Squamous Cell Carcinoma of the Larynx Arising in Multifocal Pharyngolaryngeal Oncocytic Papillary Cystadenoma: A Case Report and Review of the Literature

We report on a rare case of a laryngeal carcinoma arising in a multifocal pharyngolaryngeal oncocytic papillary cystadenoma (OPC). The disease of a 63-year-old man is well documented by computed and positron emission tomography, histology, and electron microscopy. We could show that an OPC can even develop in the pharynx. The coexistence of both tumors makes this a challenging diagnosis for pathologists. Treated by surgery and radiotherapy, both lesions dissolved. Based on the literature available, we discuss the theory that the laryngeal carcinoma might be the result of a true metaplasia facilitated by chronic irritation and recommend a regular follow-up for OPC too. As in benign oncocytic lesions, we could show that the detection of numerous mitochondria is a diagnostic indicator for malignant variants as well.     

Potential avenues for immunotherapy of colitis-associated neoplasia

In patients with inflammatory bowel disease, chronic intestinal inflammation severely increases the risk for cancer development. In fact, various aspects of inflammation such as oxidative stress, cyclooxygenases and proinflammatory cytokines have been shown to support many aspects of cancer growth. During recent years, various experimental studies have increased our understanding of the molecular mechanisms leading to colitis-associated cancer. In particular, cytokines such as TNF-α or IL-6, which are involved in the pathogenesis of inflammation and cancer development, could be promising targets for the molecular prevention of colitis-associated cancer.     

Comparison of two noninvasive devices for measurement of central systolic blood pressure with invasive measurement during cardiac catheterization

J Clin Hypertens (Greenwich). 2012; 14:575–579. © 2012 Wiley Periodicals, Inc. Recently, a new device for noninvasive assessment of central systolic blood pressure (cSBP) (BPro device with A‐Pulse) was approved by the US Food and Drug Administration, but available data are limited. In 52 patients undergoing invasive elective cardiac evaluation, central hemodynamics were measured invasively. Immediately thereafter, radial artery waveforms were sampled by two noninvasive techniques, the BPro and, as a comparator, the SphygmoCor System. Then, central hemodynamics were measured invasively for a second time. The invasively recorded cSBP (137±27 mm Hg) did not differ with both noninvasively assessed cSBP by BPro (136±21 mm Hg, P=.627 vs invasive cSBP) and by SphygmoCor (136 ± 23 mm Hg, P=.694 vs invasive cSBP) and correlated highly between invasively recorded and both noninvasively assessed cSBP. However, using Bland‐Altman plots, spreading of compared data of both devices can be found (BPro: 0.87±13 mm Hg vs invasive cSBP; SphygmoCor: 0.77±14 mm Hg vs invasive cSBP). There was an excellent correlation of both noninvasive devices for the calculation of cSBP (r=0.961, P<.001). cSBP differed by only 0.1±6 mm Hg (P=.913) between the two noninvasive devices. Therefore, both noninvasive devices showed an accurate agreement in cSBP compared with invasively measured cSBP.     

Transmission Dynamics of Extended-Spectrum β-lactamase-Producing Enterobacteriaceae in the Tertiary Care Hospital and the Household Setting

Background.?Studies about transmission rates of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in hospitals and households are scarce. Methods.?Eighty-two index patients with new carriage of ESBL-producing Escherichia coli (ESBL-Ec; n?=?72) or ESBL-producing Klebsiella pneumoniae (ESBL-Kp; n?=?10) and their hospital (n?=?112) and household (n?=?96) contacts were studied prospectively from May 2008 through September 2010. Isolates were phenotypically and molecularly characterized (sequencing of bla genes, repetitive extragenic palindromic polymerase chain reaction, pulse-field gel electrophoresis, and multilocus sequence typing). Transmission was defined as carriage of a clonally-related ESBL producer with identical bla(ESBL) gene(s) in the index patient and his or her contact(s). Results.?CTX-M-15 was the most prevalent ESBL in ESBL-Ec (58%) and ESBL-Kp (70%) in the index patients. Twenty (28%) ESBL-Ec isolates were of the hyperepidemic clone ST131. In the hospital, transmission rates were 4.5% (ESBL-Ec) and 8.3% (ESBL-Kp) and the incidences of transmissions were 5.6 (Ec) and 13.9 (Kp) per 1000 exposure days, respectively. Incidence of ESBL-Kp hospital transmission was significantly higher than that of ESBL-Ec (P?相似文献   

Drug-Induced Pancreatitis

Drugs are thought to be a rare cause for acute pancreatitis; however 525 different drugs are listed in the World Health Organization (WHO) database suspected to cause acute pancreatitis as a side effect. Many of them are widely used to treat highly prevalent diseases. The true incidence is not entirely clear since only few systematic population based studies exist. The majority of the available data are derived from case reports or case control studies. Furthermore, the causality for many of these drugs remains elusive and for only 31 of these 525 dugs a definite causality was established. Definite proof for causality is defined by the WHO classification if symptoms reoccur upon rechallenge. In the actual algorithm the diagnosis is confirmed if no other cause of acute pancreatitis can be detected, and the patient is taking one of the suspected drugs.