OBJECTIVE: To report the association of nonpuerperal galactorrhea and severe pruritus with clinical stage IIB Hodgkin's lymphoma. METHODS: We present a detailed history, findings on physical examination, laboratory data, and results of diagnostic imaging in a 25-year-old woman. A review of the related literature and speculations about possible etiologic factors for this association are provided. RESULTS: Dermatologic evaluation of the patient revealed lichen simplex chronicus with multiple excoriations on the anterior chest area and lower extremities. High serum prolactin concentrations and easily expressible galactorrhea were present. Magnetic resonance imaging of the sella with 1-mm cuts, however, revealed a normal pituitary gland. Computed tomography showed multiple enlarged mediastinal lymph nodes, and a left supraclavicular lymph node biopsy revealed the presence of Reed-Sternberg cells and lymphocyte alterations consistent with the diagnosis of Hodgkin's lymphoma. After one cycle of chemotherapy for management of the lymphoma, parallel reductions in serum prolactin concentrations and galactorrhea were noted. CONCLUSION: Possible causes for this syndrome include afferent mammary nerve stimulation resulting from scratching of pruritic skin and cytokine-induced hypersecretion of prolactin attributable to the lymphoma. Although uncommon, this syndrome may serve as an important harbinger of developing Hodgkin's lymphoma, and its disappearance may signify a therapeutic response.

Adult↗

PubMedDate not supplied

[Comparative genetic alterations in small and non-small lung cancer].

Explore the source record for details and available documents.

Carcinoma, Non-Small-Cell Lung↗

PubMedDate not supplied

Liver hemangioma revisited: current surgical indications, technical aspects, results.

BACKGROUND/AIMS: New developments regarding the diagnosis of liver hemangiomas, surgical indication and therapeutic options emerged recently. We reviewed our experience from the point of view of these modern developments. METHODOLOGY: Fifty-seven patients with liver hemangiomas were retrospectively studied. The relationship between size, symptoms and treatment was assessed. RESULTS: Indication for surgery was the size of the lesion in 5 patients, symptomatology in 48 and uncertain diagnosis in 4. Increase in size was noted in four patients. Six patients had associated intraabdominal benign or malignant pathology. The treatment of choice was enucleation. Postoperative complications were noted in 6 patients and mortality was nil. In 3 patients the hemangiomas recurred and were reresected in 2. CONCLUSIONS: Hemangiomas should be resected when larger than 10 cm and when they become symptomatic. With the modern diagnostic work-up, uncertainty of diagnosis as an indication for surgery should be rare. Surgery remains the main treatment, with a low morbidity and mortality if performed in a specialized hepatobiliary unit. Enucleation is the surgical option of choice. In selected cases laparoscopic enucleation can be performed with good results.

Adult↗

PubMedDate not supplied

[Postoperative rehabilitation of patients operated on for gastric neoplasms].

Explore the source record for details and available documents.

Adolescent↗

PubMedDate not supplied

IgA monoclonal and polyclonal proteins as regulatory factors of the NK cytotoxic activity.

The presence of receptors for IgA (IgAR) on natural killer (NK) cells was only indirectly suggested yet. To elucidate the presence of IgAR on NK cells and its possible role in modulation of the NK activity, was initiated a preliminary study carried out in a homologous system, using human non adherent lymphocytes (NAL) and human seric or secretory IgA. A proportion of over 20% NK cells (CD16+ CD56+) was determined by flow-cytometry in the NAL-cells population. Dose-dependent IgA-binding to NAL cells was determined, showing a limitation of the IgA+ NAL proportion for a cell population of 32% and a ligand concentration of 4 mg/ml/10(7) cells. The binding parameters of the IgA/IgAR system, calculated by Scatchard procedure, revealed values of the affinity constant (K) and of the maximum number of ligand molecules bound/cell (n) depending on the aggregation degree of the ligands: K-values of 1.0 and 0.4 x 10(7) M-1 for dimeric and respectively, monomeric IgA, and n-values of 0.8 and 1.7 molecules/cell, respectively. A proportion of 3% IgA molecules endowed with cytophilic property was also calculated. The turnover rate of secretory IgA (sIgA) on the NAL cells surface showed values of the ligand half time (T 1/2) of 1 h. The effect of polyclonal IgA, (sIgA and normal seric IgA) and of monoclonal IgA myeloma (monomeric and dimeric IgA) on the NK cytotoxicity target K562 cell line was of inhibition, depended on the ligand doses and varied with the IgA type. The possible relevance of immunoglobulins A and of the activity of natural killer cells in processing of some mechanisms of the antiviral protection was discussed.

Cytotoxicity, Immunologic↗

PubMedDate not supplied

[Uremigenic cholangitis].

The treatment is presented, applied in a case of severe angiocholitis complicated by acute renal failure, known in the literature under the name of uremigenic angiocholitis. After three emergency hospitalizations, two interventions consisting in surgical drainage, de-shocking procedures, treatment of the hepato-renal failure and applications of wide-range antibiotics for the treatment of infection the angiocholitic phenomena disappeared and the hepato-renal failure is on the way to recovery. At this moment of the evolution the patient developed atrial fibrillation that was improved by Narcotan anesthesia. The efficiency is remarked of the treatment with large amounts of Furosemid in the anuric period, as a means to avoid extra-renal depuration.

Cholangitis↗

PubMedDate not supplied

[Palliative total gastrectomy in advanced malignancies of the stomach].

The diagnosis of the malignancies of the stomach is generally late (stages III and IV to a medium value of 80% of patients). Therefore it is necessary a surgical treatment in order to effectuate the extirpation of the lesions and to warn or to treat the complications in course of the neoplastic disease. The indications and the results of the palliative total gastrectomy (PTG) are analyzed in the present study. Between 1992 and 1999 there were studied retrospectively and prospectively during three successive periods of time, 217 patients (pts.) with PTG. This group of pts. represents 22.1% of the total number of pts. operated on for gastric malignancies (carcinoma particularly). The indication of PTG was established only after one complex evaluation of the every patient from the point of view of his general and biological status. 142 (65.4%/217) of the analyzed pts. presented at the admission in the hospital various complications of the malignant disease (gastric different stenosis, digestive hemorrhages, loco-regional invasion). The lymph nodes metastases and the systemic metastases (in the liver especially) as well as the invasion in the neighbouring viscera imposed sometimes the extension of the PTG with partial or total extirpation of the invaded organs. A proportion of 61% pts. were submitted to those type of enlarged surgical interventions without radical intentions; all the operated pts. remained by necessity in R1 or R2 types of operations. The reconstructive preferred anastomosis was effectuated with an Y jejunal ansa à la Roux completed or not by a "J" reservoir. Microscopically pathologic lesions were: adenocarcinoma and carcinoma (82%), followed by primitive lymphoma (11.5%), and others malignant forms of lesions (approximately 6%). The general perioperative morbidity was 32.5% divided in: 12.3% having a surgical cause (the majority anastomotic leakages +/- septically complications or precocious occlusions); 20.2% complications depending by the general status and altered biology of the patients. Perioperative mortality was 10.1% (22 pts.) comparable with other experiences published in the international literature in those forms of advanced gastric cancer operated by PTG. The average outcome of the operated followed pts. was 16-18 month (extremes 12 months and 29 months). A better quality of life and a variable disease-free period was obtained. As a conclusion we think that the PTG is a advantageous modality of surgical treatment with an acceptable rate of perioperative morbidity and mortality. The outcome of operated pts. is superior comparable with that of nonoperated pts. or with that secondary to other palliative surgical interventions. The importance of adjuvant treatment (chimeo- or radiotherapy) remain to be appreciated in the future.

Adenocarcinoma↗