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Small Bowel Perforation Caused by Metastasis from an Extra-Abdominal Malignancy: Report of Three Cases 总被引:2,自引:0,他引:2
Small bowel perforation is rarely caused by metastasis from an extra-abdominal malignancy. This report describes three cases
of small bowel perforation that occurred secondary to a metastatic tumor. The first case involved a 72-year-old man with malignant
lymphoma of the larynx that had been treated with chemo- and radiation therapy; the second involved a 70-year-old man with
rhabdomyosarcoma of the mediastinum that had been treated with radiation therapy; and the third involved a 41-year-old man
with lung carcinoma that had been treated with surgery 10 months prior to perforation. Each patient presented with acute abdominal
pain, had X-ray findings of free air in the abdomen, and underwent limited emergency surgery. Wedge resection and closure
of the ileum was performed for the first patient and partial bowel resection with the creation of an intestinal stoma was
performed for the second and third patients. In each case, the histologic findings of the resected specimens were consistent
with the extra-abdominal primary tumors. Although the patients recovered sufficiently to begin eating and moving about, all
three died of cancer or cancer-related complications within 45 days of surgery. We conclude that surgeons should be aware
of the poor prognosis of such patients and perform only the minimal surgery required.
Received: April 7, 2000 / Accepted: September 26, 2000 相似文献
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Hidden from the host: Spiroplasma bacteria infecting Drosophila do not cause an immune response,but are suppressed by ectopic immune activation 总被引:2,自引:0,他引:2
Insects and other arthropods have an effective innate immune system that can clear infections with bacteria and other microorganisms. Despite this ability, one group of bacteria, the spiroplasmas, survive unharmed within the haemolymph of a wide range of arthropod hosts. We investigated the interaction between one member of this clade, a relative of Spiroplasma poulsonii, and the immune system of its Drosophila host. Expression of antimicrobial genes in spiroplasma-infected flies did not differ from wild-type controls either in the naturally infected state, nor after septic shock. We therefore concluded that spiroplasma infection did not induce an immune response in its host, but that this absence of response was unlikely to be because the bacterium inhibited response. Further experiments revealed immune reactions induced ectopically did reduce parasite titre. We therefore conclude that this bacterium has a novel form of interaction with its host, being hidden from the host immune system, but potentially suppressible by it. 相似文献
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Fujinaga S Kaneko K Ohtomo Y Murakami H Takemoto M Takada M Shimizu T Yamashiro Y 《Pediatric nephrology (Berlin, Germany)》2006,21(2):277-280
Thin basement membrane nephropathy (TBMN) is characterized clinically by persistent hematuria, minimal proteinuria, normal renal function, another family member with hematuria, and a benign course. Especially in childhood TBMN, proteinuria of any degree is reported to be uncommon. We report on a boy with benign familial hematuria found by urinary screening at 3 years of age who presented with nephrotic syndrome (NS) at 15 years of age. His renal histology showed TBMN associated with minimal change disease (MCD). Treatment with corticosteroid resulted in complete remission of NS in a short period of time, while isolated hematuria persisted during the follow-up period despite this therapy. We speculate, therefore, that the nephrotic range proteinuria is not due to TBMN but rather is the manifestation of associated MCD. Several cases of TBMN with NS have been reported in adults, but it has not yet been reported in children in the literature. To our knowledge, this is the first case of childhood TBMN associated with NS resulting from coincidental MCD. 相似文献
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Norio Kondo Toshio Yoshihara Yukie Yamamura Kaoru Kusama Eri Sakitani Yukako Seo Mayako Tachikawa Keiko Kujirai Erika Ono Yasuyo Maeda Tomohito Nojima Akiko Tamiya Emiri Sato Manabu Nonaka 《Auris, nasus, larynx》2018,45(4):772-776
Objective
To assess the general guidelines for the removal of sialoliths for submandibular gland sialolithiasis using sialendoscopy alone.Methods
We analyzed 61 sialoliths treated using sialendoscopy in 42 patients with submandibular gland sialolithiasis. We evaluated the submandibular gland sialoliths and divided each case based upon the location: the Wharton’s duct or the hilum. We measured the major and minor axes of the sialoliths using a soft tissue computed-tomography (CT) scan and evaluated the removal rate of the sialoliths using sialendoscopy alone.Results
The removal rate of the sialoliths in the Wharton’s duct (52.6%) was significantly higher than that in the hilum of the submandibular gland (26.1%) (P = 0.042). The minor axis was significantly correlated to the treatment outcome of sialendoscopy alone for all cases (P = 0.030). A significant correlation was observed for cases involving the hilum of the submandibular gland and the measurement of the minor axes of the sialoliths for the treatment outcome of sialendoscopy alone (P = 0.009). The major axis showed no correlation with the treatment outcomes of sialendoscopy alone.Conclusion
The measurement of the minor axes of the sialoliths with a soft tissue CT scan was correlated with treatment outcome of sialendoscopy alone for all cases, particularly sialoliths in the hilum. The easurement of the major axis showed no correlation with outcomes of sialendoscopy alone. 相似文献9.
Toru Morioka Naoki Niikura Nobue Kumaki Shinobu Masuda Takayuki Iwamoto Kozue Yokoyama Rin Ogiya Risa Oshitanai Mayako Terao Banri Tsuda Takuho Okamura Yuki Saito Yasuhiro Suzuki Yutaka Tokuda 《Breast cancer (Tokyo, Japan)》2018,25(6):768-777
Background
Routine analysis of Ki-67 is not widely recommended for clinical decision-making because of poor reproducibility. Furthermore, counting numerous cells can be laborious for pathologists. Digital image analysis for immunohistochemical analysis was recently developed; however, the clinical efficacy of the Ki-67 index obtained using image analysis is unknown.Methods
We retrospectively identified female patients with breast cancer with immunohistochemical Ki-67 and survival data using the pathology database at the Tokai University, Japan. Ki-67 expression was scored by three pathologists. Slides were scanned and converted to virtual slides; Ki-67-positive cells were counted using image analysis. Ki-67 indices obtained by the pathologist’s scoring and image analysis were evaluated by 2?×?2 analysis. Relationships between Ki-67 index and survival outcomes were evaluated using the Kaplan–Meier method and compared using the log-rank test.Results
Based on the 2?×?2 analysis, Ki-67 index obtained using image analysis was moderately correlated with the pathologist’s scoring for all patients (κ 0.41; sensitivity, 0.573; specificity, 0.878). Poorer relapse-free survival was associated with high Ki-67 index than with low Ki-67 index for estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and stage I or II patients scored by pathologists (p?<?0.001) and obtained using image analysis (p?=?0.031).Conclusions
The Ki-67 indices obtained using image analysis were moderately correlated with those scored by pathologists. Digital image analysis can be effective for measuring Ki-67 values, because they are associated with relapse-free survival in estrogen receptor-positive, human epidermal growth factor receptor 2-negative, and patients at stage I or II.10.
Banri Tsuda Asuka Miyamoto Kozue Yokoyama Rin Ogiya Risa Oshitanai Mayako Terao Toru Morioka Naoki Niikura Takuho Okamura Hirohito Miyako Yuki Saito Yasuhiro Suzuki Yoshie Kametani Yutaka Tokuda 《Breast cancer (Tokyo, Japan)》2018,25(3):284-291