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2.
World J Clin Cases ; 7(18): 2888-2893, 2019 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-31616707

RESUMO

BACKGROUND: Takayasu arteritis is a rare but intractable chronic disease in young female patients. Percutaneous transluminal angioplasty of the involved renal arteries has been reported; however, few studies have reported the use of drug coated balloon angioplasty in the treatment of Takayasu arteritis. We aimed to demonstrate five young female patients who presented with a history of hypertension due to Takayasu arteritis. CASE SUMMARY: From April 2017 to October 2018, five female patients were diagnosed with hypertension due to Takayasu arteritis by computed tomography angiography (CTA) and laboratory tests. Four patients had a complaint of headache with or without dizziness, and one patient showed no symptom. There was no significant family or past history of hypertension or kidney disease, and the physical examinations were almost normal on admission. We performed a treatment by drug coated balloon angioplasty. Blood pressure decreased dramatically in all patients after balloon angioplasty, and the patency of treated renal artery was demonstrated with CTA over 5 months after the angioplasty procedure. CONCLUSION: Drug coated balloon angioplasty is safe and effective for renal artery stenosis due to Takayasu arteritis. A prospective study with a larger sample size is necessary to further demonstrate the effectiveness of the treatment.

3.
J Vasc Surg Cases Innov Tech ; 5(2): 183-186, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31193596

RESUMO

Graft aneurysm after ascending aorta to abdominal aorta bypass is a rare complication of repair of coarctation of the aorta. We present a case of an aneurysm measuring 75 mm in diameter at the midportion of the prosthetic graft in a 33-year-old man. To prevent aneurysm rupture, redo ascending-to-abdominal aortic bypass was performed through an upper ministernotomy and upper midline laparotomy. No postoperative complications occurred. The patient was successfully discharged on postoperative day 6. Although ascending-to-abdominal aortic bypass can achieve long-term patency, the prosthetic graft still has the rare risk of aneurysm formation, as highlighted in this case. Early diagnosis and timely management of this rare complication are essential in preventing aneurysm rupture.

4.
Am J Physiol Lung Cell Mol Physiol ; 315(5): L653-L661, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30091378

RESUMO

Acute respiratory distress syndrome (ARDS) is characterized by unrelenting polymorphonuclear neutrophil (PMN) inflammation and vascular permeability. The matrikine proline-glycine-proline (PGP) and acetylated PGP (Ac-PGP) have been shown to induce PMN inflammation and endothelial permeability in vitro and in vivo. In this study, we investigated the presence and role of airway PGP peptides in acute lung injury (ALI)/ARDS. Pseudomonas aeruginosa-derived lipopolysaccharide (LPS) was instilled intratracheally in mice to induce ALI, and increased Ac-PGP with neutrophil inflammation was noted. The PGP inhibitory peptide, arginine-threonine-arginine (RTR), was administered (it) 30 min before or 6 h after LPS injection. Lung injury was evaluated by detecting neutrophil infiltration and permeability changes in the lung. Pre- and posttreatment with RTR significantly inhibited LPS-induced ALI by attenuating lung neutrophil infiltration, pulmonary permeability, and parenchymal inflammation. To evaluate the role of PGP levels in ARDS, minibronchoalveolar lavage was collected from nine ARDS, four cardiogenic edema, and five nonlung disease ventilated patients. PGP levels were measured and correlated with Acute Physiology and Chronic Health Evaluation (APACHE) score, P a O 2 to FIO2 (P/F), and ventilator days. PGP levels in subjects with ARDS were significantly higher than cardiogenic edema and nonlung disease ventilated patients. Preliminary examination in both ARDS and non-ARDS populations demonstrated PGP levels significantly correlated with P/F ratio, APACHE score, and duration on ventilator. These results demonstrate an increased burden of PGP peptides in ARDS and suggest the need for future studies in ARDS cohorts to examine correlation with key clinical parameters.


Assuntos
Inflamação/etiologia , Lesão Pulmonar/etiologia , Infiltração de Neutrófilos/imunologia , Neutrófilos/imunologia , Oligopeptídeos/metabolismo , Prolina/análogos & derivados , Síndrome do Desconforto Respiratório do Adulto/etiologia , Adulto , Animais , Permeabilidade Capilar , Estudos de Casos e Controles , Feminino , Humanos , Inflamação/metabolismo , Inflamação/patologia , Lesão Pulmonar/metabolismo , Lesão Pulmonar/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Neutrófilos/metabolismo , Neutrófilos/patologia , Prolina/metabolismo , Síndrome do Desconforto Respiratório do Adulto/metabolismo , Síndrome do Desconforto Respiratório do Adulto/patologia
5.
Exp Cell Res ; 359(2): 356-360, 2017 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-28803067

RESUMO

Lung cancer remains a leading cause of cancer-related mortality, with metastatic progression remaining the single largest cause of lung cancer mortality. Hence it is imperative to determine reliable biomarkers for lung cancer prognosis. We performed quantitative real-time PCR (qRT-PCR) analysis to explore epithelial-mesenchymal transition (EMT) inducers that regulate EMT process in three patients with advanced lung cancer disease. Peroxisome proliferator-activated receptor gamma (PPARGC1A) was uniformly the topmost overexpressed gene in all three human non-small cell lung cancer (NSCLC) patient samples. Further evaluation in human normal lung and metastatic lung cancer cell lines revealed that the expression of PPARGC1A was upregulated in metastatic lung cancer cell lines. Metagenomic analysis revealed direct correlation among PPARGC1A, zinc-finger transcription factor snail homolog 1 (SNAI1), and metastatic lung disease. Upregulation of PPARGC1A transcript expression was independent of a differential upregulation of the upstream AMP-dependent protein kinase (AMPK) activation or steady state expression of the silent mating type information regulation 2 homolog 1 (SIRT1). Xenograft tail vein colonization assays proved that the high expression of PPARGC1A was a prerequisite for metastatic progression of lung cancer to brain. Our results indicate that PPARGC1A might be a potential biomarker for lung cancer prognosis.


Assuntos
Biomarcadores Tumorais/genética , Neoplasias Encefálicas/genética , Carcinoma Pulmonar de Células não Pequenas/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Pulmonares/genética , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/genética , Fatores de Transcrição da Família Snail/genética , Proteínas Quinases Ativadas por AMP/genética , Proteínas Quinases Ativadas por AMP/metabolismo , Animais , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/secundário , Carcinoma Pulmonar de Células não Pequenas/metabolismo , Carcinoma Pulmonar de Células não Pequenas/secundário , Linhagem Celular , Linhagem Celular Tumoral , Transição Epitelial-Mesenquimal , Feminino , Perfilação da Expressão Gênica , Humanos , Pulmão/metabolismo , Pulmão/patologia , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Camundongos , Camundongos Nus , Estadiamento de Neoplasias , Transplante de Neoplasias , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Transdução de Sinais , Sirtuína 1/genética , Sirtuína 1/metabolismo , Fatores de Transcrição da Família Snail/metabolismo , Ativação Transcricional
6.
Sci Rep ; 6: 31848, 2016 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-27545810

RESUMO

Odorant binding proteins (OBPs) play critical roles in chemical communication of insects, as they recognize and transport environmental chemical signals to receptors. The diving beetle Cybister japonicus Sharp shows a remarkable sexual dimorphism. The foreleg tarsi of males are equipped with large suction cups, believed to help holding the female during underwater courtship and mating. Here, we identified two OBPs highly and specifically expressed in male tarsi, suggesting important functions of these structures in chemical communication. The first protein, CjapOBP1, exhibits the 6 conserved cysteines motif of classic OBPs, while the second, CjapOBP2, contains only four cysteines and can be assigned to the sub-class of C-minus OBPs. Both proteins were expressed in a bacterial system and the purified recombinant proteins were used to for antibodies preparation. Western Blot analysis showed that CjapOBP1 is predominantly expressed in male tarsi and could be also detected in antennae and palpi of both sexes, while CjapOBP2, besides male tarsi, is also present in testis. Ligand-binding experiments showed a good binding affinity between CjapOBP1, CjapOBP2 and citral and coniferyl aldehyde, respectively. These results support a possible function of these two OBPs in the male foreleg tarsi of diving beetles in chemical communication.


Assuntos
Clonagem Molecular/métodos , Besouros/fisiologia , Receptores Odorantes/genética , Receptores Odorantes/metabolismo , Motivos de Aminoácidos , Animais , Antenas de Artrópodes/metabolismo , Besouros/metabolismo , Feminino , Proteínas de Insetos/química , Proteínas de Insetos/genética , Proteínas de Insetos/metabolismo , Masculino , Modelos Moleculares , Especificidade de Órgãos , Filogenia , Receptores Odorantes/química , Caracteres Sexuais , Comportamento Sexual Animal , Testículo/metabolismo
7.
Asian Pac J Cancer Prev ; 15(12): 4951-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24998570

RESUMO

PURPOSE: To investigate IQGAP1 and IQGAP2 expression in hepatocellular carcinoma (HCC) and itsassociation with HCC clinicopathological characteristics and survival outcomes. METHODS: IQGAP1 and IQGAP2 mRNA and protein were measured in HCC tissues, para-tumor tissues and normal tissues by RT-PCR and Western blotting. We further examined 150 HCC samples with adjacent para-tumor tissues and 11 normal specimens by immunohistochemistry to evaluate the correlation of IQGAP1 and IQGAP2 with clinicopathological features and prognosis. RESULTS: IQGAP1 mRNA and protein were up-regulated while IQGAP2 mRNA and protein were down-regulated in human HCC tissues compared with para-tumor and normal liver tissues (p<0.05). IQGAP1 expression was higher in primary HCC (122/150, 81.3%) than matched adjacent tissues (30/150, 20%, p<0.001), whereas IQGAP2 was lower (31/150, 20.7% as compared to 112/150, 74.7%, P<0.001). Positive IQGAP1 expression correlated with larger tumor size (p=0.002), advanced TNM stage (p=0.002) and tumor differentiation (III and IV, p=0.034). Negative IQGAP2 expression was significantly associated with larger tumor size (p=0.009), multicentric tumor occurrence (p=0.01), advanced TNM stage (0.009) and tumor differentiation (III and IV, p=0.020). Survival analysis revealed that patients with either IQGAP1+ or IQGAP2- tumors had significantly reduced disease-free survival (p<0.001 and 0.006 respectively) and overall survival (p<0.001 for both). Multivariate analysis showed that IQGAP1/2 switch was an independent prognosis factor for disease-free survival (HR=2.824) and overall survival (HR=2.189). CONCLUSION: Positive IQGAP1 and negative IQGAP2 expression were closely correlated with tumor progression and could be used as adjunctive biomarkers to improve prognostication for HCC patients.


Assuntos
Biomarcadores Tumorais/metabolismo , Carcinoma Hepatocelular/metabolismo , Neoplasias Hepáticas/metabolismo , Recidiva Local de Neoplasia/metabolismo , Proteínas Ativadoras de ras GTPase/metabolismo , Biomarcadores Tumorais/genética , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/secundário , Estudos de Casos e Controles , Progressão da Doença , Feminino , Seguimentos , Humanos , Técnicas Imunoenzimáticas , Fígado/metabolismo , Fígado/patologia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Taxa de Sobrevida , Proteínas Ativadoras de ras GTPase/genética
8.
Chin Med J (Engl) ; 126(10): 1890-4, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23673105

RESUMO

BACKGROUND: Chronic kidney disease (CDK) is a worldwide health problem, but there is currently no effective treatment that can completely cure this disease. Recently, studies with mesenchymal stem cells (MSCs) on treating various renal diseases have shown breakthroughs. This study is to observe the homing features of MSCs transplanted via kidney artery and effects on renal fibrosis in a reversible unilateral ureteral obstruction (R-UUO) model. METHODS: Thirty-six Balb/c mice were divided into UUO group, UUO-MSC group, and sham group randomly, with 12 mice in each group. The MSCs had been infected by a lentiviral vector to express stably the luciferase reporter gene and green fluorescence protein genes (Luc-GFP-MSC). Homing of MSCs was tracked using in vivo imaging system (IVIS) 1, 3, 14, and 28 days after transplantation. Imaging results were verified by detecting GFP expression in frozen section under a fluorescence microscope. E-cadherin, α-SMA, TGF-ß1, and TNF-α mRNA expression in all groups at 1 and 4 weeks after transplantation were analyzed by quantitative PCR. RESULTS: Transplanted Luc-GFP-MSCs showed increased Luciferase expression 3 days after transplantation. The expression decreased from 7 days, weakened thereafter and could not be detected 14 days after transplantation. Quantitative PCR results showed that all gene expressions in UUO group and UUO-MSC group at 1 week had no statistical difference, while at 4 weeks, except TGF-ß expression (P > 0.05), the expression of E-cadherin, α-SMA, and TNF-α in the above two groups have statistical difference (P < 0.01). CONCLUSION: IVIS enables fast, noninvasive, and intuitive tracking of MSC homing in vivo. MSCs can be taken home to kidney tissues of the diseased side in R-UUO model, and renal interstitial fibrosis can be improved as well.


Assuntos
Fibrose/patologia , Nefropatias/patologia , Transplante de Células-Tronco Mesenquimais/métodos , Obstrução Ureteral/terapia , Animais , Células Cultivadas , Fibrose/terapia , Nefropatias/terapia , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/fisiologia , Camundongos , Camundongos Endogâmicos BALB C , Reação em Cadeia da Polimerase em Tempo Real
9.
Oncol Lett ; 5(3): 749-755, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23426528

RESUMO

SMC1A (structural maintenance of chromosomes 1A), which encodes a structural subunit of the cohesin protein complex, is necessary for the process of sister chromatid cohesion during the cell cycle. Mutation and deregulation of SMC1A are highly relevant to diverse human diseases, including Cornelia de Lange syndrome and malignant carcinomas. In order to further investigate the role of SMC1A in the oncogenesis of lung cancer, SMC1A-specific short hairpin RNA (shRNA)-expressing lentivirus (Lv-shSMC1A) was constructed and used to infect A549 and H1299 cells. SMC1A mRNA and protein expression levels were downregulated in A549 and H1299 cells as demonstrated by real-time PCR and western blot assays. We found that SMC1A inhibition resulted in significantly impaired proliferation and colony formation as well as reduced invasiveness of tumor cells. Notably, Lv-shSMC1A-infected cancer cells exhibited a greater proportion of cells in the G0/G1 phase, but a lower proportion of S phase cells, compared to the parent or Lv-shCon infected cancer cells. Moreover, a greater proportion of sub-G1 apoptotic cells was observed in Lv-shSMC1A-infected cells. These results suggest that SMC1A is a novel proliferation regulator that promotes the growth of lung cancer cells, and that down-regulation of SMC1A expression induces growth suppression of A549 and H1299 cells via G1/S cell cycle phase arrest and apoptosis pathways. Therefore, SMC1A may serve as a new molecular target for lung cancer therapy.

10.
Pathol Oncol Res ; 19(2): 303-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23225158

RESUMO

The multiple myeloma SET domain (MMSET) involved in the t(4;14)(p16;q32) chromosomal translocation encodes a histone lysine methyltransferase. High expression of MMSET is common translocation in multiple myeloma (MM) and is associated with the worst prognosis. Recent studies have shown that overexpression of MMSET is significant in other tumor types compared to their normal tissues. However, little is known about its role in hepatocellular carcinoma (HCC). In these study we investigate the expression of MMSET in HCC and to make correlations with clinicopathologic features. Twenty-eight pairs of HCC and adjacent non-tumor tissues, and eight normal liver tissues were collected for MMSET detection by western blotting and real time-PCR analysis. Immunohistochemistry was used to determine the expression of MMSET in HCC and adjacent non-tumor tissues from 103 patients. Overexpression of MMSET was significantly associated with Edmondson stage, vascular invasion. Moreover, Kaplan-Meier curves showed that MMSET upregulated was associated with shorter overall survival and disease-free survival in HCC patient. In conclusion, our study demonstrates for the first time that overexpression of MMSET is an independent prognostic factor and is correlated with poor survival in HCC patients.


Assuntos
Carcinoma Hepatocelular/metabolismo , Histona-Lisina N-Metiltransferase/genética , Neoplasias Hepáticas/genética , Proteínas Repressoras/genética , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patologia , Intervalo Livre de Doença , Feminino , Seguimentos , Histona-Lisina N-Metiltransferase/biossíntese , Histona-Lisina N-Metiltransferase/metabolismo , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/metabolismo , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Proteínas Repressoras/biossíntese , Proteínas Repressoras/metabolismo , Regulação para Cima
11.
J Laparoendosc Adv Surg Tech A ; 22(3): 259-63, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22335570

RESUMO

PURPOSE: Exposing the recurrent laryngeal nerve (RLN) during all types of thyroid surgery is essential to protect this nerve. Endoscopic thyroidectomy (ET) has gained acceptance from both patients and physicians, in part due to the cosmetic benefits. Therefore, the avoidance of intraoperative RLN impairment during ET is of critical significance. We have developed a standard approach to expose the RLN during ET that prevents RNL impairment. PATIENTS AND METHODS: ET was performed in 120 consecutive patients with thyroid disease. In order to develop a standard procedure that protects the RLN, several steps that differed from the traditional open procedure were introduced. First, the thyroid gland was freed from the isthmus instead of the superior pole. Then, the inferior pole of the thyroid gland was meticulously freed, and the lateral side of the thyroid gland was freed followed by the superior pole. At this point, the RLN was easily visualized in the tracheoesophageal groove. The thyroidectomy was then performed simultaneously with exposure of the RLN from the inferior to superior aspects. All RLNs were exposed when hemithyroidectomies, subtotal thyroidectomies, or total thyroidectomies were performed. The operative time and parathyroid hormone (PTH) and calcium levels were recorded prospectively and analyzed. RESULTS: Using this method, all RLNs were easily exposed within 15 minutes. Only one case of transient RLN palsy occurred due to accidental contact of the harmonic scalpel to the nerve. Postoperative hypocalcemia occurred in 23 cases (19.2%), and the PTH level decreased significantly in 33 cases (27.5%). The PTH levels returned to normal within 3 months. CONCLUSION: Use of the described approach to expose and protect the RLN when performing ET is safe and feasible.


Assuntos
Endoscopia/métodos , Nervo Laríngeo Recorrente/cirurgia , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/métodos , Adulto , Idoso , Cálcio/sangue , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Fatores de Tempo , Resultado do Tratamento , Paralisia das Pregas Vocais/etiologia , Paralisia das Pregas Vocais/prevenção & controle
12.
Mol Cell Biochem ; 355(1-2): 27-33, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21519921

RESUMO

MED19 is a subunit of Mediator that is an essential component of RNA polymerase II-mediated transcription machinery. High expression levels of MED19 were examined in human lung adenocarcinoma tissues by immunohistochemical assay. MED19-specific short hairpin RNA (shRNA) expressing lentivirus was constructed and infected lung cancer cell line A549. MED19 mRNA and protein expression levels were downregulated in A549 cells as evidenced by real-time PCR and western blot assays. Importantly, MED19 inhibition resulted in impaired proliferation and colony formation, and induced accumulation of G1-phase cells and mitigated invasiveness of cells. More importantly, downregulation of MED19 expression reduced the tumorigenicity of A549 cells in vivo. It was suggested that MED19 is a novel proliferation regulator that promotes growth of lung cancer cells, thereby indicating that MED19 may serve as a new molecular target for lung cancer therapy.


Assuntos
Adenocarcinoma/metabolismo , Proliferação de Células , Transformação Celular Neoplásica , Neoplasias Pulmonares/metabolismo , Complexo Mediador/metabolismo , Adenocarcinoma/patologia , Animais , Estudos de Casos e Controles , Ciclo Celular , Linhagem Celular Tumoral , Feminino , Vetores Genéticos , Humanos , Lentivirus , Neoplasias Pulmonares/patologia , Complexo Mediador/genética , Camundongos , Camundongos Nus , Invasividade Neoplásica/genética , Transplante de Neoplasias , Interferência de RNA , Carga Tumoral/genética
13.
Eur Radiol ; 20(6): 1424-30, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20179942

RESUMO

OBJECTIVE: To investigate the value of computed tomography (CT) perfusion imaging for assessment of angiogenesis in liver cancer. METHODS: Twenty-one patients with histologically proven liver cancer underwent CT perfusion examination. We compared the following perfusion parameters in the tumour area versus the non-tumour area: total blood flow (TBF), hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic arterial perfusion index (HAPI). Slices of postoperative specimen were stained with haematoxylin-eosin and anti-CD34 immunohistochemistry. The slices were evaluated with emphasis on the CD34-positive neovasculature in the tumour parenchyma. Tumour microvascular density (MVD) was calculated according to the Weidner method. Pearson correlation was used to detect correlations between tumour MVD and tumour perfusion parameters. RESULT: TBF and HPP in the tumour area were lower than in the non-tumour area (P < 0.05). HAP and HAPI in the tumour area were higher than those of the non-tumour area (P < 0.05). TBF and HAP in the tumour area correlated with MVD in the tumour (P < 0.05), with correlation coefficients of 0.849 and 0.829, respectively. CONCLUSION: CT perfusion imaging can quantitatively assess the blood supply and its distribution in liver cancer. TBF or HAP may be a useful parameter in assessing angiogenesis of liver cancer.


Assuntos
Neoplasias Hepáticas/diagnóstico por imagem , Neovascularização Patológica/diagnóstico por imagem , Imagem de Perfusão/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Feminino , Humanos , Neoplasias Hepáticas/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
14.
Zhonghua Wei Chang Wai Ke Za Zhi ; 11(1): 19-23, 2008 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-18197487

RESUMO

OBJECTIVE: To summarize the experience of surgical treatment for cervical esophageal carcinoma. METHODS: Clinical and follow-up data of 82 patients with cervical esophageal carcinoma undergone surgical treatment in Henan Provincial Cancer Hospital from Dec. 1993 to Dec. 2005 were analyzed retrospectively. The difference of the therapeutic regimen and 5-year survival rate of these patients were evaluated. RESULTS: Before 1997, patients mainly underwent surgical therapy solely (27 cases). After 1997, 50 cases received surgical therapy following neoadjuvant radiotherapy (multimodality group), except 5 early-stage cases received surgical therapy solely. Seventy-three patients underwent esophagectomy without thoracotomy, including 21 cases of invert-stripping of the esophagus, and 52 cases of blunt denudation of esophagus. Nine patients underwent transthoracic esophagectomy. Concurrent monolateral or bilateral cervical lymph node dissection accounted for 14 cases and combined organ resection 12 cases. No serious hemorrhage and tracheal or bronchial tearing occurred. No hospital death occurred. Postoperative complications were found in 14 patients, and the incidence of complication was 19.5%. In sole surgery group, upper incised margins of 5 patients were confirmed to be positive. The laryngeal function of 26 patients in sole surgery group was preserved, while 47 patients in multimodality group preserved. Lymph node metastasis occurred in 14 cases, including 13 cases cervical lymph node metastasis (monolateral 9, bilateral 4) and 1 case of upper mediastinal lymph node metastasis. During follow-up, 3 patients were lost. The total 5-year survival rate was 43%. The patients in multimodality group had higher 5-year survival rate as compared to those in sole surgery group. (50.2% vs 33.9%,chi(2 )=7.17,P=0.007). The 5-year survival rates of patients with transthoracic esophagectomy, esophagectomy plus concurrent monolateral or bilateral cervical lymph nodes dissection or combined organ resection were 36.5%, 45.8% and 33.3% respectively. All the 5-year survival rates of these subgroups were lower as compared to multimodality group. CONCLUSIONS: For patients with early stage cervical esophageal carcinoma and with proximal end of residual normal esophagus longer than 2 cm, the optimal therapy should be surgery. For most of the patients, surgery combined with neoadjuvant radiotherapy is the ideal therapeutic strategy, which can lower the risk of positive revised margin, improve the possibility of preserving the laryngeal function and result in the improvement of 5-year survival rate. Esophagectomy without thoracotomy should be preferred. Combined organ resection or bilateral lymph node dissection should be chosen carefully because these operating procedures may lead to severe injury and function lose.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Estudos Retrospectivos
15.
Zhonghua Wei Chang Wai Ke Za Zhi ; 10(2): 124-6, 2007 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-17380449

RESUMO

OBJECTIVE: To study the feasibility and effect of Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with laryngeal function preservation. METHODS: The data of 28 patients with cervical esophageal carcinoma, collected from Aug. 1997 to Nov. 2005, were investigated retrospectively. RESULTS: All the 28 patients were diagnosed as cervical esophageal squamous cell carcinoma. Among them, 12 patients underwent surgery (surgery group), while the other 16 patients underwent surgery plus radiation therapy preoperatively or postoperatively (multimodality therapy group). No uncontrolled intraoperative and postoperative hemorrhage and tracheal tear occurred. The incidence of complications was 21.4% (6/28), including cervical anastomotic leakage in 2 patients and recurrent laryngeal nerve injury in 4 patients. The overall 5-year survival rate was 50.3%. The 5-year survival rate was 25.7% in surgery group and 66.1% in multimodality therapy group, and the difference between two groups was statistically significant (chi(2)=4.07; P=0.0438). CONCLUSIONS: Blunt esophageal denudation without thoracotomy in the treatment of cervical esophageal carcinoma with larynx function preservation is possible. Combined with radiotherapy preoperatively or postoperatively, the survival time in patients with cervical esophageal carcinoma is able to be prolonged.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Esofagoplastia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço , Estudos Retrospectivos
16.
Zhonghua Yi Xue Za Zhi ; 86(45): 3197-200, 2006 Dec 05.
Artigo em Chinês | MEDLINE | ID: mdl-17313786

RESUMO

OBJECTIVE: To investigate the frequency, distribution, and feature of lymph node metastasis in thoracic esophageal carcinoma, and to provide evidence for lymph node dissection and the multidisciplinary therapy for patients with esophageal carcinoma postoperatively. METHODS: The clinical data of 623 patients with thoracic esophageal carcinoma who had undergone esophagectomy plus lymph node dissection were studied to analyze the characteristics of lymph node metastasis. RESULTS: Totally 3689 of lymph node groups (with 8603 nodes) were dissected. The lymph node metastasis rate was 47.2% and lymph node metastasis ratio was 10.3%. No lymph node metastasis was found in the patients of Tis stage, while lymph node metastasis was found in the patients of other stages. There were significantly differences in lymph node metastasis rate and ratio among the patients of different T stages (chi2 = 38.407, P = 0.00, and chi2 = 118.438, P = 0.000). The higher the T stage, the higher the lymph node metastasis rate and ratio (r = 1, P = 0.000, and r = 1, P = 0.000). Different pathological types of esophageal carcinoma had different lymph node metastasis ratio (chi2 = 84.577, P = 0.000), however, there was no significant difference in lymph node metastasis rate among different pathological types (chi2 = 6.284, P = 0.179). The patients with squamous carcinoma had the lowest lymph node metastasis ratio and lymph node metastasis rate. The lymph node metastasis was mainly regional and extended vertically in both directions. Leaping over metastasis was another feature. All segments of thoracic esophageal carcinoma, especially lower thoracic esophageal carcinoma, could metastasize to the celiac lymph nodes. CONCLUSION: Lymph node dissection should be carried out properly in treatment of esophageal carcinoma and regional celiac lymph nodes should be explored and dissected more cautiously. Because surgical treatment is relatively radical in treatment of esophageal carcinoma, and taking the trend of lymph node metastasis and other indication into account, rational multidisciplinary therapy conducted as soon as possible should be adopted in the treatment of esophageal carcinoma.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Esofágicas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Tórax
17.
Zhonghua Wai Ke Za Zhi ; 43(5): 301-3, 2005 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-15842937

RESUMO

OBJECTIVE: To study the surgical treatment of recurrent laryngeal nerve (RLN) injury caused by thyroid operation. METHODS: From 1970 to 2001, 50 patients with RLN injury were caused by thyroid operation. The causes, location, type, operative procedures and follow-up were retrospectively analyzed. RESULTS: Unilateral RLN injury occurred in 46 cases and bilateral nerve injury in 4 cases. The RLN injuries were located within 2cm below the point of RLN entering to throat in 45 nerves (83.3%), other places in 6 nerves (11.3%), and unknown location in 3 nerves (5.4%). Transection of the nerve was found in 19 nerves (36.5%), suture or scare pressing the nerve in 35 nerves (64.8%). All the injured nerves were repaired surgically. Meanwhile all 4 patients with bilateral RLN injuries underwent tracheotomy. Of the 50 cases, 44 cases (88.0%) were followed up for more than 1.5 years. Among the 44 followed-up patients, phonation was restored to normal or obvious improvement in 42 cases (95.5%), and improvement in 2 (4.5%). Of the 35 patients with 39 nerves underwent indirect or direct laryngoscopy, the affected vocal cord movement entirely recovered in 21 cords (53.8%), partially recovered in 7 cords (17.9%), uncovered in 11 cords (28.3%). There was no relation between the recovery of phonation or vocal cord movement with the timing or the procedure of repairing operation. CONCLUSIONS: The location of most RLN injuries caused by thyroid surgery are just below the point of RLN entering to throat, and most are mechanical injury, and need operation to resolve the cause. Once the RLN injury is made, an operation should be performed as early as possible.


Assuntos
Traumatismos do Nervo Laríngeo Recorrente , Tireoidectomia/efeitos adversos , Paralisia das Pregas Vocais/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Paralisia das Pregas Vocais/etiologia
18.
Zhonghua Er Bi Yan Hou Ke Za Zhi ; 39(7): 415-8, 2004 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-15469114

RESUMO

OBJECTIVE: To investigate clinical significance of non-recurrent laryngeal nerve. METHODS: Clinical data from 4 cases of non-recurrent laryngeal nerve and related literature review was made to acknowledge its incidence, variant types and matters concerned during thyroid surgery. RESULTS: Seven hundred and nineteen recurrent laryngeal nerves were exposed during 2156 thyroid operations in Xiangya Hospital, from which 4 were confirmed to hold non-recurrent laryngeal nerves (0.56%). Two cases were found on the right side and the other 2 on the left. Among the 4 cases, 3 (patients) were found to have non-recurrent laryngeal nerves during reoperation because of voice horse after the first operation. The other one was recognized during the first operation. CONCLUSIONS: Non-recurrent laryngeal nerve, a rare anomaly, is very vulnerable during thyroid surgery. Knowing the related knowledge of the non-recurrent laryngeal nerve and its types is helpful to avoid its damage during thyroid surgery.


Assuntos
Nervo Laríngeo Recorrente/cirurgia , Tireoidectomia/métodos , Paralisia das Pregas Vocais/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Laríngeo Recorrente/anormalidades , Estudos Retrospectivos
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