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1.
J Oral Maxillofac Surg ; 78(11): 2072.e1-2072.e12, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32621806

RESUMO

PURPOSE: Facial asymmetry associated with unilateral condylar hyperplasia can benefit from condylectomy, which aims to arrest the pathologic condylar growth and restore an appropriate posterior height. However, there are several cases in which condylar hyperplasia is combined with various dentofacial deformities, for which joint surgery has to be accompanied by concomitant orthognathic surgery. The literature is relatively poor of examples in which virtual planning for orthognathic surgery includes the evaluation of condylectomy, which is often manually performed. The aim of this study was to present and discuss a workflow for 1-stage computer-guided customized management of skeletal asymmetry by simultaneous condylectomy and orthognathic surgery. MATERIALS AND METHODS: Five patients were enrolled in this study from 2018 to 2019. All patients underwent combined virtual planning of orthognathic surgery and condylectomy. Virtual surgery was translated into real surgical coordinates using patient-specific surgical guides and custom-designed osteosynthesis plates. RESULTS: All surgical procedures were uneventful, and in all patients, virtual planning was successfully brought into the operating room with high accuracy, as confirmed by superimposition analyses. Symmetrization of the face and achievement of correct occlusion were observed in all cases. CONCLUSIONS: The presented protocol is a reliable solution for the combined planning of orthognathic surgery and condylectomy. Virtual planning, surgical guides, and custom-designed plates allow computerized simulations to be replicated in the real patient.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/patologia , Assimetria Facial/cirurgia , Humanos , Hiperplasia/cirurgia , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia
3.
J Surg Res ; 255: 130-134, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32543378

RESUMO

BACKGROUND: Surgery is the definitive management of primary hyperparathyroidism and the only curative therapy. However, many surgeons are hesitant to operate on individuals with mild primary hyperparathyroidism, with an even greater reluctance to operate on those who underwent a previous parathyroidectomy. We hypothesize that patients with mild primary hyperparathyroidism who undergo a re-operation have equivalent outcomes compared with those who undergo a first-time (FT) operation. METHODS: We reviewed a prospective database of 459 patients with mild primary hyperparathyroidism who underwent surgery by one endocrine surgeon. Of these patients, 59 had a re-operative (RE-OP) parathyroid surgery. We compared these patients to those with mild primary hyperparathyroidism who had FT surgery (n = 400) using either the Pearson chi-square, Fisher's exact test, or Student's t-test where appropriate. RESULTS: The mean age of our cohort was 60 ± 14 y, with 86% females. Patients in the RE-OP group had similar preoperative calcium and parathyroid hormone levels compared with those in the FT group. Most patients who underwent a RE-OP surgery had four gland hyperplasia on pathology (49.2%). Patients in the RE-OP and FT groups both had high and similar cure rates (100% versus 99.8%, P = 0.70). RE-OP patients had a higher rate of recurrent hyperparathyroidism (10.3% versus 3.3%, P = 0.025). CONCLUSIONS: In patients with mild primary hyperparathyroidism, those who undergo RE-OP parathyroidectomy have a high cure rate that is similar to FT surgery. Therefore, we recommend that these patients with recurrence of mild hyperparathyroid disease be considered for parathyroidectomy.


Assuntos
Hiperparatireoidismo Primário/cirurgia , Paratireoidectomia/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Reoperação/efeitos adversos , Adulto , Idoso , Cálcio/sangue , Feminino , Seguimentos , Humanos , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/diagnóstico , Hiperplasia/diagnóstico , Hiperplasia/cirurgia , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/patologia , Glândulas Paratireoides/cirurgia , Hormônio Paratireóideo/sangue , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(19): e19989, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384452

RESUMO

This study aimed to establish an optimal protocol for Tc-sestamibi parathyroid imaging for lesion localization in patients with hyperparathyroidism (HPT).We retrospectively enrolled 35 consecutive patients who underwent dual-phase (at 10 minutes and 120 minutes) Tc-sestamibi parathyroid scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT). Twenty seven patients had primary HPT, and 8 had secondary or tertiary HPT. Three nuclear medicine physicians independently analyzed the parathyroid images for lesion localization at 9 predefined parathyroid locations using the following 4 different image sets blinded to the clinical information:All SPECT or SPECT/CT image sets were analyzed with dual-phase planar images. The image results were compared with the histopathological results after surgery.Dual-phase SPECT/CT showed the highest positive rate of 85.7% in the patient-based analysis and 13.7% in the location-based analysis. Of 35 patients, surgical pathological results were available in 21 (16 adenomas in 16 primary HPTs and 16 hyperplasias in 5 secondary or tertiary HPTs). Dual-phase SPECT/CT showed the sensitivity values of 100% and 84.4% in the patient-based and location-based analysis, respectively, which were the highest sensitivity values among all image sets. In the primary HPT subgroup, dual-phase SPECT/CT showed the highest sensitivity value of 93.8% in the location-based analyses, whereas dual-phase SPECT, early SPECT/CT, and delayed SPECT/CT showed the sensitivity values of 62.5%, 81.3%, and 81.3%, respectively. In the secondary or tertiary HPT subgroup, dual-phase SPECT/CT also showed the highest sensitivity value of 75.0%, whereas early SPECT/CT, delayed SPECT/CT, and dual-phase SPECT showed the sensitivity values of 43.8%, 56.3%, and 68.8%, respectively.Compared with dual-phase SPECT or single-phase SPECT/CT, the dual-phase SPECT/CT imaging protocol for Tc-sestamibi scintigraphy showed the highest positive rate and sensitivity, and was optimal for parathyroid lesion localization.


Assuntos
Hiperparatireoidismo , Hiperplasia , Glândulas Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides , Cintilografia , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tecnécio Tc 99m Sestamibi/farmacologia , Feminino , Humanos , Hiperparatireoidismo/diagnóstico , Hiperparatireoidismo/etiologia , Hiperplasia/diagnóstico , Hiperplasia/patologia , Hiperplasia/cirurgia , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/patologia , Neoplasias das Paratireoides/cirurgia , Cintilografia/métodos , Cintilografia/normas , Compostos Radiofarmacêuticos/farmacologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
5.
Sci Rep ; 10(1): 6206, 2020 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-32277134

RESUMO

To evaluate safety and efficacy of one- vs. two-session radiofrequency ablation (RFA) of parathyroid hyperplasia for patients with secondary hyperparathyroidism (SHPT) and to compare the outcome of both methods on hypocalcemia. Patients with secondary hyperparathyroidism underwent ultrasound guided RFA of parathyroid hyperplasia. Patients were alternately assigned to either group 1 (n = 28) with RFA of all 4 glands in one session or group 2 (n = 28) with RFA of 2 glands in a first session and other 2 glands in a second session. Serum parathyroid hormone (PTH), calcium, phosphorus and alkaline phosphatase (ALP) values were measured at a series of time points after RFA. RFA parameters, including operation duration and ablation time and hospitalization length and cost, were compared between the two groups. Mean PTH decreased in group 1 from 1865.18 ± 828.93 pg/ml to 145.72 ± 119.27 pg/ml at 1 day after RFA and in group 2 from 2256.64 ± 1021.72 pg/ml to 1388.13 ± 890.15 pg/ml at 1 day after first RFA and to 137.26 ± 107.12 pg/ml at 1 day after second RFA. Group 1's calcium level decreased to 1.79 ± 0.31 mmol/L at day 1 after RFA and group 2 decreased to 1.89 ± 0.26 mmol/L at day 1 after second session RFA (P < 0.05). Multivariate analysis showed that hypocalcemia was related to serum ALP. Patients with ALP ≥ 566 U/L had lower calcium compared to patients with ALP < 566 U/L up to a month after RFA (P < 0.05). Group 1's RFA time and hospitalization were shorter and had lower cost compared with Group 2. US-guided RFA of parathyroid hyperplasia is a safe and effective method for treating secondary hyperparathyroidism. Single-session RFA was more cost-effective and resulted in a shorter hospital stay compared to two sessions. However, patients with two-session RFA had less hypocalcemia, especially those with high ALP.


Assuntos
Hiperparatireoidismo Secundário/cirurgia , Hipocalcemia/etiologia , Ablação por Radiofrequência/métodos , Adulto , Feminino , Seguimentos , Humanos , Hiperparatireoidismo Secundário/sangue , Hiperparatireoidismo Secundário/patologia , Hiperplasia/sangue , Hiperplasia/patologia , Hiperplasia/cirurgia , Hipocalcemia/sangue , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/patologia , Glândulas Paratireoides/cirurgia , Hormônio Paratireóideo/sangue , Ablação por Radiofrequência/efeitos adversos
6.
Surg Technol Int ; 35: 197-201, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32120449

RESUMO

INTRODUCTION: Progressive saphenous vein graft (SVG) failure remains a key limitation to the long-term success of coronary artery bypass grafting (CABG). SVG disease after the first year is dominated by intimal hyperplasia, which predisposes the SVG to thrombosis and accelerated atherosclerosis. The objective of this study was to review and summarize the latest experimental and clinical data on the use of mechanical external stents for vein grafts. METHODS: In January 2020, the PubMed database was searched using the terms "external stent", "CABG", "saphenous vein graft" and "intimal hyperplasia". The results were reviewed and only randomized experimental and clinical studies that analyzed the effect of external stenting on venous intimal hyperplasia were included in the analysis, together with studies that investigated the clinical benefit of external stenting. RESULTS: Eight experimental and four clinical trials met the search criteria. Controlled trials in different large animal models concluded that external stenting significantly reduced intimal hyperplasia 3-6 months post implantation, and reduced both thrombosis rates and the development of lumen irregularities. Data from randomized controlled trials with a follow-up period of 1-4.5 years supported the pre-clinical findings and demonstrated that external stents significantly reduced vein graft disease. CONCLUSION: Strong evidence indicates that supporting the vein with external stents is safe and leads to clear advantages at both the anatomical and cellular levels. With the further accumulation of consistent positive results, external stenting of SVG may become the standard of care in future CABG.


Assuntos
Ponte de Artéria Coronária/métodos , Oclusão de Enxerto Vascular/prevenção & controle , Veia Safena/transplante , Stents , Túnica Íntima/patologia , Animais , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Implante de Prótese Vascular/métodos , Oclusão de Enxerto Vascular/etiologia , Humanos , Hiperplasia/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Veia Safena/cirurgia , Trombose/etiologia , Trombose/prevenção & controle , Túnica Íntima/cirurgia , Grau de Desobstrução Vascular
7.
Urologe A ; 59(4): 398-407, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32055934

RESUMO

Bladder neck stenosis (BNS) after simple prostatectomy and vesicourethral anastomosis stenosis (VUAS) after radical prostatectomy for prostate cancer are common sequelae. However, the two entities differ in their pathology, anatomy and their surgical results. VUAS has an incidence of 0.2-28%. Commonly, VUAS occurs within the first 2 years after surgery. Initial therapy should be performed endourologically: dilatation, (laser) incision or resection. After three unsuccessful treatment attempts, open reconstruction should be considered. Different surgical approaches (abdominal, perineal, abdominoperineal) have been described. All are associated with good success rates. However, they are accompanied by high rates of urinary incontinence. Incontinence can be treated safely by implantation of an artificial urinary sphincter. The incidence of BNS is around 5% for all types of surgery for benign prostate hyperplasia. It occurs within the first 2 years after surgery. Initial treatment should be performed endourologically. In case of recalcitrant BNS, open reconstruction is indicated. The YV-plasty is an established procedure, and the T­plasty represents a modification. Success rates of both procedures are high. Robot-assisted reconstructive procedures have been described for both VUAS and BNS.


Assuntos
Anastomose Cirúrgica/métodos , Hiperplasia/cirurgia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Estreitamento Uretral/complicações , Constrição Patológica , Humanos , Masculino , Recidiva Local de Neoplasia , Complicações Pós-Operatórias , Neoplasias da Próstata/patologia , Uretra
8.
Am J Case Rep ; 21: e919856, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31941879

RESUMO

BACKGROUND Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon benign breast lesion. CASE REPORT PASH is reported in a young female in treatment for neurological diseases with multi-drug therapy (clonazepam, valproate and risperidone). Her menstrual cycles are irregular, and she reached menarche very late. CONCLUSIONS The higher PASH prevalence in premenopausal woman (the majority of whom are actively taking oral contraceptive pills), in 24% to 47% of men with gynecomastia and during pregnancy supports a hormonal etiology; the interaction between clonazepam, valproate, risperidone and progesterone could increase the level of progesterone that could stimulate PASH growth.


Assuntos
Angiomatose/diagnóstico , Doenças Mamárias/diagnóstico , Mama/patologia , Hiperplasia/diagnóstico , Células Estromais/patologia , Adulto , Angiomatose/etiologia , Angiomatose/cirurgia , Biópsia com Agulha de Grande Calibre , Mama/citologia , Doenças Mamárias/etiologia , Doenças Mamárias/cirurgia , Interações Medicamentosas , Feminino , Humanos , Hiperplasia/etiologia , Hiperplasia/cirurgia , Mastectomia Segmentar , Progesterona/metabolismo
9.
J Stomatol Oral Maxillofac Surg ; 121(4): 397-403, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31904534

RESUMO

Coronoid hyperplasia is one of the rare causes of progressive limitation of mouth opening due to impingement of the enlarged coronoid process of the mandible on the zygomatic bone. A review was performed on all cases reports and case series on coronoid hyperplasia. Gender, age at treatment, age of onset, types of hyperplasia (unilateral/bilateral), associated history, treatment, surgical approach, preoperative mouth opening, intraoperative mouth opening, mouth opening at follow up and follow up period were recorded and analyzed. A total of 82 articles which reported 115 cases were included. Coronoid hyperplasia was commonly reported at mean age of 22.64 years old with male preponderance. Most of the cases were diagnosed and treated between the age of 11-20 years old. This condition commonly involved bilateral coronoid process of mandible. The mean width of preoperative mouth opening was 16.5mm and was improved to a mean mouth opening of 36.3mm intraoperatively. Mean mouth opening was 34.8mm at an average follow up of 19 months. While the etiopathogenesis of coronoid hyperplasia is still not conclusive, treatment with either coronoidectomy or coronoidotomy produced good improvement in mouth opening.


Assuntos
Mandíbula , Osteotomia Mandibular , Adolescente , Adulto , Criança , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patologia , Hiperplasia/cirurgia , Masculino , Mandíbula/patologia , Mandíbula/cirurgia , Adulto Jovem , Zigoma
10.
J Surg Res ; 246: 335-341, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31635835

RESUMO

BACKGROUND: Persistent/recurrent hyperparathyroidism occurs in 2%-5% of patients with sporadic primary hyperparathyroidism (PHPT). In this study, the incidence and time to recurrence in patients with single-gland disease (SGD), double adenomas (DAs), or four-gland hyperplasia (FGH) at initial parathyroidectomy were compared. METHODS: This retrospective review included adult patients with sporadic PHPT who underwent initial parathyroidectomy with intraoperative parathyroid hormone monitoring (IOPTH) from 1/2000 to 12/2016 with ≥6 mo follow-up. An abnormal parathyroid was defined by a gland weight of ≥50 mg. A concurrent serum calcium >10.2 mg/dL and parathyroid hormone >40 pg/mL was defined as persistent PHPT if present <6 mo and recurrent PHPT if present ≥6 mo postoperatively after initial normocalcemia. RESULTS: Of 1486 patients, 1203 (81%) had SGD, 159 (11%) DA, and 124 (8%) FGH. Among the 3 groups, there was no difference in the percent decrease from the baseline or time of excision to final postexcision IOPTH levels between groups (79% versus 80% versus 80%, respectively; P = 0.954) or in the proportion of patients with a final IOPTH ≥40 (22% versus 18% versus 14%; P = 0.059). Overall, 22 (1.5%) had persistent PHPT and 26 (1.7%) had recurrent PHPT. Persistent PHPT was more frequent with DAs (6; 3.8%) than other groups (SGD: 16, 1.3%; FGH: 0; P = 0.02). At median follow-up of 33 mo (IQR, 18-60), there was no difference in recurrence rate (1.6% versus 2.5% versus 2.4%; P = 0.57) or median time (mo) to recurrence (SGD: 59 [IQR, 21-86], DAs: 36 [IQR, 29-58], FGH: 23 [IQR, 17-40]; P = 0.46). CONCLUSIONS: Recurrent PHPT occurred in 1.7% of patients who underwent curative initial parathyroidectomy, with no difference in incidence or time to recurrence between groups based on the number of glands removed. Patients with DA more commonly had persistent PHPT, raising the possibility of unrecognized FGH.


Assuntos
Adenoma/epidemiologia , Hiperparatireoidismo Primário/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Glândulas Paratireoides/patologia , Neoplasias das Paratireoides/epidemiologia , Adenoma/complicações , Adenoma/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Hiperparatireoidismo Primário/etiologia , Hiperparatireoidismo Primário/cirurgia , Hiperplasia/complicações , Hiperplasia/cirurgia , Incidência , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/complicações , Recidiva Local de Neoplasia/cirurgia , Glândulas Paratireoides/cirurgia , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/cirurgia , Paratireoidectomia/métodos , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Tempo
11.
World Neurosurg ; 133: 308-313, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31525486

RESUMO

BACKGROUND: Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion that is uncommon in the central nervous system. To our knowledge, there has been only one previous report of occurrence in the pineal region. We present a second case and a review of the literature. CASE DESCRIPTION: A 28-year-old woman presented with 1 month of headaches and visual auras. Brain magnetic resonance imaging scan demonstrated a 2.6- × 1.8- × 1.3-cm nonenhancing T1-hypointense, T2-/fluid-attenuated inversion recovery-hyperintense pineal region mass with cerebral aqueduct obstruction and hydrocephalus. She underwent placement of a right extraventricular drain followed by complete surgical resection. Histologic analysis was consistent with IPEH. CONCLUSIONS: Although rare, IPEH is an entity that should be considered in the differential diagnosis for intracranial masses with radiographic features characteristic of vascular lesions. Tissue sampling is imperative for distinction from more malignant entities. Complete resection is curative and is the standard of care when feasible. Given the risk of local progression and neurologic compromise with subtotal resection of central nervous system lesions, further study regarding adjuvant treatment options is warranted.


Assuntos
Neoplasias Encefálicas/cirurgia , Glândula Pineal/cirurgia , Neoplasias Vasculares/cirurgia , Adulto , Neoplasias Encefálicas/diagnóstico por imagem , Drenagem , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/cirurgia , Imagem por Ressonância Magnética , Procedimentos Neurocirúrgicos , Glândula Pineal/diagnóstico por imagem , Resultado do Tratamento , Neoplasias Vasculares/diagnóstico por imagem
12.
J Craniofac Surg ; 30(6): e576-e578, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31756883

RESUMO

Oculo-auriculo-fronto-nasal syndrome (OAFNS) is a rare anomaly characterized by features overlapping those of frontonasal dysplasia (FND) and the oculo-auriculo-vertebral spectrum (OAVS). The FND features malformation of frontonasal process-derived structures, characterized by anomalies in the central portion of the face. The OAVS is characterized by developmental anomalies of the first and second pharyngeal arches. The OAFNS is a condition with clinical features of both FND and OAVS.Here, the authors present the case of a male with OAFNS who not only exhibited typical OAFNS symptoms but also a dysplastic bony structure that bridged the anterior nasal spine and inferior nasal bones, and unilateral type 3 Duane retraction syndrome (absence of right-eye abduction). Abnormal nasal bones are characteristic of OAFNS; such abnormalities are absent from FND and OAVS. The authors reduced the dysplastic nasal bony structure via open external rhinoplasty, followed by lateral nasal osteotomy when he was 16 years of age. The nasal dorsum appeared natural after surgery and he was satisfied with the result.


Assuntos
Anormalidades Craniofaciais/diagnóstico por imagem , Síndrome da Retração Ocular/diagnóstico por imagem , Face/anormalidades , Hiperplasia/diagnóstico por imagem , Adolescente , Anormalidades Craniofaciais/cirurgia , Síndrome da Retração Ocular/cirurgia , Face/diagnóstico por imagem , Face/cirurgia , Humanos , Hiperplasia/cirurgia , Masculino , Osso Nasal , Nariz
13.
Tokai J Exp Clin Med ; 44(4): 73-79, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31768994

RESUMO

A 49-year-old woman, with a medical history of rheumatism, was admitted to our hospital with chief complaints of bilateral enlargement and redness of breasts. She underwent weekly breast examinations. Mammography findings were reported as category 3 for both breasts. Breast ultrasonography, magnetic resonance imaging, and chest contrast computed tomography revealed a massive tumor in the left BD region, however, there were no findings for suspected malignancy. Needle biopsy did not yield histologically malignant cells in both breasts. Mammary interstitium was edematous, and capillary-like slit structures were observed. The stroma stained with alcian blue and destained with hyaluronidase treatment. Since the stroma tested positive for vimentin, calponin, and CD34 and negative for CD31, the patient was diagnosed as (PASH). Because both breasts had similar diagnosis based on histopathologic findings, bilateral mastectomy was performed. Details about the origin of bilateral PASH are unknown but it may be related to the development of rheumatoid arthritis. Additionally, systemic autoimmune diseases like rheumatism may be the reason for repeated contraction and enlargement of PASH.


Assuntos
Angiomatose/diagnóstico por imagem , Angiomatose/patologia , Doenças Mamárias/diagnóstico por imagem , Doenças Mamárias/patologia , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Angiomatose/complicações , Angiomatose/cirurgia , Artrite Reumatoide/complicações , Doenças Mamárias/complicações , Doenças Mamárias/cirurgia , Feminino , Humanos , Hiperplasia/complicações , Hiperplasia/cirurgia , Imagem por Ressonância Magnética , Mamografia , Mastectomia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Ultrassonografia Mamária
15.
J Cancer Res Ther ; 15(4): 755-759, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31436228

RESUMO

Objectives: The objective of this study is to determine the diagnostic ability of percutaneous core biopsy immediately after microwave ablation (MWA) for lung ground-glass opacity (GGO). Materials and Methods: Seventy-four patients with 74 lung GGOs were enrolled and treated with MWA. A percutaneous core needle biopsy was performed pre- and immediately post-MWA. All biopsy specimens were histologically examined by hematoxylin and eosin staining and immunostaining. Histologically, atypical adenomatous hyperplasia (AAH), adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (AC) were identified as positive, while chronic inflammation or normal lung tissue was identified as negative. Results: The outcomes of pre-MWA histological diagnosis were AAH (n = 4), AIS (n = 16), MIA (n = 14), AC (n = 29), chronic inflammation (n = 2), and lung tissue (n = 9) with an 85.1% (63/74) positive diagnosis rate. The outcomes of the immediately post-MWA histological diagnosis were AAH (n = 5), AIS (n = 10), MIA (n = 11), AC (n = 29), chronic inflammation (n = 1), and lung tissue (n = 18) with a 74.3% (55/74) positive diagnosis rate. There was no significant difference in the positive diagnosis rate between the pre- and immediately post-MWA groups (P = 0.10). The outcomes of the combined diagnosis of pre- and immediately post-MWA were AAH (n = 4), AIS (n = 16), MIA (n = 16), AC (n = 31), chronic inflammation (n = 2), and lung tissue (n = 5) with a positive diagnosis rate of 90.5% (67/74), which was higher than that by pre-MWA biopsy (P < 0.05). The main complications were pneumothorax (n = 45, 60.8%), hemoptysis (n = 24, 32.4%), pleural effusion (n = 39, 52.7%), and pulmonary infection (n = 10, 13.5%). Conclusions: Immediately post-MWA core biopsy has promising efficacy for histological diagnosis of lung GGOs.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico , Hiperplasia/diagnóstico , Neoplasias Pulmonares/diagnóstico , Micro-Ondas , Lesões Pré-Cancerosas/diagnóstico , Adenocarcinoma de Pulmão/cirurgia , Biópsia com Agulha de Grande Calibre , Feminino , Humanos , Hiperplasia/cirurgia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/cirurgia , Prognóstico
16.
Anticancer Res ; 39(8): 3991-4002, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366480

RESUMO

BACKGROUND: Different phenomena can result in enlargement of mental foramen and mandibular canal. At the foreground of diagnosis is the assessment of the biological properties of the tissue which causes such detailed lesions of the skeleton. CASE REPORT: This report describes a palpable mass at the site of the mental foramen with radiological evidence of an extensive enlargement of the bony portion of the inferior alveolar nerve. These findings were the reason for surgical exploration. Surprisingly, the mass was inflammatory tissue that had proliferated in the canal and foramina. The lesion had grown around the nerve and did not infiltrate it. The diagnosis of lymphatic hyperplasia was made. Other potential causes of the unusual radiological and clinical findings are explained with reference to the literature. CONCLUSION: Imaging does not provide a safe assessment of tumor biology. Surgical exploration with detailed tissue examination of the tumor provides the basis for appropriate therapy.


Assuntos
Hiperplasia/patologia , Tecido Linfoide/patologia , Mandíbula/patologia , Nervo Mandibular/patologia , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/cirurgia , Tecido Linfoide/diagnóstico por imagem , Tecido Linfoide/cirurgia , Mandíbula/diagnóstico por imagem , Nervo Mandibular/diagnóstico por imagem , Radiografia , Inquéritos e Questionários
17.
Plast Reconstr Surg ; 144(2): 443-455, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31348358

RESUMO

BACKGROUND: Lower eyelid defects are traditionally classified based on depth and 25 percent increments in defect width. The authors propose a new classification system that includes the vertical defect component to predict functional and aesthetic outcomes. METHODS: A retrospective review of patients who underwent lower lid reconstruction performed by a single surgeon was performed. Defects were classified into four categories based on the vertical component: (1) pretarsal; (2) preseptal; (3) eyelid-cheek junction; and (4) complex pretarsal/preseptal. Preoperative and postoperative central and lateral marginal reflex distance-2 values were obtained. Aesthetic outcomes were evaluated by three blinded reviewers. Outcomes were compared using one-way analysis of variance and analysis of covariance with Bonferroni corrected post hoc comparisons to control for defect area and width. RESULTS: Thirty-four patients underwent reconstruction of lower eyelid defects. There were 12 pretarsal defects (type I), nine preseptal defects (type II), nine eyelid-cheek defects (type III), and four complex pretarsal/preseptal defects (type IV). Postoperative retraction was highest in the complex pretarsal/preseptal group at 75 percent, with a significantly greater change from preoperative to postoperative central and lateral marginal reflex distance-2 compared with the other groups (p < 0.01) and worse postoperative mean aesthetic scores (p < 0.001). Type IV patients had significantly more revision operations (mean, 5.5) compared with the other groups (p < 0.001). CONCLUSIONS: The vertical dimension of lower eyelid defects is an important variable. A new classification system is proposed that supplements width-based methods for improved surgical planning and prediction of postoperative outcomes in lower eyelid reconstruction. CLINICAL QUESTION/LEEVL OF EVIDENCE: Therapeutic, IV.


Assuntos
Doenças Palpebrais/cirurgia , Pálpebras/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Palpebrais/classificação , Neoplasias Palpebrais/cirurgia , Feminino , Humanos , Hiperplasia/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/patologia , Dimensão Vertical , Adulto Jovem
18.
Cell Mol Biol (Noisy-le-grand) ; 65(5): 49-53, 2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31304906

RESUMO

The aim of the present study was to investigate the correlation between human papillomavirus (HPV) type 6/11 and 16/18 infections and glandular thickening mammary gland hyperplasia in order to explore methods for preventing glandular thickening mammary gland hyperplasia. A total of 240 patients with glandular thickening mammary gland hyperplasia who were treated by surgery in our hospital from January 2012 to June 2017 were enrolled in the present study. The hyperplastic breast tissue and adjacent normal breast tissue were taken to test HPV type 6/11 and 16/18 infections using conventional PCR and in situ hybridization techniques. The correlations between HPV type 6/11 and 16/18 infections and glandular thickening mammary gland hyperplasia were analyzed using statistical methods of chi-square test. The infection rates of HPV type 6/11 and 16/18 in the hyperplastic breast tissue were 31.95% and 34.91%, respectively and 11.83% and 14.79% in the normal breast tissue, respectively. The differences were statistically significant (all p<0.05). HPV type 6/11 and 16/18 infections may be closely related to the development of glandular thickening mammary gland hyperplasia, and may be one of the causes of glandular thickening mammary gland hyperplasia.


Assuntos
Papillomavirus Humano 11/genética , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Hiperplasia/virologia , Glândulas Mamárias Humanas/patologia , Infecções por Papillomavirus/patologia , Distribuição de Qui-Quadrado , DNA Viral/genética , Feminino , Humanos , Hiperplasia/prevenção & controle , Hiperplasia/cirurgia , Hibridização In Situ , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Globinas beta/genética
19.
Int J Pediatr Otorhinolaryngol ; 125: 107-112, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31280031

RESUMO

OBJECTIVE: To investigate the clinical, imaging and pathological features of congenital infiltrating lipomatosis of the face (CILF) and to discuss whether it is a subtype of hemifacial hyperplasia (HH). METHODS: Sixteen patients diagnosed with CILF were included in this study. All patients had undergone panoramic radiography and spiral CT examinations. Thirteen patients received biopsy, surgery treatment and pathological examination. The clinical documentation and imaging data were retrospectively reviewed. RESULTS: The cheeks (14/16), parotid glands (12/16), tongues (9/16), masticatory muscles (8/16) and the lips (7/16) were the most frequently affected soft tissue organs. The maxilla (14/16), zygoma (13/16), mandible (13/16) were involved among the maxillofacial bones. Dental malformations included macrodontia (8/16), poor formation of the roots (7/16), accelerated tooth germ development or premature eruption of permanent teeth (7/16) and missing of the permanent teeth (4/16). All malformations were restricted to one side of the face and did not trespass the middle line. Pathologically, CILF was featured by the diffuse infiltration of redundant mature adipose tissue into the tissue of the affected organ. CONCLUSION: CILF is a congenital developmental facial malformation characterized by infiltration of nonencapsulated, mature adipose tissue, resulting in facial soft and hard tissue hypertrophy and dental malformations in hemifacial structures. CILF could be considered as a subtype of HH.


Assuntos
Face/anormalidades , Face/cirurgia , Assimetria Facial/congênito , Hiperplasia/etiologia , Lipomatose/congênito , Lipomatose/diagnóstico por imagem , Adolescente , Adulto , Criança , Pré-Escolar , Face/diagnóstico por imagem , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/etiologia , Assimetria Facial/cirurgia , Feminino , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/cirurgia , Lipomatose/cirurgia , Masculino , Radiografia Panorâmica , Estudos Retrospectivos , Tomografia Computadorizada Espiral , Anormalidades Dentárias/diagnóstico por imagem , Anormalidades Dentárias/etiologia , Adulto Jovem
20.
Acta Neurol Scand ; 140(4): 296-300, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31231790

RESUMO

BACKGROUND: Mild malformation of cortical dysplasia (mMCD) with oligodendroglial hyperplasia (MOGHE) is an epilepsy-related pathologic entity highlighted in post-surgical specimens of frontal lobe epilepsy (FLE) patients. AIMS OF THE STUDY: We present two temporal lobe epilepsy (TLE) cases with MOGHE and discuss clinical, neurophysiological, and neuroimaging features that may be indicative of surgical outcome. METHODS: We identified two cases with MOGHE out of 30 temporal lobe epilepsy (TLE) surgical patient cohort, whose pathological distribution spared the hippocampal structures. RESULTS: The TLE cases shared common features with the FLE series in terms of patient profiles, MRI findings and post-surgical outcome. TLE plus seizure semiology combined with extratemporal scalp electroencephalographic (EEG) and electrocorticographic (ECoG) epileptiform elements at a distance from the imaging lesion were suggestive of an underlying multifocal pathology. CONCLUSIONS: MOGHE pathology has to be considered in the decision-making process for TLE epilepsy surgery when this constellation of features is met.


Assuntos
Epilepsia do Lobo Temporal/diagnóstico por imagem , Malformações do Desenvolvimento Cortical/diagnóstico por imagem , Oligodendroglia/patologia , Lobo Temporal/diagnóstico por imagem , Adolescente , Eletroencefalografia/métodos , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/cirurgia , Feminino , Humanos , Hiperplasia/complicações , Hiperplasia/diagnóstico por imagem , Hiperplasia/cirurgia , Imagem por Ressonância Magnética/métodos , Malformações do Desenvolvimento Cortical/complicações , Malformações do Desenvolvimento Cortical/cirurgia , Lobo Temporal/cirurgia
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