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At least 415 records · Page 23Linked to original sources
PubMed1995

Patterns of recurrence after nerve-sparing surgery for rectal adenocarcinoma with special reference to loco-regional recurrence.

PURPOSE: Since the early 1980s to relieve functional disturbances after rectal excision, we have been performing nerve-sparing surgery for rectal cancer. The aim of this study was to analyze patterns of recurrences, especially concerning causes of local ones. Furthermore, we would like to address the criteria we used in patient selection to effect successful nerve-sparing surgery. METHODS: From 1982 to 1991, 306 patients underwent nerve-sparing operations, which may be categorized into three types: 1) total autonomic nerve preservation (125 cases), 2) complete pelvic nerve preservation (105 cases), and 3) partial pelvic nerve preservation with removal of parasympathetic nerve (79 cases). Single and multivariant regression analyses were conducted to investigate patterns of recurrence, especially causes of local ones. RESULTS: Sixty-five patients (21 percent) developed recurrent tumors, 19 of which (6.2 percent) were local. Using Dukes terms, there were five patients with Dukes A 13 with Dukes B, and 47 (35 percent) with Dukes C stages. Rate of local recurrences was 13 percent in patients with Dukes C tumor. According to single-variant analysis of Dukes C patients, the following factors are thought to influence local recurrences: number of lymph nodes metastases, level of primary growth, and direction of lymphatic spread. Multivariate regression analysis suggested that lymph node metastasis was the most important and influencing factor on local regrowth (P < 0.002). CONCLUSIONS: Compared with local recurrences is so-called extended surgery appeared to be lower. Our current policy is aggressive application of nerve-sparing surgery, even to patients with node-positive rectal cancer, taking into consideration the exact extent of cancer spread. From the viewpoint of neuroanatomy related to mesorectum, we discussed patient determination for our nerve-sparing surgery.

Adenocarcinoma↗
PubMed2001

Factors influencing the internalization of Staphylococcus aureus and impacts on the course of infections in humans.

Staphylococcus aureus is the primary etiological agent of several human diseases. S. aureus has classically been considered an extracellular pathogen; however, recent evidence indicates that S. aureus invades and persists in non-professional phagocytes. Experiments demonstrate that actin microfilaments, microtubules, receptor-mediated endocytosis, and protein tyrosine kinases play important roles in the uptake of S. aureus. Fibronectin-binding proteins and beta-integrins are implicated as critical cell surface molecules associated with internalization of S. aureus by non-phagocytic cells. Following invasion of eukaryotic cells, S. aureus induces the release of cytokines that have the potential to exacerbate disease and induce apoptosis. Finally, S. aureus has the ability to persist inside host cells as small colony variants, a phenotype associated with persistent and recurrent infections.

Animals↗
PubMed2000

Localized (solitary) fibrous tumors of the pleura: an analysis of 55 patients.

BACKGROUND: Localized (solitary) fibrous tumors (LFTPs) of the pleura are rare, slow-growing neoplasms thought to originate from submesothelial connective tissue. The aim of this article is to present 55 new cases of LFTP, and to discuss the treatment of choice and the clinical behavior of such neoplasms. METHODS: From July 1990 to November 1999, 55 patients (32 male, 23 female) with an LFTP were surgically treated at our Institution. Neoplasms were considered to be malignant if one or more of the following histologic features were present: high cellularity with crowding and overlapping of nuclei; high mitotic activity; or mild, moderate, or marked pleomorphism. RESULTS: No operative mortality was reported. Forty-eight of the cases arose from the visceral pleura and seven arose from the parietal pleura. A local removal of the neoplasm with free surgical margins was accomplished by video-assisted thoracic surgery in 39 patients and by standard thoracotomy in 10 patients. Four patients underwent formal lung resections, 1 had thymectomy, and 1 had en bloc chest wall resection. Four malignant variants were identified. One patient developed local recurrence and underwent redo surgery with chest wall resection. One patient died of unrelated disease. The remaining patients are alive and disease free at a median follow-up of 53.2 months. CONCLUSIONS: LFTPs show a benign outcome in most of the cases. Video-assisted thoracic surgery, with intraoperative assessment of the surgical margins, represents the treatment of choice.

Adolescent↗
PubMed2000

Malignant granular cell tumor of the vulva in a 17-year-old: Case report and literature review.

Granular cell tumors are uncommon soft tissue tumors. Although the majority of these tumors are benign, a rare malignant variant exists which is aggressive, with local recurrence rates up to 70% and 3-year survival rates of less than 50%. We present a case of malignant granular cell tumor of the vulva in a 17-year-old, the sixth such case to be reported at this site. She was treated with a left hemivulvectomy and ipsilateral groin node dissection followed by postoperative radiation therapy. She remains free of disease at 16 months. Patients with malignant granular cell tumor or granular cell tumor of malignant potential are best managed with wide local excision and regional lymph node dissection.

Journal Article↗
PubMed1985

[Hyperimmunoglobulinemia E, recurring staphylococcal infections and a defect in granulocyte chemotaxis in adults. A variant of Job's syndrome].

Two cases in adults with recurrent staphylococcal infections associated with abnormal granulocytic chemotaxis and hyperimmunoglobulinaemia E (Job's syndrome) are described. The pathophysiological mechanisms seems to consist of an abnormal IgE reaction against staphylococcal antigens causing secondary abnormality of granulocyte function. Abnormal cellular immune function was demonstrated in vitro and in vivo. Corticosteroid administration at first proved effective in both patients. One patient developed Hodgkin's disease of the mixed type in the course of the disease.

Adrenal Cortex Hormones↗
PubMed1991

Placental site trophoblastic tumor in a postmenopausal woman.

Placental site trophoblastic tumor is a rare neoplasm that arises in the trophoblastic tissue of the placental bed. This case report is unusual because of the patient's advanced age at the time of diagnosis and the favorable response of the disease to chemotherapy. Although the clinical course is benign for most patients with placental site trophoblastic tumor, the malignant variant of the disease is characterized by recurrence, relative insensitivity to radiation and chemotherapy, and death. To the authors' knowledge, the 53-year-old woman reported is the oldest patient with histologically confirmed placental site trophoblastic tumor. Initially, surgery, radiation, and multiagent chemotherapy failed to control vaginal and pulmonary metastatic disease. After administration of four treatment cycles of a "second-line" chemotherapeutic regimen consisting of cyclophosphamide and cisplatin, complete clinical and radiologic remission was achieved. The patient's serum level of human chorionic gonadotropin has remained undetectable, and she has been without measurable evidence of disease for 16 months.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Tumors of the cornea and conjunctiva.

This article reviews the literature published in 1996 regarding conjunctival and corneal tumors. There is an increased incidence of squamous cell carcinoma of the conjunctiva in patients with HIV infection, especially in young individuals and Africans. Presumed causative factors for conjunctival squamous cell carcinoma include ultraviolet light, HIV infection, human papillomavirus and other unknown factors. Metastatic tumors to the conjunctiva appear at an advanced stage of the disease, and metastases to the conjunctiva are a poor prognostic sign for survival. Reviews of premalignant lesions of the conjunctiva, including diagnosis, treatment, and recurrence, are discussed. Spindle cell and mucoepidermoid variants of squamous cell carcinoma of the conjunctiva have a worse prognosis for intraocular extension compared with usual conjunctival squamous cell carcinoma.

Conjunctival Neoplasms↗
PubMed2005

Peripheral odontogenic keratocyst.

BACKGROUND: An odontogenic keratocyst can develop at virtually any site in the jaws and is of concern because of its aggressive clinical behavior. It represents 3% to 12% of all odontogenic cysts. This paper describes the rare peripheral presentation of an odontogenic keratocyst localized to the maxillary anterior gingiva and its differential diagnosis. METHODS: A patient presented with a round yellow nodule on the maxillary gingiva between the left canine and first premolar. Clinical examination ruled out periapical abscess, periodontal abscess, and lateral periodontal cyst. A differential diagnosis included a gingival cyst, neuroma, neurilemoma, and mesenchymoma. The cyst ruptured during excisional biopsy revealing contents typical of an odontogenic keratocyst (OKC). Histology confirmed the peripheral OKC diagnosis. A conservative surgical treatment was performed assuming a less aggressive clinical course for the peripheral odontogenic keratocyst. Close follow-up was planned. RESULTS: To our knowledge, only 13 cases of peripheral OKC have been reported in the literature. Presently it is unknown if the peripheral variant shares the aggressive clinical behavior and recurrence rate of intraosseous OKC. CONCLUSION: This paper may contribute to the limited clinical knowledge base for the peripheral odontogenic keratocyst and assist clinicians in the identification and management of such lesions.

Aged, 80 and over↗
PubMedDate not supplied

Congenital microangiopathic haemolytic anemia: a variant of thrombotic thrombocytopenic purpura?

We describe a child with recurrent microangiopathic haemolytic anemia (MAHA) and thrombocytopenia (TCP) who presented on the first day of life. Remission was maintained only by regular infusions of fresh frozen plasma (FFP). This case shows similarities with others described in the literature as examples of thrombotic thrombocytopenic purpura (TTP), although the absence of renal or neurological involvement distinguishes this disorder from classical TTP.

Anemia, Hemolytic, Congenital↗
PubMed2001

Blastic variant of mantle cell lymphoma following interfollicular Hodgkin's lymphoma.

Infrequently, patients are diagnosed with Hodgkin's lymphoma and a morphologically distinct lymphoma. While specific subtypes of lymphomas (including Hodgkin's lymphoma) may present diagnostic difficulties, fine needle aspiration biopsy (FNAB) is sometimes useful in the evaluation and classification of these lymphoproliferative processes. We report a case of the blastic variant of mantle cell lymphoma following Hodgkin's lymphoma, interfollicular variant. A 66-year-old woman with a history of Hodgkin's lymphoma presented with increasing contralateral cervical adenopathy three years after receiving chemotherapy. FNAB with ancillary immunophenotypic characterization identified mantle cell lymphoma, blastic variant. Subsequent excisional biopsy confirmed this diagnosis and also aided in the exclusion of recurrent Hodgkin's lymphoma. In addition to identifying the previously unreported combination of blastic variant of mantle cell lymphoma and Hodgkin's lymphoma, this case emphasizes the utility of FNAB in evaluation of new masses in patient's with a previous diagnosis of Hodgkin's lymphoma.

Biopsy, Needle↗
PubMed2004

Soft tissue giant cell tumor of low malignant potential.

Giant cell tumor of soft tissue (GCT-ST) is a rare tumor first described in 1972 by Salm and Sissons, followed shortly by Guccion and Enzinger. This tumor has been considered to be synonymous with the giant cell variant of malignant sarcoma with frequent local recurrence and metastasis. Recently GCT-ST has been described as a distinct entity of relatively benign prognosis, yet lacking marked atypia and pleomorphism, even in the presence of mitotic activity and vascular invasion. Now some authors think that GCT-ST represents the soft tissue analog of giant cell tumor of bone because of their histological and immunohistochemical similarity. Some reports documented these pathological new findings, but clinical case reports with description of imagings and surgery on the basis of these knowledge are very few. The authors describe the clinical, radiological, morphologic and histopathologial features of a case of GCT-ST occurring primarily in the subcutaneous tissue of the thigh with a review of the literature.

Antigens, Differentiation↗
PubMed1989

Duodenal atresia.

The intestinal obstruction of duodenal atresia needs urgent differential diagnosis from malrotation with its risk of midgut volvulus and gangrene. There is an uncommon variant with a high incidence of familial recurrence, and a significant association with Down's syndrome, although the majority of the babies are otherwise normal. Oblique end-to-end anastomosis around the atresia is the preferred treatment and has a high success rate.

Anastomosis, Surgical↗
PubMed1984

Cutaneous leukocytoclastic vasculitis with hyperglobulinemia and splenomegaly. A variant of hyperglobulinemic purpura of Waldenström.

Patient with hepatosplenomegaly and recurrent small purpuric lesions of cutaneous leukocytoclastic vasculitis was found to have a polyclonal elevation of gamma-globulin and a persistently elevated ESR. Circulating immune complexes were detected that support the concept of a postulated immune complex pathogenesis. Indomethacin therapy was ineffective, but prednisone therapy resulted in notable clinical improvement and the return of elevated immunoglobulin levels to the normal range. Patients with hyperglobulinemic purpura, which may be a subset of leukocytoclastic vasculitis, should be examined for associated conditions.

Adult↗
PubMedDate not supplied

[Diagnostic endoscopy in pediatric rhinology].

The paper provides a description on indications to diagnostic endoscopy, its techniques, specific pediatric features, types of anesthesia. Typical complications are specified. Emphasis is placed on local developmental defects of the nasal cavity, lateral wall in particular, as they interfere with natural sinus drainage in many children with chronic and recurrent sinusitis, chronic rhinitis. The tables detail variants of the above deformities with specification of the likely site of stenosis in so-called osteomeatal zone. It is believed that minor surgical correction in the above zone is more preferable than extended radical operations. This seems important in pediatric practice.

Adolescent↗
PubMed2006

Marburg I polymorphism of factor VII-activating protease and risk of recurrent venous thromboembolism.

Whether a single nucleotide polymorphism (1601 G > A) in the factor VII-activating protease gene (FSAP Marburg I) is a risk factor for venous thromboembolism (VTE) is unclear. We investigated the relevance of the variant with respect to recurrentVTE. 854 patients with a first unprovoked VTE were followed for an average of 41 months after discontinuation of anticoagulation. Study endpoint was symptomatic recurrent VTE. VTE recurred in 7 of 41 patients (17%) with and in 106 of 813 patients (13%) without the variant. After 3 years, the probability of recurrence was 20.0% (95% CI, 5.3% to 34.6%) among patients with and 12.2% (95% CI, 9.6% to 14.8%) among those without FSAP Marburg I (p = 0.5). The relative recurrence risk among carriers of the variant was 1.3 (95% CI, 0.6 to 2.8; p = 0.5) before and 1.5 (95% CI, 0.7 to 3.3; p = 0.3) after adjustment for potentially confounding factors. We conclude that FSAP Marburg I is, if at all, only a mild factor for recurrent VTE. Patients with FSAP Marburg I most probably will not benefit from extended anticoagulation.

Anticoagulants↗
PubMed2006

HLA-A24 and survivin: possibilities in therapeutic vaccination against cancer.

Recently, it was described that an HLA-A24 restricted peptide derived from the survivin splice variant survivin-2B can be recognized by CD8+ cytotoxic T-cells. The identification of an HLA-A24 epitope is critical for survivin-based immunotherapy as HLA-24 is the most frequent HLA allele in Asia. Consequently, this survivin-2B epitope is already a target in a clinical study in patients with advanced or recurrent colorectal cancer expressing survivin. However, the splice variant survivin-2B has been described to be pro-apoptotic, and is only expressed at low levels in most malignant tissues. Furthermore, survivin-2B expression are significantly decreased in later tumor stages and inversely correlated with tumor differentiation and invasion. Consequently, survivin is a more general vaccination candidate than the splice variant survivin-2B. Here, we on the basis of spontaneous immune responses in HLA-A24+ cancer patients describes that a HLA-A24-restricted survivin epitopes does indeed exist. Consequently, this epitope is an attractive target for the ongoing survivin-based peptide immunotherapy against cancer.

Editorial↗
PubMedDate not supplied

The effect of mannose-binding protein gene polymorphisms in recurrent respiratory system infections in children and lung tuberculosis.

Mannose-binding lectin (MBL) is able to bind pathogens as an opsonin and plays an important role in the innate immunity. The aim of the present study was to determine the frequencies of the MBL gene variants in the Turkish population and to examine the presence of any association between MBL variants and development of tuberculosis (TB) in adults and recurrent respiratory tract infections in children. Two structural gene mutations in exon 1 of MBL gene (codon 54 and codon 57) were studied. The overall distribution of genotypes did not significantly differ between controls and TB patients/children with recurrent respiratory system infections. The frequency of allele B was calculated as 0.14, 0.09 and 0.06 for control, TB patients and children with recurrent respiratory system infections, respectively. It was found to be significantly lower in children with recurrent respiratory system infections than in controls (chi2: 4.68, d.f: 1, p: 0.030).

Adult↗
PubMed2000

Polymorphisms in glycoprotein (GP) lb alpha are not associated with adverse outcomes in primigravidae.

The platelet glycoprotein lb-IX complex is critical in platelet adhesion under conditions of high shear stress. Three genetic polymorphisms in the GPlbalpha subunit have been variably associated with thrombotic disorders. Women with serious obstetrical complications have an increased incidence of polymorphisms in other coagulation factors predisposing them alpha to thrombosis. Three GPlb variants were genotyped in 271 women in an Irish primigravid population, 258 with recorded outcomes, and in 22 patients with recurrent thrombosis and 15 patients with recurrent fetal loss. These were: the 13 amino acid variable number of tandem repeats (VNTR A/B/C/D), the Thr145Met antigen (HPA2) and a variant in the 'Kozak' sequence 5 bases upstream of the methionine initiation codon (T-5C). The VNTR B and HPA2b (145Met) alleles were strongly associated with each other, as found in previous analyses of Caucasian populations (estimated haplotype frequency 5%). The Kozak rarer C variant was found at an allele frequency of 9.1%, and appeared completely associated with the commonest haplotype of the other markers (VNTR/C, 145Thr). GPlb alpha genotype did not have any marked influence on pregnancy outcome. The Kozak/C variant was not significantly elevated in the 15 primigravidae patients who miscarried compared with 233 normal outcomes (OR=2.09, CI=0.7-6.4), neither was the 145Met variant (P =0.38). The Kozak/C variant was not elevated in the six primigravidae patients who developed pre-eclampsia (OR=0.84, CI=0.1-7.3). Comparison of the 271 primigravidae with 15 recurrent fetal loss patients showed no association between Kozak/C and recurrent fetal loss (OR=0.65, CI=0.1-3.0), nor with the 145Met variant (OR=0.62, CI=0.1-4.9). Combining miscarriage cases, recurrent thrombosis cases, pre-eclampsia, and intrauterine growth retardation outcome groups together, there is still no significant genotypic difference compared with normal outcome (OR=0.90, CI=0.4-1.9). Genetic variants of GPlbalpha are unlikely to contribute to adverse events associated with thrombosis in a primigravidae population.

Journal Article↗