RESUMO
We perform two-dimensional coherent spectroscopy on CdSe/CdZnS core-shell colloidal quantum dots at cryogenic temperatures. In the two-dimensional spectra, sidebands due to electronic coupling with CdSe lattice LO-phonon modes are observed to have evolutions deviating from the exponential dephasing expected from Markovian spectral diffusion, which is instantaneous and memoryless. Comparison to simulations provides evidence that LO-phonon coupling induces energy-gap fluctuations on the finite timescales of nuclear motion. The femtosecond resolution of our technique probes exciton dynamics directly on the timescales of phonon coupling in nanocrystals.
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OBJECTIVES: The impact of characteristics of neighbourhood environment on physical activity and obesity-related diseases is still the subject of debate. This study aimed to explore the impact of urban neighbourhood environment on physical activity and obesity-related diseases. STUDY DESIGN: Cross-sectional study. METHODS: Individuals who participated in the 2009 national health-screening programme, submitted all necessary information, and had lived in Community 1 (Haengdang) or Community 2 (Ilsan) for at least 2 years (n = 16,178) were selected for inclusion in this study. Anthropometric measures were taken and physical activity was assessed using a short questionnaire. RESULTS: No significant difference in the trigger factors for walking, including the amount of neighbourhood park space, number of shopping malls, and distance between the community and shopping malls, was found between the two communities. However, Community 2 had a better street environment than Community 1. Participants who lived in Community 2 were more physically active [adjusted odds ratio (OR) 1.31, 95% confidence interval (CI) 1.16-1.48] and walked more regularly (adjusted OR 1.09, 95% CI 1.02-1.17) than participants who lived in Community 1, and were less likely to have abdominal obesity (adjusted OR 0.83, 95% CI 0.77-0.91), hypertension (adjusted OR 0.88, 95% CI 0.80-0.97) and diabetes (adjusted OR 0.86, 95% CI 0.75-0.99). However, the risk of dyslipidaemia, especially in terms of low-density lipoprotein cholesterol, was higher in Community 2. CONCLUSIONS: These results suggest that a walkable environment has a positive influence on hypertension and diabetes, and physical activity is the possible mechanism for this association. A walkable environment may function as an important tool for health promotion in urban areas.
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Planejamento Ambiental/estatística & dados numéricos , Atividade Motora , Obesidade/epidemiologia , Características de Residência/estatística & dados numéricos , Saúde da População Urbana/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Caminhada/estatística & dados numéricos , Adulto JovemRESUMO
Two recent genome-wide association studies have identified that the rs2274223 single-nucleotide polymorphism inphospholipase C epsilon 1 and the single-nucleotide polymorphism rs13042395 in C20orf54 are involved in esophageal squamous cell carcinoma (ESCC) in Chinese populations. We hypothesized that genetic polymorphisms of phospholipase C epsilon 1 and C20orf54 are also associated with ESCC in a Korean population. The rs2274223 and rs13042395 genotyping was performed using high-resolution melting analysis. The rs2274223 GG genotype was significantly associated with an increased risk of ESCC (odds ratio [OR]=1.86, 95% confidence interval [CI]=1.08-3.25) compared with the rs2274223 AA genotype. The rs13042395 G allele showed a significantly decreased risk of ESCC in the younger age group (OR=0.71, 95% CI=0.52-0.97) and no significant association in the older group (OR=1.19, 95% CI=0.87-1.62). We observed that the rs2274223 polymorphism was associated with an increased risk of ESCC in this Korean case-control study and that age may modify the association between the rs13042395 polymorphism and the risk of ESCC.
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Carcinoma de Células Escamosas/genética , Neoplasias Esofágicas/genética , Proteínas de Membrana Transportadoras/genética , Fosfoinositídeo Fosfolipase C/genética , Adulto , Idoso , Povo Asiático/genética , Estudos de Casos e Controles , Carcinoma de Células Escamosas do Esôfago , Feminino , Loci Gênicos , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polimorfismo de Nucleotídeo Único , Reprodutibilidade dos Testes , República da Coreia , RiscoRESUMO
BACKGROUND: We evaluated the efficacy and safety of tepotinib in patients with various solid cancers harboring MET exon 14 skipping mutation (METex14) or MET gene amplification. PATIENTS AND METHODS: A phase II, multicenter study was conducted in patients with advanced or metastatic solid cancers who progressed after standard treatment, harboring either METex14 or MET amplification detected in tissue-based next-generation sequencing (NGS). The primary endpoint was objective response rate (ORR). For exploratory analyses, we analyzed the gene profiles using plasma NGS test. RESULTS: Thirty-five patients were enrolled. The ORR was 57.6% for all patients, 52.2% for those with METex14, and 70% for those with MET amplification. Median progression-free survival (PFS) was 8 months [95% confidence interval (CI) 4.5-11.5 months] and median overall survival (OS) was 14 months (95% CI 7.8-20.2 months) in all patients. For patients with non-small-cell lung cancer with METex14, the median PFS was 9 months (95% CI 4.7-13.4 months) and the median OS was 17 months [95% CI not applicable (NA)-NA]. For patients with MET amplification, the median PFS was 7 months (95% CI 1.5-12.5 months) and the median OS was 10 months (95% CI 5.8-14.2 months). The ORR of patients with MET dysregulation detected by plasma NGS was 72.2%, whereas the ORR was 30% in those without detection. The most common adverse events were peripheral edema, asthenia, transaminase elevation, and anorexia, mostly grade 1 or 2. CONCLUSIONS: Tepotinib demonstrated consistent antitumor activity in patients with METex14, and promising antitumor activity in various cancers with MET amplification. Detection of MET dysregulation by plasma NGS may predict the response to tepotinib.
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Éxons , Amplificação de Genes , Mutação , Neoplasias , Proteínas Proto-Oncogênicas c-met , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Proteínas Proto-Oncogênicas c-met/genética , Idoso , Neoplasias/tratamento farmacológico , Neoplasias/genética , Adulto , Éxons/genética , Pirimidinas/uso terapêutico , Pirimidinas/farmacologia , Idoso de 80 Anos ou mais , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Piperidinas , PiridazinasRESUMO
BACKGROUND: Human epidermal growth factor receptor 2 (HER2) is a widely explored therapeutic target in solid tumors. We evaluated the efficacy and safety of trastuzumab-pkrb, a biosimilar of trastuzumab, in combination with paclitaxel, in HER2-positive recurrent or metastatic urothelial carcinoma (UC). PATIENTS AND METHODS: We enrolled 27 patients; they were administered a loading dose of 8 mg/kg trastuzumab-pkrb on day 1, followed by 6 mg/kg and 175 mg/m2 paclitaxel on day 1 every 3 weeks, intravenously. All patients received six cycles of the combination treatment and continued to receive trastuzumab-pkrb maintenance until disease progression, unacceptable toxicity, or for up to 2 years. HER2 positivity (based on immunohistochemistry analysis) was determined according to the 2013 American Society of Clinical Oncology /College of American Pathologists HER2 testing guidelines. The primary endpoint was objective response rate (ORR); the secondary endpoints were overall survival (OS), progression-free survival (PFS), and safety. RESULTS: Twenty-six patients were evaluated via primary endpoint analysis. The ORR was 48.1% (1 complete and 12 partial responses) and the duration of response was 6.9 months [95% confidence interval (CI) 4.4-9.3 months]. With a median follow-up of 10.5 months, the median PFS and OS were 8.4 months (95% CI 6.2-8.8 months) and 13.5 months (95% CI 9.8 months-not reached), respectively. The most common treatment-related adverse event (TRAE) of any grade was peripheral neuropathy (88.9%). The most common grade 3/4 TRAEs were neutropenia (25.9%), thrombocytopenia (7.4%), and anemia (7.4%). CONCLUSIONS: Trastuzumab-pkrb plus paclitaxel demonstrates promising efficacy with manageable toxicity profiles in patients with HER2-positive recurrent or metastatic UC.
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Medicamentos Biossimilares , Carcinoma de Células de Transição , Neoplasias da Bexiga Urinária , Humanos , Trastuzumab/efeitos adversos , Medicamentos Biossimilares/efeitos adversos , Paclitaxel/farmacologiaRESUMO
BACKGROUND: There is no clear consensus on the recommended second-line treatment for patients with metastatic pancreatic cancer who have disease progression following gemcitabine-based therapy. We retrospectively evaluated the clinical outcomes of liposomal irinotecan (nal-IRI) plus fluorouracil/leucovorin (FL) and FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) in patients who had failed on the first-line gemcitabine-based therapy. PATIENTS AND METHODS: From January 2015 to August 2019, 378 patients with MPC who had received nal-IRI/FL (n = 104) or FOLFIRINOX (n = 274) as second-line treatment across 11 institutions were included in this retrospective study. RESULTS: There were no significant differences in baseline characteristics between groups, except age and first-line regimens. With a median follow-up of 6 months, the median progression-free survival (PFS) was 3.7 months with nal-IRI/FL versus 4.6 months with FOLFIRINOX (P = 0.44). Median overall survival (OS) was 7.7 months with nal-IRI/FL versus 9.7 months with FOLFRINOX (P = 0.13). There was no significant difference in PFS and OS between the two regimens in the univariate and multivariate analyses. The subgroup analysis revealed that younger age (<70 years) was associated with better OS with FOLFIRINOX. In contrast, older age (≥70 years) was associated with better survival outcomes with nal-IRI/FL. Adverse events were manageable with both regimens; however, the incidence of grade 3 or higher neutropenia and peripheral neuropathy was higher in patients treated with FOLFIRINOX than with nal-IRI/FL. CONCLUSIONS: Second-line nal-IRI/FL and FOLFIRINOX showed similar effectiveness outcomes after progression following first-line gemcitabine-based therapy. Age could be the determining factor for choosing the appropriate second-line therapy.
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Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Pancreáticas , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Fluoruracila/efeitos adversos , Humanos , Irinotecano/uso terapêutico , Leucovorina/efeitos adversos , Oxaliplatina/uso terapêutico , Neoplasias Pancreáticas/tratamento farmacológico , República da Coreia , Estudos RetrospectivosRESUMO
BACKGROUND: This meta-analysis aimed to investigate the effect of antioxidant supplements on the primary and secondary prevention of cancer as reported by randomized controlled trials. METHODS: We searched Medline (PubMed), Excerpta Medica database, and the Cochrane Review in October 2007. RESULTS: Among 3327 articles searched, 31 articles on 22 randomized controlled trials, which included 161 045 total subjects, 88 610 in antioxidant supplement groups and 72 435 in placebo or no-intervention groups, were included in the final analyses. In a fixed-effects meta-analysis of all 22 trials, antioxidant supplements were found to have no preventive effect on cancer [relative risk (RR) 0.99; 95% confidence interval (CI) 0.96-1.03). Similar findings were observed in 12 studies on primary prevention trials (RR 1.00; 95% CI 0.97-1.04) and in nine studies on secondary prevention trials (RR 0.97; 95% CI 0.83-1.13). Further, subgroup analyses revealed no preventive effect on cancer according to type of antioxidant, type of cancer, or the methodological quality of the studies. On the other hand, the use of antioxidant supplements significantly increased the risk of bladder cancer (RR 1.52; 95% CI 1.06-2.17) in a subgroup meta-analysis of four trials. CONCLUSIONS: The meta-analysis of randomized controlled trials indicated that there is no clinical evidence to support an overall primary and secondary preventive effect of antioxidant supplements on cancer. The effects of antioxidant supplements on human health, particularly in relation to cancer, should not be overemphasized because the use of those might be harmful for some cancer.
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Antioxidantes/uso terapêutico , Suplementos Nutricionais , Neoplasias/prevenção & controle , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Little is known about the relative efficacy of high-protein vs. conventional diet plans that include partial meal replacements on body fat loss in obese subjects with metabolic syndrome. OBJECTIVE: We aimed to evaluate the efficacy of two low-calorie diets with partial meal replacement plans-a high-protein plan (HP) and a nutritionally balanced conventional (C) plan-on reducing obesity in obese subjects with metabolic syndrome. DESIGN: In a 12-week, double-blind study, we randomised 75 participants to either the HP- or the C-plan group. We recorded key metrics at 0 and 12 weeks. RESULTS: The overall mean weight loss was 5 kg in the HP-plan group and 4.9 kg in the C-plan group (p = 0.72). Truncal fat mass decreased 1.6 kg in the HP-plan group (p < 0.05) and 1.5 kg in the C-plan group (p < 0.05), while whole body fat mass decreased 2.5 kg in the HP-plan group (p < 0.05) and 2.3 kg in the C-plan group (p < 0.05). Between-group losses did not differ significantly for truncal (p = 0.52) or whole body (p = 0.77) fat mass. Among subjects with > or = 70% dietary compliance, however, truncal and whole body fat mass decreased more in the HP-plan group (Delta 2.2 kg and Delta 3.5 kg respectively) than in the C-plan group (Delta 1.3 kg and Delta 2.3 [corrected] kg respectively) (p < 0.05). CONCLUSION: The HP- and C-plans had a similar effect on weight and abdominal fat reduction, but the HP-plan was more effective in reducing body fat among compliant subjects.
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Síndrome Metabólica/complicações , Obesidade/dietoterapia , Gordura Abdominal/patologia , Adiposidade , Índice de Massa Corporal , Peso Corporal/fisiologia , Restrição Calórica/métodos , Dieta Redutora/métodos , Proteínas Alimentares/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Masculino , Síndrome Metabólica/patologia , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/patologia , Cooperação do PacienteAssuntos
Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/terapia , Esofagoscopia/efeitos adversos , Embolia Intracraniana/diagnóstico , Embolia Intracraniana/etiologia , Células Neoplásicas Circulantes , Stents/efeitos adversos , Idoso , Humanos , Imageamento por Ressonância Magnética , MasculinoRESUMO
Extrapulmonary small cell carcinoma is a rare neoplasm. It is an aggressive malignant tumour characterized by rapid local progression and early metastasis. We report a case of small cell carcinoma arising in the transverse colon in a 34-year-old man who presented with epigastric pain. On CT, a poorly enhancing bulky mass encircling the transverse colon with extensive regional lymph node metastases was observed. A segmental annular narrowing with thick interhaustral folds of the transverse colon was found by barium enema examination. This is the first report of barium study and CT findings of extrapulmonary small cell carcinoma of the colon.
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Sulfato de Bário , Carcinoma de Células Pequenas/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Meios de Contraste , Tomografia Computadorizada por Raios X/métodos , Adulto , Enema/métodos , Humanos , MasculinoRESUMO
We report a series of 10 patients who had a rapid expansion of a hypertensive intracerebral hemorrhage (HICH). It occurred in approximately 3% of 320 patients who sought treatment for HICH during the past 2 years. The site of hemorrhage was the putamen in 6 patients and the thalamus in 4 patients. Neurological deterioration occurred in a mean time of 40 hours after the onset of symptoms (range, 5.5-109 h). Fifty percent of all patients deteriorated within 24 hours. Persistent hypertension was recorded in all patients. Repeat computed tomography showed an increase of hematoma volume that was twice as large in thalamic hemorrhage and about three times as large in putaminal hemorrhage. Six patients died, whereas 3 survived with severe disability and 1 survived with moderate disability. This study indicates that continued or subsequent bleeding can occur in HICH. If those lesions are not detected early and microsurgically evacuated, they are almost always fatal. Early stereotactic evacuation with urokinase irrigation is considered more dangerous than open craniotomy by microsurgical techniques. We stress the need for attention to this problem during the acute phase of HICH.
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Hemorragia Cerebral/diagnóstico por imagem , Hipertensão/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Hemorragia Cerebral/mortalidade , Hemorragia Cerebral/cirurgia , Feminino , Seguimentos , Escala de Coma de Glasgow , Humanos , Hipertensão/mortalidade , Hipertensão/cirurgia , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/mortalidade , Recidiva , Taxa de SobrevidaRESUMO
The extended single-reaction multiplex PCR (esr-mPCR) developed in this study to detect staphylococcal enterotoxins (SEs), including SEA, SEB, SEC, SED, SEE, SEH, SEI, and SEJ, requires fewer sets of primers than other conventional multiplex PCRs and can be used to detect newly identified staphylococcal enterotoxins SEs more readily. Esr-mPCR analysis of 141 isolates of Staphylococcus aureus obtained from abattoir and livestock product samples revealed that 27 of the S. aureus isolates were toxigenic, and two were 2 multitoxigenic isolates. The most prevalent SE type was SEI followed by SEA and SEH. In addition, we investigated the clonal relatedness of toxigenic S. aureus isolates by arbitrarily primed PCR (AP-PCR). AP-PCR analysis of toxigenic S. aureus isolates revealed that the discriminatory power of AP-PCR was 9 (D=0.81), 8 (D=0.77), and 10 types (D=0.83) with primers AP1, ERIC2, and AP7, respectively. The combination of three each AP-PCR result could rearrange toxigenic S. aureus isolates into 10 types and five subtypes, with the D-value of 0.92. Interestingly, our data showed that toxigenic S. aureus isolates from different sources had different fingerprinting patterns although some of them carried the same types of SE genes. These data suggest that combinations of esr-mPCR and AP-PCR can provide a powerful approach for epidemiological investigation of toxigenic S. aureus isolates.
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DNA Bacteriano/genética , Enterotoxinas/genética , Reação em Cadeia da Polimerase/métodos , Staphylococcus aureus/metabolismo , Matadouros , Técnicas de Tipagem Bacteriana , Impressões Digitais de DNA , Primers do DNA , DNA Bacteriano/isolamento & purificação , Enterotoxinas/isolamento & purificação , Microbiologia de Alimentos , Intoxicação Alimentar Estafilocócica/prevenção & controle , Staphylococcus aureus/classificação , Staphylococcus aureus/isolamento & purificaçãoRESUMO
Vero cytotoxin (VT)-producing Escherichia coli (VTEC), such as E. coli O157:H7, are emerging foodborne pathogens worldwide. VTs are associated with hemorrhagic colitis and hemolytic uremic syndrome in humans. Attachment of the B subunit of VTs to its receptor, globotriaosylceramide (Gb3), at gut epithelium is the primary step and, consequently, the A subunit of VTs inhibits protein synthesis in the target cell. Proinflammatory cytokines, such as tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta, up-regulate Gb3 expression, increase sensitivity to VTs, and enhance VT action in developing disease. Currently, there is a growing interest in probiotics, given the increasing occurrence of antibiotic-resistant bacteria. In particular, much work on bifidobacteria among probiotics, regarded as microorganisms targeted for technological and therapeutic applications, has been performed. In Korea, the neutralizing effect of the culture supernatant of Bifidobacterium longum HY8001, Korean isolate, against the VTs from E. coli O157:H7 was found. Therefore, this study focused on the raveling of the inhibitory effect of B. longum HY8001 against VTs, through the interference B subunit of VTs and Gb3 interaction. Mice were inoculated intragastrically with B. longum HY8001 culture supernatant before and after challenge with E. coli O157:H7. Control mice were inoculated intragastrically only with E. coli O157:H7. Cytokine, TNF-alpha, and IL-1beta levels in sera and expression of their mRNA were decreased, and expression of Gb3 in renal tubular epithelial cells was reduced in mice treated with B. longum HY8001 culture supernatant. In competitive enzyme-linked immunosorbent assays (ELISAs), the culture supernatant of B. longum HY8001 primarily binds VTs to interfere the VTs with Gb3 interaction. These results suggest that soluble substance(s) in B. longum HY8001 culture supernatant may have inhibitory activity on the expression of Gb3, VT-Gb3 interaction, or both. Further study should be done to elucidate the property of soluble substances in B. longum HY8001 culture supernatant.
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Escherichia coli O157/metabolismo , Probióticos/administração & dosagem , Toxinas Shiga/antagonistas & inibidores , Triexosilceramidas/antagonistas & inibidores , Animais , Bifidobacterium , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imuno-Histoquímica , Interleucina-1/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Triexosilceramidas/metabolismo , Fator de Necrose Tumoral alfa/metabolismoRESUMO
An efficacy test of GC-100X, a noncorrosive alkaline ionic fluid (pH 12) composed of free radicals and supplemented with xylitol, was carried out against six major foodborne pathogens-Staphylococcus aureus FRI 913, Salmonella enterica serovar Enteritidis ATCC 13076, S. enterica serovar Typhimurium DT104 Korean isolate, Vibrio parahaemolyticus ATCC 17803, Escherichia coli O157:H7 ATCC 43894, and Pseudomonas aeruginosa KCTC 1637-at three different temperatures (4, 25, and 36 degrees C) with or without organic load (2% yeast extract). Results revealed a more than 4-log10 (CFU/ml) reduction (1.0 x 10(4) CFU/ml reduction) against all pathogens reacted at 37 degrees C for 3 h in the absence of organic material. GC-100X solution diluted with an equal volume of distilled or standard hard water (300 ppm CaCO3) showed effective bactericidal activity, particularly against gram-negative bacteria. Washing efficacy of GC-100X solution was compared against E. coli O157:H7 on cherry tomato surfaces with those of a commercially used detergent and chlorine water (100 ppm). Viable cell counts of E. coli O157:H7 that had penetrated to the cores of tomatoes after sanitizing treatment revealed that GC-100X stock and its 5% diluted solutions had similar washing effects to 100-ppm chlorine water and were more effective than the other kitchen detergent. These results indicate that GC-100X has good bactericidal and sanitizing activities and is useful as a new sanitizer for food safety and kitchen hygiene.
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Desinfetantes/farmacologia , Escherichia coli O157/efeitos dos fármacos , Solanum lycopersicum/microbiologia , Cloro/farmacologia , Contagem de Colônia Microbiana , Escherichia coli O157/crescimento & desenvolvimento , Microbiologia de Alimentos , Concentração de Íons de Hidrogênio , Temperatura , Fatores de Tempo , Resultado do Tratamento , Xilitol/farmacologiaRESUMO
Carcinoid tumor of the pancreas is rare. Moreover, obstructive pancreatitis secondary to a pancreatic carcinoid tumor is extremely rare. We report a case of pancreatic carcinoid tumor in a 50-year-old male who presented with pancreatitis. On multislice helical computed tomography, the main pancreatic duct was obstructed by a small round tumor, and the main pancreatic duct proximal to the tumor was dilated. The correlation between the main pancreatic duct and the tumor was well depicted on minimum intensity projection image. This is the first report of multislice helical computed tomorgraphic and minimum intensity projection image findings of a pancreatic carcinoid tumor presenting with pancreatitis.
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Tumor Carcinoide/complicações , Tumor Carcinoide/diagnóstico por imagem , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Pancreatite/etiologia , Tomografia Computadorizada Espiral , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We reviewed serial computed tomographic (CT) scans of 58 patients with traumatic subdural hygroma (SDG) to investigate its natural history. All were re-evaluated with a special reference to the size and density of SDG. Thirty-four patients (58.6%) were managed conservatively and 24 patients (41.4%) underwent surgery. The lesion was described as remained, reduced, resolved, enlarged and changed. Means of interval from injury to diagnosis and any changes in CT were calculated. SDGs were resolved in 12 (20.7%), reduced in 15 (25.9%), remained in 10 (17.2%), enlarged in 2 (3.4%), and changed into chronic subdural hematoma (CSDH) in 19 patients (32.8%). SDG was diagnosed at 11.6 days after the injury. It was enlarged at 25.5 days, remained at 46.0 days, reduced at 59.3 days, resolved at 107.5 days, and changed into CSDH at 101.5 days in average. SDGs were developed as delayed lesions, and changed sequentially. They enlarged for a while, then reduced in size. The final path of a SDG was either resolution or CSDH formation. Nearly half of SDGs was resolved or reduced within three months, however, 61.3% of unresolved or unreduced SDG became iso- or hyperdense CSDH. These results suggest that the unresolved SDG is the precursor of CSDH.
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Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/patologia , Derrame Subdural/diagnóstico por imagem , Derrame Subdural/patologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Traumatismos Craniocerebrais/complicações , Progressão da Doença , Hematoma Subdural Crônico/etiologia , Humanos , Lactente , Estudos Longitudinais , Linfangioma/diagnóstico por imagem , Linfangioma/etiologia , Linfangioma/patologia , Pessoa de Meia-Idade , Derrame Subdural/etiologiaRESUMO
Massive hemorrhage from ruptured hepatocellular carcinoma is uncommon. We report our experience in three cases of ruptured hepatocellular carcinoma diagnosed by computed tomography (CT). CT was useful in detecting ruptured hepatocellular carcinoma showing the parenchymal tumor per se, defining the extent of the hematoma, and showing serial density changes with the age of the hematomas.
Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Carcinoma Hepatocelular/complicações , Hematoma/etiologia , Humanos , Hepatopatias/etiologia , Neoplasias Hepáticas/complicações , Masculino , Pessoa de Meia-Idade , Ruptura Espontânea , Tomografia Computadorizada por Raios XRESUMO
We present a series of 61 traumatic subdural hygromas, and discuss the pathogenic mechanisms and natural history of this condition. It commonly occurred in patients over 50 years of age and before 5 years of age. Fifty-two cases (85.2%) were diagnosed 3 days after head injury. Glasgow Coma Score (GCS) on admission was 3-8 in 24 (39.3%), 9-12 in 15 (24.6%) and 13-15 in 22 patients (36.1%). Although three patients (4.9%) showed slow deterioration, most hygromas were clinically 'silent'. Thirty-eight patients (62.3%) were managed conservatively and 23 patients (37.7%) underwent surgery. Only five patients (21.7%) showed gross improvement after surgery, even though surgery was performed only for enlarged hygromas shown by serial computed tomography. In five patients (8.2%), a chronic subdural haematoma subsequently developed from a hygroma. A favourable outcome (good recovery or moderate disability) occurred in 59%, an unfavourable outcome (severe disability and vegetative state) in 28%, and death resulted in 13%. Outcome was closely related to the severity of primary head injury.
Assuntos
Traumatismos Craniocerebrais/complicações , Linfangioma Cístico/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Traumatismos Craniocerebrais/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Linfangioma Cístico/diagnóstico , Linfangioma Cístico/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We present a case of lumbosacral fracture-dislocation, which was spontaneously reduced during radiological examination. Such rapid reduction is, however, not reliable for long-term stability. We would like to report this case briefly because spontaneous reduction of lumbosacral fracture-dislocation has not been reported previously.
Assuntos
Luxações Articulares/fisiopatologia , Vértebras Lombares/lesões , Sacro/lesões , Fraturas da Coluna Vertebral/fisiopatologia , Adulto , Humanos , Luxações Articulares/cirurgia , Masculino , Fraturas da Coluna Vertebral/cirurgiaRESUMO
We report a unique case of a 12-year-old girl with unilateral proptosis form orbital extension of an extensive bilateral cephalhematoma. Loss of vision in the left eye due to severe proptosis was reversed by prompt aspiration and tarsorrhaphy.