16 research outputs found
Undifferentiated giant cell type carcinoma of the gallbladder with sarcomatoid dedifferentiation: a case report and review of the literature
Patient endothelial colony-forming cells to model coronary artery disease susceptibility and unravel the role of dysregulated mitochondrial redox signalling
Mechanisms involved in the individual susceptibility to atherosclerotic coronary artery disease (CAD) beyond traditional risk factors are poorly understood. Here, we describe the utility of cultured patient-derived endothelial colony-forming cells (ECFCs) in examining novel mechanisms of CAD susceptibility, particularly the role of dysregulated redox signalling. ECFCs were selectively cultured from peripheral blood mononuclear cells from 828 patients from the BioHEART-CT cohort, each with corresponding demographic, clinical and CT coronary angiographic imaging data. Spontaneous growth occurred in 178 (21.5%) patients and was more common in patients with hypertension (OR 1.45 (95% CI 1.03–2.02), p = 0.031), and less likely in patients with obesity (OR 0.62 [95% CI 0.40–0.95], p = 0.027) or obstructive CAD (stenosis > 50%) (OR 0.60 [95% CI 0.38–0.95], p = 0.027). ECFCs from patients with CAD had higher mitochondrial production of superoxide (O2 −–MitoSOX assay). The latter was strongly correlated with the severity of CAD as measured by either coronary artery calcium score (R2 = 0.46; p = 0.0051) or Gensini Score (R2 = 0.67; p = 0.0002). Patient-derived ECFCs were successfully cultured in 3D culture pulsatile mini-vessels. Patient-derived ECFCs can provide a novel resource for discovering mechanisms of CAD disease susceptibility, particularly in relation to mitochondrial redox signalling.Marie Besnier, Meghan Finemore, Christine Yu, Katharine A. Kott, Stephen T. Vernon, Nicole A. Seebacher, Elijah Genetzakis, Anamarija Furman, Owen Tang, Ryan L. Davis, Thomas Hansen, Peter J. Psaltis, Kristen J. Bubb, Steven G. Wise, Stuart M. Grieve, Belinda A. Di Bartolo, and Gemma A. Figtre
Colonic duplication in adults: Report of two cases presenting with rectal bleeding
Gastrointestinal duplication is an uncommon congenital abnormality in
two-thirds of cases manifesting before the age of 2 years. Ileal
duplication is common while colonic duplication, either cystic or
tubular, is a rather unusual clinical entity that remains asymptomatic
and undiagnosed in most cases. Mostly occurring in pediatric patients,
colonic duplication is encountered in adults only in a few cases. This
study reports two cases of colonic duplication in adults. Both cases
presented with rectal bleeding on admission. The study was focused on
clinical, imaging, histological, and therapeutical aspects of the
presenting cases. Gastrografin enema established the diagnosis in both
cases. The cystic structure and the adjacent part of the colon were
excised en-block. The study implies that colonic duplication, though
uncommon, should be included in the differential diagnosis of rectal
bleeding. (c) 2005 The WJG Press and Elsevier Inc. All rights reserved
Pretreatment tumor lysis syndrome associated with bulky retroperitoneal tumors. Recognition is the mainstay of therapy
Acute pretreatment tumor lysis syndrome is a rare complication of cancer. Early recognition and aggressive management are mandatory for prevention of the adverse sequelae of the syndrome. Here we present 2 cases of pretreatment tumor lysis syndrome, concluding that this clinical entity should be in the differential diagnosis of acute renal failure associated with malignancy, as early recognition is in fact the mainstay of treatment
Unintentional parathyroidectomy during total thyroidectomy
Background. Unintentional parathyroidectomy during thyroidectomy has been evaluated in a few studies. Moreover, the impact of the surgeon's experience and operative technique has not been evaluated. Our aim was to identify the incidence of unintentional parathyroidectomy during total thyroidectomy, its clinical consequences, and factors affecting its occurrence. Methods. We reviewed all total thyroidectomies during a 2-year period. Patients were categorized into 2 groups: those with unintentional parathyroidectomy (parathyroidectomy group) and those without unintentional parathyroidectomy (no-parathyroidectomy group). Results. Incidental parathyroidectomy occurred in 100 (19.7%) of the 508 patients. The groups were comparable in age, thyroid weight and pathology, operative time, surgeon experience (high/low volume), operative technique (suture-ligation, LigaSure, or Ultracision), postoperative calcium, and transient hypocalcemia. No permanent hypocalcemia occurred. However, 11% of the parathyroidectomy group was men compared with 22% of the no-parathyroidectomy group (p = .002). Conclusions. Unintentional parathyroidectomy, although common, has no clinical consequences. Unlike surgeon's experience and operative technique, patient sex was the only factor affecting its occurrence. © 2007 Wiley Periodicals, Inc
Schwannoma of thigh mimicking pseudoaneurysm of the profunda femoral artery
Femoral and popliteal artery aneurysms constitute the majority of
peripheral arterial aneurysms. However, aneurysm of the profunda femoral
artery is highly uncommon, being mainly of traumatic and mycotic origin.
Diagnosis is usually straightforward with clinical and radiological
examination, and such aneurysms are only rarely misdiagnosed as tumors.
We herein report a case of preoperatively diagnosed pseudoaneurysm of
the profunda femoral artery that was intraoperatively found to be a soft
tissue tumor and finally revealed to be a schwannomma, by pathology. Our
case’s unusual presentation considerably confounded both diagnosis and
management, thus providing a salutary clinical lesson
Vertical rotation and impaction to the choledochal duct of a migrated biliary self-expanding metal stent
Self-expanding metal stent (SEMS) placement is a well accepted and
highly effective method for both treating and palliating obstructive
lesions of the biliary tree, still complications may occur including
premature occlusion and stent migration. Migration can occur either
proximally or distally, usually early after SEMS placement and almost
exclusively in covered ones. Distal migration is the most common type
and is reported in 5.8% to 6% of cases. In our case, proximal
migration of the stent occurred and surprisingly it rotated and impacted
to the common bile duct transversally. This precluded any attempt to
reposition or remove the SEMS. We effectively treated this unusual
complication by placing an additional plastic stent into the common bile
duct that restored biliary drainage