Production of immunoregulatory polysaccharides from Crassostrea hongkongensis and their positive effects as a nutrition factor in modulating the effectiveness and toxicity of 5-FU chemotherapy in mice.

Related Articles

Production of immunoregulatory polysaccharides from Crassostrea hongkongensis and their positive effects as a nutrition factor in modulating the effectiveness and toxicity of 5-FU chemotherapy in mice.

Food Funct. 2016 Jan;7(1):390-7

Authors: Cai B, Chen H, Sun H, Wan P, Sun H, Pan J

Abstract
Chemotherapy is generally accompanied by undesirable side effects, such as immunosuppression and malnutrition, which reduce tolerance to cancer therapies. Prior studies have shown that immunonutrition improves the clinical outcomes of cancer patients. In this study, immunoregulatory polysaccharides from Crassostrea hongkongensis were included in a nutrition formula that was administered to S180 tumor-bearing mice in combination with 5-fluorouracil (5-FU) treatment. The C30-60% fraction of the polysaccharides was characterized as a branched polysaccharide, with a high amount of d-glucose (96.76% of the total) and the highest uronic acid and sulfate groups' content among all of the polysaccharide fractions. The C30-60% polysaccharide fraction showed a maximal proliferative effect on RAW264.7 cells and T lymphocytes at a concentration of 0.0391 mg mL(-1) and 0.0781 mg mL(-1), respectively. Moreover, the combination treatment of the C30-60% polysaccharide-based nutrition formula (OPNF) with the administration of 5-FU effectively inhibited the growth of tumors and notably increased the leucocyte and lymphocyte counts in S180 tumor-bearing mice. In addition, a slight increase in the erythrocyte and hemoglobin values was observed in the mice treated with the combination of OPNF and 5-FU. These results suggest that supplementation with a C30-60%-based enteral formula would be beneficial for patients undergoing chemotherapy with 5-FU.

PMID: 26507007 [PubMed - indexed for MEDLINE]

http://ift.tt/2eqs5St

Ewing sarcoma/primitive neuroectodermal tumor of the kidney: A report of three cases.

Ewing sarcoma/primitive neuroectodermal tumor of the kidney: A report of three cases.

Int J Surg Case Rep. 2016 Oct 18;28:330-334

Authors: Abolhasani M, Salarinejad S, Moslemi MK

Abstract
INTRODUCTION: Ewing sarcoma/Primitive neuroectodermal tumor of the kidney (ES/PNET) is a member of Ewing's sarcoma family, occurring in young adults and has aggressive clinical behavior and poor prognosis. However, its discrimination from the renal cell carcinoma (RCC) is very difficult preoperatively. We present three cases of this rare disease that were managed in two academic centers.
PRESENTATION OF CASES: Herein we report three cases of ES/PNET of the kidney, 2 young men complaining of right flank pain and gross hematuria and one young woman complaining of left subcostal pain. In two cases computerized tomography (CT) scan revealed huge renal masses which were excised by radical nephrectomy. Microscopic examination of the nephrectomy specimen showed primitive neuroectodermal tumor features which confirmed by immunohistochemistry (IHC). Two of 3 patients were treated with adjuvant chemotherapy and the third patient with neoadjuvant chemotherapy. They were symptom-free until now.
DISCUSSION: The clinical course and prognosis of ES/PNET are different from renal cell carcinoma (RCC) and definite pathologic diagnosis is necessary for optimum treatment. For definite diagnosis, in addition to cytogenetic analysis; other techniques may be needed; such as fluorescent in situ hybridization (FISH), reverse transcriptase-polymerase chain reaction (RT-PCR) of the t (11; 22) translocation or the EWS-FLI and related gene fusions [1].
CONCLUSION: Up to our knowledge and search in English literature, this is the first case series that was reported from a major referral center from our country, Iran.

PMID: 27776324 [PubMed - as supplied by publisher]

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Report of a case with gallbladder carcinoma: P53 expression of the peritumor epithelium might predict biliary tract recurrence.

Report of a case with gallbladder carcinoma: P53 expression of the peritumor epithelium might predict biliary tract recurrence.

Int J Surg Case Rep. 2016 Oct 18;28:325-329

Authors: Takano A, Nakagomi H, Ikegame K, Yamamoto A, Watanabe H, Nakada H, Inoue M, Sugai H, Yasutome M, Furuya K, Hada M, Miyasaka Y, Oyama T, Omata M

Abstract
INTRODUCTION: The over-expression of P53 protein in gallbladder carcinoma is a biomarker correlating with a poor survival. However, the significance of P53 expression in peritumor tissues is unknown. We experienced a case of gallbladder carcinoma where the operative specimen showed over-expression of P53 on the peritumor epithelium, and early recurrence developed at the biliary tract.
PRESENTATION OF CASE: A 74-year-old female patient was referred to our hospital due to wall thickening of the gallbladder on ultrasonography. Radiographic examinations revealed wall thickening at the fundus of gallbladder and no abnormalities of the biliary tract or surrounding lymph nodes. We performed open cholecystectomy and lymph node dissection without extrahepatic bile duct resection, as a frozen section of the surgical stump of the cystic duct was cancer-free. However, a pathological examination revealed over-expression of P53 protein in the epithelium of the peritumor to the cystic duct, which were diagnosed as normal on hematoxylin eosin staining. The patient developed bile duct metastases, two and half years after the operation. She underwent endoscopic stenting for the obstruction of bile duct with no additional therapy, and died 6 months later.
DISCUSSION AND CONCLUSION: The immunohistochemical staining of the GB wall or surgical stump for a surgical specimen of GBC may be crucial to predict the bile duct recurrence.

PMID: 27776323 [PubMed - as supplied by publisher]

http://ift.tt/2eFclHW

Atraumatic diplaced bilateral femoral neck fracture in a patient with hypophosphatemic rickets in postpartum period: A missed diagnosis.

Atraumatic diplaced bilateral femoral neck fracture in a patient with hypophosphatemic rickets in postpartum period: A missed diagnosis.

Int J Surg Case Rep. 2016 Oct 17;28:321-324

Authors: Uzun E, Günay AE, Kızkapan TB, Mutlu M

Abstract
INTRODUCTION: Simultaneous bilateral femoral neck fracture is an uncommon condition. There are very few cases reported in the literature and most of these cases have underlying bone pathologies such as renal osteodystrophy and osteomalacia. In some cases bilateral femoral neck fractures occur due to generalized seizures or high-energy trauma.
PRESENTATION OF CASE: In this case report "atraumatic bilateral femoral neck fracture in a 26year old woman in postpartum period with hypophosphatemic rickets disease" is presented.
DISCUSSION: Femoral neck fractures are more frequently seen in elderly because of the reduction of bone quality and developing osteoporosis. In the literature generalized epilepsy, osteomalacia, hypovitaminosis D and chronic renal failure are shown as facilitating causes of bilateral femoral neck fractures. In patients without any additional pathology electric shock, electroconvulsive therapy, and high-energy trauma can lead to femoral neck fractures. In our patient there was also an underlying pathology, she has been followed due to autosomal recessive hypophosphatemic rickets disease since she was one year old. In the treatment of bilateral femoral neck fractures open/closed reduction internal fixation or hip arthroplasty are applied.
CONCLUSION: For patients with bone metabolic diseases and/or the patients in pregnancy and postpartum period, preventive measures should be increased to reduce the risk of pathologic fracture. Admitting to the hospital physicians must be more careful about detecting fractures in these patients.

PMID: 27771603 [PubMed - as supplied by publisher]

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Primary leiomyosarcoma of the greater omentum: a case report.

Primary leiomyosarcoma of the greater omentum: a case report.

Int J Surg Case Rep. 2016 Oct 14;28:317-320

Authors: Brañes A, Bustamante C, Valbuena J, Pimentel F, Quezada N

Abstract
INTRODUCTION: Greater omentum leiomyosarcomas are rare tumors with only a few cases reported in literature.
PRESENTATION OF CASE: We report the case of a 68-year-old man who consulted complaining of diffuse abdominal pain without a palpable mass at physical examination. Imaging studies revealed a solid-cystic lesion in the right lower quadrant. Surgical resection was performed and the tumor was diagnosed as a leiomyoscarcoma by histological and immunohistochemical examinations.
DISCUSSION: Surgical resection of all lesions seems to be a reasonable therapeutic approach if resection is feasible. Chemotherapy may be used in selected cases.
CONCLUSION: More cases are needed to define the best treatment approach of this disease.

PMID: 27771602 [PubMed - as supplied by publisher]

http://ift.tt/2eFbW8q

R gas under diaphragm.

R gas under diaphragm.

Int J Surg Case Rep. 2016 Oct 14;28:314-316

Authors: Ramachar Sreevathsa M, Melanta K

Abstract
INTRODUCTION: The most common cause of gas under diaphragm is hollow viscous perforation. In 10% of cases it can be due to rare causes, both abdominal and extra-abdominal, one of them being intra abdominal infection by gas forming organisms.
PRESENTATION OF THE CASE: A 51 year old male patient, a poorly controlled diabetic, presented with a second episode of severe pain abdomen and abdominal distention, with lower abdominal tenderness. Plain Xray of the abdomen in erect posture showed gas under the right dome of diaphragm and ultrasound abdomen confirmed gross pneumoperitoneum. On emergency laparotomy, a pancreatic abscess was discovered, which had ruptured through the inferior leaf of the transverse mesocolon.
DISCUSSION: There are many obscure causes for extra-intestinal and extra abdominal sources for gas under diaphragm which contribute to 10% of the etiology for the same.These are as follows: post laparotomy status, ruptured liver abscess, retroperitoneal air, biliary-enteric fistula, gall stone ileus, incompetent sphincter of Oddi, focal biliary lipomatosis, post scuba diving, post adeno-tonsillectomy, post dental extraction, following arthroscopy of the knee, intra abdominal sepsis by gas forming organisms and pneumatosis coli to name a few. In this case, Klebsiella was responsible for producing gas under the diaphragm.
CONCLUSION: Pancreatic abscess, in particular, as a extraintestinal source for gas under diaphragm has not been reported in English literature.

PMID: 27771601 [PubMed - as supplied by publisher]

http://ift.tt/2eqwuoz

Deep venous thrombosis as the single sign of unexpected metastatic urinary tract cancer in a patient with a history of cutaneous melanoma: A case report.

Deep venous thrombosis as the single sign of unexpected metastatic urinary tract cancer in a patient with a history of cutaneous melanoma: A case report.

Int J Surg Case Rep. 2016 Oct 14;28:310-313

Authors: Mikkelsen J, Matzen SH

Abstract
INTRODUCTION: Cancer is a recognized risk factor of venous thromboembolism (VTE) as it induces a prothrombotic state through various mechanisms of activation of coagulation. Recognizing occult cancer as a risk factor is equally important. In patients with no known thromboembolic risk factors, utilizing PET/CT as a screening tool may be considered in order to reveal occult malignancy associated with otherwise unexplainable VTE.
METHODS: This case report has been reported in line with the SCARE criteria.
PRESENTATION OF CASE: We describe a case of deep venous thrombosis of the lower leg as the single sign of metastatic urinary tract cancer. The patient had a history of cutaneous melanoma but no thromboembolic risk factors. Following treatment for deep venous thrombosis, the patient was referred directly to the plastic surgery department for further examination including PET/CT due to suspicion of metastatic melanoma.
DISCUSSION: Screening for occult cancer in patients with unprovoked VTE has so far not been shown to benefit survival. As new treatments emerge, significant improvement in prognosis might be expected with early diagnosis of occult cancer and initiation of treatment. Thus an open mind should be kept towards utilizing advanced diagnostic tools such as PET/CT to screen for occult cancer in patients presenting with unprovoked VTE.
CONCLUSION: This case highlights the importance of considering all possible causes and utilizing targeted diagnostic tools when assessing a patient with seemingly unprovoked deep venous thrombosis. A whole-body PET/CT scan ultimately proved significant in revealing occult metastatic cancer of a completely different origin than expected.

PMID: 27771600 [PubMed - as supplied by publisher]

http://ift.tt/2eF9QWf

Cerebellopontine angle gangliogliomas: Report of two cases.

Cerebellopontine angle gangliogliomas: Report of two cases.

Neurochirurgie. 2016 Oct 19;:

Authors: Boissonneau S, Terrier LM, De La Rosa Morilla S, Troude L, Lavieille JP, Roche PH

Abstract
BACKGROUND: Gangliogliomas are rare tumors of the central nervous system. We report two unusual cases of gangliogliomas located in the cerebellopontine angle (CPA).
POPULATION AND METHODS: The first patient was a 57-year-old woman, who presented with dizziness and harbored a non-enhanced heterogeneous mass located in the cisternal space of the CPA. A partial microsurgical removal was performed, and the pathological examination concluded a grade I ganglioglioma according to the WHO Classification. The postoperative course was uneventful without any adjuvant treatment and the 5-year imaging follow-up indicated a stable remnant tumor. The second patient was a 35-year-old male who presented with acute vertigo and imbalance associated with recent prominent headaches; MR imaging showed a large heterogeneous and post-contrast enhanced tumor mass located in the CPA cistern with a mass effect on the brain. An optimal subtotal surgical resection was performed. The pathologists concluded a WHO grade III ganglioglioma. In spite of adjuvant radiotherapy and chemotherapy, the evolution proved unfavorable and patient died from cancer complications within a 2-year period. In both cases, the precise origin of the tumor could not be clearly identified even if the major component was present in the cisternal space.
CONCLUSION: Gangliogliomas growing into the cisternal spaces are exceedingly rare particularly in the CPA. Due to its infiltrating behavior and major difficulties to identify the tumor margins, total resection is not routinely feasible. The histological grading is the most important predictor for oncological prognosis.

PMID: 27771109 [PubMed - as supplied by publisher]

http://ift.tt/2eqvTkg

The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data.

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The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data.

J Evid Based Complementary Altern Med. 2016 Apr;21(2):138-42

Authors: Ndetan H, Hawk C, Sekhon VK, Chiusano M

Abstract
The purpose of this study was to explore the role of chiropractic in the treatment of dizziness or balance disorders through an analysis of data from the 2008 National Health Interview Survey. Odds ratios and 95% confidence intervals (CIs) were used to assess the likelihood that respondents with dizziness or balance problems perceived that they were helped by specified practitioners. Eleven percent of respondents reported having had a balance or dizziness problem; more than 35% were aged 65 years and older. The odds ratio for perceiving being helped by a chiropractor was 4.36 (95% CI, 1.17-16.31) for respondents aged 65 years or older; 9.5 (95% CI, 7.92-11.40) for respondents reporting head or neck trauma; and 13.78 (95% CI, 5.59-33.99) for those reporting neurological or muscular conditions as the cause of their balance or dizziness.

PMID: 26362851 [PubMed - indexed for MEDLINE]

http://ift.tt/2eNyUcu

Hepatitis B reactivation during everolimus treatment.

Hepatitis B reactivation during everolimus treatment.

Acta Oncol. 2016 Oct 24;:1-2

Authors: Mir O, Toulmonde M, Coriat R, Ropert S, Loulergue P

PMID: 27771976 [PubMed - as supplied by publisher]

http://ift.tt/2equGcs

Myelofibrosis: an update on drug therapy in 2016.

Myelofibrosis: an update on drug therapy in 2016.

Expert Opin Pharmacother. 2016 Oct 22;

Authors: Bose P, Verstovsek S

Abstract
INTRODUCTION: Primary myelofibrosis (PMF) is the least common but the most aggressive of the classic Philadelphia chromosome-negative myeloproliferative neoplasms. Survival is much shorter in PMF than in polycythemia vera (PV) or essential thrombocythemia (ET). Post-PV/ET myelofibrosis (MF) is clinically indistinguishable from PMF and approached similarly.
AREAS COVERED: Current pharmacologic therapy of MF revolves around the Janus kinase 1/2 (JAK1/2) inhibitor ruxolitinib, which dramatically improves constitutional symptoms and splenomegaly in the majority of patients, and improves overall survival (OS). However, allogeneic stem cell transplantation remains the only potential cure. Other JAK inhibitors continue to be developed for MF, and momelotinib and pacritinib are in phase III clinical trials. Anemia is common in MF, and initially worsened by ruxolitinib. Momelotinib and pacritinib may prove advantageous in this regard. Current strategies for managing anemia of MF include danazol, immunomodulatory drugs and erythroid stimulating agents, either alone or in combination with ruxolitinib.
EXPERT OPINION: A number of other agents, representing diverse drug classes, are in various stages of development for MF. These include newer JAK inhibitors, other signaling inhibitors, epigenetic modifiers, anti-fibrotic agents, telomerase inhibitors, and activin receptor ligand traps (for anemia). Hopefully, these novel therapies will further extend the clinical benefits of ruxolitinib.

PMID: 27774820 [PubMed - as supplied by publisher]

http://ift.tt/2eNCvY4

New treatment strategies for HIV-positive cancer patients undergoing antiblastic chemotherapy.

New treatment strategies for HIV-positive cancer patients undergoing antiblastic chemotherapy.

Expert Opin Pharmacother. 2016 Oct 22;

Authors: Berretta M, Di Francia R, Stanzione B, Facchini G, LLeshi A, De Paoli P, Spina M, Tirelli U

Abstract
INTRODUCTION: The introduction of Highly Active Antiretroviral Therapy (HAART) into clinical practice has dramatically changed the outcome of HIV-infected patients by prolonging their survival. The increase in life expectancy has led to an increased risk of non-AIDS-related mortality and morbidity, including cardiovascular diseases, neurocognitive diseases, neuroendocrine dysfunctions and cancer. Areas Covered: The GICAT (Italian Cooperation Group on AIDS and Tumors) has demonstrated that patients who receive a multidisciplinary approach with the combination of anticancer agents (AC) and HAART can achieve better responses and survival rates than patients who receive AC alone. The first obstacle for the oncologist to plan treatment for cancer HIV-patients is the preliminary evaluation of drug-drug interactions between AC and HAART. Recent progress in pharmacogenomics could provide a new approach for personalized treatments. The rationale of this review is to summarize the existing data on the impact of HAART on the clinical management of cancer patients with HIV/AIDS and DDIs between antiretrovirals and AC. In addition, to maximize the efficacy of both concomitant therapy and to minimize the risk of DDIs, a currently useful list of pharmacogenomic markers of key metabolic enzymes is provided. Expert opinion: In this scenario, the importance of cooperation between oncologists and other health specialists (i.e., infectivologists, pharmacists, genetics and lab specialists) must not be underestimated in the management of these patients with the aim of planning an individual treatment strategy.

PMID: 27771974 [PubMed - as supplied by publisher]

http://ift.tt/2eqsx0p

pH Impedance vs. traditional pH monitoring in clinical practice: an outcome study.

Related Articles

pH Impedance vs. traditional pH monitoring in clinical practice: an outcome study.

J Gastroenterol. 2016 Feb;51(2):130-7

Authors: Pugliese D, Mauro A, Consonni D, Bravi I, Tenca A, Elvevi A, Conte D, Penagini R

Abstract
BACKGROUND: The addition of impedance to 24-h pH monitoring has allowed detection of weakly acidic reflux, but the extent to which pH-impedance (pH-MII) monitoring improves outcomes is unknown.
METHODS: This was a prospective observational study. Patients referred for pH or pH-MII monitoring completed a standardized questionnaire on improvement in the dominant symptom, their satisfaction, and treatment at 3 and 12 months after the test during a telephone interview.
RESULTS: A total of 184 patients (mean age, 52 years, range, 19-82 years; 35 % with typical symptoms; and 89 % tested off therapy) completed pH (n = 92) or pH-MII monitoring (n = 92) over a period of 15 months. The two arms were similar in terms of demographic, clinical, and endoscopic variables. Ten patients in the pH-MII arm showed evidence of weakly acidic reflux disease. There was no difference in the percentage of patients in the pH and pH-MII monitoring arms who experienced improvement in their dominant symptom after 3 (58 vs. 63 %; p = 0.621) or 12 months (66 vs. 70 %; p = 0.234), and the same was true for patient satisfaction. There were also no between-group difference in the use of proton pump inhibitors (PPIs) after 3 (63 vs. 68.5 %; p = 0.437) or 12 months (47 vs. 60.5 %; p = 0.051). PPIs were prescribed more frequently after a positive test (p < 0.001) although they were used by 45.6 % of the negative patients. Only one patient underwent fundoplication.
CONCLUSIONS: Two-thirds of patients undergoing pH-MII monitoring experience a positive outcome, similarly to what occurs after traditional pH monitoring. Physicians often pay little attention to the test results, especially if they are negative.

PMID: 26033511 [PubMed - indexed for MEDLINE]

http://ift.tt/2ejqY3h

"Reg Anesth Pain Med"[jour]; +34 new citations

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Surgical resection of sinonasal hemangiopericytoma involving anterior skull base: case reports and literature review.

Surgical resection of sinonasal hemangiopericytoma involving anterior skull base: case reports and literature review.

Am J Otolaryngol. 2016 Sep 28;:

Authors: Simmonds JC, Rebeiz EE

Abstract
Hemangiopericytomas are soft tissue tumors composed of pericytic cells that are characterized by their "staghorn" vascular branching and their variable clinical presentation. Fifteen to 25% of all HPC occur in the head and neck, with only 5% found in the nose or paranasal sinuses. Sinonasal hemangiopericytoma (SNHPC) is considered distinct from its soft tissue counterpart - the former showing a more uniform cellular organization, has convincing pericytic differentiation and is associated with a far better prognosis. With less than 200 cases of SNHPC reported in the literature, only limited assumptions can be made about this rare tumor. The purpose of this article is to add to the growing body of literature on this disease. We report two new cases of SNHCP - both in female patients who presented with epistaxis and anosmia. Pulsatile vascular masses were visualized with nasal endoscopy - one in the left middle meatus and the second one near the cribriform plate. CT and MRI studies show enhancing masses in the left nasal cavities with thinning and erosion of the skull base. Diagnoses were confirmed by pathology which reported spindle cell neoplasm staining positively for VEGF, NSE, factor XIIIa, S-100 protein, and CD34, and negative for actin, desmin, CD31, and pankeratin, consistent with hemangiopericytoma. In one patient, embolization of the sphenopalatine and labial artery as well as pre-operative radiation therapy was performed before complete endoscopic resection was undertaken. The second patient had a tumor invading the skull base, so a craniofacial resection was performed. Both patients remained free of disease two years after surgery. Review of the literature and treatment options are discussed.

PMID: 27773560 [PubMed - as supplied by publisher]

http://ift.tt/2fbpCKp

Comparison of the Surgical Outcome of Pterional and Frontotemporal-orbitozygomatic Approaches and Determination of Predictors of Recurrence for Sphenoid Wing Meningiomas.

Comparison of the Surgical Outcome of Pterional and Frontotemporal-orbitozygomatic Approaches and Determination of Predictors of Recurrence for Sphenoid Wing Meningiomas.

World Neurosurg. 2016 Oct 19;:

Authors: Bir SC, Maiti T, Konar S, Nanda A

Abstract
OBJECTIVE: The pterional/frontotemporal orbitozygomatic (FTOZ) approaches are the two widely used procedures for resection of sphenoid wing meningiomas. However, a comparison of outcomes and complications of these two approaches has not been well described yet. Here, we investigated the outcomes, complications and predictors of favorable outcomes of these two approaches.
METHODS: Data of ninety consecutive cases with sphenoid wing meningiomas between 1995 and 2015 was reviewed retrospectively. A Kaplan-Meier survival analysis and Cox proportional hazards regression model was used to determine the recurrence-free (RFS) survival and independent predictor of RFS.
RESULTS: In this study, the overall recurrence rate after tumor excision with pterional and FTOZ approaches was 36.5% and 12.2% respectively (p=0.001). Based on surgical approach, the median RFS of the patients with sphenoid wing meningiomas also varied significantly (pterional, 114 months vs. FTOZ, 145 months, p=0.03). The median RFS for patients with sphenoid wing meningiomas also varied according to the extent of resection (gross total resection, 146 months vs. sub-total resection, 52 months, p=0.009). In Cox regression analysis, FTOZ approach (p=0.041), gross total resection (p=0.047), and Karnofsky performance score (KPS) >70 (p=0.04) were revealed as significant predictors of favorable outcome after resection of sphenoid wing meningiomas.
CONCLUSIONS: In summary, sphenoid wing meningiomas undergoing extensive skull base approach (FTOZ) and gross total resection (GTR) had a low recurrence rate and higher RFS. Even though FTOZ with GTR is preferable to resect the sphenoid wing meningiomas, the procedure should be tailored to each patient depending on the risks and surgical morbidity.

PMID: 27771478 [PubMed - as supplied by publisher]

http://ift.tt/2ejsdPY

Image-guided transoral approach in severe craniovertebral junction malformations at the golden age of endoscopy: Regarding 2 cases.

Image-guided transoral approach in severe craniovertebral junction malformations at the golden age of endoscopy: Regarding 2 cases.

Neurochirurgie. 2016 Oct 19;:

Authors: Mazerand E, Karmani N, Le Fournier L, Laccourreye L, Fournier HD

Abstract
INTRODUCTION: The image-guided transoral approach (IGTOA) provides a safe exposure to skull base midline lesions and the ventral aspect of the craniovertebral junction (CVJ). The IGTOA has several advantages: the head being placed in the extended position, it decreases the brainstem angulation during surgery; the approach being done through the avascular median pharyngeal raphe, not only lowers the bleeding risk but also provides a direct access to the bony pathology and granulation tissue accessible only via the ventral route. Wide field exposure and maneuverability are necessary to deal with the entire ventral brainstem compression in case of severe CVJ malformation to safely perform partial clivectomy and odontoidectomy.
PRESENTATION OF TWO CASES: We illustrate the cases of two patients, 52-year-old and 42-year-old males, who presented with an impressive craniovertebral junction malformation, confirmed on CT and MRI images. They first underwent surgery by IGTOA, later completed by occipitocervical fixation. For the two patients, outcomes were assessed respectively at 4 and 5 years and showed satisfactory results both clinically and radiologically.
CONCLUSION: In patients with marked ventral compression, the IGTOA provides direct and guided access to the anterior aspect of the CVJ and effective means for odontoidectomy and clivectomy. This approach is more easily maneuverable compared to the endonasal endoscopic approach. The IGTOA approach is quite a complex technique, requiring multidisciplinary skills, but it should primarily be used in difficult situations. We suggest that endonasal endoscopy is over-utilized. We consider that endoscopy should not be routinely performed and kept only for well-selected cases.

PMID: 27771110 [PubMed - as supplied by publisher]

http://ift.tt/2fbrfaU

Surgical anatomy of the spinal accessory nerve: review of the literature and case report of a rare anatomical variant.

Related Articles

Surgical anatomy of the spinal accessory nerve: review of the literature and case report of a rare anatomical variant.

J Laryngol Otol. 2016 Oct;130(10):969-972

Authors: Overland J, Hodge JC, Breik O, Krishnan S

Abstract
OBJECTIVE: To evaluate the prevalence of variations in the anatomical route of the spinal accessory nerve from the base of the skull to the point where it enters the trapezius muscle. A case report is used to demonstrate an example of a rare but clinically important anatomical variant of this nerve.
METHODS: An independent review of the literature using Medline, PubMed and Q Read databases was performed using combinations of terms including 'spinal accessory nerve', 'anatomy', 'surgical anatomy', 'anatomical variant', 'cranial nerve XI' and 'shoulder syndrome'.
RESULTS: Our report demonstrates marked variation in spinal accessory nerve anatomy. At the point of crossing over the internal jugular vein, the spinal accessory nerve passes most commonly laterally (anterior) to the internal jugular vein. The reported incidence of this lateral relationship varies from 67 to 96 per cent. The nerve can also pierce the internal jugular vein, as demonstrated in our case study, with incidence ranging from 0.48 to 3.3 per cent.
CONCLUSION: Anatomical variations of the spinal accessory nerve are not uncommon, and it is important for the surgeon to be aware of such variations when undertaking surgery in both the anterior and posterior triangles of the neck.

PMID: 27268496 [PubMed - in process]

http://ift.tt/2eju3A8

A rare case of a pineoblastoma with a rhabdomyoblastic component.

A rare case of a pineoblastoma with a rhabdomyoblastic component.

Neuropathology. 2016 Oct 24;:

Authors: Homma T, Hemmi A, Ohta T, Kusumi Y, Yoshino A, Hao H

Abstract
Pineal anlage tumor (PAT) is a rare subtype of pineoblastoma (PB), which shows a poor prognosis. We report a case of a 5-year-old boy with PB with a rhabdomyoblastic component. He presented at a local clinic with vomiting and was transferred to our hospital following discovery of a pineal mass. An endoscopic biopsy was performed and was diagnosed as a PB with a rhabdomyoblastic component. Histopathology of PAT is characterized by both neuroectodermal and ectomesenchymal differentiation, and only a few confirmed cases have been reported. Although the histopathological features of the reported case resembled that of PAT, the ectomesenchymal component in the presented case was only a rhabdomyoblastic one. Therefore, we have diagnosed this case as PB with a rhabdomyoblastic component. As PAT is a rare pineal tumor, clinical, histopathological and genetic evaluation of additional cases is needed to define the characteristics of PAT as one of the pineal gland tumors.

PMID: 27775846 [PubMed - as supplied by publisher]

http://ift.tt/2ejrcYk

Neurocysticercosis: a review on status in India, management, and current therapeutic interventions.

Neurocysticercosis: a review on status in India, management, and current therapeutic interventions.

Parasitol Res. 2016 Oct 24;

Authors: Ahmad R, Khan T, Ahmad B, Misra A, Balapure AK

Abstract
Tapeworms (cestodes) are segmented flatworms responsible for causing diseases that may prove fatal and difficult to treat in the absence of proper treatment and efficient drugs. Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system and a major contributor to epilepsy caused by the metacestode (larva) of the human tapeworm Taenia solium, characterized by a range of pathological symptoms including epileptic seizures, headaches, and hydrocephalus. Cysticercosis is considered as a "biological imprint" of the socioeconomic development of a community in general and a country in particular. It is the single most common cause of epilepsy in the resource-poor endemic regions of the world, including most of South and Central America, India, Southeast Asia, China, and sub-Saharan Africa. A vast degree of variation in the neuropathology and clinical symptoms of NCC often makes it difficult to diagnose and manage. To add to it, emerging drug resistance to known anti-parasitic agents, together with the inability of these agents to prevent re-infection and relapse, further complicates the disease scenario. The aim of the current review was to provide the latest update on NCC with special emphasis on the Indian scenario, along with current and novel methods of diagnosis as well as scope of development for novel detection techniques, novel targets for drug development, and therapeutic interventions, as well as future challenges.

PMID: 27774576 [PubMed - as supplied by publisher]

http://ift.tt/2fbrzqf

Closure of Skin Incision by Dual Wavelength (980&1064 nm) Laser Application.

Closure of Skin Incision by Dual Wavelength (980&1064 nm) Laser Application.

J Cosmet Laser Ther. 2016 Oct 24;:1-13

Authors: Uba AI, Tabakoglu HO, Abdullahi UA, Sani MM

Abstract
Thermal effect of dual wavelength (980 & 1064nm) laser application in skin incision closure was assessed on 18 male and female Wister rats. 1cm-long Incisions were made on the shaved dorsal region of 220-250g animals. The incisions were closed by laser irradiation at 1W and exposure time, 5 seconds in Continuous wave mode (CW) and 1W and exposure time, 10 seconds in pulsed mode to deliver a total energies, 5J and 10J per spot onto the incisions respectively. Animals from each group were sacrificed at 0th, 4th and 7th days and the skin samples of the weld area were excised for histological analysis using H&E Stain. Mean thermally altered area (TAA) of CW mode laser treated groups was found to increase significantly (p<0.05) compared with pulsed mode laser treated group at 0(th) and 4(th) days post-irradiation while no significant difference (p>0.05) was statistically found at 7th day post-irradiation. Moreover, tighter closure was observed with CW group at 7th day post-irradiation. We thus conclude that 1W, 5J for 5 seconds CW mode laser application of 980 & 1064nm combined beam form in skin incision closure was found to have absolute wound healing capability with minimal thermal alteration.

PMID: 27775451 [PubMed - as supplied by publisher]

http://ift.tt/2eCeq5P

Evaluating photographic scales of facial pores and diagnostic agreement of tests using latent class models.

Evaluating photographic scales of facial pores and diagnostic agreement of tests using latent class models.

J Cosmet Laser Ther. 2016 Oct 24;:1-15

Authors: Ning Y, Qing Z, Qing W, Li L

Abstract
BACKGROUND: Ordinal severity scales illustrated by photographs have been widely developed to help dermatologists evaluating skin problems or improvements. Numerous scales have been published and none of them were used for assessing facial pores.
METHODS: A five-point photographic scale of facial pores was formulated and photographs of pores on nasal ala from 128 female volunteers were acquired. Five dermatologists with similar experiences rated the 128 photographs independently using the reference photographs. Latent Class Models(LCM) were used to analyze the data. Firstly we hypothesized that the conditional probabilities of the five dermatologists were identical to build the first LCM, and without the restriction to formulate the second LCM. Conditional probability and posterior probability were also calculated.
RESULTS: The five-point scales were ambiguous for the raters actually had difficulties in distinguishing between some adjacent categories. Adjacent categories were pooled for reanalyzing and the model fitted well.
CONCLUSIONS: The newly developed photographic scale of Chinese facial pores should be redefined to improve their quality and reproducibility in future studies. A standardized scales for measurement of ageing and response to cosmetic therapy were essential for assessing diagnostic experiment. The LCM can effectively deal with diagnostic test of agreement and reproducibility.

PMID: 27775445 [PubMed - as supplied by publisher]

http://ift.tt/2eAxzZ1

Angiogenesis inhibitor; +23 new citations

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Angiogenesis inhibitor

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PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Evaluating the effect of hydrocephalus cause on the manner of changes in the effective parameters and clinical symptoms of the disease.

Evaluating the effect of hydrocephalus cause on the manner of changes in the effective parameters and clinical symptoms of the disease.

J Clin Neurosci. 2016 Oct 20;:

Authors: Gholampour S, Fatouraee N, Seddighi AS, Seddighi A

Abstract
In the present study, the heads of 11 normal subjects and 21 patients affected by hydrocephalus due to three different causes were simulated using fluid-structure interaction (FSI). To validate the results, the calculated diagram of CSF velocity in aqueduct of Sylvius (AS) was compared with the similar velocity diagram measured using Cine PC-MRI for the same subject. After ensuring the agreement of results, other outputs such as CSF pressure were calculated non-invasively using FSI. The intracranial pressure and CSF pressure in AS and behind the optic nerve sheath were in patients 5-5.3 times the value in normal subjects and the ventricular system volume in patients was 10.2-11.1 times the value in normal subjects. However, the difference between the coefficient of variation and the maximum value of pressure and volume in different types of hydrocephalus was small. Furthermore, the difference between CSF stroke volumes in various types of hydrocephalus patients was less than 4.4%. Results showed that the intensity of clinical symptoms was similar in patients with similar CSF pressure and the cause of the hydrocephalus disease didn't have any significant effect on the intensity of patients' clinical symptoms and the manner of changes in effective parameters on disease. It was also found that the relation of CSF pressure and volume was 16.7% greater in patients with non-communicating hydrocephalus than in patients with communicating hydrocephalus. These results enhance the insight into hydrocephalus bio-mechanism and can help to choose the proper treatment method for hydrocephalus patients.

PMID: 27773546 [PubMed - as supplied by publisher]

http://ift.tt/2eAucAZ

Comparison of Conscious Sedation and Asleep-Awake-Asleep Techniques for Awake Craniotomy.

Comparison of Conscious Sedation and Asleep-Awake-Asleep Techniques for Awake Craniotomy.

J Clin Neurosci. 2016 Oct 19;:

Authors: Dilmen OK, Akcil EF, Oguz A, Vehid H, Tunali Y

Abstract
Since awake craniotomy (AC) has become a standard of care for supratentorial tumour resection, especially in the motor and language cortex, determining the most appropriate anaesthetic protocol is very important. The aim of this retrospective study is to compare the effectiveness of conscious sedation (CS) to "awake-asleep-awake" (AAA) techniques for supratentorial tumour resection. Forty-two patients undergoing CS and 22 patients undergoing AAA were included in the study. The primary endpoint was to compare the CS and AAA techniques with respect to intraoperative pain and agitation in patients undergoing supratentorial tumour resection. The secondary endpoint was comparison of the other intraoperative complications. This study results show that the incidence of intraoperative agitation and seizure were lower in the AAA group than in the CS group. Intraoperative blood pressures were significantly higher in the CS group than in the AAA group during the pinning and incision, but the level of blood pressures did not need antihypertensive treatment. Otherwise, blood pressures were significantly higher in the AAA group than in the CS group during the neurological examination and the severity of hypertension needed statistically significant more antihypertensive treatment in the AAA group. As a result of hypertension, the amount of intraoperative bleeding was higher in the AAA group than in the CS group. In conclusion, the AAA technique may provide better results with respect to agitation and seizure, but intraoperative hypertension needed a vigilant follow-up especially in the wake-up period.

PMID: 27771234 [PubMed - as supplied by publisher]

http://ift.tt/2eAxQeo

CADASIL mimicking multiple sclerosis: The importance of clinical and MRI red flags.

CADASIL mimicking multiple sclerosis: The importance of clinical and MRI red flags.

J Clin Neurosci. 2016 Oct 20;:

Authors: Joshi S, Yau W, Kermode A

Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited small vessel disease, manifesting as recurrent ischaemic events, migraine with aura, behavioural disturbance and cognitive decline. We report two patients with CADASIL masquerading as multiple sclerosis (MS). A 23year old female presented with a visual scotoma and was discovered to have a corresponding retinal cotton wool spot. MRI brain revealed diffuse T2 hyperintensities suggestive of demyelination. A 56year old male presented with transient sequential paraesthesia, initially of the perineum followed by the right leg. He also reported memory and mood impairment with a history of migraine with aura. MRI of the brain showed diffuse bilateral white matter lesions with sparing of the anterior temporal poles. Both patients satisfied the modified McDonald diagnostic criteria and were initially thought to have MS. However, they did not satisfy the caveat of "no better explanation" and on subsequent testing NOTCH 3 mutations were identified in both patients [1]. These cases highlight the importance of careful clinical assessment and neuroimaging findings in identifying clinical and paraclinical 'red-flags' for a diagnosis other than MS.

PMID: 27773545 [PubMed - as supplied by publisher]

http://ift.tt/2e6tgRI

The emergent role of exosomes in glioma.

The emergent role of exosomes in glioma.

J Clin Neurosci. 2016 Oct 19;:

Authors: Gourlay J, Morokoff AP, Luwor RB, Zhu HJ, Kaye AH, Stylli SS

Abstract
Extracellular vesicles (EVs) are known mediators of intercellular communication for both normal and tumour cells. With the capability to transfer nucleic acids, proteins and lipids, EVs are able to influence numerous functional and pathological aspects of both donor and recipient cells. The tumour microenvironment possesses a high level of complex heterogeneity, particularly within the most prominent brain malignancy, glioblastoma multiforme (GBM). This complexity relies on a network-based communication between many different components of the local niche, including the various cell types, stroma, blood vessels, secreted factors and surrounding matrix. Exosomes are one type of EV which facilitates this intercellular communication and cross-talk within the tumour microenvironment. Exosomes secreted by tumour cells are increasingly recognized in a number of processes underlying tumour progression including facilitating the transport of receptors, signalling molecules, oncogenic genes and miRNA. They are emerging as a key component in the biogenesis of glioma, in addition to contributing to the modification of the surrounding microenvironment to support tumour progression. In this review we describe advancements in the understanding of the biology of exosomes, as well as their roles in tumour progression, as a tumour biomarker for tracking cancer progression, and as a potential therapeutic target/delivery system, with a contextual emphasis on GBM.

PMID: 27771233 [PubMed - as supplied by publisher]

http://ift.tt/2e6qI5Q

Mantle Cell Lymphoma With MYC Rearrangement: A Report of 17 Patients.

Mantle Cell Lymphoma With MYC Rearrangement: A Report of 17 Patients.

Am J Surg Pathol. 2016 Oct 21;

Authors: Hu Z, Medeiros LJ, Chen Z, Chen W, Li S, Konoplev SN, Lu X, Pham LV, Young KH, Wang W, Hu S

Abstract
MYC rearrangement in mantle cell lymphoma (MCL) is rare, and its clinicopathologic significance is not well defined. We report 17 cases of MCL with 8q24/MYC rearrangement, detected at the time of initial diagnosis of MCL in 10 patients and subsequently during the clinical course in 7 patients. There were 12 men and 5 women with a median age of 61 years (range, 49 to 81 y). Fourteen patients had lymphadenopathy (Ann Arbor stage III/IV), and 3 patients presented with a leukemic pattern without lymphadenopathy. Thirteen of 14 patients with available karyotyping data had a complex karyotype. In 8 cases the partner chromosome locus was an IG locus: t(8;14) (n=7) and t(8;22) (n=1). When MYC rearrangement was detected, most patients had a high-risk MCL international prognostic index, and the lymphoma cells had histologically aggressive features. Immunophenotypic analysis showed that the lymphoma cells were positive for cyclin D1 (n=16/16), Myc (9/11), and P53 (n=9/9). The Ki-67 proliferation rate was high (≥60%) in 10/11 cases. All patients received chemotherapy. The median follow-up time was 23 months. Clinical follow-up was available for 14 patients and treatment response in 13 patients. Eleven of 13 patients had refractory or relapsed disease, and 11 patients died. In conclusion, MCL with MYC rearrangement is characterized by advanced-stage disease, aggressive morphologic features, a high proliferation rate, p53 expression, a complex karyotype, and a poor prognosis. We believe these neoplasms fit within the overall concept of double-hit lymphoma, and the designation double-hit MCL may be helpful. We also believe that MYC rearrangement in MCL conveys important prognostic information that should be incorporated into the pathology report.

PMID: 27776009 [PubMed - as supplied by publisher]

http://ift.tt/2eNwue4

Massive pulmonary embolism and a cardiac mass: Thrombus or metastasis?

Massive pulmonary embolism and a cardiac mass: Thrombus or metastasis?

Turk Kardiyol Dern Ars. 2016 Oct;44(7):597-599

Authors: Gül M, Babat N, Uçar FM, Kuyumcu MS, Özeke Ö

Abstract
Cardiac mass can be described as an abnormal structure within or directly contiguous to the heart. Tumors and thrombi are the most common types of cardiac masses. Intracardiac thrombi have been encountered in various clinical settings and can result in severe morbidity and mortality due to embolic events. Cardiac neoplasms are extremely rare, and are usually metastatic tumors. The major primary malignancies associated with cardiac metastases include cancers of the lung, breast, stomach, and liver, and lymphoma, leukemia, and melanoma. Osteosarcoma (OS) is the most common type of bone malignancy, and is almost always highly malignant. A previous study demonstrated that OS very rarely metastasizes to the heart. Presently reported is an unusual case of OS with intracaval, right atrial, and right ventricular extension that was misdiagnosed as venous thrombus.

PMID: 27774970 [PubMed - in process]

http://ift.tt/2eqoEZq

A Rare Location of a Neuroendocrine Tumor.

A Rare Location of a Neuroendocrine Tumor.

Cureus. 2016 Sep 21;8(9):e794

Authors: Chaaya G, Vasquez JB, Zayat V

Abstract
Neuroendocrine tumors (NETs) arising in the duodenum are rare neoplasms that are often classified as indolent and have a low potential to metastasize. Although rare, multiple reports cite an increasing incidence of duodenal NETs. Symptoms are usually nonspecific and the diagnosis is made via endoscopy. Endoscopic resection is the mainstay of therapy. The prognosis is usually favorable. We describe a case of a duodenal NET that presented with vague symptoms in order to increase the awareness of this rare but increasing in frequency entity.

PMID: 27774362 [PubMed - in process]

http://ift.tt/2eAxe8k

Brain Metastasis of Pleural Mesothelioma after a Subarachnoid Hemorrhage.

Related Articles

Brain Metastasis of Pleural Mesothelioma after a Subarachnoid Hemorrhage.

Intern Med. 2016;55(7):779-81

Authors: Hirooka A, Tamiya A, Kanazu M, Nonaka J, Yonezawa T, Asami K, Atagi S

Abstract
Malignant pleural mesothelioma (MPM) is an uncommon, fatal neoplasm induced by asbestos exposure. Brain metastases from MPM are extremely rare, with most such cases diagnosed only at the time of autopsy. This report describes what we believe to be the first case of MPM metastasizing to the brain after a subarachnoid hemorrhage, as well as the subsequent surgical removal of the brain metastasis.

PMID: 27041164 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6r3p4

Coexistence of splenic hemangioma and vascular malformation of the vertebrae.

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Coexistence of splenic hemangioma and vascular malformation of the vertebrae.

BMC Res Notes. 2016 Feb 09;9:76

Authors: Jalaeikhoo H, Ariana M, Kashfi SM, Azimzadeh P, Narimani A, Dadpay M, Keyhani M

Abstract
BACKGROUND: Cavernous hemangioma is an encapsulated mass of dilated, endothelial lined vascular channels filled with slowly flowing blood. Cavernous hemangioma of the spleen is a rare condition with less than 100 reports so far. Hemangioma of the vertebral is a benign vascular legion around one or two vertebrae. These are usually asymptomatic and discovered incidentally. In this study we reported an extreme rare case of splenic hemangioma coexistence with vascular malformation of the vertebrae. To our knowledge this is the first report of coexistence of splenic hemangioma and hemangioma of the vertebra.
CASE PRESENTATION: A 20-year-old iranian male with splenomegaly, abdominal pain, diarrhea and pancytopenia who was first highly suspicious for malignancy referred to our center for evaluation of the diagnostic workup. After full examination we detected a very rare case with a giant, solitary cavernous hemangioma of the spleen and multiple hemangiomas in his vertebrae. Histopathology of the spleen showed a large cavernous hemangioma occupying almost the entire spleen with large areas of infarction necrosis with multiple hemangiomas of the vertebrae.
CONCLUSION: It is extremely rare to have a splenic hemangioma concurrent with vertebra hemangioma and this is clinically very important to consider splenic hemangioma in differential diagnosis of splenomegaly for a better therapeutic management in related patients.

PMID: 26860733 [PubMed - indexed for MEDLINE]

http://ift.tt/2eAy0Cp

Gastrointestinal Neuroendocrine Tumors in Two Children.

Related Articles

Gastrointestinal Neuroendocrine Tumors in Two Children.

Indian Pediatr. 2016 Jan;53(1):70-2

Authors: Koca T, Dereci S, Karahan N, Akcam M

Abstract
BACKGROUND: Enterochromaffin-like cell hyperplasia and neuroendocrine tumors are relatively rare in childhood.
CASE CHARACTERISTICS: A 15-year-old girl who presented with epigastric pain and a 6-year-old boy who was admitted with hematochezia. Endoscopy revealed nodules in the stomach in Case 1, and polyploidy lesion in the rectum in Case 2.
OUTCOME: Enterochromaffin-like cell hyperplasia in Case 1 and neuroendocrine tumor in Case 2.
MESSAGE: A low index of suspicion for neuroendocrine tumors in children can result in delay in the detection of these rare but potentially malignant diseases.

PMID: 26840681 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6sB2s

Management of Intravenous Leiomyomatosis of Uterus with Extension to Heart.

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Management of Intravenous Leiomyomatosis of Uterus with Extension to Heart.

Arch Iran Med. 2016 Feb;19(2):147-9

Authors: Alizade K, Maddah G, Jafarian AH, Khamene Bagheri A, Jafarzadeh Esfehani R, Mirzaeian S

Abstract
Leiomyoma is a benign smooth muscle tumor. Intra-venous extensions of these tumors occur due to tumor growth within uterine vein or lymphatic vessels. In rare cases, intracaval and intracardiac extension can also be seen. Clinical suspicion of this disease should become certain by use of imaging techniques. While the treatment is complete resection of the tumor, one or two-stage surgery can be planned for patient depending on tumor extension and patient's condition. In this report, a 52-year-old woman with a rare presentation of uterine leiomyoma will be discussed. While the tumor was extended toward right atrium, the patient had nonspecific symptoms. By use of two-stage surgery, separated laparotomy and cardiopulmonary bypass, the tumor was completely removed.

PMID: 26838087 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6tKXU

Primary pleuropulmonary synovial sarcoma: a case report.

Related Articles

Primary pleuropulmonary synovial sarcoma: a case report.

Int J Clin Exp Pathol. 2015;8(11):15426-8

Authors: Yuan L, Guan Z, Dai X, Xu J

Abstract
Pleuropulmonary synovial sarcoma (PPSS) is an extremely rare malignant tumor, which is increasingly recognized as a subtype of sarcoma with a distinctive chromosomal translocation specific to synovial sarcoma. It is often presents like any thoracic tumor with symptoms such as chest pain or cough. Here we report a case of PPSS in a 49-year-old woman presenting with cough, shortness of breath and chest pain. And who were found upon histologic examination of the resection specimen to have cystic primary pleuropulmonary synovial sarcoma.

PMID: 26823907 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6r8cJ

Renal pelvis urothelial carcinoma of the upper moiety in complete right renal duplex: a case report.

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Renal pelvis urothelial carcinoma of the upper moiety in complete right renal duplex: a case report.

Int J Clin Exp Pathol. 2015;8(11):15422-5

Authors: Zhang Y, Yu Q, Zhang Z, Liu R, Xu Y

Abstract
Urothelial carcinoma (UC) originated from renal pelvis is the common tumor of the urinary system, however, neoplasia of the renal pelvis in duplex kidneys is extremely rare, especially in the complete renal and ureteral duplex cases. We present the first case of renal pelvis UC of the upper moiety in a complete right renal duplex. This male patient has bilateral complete renal and ureteral duplex. To the best of our knowledge, this is the first reported case of renal pelvis UC in a complete renal duplex system. After this experience we feel that the diagnosis of renal pelvis UC in duplex kidneys is not so easy, and once the diagnosis is determined, the whole renal duplex units and bladder cuff or ectopic orifice should be excised radically.

PMID: 26823906 [PubMed - indexed for MEDLINE]

http://ift.tt/2eAz8Gf

Metastasis of breast cancer to renal cancer: report of a rare case.

Related Articles

Metastasis of breast cancer to renal cancer: report of a rare case.

Int J Clin Exp Pathol. 2015;8(11):15417-21

Authors: Huo Z, Gao Y, Yu Z, Zuo W, Zhang Y

Abstract
Tumor-to-tumor metastasis (TTM) is a rare phenomenon. We present a case of an invasive ductal carcinoma (IDC) of the breast metastasizing to a clear cell renal cell carcinoma (RCC). Breast cancer (BC) metastasis to the RCC is rarely reported, especially in resected kidney tumor. In several cases reported, IDC was the exclusively histologic type of BC metastasized to RCC. It seems that the different molecular type of IDC doesn't affect the metastatic tendencies to RCC. TTM was an indicator of diffuse disease. For any patient with a history of breast cancer, especially with multi-organs metastasis, resection of kidney tumor should be carefully considered.

PMID: 26823905 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6pIPl

Cardial leiomyosarcoma with multiple lesions involved: a case report.

Related Articles

Cardial leiomyosarcoma with multiple lesions involved: a case report.

Int J Clin Exp Pathol. 2015;8(11):15412-6

Authors: Lv Y, Pang X, Zhang Q, Jia D

Abstract
BACKGROUND: Leiomyosarcoma of the heart is extremely rare and may involve many symptoms. The outcome is poor and the median survival is only 6 months.
CASE PRESENTATION: A 43-years-old female patient complained of palpitation and dyspnea and was diagnosed as bilateral iliac vein-inferior vena cava-right atrium-pulmonary masses. Pathological diagnosis was leiomyosarcoma of vascular origin and she survived for 12 months after surgery.
CONCLUSION: According to the summarization of 30 vascular leiomyosarcoma cases with heart involved we can find that surgical resection is the basic treatment for cardiac leiomyosarcoma, and surgery combined with chemotherapy may be able to further prolong survival.

PMID: 26823904 [PubMed - indexed for MEDLINE]

http://ift.tt/2eAxdkM

Lobulated adenomyoepithelioma: a case report showing immunohistochemical profiles.

Related Articles

Lobulated adenomyoepithelioma: a case report showing immunohistochemical profiles.

Int J Clin Exp Pathol. 2015;8(11):15407-11

Authors: Zhu J, Ni G, Wang D, He Q, Li P

Abstract
Lobulated adenomyoepithelioma of the breast is an extremely rare lesion, with hyperplasia of myoepithelial cells and glandular epithelial cells. We present a case of a 51-year-old woman with a small painless hard lump in each breast. The lesion in the left breast was an irregular solid mass, and the right breast showed a subareolar nodule with bloodstained nipple discharge. The final diagnosis was intraductal papillary carcinoma in the right breast and lobulated adenomyoepithelioma in the left breast. In the left breast lesion, histopathologic examination revealed multiple nodules composed of proliferative glandular epithelial cells and surrounding myoepithelial cells. Solid nests of clear or eosinophilic myoepithelial cells proliferated around compressed epithelial-lined space. Smaller satellite nodules were seen. Immunohistochemistry revealed myoepithelial cells were positive for P63, smooth muscle actin, calponin, 34βE12, CK5/6 and CK14, while glandular epithelial cells were positive for AE1/AE3 and CK7. Lobulated adenomyoepithelioma has a high chance of recurrence and malignant degeneration due to inadequate excision. Therefore, understanding of the pathological morphology and accurate diagnosis is important for surgical planning. Moreover, close follow-up is recommended for patients with lobulated adenomyoepithelioma despite the lesion being reported as benign.

PMID: 26823903 [PubMed - indexed for MEDLINE]

http://ift.tt/2fbmkqx

Pulmonary arterial hypertension due to pulmonary vascular amyloid deposition in a patient with multiple myeloma.

Related Articles

Pulmonary arterial hypertension due to pulmonary vascular amyloid deposition in a patient with multiple myeloma.

Int J Clin Exp Pathol. 2015;8(11):15391-5

Authors: Hashimoto H, Kurata A, Mizuno H, Nashiro T, Hangaishi A, Kuroda M, Usuki K, Horiuchi H

Abstract
Systemic amyloidosis is characterized by amyloid deposition throughout the body and subsequent dysfunction of various organs. Although pulmonary amyloidosis does occur, pulmonary hypertension (PH) caused by amyloidosis is extremely rare. In most of these cases, amyloid deposition occurred diffusely in alveolar septa, indicating that PH was due to lung disease and/or hypoxia. On the other hand, the mechanism of PH due to amyloid deposition in the pulmonary arteries has never been demonstrated. Here, we report the first case of PH due to amyloid deposition in pulmonary elastic arteries and muscular artery, which was complicated by multiple myeloma (MM). In the autopsy specimen of the patient, amyloid deposition was found mainly in the pulmonary arterial media, along with intimal thickening with luminal narrowing. PH thus appeared to be caused by marked decrease of pulmonary elasticity due to the amyloid deposition in the arterial media that resulted in stasis of the blood flow and subsequent luminal narrowing. Our present data demonstrates a new concept of PH caused by amyloidosis, namely, pulmonary arterial hypertension due to amyloidosis.

PMID: 26823900 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6sofJ

Diverse proportion in composite pheochromocytoma-ganglioneuroma may induce varied clinical symptom: comparison of two cases.

Related Articles

Diverse proportion in composite pheochromocytoma-ganglioneuroma may induce varied clinical symptom: comparison of two cases.

Int J Clin Exp Pathol. 2015;8(11):15369-74

Authors: Zhang BY, Zhao M, Li B, Zhang JM

Abstract
Composite pheochromocytoma-ganglioneuroma is extremely rare. We described two cases of composite pheochromocytomas in the adrenal medullar. Case 1 was a 70-year-old male presenting with lower abdominal pain and normal blood electrolytes. Case 2 was a 48-year-old female with palpitation and back tenderness. Biochemical investigations showed hypocalcium, hypokalemia and high level of vma. The histological images and the immunohistochemical staining demonstrated the two cases composed of pheochromocytoma and ganglioneuromoma components. Ganglioneuroma component in case 2 accounted for more proportion than that in case 1. We speculated that the varied clinical symptoms were related with the diverse proportions in composite pheochromocytome-ganglioneuroma.

PMID: 26823896 [PubMed - indexed for MEDLINE]

http://ift.tt/2eAxZyl

Benign fibrous histiocytoma of the fronto-temporo-parietal region: a case report and review of the literature.

Related Articles

Benign fibrous histiocytoma of the fronto-temporo-parietal region: a case report and review of the literature.

Int J Clin Exp Pathol. 2015;8(11):15356-62

Authors: Chen H, Li P, Liu Z, Xu J, Hui X

Abstract
Primary benign fibrous histiocytoma (BFH) at the skull is extremely rare. Here we report a case of a 22-year-old man presented with a 1-year history of progressive enlargement subcutaneous mass on the right side of the fronto-temporo-parietal region without symptoms. The tumor was radical resected through craniotomy and the bone defect was repaired by pre-plasticity titanium mesh. Histopathologic examination confirmed a benign fibrous histiocytoma, and no signs of tumor recurrence were detected at 3-year follow-up.

PMID: 26823894 [PubMed - indexed for MEDLINE]

http://ift.tt/2e6tbgS

Invasive urothelial carcinoma with chordoid features of the ureter: a rare entity and review of literature.

Related Articles

Invasive urothelial carcinoma with chordoid features of the ureter: a rare entity and review of literature.

Int J Clin Exp Pathol. 2015;8(11):15344-9

Authors: Wei J, Yue Z, Song D, Wang Q, Teng X

Abstract
Invasive urothelial carcinoma (UC) is characterized by some histologic variants that can sometimes lead to diagnostic difficulty. In addition to those described by the World Health Organization. Recently invasive urothelial carcinoma with chordoid features (UCC) has been described as a distinct entity and there are relatively few reported cases in the English-language literature. To date 13 cases of UCC have been reported in 2 case series, respectively in 2009 and 2015. We report the 14(th) case in an 80-year-old female, and to the best of our knowledge this is the second case report of UCC in the ureter. She was admitted to our hospital with macroscopic haematuria and unspecific left lower abdominal pain. Computed tomography scan revealed a soft tissue nodule in the middle of the left ureter. The left nephroureterectomy was performed. Morphologically, 85% areas had acellular myxoid stroma was associated with the neoplastic cells. The neoplastic cells had scant eosinophilic cytoplasm and were arranged into cords closely mimicking chordoma or extraskeletal myxoid chondrosarcoma. 15% areas was typical invasive urothelial carcinoma, and focal areas had transition phenomenon between them. Immunohistochemically, the tumor cells were positive for CK, 34βE12 and p63, but were negative for S100, AFP, CD34, Syn and CgA. The final histopathological diagnosis was UCC of the ureter.

PMID: 26823892 [PubMed - indexed for MEDLINE]

http://ift.tt/2eAwbWh

Tracheal T-tube: a novel endoscopic insertion technique.

Tracheal T-tube: a novel endoscopic insertion technique.

J Laryngol Otol. 2016 Oct;130(10):967-968

Authors: Rahimah AN, Shahfi FI, Masaany M, Gazali N, Siti SH

Abstract
BACKGROUND: Laryngotracheal stenosis is a complex condition of airway compromise involving either the larynx or trachea, or both.
OBJECTIVES: This paper describes a new method of endoscopically inserting a silicone tracheal T-tube as treatment for laryngotracheal stenosis. The advantages of this method over previously described methods are discussed.

PMID: 27774924 [PubMed - in process]

http://ift.tt/2eNArz9

Isotretinoin in acne: a single-centre experience

http://ift.tt/2eMPA2J

Isotretinoin in acne: a single-centre experience

http://ift.tt/2eMPA2J

Who is afraid of the invisible snake? Subjective visual awareness modulates posterior brain activity for evolutionarily threatening stimuli

Publication date: December 2016
Source:Biological Psychology, Volume 121, Part A
Author(s): Simone Grassini, Suvi K. Holm, Henry Railo, Mika Koivisto
Snakes were probably one of the earliest predators of primates, and snake images produce specific behavioral and electrophysiological reactions in humans. Pictures of snakes evoke enhanced activity over the occipital cortex, indexed by the "early posterior negativity" (EPN), as compared with pictures of other dangerous or non-dangerous animals. The present study investigated the possibility that the response to snake images is independent from visual awareness. The observers watched images of threatening and non-threatening animals presented in random order during rapid serial visual presentation. Four different masking conditions were used to manipulate awareness of the images. Electrophysiological results showed that the EPN was larger for snake images than for the other images employed in the unmasked condition. However, the difference disappeared when awareness of the stimuli decreased. Behavioral results on the effects of awareness did not show any advantage for snake images.



http://ift.tt/2f3LKXS

Neural Markers of Attention to Aversive Pictures Predict Response to Cognitive Behavioral Therapy in Anxiety and Depression

Publication date: Available online 23 October 2016
Source:Biological Psychology
Author(s): Jonathan P. Stange, Annmarie MacNamara, Olga Barnas, Amy E. Kennedy, Greg Hajcak, K. Luan Phan, Heide Klumpp
Excessive attention toward aversive information may be a core mechanism underlying emotional disorders, but little is known about whether this is predictive of response to treatments. We evaluated whether enhanced attention toward aversive stimuli, as indexed by an event-related potential component, the late positive potential (LPP), would predict response to cognitive behavioral therapy (CBT) in patients with social anxiety disorder and/or major depressive disorder. Thirty-two patients receiving 12 weeks of CBT responded to briefly-presented pairs of aversive and neutral pictures that served as targets or distracters while electroencephaolography was recorded. Patients with larger pre-treatment LPPs to aversive relative to neutral distracters (when targets were aversive) were more likely to respond to CBT, and demonstrated larger reductions in symptoms of depression and anxiety following treatment. Increased attention toward irrelevant aversive stimuli may signal attenuated top-down control, so treatments like CBT that improve this control could be beneficial for these individuals.



http://ift.tt/2eGG02Y

Wheelchair control by elderly participants in a virtual environment with a brain-computer interface (BCI) and tactile stimulation

Publication date: Available online 20 October 2016
Source:Biological Psychology
Author(s): Andreas Herweg, Julian Gutzeit, Sonja Kleih, Andrea Kübler
Tactile event-related potential (ERP) controlled brain-computer-interfaces (BCI) are rarely used as input signal due to their low accuracy and speed (information transfer rate, ITR). Age-related loss of tactile sensibility might further decrease their viability for the target population of BCI. In this study we investigated whether training improves tactile ERP-BCI performance within a virtual wheelchair navigation task. Elderly subjects participated in 5 sessions and tactors were placed at legs, abdomen and back. Mean accuracy and ITR increased from 88.43%/4.5 bits min⁻¹ in the 1st to 92.56%/4.98 bits min⁻¹ in the last session. The mean P300 amplitude increased from 5.46μV to 9.22μV. In an optional task participants achieved an accuracy of 95,56% and an mean ITR of 20,73 bits min⁻¹ which is the highest ever achieved with tactile stimulation. Our sample of elderly people further contributed to the external validity of our results.



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Heart rate variability: Pre-deployment predictor of post-deployment PTSD symptoms

Publication date: Available online 20 October 2016
Source:Biological Psychology
Author(s): Jeffrey M. Pyne, Joseph I. Constans, Mark D. Wiederhold, Douglas P. Gibson, Timothy Kimbrell, Teresa L. Kramer, Jeffery A. Pitcock, Xiaotong Han, D. Keith Williams, Don Chartrand, Richard N. Gevirtz, James Spira, Brenda K. Wiederhold, Rollin McCraty, Thomas R. McCune
Heart rate variability is a physiological measure associated with autonomic nervous system activity. This study hypothesized that lower pre-deployment HRV would be associated with higher post-deployment post-traumatic stress disorder (PTSD) symptoms. Three-hundred-forty-three Army National Guard soldiers enrolled in the Warriors Achieving Resilience (WAR) study were analyzed. The primary outcome was PTSD symptom severity using the PTSD Checklist − Military version (PCL) measured at baseline, 3- and 12-month post-deployment. Heart rate variability predictor variables included: high frequency power (HF) and standard deviation of the normal cardiac inter-beat interval (SDNN). Generalized linear mixed models revealed that the pre-deployment PCL*ln(HF) interaction term was significant (p<.0001). Pre-deployment SDNN was not a significant predictor of post-deployment PCL. Covariates included age, pre-deployment PCL, race/ethnicity, marital status, tobacco use, childhood abuse, pre-deployment traumatic brain injury, and previous combat zone deployment. Pre-deployment heart rate variability predicts post-deployment PTSD symptoms in the context of higher pre-deployment PCL scores.



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