Angiosarcoma — a malignant neoplasm secondary to radiotherapy for breast cancer in a female patient following breast-conserving treatment — a case report

Angiosarcoma is a rare malignant neoplasm, accounting for 1–2% of all sarcomas. The main cause of developing secondary angiosarcoma is radiotherapy. We analysed the case of a 52-year-old woman with breast cancer, who had undergone breast-conserving therapy. Four years after finishing treatment, she was diagnosed with secondary angiosarcoma in the irradiated area. The patient underwent a mastectomy. The disease relapsed six months after the operation in form of local recurrence, as well as liver and lung metastases. The patient’s condition gradually deteriorated despite treatment (chemotherapy and symptomatic management). The patient died due to cardiorespiratory failure nine months after the diagnosis of secondary malignancy.Naczyniakomięsak jest rzadkim nowotworem. Częstość jego występowania szacuje się na 1 - 2% spośród wszystkich mięsaków. Mięsaki wtórne najczęściej rozwijają się po radioterapii. Przeanalizowano przypadek 52 – letniej chorej na raka piersi prawej uprzednio poddanej leczeniu radykalnemu. Po 4 latach od zakończenia powyższego leczenia, w obszarze radioterapii zdiagnozowano u niej nowotwór wtórny – naczyniakomięsaka. Pacjentka została poddana mastektomii. Pół roku od operacji, nastąpiła progresja – wznowa miejscowa oraz przerzuty do płuc i wątroby. Stan pacjentki pomimo stosowanego leczenia – chemioterapii oraz leczenia objawowego, ulegał stopniowemu pogorszeniu. Pacjentka po 9 miesiącach od postawienia rozpoznania nowotworu wtórnego zmarła z powodu niewydolności krążeniowo - oddechowej

Architecting Enterprise Applications for the Cloud: The Unicorn Universe Cloud Framework

© Springer International Publishing AG, part of Springer Nature 2018. Recent IT advances that include extensive use of mobile and IoT devices and wide adoption of cloud computing are creating a situation where existing architectures and software development frameworks no longer fully support the requirements of modern enterprise application. Furthermore, the separation of software development and operations is no longer practicable in this environment characterized by fast delivery and automated release and deployment of applications. This rapidly evolving situation requires new frameworks that support the DevOps approach and facilitate continuous delivery of cloud-based applications using micro-services and container-based technologies allowing rapid incremental deployment of application components. It is also becoming clear that the management of large-scale container-based environments has its own challenges. In this paper, we first discuss the challenges that developers of enterprise applications face today and then describe the Unicorn cloud framework (uuCloud) designed to support the development and deployment of cloud-based applications that incorporate mobile and IoT devices. We use a doctor surgery reservation application “Lekar” case study to illustrate how uuCloud is used to implement a large-scale cloud-based application

Naczyniakomięsak — nowotwór wtórny po radioterapii u chorej na raka piersi leczonej oszczędzająco — opis przypadku

Naczyniakomięsak (AS) występuje rzadko — częstość szacuje się na 1–2% spośród wszystkich mięsaków. Mięsaki wtórne najczęściej rozwijają się po radioterapii (RT). Przeanalizowano przypadek 52-letniej chorej z rozpoznaniem raka piersi prawej uprzednio poddanej radykalnemu leczeniu oszczędzającemu. Po 4 latach od zakończenia leczenia w obszarze RT rozpoznano u chorej obecność wtórnego AS. Chorą poddano mastektomii. Po 6 miesiącach od operacji nastąpił nawrót choroby pod postacią wznowy miejscowej oraz przerzutów do płuc i wątroby. Stan chorej, mimo zastosowanego leczenia (chemioterapia i postępowanie objawowe), stopniowo się pogarszał. Chora po 9 miesiącach od postawienia rozpoznania nowotworu wtórnego zmarła z powodu niewydolności krążeniowo-oddechowej

Electroesophagogram in gastroesophageal reflux disease with a new theory on the pathogenesis of its electric changes

BACKGROUND: In view of the disturbed esophageal peristaltic activity and abnormal esophageal motility in gastroesophageal reflux disease, (GERD), we investigated the hypothesis that these changes result from a disordered myoelectric activity of the esophagus. METHODS: The electric activity of the esophagus (electroesophagogram, EEG) was studied in 27 patients with GERD (16 men, 11 women, mean age 42.6 ± 5.2 years) and 10 healthy volunteers as controls (6 men, 4 women, mean age 41.4 ± 4.9 years). According to the Feussner scoring system, 7 patients had a mild (score 1), 10 a moderate (score 2) and 10 a severe (score 3) stage of the disease. One electrode was applied to the upper third and a second to the lower third of the esophagus, and the electric activity was recorded. The test was repeated after the upper electrode had been moved to the mid-esophagus. RESULTS: The EEG of the healthy volunteers showed slow waves and exhibited the same frequency, amplitude and conduction velocity from the 2 electrodes of the individual subject, regardless of their location in the upper, middle or lower esophagus. Action potentials occurred randomly. In GERD patients, score 1 exhibited electric waves' variables similar to those of the healthy volunteers. In score 2, the waves recorded irregular rhythm and lower variables than the controls. Score 3 showed a "silent" EEG without waves. CONCLUSION: The electric activity in GERD exhibited 3 different patterns depending on the stages of GERD. Score 1 exhibited a normal EEG which apparently denotes normal esophageal motility. Score 2 recorded irregular electric waves variables which are presumably indicative of decreased esophageal motility and reflux clearance. In score 3, a "silent" EEG was recorded with probably no acid clearance. It is postulated that the interstitial cells of Cajal which are the electric activity generators, are involved in the inflammatory process of GERD. Destruction of these cells appears to occur in grades that are in accordance with GERD scores. The EEG seems to have the potential to act as an investigative tool in the diagnosis of GERD stages

Mucin pattern reflects the origin of the adenocarcinoma in Barrett's esophagus: a retrospective clinical and laboratorial study

<p>Abstract</p> <p>Background</p> <p>Mucin immunoexpression in adenocarcinoma arising in Barrett's esophagus (BE) may indicate the carcinogenesis pathway. The aim of this study was to evaluate resected specimens of adenocarcinoma in BE for the pattern of mucins and to correlate to the histologic classification.</p> <p>Methods</p> <p>Specimens were retrospectively collected from thirteen patients who underwent esophageal resection due to adenocarcinoma in BE. Sections were scored for the grade of intestinal metaplasia. The tissues were examined by immunohistochemistry for MUC2 and MUC5AC antibodies.</p> <p>Results</p> <p>Eleven patients were men. The mean age was 61 years old (varied from 40 to 75 years old). The tumor size had a mean of 4.7 ± 2.3 cm, and the extension of BE had a mean of 7.7 ± 1.5 cm. Specialized epithelium with intestinal metaplasia was present in all adjacent mucosas. Immunohistochemistry for MUC2 showed immunoreactivity in goblet cells, while MUC5AC was extensively expressed in the columnar gastric cells, localizing to the surface epithelium and extending to a variable degree into the glandular structures in BE. Tumors were classified according to the mucins in gastric type in 7/13 (MUC5AC positive) and intestinal type in 4/13 (MUC2 positive). Two tumors did not express MUC2 or MUC5AC proteins. The pattern of mucin predominantly expressed in the adjacent epithelium was associated to the mucin expression profile in the tumors, p = 0.047.</p> <p>Conclusion</p> <p>Barrett's esophagus adenocarcinoma shows either gastric or intestinal type pattern of mucin expression. The two types of tumors developed in Barrett's esophagus may reflect the original cell type involved in the malignant transformation.</p

Vitamin C does not improve the efficacy of Helicobacter pylori eradication in smokers

Purpose: To evaluate the hypothesis that vitamin C improves the efficacy of Helicobacter pylori eradication in smokers when combined with pantoprazole, amoxicillin, and clarithromycin. Materials and methods: The study completed 90 subjects of 98 enrolled, 58 smokers 32 nonsmokers. Helicobacter pylori status was determined by two methods, CLO test, and histology. Vitamin C (500 mg) was administered three times daily. The patients were considered as cured of H. pylori if the CLO test result and histology were negative 4 weeks after completion of eradication therapy. Results: Smokers had lower effectiveness of eradication therapy than non-smokers and the administration of vitamin C had not affected the outcome of eradication therapy. Conclusions: Vitamin C (500 mg tid) does not improve the eradication therapy when pantoprazole, amoxicillin, and clarithromycin were used

The influence of Helicobacter pylori eradication therapy on the presence of H. pylori antigens in dental plaque and saliva

Purpose: The aim of this study was to evaluate the presence of H. pylori antigens in the oral cavity (dental plaque and saliva) of patients undergoing systemic eradication therapy. Materials and methods: The study was conducted in 49 subjects with H. pylori stomach infection. H. pylori antigens in dental plaque and saliva were evaluated with immunological method. Results: In subjects with initial H. pylori oral infection, the presence of H. pylori antigens in the oral cavity 6 weeks after successful or unsuccessful H. pylori eradication therapy in the stomach was 47.0% and 50.0%, respectively. In subjects without initial oral infection with H. pylori, the presence of H. pylori antigens in the oral cavity 6 weeks after successful and unsuccessful eradication therapy in the stomach was 30.0% and 20.0%, respectively. Conclusions: The immunological method detecting H. pylori antigens in the dental plaque and saliva cannot be recommended to evaluate the efficacy of H. pylori eradication in the oral cavity

The clinical importance of Helicobacter pylori antigens detected in the dental plaque and feces

Purpose:It is expected that H. pylori residing outside the stomach influences the results of the stool test. The aim of the study was to investigate the occurrence of H. pylori antigens in dental plaque and feces of the patients with H. pylori infected and non-infected stomachs.Materials and methods: The study was conducted in 188 dentate patients, 107 with H. pylori infected and 81 non-infected stomachs. Stomach infection with H. pylori was evaluated with CLO test, histology and culture. The stomach was classified as infected if at least two of three tests (CLO test, culture, histology) were positive and as non-infected if all three tests were negative. Dental plaque was taken only from the natural teeth. On the day of the gastroscopic examination or on the next two days a stool sample was collected for H. pylori antigens testing. H. pylori antigens in dental plaque and feces were determined by immunological method.Results:In 60.8% of subjects with an infected stomach, H. pylori antigens were present both in the dental plaque and feces, in 37.4% in feces only, in 0.9% only in the dental plaque, and in 0.9% neither in the dental plaque nor feces. In 46.9% of subjects with a non-infected stomach, H. pylori antigens were found neither in the dental plaque nor feces, in 24.7% both in the dental plaque and feces, in 23.5% only in the dental plaque, and in 4,9% only in feces.Conclusions: There is a weak association between the occurrence of H. pylori antigens in feces and the dental plaque, and also between the occurrence of the antigens in the dental plaque and stomach infection

Application of Helicobacter pylori antigen test to evaluate gastric mucosa specimens

Purpose: To investigate, whether the test documenting the presence of Helicobacter pylori (H. pylori) antigens in the gastric mucosa may be used as diagnostic test. Materials and methods: Mucosal specimens taken from eighty-three patients during gastroscopic examination were subjected to rapid urease test (CLO test), histology, and H. pylori culture. The same biopsy specimens that had been evaluated in the CLO test or collected into the transport medium for bacterial culture were used to detect H. pylori antigens. An amplified immunoassay for the detection of H. pylori antigens in stool was used for gastric mucosa specimens. The sensitivity and specificity of the H. pylori antigen test were evaluated in relation to the results of each verifying test (CLO test, histology, culture) separately and to all 3 tests analysed together. Results: The sensitivity and specificity of the H. pylori antigen test in relation to the CLO test, histological examination, and H. pylori culture were 85.4% and 90.5%, 76.1% and 83.4%, and 90.7% and 90.0% for specimens taken for the CLO test and 90.0% and 82.0%, 78.0% and 81.0%, and 93.0% and 88.0% for specimens taken for bacterial culture, respectively. The sensitivity and specificity of the antigen test in relation to all 3 verifying tests analysed together were 91.3% and 97.3% for specimens taken for the CLO test, and 91.7% and 97.1% for specimens taken for bacterial culture, respectively. Conclusions: H. pylori antigen test in gastric mucosa specimens may be a sufficiently reliable source of information about stomach infection