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1.
Zhonghua Zhong Liu Za Zhi ; 45(4): 322-329, 2023 Apr 23.
Article in Chinese | MEDLINE | ID: mdl-37078213

ABSTRACT

Objective: To produce chimeric antigen receptor T cells (CAR-T) targeting human hepatocyte growth factor/c-Met (HGF/c-Met) protein and detect its cytotoxicity against non-small cell lung cancer (NSCLC) cells H1975 in vitro. Methods: The whole gene sequence of c-Met CAR containing c-Met single-chain fragment variable was synthesized and linked to lentiviral vector plasmid, plasmid electrophoresis was used to detect the correctness of target gene. HEK293 cells were transfected with plasmid and the concentrated solution of the virus particles was collected. c-Met CAR lentivirus was transfected into T cells to obtain second-generation c-Met CAR-T and the expression of CAR sequences was verified by reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) and western blot, and the positive rate and cell subtypes of c-Met CAR-T cells were detected by flow cytometry. The positive expression of c-Met protein in NSCLC cell line H1975 was verified by flow cytometry, and the negative expression of c-Met protein in ovarian cancer cell line A2780 was selected as the control. The cytotoxicity of c-Met CAR-T to H1975 was detected by lactate dehydrogenase (LDH) cytotoxicity assay at 1∶1, 5∶1, 10∶1 and 20∶1 of effector: target cell ratio (E∶T). Enzyme-linked immunosorbent assay (ELISA) was used to detect the release of cytokines such as TNF-α, IL-2 and IFN-γ from c-Met CAR-T co-cultured with H1975. Results: The size of band was consistent with that of designed c-Met CAR, suggesting that the c-Met CAR plasmid was successfully constructed. The results of gene sequencing were consistent with the original design sequence and lentivirus was successfully constructed. CAR molecules expression in T cells infected with lentivirus was detected by western blot and RT-qPCR, which showed c-Met CAR-T were successfully constructed. Flow cytometry results showed that the infection efficiency of c-Met CAR in T cells was over 38.4%, and the proportion of CD8(+) T cells was increased after lentivirus infection. The NSCLC cell line H1975 highly expressed c-Met while ovarian cancer cell line A2780 negatively expressed c-Met. LDH cytotoxicity assay indicated that the killing efficiency was positively correlated with the E∶T, and higher than that of control group, and the killing rate reached 51.12% when the E∶T was 20∶1. ELISA results showed that c-Met CAR-T cells released more IL-2, TNF-α and IFN-γ in target cell stimulation, but there was no statistical difference between c-Met CAR-T and T cells in the non-target group. Conclusions: Human NSCLC cell H1975 expresses high level of c-Met which can be used as a target for immunotherapy. CAR-T cells targeting c-Met have been successfully produced and have high killing effect on c-Met positive NSCLC cells in vitro.


Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Ovarian Neoplasms , Receptors, Chimeric Antigen , Humans , Female , Receptors, Chimeric Antigen/genetics , CD8-Positive T-Lymphocytes , Interleukin-2/pharmacology , Tumor Necrosis Factor-alpha , Cell Line, Tumor , HEK293 Cells , Immunotherapy, Adoptive
2.
Fa Yi Xue Za Zhi ; 37(2): 145-150, 2021 Apr.
Article in English, Chinese | MEDLINE | ID: mdl-34142473

ABSTRACT

ABSTRACT: Objective To investigate the correlation between the polymorphism of 4 coagulation-related genes, rs1799963 (coagulation factor V gene Leiden), rs6025 (prothrombin gene G20210A), rs1042579 (thrombomodulin protein gene c.1418C>T) and rs1801131 (methylenetetrahydroflate reductase gene) and lower extremity deep venous thrombosis (LEDVT). Methods The 4 genotypes mentioned above of 150 LEDVT patients and 153 healthy controls were detected by the kompetitive allele specific polymerase chain reaction (KASP), then related blood biochemical indicators were collected, binary Logistic regression was established to screen the independent risk factors of LEDVT, and the correlation between polymorphism of 4 coagulation-related genes and LEDVT and its indicators under different genetic modes after adjusting confounding factors were analyzed. Results Five variables, D-dimer, fibrinogen degradation product, homocysteine, sex and age might be the risk factors of LEDVT. These variables were put into 4 genetic inheritance models, and adjusted in binary Logistic regression. The results suggested that the mutations of rs1042579 were correlated with LEDVT under dominant inheritance mode. Conclusion The gene polymorphism of rs1799963, rs6025 and rs1801131 has no significant correlation with the formation of LEDVT. The gene polymorphism of rs1042579 plays a role under dominant inheritance mode, and might be an independent risk factor for formation of LEDVT.


Subject(s)
Venous Thrombosis , Blood Coagulation/genetics , Humans , Lower Extremity , Polymorphism, Genetic , Risk Factors , Venous Thrombosis/genetics
3.
Zhonghua Yi Xue Za Zhi ; 101(6): 405-409, 2021 Feb 09.
Article in Chinese | MEDLINE | ID: mdl-33611889

ABSTRACT

Objective: To evaluate the short-term effect of left subclavian artery (LSA) reconstruction with pre fenestration and external branch thoracic endovascular aortic repair (TEVAR) in the treatment of aortic arch descending lesions. Methods: The clinical data of 79 patients with aortic diseases who received LSA reconstruction in Tianjin Medical University General Hospital from November 2015 to October 2019 were analyzed retrospectively. According to different LSA reconstruction methods, they were divided into the fenestrated group (group f) 50 cases and the external branched group (group b) 29 cases. The surgical success rate, intraoperative and postoperative complication rate, re-intervention rate, mortality rate, and the change of the true and false lumen area of the dissection were compared and analyzed. Results: There were no significant differences in the perioperative and recent total complication rate, secondary intervention rate and mortality between the two groups (χ²=0, 1.246, 0.156, all P>0.05). The operation time of group f [(123.0±40.7 min)] was significantly longer than that of group b ((84.2±16.3) min, t=2.173, P=0.034). The degree of false lumen thrombosis of the stent segment was better than that of the non-stent segment (χ²=7.213, 14.359, both P<0.05) in the two groups after surgery, but no significant difference between the two groups (χ²=1.510, 0.886, both P>0.05). There was no significant difference in the change rate of the true and false lumen on each plane of the dissection between the two groups (all P>0.05). Conclusions: Both fenestrated and external branched TEVAR reconstruction LSA have good safety and effectiveness in treating aortic arch descending lesions. The external branched TEVAR takes less time, has higher effectiveness for lesions with shorter landing zone, and has better aortic remodeling effect in the stent segment soon; and the fenestrated TEVAR has better economy.


Subject(s)
Aortic Aneurysm, Thoracic , Aortic Dissection , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Aortic Dissection/surgery , Aorta, Thoracic/surgery , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis , Humans , Retrospective Studies , Stents , Time Factors , Treatment Outcome
4.
Zhonghua Zhong Liu Za Zhi ; 41(11): 820-825, 2019 Nov 23.
Article in Chinese | MEDLINE | ID: mdl-31770848

ABSTRACT

Objective: To establish a nude mouse model of subcutaneous lung cancer using dual fluorescence reporting genes of luciferase (Luc) and near-infrared fluorescent protein (iRFP). Methods: The Luc and iRFP expressed lentiviral vector was constructed by Gateway method. After verified by sequencing, the lentivirus particle was prepared and infected into lung cancer A549 cells. Successfully infected A549 (mA549) cells were selected by puromycin and amplified. The expression of Luc and iRFP were observed under fluorescence microscope, and the expression of c-Met protein on the cell surface was detected by immunofluorescence. Twelve female nude mice were randomly divided into 2 groups, 6 in each group. A549 and mA549 cells were inoculated subcutaneously into the right forelimb of nude mice. The growth and fluorescence expression of the tumor were observed by in vivo imaging. The tumor formation was evaluated by hematoxylin-eosin (HE) staining and immunohistochemistry. Results: The Luc and iRFP stably expressed mA549 cell line was successfully constructed. The expressions of iRFP and Luc in mA549 cells were observed under fluorescence microscope. The results of immunofluorescence showed that c-Met protein expressed in both A549 cells and mA549 cells. The growth period of mA549 xenograft in nude mice was moderate and the tumorigenesis rate was 100%. The growth trend of mA549 cells in vivo was not significantly different from that of A549 cells (P>0.05). HE staining and immunohistochemistry results showed that the tumor issues displayed typical histopathological features of tumor. Immunohistochemistry results showed that both A549 and mA549 tumors expressed c-Met protein. Conclusion: A stable, real-time monitoring model of iRFP-Luc-A549 lung cancer cell xenograft in nude mice was successfully constructed.


Subject(s)
Lung Neoplasms/pathology , Neoplasm Transplantation/methods , A549 Cells , Animals , Cell Line, Tumor , Female , Fluorescence , Genes, Reporter , Humans , Immunohistochemistry , Luciferases/genetics , Luminescent Proteins/genetics , Lung , Mice , Mice, Nude , Proto-Oncogene Proteins c-met/genetics , Random Allocation , Red Fluorescent Protein
5.
Transplant Proc ; 50(10): 3100-3104, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30577173

ABSTRACT

Splitting deceased donor livers and creating 3 grafts from a whole liver may be feasible and shorten the waiting time for organ donation in patients with high mortality rates. We hypothesized that it might be reasonable to procure 3 grafts for donation from one deceased donor liver by splitting the liver into left (segment II, III, IV), right anterior (segment V, VIII), and right posterior lobes (segment VI, VII) for liver transplantation according to the portal system trifurcated variations. We designed the right anterior branch with the main portal trunk and middle hepatic artery to become inflow of right anterior lobe, the left portal vein and left hepatic artery to become the inflow of left lobe and right posterior branch, and right hepatic artery to become the inflow of right posterior lobe. We retrospectively reviewed the volumetric computed tomography and magnetic resonance cholangiopancreatography of 153 liver donors. The hepatic and portal veins, hepatic artery, and biliary system were reorganized and classified. The volumetric proportions of the liver grafts were measured. Trifurcation of the portal vein variation was found in approximately 13.7% of portal systemic variations. The left lobe accounted for 29.18% of the total liver volume, the right anterior lobe, 35.22%, and the right posterior lobe, 35.6%. We validated this principle by dissecting the explanted liver and identified the triple grafts' weights, percentages, vessels, and biliary ducts system. The splitting of deceased donor livers into 3 split liver grafts for use in liver transplantation surgery can be clinically useful.


Subject(s)
Allografts/blood supply , Liver Transplantation/methods , Liver/blood supply , Liver/diagnostic imaging , Adult , Biliary Tract/diagnostic imaging , Cholangiopancreatography, Magnetic Resonance , Cone-Beam Computed Tomography , Female , Hepatic Artery/diagnostic imaging , Hepatic Veins/diagnostic imaging , Humans , Male , Portal Vein/diagnostic imaging , Retrospective Studies
6.
Zhonghua Yi Xue Za Zhi ; 98(12): 921-925, 2018 Mar 27.
Article in Chinese | MEDLINE | ID: mdl-29665666

ABSTRACT

Objective: To evaluate the early results of fenestrated endovascular aortic repair (FEVAR) using physician-modified stent grafts (PMSGs) for the treatment of patients with thoracoabdominal pathologies. Methods: Nineteen consecutive patients who underwent FEVAR using PMSGs between April 2012 and September 2017 were retrospectively reviewed. The modality of FEVAR technique was assessed, perioperative clinical data was recorded and the early results were evaluated. Results: Indications were thoracoabdominal aortic pathologies, including juxtarenal abdominal aortic aneurysm (JAAA) (n=12), chronic thoracoabdominal aortic dissection with aneurysmal dilatation (n=3), thoracoabdominal aortic aneurysm (TAAA) (n=1), infrarenal AAA with an accessory renal artery in the segment of the aneurysmal neck (n=2) and type Ⅰ endoleak after EVAR for AAA(n=1). Nineteen fenestrated stent grafts were deployed , including custom-made Cook Zenith fenestrated stent graft(n=1), home-made Cook Zenith TX2 fenestrated stent graft(n=6), home-made Cook Zenith TFFB fenestrated stent graft(n=9), home-made Cook Zenith Cuff fenestrated stent graft(n=2), home-made Gore C3 fenestrated stent graft(n=1). Mean duration for stent graft modification was 110 (90-140) min. Mean operative time was 268.0 (59.0-334.0) min, and fluoroscopy time was 66.0 (15.0-175.0) min. There were a total of 50 target vessels, of which 45 (95%) were stented. Bare metal stents were used in 28 vessels, and covered stents were used in 17 vessels. Technical success rate was 100%. No intraoperative target vessel loss was observed. Perioperative mortality was 5.3% (1/19). Endoleaks were persisted even after ballooning in five patients. A small type Ⅰ proximal endoleak and type Ⅲ endoleak were found in 2 and 1 patients, respectively. Type Ⅲ endoleak combined with type Ⅱ endoleak were observed in 2 patients. All the endoleaks were accepted and needed watching. In two patients, iliofemoral artery problems were resolved after local endarterectomy and stenting. Two patients presented renal deterioration postoperatively and recovered after the conservative therapy. Median length of stay was 6.6 (2.0-12.0)d. No early reintervention (<30 days) was performed. The mean duration of follow-up was 11.2 (2.0-41.0) months. One patient died 6 months after FEVAR due to advanced renal carcinoma. All target vessels remained patent except for one accessory artery occlusion. Conclusion: FEVAR using PMSGs may be a viable alternative for high-risk patients with thoracoabdominal pathologies.


Subject(s)
Aorta , Aortic Aneurysm, Abdominal , Blood Vessel Prosthesis , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Humans , Prosthesis Design , Retrospective Studies , Stents , Time Factors , Treatment Outcome
7.
Fa Yi Xue Za Zhi ; 33(1): 6-10, 2017 Feb.
Article in English | MEDLINE | ID: mdl-29231000

ABSTRACT

OBJECTIVES: To investigate the time-dependent expression of metallothionein (MT) 1A mRNA and MT2A mRNA in contused skeletal muscle of rats. METHODS: A total of 54 Sprague-Dawley rats were used in this study. The rats were divided into two parts: control group (n=6) and contusion groups (0.5, 1, 6, 12, 18, 24, 30, and 36 h after contusion, n=6). Total RNA was extracted from skeletal muscle. The expression levels of MT1A mRNA and MT2A mRNA were detected by SYBR Green I real-time PCR. RESULTS: The expression trends of the two potential marker genes were related to wound age. In addition to 0.5 h, there were significant contrasts between the control group and contused group (P<0.05), about the expression levels of MT1A mRNA and MT2A mRNA in different phases. As the extension of wound age, the relative expression of MT1A mRNA and MT2A mRNA at 1 h, 6 h, 12 h and 18 h after contusion demonstrated upgrade tendency until its expression levels in 18 h peak with 239.41±15.20 and 717.42±50.76, respectively. When time extends to 24 h after injury, the expression of above two marks decreased, respectively. The MT1A mRNA and MT2A mRNA expression levels increased at 30 h and then decreased. CONCLUSIONS: Determination of MT1A mRNA and MT2A mRNA levels by real-time PCR may be useful for the estimation of wound age.


Subject(s)
Contusions/genetics , Contusions/metabolism , Muscle, Skeletal/metabolism , RNA, Messenger/metabolism , Animals , Contusions/pathology , Gene Expression Regulation , Genetic Markers , Metallothionein , Muscle, Skeletal/injuries , Rats , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Time Factors , Wound Healing
8.
Zhonghua Yi Xue Za Zhi ; 96(45): 3642-3646, 2016 Dec 06.
Article in Chinese | MEDLINE | ID: mdl-27978899

ABSTRACT

Objective: To investigate the clinical value of endovascular aneurysm repair(EVAR) using fenestration on table for abdominal aortic aneurysm(AAA) with short proximal neck. Methods: A retrospective analysis of four cases with short proximal neck AAA from Aug. 2015 to May. 2016 of Tianjin Medical University General Hospital treated by EVAR using fenestration on table. Fenestrated stent-grafts were designed according to the preoperative computer tomography angiography(CTA) data. All cases underwent EVAR with the fenestrated stent-grafts on table to revascularize visceral branches. Results: FEVAR was performed in all of the 4 cases successfully. Device deploying success rate was 100%. No type Ⅰ endoleak was found in all of the 4 cases. Transient renal dysfunction occurred in two cases during 7 post-operative days and improved with the medical treatment. Mean follow-up period was 4.7 months(range, 1-9 months). CTA (3 cases) and ultrasonic imaging(1 case) were performed postoperatively. No endoleak was found around fenestrated stent graft and patency of visceral stent grafts were maintained in all of the 4 cases. Conclusion: EVAR using fenestration on table for short proximal neck AAA is safe and feasible, which expand the indication of EVAR for AAA, and the long-term safety and outcomes of this technique need to be assessed in the future.


Subject(s)
Aortic Aneurysm, Abdominal , Blood Vessel Prosthesis Implantation , Endoleak , Endovascular Procedures , Humans , Retrospective Studies , Stents , Treatment Outcome
9.
BJOG ; 123(3): 439-46, 2016 Feb.
Article in English | MEDLINE | ID: mdl-25800522

ABSTRACT

OBJECTIVE: To estimate the accuracy of transvaginal ultrasound (TVS) measurement of endometrial thickness (ET) in diagnosing endometrial cancer in postmenopausal women with vaginal bleeding (PMB). DESIGN: Retrospective cohort study. SETTING: One-stop PMB clinic in a Hong Kong teaching hospital. POPULATION: A cohort of 4383 women with PMB. METHODS: Transvaginal ultrasonic measurement of ET and endometrial biopsies were obtained in women presenting with PMB between 2002 and 2013. Endometrial histology was used as the reference standard to calculate accuracy estimates. MAIN OUTCOME MEASURES: Accuracy data for TVS ET presented as sensitivity, specificity, and area under the receiver operator characteristic (ROC) curve. RESULTS: Endometrial cancer was diagnosed in 3.8% of women. The median ET in those with endometrial cancer was significantly higher than those with benign conditions (15.7 versus 3.2 mm, P < 0.001). The area under the ROC curve was 0.92 (95% CI 0.89-0.94). The sensitivity for the detection of endometrial cancer at 3-, 4-, and 5-mm cut-offs were 97.0% (95% CI 94.5-99.6%), 94.1% (95% CI 90.5-97.6%), and 93.5% (95% CI 89.7-97.2%), respectively. The corresponding estimates of specificity at these thresholds were 45.3% (95% CI 43.8-46.8%), 66.8% (65.4-68.2%), and 74.0% (72.7-75.4%). CONCLUSIONS: Transvaginal ultrasound using a 3-mm cut-off has high sensitivity for detecting endometrial cancer and can identify women with PMB who are highly unlikely to have endometrial cancer, thereby avoiding more invasive endometrial biopsy.


Subject(s)
Endometrial Neoplasms/complications , Endometrial Neoplasms/pathology , Endometrium/pathology , Postmenopause , Uterine Hemorrhage/etiology , Biopsy , Cohort Studies , Endometrial Neoplasms/diagnostic imaging , Endometrium/diagnostic imaging , Female , Humans , Middle Aged , Retrospective Studies , Ultrasonography
10.
Genet Mol Res ; 14(1): 2742-9, 2015 Mar 31.
Article in English | MEDLINE | ID: mdl-25867423

ABSTRACT

Adipocyte fatty acid-binding protein (A-FABP), the most abundant FABP in adipocytes, controls fatty acid uptake, transport, and metabolism in fat cells. We constructed a transgenic mice model that overexpressed the cattle A-FABP gene to investigate the relationship between A-FABP expression and intermuscular fat deposition. There was no significant difference in body weight and serum biochemical indexes between transgenic and wild-type mice. Further, there were no significant differences in intermuscular triglyceride content and A-FABP expression levels over three generations of transgenic mice. However, abdominal adipose rate, A-FABP protein content, and intermuscular triglyceride levels of transgenic mice were significantly higher than those of wild-type mice. In addition, triglycerides were remarkably higher in the skeletal muscle but lower in the myocardium of transgenic mice. Thus, overexpression of cattle A-FABP gene promoted fat deposition in the skeletal muscle of transgenic mice.


Subject(s)
Adipocytes/metabolism , Adipose Tissue/metabolism , Fatty Acid-Binding Proteins/metabolism , Muscles/metabolism , Abdominal Fat/metabolism , Animals , Cattle , Enzyme-Linked Immunosorbent Assay , Fats/metabolism , Fatty Acid-Binding Proteins/genetics , Fatty Acids/metabolism , Gene Expression , Mice, Transgenic , Muscle, Skeletal/metabolism , Myocardium/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Triglycerides/metabolism
11.
Eur J Surg Oncol ; 40(2): 214-9, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24316111

ABSTRACT

BACKGROUND: The role of surgery in the management of large hepatocellular carcinomas (HCCs) is controversial. Advanced age and comorbidities are taken into account when major surgery is considered. PURPOSE: To compare the outcomes of liver resection (LR) and transarterial chemoembolization (TACE) for resectable HCC in patients aged 70 years or older. PATIENTS AND MATERIALS: This study included 70 patients aged 70 years or older treated for large HCCs (≥5 cm) between January 2007 and December 2012: 37 underwent LR and 33 underwent TACE. The outcomes of these patients were retrospectively analyzed. Univariate and multivariate Cox proportional hazard models were established. Kaplan-Meier survival curves were generated, and survival data were compared using the log-rank test. RESULTS: Hospital stay was significantly longer in the LR group than in the TACE group (10 days vs 8.5 days; P = 0.003). Treatment-related complications were more frequent in the TACE group, but this difference was not statistically significant. LR was associated with a better disease-free survival rate, median survival rate and cumulative overall survival rate. CONCLUSION: Our results showed that LR could be a safe and effective treatment option for HCC tumors ≥5 cm in patiets aged 70 years or older.


Subject(s)
Age Factors , Carcinoma, Hepatocellular/surgery , Liver Neoplasms/surgery , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic , Contraindications , Disease-Free Survival , Female , Hepatectomy , Humans , Kaplan-Meier Estimate , Length of Stay , Liver Neoplasms/pathology , Liver Neoplasms/therapy , Male , Prognosis , Proportional Hazards Models , Retrospective Studies , Survival Rate , Treatment Outcome
12.
Ir J Med Sci ; 183(1): 71-5, 2014 Mar.
Article in English | MEDLINE | ID: mdl-23757214

ABSTRACT

AIMS: The aim of this study was to analyze the association between the status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) in breast cancer with neoadjuvant therapy by using tissue biopsy and surgical specimens. METHODS: This study included 78 patients with breast cancer, who presented to our hospital between June 1999 and June 2011, and were treated with neoadjuvant therapy and subsequent mastectomy or partial mastectomy. All clinicopathological data regarding pre-neoadjuvant biopsy and definitive surgical specimens were reviewed for accuracy. The status of ER, PR, and HER2 was determined by immunohistochemistry. RESULTS: Paired samples from 78 women (mean age 51.4 ± 11.7 years) were successfully analyzed. A switch in the status of ER was identified in 16 patients (20 %); PR, in 18 (23 %); and HER2, in 27 (35 %). There were no significant differences in the status of ER, PR, and HER2 between the primary tumor and the resected tumor after neoadjuvant therapy. Neoadjuvant therapy does not significantly influence the status of the steroid hormone receptors and the HER2 level in our study. CONCLUSIONS: Initial biopsy may be reliable for determining the appropriate adjuvant therapy, but final pathology are still needed to evaluate the prognosis and provided the alternative treatment when tumor recurrence. Further prospective study is needed to optimize the care available for breast cancer patients.


Subject(s)
Biomarkers, Tumor/metabolism , Breast Neoplasms/therapy , Carcinoma, Ductal, Breast/therapy , Carcinoma, Lobular/therapy , Receptor, ErbB-2/metabolism , Adult , Aged , Biopsy , Breast Neoplasms/metabolism , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/metabolism , Carcinoma, Ductal, Breast/pathology , Carcinoma, Lobular/metabolism , Carcinoma, Lobular/pathology , Chemotherapy, Adjuvant , Female , Humans , Mastectomy , Middle Aged , Neoadjuvant Therapy , Patient Selection , Predictive Value of Tests , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Retrospective Studies , Treatment Outcome
13.
Hong Kong Med J ; 19(6): 511-7, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23784533

ABSTRACT

OBJECTIVE: To assess perioperative and short-term outcomes after tension-free vaginal mesh repair of pelvic organ prolapse in local Chinese women. DESIGN: Case series. SETTING: The urogynaecology unit of a university teaching hospital in Hong Kong. PATIENTS: All women with stage III or more pelvic organ prolapse who underwent tension-free vaginal mesh repair with or without vaginal hysterectomy from May 2007 to June 2011. MAIN OUTCOME MEASURES: Perioperative and short-term outcomes. RESULTS: In all, 47 women underwent the procedure during the study period. The mean operating time was 94 minutes, the mean estimated blood loss was 163 mL, and the mean hospital stay was 4 days. Four patients had visceral injuries, all of which were identified and repaired during the operation; all four patients recovered uneventfully. The mean duration of follow-up was 25 (standard deviation, 13) months. Pelvic organ prolapse quantification improved significantly; nine (19%) of the patients had recurrent stage II prolapse but only one was symptomatic, six (13%) had postoperative mesh exposure, three of whom underwent mesh excision. There were five (11%) who had de-novo urodynamic stress incontinence, which was mostly mild and managed conservatively. Overall 91% (43/47) were satisfied with their operative outcome. CONCLUSIONS: The success rate of tension-free vaginal mesh repair for the treatment of pelvic organ prolapse in local Chinese women was comparable to rates reported internationally. There was a high degree of subjective satisfaction with the procedure. There were low rates of mesh exposure and de-novo stress incontinence that was mostly asymptomatic or mild.


Subject(s)
Hysterectomy, Vaginal , Pelvic Organ Prolapse/surgery , Surgical Mesh , Urinary Incontinence, Stress/epidemiology , Aged , Aged, 80 and over , Female , Follow-Up Studies , Hong Kong , Humans , Middle Aged , Operative Time , Patient Satisfaction , Recurrence , Retrospective Studies , Treatment Outcome , Urodynamics
14.
Eur J Surg Oncol ; 37(9): 758-64, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21764539

ABSTRACT

AIMS: The purpose of the study was to explore factors predictive of breast cancer as diagnosed by excision biopsy in cases with a diagnosis of atypical ductal hyperplasia (ADH) on ultrasound-guided core needle biopsy (CNB). PATIENTS AND METHODS: We carried out diagnosis of breast lesions by ultrasound-guided CNB in a single hospital in Taiwan from November 2003 to October 2009. Patients who were diagnosed with ADH and subsequently underwent excision biopsy were included in this study (n = 124). RESULTS: Fifty-six of the 124 patients who were included (45.2%) had cancer, and the remaining 68 had benign lesions. By multivariate analysis of all clinical characteristics and on the basis of the imaging features in these cases, older patient age (≥50 y/o, OR: 3.910, p = 0.005), larger tumour size (≥15 mm, OR: 3.398, p = 0.013), and the presence of architectural distortion by mammography (OR: 10.7, p = 0.036) were found likely to be associated with breast cancer. CONCLUSIONS: Open biopsy is necessary in patients who were diagnosed with ADH on CNB. Older patients (≥50 y/o), with a larger tumour size (≥15 mm) and an abnormal mammography are especially likely to have breast cancer.


Subject(s)
Biopsy, Needle , Breast Neoplasms/pathology , Breast/pathology , Precancerous Conditions/pathology , Ultrasonography, Interventional , Adult , Aged , Aged, 80 and over , Biopsy , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Female , Humans , Hyperplasia , Middle Aged , Precancerous Conditions/diagnosis
15.
Acta Chir Belg ; 111(2): 94-6, 2011.
Article in English | MEDLINE | ID: mdl-21618856

ABSTRACT

We report a rare case of breast cancer concomitant with progesterone-receptor-positive renal cell carcinoma. A 48-year-old woman was diagnosed as having infiltrating ductal carcinoma of the breast and underwent modified radical mastectomy. A synchronous retroperitoneal tumour was detected by sonography of the abdomen in a routine cancer staging. Initially, the tumour was diagnosed as a synchronous retroperitoneal metastasis by needle biopsy; further tests revealed that it was progesterone receptor-positive. The retroperitoneal tumour showed poor response to full courses of adjuvant chemotherapy for breast cancer. Subsequently, the patient underwent a radical operation that included nephrectomy. The final pathology confirmed a sarcomatoid renal cell carcinoma. The post-operative course was uneventful. The patient had no recurrence at the 1-year follow-up. In this report, accurate diagnosis and adequate treatment were discussed. An intra-abdominal tumour with progesterone receptor- (PR) positive features is usually considered to be metastatic in breast cancer patients. For breast cancer patients with a PR-positive retroperitoneal tumour, renal cell carcinoma should be differentiated from a metastatic lesion of breast cancer, even if PR-expression is rare in renal cell carcinoma. To the best of our knowledge, this is the first case of PR-positive expression in breast cancer concomitant with renal carcinoma. In clinical settings, it is challenging for the surgeon to make an accurate diagnosis and to provide prompt treatment in such cases.


Subject(s)
Carcinoma, Renal Cell/diagnosis , Carcinoma, Renal Cell/metabolism , Kidney Neoplasms/diagnosis , Kidney Neoplasms/metabolism , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/metabolism , Receptors, Progesterone/metabolism , Retroperitoneal Neoplasms/diagnosis , Retroperitoneal Neoplasms/metabolism , Breast Neoplasms/pathology , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/surgery , Female , Humans , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/surgery , Middle Aged , Nephrectomy , Retroperitoneal Neoplasms/diagnostic imaging , Retroperitoneal Neoplasms/surgery , Tomography, X-Ray Computed
16.
Z Gastroenterol ; 47(12): 1208-10, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19960399

ABSTRACT

OBJECTIVE: Mesenteric cyst is a rare intra-abdominal lesion. Most patients with mesenteric cysts are asymptomatic. Symptomatic mesenteric cysts are associated with cyst size, cyst location, and complications, including infection, rupture, hemorrhage, and intestinal obstruction. Volvulus is a rare complication of mesenteric cyst. SUBJECT: We report a 50-year-old woman with colicky epigastric pain for three days. The symptoms exacerbated in the supine position and were relieved in the sitting position. Computed tomography of her abdomen revealed a huge cystic lesion with a whirl sign of mesentery vessels. She had the history of gastro-esophageal reflux disease. RESULT: Segmental resection of the small intestine with end-to-end anastomosis was performed. Histology indicated a hemorrhagic pseudocyst. The patient recovered well after surgery. CONCLUSION: Mesenteric pseudocyst rarely results in volvulus of small intestine. Our case is the eleventh case reported in the English literature. Atypical presentation of epigastric pain while lying down may lead to mis-diagnosis. This case reminds the clinicians this rare complication.


Subject(s)
Intestinal Volvulus/complications , Intestinal Volvulus/diagnosis , Intestine, Small/pathology , Mesenteric Cyst/complications , Mesenteric Cyst/diagnosis , Female , Humans , Intestinal Volvulus/surgery , Intestine, Small/diagnostic imaging , Intestine, Small/surgery , Mesenteric Cyst/surgery , Middle Aged , Radiography , Rare Diseases , Treatment Outcome
17.
Br J Oral Maxillofac Surg ; 44(4): 322-4, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16310907

ABSTRACT

Cherubism is a benign lesion that causes painless symmetrical enlargement of the jaws, usually with a familial tendency. We describe in two Chinese families two cases of the aggressive form of cherubism with extensive swelling on both sides of the mandible, typical microscopic findings, and apparent familial history.


Subject(s)
Cherubism/pathology , Mandible/pathology , Mandibular Diseases/pathology , Adult , Cherubism/diagnostic imaging , Cherubism/surgery , Child , Female , Humans , Male , Mandible/diagnostic imaging , Mandible/surgery , Mandibular Diseases/diagnostic imaging , Mandibular Diseases/surgery , Radiography , Treatment Outcome
19.
World J Gastroenterol ; 3(1): 54-5, 1997 Mar 15.
Article in English | MEDLINE | ID: mdl-27006588

ABSTRACT

AIM: A model of experimental gastric dysrhythmia in rabbits was set up to evaluate the effect of different acupoints on regulating gastric dysrhythmia in rabbits so as to promote acupuncture treatment for this kind of disease. METHODS: A model of gastric dysrhythmia in rabbits was established by the rotation method using the basic electrical rhythm (BER) as an objective index. After puncturing at the points of Zusanli (ST36), Neiguan (PC6), Tiaokou (ST38) and Tianquan (PC2) in the four groups of experimental gastric dysrhythmia rabbits, the difference in regulatory effects on the disturbance and frequency of the gastric electric slow wave was observed. RESULTS: Before needling at the specific acupoints Zusanli and Neiguan, the percentage of disturbance electric slow wave for the Zusanli and Neiguan groups was 57.0785 ± 10.644 and 55.5173 ± 6.0500, respectively; after such needling, the percentage was 43.7823 ± 10.1518 and 43.5147 ± 6.8983 for the Zusanli and Neiguan groups, respectively, while the frequency of electric slow wave for the Zusanli and Neiguan groups was 2.2870 ± 0.3800 and 2.4020 ± 0.3536, respectively, before needling and after needling, the frequency was 2.7090 ± 0.5865 and 2.9220 ± 0.4923 for the Zusanli and Neiguan groups, respectively. Comparing the percentage and frequency for the Zusanli and Neiguan groups before and after needling, the result shows that both groups have a significant difference statistically (P < 0.05) but between the Zusanli and Neiguan groups, there was no significant difference. Before and after needling the nonspecific acupoints of Tiaokou and Tianquan, there was no difference between the Tiaokou and Tianquan groups. Between the Zusanli and Tiaokou groups and the Neiguan and Tianquan groups, there are significant differences in regulating gastric dysrhythmia. CONCLUSION: This model is suitable for the observation of gastric dysrhythmia. The specific acupoints of Zusanli and Neiguan have good effects on the treatment of gastric dysrhythmia.

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