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The use of narrow band imaging (NBI) and further technological achievements concerning the resolution and magnification of endoscopic images have revolutionized laryngology in the past 10 years. The diagnosis and therapy of dysplasia and early laryngeal carcinoma have become significantly easier. There are also clear benefits for benign laryngeal lesions. Central to these techniques is the assessment of epithelial, connective tissue and vascular changes caused by diverse diseases.
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Aumento de la Imagen/métodos , Enfermedades de la Laringe/patología , Mucosa Laríngea/patología , Laringoscopios , Laringoscopía/instrumentación , Laringoscopía/métodos , Diseño de Equipo , Medicina Basada en la Evidencia , Humanos , Enfermedades de la Laringe/diagnóstico por imagen , Mucosa Laríngea/diagnóstico por imagen , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Evaluación de la Tecnología BiomédicaRESUMEN
AIMS: Tissue responses to debris formed by abrasion of polymethylmethacrylate (PMMA) spacers at two-stage revision arthroplasty for prosthetic joint infection are not well described. We hypothesised that PMMA debris induces immunomodulation in periprosthetic tissues. PATIENTS AND METHODS: Samples of tissue were taken during 35 two-stage revision arthroplasties (nine total hip and 26 total knee arthroplasties) in patients whose mean age was 67 years (44 to 85). Fourier transform infrared microscopy was used to confirm the presence of PMMA particles. Histomorphometry was performed using Sudan Red and Haematoxylin-Eosin staining. CD-68, CD-20, CD-11(c), CD-3 and IL-17 antibodies were used to immunophenotype the inflammatory cells. All slides were scored semi-quantitatively using the modified Willert scoring system. RESULTS: The mean CD-68 scores did not show any significant change during the six weeks between the stages. Perivascular and diffuse scores showed significant difference in CD-3, CD-20, CD-11(c) and IL-17. At the time of re-implantation, a shift in the pattern of the expression of dendritic cells towards a perivascular arrangement and towards the periphery of PMMA particles was observed. Positive microbiological cultures were found at the time of re-implantation in three patients. Five further revisions were required for other reasons. CONCLUSION: Our results represent a biological reaction of the synovial tissues to spacers with a less diffuse expression of dendritic cells and an increased expression of perivascular lymphocytes. The use of spacers in two-stage revision for infection probably induces an immunomodulation of synovial tissues. Cite this article: Bone Joint J 2016;98-B:1062-8.
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Artroplastia de Reemplazo de Cadera/métodos , Artroplastia de Reemplazo de Rodilla/métodos , Cementos para Huesos/farmacología , Polimetil Metacrilato/farmacología , Infecciones Relacionadas con Prótesis/inmunología , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Antígenos CD/metabolismo , Células Dendríticas/inmunología , Femenino , Prótesis de Cadera , Humanos , Inmunomodulación/efectos de los fármacos , Inmunomodulación/inmunología , Interleucina-17/metabolismo , Prótesis de la Rodilla , Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Osteoartritis de la Cadera/inmunología , Osteoartritis de la Cadera/cirugía , Osteoartritis de la Rodilla/inmunología , Osteoartritis de la Rodilla/cirugía , Reoperación , Membrana Sinovial/inmunologíaAsunto(s)
Patología/tendencias , Investigación/tendencias , Sociedades Médicas/tendencias , Predicción , Alemania , HumanosRESUMEN
BACKGROUND: The aim of the current study was to investigate the role of BRCA1 promoter methylation as predictive factor of response to platinum-taxane-based therapy in sporadic ovarian cancer. PATIENTS AND METHODS: BRCA1 promoter methylation was analyzed in 42 sporadic epithelial ovarian cancers. The results were validated in a second cohort of 137 ovarian cancer patients. RESULTS: BRCA1 promoter methylation was observed in 35.7 % of patients in the first group and in 33.6 % in the second group. BRCA1 promoter methylation was associated with significant increase in median progression-free survival (PFS) of ovarian cancer patients receiving adjuvant platinum-taxane-based chemotherapy (P = 0.008). Multivariate analysis revealed that BRCA1 promoter methylation remains a favorable factor in regard to PFS (HR 0.52; 95 % CI 0.32-0.85, P = 0.009) after adjustment for other prognostic factors. Under the patients with recurrent disease, BRCA1 promoter methylation was associated with significant longer median PFS of 18.5 months in comparison with 12.8 months PFS for patients without BRCA1 promoter methylation. CONCLUSIONS: BRCA1 promoter methylation is predictive for better response to platinum-taxane-based therapy in EOC.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Proteína BRCA1/genética , Biomarcadores de Tumor/genética , Neoplasias Glandulares y Epiteliales/tratamiento farmacológico , Neoplasias Glandulares y Epiteliales/genética , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/genética , Regiones Promotoras Genéticas/genética , Adulto , Anciano , Anciano de 80 o más Años , Hidrocarburos Aromáticos con Puentes/administración & dosificación , Carcinoma Epitelial de Ovario , Supervivencia sin Enfermedad , Femenino , Humanos , Metilación/efectos de los fármacos , Persona de Mediana Edad , Compuestos Organoplatinos/administración & dosificación , Pronóstico , Taxoides/administración & dosificación , Adulto JovenRESUMEN
The aim of the current study was to investigate the role of BRCA1 gene aberrations in sporadic triple-negative breast cancer (TNBC) and its impact on anthracycline-based therapy. BRCA1 promoter methylation was analyzed in 70 TNBC and compared with the clinical and pathologic characteristics. As a control group, we used 70 patients with non-TNBC. BRCA1 promoter methylation was observed in 65.2 % of patients and was similar in both groups. BRCA1 promoter methylation was associated with decreased intensity of BRCA1 protein expression (P = 0.002) and significant increase of median disease-free survival (DFS) of TNBC patients receiving adjuvant anthracycline-based chemotherapy (P = 0.001). Multivariate analysis revealed that BRCA1 promoter methylation remains a favorable factor in regard to DFS (HR 0.224; 95 % CI 0.092-0.546, P = 0.001) in TNBC after adjustment for other prognostic factors. In contrast, in non-TNBC, BRCA1 promoter methylation was not associated with any clinical and pathologic parameters. BRCA1 promoter methylation is a common mechanism of BRCA1 gene aberration in sporadic breast cancer and is predictive for better response to anthracycline-based therapies.
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Proteína BRCA1/genética , Metilación de ADN , Regiones Promotoras Genéticas , Neoplasias de la Mama Triple Negativas/genética , Adulto , Anciano , Anciano de 80 o más Años , Antraciclinas/uso terapéutico , Antineoplásicos/uso terapéutico , Proteína BRCA1/metabolismo , Femenino , Humanos , Metástasis Linfática , Persona de Mediana Edad , Mutación , Clasificación del Tumor , Pronóstico , Resultado del Tratamiento , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Neoplasias de la Mama Triple Negativas/mortalidad , Neoplasias de la Mama Triple Negativas/patología , Carga TumoralRESUMEN
UNLABELLED: â¼HISTORY AND ADMISSION FI NDINGS: A 61-year-old woman presented with a 2-month-history of progressive deterioration, increasing exertional dyspnoea and pain in the right upper abdomen (past medical history: bronchial asthma and hypertension). The physical examination showed mild generalized weakness, tenderness in the right upper abdomen, and ascites. INVESTIGATIONS: Laboratory studies did not reveal any hormonal abnormalities. A CT angiogram revealed a mass of the right adrenal gland with distinct invasion into the inferior vena cava, and tumour thrombosis that extended proximally into the right atrium. Distally, the tumour ended at the caudate lobe of the liver with an extensive peripherally engulfed thrombus from the inferior vena cava down to the common iliac -veins. TREATMENT AND COURSE: An open right adrenalectomy with resection of the periadrenal tissue and exstirpation of the intracaval tumour thrombus (by cavotomy under digital occlusion of the blood flow from the vena cava into the right atrium - cardiac surgeon) was carried out with no significant postoperative complications. Subsequently, the patient underwent adjuvant mitotane therapy for 3 years. So far, no recurrence has occurred during a course of 7 years. CONCLUSION: Tumour induced thrombotic occlusion of the inferior vena cava and other veins is rare, especially with right atrium involvement. In the absence of other effective treatment options, the combination of radical resection and adjuvant mitotane therapy remains the only successful curative treatment for primary invasive pararenal gland carcinoma.
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Neoplasias de la Corteza Suprarrenal/patología , Neoplasias de la Corteza Suprarrenal/cirugía , Conducta Cooperativa , Comunicación Interdisciplinaria , Células Neoplásicas Circulantes/patología , Vena Cava Inferior/patología , Vena Cava Inferior/cirugía , Neoplasias de la Corteza Suprarrenal/irrigación sanguínea , Neoplasias de la Corteza Suprarrenal/tratamiento farmacológico , Adrenalectomía/métodos , Angiografía , Quimioterapia Adyuvante , Terapia Combinada , Diagnóstico Diferencial , Embolectomía/métodos , Femenino , Humanos , Escisión del Ganglio Linfático , Persona de Mediana Edad , Mitotano/efectos adversos , Mitotano/uso terapéutico , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Pronóstico , Arteria Renal/patología , Arteria Renal/cirugía , Tomografía Computarizada por Rayos XRESUMEN
HISTORY AND ADMISSION FINDINGS: A 61-year-old woman presented with a 2-month-history of progressive deterioration, increasing exertional dyspnoea and pain in the right upper abdomen (past medical history: bronchial asthma and hypertension). The physical examination showed mild generalized weakness, tenderness in the right upper abdomen, and ascites. INVESTIGATIONS: Laboratory studies did not reveal any hormonal abnormalities. A CT angiogram revealed a mass of the right adrenal gland with distinct invasion into the inferior vena cava, and tumour thrombosis that extended proximally into the right atrium. Distally, the tumour ended at the caudate lobe of the liver with an extensive peripherally engulfed thrombus from the inferior vena cava down to the common iliac veins. TREATMENT AND COURSE: An open right adrenalectomy with resection of the periadrenal tissue and extirpation of the intracaval tumour thrombus (by cavotomy under digital occlusion of the blood flow from the vena cava into the right atrium) was carried out with no significant postoperative complications. Subsequently, the patient underwent adjuvant mitotane therapy for three years. So far, no recurrence has occurred during a course of 7 years. CONCLUSION: Tumour induced thrombotic occlusion of the inferior vena cava and other veins is rare, especially with right atrium involvement. In the absence of other effective treatment options, the combination of radical resection and adjuvant mitotane therapy remains the only successful curative treatment for primary invasive adrenal gland carcinoma.
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Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Conducta Cooperativa , Atrios Cardíacos/patología , Comunicación Interdisciplinaria , Células Neoplásicas Circulantes/patología , Trombosis/diagnóstico , Trombosis/patología , Vena Cava Inferior/patología , Neoplasias de las Glándulas Suprarrenales/tratamiento farmacológico , Neoplasias de las Glándulas Suprarrenales/cirugía , Quimioterapia Adyuvante , Terapia Combinada , Femenino , Estudios de Seguimiento , Venas Hepáticas/patología , Humanos , Vena Ilíaca/patología , Persona de Mediana Edad , Invasividad Neoplásica , Estadificación de Neoplasias , Trombosis/cirugía , Tomografía Computarizada por Rayos X , Vena Cava Inferior/cirugíaRESUMEN
PURPOSE: Irreversible electroporation (IRE) is a novel nonthermal tissue ablation technique by high current application leading to apoptosis without affecting extracellular matrix. Previous results of renal IRE shall be supplemented by functional MRI and differentiated histological analysis of renal parenchyma in a chronic treatment setting. METHODS: Three swine were treated with two to three multifocal percutaneous IRE of the right kidney. MRI was performed before, 30 min (immediate-term), 7 days (short-term), and 28 days (mid-term) after IRE. A statistical analysis of the lesion surrounded renal parenchyma intensities was made to analyze functional differences depending on renal part, side and posttreatment time. Histological follow-up of cortex and medulla was performed after 28 days. RESULTS: A total of eight ablations were created. MRI showed no collateral damage of surrounded tissue. The highest visual contrast between lesions and normal parenchyma was obtained by T2-HR-SPIR-TSE-w sequence of DCE-MRI. Ablation zones showed inhomogeneous necroses with small perifocal edema in the short-term and sharp delimitable scars in the mid-term. MRI showed no significant differences between adjoined renal parenchyma around ablations and parenchyma of untreated kidney. Histological analysis demonstrated complete destruction of cortical glomeruli and tubules, while collecting ducts, renal calyxes, and pelvis of medulla were preserved. Adjoined kidney parenchyma around IRE lesions showed no qualitative differences to normal parenchyma of untreated kidney. CONCLUSIONS: This porcine IRE study reveals a multifocal renal ablation, while protecting surrounded renal parenchyma and collecting system over a mid-term period. That offers prevention of renal function ablating centrally located or multifocal renal masses.
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Electroporación/métodos , Riñón/patología , Animales , Apoptosis , Imagen por Resonancia Magnética/métodos , Masculino , Modelos Animales , PorcinosRESUMEN
Barrett's esophagus (BE) is one of the most common premalignant lesions in which normal squamous epithelium of the esophagus is replaced by metaplastic columnar epithelium. Esophageal adenocarcinoma (EA) develops through progression from BE to low- and high-grade dysplasia (LGD/HGD) and to adenocarcinoma. It is widely accepted that inflammation can increase cancer risk, promoting tumor progression. Therefore, inflammation is regarded as the seventh hallmark of cancer. In recent years, the inflammation-cancer connection of Barrett's carcinogenesis has been intensively studied, unraveling genetic abnormalities. Besides genetic alterations, inflammation is also epigenetically linked to loss of protein expression through transcriptional silencing via promoter methylation. Key mediators linking inflammation and Barrett's carcinogenesis include reactive oxygen species (ROS), NFκB, inflammatory cytokines, prostaglandins, and specific microRNAs (miRNAs). Therefore, the decipherment of molecular pathways that contain these and novel inflammatory key mediators is of major importance for diagnosis, therapy, and prognosis. The detailed elucidation of the signaling molecules involved in Barrett's carcinogenesis will be important for the development of pharmaceutical inhibitors. We herein give an overview of the current knowledge of the inflammation-mediated genetic and epigenetic alterations involved in Barrett's carcinogenesis. We highlight the role of oxidative stress and deregulated DNA damage checkpoints besides the NFκB pathway.
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Adenocarcinoma/diagnóstico , Esófago de Barrett/diagnóstico , Neoplasias Esofágicas/diagnóstico , Esofagitis Péptica/patología , Esófago/patología , Reflujo Gastroesofágico/diagnóstico , Adenocarcinoma/genética , Adenocarcinoma/metabolismo , Esófago de Barrett/genética , Esófago de Barrett/metabolismo , Daño del ADN , Progresión de la Enfermedad , Epigénesis Genética , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/metabolismo , Esofagitis Péptica/genética , Esofagitis Péptica/metabolismo , Esófago/metabolismo , Reflujo Gastroesofágico/genética , Reflujo Gastroesofágico/metabolismo , Humanos , FN-kappa B/metabolismo , Estrés Oxidativo , Especies Reactivas de OxígenoRESUMEN
We investigated the methylation status of mismatch repair gene hMLH1 in 80 primary human endometrial carcinomas (ECs) and in 30 metastatic lesions. It was correlated to the expression of hMLH1 protein, microsatellite instability (MSI) of ECs and to the well-known clinico-pathological variables of cancer. The hMLH1 promoter methylation was detected in 24 out of 64 (37.5 %) primary ECs but only in one out of 18 (5.6 %) metastatic lesions investigated. Promoter hMLH1 hypermethylation was found more often in early stage ECs and was associated with a decrease of hMLH1 protein expression immunohistochemically. An inverse relationship between hMLH1 expression and clinical stage of the disease was found (p = 0.048). Interestingly, there was a significant correlation between MSI and hMLH1 protein expression level (p = 0.042). MSI phenotype was found more often in EC metastases compared to the primary tumors (66.7 % vs 29.3 %; p = 0.039). However, neither hMLH1 promoter hypermethylation nor MSI was independent predictive factors for patient's outcome. Using an in vitro model we showed that hMLH1 methylation is reversible. These data showed that hMLH1 methylation with a consequent protein decrease occurred early during EC tumorigenesis and may cause a MSI phenotype, which occurs relatively late. MSI may be an important mechanism supporting further the tumor progression. These findings may have importance for the specific chemosensitization of the primary tumors/metastases and can improve our understanding of endometrial carcinogenesis in humans.
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Proteínas Adaptadoras Transductoras de Señales/metabolismo , Metilación de ADN , Enzimas Reparadoras del ADN/metabolismo , Neoplasias Endometriales/genética , Neoplasias Endometriales/patología , Inestabilidad de Microsatélites , Metástasis de la Neoplasia/genética , Proteínas Nucleares/metabolismo , Proteínas Adaptadoras Transductoras de Señales/genética , Adulto , Anciano , Anciano de 80 o más Años , Azacitidina/farmacología , Línea Celular Tumoral , Metilación de ADN/efectos de los fármacos , Reparación del ADN , Enzimas Reparadoras del ADN/genética , ADN de Neoplasias/genética , ADN de Neoplasias/metabolismo , Neoplasias Endometriales/metabolismo , Neoplasias Endometriales/mortalidad , Femenino , Humanos , Repeticiones de Microsatélite/genética , Persona de Mediana Edad , Homólogo 1 de la Proteína MutL , Clasificación del Tumor , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/metabolismo , Proteínas Nucleares/genética , Fenotipo , Pronóstico , Regiones Promotoras GenéticasRESUMEN
The project Pathowiki (www.pathowiki.org) is a free expert database for texts, images, virtual slides and links to all subject areas of pathology in the internet. The aim of this project is to integrate all available information and media, in particular virtual microscopy, to achieve a fast overview of a relevant subject area. Here we present the project's basic functions and applications and evaluate the project with respect to the ongoing digital developments in pathology.
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Bases de Datos como Asunto/organización & administración , Sistemas Especialistas , Internet/organización & administración , Patología/organización & administración , Instrucción por Computador , Curriculum , Educación Médica Continua , Alemania , Humanos , Patología/educación , Interfaz Usuario-ComputadorRESUMEN
Glioblastomas are known to be highly chemoresistant, but HDAC inhibitors (HDACi) have been shown to be of therapeutic relevance for this aggressive tumor type. We treated U87 glioblastoma cells with trichostatin A (TSA) to define potential epigenetic targets for HDACi-mediated antitumor effects. Using a cDNA array analysis covering 96 cell cycle genes, cyclin-dependent kinase inhibitor p21(WAF1) was identified as the major player in TSA-induced cell cycle arrest. TSA slightly inhibited proliferation and viability of U87 cells, cumulating in a G1/S cell cycle arrest. This effect was accompanied by a significant up-regulation of p53 and its transcriptional target p21(WAF1) and by down-regulation of key G1/S regulators, such as cdk4, cdk6, and cyclin D1. Nevertheless, TSA did not induce apoptosis in U87 cells. As expected, TSA promoted the accumulation of total acetylated histones H3 and H4 and a decrease in endogenous HDAC activity. Characterizing the chromatin modulation around the p21(WAF1) promoter after TSA treatment using chromatin immunoprecipitation, we found (1) a release of HDAC1, (2) an increase of acetylated H4 binding, and (3) enhanced recruitment of p53. p53-depleted U87 cells showed an abrogation of the G1/S arrest and re-entered the cell cycle. Immunofluorescence staining revealed that TSA induced the nuclear translocation of p21(WAF1) verifying a cell cycle arrest. On the other hand, a significant portion of p21(WAF1) was present in the cytoplasmic compartment causing apoptosis resistance. Furthermore, TSA-treated p53-mutant cell line U138 failed to show an induction in p21(WAF1), showed a deficient G2/M checkpoint, and underwent mitotic catastrophe. We suggest that HDAC inhibition in combination with other clinically used drugs may be considered an effective strategy to overcome chemoresistance in glioblastoma cells.
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Apoptosis/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Glioblastoma/metabolismo , Inhibidores de Histona Desacetilasas/farmacología , Ácidos Hidroxámicos/farmacología , Proteína p53 Supresora de Tumor/metabolismo , Antineoplásicos/farmacología , Línea Celular Tumoral , Inmunoprecipitación de Cromatina , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/genética , Inhibidor p21 de las Quinasas Dependientes de la Ciclina/metabolismo , Citometría de Flujo , Técnica del Anticuerpo Fluorescente , Perfilación de la Expresión Génica , Glioblastoma/genética , Humanos , Immunoblotting , Análisis de Secuencia por Matrices de Oligonucleótidos , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Proteína p53 Supresora de Tumor/genéticaRESUMEN
Metallic orthopedic devices are composed of elements known to be skin sensitizers in the general population and metal-on-metal hip prostheses in particular have the theoretical advantage of producing less abrasive wear than metal-on-polyethylene prostheses. However, there is concern about the possibility of hypersensitivity reactions with typical elicitors, such as nickel, chromium or cobalt. These materials are also used for total knee arthroplasty (TKA) and may elicit an immune response the role of which is still unclear in the outcome of arthroplasty. The immune response is dominated by perivascular T and B lymphocyte tissue infiltration around the hip replacement. The infiltrates are mostly surrounded by so-called high endothelial venules. This reaction is associated with periprosthetic osteolysis and aseptic loosening of the prostheses. The differentiation of hypersensitivity and low-grade infection is initially a diagnosis by exclusion using aspiration cultures. The final diagnosis is only resolved by histological investigation of synovial tissue. A close cooperation between orthopedic surgeons, pathologists and microbiologists is necessary to diagnose specific cellular differences in hypersensitivity and infection in tissue investigations.
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Infecciones Bacterianas/diagnóstico , Hipersensibilidad/diagnóstico , Hipersensibilidad/etiología , Metales/efectos adversos , Infecciones Relacionadas con Prótesis/diagnóstico , Diagnóstico Diferencial , Humanos , Hipersensibilidad/prevención & controlRESUMEN
Biopsies and resection specimens of the gastrointestinal tract are a major part of the routine workload in many histopathology departments, whereby polypoid lesions are generally the main focus. In addition to distinguishing non-neoplastic from neoplastic polyps and evaluating the grade of dysplasia of the latter, the pathologist should always consider the possibility of an underlying polyposis syndrome. Not only have additional hereditary polyposis syndromes been identified in recent years due to a better understanding of their genetic and epigenetic alterations but also knowledge on well known polyposes has improved, leading to subtyping of various forms according to their different genotype. It is essential for the histopathologist to understand that the conventional histomorphology of individual polyps combined with information on the number and distribution of these lesions and clinical data can provide clues regarding a possible hereditary background. Therefore, the correct histological assessment of polyps is not just about getting the diagnosis right, it might also lead to genetic screening of family members and spouses.
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Poliposis Adenomatosa del Colon/patología , Poliposis Adenomatosa del Colon/clasificación , Poliposis Adenomatosa del Colon/genética , Proteína de la Poliposis Adenomatosa del Colon/genética , Adolescente , Adulto , Niño , Preescolar , Cromosomas Humanos Par 5/genética , Colonoscopía , Conducta Cooperativa , ADN Glicosilasas/genética , Análisis Mutacional de ADN , Diagnóstico Diferencial , Pruebas Genéticas , Humanos , Lactante , Comunicación Interdisciplinaria , Mucosa Intestinal/patología , Poliposis Intestinal/congénito , Poliposis Intestinal/genética , Poliposis Intestinal/patología , Síndromes Neoplásicos Hereditarios , Grupo de Atención al Paciente , Síndrome de Peutz-Jeghers/genética , Síndrome de Peutz-Jeghers/patología , Adulto JovenRESUMEN
In contrast to normal cartilage, which is avascular, angiogenesis is characteristic of cartilage tumors. In this review, we outline the basic principles of angiogenesis with regard to recent findings on differential morphological and molecular aspects of angiogenesis in cartilage tumors, including enchondromas, conventional chondrosarcomas and dedifferentiated chondrosarcomas. Furthermore, we describe the effects of hypoxia and interleukin-1ß on angiogenic signaling in chondrosarcoma cells.
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Neoplasias Óseas/irrigación sanguínea , Neoplasias Óseas/patología , Enfermedades de los Cartílagos/patología , Cartílago/irrigación sanguínea , Condroma/irrigación sanguínea , Condroma/patología , Condrosarcoma/irrigación sanguínea , Condrosarcoma/patología , Neovascularización Patológica/patología , Hipoxia de la Célula/fisiología , Humanos , Interleucina-1beta/fisiología , Transducción de Señal , Factor A de Crecimiento Endotelial Vascular/fisiologíaRESUMEN
BACKGROUND: The best known clinical picture of a one-sided necrotisising, infectious tonsillitis is the by Plaut and Vincent (1894) described angina Plaut-Vincent. In addition to this fusospirochetosis it is in case of necrotisising inflammations in the oropharynx differential-diagnostically important to consider also the anaerobic type Prevotella, especially Prevotella disiens as a potential trigger . MATERIAL AND METHODS: Because the clinical course forms of a necrotisising oropharyngeal inflammations can be very different and complicate so a suitable diagnosis, it is very important to get a complete and perfect cause proof. For getting this proof a correct test production, transport and cultivation are of extreme importance . RESULTS: The type Prevotella consists of different species gram-negative, obligate anaerobic strains. They are regarded as a cause of suppurating inflammations and abscesses of the genital tract and are components of the aerobic anaerobic mixed flora in case of gingival infections. The sole proof in the microbiological culture as a smear test result of a one-sided necrotisising tonsillitis has to be seen as a first description by reason of missing literature . IMPLICATION: As triggers for one-sided necrotisising tonsillitis are considered different causes. Next a carcinoma of the tonsil, Lues, Angina Plaut-Vincent have to be excluded. An infection with Prevotella disiens is an extremely rare variation in contrast. However, the transmission is possible by insufficient hygiene, lack phenomena and sexual intercourse and to consider therefore as an exclusion diagnosis.
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Infecciones Bacterianas/diagnóstico , Tonsila Palatina/patología , Tonsilitis/diagnóstico , Antibacterianos/uso terapéutico , Infecciones Bacterianas/patología , Infecciones Bacterianas/terapia , Técnicas Bacteriológicas , Infecciones por Bacteroidaceae/diagnóstico , Infecciones por Bacteroidaceae/patología , Infecciones por Bacteroidaceae/terapia , Diagnóstico Diferencial , Infecciones por Fusobacterium/diagnóstico , Infecciones por Fusobacterium/patología , Infecciones por Fusobacterium/terapia , Gingivitis Ulcerosa Necrotizante/diagnóstico , Gingivitis Ulcerosa Necrotizante/patología , Gingivitis Ulcerosa Necrotizante/terapia , Humanos , Necrosis , Úlceras Bucales/diagnóstico , Prevotella , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/patología , Tonsilectomía , Tonsilitis/patología , Tonsilitis/terapiaRESUMEN
BACKGROUND: Despite its rare occurrence, inflammatory myofibroblastic pseudotumour (IMT) is relevant in the differential diagnosis of intestinal lesions. By the mean of an extraordinary case report, tumour site and specific characteristics, finding of the correct diagnosis, therapeutic management, and outcome of extrapulmonary IMT is decribed based also on relevant references from the literature. CASE REPORT: A 39-year old man experienced a multifocal thoracic recurrence and abdominal metastasis of IMT 12 years after successful primary resection of pulmonary IMT. The intra-abdominal lesion localised in the jejunal mesenteric tissue was removed surgically (resection status, R 0) by segmental resection of the mid-jejunum (length: 80 cm) followed by jejunojejunostomy. Histology evaluation confirmed IMT. Thoracic surgeons advised against a surgical approach to the pulmonary and thoracic lesions because of their number and proximity to the superior vena cava as well as mediastinal infiltration. Despite receiving repeated advice from his physicians, the patient has not agreed to combined immunosuppressive treatment with cyclophosphamide and steroids, because of his desire for children. He underwent 5 months of systemic steroid treatment, starting in the third postoperative month, which he then chose to stop because of Cushing symptomatology. He agreed to a computed tomography (CT) scan follow-up 12 months after surgery, which revealed slight local progression of the remaining pulmonary lesion. Administration of a second steroid medication was initiated at a lower dose. No further CT scans were obtained. At present, he is consulting with an alternative medicine practitioner. CONCLUSION: This report documents a rarely described case of IMT at a jejunal mesenteric tumour site, interpreted as an uncommon late and extraordinary, metastatic, multifocal recurrence found 12 years (!) after surgical resection of the primary pulmonary tumour.