5.2%, including five hemangioblastic (0.9%) and 24 hemangiopericytic (4.3%)]. Anatomical locations were parasagittal/falx area (35%), cerebral convexity (19.3%), sphenoid wing (10.2%), posterior fossa (7.4%), tuberculum sellae (6.7%), olfactory groove (5.7%), tentorium (4.8%), middle fossa (3.7%), and others (7.4%). Recurrence occurred in 83 patients, with a total 19.4% recurrence rate at five years. Sex, histologic grade, and tumor location were associated with recurrence. The recurrence rate was 19% for males and 12% for females (p < 0.05); while it was 42.9%, 64.3%, and 69.6%, respectively for atypical, anaplastic and hemangiopericytic meningiomas, which was much higher than 12.2% for benign ones (p < 0.005). Tumors in less accessible surgical sites also had a higher recurrence rate (p < 0.005). There was no correlation between the age of patients, the tumor size, and the histological subtypes and variants. Of the 49 spinal meningiomas, the majority occurred in adult females (80%), were benign in nature (98%) and thoracic in location (71.4%).