Assuntos
Hérnia Abdominal/etiologia , Estomia/efeitos adversos , Gastropatias/etiologia , Descompressão , Feminino , Dilatação Gástrica/etiologia , Hérnia Abdominal/diagnóstico por imagem , Hérnia Abdominal/terapia , Humanos , Pessoa de Meia-Idade , Gastropatias/diagnóstico por imagem , Gastropatias/terapia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Acute severe pancreatitits may be complicated by the development of 'walled-off pancreatic necrosis' (WOPN), which is characterised by a mixture of solid components and fluids on imaging studies as a consequence of organised pancreatic tissue necrosis. We present here an overview of the definition, clinical features, and diagnostic and therapeutic management of this clinical condition, which is mostly based on consensus as adequate clinical trials are lacking.
Assuntos
Pâncreas/patologia , Pancreatite Necrosante Aguda/patologia , Doença Aguda , Consenso , Humanos , Pâncreas/cirurgia , Pancreatite Necrosante Aguda/cirurgia , PrognósticoRESUMO
A significant proportion of extracellular nucleic acids in plasma circulate highly protected in tumor-specific exosomes, but it is unclear how the release of exosomes is modulated in carcinogenesis. We quantified by cytometry exosomes in plasma of 91 colorectal cancer patients to evaluate their potential as a tumor indicator and their repercussions on diagnosis and prognosis. We examined the involvement of TSAP6, a TP53-regulated gene involved in the regulation of vesicular secretion, in levels of circulating exosomes in plasma of colorectal patients and in HCT116 TP53-(wild-type and null) human colorectal cancer cell lines. The fraction of exosomes in cancer patients was statistically higher than in healthy controls (mean rank » 53.93 vs. 24.35). High levels of exosomes in plasma of patients correlated with high levels of carcino-embryonic antigen (P » 0.029) and with poorly differentiated tumors (P » 0.039) and tended to have shorter overall survival than patients with low levels (P » 0.056). Release of exosomes did not correlate with TSAP6 expression; and regulation of TSAP6 by TP53 was not shown either in tumor samples or in HCT116 cell lines. Although it was not suggested that the TP53/TSAP6 pathway regulates the release of exosomes into the plasma of colorectal cancer patients, the level of circulating exosomes may be used as a tumor indicator, because it correlates with poor prognosis parameters and shorter survival.
Assuntos
Neoplasias Colorretais/sangue , Exossomos/metabolismo , Biomarcadores Tumorais , Antígeno Carcinoembrionário/biossíntese , Antígeno Carcinoembrionário/sangue , Proteínas de Ciclo Celular , Diferenciação Celular , Linhagem Celular Tumoral , Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Exossomos/genética , Feminino , Genes p53 , Células HCT116 , Humanos , Masculino , Proteínas Oncogênicas/genética , Proteínas Oncogênicas/metabolismo , Oxirredutases , Prognóstico , RNA Mensageiro/biossíntese , Vesículas Secretórias/metabolismo , Proteína Supressora de Tumor p53/metabolismoRESUMO
Angiomyolipoma of the liver (AML) is an infrequent neoplasm composed of three tissues (adipose, muscle and vessels). In spite of advances in radiology, preoperative correct diagnosis is difficult. Clasically, a conservative management strategy was adopted in patients with asymptomatic tumors less than 5 cm with undoubtful diagnosis. But after publishing some few cases of malignant angiomyolipoma a more radical has been advocated. Laparoscopic resection of liver tumors is becoming a excellent approach for operating on benign liver tumors. Usually is performed using five trocars but in some cases a less invasive technique with three trocars could be used. We present a laparoscopic resection of liver angiomyolipoma in a 65 year-old male using only three trocars and also discuss the optimal management of AML and technical tips of three-trocar technique.
