Pituitary gland metastasis from adenocarcinoma of the prostate

Journal ArticleA case of prostatic carcinoma metastasis to the pituitary gland is reported. The presentation and rarity of such a lesion is addressed. The literature review yielded only isolated case reports of symptomatic brain metastases unassociated with bone disease from adenocarcinoma of the prostate. The management options of such a lesion are discussed

Prediction of Patients with Acute Cholecystitis Requiring Emergent Cholecystectomy: A Simple Score

The objective was to develop a score, to stratify patients with acute cholecystitis into high, intermediate, or low probability of gangrenous cholecystitis. The probability of gangrenous cholecystitis (score) was derived from a logistic regression of a clinical and pathological review of 245 patients undergoing urgent cholecystectomy. Sixty-eight patients had gangrenous inflammation, 132 acute, and 45 no inflammation. The score comprised of: age > 45 years (1 point), heart rate > 90 beats/min (1 point), male (2 points), Leucocytosis > 13,000/mm3 (1.5 points), and ultrasound gallbladder wall thickness > 4.5 mm (1 point). The prevalence of gangrenous cholecystitis was 13% in the low-probability (0–2 points), 33% in the intermediate-probability (2–4.5 points), and 87% in the high probability category (>4.5 points). A cutoff score of 2 identified 31 (69%) patients with no acute inflammation (PPV 90%). This scoring system can prioritize patients for emergent cholecystectomy based on their expected pathology

Impaired insulin secretion of aging: Role of renal failure and hyperparathyroidism

Impaired insulin secretion of aging: Role of renal failure and hyperparathyroidism. Available data indicate that insulin secretion is impaired with aging. Almost all the studies that examined insulin secretion by old animals did not take into consideration the state of renal function or the blood levels of parathyroid hormone (PTH). Old animals may have chronic renal failure (CRF) and secondary hyperparathyroidism, and both of these conditions impair insulin secretion. It is possible, therefore, that the impaired insulin secretion of aging is not due to old age per se, but rather to associated CRF and excess PTH. The present study examined this issue in adult (6 month old) and senescent rats (2 years old) with and without CRF and excess PTH. Senescent rats without CRF had normal renal function and normal blood levels of PTH, and the values were not different from those observed in adult rats. Creatinine clearance in senescent rats with CRF was significantly (P < 0.01) lower and serum levels of PTH were significantly (P < 0.01) higher than in senescent animals without CRF and than in the adult rats as well. Only the senescent rats with CRF displayed glucose intolerance during intravenous glucose tolerance test. For any given level of blood glucose, plasma insulin levels were lower in senescent rats with CRF than in the adult rat or senescent animals without CRF. Both initial phase (139 ± 45 pg/islet · 8 min) and total (808 ± 216 pg/islet · 33 min) insulin secretion from pancreatic islets of the senescent rats with CRF and excess PTH were significantly lower than those in senescent rats with normal renal function (658 ± 117 pg/islet · 8 min and 3294 ± 290 pg/islet · 33 min, respectively) or in adult rats (710 ± 134 pg/islet · 8 min and 3183 ± 366 pg/islet · 33 min, respectively). There were no significant differences in insulin secretion between the adult rats and the senescent ones with normal renal function. The data demonstrate that the impaired insulin secretion by the pancreatic islets in old rats is not necessarily related to the higher age per se, but is due to the associated CRF and secondary hyperparathyroidism that develops in many, but not all old animals. Our results indicate that studies examining the effect of aging on body function should take into consideration the level of renal function and of the serum PTH, since both CRF and excess PTH adversely affect the functional integrity of many organs

Ringkasan patologi anatomi, Ed. 2/ Chandrasoma

xi, 944 hal. : ill.; 27 cm

Ringkasan patologi anatomi, Ed. 2/ Chandrasoma

xi, 944 hal. : ill.; 27 cm

Ringkasan patologi anatomi, Ed. 2/ Chandrasoma

xi, 944 hal. : ill.; 27 cm

Ringkasan patologi anatomi, Ed. 2/ Chandrasoma

xi, 944 hal. : ill.; 27 cm