3 research outputs found
Persistent left superior vena cava leads to catheter malposition during PICC port placement
Introduction: We present a case of peripherally inserted central catheter (PICC) port placement where the catheter had been malpositioned to the persistent left superior vena cava. Methods: Despite the obvious elevation of the P-wave signaling proximity of the catheter tip to the sinus node, the catheter was not in the desired location within the superior vena cava or the right atrium, because of the presence of a persistent left superior vena cava. Computed tomography was used in order to locate the catheter. Results: The catheter was located in the persistent left superior vena cava. Conclusions: Malpositioning of the catheter in the persistent left superior vena cava occurs in 0.3%-0.5% of patients. The catheter was subsequently removed. © 2015 Wichtig Publishing
Nm-23, c-erbB-2, and progesterone receptor expression in invasive breast cancer: Correlation with clinicopathologic parameters
Downregulation of nm-23 antimetastasis gene has been associated with
disease progression in some human tumors. NPD kinase A is the product of
the H-1 isotype of the nm23 gene and its value as a marker of metastatic
potential is well worth investigating. The expression of the nm23-H1
gene peptide was immunohistochemically evaluated in 191 primary mammary
cancer tissues. A three-step immunoperoxidase staining procedure was
performed and any association of our results with several classical
clinicopathologic indicators, including hormonal status and c-erbB-2
oncoprotein membrane immunoexpression, was examined. NDP kinase
A-positive cytoplasmic immunolabeling was noticed in 64% of all
specimens (123/191) which frequently demonstrated positive progesterone
receptor (PgR) status (p = 0.001) and were furthermore characterized by
high PgR immunoreactivity rates. This association was significant by
both univariate and multivariate statistical analysis. The double
nm23-H1(+)/PgR(+) phenotype was more frequently detected than any other
combined phenotype of these markers. The nm23-H1 gene peptide was
generally detected in a remarkable proportion of malignant cells, either
in the invasive or the intraductal tumor components. Notably, large-cell
ductal carcinomas in situ were characterized by lower nm23-H1
immunoreactivity rates when compared with other in situ. cancer types.
Quantitatively increased nm23-H1 immunopositive staining was more
frequently observed in special histologic types of infiltrating cancers,
in high nuclear grade tumors, as well as in carcinomas with high PgR
levels (p = 0.05). The nm23-H1(-)/c-erbB-2(+) phenotypewas more often
detected in the cancers of this study than the nm23-H1(+)/c-erbB-2(+)
one. The former phenotype was correlated to postmenopausal ages as well
as to extensive axillary nodal involvement by univariate statistical
analysis. It is noteworthy that nm23-H1(-) status, on its own, was not
statistically associated either with the presence or with a high number
of involved lymph nodes. On the contrary, nm23-H1 immunopositivity was,
paradoxically, more frequently observed in tumors of relatively
increased TN tumor stage. Tumor progression is thus more likely to
depend on the c-erbB-2 gene’s overexpression. Possibly, any favorable
outcome in nm23-H1(+) cases might be due to the fact that they also
express PgR, which is a marker of a more functionally differentiated
phenotype