[Squamous carcinoma of the thyroid: apropos of a case].
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Biomedical subjects
Publications and source records attributed to A Rives.
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An experimental long-term hepatotoxicity study of cyanamide in Sprague-Dawley and Wistar rats has been carried out. After six months oral administration of cyanamide (2.7 and 25 mg/kg/day) no significant histological changes have been observed in the liver. Similarly, a one year intraperitoneal administration of 8 and 16 mg/kg/day has not induced any hepatic change. Specifically, no inclusion bodies in any cyanamide treated rat have been detected. Moreover, hepatic biochemical parameters have shown no significant impairment of hepatic function at doses used in human therapy (0.5-1 mg/kg).
A case of malignant polyposis coli, occurring in a 71-year-old man in association with a primary invasive adenocarcinoma of the gallbladder is presented. The eventuality that the carcinoma of the gallbladder could be a metastasis from the colonic neoplasia was excluded due to the observation in the mucosa of the gallbladder of changes corresponding to carcinoma in situ. This is the fourth case reported of polyposis coli coexisting with a carcinoma of the biliary tract.
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The development of acute respiratory failure (ARF) in patients with hematologic disorders (HDs) is a life-threatening condition which does not respond well to intensive therapy. We present our experience in the use of intensive therapy for a group of 30 patients suffering from leukemia (21 cases), bone-marrow aplasia (6 cases), or lymphoma (3 cases). Seven had undergone bone-marrow transplantation. All 30 patients were hypoxemic and responded poorly to the administration of high oxygen concentrations via face mask. All were admitted to our intensive respiratory unit (IRU), where 26 received oxygen via mechanical ventilation, and 4 received continuous positive airway pressure (CPAP). Definitive diagnosis was established in 19 (63%) patients. A premortem diagnosis obtained in 8 (26%) cases did not change therapy. The diagnostic accuracy of serology and transbronchial biopsy was low. Of the 6 (20%) patients who recovered from ARF, only 2 were discharged from the hospital. The remaining 24 (80%) patients died in the IRU.
In a series of 500 autopsies cancer was found to be the first cause of death (24.6 por 100), followed by infectious diseases (23.8 per 100), and vascular diseases (22.2 per 100). The most frequent kind of malignant tumors found were lung neoplasms (17.8 per 100), followed by leukemias (17.0 per 100) and digestive tract tumors (11.3 per 100). Metastases were produced most frequently by tumors of the lungs (82.6 per 100), liver (81.8 per 100) and digestive tract (64.2 per 100). Metastases were found mainly in the lymph glands and liver.
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Anatomopathologic diagnosis were studied in a series of 500 clinical autopsies (440 adults and 9 children between 1 and 14 years old). Cancer was the most frequent cause of death (27.7%) followed by infectious processes (26.9%) divided between respiratory infections (14.3%), non-respiratory (8.8%) and tuberculosis (3.8%). Vascular disorders accounted for 25.2% and cirrhosis for 10.2%. The diagnosis of cancer were incorrect in 28.8%, of those, 16% were over-assessed and 12.8% under-assessed. Cancer was multiple in 2.7% of all cases, hepatic cancer was found in 17.6% of cirrhosis cases and in 11% of all cases, thromboembolism of different degree was seen.
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The case of an association of three well-differentiated pathologies is reported. A 40-year-old woman with a toxic thyroid adenoma developed acute polyarthritis during the course of the disease. The articular symptoms together with chest X-rays and a consistently negative PPD (1:100) were suggestive of sarcoidosis. This was later confirmed by the discovery of non-caseating granulomas in the liver and superficial lymph nodes, and by a positive Kveim's test. Histopathologic examination of the thyroid gland confirmed the existence of the adenoma. Sarcoid infiltration was not observed, but on the other hand the typical images of subacute granulomatous thyroiditis (De Quervain's thyroiditis) were discovered.
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Several authors have suggested that the risk of developing aminoglycoside nephrotoxicity is greater in cirrhotic patients than in the noncirrhotic population. However, this has not been confirmed by other investigators. To compare the intensity and characteristics of aminoglycoside nephrotoxicity in cirrhotic and normal rats, 31 rats with carbon tetrachloride-induced cirrhosis with ascites and 35 control rats were treated with gentamicin. Each group of rats was divided into two subgroups in order to receive 10 or 40 mg per kg per day of gentamicin, and different subsets of animals were killed on Days 4, 8 and 12 of treatment for renal histological examination and determination of renal tissue gentamicin concentration. Urine volume, osmolality, sodium excretion and N-acetyl-beta-D-glucosaminidase activity were measured daily throughout the study. Creatinine clearance and trough plasma concentration of gentamicin were determined in each animal immediately before killing. There were no significant differences between cirrhotic and control rats in relation to the magnitude of changes in urine volume, osmolality, sodium excretion and N-acetyl-beta-D-glucosaminidase activity and creatinine clearance during gentamicin administration. The values of a histopathological score semiquantitatively assessing the renal morphological changes observed by light microscopy were not significantly different in cirrhotic and control rats. In addition, similar trough plasma and renal cortical tissue concentrations of gentamicin were observed in both groups of animals. These results suggest that, in this experimental model, cirrhosis does not increase the risk for aminoglycoside nephrotoxicity.
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The cytoarchitecture and fine structure of seven cortical tubera were studied by means of camera lucida drawings and Golgi sections in the coronal, sagittal, and tangential planes. Varied structural disorganization was observed in different tubera. Cytoarchitectural study revealed the absence of laminar and columnar cortical organization, whereas Golgi's method showed abnormal neuronal orientation and distribution. Pyramidal neurons manifested malrotation and orientation of the apical dendrites in aberrant directions. Large numbers of stellate cells in addition to medium-sized and small pyramids predominated in the intermediate and deep regions of the tubera. A generalized but focally accentuated disorder of cell migration and neuronal organization is postulated.