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.

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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]

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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]

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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]

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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]

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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]

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