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21.
Karvouni E Papakonstantinou K Dimopoulou C Kairi-Vassilatou E Hasiakos D Gennatas CG Kondi-Paphiti A 《Archives of gynecology and obstetrics》2009,279(2):199-201
Background Extragenital carcinomas secondarily involving the uterus are very rare and they usually occur as a manifestation of widespread
disease. When the metastases involve the endometrium in a diffuse, permeative pattern, sparing the glands, they may cause
problems in the diagnosis.
Case A case of metastatic carcinoma to the endometrium with a decidua-like pattern is reported. The patient had a history of breast
carcinoma and presented with vaginal bleeding. The pathologic findings in the uterine curettings raised the differential diagnosis
between metastatic breast carcinoma and non-neoplastic stromal lesions. The presence of nuclear atypia and mitotic activity
along with the appropriate immunohistochemical findings revealed the neoplastic nature of the endometrial lesion and confirmed
its origin from the breast.
Conclusion Unusual uterine bleeding in a patient with breast cancer should alert the gynecologist to the possibility of metastatic breast
disease. Furthermore, the metastasis to the uterus and to other organs of the genital tract can be considered as a preterminal
event. 相似文献
22.
Meyers BS Sirey JA Bruce M Hamilton M Raue P Friedman SJ Rickey C Kakuma T Carroll MK Kiosses D Alexopoulos G 《Archives of general psychiatry》2002,59(8):729-735
BACKGROUND: Twenty years have elapsed since the National Institute of Mental Health Collaborative Depression Study reported on the early course and treatment of major depression within the mental health sector. Using similar methods, an observational study was conducted to assess relationships between initial depression severity, personality dysfunction and other baseline characteristics, subsequent treatment, and 3-month outcomes among persons admitted to public and voluntary sector outpatient clinics, including 1 academic program. METHODS: A 2-stage sampling technique was used to recruit subjects (N = 165) diagnosed by the Structured Clinical Interview for DSM-IV, Patient Version, as having a major depression episode. Sociodemographic and clinical characteristics were assessed at admission. Data on treatment and outcome were obtained at 3 months using structured instruments from the Longitudinal Interview Follow-up Evaluation. Logistic regression was used to assess hypothesized predictors of early recovery. Analyses were carried out in the total sample and after dichotomizing subjects by baseline depression severity. RESULTS: Fifty (30.3%) of the 165 subjects met recovery criteria. Less than half of the subjects (45%) met criteria for adequate pharmacotherapy. Less severe depression, having received adequate antidepressant treatment, female sex, and being married independently predicted early recovery. In the more depressed subgroup, early recovery was associated with female sex. Among less severely depressed subjects, high personality dysfunction scores and being married were significant predictors. CONCLUSIONS: Initial depression severity and receiving adequate pharmacotherapy predict early recovery in individuals with major depression seeking outpatient treatment. A minority of persons receive intensive antidepressant treatment. Less severe personality dysfunction and being married predicts early recovery among persons with less severe depression. 相似文献
23.
Mavragani CP Pikazis D Aroni K Paikos S Voulgarelis M 《American journal of hematology》2004,76(2):139-142
We report two cases with cutaneous lesions found to be associated with factor V Leiden mutation and low S protein levels. At the time of presentation, no other symptoms were reported. Histopathology of both lesions revealed the presence of widespread intravascular thrombi. The therapeutic response to oral anticoagulants in the first case was dramatic, leading to complete healing of the lesions. Inherited causes of thrombophilia manifested as cutaneous lesions, although rare, should be considered in the differential diagnosis of occlusive vasculopathy. 相似文献
24.
Neuroendocrine aspects of chronic fatigue syndrome 总被引:1,自引:0,他引:1
Papanicolaou DA Amsterdam JD Levine S McCann SM Moore RC Newbrand CH Allen G Nisenbaum R Pfaff DW Tsokos GC Vgontzas AN Kales A 《Neuroimmunomodulation》2004,11(2):65-74
Chronic fatigue syndrome (CFS) is a serious health concern affecting over 800000 Americans of all ages, races, socioeconomic groups and genders. The etiology and pathophysiology of CFS are unknown, yet studies have suggested an involvement of the neuroendocrine system. A symposium was organized in March 2001 to explore the possibility of an association between neuroendocrine dysfunction and CFS, with special emphasis on the interactions between neuroendocrine dysfunction and other abnormalities noted in the immune and autonomic nervous systems of individuals with CFS. This paper represents the consensus of the panel of experts who participated in this meeting. 相似文献
25.
Lin E Gletsu N Fugate K McClusky D Gu LH Zhu JL Ramshaw BJ Papanicolaou DA Ziegler TR Smith CD 《Archives of surgery (Chicago, Ill. : 1960)》2004,139(7):780-784
HYPOTHESIS: Circulating ghrelin, produced primarily in the stomach, is a powerful orexigen. Ghrelin levels are elevated in states of hunger, but rapidly decline postprandially. Early alterations in ghrelin levels in morbidly obese patients undergoing weight reduction surgery may be attributed to gastric partitioning. DESIGN AND PATIENTS: Thirty-four patients underwent Roux-en-Y gastric bypass with a completely divided gastroplasty to create a 15-mL vertically oriented gastric pouch. Eight other patients underwent other gastric procedures that did not involve complete division of the stomach, including 4 vertical banded gastroplasties and 4 antireflux surgical procedures. Six additional patients undergoing antireflux surgery served as lean control subjects. Plasma samples were obtained before surgery and immediately after surgery. In a substudy, plasma was collected after Roux-en-Y limb formation and after dividing the stomach to identify any changes in plasma ghrelin levels. SETTING: Tertiary university medical center. MAIN OUTCOME MEASURES: Ghrelin levels at different stages of surgical intervention. RESULTS: Mean +/- SEM preoperative and postoperative ghrelin levels in the gastric bypass group were 355 +/- 20 and 246 +/- 13 pg/mL, respectively (P<.001). In the vertical banded gastroplasty group and in all patients undergoing antireflux surgery, ghrelin levels were not significantly changed. CONCLUSIONS: Compared with morbidly obese humans, lean controls had significantly higher plasma ghrelin levels at baseline. A divided gastroplasty creating a small proximal gastric pouch results in significant early declines in circulating ghrelin levels that are not observed with other gastric procedures. This may explain, in part, the loss of hunger sensation and rapid weight loss observed following gastric bypass surgery. 相似文献
26.
Modern diagnostic methods allow the evaluation of the connection between rhinoviruses and atopy. Recent studies suggest that rhinoviruses are present in the adenoids at higher titers than in other specific sites, after inoculation of nasal mucosa or conjunctiva in volunteers. Therefore, it is possible that they might be responsible for specific local changes, while such changes may be influenced by atopy. This review focuses on the interactions between rhinoviral infection, the host's immune status and adenoidal disease. 相似文献
27.
28.
Giatromanolaki A Koukourakis MI Kakolyris S Mavroudis D Kouroussis C Mavroudi C Perraki M Sivridis E Georgoulias V 《International journal of cancer. Journal international du cancer》2004,108(4):620-627
The assessment of tumor molecular features in combination with the detection of occult malignant cells may provide important clinical information, beyond the standard staging of breast cancer. Using a nested RT-PCR technique, we assessed prospectively the presence of cytokeratin-19 (CK19) mRNA positive cells in the blood of 100 operated patients with breast cancer before the initiation of adjuvant chemotherapy and local radiotherapy. Tissue samples were prospectively collected and analyzed for estrogen (ER) and progesterone (PgR) receptor, c-erbB-2 overexpression, mutant-p53 and bcl-2 protein accumulation, proliferation index and microvessel density (MVD). CK-19 mRNA-positive cells were detected in the peripheral blood of 33% of patients. Simultaneous display of high intratumoral MVD and of CK-19 mRNA-positive cells, which characterized highly angiogenic and disseminated in the peripheral blood (HAD) disease was noted in 25% of patients. Detection of CK-19 positive cells was significantly associated with increased MVD (p = 0.002). In univariate analysis (median follow-up 30 months) CK19 mRNA detection and MVD were the most significant factors related to a short relapse-free survival (RFS), (p < 0.0001). In multivariate analysis, CK19 positivity, high MVD and c-erbB-2 overexpression were the only significant and independent variables associated with relapse (p = 0.0005, 0.03 and 0.04, respectively). Patients with HAD had an expected relapse rate close to 70% vs. <5% in the remaining patients irrespectively of the used chemotherapy regimen. The simultaneous presence of high MVD and CK19-positive cells in the blood of patients with early breast is linked with poor prognosis, which cannot be improved with standard chemotherapy regimens. 相似文献
29.
Athanasas K Magiatis P Fokialakis N Skaltsounis AL Pratsinis H Kletsas D 《Journal of natural products》2004,67(6):973-977
Two new and four known phloroglucinol derivatives were isolated from the dichloromethane extract of the Greek endemic plant Hypericum jovis. Their antioxidant activity was evaluated in vitro with the DPPH assay and in cell cultures using the DCFH-DA assay. All six compounds demonstrated significant antioxidant activity, while two of them possessed activity at a cellular level comparable to Trolox, protecting against ROS. 相似文献
30.
Niki?Malliaraki Dimitris?Mpliamplias Marilena?Kampa Kostas?Perakis Andrew?N?Margioris Elias?CastanasEmail author 《BMC nephrology》2003,4(1):4