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Heidemann J Ogawa H Otterson MF Shidham VB Binion DG 《Diseases of the colon and rectum》2004,47(1):118-122
PURPOSE:
Desmoid tumors are uncommon, benign, fibrous lesions occurring sporadically and in association with familial adenomatous polyposis. Typical clinical features include a locally aggressive behavior, an unpredictable course, and a high propensity for recurrence after surgical resection. There are no standard medical or surgical approaches, and no markers for monitoring medical therapy of desmoid tumors.
METHODS:
We report two cases of mesenteric desmoid tumors treated with interferon alfa-2b and toremifene, a novel regimen devised to block angiogenesis. Pre- and posttreatment desmoid tumor tissues were obtained in one patient during a repeat resection for recurrent stenosing Crohns disease and examined for mean vessel count and cellular proliferation levels by immunostaining for the endothelial surface antigen CD31 and the proliferation associated nuclear antigen, Ki-67, respectively. We assessed plasma D-dimers, a potential marker of angiogenic activity, and followed this throughout the course of antiangiogenic therapy in our two patients.
RESULTS:
Examination of posttreatment tissue revealed a significant decrease in microvessel density (P < 0.02) and Ki-67-positive nuclei (P < 0.0001) compared with pretreatment tissue. Both patients demonstrated a prompt and sustained drop in previously elevated plasma D-dimer levels, which correlated clinically with lesion regression and sustained remission.
CONCLUSIONS:
Treatment with toremifene and interferon alfa-2b was successful and well tolerated in our two patients. Our data suggest a combined antiangiogenic and antiproliferative mechanism of action. Furthermore, normalization of previously elevated plasma D-dimers may emerge as a strategy to monitor treatment efficacy in mesenteric desmoid tumors. 相似文献
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The authors discuss an interesting case of a Pacinian corpuscle neuroma in the thumb of an elderly woman who presented with severe digital pain. The pain was initially attributed to osteoarthritis of the interphalangeal joint of the thumb. The clinical signs were very subtle. The patient had complete pain relief following excision of the tumour. Pacinian corpuscle neuromas are rare, with only about 70 cases reported in the literature. The histology, presenting features and associated conditions are discussed in detail. In addition to a neuroma or glomus tumour, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of digital or palmar pain of unknown etiology. 相似文献
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Sasikala Balasubramanian Elavenil Panneerselvam Gayathri Gopi Komagan Prabhu Nakkeeran Aditi Rajendra Sharm Krishnakumar Raja VB 《中华创伤杂志(英文版)》2019,22(1):34-40
Purpose
The purpose of the study is to compare the surgical access and post-operative outcome of two intra-oral incisions used for approaching a mandibular body fracture.Methods
This clinical trial involved 60 patients with mandibular body fractures who were randomly allocated to control and study groups. The fractures were approached using the routine vestibular incision in the control group and crevicular incision with vertical release in the study group. The effects of incision design on the post-surgical outcome variables like swelling, trismus, paresthesia, wound healing and gingival recession were statistically analysed with non-parametric tests by using SPSS 22.0 software. Comparison of continuous variables between the groups and time points was done using Mann Whitney test and Friedman test respectively. Chi-square test was used to compare proportions between groups. Dunn's test with Bonferroni correction was used for pair wise comparisons.Results
The study group demonstrated favourable surgical outcome in the immediate postoperative phase as compared to the control group. The difference in mouth opening, swelling and neurosensory impairment between the two groups was found to be statistically significant (p < 0.05).Conclusion
Crevicular incision was found to be an ideal alternative to vestibular incision in achieving surgical access and fixation of mandibular body fractures with reduction in postoperative patient discomfort and better surgical outcome. 相似文献60.
Steinberg HV; Nelson RC; Murphy FB; Chezmar JL; Baumgartner BR; Delaney VB; Whelchel JD; Bernardino ME 《Radiology》1987,162(2):337-342
A prospective study compared the efficacy of Doppler ultrasonography (US) and magnetic resonance (MR) imaging in evaluating 38 renal allografts, with specific attention to transplant rejection. Forty-three Doppler US and 42 MR examinations were performed and interpreted. Histologic correlation was obtained from 22 biopsy or nephrectomy specimens. Clinical correlation or a response to instituted therapy was used as confirmation in the remaining allografts. Accuracy in identifying cyclosporine toxicity or acute tubular necrosis could not be evaluated because there were few such cases, with concomitant rejection in most. The ability to predict and identify presence or absence of rejection was not affected by different serum creatinine values. Doppler US was significantly superior to MR imaging in identifying allograft rejection, demonstrating a higher sensitivity (95% vs. 70%), specificity (95% vs. 73%), and accuracy (95% vs. 71%). Because of its low cost and accessibility, Doppler US should become the primary modality for renal transplant screening. 相似文献