Metastatic hepatic paraganglioma 6 years after carotid body tumor resection.
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Carotid Body Tumor↗
Biomedical subjects
Alden M Parsons
Publications and source records attributed to Alden M Parsons.
Smoking is associated with increased telomerase activity in short-term cultures of human bronchial epithelial cells.
Telomerase plays an important role in the maintenance of telomere ends in normal and tumor cells and ectopic expression can immortalize human bronchial epithelial (HBE) cells. We assessed telomerase activation, growth properties and methylation status in the hTERT promoter in a panel of HBE cell cultures in relation to smoking and previous lung cancer history. HBE cells were obtained from a total of 26 subjects, six of whom were lifelong non-smokers, while 20 subjects had a smoking history, including seven who had lung carcinoma. Telomerase activity was determined using the telomeric repeat amplification protocol (TRAP). Maximum passage number and time to senescence were also determined through extended culturing. The distribution of the telomerase activity between ever-smokers and never-smokers was significantly different (P=0.03, F-test), and there was a strong correlation between telomerase activity and the number of pack-years smoked (P=0.0012, F-test for slope). A small difference in telomerase activity was observed according to lung cancer status (P=0.02, F-test). Telomerase activity was not correlated with maximum passage number after extended culturing or with time to senescence. None of the HBE cultures demonstrated methylation of the hTERT promoter. Our results indicate an association between tobacco carcinogen exposure and telomerase activity in normal bronchial epithelium, although a causative role of tobacco smoking in the (re)activation of telomerase can not be proven. An increase in telomerase activity in normal bronchial epithelium might extend the lifespan of cells at risk for malignant transformation, and thus contribute to lung carcinogenesis.
Adolescent↗
Of buffaloes, horseshoes, and having no connections.
We report a patient with multiple congenital pulmonary anomalies, including unilateral pulmonary artery agenesis with an atretic left lung, "buffalo chest," and a variant of the anatomic anomaly "horseshoe lung," discovered during double lung transplantation. Both hemithoraces were filled by the right lung. The right chest was occupied primarily by the anatomic right lower lobe, and the left chest by the right middle lobe at the apex and the anatomic right upper lobe at the base.
Abnormalities, Multiple↗
Chromosomal abnormalities in bronchial epithelium from smokers, nonsmokers, and lung cancer patients.
The identification of individuals who are at greatest risk of developing lung cancer would greatly improve diagnosis and possibly lead to early treatment. To study the use of karyotypes for this purpose, we used short-term human bronchial epithelial (hBE) cell cultures from nonsmokers, smokers, and lung cancer patients. Twenty-five metaphases were scored for hBE cell cultures obtained from 32 patients: 8 were nonsmokers, and 24 had a history of smoking (of whom 11 had had lung cancer surgery). The number of abnormal metaphases ranged from 0 to 4 per cell culture. No overall differences in the number of abnormal metaphases were observed between nonsmokers and smokers or between lung cancer patients and non-lung cancer patients. The most commonly observed abnormalities were structural changes in chromosome 1 (six cultures), loss of chromosome 17 (six cultures), and trisomy of chromosome 20 (three cultures). These specific alterations were found almost exclusively in patients with a history of tobacco smoking. The results did not indicate that general chromosomal abnormalities are a useful marker for tobacco smoke exposure or cancer risk.
Adolescent↗
Thymic tumors.
Thymic tumors include thymic carcinoma, which exhibit aggressive behavior, and thymomas, which manifest a more indolent course. Complete resection is the mainstay of treatment, and there appears to be little benefit to partial resection. Postoperative radiotherapy may be useful in incompletely resected patients. Preoperative chemotherapy appears to increase the rate of complete resection and survival of patients with a stage III or IVa thymoma and should strongly be considered in such cases.
Carcinoid Tumor↗
Accuracy of helical CT in the detection of pulmonary metastases: is intraoperative palpation still necessary?
BACKGROUND: Pulmonary metastasectomy is well accepted in patients with isolated metastases from an extrathoracic malignancy. The standard approach involves careful intraoperative palpation of the lungs because more metastases are frequently found than were seen by preoperative conventional computed tomography (CT). Helical CT detects more nodules than conventional CT, raising the question of whether palpation of the lungs is still necessary if helical CT is used. METHODS: Retrospective review was done of medical records of patients undergoing metastasectomy with curative intent at the University of North Carolina (UNC) from 1999 to 2003. During this time at UNC, helical CT was routinely performed using a standardized technique, and all metastasectomy patients underwent manual lung palpation. The primary outcome measure of this study was whether malignant nodules (palpated, resected, and proven histologically) were reliably detected preoperatively by helical CT. RESULTS: Thirty-four patients were identified who underwent 41 cases of pulmonary metastasectomy with lung palpation. Our analysis revealed that in 22% (9/41), more malignant nodules were found intraoperatively than were detected by helical CT. Of 88 malignant intraparenchymal nodules, 69 were detected by helical CT (sensitivity 78%). Subset analyses of tumor histology, disease-free interval, the presence of a single lesion versus multiple lesions, the interval between the CT and metastasectomy, and the size of the largest lesion were unable to identify a cohort in which lung palpation was no longer needed after preoperative helical CT. CONCLUSIONS: Despite the advent of helical CT, palpation of the lung is necessary if the goal is to resect all detectable disease.
Adolescent↗
Multifocal right atrial myxoma and pulmonary embolism.
Multifocal cardiac myxoma with greater than two foci is rarely reported in the literature. We report a case of a 22-year-old woman who presented with profound right heart failure, and was found to have seven right atrial myxomas with bilateral pulmonary embolism, including near-complete occlusion of right pulmonary arterial flow. Multifocal atrial myxoma occurs most often in the familial setting, and often is associated with recurrence. Her disease was nonfamilial. She was successfully treated with surgical resection, and has had complete recovery with no evidence of recurrence over a 4-year period.
Adult↗