Pseudoaneurysm originating from left ventricle aneurysm: An autopsy case and review of literature

Dogan, Kamil Hakan/0000-0002-7685-266XWOS: 000327719700001PubMed: 24237794Rupture of the free wall of the left ventricle is a catastrophic complication of acute myocardial infarction. Rarely, free wall rupture is contained by overlying adherent pericardium, producing a pseudoaneurysm of the left ventricle. In this report, a case of a left ventricular pseudoaneurysm due to a previous myocardial infarction is described. A 55-year-old woman had a severe chest pain 11 months prior to death. No cardiac investigation was performed. Three days prior to death, she suffered from fatigue and weakness, and had a witnessed sudden cardiac death. At autopsy, a 8.5 x 10 x 8 cm pseudoaneurysm of the left ventricle was found. There was severe coronary artery atherosclerosis. There were extensive adhesions between pericardium and pseudoaneurysm wall. The cause of death was attributed to heart failure and resulting arrhythmia. The case illustrates the rare event of left ventricular pseudoaneurysm first diagnosed at forensic autopsy. (C) 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved

Effects of phototherapy on the growth plate in newborn rats

The aim of the present study was to evaluate the effect of phototherapy and oxidative stress on the growth plate of newborn rats. Forty newborn Sprague-Dawley rats were randomized into a phototherapy group and a control group. Twenty of the rats received phototherapy for 7 days. All zones of the growth plate were assessed with quantitative histomorphometric analysis. Individual zonal lengths were measured for the reserve zone (RZ), the proliferative zone (PZ), the hypertropbic zone (HZ), ossifying cartilage (OC), and total zone (TZ) of the growth plate. Levels of plasma malondialdehyde (MDA), an index of oxidative stress, were also evaluated. Compared with zonal lengths on day 7 after phototherapy between the two groups, the phototherapy group had significantly lower values than those of controls for RZ (5.13 +/- 0.36 vs. 6.4 +/- 0.85 mm X 10(-2); P < 0.001), PZ (20.6 +/- 3.0 vs. 29.25 +/- 1.68 mm X 10(-2); p < 0.001), HZ (15.4 +/- 1.44 vs. 20.87 +/- 1.12 mm X 10(-1); P < 0.001), OC (47.08 +/- 4.25 vs. 62.06 +/- 3.7 mm X 10(-2); p < 0.001), and TZ (88.15 +/- 6.56 vs. 118.48 +/- 4.50 mm X 10(-2); p < 0.001). Plasma MDA levels were correlated with the size of the PZ in the phototherapy group (r = -0.53, P = 0.01). In a multivariate regression model for all rats, being in the phototherapy group was the best predictor of the size of the TZ (beta = -0.94, P < 0.001), with the total variance explained being 88%. These results suggest that in newborn rats, receiving phototherapy is associated with early impairment of growth plate structure, and oxidative stress may be the main risk factor for growth plate injury

A lung adenocarcinoma patient with EGFR mutation in exon 18 and ALK-rearrangement who treated with erlotinib and crizotinib

Concomitant mutations of echinoderm microtubule-associated protein-like 4 (EML4) anaplastic lymphoma kinase (ALK) translocation and epidermal growth factor receptor (EGFR) can be found rarely in lung adenocarcinoma. We present a case of harboring EML4/ALK rearrangement lung adenocarcinoma who previously received erlotinib. A 42-year-old male who was diagnosed as lung adenocarcinoma and received many series of cytotoxic regimens. A partial tumor response was achieved with crizotinib after failure with erlotinib therapy. After progressive disease, biopsy of new liver lesion showed EML4/ALK rearrangement. Thus crizotinib was administrated. A partial tumor response was achieved with crizotinib after failure with erlotinib therapy and chemotherapy. We conclude that it is important to evaluate for EML4/ALK rearrangement even the patient has EGFR mutation. Concomitant EGFR exon 18 and EML4-ALK mutations can occur in lung adenocarcinoma. EML4/ALK related TKIs may be more effective in these patients. Keywords: Non-small cell lung cancer, Erlotinib, Epidermal growth factor receptor, Anaplastic lymphoma kinase, Crizotini

Survivin Expression May Affect The Neoadjuvantchemotherapy Response İn Breast Cancer Patients

To investigate whether there is a predictive effect of NF-kappaB, survivin, and Ki-67 expressions on pathological response and disease relapse in breast cancer (BC) patients. Ki-67, survivin and NF-kappaB expressions were analyzed in the pathology specimens of breast biopsy before and after neoadjuvant chemotherapy (NeoCT) in BC patients (n52). Event -free survival (EFS) (defined as recurrence or metastasis free) analyze was performed. The median overall survival was 43.5 months and the median EFS was 51 months (95% CI: 33.3-68.9) in all patients. The expression percentages of NF-kappaB, survivin, and Ki-67 significantly decreased after NeoCT (p>0.001). Survivin expression level before NeoCT was significantly higher in patients who did not respond to NeoCT than both partial-responders and complete-responders (p0.038, p0.010, respectively). Type of NeoCT was the only independent factor on pathological response status (p0.007). Addition of taxanes to NeoCT improved pathological complete response rates about six times. However, no predictor was found to be a prognostic factor for EFS in multivariate analyze. Higher survivin expression level before NeoCT may be associated with poor pathological response to NeoCT. These findings must be tested with prospective clinical trials