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At least 397 records · Page 22Linked to original sources
PubMed2000

Surgical implications of multicentricity in renal cell carcinoma.

PURPOSE: To determine the incidence and metastatic pattern of multifocal renal cell carcinoma in radical nephrectomy specimens and to use these findings to guide the choice of operative procedure. MATERIALS AND METHODS: Pathology reports for 161 patients who underwent radical nephrectomy at Walter Reed Army Medical Center between 1980 and 1995 were reviewed to evaluate tumor size, stage, and incidence of multifocal tumors. RESULTS: Multicentric neoplasms occurred in 16 of 161 (9.9%) radical nephrectomy specimens from the same institution. Thirteen of the 16 multifocal tumors had cross-sectional diameters > or = 3.5 cm. Of the 16 multifocal carcinomas, 11 were noted in stage I tumors. Multifocal neoplasms were not identified with primary tumors of < 2 cm. CONCLUSION: Our data support previous reports that the incidence of multicentric renal malignancy is low and suggest that patients with small, unilateral masses (< 2 cm) can undergo kidney-sparing surgery with little risk of local recurrence.

Carcinoma, Renal Cell↗
PubMed2001

[A unique case of destructive polyarthritis associated with multicentric Castleman's disease].

This is an original report of a 75-year-old woman suffering from multicentric Castleman's disease associated with a destructive polyarthritis, which do not correspond to any known rhumatologic disease. Cattleman's disease (angiofollicular lymph node hyperplasia) is a lymphoproliferative disorder of unknown etiology. Two forms are described: a localized and a multicentric. In the literature, associations of Cattleman's disease and connective tissue disease such as rheumatoid arthritis have been described. Association with POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, M component, skin changes) and amylosis have also been described.

Aged↗
PubMed1998

[Multicentre, randomized, prospective and comparative study of ceftriaxone, cefotaxime and cefuroxime in treating mild to moderate respiratory tract infection].

OBJECTIVE: The objective of this multicentre, randomized, prospective and comparative study was to evaluate and compare the efficacy and safety of 1 g intravenous ceftriaxone (active ingredient of Rocephin), 3 g intravenous cefoiaxime (active ingredient of clafron), and 2.25 g intavenous cefuroxime (active ingredient of Zinacef). METHOD: In this multicentre, randomized, prospective and comparative study, patients received 1 g of ceftriaxone intravenously once a day (group A), or 1 g of cefotaxime intravenously three times a day (group B), or 0.75 g of cefuroxime intravenously three time a day (group C). 197 patients were enrolled in the study, and in 142 (48 in group A, 46 in group B and 48 in group C) we were able to make an evaluation. RESULT: The overall efficacy (bacteriological eradication plus clinical cure or clear improvement) of ceftriaxone, cefotaxime and cefuroxime were 81%, 83%, 79% respectively (P > 0.05). The eradication rate for three groups were 80%, 78%, 75% (P > 0.05). No adverse events occured. CONCLUSION: Data obtained in our study indicate that for the majority of patients with lower respiratory tract infections, 1 g ceftriaxone, 3 g cefotaxime and 2.25 g cefuroxime are effective and safe, and 7 days therapy is enough, but the use of 1 g ceftriaxone is more convenient.

Adolescent↗
PubMed2002

A European multicentre, placebo-controlled supplementation study with alpha-tocopherol, carotene-rich palm oil, lutein or lycopene: analysis of serum responses.

Increased levels of oxidative stress have been implicated in tissue damage and the development of chronic diseases, and dietary antioxidants may reduce the risk of oxidative tissue damage. As part of a European multicentre project, several studies were undertaken with the aim of testing whether the consumption of foods rich in carotenoids reduces oxidative damage to human tissue components. We describe here the serum response of carotenoids and tocopherols upon supplementation with carotenoids from natural extracts (alpha-carotene+beta-carotene, lutein or lycopene; 15 mg/day) and/or with alpha-tocopherol (100 mg/day) in a multicentre, placebo-controlled intervention study in 400 healthy male and female volunteers, aged 25-45 years, from five European regions (France, Northern Ireland, Republic of Ireland, The Netherlands and Spain). Supplementation with alpha-tocopherol increased serum alpha-tocopherol levels, while producing a marked decrease in serum gamma-tocopherol. Supplementation with alpha- + beta-carotene (carotene-rich palm oil) resulted in 14-fold and 5-fold increases respectively in serum levels of these carotenoids. Supplementation with lutein (from marigold extracts) elevated serum lutein (approx. 5-fold), zeaxanthin (approx. doubled) and ketocarotenoids (although these were not present in the supplement), whereas lycopene supplementation (from tomato paste) resulted in a 2-fold increase in serum lycopene. The isomer distributions of beta-carotene and lycopene in serum remained constant regardless of the isomer composition in the capsules. In Spanish volunteers, additional data showed that the serum response to carotenoid supplementation reached a plateau after 4 weeks, and no significant side effects (except carotenodermia) or changes in biochemical or haematological indices were observed throughout the study. This part of the study describes dose-time responses, isomer distribution, subject variability and side effects during supplementation with the major dietary carotenoids in healthy subjects.

Adult↗
PubMed2002

Multicentric Castleman's disease, non-Hodgkin's lymphoma, and Kaposi's sarcoma: a rare simultaneous occurrence.

A rare simultaneous occurrence of multicentric Castleman's disease, non-Hodgkin's lymphoma, and Kaposi's sarcoma was diagnosed in a 70-year-old man who presented with fever, polyarthralgia, weight loss, vascular purpura, anemia, generalized lymphadenopathy, and hepatosplenomegaly. He had no risk of HIV infection and serological tests for HIV were negative twice, but a low number of T-cells and a reversed CD4/CD8 ratio were observed. During hospitalization, he developed Kaposi's sarcoma at the right sole. Lymph node biopsies revealed multicentric Castleman's disease together with a large B-cell lymphoma, which showed monotypic IgM-lambda lymphocytes. To our knowledge, this is the first report in which systemic manifestations of all three diseases occurred simultaneously prior to any specific treatment. The altered immune status and human herpesvirus-8 infection might have played a role in the pathogenesis of this occurrence.

Aged↗
PubMed2002

Multicentric parenchymal xanthogranuloma in a child: case report and review of the literature.

OBJECTIVE AND IMPORTANCE: Xanthogranulomas of the central nervous system are rare, and asymptomatic lesions are often identified in autopsies. We report the first case of a multicentric, cystic, intraparenchymal xanthogranuloma, involving both the supra- and infratentorial compartments, in a 16-month-old girl. CLINICAL PRESENTATION: The clinical presentation consisted of a focal motor seizure in an otherwise healthy infant. INTERVENTION: Gross total removal of the infratentorial lesion was accomplished via a midline suboccipital craniotomy. CONCLUSION: Intracranial xanthogranulomas are rare, and limited experience with the diagnosis of these lesions has been reported. Although most cases are asymptomatic, this case involves a symptomatic, multicentric, intraparenchymal xanthoma in a pediatric patient. Our review of the literature provides further insights regarding the clinical, radiological, and pathological behavior of these lesions and examines the available treatment strategies.

Craniotomy↗
PubMed2003

[A case of multicentric Castleman's disease with pulmonary involvement].

In a man aged 34 who had been experiencing frequent coughing since November 2001, a chest radiograph showed infiltration shadows in both lung fields. Chest CT showed diffuse centrilobular nodules and multiple mediastinal lymphadenopathy. Laboratory examination revealed high values for C-reactive protein and the erythrocyte sedimentation rate, together with polyclonal hyperimmunoglobulinemia and an elevated interleukin-6 level. We suspected multicentric Castleman's disease, and so performed thoracoscopic mediastinal lymph node biopsy and lung biopsy. The former disclosed follicular hyperplasia and plasma cell infiltration in the interfollicular area, suggesting a diagnosis of Castleman's disease, plasma cell type. The lung biopsy showed heavy infiltration of plasma cells. The diagnosis was therefore multicentric Castleman's disease (MCD) with pulmonary involvement. The chest CT findings were tpical characteristics of pulmonary involvement in patients with MCD.

Adult↗
PubMed2000

Recruitment to multicentre trials: the impact of external influences.

A multicentre randomised controlled trial needs to recruit sufficiently large numbers of centres, clinicians and patients Delays in reaching recruitment targets are common and often necessitate extended recruitment periods with associated increased costs. The Scottish Back Trial and the MRC Laparoscopic Hernia Trial are used to illustrate how national clinical, economic and political factors can impact on the conduct of a multicentre trial. Changes in clinical practice, restructuring of the NHS and research and development funding, and changes in the procedures for obtaining local research ethics committee approval had adverse effects on recruitment. In addition, the extent to which changes in patient knowledge and attitudes to clinical trials could influence recruitment should not be ignored. In response to these obstacles both trials extended the recruitment period, identified additional recruitment centres and reduced the overall sample size. External factors which could compromise the successful completion of a d trial need to be recognised and addressed at an early stage.

Herniorrhaphy↗
PubMed2001

[Obstructive sleep syndrome, a prospective multicentric study (SASOM)].

UNLABELLED: A prospective multicentric study ("SASOM" for "Syndrome d'Apnées du Sommeil") was carried out from 1996 to 1998 among pulmonary departments of 57 French general Hospitals, about diagnostic, treatment and outcome of Obstructive Sleep Apnea Syndrome (OSAS). All successive adult patients diagnosed by polygraphic recording as having OSAS were included. Mean characteristics of the 1720 patients (1455 M, 245 W) were as follows: age 58 years, BMI 34, FEVI 86%, VC 88%, PO2 77 mmHg, PCO(2) 42 mmHg, AHI 46. Other determined values were: clinical signs, systemic hypertension, treatment, follow-up during 18 months. Main results were: - there was a strong correlation between clinical signs and AHI, - 70% of the patients (n=1227) were treated with CPAP; among them, withdrawals were 7% at 6 months, 15% at 1 year, 20% at 18 months, 24% at 2 years, - among patients whose AHI was<30, and who were treated, withdrawals were 33% at 18 months, - there was non difference of diagnostic, treatment and follow-up according to the modalities of the diagnostic (ventilation polygraphy of full polysomnography). CONCLUSION: Among a large population of 1720 OSAS without any selection in this multicentric study: - clinical signs are correlated with AHI, - a full polysomnography is not required of the initial diagnosis, - among the less severe patients who are treated by CPAP, the compliance is quite good at 18 months.

Adult↗
PubMed1992

Severe progressive erosive arthritis in multicentric reticulohistiocytosis: possible involvement of cytokines in synovial proliferation.

A case of multicentric reticulohistiocytosis complicated by severe progressive erosive arthritis in a 40-year-old man is described. The diagnosis was confirmed by biopsies of the cutaneous nodule and the synovial tissue of the right knee joint. Destructive changes in the multiple joints rapidly progressed and resulted in severe progressive erosive arthritis. Immunohistochemical staining revealed that the histiocytes reacted positively to interleukin 1 beta and platelet derived growth factor B, leading to the speculation that these cytokines may play a role in the synovial proliferation seen in patients with multicentric reticulohistiocytosis.

Adult↗
PubMed1992

Multicentric cutaneous pythiosis in a foal.

A 5-month-old male Quarter Horse was examined because of multicentric, granulomatous, cutaneous lesions of the dorsum and prepuce. The cutaneous lesions were excised, and sodium iodide was administered orally for 2 weeks. Multicentric cutaneous pythiosis was diagnosed by histologic examination and immunoperoxidase staining of excised tissues. By 3 months after surgery, all lesions had healed.

Animals↗
PubMed2004

[A multicentric glioma presenting different pathological appearances: a case report].

We report a multicentric glioma case which revealed different pathological appearances. A 45-year-old male had been admitted to our hospital complaining of an attack of transient sudden aphasia. On magnetic resonance imaging (MRI), T1-weighted images revealed a low intensity and T2-weighted images demonstrated a homogeneous high intensity abnormal mass in the frontal lobe, which was not enhanced with gadolinium. Removal of the tumor was performed through a right frontal transcortical approach in March, 2002. Histological diagnosis was gemistocytic astrocytoma. The patient's condition was uneventful and postoperative MRI revealed a marked decrease in the volume of the tumor. A total of 54 Gy radiation to the brain in the locality was performed. Four months after the initial surgery, the patient suffered from incomplete right hemiparesis. MRI showed a left parietal abnormal mass which had a ring formation enhancement after gadolinium administration. This Neuro-radiological examination demonstrated complete independence from the initial right frontal tumor. A second surgery which was concerned with cyst aspiration was carried out on August 10, 2002. During the next month, a third operation for partial removal of a left parietal abnormal mass was performed. Histological diagnosis was anaplastic astrocytoma. The right frontal and left parietal tumors revealed neither continuous relation suggesting intracerebral invasion, nor dissemination through the subarachnoid space nor intracerebral metastasis. Our case was diagnosed as multicentric glioma with different pathological appearances, of which only 9 cases have been reported previously.

Astrocytoma↗
PubMed1992

Long-term multicentre trial in chronic nonspecific lung disease: methodology and baseline assessment in adult patients. Dutch CNSLD Study Group.

Airways obstruction and airways hyperresponsiveness are two dominant features in patients with chronic nonspecific lung disease (asthma and chronic obstructive pulmonary disease (COPD)). We set up a study to determine whether long-term (3 yrs) therapeutic intervention directed at airways obstruction and hyperresponsiveness is superior to one directed at airways obstruction alone. Patients were selected on functional criteria (age, baseline forced expiratory volume in one second (FEV1), and airways hyperresponsiveness) and, furthermore, extensively characterized by history, smoking habits, allergy, reversibility of airways obstruction and quality of life. The methodology and practical problems of setting up this large multicentre study are outlined, together with an analysis of baseline data. Standardization of methods and techniques and recruitment of patients required much effort, recruitment taking about twice as long as expected. A 3 month feasibility study allowed us to eliminate minor problems in the protocol. Over a 16 month period, 274 adult patients (18-60 yrs) from the out-patient clinics of six university centres entered the study; 99 met the diagnostic criteria for asthma, 51 for COPD, 88 for asthmatic bronchitis, and 36 could not be classified. Their mean (SD) FEV1% pred was 65.1 (15.2)%. Their geometric mean provoking concentration of histamine producing a 20% fall in FEV1 (PC20 histamine) was 0.28 mg.ml-1. In a multiple regression analysis, more severe airways hyperresponsiveness was associated with lower prechallenge FEV1% pred (p less than 0.0001), higher pack-years of smoking (p = 0.0099), blood eosinophil count (p = 0.0004), skin test reactivity (p = 0.0047) and with female sex (p = 0.0302). We conclude that setting up long-term multicentre trials in chronic nonspecific lung disease (CNSLD) is feasible and that these may offer valuable information on treatment and outcome of the disease.

Adult↗
PubMed2004

[Multicentric extrahepatic bile ducts carcinoma. Clinical presentation, pathologic features and management].

Extrahepatic bile ducts carcinoma (EHBC) arises usually in the upper third of the biliary tract. They are rarely multicentric associated or not to a gallbladder carcinoma. We report the case of a 53 years man operated for a head pancreas. Laparatomy revealed a tumour of the middle common bile duct extending to the cystic duct. Histologically it was a multicentric carcinoma of variable types occurring in several sites of the biliary tract. Patient had undergone a simple resection without any complications 9 months later. Although EHBC are morphologically similar to those of the gallbladder, their risk factors, epidemiology and treatment are different. Prognosis depends on proximal involvement of perihilar bile ducts which makes the treatment only palliative.

Adenocarcinoma↗
PubMedDate not supplied

Diffuse large B-cell lymphoma arising from a multicentric mixed variant of Castleman's disease.

This case report describes a patient with multicentric mixed type Castleman's disease and concomitant non-Hodgkin's lymphoma of diffuse large B cell type in the neck. Multicentric CD is a systemic illness with disseminated lymphadenopathy; its aggressive and usually fatal course is associated with infectious complications and risk for malignant tumors, such as lymphoma or Kaposi sarcoma.

Aged↗
PubMed2004

[Multicentric giant cell tumour. The case report].

The case of a 28 year old woman with multicentric giant cell bone tumours was described. Seven tumours' locations were found: Th3, the right and left humerus and tibia, the right femur and the right hip bone. All tumours were treated by a local resection with a following alcohol adjuvant therapy. Considering young age of the patient and multicentric location no radiotherapy was performed. During follow up no relapse in long bones and in the hip bone was found. After 6 months the relapse in Th3 was reoperated. During the last control examination, the next tumour of a distal part of right tibia was found.

Adult↗
PubMedDate not supplied

Multicentric reticulohistiocytosis presenting with papulonodular skin eruption and polyarthritis.

Multicentric reticulohistiocytosis is a rare multisystem disease, presenting with skin lesions and erosive polyarthritis, which is often associated with malignancy. A 2 year untreated natural course of multicentric reticulohistiocytosis, in which the typical nodular skin manifestation of the disease and polyarticular arthritis was present, is described in a 34-year-old lady with no history of major medical disease. Histopathology showed the characteristic histiocytic and multinucleated giant cell infiltrate with ground glass cytoplasm. Massive destruction of articular surfaces and new papular skin lesions accompanied by atrophic scars of previous skin lesions developed after 2 years of untreated active disease.

Adult↗
PubMed2005

Major salivary gland diseases. Multicentre study.

This multicentre study involved 28 Italian ORL Centres responding to a questionnaire sent by us which allowed recruitment of a high large number of cases of parotid neoplasms observed over a 10-year period. Statistical data obtained partly confirmed previous findings. Benign tumours account for 80% of case histories with a relationship 1:4 M/F, the most frequent being pleomorphic adenoma (57.3% of cases), followed by Warthin's tumour (32.4%), this rating not having been confirmed in case histories (8-10%) in the literature. Malignant tumours instead were fewer in number compared to the literature (14% vs 25-30%); the most frequent being mucoepidermoid carcinoma (18.2%) of which 44% G1, 33% G2 and 23% G3. Adenoid-cystic carcinoma was observed in 15.3% and < or = 10% for all the other most frequent histological malignant neoplasms. Diagnostic work-up included echotomography and fine-needle aspiration biopsy, less used imaging techniques were computed tomography, magnetic resonance imaging, Sialo-computed tomography. During this multicentre investigation more widespread use of imaging techniques has, however, been observed. The greater use of ecotomography and of fine-needle aspiration biopsy was due to simplicity of application and low cost offering good sensitivity and specificity. Surgical treatment of benign tumours consisted, in 50% of cases, in superficial paroditectomy and in approximately 30% of total paroditectomy. Enucleoresection was limited to approximately 15% of neoplasms, enucleation to <10% of cases with only 2% of pleomorph adenoma due to the well-known anatomo-pathological characteristics which may lead to relapse. For malignant neoplasms, total parotidectomy was performed in approximately 50% of cases, while in the remaining 50% an almost equal rate of superficial parotidectomy was carried out and enlarged parotidectomy, with or without sacrificing the facial nerve, which was rebuilt in 60% of cases. The lateral neck dissection most frequently carried out was of functional type in 54% and selective type in 46% with removal of levels I-III and II-IV in approximately 60% of cases. Sentinel lymph node was observed in a limited number of centres. When no clinically evident lymph nodes were present (NO) considering the tumour histotype, two thirds of patients underwent surgery or radiotherapy, while in the remainder the wait-and-see attitude was prefered. Post-operative-complementary radiotherapy was very frequently performed instead of chemotherapy. Oncological results obtained were compared with those reported in the literature: in fact for all benign neoplasms relapse ratings are about 5%, while for malignant tumours the worst prognosis was in squamous cell carcinoma with median of 37.7 on survival and metastasis rate of 16.5%. Finally, mucoepidermoid carcinoma tumours showed best survival, followed by adenoid-cystic carcinoma with ranges, respectively, 83 and 81.

Adult↗