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1.
Eur J Gynaecol Oncol ; 36(2): 192-6, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26050359

RESUMEN

AIMS: For the screening of cervical abnormalities, human papillomavirus (HPV) DNA testing is widely used along with Papanicolaou (Pap) testing. Although the sensitivity of the HPV DNA testing is good, its specificity is relatively low. In the present study, the authors evaluated the use of the Gen-Probe APTIMA HPV Assay for the detection of HPV mRNA and compared it with HPV DNA testing. MATERIALS AND METHODS: Liquid cervical Pap specimens collected from 410 women were assessed using the APTIMA test, the Qiagen Hybrid Capture 2 HPV DNA (HC2) Test, and the AMPLICOR HPV Test. RESULTS: The sensitivity and specificity for the detection of high-risk HPV were 85.6% and 99.2% for the APTIMA test, 94.1% and 98.4% for the HC2 test, and 90.2% and 95.7% for the AMPLICOR test, respectively. As the severity of the cervical lesion progressed, the positive rate of the three tests indicated a similar increase. The clinical sensitivity and specificity for the detection of squamous intraepithelial lesion (SIL) were 91.2% and 84.2% for the APTIMA test, 94.5% and 80.4% for the HC2 test, and 87.9% and 78.2% for the AMPLICOR test, respectively. CONCLUSION: The APTIMA is sensitive and specific for the detection of high-risk HPV. In the specimens with SIL, the APTIMA test is more specific than the HC2 and the AMPLICOR tests. This indicates that the APTIMA test may improve patient management and reduce the cost of screening.


Asunto(s)
Papillomaviridae/aislamiento & purificación , ARN Mensajero/análisis , ARN Viral/análisis , Displasia del Cuello del Útero/virología , Neoplasias del Cuello Uterino/virología , Adulto , Anciano , ADN Viral/análisis , Femenino , Humanos , Persona de Mediana Edad , Prueba de Papanicolaou , Papillomaviridae/genética , Neoplasias del Cuello Uterino/diagnóstico , Displasia del Cuello del Útero/diagnóstico
2.
Geburtshilfe Frauenheilkd ; 73(7): 698-704, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24771926

RESUMEN

Objective: Small cell ovarian carcinomas (SCOC) are differentiated into two types: hypercalcaemic (SCOCHT) and pulmonary (SCOCPT). Unfortunately, little is known about pulmonary-type small cell ovarian carcinoma. Study Design: We carried out a systematic analysis of all available reports in the literature on individual cases of SCOCHT and SCOCPT. Results: We found that patients with SCOCPT were significantly older than those with SCOCHT. Vimentin and chromogranin detection by immunohistochemistry allow good differentiation between the two types. Interestingly, SCOCPT but not SCOCHT was found to be associated with other benign and malignant ovarian tumours in about 44 % of cases. Although the percentage of R0/R1 resections was high (~ 74 %), survival was poor; even in patients with disease limited to the ovaries (stage Ia and Ib) the recurrence rate was 40 %. Chemotherapy with etoposide or anthracyclines could be useful. Conclusion: Taking the limitations of our study such as its retrospective nature into account and based on the results from studies of small cell carcinomas originating from other tumour sites, we conclude that treatment of SCOCPT should be based on the therapies used to treat other small cell carcinomas. Surgery is appropriate, especially in very early stages of disease, but chemotherapy should not be omitted. Newer concepts such as treatment with somatostatin analogues could help to control symptoms and stabilise some slow-growing tumours.

3.
Interv Neuroradiol ; 17(1): 49-57, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21561558

RESUMEN

Although endovascular surgery is now widely used to treat intracranial aneurysms, no comparative studies of clipping versus endovascular surgery to address distal ACA aneurysms at the same institution are available. We compared the results of these treatment modalities to address distal ACA aneurysms at our institution. We treated 68 patients with ruptured distal ACA aneurysms (endovascular surgery, n=13; clipping surgery, n=55). We performed a retrospective comparison of the treatment outcomes. To study the efficacy of endovascular surgery we classified all our cases into three types: type A were small-necked aneurysms, type B were wide-necked aneurysms on the parent artery, and type C were aneurysms in which the A3 portion of the ACA arose from the aneurysmal dome near the neck. Intraoperative hemorrhage occurred in 7.7% of aneurysms treated by endovascular surgery and in 34.5% treated by clipping surgery. In 7.7% of the endovascularly-treated aneurysms we noted coil migration during embolization surgery; venous infarction due to cortical vein injury occurred in 7.3% of clipped aneurysms. Of the endovascularly-treated aneurysms, 7.7% manifested post-embolization hemorrhage; 23.1% manifested coil compaction. In clipping surgery, postoperative rerupture occurred in 1.8% of the aneurysms; one patient presented with postoperative acute epidural hematoma. Clip dislocation was noted in 1.8% of aneurysms. Angiography was indicative of post-treatment vasospasm in 7.7% of aneurysms treated endovascularly and in 50.9% of the clipped aneurysms. The clinical outcome showed no significant difference between endovascular surgery and clipping surgery.


Asunto(s)
Aneurisma Roto/cirugía , Aneurisma Roto/terapia , Embolización Terapéutica , Aneurisma Intracraneal/cirugía , Aneurisma Intracraneal/terapia , Adulto , Anciano , Anciano de 80 o más Años , Aneurisma Roto/diagnóstico por imagen , Angiografía Cerebral , Femenino , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos , Instrumentos Quirúrgicos , Resultado del Tratamiento
4.
Interv Neuroradiol ; 16(3): 317-21, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20977867

RESUMEN

Non-traumatic subgaleal hematoma is very rare. We present a case of refractory non-traumatic subgaleal hematoma occurring in a 15-year-old male patient. The patient was successfully treated by embolization of the superficial temporal artery. This therapeutic approach to refractory non-traumatic subgaleal hematoma is discussed.


Asunto(s)
Embolización Terapéutica , Hematoma Epidural Craneal/diagnóstico por imagen , Hematoma Epidural Craneal/terapia , Arterias Temporales/diagnóstico por imagen , Adolescente , Angiografía Cerebral , Humanos , Masculino , Tomografía Computarizada por Rayos X , Legrado por Aspiración
5.
Sarcoidosis Vasc Diffuse Lung Dis ; 27(2): 153-9, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-21319598

RESUMEN

Sarcoid reactions are relatively rare manifestations of epithelioid cell granulomas associated with malignancy; they are especially found in the lymph nodes draining malignant tumors, but rarely found in other organs. We present a case of a 60-year-old female with sarcoid reactions in the spleen identified during the consecutive diagnosis and management of ovarian, breast, and thyroid carcinomas during a period of about 2 years. The symptoms and laboratory data suggestive of systemic sarcoidosis were absent except for a slight mediastinal lymphadenopathy detected only by a computed tomographic scan. The splenic granulomas were accompanied by dendritic cells of mature and immature types, the latter being different from the reported nodal counterparts. To our knowledge, this is the first reported case of splenic sarcoid reactions associated with multiple cancers, and the first reported immunohistochemical detection of dendritic cells in splenic granuloma.


Asunto(s)
Granuloma/complicaciones , Neoplasias Primarias Múltiples/complicaciones , Enfermedades del Bazo/complicaciones , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/metabolismo , Células Dendríticas/metabolismo , Femenino , Granuloma/metabolismo , Granuloma/cirugía , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Neoplasias Primarias Múltiples/metabolismo , Neoplasias Ováricas/complicaciones , Sarcoidosis/diagnóstico , Sarcoidosis/metabolismo , Bazo/citología , Bazo/metabolismo , Esplenectomía , Enfermedades del Bazo/metabolismo , Enfermedades del Bazo/cirugía , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Tiroides/metabolismo
6.
Acta Radiol ; 50(9): 979-83, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19863406

RESUMEN

BACKGROUND: Positron emission tomography (PET)-computed tomography (CT) may be useful in the post-treatment follow-up of breast cancer patients. PURPOSE: To assess the usefulness of (18)F-fluorodeoxyglucose (FDG) PET-CT (PET-CT) for postoperative monitoring of breast cancer patients. MATERIAL AND METHODS: One hundred twenty-nine PET-CT studies performed on 55 female postoperative breast cancer patients (median age 56 years, range 36-86 years) were analyzed. The median interval between the PET-CT studies was 6 months (range 1-15 months). In order to determine the usefulness of serial PET-CT examinations in the postoperative follow-up of breast cancer patients, the PET-CT findings were compared with the physical findings, findings obtained by other imaging modalities, and the (18)F-FDG-PET (PET) findings. RESULTS: The PET findings were negative in 4 metastatic bone lesions with a positive bone scan. The PET findings were also negative in 6 of 9 osteogenic bone metastases and one of 64 osteolytic bone lesions. There were 5 cases with false-positive of PET, which were determined to be areas of soft-tissue hyperactivity. All false-positive/-negative findings were corrected by the addition of CT. CONCLUSION: The results of this study lend support to the clinical role of PET-CT in the postoperative follow-up/monitoring of breast cancer patients.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Fluorodesoxiglucosa F18 , Radiofármacos , Tomografía Computarizada de Emisión/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/cirugía , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Metástasis de la Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/diagnóstico por imagen , Imagen de Cuerpo Entero
7.
Kyobu Geka ; 62(3): 238-40, 2009 Mar.
Artículo en Japonés | MEDLINE | ID: mdl-19280958

RESUMEN

Native aortic valve thrombosis is an uncommon event. We describe the case of a 76-year-old man who suffered acute myocardial infarction associated with native aortic valve thrombosis diagnosed by cardiac catheterization. Since the thrombus was localized on the right coronary cusp and occluded right coronary artery, rescue revascularization was performed using perfusion catheter, which was continuously engaged to the right coronary artery. Operation was immediately performed under cardiopulmonary bypass. After incision of ascending aorta, thrombus was removed easily and aortic valve was preserved without degenerative change. Histological study showed a typical thrombus without any specific findings. He had a good clinical course and discharged 9 days after the operation. He had no history of heart valve disease, left heart catheterization or bacterial endocarditis. Since laboratory data showed 41% in protein C antigen and 32% of protein C activity, he was diagnosed of protein C deficiency. Our report emphasize that this thrombus formation may be caused by protein C deficiency.


Asunto(s)
Válvula Aórtica/cirugía , Enfermedades de las Válvulas Cardíacas/etiología , Enfermedades de las Válvulas Cardíacas/cirugía , Infarto del Miocardio/etiología , Deficiencia de Proteína C/complicaciones , Trombosis/etiología , Trombosis/cirugía , Anciano , Cateterismo Cardíaco , Trombosis Coronaria/etiología , Enfermedades de las Válvulas Cardíacas/diagnóstico , Humanos , Masculino , Infarto del Miocardio/prevención & control , Deficiencia de Proteína C/diagnóstico , Prevención Secundaria , Trombosis/diagnóstico
8.
Minim Invasive Neurosurg ; 51(4): 193-8, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18683108

RESUMEN

The treatment of dissecting aneurysms of the vertebral artery (VA) involving the posterior inferior cerebellar artery (PICA) or presenting with hypoplasia of the contralateral VA is controversial. We describe our experience with 4 ruptured and 2 unruptured VA dissecting aneurysms and discuss the efficacy of endovascular surgery using stents. All patients were male; their mean age was 50.7 years. According to World Federation of Neurological Surgeons (WFNS) grading, 3 of the ruptured aneurysms were grade V, the other was grade I. All patients were successfully treated using stents; in 5 we also coil-embolized the aneurysmal lumen. One aneurysm was treated by the placement of 2 stents covering the dissection site; there was a danger of aneurysmal rupture during coil embolization. No technical complications were encountered although one patient suffered minor rebleeding 5 days post-treatment. Delayed vasospasm occurred in 4 cases. According to the Glasgow Outcome Scale (GOS), at 3 months after treatment 2 patients had made a good recovery, one was moderately disabled, one suffered severe disability, and 2 had died. One death each was due to acute myocardial and brain stem infarction. Endovascular surgery using stents may be a useful treatment in patients in poor condition who manifest dissecting VA aneurysms involving the PICA or hypoplasia of the contralateral VA, especially in the acute period after rupture.


Asunto(s)
Embolización Terapéutica/instrumentación , Aneurisma Intracraneal/cirugía , Stents , Procedimientos Quirúrgicos Vasculares/instrumentación , Disección de la Arteria Vertebral/cirugía , Adulto , Anciano , Tronco Encefálico/irrigación sanguínea , Tronco Encefálico/diagnóstico por imagen , Tronco Encefálico/patología , Infartos del Tronco Encefálico/epidemiología , Angiografía Cerebral , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/métodos , Resultado Fatal , Escala de Consecuencias de Glasgow , Cefalea/etiología , Cefalea/patología , Cefalea/fisiopatología , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/patología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Prótesis e Implantes/efectos adversos , Prótesis e Implantes/estadística & datos numéricos , Estudios Retrospectivos , Stents/efectos adversos , Stents/estadística & datos numéricos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Inconsciencia/etiología , Inconsciencia/patología , Inconsciencia/fisiopatología , Procedimientos Quirúrgicos Vasculares/efectos adversos , Procedimientos Quirúrgicos Vasculares/métodos , Vasoespasmo Intracraneal/epidemiología , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/patología , Arteria Vertebral/cirugía , Disección de la Arteria Vertebral/diagnóstico por imagen , Disección de la Arteria Vertebral/patología
9.
Interv Neuroradiol ; 14(2): 137-41, 2008 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-20557754

RESUMEN

SUMMARY: Angiosarcoma is a rare, highly malignant tumor with a poor clinical outcome. From January 2004 to September 2005, we advocated transarterial chemotherapy using a port system for four patients with angiosarcomas of the face and scalp. A heparin coated ANTHRON P-Ucatheter was introduced into the feeding artery. The proximal part of the P-U catheter was connected to the port system and buried in subcutaneous tissue. The amount of chemotherapeutic drug applied using the port system was almost the same as the conventional intravenous dose. Paclitaxel was the standard agent, at 50-100 mg/diluted in 15-30 ml of physiological saline fluid slowly injected over 0.5-1 hour. For immunotherapy where appropriate, r-IL2 was mainly used at a dose of 70.000U/ diluted in 5 ml of physiological saline fluid injected into the port system over 30 seconds. This was continued for two to three weeks (five days/week) until recognition of a disappearance of the tumor. Macroscopic size reduction of the tumor was achieved in three out of the four cases. One case could not be evaluated because of eruptions induced by immunotherapy. Unfortunately two patients died after placement of port system, but the other two are still alive and are enjoying useful lives. Transarterial infusion chemotherapy using such a port system may be particularly effective for angiosarcoma in the early stages because small lesions with limited invasion mean a small territory of blood supply to be covered, and useful life was possible because the port system embedded in subcutaneous tissue allows treatment in an out-patient clinic.

10.
Interv Neuroradiol ; 14(2): 179-84, 2008 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-20557759

RESUMEN

SUMMARY: As endovascular surgery (EVS) of symptomatic unruptured aneurysms can result in symptom exacerbation due to intra-aneurysmal thrombosis or lump formation by coils, this treatment remains controversial. We present five women ranging in age from 58 to 76 years (mean 65.6 years) who suffered post-EVS symptom exacerbation attributable to local inflammation. The aneurysms measured from 8 to 25 mm (mean 19 mm) and were located at the cavernous portion in four patients and at the origin of the ophthalmic artery in one. All underwent endosaccular embolization under local anesthesia. Immediately after embolization, 24 h anticoagulation therapy was started via the continuous injection of heparin; they also received antiplatelet therapy. At one to three days post-EVS, all five patients manifested worsening of their cranial nerve symptoms. In three other patients the symptoms were improved after EVS. We posit that inflammation induced by coil embolization may worsen cranial nerve symptoms transiently. Our findings suggest that post-EVS followup is necessary and that patients exhibiting aninflammatory reaction be treated with anti-inflammatory drugs.

11.
Interv Neuroradiol ; 13 Suppl 1: 48-52, 2007 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-20566076

RESUMEN

SUMMARY: With the existence of vasospasm, it is recommended that direct clipping surgery for a ruptured aneurysm be delayed until its disappearance, but this may be associated with aneurysmal re-rupture resulting in a poor outcome for the patients. Indications for endovascular coil embolization in such cases are discussed. Since November in 2003, we have applied endovascular coil embolization in 11 consecutive patients with ruptured aneurysms and apparent vasospasm of the parent artery from two to 17 days (average: eight days) after initial subarachnoid hemorrhage. Three patients had aneurysmal re-rupture before treatment, but the other eight had only experienced the one episode of subarachnoid hemorrhage. With one exception, all endovascular procedures could be successfully performed, resulting in complete occlusion of aneurysms and remarkable dilatation of inserted spastic vessels without technical complications or aneurysmal re-rupture. For the one case of failure because of a tortuous artery, direct clipping surgery was performed after disappearance of vasospasm. Cerebral infarction occurred in four, but only one correlated with the distribution of catheterization, and neurological deficits had completely disappeared three months after the onset. This preliminary report concerning a small number of patients suggests that endovascular coil embolization is not contra-indicated for aneurysms with vasospasm requiring catheterization. A large study for confirmation is now warranted.

12.
Interv Neuroradiol ; 13 Suppl 1: 163-9, 2007 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-20566096

RESUMEN

SUMMARY: Whether endovascular surgery is able to reduce the mass effects of unruptured aneurysms is still controversial, although some reports have suggested efficacy in cases of internal carotid artery aneurysms with cranial nerve palsy. Here we assessed outcome in a series of cases. Between April 1992 and April 2005, 18 patients with unruptured internal carotid artery aneurysms presenting with cranial nerve palsy were treated by endovascular surgery. The patients were two males and 16 females aged from 19 to 84 (mean 59.6 years). Aneurysms were located in the cavernous portion in 14, at the origin of the ophthalmic artery in one and at the origin of P-com in three. The aneurysms were all embolized using Guglielmi detachable coils, Interlocking detachable coils, Cook's detachable coils or Trufill DSC and detachable Balloons were applied to occlude the proximal parent artery.We analyzed the efficacy of endovascular surgery for such aneurysms retrospectively. The mean aneurysm size was 21.4 mm and the mean follow-up period was 57.7 months. Palsy of II(nd) cranial nerve was evident in three patients, of the III(rd) in eight, of the V(th) and V(th) in one each, and of the VI(th) in nine. Post embolization occlusion was complete in nine patients and neck remnant in the other seven. Regarding complications of endovascular surgery, one case (5.6%) showed TIA after embolization. Overall 11 (46%) cranial nerve symptoms showed complete resolution, eight (33%) showed some improvement, and five (21%) were unchanged. In three cases (12.5%), the symptoms worsened after treatment. The shorter the duration of symptoms was a factor predisposing to resolution of symptoms. In complete resolution cases, the timing of treatment after symptoms appeared and the time of complete resolution were in proportion. These results showed that there is no difference in reduction of mass effects between surgical clipping and endovascular surgery for unruptured internal carotid artery aneurysms.With endovascular surgery, the rapidity of treatment after symptoms is the most important factor for successful results.

13.
J Exp Clin Cancer Res ; 25(3): 433-42, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-17167985

RESUMEN

Poorly differentiated adenocarcinoma (Por) and signet-ring cell carcinoma (Sig) are rare but highly malignant types of colorectal cancer. To explore their genetic backgrounds we investigated TGF-beta type II receptor (TGF-beta RII) and SMAD4 in the TGF-beta signaling pathway, and to identify their mutator phenotype we examined microsatellite instability (MSI) status. Loss of SMAD4 expression was significantly more frequent in Por (12 of 38; 31%) and Sig (4 of 5; 80%) tumors than in well (Well) and moderately differentiated (Mod) carcinomas (p = 0.04, 0.003, respectively). Mutation of the SMAD4 gene was detected in 2 of 26 Por tumors. MSI was positive in 14 of the 38 Por tumors and in 1 of the 5 Sig tumors, but in none of the Well or Mod tumors examined. We also found mutation of TGF-beta RII, a putative target of MSI, in 10 of 35 Por tumors (28.6%), but in none of 3 Sig tumors. As a whole, about 50% of the Por tumors and 80% of the Sig tumors showed abnormalities of either TGF-beta RII or SMAD4 expression. This suggests that disruption of the TGF-beta signaling pathway may play a central role in the pathogenesis of Por and Sig tumors of the colorectum.


Asunto(s)
Adenocarcinoma/genética , Carcinoma de Células en Anillo de Sello/genética , Diferenciación Celular , Neoplasias Colorrectales/genética , Mutación/genética , Proteína Smad4/genética , Adenocarcinoma/patología , Carcinoma de Células en Anillo de Sello/patología , Neoplasias Colorrectales/patología , ADN de Neoplasias , Femenino , Humanos , Técnicas para Inmunoenzimas , Masculino , Inestabilidad de Microsatélites , Persona de Mediana Edad , Proteínas Serina-Treonina Quinasas , Receptor Tipo II de Factor de Crecimiento Transformador beta , Receptores de Factores de Crecimiento Transformadores beta/genética , Proteína Smad4/metabolismo
14.
Kidney Int ; 70(10): 1717-24, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16985520

RESUMEN

Dysregulated production of adipocytokines may be involved in the development of atherosclerotic cardiovascular disease in metabolic syndrome and chronic kidney disease (CKD) associated with metabolic syndrome. The aim of this study was to determine the effects of treatment with angiotensin II (Ang II) type-1 receptor blocker (ARB) on the regulation of adipocytokines. Olmesartan, an ARB, significantly blunted the age- and body weight-associated falls in plasma adiponectin both in genetically and diet-induced obese mice, without affecting body weight, but had no effect on plasma adiponectin levels in lean mice. Olmesartan also ameliorated dysregulation of adipocytokines in obesity, such as tumor necrosis factor-alpha, plasminogen activator inhibitor-1, monocyte chemotactic protein-1, and serum amyloid A3. Olmesartan significantly reduced reactive oxygen species originating from accumulated fat and attenuated the expression of nicotinamide adenine dinucleotide phospho hydrogenase oxidase subunits in adipose tissue. In cultured adipocytes, olmesartan acted as an antioxidant and improved adipocytokine dysregulation. Our results indicate that blockade of Ang II receptor ameliorates adipocytokine dysregulation and that such action is mediated, at least in part, by targeting oxidative stress in obese adipose tissue. Ang II signaling and subsequent oxidative stress in adipose tissue may be potential targets for the prevention of atherosclerotic cardiovascular disease in metabolic syndrome and also in metabolic syndrome-based CKD.


Asunto(s)
Adiponectina/metabolismo , Tejido Adiposo/metabolismo , Bloqueadores del Receptor Tipo 1 de Angiotensina II/farmacología , Imidazoles/farmacología , Estrés Oxidativo/efectos de los fármacos , Tetrazoles/farmacología , Tejido Adiposo/efectos de los fármacos , Angiotensina II/fisiología , Animales , Aterosclerosis/fisiopatología , Aterosclerosis/prevención & control , Células Cultivadas , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Regulación de la Expresión Génica/genética , Enfermedades Renales/fisiopatología , Enfermedades Renales/prevención & control , Síndrome Metabólico/metabolismo , Síndrome Metabólico/fisiopatología , Ratones , Ratones Endogámicos C57BL , Obesidad/metabolismo , Obesidad/fisiopatología , Estrés Oxidativo/fisiología , Inhibidor 1 de Activador Plasminogénico/genética , Inhibidor 1 de Activador Plasminogénico/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Especies Reactivas de Oxígeno/metabolismo , Proteína Amiloide A Sérica/genética , Proteína Amiloide A Sérica/metabolismo , Transducción de Señal/fisiología , Factor de Necrosis Tumoral alfa/genética , Factor de Necrosis Tumoral alfa/metabolismo
15.
Clin Neuropathol ; 25(1): 25-8, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16465771

RESUMEN

OBJECTIVE: The histogenesis of craniopharyngioma is not fully understood. We encountered a ciliated craniopharyngioma, the details of which may shed light on the histogeny of craniopharyngioma in general. PATIENT: A 74-year-old man presented with visual disturbance. Computed tomography showed an intra-suprasellar cyst including a solid tumor. Transsphenoidal surgery was performed. During surgery, the cyst was found to contain mucoid milky-white fluid and a solid tumor 1 cm in diameter. Histologically, the tumor was shown to be a papillary type craniopharyngioma with foci of ciliated columnar epithelial cells. Ciliated craniopharyngioma was diagnosed. CONCLUSION: Our findings in this case together with findings in other reported cases suggest that the basal cells of Rathke cleft cyst transform to papillary type craniopharyngioma after squamous metaplasia, explaining the presence of the cilia and goblet cells.


Asunto(s)
Quistes del Sistema Nervioso Central/patología , Craneofaringioma/patología , Neoplasias Hipofisarias/patología , Anciano , Quistes del Sistema Nervioso Central/cirugía , Craneofaringioma/cirugía , Humanos , Masculino , Neoplasias Hipofisarias/cirugía , Tomografía Computarizada por Rayos X
16.
Interv Neuroradiol ; 12(Suppl 1): 148-53, 2006 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-20569621

RESUMEN

SUMMARY: Polyvinyl alcohol (PVA) particles have been widely used as an embolic material for endovascular treatment of vascular enriched tumors, especially for meningiomas. However, there are disadvantages with their use due to the fact that they are radiolucent, with a very irregular shape and a tendency for self-adhesion. With alternative organic liquids there is also a possibility of toxicity. We have therefore developed a new embolic material, platinum balls, which feature radioopacity, a relatively well-defined oval shape, multi-pitted and indented surfaces on electron microscopy and a lower tendency for self-adhesion Based on positive findings in experimental studies, embolization of meningiomas was conducted with platinum balls in 27 patients and the results compared with findings for a matched group previously treated with PVA particles.Total volume of blood transfused during surgery was comparable in the two cases, although a tendency for lower values was noted with the platinum balls, and outcome was equally positive.

17.
Interv Neuroradiol ; 11(3): 287-95, 2005 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-20584489

RESUMEN

SUMMARY: The purpose of this paper is to clarify advantages and disadvantages of platinum liquid coils as an embolic material for AVMs. During the last eight years, 50 endovascular procedures using liquid coils were conducted in our institute for 19 cases with AVMs, 15 of which were located in the eloquent area. All but one presented with haemorrhage, the exception demonstrating repeated ischemic symptoms. Only liquid coils were used as the embolic material to obliterate the nidus and feeders. In ten of the 15 patients with AVMs located in the eloquent area and one case rejecting surgery, liquid coil embolization was applied one to 11 times (average 3.5 times) to achieve decrease in size and this was then followed by radiosurgery. The remaining eight AVM patients underwent total removal after liquid coil embolization. No complications were encountered during the peri-embolization period. In all cases, the purpose of embolization was to diminish the size to facilitate radiosurgery and decrease bleeding during surgery. The liquid coil has advantages as a material for embolization of AVMs; it is non-toxic and bioinart material; it seldom occludes normal minute vascular channels; when it used in a nidus, it seldom to migrates in the venous direction, and it has good radio-opacity and offers good marking for surgery. Appropriate applications include preoperative embolization or pre-radiosurgical embolization of AVMs, especially when staged embolizations are performed to reduce risk of perfusion pressure breakthrough in patients which are large or located in the eloquent area.

18.
Verh Dtsch Ges Pathol ; 88: 231-6, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-16892557

RESUMEN

Thromboangiitis obliterans (TAO), the Winiwarter-Buerger disease, is a vasoocclusive disease of unknown etiology which typically affects medium-sized extremital vessels of young male smokers. While the diagnosis of TAO is largely based on patients' presentation and clinical criteria, pathological substrates have been poorly defined and repeatedly disputed. Comparing the histology and immunohistochemistry of TAO especially with those of arteriosclerosis obliterans (ASO) and thromboembolism in two larger studies, we recently identified several features with significant meaning for the differential diagnosis. The unique tissue appearance of TAO is in favor of a general disorder of minute vessels indicating periarteritis rather than pure endarteritis, whereas an inflammatory reaction directed to the internal elastic lamina corresponds with the severity of disease. Since TAO or its syndromic equivalent is probably more common than currently diagnosed, the presented pathological criteria may help to identify latent cases, the overlap with ASO, and untypical organ involvement of TAO.


Asunto(s)
Tromboangitis Obliterante/patología , Edad de Inicio , Brazo/irrigación sanguínea , Arteriopatías Oclusivas/patología , Arteriosclerosis Obliterante/patología , Humanos , Persona de Mediana Edad , Fumar/efectos adversos , Tromboangitis Obliterante/etiología
19.
Interv Neuroradiol ; 10(3): 225-30, 2004 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-20587234

RESUMEN

SUMMARY: Endovascular surgery has been proposed as an alternative treatment for cerebral aneurysms. However, for wide neck and large sized lesions it is very difficult to obtain complete occlusion and tissue organization. The present study was conducted to examine the efficacy of electrical thrombosis for cerebral aneurysms and parent arterial occlusions using Interlocking Detachable Coils (IDCs), focusing on the minimum current volume and stimulation time required for stable electrical thrombosis formation. We used ten mixed-breed adult dogs (in the study body weights 9-12 kg; males: 5, females: 5). Guiding catheter sand microcatheters were introduced into both sides of the distal external carotid artery (ECA) and placed at the same level. To prevent migration, IDCs (4 mm x 12 cm) were placed in the ECA without being detached. After confirming no vessel occlusion, we applied a positive current (2-6 mA) to the coil on one side and performed angiography every ten minutes to observe whether vessel occlusion with electrothrombosis had occurred. It was determined that to achieve complete occlusion of the external carotid arteries in mixedbreed dogs, a minimum stimulation current of 4mA and a minimum stimulation time of ten to 20 minutes are required.

20.
Acta Neurochir (Wien) ; 144(1): 97-101, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11807652

RESUMEN

BACKGROUND: A rare case of a left temporal arteriovenous malformation (AVM) with bleeding 10 days after removal of another hemorrhagic AVM in the frontal lobe is reported. METHOD: A 47-year-old man had an attack of headache and vomiting and was admitted to our hospital. On admission, a CT scan showed subcortical hemorrhage in the left frontal lobe. Left carotid angiography revealed four AVMs and a vertebro-basilar angiogram demonstrated a vascular malformation. FINDINGS: First, a hemorrhagic AVM was removed with a hematoma. Following the operation, left carotid angiograms continued to show, AVMs, particularly a temporal AVM with increased blood flow, and after 10 days this hemorrhaged. This was surgically resected and the remaining small AVMs were treated by stereotactic radiosurgery. INTERPRETATION: The patient had a high risk of hemorrhage. Adding hemodynamic stress to this situation, hemorrhage would have been expected to occur at an early time after the initial intervention for hemorrhagic AVM. Considering the risk of hemorrhage, other AVMs should undergo surgery as soon as possible after resection of hemorrhagic AVM.


Asunto(s)
Hemorragia Cerebral/etiología , Lóbulo Frontal/patología , Malformaciones Arteriovenosas Intracraneales/patología , Angiografía Cerebral , Hemorragia Cerebral/patología , Hemodinámica , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/cirugía , Masculino , Persona de Mediana Edad , Factores de Riesgo , Lóbulo Temporal/patología
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