Αρχειοθήκη ιστολογίου

Κυριακή 11 Ιουλίου 2021

Sequential occurrence of different subtypes of nonpuerperal mastitis in contralateral breasts: a report of two cases

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Int J Clin Exp Pathol. 2021 Jun 15;14(6):782-785. eCollection 2021.

ABSTRACT

BACKGROUND: Nonpuerperal mastitis (NPM) is a nonspecific chronic inflammation in the breast. The two most common pathologic subtypes are idiopathic granulomatous mastitis (IGM) and plasma cell mastitis (PCM). The cause of NPM is unknown, and the recurrence rate is high; however, the sequential development of two different pathologic subtypes of NPM in contralateral breasts of the same patient is rare.

CASE SUMMARY: Two women who were in their 30 s and with a history of childbearing had an inflammatory mass in one breast, which was identified as PCM by core needle biopsy. However, 1 year after treatment, IGM occurred in the contralateral breast. Histopathologic results after the surgery confirmed both diagnoses. New-onset PCM in both patients was successfully treated with local extended surgical resection and antibiotics combined with incision and drainag e. The IGM that developed in the contralateral breast after 1 year was treated with local extended surgical resection and oral steroids. No signs of NPM recurrence were observed in either breast after a follow-up period of more than 1 year.

CONCLUSION: Because recurrence after NPM treatment often occurs in the affected breast, the contralateral breast, which does not often exhibit morbidity factors, is often ignored during treatment follow-up. However, our cases suggest that patients with the occurrence of NPM in one breast should undergo long-term follow-up of the contralateral breast by close monitoring. NPM recurrence should also be considered when there is pain, redness, and swelling in the contralateral breast.

PMID:34 239681 | PMC:PMC8255195

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Survival analysis of recurrent squamous cell carcinoma of the lower oral cavity treated by surgery

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Int J Clin Exp Pathol. 2021 Jun 15;14(6):713-719. eCollection 2021.

ABSTRACT

The aim of the present study was to investigate the survival of individuals with squamous cell carcinoma of the lower oral cavity who underwent surgical treatment and experienced recurrence, considering the site of the recurrent disease. A retrospective longitudinal study was conducted, comparing the survival rates of patients with and without recurrence and considering the site of recurrence (local, regional, distant). Statistical analysis was performed with SPSS and a p-value ≤ 0.05 was considered significant. The sample comprised 150 patients, 59 (39.3%) of whom experienced recurrence. Local recurrence occurred in 35 patients (23.4%), regional recurrence in 17 (11.3%), and distant recurrence in seven (4.6%). The average survival of participants with local, regional, and distant recurrence was 12, five, and two months, respectively. Patients with re current disease had worse survival than those who did not (P < 0.001). Patients with local recurrence had better survival than those with regional/distant recurrence (P = 0.011). All patients with regional and distant recurrence had deceased by the last follow-up. In conclusion, patients with local recurrence of squamous cell carcinoma of the lower oral cavity treated by surgery have a better survival rate than those with regional and distant recurrence. Local recurrence poses the possibility of curative salvage therapy.

PMID:34239672 | PMC:PMC8255197

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Effects of interventional therapy on AQP4 gene expression and neuron apoptosis in rabbits with ischemic brain injury caused by carotid artery stenosis

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Int J Clin Exp Pathol. 2021 Jun 15;14(6):786-793. eCollection 2021.

ABSTRACT

Objective: To explore the effects of interventional therapy (IT) on Aquaporin-4 (AQP4) gene expression and neuron apoptosis in rabbits with ischemic brain injury caused by carotid artery stenosis, and to further optimize the therapeutic regime of clinical ischemic brain injury (IBI). Methods: 30 New Zealand rabbits were randomly divided into three groups: Sham group (n=10), IBI group (n=10) and IBI+IT group (n=10). A rabbit model of carotid artery stenosis was established to induce IBI. 12 hours later, interventional therapy was achieved through percutaneous transluminal coronary angioplasty (PTCA) by pumping up the balloon to widen the catheter. The expression of AQP4 mRNA and protein were determined by reverse transcription polymerase chain reaction (RT-PCR) and western blot, respectively. The distributions of rabbit hippocampus and cerebral co rtex were detected by Nissl staining. The neuronal function of rabbits in the three groups after surgery was assessed with mNSS score. TUNEL (Terminal Transferase-mediated dUTP Nick End-labelling) staining was used to observe neuron apoptosis in rabbit brain tissue. The expressions of Bax and Bcl-2 protein were detected by western blot. Markers of oxidative stress in rabbit brain tissues were detected by Reactive Oxygen Species ELISA Kits. Morphology of the organelles in rabbit brain tissues was observed with transmission electron microscopy (TEM). Results: The protein and mRNA expressions of AQP4 in rabbit brain tissues were significantly decreased in the IBI group. Nissl staining results showed that IT improved IBI in rabbit hippocampus. In addition, IT significantly ameliorated the neuronal function of rabbits, and reduced the apoptosis and oxidative stress level of neurons in brain tissues. Furthermore, we found that after IT, organelle damage was significantly reduced in rabbit neurons. Conclusion: After receiving IT, AQP4 gene level and neuron apoptosis were significantly reduced in rabbit brain tissues with ischemic brain injury from carotid artery stenosis.

PMID:34239682 | PMC:PMC8255198

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Cholesterol granuloma mimicking ovarian cancer

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Int J Clin Exp Pathol. 2021 Jun 15;14(6):741-745. eCollection 2021.

ABSTRACT

Cholesterol granuloma is a consequence of a chronic inflammatory reaction with accumulation of cholesterol crystals in the tissue. Ovarian cholesterol granuloma is rarely reported in the literature and can be misdiagnosed as ovarian cancer during surgery due to pelvic fibrosis and adhesion secondary to chronic inflammation, especially in postmenopausal women. We present a patient who had been referred to our gynecologic oncology clinic. The patient was a 65-year-old overweight female. She was referred to our tertiary hospital due to suspicion of ovarian cancer since she had CA 125 level above 3000 U/ml with a pelvic mass. To date, no cases of cholesterol granuloma causing CA 125 level above 3000 U/ml have been reported in the literature. We performed an elective diagnostic laparotomy to rule out occult malignancy. After removing the mass, it was sent for froze n section intraoperative consultation. Grossly the mass had irregular surface with yellow-brown appearance. The final diagnosis of cholesterol granuloma with serous cystadenofibroma was made. No evidence of malignancy was found. Symptoms, clinical and intraoperative findings of ovarian choloesterol granuloma can be misdiagnosed as cancer. Since the final diagnosis of a pelvic mass depends on histologic analysis, cholesterol granuloma should be kept in mind as a differential diagnosis of pelvic mass.

PMID:34239676 | PMC:PMC8255208

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Effect of Otolaryngology Residency Program Training on Obstructive Sleep Apnea Practice

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Abstract

According to the importance of management of obstructive sleep apnea syndrome by otolaryngologists, this study was designed to investigate knowledge, attitudes and practice of junior and senior residents of otolaryngology and evaluate the effect of current residency training program on choosing the first lines of treatment. A total of 110 residents of otolaryngology were selected. Our study tools were obstructive sleep apnea knowledge and attitudes (OSAKA and OSAKA-KIDS) questionnaires. The participants were classified as junior and senior. Senior residents had significantly higher total knowledge score for OSAKA based on independent t test (12.73 Vs. 10.52). No significant difference was observed for OSAKA-KIDS (11.31 Vs. 10.69). The most frequent choice for the first line was CPAP (63.8%) and weight loss (41.5%) among junior and senior residents, respectively. Although the knowledge of otolaryngology residents increased during their program, the choice of first line treatment in obstructive sleep apnea was different between junior and senior residents. We found a need for further multidisciplinary education for residents especially in the management of sleep apnea particularly toward CPAP usage and this syndrome in pediatrics.

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Myoepithelioma of the Parotid Gland: A Case Report and Literature Review

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Abstract

Tumors of the salivary glands are rare and have various histo-pathological subtypes. The overall incidence is 2.5–3 per 100,000 patients per year. Myoepithelioma of the parotid gland is very rare with an incidence of only 1–1.5% among all salivary gland tumors. The diagnostic criteria for benign myoepithelioma were laid down on the basis of the work of Barnes and Sciubba. A 30-year-old lady presented to our university with a mass slowly increasing in size. There were no aggravating and/or relieving factors found. On examination a 3 × 3 cm diffuse swelling was found around the right pre auricular area. Fine Needle Aspiration Cytology (FNAC) was performed. The findings were suggestive of a pleomorphic adenoma. The patient underwent a right sided superficial parotidectomy to remove the tumor. The final histopathology report revealed the tumor to be a myoepithelioma. Myoepithelioma is a benign salivary gland neoplasm formed almost entirely of myoepithel ial cells arranged in a sheet, island or cord-like fashion. On CT scans, it presents as a well-circumscribed homogenous lesion with lobulated or smooth margins. Myoepitheliomas may also have nodules that enhance under contrast and areas of linear bands that do not. The recommended treatment for a myoepithelioma is complete surgical excision with wide margins. It has a very low recurrence rate compared to the 15–18% recurrence rate for pleomorphic adenomas. Utilization of immunohistochemical staining is of utmost importance in suspected myoepithelioma cases to ensure proper treatment and follow-up. Myoepitheliomas are rare tumors which must be included in the differential if a patient presents with a tumor of characteristics similar to those described above. Immunohistochemistry and electron microscopy are useful tools for the diagnosis of myoepitheliomas.

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Low Antioxidant Enzyme Levels and Oxidative Stress in Laryngopharyngeal Reflux (LPR) Patients

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Laryngopharyngeal reflux disease (LPR) is a characterized by symptoms different from gastroesophageal reflux disease (GERD). LPR can causes chronic mucosal inflammation which may lead to an increase in cytokine production, and a systemic decrease in antioxidant enzyme levels. Our aim in this study is to evaluate antioxidant enzyme levels in patients with LPR.
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Urinary iodine concentration and radioactive iodine therapeutic response in patients with differentiated thyroid cancer

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Biomark Med. 2021 Jul 9. doi: 10.2217/bmm-2020-0745. Online ahead of print.

ABSTRACT

Aim: Urinary iodine concentration (UIC) may assess radioactive iodine ablation. Materials & methods: According the 2015 American Thyroid Association guidelines, patients were categorized into low- to intermediate-risk or high-risk groups. The iodine concentration in the morning urine specimens was measured by the ceric ion-arsenious acid method. Results: In the low- to inte rmediate-risk group (113 cases), nonexcellent response (non-ER) was associated with higher UIC, higher UIC subgroups (p < 0.05), higher pre-ablative stimulated thyroglobulin levels (p < 0.01). In the high-risk group (68 cases), the non-ER rate was higher in the higher pre-ablative stimulated thyroglobulin group (p < 0.01), but not significantly different between the UIC and UIC subgroups (p > 0.05). Conclusion: The non-ER rate was related to UIC in the low- to intermediate-risk group; however, UIC did not affect the non-ER rate in the high-risk group.

PMID:34241549 | DOI:10.2217/bmm-2020-0745

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Dynamic sleep MRI in obstructive sleep apnea: a systematic review and meta-analysis

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Eur Arch Otorhinolaryngol. 2021 Jul 9. doi: 10.1007/s00405-021-06942-y. Online ahead of print.

ABSTRACT

PURPOSE: The objective of this study is to systematically review the international literature for dynamic sleep magnetic resonance imaging (MRI) as a diagnostic tool in obstructive sleep apnea (OSA), to perform meta-analysis on the quantitative data from the review, and to discuss its implications in future research and potential clinical applications.

STUDY DESIGN: A comprehensive review of the literature was performed, followed by a detailed analysis of the relevant data that has been published on the topic.

METHODS: Clinical key, Uptodate, Ovid, Ebscohost, Pubmed/MEDLINE, Scopus, Dynamed, Web of Science and The Cochrane Library were systematically searched. Once the search was completed, dynamic sleep MRI data were analyzed.

RESULTS: Nineteen articles reported on 410 OSA patients and 79 controls that underwent dy namic sleep MRI and were included in this review. For meta-analysis of dynamic sleep MRI data, eight articles presented relevant data on 160 OSA patients. Obstruction was reported as follows: retropalatal (RP) 98%, retroglossal (RG) 41% and hypopharyngeal (HP) in 5%. Lateral pharyngeal wall (LPW) collapse was found in 35/73 (48%) patients. The combinations of RP + RG were observed in 24% and RP + RG + LPW in 16%. If sedation was used, 98% of study participants fell asleep compared to 66% of unsedated participants.

CONCLUSIONS: Dynamic sleep MRI has demonstrated that nearly all patients have retropalatal obstruction, retroglossal obstruction is common and hypopharyngeal obstruction is rare. Nearly all patients (98%) who are sedated are able to fall asleep during the MRI. There is significant heterogeneity in the literature and standardization is needed.

PMID:34241671 | DOI:10.1007/s00405-021-06942-y

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The evaluation of superior semicircular canal bone thickness and radiological patterns in relation to age and gender

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Surg Radiol Anat. 2021 Jul 9. doi: 10.1007/s00276-021-02797-4. Online ahead of print.

ABSTRACT

PURPOSE: The present study aims to evaluate the superior semicircular canal (SSC) bone thickness and radiological patterns in relation to age and gender in a Turkish population using cone beam computed tomography (CBCT).

METHODS: A total of 450 temporal bones were evaluated in the study by two examiners. The radiological patterns of SSC were categorized as follows: dehiscent, papyraceous, normal, thick and pneumatised patterns. The bone thickness of SSCs were measured.

RESULTS: The mean bone thickness of the SSC for females was 1.079 ± 0.8 mm. For males, the mean bone thickness was 0.952 ± 0.6 mm. There was no significant difference between males and females for the mean bone thickness of the SSC. (p > 0.05) The normal pattern was found in 258 temporal bones (57.3%). Seventy-two cases (16%) were defined as "papyraceous pattern"; 23 cases (5.1%) were defined as "thick pattern" and 42 cases (9.3%) were defined as "pneumatised pattern". SSC dehiscence was determined in 55 cases (12.2%). There was no significant difference between radiological patterns for age groups and gender (p > 0.05).

CONCLUSION: There was no significant relationship between SSC bone thickness with age and gender. The radiological patterns of SSC were not associated with age and gender. Radiologists evaluating the head and neck region for various reasons should be a ware of these structures and report not only the SSC dehiscence but also the papyraceous pattern.

PMID:34241668 | DOI:10.1007/s00276-021-02797-4

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Blocking the Thyrotropin Receptor with K1-70 in a Patient with Follicular Thyroid Cancer, Graves' Disease, and Graves' Ophthalmopathy

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Abstract
Background: We report the therapeutic use of K1-70™, a thyrotropin receptor (TSHR) antagonist monoclonal antibody, in a patient with follicular thyroid cancer (FTC), Graves' disease (GD), and Graves' ophthalmopathy (GO).

Methods: A 51-year-old female patient, who smoked, presented in October 2014 with FTC complicated by GD, high levels of TSHR autoantibodies with high thyroid stimulating antibody (TSAb) activity, and severe GO. K1-70 was administered at 3 weekly intervals with the dose adjusted to block TSAb activity. Her cancer was managed with lenvatinib and radioiodine therapy.

Results: Following initiation of K1-70 therapy, TSAb activity measured in serum decreased and GO (proptosis and inflammation) improved. On K1-70 monotherapy during the pause in lenvatinib, several metastatic lesions stabilized while others showed progression attenuation compared with that before lenvatinib therapy.

Conclusions: These observations suggest that blocking TSHR stimulation with K1-70 can be an effective treatment for GO and may also benefit select patients with FTC and GD.

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Thyroid, Ahead of Print.
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