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Krukenberg tumors of the ovary. Ultrastructural, histochemical and immunohistochemical studies of 15 cases 总被引:1,自引:0,他引:1
The ultrastructural, histochemical, and immunohistochemical characteristics of 12 classical signet ring cell Krukenberg tumors (CKT) and three tubular Krukenberg tumors (TKT) were evaluated and related to their possible influence on the ovarian stroma. In CKT, single signet ring cells predominated over lumen-forming cells and contained ultrastructural and histochemical characteristics similar to goblet cells in colonic and ovarian mucinous adenocarcinomas. In TKT, lumen-forming nonsecretory and secretory signet ring cells were prominent. Rare argentaffin cells were found in TKT but not in CKT. Cells in both CKT and TKT produced neutral and sialomucins. The stroma contained extracellular mucin, hypertrophied stromal fibroblasts and myofibroblasts, and in two cases stromal lutein cells with steroidogenic type ultrastructure. It appears that Krukenberg tumors are made up exclusively of intestinal type cells. Based on cell differentiation, TKT is better differentiated than CKT. Hypertrophy and hyperplasia of ovarian stromal cells may occur in response to malignant growth and/or the extracellular mucinous products of malignant cells and may play a role in the control of tumor invasiveness. None of the 15 cases were immunohistochemically positive for chorionic gonadotropin, placental lactogen, or luteinizing hormone. These hormones are suspected to be related to stromal luteinization in KT. 相似文献
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WILLIAM W. O'NEILL M.D. PATRICK SERRUYS M.D. Ph.D. MERRILL KNUDTSON M.D. † GERRIT-ANN VAN ES M.D.‡ GERALD C. TIMMIS M.D. § COEN VAN DER ZWAAN M.D. JAY KLEIMAN M.D. M.P.A. ¶ KERRY BARKER Ph.D. ¶ ROGER DREILING M.D. # RICHARD HUBBARD M.D. ¶ JOHN ALEXANDER M.D. M.P.H. ¶ ROBERT ANDERS PHARM.D. ¶ 《Journal of interventional cardiology》1999,12(2):109-116
Clinical trials have demonstrated the efficacy of glycoprotein (GP) IIb/IIIa antagonists in preventing the thrombotic end points of death, myocardial infarction, and urgent revascularization when they are administered at the time of percutaneous coronary revascularization (PTCR). It has been postulated that prolongation of receptor blockade beyond acute intervention would extend the clinical benefit of these agents. The Evaluation of Oral Xemilofiban in Controlling Thrombotic Events (EXCITE) study was a multicenter, international, randomized placebo-controlled trial of the oral GP IIb/IIIa antagonist Xemilofiban administered prior to and after PTCR. The study was designed to assess the efficacy and safety of continuing oral xemilofiban for 6 months to prevent these primary thrombotic end points. More than 7,200 patients were randomized in 29 countries to receive placebo or one of two doses of xemilofiban. Stenting was performed at the discretion of the operator. All patients received aspirin and periprocedural heparin; all stented patients received continuous xemilofiban, or ticlopidine for 2–4 weeks followed by xemilofiban-placebo. Most patients were also evaluated 1 month after conclusion of the study drug treatment. Clinical data from up to 6 months of drug treatment and 1 month posttreatment were used to evaluate the acute and long-term efficacy and safety of xemilofiban. Secondary end points included the need for any revascularization, repeat hospitalization for unstable angina, and nonhemorrhagic stroke. The cumulative incidence of bleeding events and effects of xemilofiban in stented and nonstented patients were evaluated. The efficacy of continuing xemilofiban and aspirin therapy as the sole antithrombotic medications following stent deployment was assessed against a ticlopidine and aspirin control group. The incremental clinical benefit of long-term receptor blockade over acute receptor antagonism was evaluated. 相似文献
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ES Dimitry MRCOG M Phil RK Atalla RCOG 《International journal of clinical practice》1996,50(7):376-380
The recent increase in the incidence of ectopic pregnancies was associated with rapid improvement in the diagnostic and therapeutic techniques. Quantitative serum B-HCG radioimmunoassay and high resolution vaginal ultrasonography have facilitated early diagnosis of ectopic pregnancy allowing a more conservative approach to patient management. Different conservative surgical and medical lines of management recently developed were associated with and increased chance of subsequent intrauterine pregnancy with no increase in the incidence of repeat ectopic pregnancy. Outpatient systemic medical treatment seems to be a preferred alternative to conservative surgery. In selected cases, it is associated with a lower complication rate and promising result for fertility. (Br J Clin Pract 1996; 50(7) : 376-380.) 相似文献
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乙肝病毒和人乳头状瘤病毒分别是肝细胞癌和子宫颈癌的风险因素,针对这2种病毒感染的疫苗已在临床上成功用于癌症化学预防。分子靶向药物能够预防乳腺癌(雷洛昔芬与他莫昔芬)、大肠腺瘤(塞来昔布)和前列腺癌(非那雄胺)。然而,化学预防广泛应用于临床还不现实。分子靶标的深入研究将扩展化学预防的范围并使其个性化。 相似文献
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Q fever is caused by Coxiella burnetii and often has an insidious clinical presentation. We describe a rare case of Q fever infection of an aortic graft presenting with pyrexia and constant severe midlumbar pain due to erosion of multiple vertebral bodies. After successful treatment with graft resection and extra-anatomic vascular reconstruction, the patient continues on lifelong antibiotic therapy. We also present regional Q fever epidemiologic data together with a review of all previously documented cases of Q fever infections of vascular prostheses. 相似文献
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Eleven adolescent diabetics, aged 15.1 +/- 1.3 years (mean +/- 1SD) in poor glycaemic control (HbA1 12.0 +/- 1.5% at entry) were commenced on a four times daily insulin injection regimen using the Penject fountain-pen syringe with Initard (50:50 mixture of porcine soluble and isophane) insulin on a sliding scale. Diabetic control improved over a 3-month period, assessed by a reduction in both the mean preprandial blood glucose concentrations (10.9 +/- 3.3 mmol/l to 7.7 +/- 2.3 mmol/l) and mean glycosylated haemoglobin concentrations (12.0 +/- 1.5% to 9.5 +/- 0.9%). Further improvement was again seen in 5 patients who remained on four daily injections for an additional 3 months (mean HbA1: 9.6 +/- 0.9% to 8.4 +/- 1.0%), whereas diabetic control in 6 patients who returned to twice daily injections deteriorated (mean HbA1 rose from 9.5 +/- 1.0% to 10.6 +/- 1.6%). Multiple insulin injections using an injection pen are acceptable to adolescent diabetics and improve their control. 相似文献