Acute Liver Failure Secondary to Hepatic Infiltration of Malignant Melanoma.

Acute liver failure due to malignant melanoma is uncommon. We presents a case of acute liver failure secondary to hepatic infiltration of a malignant melanoma. An 86-year-old man was admitted with elevated liver enzymes and an increased lactate dehydrogenase level. His condition progressed to acute liver failure, but the etiology of liver failure was unclear. Esophagogastroduodenoscopy was performed to evaluate dyspepsia, which showed signs indicative of malignant melanoma. Based on the endoscopy findings and elevated liver enzyme levels, liver biopsy was performed to confirm the presence of malignant melanoma. Hepatic infiltration of malignant melanoma was observed histologically. However, massive and diffuse liver metastasis is very rare and difficult to identify on imaging studies. If the etiology of liver failure is unclear, diffuse metastatic melanoma infiltration should be considered as differential diagnosis. Early liver biopsy can help to clarify the diagnosis.

Efecto del nivel de suplementación con propilenglicol durante el período de transición a la lactancia sobre actividad ovárica y desempeño reproductivo en vacas Holstein / Effect of supplementation level with propylene glycol during the transition period to lactation on ovarian activity and reproductive performance in Holstein cows / Efeito do nível de suplementação com propileno glicol durante o período de transição para a lactação na atividade ovariana e desempenho reprodutivo em vacas Holstein

Resumen Introducción. Esta investigación se enfoca en estudiar la inclusión del propilenglicol (PG) como compuesto energético y su posible efecto en la disminución del balance energético negativo. Objetivo. Evaluar parámetros reproductivos, específicamente tasa de parto al primer servicio, días abiertos, primer calor observado, así como su efecto en la secreción de insulina y actividad ovárica. Materiales y métodos. Veinte (20) vacas Holstein fueron asignadas a uno de cuatro niveles de suplementación: 0, 300, 500 y 700 g de PG / día mezclados en el concentado, desde el día10 antes del parto el día 20 posparto. Se tomaron muestras de sangre los días 10 y 5 antes del parto, el día del parto y los días 5, 10, 15 y 20 posparto para determinar la concentración de insulina, y se realizaron exámenes ultrasonográficos para determinar actividad ovárica. Todos los datos para la evaluación de los parámetros reproductivos fueron tomados diariamente observando los animales 30 minutos en la mañana y 30 minutos en la tarde, y prestando atención en la presentación de calores. Resultados. No se observaron diferencias significativas para las variables estudiadas con los diferentes tratamientos (p>0,05). El análisis de constrastes octogonales mostró una tendencia en la disminución de los días abiertos cuando se incluyó una dosis de 500 g de propilenglicol. Conclusión. La inclusión de propilenglicol no tuvo efecto significativo sobre la secreción de insulina, ni sobre el número y tamaño de los folículos preovulatorios (p>0,05). Es muy probable que el modo de suministro de propilenglicol y el tiempo de colecta de las muestras de sangre influyeran en la identificación del pico de secresión de insulina.

Abstract Introduction. This paper mainly focuses on the study of the inclusion of propylene glycol (PG) as energy compound and its possible effect on minimizing the negative energy balance. Objective. Evaluate on reproductive parameters, specifically on rates of calving to first service, days open, calving to first observed heat, as well as its effect on insulin secretion and ovarian activity. Materials and Methods. 20 Holstein cows were assigned to one of four supplementation levels: 0, 300, 500 and 700 grams of PG / day mixed in food, from day10 prepartum and through day 20 postpartum. Blood samples were collected on10 and 5 prepartum and days 0, 5, 10, 15 and 20 postpartum to determine the concentration of insulin were also done to determine transrectal ultrasound follicular growth and ovarian resumption. All data for the evaluation of reproductive parameters were taken from the day of delivery, making daily observations of animals 30 minutes in the morning and 30 minutes in the afternoon to record possible heat presented. Results. There were no significant differences for the variables within the different treatments (p> 0.05), only a trend to decrease the open days when you include a dose of 500 g of propylene glycol with respect to the other groups. Conclusions. The inclusion of propylene glycol had no significant effect on insulin secretion, or the number and size of preovulatory follicles (p> 0.05). It is very likely that the propylene supply mode and time of collection of blood samples affect the identification of the increase in insulin secretion.

Resumo Introdução. Esta pesquisa centra-se no estudo da inclusão de propileno glicol (PG) como um composto energético e seu possível efeito na redução do balanço energético negativo. Objetivo. Avalie os parâmetros reprodutivos, especificamente a taxa de parto no primeiro serviço, dias abertos, primeiro calor observado, bem como seu efeito na secreção de insulina e na atividade ovariana. Materiais e métodos. 20 vacas Holstein foram atribuídas a um dos quatro níveis de suplementação: 0, 300, 500 e 700 g PG / dia misturados no concentrado, a partir do dia 10 antes da entrega no dia 20 pós-parto. As amostras de sangue foram tomadas nos dias 10 e 5 antes do parto, no dia da entrega e nos dias 5, 10, 15 e 20 pós-parto para determinar a concentração de insulina e os exames de ultra-som foram realizados para determinar a atividade do ovário. Todos os dados para a avaliação dos parâmetros reprodutivos foram tomados diariamente observando os animais 30 minutos pela manhã e 30 minutos à tarde prestando atenção na apresentação de cicatrizes. Resultados. Não foram observadas diferenças significativas nas variáveis estudadas com os diferentes tratamentos (p> 0,05). A análise de construções octogonais mostrou tendência na diminuição dos dias abertos quando foi incluída uma dose de 500 gr de propileno glicol. Conclusão. A inclusão de propileno glicol não teve efeito significativo na secreção de insulina, nem no número e tamanho dos folículos pré-ovulatórios (p> 0,05). É muito provável que o modo de entrega de propileno glicol e o tempo de coleta das amostras de sangue influenciem a identificação da secreção máxima de insulina.

Depth of Hepatic Infiltration and Lymph Node Swelling as Factors for Considering Surgery for T2-4 Gallbladder Carcinoma Patients.

BACKGROUND/AIM: The aim of the present study was to clarify if the degree of hepatic infiltration and lymph node swelling of gallbladder carcinoma (GBC) should be held as deciding factors for T2-4 GBC patients to undergo surgery. PATIENTS AND METHODS: Fifty consecutive patients with T2-4 GBC who underwent surgery were reviewed retrospectively. We investigated the preoperative information and imaging factors as predictors of survival. RESULTS: The estimated overall survival in all patients was lower in patients with hepatic infiltration ≥5 mm (n=12) than in those with <5 mm (n=38) (p=0.003). Multivariate analyses demonstrated that liver infiltration ≥5 mm (OR=2.251; 95%CI=0.906-5.596, p=0.081) and lymph node swelling (OR=2.462; 95%CI=1.034-5.859, p=0.042) were risk factors of poor survival. CONCLUSION: Our results suggested that ≥5 mm liver infiltration and lymph node swelling may serve as deciding factors for surgery consideration in GBC patients.

Acute liver failure associated with diffuse liver infiltration by metastatic breast carcinoma: A case report.

Diffuse parenchymal metastasis is an unusual pattern of liver metastasis that is capable of causing liver failure. In the present study, the authors describe malignant infiltration of the liver by primary breast carcinoma in an autopsy of a 49-year-old female who had a rapid onset of liver failure and died after three weeks. Ultrasonography and computed tomography (CT) scans of the abdomen, as well as macroscopic examination, failed to detect liver metastasis; while microscopic examination revealed diffuse tumor cells with a loss of E-cadherin expression infiltrating into the liver parenchyma. The prognosis of liver failure associated with malignant infiltration is extremely poor; the survival time of patients is extremely low. Liver biopsy may be the most efficient technique for confirming the diagnosis during the patient's life.