RESUMO
Subcutaneous fat necrosis of the newborn (ScFN) is an uncommon condition of neonates and infants. The disorder is caused by generalized and local tissue hypoperfusion. The ScFN tends to improve spontaneously with or without some severe complications such as hypercalcemia. The ScFN may occur as iatrogenic after hypothermic surgical interventions. We present iatrogenic ScFN in a newborn with uncomplicated hypercalcemia due to cold exposure on operating table during at an umbilical cord hernia operation. To our knowledge, this is the first report of a patient in whom ScFN occurred during a commonly performed and relatively short-term "nonhypothermic" operation.
Assuntos
Complicações Pós-Operatórias/patologia , Gordura Subcutânea/patologia , Hérnia Umbilical/cirurgia , Humanos , Hipercalcemia/etiologia , Hipotermia/etiologia , Hipotermia/patologia , Doença Iatrogênica , Recém-Nascido , Masculino , Necrose , Complicações Pós-Operatórias/etiologiaRESUMO
We assessed the influence of maternal nicotine exposure during gestation on perinatal expression of HSP70 and VEGF in rat lung parenchyma and lung vessels. Adult white Sprague-Dawley virgin rats were mated with adult male rats over 2 days, with two females for every male. After confirming pregnancy, 30 gravid rats (dams) were then randomly assigned to two equal groups (one experimental and one control; n=15 in each). Experimental dams were treated with subcutaneus (s.c.) (-)-nicotine tartrate, 3 mg/kg body weight/day, during pregnancy from gestational days 9 through 21. After sacrifice, lungs were removed en bloc and formalin-fixed, and paraffinembedded tissue sections were evaluated by immunohistochemistry using a three-step streptavidin-biotin-peroxidase method with monoclonal antibodies directed against HSP70 or VEGF. HSP70 and VEGF expression was increased in the vascular smooth muscle cells of the experimental group (t1) compared to the control group (t(2))t(1)=7.593, t(2)=4.666, p<0.05). The number of bronchioles that stained positively with HSP70 was higher in the nicotineexposed group than in the control group (t(1)=9.274, t(2)=6.956, p<0.05). In conclusion, gestational nicotine exposure increased the expression of VEGF and HSP70 in rat lung parenchyma, especially in the airway epithelium and vascular smooth muscle cells. In vascular smooth muscle cells, these molecules may contribute to nicotine-related hypoxic pulmonary hypertension.
Assuntos
Vasos Sanguíneos/efeitos dos fármacos , Proteínas de Choque Térmico HSP70/metabolismo , Pulmão/irrigação sanguínea , Exposição Materna , Nicotina/toxicidade , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Vasos Sanguíneos/citologia , Vasos Sanguíneos/metabolismo , Endotélio Vascular/química , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Feminino , Proteínas de Choque Térmico HSP70/análise , Masculino , Miócitos de Músculo Liso/química , Miócitos de Músculo Liso/efeitos dos fármacos , Miócitos de Músculo Liso/metabolismo , Gravidez , Ratos , Ratos Sprague-Dawley , Fator A de Crescimento do Endotélio Vascular/análiseRESUMO
BACKGROUND: Malignant mesothelioma (MM) is a fatal neoplasm which frequently results from exposure to asbestos or erionite. METHOD: Sixty-seven patients with MM were seen between 1990 and 2001. Their clinical and radiological features, as well as the therapy, were retrospectively evaluated. RESULTS: In 51 patients (76.1%), the MM was confined to the pleura, in 14 patients it was exclusively peritoneal and in two patients, it involved both areas. Of the 67 cases, 35 (52.2%) were women. The mean (+/- SD) age for all cases was 57.6+/-11.5 years. Dyspnea (67.2%), cough (55.2%) and chest pain (50.7%) were the most frequent symptoms of onset. Pleural effusion (92.4%) was the most common chest x-ray finding, whereas pleural effusion (60.8%), pleural nodules (34.7%) and pleural thickening (34.7%) were the most common computed tomography findings in pleural MM patients. The histological subtypes of MM were determined as epithelial in 60 patients (89.5%), sarcomatous in four patients (5.9%) and mixed in three patients (4.4%). Although 50.7% and 25.4% of the cases were exposed to erionite and asbestos, respectively, 23.9% of the cases recalled no exposure to asbestos or erionite. Exposures were environmental as opposed to occupational. Thirty-five patients (52.2%) were administered chemotherapy, and follow-up data were available for 22 patients. For these patients, the two-year survival rate was 22% and the two-year progression-free interval was 15.7%. There were no differences between patients with asbestos and erionite exposure. CONCLUSION: MM should be considered when exudative pleural effusion is detected in a patient who has been exposed to asbestos or erionite. MM is a major public health problem in parts of Turkey and compulsory environmental control of fibrous mineral should be considered.
Assuntos
Mesotelioma/epidemiologia , Neoplasias Pleurais/epidemiologia , Adulto , Idoso , Amianto/efeitos adversos , Exposição Ambiental , Feminino , Humanos , Masculino , Mesotelioma/diagnóstico , Mesotelioma/diagnóstico por imagem , Mesotelioma/etiologia , Pessoa de Meia-Idade , Derrame Pleural/etiologia , Neoplasias Pleurais/diagnóstico , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/etiologia , Tomografia Computadorizada por Raios X , Turquia/epidemiologia , Zeolitas/efeitos adversosRESUMO
Association between malignancy and congenital pulmonary airway malformation is a rare entity in childhood. Herein, we describe a three-day-old infant with respiratory distress and cystic lung lesion on her left lung. A lobectomy was performed at the age of three days, and the patient was diagnosed with congenital pulmonary airway malformation and adenocarcinoma in situ.
Assuntos
Adenocarcinoma in Situ/patologia , Malformação Adenomatoide Cística Congênita do Pulmão/diagnóstico , Neoplasias Pulmonares/patologia , Adenocarcinoma in Situ/cirurgia , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Feminino , Humanos , Lactente , Neoplasias Pulmonares/cirurgiaRESUMO
Subcutaneous fat necrosis of the newborn (ScFN) is an uncommon condition caused by generalized and/or local tissue hypoperfusion. The skin lesions of ScFN tend to improve spontaneously. However, ScFN may also lead to complications which cause serious problems. The severity of the etiologic factors contributing to the development of the disease determines the severity of complications. Therefore, these patients should be closely monitored for complications, especially for hypercalcemia which may be life-threatening. The severity and duration of hypercalcemia are associated with the extensity of skin lesions. We present a newborn who developed ScFN as a result of systemic hypotension. The ScFN resolved after the first few weeks of life, but the patient developed mild hypercalcemia during the 4-month follow-up period. The infant was breast-fed during follow-up, and vitamin D prophylaxis was not initiated. The hypercalcemia resolved within four months without any complications. We would like to draw attention to the need to monitor serum calcium levels in these infants and to refrain from initiating vitamin D prophylaxis in the first months of life.
Assuntos
Necrose Gordurosa/complicações , Gordura Subcutânea/patologia , Cálcio/sangue , Necrose Gordurosa/patologia , Feminino , Seguimentos , Humanos , Hipercalcemia/etiologia , Lactente , Recém-NascidoRESUMO
In this paper, we report a case of angiomyolipoma with cavoatrial extension in a 55-yr-old woman. Multislice computed tomography revealed a hypodense mass extending into the right atrium through the right renal vein and inferior vena cava without a renal mass. The patient underwent surgery, and right atrial mass was resected. Pathologic evaluation revealed a tumor consisting of mature adipose tissue, smooth muscle and vessels consistent with angiomyolipoma. Our case reminds us of the rare possibility that angiomyolipoma, which is classified as a benign tumor, may invade the inferior vena cava or right atrium.