RESUMO
BACKGROUND: Meningiomas are the second most common primary intracranial tumors after gliomas. Epigenetic biomarkers such as DNA methylation, which is found in many tumors and is thus important in tumorigenesis can help diagnose meningiomas and predict response to adjuvant chemotherapy. We investigated aberrant O6- methyl guanine methyltransferase (MGMT) methylation in meningiomas. MATERIALS AND METHODS: Sixty-one patients were classified according to the WHO grading, and MGMT promoter methylation status was examined via the methylation-Specific PCR(MSP) method. RESULTS: MGMT promoter methylation was found in 22.2% of grade I, 35% of grade I with atypical features, 36% of grade II, and 42.9% of grade III tumors. CONCLUSIONS: There was an increase, albeit not statistically significant, in MGMT methylation with a rise in the tumor grade. Higher methylation levels were also observed in the male gender.
Assuntos
Metilação de DNA , Metilases de Modificação do DNA/genética , Enzimas Reparadoras do DNA/genética , Neoplasias Meníngeas/genética , Neoplasias Meníngeas/patologia , Meningioma/genética , Meningioma/patologia , Proteínas Supressoras de Tumor/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Regiões Promotoras Genéticas , Adulto JovemRESUMO
OBJECTIVES: Rehospitalization is a significant burden for transplant systems, which use data on hospitalization to monitor practice outcomes. In this study, all rehospitalizations after successful lung transplant performed in our medical center during an 8-year period were assessed for cause, health care resource use, cost, and outcome. MATERIALS AND METHODS: We performed a retrospective chart review of all rehospitalizations of lung transplant recipients in Masih Daneshvari Hospital in Darabad, Tehran, between 2000 and 2008. Baseline data (each patient's age at transplant and rehospitalization, sex, primary lung disease, medications used), cause of rehospitalization (infection, graft rejection, surgical complications, type of infection), health care resources use (length of hospital stay, intensive care unit stay, physician visits, imaging), rehospitalization costs (accommodations, personnel, drugs, paraclinical [ie, laboratory] tests, supplies, procedures) and outcome (death, survival) were noted. RESULTS: In 69% of patients who were rehospitalized after having received a lung transplant, the cause was infection. Other causes were acute rejection in 31% and surgical complications in 6.9%. In 10.3% of those patients, the primary cause for rehospitalization could not be specified. The mean (SD) duration of rehospitalization was 12.8 -/+ 10.4 days. Treatment in the intensive care unit was necessary for 93.1% of the study subjects. The mean (SD) number of physician visits was 27.8 -/+ 27.7, and the fatality rate in the patients studied was 13.8%. CONCLUSIONS: These data may guide the monitoring of the causes, burden, and outcomes of lung transplants performed in our medical center in Iran and in other medical centers.
Assuntos
Doenças Transmissíveis/terapia , Atenção à Saúde/estatística & dados numéricos , Rejeição de Enxerto/terapia , Hospitalização , Transplante de Pulmão/efeitos adversos , Avaliação de Processos e Resultados em Cuidados de Saúde , Adulto , Doenças Transmissíveis/economia , Doenças Transmissíveis/etiologia , Cuidados Críticos/estatística & dados numéricos , Atenção à Saúde/economia , Testes Diagnósticos de Rotina/estatística & dados numéricos , Feminino , Rejeição de Enxerto/economia , Rejeição de Enxerto/etiologia , Custos Hospitalares , Hospitalização/economia , Humanos , Irã (Geográfico) , Tempo de Internação , Transplante de Pulmão/economia , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde/economia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
In this report, a case of metaplastic thymoma arising in a thymic cyst wall is discussed. The patient was a 61-year-old male whose chief complaint was sweating and chest pain. Imaging study revealed a mediastinal mass with right hemithoracic extension. He underwent surgical resection of the mass and remnants of the thymus. Histologic studies showed a primary thymic neoplasm with a biphasic histologic pattern composed of 2 distinct epithelial and stromal components arising in a thymic cyst wall. Immunohistochemically, the epithelial component was cytokeratin positive and focally reactive for EMA. Marked expression of EMA and vimentin was seen in spindle cells. Metaplastic thymoma is an extremely rare variant of primary thymic epithelial neoplasms with only a few cases reported in the literature.