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1.
Mol Med Rep ; 20(3): 2441-2449, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31322276

RESUMO

Tissue remodeling is the pathological basis of the symptoms encountered in chronic rhinosinusitis (CRS). Epithelial­mesenchymal transition (EMT) may participate in this process. The present study was designed to investigate the involvement of EMT in CRS. In addition, the prognostic value of the EMT biomarker α­smooth muscle actin (α­SMA) was assessed in patients with CRS who underwent endoscopic sinus surgery (ESS). A total of 13 patients with CRS without nasal polyps (CRSsNP), 13 patients with CRS with nasal polyps (CRSwNP) and 13 control subjects were enrolled. The expression of EMT markers was determined in sinonasal specimens by qPCR, western blot and immunofluorescence assays. EMT features were evaluated in primary nasal epithelial cells (NECs) with transforming growth factor (TGF)­ß1 stimulation. The associations were assessed between α­SMA expression and the clinical features of CRS. Epithelial and mesenchymal markers were overexpressed in the sinonasal specimens of both CRSsNP and CRSwNP patients. Alterations in the expression pattern were more apparent in the CRSsNP patients. Following incubation of primary NECs with TGF­ß1, a mesenchymal shape was acquired. In addition, NECs that co­expressed α­SMA and cytokeratin were readily detected and the protein levels of α­SMA were elevated. In contrast to α­SMA, the levels of E­cadherin were decreased. The protein levels of α­SMA were negatively correlated with endoscopic scores and several postoperative symptoms. In conclusion, partial EMT occurred in patients with CRS, notably in CRSsNP patients. Moreover, primary NECs could undergo EMT following TGF­ß1 treatment in vitro. In addition, α­SMA could be considered an efficient predictor for postoperative endoscopic and symptomatic outcomes in patients with CRS treated with ESS.


Assuntos
Actinas/análise , Transição Epitelial-Mesenquimal , Sinusite/diagnóstico , Sinusite/cirurgia , Adulto , Biomarcadores/análise , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Sinusite/patologia , Resultado do Tratamento
2.
Open Forum Infect Dis ; 5(10): ofy228, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30302354

RESUMO

Background: Chronic and granulomatous invasive fungal rhinosinusitis are important causes of blindness and craniocerebral complications. However, the classification of these 2 diseases remains controversial. Methods: We retrospectively analyzed patients with chronic and granulomatous invasive fungal rhinosinusitus in a Chinese tertiary hospital from 2009 to 2017, with a focus on classification and comparisons. Results: Among 55 patients enrolled in our study, 11 (11/55, 20%) had granulomatous invasive fungal rhinosinusitis (GIFRS) and 44 (44/55, 80%) had chronic invasive fungal rhinosinusitis (CIFRS). Aspergillus fumigatus and Dematiaceous hyphomycetes were identified in 2 patients with GIFRS. Compared with granulomatous type, CIFRS was more frequently encountered in immunocompromised patients (P = .022), and the time from onset to diagnosis was much shorter (P = .001). Proptosis and orbital apex syndrome showed no significant difference between granulomatous and CIFRS in our study. The treatment options and prognosis of both diseases also showed no significant difference. Conclusions: Despite the consensus on histopathology, the classification of the chronic and granulomatous types may need further evaluation in clinical considerations.

3.
Ultrason Sonochem ; 48: 103-109, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30080531

RESUMO

In this work, a novel ultrasonic-assisted thermal cracking method for improving the yield of light oil from the thermal cracking of Huizhou atmospheric residue (HAR) is proposed and demonstrated. To achieve this, a self-developed autoclave ultrasonic reactor (20 kHz; 200 W) was designed. Gas chromatography (GC), and elemental analyser (EA) were employed to analyse the composition of gaseous and liquid products after the cracking of residual oil. Compared to the traditional thermal cracking process under similar conditions (430 °C; 8 MPa; 2 h), the ultrasonic-based process produced lower gas products (ca. 0.6%), higher gasoline and diesel fractions (ca. 10%), vacuum residue, and lower yield of coke yield (ca. 4%). In addition, coke produced by the ultrasonic-assisted thermal cracking method exhibited spherical morphology with narrow size distribution and smooth surface with small amounts of adsorbents attached to it. The derivative characteristic peak (101 crystal face) at 2θ of 43.56° belonged to α-graphite. The abnormal high local temperature and pressure conditions produced by ultrasonication were the key factors for the thermal cracking of residual oil. The experimental results indicated that the ultrasonic-assisted thermal cracking can dramatically lead to higher yield of light oil, higher degree of cleavage, and more favourable reactions under the same conditions (as those of traditional thermal cracking). Therefore, compared to the traditional delayed coking process, the proposed ultrasonic-assisted technology can significantly decrease the power consumption. This study has vital significance in predicting and enhancing the performance of thermal cracking on a large scale.

4.
J Craniofac Surg ; 27(7): e709-e713, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27564072

RESUMO

OBJECTIVES: This study evaluates the impact combined endonasal endoscopic resection and radiotherapy for skull base chordomas. METHODS: Thirty-two patients with skull base chordomas between July 2006 and June 2015 were divided into 2 groups: the surgery alone group and the surgery with radiation therapy group. RESULTS: Gross total resection was achieved in 9 (28.1%) patients with skull base chordoma, subtotal resection was achieved in 16 (50.0%) patients, and partial resection was achieved in 7 (21.9%) patients. The progression-free survival (PFS) rate at 3 and 5 years was 44.0% and 16.5%, respectively. The overall survival (OS) rate at 3 and 5 years was 79.4% and 69.5%, respectively. Kadish staging predicted PFS and OS with statistical significance when the extent of resection was categorized into gross total resection, subtotal resection, and partial resection (P = 0.035 and P = 0.003, respectively). There was a significant OS advantage for the surgery plus radiation group compared with the surgery alone group (P = 0.035). CONCLUSION: Gross total resection can achieve very good results for the treatment of skull base chordomas. Postoperative adjuvant radiation therapy is recommended for all skull base chordomas, as it offered a higher OS rate.


Assuntos
Cordoma/radioterapia , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias da Base do Crânio/radioterapia , Adulto , Idoso , Cordoma/mortalidade , Cordoma/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias da Base do Crânio/mortalidade , Neoplasias da Base do Crânio/cirurgia , Análise de Sobrevida , Resultado do Tratamento
5.
J Craniofac Surg ; 27(4): 1021-4, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27213739

RESUMO

OBJECTIVE: To introduce appropriate surgical procedures for the endoscopic repair of the internal carotid artery (ICA) injury. METHODS: Two patients with ICA injury during the endoscopic endonasal approach surgery were reviewed. RESULTS: Internal carotid artery injury during the endonasal skull-base approach was a rare complication. Once ICA injury occurred, 2 large bore suctions were placed immediately for drainage and the bleeding point was located. Then, an oxidized regenerated cellulose was quickly pressed onto the bleeding point and was held there to stop the bleeding. Afterward, a free graft of fascia lata was inserted and the free fat graft was compressed for repair. Absorbable packing materials were used for nasal packing. CONCLUSIONS: Endoscopic repair utilizing oxidized regenerated cellulose and a free fascia lata graft is a safe and feasible surgical option for ICA injury.


Assuntos
Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Interna/inervação , Celulose Oxidada/farmacologia , Fascia Lata/transplante , Retalhos de Tecido Biológico , Cirurgia Endoscópica por Orifício Natural/métodos , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Angiografia , Lesões das Artérias Carótidas/diagnóstico , Feminino , Hemostáticos/farmacologia , Humanos , Masculino , Pessoa de Meia-Idade , Nariz , Tomografia Computadorizada por Raios X
6.
Oncol Lett ; 10(3): 1267-1270, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26622661

RESUMO

Nasopharyngeal angiofibroma (NA) primarily affects adolescent males. The incidence of NA in the elderly, however, is extremely low. The present study describes a 72-year-old male with NA that presented with typical symptoms and radiological findings. The location and extension of the tumor was too lateral and inferior to be effectively resected by an endoscopic approach. Therefore, a combination of endoscopic and open approaches was considered. The tumor was completely resected using an image-guided endoscopic-assisted sublabial and buccolabial incision approach. The post-operative histopathological and immunohistochemical analysis confirmed the diagnosis of NA. The present study demonstrated the occurrence of NA in the elderly, and highlighted the potential of an image-guided endoscopic-assisted sublabial and buccolabial incision approach for the treatment of NA in the elderly.

7.
Eur Arch Otorhinolaryngol ; 272(9): 2313-8, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25318688

RESUMO

Sinonasal Rosai-Dorfman disease (S-RDD) is a rare form of RDD limited to the sinonasal cavity. Multipatient studies of Chinese S-RDD and documentation of its clinical spectrum are rare. This study aimed to identify the clinical profiles of Chinese S-RDD. Medical records of and tissue sections from 10 patients diagnosed with S-RDD between 2007 and 2014 were reviewed. Data on clinical presentations, endoscopy signs, imageological change, treatment and outcome were analyzed. The mean age of five male and five female patients at the first visit was 40.3 years and the mean follow-up period was 58.6 months. Based on the lesion sites, five cases were divided into an anterior sinonasal group, accompanied by symptoms of epistaxis, nasal obstruction and nasal dorsal deformity. Five other cases were divided into a posterior sinonasal group, accompanied by symptoms of hyposmia, epistaxis and nasal obstruction. Endoscopy signs and imageological changes in the anterior group showed diffuse infiltration of the RDD lesion under the septum mucosa, but in the posterior group the RDD lesions often showed as formations on polyps. At the end of follow-up, only one case spontaneously resolved without surgery; two cases in the anterior sinonasal group and three cases in the posterior sinonasal group recurred after endoscopic surgery, but surgery can result in short-term symptomatic control and restoration of function in all cases. S-RDD of the anterior and posterior sinonasal cavity may have different clinical characteristics; endoscopic surgery is effective for short-term symptomatic control and restoration of function for S-RDD.


Assuntos
Histiocitose Sinusal/cirurgia , Doenças Nasais/cirurgia , Doenças dos Seios Paranasais/cirurgia , Adolescente , Adulto , Endoscopia , Epistaxe/etiologia , Feminino , Seguimentos , Histiocitose Sinusal/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/cirurgia , Obstrução Nasal/etiologia , Septo Nasal/cirurgia , Doenças Nasais/diagnóstico , Doenças dos Seios Paranasais/diagnóstico , Recidiva , Estudos Retrospectivos , Adulto Jovem
8.
BMC Cancer ; 14: 608, 2014 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-25149057

RESUMO

BACKGROUND: The role of postoperative adjuvant treatment for sinonasal malignant melanoma remains unclear. This study evaluates the impact of three different surgical and postoperative adjuvant treatment modalities: surgery alone(open and endoscopic approaches), surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy on survival of patients with primary sinonasal malignant melanoma (SMM). METHODS: The data of 69 patients who underwent primary surgical treatments at Eye & ENT hospital of Fudan University between January 1st, 2000 and December 31st, 2010 were retrospectively reviewed. Survival comparison of different surgical and postoperative adjuvant treatment modalities (surgery alone, surgery plus radiotherapy and surgery, radiotherapy plus chemotherapy), as well as survival comparison between open and endoscopic surgical approaches were performed. Curves depicting survival were performed using Kaplan-Meier method. Statistical analysis was performed using log-rank test software SPSS19 and p < .05 is considered as statistically significant. RESULTS: The median overall survival time was found to be 18 months for surgery alone (27 cases), 32 months for surgery plus radiotherapy (24 cases), 42 months for surgery, radiotherapy plus chemotherapy (18 cases). The 3 and 5 year survival rates for groups mentioned above were 14.8% and 5.6%, 45.1% and 31.6%, 55% and 32.1%, respectively. Statistical significances were found not only between surgery alone and surgery plus radiotherapy treatment group (P = 0.012), but also surgery alone and surgery, radiotherapy plus chemotherapy group (P = 0.002). There was no statistically significant survival difference found between the two different surgical approaches (41 cases for open approach and 28 cases for endoscopic approach). CONCLUSIONS: Sinonasal malignant melanoma is a disease with a poor prognosis. Patients who underwent surgery plus radiotherapy or surgery, radiotherapy plus chemotherapy had better survival outcomes than those underwent surgery alone. Endoscopic approach provided similar survival outcome as an open approach.


Assuntos
Melanoma/terapia , Neoplasias dos Seios Paranasais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Terapia Combinada , Feminino , Humanos , Masculino , Melanoma/mortalidade , Melanoma/cirurgia , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/cirurgia , Radioterapia Adjuvante , Estudos Retrospectivos , Análise de Sobrevida , Taxa de Sobrevida , Resultado do Tratamento
9.
J Biopharm Stat ; 24(3): 600-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24697196

RESUMO

For paired binary data, McNemar's test is widely used to test marginal homogeneity or symmetry for a 2 by 2 contingency table. In this article, we extend McNemar's test by considering a series of paired binary data in which the series is defined by a stratification factor. We provide a test for testing homogeneous stratum effects. For illustration, we apply our test to a cancer epidemiology study. Finally, we conduct simulations to show that our test preserves the nominal type I error level and evaluate the power of our test under various scenarios.


Assuntos
Ensaios Clínicos como Assunto/estatística & dados numéricos , Simulação por Computador , Análise por Pareamento , Modelos Estatísticos , Biomarcadores/análise , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Feminino , Humanos , Razão de Chances
10.
Artigo em Chinês | MEDLINE | ID: mdl-24342244

RESUMO

OBJECTIVE: To demonstrate the clinical outcomes of maximal medical therapy(MMT) and functional endoscopic sinus surgery+ maximal medical therapy (FESS+MMT) for moderate to severe chronic rhinosinusitis without nasal polyps (CRSsNP) in China, to provide clinical evidence for treatment recommendation. METHODS: A prospective multicenter case control study consisting of 90 strictly selected CRSsNP patients were carried out by ENT Hospital of SUN Yet-sen university and 7 other university affiliated hospitals across China from March 2011 to October 2012. All patients were selected to MMT group or FESS+MMT group followed by 3 months treatment and 6 months follow up. Treatment efficacy evaluation indicators included improvement of visual analogue scale (VAS) score, quality of life, CT score and post-operative nasal endoscopic evaluations. SPSS16.0 software was used to analyze the data. RESULTS: All patients enrolled complied with moderate to severe CRSsNP evaluation criteria. There were no significant differences found in the baseline data between two groups (P > 0.05). (1) At the 3 time points (pre-treatment, 3 months and 6 mongths after treatment) , VAS overall symptom score in MMT group were 6.52 ± 2.61, 2.66 ± 2.10, 2.40 ± 1.56, significant differences were found among them (t value were 2.083 and 2.295, both P < 0.05); in FESS+MMT group the values were 6.99 ± 2.70, 0.95 ± 0.84, 0.60 ± 0.81, significant differences were found among them (t value were 3.582 and 5.196, both P < 0.05); SNOT-20 score in MMT group were 38.61 ± 17.36, 18.59 ± 14.04, 18.40 ± 8.91, significant differences were found among them (t value were 2.737 and 2.657, both P < 0.05); in FESS+MMT group the values were 38.21 ± 19.61, 5.94 ± 5.01, 2.65 ± 2.31, significant differences were found among them (t value were 3.247, 3.319, both P < 0.05). (2) FESS+MMT group relative to the MMT group in VAS overall symptom score and quality of life improvements appeared earlier and were more pronounced. (3) Overall treatment efficacy showed that in MMT group: complete control 14 cases (30.4%), partially control 31 cases (67.4%), uncontrolled 1 cases (2.2%); In FESS+MMT group: complete control 17 cases (38.6%), partially control 26 cases (59.1%), uncontrolled 1 cases (2.3%). (4) Patients' satisfaction survey showed that the number of the patients who were very satisfied with the efficacy in the FESS+MMT group were 2 times higher than the MMT group. CONCLUSIONS: (1) For moderate to severe CRSsNP, both MMT and FESS+MMT treatment can effectively control the overall symptoms and classified symptoms, reduce CT scores and significantly improve the quality of life, the ineffective rate is less than 5%. (2) FESS+MMT group in terms of improving symptoms and the onset time are better than MMT group, especially in improving the stuffy nose, head and face fullness, and mental and physical symptoms are better than MMT group. (3) FESS+MMT group showed better results in patient satisfaction survey compared to the MMT group. Therefore for moderate to severe CRSsNP patients, FESS+MMT therapy could be recommended as the preferred treatment.


Assuntos
Qualidade de Vida , Sinusite , Estudos de Casos e Controles , Doença Crônica , Endoscopia , Humanos , Pólipos Nasais/cirurgia , Estudos Prospectivos , Sinusite/cirurgia
12.
Chin Med J (Engl) ; 126(10): 1934-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23673113

RESUMO

BACKGROUND: It is well recognized that meteorological factors have important infuences on the onset and development of many kinds of diseases. The present study was undertaken to investigate the effects of the meteorological elements on admission rates of cerebral infarction patients with hypertensive nephropathy at Changchun city, Jilin Province, northeast China. METHODS: A total of 763 medical records of inpatients from nine hospitals at Changchun city, during a period from April 6 to April 17 in 2010, were reviewed. These patients were admitted to hospitals due to the occurrence of cerebral infarction. The hypertensive nephropathy was evidenced with certain diagnosis of essential hypertension and hypertension-related kidney injuries. The cerebral infarction was diagnosed according to the World Health Organization (Stroke) standard. All the meteorological data were from practical monitoring records in Jilin Province Meteorological Observatory. The relationships between the epidemiological prevalence of cerebral infarction and meteorological variables were analyzed using the time series models of statistics. RESULTS: Compared with admission rates before the violent change in meteorological status (April 6 to April 17, 2010), the number of admission patients suffering from cerebral infarction remarkably peaked on April 12. Such an increase was highly correlated with heavy precipitation, elevation of daily average relative humidity, and reduction of average daily air temperature. With the betterment of the meteorological conditions on April 17, the admission rates of cerebral infarction patients dropped to the same level as the dates before snowing (April 6 to April 11). CONCLUSIONS: The meteorological changes are highly associated with the occurrence of cerebral infarction in patients with hypertensive renal injury in northeast China. This study also suggested that an intensive medical interference for those patients with hypertension-induced organ injuries is very necessary in preventing the occurrence of cerebral infarction with hypertensive nephropathy when there is a violent change in meteorological condition.


Assuntos
Infarto Cerebral , Hospitalização/estatística & dados numéricos , Hipertensão Renal , Conceitos Meteorológicos , Nefrite , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos
13.
Laryngoscope ; 123(6): 1334-40, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23616386

RESUMO

OBJECTIVES/HYPOTHESIS: To investigate how quickly an allergic rhinitis (AR) patients' symptoms will improve with sublingual immunotherapy (SLIT). STUDY DESIGN: Double-blind placebo study. METHODS: This is a multicenter, randomized, double-blind, placebo-controlled study of SLIT used to treat house dust mite-induced AR. A total of 120 AR patients, aged 4 to 60 years, were treated for 6 months and randomized into two groups: 1) SLIT with Dermatophagoides pteronyssinus (D.p.) and Dermatophagoides farina (D.f.) extract (n = 60) ; and 2) matched placebo controls (n = 60). Symptom, medications received, and a visual analog scale score were recorded during the whole study. Serum-specific IgE and IgG4 to D. p. and D. f. were assessed before and after the treatment. RESULTS: Eighty-five patients (70.8%) completed the study. Twelve patients (20%) chose to withdraw from the SLIT group, but none because of serious adverse effects. The total symptom and visual analog scores VAS in the SLIT group decreased significantly when compared to the placebo controls (P <0.05) after week 14, as well as for the significant (P <0.05) improvement of all individual AR symptoms in the SLIT group (e.g., sneezing, nasal discharge, itching, and nasal obstruction) after week 22. There was a significant (P <0.05) increase of IgG4 to both D.f. and D.p. in the SLIT, but not in the placebo group after treatment. CONCLUSION: SLIT with a mixture of D.f. and D.p. extract is an effective and safe treatment for patients with house dust mite-induced AR. Its onset of action can be observed as early as 14 weeks after treatment.


Assuntos
Alérgenos/administração & dosagem , Antígenos de Dermatophagoides/administração & dosagem , Dermatophagoides farinae/imunologia , Dermatophagoides pteronyssinus/imunologia , Dessensibilização Imunológica/métodos , Rinite Alérgica Perene/terapia , Administração Sublingual , Adolescente , Adulto , Alérgenos/uso terapêutico , Animais , Anticorpos Anti-Idiotípicos/sangue , Anticorpos Anti-Idiotípicos/imunologia , Antígenos de Dermatophagoides/uso terapêutico , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Imunoglobulina A/imunologia , Imunoglobulina E/imunologia , Masculino , Pessoa de Meia-Idade , Rinite Alérgica , Rinite Alérgica Perene/sangue , Rinite Alérgica Perene/imunologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
14.
Head Neck ; 35(12): 1719-25, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23471755

RESUMO

BACKGROUND: The purpose of this study was to examine endoglin (CD105) expression on microvessel endothelial cells (ECs) in juvenile nasopharyngeal angiofibroma (JNA) and its relationship with recurrence. METHODS: Immunohistochemistry was performed to detect CD105 expression in a tissue microarray from 70 patients with JNA. Correlation between CD105 expression on microvessel ECs and clinicopathological features, as well as tumor recurrence, were analyzed. RESULTS: Immunohistochemistry revealed CD105 expression on ECs but not in stroma of patients with JNA. Chi-square analysis indicated CD105-based microvessel density (MVD) was correlated with JNA recurrence (p = .013). Univariate and multivariate analyses determined that MVD was a significant predictor of time to recurrence (p = .009). The CD105-based MVD was better for predicting disease recurrence (AUROC: 0.673; p = .036) than other clinicopathological features. CONCLUSIONS: MVD is a useful predictor for poor prognosis of patients with JNA after curative resection. Angiogenesis, which may play an important role in the occurrence and development of JNA, is therefore a potential therapeutic target for JNA.


Assuntos
Angiofibroma/irrigação sanguínea , Antígenos CD/metabolismo , Células Endoteliais/metabolismo , Microvasos/citologia , Neoplasias Nasofaríngeas/irrigação sanguínea , Receptores de Superfície Celular/metabolismo , Adolescente , Adulto , Angiofibroma/metabolismo , Angiofibroma/patologia , Angiofibroma/cirurgia , Criança , Endoglina , Humanos , Imuno-Histoquímica , Masculino , Análise Multivariada , Neoplasias Nasofaríngeas/metabolismo , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasofaríngeas/cirurgia , Recidiva Local de Neoplasia/metabolismo , Prognóstico , Curva ROC , Análise Serial de Tecidos , Adulto Jovem
15.
Int J Pediatr Otorhinolaryngol ; 76(10): 1501-6, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22832240

RESUMO

OBJECTIVE: The aim of this study is to evaluate endoscopic assisted sublabial and buccolabial incision approach as treatment option for Juvenile nasopharyngeal angiofibroma (JNA) with extensive infratemporal fossa (ITF) extension. METHODS: Seven patients diagnosed as JNA with extensive ITF extension and underwent surgery at our department between 2006 and 2010 were retrospectively reviewed. All patients underwent diagnostic arteriography followed by embolization preoperatively and intratumor injection with N-butyl cyanoacrylate (NBCA). Endoscopic assisted sublabial and buccolabial incision approach was used to remove the tumors. RESULTS: Complete resections of the tumors were achieved in all patients. Mean blood loss was 700 ml. The follow-up period ranged from 9 to 20 months, with a mean of 14.3 months. One patient had a recurrent tumor six months after operation. CONCLUSIONS: Endoscopic assisted sublabial and buccolabial incision is an optional approach to remove JNA with extensive ITF extension.


Assuntos
Angiofibroma/cirurgia , Endoscopia/métodos , Neoplasias Nasofaríngeas/cirurgia , Osso Temporal/cirurgia , Adolescente , Angiofibroma/patologia , Perda Sanguínea Cirúrgica , Criança , Embolização Terapêutica , Embucrilato/administração & dosagem , Humanos , Injeções , Masculino , Neoplasias Nasofaríngeas/patologia , Invasividade Neoplásica , Estudos Retrospectivos , Osso Temporal/patologia
16.
Midwifery ; 28(2): 222-7, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21419534

RESUMO

AIM: this study aimed to explore new parents' views and experiences during their transition to parenthood. BACKGROUND: in China the one-child birth policy may bring more stress and challenges for the new parents due to the lack of experience and greater expectations of their new role. China is also at a stage of rapid economic and social development which creates new conditions for parenthood. METHODS: a cross-sectional survey was conducted from February to September 2009 among 232 mothers and fathers, yielding a 83.6% response rate (n=194 couples). The questionnaire included: the Family Assessment Device-General Function Scale, the Family Resources Scale, the Family Adaptation Scale, and the Chinese Perceived Stress Scale. RESULTS: there were no significant differences between mothers' adaptation and fathers' adaptation during the postpartum period, as well as their perceived stress, family function and family resources (p>0.05). Method of childbirth was not related to adaptation. About 29% of variance in mothers' adaptation could be explained by satisfaction with the infant's gender (B=0.295, p<0.001), fathers' adaptation (B=0.236, p<0.001), and family resources (B=0.179, p=0.016). About 42% of variance in fathers' adaptation could be explained by mothers' adaptation (B=0.268, p<0.001), satisfaction with marriage (B=0.248, p=0.002), satisfaction with the infant's gender (B=0.209, p<0.007), and family resources (B=0.206, p=0.002). CONCLUSION: this study highlights the importance of family resources to family adaptation and antenatal and postnatal education programmes as part of family-centred care. The possible influences of culture and policies need to be considered by health-care professionals developing strategies to facilitate family adaptation to the early parenthood.


Assuntos
Adaptação Psicológica , Pai/psicologia , Mães/psicologia , Pais/psicologia , Período Pós-Parto/psicologia , China , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Gravidez , Estresse Psicológico , Inquéritos e Questionários
17.
Int J Pediatr Otorhinolaryngol ; 75(9): 1088-92, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21719122

RESUMO

OBJECTIVE: Juvenile nasopharyngeal angiofibroma (JNA) is a rare vascular tumor of the nasopharynx occurring in young males. The aim of this study was attempt to find out the site of origin and the common expansion routes of JNA. METHODS: The CT examinations of 46 untreated patients with histologically proven JNA were retrospectively analyzed. Evidence of tumor spreading of the locations are those following CT characteristics: (a) expansion and/or erosion of bony wall; (b) obliteration of normal fatty planes. In addition, three dimensional reconstruction technology was used to make further study. RESULTS: The pterygoid canal was affected in all untreated cases and therefore was considered as the origin of JNA. Nineteen patients' tumors (41.3%) originated from the front part of pterygoid canal and the other 27 ones (58.7%) from the post part of pterygoid canal. Pterygoid canal, choanae and nasal cavity are the three most common sites of JNA. CONCLUSION: The possible site of origin is pterygoid canal. After originating from this point, the tumor will invade sphenopalatine foramen, sphenoid sinus and pterygopalatine fossa first, and then into adjacent structure through aforementioned three sites.


Assuntos
Angiofibroma/diagnóstico por imagem , Angiofibroma/patologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Intensificação de Imagem Radiográfica , Adolescente , Adulto , Angiofibroma/cirurgia , Biópsia por Agulha , Criança , Estudos de Coortes , Seguimentos , Humanos , Interpretação de Imagem Assistida por Computador , Imuno-Histoquímica , Masculino , Neoplasias Nasofaríngeas/cirurgia , Estadiamento de Neoplasias , Doenças Raras , Estudos Retrospectivos , Medição de Risco , Osso Esfenoide/diagnóstico por imagem , Osso Esfenoide/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Adulto Jovem
18.
Am J Otolaryngol ; 32(2): 162-4, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-20022672

RESUMO

Intracavernous carotid hemorrhage is a rare cause of epistaxis. We present a case of epistaxis caused by postradiotherapy and nontraumatic cavernous internal carotid artery (ICA) hemorrhage. An 80-year-old man was admitted to our hospital with a one week history of recurrent left-sided epistaxis and a past history of radiotherapy after radical maxillectomy. Emergent angiography revealed a leak in the cavernous segment of the ICA and subsequent detachable balloon occlusion embolization of the left internal carotid artery was performed without sequelae. We conclude that carotid artery hemorrhage must be considered in the differential diagnosis of profuse and recurrent epistaxis, especially for patients after craniofacial radiotherapy. ICA embolization is the definitive treatment provided cross circulation is adequate.


Assuntos
Doenças das Artérias Carótidas/diagnóstico , Artéria Carótida Interna , Epistaxe/etiologia , Hemorragias Intracranianas/complicações , Idoso de 80 Anos ou mais , Doenças das Artérias Carótidas/complicações , Artéria Carótida Interna/efeitos da radiação , Diagnóstico Diferencial , Humanos , Hemorragias Intracranianas/diagnóstico , Masculino , Radioterapia/efeitos adversos
19.
Artigo em Inglês | MEDLINE | ID: mdl-20453548

RESUMO

AIMS: Our purpose was to evaluate the diagnosis and combined modality treatment of esthesioneuroblastoma treated at 1 institution. METHODS: A retrospective analysis of clinical information regarding presentation, immunohistochemical results, treatment and outcome was performed on 21 patients with esthesioneuroblastoma. RESULTS: Two patients had Kadish A, 12 had Kadish B and 7 had Kadish C disease. The mean follow-up was 41.9 months. Immunohistochemical stains were performed in 17 cases, and the tumors were focal positive or showed positive immunoreactivity to neuron-specific enolase (17/17, 100%), synaptophysin (13/17, 76.5%), S-100 protein (8/17, 47.1%), epithelial membrane antigen (5/17, 29.4%), chromogranin A (4/17, 23.5%), vimentin (3/17, 17.6%) and cytokeratin (2/17, 11.8%). Generally, the patients were treated with preoperative radiotherapy (Kadish A and Kadish B) and preoperative chemoradiotherapy (Kadish C) after the initial biopsy, followed by surgery. Surgical approaches (n = 21) consisted of 12 lateral rhinotomies, 5 craniofacial resections, 3 endoscopic sinus surgeries and 1 midfacial degloving approach. The 5-year crude overall survival rate was 76.2%. CONCLUSIONS: Esthesioneuroblastoma is an uncommon malignant tumor. Thorough histological evaluation is the key to correct diagnosis and differentiation. Preoperative radiotherapy or chemoradiotherapy can give surgeons the chance to choose different surgical approaches, especially the endoscopic surgical techniques, in the future.


Assuntos
Estesioneuroblastoma Olfatório , Cavidade Nasal/patologia , Neoplasias Nasais , Adulto , Antineoplásicos/uso terapêutico , Biópsia , Criança , Cromogranina A/metabolismo , Terapia Combinada , Estesioneuroblastoma Olfatório/patologia , Estesioneuroblastoma Olfatório/cirurgia , Estesioneuroblastoma Olfatório/terapia , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Queratinas/metabolismo , Masculino , Pessoa de Meia-Idade , Mucina-1/metabolismo , Cavidade Nasal/metabolismo , Cavidade Nasal/cirurgia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Neoplasias Nasais/terapia , Fosfopiruvato Hidratase/metabolismo , Radioterapia , Estudos Retrospectivos , Proteínas S100/metabolismo , Sinaptofisina/metabolismo , Vimentina/metabolismo , Adulto Jovem
20.
J Otolaryngol Head Neck Surg ; 39(1): 56-61, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20122346

RESUMO

OBJECTIVE: Surgical outcomes and prognostic factors were analyzed to determine what factors increase the probability of juvenile nasopharyngeal angiofibroma (JNA) recurrence. METHODS: Ninety-seven males with JNA were diagnosed and underwent surgery at Fudan University Affiliated Eye, Ear, Nose and Throat Hospital from 1997 to 2006. Clinical data were extracted from medical records and were used in the statistical analysis. RESULTS: The total recurrence rate of JNA was 39.2% after the initial surgery. A patient whose tumour staging was higher was more likely to have a recurrence than a patient whose tumour staging was lower (p = .0031). The recurrence rates in two groups (age >or= 18 years group and < 18 years group) were 26.8% and 48.2%, respectively (p = .03). The recurrence rates with tumour size < 4 cm and >or= 4 cm were 21.7% and 54.9%, respectively (p = .0008). CONCLUSION: The significant predictors of recurrence in our study were age at diagnosis, tumour size, and Radkowski classification.


Assuntos
Angiofibroma/patologia , Neoplasias Nasofaríngeas/patologia , Adolescente , Adulto , Angiofibroma/diagnóstico por imagem , Angiofibroma/terapia , Criança , Pré-Escolar , Terapia Combinada , Epistaxe/epidemiologia , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Obstrução Nasal/epidemiologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/terapia , Estadiamento de Neoplasias , Recidiva , Fatores de Risco , Tomografia Computadorizada por Raios X , Adulto Jovem
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