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PubMed2004

Serum leptin level in patients with functional dyspepsia.

UNLABELLED: BACKGROUND/GOAL: Previous studies have shown that leptin plays a major role in the amount of food consumption. Recently, leptin and its receptors have been found in the human gastric mucosa. The aim of this study was to seek any possible correlation between serum leptin level and subtypes and pathological findings in functional dyspepsia. MATERIALS AND METHODS: In a prospective study, we randomly select 44 patients as dysmotility-like and ulcer-like dyspepsia (according to ROME II criteria) in two equivalent groups and compared them with 22 healthy volunteers control group who matched the patients in relation to age, sex and body mass index. From each patient, a fasting blood sample for leptin level and two antral biopsies for evaluating the intensity of gastritis and Helicobacter pylori infection were provided and compared with the control group. RESULTS: Compared to the control group, serum leptin level was significantly higher in patients with dysmotility-like dyspepsia (P < 0.05). Leptin level were also significantly correlated with the presence of gastritis and H. pylori infection (P < 0.05). CONCLUSION: Leptin may have a role in the pathogenesis of the dysmotility variety of non-ulcer dyspepsia through mechanisms other than H. pylori infection. Further studies based on gastric leptin immunohistochemistry may need correlation between symptoms of functional dyspepsia and gastric leptin expression.

Adolescent↗

PubMed2003

FHIT mRNA expression in thymoma.

AIMS: The FHIT gene is located at 3p14.2 a region frequently lost in multiple tumour types. Loss of FHIT expression has been found to occur frequently in multiple tumour types. We wished to investigate that FHIT mRNA levels in a series of thymomas. METHODS: Expression of FHIT messenger ribonucleic acid (RNA) was evaluated by reverse transcription-polymerase chain reaction (RT-PCR) using a LightCycler in 49 thymomas and 11 adjacent histologically normal thymus samples from patients. RESULTS: FHIT transcripts in tumour samples (28.6+/-35.8) at levels significantly lower than those in normal thymus samples (573.9+/-1028.0, p=0.001). No relationship was seen between FHIT gene expression and age, gender, or pathological thymoma subtypes. FHIT mRNA expression in invasive thymomas (stage II-IV, 34.5+/-39.2) was significantly higher than that in stage I thymomas (20.7+/-29.7, p=0.01). Immunohistochemistry showed that p21 protein positive thymoma had a tendency towards higher FHIT gene expression than in p21 negative thymoma. CONCLUSIONS: Decreased FHIT expression might be seen in early stage thymoma, suggesting that loss of FHIT expression may associate with tumorigenesis of thymoma.

Acid Anhydride Hydrolases↗

PubMed2003

Hyperlexia profiles.

Two hyperlexic individuals were tested on reading outcome measures and on basic skills shown to be critical in reading acquisition. Results suggested distinct pathways to superior word recognition skills that can be described under a contemporary model of skilled reading, with differential acquisition of basic skills; superior word recognition skill was associated in both cases with specialized development in one basic area, that of orthographic processing. Results supported an asset rather than a deficit analysis of hyperlexia: Rather than assimilating to reading pathology (dyslexia) subtypes, hyperlexia was seen to be accompanied by assets that are absent in dyslexic profiles.

Adolescent↗

PubMed2003

Sphingosine 1-phosphate pathway therapeutics: a lipid ligand-receptor paradigm.

New insights have been gained into the therapeutic relevance of the sphingosine 1-phosphate (S1P) pathway, on the basis of reverse pharmacological approaches to defining the mechanism of action of the immunosuppressive agent FTY720. Natural and synthetic sphingosine 1-phosphate receptor agonists can make picomolar interactions with their cognate G-protein-coupled receptors, and provide chemical approaches to defining the contribution of distinct receptor subtypes to pathology, physiology and treatment. The chemistry of S1P receptors and their synthetic ligands present a paradigm for the understanding of lipid-receptor interactions and their contribution to physiology and pathology. These approaches can potentially be extended to a broad, related family of G-protein-coupled receptors that share ligands and ligand similarities.

Animals↗

PubMed2004

Frontotemporal lobar degeneration with ubiquitin-only-immunoreactive neuronal changes: broadening the clinical picture to include progressive supranuclear palsy.

The frontotemporal lobar degenerations (FTLDs) are a group of disorders in which the clinical picture is not necessarily predictive of the underlying neuropathology. The FTLD with ubiquitin-only-immunoreactive neuronal changes (FTLD-U) subtype is pathologically characterized by ubiquitin-positive, tau and alpha-synuclein-negative neuronal cytoplasmic inclusions in the frontotemporal cortex and hippocampal dentate fascia. When similar pathological changes are accompanied by histological features of motor neuron disease (MND), the term FTLD-MND is used. The latter pathological changes may be found in patients with or without clinical evidence of MND. We retrospectively reviewed the clinical details of three patients with a rapidly progressive, levodopa-unresponsive bradykinetic-rigid syndrome and frontal cognitive impairment. A diagnosis of progressive supranuclear palsy (PSP) had been considered in all three cases at initial presentation. Two of the cases fulfilled clinical diagnostic criteria for PSP, which was the final clinical diagnosis during life. Pathological analysis showed typical histological appearances of FTLD-MND in two cases and of FTLD-U in one case. Semi-quantitative analysis of pathological load seemed to correlate with the clinical phenotype. FTLD-U or FTLD-MND should be considered in the differential diagnosis of progressive frontal dementia with an akinetic rigid syndrome and supranuclear gaze palsy or Steele-Richardson-Olszewski disease.

Aged↗

PubMed2004

Paraganglioma-like dermal melanocytic tumor: a unique entity distinct from cellular blue nevus, clear cell sarcoma, and cutaneous melanoma.

We are reporting a previously undescribed primary dermal melanocytic tumor identified by reviewing all dermal melanocytic tumors referred in consultation that did not qualify histologically as a previously described entity. From these cases, 8 were remarkably similar. We termed them "paraganglioma-like dermal melanocytic tumor" (PDMT) based on their nested growth pattern. This term is used descriptively and does not imply any histogenetic or biologic similarity to true paraganglioma. PDMT is primarily a tumor of the extremities of adult females (18-53 years, mean 35 years; males 2; females 6) which present as a dermal nodule (range, 0.5-4.2 cm; mean, 1.4 cm) composed of nests of clear to amphophilic oval cells separated by delicate fibrous strands. Nuclear atypia was mild and mitotic activity low (1-4 mitoses/10 HPF). Melanin was not obvious on light microscopy. Tumors expressed S-100 protein (8 of 8), Melan-A (4 of 8), HMB-45 (8 of 8), and microphthalmia transcription factor (8 of 8) and lacked pancytokeratin (8 of 8) and smooth muscle actin (8 of 8). FISH analysis of 5 cases revealed an intact EWS gene locus, supporting absence of the clear cell sarcoma 12;22 translocation. Follow-up information in 8 patients (range, 35-92 months; mean, 54 months) indicated that all were alive without disease. PDMT comprises a clinically and pathologically unique subtype of dermal melanocytic tumors. Our study suggests a benign course, although a lesion of low malignant potential cannot be excluded.

Adolescent↗

PubMed2005

Malignant melanoma of the skin: risk, tumour characteristics and mortality in adult twins born in Norway between 1905 and 1945 - a cohort study.

In this cohort study, data on the observed reduced incidence of malignant melanoma (MM) of the skin in twins compared with a control group were related to tumour characteristics and all-cause mortality. The twin cohort consisted of 20 926 individuals and the control group included individuals picked at random and matched to the twin cohort with respect to age, sex and place of birth. The cohorts were linked to the Cancer Registry of Norway and all cases of MM diagnosed from 1960 to 1999 were followed until October 2003. The mean observation time from diagnosis to death or censoring was 10.9 years (SD, +/-8.5 years). The relative risk of MM for the twins was 0.68 [95% confidence interval (CI): 0.55, 0.83]. No statistically significant difference was found in the distribution of histopathological subtypes or pathological stage between the cohorts. The crude all-cause mortality risk for the twin cases was 0.79 (95% CI: 0.58, 1.07). Stratified analysis indicated effect modification by gender on all-cause mortality risk (Breslow-Day test of homogeneity P=0.02). Multivariate analysis was performed separately for men and women. The adjusted mortality risk ratio for male twin cases was 1.11 (95% CI: 0.75, 1.65) and for female twin cases 1.05 (95% CI: 0.61, 1.8). The twins had a lower relative risk of MM compared with the control group, but similar tumour characteristics and all-cause mortality.

Adult↗

PubMed2006

Renal artery embolization: clinical indications and experience from over 100 cases.

OBJECTIVE: To review current indications and techniques for renal artery embolization (RAE) and more specifically to review cases of RAE before nephrectomy for treating patients with a large renal mass. PATIENTS AND METHODS: All RAEs done at our institution between May 1993 and December 2005 were reviewed. Patients were identified using a database assembled by the Division of Cardiovascular Interventional Radiology. Indications, techniques and RAE-related complications were then obtained from a retrospective review of medical records. Additional data for patients undergoing preoperative infarction were acquired, including estimated blood loss (EBL), transfusion requirement, pathological size, subtype, grade, stage, and level of tumour thrombus if present. RESULTS: In all, there were 121 RAEs, 69 in males and 52 in females (mean age 57.6 years, range 11-89). Metallic microcoils were the most often used embolization agent, followed by acrylic microspheres (embospheres), polyvinyl alcohol particles, absolute ethanol, and Gelfoam (Pharmacia & Upjohn, USA). The most common indication for RAE was infarction before nephrectomy (54.5%). Other indications included symptomatic angiomyolipomas, palliation of unresectable renal cancer, haemorrhage, perinephric bleeding in end-stage renal disease, vascular lesions, malignant hypertension, and sequelae of end-stage renal disease. RAE-associated complications including coil migration, incomplete embolization, and groin haematoma (in 5.0%). Symptoms of post-infarction syndrome were common, with 74.4% of patients having flank pain, nausea, or vomiting; the vast majority of these symptoms were mild and self-limited. In patients having nephrectomy after RAE the median (range) interval from RAE was 2 (0-78) days. The mean tumour size was 11.2 (3.5-25) cm and 46% of patients had tumour thrombus present in either the renal vein or inferior vena cava (IVC). The mean (median) overall EBL in patients having nephrectomy after RAE was 1048 (725) mL. The mean transfusion requirement over the course of hospitalization was 3.9 units of packed red blood cells. CONCLUSIONS: RAE is a safe and effective therapeutic tool for many urological, renal and vascular conditions. Its use has increased at our institution due to improved techniques, embolization materials, and our increasing use of RAE as an adjuvant procedure for patients requiring nephrectomy with or without IVC thrombectomy. There are many potential operative advantages for patients having RAE before surgery, with minimal morbidity. It is likely that the lack of prospective randomized trials is the primary reason why it is underutilized in the preoperative setting.

Adolescent↗

PubMed2006

Pathobiology of classical Hodgkin lymphoma.

The World Health Organization has acknowledged the malignant nature of classical Hodgkin lymphoma (cHL), which encompasses four histological subtypes. The diagnosis of cHL is based on the detection of malignant Hodgkin and Reed-Sternberg cells (HRSC) confirmed by immunophenotyping and the detection of growth patterns specific to each histological subtype. The pathologic HRSC arise from germinal center or immediate postgerminal cells that lack detectable immunoglobulin/B-cell antigen receptor expression, with a consequent loss of B-cell identity; very few cHL cases are of T-cell origin. To escape apoptosis, which normally occurs in B cells with nonfunctioning antigen receptor machinery, HRSC develop concurrent antiapoptotic mechanisms by activation of nuclear factor-kappaB or are rescued by Epstein-Barr virus infection. HRSC are characterized by a variable and inconstant immunophenotype, with a remarkable loss of lineage-specific cell antigens and expression of antigens of other cell lineages. The master plan of B-cell identity in HRSC is disturbed not only at the immunoglobulin expression level, but also at the transcriptional factor level. HRSC are further characterized by profound cell cycle deregulation with futile replication, multinucleation and poly- and aneuploidy. Here, we review pathobiological aspects of cHL with respect to lymphomagenesis and routine diagnostics.

Hodgkin Disease↗

PubMed2002

Single nucleotide polymorphisms in the 3' untranslated region of vascular endothelial growth factor gene in Japanese population with or without renal cell carcinoma.

We investigated native Japanese subjects whether C702T, C936T and G1612A polymorphisms in the 3' untranslated region (3'-UTR) of vascular endothelial growth factor (VEGF) gene are associated with the risk of renal cell carcinoma (RCC). Genomic DNAs from 145 RCC patients and 145 healthy controls were examined by polymerase chain reaction-based restriction fragment length polymorphism. Variant allele frequencies of C702T, C936T and G1612A were 0.00, 0.20 and 0.13 in the controls, respectively. The C702T and G1612A allele frequencies were significantly different between the Japanese population and the Caucasian population reported elsewhere. For each of C936T and G1612A polymorphisms, there was no statistically significant difference in the distribution of genotype frequencies between the cases and controls. Odds ratios and 95% confidence intervals computed by logistic regression analyses were not statistically significant. Stratification for the RCC cases according to pathological cell subtype, grade or stage failed to reveal any significant heterogeneity with respect to the genotype of each VEGF polymorphism. We revealed that there are significant ethnic differences in the C702T and G1612A allele frequencies, but suggested that C702T, C936T and G1612A polymorphisms in the 3'-UTR of VEGF gene are not associated with the risk of RCC, at least in Japanese population.

3' Untranslated Regions↗

PubMed1999

Isolated cerebral hydatid cysts: a comparative study of two different types of presentations.

OBJECTIVES: To demonstrate the existence of two imaging patterns of cerebral hydatidosis and discuss its clinical importance. MATERIAL AND METHODS: A retrospective review of six cases of cerebral hydatidosis using various imaging techniques including CT, MRI, angiography and cystogram. RESULTS: Clinically the most common findings included papilloedema, headache and vomiting. Two of the cases reported recurrence of symptoms and were reoperated. The first 4 cases presented the classical signs of unilocular well defined cysts while the last two cases had multilocular, often polygonal cysts with perifocal edema, calcification and membrane detachment. CONCLUSION: Two radiologically and pathologically distinct subtypes of hydatidosis exist. Division into groups may assist decision over treatment protocol.

Adult↗

PubMed1999

[The experience of treatment of 7 cases of olfactory neuroblastoma].

OBJECTIVE: To improve the treatment result of olfactory neuroblastoma. METHOD: Introduce the experience of treatment of 7 patients with this disease. Among these 7 cases, 2 of them were stage B while the others were stage C according to the system proposed by Kadish. 3 cases received radiotherapy alone, and 4 others received radiotherapy pre-operation. The radiation dose was 5000-7000 cGy. All the patients were followed-up until December 1997. RESULT: 5 cases are still alive, survival time are 20, 22, 23, 29 and 76 months respectively. The other 2 patients died with the survival time of 6 and 48 months respectively. CONCLUSION: Radiotherapy seems effective in the treatment of olfactory neuroblastoma; the combination of chemo-radio-therapy is preferable for advanced or metastasis olfactory neuroblastoma. We extrapolate there are different subtypes on pathology in this tumor.

Adolescent↗

PubMedDate not supplied

Late infantile type neuronal ceroid lipofuscinosis: report of one case.

A 4-year-10-month-old boy with late infantile type neuronal ceroid lipofuscinosis was reported. He presented with progressive dementia, loss of visual acuity, gradual regression of speech and motor functions, and myoclonic jerks. A hyperactive deep tendon reflex was noted, but there was neither muscle weakness nor hepatomegaly. Serum lactate, pyruvate and ammonia levels were within normal limits. The funduscopic examination showed diffuse mottling of the retinal pigmented epithelium. The electroencephalogram showed irregular bilateral spike-and-waves or polyspike-and-waves and isolated focal spikes from the bilateral parieto-occipital regions. The wave forms of visual evoked potentials were flat. The electroretinogram was unrecordable. The somatosensory evoked potentials showed prolonged central conduction times from bilateral median nerves. The brainstem auditory evoked potentials were within normal limits. Diffuse cerebral and cerebellar atrophy were noted on magnetic resonance imaging. The diagnosis was confirmed by the electron-dense cytoplasmic inclusion bodies within the conjunctival squamous epithelial cells. No specific treatment was available. Regular anticonvulsants were not given during follow-up because seizures attacked him only on occasion. His visual acuity was progressively impaired. In addition to nearly total absence of speech, an inability to communicate and walk independently was also noted. The clinical features according to the subtypes, radiology, pathology, managements and prenatal diagnosis for this case are discussed.

Child, Preschool↗

PubMed1996

[Two stage nephron sparing operation for synchronous bilateral renal cell carcinoma: a case report].

We present a case of synchronous bilateral renal cell carcinoma successfully treated with preservation of renal function. A 68-year-old man was admitted with complaints of gross hematuria and left back pain in February 1994. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a round mass 5 cm in diameter in the middle posterior portion of the right kidney and another one 7 cm in diameter in the upper pole of the left kidney. At first the right renal mass was enucleated in situ with a temporary vascular occlusion under surface cooling. Left radical nephrectomy was followed after confirmation of functional recovery of the right kidney on the 20th postoperative day of the first operation. Histopathological examination of the surgical specimens revealed that both masses were renal cell carcinoma, alveolar type, clear cell subtype. The pathological stage of the right and left renal cell cancer was pT2 and pT3a, respectively. The patient retained good renal function, with a serum creatinine concentration of 1.2 mg/dl and has been free of disease for nine months after the second operation.

Aged↗

PubMed1998

[Studies of microsatellite instability in Chinese gastric cancer tissues].

OBJECTIVE: To identify the microsatellite instability(MSI) rates in Chinese gastric cancer samples. METHODS: 29 microsatellite markers were selected to examine 42 paired gastric cancer tissues for MSI on all chromosomes except Y. RESULTS: The total frequency of MSI in all 42 gastric cancers was 33.9% with higher rates at loci of D3S1577, D3S1067,D8S279,D9S257, D1S248, D7S520 and D2S147,and the highest rate at D3S1577 and D3S1067(51.35%). MSI varied with different pathological types. The frequencies of MSI were signi- ficantly higher in poorly differentiated tumors and signet cell types, compared with well differentiated tumors(P=0.0026 and 0.0013 by chi-square test),and no difference was noted between poorly differentiated and signet cell types. CONCLUSION: MSI may play an important role in Chinese gastric cancer, particularly the poorly differentiated adenocarcinomas. The data presented here further support the previous hypothesis that pathologically distinct subtypes of gastric cancer undergo different genetic pathways during tumorigenesis.

Adult↗

PubMed1980

Influence of histologic subtype of small cell carcinoma of the lung on clinical presentation, response to therapy, and survival.

Patients with small cell carcinoma of the lung (SCCL) were histologically subtyped according to the Working Party for Therapy of Lung Cancer classification and were treated with combination chemotherapy. Of the 103 patients studied, 54 had the lymphocyte-like (oat cell) subtype, 41 had the intermediate cell subtype, and 8 had a mixture of the two. No significant difference in initial performance status, extent of disease, chemotherapeutic response rate, or survival (median, 10.2 mo) was noted among the histologic subtypes. When the histologic subtype of the primary biopsy tissue was compared with the subtype of other pathology specimens from the same patient, concordance of subtype was present in 74% of the patients. In the remaining 26%, two or three histologic subtypes were present. This study demonstrates no clinically significant differences among the various histologic subtypes of SCCL in patients extensively staged and treated with aggressive cytotoxic therapy. Because of this and because concurrent biopsy tissues from multiple sites in the same patient may vary in subtype, we conclude that prognostic or therapeutic decisions should not be based on SCCL subtype.

Carcinoma, Small Cell↗

PubMed1997

Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS).

PURPOSE: The role of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS) is controversial. In particular, there is little data for outcome with radiation in a group of patients comparable to those treated with local excision and surveillance (mammographic calcifications < or = 2.5 cm, negative resection margins, negative postbiopsy mammogram). This study reports outcome of conservative surgery and radiation for mammographically detected DCIS with an emphasis on results in patients considered candidates for excision alone. METHODS AND MATERIALS: From 1983 to 1992, 110 women with mammographically detected DCIS (77% calcifications +/- mass) and no prior history of breast cancer underwent needle localization and biopsy with (55%) or without a reexcision and radiation. Final margins of resection were negative in 62%, positive 7%, close 11%, and unknown 20%. The median patient age was 56 years. The most common histologic subtype was comedo (54%), followed by cribriform (22%). The median pathologic tumor size was 8 mm (range 2 mm to 5 cm). Forty-seven percent of patients with calcifications only had a negative postbiopsy mammogram prior to radiation. Radiation consisted of treatment to the entire breast (median 50.00 Gy) and a boost to the primary site (97%) for a median total dose of 60.40 Gy. RESULTS: With a median follow-up of 5.3 years, three patients developed a recurrence in the treated breast. The median interval to recurrence was 8.8 years and all were invasive cancers. Two (67%) occurred outside the initial quadrant. The 5- and 10-year actuarial rates of recurrence were 1 and 15%. Cause-specific survival was 100% at 5 and 10 years. Contralateral breast cancer developed in two patients. There were too few failures for statistical significance to be achieved with any of the following factors: patient age, family history, race, mammographic findings, location primary, pathologic size, histologic subtype, reexcision, or final margin status. However, young age, positive or close margins, and the presence of a mass without calcifications had a trend for an increased risk of recurrence. There were no recurrences in the subset of 16 patients who would be candidates for surveillance by Lagios' criteria. CONCLUSION: For selected patients, conservative surgery and radiation for mammographically detected DCIS results in a low risk of recurrence in the treated breast and 100% 5- and 10-year cause-specific survival. Improved mammographic and pathologic evaluation results in better patient selection and reduces the risk of the subsequent appearance of DCIS in the biopsy site. The identification of risk factors for an ipsilateral invasive breast recurrence is evolving.

Adult↗

PubMed2000

Risk factors for hyperplasia-associated versus atrophy-associated endometrial carcinoma.

OBJECTIVE: Endometrial cancer can be divided into atrophy-associated and hyperplasia-associated subtypes. It has been suggested that these subtypes have different pathologic features and prognoses. This preliminary study explores whether these subtypes are associated with different risk factors. STUDY DESIGN: Hysterectomies performed in cases of endometrial carcinoma with evaluable benign endometrium on routine processing were reviewed, and clinical data were abstracted from medical records. Forty-eight subjects with atrophy-associated and 28 subjects with hyperplasia-associated cancers were studied. RESULTS: We found younger age, higher weight, absence of cigarette smoking, and earlier menarche in subjects with hyperplasia-related cancers. CONCLUSIONS: Our findings support the idea that hyperplasia-associated endometrial cancer is estrogen-related but also suggest that atrophy-associated cases may result from a different causal pathway. Epidemiologic studies may yield more precise and accurate measures of association if atrophy-associated and hyperplasia-associated endometrial cancers are considered separately.

Adenocarcinoma↗