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81.
Schettini ST da Fonseca JH Abib SC Telles CA Haber MX Rizzo MF Saba da Silva NS Petrilli AS 《Pediatric surgery international》2000,16(7):529-532
We review our experience and the literature in treating 4 patients with Wilms' tumor (WT) with intracardiac extension among
92 patients with this neoplasm. Cardiopulmonary bypass with circulatory arrest and profound hypothermia was used. There were
3 boys (3 years, 4 years 5 months, and 15 years) and 1 girl (6 years). The follow-up periods were 8 months, 3 years, 2 years
6 months, and 15 years, respectively. We had no surgical complications and conclude that the preoperative diagnosis is extremely
important. These patients must be transferred to institutions where concomitant cardiac procedures can be performed. In treating
patients with WT, Doppler ultrasound must be used preoperatively in all cases, not only those in which clinical and radiologic
signs of intravascular involvement are found. We propose that preoperative chemotherapy should be used, as it shrinks the
thrombus and causes desirable adherence of the thrombus to the venous wall, reducing the probability of thromboembolism during
the surgical procedure. We also find this method safer than in our 1st case, where neither cardiac arrest nor hypothermia
was used. Our results agree with the literature that intracardiac extension of WT does not worsen its prognosis when a rational
surgical approach is used.
Accepted: 26 August 1999 相似文献
82.
Phenol sulfotransferases: hormonal regulation, polymorphism, and age of onset of breast cancer 总被引:8,自引:0,他引:8
Seth P Lunetta KL Bell DW Gray H Nasser SM Rhei E Kaelin CM Iglehart DJ Marks JR Garber JE Haber DA Polyak K 《Cancer research》2000,60(24):6859-6863
In recent years, significant effort has been made to identify genes that influence breast cancer risk. Because the high-penetrance breast cancer susceptibility genes BRCA1 and 2 play a role only in a small fraction of breast cancer cases, understanding the genetic risk of the majority of breast cancers will require the identification and analysis of several lower penetrance genes. The estrogen-signaling pathway plays a crucial role in the pathophysiology of breast cancer; therefore, polymorphism in genes involved in this pathway is likely to influence breast cancer risk. Our detailed analysis of gene expression profiles of estrogen- and 4-OH-tamoxifen-treated ZR75-1 breast cancer cells identified members of the sulfotransferase 1A (SULT1A) phenol sulfotransferase family as downstream targets of tamoxifen. On the basis of the induction of SULT1A by 4-OH-tamoxifen and the known inherited variability in SULT1A enzymatic activity, we hypothesized that polymorphism in sulfotransferase genes might influence the risk of breast cancer. Using an RFLP that distinguishes an arginine to histidine change in exon 7 of the SULT1A1 gene, we characterized SULT1A1 genotypes in relation to breast cancer risk. An analysis of 444 breast cancer patients and 227 controls revealed no effect of SULT1A1 genotype on the risk of breast cancer (P = 0.69); however, it did appear to influence the age of onset among early-onset affected patients (P = 0.04). Moreover, individuals with the higher activity SULT1A1*1 allele were more likely to have other tumors in addition to breast cancer (P = 0.004; odds ratio, 3.02; 95% confidence interval, 1.32, 8.09). The large number of environmental mutagens and carcinogens activated by sulfotransferases and the high frequency of the SULT1A1*1 allele in human populations warrants additional studies to address the role of SULT genes in human cancer. 相似文献
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Multiple myeloma is a condition usually associated with lesions of the skeleton. However, under rare circumstances, the malignant plasma cells may infiltrate the pericardium, resulting in an effusion. If left untreated, the abnormal accumulation of pericardial fluid will result in cardiac tamponade, requiring drainage. The following report describes a multiple myeloma patient who developed secondary pericardial and pleural effusions, which were surgically drained via a pleuropericardial window. 相似文献
88.
Izurieta HS Haber P Wise RP Iskander J Pratt D Mink C Chang S Braun MM Ball R 《JAMA》2005,294(21):2720-2725
Context In June 2003, the US Food and Drug Administration licensed a trivalent live, attenuated influenza vaccine (LAIV-T) for intranasal administration to healthy persons 5 to 49 years of age. Although prelicensure testing involved 20 228 vaccinees, clinical trials were not of sufficient size to detect rare adverse events reliably. Objective To identify adverse events reported following LAIV-T administration after licensure. Design, Setting, and Participants All adverse events reported to the US Vaccine Adverse Event Reporting System (VAERS) during the 2003-2004 and the 2004-2005 influenza seasons. Main Outcome Measures Numbers and proportions of reported adverse events and reporting rates of adverse events per 100 000 vaccinees. Results Approximately 2 500 000 persons received LAIV-T during the first 2 postlicensure seasons. As of August 16, 2005, VAERS received 460 adverse event reports for vaccinations received from August 2003 through July 2005. No fatalities were reported. There were 7 reports of possible anaphylaxis, 2 reports of Guillain-Barré syndrome, 1 report of Bell palsy, and 8 reports of asthma exacerbation among individuals with a prior asthma history. Events in individuals for whom the vaccine was not indicated accounted for 73 reports (16%). Conclusions Reports to VAERS in the first 2 seasons of LAIV-T use did not identify any unexpected serious risks with this vaccine when used according to approved indications. Like many vaccines and other medical products, LAIV-T may rarely cause anaphylaxis. Secondary transmission of the vaccine virus merits further investigation. Reports of asthma exacerbations in vaccinees with prior asthma history highlight the risks of vaccine use inconsistent with approved labeling. 相似文献
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