RESUMEN
A 75-year-old man who complained of upper abdominal discomfort was diagnosed with primary duodenal cancer. The patient was treated with a pancreaticoduodenectomy, ascending colectomy and postoperative chemotherapy of S-1 and irinotecan[IRIS; S-1, 80mg/m2(days 1-14); irinotecan, 100 mg/m2(days 1 and 15, every 4 weeks)]. However, after 4 IRIS cycles, computed tomography revealed a liver metastasis and massive ascites. The patient received second-line chemotherapy of tri-weekly docetaxel[60mg/m2,(day 1, every 3 weeks)]. After 2 cycles of docetaxel therapy, the liver tumor and ascites became undetectable. The patient was doing well 13 months after the operation.
Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias Duodenales/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Taxoides/uso terapéutico , Anciano , Ascitis/etiología , Docetaxel , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Humanos , Neoplasias Hepáticas/secundario , MasculinoRESUMEN
Pendred syndrome is an autosomal recessive disorder characterized by sensorineural deafness, a partial defect in iodide organification, and dyshormonogenetic goiter. Several cases of Pendred syndrome with follicular thyroid carcinomas were reported previously. Here we report identical twin patients with Pendred syndrome, who had thyroid tumors with distinct histopathological findings. 34-year-old identical twins with congenital deafness and goiter were referred to our hospital with complaint of neck discomfort. The genetic testing showed that these twin patients were compound heterozygotes carrying the same two mutations in the Pendred's syndrome (PDS / SLC26A4) gene (c2168A > G and ins2110GCTGG), which confirmed the diagnoses of Pendred syndrome. They underwent thyroidectomy. Histological examination of the thyroid tumors resected from these twin patients revealed follicular variant of papillary thyroid carcinoma, and diffuse and nodular goiter without any evidence of malignancy, respectively. To our knowledge, the former is the first case of follicular variant of papillary thyroid carcinoma in Pendred Syndrome.
Asunto(s)
Carcinoma/complicaciones , Carcinoma/diagnóstico , Enfermedades en Gemelos/diagnóstico , Bocio Nodular/complicaciones , Pérdida Auditiva Sensorineural/complicaciones , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Tiroides/diagnóstico , Gemelos Monocigóticos , Adulto , Carcinoma Papilar , Bocio Nodular/diagnóstico , Pérdida Auditiva Sensorineural/diagnóstico , Humanos , Masculino , Proteínas de Transporte de Membrana/genética , Linaje , Transportadores de Sulfato , Cáncer Papilar TiroideoRESUMEN
An effective way to overcome shortage of donors in liver transplantation (LTx) is to consider such from non-heart-beating donors (NHBDs). We investigated how a liver graft should be treated before and/or after procurement for successful LTx from an NHBD. Porcine LTx was performed with FR167653 (FR), a dual inhibitor of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta), and/or prostaglandin E(1) (PG). Animals were allocated to an FR group (n=4, donors and recipients were treated with FR), a PG group (n=4, donors and recipients were treated with PG), or an FRPG group (n=4, donors and recipients were treated with both FR and PG). No recipients in the FR group and only two of four recipients in the PG group survived, whereas all recipients in the FRPG group survived. Suppression of TNF-alpha and IL-1beta and maintenance of microcirculation are the key to successful transplantation from NHBDs.
