RESUMO
Monogenean parasites are important ectoparasites of fish, and are responsible for severe economic impacts in the aquaculture industry. They are usually treated with chemicals, but the chemicals can have harmful side effects in the fish and may pose threats to human health. Rosemary (Rosmarinus officinalis) is a common medicinal herb, with antimicrobial and antitumor properties. Here, we examined the anthelmintic activity of rosemary extract against the monogenean (Dactylogyrus minutus) in vitro and in vivo using bath treatment and oral administration. The in vitro experiments showed that parasite survival was affected by both rosemary extract concentration and the solvent (water and ethanol). Parasites were dead at 61.8±5.6 and 7.8±1.4min when exposed to 100 and 200g aqueous rosemary extract solution/L of water respectively. It took 166.7±48.2 and 5.4±1.01min to kill the parasites when exposed to 1 and 32g ethanol rosemary extract solution/L of water respectively. Moreover, pure component of rosemary extract obtained commercially used in in vitro experiments showed that 1,8-Cineole was the most toxic component of the main components tested. Parasite intensity and prevalence in fish exposed to 50 and 100g aqueous rosemary solution/L water for 30min were significantly lower than they were in controls (p<0.05). In oral treatment experiments, diets of Cyprinus carpio were supplemented with eight different concentrations of aqueous rosemary extract. The intensity of parasites was significantly less in fish fed for 30days with feed containing 60, 80 and 100ml aqueous extract/100g feed than in control (p<0.05). Together these results indicate that rosemary is a promising candidate for prevention and control of monogenean infection.
Assuntos
Anti-Helmínticos/farmacologia , Carpas/parasitologia , Doenças dos Peixes/tratamento farmacológico , Helmintíase Animal/tratamento farmacológico , Extratos Vegetais/farmacologia , Rosmarinus/química , Animais , Anti-Helmínticos/química , Anti-Helmínticos/isolamento & purificação , Aquicultura , Cicloexanóis/química , Cicloexanóis/isolamento & purificação , Cicloexanóis/farmacologia , Eucaliptol , Doenças dos Peixes/parasitologia , Doenças dos Peixes/prevenção & controle , Helmintíase Animal/parasitologia , Helmintíase Animal/prevenção & controle , Monoterpenos/química , Monoterpenos/isolamento & purificação , Monoterpenos/farmacologia , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Folhas de Planta/química , Plantas Medicinais , Platelmintos/efeitos dos fármacosRESUMO
UNLABELLED: The aim of this study was to determine the recommended dose of irinotecan in combination with the fixed dose of oral UFT as first-line therapy in patients with advanced or recurrent colorectal cancer, and to evaluate the response rate and overall survival as a phase II study. PATIENTS AND METHODS: Thirteen patients were recruited into a phase I trial. Four doses of irinotecan ranging from 60 to 150 mg/m2/day were administered intravenously on day 1 and day 16 in combination with UFT given orally from day 2 to day 15. In a phase II study, 53 patients received at least one cycle of this therapy. RESULTS: The recommended dose of this combination was determined as irinotecan 120 mg/m2/day and UFT 400 mg/m2/day. Dose-limiting toxicities were neutropenia and prolonged leucopenia. On an intent-to-treat analysis, the response rate in the phase II study was 24.5% (95% confidence interval 13.8% to 38.2%). The median overall survival time was 20.3 months (95% confidence interval, 15.0-22.8 months). Out of 20 patients with stable disease, 17 who received more than 4 cycles of the regimen lived longer than the other 3 patients who received fewer than 3 cycles (p = 0.0353). Hematological adverse events were mainly grade 3/4 neutropenia observed in 6 out of 53 patients. Grade 3 non-hematological toxicities, such as diarrhea, anorexia, nausea/vomiting and alopecia were observed in 6 patients. CONCLUSION: Irinotecan combined with oral UFT was effective and well-tolerated. This regimen may be considered as a first-line therapy for advanced or metastatic colorectal cancer and may result in fairly long survival, even for patients with stable disease.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Camptotecina/administração & dosagem , Camptotecina/efeitos adversos , Camptotecina/análogos & derivados , Neoplasias Colorretais/patologia , Esquema de Medicação , Feminino , Humanos , Irinotecano , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Tegafur/administração & dosagem , Tegafur/efeitos adversos , Uracila/administração & dosagem , Uracila/efeitos adversosRESUMO
The subject of this report is a rare case of a 5-year-old girl who developed an arachnoid cyst with a bony and dural defect in the parietal convexity. She had no history of head trauma or infection. Surgical exploration revealed the bulging lesion to consist of cerebrospinal fluid-containing spongy subcutaneous tissue and to extend into the bony and dural defect. The arachnoid cyst cavity was found beneath the subcutaneous lesion and was not connected to the adjacent subarachnoid space. Histologically, the subcutaneous tissue contained a complex of sinusoidal channels formed by an abundance of migrating arachnoidal cells, thus mimicking meningocele.
Assuntos
Cistos Aracnóideos/congênito , Cistos Aracnóideos/diagnóstico , Meningocele/diagnóstico por imagem , Meningocele/patologia , Cistos Aracnóideos/cirurgia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
We cloned the full-length cDNA of max gene from the common carp (Cyprinus carpio). The cDNA clone of carp max consists of 1209 bp and contained an ATG-initiated ORF consisting of 156 aa. The carp MAX share 76.7-93.8% aa identity with those of human, mouse, rat, chicken, Xenopus and zebrafish, respectively. The 15 bp alternative splicing was observed in the loop region of helix-loop-helix and is not previously described in mammalian max sequences. Transcripts of max gene were observed in all of the tissues of carp investigated in this study. The highest expression was found in the ovary, and the transcripts in hepatopancreas and heart were low. Two carp c-myc genes (CAM1 and CAM2) showed differential expression pattern. The expression of max was concomitant with CAM2 expression, but not with CAM1. It has been reported that MYC/MAX heterodimer as a regulator of gene expression has been maintained throughout vertebrate evolution, and the expression of c-myc has been concomitant with max expression. In addition, according to phylogenetic analysis, CAM1 is evolving faster than CAM2 after gene duplication. Therefore, this result suggests that CAM1 may evolve to obtain a new function different from c-myc.
Assuntos
Carpas/genética , Proteínas de Ligação a DNA/genética , Genes myc , Sequências Hélice-Alça-Hélice , Zíper de Leucina , Fatores de Transcrição/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos , Fatores de Transcrição de Zíper de Leucina Básica , DNA Complementar , Perfilação da Expressão Gênica , Humanos , Dados de Sequência Molecular , Homologia de Sequência de AminoácidosRESUMO
OBJECT: Acquisition of invasive and metastatic potentials through proteinase expression is an essential event in tumor progression. Among proteinases, matrix metalloproteinases (MMPs) are thought to play a key role in tumor progression through the degradation of the extracellular matrix. In the present study, the authors examined the role of MMP-2 (gelatinase A) and membrane type 1 MMP (MT1-MMP), an activator of the zymogen of MMP-2, proMMP-2, together with tissue inhibitors of metalloproteinases (TIMP-1 and TIMP-2) in the invasion of astrocytic tumors in humans. METHODS: Analyses performed using sandwich enzyme immunoassays demonstrated that the production levels of pro-MMP-2 and TIMP-1, but not TIMP-2, are significantly higher in glioblastomas multiforme than in other grades of astrocytic tumors. Quantitative reverse transcription-polymerase chain reaction indicated that MT1-MMP is expressed predominantly in glioblastoma tissues, and its expression levels are significantly enhanced as tumor grade increases. In addition, the expression levels and proMMP-2 activation ratio were remarkably higher in glioblastomas associated with cerebrospinal fluid (CSF) dissemination than in those not associated with CSF dissemination. In contrast, an examination of TIMP-2 levels showed a reverse correlation. Like MT1-MMP, TIMP-1 and TIMP-2 were immunolocalized to neoplastic cells in glioblastoma samples. To study the roles of these molecules in the invasion of astrocytic tumors more fully, stable transfectants expressing the MT1-MMP gene were developed in a U251 human glioblastoma cell line. The MT1-MMP transfectants displayed prominent activation of proMMP-2 and invasive growth in three-dimensional collagen gel; however, mock transfectants and parental cells displayed noninvasive growth without the activation. The invasion and gelatinolytic activity of the transfectants were completely inhibited by addition of recombinant TIMP-2, but not recombinant TIMP-1. CONCLUSIONS: These results indicate that MT1-MMP may contribute to tumor invasion and CSF dissemination of glioblastoma cells on the basis of an imbalance of TIMP-2.
Assuntos
Astrocitoma/enzimologia , Astrocitoma/patologia , Neoplasias Encefálicas/enzimologia , Neoplasias Encefálicas/patologia , Metaloproteinase 1 da Matriz/metabolismo , Inibidor Tecidual de Metaloproteinase-2/metabolismo , Divisão Celular , Colágeno , Precursores Enzimáticos/análise , Precursores Enzimáticos/metabolismo , Gelatina/metabolismo , Gelatinases/análise , Gelatinases/metabolismo , Géis , Regulação Enzimológica da Expressão Gênica , Humanos , Técnicas Imunoenzimáticas , Imuno-Histoquímica , Metaloproteinase 1 da Matriz/análise , Metaloproteinase 1 da Matriz/genética , Metaloendopeptidases/análise , Metaloendopeptidases/metabolismo , Invasividade Neoplásica/patologia , RNA Mensageiro/análise , Inibidor Tecidual de Metaloproteinase-1/análise , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Inibidor Tecidual de Metaloproteinase-2/análise , Transfecção , Células Tumorais CultivadasRESUMO
BACKGROUND: We assessed the importance of Thymidylate Synthase (TS) expression as a prognostic factor and as an index of therapeutic efficacy in patients with colorectal carcinoma. PATIENTS AND METHODS: TS expression in 66 patients with colorectal carcinoma was immunohistochemically assessed using the anti-TS antibody. TS expression, TS activity, clinicopathological characteristics and survival were evaluated and the correlation among them was studied. RESULTS: The cases studied included 53 patients with low grade positive/negative and 13 patients with high grade positive TS expression. TS levels were 8.69 +/- 10.01 pmol/g and 14.82 +/- 11.38 pmol/g, respectively. There was not correlation between clinicopathological characteristics and TS expression. Considering TS expression, the 5-year survival rate was significantly better for the 75.5% of the patients with low grade positive/negative TS than for the 38.5% of the patients with high grade positive TS (p < 0.01). CONCLUSION: The immunohistochemical expression of TS should be further investigated as a prognostic factor of survival and as an index of chemotherapeutic efficacy in colorectal carcinoma.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/enzimologia , Timidilato Sintase/biossíntese , Anticorpos , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioterapia Adjuvante , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Modelos de Riscos Proporcionais , Análise de Sobrevida , Tegafur/administração & dosagem , Timidilato Sintase/imunologia , Resultado do Tratamento , Uracila/administração & dosagemRESUMO
Continuous intravenous injection of 5-FU was given at 300 mg/m2 to patients with gastric or colorectal cancer for consecutive 3 days preoperatively, and the relationships between the time until collection of samples (from final administration of 5-FU to excision of tissue samples) and total thymidylate synthase (TS total) activity, free thymidylate synthase (TS free) activity, thymidylate synthase inhibition rate (TSIR), thimidine kinase (TK) activity, and tissue 5-FU and FdUMP concentrations investigated. TS total was shown to gradually reduce with time, but the relationship between time and the other assay items could not be identified due to large variability in the data. TS total and TK also proved to be affected also by the sites at which the samples were collected, and exhibited significantly higher enzyme activity in tumor tissue than that in normal tissue.
Assuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Neoplasias Colorretais/enzimologia , Fluoruracila/administração & dosagem , Neoplasias Gástricas/enzimologia , Timidina Quinase/metabolismo , Timidilato Sintase/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/tratamento farmacológico , Esquema de Medicação , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Neoplasias Gástricas/tratamento farmacológicoRESUMO
BACKGROUND: Tegafur-uracil(UFT;TAIHO Pharmaceutical Co.Ltd, Tokyo, Japan) is commonly used to treat digestive cancers. However, the inhibitors of metastasis in this agent have not been fully examined. To investigate a cell adhesion molecule, CD44, which may very well contribute to the pathogenesis of metastasis, we examined the association of CD44 and the thymidylate synthase inhibition rate(TSIR) with prognosis, and examined the expression of apoptosis in patients who were administrated tegafur-uracil before surgery for colorectal cancer. MATERIALS AND METHODS: This study included 66 patients who underwent curative resection of colorectal cancer. In these patients, tegafur-uracil(600 mg) was orally administered every day for 3 to 7 days before surgery, and Tegafur-uracil (400 mg) was orally administered every day for 2 years after surgery. CD44 and apoptosis were detected immunohistochemically and by the TUNNEL method, respectively. The TSIR was calculated from the total TS level, and free TS levels by modified Spears' method using fresh tumor tissue specimens. RESULTS: The TSIR of non-recurrent patients was significantly higher than that of recurrent patients(p < 0.05). The 5-year survival rate in CD44-low grade positive/negative patients (81.6%) was significantly higher than that in CD44-high grade positive patients (46.4%) (p < 0.005). The 5-year survival rate in apoptosis-high grade positive patients (89.7%) was significantly higher than that in apoptosis-low grade positive/negative patients(46.4%) (p < 0.001). With respect to the relationship between CD44 and apoptosis, the proportion of apoptosis-high grade positive patients among CD44-low grade positive/negative patients (55.3%) was significantly higher than that among CD44-high grade positive patients(28.6%) (p < 0.05). In the multivariate analysis, the CD44 expression was suggestive of an independent prognostic factor. CONCLUSION: Based on our results for TSIR, Tegafur-uracil may induce apoptosis of tumor cells in patients by the inhibition of thymidylate synthase. It was suggested that CD44 expression could be used as a possible independent predictor of survival. In addition, it was suggested that UFT, via the inhibition of CD44 expression caused the inhibition of distant metastasis.
Assuntos
Antineoplásicos/uso terapêutico , Apoptose , Neoplasias Colorretais/tratamento farmacológico , Receptores de Hialuronatos/metabolismo , Tegafur/uso terapêutico , Timidilato Sintase/metabolismo , Uracila/uso terapêutico , Idoso , Quimioterapia Adjuvante , Neoplasias Colorretais/metabolismo , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Terapia Combinada , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Taxa de SobrevidaRESUMO
We determined the heterogeneous transcription start points (tsp) of two c-myc genes from the common carp (Cyprinus carpio), tetraploid teleost, by the oligo-capping method and showed the existence of the first exon. This is the first report on the existence of the first exons of the fish c-myc gene. Transcription of the two carp c-myc genes started from at least four sites in CAM1, locating from -752 to -381bp upstream of the translation start site, and from 12 sites in CAM2, locating from -586 to -413bp upstream respectively. The first introns of CAM1 and CAM2 were deduced to be 335 and 356bp, respectively. They shared 86.9% nt identity, lower than those of the second exons (94.1%), and third exons (92.3%), which suggest that the first exons evolved faster. No nt identities were found between the c-myc first exons of carp and other vertebrates. The putative promoter regions in CAM1 and CAM2 contained no obvious TATA or CCAAT boxes in the expected positions.
Assuntos
Carpas/genética , Genes myc/genética , Animais , Sequência de Bases , Éxons , Íntrons , Dados de Sequência Molecular , Regiões Promotoras Genéticas , Isoformas de Proteínas/genética , Alinhamento de Sequência , Análise de Sequência de DNA , Homologia de Sequência do Ácido Nucleico , Transcrição GênicaRESUMO
This study was conducted to evaluate lymph node metastasis as a key prognostic factor in esophageal cancer. Metastatic lesions in lymph nodes were grouped by histological morphology as intracapsular or extracapsular, and the significance of lymph node metastasis was evaluated by relating metastatic lesions to clinical pathologic factors and patient prognosis. In our hospital, 46 of 81 patients who underwent resection of esophageal cancer developed lymph node metastasis. These 46 patients were enrolled in a study analyzing the relationship between the metastatic mode and the clinicopathological factors. The frequency of extracapsular metastasis was significantly high in patients with a profound depth of cancer, three or more metastases, distant metastasis (n3 and n4), or severe lymphatic invasion. The prognosis was significantly worse in patients with extracapsular metastasis, and this tendency was also seen even in patients with three or more metastases, limited metastasis (n1 and n2), or mild lymphatic invasion (ly0 and ly1). These findings suggest that the metastatic mode reflects the degree of esophageal cancer progression and is an important prognostic factor.
Assuntos
Carcinoma/patologia , Carcinoma/secundário , Neoplasias Esofágicas/patologia , Invasividade Neoplásica/patologia , Idoso , Carcinoma/mortalidade , Carcinoma/terapia , Intervalo Livre de Doença , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/terapia , Estudos de Avaliação como Assunto , Feminino , Humanos , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Taxa de SobrevidaRESUMO
The subjects in this study consisted of 40 preoperative untreated esophageal squamous cell carcinoma patients. While p53 did not significantly correlate with the clinicopathological factors, E-cadherin significantly correlated with lymphatic invasion, vascular invasion, the depth of invasion, the degree of lymph node metastasis, the histological stage, and the number of lymph node metastases. Epidermal growth factor receptor (EGFR) significantly correlated with age, the depth of invasion, and the number of lymph node metastases. The 5-year cumulative survival rate was 45.7% in the p53-positive cases and 61.9% in the p53-negative cases, with no significant difference, and 87.8% in the E-cadherin-positive cases and 19.1% in the -negative cases, and the difference was significant. The prognosis was significantly poor in EGFR-positive subjects: the 5-year survival rate was 38.6% in EGFR-positive cases and 68% in -negative cases. The 5-year survival rate in E-cadherin-negative, EGFR-positive cases was 0%, while it was 91.7% in the reverse pattern, and this difference was significant. These findings suggest that both E-cadherin and EGFR are important prognostic factors, and a more precise prognosis can thus be obtained by combining them. Such a combined technique may be very useful as an indicator for grading the biological malignancy of esophageal cancer.
Assuntos
Caderinas/análise , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/mortalidade , Receptores ErbB/análise , Neoplasias Esofágicas/metabolismo , Neoplasias Esofágicas/mortalidade , Proteína Supressora de Tumor p53/análise , Adulto , Idoso , Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Feminino , Humanos , Imuno-Histoquímica , Linfonodos/patologia , Metástase Linfática , Tecido Linfoide/patologia , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Prognóstico , Taxa de SobrevidaRESUMO
BACKGROUND: Distant metastases from colorectal cancer are generally refractory to conventional therapies, with the exception of surgical resection. The aim of this study was to evaluate the clinical application of endogenous TNF induction therapy by using a mutant TNF (rTNF-SAM2) as a primer in endogenous/exogenous TNF therapy (EET therapy) in patients with pulmonary metastases from colorectal cancer. METHODS: The subjects were 17 patients, 5 of whom underwent EET therapy alone and 12 of whom underwent EET therapy and the administration of anticancer agents. RESULTS: Partial response was observed in 6 patients (50%) who underwent EET therapy with anticancer agents. In seven (53.8%) of 13 patients who showed a high serum CEA value, their CEA levels were considered to be improved. Severe toxic effects occurred in 3 of the patients studied (17.6%). The mean survival was 26.0 months among those with a partial response and 16.6 months among those with no change. No significant difference was observed between these two groups. Histological assessments indicated that tumor necrosis, fibrosis and cellular infiltration tended to intensify in cases treated with EET therapy compared with the cases who received surgery alone. CONCLUSION: EET therapy with anticancer agents is well-tolerated and effective for pulmonary metastases from colorectal cancer.
Assuntos
Antineoplásicos/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Indução de Remissão/métodos , Fator de Necrose Tumoral alfa/uso terapêutico , Adulto , Idoso , Antígeno Carcinoembrionário/sangue , Neoplasias Colorretais/imunologia , Neoplasias Colorretais/patologia , Feminino , Humanos , Imunidade Celular , Neoplasias Pulmonares/imunologia , Neoplasias Pulmonares/secundário , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes/uso terapêutico , Taxa de Sobrevida , Resultado do TratamentoRESUMO
OBJECTIVE: Intrathecal fibrinolytic therapy has been used as one of the anticerebral vasospasm (VS) preventative therapies in patients with subarachnoid hemorrhage (SAH). However, the changes in coagulation and fibrinolysis in the blood and cerebrospinal fluid (CSF) after SAH remain unknown. METHODS: Fifty patients with SAH caused by ruptured cerebral aneurysms were studied postoperatively to detect the serial changes of the thrombin-antithrombin III complex, active plasminogen activator inhibitor (PAI)-1, and tissue plasminogen activator (tPA)-PAI complex (tPA-PAI) activities in the plasma and CSF collected from cisternal drainage catheters. RESULTS: The CSF levels of all parameters and plasma PAI-1 levels were significantly higher in patients with severe SAH than in those with mild SAH. There was no relationship between the CSF and plasma levels of these parameters (except the CSF levels of tPA-PAI) and the initial neurological statuses. The CSF PAI-1 levels increased to greater than 20 ng/ml near the time of the occurrence of cerebral VS, whereas they remained below 20 ng/ml in patients without VS. The CSF tPA-PAI levels showed the highest peak near the time of VS remission. The CSF PAI-1 and tPA-PAI levels were significantly lower in patients with good outcomes than in those with poor outcomes. CONCLUSION: Both the coagulative and fibrinolytic systems were activated in the CSF and plasma after SAH in correlating to the amount of SAH clot. The intrathecal administration of fibrinolytic agents should be started early after surgery, before CSF PAI-1 levels increase, for patients with severe SAH. Patients with CSF PAI-1 levels greater than 20 ng/ml experienced high incidence of VS and poor outcomes.
Assuntos
Coagulação Sanguínea , Fibrinólise , Hemorragia Subaracnóidea/sangue , Hemorragia Subaracnóidea/líquido cefalorraquidiano , Adulto , Idoso , Encéfalo/cirurgia , Feminino , Humanos , Incidência , Aneurisma Intracraniano/complicações , Ataque Isquêmico Transitório/líquido cefalorraquidiano , Ataque Isquêmico Transitório/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema Nervoso/fisiopatologia , Inibidor 1 de Ativador de Plasminogênio/sangue , Inibidor 1 de Ativador de Plasminogênio/líquido cefalorraquidiano , Período Pós-Operatório , Ruptura Espontânea , Índice de Gravidade de Doença , Hemorragia Subaracnóidea/fisiopatologia , Ativador de Plasminogênio Tecidual/líquido cefalorraquidiano , Resultado do TratamentoRESUMO
Blood flow and blood distribution were investigated in 40 patients with normal small intestine and the relation between blood flow and the morphological features of Crohn's disease was examined in 11 patients with Crohn's disease by laser Doppler flowmetry from the serosal side during surgery. In normal small intestine, blood flow was measured at six points: upper, middle, and lower small intestine, each of the mesenteric borders, and the antimesenteric surface. In Crohn's disease, macroscopically normal tissue and affected lesions were observed in detail by intraoperative endoscopy after blood flow measurement. The blood flow values in the normal small intestine gradually decreased from the upper to the lower small intestine. As the level of inflammation progressed in Crohn's disease the blood flow values gradually decreased; the exudative stage of Crohn's disease (aphthoid ulcer) showed blood flow values that were slightly below those in macroscopically normal tissue. These results are the first to demonstrate decreased blood flow in affected lesions in Crohn's disease and changes in blood flow according to the degree of inflammation in vivo.
Assuntos
Doença de Crohn/fisiopatologia , Intestino Delgado/irrigação sanguínea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Intestino Delgado/anatomia & histologia , Fluxometria por Laser-Doppler , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo RegionalRESUMO
A 47-year-old man with ascending colon cancer with multiple liver metastases and bone metastasis (VII thoracic vertebra) showed a remarkable response to the combination therapy of tegafur and cisplatin. Tegafur (1,200 mg/day) was administered through continuous intravenous infusion mixed with IVH, and cisplatin was given every two weeks at a dose of 100 mg. The total dose of tegafur was 39.6g and that of cisplatin was 300mg. After therapy, primary and metastatic lesions were remarkably reduced according to various imaging techniques, and the serum CEA level of 34ng/ml at diagnosis decreased 3.7 ng/ml. Various tumor-related symptoms were improved. Drug toxicity caused slight nausea and leucopenia. Right hemicolectomy with R2 lymph node dissection was performed after chemotherapy. Histologically, primary lesion and regional lymph nodes showed diffuse fibrosis and necrosis, and only a few cancer cells remained some vessels. These results suggested that the combination chemotherapy of tegafur and cisplatin is useful for the treatment of colon cancer.
Assuntos
Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/secundário , Neoplasias do Colo/tratamento farmacológico , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Cisplatino/administração & dosagem , Neoplasias do Colo/patologia , Esquema de Medicação , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Tegafur/administração & dosagemRESUMO
A 64-year-old women with gallbladder cancer was treated by extended cholecystectomy and regional lymph node dissection. At 18 months after surgery, an enlarged retroperitoneal lymph node due to recurrence was demonstrated by computed tomography, and CEA and CA 19-9 showed high serum levels. Combination chemotherapy consisting of UFT administered orally at 200 mg daily and CDDP infused at 40 mg/m2 every 2 weeks was performed in 3 courses. After this therapy, the retroperitoneal lymph node was undetectable by computed tomography and both CEA and CA 19-9 decreased to within normal levels. It appeared that this chemotherapy is effective for gallbladder cancer.
Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Vesícula Biliar/tratamento farmacológico , Linfonodos/patologia , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Cisplatino/administração & dosagem , Feminino , Neoplasias da Vesícula Biliar/patologia , Neoplasias da Vesícula Biliar/cirurgia , Humanos , Excisão de Linfonodo , Metástase Linfática , Pessoa de Meia-Idade , Tegafur/administração & dosagem , Uracila/administração & dosagemRESUMO
The authors present a case of lipoma in the sylvian fissure associated with a saccular aneurysm of the middle cerebral artery. The aneurysm was successfully clipped following the partial resection of the tumor. This is the first reported case of this combined pathology. The value of cerebral angiography in this disease entity and the possible etiology of the association of an aneurysm with a lipoma are discussed.
Assuntos
Neoplasias Encefálicas/complicações , Aneurisma Intracraniano/complicações , Lipoma/complicações , Adulto , Neoplasias Encefálicas/diagnóstico , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico , Lipoma/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
A total 37 patients with Crohn's disease who underwent intraoperative endoscopy during resection of the affected intestine were evaluated in this study. The average age of the patients at surgery was 23.2 years. The residual lesions in the remaining intestine identified by intraoperative endoscopy were classified according to their pathologic profiles into three groups: A, B and C. In group A, comprising patients with longitudinal ulcers and/or a cobblestone appearance, 10 of 12 patients had recurrence. In 5 of these 10, the residual lesions were exacerbated and 2 required a further operation. The remaining 5 patients showed recurrence at the site of previous anastomosis and 2 of these 5 required additional surgery. In group B, comprising patients with small ulcers, aphthoid ulcers, or scars, and group C, comprising patients with no residual lesions, recurrence was observed in 13 of 16, and 3 of 9 patients, respectively. The recurrent lesions were all found proximal to, or at the site of previous anastomosis. Additional operations were performed on 3 of the group B patients. The findings of this study revealed that recurrence requiring additional surgery is more frequent at the site of anastomosis, regardless of the endoscopic appearance of the residual lesions.
Assuntos
Doença de Crohn/cirurgia , Endoscopia Gastrointestinal , Adolescente , Adulto , Criança , Doença de Crohn/patologia , Feminino , Humanos , Cuidados Intraoperatórios , Masculino , Recidiva , ReoperaçãoRESUMO
Tegafur and UFT are most widely used for the treatment of cancers of the gastrointestinal tract. FdUMP, a metabolite of 5-fluorouracil(5-FU), is known to have an inhibitory activity of thymidylate synthase (TS). We administered 600 mg/day of tegafur or UFT to 37 patients with cancer of the large bowel beginning 1 week prior to surgery and then measured the concentrations of tegafur and 5-FU, and TS inhibition rate in the excised tissue. Our results showed that the concentrations of 5-FU in tumor were 0.077 +/- 0.026 microgram/g in tegafur group and 0.208 +/- 0.143 microgram/g in UFT group, with the UFT showing significantly higher levels (p less than 0.05). On the other hand, TS inhibition rates in tumor tissue were 45.5 +/- 13.3% in tegafur group and 56.1 +/- 13.0% in UFT group, with a significantly higher level existing in the latter group (p less than 0.05). Furthermore, the same high 5-FU concentration and TS inhibition rates were observed in the lymph nodes affected by metastasis. No difference between the tegafur and UFT groups was noted in normal tissue or normal lymph nodes, and compared to tegafur, UFT showed an effective action on cancerous large bowel tissue.