RESUMO
We report the properties of an A-site spinel magnet, CoAl2-xGaxO4, and analyze its anomalous, low-temperature magnetic behavior, which is derived from inherent, magnetically frustrated interactions. Rietveld analysis of the x-ray diffraction profile for CoAl2-xGaxO4revealed that the metallic ions were randomly distributed in the tetrahedral (A-) and octahedral (B-) sites in the cubic spinel structure. The inversion parameterηcould be controlled by varying the gallium (Ga) composition in the range 0.055 ⩽η⩽ 0.664. The composition-induced Néel-to-spin-glass (NSG) transition occurred between 0.05 ⩽η⩽ 0.08 and was verified by measurements of DC-AC susceptibilitiesχand thermoremanent magnetization (TRM) below the Néel transition temperatureTN. The relaxation rate and derivative with respect to temperature of TRM increased at bothTNand the spin glass (SG) transition temperatureTSG. The TRM decayed rapidly above and below these transitions. TRM was highly sensitive to macroscopic magnetic transitions that occurred in both the Néel and SG phases of CoAl2-xGaxO4. In the vicinity of the NSG boundary, there was a maximum of the TRM relaxation rate atTmax
RESUMO
A 53-year-old woman with a double, double, double (DDD) pacemaker due to complete atrioventricular block was admitted to our hospital with a diagnosis of congestive heart failure. At the time of admission, she was in a hypoxic state with cyanosis and clubbed finger. The ultrasonic cardiogram showed a severe degree of tricuspid valve regurgitation and a thin left ventricular septal wall. Transesophageal echocardiography revealed a patent foramen ovale (PFO) with continuous right to left shunt flow. She was diagnosed with cardiac sarcoidosis with hypoxemia caused by PFO. PFO closure and tricuspid valve annuloplasty (DeVega method) were performed. Following surgery, the patient's hypoxemia improved and the cyanosis disappeared. The patient was discharged 37 days after the operation.
Assuntos
Cardiomiopatias/diagnóstico , Forame Oval Patente/diagnóstico , Hipóxia/diagnóstico , Feminino , Forame Oval Patente/complicações , Forame Oval Patente/cirurgia , Humanos , Hipóxia/etiologia , Pessoa de Meia-Idade , Sarcoidose/diagnósticoRESUMO
Myxomas are account for approximately half of primary cardiac tumors, and 75% cases originate in left atrium. We report our experience of a right atrial myxoma. A 68-year-old woman was referred to us due to anorexia, general fatigue and facial edema. Echocardiogram, computed tomography (CT), magnetic resonance imaging (MRI), and catheter angiocardiogram revealed a huge tumor in right atrium. The tumor was resected completely with the attached right atrial free wall under cardiopulmonary bypass. Pathological examination showed myxomatous tissue. Postoperative course was uneventful. She discharged the hospital on the 37th day after the operation, and is now doing well without any symptoms.
Assuntos
Neoplasias Cardíacas/cirurgia , Mixoma/cirurgia , Idoso , Ponte Cardiopulmonar , Feminino , Átrios do Coração , HumanosRESUMO
This study was carried out to determine risk factors for delirium after major head and neck cancer surgery. The postoperative experience of 38 patients who underwent major head and neck cancer surgery and were managed in the high care unit was retrospectively examined by reviewing their medical records. Delirium was defined as confusion and abnormal behavior that interfered with postoperative recovery. Postoperative delirium occurred in 10 patients (26.3%) who all had stage IV cancer, flap reconstruction, an operative time of more than 10 h, blood transfusion of more than 4 units or infusion of more than 5000 ml, which together suggested the risk of delirium increased significantly with extensive surgery. Delirium occurred less frequently in patients with minor tranquilizer use for postoperative sleep disorder. Multivariative analyses showed an operative time of >10 h and no use of minor tranquilizer as significant factors for increasing the incidence of delirium, with odds ratios (95% confidence interval) of 11.4 (1.5-83.8) and 9.8 (1.5-66.0), respectively.
Assuntos
Delírio/etiologia , Neoplasias de Cabeça e Pescoço/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiolíticos/administração & dosagem , Delírio/prevenção & controle , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Retalhos Cirúrgicos , Fatores de TempoRESUMO
We report a 43-year-old patient of De Bakey type I aortic dissection [DA (I)] with a 2-year-history of systemic lupus erythematosus (SLE). He had had no treatment for SLE before the onset of dissection. Computed tomography (CT) on admission revealed DA (I), and he underwent emergency operation. Since the aortic valve and the left main coronary artery were severely damaged, aortic root replacement was performed. Coronary buttons were prepared in Carrel method and coronary reconstruction was performed in Piehler modification. After surgery, he suffered from repetitive hemolytic anemia. Corticosteroid therapy and rinsed blood transfusion were very effective for anemia. The combination with SLE and DA (I) was rare and this report of successful aortic root replacement is the second literature among English and Japanese papers.
Assuntos
Aneurisma Aórtico/cirurgia , Dissecção Aórtica/cirurgia , Implante de Prótese Vascular , Lúpus Eritematoso Sistêmico/complicações , Adulto , Aorta/cirurgia , Insuficiência da Valva Aórtica/complicações , Combinação de Medicamentos , Transfusão de Eritrócitos , Formaldeído/uso terapêutico , Gelatina/uso terapêutico , Humanos , Masculino , Resorcinóis/uso terapêuticoRESUMO
A premature infant with double outlet right ventricle and pulmonary atresia with a birth weight of 1092 g is reported. He underwent right modified Blalock-Taussig (RMBT) shunt with an expand-polytetrafluoroethylene (ePTFE) tube of 3.0 mm in diameter between the right subclavian artery and the right pulmonary artery through right thoracotomy. Eleven days later, he had to undergo central shunt between the innominate artery and the main pulmonary trunk due to poor pulmonary blood flow. Soon after the central shunt, severe heart failure occurred due to excessive pulmonary blood flow. RMBT division was performed immediately. He finally attained definitive repair at 17 months of age. Postoperative course was uneventful and he was discharged on the 17th postoperative day.
Assuntos
Dupla Via de Saída do Ventrículo Direito/cirurgia , Recém-Nascido de muito Baixo Peso , Atresia Pulmonar/cirurgia , Prótese Vascular , Procedimentos Cirúrgicos Cardíacos/métodos , Dupla Via de Saída do Ventrículo Direito/complicações , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Politetrafluoretileno , Atresia Pulmonar/complicaçõesRESUMO
A 70-year-old woman presented with severe respiratory insufficiency similar to an asthma attack. Computed tomography (CT) revealed an atherosclerotic aneurysm (maximum diameter 106 mm) on the aortic arch which resulted in a severe tracheal compression. We performed an aortic arch replacement. After the operation, we tried to manage breathing without a respirator twice without success. We then performed a tracheotomy on the 12th day after operation. The patient could breathe independently on the 19th day after the first operation. Peri-and postoperative respiratory management was difficult but the patient was discharged on the 86th day after operation without further complication.
Assuntos
Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular , Insuficiência Respiratória/etiologia , Estenose Traqueal/complicações , Idoso , Aorta Torácica/cirurgia , Feminino , Humanos , Tomografia Computadorizada por Raios X , Estenose Traqueal/cirurgia , Traqueotomia , Procedimentos Cirúrgicos VascularesRESUMO
This study investigates the applicability of the novel antioxidant protein, peroxiredoxin (Prx) I as a marker for tumor status in oral squamous cell carcinoma (SCC). Samples from 53 patients with SCC in the oral cavity were examined by immunohistochemistry. Correlations between the expression level of Prx I and proliferating cell nuclear antigen (PCNA), the clinical features of tumors, and their histopathological classifications were statistically analyzed. Cases exhibiting low Prx I expression level included significantly more with larger tumor mass cases (T-category, P=0.004), positive lymph node metastasis (N-category, P=0.015), advanced stage (P=0.002), and poorly differentiated cells (P=0.020). There was no significant difference between Prx I expression and the other indices.
Assuntos
Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/química , Neoplasias Bucais/química , Peroxidases/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Estadiamento de Neoplasias , Peroxirredoxinas , Antígeno Nuclear de Célula em Proliferação/análise , Taxa de SobrevidaRESUMO
c-Abl is proto-oncogene product. c-Abl has roles in signal transduction, cell cycle regulation, and inhibition of apoptosis. There are many reports about c-Abl function in hematopoietic cells, but few are concerned with solid tumors. In the present study, biopsy specimens from 44 patients with oral squamous cell carcinomas were subjected to immunohistochemistry, and the expression levels of c-Abl were correlated with clinicopathological features. Statistical analyses revealed that c-Abl expression was significantly associated with T-category (p = 0.011), sex (p = 0.014), and differentiation (p = 0.007), but no significant difference was observed with N-category, age, primary tumor region, or the other histological gradings. The low c-Abl expression group included more T4, male, and poorly differentiated cases. There was a trend towards longer tendency survival in the high expression group, but the difference was not significant. We conclude that c-Abl is a good candidate for a tumor-expansion marker.
Assuntos
Carcinoma de Células Escamosas/metabolismo , Genes abl/genética , Neoplasias Bucais/metabolismo , Proteínas de Neoplasias/metabolismo , Proteínas Proto-Oncogênicas c-abl/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/genética , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/genética , Proteínas de Neoplasias/genética , Estadiamento de Neoplasias , Proto-Oncogene MasRESUMO
To establish sonographic criteria for differentiating metastasis and nonmetastasis in small cervical lymph nodes, correlations between sonographic parameters and histological diagnosis were statistically examined in 117 lymph nodes with maximal diameter of up to 10 mm in the sonographic findings, consisting of 26 metastatic and 91 nonmetastatic nodes. The equations obtained with logistic regression analysis showed lambda predictive values of -1.5 and 0.5 as effective cutoff-point criteria, and were considered to be a reliable indicator for differentiating small nodes with predictive values outside of -1.5 < lambda < 0.5. The sensitivity, specificity and accuracy with predictive values outside of -1.5 < lambda < 0.5 were 83%, 97% and 95%, respectively.
Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Linfonodos/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Modelos Logísticos , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pescoço , Estadiamento de Neoplasias , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricosRESUMO
To predict the response of lymph node metastasis to preoperative radiochemotherapy sonographically, the correlation between ultrasonographs and histologic features was retrospectively examined in 43 metastatic cervical lymph nodes from 24 patients with squamous cell carcinoma in the oral and maxillofacial region. Ultrasonographs were compared among poor-, good-, and complete-response lymph nodes. Before radiochemotherapy, hypoechoic internal echo and intranodal blood perfusion demonstrated many complete-response nodes; in contrast, most poor-response nodes showed peripheral blood perfusion and an avascular pattern, but did not have specific internal echo intensity. Complete-response nodes showed a significant reduction in their maximum and minimum diameters after radiochemotherapy. These results indicate that ultrasonography is useful for predicting the response of cervical lymph node metastasis to radiochemotherapy.
Assuntos
Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia , Metástase Linfática/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
An adenoid cystic carcinoma, arising in the pterygopalatine fossa and presenting with a visual deficit as the initial symptom in a 44-year-old woman, is reported. Magnetic resonance imaging was valuable in diagnosing the primary site and extension of the tumor.
Assuntos
Carcinoma Adenoide Cístico/complicações , Neoplasias da Base do Crânio/complicações , Osso Esfenoide , Transtornos da Visão/etiologia , Adulto , Biópsia , Carcinoma Adenoide Cístico/diagnóstico , Carcinoma Adenoide Cístico/terapia , Terapia Combinada , Evolução Fatal , Feminino , Humanos , Parestesia/diagnóstico , Parestesia/etiologia , Neoplasias da Base do Crânio/diagnóstico , Neoplasias da Base do Crânio/terapia , Osso Esfenoide/patologia , Transtornos da Visão/diagnósticoRESUMO
An ultrasound-guided surgical drainage technique in which grey-scale and colour Doppler ultrasonography were combined is described. The technique was performed for eight deep subcutaneous abscesses subsequent to odontogenic infection, and provided easy detection and accurate, reliable penetration of abscesses that were difficult to locate by physical examination. Colour Doppler ultrasonography is particularly useful for differentiating blood vessels from the static space of abscesses.
Assuntos
Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Face/cirurgia , Infecção Focal Dentária/diagnóstico por imagem , Infecção Focal Dentária/cirurgia , Pescoço/cirurgia , Abscesso/complicações , Adolescente , Adulto , Idoso , Feminino , Infecção Focal Dentária/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Sucção/métodos , Ultrassonografia Doppler/métodos , Ultrassonografia de Intervenção/métodosRESUMO
Peroxiredoxin (Prx) I is an antioxidant protein expressed in proliferating cells. We investigated Prx I as marker for tongue cancer status by correlating clinical features with Prx I expression. Samples from 132 patients with squamous cell carcinoma in the tongue were examined by immunohistochemistry with an anti-Prx I antibody. Correlations between Prx I expression and the clinical features of tumors were statistically determined using univariate and multivariate analyses. Univariate analysis showed Prx I was significantly associated with local recurrence (P=0.033). By multiple logistic regression analysis, Prx I expression was associated with local recurrence (odds ratio: 2.84; 95% confidence interval: 1.09-7.43; P=0.034) and lymph node recurrence (odds ratio: 2.86; 95% confidence interval: 1.02-8.01; P=0.046). Our results suggested that Prx I expression indicates tumors with a high potential for recurrence. Prx I may be used clinically to guide treatment for squamous cell carcinoma of the tongue.
Assuntos
Carcinoma de Células Escamosas/enzimologia , Recidiva Local de Neoplasia/enzimologia , Peroxirredoxinas/biossíntese , Neoplasias da Língua/enzimologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Biomarcadores Tumorais , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Feminino , Expressão Gênica , Humanos , Técnicas Imunoenzimáticas , Modelos Logísticos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias da Língua/genética , Neoplasias da Língua/patologiaRESUMO
PURPOSE: To ascertain whether Doppler color flow imaging can demonstrate the characteristics of blood flow within vascular lesions. MATERIALS AND METHODS: Two cases with vascular malformation in the soft tissues of the maxillofacial region were examined. One was an arteriovenous, high-flow type malformation involving the tongue, the floor of the mouth, and the mandible. The other was a venous, low-flow type malformation of the whole tongue. The technique used was the same as that for the extraoral approach in conventional ultrasound imaging. RESULTS: Doppler color flow imaging provided valuable information on the hemodynamic characteristics of the vascular malformations when comparing with other diagnostic forms of imaging, and clearly differentiated between high- and low-flow vascular lesions. CONCLUSION: Doppler color flow imaging was suggested to be another method in our armamentarium for differential diagnosis of vascular malformations.
Assuntos
Malformações Arteriovenosas/diagnóstico por imagem , Língua/irrigação sanguínea , Ultrassonografia Doppler em Cores , Adolescente , Adulto , Angiografia , Velocidade do Fluxo Sanguíneo , Diagnóstico Diferencial , Humanos , Masculino , Soalho Bucal/irrigação sanguínea , Veias/anormalidades , Veias/diagnóstico por imagemRESUMO
PURPOSE: This retrospective study was done to establish an objective criterion for sonographic diagnosis of cervical lymph node metastasis of squamous cell carcinoma in the oral and maxillofacial region. PATIENTS AND METHODS: A quantitative criterion for differentiating metastatic from nonmetastatic nodes was statistically calculated using logistic regression analysis of 106 cervical lymph nodes in 41 patients. A prospective study was then conducted to ascertain the reliability of the criterion for 82 nodes in another 23 patients. RESULTS: The following equation was obtained from the retrospective study: Y = 1/(1+e(-lambda) (lambda = -7.5709 + 4.2423 X1 + 1.9354 X2 + 0.5507 X3) Y represents the predicted value; lambda, also representing a predicted value, was defined as negative for nonmetastatic and positive for metastatic nodes; X1, signifying the existence of an echogenic hilus, was defined as 0 for presence and 1 for absence; X2, signifying the internal echo pattern, was defined as 0 for homogeneous and 1 for heterogeneous; X3, signifying the minimal diameter, was the actual measured value (mm). This equation showed a sensitivity of 82%, a specificity of 91%, and an accuracy of 88% in the prospective study. CONCLUSION: The equation calculated by logistic regression analysis was a reliable criterion for diagnosing cervical lymph node metastasis.
Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Faciais/diagnóstico por imagem , Neoplasias Maxilomandibulares/diagnóstico por imagem , Neoplasias Bucais/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Neoplasias Faciais/patologia , Feminino , Humanos , Neoplasias Maxilomandibulares/patologia , Modelos Logísticos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Pescoço , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estatísticas não Paramétricas , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricosRESUMO
Many surgical methods have been developed for reconstruction of extensive defects resulting from resection of lower lip cancer, with the aim of achieving of normal appearance and function. However, observers' subjective evaluation, which is the method usually employed, makes comparison of the outcomes of appearance and function obtained from different techniques difficult. In this paper, a speech intelligibility test and electromyography were used as objective means of evaluating the motor function of the reconstructed lower lip.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Labiais/cirurgia , Lábio/fisiologia , Músculo Esquelético/transplante , Transplante de Pele/métodos , Retalhos Cirúrgicos/métodos , Carcinoma de Células Escamosas/reabilitação , Eletromiografia , Estética , Humanos , Lábio/cirurgia , Neoplasias Labiais/reabilitação , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Inteligibilidade da Fala , Resultado do TratamentoRESUMO
An extremely rare phosphoglyceride deposition disease is reported. A healthy 62-year-old Japanese woman suffered from tumors that repeatedly appeared in injured soft tissues for more than 20 years. No immunologic disorders or abnormal laboratory data were found. Histology showed foreign body granulomas consisting of macrophages surrounding yellowish-white crystals. The crystals were weakly positive by von Kossa's method, were dissolved in 30% acetic acid with gas, and were easily dissolved in 0.1 N NaOH or potassium hydroxide, losing their crystal structure. Using a scanning electron microscopy X-ray microanalyzer, phosphorus and calcium peaks were detected. Phosphoglycerides were detected by microscopic infrared spectrophotometry and microsampling mass spectrometry. The gold hydroxamic acid method for detecting phosphoglyceride showed strong positive staining in the crystals. Based on the above analyses, the deposited crystals were regarded as phosphoglyceride, which bound calcium as a counter ion. The crystals tended to be deposited at sites of injury, where macrophages had accumulated. The patient had received many injections of a medicine made from alcohol extract from bovine liver. We suspect that this medicine was related to the cause of the deposition as the deposition repeatedly appeared at the site of the injections.