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1.
J Indian Assoc Pediatr Surg ; 27(5): 577-584, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36530832

RESUMO

Background: This is a prospective study of the clinico-etiologic profile and factors affecting outcomes in 40 children managed for necrotizing fasciitis (NF). Materials and Methods: Demographic details, clinical characteristics, and laboratory parameters were recorded, and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated. Primary outcome (survival vs. nonsurvival) was noted, and prognostic factors were identified. Results: Initiating factors included boils (45%), i.v. cannula extravasations (22.5%), and blunt trauma (17.5%). Lesion (s) were predominantly on the lower limbs (35%) and trunk (25%). Twenty-two patients (55%) had <5% body surface area (BSA) involved. Severely deranged clinical and laboratory parameters were common. Ultrasound localized fluid collections. Pus cultures showed methicillin-resistant Staphylococcus aureus (52.5%), methicillin-sensitive S. aureus [27.5%], and polymicrobial growth (20%). Blood culture was positive in 24 patients (60%). Most isolates were sensitive to clindamycin and amoxy-clavulanate. Prognostic factors for mortality (n = 6; 15%) included categorization as "Sick," BSA involvement >10%, thrombocytopenia, raised serum creatinine, late debridement, and polymicrobial blood culture isolates. All six nonsurvivors had a LRINEC score of ≥8 and positive blood cultures. Six patients (20.7%) developed unsightly scars and 5 (17.24%) contractures across joints. Conclusions: Pediatric NF has significant morbidity and mortality. Patients with adverse prognostic factors can benefit from early referral to a facility with a critical care unit. Adequate wound management is essential to minimize residual deformity.

2.
J Oral Pathol Med ; 47(7): 660-664, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29675970

RESUMO

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a cancer of the oral cavity that is a major health problem in India. There is an urgent need to identify biomarkers that have prognostic significance. We studied HIF-1α levels as well as single-nucleotide polymorphism of HIF-1α gene in cancer and healthy controls. METHODS: Fifty newly diagnosed OSCC patients and 50 age and sex-matched healthy control were included in the study. Serum concentrations of HIF-1α were measured by sandwich ELISA; whereas HIF-1α gene polymorphism study was performed using restriction enzyme digestion by HpH I. RESULTS: The major genotype observed was CC genotype in both control (84%) and patients (86%) followed by CT genotype (control 16%, cases 14%). CT genotype led to more aggressive tumors. On subgroup analysis based on prognosis, the median overall survival of patients who were treatment responders was 488 days (16.2 months) and that of the patients with progressive disease was 365 days (12.1 months). The patients who expired during the study observation period had median survival of 330 days (11 months). CONCLUSION: Our study showed that CT genotype for C1772T polymorphism of HIF-1α predisposes to aggressive tumor phenotype in patients with OSCC. Moreover, patients with CT genotype had poor survival rate as compared to CC genotype. A cut-off value of 460 pg/mL of HIF-1α can help to segregate patients with OSCC from healthy controls.


Assuntos
Biomarcadores Tumorais/genética , Estudos de Associação Genética , Genótipo , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Neoplasias Bucais/genética , Polimorfismo Genético/genética , Biomarcadores Tumorais/sangue , Feminino , Humanos , Subunidade alfa do Fator 1 Induzível por Hipóxia/sangue , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/mortalidade , Valor Preditivo dos Testes , Prognóstico , Taxa de Sobrevida , Fatores de Tempo
3.
Lancet ; 388(10061): 2753-2762, 2016 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-27865535

RESUMO

BACKGROUND: Ménière's disease is characterised by severe vertigo attacks and hearing loss. Intratympanic gentamicin, the standard treatment for refractory Ménière's disease, reduces vertigo, but damages vestibular function and can worsen hearing. We aimed to assess whether intratympanic administration of the corticosteroid methylprednisolone reduces vertigo compared with gentamicin. METHODS: In this double-blind comparative effectiveness trial, patients aged 18-70 years with refractory unilateral Ménière's disease were enrolled at Charing Cross Hospital (London, UK) and Leicester Royal Infirmary (Leicester, UK). Patients were randomly assigned (1:1) by a block design to two intratympanic methylprednisolone (62·5 mg/mL) or gentamicin (40 mg/mL) injections given 2 weeks apart, and were followed up for 2 years. All investigators and patients were masked to treatment allocation. The primary outcome was vertigo frequency over the final 6 months (18-24 months after injection) compared with the 6 months before the first injection. Analyses were done in the intention-to-treat population, and then per protocol. This trial is registered with ClinicalTrials.gov, number NCT00802529. FINDINGS: Between June 19, 2009, and April 15, 2013, 256 patients with Ménière's disease were screened, 60 of whom were enrolled and randomly assigned: 30 to gentamicin and 30 to methylprednisolone. In the intention-to-treat analysis (ie, all 60 patients), the mean number of vertigo attacks in the final 6 months compared with the 6 months before the first injection (primary outcome) decreased from 19·9 (SD 16·7) to 2·5 (5·8) in the gentamicin group (87% reduction) and from 16·4 (12·5) to 1·6 (3·4) in the methylprednisolone group (90% reduction; mean difference -0·9, 95% CI -3·4 to 1·6). Patients whose vertigo did not improve after injection (ie, non-responders) after being assessed by an unmasked clinician were eligible for additional injections given by a masked clinician (eight patients in the gentamicin group vs 15 in the methylprednisolone group). Two non-responders switched from methylprednisolone to gentamicin. Both drugs were well tolerated with no safety concerns. Six patients reported one adverse event each: three in the gentamicin group and three in the methylprednisolone group. The most common adverse event was minor ear infections, which was experienced by one patient in the gentamicin group and two in the methylprednisolone group. INTERPRETATION: Methylprednisolone injections are a non-ablative, effective treatment for refractory Ménière's disease. The choice between methylprednisolone and gentamicin should be made based on clinical knowledge and patient circumstances. FUNDING: Ménière's Society and National Institute for Health Research Imperial Biomedical Research Centre.


Assuntos
Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Gentamicinas/uso terapêutico , Doença de Meniere/complicações , Metilprednisolona/uso terapêutico , Método Duplo-Cego , Feminino , Perda Auditiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Vertigem/prevenção & controle
4.
Int Ophthalmol ; 34(3): 639-42, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23896979

RESUMO

Lymphoid neoplasms of the orbit account for approximately 6-8 % of all orbital tumors and 15 % of all ocular adnexal tumors. We report an unusual case of T-cell lymphoblastic lymphoma occurring in a 30-year-old man, presenting as red, painless, firm swelling in the Tenon's capsule of the eye.


Assuntos
Neoplasias Oculares/patologia , Leucemia-Linfoma Linfoblástico de Células T Precursoras/patologia , Cápsula de Tenon , Adulto , Humanos , Masculino
5.
Cureus ; 16(6): e61645, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38975443

RESUMO

Xeroderma pigmentosum is a rare autosomal recessive disorder resulting in heightened cutaneous photosensitivity due to aberrant DNA repair mechanisms. Early-life developmental delay and cognitive impairment have been described in xeroderma pigmentosum cases. However, psychiatric symptoms in adulthood as the presenting feature of xeroderma pigmentosum have not been reported. We report a young adult with xeroderma pigmentosum group G presenting with prominent neuropsychiatric manifestations and evidence of neurodegeneration. The clinical, laboratory, and radiological findings, skin biopsy, and the results of the genetic testing of the patient have been described after obtaining written and informed consent. A young adult male with skin photosensitivity since infancy developed hyper-religiosity, delusions, suicidal ideations, speech hypernasality, lower limb spasticity, and cognitive impairment over the past four years. The MRI of the brain showed diffuse cerebral atrophy. The skin biopsy from bilateral cheeks showed evidence of flattening and thinning of rete ridges, pigment incontinence, and perivascular and periappendageal inflammatory infiltrate. The whole exome sequencing in ethylenediaminetetraacetic acid (EDTA) blood revealed a compound heterozygous likely pathogenic mutation in intron 13 (c.2880-2A>G (3' splice site)) and a mutation in exon 15 (c.3146del (p.Asp1049ValfsTer12)) in the ERCC5 gene suggestive of xeroderma pigmentosum group G. This case highlights that prominent neuropsychiatric features in adulthood can occur due to xeroderma pigmentosum. Thus, xeroderma pigmentosum group G should be considered as a possibility among young adults presenting with neuropsychiatric features, evidence of neurodegeneration, and early-life skin photosensitivity.

6.
Dermatol Online J ; 19(2): 10, 2013 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-23473280

RESUMO

Pachydermoperiostosis is a primary form of hypertrophic osteoarthropathy, which presents with pachydermia, digital clubbing, and radiologic periostosis. Pachydermoperiostosis occurs owing to mutations of the gene encoding for 15-hydroxyprostaglandin dehydrogenase (15HPGD). Clinical manifestations of PDP are thought to relate to excessive collagen formation and dysregulation of matrix proteins because of fibroblastic hyperactivation. We present a very rare case of the complete form of pachydermoperiostosis in a young Indian male.


Assuntos
Osteoartropatia Hipertrófica Primária/complicações , Periostite/etiologia , Povo Asiático/genética , Humanos , Masculino , Mutação , Osteoartropatia Hipertrófica Primária/diagnóstico , Osteoartropatia Hipertrófica Primária/genética , Periostite/patologia , Adulto Jovem
7.
Indian J Surg Oncol ; 14(4): 963-967, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38187856

RESUMO

Acantholytic squamous cell carcinoma is an infrequent subtype of squamous cell carcinoma. This tumour variant being rare in itself has been rarely described at the penile location, thus leading to a limitation on information of pathological and immunohistochemical findings and prognosis. Clinical observations indicate an aggressive biologic behaviour. The cytological features on fine-needle aspiration cytology samples have rarely been described in literature. It is imperative for pathologists to be aware of the cytological features so as to allow the distinction of this variant from conventional squamous carcinoma. Here, we explore an intriguing case of a metastatic tumour to inguinal lymph node with the primary lesion at the penis which constituted a diagnostic challenge on cytological examination.

8.
Trop Doct ; 53(2): 309-312, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36798038

RESUMO

Cardiac involvement in tuberculosis is relatively rare when compared to other organs and often involves the pericardium leading to constrictive pericarditis. Myocardial tuberculoma is exceedingly rare and only seldom cases have yet been reported. Our report is of a case diagnosed on fine-needle aspiration cytology.


Assuntos
Tuberculose , Humanos , Biópsia por Agulha Fina , Tuberculose/diagnóstico , Citodiagnóstico , Pericárdio
9.
J Cancer Res Ther ; 18(6): 1827-1831, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36412456

RESUMO

Keratinizing desquamative squamous metaplasia (KDSM) of the upper urinary tract is a rare entity. The present case is of a 45-year-old female patient with an 8-month history of abdominal lump, recurrent right lumbar pain, intermittent fever, and oliguria. Computed tomography kidney, ureter, and bladder revealed a grossly enlarged right kidney along with heterogeneously enhancing soft tissue density mass and internal septations. A differential diagnosis of renal cell carcinoma, urothelial carcinoma, tuberculosis, and pyonephrosis of the kidney was considered as per the clinical and radiological presentation. Intraoperatively, thick fluid was seen in the kidney and its pedicle was seen adhered to duodenum. Partial nephrectomy was done and on microscopic examination squamous cell carcinoma (SCC) was seen arising in the setting of KDSM. Postoperatively, the patient showed an exponential rise of total leukocyte count (100/153 × 103/µl) and serum calcium levels (10.1/17.2/20.4 mg/dl); eventually started deteriorating and later succumbed to illness. We report this rare association of SCC of the renal pelvis arising in KDSM along with the double paraneoplastic syndrome.


Assuntos
Carcinoma de Células Escamosas , Carcinoma de Células de Transição , Neoplasias Renais , Síndromes Paraneoplásicas , Neoplasias da Bexiga Urinária , Feminino , Humanos , Pessoa de Meia-Idade , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/cirurgia , Carcinoma de Células de Transição/complicações , Neoplasias da Bexiga Urinária/patologia , Pelve Renal/patologia , Metaplasia/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Neoplasias Renais/patologia , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/etiologia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia
10.
Int Orthod ; 20(2): 100635, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35562286

RESUMO

INTRODUCTION: Tooth autotransplantation is a viable surgical treatment option for patients with missing permanent teeth. Premolars are generally used for autotransplantation but often require extensive modifications. This case report evaluates the use of supernumerary tooth as an alternative option for premolar autotransplantation. This report shows successful supernumerary tooth autotransplantation with 6-year follow-up. METHODS: A 13-year-old male with non-contributory medical history was referred for a missing maxillary left central incisor (#9) and presence of a supernumerary tooth. The clinical and radiographic examination revealed presence of supernumerary tooth with similar dimensions to a central incisor. The treatment plan included autotransplantation of the supernumerary tooth to replace the missing central incisor (short-term) and future implant replacement of the autotransplanted tooth when jaw growth ceases (long-term). The patient and parents consented to treatment. A 3-D tooth replica was constructed based on CBCT analyses. Site #9 was prepared using split ridge technique to create a socket to house the 3-D replica. Upon achieving proper socket form, the supernumerary tooth was extracted and autotransplanted in the prepared socket. The supernumerary tooth was splinted, and the bite opened posteriorly using composite to eliminate any occlusal interferences. RESULTS: The patient was followed up clinically and radiographically. The autotransplanted supernumerary tooth integrated well within the newly created socket and remained functional at the 6-year follow-up. CONCLUSIONS: The current case presents successful management of supernumerary tooth autotransplantation with 6-year follow-up. The results show stable periodontium with satisfactory functional and aesthetic results.


Assuntos
Anodontia , Dente Supranumerário , Adolescente , Estética Dentária , Seguimentos , Humanos , Incisivo/diagnóstico por imagem , Incisivo/cirurgia , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Dente Supranumerário/diagnóstico por imagem , Dente Supranumerário/cirurgia , Transplante Autólogo
11.
Lepr Rev ; 82(4): 371-82, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22439277

RESUMO

OBJECTIVES: To analyse the serum levels of cytokines in leprosy patients, to correlate them with clinico-histopathological profile, and to study the effect of standard multidrug therapy on serum cytokine levels. DESIGN: Serum immunoassays of TNF-alpha, IFN-gamma, IL-1 beta and IL-10 were performed by ELISA in 61 newly diagnosed cases of leprosy before starting therapy and during reactional episodes. Of these, cytokine assays could be performed in 17 cases after completion of therapy. RESULTS: Levels of all the studied cytokines were significantly raised in cases compared to controls (P < 0.05). Levels of TNF-alpha and IFN-gamma were significantly raised in paucibacillary cases whereas all the studied cytokines were raised in multibacillary cases with rise in IL-1 beta and IL-10 being statistically significant (P < 0.001). No significant difference was however noted between TT and BT type; and BB, BL and LL types. All the studied cytokines were raised in reactional cases as compared to non-reactional cases. Comparing Type 2 reaction (T2R) and Type 1 reaction (T1R) cases, levels of IFN-gamma, IL-1 beta and IL-10 were higher in T2R cases but only IL-10 was found to be statistically significant (P = 0.05) while TNF-alpha was higher in T1R cases. Post therapy serum levels of all the studied cytokines were significantly lower than pretherapy levels (P < 0.05) and were comparable to controls. Among the paucibacillary cases, levels of all the cytokines were seen to decrease after 6 months of standard multidrug therapy. In the multibacillary cases, mean levels of the cytokines were found to decrease after 1 year of therapy except IFN-gamma. CONCLUSION: Serum cytokine estimation may have a significant role in classifying various forms of leprosy and can be used to monitor therapy.


Assuntos
Citocinas/sangue , Hanseníase/sangue , Hanseníase/patologia , Adulto , Antibacterianos/uso terapêutico , Monitoramento de Medicamentos , Feminino , Humanos , Hanseníase/tratamento farmacológico , Masculino , Adulto Jovem
12.
Trop Doct ; 51(4): 588-590, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33977778

RESUMO

Extra-lymphatic manifestation of filariasis, especially as acute renal failure, is uncommon and may be clinically unsuspected. We document the case of a 60 year old elderly male who presented with bilateral pedal oedema, fatigue and abdominal distension. Investigations revealed severe anaemia, splenomegaly and acute renal failure. Bone marrow aspiration was performed to evaluate the clinical suspicion of malignancy. Out of eight smears examined, microfilaria (Brugia malayi) were identified in two. This presentation was devoid of peripheral eosinophilia. The patient was commenced on a regimen of diethylcarbamazine, on which he made a good recovery. The incidence of extra-lymphatic filariasis is largely unknown and sparsely reported. Such a presentation should be kept in mind by both clinicians and pathologists as it is potentially treatable.


Assuntos
Injúria Renal Aguda , Brugia Malayi , Filariose , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Idoso , Animais , Dietilcarbamazina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Esplenomegalia/etiologia
13.
Cureus ; 13(5): e14880, 2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-34104606

RESUMO

Immune hemolytic anemia is very rarely associated with chronic liver disease. Diagnosis is often complicated in critically ill patients, where an etiological diagnosis can be elusive, especially in routine health care settings. A 48-year-old man presented with jaundice for three months. Ultrasonography showed features of chronic liver disease. Fibroscan showed increased parenchymal stiffness suggesting cirrhosis. Investigations revealed immune hemolytic anemia and thrombocytopenia. A percutaneous liver biopsy was not performed due to worsening thrombocytopenia. Isolated protein C deficiency and portal vein thrombosis were noted in subsequent testing. The patient eventually succumbed to illness. Coagulopathy such as protein C and D-dimer elevation discovered in subsequent rounds of testing may be misleading in rapidly deteriorating patients, emphasizing the need for timely coagulation workup and imaging. Despite comprehensive testing, lack of liver biopsy, as seen herein, may hamper clinical management. Training residents in the skill of transjugular liver biopsy is necessary to manage critical patients at secondary health care facilities.

14.
Eur J Obstet Gynecol Reprod Biol ; 259: 7-11, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33556768

RESUMO

BACKGROUND: The pandemic of the severe acute respiratory distress syndrome-associated Coronavirus-2 (SARS-CoV-2) has affected millions around the world. In pregnancy the dangers to the mother and fetus are still being explored. SARS-CoV2 can potentially compromise maternal and neonatal outcomes and this may be dependent on the pregnancy stage during which the infection occurs. OBJECTIVE: The present study was done to find the histopathological alterations in the placenta of SARS-CoV-2 positive pregnancies with either no symptoms or mild coronavirus disease (COVID)-19 related symptoms and its association with neonatal outcomes. STUDY DESIGN: This was a prospective analytical study. Twenty seven asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women with a singleton pregnancy delivered between 1st July 2020 and 15th September 2020, were included as cases. An equal number of SARS-CoV-2 negative singleton pregnancies matched for maternal and gestational age during the same period were included as controls. After delivery the histopathological examination of the placenta of these women was done and the findings recorded on a predesigned proforma based on the Amsterdam consensus criteria for evidence of maternal and fetal vascular malperfusion changes. RESULTS: The baseline characteristics were comparable between the cases and controls. The following features of maternal vascular malperfusion (MVM) were significantly higher in the placentae of COVID-19 positive pregnancies: retroplacental hematomas (RPH), accelerated villous maturation (AVM), distal villous hyperplasia (DVH), atherosis, fibrinoid necrosis, mural hypertrophy of membrane arterioles (MHMA), vessel ectasia and persistence of intramural endovascular trophoblast (PIEVT). Fetal vascular malperfusion (FVM) significantly associated with the positive pregnancies were chorioangiosis, thrombosis of the fetal chorionic plate (TFCP), intramural fibrin deposition (IMFD) and vascular ectasia. Additionally, perivillous fibrin deposition was also significantly higher in the placentae of cases. The percentage of spontaneously delivered women was comparable in the two groups. The sex and weight of the newborn and the number of live births were comparable between the two groups. CONCLUSIONS: Asymptomatic or mildly symptomatic SARS-CoV-2 positive pregnant women, with otherwise uncomplicated pregnancies, show evidence of placental injury at a microscopic level. Similar findings have been demonstrated in other studies too. This placental injury apparently does not lead to poor pregnancy outcomes. The extent of this injury in symptomatic cases of COVID-19 pregnancies and its consequences on the outcomes need to be analysed.


Assuntos
COVID-19/patologia , Doenças Placentárias/patologia , Placenta/patologia , Complicações Infecciosas na Gravidez/patologia , Adulto , Peso ao Nascer , COVID-19/complicações , COVID-19/fisiopatologia , Portador Sadio , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Masculino , Placenta/irrigação sanguínea , Doenças Placentárias/etiologia , Doenças Placentárias/fisiopatologia , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Resultado da Gravidez , Estudos Prospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto Jovem
15.
Med Oncol ; 39(1): 13, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34792663

RESUMO

Incidence of human papillomavirus (HPV)-associated oral cancers is on the rise. However, epidemiological data of this subset of cancers are limited. Dental hospital poses a unique advantage in detection of HPV-positive oral malignancies. We assessed the utility of formalin-fixed paraffin-embedded (FFPE) tissues, which are readily available, for evaluation of high-risk HPV infection in oral cancer. For protocol standardization, we used 20 prospectively collected paired FFPE and fresh tissues of histopathologically confirmed oral cancer cases reported in Oral Medicine department of a dental hospital for comparative study. Only short PCRs (~ 200 bp) of DNA isolated using a modified xylene-free method displayed a concordant HPV result. For HPV analysis, we used additional 30 retrospectively collected FFPE tissues. DNA isolated from these specimens showed an overall 23.4% (11/47) HPV positivity with detection of HPV18. Comparison of HPV positivity from dental hospital FFPE specimens with overall HPV positivity of freshly collected oral cancer specimens (n = 55) from three cancer care hospitals of the same region showed notable difference (12.7%; 7/55). Further, cancer hospital specimens showed HPV16 positivity and displayed a characteristic difference in reported sub-sites and patient spectrum. Overall, using a xylene-free FFPE DNA isolation method clubbed with short amplicon PCR, we showed detection of HPV-positive oral cancer in dental hospitals.


Assuntos
Alphapapillomavirus/isolamento & purificação , Instalações Odontológicas , Neoplasias Bucais/diagnóstico , Infecções por Papillomavirus/diagnóstico , Adulto , Idoso , Alphapapillomavirus/genética , DNA Viral/genética , Feminino , Formaldeído , Genótipo , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Neoplasias Bucais/virologia , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Inclusão em Parafina , Reação em Cadeia da Polimerase , Prevalência , Fixação de Tecidos
16.
Matrix Biol ; 89: 27-42, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32001344

RESUMO

Versican is a large extracellular matrix (ECM) chondroitin sulfate (CS) proteoglycan found in most soft tissues, which is encoded by the VCAN gene. At least four major isoforms (V0, V1, V2, and V3) are generated via alternative splicing. The isoforms of versican are expressed and accumulate in various tissues during development and disease, where they contribute to ECM structure, cell growth and migration, and immune regulation, among their many functions. While several studies have identified the mRNA transcript for the V3 isoform in a number of tissues, little is known about the synthesis, secretion, and targeting of the V3 protein. In this study, we used lentiviral generation of doxycycline-inducible rat V3 with a C-terminal tag in stable NIH 3T3 cell lines and demonstrated that V3 is processed through the classical secretory pathway. We further show that N-linked glycosylation is required for efficient secretion and solubility of the protein. By site-directed mutagenesis, we identified amino acids 57 and 330 as the active N-linked glycosylation sites on V3 when expressed in this cell type. Furthermore, exon deletion constructs of V3 revealed that exons 11-13, which code for portions of the carboxy region of the protein (G3 domain), are essential for V3 processing and secretion. Once secreted, the V3 protein associates with hyaluronan along the cell surface and within the surrounding ECM. These results establish critical parameters for the processing, solubility, and targeting of the V3 isoform by mammalian cells and establishes a role for V3 in the organization of hyaluronan.


Assuntos
Versicanas/química , Versicanas/metabolismo , Processamento Alternativo , Animais , Éxons , Glicosilação , Células HEK293 , Humanos , Camundongos , Mutagênese Sítio-Dirigida , Células NIH 3T3 , Domínios Proteicos , Isoformas de Proteínas/química , Isoformas de Proteínas/metabolismo , Ratos , Versicanas/genética
19.
Otol Neurotol ; 40(4): 491-496, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30870364

RESUMO

OBJECTIVES: To determine whether long term (>48 months) symptomatic vertigo control is sustained in patients with Menière's disease from a previous comparative trial of intratympanic methylprednisolone versus gentamicin, and if the two treatments remain nonsignificantly different at long-term follow-up. STUDY DESIGN: Mail survey recording vertigo frequency in the previous one and six months, further intratympanic treatment received, and validated symptom questionnaires. SETTING: Outpatient hospital clinic setting. PATIENTS: Adult patients with definite unilateral refractory Menière's disease, who previously received intratympanic treatment in a comparative trial. INTERVENTION: A survey of trial participants who received intratympanic gentamicin (40 mg/mL) or methylprednisolone (62.5 mg/mL). OUTCOME MEASURES: Primary: number of vertigo attacks in the 6 months prior to receiving this survey compared with the 6 months before the first trial injection. Secondary number of vertigo attacks over the previous 1 month; validated symptom questionnaire scores of tinnitus, dizziness, vertigo, aural fullness, and functional disability. RESULTS: Forty six of the 60 original trial patients (77%) completed the survey, 24 from the gentamicin and 22 from the methylprednisolone group. Average follow-up was 70.8 months (standard deviation 17.0) from the first treatment injection. Vertigo attacks in the 6 months prior to receiving the current survey reduced by 95% compared to baseline in both drug groups (intention-to-treat analysis, both p < 0.001). No significant difference between drugs was found for the primary and secondary outcomes. Eight participants (methylprednisolone = 5 and gentamicin = 3) required further injections for relapse after completing the original trial. CONCLUSION: Intratympanic methylprednisolone treatment provides effective long-lasting relief of vertigo, without the known inner-ear toxicity associated with gentamicin. There are no significant differences between the two treatments at long term follow-up.


Assuntos
Antibacterianos/administração & dosagem , Gentamicinas/administração & dosagem , Doença de Meniere/tratamento farmacológico , Metilprednisolona/administração & dosagem , Vertigem/tratamento farmacológico , Adulto , Idoso , Orelha Interna/fisiopatologia , Feminino , Seguimentos , Humanos , Injeções , Masculino , Doença de Meniere/complicações , Pessoa de Meia-Idade , Recidiva , Vertigem/etiologia
20.
Indian J Pathol Microbiol ; 51(3): 409-10, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18723974

RESUMO

Primary renal fibrosarcoma is a rare tumor. We describe a case of primary renal fibrosarcoma in a 54-year-old male who presented with abdominal lump and intermittent hematuria.


Assuntos
Fibrossarcoma/diagnóstico , Fibrossarcoma/patologia , Neoplasias Renais/diagnóstico , Neoplasias Renais/patologia , Abdome/patologia , Fibrossarcoma/complicações , Hematúria/etiologia , Humanos , Neoplasias Renais/complicações , Masculino , Pessoa de Meia-Idade
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