7 research outputs found
Simultaneous development of adenocarcinoma and gastrointestinal stromal tumor (GIST) in the stomach: case report
<p>Abstract</p> <p>Background</p> <p>Gastrointestinal stromal tumors (GISTs) and adenocarcinoma are distinct neoplasms originating from different cell layers. Approximately 20% of patients with GIST develop other cancers.</p> <p>Case presentation</p> <p>We report a case of the coexistence of adenocarcinoma and gastrointestinal stromal tumor (GIST). Gastric endoscopy showed the ulcerated tumor with bleeding along the lesser curvature of the proximal stomach and a submucosal nodule that measured about 3 cm in diameter in the lower part of the stomach body. Their pathological examination showed gastric cancer (poorly differentiated diffuse adenocarcinoma) and GIST (low-risk category). Further, immunohistochemical staining for C-kit and CD34 was positive, while that for SMA and S-100 was negative.</p> <p>Conclusion</p> <p>Although it is not easy to speculate on the coexistence of adenocarcinoma and GIST, pre-and post-operative diagnoses may be essential, and such cancer development is not considered to be unusual.</p
Systemic Thrombolysis in Patients With Acute Ischemic Stroke and Internal Carotid ARtery Occlusion: The ICARO Study.
BACKGROUND AND PURPOSE: The beneficial effect of intravenous thrombolytic therapy
in patients with acute ischemic stroke attributable to internal carotid artery
(ICA) occlusion remains unclear. The aim of this study was to evaluate the
efficacy and safety of intravenous recombinant tissue-type plasminogen activator
in these patients.
METHODS: ICARO was a case-control multicenter study on prospectively collected
data. Patients with acute ischemic stroke and ICA occlusion treated with
intravenous recombinant tissue-type plasminogen activator within 4.5 hours from
symptom onset (cases) were compared to matched patients with acute stroke and ICA
occlusion not treated with recombinant tissue-type plasminogen activator
(controls). Cases and controls were matched for age, gender, and stroke severity.
The efficacy outcome was disability at 90 days assessed by the modified Rankin
Scale, dichotomized as favorable (score of 0-2) or unfavorable (score of 3-6).
Safety outcomes were death and any intracranial bleeding.
RESULTS: Included in the analysis were 253 cases and 253 controls. Seventy-three
cases (28.9%) had a favorable outcome as compared with 52 controls (20.6%;
adjusted odds ratio (OR), 1.80; 95% confidence interval [CI], 1.03-3.15;
P=0.037). A total of 104 patients died, 65 cases (25.7%) and 39 controls (15.4%;
adjusted OR, 2.28; 95% CI, 1.36-3.22; P=0.001). There were more fatal bleedings
(2.8% versus 0.4%; OR, 7.17; 95% CI, 0.87-58.71; P=0.068) in the cases than in
the controls.
CONCLUSIONS: In patients with stroke attributable to ICA occlusion, thrombolytic
therapy results in a significant reduction in the proportion of patients
dependent in activities of daily living. Increases in death and any intracranial
bleeding were the trade-offs for this clinical benefit