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1.
Environ Sci Pollut Res Int ; 29(27): 40543-40549, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35083692

RESUMEN

Radiology workers might constantly be exposed to low-dose ionizing radiation due to their profession. Low doses of radiation in a short exposure time have the potential to alter the genome, which might potentially lead to diseases. The main objective of this study was to determine whether the amount of cell-free nucleic acids in plasma samples of radiation-exposed workers was different from the general public, in other words, non-exposed individuals. In this context, we investigated the association between radiation exposure and cell-free nucleic acids concentration by using radiation exposure parameters. The study consisted of 40 radiology workers and 40 individuals who were not exposed to ionizing radiation. The plasma concentrations of cell-free DNA, RNA, and miRNA were measured fluorometrically. We found that the ccfRNA concentration of the radiation-exposed group was significantly different from that of the non-exposed group (p = 0.0001). However, there are no differences between both groups in terms of ccfDNA and ccfmiRNA concentration. The concentration of ccfDNA is significantly correlated with working time in the fluoroscopy field (p < 0.05). We found that the concentration of ccfmiRNA was significantly correlated with working time in plain radiography (p < 0.01) and computed tomography (p < 0.05) and with total working time (p < 0.01). Similarly, the concentrations of ccfRNA were significantly correlated with working time in computed tomography (p < 0.01) and with the total working time (p < 0.05) of the workers. We found that imaging number in computed tomography significantly altered the level of ccfRNA (p = 0.006) and that working time in the computed tomography field significantly affected the ccfRNA concentration (p = 0.03, R2 = 0.36 for model). Finally, we determined that total working time was significantly associated with total ccfRNA concentration (p < 0.05, R2 = 0.25 for model). In conclusion, total RNA measured in radiation-exposed workers has the potential to predict the radiation exposure risk. Furthermore, total working time and working time in the tomography field significantly alter the level of free nucleic acids.


Asunto(s)
Ácidos Nucleicos Libres de Células , Exposición Profesional , Personal de Salud , Humanos , ARN , Radiación Ionizante
2.
Acta Cir Bras ; 35(6): e202000602, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32667589

RESUMEN

Purpose To examine the effects of quercetin on healing of experimental colon anastomosis injury in early and late period. Methods Eighty male Wistar-Albino rats were divided into 8 groups. For all groups, left colons of the rats were resected and for the rest end-to-end anastomosis was performed. Two of the groups for which the experiment protocol was ended on the 3rd and 7th day following the anastomosis were not administered with either quercetin or dimethylsulfoxide DMSO, whereas two other groups were administered with DMSO only, and four other groups were administered with quercetin dissolved in DMSO in doses of 20 and 100 mg/kg during the protocol. At the end of the study, anastomosis line was resected, histopathological evaluation was performed and bursting pressure, malondialdehyde, superoxide dismutase, catalase, and hydroxyproline levels were measured. Results Quercetin significantly increased hydroxyproline, superoxide dismutase, catalase levels, histopathological healing score, bursting pressure values and decreased malondialdehyde level in early period. It also significantly increased superoxide dismutase, catalase, and hydroxyproline levels and decreased malondialdehyde level in late period. Conclusion It was seen that quercetin speeds up the injury healing process and reveals an antioxidant effect, specifically in early period.


Asunto(s)
Colon , Anastomosis Quirúrgica , Animales , Dimetilsulfóxido , Hidroxiprolina , Masculino , Quercetina , Ratas , Ratas Wistar
3.
J Invest Surg ; 28(6): 334-40, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26270147

RESUMEN

AIM: This study aimed to investigate the effects of L-carnitine, with its known antioxidant properties and positive effects on wound healing, on the healing of colon anastomosis in a cecal ligation and puncture sepsis model in rats. MATERIALS AND METHODS: A total of 40 Sprague-Dawley rats were used. The rats were randomly divided into four groups of 10 (n = 10). Groups 1 and 2 had laparotomy and colon anastomosis performed. Groups 3 and 4 had cecal ligation and puncture (CLP) and colon anastomosis performed. Rats in Groups 1 and 3 were given 15 mL/kg intraperitoneal 0.9% isotonic NaCl, while the rats in Groups 2 and 4 were given 100 mg/kg intraperitoneal L-carnitine. On the postoperative fifth day, the rats were sacrificed and the burst pressure of anastomosis, histopathological effects, and tissue hydroxyproline levels were investigated. RESULTS: In Groups 2 and 4, the anastomosis burst pressure and histopathological results in both noninfected abdomen and presence of peritonitis were statistically high compared to the control group (p < 0.05). Though the hydroxyproline levels were also high, there was no statistically significant difference for this parameter (p > 0.05). CONCLUSIONS: The findings obtained from the experimental sepsis model showed that healing of anastomosis in both the presence of peritonitis and noninfected abdomen was positively affected by the systemic administration of L-carnitine and this may contribute to the safety of anastomosis.


Asunto(s)
Carnitina/administración & dosificación , Colon/cirugía , Sepsis/cirugía , Cicatrización de Heridas/efectos de los fármacos , Anastomosis Quirúrgica , Animales , Antioxidantes/administración & dosificación , Colon/patología , Colon/fisiopatología , Modelos Animales de Enfermedad , Hidroxiprolina/metabolismo , Inyecciones Intraperitoneales , Presión , Ratas , Ratas Sprague-Dawley , Sepsis/patología , Sepsis/fisiopatología
4.
J Am Podiatr Med Assoc ; 105(3): 260-3, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-26146974

RESUMEN

A 53-year-old man presented to the orthopedic outpatient clinic with pain and swelling in the right heel without any trauma. On physical examination and radiologic assessment, a lesion with calcification and peripheral sclerosis was detected in the medullary cavity of the calcaneus, and computed tomographic images revealed cortical thinning adjacent to the lesion. Magnetic resonance images showed a 23 × 19-mm lesion. Tru-Cut biopsy, performed to clarify the diagnosis, revealed an enchondroma. As a definitive treatment, curettage of the lesion and grafting of the cavity was performed. Although enchondromas are common pathologic abnormalities of the skeleton and are usually asymptomatic, atypical localization, such as the calcaneus, and atypical clinical manifestations, such as heel pain, should also be kept in mind.


Asunto(s)
Neoplasias Óseas/diagnóstico , Calcáneo/diagnóstico por imagen , Condroma/diagnóstico , Biopsia , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X
5.
Artículo en Inglés | MEDLINE | ID: mdl-25867903

RESUMEN

A 53-year-old man presented to the orthopedic outpatient clinic with pain and swelling in the right heel without any trauma. On physical examination and radiologic assessment, a lesion with calcification and peripheral sclerosis was detected in the medullary cavity of the calcaneus, and computed tomographic images revealed cortical thinning adjacent to the lesion. Magnetic resonance images showed a 23 × 19-mm lesion. Tru-Cut biopsy, performed to clarify the diagnosis, revealed an enchondroma. As a definitive treatment, curettage of the lesion and grafting of the cavity was performed. Although enchondromas are common pathologic abnormalities of the skeleton and are usually asymptomatic, atypical localization, such as the calcaneus, and atypical clinical manifestations, such as heel pain, should also be kept in mind.

7.
Clin Anat ; 24(2): 168-78, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21268120

RESUMEN

The purpose of this morphologic study is to investigate the course and the branching pattern of motor branches of musculocutaneous nerve (MCN) in human fetuses. Twenty upper limbs (10 right, 10 left) of spontaneously aborted formalin-fixed fetuses were dissected under a stereomicroscope to determine motor branches for the biceps brachii and brachialis and the communicating branches between the MCN and median nerve (MN). The MCN entered the proximal and middle part of coracobrachialis in 13/20 and 5/20 of arms, respectively, and the remaining 2/20 did not pierce coracobrachialis. The communication between MCN and MN was observed in 5/20 of the arms and detected only in the distal part of the coracobrachialis. The most frequently observed innervation is the type wherein a single branch to biceps brachii, which bifurcated for supplying the short and long heads (12/20). For the innervation of brachialis, the most frequent type was a single branch from the main trunk of the MCN (15/20). During the dissections, the distance between the acromion and the emerging point of the motor branches was measured. The mean distance between the acromion and the emerging point of the all motor branches for biceps brachii in all types of specimens was 33.8 ± 6.1% of acromion-lateral epicondyle length and for brachialis was 50.6 ± 11.5% of acromion-lateral epicondyle length. The data of the MCN variations in the human fetus may be useful for the clinicians and pediatric surgery.


Asunto(s)
Brazo/embriología , Feto/embriología , Neuronas Motoras/citología , Músculo Esquelético/embriología , Nervio Musculocutáneo/embriología , Aborto Espontáneo , Brazo/inervación , Femenino , Desarrollo Fetal , Edad Gestacional , Humanos , Masculino , Músculo Esquelético/inervación , Nervio Musculocutáneo/citología
8.
Kulak Burun Bogaz Ihtis Derg ; 20(4): 200-4, 2010.
Artículo en Turco | MEDLINE | ID: mdl-20626329

RESUMEN

Van der Woude syndrome is a congenital abnormality characterized by labial cysts, accessory salivary glands, pits, fistulas and paramedian sinuses of the lower lips, and is frequently associated with cleft lip and palate. This disease is the most common syndromic cleft abnormality. The disease is characterized by a single gene abnormality where craniofacial morphogenesis is affected. It has an autosomal dominant inheritance with involvement of 1q32-41 chromosomal locus. However, the gene expression profile is variable and the disease may present in some individuals with sinuses of the lower lips only. We present results of analysis of genetic penetrance in the pedigree of five cases with Van der Woude syndrome together with a review of the literature.


Asunto(s)
Anomalías Múltiples , Labio Leporino , Fisura del Paladar , Quistes , Anomalías Múltiples/genética , Adolescente , Niño , Deleción Cromosómica , Mapeo Cromosómico , Cromosomas Humanos Par 1 , Labio Leporino/genética , Fisura del Paladar/genética , Quistes/genética , Femenino , Perfilación de la Expresión Génica , Humanos , Labio/anomalías , Masculino , Linaje , Adulto Joven
9.
Clin Invest Med ; 32(5): E376-82, 2009 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-19796579

RESUMEN

AIM: To investigate the effects of radiotherapy on distraction osteogenesis performed on the same bone in an area that has not received radiation. Radiotherapy (Co60) was carried out in a region where tumors may develop, and then, on the assumption that the tumoral region had been removed, distraction osteogenesis was carried out, and the effects were investigated. METHOD: Thirty New Zealand rabbits were randomized into two groups, a study group (15 rabbits) and a control group (15 rabbits). In the study group, Co60 was administered by teletherapy to the distal half of the left tibia. Rabbits in the control group were kept in the same environment for the same period, but were not subjected to radiotherapy. Four weeks after radiotherapy, osteotomy was performed on the proximal part of the left tibia of all subjects, and distraction was carried out until 10mm. After distraction was completed, the outcomes were evaluated radiologically, scintigraphically, and histopathologically, and the results were compared. RESULTS: New bone formation achieved through distraction osteogenesis in the study group animals was inadequate, while new bone tissue achieved in the control group was superior (P < 0.001). CONCLUSION: Radiotherapy has a negative effect on distraction osteogenesis, even if performed on a different part of the bone.


Asunto(s)
Neoplasias/radioterapia , Osteogénesis/efectos de la radiación , Animales , Radioisótopos de Cobalto , Masculino , Conejos , Radiografía , Distribución Aleatoria , Tibia/diagnóstico por imagen , Tibia/patología , Tibia/cirugía
10.
Electromagn Biol Med ; 27(1): 65-72, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18327715

RESUMEN

The purpose of the present study was to investigate the anti-apoptotic bcl-2 protein in rat brain and testes after whole-body exposure to radiation emitted from 900 MHz cellular phones. Two groups (sham and experimental) of Sprague-Dawley rats of eight rats each were used in the study. Exposure began approximately 10 min after transferring into the exposure cages, a period of time when rats settled down to a prone position and selected a fixed location inside the cage spontaneously. For the experimental group, the phones were in the speech condition for 20 min per day for 1 month. The same procedure was applied to the sham group rats, but the phones were turned off. Immunohistochemical staining of bcl-2 was performed according to the standardized avidin-biotin complex method. The results of this study showed that 20 min of the radiation emitted from 900 MHz cellular phones did not alter anti-apoptotic bcl-2 protein in the brain and testes of rats. We speculate that bcl-2 may not be involved in the effects of radiation on the brain and testes of rats.


Asunto(s)
Teléfono Celular , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Ondas de Radio , Irradiación Corporal Total , Animales , Apoptosis/genética , Apoptosis/efectos de la radiación , Encéfalo/metabolismo , Encéfalo/efectos de la radiación , Regulación de la Expresión Génica/efectos de la radiación , Masculino , Proteínas Proto-Oncogénicas c-bcl-2/genética , Ratas , Ratas Sprague-Dawley , Testículo/metabolismo , Testículo/efectos de la radiación
11.
Dig Dis Sci ; 52(1): 110-8, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17151802

RESUMEN

Aspirin and nonsteroidal anti-inflammatory drug (NSAID)-induced gastrointestinal bleeding is recognized as an important health problem. We performed a single-center randomized clinical trial to compare the effect of high-dose intravenous proton pump inhibitor (omeprazole) alone (group 1) with omeprazole in combination with a low-dose prostaglandin analog (misoprostol; group 2) on clinical outcomes in patients with aspirin/NSAID-induced upper gastrointestinal bleeding. Additionally, we evaluated the contribution of Helicobacter pylori eradication therapy on the late consequences. Patients were recruited to the study if they had upper gastrointestinal bleeding with history of taking aspirin or other NSAIDs within the week before the onset of bleeding. All were evaluated in terms of probable risk factors. After the standard treatment protocol, patients with histologically proven H pylori infection were prescribed a triple eradication therapy for 14 days. The primary end points were recurrent bleeding, surgery requirement, and death rates before discharge and at the end of follow-up period. This study lasted for 2 years. A total of 249 patients with upper gastrointestinal bleeding were admitted, and 49.7% of these patients were users of aspirin/NSAIDs. There were 67 patients in group 1 and 56 in group 2. The distributions for gender, age, comorbidity, H pylori infection, and high-risk ulcer rate were similar in both groups. Among aspirin/NSAID users, endoscopy revealed duodenal ulcer in 47 (38.2%), gastric ulcer in 10 (8.1%), and erosive gastropathy in 33 (26.8%). The overall rebleeding occurred in 12.2%, death in 2.4% of the patients. The in-hospital death (P=.414), rebleeding (P=.925), and surgery (P=.547) rates were similar in both treatment groups. After the follow-up period of 3 months, overall rebleeding occurred in 4.1%, and death in 4.8% of the patients. The overall mortality rate was highest in those >65 years old, who were chronic low-dose aspirin users with comorbidity. One died of transfusion-related graft-versus-host disease. In this pilot study, we indicated that adding misoprostol (600 microg/day) to standardized proton pump inhibitor treatment did not improve or change the rebleeding or mortality rates of patients with upper gastrointestinal bleeding related to aspirin/NSAID use. Other prospective studies on higher doses of misoprostol are needed to establish the coeffect. One should bear in mind that all blood products must be irradiated before transfused to the host.


Asunto(s)
Antiulcerosos/uso terapéutico , Úlcera Duodenal/tratamiento farmacológico , Hemorragia Gastrointestinal/tratamiento farmacológico , Misoprostol/uso terapéutico , Omeprazol/uso terapéutico , 2-Piridinilmetilsulfinilbencimidazoles/administración & dosificación , 2-Piridinilmetilsulfinilbencimidazoles/uso terapéutico , Anciano , Antiinflamatorios no Esteroideos/efectos adversos , Antiinflamatorios no Esteroideos/uso terapéutico , Antiulcerosos/administración & dosificación , Aspirina/efectos adversos , Aspirina/uso terapéutico , Comorbilidad , Quimioterapia Combinada , Úlcera Duodenal/inducido químicamente , Úlcera Duodenal/epidemiología , Endoscopía Gastrointestinal , Femenino , Mucosa Gástrica/patología , Hemorragia Gastrointestinal/inducido químicamente , Hemorragia Gastrointestinal/microbiología , Hemorragia Gastrointestinal/mortalidad , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Humanos , Masculino , Persona de Mediana Edad , Misoprostol/administración & dosificación , Omeprazol/administración & dosificación , Pantoprazol , Proyectos Piloto , Estudios Prospectivos , Recurrencia
12.
Kulak Burun Bogaz Ihtis Derg ; 17(4): 228-30, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-18187976

RESUMEN

Mucormycosis is a rare, saprophytic, invasive, and fulminant fungal disease. It occurs in immunocompromised patients such as those with diabetes mellitus or blood dyscrasia, or in patients under immunosuppressive therapy. A 17-year-old female patient with diabetic ketoacidosis presented with a black-colored lesion in the auricle and external ear canal. Physical examination showed necrosis of the auricle, external ear canal, and neighboring skin. She also had facial paralysis. Debridement of the necrotic tissues was performed and the samples were submitted for microbiologic and histopathologic examination, which showed nonseptate hyphae. Postoperatively, systemic amphotericin B was empirically administered. The patient died on the seventh day.


Asunto(s)
Cetoacidosis Diabética , Oído Externo/patología , Mucormicosis/diagnóstico , Adolescente , Terapia Combinada , Diagnóstico Diferencial , Resultado Fatal , Femenino , Humanos , Mucormicosis/diagnóstico por imagen , Mucormicosis/patología , Mucormicosis/terapia , Radiografía
13.
Kulak Burun Bogaz Ihtis Derg ; 17(6): 333-5, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-18187999

RESUMEN

Angiokeratoma circumscriptum is an uncommon vascular entity. The lesion is present at birth and usually involves the lower extremities. A 9-year-old girl presented with multiple pink-colored, small-raised lesions in the dorsal part of her tongue, which had been present since birth. There was no history of trauma, cold injury, or similar lesions elsewhere in her body. She complained of pain and rare bleeding from the lesions after eating hard foods. Physical examination showed multiple, grouped, erythematous, shiny papules mostly in the dorsal aspect of the tongue. There were no other lesions in other parts of the oral mucosa. After an incisional biopsy of the lesion, the diagnosis was made as solitary angiokeratoma circumscriptum.


Asunto(s)
Angioqueratoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Lengua/patología , Angioqueratoma/diagnóstico por imagen , Angioqueratoma/patología , Angioqueratoma/cirugía , Niño , Diagnóstico Diferencial , Femenino , Humanos , Radiografía , Neoplasias Cutáneas/diagnóstico por imagen , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía
14.
Int Urol Nephrol ; 37(4): 733-7, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16362590

RESUMEN

AIM: In this prospective study, we aimed to determine the coagulation parameters in the patients with Fournier's gangrene. METHODS: The study group is consisted of 12 consecutive Fournier's gangrene patients (11 men and 1 woman) and control group is consisted of patients with periurethral abscess (n = 2), scrotal abscess (n = 4) and epididimorchitis (n = 4). Fibrinogen, protein C, protein S, antithrombin III, lupus anticoagulant, cardiolipin IgG and IgM, prothrombin time-international normalized ratio, activated partial thromboplastin time, platelet count, proaccelerin, antihemophilic globulin (FVIII), albumin, and calcium were evaluated in all subjects. Tissue specimens were taken from Fournier's gangrene patients. These specimens were tested for arterial and venous thrombosis using light microscopy. RESULTS: All of the patients with Fournier's gangrene had both arterial and venous thrombosis in tissue specimens. The levels of fibrinogen and FVIII were high, the level of protein C was low in 12 patients. Lupus Anticoagulant was positive 11 of 12 patients. CONCLUSIONS: According to our findings, we think that some coagulation parameters (FVIII, Lupus anticoagulant, protein C, fibrinogen) may be diagnostic for Fournier's gangrene.


Asunto(s)
Factores de Coagulación Sanguínea/análisis , Gangrena de Fournier/sangre , Anciano , Anciano de 80 o más Años , Factor VIII/análisis , Femenino , Fibrinógeno/análisis , Humanos , Inhibidor de Coagulación del Lupus/sangre , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Proteína C/análisis
15.
Fertil Steril ; 84 Suppl 2: 1083-8, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16209997

RESUMEN

OBJECTIVE: To evaluate the efficacy of an anti-inflammatory and capillary regulator drug, micronized purified flavonoid fraction (MPFF), in the prevention of postoperative formation of adhesions. DESIGN: A double-blind, controlled study evaluated the efficacy of MPFF in reducing postoperative adhesion formation in a rat model. SETTING: Animal care facility of an academic research setting. ANIMAL(S): Thirty Sprague-Dawley female rats randomly divided into three groups. INTERVENTION(S): Starting on day of surgery, group 2 rats received oral MPFF (100 mg/kg per day for 7 days). Group 3 rats were intraperitoneally injected with 5 mL of saline (containing 200 mg/kg per day of MPFF for 3 days). Control rats received no medication. A standardized surgical trauma was applied in all animals. Three weeks after surgery, the rats were killed, and the adhesions were scored according to macroscopic and microscopic scales. MAIN OUTCOME MEASURE(S): Postoperative adhesions. RESULT(S): Both oral and intraperitoneal administration of MPFF reduced the scores of adhesions according to macroscopic and microscopic scales. There was no difference between the routes of administration. CONCLUSION(S): A statistically significant reduction in postoperative formation of adhesions was observed after oral and intraperitoneal administration of MPFF in our experimental animal model. However, further studies are required to reveal its mechanism of action.


Asunto(s)
Flavonoides/aislamiento & purificación , Flavonoides/uso terapéutico , Enfermedades Peritoneales/prevención & control , Complicaciones Posoperatorias/prevención & control , Adherencias Tisulares/prevención & control , Animales , Fraccionamiento Químico , Método Doble Ciego , Evaluación Preclínica de Medicamentos , Femenino , Enfermedades Peritoneales/patología , Preparaciones Farmacéuticas/aislamiento & purificación , Complicaciones Posoperatorias/patología , Ratas , Ratas Sprague-Dawley , Adherencias Tisulares/patología
16.
Am J Surg Pathol ; 29(6): 724-33, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15897739

RESUMEN

There is no uniformly applied grading system for pancreatic ductal adenocarcinoma (DA). The scheme advocated by the WHO is essentially that of Kloppel et al, and is based on the "highest grade" focus. Although it is precise with good prognostic value, it is unfortunately not widely applied, largely because of the lack of recognition and partly because of its complex nature (interpretation of multiple parameters). Furthermore, it is fundamentally different from the one used in Japan, which evaluates the overall pattern. To establish a more widely applicable, practical, and clinically relevant grading system, a scheme similar to Gleason's scoring system was developed and tested on 112 cases of resected pancreatic DA and was compared with the WHO system. In the grading system devised, patterns (P) of infiltration were classified as follows: P1, well-defined glands with easily discernible contours; P2, fused or poorly formed glands with ill-defined contours; P3, nonglandular patterns. A score was then obtained by the summation of the predominant and the secondary patterns. Scores < or =3 (at least some well-formed glands and no nonglandular pattern) was graded as G1, 4 as G2, and > or =5 (at least some nonglandular patterns and no well-formed glandular pattern) as G3. Seventy-three percent of the cases displayed mixed patterns, with disparate patterns (P1 with P3) in 13%, confirming the high degree of heterogeneity of DA. There was a significant correlation between grade and survival, better than the correlation between survival and either the major or minor patterns evaluated separately. The median survival for G1, G2, and G3 were 22, 14, and 8 months; 1-year survival 68%, 44%, and 33%; 2-year was 67%, 11%, and 0%; and 3-year was 23%, 4%, and 0%, respectively (P = 0.0019). In a multivariate analysis, correlating survival with grade, tumor size, and lymph node status, the grade was the strongest independent predictor of survival. Odds ratio of dying of disease were 3.56 (P < 0.0001) in G3 versus G1, 1.79 (P = 0.058) in G2 versus G1, and 1.98 (P = 0.03) in G3 versus G2. Compared with this, the same odds ratio were 1.17 (P = 0.01) in tumors >2 cm versus < or =2 cm and 1.78 (P = 0.01) in cases with positive versus negative lymph nodes. The WHO grading scheme was not found to have as good a correlation with survival in this study, with WHO grade 2 showing a better survival than 1. The reproducibility of both the proposed grading system and that of WHO were found to be moderately good (with kappa values of 0.43 and 0.44, respectively), when 32 slides of DA were graded by four independent observers. The grading scheme for pancreatobiliary adenocarcinoma proposed here is highly applicable because it is practical and readily adoptable. It reflects biologic characteristics of ductal carcinoma (prominent tubule formation and tumor heterogeneity). Most importantly, it is clinically relevant with good prognostic value. Lastly, it is also applicable for use in research, by utilizing "patterns," even in small specimens like microarrays or biopsies.


Asunto(s)
Carcinoma Ductal Pancreático/patología , Neoplasias Pancreáticas/patología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Reproducibilidad de los Resultados , Análisis de Supervivencia
17.
Hepatogastroenterology ; 51(60): 1732-5, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15532815

RESUMEN

BACKGROUND/AIMS: The study is designed to identify the optimal gastric mucosal biopsy site and number for identification of Helicobacter pylori, gastric atrophy and intestinal metaplasia. METHODOLOGY: Ninety-two patients were included in the study, gastric biopsies were obtained from 5 different sites: lesser curvature of the mid-antrum (A1), greater curvature of the mid-antrum (A2), incisura angularis (IA), lesser curvature of the mid-corpus (B1), greater curvature of the mid-corpus (B2). Helicobacter pylori was evaluated in sections stained with toluidine blue, and histopathological examination was performed in sections stained with hematoxylin-eosin. RESULTS: Seventy-three patients were positive for Helicobacter pylori at least in one biopsy site. Helicobacter pylori was positive in 47 patients (64.3%) in A1, in 54 patients (73.9%) in A2, in 60 patients (82.1%) in IA, 44 patients (60.2%) in B1, and in 42 patients (57.5%) in B2. The highest positivity determined was in the combination of A2 and IA sites (95.8%). Gastric atrophy was determined in 35 of 73 patients (27.1% in A1, 20% in A2, 25.7% in IA, 20% in B1, and 7% in B2). Intestinal metaplasia was determined in 31 of the Helicobacter pylori-positive patients (18% in A1, 16% in A2, 30.9% in IA, 21.8% in B1, 12.7% in B2). CONCLUSIONS: It is considered that taking biopsies from both A1 and IA sites has the highest sensitivity in detecting Helicobacter pylori. However, it is difficult to define a specific site for detecting gastric atrophy and intestinal metaplasia.


Asunto(s)
Transformación Celular Neoplásica/patología , Mucosa Gástrica/patología , Gastritis Atrófica/patología , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/aislamiento & purificación , Intestinos/patología , Adulto , Anciano , Biopsia con Aguja , Estudios de Cohortes , Estudios de Evaluación como Asunto , Femenino , Mucosa Gástrica/microbiología , Gastritis Atrófica/microbiología , Humanos , Inmunohistoquímica , Masculino , Metaplasia/patología , Persona de Mediana Edad , Medición de Riesgo , Sensibilidad y Especificidad
18.
Saudi Med J ; 25(8): 1020-3, 2004 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-15322591

RESUMEN

OBJECTIVE: Angiomyolipoma (AML) is a benign neoplasm consisting of varying mixtures of smooth muscle, blood vessels and fat. Although, most of these tumors are easy to recognize, some may pose a diagnostic dilemma due to unusual histologic features. Recently, it was suggested that melanosome-associated protein (HMB-45) immunoreactivity may be used for diagnostic confirmation of several neoplasm. The aim of this study is to analyze the diagnostic efficacy of HMB-45 in patients with AML. METHODS: This study was carried out at the Faculty of Medicine, Department of Pathology, Dicle University, Diyarbakir, Turkey, during the period January 2000 to September 2003. HMB-45 immunoreactivity was analyzed in 6 patients with AML and in 34 patients with other renal and retroperitoneal pathologies, including 10 nephrectomized patients for non-neoplastic reasons by means of immunohistochemistry. RESULTS: Patients with AML were positive for HMB-45. Whereas, HMB-45 immunoreactivity was negative in all of the histologic specimens from the patients with renal cell carcinoma, retroperitoneal sarcomas, Wilms' tumor, lipoma, leiomyoma, and nephrectomized kidneys of non-neoplastic reason. The association of AML with HMB-45 immunoreactivity was highly significant (p<0.001). CONCLUSION: Our findings suggest that HMB-45 may not be a melanocyte-restricted marker, and can be useful in differential diagnosis between AML and other tumors seen in kidney and retroperitoneal region.


Asunto(s)
Angiomiolipoma/patología , Biomarcadores de Tumor/análisis , Neoplasias Renales/patología , Proteínas de Neoplasias/metabolismo , Adolescente , Adulto , Antígenos de Neoplasias , Biopsia con Aguja , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Enfermedades Renales/patología , Masculino , Antígenos Específicos del Melanoma , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Medición de Riesgo , Muestreo , Sensibilidad y Especificidad , Turquía
19.
Pediatr Surg Int ; 20(7): 520-4, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15185109

RESUMEN

Our objective was to compare the efficacy of adjunctive intrapleural fibrinolytic agents (IPFA) (streptokinase, urokinase) on fibrinopurulent stage empyema and chronic stage empyema in children. IPFA were used in 78 pediatric patients with empyema (36 fibrinopurulent stage empyemas, 42 chronic stage empyemas) between December 1994 and September 2002. Pleural biopsy was done for staging in all cases. Streptokinase 250,000 units in 100 ml normal saline (62 patients) or 100,000 units urokinase in 100 ml normal saline (16 patients) was instilled daily into the patient's chest tube, and the tube was clamped for 4 h, followed by suction. This treatment was continued daily for 2-8 days until resolution was demonstrated by chest radiographs and/or computed chest tomography. Success of treatment was 97.2% (complete response 24/36, partial response 11/36) in the fibrinopurulent stage and 9.4% (complete response 2/42, partial response 2/42) in chronic empyema cases. In one patient with fibrinopurulent empyema, the treatment was stopped due to allergic reaction and pleural hemorrhage; this patient died 1 day later in a septic condition. Although an invasive method, the pleural biopsy technique may be an alternative way of more properly staging thoracic empyema in selected children in whom staging based on radiographic and biochemical findings is doubtful. Intrapleural fibrinolytic treatment is an effective and safe therapy of choice and may have significant benefit in most children with fibrinopurulent phase empyema, except for those with bronchopleural fistula. IPFA do not seem to be effective in children with chronic phase empyema.


Asunto(s)
Empiema Pleural/tratamiento farmacológico , Fibrinolíticos/uso terapéutico , Adolescente , Biopsia , Tubos Torácicos , Niño , Preescolar , Enfermedad Crónica , Hipersensibilidad a las Drogas/etiología , Empiema Pleural/patología , Femenino , Fibrina/antagonistas & inhibidores , Fibrinolíticos/administración & dosificación , Hemorragia/etiología , Humanos , Lactante , Masculino , Enfermedades Pleurales/etiología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/patología , Estreptoquinasa/administración & dosificación , Estreptoquinasa/uso terapéutico , Succión , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Activador de Plasminógeno de Tipo Uroquinasa/administración & dosificación , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéutico
20.
Saudi Med J ; 25(5): 621-4, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15138530

RESUMEN

OBJECTIVE: It is known that mast cells play an important role in pathogenesis of allergic rhinitis. In this study, we investigated the distribution of mast cells in the nasal mucosa of patients with seasonal allergic rhinitis during the pollen-season. METHODS: This study was carried out at the Faculty of Medicine, Dicle University, Turkey, during the grass-pollen season between, March and July in 2002. Twenty patients with seasonal allergic rhinitis (12 females and 8 males) and 20 healthy (10 females and 10 males) non-allergic controls were examined for the distribution and abundance of mast cells in nasal biopsies. Biopsies were performed in all patients and controls, once during natural provocation in the spring and were taken from the lower edge of the inferior turbinate using a forceps. The samples of nasal mucosa were fixed in 10% neutral buffered formaline, stained with 0.5% aqueous toluidine blue and hematoxylin and eosin were examined under a light microscope. RESULTS: Mast cells were observed in the nasal mucosa obtained from 12 patients (60%) and 5 patients (25%) controls cases (p=0.025). It was found out that intrapitelial mast cells are present in nasal mucosa samples of patients with SAR (seasonal allergic rhinitis) but not in the epithelium of non-allergic controls. CONCLUSION: The number of submucosal mast cells has considerably increased in the nasal mucosa samples of patients with SAR. Besides this, these cells are determined in great amounts in non-allergic individuals.


Asunto(s)
Mastocitos/inmunología , Mucosa Nasal/inmunología , Rinitis Alérgica Estacional/inmunología , Adulto , Biopsia , Recuento de Células , Femenino , Humanos , Masculino , Mastocitos/patología , Persona de Mediana Edad , Mucosa Nasal/patología , Valores de Referencia , Rinitis Alérgica Estacional/patología
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