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Sample records for adenoma silente subtipo

  1. Heterogeneity of secretory granules of silent pituitary adenomas

    DEFF Research Database (Denmark)

    Holck, S; Wewer, U M; Albrechtsen, R

    1988-01-01

    Silent pituitary adenomas were compared with hormonally active tumors taking into account the size, number, and ultrastructural characteristics of secretory granules (SG). The study group (a total of 79 primary pituitary adenomas) comprised 27 silent, 21 growth hormone (GH)-producing-, 16 prolactin...... (PRL)-producing-, 5 GH-PRL-producing- and 10 adrenocorticotropic hormone (ACTH)-producing adenomas. The SG of silent adenomas were significantly smaller than SG in endocrine active adenomas. All hormonally inactive tumors also contained small (mean, 94 nm) specific cytoplasmic granules, designated...... approximately 10 to 50% of the granules in each cell. These granules were not seen in hormonally active tumors and considered therefore diagnostic of silent pituitary adenomas....

  2. Type II muscle fibers atrophy associated with silent corticotroph adenoma in a dog.

    Directory of Open Access Journals (Sweden)

    L Insabato

    2010-11-01

    Full Text Available The Silent Corticotroph Adenoma (SCA is a pituitary adenoma variant characterized by the immunoreactivity for adrenocorticotropic hormone (ACTH and related peptides, without the clinical signs of Cushing's disease. SCA has been postulated to either secrete structurally abnormal ACTH that is inactive but detectable by immunohistochemistry or radioimmunoassay, or to secrete ACTH intermittently or at low levels continuously. Excess of ACTH has been associated to type II muscle atrophy. We describe a case of type II muscle fibers atrophy associated with silent corticotroph adenoma in a dog. The dog showed moderate to severe proximal muscle wasting and weakness with normal levels of muscle-associated enzymes. In the limb muscle biopsies, type II fibers were uniformly smaller than type I fibers. In temporalis muscles, there were few atrophic fibers, and several irregular areas of loss of enzymatic activity observed in NADH, SDH and COX stains. The tumour showed a trabecular growth pattern and immunohistochemical analysis demonstrated the presence of cytoplasmic immunoreactivity for ACTH. The muscle atrophy was considered to be related to an excess of inactive ACTH. Studying spontaneous occurring rare diseases in animals could help to understand the mechanism of similar diseases in human has well.

  3. Silent Corticotroph Adenomas After Stereotactic Radiosurgery: A Case–Control Study

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Zhiyuan; Ellis, Scott; Lee, Cheng-Chia; Starke, Robert M. [Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia (United States); Schlesinger, David [Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia (United States); Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia (United States); Lee Vance, Mary [Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia (United States); Department of Internal Medicine, University of Virginia, Charlottesville, Virginia (United States); Lopes, M. Beatriz [Division of Neuropathology, University of Virginia, Charlottesville, Virginia (United States); Sheehan, Jason, E-mail: jsheehan@virginia.edu [Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia (United States); Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia (United States)

    2014-11-15

    Purpose: To investigate the safety and effectiveness of stereotactic radiosurgery (SRS) in patients with a silent corticotroph adenoma (SCA) compared with patients with other subtypes of non–adrenocorticotropic hormone staining nonfunctioning pituitary adenoma (NFA). Methods and Materials: The clinical features and outcomes of 104 NFA patients treated with SRS in our center between September 1994 and August 2012 were evaluated. Among them, 34 consecutive patients with a confirmatory SCA were identified. A control group of 70 patients with other subtypes of NFA were selected for review based on comparable baseline features, including sex, age at the time of SRS, tumor size, margin radiation dose to the tumor, and duration of follow-up. Results: The median follow-up after SRS was 56 months (range, 6-200 months). No patients with an SCA developed Cushing disease during the follow-up. Tumor control was achieved in 21 of 34 patients (62%) in the SCA group, compared with 65 of 70 patients (93%) in the NFA group. The median progression-free survival (PFS) was 58 months in the SCA group. The actuarial PFS was 73%, 46%, and 31% in the SCA group and was 94%, 87%, and 87% in the NFA group at 3, 5, and 8 years, respectively. Silent corticotroph adenomas treated with a dose of ≥17 Gy exhibited improved PFS. New-onset loss of pituitary function developed in 10 patients (29%) in the SCA group, whereas it occurred in 18 patients (26%) in the NFA group. Eight patients (24%) in the SCA group experienced worsening of a visual field deficit or visual acuity attributed to the tumor progression, as did 6 patients (9%) in the NFA group. Conclusion: Silent corticotroph adenomas exhibited a more aggressive course with a higher progression rate than other subtypes of NFAs. Stereotactic radiosurgery is an important adjuvant treatment for control of tumor growth. Increased radiation dose may lead to improved tumor control in SCA patients.

  4. Neurocysticercosis, Meningioma, and Silent Corticotroph Pituitary Adenoma in a 61-Year-Old Woman

    Directory of Open Access Journals (Sweden)

    Maria del Pilar Ramirez

    2012-01-01

    Full Text Available We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before.

  5. Neurocysticercosis, meningioma, and silent corticotroph pituitary adenoma in a 61-year-old woman.

    Science.gov (United States)

    Ramirez, Maria Del Pilar; Restrepo, Juan E; Syro, Luis V; Rotondo, Fabio; Londoño, Francisco J; Penagos, Luis C; Uribe, Humberto; Horvath, Eva; Kovacs, Kalman

    2012-01-01

    We report here the case of a 61-year-old woman who presented with hydrocephalus and cystic and solid lesions in sella turcica, suprasellar areas, and third ventricle. After ventriculoperitoneal shunt she developed cognitive changes and the cystic lesions enlarged. Magnetic resonance imaging (MRI) demonstrated multiple cysts and a solid lesion in the sella and around the anterior clinoid process. With diagnosis of neurocysticercosis she underwent craniotomy. Pathologic examination documented two different lesions: viable and dead cysticerci with inflaming infiltration and a left anterior clinoidal meningioma. At the second surgery, six weeks later via transnasal transsphenoidal approach a silent corticotroph pituitary adenoma was removed which was studied by histology, immunohistochemistry, and electron microscopy. To our knowledge, the occurrence of these three different lesions in the sellar area was not described before.

  6. y sus subtipos

    Directory of Open Access Journals (Sweden)

    Myriam Sierra Puentes

    2005-01-01

    Full Text Available En este artículo se realiza una reseña sobre los trastornos de la alimentación, anorexia y bulimia, la relación que hacen los individuos con este comportamiento y la prevalencia, características y tratamientos más efectivos empleados en la bulimia nerviosa. Además, algunas aproximaciones para establecer subtipos de bulimia diferentes a los del DSM-IV e investigaciones sobre este trastorno del comportamiento alimentario, como la bulimia nerviosa.

  7. La bulimia nerviosa y sus subtipos

    OpenAIRE

    Myriam Sierra Puentes

    2005-01-01

    En este artículo se realiza una reseña sobre los trastornos de la alimentación, anorexia y bulimia, la relación que hacen los individuos con este comportamiento y la prevalencia, características y tratamientos más efectivos empleados en la bulimia nerviosa. Además, algunas aproximaciones para establecer subtipos de bulimia diferentes a los del DSM-IV e investigaciones sobre este trastorno del comportamiento alimentario, como la bulimia nerviosa.

  8. Parathyroid adenoma

    Science.gov (United States)

    Hyperparathyroidism - parathryoid adenoma; Overactive parathyroid gland - parathyroid adenoma ... The parathyroid glands in the neck help control calcium use and removal by the body. They do this by ...

  9. Silent thyroiditis

    Science.gov (United States)

    ... reaction of the thyroid gland. The disorder can cause hyperthyroidism, followed by hypothyroidism. The thyroid gland is located ... lymphocytic thyroiditis; Painless thyroiditis; Postpartum thyroiditis; Thyroiditis - silent; Hyperthyroidism - silent thyroiditis

  10. Silent Ischemia

    Science.gov (United States)

    ... silent ischemia: An exercise stress test can show blood flow through your coronary arteries in response to exercise. Holter monitoring records your heart rate and rhythm over a 24-hour period (or ...

  11. ADENOMA HIPOFISIS

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    Muhammad Hidayat

    2015-09-01

    Full Text Available AbstrakAdenoma hipofisis diklasifikasikan berdasarkan beberapa kriteria yaitu klinis dan endokrin, patologi, serta radiologi. Klasifikasi endokrin membedakan tumor sebagai fungsional dan nonfungsional, berdasarkan aktivitas sekretorinya in-vivo. Klasifikasi patologi berusaha untuk membatasi kelompok tumor heterogenus secara klinis dan patologis dengan kategori yaitu asidofilik, basofilik, dan kromofobik. Klasifikasi radiologi mengelompokkan tumor hipofisis berdasarkan ukuran dan karakteristik pertumbuhan, yang dapat ditemukan dari studi imaging. WHO membuat klasifikasi yang mencoba untuk mengintegrasikan semua klasifikasi yang ada dan menyediakan sinopsis praktis untuk aspek klinis dan patologis dari adenoma. Diagnosa adenoma hipofisis dibuat berdasarkan: gejala klinis dari gangguan hormon, adanya riwayat penyakit dahulu yang jelas, pemeriksaan fisik yang menunjang, pemeriksaan laboratorium yang menunjukkan disfungsi dari hormon yang terganggu, adanya pemeriksaan penunjang yang akurat seperti CTScan, MRI-Scan. Jenis, besar dan fungsi dari tumor sangat menentukan dalam mempertimbangkan penatalaksanaan dari adenoma hipofisis. Pengobatan diindikasikan pada semua pasien dengan gejala, terutama dengan hipogonadisme. Pilihan terapi termasuk kontrol dengan obat-obatan, reseksi bedah, dan terapi radiasi.AbstractPituitary adenomas are classified according to several criteria; clinical endocrine, pathology, and radiology. Endocrine classification distinguishes tumors as functional and nonfunctional, based on in-vivo secretory activity. Pathology classification seeks to restrict clinically heterogeneous group of tumors and pathological categories namely acidophilic, basophilic, and kromofobik. Radiological classification classifies pituitary tumors by size and growth characteristics, which can be found on imaging studies. WHO made a classification that attempts to integrate all existing classifications and provide practical synopsis for the clinical and

  12. ACTH adenomas transforming their clinical expression: report of 5 cases.

    Science.gov (United States)

    Zoli, Matteo; Faustini-Fustini, Marco; Mazzatenta, Diego; Marucci, Gianluca; De Carlo, Eugenio; Bacci, Antonella; Pasquini, Ernesto; Lanzino, Giuseppe; Frank, Giorgio

    2015-02-01

    OBJECT Adrenocorticotropic hormone (ACTH) adenomas have been recognized as a more aggressive and invasive subtype of pituitary adenomas. An additional and clinically relevant peculiarity of these tumors is their ability to modify their clinical expression from a silent form to Cushing disease or vice versa. The aim of this study was to review a series of patients with pituitary adenomas and analyze the clinical implications of the transformation of clinical expression in 5 cases that showed this phenomenon. METHODS The authors retrospectively reviewed a series of patients with pituitary adenoma and collected clinical, biohumoral, and neuroradiological data of those who presented with a transformation from silent ACTH adenomas to functioning tumors or vice versa. In all the cases, preoperative assessment consisted of brain MRI, ophthalmological examination, and complete baseline endocrinological investigation. In patients with clinical and/or biochemical findings suspicious for Cushing syndrome, a low-dose dexamethasone suppression test was performed to rule in or out this diagnosis. Endocrinological evaluations were repeated 1 month after surgery, 3 months after surgery, and every 6 months or annually thereafter. Ophthalmological evaluations and brain MRIs were repeated after 3 months and then every 6 or 12 months thereafter. RESULTS Five patients (2 men and 3 women) included in this series had corticotropic tumors that showed transformation from an endocrinologically silent form to manifest Cushing disease and vice versa. The mean age at presentation was 40 years (range 18-51 years). In 3 of these patients, a transformation from silent to functioning ACTH adenoma with manifest Cushing disease occurred. In 1 patient, the authors observed the transition from a functioning to a silent adenoma with spontaneous resolution of hypercortisolism. Another patient's silent adenoma "shifted" to a functioning adenoma and then regressed back to a silent form with spontaneous

  13. Subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda

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    María del Carmen Castro-Mujica

    2013-03-01

    Full Text Available El objetivo fue describir la frecuencia de los subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda (LPA y su distribución según grupo de riesgo de recaída y citomorfología. Se realizó una serie de casos que incluyó a cincuenta pacientes registrados en el Instituto Nacional de Enfermedades Neoplásicas (INEN, durante el periodo 2010-2012, con diagnóstico molecular de LPA PML/RARα y subtipos bcr1, bcr2 y bcr3 por reacción en cadena de la polimerasa con transcriptasa reversa (RT-PCR. El subtipo bcr1 fue el más frecuente (62%. Los pacientes con riesgo de recaída intermedio y morfología hipergranular fueron, en su mayoría, bcr1 (70% y todos los que poseían riesgo de recaída alto y morfología hipogranular fueron bcr3. Se concluye que en la población estudiada hay un predomino del subtipo bcr1 y que existen diferencias en la distribución de los subtipos bcr1 y bcr3 según el grupo de riesgo de recaída y citomorfología

  14. Subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda

    OpenAIRE

    2013-01-01

    El objetivo fue describir la frecuencia de los subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda (LPA) y su distribución según grupo de riesgo de recaída y citomorfología. Se realizó una serie de casos que incluyó a cincuenta pacientes registrados en el Instituto Nacional de Enfermedades Neoplásicas (INEN), durante el periodo 2010-2012, con diagnóstico molecular de LPA PML/RARα y subtipos bcr1, bcr2 y bcr3 por reacción en cadena de la polimerasa con transcriptasa...

  15. Contemporary issues in the evaluation and management of pituitary adenomas.

    Science.gov (United States)

    Pekic, S; Stojanovic, M; Popovic, V

    2015-12-01

    Pituitary adenomas are common benign monoclonal neoplasms accounting for about 15% of intracranial neoplasms. Data from postmortem studies and imaging studies suggest that 1 of 5 individuals in the general population may have pituitary adenoma. Some pituitary adenomas (mainly microadenomas which have a diameter of less than 1 cm) are exceedingly common and are incidentally diagnosed on magnetic resonance imaging (MRI) performed for an unrelated reason (headache, vertigo, head trauma). Most microadenomas remain clinically occult and stable in size, without an increase in tumor cells and without local mass effects. However, some pituitary adenomas grow slowly, enlarge by expansion and become demarcated from normal pituitary (macroadenomas have a diameter greater than 1 cm). They may be clinically silent or secrete anterior pituitary hormones in excess such as prolactin, growth hormone (GH), or adrenocorticotropic hormone (ACTH) causing diseases like prolactinoma, acromegaly, Cushing's disease or rarely thyroid-stimulating hormone (TSH) or gonadotropins (LH, FSH). The incidence of the various subtypes of pituitary adenoma varies but the most common is prolactinoma. Clinically non-functioning pituitary adenomas (NFPAs), which do not secrete hormones often cause local mass symptoms and represent one-third of pituitary adenomas. Given the high prevalence of pituitary adenomas and their heterogeneity (different tumor subtypes), it is critical that clinicians have a thorough understanding of the potential abnormalities in pituitary function and prognostic factors for behavior of pituitary adenomas in order to timely implement specific treatment modalities. Regarding pathogenesis of these tumors genetics, epigenetics and signaling pathways are the focus of current research yet our understanding of pituitary tumorigenesis remains incomplete. Although several genes and signaling pathways have been identified as important factors in the development of pituitary tumors, current

  16. Silent myocardial ischemia.

    Science.gov (United States)

    Gutterman, David D

    2009-05-01

    Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.

  17. Silent screen: book review.

    OpenAIRE

    Ó Drisceoil, Donal

    2007-01-01

    Book Review. Kevin Rockett, Irish film censorship: a cultural journey from silent cinema to internet pornography (Dublin, 2004) and Mary Corcoran and Mark O'Brien (eds), Political censorship and the democratic state: the Irish broadcasting ban (Dublin, 2005)

  18. A Silent Safety Program

    Science.gov (United States)

    Goodin, James Ronald

    2006-01-01

    NASA's Columbia Accident Investigation Board (CAIB) referred 8 times to the NASA "Silent Safety Program." This term, "Silent Safety Program" was not an original observation but first appeared in the Rogers Commission's Investigation of the Challenger Mishap. The CAIB on page 183 of its report in the paragraph titled 'Encouraging Minority Opinion,' stated "The Naval Reactor Program encourages minority opinions and "bad news." Leaders continually emphasize that when no minority opinions are present, the responsibility for a thorough and critical examination falls to management. . . Board interviews revealed that it is difficult for minority and dissenting opinions to percolate up through the agency's hierarchy. . ." The first question and perhaps the only question is - what is a silent safety program? Well, a silent safety program may be the same as the dog that didn't bark in Sherlock Holmes' "Adventure of the Silver Blaze" because system safety should behave as a devil's advocate for the program barking on every occasion to insure a critical review inclusion. This paper evaluates the NASA safety program and provides suggestions to prevent the recurrence of the silent safety program alluded to in the Challenger Mishap Investigation. Specifically targeted in the CAM report, "The checks and balances the safety system was meant to provide were not working." A silent system safety program is not unique to NASA but could emerge in any and every organization. Principles developed by Irving Janis in his book, Groupthink, listed criteria used to evaluate an organization's cultural attributes that allows a silent safety program to evolve. If evidence validates Jams's criteria, then Jams's recommendations for preventing groupthink can also be used to improve a critical evaluation and thus prevent the development of a silent safety program.

  19. Uninterrupted Sustained Silent Reading.

    Science.gov (United States)

    Meyers, Rick

    A study investigated the effect Sustained Silent Reading (SSR) has had on literacy at Estancia High School in California which recently implemented an SSR program. It also examined the role SSR has on language development, comprehension, vocabulary, student attitudes, and its corollary consequence on the development of reading habits. A survey of…

  20. Pituitary Adenoma Segmentation

    CERN Document Server

    Egger, Jan; Kuhnt, Daniela; Freisleben, Bernd; Nimsky, Christopher

    2011-01-01

    Sellar tumors are approximately 10-15% among all intracranial neoplasms. The most common sellar lesion is the pituitary adenoma. Manual segmentation is a time-consuming process that can be shortened by using adequate algorithms. In this contribution, we present a segmentation method for pituitary adenoma. The method is based on an algorithm we developed recently in previous work where the novel segmentation scheme was successfully used for segmentation of glioblastoma multiforme and provided an average Dice Similarity Coefficient (DSC) of 77%. This scheme is used for automatic adenoma segmentation. In our experimental evaluation, neurosurgeons with strong experiences in the treatment of pituitary adenoma performed manual slice-by-slice segmentation of 10 magnetic resonance imaging (MRI) cases. Afterwards, the segmentations were compared with the segmentation results of the proposed method via the DSC. The average DSC for all data sets was 77.49% +/- 4.52%. Compared with a manual segmentation that took, on the...

  1. Tubular apocrine adenoma.

    Science.gov (United States)

    Toribio, J; Zulaica, A; Peteiro, C

    1987-04-01

    We report a case of tubular apocrine adenoma located on the scalp, with characteristics of syringocystadenoma papilliferum in the superior part of the lesion. An interesting feature of the growth is its connective tissue involvement.

  2. Pituitary adenoma: a radiotherapeutic perspective.

    Science.gov (United States)

    Platta, Christopher S; Mackay, Christopher; Welsh, James S

    2010-08-01

    Pituitary adenomas comprise approximately 10% to 20% of all central nervous system neoplasms whereas autopsy series have suggested that the incidence of pituitary adenoma in the general population may approach 25%. Several treatment modalities are used in the treatment of pituitary adenomas, including observation, surgery, medical intervention, and radiotherapy. The treatment modality employed depends greatly on the type of pituitary adenoma and presenting symptoms. This review will discuss the biology of pituitary adenomas and the current management principles for the treatment of prolactinomas, Cushing disease, acromegaly, and nonsecretory adenomas, with an emphasis on the published radiotherapeutic literature.

  3. The Silent Giant.

    Science.gov (United States)

    Necek, Magdalena; Biskup, Ewelina

    2015-11-25

    SFT is a rare spindle cell neoplasm arising mostly at pleural and in rare cases at extrapleural sites. Histology and immunohistology are diagnostic tools. It is crucial to consider SFT as differential diagnosis in pulmonary nodules since they often remain clinically silent until they reach large dimension and to proceed with curative resection without delay. It is essential to follow up patients for a long period of time as recurrence may occur.

  4. Silent pain sufferers.

    Science.gov (United States)

    Watkins, Emmeline; Wollan, Peter C; Melton, L Joseph; Yawn, Barbara P

    2006-02-01

    To evaluate the proportion and characteristics of patients with chronic pain who do not seek treatment and assess whether these patients have unmet pain care needs. We performed a cross-sectional survey of residents of Olmsted County, Minnesota, from March through June 2004, with additional visit and diagnosis data from the Rochester Epidemiology Project database. Study participants were a random, population-based sample of eligible adult (>30 years) residents of Olmsted County with at least 1 visit to a local health care facility in the past 3 years. Of the 5897 eligible participants, 3575 people (60.6%) responded. Of the respondents who reported pain of more than 3 months' duration, 497 (22.4%) of the 2211 patients stated that they had not informed their physician about their pain. Of these silent sufferers, 70.6% (351/497) reported having moderate or severe pain, 49.2% (243/497) reported having frequent pain (>8 days per month), and 40.6% (202/497) met both criteria. Silent sufferers also reported that pain interfered with their general activity and sleep to a level only slightly less than the chronic pain sufferers who reported discussing their pain with a physician. Silent sufferers made an average of 5.2 ambulatory physician visits per year, which was less than those who sought physician help for their pain (8.6 ambulatory visits per year; P < .001). Men and younger participants were more likely to be silent about their pain (P < .001). More than 1 in 5 people with chronic pain did not seek physician care for their pain. This group is unknown to physicians and therefore represents an unreported patient group with an unmet need for pain care.

  5. [Prognostic implications of folliculo-stellate cells in pituitary adenomas: relationship with tumoral behavior].

    Science.gov (United States)

    Tortosa, F; Pires, M; Ortiz, S

    2016-10-01

    Introduccion. A pesar del progreso en la comprension de su patogenia, no se ha encontrado ningun marcador predictivo independiente del comportamiento agresivo de los adenomas hipofisarios que facilite el tratamiento y seguimiento de pacientes afectados. Objetivo. Analizar la expresion de celulas foliculo-estrelladas, mediante inmunomarcacion con proteina S-100, en una serie de pacientes con adenomas hipofisarios seguidos durante al menos siete años. Pacientes y metodos. Estudio retrospectivo de 51 pacientes diagnosticados de adenoma hipofisario entre 2006 y 2008, segun los criterios vigentes de la Organizacion Mundial de la Salud. Se evaluo inmunohistoquimicamente la expresion de S-100 en celulas foliculo-estrelladas, y se correlaciono con parametros clinicorradiologicos e histopatologicos del tumor y la progresion/recurrencia postoperatoria. Resultados. De 51 tumores, 40 se clasificaron como adenomas hipofisarios tipicos y 11 como atipicos. La mayoria de los tipicos mostro celulas foliculo-estrelladas positivas para S-100 (media: 3,93%); los atipicos tenian pocas o ninguna celula S-100 positivas (media: 0,83%). No hubo diferencias significativas en la expresion de S-100 con respecto a la edad o sexo del paciente, tamaño, invasividad o recidiva tumoral posquirurgica. Conclusiones. En el grupo de estudio, a excepcion de los adenomas no funcionantes inmunopositivos para prolactina, con la media mas baja y mas alta de todos los subtipos en ambos grupos (tipicos, 0,25%, frente a atipicos, 9,24%; p = 0,0028), el factor predictivo de agresividad tumoral para los adenomas hipofisarios no esta representado por un bajo valor de S-100 en las celulas foliculo-estrelladas, lo que no permite seleccionar a pacientes para un tratamiento postoperatorio intensivo.

  6. Desempeño en funciones ejecutivas en escolares por subtipo de TDAH

    OpenAIRE

    Rodríguez Sánchez, Sandra Catalina

    2012-01-01

    El objetivo de esta investigación fue comparar el desempeño en tareas de funciones ejecutivas en niños y niñas en edad escolar según el subtipo de Trastorno por Déficit de Atención con Hiperactividad (TDAH): Hiperactivo-impulsivo (TDAH-H), inatento (TDAH-I) y combinado (TDAH-C), comparados con un grupo de niños normales. La muestra fue 40 escolares entre 7 y 12 años, estrato socioeconómico muy bajo y bajo. El diseño fue descriptivo, comparativo, transversal y el análisis fue no paramétrico. S...

  7. Desempeño en funciones ejecutivas en escolares por subtipo de TDAH

    OpenAIRE

    Rodríguez Sánchez, Sandra Catalina

    2012-01-01

    El objetivo de esta investigación fue comparar el desempeño en tareas de funciones ejecutivas en niños y niñas en edad escolar según el subtipo de Trastorno por Déficit de Atención con Hiperactividad (TDAH): Hiperactivo-impulsivo (TDAH-H), inatento (TDAH-I) y combinado (TDAH-C), comparados con un grupo de niños normales. La muestra fue 40 escolares entre 7 y 12 años, estrato socioeconómico muy bajo y bajo. El diseño fue descriptivo, comparativo, transversal y el análisis fue no paramétrico. S...

  8. The threat of silent earthquakes

    Science.gov (United States)

    Cervelli, Peter

    2004-01-01

    Not all earthquakes shake the ground. The so-called silent types are forcing scientists to rethink their understanding of the way quake-prone faults behave. In rare instances, silent earthquakes that occur along the flakes of seaside volcanoes may cascade into monstrous landslides that crash into the sea and trigger towering tsunamis. Silent earthquakes that take place within fault zones created by one tectonic plate diving under another may increase the chance of ground-shaking shocks. In other locations, however, silent slip may decrease the likelihood of destructive quakes, because they release stress along faults that might otherwise seem ready to snap.

  9. Familial pituitary adenomas.

    Science.gov (United States)

    Vandeva, S; Vasilev, V; Vroonen, L; Naves, L; Jaffrain-Rea, M-L; Daly, A F; Zacharieva, S; Beckers, A

    2010-12-01

    Pituitary adenomas are benign intracranial neoplasms that present a major clinical concern because of hormonal overproduction or compression symptoms of adjacent structures. Most arise in a sporadic setting with a small percentage developing as a part of familial syndromes such as multiple endocrine neoplasia type 1 (MEN1), Carney complex (CNC), and the recently described familial isolated pituitary adenomas (FIPA) and MEN-4. While the genetic alterations responsible for the formation of sporadic adenomas remain largely unknown, considerable advances have been made in defining culprit genes in these familial syndromes. Mutations in MEN1 and PRKAR1A genes are found in the majority of MEN1 and CNC patients, respectively. About 15% of FIPA kindreds present with mutations of the aryl hydrocarbon receptor-interacting protein (AIP) gene. Mutations in the CDKN1B gene, encoding p27(Kip)¹ were identified in MEN4 cases. Familial tumours appear to differ from their sporadic counterparts not only in genetic basis but also in clinical characteristics. Evidence suggests that, especially in MEN1 and FIPA, they are more aggressive and affect patients at younger age, therefore justifying the importance of early diagnosis. In this review, we summarize the genetic and clinical characteristics of these familial pituitary adenomas.

  10. Complicaciones obstétricas y médicas en el Trastorno de Déficit Atencional/Hiperactividad (TDAH): ¿hay diferencias entre los subtipos?

    OpenAIRE

    Connie Capdevila-Brophy; José Blas Navarro-Pastor; Josep Artigas-Pallarés; Jordi Obiols-Llandrich

    2007-01-01

    El debate actual sobre los subtipos de Trastorno de Déficit Atencional/Hiperactividad (TDAH) se centra en determinar si las similitudes y diferencias halladas en la sintomatología asociada aportan evidencia para conceptualizar los subtipos como manifestaciones de distinto trastorno. El objetivo de este estudio retrospectivo ex post facto es investigar las diferencias entre los subtipos de TDAH con predominio de inatención (TDAH-I) (n = 20) y TDAH combinado (TDAH-C) (n = 39) en su historia pre...

  11. The silent sinus syndrome.

    Science.gov (United States)

    Monos, Tova; Levy, Jaime; Lifshitz, Tova; Puterman, Moshe

    2005-05-01

    Patients with silent sinus syndrome typically present for investigation of facial asymmetry. Unilateral, spontaneous enophthalmos and hypoglobus are the prominent findings at examination. Imaging of the orbit and sinuses characteristically show unilateral maxillary sinus opacification and collapse with inferior bowing of the orbital floor. It has been suggested that SSS is due to hypoventilation of the maxillary sinus secondary to ostial obstruction and sinus atelectasis with chronic negative pressure within the sinus. Treatment involves functional endoscopic sinus surgery for reestablishing a functional drainage passage, and a reconstructive procedure of the floor of the orbit for repairing the hypoglobus and cosmetic deformity. Ophthalmologists, otorhinolaryngologists, and radiologists must be familiarized with this relatively newly reported disease.

  12. Parathyroid adenoma. Case presentation

    Directory of Open Access Journals (Sweden)

    Daniel Olivera Fajardo

    2016-10-01

    Full Text Available Parathyroid Adenoma is a non-malignant tumor of the thyroid glands, which increases the levels of parathormone. This hormone regulates blood and bone levels of calcium, phosphorus and Vitamin D. Its classic triad is characterized by the increase of the levels of parathormone, hyperkalimia and Hipophosphatemia. This entity affects between 500-1000 inhabitants and is the main cause of primary Hyperparathyroidism in about 80-85% of the patients. It is presented a case of a 69 year old female patient, admitted due to pathologic fractures of hip, clavicle, and fingers, caused by primary hyperparathyroidism originated by parathyroid adenoma. For the low incidence of this entity, its publication is considered of interest for the scientific staff.

  13. Ceruminous gland adenoma

    Directory of Open Access Journals (Sweden)

    Himanshu Varshney

    2014-01-01

    Full Text Available Ceruminous adenoma is a rare neoplasm of the external auditory meatus (EAM with benign clinical behavior. They demonstrate a dual cell population of basal myoepithelial-type cells and luminal ceruminous cells. Cerumen pigment, cytokeratin 7 (CK7 and p63 can help to distinguish this tumor from other neoplasms that occur in the region. Complete surgical excision results in an excellent long-term clinical outcome. We present a case of histologically confirmed ceruminous adenoma of the EAM in a surgically treated 38-year-old female. She presented with recurrent serosanguineous discharge along with flakes from the right ear along with hearing impairment. She is doing well in last 8 months follow-up.

  14. Transformation of a Silent Adrencorticotrophic Pituitary Tumor Into Central Nervous System Melanoma

    Directory of Open Access Journals (Sweden)

    Brandon A. Miller MD, PhD

    2013-06-01

    Full Text Available Silent adrenocorticotrophic pituitary adenomas are nonfunctioning pituitary adenomas that express adrenocorticotrophic hormone (ACTH but do not cause the clinical or laboratory features of hypercortisolemia. Primary central nervous system (CNS melanoma is well documented, but rarely originates in the sellar region or pituitary gland. Here we report transformation of an aggressive silent adrenocorticotrophic pituitary adenoma that transformed into CNS melanoma and review other presentations of pituitary melanoma. A 37-year-old woman initially presented with apoplexy and an invasive nonfunctioning pituitary macroadenoma for which she underwent transphenoidal surgery. The patient underwent 3 subsequent surgeries as the tumor continued to progress. Pathology from the first 3 operations showed pituitary adenoma or carcinoma. Pathology from the final surgery showed melanoma and the magnetic resonance imaging characteristics of the tumor had changed to become consistent with CNS melanoma. Dermatologic and ophthalmologic examinations did not identify cutaneous or ocular melanoma. The patient’s disease progressed despite aggressive surgical, medical and radiologic treatment. To our knowledge, this is the first report demonstrating transformation of a primary pituitary tumor into melanoma. The mechanism of tumor transformation is unclear, but it is possible that a mutation in the original ACTH-producing tumor lead to increased cleavage of pro-opiomelanocortin or ACTH into α-melanocyte-stimulating hormone, which in turn stimulated the expression of microopthalmia transcription factor, leading to melanocytic phenotype transformation.

  15. Complicaciones obstétricas y médicas en el Trastorno de Déficit Atencional/Hiperactividad (TDAH: ¿hay diferencias entre los subtipos?

    Directory of Open Access Journals (Sweden)

    Connie Capdevila-Brophy

    2007-01-01

    Full Text Available El debate actual sobre los subtipos de Trastorno de Déficit Atencional/ Hiperactividad (TDAH se centra en determinar si las similitudes y diferencias halladas en la sintomatología asociada aportan evidencia para conceptualizar los subtipos como manifestaciones de distinto trastorno. El objetivo de este estudio retrospectivo ex post facto es investigar las diferencias entre los subtipos de TDAH con predominio de inatención (TDAH-I (n = 20 y TDAH combinado (TDAH-C (n = 39 en su historia prenatal, perinatal, del primer año y los problemas médicos posteriores. Los resultados indican que ambos subtipos presentan índices elevados de complicaciones obstétricas y problemas médicos. El subtipo TDAH-I se asocia con hemorragias prenatales, infecciones de oído y alergias, y el TDAH-C con cólicos del lactante y lesiones con sutura. La principal conclusión sugiere que las noxas de curso más continuo o dilatadas en el tiempo estarían más presentes en el grupo TDAH-I mientras que algunas características en el primer año y las lesiones que requieren suturas estarían más asociadas al subtipo TDAH-C.

  16. Adenoma de células basales parotídeo: Revisión a propósito de cuatro casos Basal cell adenoma of the parotid: A revision based on four cases

    Directory of Open Access Journals (Sweden)

    M.J. Pastor Fortea

    2005-04-01

    Full Text Available El adenoma de células basales es un tipo específico de adenoma con una apariencia histológica uniforme y monomorfa, en el que predominan las células basaliodes sin el componente mixocondroide del tumor mixto. Atendiendo a su morfología pueden ser divididos en cuatro subtipos: sólido, tubular, trabecular y membranoso. Presentamos cuatro casos de adenoma de células basales localizados en glándula parótida: uno de tipo sólido, uno de tipo trabecular y dos de tipo membranoso, tratados mediante parotidectomía superficial conservadora en todos los casos. Esta división en distintos patrones morfológicos tiene una finalidad descriptiva, salvo en el subtipo membranoso por su mayor tendencia a la multifocalidad y a la recidiva, su ocasional transformación maligna, así como por su posible asociación en un tercio de los casos a tumores ecrinos dermales. Esto implica un seguimiento más estrecho y un despistaje de posibles lesiones cutáneas asociadas.The basal cell adenoma is a specific type of adenoma, with a uniform, monomorphous histologic appearance that is dominated by basaloid cells and that does not have the myxochondroid tissue characteristic of mixed tumors. It may be divided on the basis of its morphologic pattern into four subtypes: solid, tubular, trabecular and membranous. We report four cases of basal cell adenoma subdivided as follows: one solid, one trabecular and two membranous subtypes. In all cases a conservative superficial parotidectomy was the treatment. Morphologic identification of the specific subtype is for descriptive purposes, except in the case of the membranous type, due to its tendency to be multifocal, its high recurrence rate, its occasional malignant transformation and its possible association in about onethird of the reported cases with dermal cylindromas. A close followup and screening of skin lesions is suggested for these tumors.

  17. Lacrimal Gland Pleomorphic Adenoma and Carcinoma ex Pleomorphic Adenoma

    DEFF Research Database (Denmark)

    von Holstein, Sarah L; Fehr, André; Persson, Marta;

    2014-01-01

    To study genetic alterations in lacrimal gland pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (Ca-ex-PA) with focus on copy number changes and expression patterns of the translocation target genes PLAG1, HMGA2, and CRTC1-MAML2 in relation to clinical data....

  18. Distribución de los subtipos del VIH-1 en nueve países de América del Sur, 1995-2002

    Directory of Open Access Journals (Sweden)

    V. Alberto Laguna-Torres

    2005-03-01

    Full Text Available Objetivo: Determinar la distribución de los subtipos del virus de la inmunodeficiencia humana (VIH-1 y las presencia de cepas recombinantes en Argentina, Bolivia, Colombia, Chile, Ecuador, Paraguay, Perú, Uruguay y Venezuela a través de estudios epidemiológicos y de genotipificación. Materiales y Métodos: Se incluyeron a los participantes de los protocolos realizados en los nueve paises, incluyendo poblaciones de trabajadoras sexuales (TS, hombres que tienen sexo con hombres (HSH, individuos VIH positivos, gestantes y paciente con tuberculosis (TB. Se utilizó la prueba de movilidad heteroduplex de envoltura (env HMA, ProRT, secuenciamiento completo o ambas para determinar los subtipos de VIH 1. Resultados: Se identificaron 3081 individuos positivos al VIH (de un total de 42 290 voluntarios, las prevalencias oscilaban entre menos de 1% a 29% según población estudiada, siendo mayor en los HSH. Un total de 1654 muestras (54% fueron genotipificadas. Se encontró el subtipo B en 1380 (83% muestras, el subtipo F en 218 (13%, así como los subtipos A y C en 0,1% y 0,4% respectivamente. Se hallaron subtipos recombinantes BF en 39 muestras (2% y formas recombinantes CRF01_AE(0,1%, CRF17_BF(0,4% y CRF02_AG(0,1%. En Venezuela, Colombia, Ecuador, Perú, Bolivia y Chile (paises andinos predominó el subtipo B, mientras en Argentina, Uruguay y Paraguay hubo un alto porcentaje del subtipo F. Conclusiones: En la mayoría de países andinos la epidemia de VIH-1 se concentró en los HSH con un predominio del subtipo B. El subtipo F es más frecuente en las TS en Argentina y Uruguay. Esta información es útil para implementar planes de prevención y futuros ensayos de vacunas en esta región.

  19. Parathyroid gland adenoma: Case report

    OpenAIRE

    Bojković Gradimir; Čaparević Zorica; Stojanović Dragoš Lj.; Lalošević Đorđe J.; Stojanović Mirjana

    2003-01-01

    Introduction Primary hyperparathyroidism is a generalized disorder resulting from excessive secretion of parathyroid hormone involving one or more parathyroid glands. Both familial and sporadic forms exist. Histologic examination reveals parathyroid adenoma in about 90% of patients, although it is sometimes difficult to distinguish an adenoma from a normal gland. Primary hyperparathyroidism is commonly characterized by hypercalcaemia, hypophosphatemia and excessive bone resorption. Case repor...

  20. Papillary eccrine adenoma

    Directory of Open Access Journals (Sweden)

    Laxmisha Chandrashekar

    2004-01-01

    Full Text Available A 28-year-old man came to us with a solitary skin colored, mildly tender nodule of 6 months duration on the dorsum of the right hand. On histological examination, multiple dilated ducts without apparent continuity with the surface were found in the dermis. These dilated ducts had branching tubules with eosinophilic amorphous material filling most of the lumina. The peripheral cells of the tubules resembled myoepithelial cells, whereas the luminal border cells were cuboidal or low columnar. Papillary projections arising from the inner cells were seen extending into the lumen. These features were diagnostic of a rare tumor, papillary eccrine adenoma.

  1. Síndrome del seno silente Silent sinus syndrome

    Directory of Open Access Journals (Sweden)

    Ricardo Trueba

    2008-03-01

    Full Text Available Presentamos un caso de síndrome del seno silente. Se trata de una entidad infrecuente caracterizada por enoftalmos provocada por atelectasia homolateral del seno maxilar sin síntomas nasales ni paranasales. Si bien el diagnostico es clínico, la confirmación se logra mediante las imágenes.We present a case of silent sinus syndrome. It is an uncommon entity characterized by enoftalmos caused by homolateral atelectasia of the maxillary sinus without nasal nor paranasal symptoms. Although the diagnoses is clinical, the confirmation is achieved by images.

  2. Síndrome del seno silente Silent sinus syndrome

    OpenAIRE

    2008-01-01

    Presentamos un caso de síndrome del seno silente. Se trata de una entidad infrecuente caracterizada por enoftalmos provocada por atelectasia homolateral del seno maxilar sin síntomas nasales ni paranasales. Si bien el diagnostico es clínico, la confirmación se logra mediante las imágenes.We present a case of silent sinus syndrome. It is an uncommon entity characterized by enoftalmos caused by homolateral atelectasia of the maxillary sinus without nasal nor paranasal symptoms. Although the dia...

  3. A clinicopathological and immunohistochemical study of clinically non-functioning pituitary adenomas: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Rishi Arvind

    2010-01-01

    Full Text Available Background : Non-functioning pituitary adenomas (NFPA are characterized by the lack of clinical syndrome as compared to functioning adenomas (FA but not all functioning adenomas have clinical effects. Their exact incidence varies in different series. Materials and Methods : This study was undertaken to analyze the hormonal profile of NFPA at the immunohistochemical level in the Indian population and to see if any differences exist from the earlier studies. Their biological aggressiveness was also studied by MIB-1 labeling index (MIB-! LI and Epidermal Growth Factor Receptor (EGFR expression. These parameters along with their clinical behavior were correlated with radiological features of invasiveness and size. Results : Of the 151 pituitary adenomas diagnosed during a period of one and half years, 77 (51% were NFPA with a male predominance. There was increase in the incidence of NFPA with increase in age. Immunopositivity for various hormones was observed in 64 (83% cases, either singly or in various combinations. On the basis of immunohistochemistry, NFPA were classified into three subtypes; gonadotroph adenomas, silent adenomas, and null cell adenomas. Gonadotroph adenomas were the commonest subtype. In general, NFPA showed low MIB-1LI but invasive NFPA had LI on the higher side, however, this difference was not significant. We observed EGFR positivity in two cases only; therefore the tumorigenesis mechanism may be different in NFPA. Conclusion : Although non-functional at the clinical level immunohistochemistry showed reactivity for various hormones. If a battery of immunostains including seven hormones is studied, a significant number of cases are shifted to the functional group.

  4. Desarrollo de vacunas contra el virus de la inmunodeficiencia humana tipo 1: Relevancia de la inmunidad celular contra subtipos

    Directory of Open Access Journals (Sweden)

    Ana María Rodríguez

    2010-12-01

    Full Text Available Han pasado casi 30 años de la detección de los primeros casos de infección con HIV-1 y aún no se ha conseguido desarrollar una vacuna efectiva y segura. A pesar del impacto positivo sobre la pandemia que se ha conseguido gracias a los avances en la terapia antirretroviral (TARV, el HIV/sida sigue constituyendo un grave problema para la salud pública, especialmente en los países en desarrollo, donde es difícil el acceso al tratamiento. En el mundo, 33 millones de personas viven con el virus del sida, mientras que en la Argentina se calcula que habría unos 120 000 infectados. Uno de los desafíos para lograr una vacuna contra el HIV es la variabilidad viral. El grupo M, responsable de la pandemia, se encuentra dividido en 10 subtipos y varios sub-subtipos, además de las 48 formas recombinantes circulantes y más de cien formas recombinantes únicas. La epidemia de HIV en nuestro país es tan compleja como en el resto del mundo, con la co-circulación principalmente de virus pertenecientes al subtipo B y recombinantes BF (CRF12_BF y derivadas. A pesar de la cantidad de trabajos dedicados a la caracterización de la respuesta inmune y al desarrollo de vacunas, no queda claro cuál es el impacto de la variabilidad en la elección del antígeno. Trabajos realizados en nuestro laboratorio demuestran el papel que juega la inmunidad celular con respecto a las variantes recombinantes BF, tanto en humanos como en modelos animales. Estos resultados son de importancia en el desarrollo de futuras vacunas para nuestra región.

  5. From Silent to Talkative Participants

    DEFF Research Database (Denmark)

    Nielsen, Kurt Aagaard; Olsén, Peter; Nielsen, Birger Steen

    1996-01-01

    are sceptical as to the ability of this tradition to explain the fact that workers are silent participants in negotiations. In an account of a project called 'Industry and Happiness' the authors argue that attention must be paid to workers' life situation and not only to their work experience. They further...

  6. Definición de Subtipos del Síndrome de Usher en Población Colombiana

    Directory of Open Access Journals (Sweden)

    Greizy López Leal

    2010-12-01

    Full Text Available

    Resumen

    Introducción. El Síndrome de Usher (USH, de herencia autosómica recesiva, se caracteriza por sordera congénita sensorial, Retinitis Pigmentosa y disfunción vestibular. Se conocen 3 tipos clínicos y 12 subtipos genéticos. En Colombia no se conocen las frecuencias de los subtipos genéticos ni las mutaciones más frecuentes.

    Objetivo. El objetivo de este trabajo fue definir el subtipo genético en 72 individuos con USH e identificar las mutaciones causantes de la enfermedad.

    Métodos. Se identificaron 72 individuos con USH de diferentes ciudades del país. Se realizó análisis de haplotipos para los 12 loci asociados a USH hasta el momento y análisis mutacional de los exones con mayor frecuencia de mutaciones reportadas en los genes USH.

    Resultados. Se logró definir el subtipo genético en 23 individuos y se identificó la mutación causal en 14. Se identifi caron dos mutaciones en el gen MYO7A, la p.R634X y la p.R1986X; y tres en el gen USH2A, la c.2299delG, la p.R334W, y la g.G129T.

    Conclusión. Se logró identificar el subtipo genético en el 31.9% y la mutación causal en el 19.4% de la población.

    Palabras clave: Síndrome de Usher, Retinitis Pigmentosa, Sordera, Hipoacusia Sensorial.

    Usher Syndrome Subtypes Definition in Colombian Population 

    Abstract

    Introduction. Usher Syndrome (USH, is an autosomal recessive disorder characterized by the association of sensorineural hearing loss, retinitis pigmentosa (RP and variable vestibular areflexia. Three clinical types and 12 genetic subtypes have been described. In Colombia, frequencies of genetic subtypes and more frequent mutations are unknown.

    Objective. The aim of this work was to defi ne the genetic subtype in Colombian population with USH.

    Methods. 72

  7. Subtipos disléxicos y procesos fonológicos y ortográficos en la escritura de palabras

    OpenAIRE

    Juan E. Jiménez; Celia Morales; Cristina Rodríguez

    2014-01-01

    El objetivo de este estudio consistió en examinar si existen diferencias entre subtipos disléxicos (fonológico y de superficie) y normolectores igualados en edad cronológica en los procesos fonológicos y ortográficos en la escritura de palabras. La muestra de estudio estuvo formada por un total de 104 alumnos y se distribuía de la siguiente manera: 36 normolectores igualados en edad cronológica con los subtipos disléxicos, 26 disléxicos fonológicos y 42 disléxicos de superficie. Se administra...

  8. Análisis y valoración de algunos patrones diagnósticos diferenciales en los subtipos del TDAH

    OpenAIRE

    López Calzón, Angel

    2016-01-01

    El trastorno por déficit de atención con hiperactividad es un trastorno frecuente en la infancia (entre el 3% y el 7% de os estudiantes en edad escolar sufren este trastorno) y, también, uno de los que más condiciona el rendimiento escolar. Se caracteriza por presentar un patrón persistente de conductas de desatención (o inatención), exceso de actividad (o hiperactividad) y, dificultades para controlar los impulsos (o impulsividad), lo que da lugar a tres subtipos: subtipo con predominio del ...

  9. Subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda Molecular subtypes of PML/RARα in patients with acute promyelocytic leukemia

    OpenAIRE

    2013-01-01

    El objetivo fue describir la frecuencia de los subtipos moleculares de PML/RARα en pacientes con leucemia promielocítica aguda (LPA) y su distribución según grupo de riesgo de recaída y citomorfología. Se realizó una serie de casos que incluyó a cincuenta pacientes registrados en el Instituto Nacional de Enfermedades Neoplásicas (INEN), durante el periodo 2010-2012, con diagnóstico molecular de LPA PML/RARα y subtipos bcr1, bcr2 y bcr3 por reacción en cadena de la polimerasa con tra...

  10. Non-Alcoholic Fatty Liver Disease in Subjects with Non-functioning Adrenal Adenomas

    Directory of Open Access Journals (Sweden)

    Serkan Yener

    2011-12-01

    Full Text Available Objectives: The relation between non-functioning adrenal adenoma and unfavorable metabolic status has been a debate so far. We aimed to demonstrate the prevalence of non-alcoholic fatty liver disease (NAFLD in subjects with silent adrenal adenomas.Materials and Methods: 130 consecutive subjects with non-functioning adrenal adenomas, 170 age-, gender- and BMI-matched individuals without adrenal gland disorders, and 20 patients with Cushing’s syndrome were included in the study. Fatty liver disease was diagnosed by ultrasonography and the severity was scored semiquantitatively. Liver function tests were performed. Cushing’s syndrome and non-functioning adrenal adenoma were diagnosed using appropriate tests of hypothalamus-pituitary-adrenal function.Results: The prevalence of NAFLD was 30.7%, 65.0% and 39.4% in adenoma group, Cushing’s syndrome group and control group, respectively. There was no significant difference in terms of Type 2 diabetes mellitus, hypertension and NAFLD prevalence between adenoma group and controls. NAFLD was not only more common in subjects with Cushing’s syndrome but was also more severe. Hypercortisolemia strongly predicted the development of metabolic syndrome (OR: 10.571, p=0.004. When age, gender, hypercortisolemia and metabolic syndrome were assessed, metabolic syndrome remained as the sole independent predictor of fatty liver development (OR: 9.162, p<0.001.Conclusion: Comparable prevalence between adenoma and control group was likely to be associated with similar rates of metabolic derangements and similar BMI. Cortisol excess seemed to be related with fatty liver development mainly through its unfavorable metabolic effects. Türk Jem 2011; 15: 116-20

  11. Radiosurgery for pituitary adenomas; Radiocirurgia nos adenomas hipofisarios

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Douglas Guedes de; Salvajoli, Joao Victor; Canteras, Miguel Montes; Cecilio, Soraya A. Jorge [Instituto de Radiocirurgia Neurologica, Sao Paulo, SP (Brazil)]. E-mail: dougguedes@uol.com.br

    2006-12-15

    Pituitary adenomas represent nearly 15% of all intracranial tumors. Multimodal treatment includes microsurgery, medical management and radiotherapy. Microsurgery is the primary recommendation for nonfunctioning and most of functioning adenomas, except for prolactinomas that are usually managed with dopamine agonist drugs. However, about 30% of patients require additional treatment after microsurgery for recurrent or residual tumors. In these cases, fractionated radiation therapy has been the traditional treatment. More recently, radiosurgery has been established as a treatment option. Radiosurgery allows the delivery of prescribed dose with high precision strictly to the target and spares the surrounding tissues. Therefore, the risks of hypopituitarism, visual damage and vasculopathy are significantly lower. Furthermore, the latency of the radiation response after radiosurgery is substantially shorter than that of fractionated radiotherapy. The goal of this review is to define the efficacy, safety and role of radiosurgery for treatment of pituitary adenomas and to present the preliminary results of our institution. (author)

  12. CT scan in diagnosis of pituitary adenomas, 5. CT findings of GH secreting adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Sakoda, K.; Yonezawa, M.; Gen, M. (Hiroshima Univ. (Japan). School of Medicine)

    1981-10-01

    Clinical findings and radiological findings in 19 cases of GH secreting adenoma were reported. In diagnosis of GH secreting adenoma, conventional radiography and computed tomography of the sella turcica are useful. The CT of this kind of adenomas shows a characteristically higher x-ray absorption coefficient than other adenomas.

  13. Villous adenoma of the distal appendix.

    Science.gov (United States)

    Taylor, J V; Thomas, M G; Kelly, S; Sutton, R

    1997-04-01

    Villous adenoma confined to the distal appendix has not been previously reported in conjunction with acute apendicitis. The presence of an adenoma indicates a need for further investigation due to an association with neoplasia elsewhere.

  14. Serrated adenoma of stomach: A premalignancy?

    Directory of Open Access Journals (Sweden)

    Divya Achutha Ail

    2015-01-01

    Full Text Available Serrated adenoma is a newly described entity in the group of gastric adenomas. Until date only 20 cases of gastric serrated adenoma have been reported. It is an important entity to be diagnosed accurately as it has a very high-risk of malignant transformation, especially those located in the cardia of stomach. Serrated adenoma associated with adenocarcinoma is more frequent in the elderly, but pure serrated adenoma is common in the young, in whom follow-up is mandatory. Gastric serrated adenoma has distinct location, definite histomorphology and characteristic Ki-67 immunohistochemical staining. Ki-67 staining helps to differentiated pure serrated adenoma from those associated with adenocarcinoma. We present a young adult male, incidentally detected to have gastric serrated adenoma.

  15. Mutaciones que seleccionan para resistencia a antirretrovirales y presencia de resistencia en subtipos del VIH-1 diferentes a subtipo B en pacientes con infección crónica sin tratamiento previo

    Directory of Open Access Journals (Sweden)

    Henry Balaguera

    2004-03-01

    Full Text Available

    El desarrollo de la terapia antirretroviral altamente efectiva, la cual inhibe las enzimas virales reversa transcriptasa y proteasa ha transformado dramáticamente la historia natural de la infección por el virus de la inmunodeficiencia humana tipo – 1 (VIH –1 produciendo como resultado una disminución tanto de la morbilidad como de la mortalidad asociada con esta infección (1. La falla para suprimir completamente la replicación viral podría permitir el desarrollo de cambios genotípicos en el VIH-1, los cuales se asocian con la aparicion de la resistencia a cada uno de las tres principales clases de antirretrovirales disponibles (2.

    La prevalencia de resistencia genotípica primaria del VIH-1 subtipo B contra al menos un compuesto antirretroviral es común, entre el 12 % y el 25 % en Estados Unidos (3 y se considera es mayor en pacientes recientemente infectados que en pacientes infectados crónicamente (infección mayor de 6 meses. Sin embargo, existe muy poca información acerca de la prevalencia de resistencia primaria en pacientes con VIH crónicamente infectados y quienes no han estado expuestos a previo tratamiento antirretroviral. Esta resistencia la cual está mediada por mutaciones en el gen de la polimerasa viral (pol, causa disminución de la susceptibilidad de los medicamentos antirretrovirales in vitro y está asociada con falla terapéutica. Una cohorte de pacientes adultos que reciben cuidado médico en un hospital en Boston, fue tamizada para detectar mutaciones en el genoma del VIH-1 y determinar el subtipo de virus circulante de pacientes que nunca habían recibido tratamiento con antirretrovirales (4. Mutaciones asociadas con resistencia a antirretrovirales fue identificada en 18% de 88 pacientes.

    Calidad de vida en pacientes con diferentes subtipos de estreñimiento de acuerdo a los criterios de ROMA III

    Directory of Open Access Journals (Sweden)

    M.C. Ruiz-López

    2015-01-01

    Conclusiones: Utilizando los cuestionarios PAC-QOL y SF-36 se identifican diferencias en la calidad de vida en los subtipos de estreñimiento. Los pacientes con la variante síndrome de intestino irritable con estreñimiento experimentan menor calidad de vida en todos los dominios evaluados.

  16. Clear cell myoepithelial carcinoma ex pleomorphic adenoma

    Directory of Open Access Journals (Sweden)

    Nikhil R Rabade

    2014-01-01

    Full Text Available Pleomorphic adenoma is the most common epithelial neoplasm of lacrimal gland. A clear cell myoepithelial carcinoma arising in the background of pleomorphic adenoma is common in the salivary glands but very rare in the lacrimal glands. We report the case of a 27 year old man whose lacrimal gland pleomorphic adenoma recurred several times over a period of four years and ultimately evolved into a clear cell myoepithelial carcinoma ex pleomorphic adenoma.

  17. Double pituitary adenomas: six surgical cases.

    Science.gov (United States)

    Sano, T; Horiguchi, H; Xu, B; Li, C; Hino, A; Sakaki, M; Kannuki, S; Yamada, S

    1999-05-01

    While double pituitary adenomas have been found in approximately 1% of autopsy pituitaries, those in surgically resected material have been only rarely reported. We report herein 6 cases of double pituitary adenomas, which consisted of two histologically and/or immunohistochemically different areas among approximately 450 surgical specimens. Five out of 6 patients were men and the age was ranged between 18 and 61 years old. All these 6 patients presented acromegaly or acrogigantism and hyperprolactinemia was noted in 3 patients. In 2 patients (cases 1 and 2) the two adenomas belonged to different adenoma groups (GH-PRL-TSH group and FSH/LH group), while in the remaining 4 patients (cases 3-6) the two adenomas belonged to the same group (GH-PRL-TSH group). Thus, in all patients at least one of the two adenomas was GH-producing adenoma. Reasons for a high incidence of GH-producing adenomas in surgically resected double pituitary adenomas may include the presence of a variety of histologic subtypes among GH-producing adenomas and the advantage of cytokeratin immunostaining to distinguish these subtypes. In regard to pathogenesis of double pituitary adenomas, adenomas in cases 1 and 2 may be of multicentric occurrence, while those in cases 3-6 may occur through different clonal proliferation within originally one adenoma, resulting in diverse phenotypic expressions. Since there were patients with familial MEN 1 (case 2) and familial pituitary adenoma unrelated MEN 1 (case 3), genetic background should be also considered. Double pituitary adenomas in surgically resected material may not be so infrequent. Further molecular analysis will provide new insights into understanding the pathogenesis of pituitary adenomas and their mechanisms of multidirectional phenotypic diffrentiation.

  18. [Prostatilen treatment of prostatic adenoma].

    Science.gov (United States)

    Al'-Shukri, S Kh; Gorbachev, A G; Borovets, S Iu; Belousov, V Ia; Kuz'min, I V; Chushkin, K A

    2006-01-01

    We studied efficacy of repeated courses of prostatilen in suppositories with dimexide in prostatic adenoma patients with normal micturition. Rectal suppositories contain 30 mg prostatilen and 90 mg dimexide. The course consisted of 15 suppositories. The treatment reduced clinical symptoms of infravesical obstruction, residual urine volume in administration of prostatilen in 15-day courses each 3 months. This suggests possibility of suppository prostatilen use not only as an alternative for expensive drugs but also in combination with them in treatment of initial prostatic adenoma.

  19. Underlying skills of oral and silent reading.

    Science.gov (United States)

    van den Boer, Madelon; van Bergen, Elsje; de Jong, Peter F

    2014-12-01

    Many studies have examined reading and reading development. The majority of these studies, however, focused on oral reading rather than on the more dominant silent reading mode. Similarly, it is common practice to assess oral reading abilities rather than silent reading abilities in schools and in diagnosis of reading impairments. More important, insights gained through examinations of oral reading tend to be generalized to silent reading. In the current study, we examined whether such generalizations are justified. We directly compared oral and silent reading fluency by examining whether these reading modes relate to the same underlying skills. In total, 132 fourth graders read words, sentences, and text orally, and 123 classmates read the same material silently. As underlying skills, we considered phonological awareness, rapid naming, and visual attention span. All skills correlated significantly with both reading modes. Phonological awareness contributed equally to oral and silent reading. Rapid naming, however, correlated more strongly with oral reading than with silent reading. Visual attention span correlated equally strongly with both reading modes but showed a significant unique contribution only to silent reading. In short, we showed that oral and silent reading indeed are fairly similar reading modes, based on the relations with reading-related cognitive skills. However, we also found differences that warrant caution in generalizing findings across reading modes. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. The cancer, a silent epidemic.

    Directory of Open Access Journals (Sweden)

    Edith María Beltrán Molina

    2014-03-01

    Full Text Available This article deals with some very interesting aspects related to cancer the first cause of death in many countries with a high prevalence in Cuba so it is necessary to increase prevention and education to reduce risk factors and prevalence of malignancy. Taking into account the importance of cancer awareness as well as the social therapeutic and technological resources available to Cuba for its treatment it is propose with this work to exemplify the Cuban scientific treatment of cancer as a silent epidemic of the XXI century.

  2. Lactating Adenoma of the Breast.

    Science.gov (United States)

    Barco Nebreda, Israel; Vidal, M Carmen; Fraile, Manel; Canales, Lydia; González, Clarisa; Giménez, Nuria; García-Fernández, Antonio

    2016-08-01

    Lactating adenoma is an uncommon breast palpable lesion occurring in pregnancy or lactation. Although it is a benign condition, it often requires core biopsy or even surgery to exclude malignancy. As with other solid lesions in pregnancy and lactation, lactating adenoma needs an accurate evaluation in order to ensure its benign nature. Work-up must include both imaging and histologic findings. Ultrasound evaluation remains the first step in assessing the features of the lesion. Some authors consider magnetic resonance imaging as a useful tool in cases of inconclusive evaluation after ultrasound and histologic exam in an attempt to avoid surgery. Most lactating adenomas resolve spontaneously, whereas others persist or even increase in size and must be removed. The authors present a case of a 35-year-old woman at 6 months postpartum with a lactating adenoma in her right breast. After surgical removal, breastfeeding was perfectly continued within the next 24 hours, which highlights the fact that breast surgery is most often compatible with breastfeeding. © The Author(s) 2016.

  3. Transcranial surgery for pituitary adenomas.

    Science.gov (United States)

    Youssef, A Samy; Agazzi, Siviero; van Loveren, Harry R

    2005-07-01

    Although the transsphenoidal approach is the preferred approach to the vast majority of pituitary tumors with or without suprasellar extension, the transcranial approach remains a vital part of the neurosurgical armamentarium for 1 to 4% of these tumors. The transcranial approach is effective when resection becomes necessary for a portion of a pituitary macroadenoma that is judged to be inaccessible from the transsphenoidal route because of isolation by a narrow waist at the diaphragma sellae, containment within the cavernous sinus lateral to the carotid artery, projection anteriorly onto the planum sphenoidale, or projection laterally into the middle fossa. The application of a transcranial approach in these circumstances may still be mitigated by response to prolactin inhibition of prolactinomas, the frequent lack of necessity to remove asymptomatic nonsecretory adenomas from the cavernous sinus, and the lack of evidence that sustained chemical cures can be reliably achieved by removal of secretory adenomas (adrenocorticotropic hormone, growth hormone) from the cavernous sinus. Cranial base surgical techniques have refined the surgical approach to pituitary adenomas but have had less effect on actual surgical indications than anticipated. Because application of the transcranial approach to pituitary adenomas is and should be rare in clinical practice, it is useful to standardize the technique to a default mode with which the surgical team is most experienced and, therefore, most comfortable. Our default mode for transcranial pituitary surgery is the frontotemporal-orbitozygomatic approach.

  4. Peroxisome proliferator-activated receptor gamma in the human pituitary gland: expression and splicing pattern in adenomas versus normal pituitary.

    Science.gov (United States)

    Occhi, G; Albiger, N; Berlucchi, S; Gardiman, M; Scanarini, M; Scienza, R; Fassina, A; Mantero, F; Scaroni, C

    2007-07-01

    Pituitary adenomas are slow-growing tumours arising within the pituitary gland. If secreting, they give rise to well-known syndromes such as Cushing's disease or acromegaly; when hormonally inactive, they come to clinical attention often with local mass effects or pituitary deficiency. Peroxisome proliferator-activated receptor gamma (PPARgamma), a nuclear hormone receptor with a key role in fat and glucose metabolism, but also involved in several neoplasia, has recently been detected in pituitary adenomas. In the present study, we evaluated the occurrence and splicing profile of PPARgamma in 43 cases of pituitary adenoma of different subtypes and compared it to 12 normal pituitary glands. By real-time polymerase chain reaction, PPARgamma was expressed as much in adrenocorticotrophic hormone (ACTH)-secreting and ACTH-silent adenomas as in controls, with a moderate underexpression in somatotrophinomas and prolactinomas and overexpression in 54% of nonfunctioning pituitary adenomas (NFPA). There was no apparent qualitative change in the splicing profile of pathological pituitary glands, nor was the presence of specific isoforms with dominant negative effects against PPARgamma detected. Western blotting revealed similar expression levels in the different subgroups of pituitary adenomas and normal glands. Immunohistochemistry confirmed PPARgamma expression in approximately one-half of analysed samples. The intra- and intergroup differences observed in pituitary adenomas may represent new elements in the process of understanding the different clinical responses of Cushing's and Nelson patients to PPARgamma-ligand treatment. Moreover, the higher level of PPARgamma expression detected in the NFPA subgroup may suggest its possible role as a molecular target in these pituitary adenomas, paving the way for investigations on the effectiveness of treatment with thiazolidinediones in such patients.

  5. Whole-exome sequencing identified mutational profiles of high-grade colon adenomas

    Science.gov (United States)

    Kim, Tae-Min; Rhee, Je-Keun; Park, Hyeon-Chun; Sung, Min Kim; Kim, Sung Soo; Hyeok, Chang An; Lee Hyung, Sug; Chung, Yeun-Jun

    2017-01-01

    Although gene-to-gene analyses identified genetic alterations such as APC, KRAS and TP53 mutations in colon adenomas, it is largely unknown whether there are any others in them. Mutational profiling of high-grade colon adenoma (HGCA) that just precedes colon carcinoma might identify not only novel adenoma-specific genes but also critical genes for its progression to carcinoma. For this, we performed whole-exome sequencing (WES) of 12 HGCAs and identified 11 non-hypermutated and one hypermutated (POLE-mutated) cases. We identified 22 genes including APC, KRAS, TP53, GNAS, NRAS, SMAD4, ARID2, and PIK3CA with non-silent mutations in the cancer Census Genes. Bi-allelic and mono-allelic APC alterations were found in nine and one HGCAs, respectively, while the other two harbored wild-type APC. Five HGCAs harbored either mono-allelic (four HGCAs) or bi-allelic (one HGCA) SMAD4 mutation or 18q loss that had been known as early carcinoma-specific changes. We identified MTOR, ACVR1B, GNAQ, ATM, CNOT1, EP300, ARID2, RET and MAP2K4 mutations for the first time in colon adenomas. Our WES data is largely matched with the earlier ‘adenoma-carcinoma model’ (APC, KRAS, NRAS and GNAS mutations), but there are newly identified SMAD4, MTOR, ACVR1B, GNAQ, ATM, CNOT1, EP300, ARID2, RET and MAP2K4 mutations in this study. Our findings provide resource for understanding colon premalignant lesions and for identifying genomic clues for differential diagnosis and therapy options for colon adenomas and carcinomas. PMID:28179590

  6. Underlying skills of oral and silent reading

    NARCIS (Netherlands)

    van den Boer, M.; van Bergen, E.; de Jong, P.F.

    2014-01-01

    Many studies have examined reading and reading development. The majority of these studies, however, focused on oral reading rather than on the more dominant silent reading mode. Similarly, it is common practice to assess oral reading abilities rather than silent reading abilities in schools and in d

  7. Octreotide Uptake in Parathyroid Adenoma

    Science.gov (United States)

    Karaçavuş, Seyhan; Kula, Mustafa; Cihan Karaca, Züleyha; Ünlühızarcı, Kürşad; Tutuş, Ahmet; Bayram, Fahri; Çoban, Ganime

    2012-01-01

    The patient with a history of bone pain and muscle weakness, was thought to have oncogenic osteomalacia as a result of biochemical investigations and directed to Nuclear Medicine Department for a whole-body bone scintigraphy and 111In-octreotide scintigraphy. There was no focal pathologic tracer uptake, but generalized marked increase in skeletal uptake on bone scintigraphy. Octreotide scintigraphy showed accumulation of octreotide in the region of the left lobe of the thyroid gland in the neck. Thereafter, parathyroid scintigraphy was performed with technetium-99m labeled metroxy-isobutyl-isonitryl (99mTc-MIB) and MIBI scan demonstrated radiotracer uptake at the same location with octreotide scintigraphy. The patient underwent left inferior parathyroidectomy and histopathology confirmed a parathyroid adenoma. Somatostatin receptor positive parathyroid adenoma may show octreotide uptake. Octreotide scintigraphy may be promising and indicate a possibility of using somatostatin analogues for the medical treatment of somatostatin receptor positive Conflict of interest:None declared. PMID:23487397

  8. Gene mutations in hepatocellular adenomas

    DEFF Research Database (Denmark)

    Raft, Marie B; Jørgensen, Ernö N; Vainer, Ben

    2015-01-01

    is associated with bi-allelic mutations in the TCF1 gene and morphologically has marked steatosis. β-catenin activating HCA has increased activity of the Wnt/β-catenin pathway and is associated with possible malignant transformation. Inflammatory HCA is characterized by an oncogene-induced inflammation due....... This review offers an overview of the reported gene mutations associated with hepatocellular adenomas together with a discussion of the diagnostic and prognostic value....

  9. MRI of pituitary adenomas in acromegaly

    Energy Technology Data Exchange (ETDEWEB)

    Marro, B. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Zouaoui, A. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Sahel, M. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Crozat, N. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Gerber, S. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Sourour, N. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Sag, K. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France); Marsault, C. [Service de Neuroradiologie, Batiment Babinsky, Hopital Salpetriere, 47, Bd de l`Hopital, F-75013 Paris (France)

    1997-06-01

    Adenomas causing acromegaly represent at least a quarter of pituitary adenomas. We studied 12 patients presenting with active acromegaly due to a pituitary adenoma with a 1.5 T superconductive MRI unit. All had T1-weighted sagittal and coronal sections before and after Gd-DTPA; six had coronal T2-weighted images. Surgical correlation was obtained in seven patients. Histologically, there were eight growth hormone (GH)-secreting and three mixed [GH and prolactin (PRL) secreting] adenomas, and one secreting GH, PRL and follicle-stimulating hormone. Macroadenomas (10) were more frequent than microadenomas (2). No correlation was found between serum GH and tumour size. There were nine adenomas in the lateral part of the pituitary gland; seven showed lateral or infrasellar invasion. Homogeneous, isointense signal on T1- and T2-weighted images was observed in six cases. Heterogeneous adenomas had cystic or necrotic components. (orig.). With 5 figs., 3 tabs.

  10. Giant hepatocellular adenoma; case report

    Energy Technology Data Exchange (ETDEWEB)

    Pitella, F.A.; Coutinho, A.M.N.; Coura Filho, G.B.; Costa, P.L.A.; Ono, C.R.; Watanabe, T.; Sapienza, M.T.; Hironaka, F.; Cerri, G.G.; Buchpiguel, C.A. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Inst. de Radiologia. Servico de Medicina Nuclear

    2008-07-01

    Full text: Introduction: Hepatocellular adenoma is a benign hepatic tumor identified mainly in women during fertility age, with estimated incidence of 4/1000 inhabitants. It is usually unique, well circumscribed, with or without a capsule, size varying from 1 to 30 cm, with possible central areas of necrosis and hemorrhage. Case Report: A 37-year-old female patient presenting with no comorbities, use of hormonal birth control pills for 18 years, a condition of reduction in the consistency of feces, increase in number of daily defecations, abdominal cramps, and a stuffed sensation after meals for two years. A palpable abdominal mass extending from the right hypochondriac to the right iliac fossa was noticed four months ago. A computerized tomography (CT) showed an extensive hepatic mass on the right which was considered, within the diagnostic hypotheses, hepatic adenomatosis, without ruling out secondary lesions. A hepatic scintillography with {sup 99m}Tc-DISIDA showed an extensive exophytic area from segment V to the right iliac fossa with arterialized blood flow and hepatocytic activity, as well as a hepatic nodule in segment VII with hepatocytic activity consistent with the hepatic adenomas hypothesis. The biopsy confirmed the hepatic adenoma diagnosis and the patient was submitted to a partial hepatectomy and cholecystectomy with good clinical evolution. Conclusion: Nuclear Medicine may supplement the assessment of hepatic nodules, including giant masses, thus suggesting new hypotheses and direction to therapeutic conduct. (author)

  11. Adenoma Malignum Detected on a Trauma CT

    OpenAIRE

    McEachern, James; Butcher, Matthew; Burbridge, Brent; Zhu, Yu

    2013-01-01

    Adenoma malignum is a rare subtype of cervical adenocarcinoma. Clinical presentation is variable with watery vaginal discharge being the most commonly associated finding. We report a case of adenoma malignum incidentally detected on pelvic computed tomography (CT) performed for a trauma patient. The cervical mass was further characterized by magnetic resonance (MR) imaging and remained compatible with adenoma malignum. Local cervical biopsy was suggestive of the diagnosis which was subsequent...

  12. Pleomorphic Adenoma of the Upper Lip

    Directory of Open Access Journals (Sweden)

    Ülkü KÜÇÜK

    2011-01-01

    Full Text Available Pleomorphic adenoma is the most common neoplasm of the salivary glands and is most commonly located in the parotis followed by the submandibular glands. Its localization in the minor salivary glands is mostly reported in the palate. Few publications report pleomorphic adenoma cases located in the lip.We present a 35-year-old male patient with a pleomorphic adenoma located in the upper lip.

  13. Alcohol Intake, Smoking, and Colorectal Adenoma

    OpenAIRE

    Park, Yeong Mi; Cho, Chang Ho; Kim, Sung Hi; Lee, Jung Eun

    2014-01-01

    Background: Colorectal cancer is the third most common cancer in Korea. Because colorectal adenoma is a precursor lesion of colorectal cancer, primary prevention of colorectal adenomas may be important for reducing morbidity and mortality from the disease. The aim of this study is to examine the association of alcohol consumption and cigarette smoking in relation with colorectal adenoma in a cross-sectional study of Korean adults. Methods: A total of 366 participants who underwent colonoscopy...

  14. [Old phenotype and new genotypes. Pituitary adenomas].

    Science.gov (United States)

    Gérard, C; Jedidi, H; Petrossians, P; Krzesinski, F; Daly, A; Beckers, A

    2015-11-01

    Gigantism and acromegaly, usually caused by a pituitary adenoma linked inappropriate secretion of growth hormone (GH), are generally considered as very rare diseases, even if, according to some authors, their cumulative prevalence is about 1/5000. Starting from the historical case of a giant from Liège we shall describe the different types of GH pituitary adenomas and their pathophysiology. We shall particularly discuss rare forms of inherited GH secreting pituitary adenomas like the FIPA (familial inherited isolated pituitary adenomas) and the X-LAG (X linked acrogigantism), both described for the first time in Liège, in 2000 and 2014, respectively.

  15. Unusual ocular manifestations of silent sinus syndrome

    Directory of Open Access Journals (Sweden)

    Fabricio Lopes da Fonseca

    2014-01-01

    Full Text Available Silent sinus syndrome is an acquired condition in which there is a gradual collapse of the orbital floor and inward retraction of the maxillary sinus (atelectasis of the maxillary sinus. This in turn may cause associated ocular occurrences of enophthalmos and hypotropia. This is a report of an 8 year-old boy with silent sinus syndrome and associated ocular motility disorders. The association between silent sinus syndrome and ocular motility disturbance has been recently described in the literature. However, this is an infrequent association, mainly in childhood.

  16. Controversies in cardiovascular care: silent myocardial ischemia

    Science.gov (United States)

    Hollenberg, N. K.

    1987-01-01

    The objective evidence of silent myocardial ischemia--ischemia in the absence of classical chest pain--includes ST-segment shifts (usually depression), momentary left ventricular failure, and perfusion defects on scintigraphic studies. Assessment of angina patients with 24-hour ambulatory monitoring may uncover episodes of silent ischemia, the existence of which may give important information regarding prognosis and may help structure a more effective therapeutic regimen. The emerging recognition of silent ischemia as a significant clinical entity may eventually result in an expansion of current therapy--not only to ameliorate chest pain, but to minimize or eliminate ischemia in the absence of chest pain.

  17. Characteristics of silent countingin synchronized swimmers

    Directory of Open Access Journals (Sweden)

    Sergey V. Leonov

    2012-01-01

    Full Text Available This article describes the temporal characteristics of silent counting as used duringa competition by the Russian youth team of synchronized swimmers. Theathletes listened to the music that accompanied their performance at the competition.Diff erent indices of silent counting were defi ned, such as the beginningand cessation of diff erent periods of counting, counting frequency, the stabilityof the temporal structure of silent counting, the degree of synchronization of silentcounting at diff erent moments during the sports program. We studied therelationship of these characteristics of counting with expert estimates of the athletes’sense of tempo, coordination of movements, and choreographic abilities.

  18. Towards new research strategies: silent seismogenic areas or silent sources?

    Directory of Open Access Journals (Sweden)

    E. Guidoboni

    2000-06-01

    Full Text Available Some earthquakes, particularly the strongest ones, can re-occur within hundreds or thousands of years. Therefore, the areas whose "seismic history" seems to be totally lacking in information are indeed a problem. In the past, these "silences" were interpreted in the simplest way, as an indicator of a low degree of seismicity. More recently, the results of historical research, some geological observations and the limits imposed by the physics of the seismic cycle suggest that this interpretation is wrong and must be overcome by new multi-disciplinary strategies. These strategies will involve the use of both the general pattern offered by the knowledge on the historical seismicity, and the little, though valuable information gleaned from land geology. Similar to these "silent" or "missing" earthquakes are the cases of the "missed" earthquakes which occurred in such historical and territorial conditions that they went completely unnoticed. A third case regards "underrated" earthquakes, reported as events of moderate energy. "Missing", "missed" and "underrated" earthquakes call for some reflection on the problem of completeness in the catalogue, and require innovative research projects. In recent years the Istituto Nazionale di Geofisica and SGA have developed three of such projects. These concern: 1 Sicily in the period between the ninth and thirteenth centuries; 2 the Pollino area (Northern Calabria before the nineteenth century; 3 the Velino-Sirente massif in the period between the eleventh and fourteenth centuries.

  19. Piecemeal Versus En Bloc Resection of Large Rectal Adenomas

    Science.gov (United States)

    2016-05-10

    Colorectal Adenoma With Mild Dysplasia; Colorectal Adenoma With Severe Dysplasia; Colorectal Adenomatous Polyp; Colorectal Low Grade Intraepithelial Neoplasia; Colorectal High Grade Intraepithelial Neoplasia

  20. Proton therapy of hypophyseal adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Mirakova, E.I.; Kirpatovskaya, L.E.; Lyass, F.M.; Snigireva, R.Ya.; Krymskij, V.A. (Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Nejrokhirurgii; Akademiya Meditsinskikh Nauk SSSR, Moscow. Inst. Ehksperimental' noj Ehndokrinologii i Khimii Gormonov)

    1983-10-01

    The authors present the results of proton therapy in 59 patients with different hypophyseal adenomas. The period of observation lasted from 6 mos. to 5 yrs. Irradiation was done using a multifield-convergent method and a proton beam of the ITEF synchrotron. The beam energy was 200 MeV, the beam diameter 7-15 mm. Radiation response and immediate results were evaluated for all the patients. The least favorable results were noted in the patients with prolactinomas, for which, in addition to irradiation, parlodel therapy is needed. No marked radiation reactions, neurological complications and manifestations of hypopituitarism were observed with the chosen doses and schemes of irradiation.

  1. Magnetic resonance imaging of pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Bonneville, Jean-Francois; Bonneville, Fabrice; Cattin, Francoise [University Hospital, Department of Neuroradiology, Besancon (France)

    2005-03-01

    Today, MR is the only method needed for the morphological investigation of endocrine-active pituitary adenomas. In acromegaly and Cushing's syndrome, the therapeutic attitude is directly dictated by MR data. We present the MR aspect of pituitary adenomas according to size, sex, age, endocrine activity and a few particular conditions such as hemorrhagic pituitary adenomas, pituitary adenomas during pregnancy, cavernous sinus invasion and postsurgical changes. When an intrasellar mass extending out of the sella turcica is detected, the goal of the MR examination is to indicate precisely the origin of the tumor, its extension in relation to the various surrounding structures, its structure and its enhancement in order to help in the differential diagnosis. Demonstration of very small pituitary adenomas remains a challenge. When SE T1- and Turbo SE T2-weighted sequences are non-diagnostic, enhanced imaging becomes mandatory; half-dose gadolinium injection, delayed sequence, dynamic imaging can be of some help. (orig.)

  2. Silent as a Winter Cuckoo

    Directory of Open Access Journals (Sweden)

    Pad+ma dbang chen

    2012-12-01

    Full Text Available When my grandparents were children, parents were gods and their decisions about such issues as marriage and the choice of marriage partners were final. Children had no right to choose a spouse. Many parents found a daughter-in-law with a blood relationship for their son, believing this would better ensure family harmony. Consequently, many Tibetans struggled in sad marriages. Of course, parents hoped their children would have a good, stable life and not all arranged marriages were unhappy. When Grandfather was eighteen he herded sheep on our pastureland everyday. At that time, sheep and goats covered an enormous mountain that resembled a member of the Himalayas. Herders stayed together, played, told folktales, and sang folksongs. Some wrestled and others talked about their lovers. In many ways this daily gathering resembled a celebration of victory in battle. Grandfather and his lover, Dkon mchog mtsho, herded and had lunch together everyday. They went home from the pastureland and soon met again after supper, because they loved and needed each other as fish need water. They felt that they were the happiest people in the world, and hoped to marry. Everyone understood their intimate relationship and envied their loyalty to each other. Some other girls were especially jealous because Grandfather was handsome. In time, Great-grandfather discovered their relationship and resolved to end it. Grandfather was as silent as a winter cuckoo, because he was afraid of his father. However, he thought about how to convince his parents, or how to have a life with his lover. After some days he decided to elope, went to the place where he usually met Dkon mchog mtsho, and found her there. They looked longingly at each other as Dkon mchog mtsho's tears streamed down her red cheeks and seeped into the earth.

  3. Octreotide Uptake in Parathyroid Adenoma

    Directory of Open Access Journals (Sweden)

    Seyhan Karaçavuş

    2012-08-01

    Full Text Available The patient with a history of bone pain and muscle weakness, was thought to have oncogenic osteomalacia as a result of biochemical investigations and directed to Nuclear Medicine Department for a whole-body bone scintigraphy and 111In-octreotide scintigraphy. There was no focal pathologic tracer uptake, but generalized marked increase in skeletal uptake on bone scintigraphy. Octreotide scintigraphy showed accumulation of octreotide in the region of the left lobe of the thyroid gland in the neck. Thereafter, parathyroid scintigraphy was performed with technetium-99m labeled metroxy-isobutyl-isonitryl (99mTc-MIB and MIBI scan demonstrated radiotracer uptake at the same location with octreotide scintigraphy. The patient underwent left inferior parathyroidectomy and histopathology confirmed a parathyroid adenoma. Somatostatin receptor positive parathyroid adenoma may show octreotide uptake. Octreotide scintigraphy may be promising and indicate a possibility of using somatostatin analogues for the medical treatment of somatostatin receptor positive parathyroid tumors. (MIRT 2012;21:77-79

  4. Intervención multicontextual y multicomponente en niños con trastorno por déficit de atención con hiperactividad subtipo combinado

    OpenAIRE

    Siegenthaler Hierro, Rebeca

    2009-01-01

    Este trabajo de investigación analiza la efectividad de la implementación de un programa de intervención multicontextual y multicomponente desarrollado directamente con un grupo de niños con Trastorno por Déficit de Atención con Hiperactividad del subtipo combinado, sus padres y profesores. El programa, con una duración de 10 semanas, incluyó técnicas de modificación de conducta, cognitivo-conductales, resolución de problemas, entrenamiento en habilidades sociales y acomodaciones instrucciona...

  5. Características de comorbilidad en los diferentes subtipos de trastorno por déficit de atención con hiperactividad

    OpenAIRE

    Julio César Flores Lázaro

    2009-01-01

    Las características de comorbilidad en el trastorno por déficit de atención con hiperactividad (TDA-H) tienen un importante impacto en la conducta, aprendizaje y desarrollo cognitivo de los sujetos que las presentan. Se ha planteado que el tipo particular de estas características se presentan en función del subtipo de TDA-H (inatento vs. hiperactivo-impulsivo). En este artículo se presentan las características de comorbilidad de 61 casos de niños con TDA-H divididos en primer término en inate...

  6. Giant Parotid Pleomorphic Adenoma Involving Parapharyngeal Space

    Directory of Open Access Journals (Sweden)

    Sukri Rahman

    2013-09-01

    Full Text Available AbstrakLatar belakang: Pleomorfik adenoma parotis merupakan tumor jinak kelenjar liur yang paling sering ditemukan, namun pleomorfik adenoma parotis yang sangat besar sehingga melibatkan ruang parafaring (RPF sangat jarang. Diagnosis ini sulit ditegakkan karena gejala klinisnya tidak khas. Penatalaksanaanya harus hati-hati mengingat banyak struktur vital yang beresiko mengalami trauma. Tujuan: Bagaimana menegakkan diagnosis dan penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF. Kasus: Seorang pasien perempuan 27 tahun ditegakkan diagnosis pleomorfik adenoma parotis kanan dengan melibatkan RPF. Terdapat pembengkakan pada leher yang bersifat asimtomatis dan gejala pendorongan faring dan laring yang menyebabkan disfonia, disfagia, dan defisit saraf kranial IX,X,XII. Penatalaksanaan: Pasien telah dilakukan operasi parotidektomi pendekatan transervikal–transparotid dengan preservasi arteri karotis eksterna dan saraf fasialis. Kesimpulan: Biopsi Aspirasi Jarum Halus (BAJAH dan radiologi merupakan pemeriksaan yang penting untuk menegakkan diagnosis. Penatalaksanaan pleomorfik adenoma parotis yang melibatkan RPF adalah bedah ekstirpasi komplit dengan beberapa pendekatan. .Kata kunci: tumor jinak kelenjar liur, pleomorfik adenoma, ruang parafaringAbstractBackground: Parotid pleomorphic adenoma is the most common benign salivary gland tumor, while giant parotid pleomorphic adenoma involving the parapharyngeal space (PPS is rare. It was difficult to diagnose because the clinical presentation of this tumor can be subtle. The management must be performed carefully due to anatomy relation to complex vital structure lead to traumatic injury highrisk. Purposes: How to make diagnosis and management parotid pleomorphic adenoma involving PPS. Case: A female 27 years old with diagnosis was giant parotid pleomorphic adenoma involving PPS. There was asymptomatic swelling of the neck and presence of pushing the pharynx and larynx medially causes

  7. Successful long-term control of Cushing’s disease after partial resection of gigantic ACTH-secreting pituitary adenoma

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    Vatroslav Čerina

    2016-03-01

    Full Text Available Only 4-9% of patients with Cushing’s disease (CD harbor pituitary macroadenomas. Clinical and biochemical features of macrocorticotropinomas are poorly understood. Some evidence exist that these tumors presents clinical features more similar to a non-functioning adenomas, being though defined silent corticotropinomas, rather than to ACTH-secreting adenomas. In this paper, we report a case of a 60-year old woman with a history of obesity, arterial hypertension and diabetes mellitus who presented with overt central hypothyroidism. Magnetic resonance imaging disclosed giant pituitary adenoma measuring 50 mm. Endocrinological evaluation confirmed CD: ACTH 50.3 pmol/L, urinary free-cortisol of 739 nmol/24h and cortisol of 639 nmol/L after 1 mg dexamethasone suppression test. Tumor mass was reduced by 50% using purely endoscopic transsphenoidal approach. Thirty-eight months after the partial resection, the patient had well controlled CD: ACTH 20.2 pmol/L, urinary free-cortisol of 238 nmol/24h, cortisol of 105 nmol/L after 1 mg dexamethasone suppression test. To the best of our knowledge, this is the largest ACTH-secreting adenoma ever reported. Our case suggests that tumor size does not necessarily correlate with aggressiveness of CD in patients with macrocorticotropinomas and that long-term control of CD may be achieved albeit incomplete surgical removal. Further studies are needed in order to determine the best treatment option for patients with macrocorticotropinomas.

  8. Vegetarianism as a protective factor for colorectal adenoma and advanced adenoma in Asians.

    Science.gov (United States)

    Lee, Chang Geun; Hahn, Suk Jae; Song, Min Keun; Lee, Jun Kyu; Kim, Jae Hak; Lim, Yun Jeong; Koh, Moon-Soo; Lee, Jin Ho; Kang, Hyoun Woo

    2014-05-01

    Although epidemiologic and animal studies suggest a vegetarian diet protects against the development of colorectal cancer, the relationship between vegetarian diet and incidence of colorectal adenoma is not yet conclusive, especially for Asians. The purpose of this study was to examine the protective effect of a vegetarian diet against colorectal adenoma and advanced adenoma. This cross-sectional study compared the prevalence of colorectal adenoma among Buddhist priests, who are obligatory vegetarians, with that among age and sex-matched controls. All the subjects underwent health checkups in a health-promotion center in Korea. Colorectal adenoma and advanced adenoma were both more prevalent in the general population group than in the Buddhist priest group (25.2 vs. 17.9 %, 6.7 vs. 2.0 %). However, the prevalence of metabolic syndrome, high body mass index, and waist circumference were higher in the Buddhist priest group. According to univariate analysis, non-vegetarian diet (general population) significantly increased the prevalence of colorectal adenoma and advanced adenoma compared with a vegetarian diet (Buddhist priests) (OR 1.54, 95 % CI 1.08-2.21, P = 0.018; OR 3.60, 95 % CI 1.53-8.48, P = 0.003). In a conditional regression analysis model, non-vegetarian diet was also a significant risk factor for colorectal adenoma and advanced adenoma (OR 1.52, 95 % CI 0.75-2.07, P = 0.043; OR 2.94, CI 0.97-7.18, P = 0.036). Vegetarianism may be effective in preventing both colorectal adenoma and advanced adenoma in Asians.

  9. Prevalência de subtipos do HIV-1 em amostra de pacientes de um centro urbano no sul do Brasil Prevalencia de subtipos de VIH-1 en muestra de pacientes de un centro urbano en el sur de Brasil Prevalence of HIV-1 subtypes in patients of an urban center in Southern Brazil

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    Daniel Simon

    2010-12-01

    Full Text Available OBJETIVO: Estimar a prevalência dos subtipos do HIV-1 e analisar fatores associados. MÉTODOS: Foi realizado um estudo transversal com amostra de conveniência de 80 pacientes adultos HIV-positivos atendidos em serviço especializado em DST/Aids em Canoas, RS, no período de julho de 2008 a janeiro de 2009. A determinação dos subtipos do HIV foi realizada por amplificação de fragmento do genoma viral pela reação em cadeia da polimerase seguida do seqüenciamento dos fragmentos amplificados. Variáveis sociodemográficas, clínicas e comportamentais foram coletadas em questionário estruturado. Foi realizada análise estatística univariada utilizando os testes de qui-quadrado e t de Student. RESULTADOS: Foi observada uma prevalência maior do subtipo C (43,8%; IC 95%: 32,9;54,6, seguida pelo CRF31_BC (35,0%; IC 95%: 24,6;45,5 e subtipos B (18,8%; IC 95%: 10,2;27,3 e F (2,4%; IC 95%: 0;5,9. Outros subtipos de HIV-1 não foram observados. Pacientes infectados com CRF31_BC apresentaram diagnóstico mais recente do que os pacientes infectados com o subtipo B (p OBJETIVO: Estimar la prevalencia de los subtipos de VIH-1 y analizar factores asociados. MÉTODOS: Se realizó un estudio transversal con muestra de conveniencia de 80 pacientes adultos VIH-positivos atendidos en servicio especializado en DST/Sida en Canoas, Sur de Brasil, en el período de julio de 2008 a enero de 2009. La determinación de los subtipos de VIH fue realizada por amplificación de fragmento del genoma viral por la reacción en cadena de la polimerasa seguida de la secuenciación de los fragmentos amplificados. Variables sociodemográficas, clínicas y conductuales fueron colectadas en cuestionario estructurado. Se realizó análisis estadístico univariado utilizando las pruebas de chi-cuadrado y t de Student. RESULTADOS: Se observó una prevalencia mayor del subtipo C (43,8%; IC 95%:32,9;54,6, seguido de la CRF31_BC (35,0%; IC 95%: 24,6;45,5 y subtipos B (18,8%; IC 95

  10. The pathophysiology of pituitary adenomas.

    Science.gov (United States)

    Dworakowska, Dorota; Grossman, Ashley B

    2009-10-01

    The pathogenesis of tumour formation in the anterior pituitary has been intensively studied, but the causative mechanisms involved in pituitary cell transformation and tumourigenesis remain elusive. Most pituitary tumours are sporadic, but some arise as a component of genetic syndromes such as the McCune-Albright syndrome, multiple endocrine neoplasia type 1, Carney complex and, the most recently described, a MEN1-like phenotype (MEN4) and pituitary adenoma predisposition syndromes. Some specific genes have been identified that predispose to pituitary neoplasia (GNAS, MEN1, PRKAR1A, CDKN1B and AIP), but these are rarely involved in the pathogenesis of sporadic tumours. Mutations of tumour suppressor genes or oncogenes, as seen in more common cancers, do not seem to play an important role in the great majority of pituitary adenomas. The pituitary tumour transforming gene (PTTG; securin) was the first transforming gene found to be highly expressed in pituitary tumour cells, and seems to play an important role in the process of oncogenesis. Many tumour suppressor genes, especially those involved in the regulation of the cell cycle, are under-expressed, most often by epigenetic modulation - usually promoter hypermethylation - but the regulator of these co-ordinated series of methylations is also unclear. Cell signalling abnormalities have been identified in pituitary tumours, but their genetic basis is unknown. Both Raf/MEK/ERK and PI3K/Akt/mTOR pathways are over-expressed and/or over-activated in pituitary tumours: these pathways share a common root, including initial activation related to the tyrosine kinase receptor, and we speculate that a change to these receptors or their relationship to membrane matrix-related proteins may be an early event in pituitary tumourigenesis.

  11. Pituitary prolactin adenoma with Toxoplasma gondii infection

    Institute of Scientific and Technical Information of China (English)

    张晓晖; 李青; 程虹; 阎庆国; 黄高昇

    2003-01-01

    Objective: To report two recent cases of pituitary adenoma associated with Toxoplasma gondii (T.Gondii) infection.Methods: Histological changes were observed in H & E and PAS staining sections microscopically.Immunohistochemistry was performed to classify the pituitary tumors and to confirm the diagnosis of T.gondii.Results: The cases were 43- and 19-year-old females, in which the latter one was a recurring case, and radiology examination showed that tumors existed in sellar region.Microscopically, the tumors consisted of small homogenous polygonal or round cells with abundant eosinophilic granular cytoplasm.Immunohistochemistry revealed they were prolactin-producing adenomas.Interestingly, we found toxoplasma infection in the tumor tissues, being confirmed by T.gondii sepicific antibody immunohistochemistry.Conclusion: The association of pituitary adenoma with toxoplasma raises the possibility that T.gondii may be involved in the development of certain cases of pituitary adenoma.

  12. MicroRNAs in Human Pituitary Adenomas

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    Xu-Hui Li

    2014-01-01

    Full Text Available MicroRNAs (miRNAs are a class of recently identified noncoding RNAs that regulate gene expression at posttranscriptional level. Due to the large number of genes regulated by miRNAs, miRNAs play important roles in many cellular processes. Emerging evidence indicates that miRNAs are dysregulated in pituitary adenomas, a class of intracranial neoplasms which account for 10–15% of diagnosed brain tumors. Deregulated miRNAs and their targets contribute to pituitary adenomas progression and are associated with cell cycle control, apoptosis, invasion, and pharmacological treatment of pituitary adenomas. To provide an overview of miRNAs dysregulation and functions of these miRNAs in pituitary adenoma progression, we summarize the deregulated miRNAs and their targets to shed more light on their potential as therapeutic targets and novel biomarkers.

  13. [Pleomorphic adenoma with bilateral pulmonary metastasis].

    Science.gov (United States)

    De Kerangal, X; Poirrier, P; Soulard, R; Dot, J M; Ségneuric, J B; L'Her, P; Jancovici, R; Saint-Blancart, P

    2001-11-01

    We report a new case of pleomorphous adenoma of the submaxillary glands with multiple lung metastases. Histological proof was obtained on the thoracoscopic surgical specimen. Clinically, this benign tumor presents as a malignant tumor. Diagnosis has been a subject of debate; surgical resection is indicated. Diagnosis is achieved by elimination in a patient with one or several nodules occurring in a context of recurrent pleomorphous adenoma.

  14. Subtipos disléxicos y procesos fonológicos y ortográficos en la escritura de palabras

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    Juan E. Jiménez

    2014-06-01

    Full Text Available El objetivo de este estudio consistió en examinar si existen diferencias entre subtipos disléxicos (fonológico y de superficie y normolectores igualados en edad cronológica en los procesos fonológicos y ortográficos en la escritura de palabras. La muestra de estudio estuvo formada por un total de 104 alumnos y se distribuía de la siguiente manera: 36 normolectores igualados en edad cronológica con los subtipos disléxicos, 26 disléxicos fonológicos y 42 disléxicos de superficie. Se administraron tareas de dictado de palabras que contienen sílabas cuyos sonidos corresponden a más de una grafía para la evaluación de la ruta ortográfica en la escritura. Asimismo, se administraron tareas de escritura de pseudopalabras para la evaluación de los procesos fonológicos en la escritura. Los resultados demostraron que los disléxicos de superficie utilizaban de manera menos eficiente la ruta ortográfica en la escritura de palabras en comparación a los normolectores. En cambio, no se encontraron diferencias significativas entre los grupos en el uso de la ruta fonológica en la escritura.

  15. Alcohol intake, smoking, and colorectal adenoma.

    Science.gov (United States)

    Park, Yeong Mi; Cho, Chang Ho; Kim, Sung Hi; Lee, Jung Eun

    2014-06-01

    Colorectal cancer is the third most common cancer in Korea. Because colorectal adenoma is a precursor lesion of colorectal cancer, primary prevention of colorectal adenomas may be important for reducing morbidity and mortality from the disease. The aim of this study is to examine the association of alcohol consumption and cigarette smoking in relation with colorectal adenoma in a cross-sectional study of Korean adults. A total of 366 participants who underwent colonoscopy were included (113 cases and 255 controls) in this study. Information on alcohol intake and cigarette smoking was collected from structured questionnaires. The odds ratio (ORs) and 95% confidence intervals (CIs) were calculated using the multivariate logistic regression models. Alcohol intake was associated with a higher prevalence of colorectal adenoma in men; compared to non-drinkers, ORs (95% CIs) were 11.49 (2.55-51.89) for 10-20 g/day of alcohol intake and 14.15 (3.31-60.59) for â 20 g/day of alcohol intake (P for trend = 0.003). There was a weaker association of alcohol intake for women than men; however, there was a suggestive increase in the prevalence of colorectal cancer in women. Cigarette smoking was not associated with colorectal adenoma, but we cannot rule out the possibility that this was due to low statistical power. Our study provides evidence to suggest that alcohol intake may contribute to colorectal adenoma in the Korean population. Our study results demonstrate that a larger epidemiologic study is needed.

  16. The association between location, age and advanced colorectal adenoma characteristics

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2016-01-01

    PURPOSE: Evidence supports an association between certain colorectal adenoma characteristics and predisposition to cancer. The association between anatomical location of colorectal adenoma, age and advanced adenomas needs attention. The objective of this study was to evaluate the possible...... association between occurrence of sporadic advanced adenomas with location and age. MATERIALS AND METHODS: A cross-sectional study using baseline data from index colonoscopy from a randomized controlled trial evaluating chemopreventive treatment against recurrence of colorectal adenomas was performed....... Inclusion criteria for patients were one adenoma of >1 cm in diameter or multiple adenomas of any size, or an adenoma of any size and familial disposition for colorectal cancer. Multivariate regression and propensity score-matched analyses were used to correlate location of adenomas and age with advanced...

  17. Formación de Subtipos de Niños con Problemas Escolares de Aprendizaje a Partir de la Evaluación Neuropsicológica, Capacidades Cognitivas y Comportamiento

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    Teresa Álvarez Arenal

    2009-01-01

    Full Text Available En el presente trabajo se han diferenciado subtipos de niños en edad escolar que no presentan alteración neurológica cerebral demostrable y manifiestan problemas de aprendizaje. Se han diferenciado desde la perspectiva neuropsicológica, cognitiva y del comportamiento. Las pruebas de evaluación utilizadas son: La Batería Luria-DNI, el WISC-R y las Escalas de Comportamiento Infantil (ECI. Hemos obtenido 4 subtipos: (1 Trastorno disléxico, (2 Déficit generalizado, (3 Déficit de atención y (4 Déficit mínimo.

  18. Formación de Subtipos de Niños con Problemas Escolares de Aprendizaje a Partir de la Evaluación Neuropsicológica, Capacidades Cognitivas y Comportamiento

    OpenAIRE

    Teresa Álvarez Arenal; Pablo A. Conde-Guzón

    2009-01-01

    En el presente trabajo se han diferenciado subtipos de niños en edad escolar que no presentan alteración neurológica cerebral demostrable y manifiestan problemas de aprendizaje. Se han diferenciado desde la perspectiva neuropsicológica, cognitiva y del comportamiento. Las pruebas de evaluación utilizadas son: La Batería Luria-DNI, el WISC-R y las Escalas de Comportamiento Infantil (ECI). Hemos obtenido 4 subtipos: (1) Trastorno disléxico, (2) Déficit generalizado, (3) Déficit de atención y (4...

  19. Subtipos do antígeno Austrália (HBsAg em doentes de hanseníase de São Paulo, Brasil Subtypes of Australia antigen (HBsAg in leprosy

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    Sandra Ottati

    1979-12-01

    Full Text Available Foram examinados 135 soros de pacientes com hanseníase para identificação dos subtipos ad e ay de HB sAg, tendo-se encontrado somente 3 casos positivos para o antígeno Austrália, todos eles do subtipo ad (2,2%.One hundred and thirty five sera from patients with leprosy were tested for the ad and ay subtypes of HBsAg. Only three (2,2% had HBsAg and all were ad positive.

  20. Silent Infarcts with Sickle Cell Anemia

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    J Gordon Millichap

    2002-01-01

    Full Text Available The effect of transfusion therapy on the risk for new silent infarct or stroke in children with sickle cell anemia and abnormal transcranial Doppler (TCD ultrasonography was determined at the University of Miami, FL, and other centers in the STOP trial (Stroke Prevention in Sickle Cell Anemia.

  1. Silent Way in the University Setting.

    Science.gov (United States)

    Lantolf, James P.

    The use of the Silent Way method of second language instruction in beginning and intermediate Spanish classes at the college level is described. The approach encourages student self-responsibility for learning the target language according to learning strategies selected by the student. Although the method was used during three semesters, the…

  2. Cytogenetic analysis of colorectal adenomas: karyotypic comparisons of synchronous tumors

    DEFF Research Database (Denmark)

    Bomme, L; Bardi, G; Pandis, N

    1998-01-01

    adenomas. Twenty-four colorectal adenomas from 11 patients were subjected to chromosome banding analysis. Clonal chromosome abnormalities were found in 20 tumors. Recurrent structural rearrangements involved chromosomes 1, 13, 17, and 18. The most common numerical changes were gain of chromosomes 7, 13, 20......, and 3 and loss of chromosome 18. Eight adenomas had subclones as evidence of clonal evolution. Similar clones in separate polyps were seen in tumors from 6 patients; these adenomas were always located in the same part of the large bowel. In 2 patients, both with one rectal adenoma and one adenoma...

  3. Giant serous microcystic pancreas adenoma.

    Science.gov (United States)

    Dikmen, Kursat; Bostanci, Hasan; Yildirim, Ali Cihat; Sakrak, Omer; Kerem, Mustafa

    2012-10-10

    Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11×9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12×11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pancreatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient's symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  4. Giant serous microcystic pancreas adenoma

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    Mustafa Kerem

    2012-10-01

    Full Text Available Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11x9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12x11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pan creatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient’s symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  5. Temozolomide in aggressive pituitary adenomas and carcinomas

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    Leon D. Ortiz

    2012-01-01

    Full Text Available Temozolomide is an alkylating agent used in the treatment of gliomas and, more recently, aggressive pituitary adenomas and carcinomas. Temozolomide methylates DNA and, thereby, has antitumor effects. O6-methylguanine-DNA methyltransferase, a DNA repair enzyme, removes the alkylating adducts that are induced by temozolomide, thereby counteracting its effects. A Medline search for all of the available publications regarding the use of temozolomide for the treatment of pituitary tumors was performed. To date, 46 cases of adenohypophysial tumors that were treated with temozolomide, including 30 adenomas and 16 carcinomas, have been reported. Eighteen of the 30 (60% adenomas and 11 of the 16 (69% carcinomas responded favorably to treatment. One patient with multiple endocrine neoplasia type 1 and an aggressive prolactin-producing adenoma was also treated and demonstrated a good response. No significant complications have been attributed to temozolomide therapy. Thus, temozolomide is an effective treatment for the majority of aggressive adenomas and carcinomas. Evidence indicates that there is an inverse correlation between levels of O6-methylguanine-DNA methyltransferase immunoexpression and therapeutic response. Alternatively, high-level O6-methylguanine-DNA methyltransferase immunoexpression correlates with an unfavorable response. Here, we review the use of temozolomide for treating pituitary neoplasms.

  6. HYPONATREMIA AFTER TRANSSPHENIODAL SURGERY OF PITUITARY ADENOMA

    Institute of Scientific and Technical Information of China (English)

    陶蔚; 任祖渊; 苏长保; 王任直; 杨义; 马文斌

    2003-01-01

    Objective. To clarify the frequency, presentation, associated factors, treatment and outcome of hy-ponatremia after transsphenoidal surgery of pituitary adenomas.Methods. Retrospectively reviewed the database of 183 patients who underwent transsphenoidal surgeryof pituitary adenomas between January 1999 and June 2000 in our department.Result.s. 38.8% (71/183) had postoperative hyponatremia. Among them, 59.2% (42/71) appeared onthe 4th to 7th day postoperatively. 59.2% (42/71) presented with nausea, vomiting, headache, dizzi-ness, confusion and weakness. Hyponatremia was related to age, tumor size and adenoma type, but notrelated to sex and degree of resection. Treatment consisted of salt replacement and mild fluid restrictionin 4 patients and salt and fluid replacement in 67 patients. Hyponatremia resolved within 16 days in allthe patients.Conclusions. Hyponatremia often appeared about 7 days after transsphenoidal surgery of pituitary ade-nomas, especially in elderly and patients with macroadenomas and huge pituitary adenomas. The principleof treatment was salt and fluid replacement.

  7. Benign Metastasizing Pleomorphic Adenoma: A Case Report

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    Ranjbari

    2014-12-01

    Full Text Available Introduction Pleomorphic adenoma (mixed tumor is the most common neoplasm of the salivary gland. It is usually a benign, slow-growing and well-circumscribed tumor. However, there are rare reports of a subset of these tumors metastasizing to distant sites without undergoing malignant transformation. Here we describe a case of pleomorphic adenoma of the parotid gland that metastasied to the cervical lymph node coincidentally with similar appearance of the primary lesion in the ipsilateral parotid gland. Case Presentation A 78-year-old male with right sided cervical lymph node and ipsilateral parotid mass from one year ago came to Imam Khomeini hospital. Physical examination, a painless firm mass was found within year, the parotid and lymph node of the neck concomitantly with no other organs abnormalities. A diagnosis of pleomorphic adenoma was made from completion parotidectomy and cervical lymphadenectomy. No histologic characteristic of malignancy were seen in either specimen; therefore a diagnosis of benign metastasizing mixed tumor was rendered. Discussion Benign metastasizing pleomorphic adenoma is a rare and controversial but distinct clinical entity. Although the definition of the term benign precludes metastatic disease, these tumors do not demonstrate any malignant features yet metastasized to distinct sites. It remains to be determined whether this benign metastasizing pleomorphic adenoma is really low grade salivary malignancy.

  8. Surgical management of spontaneous ruptured hepatocellular adenoma

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    Marcelo Augusto Fontenelle Ribeiro Junior

    2009-01-01

    Full Text Available AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006 with a proven diagnosis of hepatocellular adenoma (HA. Three (10.7% of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation, as well as intraperitoneal abscess (re-operation and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.

  9. Growth hormone receptor expression and function in pituitary adenomas

    DEFF Research Database (Denmark)

    Clausen, Lene R; Kristiansen, Mikkel T; Rasmussen, Lars M

    2004-01-01

    OBJECTIVE AND DESIGN: Hypopituitarism, in particular GH deficiency, is prevalent in patients with clinically nonfunctioning pituitary adenomas (NFPAs) both before and after surgery. The factors regulating the growth of pituitary adenomas in general and residual tumour tissue in particular...

  10. Radiotherapy for pituitary adenomas: an endocrinologist`s perspective

    Energy Technology Data Exchange (ETDEWEB)

    O`Halloran, D.J.; Shalet, S.M. [Christie Hospital and Holt Radium Inst., Manchester (United Kingdom)

    1996-10-01

    A brief review is given of the clinical management of patients with pituitary adenomas such as prolactinomas, adenomasin acromegoly and Leushin`s disease, and non-functioning pituitary adenomas. In particular the complications of radiotherapy are explored. (UK).

  11. Silent Sound Art: Performing the Unheard

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    Flügge, Elen

    2012-10-01

    Full Text Available This article is a reflection on silent sound art, exemplified here by the works of Peter Ablinger and Akio Suzuki, in the context of a partially historical con-sideration of the participatory subject in Installation Art, with a primary focus on artistic movements and selected works from the late 1950s to the early 1970s by John Cage, George Brecht, and La Monte Young.Dieser Beitrag ist eine Reflexion über die so genannte Silent Sound Art. Beispielhaft hierfür sind die Arbeiten von Peter Ablinger und Akio Suzuki, die im Zusammenhang mit einer teilweise historisch hergeleiteten Annahme eines teilnehmenden Subjekts in der Installationskunst interpretiert werden sollen. Hierbei wird der Schwerpunkt auf Kunstbewegungen und ausgewählte Werke aus den späten 1950ern bis in die frühen 1970er gelegt, namentlich von John Cage, George Brecht und La Monte Young.

  12. (Hardly anyone listening? Writing silent geography

    Directory of Open Access Journals (Sweden)

    Bill Boyd

    2013-10-01

    Full Text Available In 1984, J. Douglas Porteous challenged the geography world to silence. True geographical appreciation cannot be expressed in prose; the logical conclusion is for geographers to be silent. Given that they cannot be silent, Porteous advocated nontraditional writing, such as poetry. In 1994, Paul Cloke illustrated the power of reflective narrative for a geographer grappling to understand the world. In 1998, I started writing geographic poetry. In 2012, I draw these strands together in this reflective essay, drawing on a poetic journey over a decade old now. Can I reflect a sense of place or place-making that transcends traditional geographical expression? Did Porteous truly open a geographic window otherwise closed to me? I conclude the poetry does create geographical sense and sensibility, but more as constructed possibilities than as objective realities. The poetry provides glimpses into the experiences of geographical displacement encountered by many New Australians, and thus may best be considered as metageographical expressions.

  13. Silent iritis in treated bacillary negative leprosy.

    Science.gov (United States)

    Thompson, K; Job, C K

    1996-09-01

    Iridectomy specimens from 59 leprosy patients who had adequate medical records of whom 33 belong to the lepromatous (LL) leprosy variety and 16 normal controls were studied histopathologically. All patients were bacteriologically negative and had received dapsone followed by multidrug therapy (MDT), or MDT only, or only dapsone for varying periods. It was found that leprosy, particularly lepromatous disease, did not significantly decrease the age of formation of cataract. Of the 33 LL patients studied 60.6% had silent iritis. The duration of treatment had no obvious influence on the persistence of iritis. Treatment with only 2 years of MDT for LL patients did not significantly increase the prevalence of persistent silent iritis compared to those who received other types of antileprosy therapy for long periods. It is pointed out that chronic iritis is a serious complication that continues even after the patient is declared clinically and bacteriologically cured, especially in patients who had a history of chronic iritis clinically.

  14. Hyalinising trabecular adenoma of the thyroid.

    Directory of Open Access Journals (Sweden)

    Sara NINAN

    2011-12-01

    Full Text Available Hyalinising trebecular adenoma (HTA of the thyroid is rare and controversies remain regarding the diagnosis and management. It is an uncommon benign thyroid tumour that can present as a solitary thyroid nodule, a prominent nodule in a multinodular goitre, or as an incidental finding in a thyroidectomy specimen. Some considered HTA a unique entity, while others have proved it to be a variant of papillary carcinoma or have considered it a nonspecific pattern that may be seen with a variety of thyroid lesions. We report the case of a 31-year-old Chinese lady who presented with four years history of right sided goitre that was gradually increasing in size. Fine needle aspiration cytology showed appearances of follicular adenoma. Intra-operative frozen section histology of the excised right thyroid lobe was reported as trabecular adenoma which was confirmed with histopathological examination.

  15. Advanced methods of treatment of hypophysis adenoma

    Directory of Open Access Journals (Sweden)

    Kan Ya.A.

    2011-03-01

    Full Text Available Hypophysis adenomas are mostly spread in the chiasmatic cellular area. They account 18% of all new brain formations, the structure of pituitary adenomas includes prolactinomas in a large number of cases which are manifested by the syndrome of hyperprolactinemia and hormone inactive hypophysis tumours (35%. Somatotropins (13-15% are lower in frequency, the main clinical feature is acromegalia. One can rarely reveal corticotropins (8-10%, gonadotro-pins (7-9% and thyrotropins (1% and their mixed forms. Transsphenoidal surgical interventions are considered to be methods of choice treatment of hypophysis adenomas and other formations in the chiasmatic cellular area. Alternative methods of treatment are conservative. They can be as an addition to microsurgery (radiotherapy

  16. [Professional confidentiality: speak out or remain silent? ].

    Science.gov (United States)

    Daubigney, Jean-claude

    2014-01-01

    People who work with children, in their daily tasks, must choose whether to disclose information entrusted to them. However, they are subject to the law, which authorises or imposes speaking out or remaining silent. In terms of ethics, they can seek the best possible response while respecting professional secrecy when meeting an individual, in a situation, in a place or at a particular time. They must then take responsibility for that decision.

  17. Case-report: metastasizing pleomorphic adenoma of the parotid gland.

    NARCIS (Netherlands)

    Schroeff, M.P. van der; Ru, J.A. de; Slootweg, P.J.

    2007-01-01

    CASE-REPORT: Metastasizing pleomorphic adenoma of the parotid gland. We present a case of metastasizing pleomorphic adenoma (MPA). The patient died in 2002 at the age of 64 years, following on an initial diagnosis of a pleomorphic adenoma of the right parotid gland at the age of nineteen, multiple l

  18. Relationship Between Histopathology and Clinical Prognosis of Invasive Pituitary Adenoma

    Institute of Scientific and Technical Information of China (English)

    LIYong; SHUKai; DONGFangyong; WANFeng; LEITing; LILing

    2005-01-01

    Objective: To study the relationship between histopathology and clinical prognosis of invasive pituitary adenoma subjected to transsphenoidal surgery. Methods: The enrolled were 82 patients with invasive pituitary adenomas undergoing transsphenoidal surgery during Jan. 2000 May 2003 in our department with full MR imaging findings, pathology data and follow-up information. The follow-up duration was 5-30 months. Results: MR imaging findings of invasive pituitary adenoma included: depression of the sellar floor, involvement of sphenoid sinus and cavernous sinus, breakthrough of diaphragma sellae,encasement of internal carotid artery, etc. Pathological examination revealed that the invasion rate of dura in sella turcica was the highest among the structures around tumor. Pituitary adenoma apoplexy was found in 20 cases (24.4%). The total removal rate for PRL-secreting adenomas was significantly lower than that for non-secreting adenomas (P<0.01), but non-, GH-, ACTH-secreting adenomas had no significant differences. The recurrence rate of PRL-secreting adenornas was higher than that of non- and GH-secreting adenomas (P<0.05). Conclusion: Among invasive pituitary adenomas, the therapeutic effects of nonand GH-secreting pituitary adenomas are better than that of PRL-secreting adenomas. Invasive biological behaviors of invasive pituitary adenomas result in radical operation failure and postoperative recurrence.

  19. Tubulovillous Adenoma in a Urethral Neobladder Anastomosis

    Directory of Open Access Journals (Sweden)

    Bradley A. Morganstern

    2015-11-01

    Full Text Available We present a case of a tubulovillous adenoma arising in a neobladder that was managed by cystoscopic resection. A 64 year-old male underwent a cystectomy with creation of an ileocolic neobladder urinary diversion for T2 urothelial carcinoma of the bladder. Nine years following his surgery, the patient noted several episodes of gross hematuria. Cystoscopic evaluation revealed the rare occurrence of a 3 cm tubulovillous adenoma with high-grade dysplasia at the neck of the neobladder.

  20. Adenoma of anogenital mammary-like glands.

    Science.gov (United States)

    Ahmed, Sartaj; Campbell, Ross M; Li, Jin Hong; Wang, Li Juan; Robinson-Bostom, Leslie

    2007-11-01

    Adenomas in the anogenital region are uncommon. There has been debate about the origin, including ectopic breast tissue, cutaneous apocrine gland, and most recently anogenital mammary-like gland. An anogenital mass in a 36-year-old woman was excised, and histopathologic examination and immunostaining were performed. Microscopic tissue sections showed a morphologic pattern similar to that of a mammary fibroadenoma, and immunostaining demonstrated the presence of estrogen receptors and progesterone receptors. The possibility of adenomas of anogenital mammary-like glands should be considered when evaluating patients with a mass in this area with confirmation by tissue biopsy or aspiration cytology.

  1. Temozolomide and pasireotide treatment for aggressive pituitary adenoma: expertise at a tertiary care center.

    Science.gov (United States)

    Ceccato, Filippo; Lombardi, Giuseppe; Manara, Renzo; Emanuelli, Enzo; Denaro, Luca; Milanese, Laura; Gardiman, Marina Paola; Bertorelle, Roberta; Scanarini, Massimo; D'Avella, Domenico; Occhi, Gianluca; Boscaro, Marco; Zagonel, Vittorina; Scaroni, Carla

    2015-03-01

    Aggressive pituitary adenomas (PAs) are clinically challenging for endocrinologists and neurosurgeons due to their locally invasive nature and resistance to standard treatment (surgery, medical or radiotherapy). Two pituitary-directed drugs have recently been proposed: temozolomide (TMZ) for aggressive PA, and pasireotide for ACTH-secreting PA. We describe the experience of our multidisciplinary team of endocrinologists, neurosurgeons, neuroradiologists, oncologists, otolaryngologists and pathologists with TMZ and pasireotide treatment for aggressive PAs in terms of their radiological shrinkage and genetic features. We considered five patients with aggressive PA, three of them non-secreting (two ACTH-silent and one becoming ACTH secreting), and two secreting (one GH and one ACTH). TMZ was administrated orally at 150-200 mg/m(2) daily for 5 days every 28 days to all 5 patients, and 2 of them also received pasireotide 600-900 µg bid sc. We assessed the MRI at the baseline and during TMZ or pasireotide treatment. We also checked for MGMT promoter methylation and IDH, BRAF and kRAS mutations. Considering TMZ, two patients showed PA progression, one stable disease and two achieved radiological and clinical response. Pasireotide was effective in reducing hypercortisolism and mass volume, combined with TMZ in one case. Both treatments were generally well tolerated; one patient developed a grade 2 TMZ-induced thrombocytopenia. None of patients developed hypopituitarism while taking TMZ or pasireotide treatment. No genetic anomalies were identified in the adenoma tissue. TMZ and pasireotide may be important therapies for aggressive PA, alone or in combination.

  2. Light bodies in human pituitary adenomas

    DEFF Research Database (Denmark)

    Holck, S; Wewer, U M; Albrechtsen, R

    1987-01-01

    Light bodies are large cytoplasmic granules originally described in the gonadotrophic cells of the rat pituitary gland. In order to determine whether similar bodies occur in the human anterior pituitary gland, 89 pituitary adenomas and periadenomatous tissue from 20 cases were examined by transmi......Light bodies are large cytoplasmic granules originally described in the gonadotrophic cells of the rat pituitary gland. In order to determine whether similar bodies occur in the human anterior pituitary gland, 89 pituitary adenomas and periadenomatous tissue from 20 cases were examined...... by transmission electron microscopy. Double membrane bound bodies with filamentous internal structure identical to rodent light bodies were identified in 10 hormone-producing adenomas: 5 PRL, 1 PRL-GH, 2 GH, and 2 ACTH-producing tumours. No light bodies were found in the remaining 79 tumours nor in the pituitary...... cells in periadenomatous tissue from 20 cases. These results show that some human pituitary adenomas may contain light bodies identical to those seen in gonadotrophs of rat pituitary....

  3. Genotype phenotype classification of hepatocellular adenoma

    Institute of Scientific and Technical Information of China (English)

    Paulette Bioulac-Sage; Jean Frédéric Blanc; Sandra Rebouissou; Charles Balabaud; Jessica Zucman-Rossi

    2007-01-01

    Studies that compare tumor genotype with phenotype have provided the basis of a new histological/molecular classification of hepatocellular adenomas. Based on two molecular criteria (presence of a TCF1/HNF1α or β-catenin mutation), and an additional histological criterion (presence or absence of an inflammatory infiltrate), subgroups of hepatocellular adenoma can be defined and distinguished from focal nodular hyperplasia. Analysis of 96 hepatocellular adenomas performed by a French collaborative network showed that they can be divided into four broad subgroups: the first one is defined by the presence of mutations in TCF1 gene inactivating the hepatocyte nuclear factor 1 (HNF1α); the second by the presence of β-catenin activating mutations; the category without mutations of HNF1α or β-catenin is further divided into 2 subgroups depending on the presence or absence of inflammation. Therefore, the approach to the diagnosis of problematic benign hepatocytic nodules may be entering a new era directed by new molecular information. It is hoped that immunohistological tools will improve significantly diagnosis of liver biopsy in our ability to distinguish hepatocellular adenoma from focal nodular hyperplasia (FNH), and to delineate clinically meaningful entities within each group to define the best clinical management. The optimal care of patients with a liver nodule will benefit from the recent knowledge coming from molecular biology and the combined expertise of hepatologists, pathologists, radiologists, and surgeons.

  4. MRI of pituitary adenomas following treatment

    Energy Technology Data Exchange (ETDEWEB)

    Gouliamos, A. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Athanassopoulou, A. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Rologis, D. [Neurosurgical Clinic, Athens General Hospital (Greece); Kalovidouris, A. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Kotoulas, G. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Vlahos, L. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece); Papavassiliou, C. [Dept. of Radiology, CT and MRI Section, Areteion Hospital, Univ. of Athens (Greece)

    1993-10-01

    The purpose of this study was to assess pituitary adenomas following surgical and/or medical treatment in 28 patients. All patients were evaluated with both computed tomography (CT) and magnetic resonance imaging (MRI). The results were correlated with the clinical findings. Apart from the visualization of the adenoma itself (either residual or recurrent) other findings and in particular, morphological changes of the optic chiasm, the pituitary stalk and the sellar floor were evaluated with both imaging modalities. By comparing the two imaging modalities it was found that MRI was superior to CT in demonstrating residual/recurrent adenoma as well as evaluating the morphological changes of the optic chiasm and optic nerves. CT was superior or equal to MR in demonstrating the sellar floor changes. The intra-operatively implanted fat was equally seen by CT and MR. In conclusion, the anatomical variations of the optic chiasm and pituitary stalk are better visualized by MRI and allow a more precise evaluation of changes attributed to surgical or medical treatment of pituitary adenomas. (orig.)

  5. Angioscan exploration of morphology of pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Tabarin, A.; David, J.P.; Drouillard, J. and others

    1987-01-01

    Considerable progress has been made in the morphologic study of pituitary due to the availability of angioscan programs. An exceptional case is presented of a persistent intrasellar trigeminal artery associated with prolactinoma. Based on technological progress in CT scan imaging the place of angiographic explorations in the investigation of pituitary adenoma is reconsidered.

  6. Nephrogenic adenoma. Reports of two cases

    DEFF Research Database (Denmark)

    Osther, P J; Starklint, H

    1989-01-01

    Nephrogenic adenoma is a rare lesion of the urinary tract. Two cases in the urinary bladder are described. Histologically the tumor consists of cystic and tubular structures resembling the distal part of the nephron. The etiology and pathogenesis are discussed and a new etiologic theory...

  7. Application of Silent Way in Foreign Language Teaching

    Institute of Scientific and Technical Information of China (English)

    朱怡宁

    2013-01-01

      The Silent Way (SW) is language teaching method which teacher keeps silent much of the time making students to pro⁃duce the new language. This paper aims to apply SW to English teaching and figure out the idea why Silent Way couldn't be a wide⁃ly-adopted teaching method. In terms of the characteristics of this innovational teaching method, it has some advantages as well as inevitable defects.

  8. Thyroid Adenomas After Solid Cancer in Childhood

    Energy Technology Data Exchange (ETDEWEB)

    Haddy, Nadia; El-Fayech, Chiraz; Guibout, Catherine; Adjadj, Elisabeth [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Thomas-Teinturier, Cecile [Radiation Epidemiology Group, INSERM, Villejuif (France); Hopital Bicetre, Bicetre (France); Oberlin, Odile [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Veres, Cristina [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Pacquement, Helene [Institut Curie, Paris (France); Jackson, Angela [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Munzer, Martine; N' Guyen, Tan Dat [Institut Jean Godinot, Reims (France); Bondiau, Pierre-Yves [Centre Antoine Lacassagne, Nice (France); Berchery, Delphine; Laprie, Anne [Centre Claudius Regaud, Toulouse (France); Bridier, Andre; Lefkopoulos, Dimitri [Institut Gustave Roussy, Villejuif (France); Schlumberger, Martin [Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Rubino, Carole; Diallo, Ibrahima [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France); Vathaire, Florent de, E-mail: florent.devathaire@igr.fr [Radiation Epidemiology Group, INSERM, Villejuif (France); Institut Gustave Roussy, Villejuif (France); Univ. Paris-Sud, Villejuif (France)

    2012-10-01

    Purpose: Very few childhood cancer survivor studies have been devoted to thyroid adenomas. We assessed the role of chemotherapy and the radiation dose to the thyroid in the risk of thyroid adenoma after childhood cancer. Methods and Materials: A cohort of 3254 2-year survivors of a solid childhood cancer treated in 5 French centers before 1986 was established. The dose received by the isthmus and the 2 lobes of the thyroid gland during each course of radiation therapy was estimated after reconstruction of the actual radiation therapy conditions in which each child was treated as well as the dose received at other anatomical sites of interest. Results: After a median follow-up of 25 years, 71 patients had developed a thyroid adenoma. The risk strongly increased with the radiation dose to the thyroid up to a few Gray, plateaued, and declined for high doses. Chemotherapy slightly increased the risk when administered alone but also lowered the slope of the dose-response curve for the radiation dose to the thyroid. Overall, for doses up to a few Gray, the excess relative risk of thyroid adenoma per Gray was 2.8 (90% CI: 1.2-6.9), but it was 5.5 (90% CI: 1.9-25.9) in patients who had not received chemotherapy or who had received only 1 drug, and 1.1 (90% CI: 0.4-3.4) in the children who had received more than 1 drug (P=.06, for the difference). The excess relative risk per Gray was also higher for younger children at the time of radiation therapy than for their older counterparts and was higher before attaining 40 years of age than subsequently. Conclusions: The overall pattern of thyroid adenoma after radiation therapy for a childhood cancer appears to be similar to that observed for thyroid carcinoma.

  9. Silent giant left atrium. A case report.

    Science.gov (United States)

    Badui, E; Delgado, C; Enciso, R; Graef, A; Solorio, S; Madrid, R; Cruz, H

    1995-05-01

    A sixty-two-year-old white woman with a 14.5 cm (145 mm) silent giant left atrial enlargement secondary probably to rheumatic heart disease is presented. Aside from mild progressive shortness of breath during the past year, the patient had been asymptomatic all her life. Her clinical picture was manifested for the first time by syncope secondary to slow atrial fibrillation, for which a permanent pacemaker was required. The correct diagnosis of the enlarged chamber was not possible through the routine chest roentgenogram. In this case, the echocardiogram, nuclear angiogram, and computed tomography were the pertinent studies needed to reach the diagnosis.

  10. Silent ischemia and beta-blockade

    DEFF Research Database (Denmark)

    Egstrup, K

    1991-01-01

    and should also be directed at the other coronary artery risk factors of the patients. The effects of beta-blockers, which reduce the duration and frequency of silent ischemic episodes, is well described. The effect is most pronounced in the morning, when the frequency of ischemia is highest......, and the mechanism of action seems mainly mediated through a reduction in myocardial oxygen demand. beta-Blockers have shown effectiveness in both effort-induced angina and mixed angina, and increased anti-ischemic potency may be achieved by combination therapy with a calcium antagonist. Abrupt withdrawal of beta-blockers...

  11. An introduction to silent speech interfaces

    CERN Document Server

    Freitas, João; Dias, Miguel Sales; Silva, Samuel

    2017-01-01

    This book provides a broad and comprehensive overview of the existing technical approaches in the area of silent speech interfaces (SSI), both in theory and in application. Each technique is described in the context of the human speech production process, allowing the reader to clearly understand the principles behind SSI in general and across different methods. Additionally, the book explores the combined use of different data sources, collected from various sensors, in order to tackle the limitations of simpler SSI approaches, addressing current challenges of this field. The book also provides information about existing SSI applications, resources and a simple tutorial on how to build an SSI.

  12. Silent Localization of Underwater Sensors Using Magnetometers

    Science.gov (United States)

    Callmer, Jonas; Skoglund, Martin; Gustafsson (Eurasipmember), Fredrik

    2010-12-01

    Sensor localization is a central problem for sensor networks. If the sensor positions are uncertain, the target tracking ability of the sensor network is reduced. Sensor localization in underwater environments is traditionally addressed using acoustic range measurements involving known anchor or surface nodes. We explore the usage of triaxial magnetometers and a friendly vessel with known magnetic dipole to silently localize the sensors. The ferromagnetic field created by the dipole is measured by the magnetometers and is used to localize the sensors. The trajectory of the vessel and the sensor positions are estimated simultaneously using an Extended Kalman Filter (EKF). Simulations show that the sensors can be accurately positioned using magnetometers.

  13. Combustion Enhancement with a Silent Discharge Plasma

    Science.gov (United States)

    Rosocha, Louis

    2003-10-01

    It is well known that the application of an external electric field to a flame can affect its propagation speed, stability, and combustion chemistry (Lawton & Weinberg 1969). External electrodes, arc discharges, and plasma jets have been employed to allow combustible gas mixtures to operate outside their flammability limits by gas heating, injection of free radicals, and field-promoted flame stabilization (Yagodnikov & Voronetskii 1994). Other investigators have carried out experiments with silent electrical discharges applied to propagating flames (Inomata et al 1983, Kim et al 2003). These have demonstrated that the flame propagation velocity is actually decreased (combustion retarded) when a silent discharge is applied directly to the flame region, but that the flame propagation velocity is increased (combustion promoted) when a silent discharge is applied to the unburned gas mixture upstream of a flame. Two other recent works have considered the possibility of combustion enhancement in aircraft gas turbine engine combustor mixers by using a plasma-generating fuel nozzle, that employs an electric-arc or microwave plasma generator, to produce dissociated fuel or ionized fuel (Johnson et al 2001); and pulsed corona-enhanced detonation of fuel-air mixtures in jet engines (Wang et al 2003). In contrast to these prior works, we have employed a silent discharge plasma (SDP) reactor to break up large fuel molecules into smaller molecules and create free radicals or other active species in a gas stream before the fuel is mixed with an oxidizer and combusted. In experiments reported here, a cylindrical SDP reactor was used to 'activate' propane before mixing it with air and igniting the combustible gas mixture. With the plasma, the physical appearance of the flame changes and substantial changes in mass spectrometer fragmentation peaks are observed (e.g., propane fragments decrease and water and carbon dioxide increase). This indicates that the combustion process is

  14. Secondary silent sinus syndrome:case report

    Institute of Scientific and Technical Information of China (English)

    王绪锐; 赵小冬

    2004-01-01

    @@ Silent sinus syndrome (SSS) is characterized by spontaneous and progressive unilateral enophthalmos with no other symptoms. Maxillary sinus atelectasis displayed on CT will be helpful for clinical diagnosis. The operation for better maxillary sinus ventilation shows good therapeutic effects and prognosis. In 1964, Montgometry1 described the first case of patient whose enophthalmos was caused by mucocele of the maxillary sinus. Since then, all otolaryngologists have taken more and more attention to this syndrome. And by June 2000, a total of 45 cases had been reported worldwide.

  15. Ectopic Adrenocorticotropic Hormone-Secreting Pituitary Adenomas: An Underestimated Entity.

    Science.gov (United States)

    Knappe, Ulrich J; Jaspers, Christian; Buschsieweke, Desirée; Reinbold, Wolf-Dieter; Alomari, Ali; Saeger, Wolfgang; Ehlenz, Klaus; Mann, W Alexander; Kann, Peter Herbert; Feldkamp, Joachim

    2017-04-01

    The diagnosis of Cushing disease is based on endocrinological pa-rameters, with no single test being specific. In some patients, dynamic thin-slice sellar magnetic resonance imaging fails to detect a pituitary tumor. The purpose of this study is to investigate the role of ectopic pituitary adenoma in this situation. In a retrospective chart review, 5 patients (6%) with ectopic adenomas were identified in 83 consecutive patients undergoing transsphenoidal surgery for adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas by 1 surgeon. In all 5 patients (all female, 32-41 years of age), an exclusively extrasellar ACTH-secreting adenoma was excised. Three adenomas were located in the cavernous sinus, 1 in the sphenoid sinus, and 1 in the ethmoidal cells. Histologically, none of the tumors showed signs of aggressiveness. Three of the 5 adenomas specifically expressed somatostatin receptor 5. In 4 patients with Cushing disease, postoperative remission was obtained, with 1 recurrence after 14 months. In the patient with Nelson syndrome, ACTH decreased from >800 to ectopic adenoma (positive for somatostatin receptor 5) in the ethmoidal cells turned out to be positive on gallium 68 DOTATATE positron emission tomography/computed tomography. The incidence of primarily ectopic ACTH-secreting adenomas in this series was 6%. In cases of negative MRI findings, an ectopic ACTH-secreting adenoma should be taken into account. 68 Ga DOTATATE positron emission tomography/computed tomography may identify ectopic pituitary adenomas. Hypophysectomy should always be avoided in primary surgery for CD.

  16. Diagnostic criteria in invasive pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Moldovan Ioana-Maria

    2016-09-01

    Full Text Available Pituitary adenomas are benign pituitary primary tumors, the most frequent type of tumor in the pituitary fossa. An important part, around 1/3 of the pituitary adenomas manifests an aggressive behavior, growing faster and invading into parasellar areas (cavernous sinus, neural tissues and bones. Objectives: the first aim of this paper is to review the last findings about invasiveness diagnostic criteria, imagistic and biomarkers, which can be used in the classification of pituitary tumors and also to predict the probability of invasiveness, tumor recurrence and suspicion of malignancy. The second aim is to highlight the morphological and clinic types of invasive pituitary adenomas. Materials and methods: we performed a systematic review and analysis of the published articles, searching PubMed between January 1985 and December 2015. There were selected articles published in English, reviews and abstracts. During the advanced search type in PubMed, combinations of the following keywords were used: “pituitary adenoma”, “invasive”, “aggressive”, “biomarkers”, “classification”, “histological subtypes”, ‘”immunohistochemical markers”. Results: 215 articles were selected, regarding diagnostic, prognostic and therapeutic aspects. There were some histological subtypes of pituitary adenomas known as having an aggressive clinical behavior. Several biomarkers were identified as being associated with the invasive feature: proliferation markers (Ki-67 index, number of mitoses, p53 & p27 expression, microvascularization density, telomerase, topoisomerase 2 Alpha, matrix metalloproteinases, protein kinase C, cyclooxygenase-2, E-cadherin, transcription Factors, genetic alterations (PTTG gene, Galectin-3 protein/ LGALS3 gene, apoptosis markers. Based on their invasion and proliferation characteristics, pituitary tumors are proposed to be classified into five grades (1a, 1b, 2a, 2b, 3, the grade 2b tumor with high risk of recurrence

  17. Prevalência de anticorpos para o vírus da Influenza Eqüina, subtipo H3N8, em eqüídeos apreendidos no Estado do Rio de Janeiro

    OpenAIRE

    Oliveira, Gabrielle Sales; Schiavo,Paula Amorim; Mazur, Carlos; Andrade,Cláudio de Moraes

    2005-01-01

    O vírus Influenza A, subtipo H3N8, é o agente etiológico da Influenza Eqüina, responsável por diversas epidemias e endemias respiratórias em nível mundial, inclusive no Estado do Rio de Janeiro, Brasil. O objetivo deste trabalho foi avaliar a importância de eqüídeos errantes, como fontes de infecção do vírus Influenza, subtipo H3N8. A enquete foi realizada a partir da pesquisa de anticorpos específicos para este vírus em 1106 soros analisados através da prova de inibição da hemaglutinação. O ...

  18. Prevalência de anticorpos para o vírus da Influenza Eqüina, subtipo H3N8, em eqüídeos apreendidos no Estado do Rio de Janeiro

    OpenAIRE

    Oliveira,Gabrielle Sales de; Schiavo,Paula Amorim; Mazur,Carlos; Andrade,Cláudio de Moraes

    2005-01-01

    O vírus Influenza A, subtipo H3N8, é o agente etiológico da Influenza Eqüina, responsável por diversas epidemias e endemias respiratórias em nível mundial, inclusive no Estado do Rio de Janeiro, Brasil. O objetivo deste trabalho foi avaliar a importância de eqüídeos errantes, como fontes de infecção do vírus Influenza, subtipo H3N8. A enquete foi realizada a partir da pesquisa de anticorpos específicos para este vírus em 1106 soros analisados através da prova de inibição da hemaglutinação. O ...

  19. Silent Conversations in the Labyrinth of Artistic Research and Practice

    Science.gov (United States)

    Eis, Andrea

    2013-01-01

    This essay explores silent conversations with the past, but also navigates through the labyrinth of artistic process, with its manifold passages of research, chance occurrence and aesthetic experimentation. The double metaphors of silent conversations and labyrinths apply to the essay and the artwork within it, to the research and to the practice.…

  20. Silent Way in a University Setting: An Applied Research Report.

    Science.gov (United States)

    Lantolf, James P.

    1986-01-01

    A study comparing the use of the Silent Way technique in an experimental setting with its use in a real classroom setting suggests that results of experimental research cannot necessarily be transferred directly to the classroom. Student compositions based on ten Silent Way worksheets and an editing task are appended. (MSE)

  1. Silent trade and the supposed continuum between OIE and NIE

    NARCIS (Netherlands)

    Dolfsma, W.A.; Spithovem, A.

    2008-01-01

    New institutional Economics (NIE) claims that Silent Trade exists. Indeed, it would constitute the first step 'as trade moves beyond the border of the village' (North). In this brief article we show both that Silent Trade - trade between parties who have only the most minimal of a shared frame of re

  2. Pleomorphic Adenomas of the Parapharyngeal Space

    Directory of Open Access Journals (Sweden)

    İstemihan Akın

    2014-01-01

    Full Text Available Background. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. Case Presentation. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. Extensive preoperative diagnostic workup was done in order to verify the nature and size of the tumour and the proximity to the large vessels. Review of the literature, clinical features, pathology, radiological findings, and treatment of these tumours are discussed. Conclusion. The excision of the tumor through submandibular transcervical approach, without cutting the mandible, turned out to be a safe and radical approach in all three cases.

  3. Orbital Lymphoma Mimicking Lacrimal Gland Pleomorphic Adenoma

    Directory of Open Access Journals (Sweden)

    Diego Strianese

    2013-09-01

    Full Text Available Purpose: To describe the case of a patient affected by orbital lymphoma mimicking pleomorphic adenoma of the lacrimal gland. Methods: This was a retrospective case report. Results: We present the case of a patient with 15-year history of slowly progressive left proptosis and inferomedial bulbar dislocation who had the presumptive diagnosis of lacrimal gland pleomorphic adenoma based on clinical and radiological features. The patient underwent lateral orbitotomy and lacrimal gland excision. Postoperative histological features were consistent with low-grade B-cell non-Hodgkin lymphoma. Conclusion: The accepted clinico-radiological criteria used for the diagnosis of lacrimal gland fossa lesions might have a certain false-positive rate, even in recent years. The initial surgical approach with the appropriate choice between fine-needle aspiration biopsies, intraoperative biopsies and lacrimal gland excisions might be a challenge.

  4. Metanephric Adenoma: clinical, imaging, and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Torricelli, Fabio Cesar Miranda; Marchini, Giovanni Scala, E-mail: fabio_torri@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Urologica; Campos, Rodrigo Sousa Madeira [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Dept. de Urologia; Gil, Antonio Otero [Instituto Dante Pazanezzi, Sao Paulo, SP (Brazil)

    2011-07-01

    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  5. Temozolomide in aggressive pituitary adenomas and carcinomas

    OpenAIRE

    Leon D. Ortiz; Luis V. Syro; Scheithauer, Bernd W.; Fabio Rotondo; Humberto Uribe; Camilo E Fadul; Eva Horvath; Kalman Kovacs

    2012-01-01

    Temozolomide is an alkylating agent used in the treatment of gliomas and, more recently, aggressive pituitary adenomas and carcinomas. Temozolomide methylates DNA and, thereby, has antitumor effects. O 6-methylguanine-DNA methyltransferase, a DNA repair enzyme, removes the alkylating adducts that are induced by temozolomide, thereby counteracting its effects. A Medline search for all of the available publications regarding the use of temozolomide for the treatment of pituitary tumors was perf...

  6. ROLE OF RADIOFREQUENCY ABLATION IN ADENOMA SEBACEUM

    Directory of Open Access Journals (Sweden)

    Ch. Madh

    2016-03-01

    Full Text Available Adenoma sebaceum, pathognomonic of tuberous sclerosis, are tiny angiofibromas which commonly occur over central part of face. Recurrence after treatment is common and hence a need for inexpensive, safe and efficient treatment is required. Radiofrequency ablation is a safe and an economical procedure and has been known to cause less scarring with good aesthetic results compared to other ablative methods such as electrocautery.

  7. Current practice for diagnosis and management of silent atrial fibrillation

    DEFF Research Database (Denmark)

    Dobreanu, Dan; Svendsen, Jesper Hastrup; Lewalter, Thorsten

    2013-01-01

    Although it is well known that silent atrial fibrillation (AF) is associated with morbidity and mortality rates similar to those of symptomatic AF, no specific strategy for screening and management of this form of AF has been advocated. The purpose of this survey was to identify current practices...... for the diagnosis and management of silent AF. This survey is based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network partners. Responses were received from 33 centres in 16 countries. The preferred screening methods for silent AF in patients with rhythm control...... episode of silent AF was documented, without recommending further investigations. The results of this survey have confirmed that there is currently no consensus regarding the screening and management of patients with silent AF and that clinical practice is not always consistent with the few existing...

  8. Ectopic parathyroid adenoma in the soft palate: a case report.

    Science.gov (United States)

    Chang, Brent A; Sharma, Anil; Anderson, Donald W

    2016-10-18

    Ectopic parathyroid adenomas can occur in numerous anatomic locations. While ectopic parathyroid adenomas can rarely occur in the pharyngeal region, this has not previously been described in the soft palate. We report the first case of ectopic parathyroid adenoma within the soft palate. A 59 year old woman presented with hyperparathyroidism. She remained persistently hyperparathyroid after initial parathyroidectomy. Repeat exploration for a lesion suspicious on PET-CT for an ectopic parathyroid adenoma in the parapharyngeal region was unsuccessful in treating the hyperparathyroidism. An ectopic adenoma in the soft palate was eventually discovered. Removal through a transoral approach was successful in treating the hyperparathyroidism. Ectopic parathyroid adenomas can occur in various anatomical locations that may be missed even with the use of the various imaging modalities. The soft palate should be added to the list of possible ectopic locations high in the neck.

  9. Lymphocitic infundibuloneurohypophysitis mimicking a pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Hubertus Maximilian Mehdorn

    2011-04-01

    Full Text Available A rare case of infundibulo-neurohypophysitis mimicking a pituitary adenoma is presented. A 69-years-old female patient developed polyuria and polydipsia. Laboratory analysis revealed central diabetes insipidus. No hormonal abnormalities. Cranial-magnetic resonance imaging (MRI showed a left sided mass in the adenohypophysis presuming a pituitary adenoma. The mass had contact to both internal carotids. Admission to our department for neurosurgical treatment followed. Ophthalmo - logic examination and neurological examination yielded normal findings. A second MRI focussing on the sellar-region showed a leftsided (T2-MRI.hyperintense, distended adenohypophysis, without contrast enhancement in T1. The stalk appeared thickened. T1- weighted sequences of the neurohypophysis showed loss of signal intensity. We diagnosed an infundibulo-neurohypophysitis and abstai - ned from surgical removal. The patient was discharged under treatment with corticosteroids and desmopressin. Hypophysitis is rare and shows special clinical characteristics. Despite defined radiological features to differentiate between hypophysitis and adenoma the possibility of misdiagnosis, and unnecessary surgical procedures, should always kept in mind.

  10. Bile Duct Adenoma with Oncocytic Features

    Directory of Open Access Journals (Sweden)

    E. J. Johannesen

    2014-01-01

    Full Text Available Bile duct adenomas are benign bile duct proliferations usually encountered as an incidental finding. Oncocytic bile duct neoplasms are rare and the majority are malignant. A 61-year-old male with a diagnosis of colorectal adenocarcinoma was undergoing surgery when a small white nodule was discovered on the surface of the right lobe of his liver. This lesion was composed of cytologically bland cells arranged in tightly packed glands. These cells were immunopositive for cytokeratin 7, negative for Hep Par 1, contained mucin, and had a Ki67 proliferation index of 8%. The morphology, immunophenotype, presence of mucin, and normal appearing bile ducts, as well as the increased Ki67 proliferation rate, were consistent with a bile duct adenoma with oxyphilic (oncocytic change. Oncocytic tumors in the liver are rare; the first described in 1992. Only two bile duct adenomas with oncocytic change have been reported and neither of them had reported mucin production or the presence of normal appearing bile ducts within the lesion.

  11. Nuevos mecanismos involucrados en la patogénesis de adenomas hipofisarios New mechanisms involved in the pathogenesis of pituitary adenomas

    Directory of Open Access Journals (Sweden)

    D. Giacomini

    2003-04-01

    Full Text Available Analizamos molecularmente tumores formados por clones estables de la línea lactosomatotrofa GH3 Smad-4 (transductor de señales de la proteína morfogénica de hueso-4, BMP-4 dominante negativo (Smad-4dn que bloquea el transductor Smad que desarrollan tumores de menor tamaño que los controles en ratones nude, pero que presentaron un crecimiento tardío. Encontramos que en éstos la expresión/control de Smad-4dn se perdió y que sobreexpresan c-Myc. Concordantemente, BMP-4 se sobreexpresa y estimula la expresión de c-Myc en prolactinomas humanos pero no en otros adenomas o en hipófisis normales. Además en células GH3, ICI 182,780 (bloqueante de estrógenos inhibe la estimulación de c-Myc por BMP-4 y el cotratamiento BMP-4/estrógenos posee un efecto aditivo sobre la proliferación celular. Al bloquear BMP-4 con ICI y estrógenos (E2 con Smad-4dn se bloquea significativamente cada efecto estimulatorio sobre la proliferación. A su vez Smad-4 interacciona físicamente con los dos subtipos de receptores de estrógenos, ERa/ERb. Demostramos por primera vez el rol de BMP-4 en la tumorigénesis de prolactinomas, involucrando un crosstalk funcional BMP-4/estrógenos.We studied Smad-4dn tumors generated from lactosomatotrophic GH3 cells stably transfected with a dominant negative form of Smad-4 (a bone morphogenetic protein-4, BMP-4, signal co-transducer which had reduced tumorigenicity in nude mice, but had showed a late increase in tumor size. We found that they had lost in vivo the expression of Smad-4dn and had recovered c-Myc expression. In accordance, BMP-4 is overexpressed and stimulates the expression of c-Myc in human prolactinomas, but not in other human pituitary adenomas or normal pituitary. In adittion ICI 182,780 inhibited BMP-4 stimulated c-Myc expression and BMP-4 and 17b-estradiol in combination had an additive effect on GH3 cell proliferation. Their action was inhibited by blocking BMP-4 with ICI 182,780 or 17b-estradiol with

  12. File list: His.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Dig.10.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.10.AllAg.Intestinal_adenoma.bed ...

  13. File list: His.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Dig.50.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.50.AllAg.Intestinal_adenoma.bed ...

  14. File list: His.Dig.05.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Dig.05.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.05.AllAg.Intestinal_adenoma.bed ...

  15. File list: His.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available His.Dig.20.AllAg.Intestinal_adenoma mm9 Histone Digestive tract Intestinal adenoma ...http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/His.Dig.20.AllAg.Intestinal_adenoma.bed ...

  16. Silent Localization of Underwater Sensors Using Magnetometers

    Directory of Open Access Journals (Sweden)

    Jonas Callmer

    2010-01-01

    Full Text Available Sensor localization is a central problem for sensor networks. If the sensor positions are uncertain, the target tracking ability of the sensor network is reduced. Sensor localization in underwater environments is traditionally addressed using acoustic range measurements involving known anchor or surface nodes. We explore the usage of triaxial magnetometers and a friendly vessel with known magnetic dipole to silently localize the sensors. The ferromagnetic field created by the dipole is measured by the magnetometers and is used to localize the sensors. The trajectory of the vessel and the sensor positions are estimated simultaneously using an Extended Kalman Filter (EKF. Simulations show that the sensors can be accurately positioned using magnetometers.

  17. The silent organizational pathology of insidious intimidation.

    Science.gov (United States)

    Zimmerman, Theresa; Amori, Geri

    2011-01-01

    While organizations are valiantly striving to address acts of disruption among physicians and nurses, a silent and yet equally disruptive pathology is spreading through the veins of the organization. This behavior is found among all ranks and responsibilities, from the C-suite to the housekeeping staff. It occurs daily and is rarely reported. It continues because its nature is such that it is difficult to measure, the victims often feel helpless, and the perpetrators are often those in positions that are not normally perceived to be as essential to the flow of patient care. Nonetheless, this insidious intimidation chills communication, reduces morale, and ultimately harms patients. Organizations that desire a culture of safety and comfort must address this behavior through individual coaching, education of all staff, a willingness to tackle system frustrations that amplify and perpetuate the behavior, and establish processes for dealing fairly and firmly with the behavior.

  18. Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas

    DEFF Research Database (Denmark)

    Erichsen, Rune; Baron, John A; Snover, Dale;

    2014-01-01

    Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas......Risk of colorectal cancer in patients with sessile serrated adenomas/polyps is the same magnitude or even higher than in patients with conventinal adenomas...

  19. Sequels after radiotherapy of adenoma of adenohypophysis. Folgen einer Hypophysenadenombestrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Knuepffer, J.; Helpap, B. (Staedtisches Krankenhaus, Singen (Germany). Inst. fuer Pathologie); Saeger, W. (Marienkrankenhaus, Hamburg (Germany). Abt. fuer Pathologie)

    1991-10-01

    14 years before his death, iridium seeds were implanted in the adenohypophysis of a 69-year-old patient with a STH producing adenoma of the adenohypophysis and acromegaly. 5 years after recurrence, transsphenoidal hypophysectomy was done. The patient died of central dysregulation due to cerebral insults. At autopsy, a recurrence of the undifferentiated acidophilic adenoma was found within the sphenoidal bone corpus. Immunohistochemistry was positive for STH, prolactin, TSH, LH, and FSH. Besides the adenoma, a mucoepidermoid carcinoma was found within the sphenoid cavity. This carcinoma may be a consequence of the radiotherapy of the adenoma of the adenohypophysis. (orig.).

  20. Diagnosis and treatment of pituitary adenomas.

    Science.gov (United States)

    Chanson, P; Salenave, S

    2004-12-01

    Pituitary tumors cause symptoms by secreting hormones (prolactin, PRL, responsible for amenorrhea-galactorrhea in women and decreased libido in men; growth hormone, GH, responsible for acromegaly; adrenocorticotropic hormone, ACTH, responsible for Cushing's syndrome; thyroid-stimulating hormone, TSH, responsible for hyperthyroidism), depressing the secretion of hormones (hypopituitarism), or by mass-related effects (headaches, visual field abnormalities...). All patients with pituitary tumors should be evaluated for gonadal, thyroid and adrenal function as well as PRL and GH secretion. Specific stimulation and suppression tests for pituitary hormones are performed in selected situations for detecting the type of hypersecretion or the response to treatment. Imaging procedures (mainly magnetic resonance imaging, MRI, nowadays) determine the presence, size and extent of the lesion. The classification of pituitary tumors is based on the staining properties of the cell cytoplasm viewed by light microscopy and immunocytochemistry revealing the secretory pattern of the adenoma. Treatment of pituitary adenomas consists of surgery (performed in more than 99% of cases via a transphenoidal route) and radiotherapy, generally fractionated or, in selected cases, using stereotactic techniques such as gamma-knife. The availability of medical treatment (dopamine, DA, agonists, somatostatin analogs, GH-receptor antagonists...) has profoundly modified the indications of radiotherapy, drugs being now generally used as a second-line treatment, after surgery (or even as first-line treatment). Based on the results of the different treatment modalities for each type of pituitary adenoma, recommendations will be proposed. They may be summarized as follows. For treatment of GH-secreting adenomas, trans-sphenoidal surgery is the first-line therapy except when the macroadenoma is giant or if surgery is contra-indicated; postoperative radiation therapy (fractionated, or by gamma-knife) is

  1. DNA aneuploidy in colorectal adenomas: Role in the adenoma-carcinoma sequence Aneuploidía del ADN en adenomas colónicos: Papel en la secuencia adenoma-carcinoma

    Directory of Open Access Journals (Sweden)

    M. Alcántara Torres

    2005-01-01

    Full Text Available Introduction: aneuploidy has been observed in 6-27% of lesions known to be precursors of colorectal cancer, such as adenomas or ulcerative colitis. It has been suggested that aneuploidy may predispose to malignancy in these cases. However, its role in the adenoma-carcinoma sequence has not been definitely established. The objective of this study was to assess the incidence of aneuploidy in colon adenomas, as well as to study its possible role in the adenoma-carcinoma sequence. Material and methods: the study was performed on a series of 57 large bowel adenomas measuring 10 mm or more, collected from 54 consecutive patients. All specimens were obtained either by endoscopic or by surgical resection. There were 49 adenomas with low-grade dysplasia, two with high-grade dysplasia, two intramucous carcinomas, and four microinvasive carcinomas. A flow cytometric DNA analysis was performed in fresh specimens following Vindelov´s method. Results: aneuploid DNA was detected in five out of 49 low-grade dysplasia adenomas (10%, in all four high-grade dysplasia adenomas or intramucous carcinomas (100%, and in three out of four microinvasive carcinomas (75%. The association between aneuploidy and high-grade dysplasia adenomas, intramucous, or microinvasive carcinoma was statistically significant (p Introducción: en patología benigna de intestino grueso precursora del cáncer colorrectal, como adenomas o colitis ulcerosa, se ha observado aneuploidía en el 6-27% de los casos y se ha sugerido que su presencia predispone al desarrollo de malignidad. Sin embargo, su papel en la secuencia adenoma-carcinoma no se ha demostrado de forma concluyente. El objetivo de nuestro trabajo fue valorar la incidencia de aneuploidía en adenomas colónicos, con y sin signos de malignidad, y estudiar su posible papel en la secuencia adenoma-carcinoma. Material y métodos: el estudio se realizó en una serie de 57 adenomas de intestino grueso, de 10 o más mil

  2. Contrast-enhanced ultrasound in diagnosis of gallbladder adenoma

    Institute of Scientific and Technical Information of China (English)

    Hai-Xia Yuan; Jia-Ying Cao; Wen-Tao Kong; Han-Sheng Xia; Xi Wang; Wen-Ping Wang

    2015-01-01

    BACKGROUND:Gallbladder adenoma is a pre-cancerous neoplasm and needs surgical resection. It is dififcult to differ-entiate adenoma from other gallbladder polyps using imaging examinations. The study aimed to illustrate characteristics of contrast-enhanced ultrasound (CEUS) and its diagnostic value in gallbladder adenoma. METHODS:Thirty-seven patients with 39 gallbladder adenoma-toid lesions (maximal diameter≥10 mm and without metastasis) were enrolled in this study. Lesion appearances in conventional ultrasound and CEUS were documented. The imaging features were compared individually among gallbladder cholesterol polyp, gallbladder adenoma and malignant lesion. RESULTS:Adenoma lesions showed iso-echogenicity in ul-trasound, and an eccentric enhancement pattern, "fast-in and synchronous-out" contrast enhancement pattern and homo-geneous at peak-time enhancement in CEUS. The homogenic-ity at peak-time enhancement showed the highest diagnostic ability in differentiating gallbladder adenoma from cholesterol polyps. The sensitivity, speciifcity, positive predictive value, negative predictive value, accuracy and Youden index were 100%, 90.9%, 92.9%, 100%, 95.8% and 0.91, respectively. The characteristic of continuous gallbladder wall shown by CEUS had the highest diagnostic ability in differentiating adenoma from malignant lesion (100%, 86.7%, 86.7%, 100%, 92.9% and 0.87, respectively). The characteristic of the eccentric enhance-ment pattern had the highest diagnostic ability in differenti-ating adenoma from cholesterol polyp and malignant lesion, with corresponding indices of 69.2%, 88.5%, 75.0%, 85.2%, 82.1% and 0.58, respectively. CONCLUSIONS:CEUS is valuable in differentiating gallbladder adenoma from other gallbladder polyps (≥10 mm in diameter). Homogeneous echogenicity on peak-time enhancement, a con-tinuous gallbladder wall, and the eccentric enhancement pat-tern are important indicators of gallbladder adenoma on CEUS.

  3. Silent ischemia and severity of pain in acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F

    1991-01-01

    An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly...... in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may...

  4. Heterogeneity of colorectal adenomas, the serrated adenoma, and implications for screening and surveillance

    Institute of Scientific and Technical Information of China (English)

    Hugh James Freeman

    2008-01-01

    Current algorithms for screening and surveillance for colon cancer are valuable, but may be limited by the underlying nature of the targeted neoplastic lesions. Although part of the success of adenoma removal relates to interruption of so-called "adenoma-carcinoma sequence", an alternate serrated pathway to colon cancer may pose difficulties with the ultimate results achieved by traditional colonoscopic methods. The endpoint carcinoma in this unique pathway may be derived from a dysplastic serrated adenoma. These tend to be located primarily in the right colon, especially in females, and are frequently associated with coexistent colon cancer. Unfortunately, however, there are few, if any, other identifiable risk factors, including age or family history of colon polyps or colon cancer. Moreover, this alternate serrated pathway may itself also be quite biologically heterogeneous as reflected in sessile serrated adenomas (SSA) with virtually exclusive molecular signatures defined by the presence of either BRAF or KRAS mutations. Screening algorithms in the future may need to be modified and individualized, depending on new information that likely will emerge on the natural history of these biologically heterogeneous lesions that differs from traditional adenomatous polyps.

  5. Pleomorphic adenoma of the parotid gland 1985-2010

    DEFF Research Database (Denmark)

    Andreasen, Simon; Therkildsen, Marianne H; Bjørndal, Kristine

    2016-01-01

    one recurrence. An incidence of 4.29/100,000/year was found. The rate of malignant transformation in recurrent pleomorphic adenoma was 3.3%. CONCLUSION: We report an up-to-date assessment of the epidemiology of pleomorphic adenoma. We found an increasing incidence and low recurrence rate compared...

  6. Large Brunner's gland adenoma: Case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Alba Rocco; Pasquale Borriello; Debora Compare; Patrizia De Colibus; Loredana Pica; Alessandro Iacono; Gerardo Nardone

    2006-01-01

    Brunner's gland adenoma (BGA) is a very rare benign tumour of the duodenum, which is usually asymptomatic and discovered incidentally at endoscopy. Occasionally,this lesion may be large, causing upper gastrointestinal haemorrhage or intestinal obstruction. The case had a large Brunner's gland adenoma, presenting melena that was managed by endoscopic excision.

  7. Resection of a large ectopic parathyroid adenoma: A case report

    Directory of Open Access Journals (Sweden)

    Seijiro Sato

    2016-01-01

    Discussion and conclusions: Parathyroid adenomas and parathyroid carcinomas have disparate natural histories, but they can be difficult to differentiate on the basis of preoperative clinical characteristics. We believe that long-term follow-up of these cases is required because there have been few reports on the postoperative natural history of large parathyroid adenomas.

  8. Simple numerical chromosome aberrations in two pituitary adenomas

    DEFF Research Database (Denmark)

    Dietrich, C U; Pandis, N; Bjerre, P

    1993-01-01

    Cytogenetic analysis of short-term cultures of one non-secreting and one prolactin-producing pituitary adenoma revealed simple clonal numerical abnormalities in both tumors. The karyotype of the non-secreting adenoma was 48,XX, +4, +9[42]/49,XX, +4, +9, +20[2]/46,XX[6]. In the prolactin-secreting...

  9. [Colorectal adenomas: postpolypectomy surveillance strategies and chemoprevention].

    Science.gov (United States)

    Castells, Antoni

    2008-10-01

    Colorectal adenomas are the most fully characterized premalignant lesions in the development of colorectal cancer. Consequently, the identification and resolution of these lesions, as well as the follow-up of affected patients, are a priority in the prevention of this neoplasm. The studies presented in the annual meeting of the American Gastroenterological Association 2008 show that the results of current surveillance strategies can be improved with a view to reducing the rate of interval neoplasia. Improvement of these results includes optimization of the endoscopic technique (colonic preparation, cecal intubation, withdrawal time, etc.) as well as the incorporation of new diagnostic methods and the possible administration of chemopreventive drugs.

  10. Expression of Neuropeptide Y in Human Pituitary Adenoma

    Institute of Scientific and Technical Information of China (English)

    Laizhao Chen; Jingjian Ma; Anchao Zheng; Honggang Zheng

    2006-01-01

    OBJECTIVE Neuropeptid e Y (NPY) acts as a neuroendocrine modulator in the anterior pituitary, and NPY mRNA and NPY-immunoreactivity have been detected in normal human anterior pituitaries. However, only a few studies of NPY expression in human pituitary adenomas have been published. Our study was conducted to determine whether or not adenomatous cells express NPY, to investigate the relationship between NPY expression and the subtypes of pituitary adenoma and to explore the clinical significance of NPY.METHODS The study included tissues from 58 patients with pituitary adenomas who underwent surgery because of their clinical diagnosis.Using a highly specific anti-NPY polyclonal antibody, immunohistochemical analysis was performed on the surgically removed pituitary adenomas. Six fresh specimens also were examined using immuno-electron microscopy. NPY was labeled with colloidal gold in order to study the distribution of NPY at the subcellular level.RESULTS The NPY expression level was significantly different among subgroups of pituitary adenomas (P<0.05). NPY was immuno-detected in 58.6% of all adenomas, in 91.7% of gonadotrophic adenomas and in 14.3% of prolactinomas. NPY expression was slightly lower in invasive pituitary adenomas compared to noninvasive adenomas, but the difference was not significant (t=1.81, P>0.05). Of particular interest was the finding that vascular endothelial cells showed positive NPY expression in some pituitary adenomas. Parts of strongly positive tumor cells were seen in channels formed without endothelial cells, but which contained some red blood cells in a formation similar to so-called vasculogenic mimicry. Immuno-electron microscopy demonstrated that 4 of the 6 fresh specimens displayed positive NPY staining with a high density of gold particles located mainly in the secretory granulas. In addition, gold particles were sparsely detected in the rough endoplasmic reticulum and cell matrix.CONCLUSION NPY exists in pituitary adenomas

  11. Complete genome amplification of Equine influenza virus subtype 2 Amplificación del genoma completo del subtipo 2 del virus de la influenza equina

    Directory of Open Access Journals (Sweden)

    G. H. Sguazza

    2009-12-01

    Full Text Available This work reports a method for rapid amplification of the complete genome of equine influenza virus subtype 2 (H3N8. A ThermoScriptTM reverse transcriptase instead of the avian myeloblastosis virus reverse transcriptase or Moloney murine leukemia virus reverse transcriptase was used. This enzyme has demonstrated higher thermal stability and is described as suitable to make long cDNA with a complex secondary structure. The product obtained by this method can be cloned, used in later sequencing reactions or nested-PCR with the purpose of achieving a rapid diagnosis and characterization of the equine influenza virus type A. This detection assay might be a valuable tool for diagnosis and screening of field samples as well as for conducting molecular studies.En este trabajo comunicamos un método rápido que permite la amplificación del genoma completo del subtipo 2 (H3N8 del virus de la influenza equina. Se utilizó la enzima transcriptasa reversa ThermoScriptTM en lugar de la transcriptasa reversa del virus de la mieloblastosis aviar o la transcriptasa reversa del virus de la leucemia murina de Moloney. Esta enzima ha demostrado tener una alta estabilidad térmica y la capacidad de hacer largas copias de ADN con una estructura secundaria compleja. El producto obtenido por esta técnica puede ser clonado y utilizado posteriormente en reacciones de secuenciación o de PCR anidada con la finalidad de lograr un diagnóstico rápido y la caracterización del virus de la influenza equina tipo A. Este ensayo de detección puede llegar a ser una valiosa herramienta para el diagnóstico y el análisis de muestras de campo, así como para la realización de estudios moleculares.

  12. Inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum

    Institute of Scientific and Technical Information of China (English)

    Ji Hoon Kim; Jong-Jae Park; Jung Woo Choi; Yeon Seok Seo; Beom Jae Lee; Jong Fun Yeon; Jae Seon Kim; Kwan Soo Byun; Young-Tae Bak; Insun Kim

    2007-01-01

    Benign neoplasia of the duodenum are very rare.Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern.Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner's glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner's glands has been suggested as a precursor for gastric metaplasia.Therefore, these findings argued that this adenoma arises from Brunner's glands through gastric metaplasia.This is the first case of inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum with gastric metaplasia.

  13. Ectopic pituitary adenoma presenting as midline nasopharyngeal mass.

    LENUS (Irish Health Repository)

    Ali, R

    2012-02-01

    INTRODUCTION: Ectopic pituitary adenomas are extremely rare. We report a case of ectopic pituitary adenoma in the midline of the nasopharynx. This adenoma probably arose from the pharyngeal remnant of Rathke\\'s pouch. METHODS: We discuss a case of a lady who presented to our unit with 2 months history of dryness and sensation of lump in her throat and a long standing history of hypothyroidism. Examination of nasopharynx revealed a smooth and fluctuant midline mass. CT scan of nose and paranasal sinuses confirmed the midline mass with small defect communicating with the sphenoid sinus. An initial diagnosis of Thornwaldt\\'s cyst was made and she underwent upper aerodigestive tract endoscopy and marsupialization of the mass. Histopathological examination revealed ectopic pituitary adenoma. CONCLUSION: Ectopic pituitary adenoma is an important differential diagnosis for a midline nasopharyngeal mass. It is recommended that prior to surgical resection of midline nasopharyngeal mass biopsy is taken and MRI is performed.

  14. [Image-guided endoscopic transsphenoidal removal of pituitary adenoma].

    Science.gov (United States)

    Zhang, Qui-Hang; Liu, Hai-Sheng; Yang, Da-Zhang; Cheng, Jing-Yu

    2005-01-01

    To assess the role of neuronavigation in assisting endoscopic transsphenoidal surgery for pituitary adenomas. Ten endoscopic endonasal transsphenoidal reoperations for pituitary adenomas were selected. Clinical records were reviewed retrospectively. Five of 10 patients had gigantic adenoma, 3 microadenoma, 2 large adenoma. The mean setup time was 5 minutes, and the operative time was 50 minutes in image-guided procedures. In all cases, the system worked well without malfunction. Continuous information regarding instrument location and trajectory was provided to the surgeon. Measurements of intraoperative accuracy in the axial, coronal, and.sagittal planes indicated a mean verified system error of 1.5 mm. for pituitary adenomas. After operation, the symptoms relieved in all patients. Neuronavigation can be applied during endonasal transsphenoidal endoscopic surgery and requires a minimal amount of time. It makes reoperation easier, faster, and safer.

  15. Silent Circulation of Ross River Virus in French Polynesia

    Directory of Open Access Journals (Sweden)

    Maite Aubry

    2015-08-01

    Discussion: Our results support the existence of autochthonous RRV transmission and suggest that this pathogen has silently circulated in French Polynesia. These findings raise the question of possible undetected circulation of RRV in other Pacific Island Countries and Territories.

  16. Silent store detection and recording in memory storage

    Energy Technology Data Exchange (ETDEWEB)

    Bose, Pradip; Cher, Chen-Yong; Nair, Ravi

    2017-03-07

    An aspect includes receiving a write request that includes a memory address and write data. Stored data is read from a memory location at the memory address. Based on determining that the memory location was not previously modified, the stored data is compared to the write data. Based on the stored data matching the write data, the write request is completed without writing the write data to the memory and a corresponding silent store bit, in a silent store bitmap is set. Based on the stored data not matching the write data, the write data is written to the memory location, the silent store bit is reset and a corresponding modified bit is set. At least one of an application and an operating system is provided access to the silent store bitmap.

  17. Silent store detection and recording in memory storage

    Energy Technology Data Exchange (ETDEWEB)

    Bose, Pradip; Cher, Chen-Yong; Nair, Ravi

    2017-03-14

    An aspect includes receiving a write request that includes a memory address and write data. Stored data is read from a memory location at the memory address. Based on determining that the memory location was not previously modified, the stored data is compared to the write data. Based on the stored data matching the write data, the write request is completed without writing the write data to the memory and a corresponding silent store bit, in a silent store bitmap is set. Based on the stored data not matching the write data, the write data is written to the memory location, the silent store bit is reset and a corresponding modified bit is set. At least one of an application and an operating system is provided access to the silent store bitmap.

  18. Silent store detection and recording in memory storage

    Science.gov (United States)

    Bose, Pradip; Cher, Chen-Yong; Nair, Ravi

    2016-09-20

    An aspect includes receiving a write request that includes a memory address and write data. Stored data is read from a memory location at the memory address. Based on determining that the memory location was not previously modified, the stored data is compared to the write data. Based on the stored data matching the write data, the write request is completed without writing the write data to the memory and a corresponding silent store bit, in a silent store bitmap is set. Based on the stored data not matching the write data, the write data is written to the memory location, the silent store bit is reset and a corresponding modified bit is set. At least one of an application and an operating system is provided access to the silent store bitmap.

  19. Using Vocal and Silent Reading Approaches for the Enhancement ...

    African Journals Online (AJOL)

    Nekky Umera

    of teaching reading skills in English Language through the use of vocal and silent reading ... Performance, English Language, Effective Teaching and Learning. Introduction. Language ..... Reflections on Nigeria's literacy culture. The. Guardian ...

  20. [Clinical and roentgenological manifestations of the silent sinus syndrome].

    Science.gov (United States)

    Piskunov, S Z; Piskunov, I S; Zav'ialov, F N; Solodilova, N M

    2011-01-01

    Analysis of the results of the examination and treatment of four patients presenting with the silent sinus syndrome provided materials for the generalized characteristic of clinical and roentgenological manifestations of this condition.

  1. High Pain Tolerance Tied to 'Silent' Heart Attack Risk

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_162666.html High Pain Tolerance Tied to 'Silent' Heart Attack Risk Unusual symptoms ... is. But the new findings suggest that pain tolerance might be a factor. Using a standard test ...

  2. Silent Synapse-Based Circuitry Remodeling in Drug Addiction.

    Science.gov (United States)

    Dong, Yan

    2016-05-01

    Exposure to cocaine, and likely other drugs of abuse, generates α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor-silent glutamatergic synapses in the nucleus accumbens. These immature synaptic contacts evolve after drug withdrawal to redefine the neurocircuital properties. These results raise at least three critical questions: (1) what are the molecular and cellular mechanisms that mediate drug-induced generation of silent synapses; (2) how are neurocircuits remodeled upon generation and evolution of drug-generated silent synapses; and (3) what behavioral consequences are produced by silent synapse-based circuitry remodeling? This short review analyzes related experimental results, and extends them to some speculations. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  3. Cutaneous silent period in myofascial pain syndrome.

    Science.gov (United States)

    Kilinc, Ozden; Sencan, Savas; Ercalik, Tulay; Koytak, Pinar Kahraman; Alibas, Hande; Gunduz, Osman Hakan; Tanridag, Tulin; Uluc, Kayihan

    2017-09-06

    An increased response to painful stimuli without spontaneous pain suggests a role of central hyperexcitability of pain pathways in the pathogenesis of myofascial pain syndrome (MPS). In this study we aimed to test the hypothesis that spinal pain pathways are affected in MPS. We used cutaneous silent period (CSP) parameters to demonstrate the hyperexcitability of spinal pain pathways in MPS. Twenty-nine patients diagnosed with MPS and 30 healthy volunteers were included in the study. The CSP recordings were performed in the right upper and left lower extremities. In both upper and lower extremities, patients had prolonged CSP latencies (P = 0.034 and P = 0.049 respectively) and shortened CSP durations (P = 0.009 and P = 0.008, respectively). Delayed and shortened CSP in MPS patients implies dysfunction in the inhibitory mechanism of the spinal/supraspinal pain pathways, suggesting central sensitization in the pathogenesis of MPS and supporting our research hypothesis. Muscle Nerve, 2017. © 2017 Wiley Periodicals, Inc.

  4. Adenoma incidence decreases under the effect of polypectomy

    Institute of Scientific and Technical Information of China (English)

    Isadora Rosa; Carlos N Leit(a)o; Paulo Fidalgo; José Soares; Susana Vinga; Carla Oliveira; Jo(a)o P Silva; Susana M Ferro; Paula Chaves; António G Oliveira

    2012-01-01

    AIM:To investigate whether,under the influence of polypectomy,the incidence of adenoma decreases with age.METHODS:Consecutive patients with colonic adenomas identified at index colonoscopy were retrospectively selected if they had undergone three or more complete colonoscopies,at least 24 mo apart.Patients who had any first-degree relative with colorectal cancer were excluded.Data regarding number of adenomas at each colonoscopy,their location,size and histological classification were recorded.The monthly incidence density of adenomas after the index examination was estimated for the study population,by using the person-years method.Baseline adenomas were excluded from incidence calculations but their characteristics were correlated with recurrence at follow-up,using the x2 test.RESULTS:One hundred and fifty-six patients were included (109 male,mean age at index colonoscopy 56.8 ± 10.3 years),with follow-up that ranged from 48 to 232 mo.No significant correlations were observed between the number,the presence of villous component,or the size of adenomas at index colonoscopy and the presence of adenomas at subsequent colonoscopies (P =0.49,0.12 and 0.78,respectively).The incidence of colonic adenomas was observed to decay from 1.4%person-months at the beginning of the study to values close to 0%,at 12 years after index colonoscopy.CONCLUSION:Our results suggest the sporadic formation of adenomas occurs within a discrete period and that,when these adenomas are removed,all neoplasia-prone clones may be extinguished.

  5. Coincidence of cerebrovascular accident and silent myocardial infarction.

    Science.gov (United States)

    Badui, E; Estañol, B; Garcia-Rubi, D

    1982-11-01

    Although it is well known that a myocardial and a cerebral infarction may be coincident, the nature of this association is not clear. The problem is further complicated because the myocardial infarction may be silent. This is a report of 3 patients with cerebral infarct in whom a silent recent myocardial infarction was found. All patients with cerebrovascular disease should be screened for a possible myocardial lesion.

  6. Recurrent Silent Thyroiditis as a Sequela of Postpartum Thyroiditis

    OpenAIRE

    Preaw Hanseree; Vincent Bryan Salvador; Issac Sachmechi; Paul Kim

    2014-01-01

    Thyroiditis encompasses a group of disorders characterized by thyroid inflammation. Though clinically indistinguishable from silent thyroiditis, postpartum thyroiditis occurs in women within 12 months after delivery. Recurrent postpartum thyroiditis in subsequent pregnancies is common, but recurrent silent thyroiditis is rare. We reported a case of patient with recurrent episodes of thyroiditis, unrelated to pregnancy, after an episode of postpartum thyroiditis. It is of interest that postpar...

  7. Usefulness of percutaneous transluminal coronary angioplasty in silent myocardial ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Hou, Mami [Toho Univ., Tokyo (Japan). School of Medicine

    1996-04-01

    The usefulness of percutaneous transluminal coronary angioplasty (PTCA) was assessed in patients with exercise-induced asymptomatic myocardial ischemia (silent ischemia) and compared with exercise-induced symptomatic myocardial ischemia (symptomatic ischemia). Patients with single vessel coronary artery disease (51 with angina pectoris, 40 with old myocardial infarction) and evidence of stress-induced ischemia on thallium-201 single photon emission computed tomography (SPECT) underwent successful PTCA. Thirty-seven percent of angina patients and 60% of infarction patients showed asymptomatic exercise-induced ischemia. There was no significant difference in population characteristics between silent and symptomatic patients. Patients with silent angina had significantly higher percentage thallium uptake and washout rate than symptomatic patients. After PTCA, both percentage diameter stenosis and percentage thallium uptake were improved in all patients with angina irrespective of the presence or absence of symptoms. There were no significant differences in percentage thallium uptake and washout rate between patients with silent and symptomatic infarction. After PTCA, percentage diameter stenosis, percentage thallium uptake, and washout rate improved in all infarction patients irrespective of the symptoms. Zero percent of silent angina patients, 12% of symptomatic angina patients, 12% of silent infarction patients, 19% of symptomatic infarction patients had cardiac events during about 4.5 years after PTCA. The incidence of cardiac events did not significantly differ in any patient group. PTCA improved myocardial perfusion in all patients, and the incidence of cardiac events did not differ between the silent and symptomatic groups. Revascularization with PTCA is suitable for patients with silent as well as symptomatic ischemia. (author).

  8. Silent aspiration: results of 2,000 video fluoroscopic evaluations.

    Science.gov (United States)

    Garon, Bernard R; Sierzant, Tess; Ormiston, Charles

    2009-08-01

    The purpose of this retrospective study of aspiration and the lack of a protective cough reflex at the vocal folds (silent aspiration) was to increase the awareness of nursing staffs of the diagnostic pathology groups associated with silent aspiration. Of the 2,000 patients evaluated in this study, 51% aspirated on the video fluoroscopic evaluation. Of the patients who aspirated, 55% had no protective cough reflex (silent aspiration). The diagnostic pathology groups with the highest rates of silent aspiration were brain cancer, brainstem stroke, head-neck cancer, pneumonia, dementia/Alzheimer, chronic obstructive lung disease, seizures, myocardial infarcts, neurodegenerative pathologies, right hemisphere stroke, closed head injury, and left hemisphere stroke. It is of high concern that the diagnostic groups identified in this research as having the highest risk of silent aspiration be viewed as "red-flag" patients by the nursing staff caring for them. Early nursing dysphagia screens, with close attention to the clinical symptoms associated with silent aspiration, and early referral for formal dysphagia evaluation are stressed.

  9. Strategies to Increase Adenoma Detection Rates.

    Science.gov (United States)

    Brand, Eelco C; Wallace, Michael B

    2017-03-01

    The adenoma detection rate (ADR), i.e., the proportion of average risk patients with at least one adenoma detected during screening colonoscopy, is inversely associated with the development of interval colorectal cancer. Increasing the ADR is therefore an important proxy for increase in quality and efficacy of (screening) colonoscopy. Several potentially modifiable factors, such as, procedural and technological factors, and quality improvement programs, and their effect on the ADR will be reviewed. Procedural factors, such as, bowel preparation, withdrawal time, and position changes of the patient are associated with the ADR. While the relation of others, such as inspection during insertion, use of antispasmodic agents, and second inspection in the proximal colon, with the ADR is not completely clear. Many new colonoscopy technologies have been evaluated over recent years and are still under evaluation, but no unequivocal positive effect on the ADR has been observed in randomized trials that have mostly been performed by experienced endoscopists with high baseline ADRs. Several quality improvement programs have been evaluated and seem to have a positive effect on endoscopists' ADR. Increase in ADR is important for the protective benefit of colonoscopy. There are now extensive methods to measure, benchmark, and improve ADR but increased awareness of these is critical. We have provided an overview of potential factors that can be used to increase personal ADRs in every day practice.

  10. Clonal karyotypic abnormalities in colorectal adenomas: clues to the early genetic events in the adenoma-carcinoma sequence

    DEFF Research Database (Denmark)

    Bomme, L; Bardi, G; Pandis, N

    1994-01-01

    Cytogenetic analysis of short-term cultures from colorectal adenomas revealed acquired clonal chromosome aberrations in 14 of 17 tumors. In 4 adenomas, only numerical changes were found, whereas 10 had structural rearrangements. Trisomy 7 was found as the sole change in one of the tumors and toge......Cytogenetic analysis of short-term cultures from colorectal adenomas revealed acquired clonal chromosome aberrations in 14 of 17 tumors. In 4 adenomas, only numerical changes were found, whereas 10 had structural rearrangements. Trisomy 7 was found as the sole change in one of the tumors...... and together with other numerical changes in another. A +7 was also present in one case with structural aberrations. Other recurrent numerical aberrations were -14 and -18, both found in 2 adenomas with structural karyotypic changes; in addition, one chromosome 14 was lost in one of the tumors with only...

  11. [The ECCIS study: the epidemiology and clinical picture of silent ischemic cardiopathy. Epidemiologia e Clinica della Cardiopatia Ischemica Silente].

    Science.gov (United States)

    Fazzini, P F; Prati, P L; Rovelli, F; Antoniucci, D; Menghini, F; Seccareccia, F; Menotti, A

    1994-12-01

    The ECCIS project (Epidemiology and Clinic of Silent Ischemic Heart Disease) is an italian epidemiological study based on a population sample of 4,842 totally asymptomatic men aged 40-59 whose primary aim is the evaluation of the prevalence of totally silent myocardial ischemia and silent myocardial infarction. The systemic search for markers of silent ischemia and infarction was pursued along 3 screening stages: the 1st stage included resting electrocardiogram, hyperventilation test, exercise electrocardiogram and 24-hour Holter electrocardiogram; the 2nd stage included echocardiogram, thallium-201 scintigraphy in conjunction with exercise test or dypiridamole test, exercise radionuclide ventriculography and ergometrine test; the 3rd stage included coronary angiography. After the completion of the 1st stage procedures 439 men (9.1%) with abnormal results and low probability of disease were invited to the 2nd stage and 387 accepted to undergo the diagnostic procedures. After the completion of the 2nd stage, 104 men with moderate or high suspicion of silent myocardial ischemia or infarction were invited to perform coronary angiography but only 62 men accepted to undergo the 3rd stage procedures (participation rate 59.6%). The final diagnosis of totally silent myocardial ischemia or infarction on the basis of predefined criteria was established in 25 patients. The prevalence of silent ischemic heart disease on the overall original 4,842 men was 0.52% (95% CL, 0.32 and 0.72%), while the final estimate after adjusting for participation rates at 2nd and 3rd stages was 0.89% (95% CL, 0.6 and 1.1%). The results of the ECCIS study show that the prevalence of silent myocardial ischemia is definitely lower than that revealed by prior epidemiological studies in Norway and in USA.

  12. Reg Ⅳ, a differentially expressed gene in colorectal adenoma

    Institute of Scientific and Technical Information of China (English)

    张宇伟; 来茂德; 谷雪梅; 罗敏捷; 邵丽娜

    2003-01-01

    ObjectiveTo discover and identify differentially expressed genes associated with colorectal adenoma formation and the role of RegⅣ in colorectal adenoma differentiation.MethodsA subtracted cDNA library was constructed with cDNAs that were isolated from either the normal mucosa or adenoma tissue of a single patient. Suppressive subtractive hybridization (SSH) combined with virtual northern blotting was used to characterize differentially expressed genes and contigs were assembled by electronic cloning (in silico cloning) with the EST database. Semi-quantitative RT-PCR was performed in 9 colorectal adenomas.ResultsThe amino acid sequence was determined with open reading frame (ORF) prediction software and was found to be 100% homologous to the protein product of RegⅣ (a novel gene isolated from a large inflammatory bowel disease library). RegⅣ was found to be highly expressed in all of the adenoma samples (9/9) compared with the normal mucosa samples, while 5/6 cases showed RegⅣ to be more strongly expressed in adenocarcinoma.Conclusion RegⅣ may play an important role in the initiation of colorectal adenoma differentiation, and its detection may be useful in the early diagnosis of colorectal adenoma formation.

  13. Diagnosis and Surgical Treatment of Parathyroid Adenoma (24 Case Report)

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Junchu Zhang; Daqiao Zhu; Zhiqian Hu; Qiang Wang

    2005-01-01

    OBJECTIVE To summarize the experience in diagnosing and treating parathyroid adenoma.METHODS Twenty-four patients were diagnosed with parathyroid adenoma and received parathyroidectomy in our hospital. Sixteen of them presented with hyperparathyroidism. The patients received ultrasounography, CT or 99mTc-MIBI to locate the tumor site. Serum concentrations of PTH and calcium were checked before the operation. All operations were performed under general anesthesia. The adenomas were resected and the four glands explored.RESULTS All of the patients were cured and there was no mortality in our group. The symptoms of hyperparathyroidism remitted to various degrees after the operation. PTH dropped to the normal range 2 days after operation.Serum calcium concentrations declined to different levels from the first day after operation. Seven patients developed hypocalcemia post-operation but recovered by injection of calcium gluconate. Only one of the patients with parathyroid adenoma recurred 2 years after the operation and was found to have malignancy of the parathyroid adenoma.CONCLUSION Not all the patients with parathyroid adenoma had clinical manifestations. The CT and 99mTc-MIBI were more accurate than ultrasounography in locating the adenoma. The four glands should be explored during the operation. Protecting the recurrent laryngeal nerve from being injuried and maintaning secure hemastasis were most important.

  14. Myxoid Adrenocortical Adenoma: Magnetic resonance imaging and pathology correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Un [Dept. of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of); Kim, Suk; Lee, Jun Woo; Lee, Nam Kyung; Ha, Hong Koo; Park, Won Young [Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2014-04-15

    We report a case of a 74-year-old female with myxoid adrenocortical adenoma which showed different magnetic resonance imaging findings compared to those of a typical adrenocortical adenoma. The myxoid change in the adrenocortical adenoma is a rare form of degeneration. It presents a considerable diagnostic challenge to both radiologists and clinicians because it can mimic other adrenal tumor types on imaging. The MRI findings of the presented case included a high signal intensity on T2-weighted images similar to that of fluid and delayed progressive enhancement.

  15. MR of pituitary micro-adenomas; IRM des microadenomes hypophysaires

    Energy Technology Data Exchange (ETDEWEB)

    Le Marec, E.; Ait Ameur, A.; David, H.; Pharaboz, C. [Hopital d`Instruction des Armees Begin, 94 - Saint-Mande (France)

    1997-12-31

    Most of the time, rationales to look for pituitary micro-adenomas are based on endocrinal disorder. MRI is often helpful to confirm diagnosis. It gives information about micro-adenomas size and localisation. If conventional sequence are inadequate, a dynamic sequence has then to be performed after Gadolinium injection. Any disorder observed from the pituitary gland must be correlated with the clinical observation and results from biochemistry analysis. False positive happens quite open because of gland morphological variation, incidentalomas and partial volumes. MRI offers the possibility to follow-up treated micro-adenomas evolution especially to detect recurrence. (author)

  16. Laparoscopic Partial Adrenalectomy for Bilateral Cortisol-secreting Adenomas

    Directory of Open Access Journals (Sweden)

    Jeffrey P. Domino

    2007-04-01

    Full Text Available Bilateral cortisol-secreting adenomas are a rare cause of Cushing's syndrome. We report a case of a 35-year-old woman who presented with ACTH-independent Cushing's syndrome and bilateral adrenal adenomas. Adrenal venous sampling confirmed both adenomas to be hyper-secreting cortisol. She underwent bilateral laparoscopic adrenalectomy; total right and partial left adrenalectomies. At 2-year follow-up, she is maintained on low-dose fludrocortisone and hydrocortisone, and without recurrence of hypercorticolism. Laparoscopic partial adrenalectomy is a feasible option for this rare condition; however, long-term follow-up is needed to determine her total independence from steroid usage.

  17. Follicle stimulating hormone secreting pituitary adenoma: a challenging diagnosis

    Directory of Open Access Journals (Sweden)

    Madhuri Alap Mehendale

    2015-04-01

    Full Text Available FSH secreting pituitary adenomas are relatively uncommon brain tumours and usually non-functioning. But in rare cases they produce ovarian hyperstimulation. We report a case of a 32 year old female P2L2, with amenorrhoea of 1 year, pain in abdomen and galactorrhoea since 6 months. Initially thought to be a simple prolactinoma with multicystic ovaries, but after thorough investigations to our surprise diagnosed to be a rare case of gonadotropin secreting pituitary adenoma. Patient was successfully managed by excision of the pituitary adenoma. [Int J Reprod Contracept Obstet Gynecol 2015; 4(2.000: 493-496

  18. Metaplasia intestinal e carcinoma gástrico: correlação com os subtipos histológicos da neoplasia

    Directory of Open Access Journals (Sweden)

    Rodrigues Luiz Gustavo M.

    2001-01-01

    Full Text Available Introdução: O papel da metaplasia intestinal (MI como lesão pré-cancerosa gástrica não está completamente esclarecido. Objetivos: Analisar a distribuição e o tipo de MI em relação aos tipos de carcinoma gástrico (CG. Material e Método: Analisaram-se 71 peças de gastrectomia por CG. Amostras da neoplasia e da mucosa a intervalos regulares de toda a peça foram processadas rotineiramente; os cortes histológicos foram corados por HE e histoquímica para mucinas. A gastrite crônica atrófica (GCA e a MI foram analisadas quanto a topografia, intensidade e tipo e correlacionadas com o subtipo da neoplasia. Resultados: Diagnosticaram-se 42 (59% CGs do tipo intestinal (CaI, 17 (24% difusos (CaD e 12 (17% não foram classificáveis. A GCA e a MI foram mais intensas no CaI do que no CaD (p = 0,02; p = 0,004. Observaram-se focos de MI dos tipos I, II e III em 21 CaI (50%, enquanto que 5/17 (29% CaD com MI apresentavam focos de MI de tipos I e II. A MI do tipo III foi diagnosticada em 21 CaI (50% e em seis CaD (35% (p = 0,04; nas áreas peritumorais com MI, a do tipo III foi detectada em 13/34 (38% CaI e 3/10 (30% CaD. Houve correlação entre a intensidade da MI e o tipo da lesão (p = 0,005, observando-se MI de tipo III predominantemente quando as lesões eram de intensidade moderada a acentuada. Conclusões: A MI de tipo III pode ser considerada um marcador da intensidade do processo metaplásico. Sua presença em 50% dos CaI limita seu papel como lesão de risco e reforça a hipótese da existência de diversas vias carcinogênicas para o CG.

  19. Sellar lesion: Not always a pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Rao Shalinee

    2008-04-01

    Full Text Available Inflammatory lesions of the hypophysis account for 0.5% of all symptomatic diseases of the pituitary, which include lymphocytic hypophysitis, granulomatous hypophysitis with or without specific etiology and pituitary abscess. Sellar tuberculoma is a rare type of granulomatous hypophysitis. We document a case of a postmenopausal lady who presented with galactorrhea, headache and blurring of vision. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed caseating granulomas, along with normal areas of preserved pituitary gland and a final diagnosis of tuberculous hypophysitis was made. This case is being documented due to the extremely rare involvement of the pituitary gland by granulomatous lesions such as tuberculosis and to emphasize the role of intraoperative consultation to obviate the need for radical surgery in such lesions.

  20. Hiperparatiroidismo primario por adenoma paratiroideo mediastinal

    Directory of Open Access Journals (Sweden)

    Jeffry Solís-Torres

    2015-06-01

    Full Text Available El hiperparatiroidismo primario cursa con un aumento de la secreción de hormona paratiroidea, generalmente debido a un adenoma, e hipercalcemia. Su presentación clásica se diagnostica con la determinación de calcio sérico y de hormona paratiroidea, asociada con estudios de imágenes. Su tratamiento es quirúrgico y tiene altas tasas de éxito. Se analiza el caso de una paciente hipertensa, de 63 años, con historia de pérdida de apetito y debilidad de un año y medio de evolución, por lo que se le realizaron exámenes de laboratorio que revelaron hipercalcemia y elevación de la hormona paratiroidea. Se le indicó entonces una gamagrafía con Tecnecio 99, que evidenció un nódulo de 18mm de diámetro, ubicado 2 centímetros caudal al lóbulo tiroideo derecho. Se le efectuó una exploración cervical sin encontrarse la lesión, por lo que requirió una esternotomía media superior, que permitió encontrar un adenoma en el mediastino superior, detrás de la vena braquiocefálica derecha, de manera que se procedió a su extracción. Los controles de calcio y de hormona paratiroidea a las 24 horas estaban entre los límites normales, y se egresó.

  1. Sex-specific prevalence of adenomas, advanced adenomas, and colorectal cancer in individuals undergoing screening colonoscopy.

    Science.gov (United States)

    Ferlitsch, Monika; Reinhart, Karoline; Pramhas, Sibylle; Wiener, Caspar; Gal, Orsolya; Bannert, Christina; Hassler, Michaela; Kozbial, Karin; Dunkler, Daniela; Trauner, Michael; Weiss, Werner

    2011-09-28

    Although some studies have shown that men are at greater age-specific risk for advanced colorectal neoplasia than women, the age for referring patients to screening colonoscopy is independent of sex and usually recommended to be 50 years. To determine and compare the prevalence and number needed to screen (NNS) for adenomas, advanced adenomas (AAs), and colorectal carcinomas (CRCs) for different age groups in men and women. Cohort study of 44,350 participants in a national screening colonoscopy program over a 4-year period (2007 to 2010) in Austria. Prevalence and NNS of adenomas, AAs, and CRCs in different age groups for men and women. The median ages were 60.7 years (interquartile range [IQR], 54.5-67.5 years) for women and 60.6 years (IQR, 54.3-67.6 years) for men, and the sex ratio was nearly identical (51.0% [22,598] vs 49.0% [21,572]). Adenomas were found in 19.7% of individuals screened (95% CI, 19.3%-20.1%; n = 8743), AAs in 6.3% (95% CI, 6.1%-6.5%; n = 2781), and CRCs in 1.1% (95% CI, 1.0%-1.2%; n = 491); NNS were 5.1 (95% CI, 5.0-5.2), 15.9 (95% CI, 15.4-16.5), and 90.9 (95% CI, 83.3-100.0), respectively. Male sex was significantly associated with a higher prevalence of adenomas (24.9% [95% CI, 24.3%-25.4%] vs 14.8% [95% CI, 14.3%-15.2%]; P prevalence of AAs in 50- to 54-year-old individuals was 5.0% (95% CI, 4.4%-5.6%) in men but 2.9% (95% CI, 2.5%-3.4%) in women (adjusted P = .001); the NNS in men was 20 (95% CI, 17.8-22.6) vs 34 in women (95% CI, 29.1-40; adjusted P = .001). There was no statistical significance between the prevalence and NNS of AAs in men aged 45 to 49 years compared with women aged 55 to 59 years (3.8% [95% CI, 2.3%-6.1%] vs 3.9% [95% CI, 3.3%-4.5%] and 26.1 [95% CI, 16.5-44.4] vs 26 [95% CI, 22.5-30.2]; P = .99). Among a cohort of Austrian individuals undergoing screening colonoscopy, the prevalence and NNS of AAs were comparable between men aged 45 to 49 years and women aged 55 to 59 years.

  2. Coffee intake and the risk of colorectal adenoma: The colorectal adenoma study in Tokyo.

    Science.gov (United States)

    Budhathoki, Sanjeev; Iwasaki, Motoki; Yamaji, Taiki; Sasazuki, Shizuka; Tsugane, Shoichiro

    2015-07-15

    Coffee is a commonly consumed beverage which contains several potential anticarcinogenic and chemopreventive compounds, and has been hypothesized to have protective effects in colorectal neoplasia. However, the limited available data on coffee consumption in relation to colorectal adenoma (CRA), a precursor lesion to most colorectal cancers, remain largely inconsistent. In this study, we evaluated the association of coffee intake with the risk of CRA in a middle-aged Japanese population. Study subjects were selected from examinees who underwent total colonoscopy as part of a cancer screening program and responded to self-administered dietary and lifestyle questionnaires. A total of 738 patients with adenoma and 697 controls were included in the study. Coffee intake was assessed with a food frequency questionnaire, and divided into quartiles based on the distribution among controls. Unconditional logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI) of CRA, with adjustment for potential confounding factors. High coffee consumption was associated with a reduced risk of CRA, with a multivariate-adjusted OR for the highest versus lowest quartile of coffee intake of 0.67 (95% CI = 0.48-0.93; ptrend  = 0.02). The inverse association of coffee intake was limited to proximal (OR = 0.64; 95%CI = 0.44-0.95; ptrend  = 0.04) and distal colon adenoma (OR = 0.62; 95%CI = 0.39-0.99; ptrend  = 0.06), and appeared to be more evident with small (OR = 0.68; 95%CI = 0.49-0.96; ptrend  = 0.04) and single adenomas (OR = 0.65; 95%CI = 0.44-0.95; ptrend  = 0.02). Green tea intake was not found to be associated with CRA risk. This study provides support for the protective effect of coffee drinking on colon adenomas, a precursor of colon cancer.

  3. The Competency of Rational Silent Reading, Its Synthesized Development

    Directory of Open Access Journals (Sweden)

    Vytautas Šernas

    2011-04-01

    Full Text Available The European Board documents [6] approved by the Ministry of Education [7, 8] orient the European countries, teachers to ensure a very good, masterful acquisition of three languages (Vantage B2. This attitude is related to an individual’s acquired level of the rational silent reading. The author has been interested in the problem of rational silent reading for 35 years. In the empirical research and experiments there took part more than 500 pupils, students, teachers, employees of different spheres, secondary schools graduates. From the point of view of rational silent reading Lithuania is significantly lagging behind other countries. There are many reasons for that. In order to highlight them there has been briefly studied the content of the rational silent reading according to B2 level; touched on the most significant dimensions of this competency, reviewed the consistent patterns and content of the teaching and learning process of the rational silent reading as well as the norms of such reading in Lithuanian, English, Russian, French. Some research results are presented. At the end there has been given the whole mosaic of recommendations, based on the research, different glottoeducological, psychological, psycholinguistic, physiological, linguistic, etc literature. The aim of the article is to invite teachers, scientists to participate actively in this problem solution under the new Lithuanian conditions.

  4. Metanephric adenoma: Management in a 7-year-old child

    Directory of Open Access Journals (Sweden)

    Katharine Caldwell

    2015-12-01

    Full Text Available We report the case of a 7-year-old girl in whom a left renal mass was incidentally discovered on computerized tomography (CT scan during evaluation for acute perforated appendicitis. The presence of polycythemia and the radiographic characteristics of the mass suggested a metanephric adenoma but a Wilm's tumor could not be excluded with preoperative studies. Gross inspection and intra-operative ultrasound of the tumor supported the suspicion of a metanephric adenoma and a partial nephrectomy was performed. Frozen section and permanent pathologic analysis confirmed a benign metanephric adenoma. At current date, patient is recovering well and polycythemia has resolved. A review of the management of metanephric adenoma in the child is presented.

  5. Pathobiology and oncogenesis of pituitary corticotroph adenomas in dogs

    NARCIS (Netherlands)

    Hanson, J.M.

    2007-01-01

    Pituitary-dependent hyperadrenocorticism (PDH) or Cushing's disease is a common endocrinopathy in the elderly dog caused by a pituitary adrenocorticotrophic hormone (ACTH) producing tumor (corticotroph adenoma) of unknown pathogenesis. Surgical removal of the pituitary tumor is applied as routine

  6. Coexistent adenocarcinoma and microcystic adenoma of the pancreas.

    Science.gov (United States)

    Posniak, H V; Olson, M C; Demos, T C

    1991-01-01

    A case with coexistent pancreatic adenocarcinoma and microcystic adenoma is presented. These diagnoses were suspected on the basis of their computed tomography (CT) appearances and confirmed with CT-guided fine-needle aspiration.

  7. Silent Revolution in Research for Sustainability

    Directory of Open Access Journals (Sweden)

    Bruce Alder

    2016-06-01

    Full Text Available Is research ‘fit-for-purpose’ for realizing sustainable development? More than two decades after the Brundtland report and UNCED Earth summit, the world has now adopted Sustainable Development Goals(SDGs. Rather than a cause for celebration, this delay should encourage reflection on the role of research in society. Why is it so difficult to realize sustainability in practice? The answer lies in the fact that universities and research centres persist with 19th century methods of data gathering, scholarly analysis, and journal articles. Today’s world needs science in real-time, whether to detect drought, confront Ebola, or assist refugees. Research needs to work faster and embrace 21st century practices including data science, open access, and infographics.A silent revolution is occurring in the ways of organizing and conducting research, enabled by new technology and encouraging work that tackles the key challenges facing society. A variety of new arrangements have come into existence that promote international collaboration, including Horizon 2020 with its emphasis on societal challenges, the Bill & Melinda Gates Foundation which has inspired a family of grand challenges funds on health and development, and the Future Earth joint program of research for global sustainability. These arrangements not only control billions of dollars in research funding, they also influence the strategies of national research councils and international organizations. The result is no less than a transformation in the incentives that reward how researchers invest their time and effort.Why is a revolution needed? Within research, substantial growth in knowledge production coincided with fragmentation among disciplines. One can easily find expertise and publications in soil science or agronomy, yet integrated efforts on food security and climate adaptation remain scarce. Beyond research, society remains largely uninformed, as academics avoid engaging in public

  8. Molecular screening of pituitary adenomas for gene mutations and rearrangements

    Energy Technology Data Exchange (ETDEWEB)

    Herman, V.; Drazin, N.Z.; Gonskey, R.; Melmed, S. (Cedars-Sinai Medical Center, Los Angeles, CA (United States))

    1993-07-01

    Although pituitary tumors arise as benign monoclonal neoplasms, genetic alterations have not readily been identified in these adenomas. The authors studied restriction fragment abnormalities involving the GH gene locus, and mutations in the p53 and H-, K-, and N-ras genes in 22 human GH cell adenomas. Twenty two nonsecretory adenomas were also examined for p53 and ras gene mutations. Seven prolactinoma DNA samples were tested for deletions in the multiple endocrine neoplasia-1 (MEN-1) locus, as well as for rearrangements in the hst gene, a member of the fibroblast growth factor family. In DNA from GH-cell adenomas, identical GH restriction patterns were detected in both pituitary and lymphocyte DNA in all patients and in one patient with a mixed GH-TSH cell adenoma. Using polymerase chain reaction (PCR)-single stranded conformation polymorphism analysis, no mutations were detected in exons 5, 6, 7 and 8 of the p53 gene in GH cell adenomas nor in 22 nonsecretory adenomas. Codons 12/13 and 61 of H-ras, K-ras, and N-ras genes were also intact on GH cell adenomas and in nonsecretory adenomas. Site-specific probes for chromosome 11q13 including, PYGM, D11S146, and INT2 were used in 7 sporadic PRL-secreting adenomas to detect deletions of the MEN-1 locus on chromosome 11. One patient was identified with a loss of 11p, and the remaining 6 patients did not demonstrate loss of heterozygosity in the pituitary 11q13 locus, compared to lymphocyte DNA. None of these patients demonstrated hst gene rearrangements which also maps to this locus. These results show that p53 and ras gene mutations are not common events in the pathogenesis of acromegaly and nonsecretory tumors. Although hst gene rearrangements and deletions of 11q13 are not associated with sporadic PRl-cell adenoma formation, a single patient was detected with a partial loss of chromosome 11, including the putative MEN-1 site. 31 refs., 5 figs., 2 tabs.

  9. Minimally invasive treatment of hepatic adenoma in special cases

    Energy Technology Data Exchange (ETDEWEB)

    Nasser, Felipe; Affonso, Breno Boueri; Galastri, Francisco Leonardo [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Odisio, Bruno Calazans [MD Anderson Cancer Center, Houston (United States); Garcia, Rodrigo Gobbo [Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)

    2013-07-01

    Hepatocellular adenoma is a rare benign tumor that was increasingly diagnosed in the 1980s and 1990s. This increase has been attributed to the widespread use of oral hormonal contraceptives and the broader availability and advances of radiological tests. We report two cases of patients with large hepatic adenomas who were subjected to minimally invasive treatment using arterial embolization. One case underwent elective embolization due to the presence of multiple adenomas and recent bleeding in one of the nodules. The second case was a victim of blunt abdominal trauma with rupture of a hepatic adenoma and clinical signs of hemodynamic shock secondary to intra-abdominal hemorrhage, which required urgent treatment. The development of minimally invasive locoregional treatments, such as arterial embolization, introduced novel approaches for the treatment of individuals with hepatic adenoma. The mortality rate of emergency resection of ruptured hepatic adenomas varies from 5 to 10%, but this rate decreases to 1% when resection is elective. Arterial embolization of hepatic adenomas in the presence of bleeding is a subject of debate. This observation suggests a role for transarterial embolization in the treatment of ruptured and non-ruptured adenomas, which might reduce the indication for surgery in selected cases and decrease morbidity and mortality. Magnetic resonance imaging showed a reduction of the embolized lesions and significant avascular component 30 days after treatment in the two cases in this report. No novel lesions were observed, and a reduction in the embolized lesions was demonstrated upon radiological assessment at a 12-month follow-up examination.

  10. Endoscopic resection of a huge Brunner's gland adenoma

    Institute of Scientific and Technical Information of China (English)

    Binbin ZHANG; Xu REN; Xiufen TANG; Yuxin CHI; Xuesong SHI

    2008-01-01

    Brunner's gland adenoma is a rare tumour of the duodenum, which is usually benign. A 71-year-old woman presenting with epigastric pain, upper gastro-intestinal haemorrhage and melaena was reported in this paper. Upper gastro-intestinal (GI) endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb. Endoscopic polypectomy was successfully performed by clipping and nylon thread without any com-plications. Histological examination revealed a Brunner's gland adenoma.

  11. An unusual presentation of lacrimal gland pleomorphic adenoma

    Directory of Open Access Journals (Sweden)

    Josie Naomi Iyeyasu

    2013-10-01

    Full Text Available Tumors of the lacrimal gland are rare in clinical practice. Among all of them, the most common epithelial tumor is the lacrimal gland pleomorphic adenoma, which is a benign indolent tumor that usually affects adults in the third and fourth decades of life. We present an unusual case of lacrimal gland pleomorphic adenoma. Its management, radiological findings and outcomes are also described, along with a brief review of the literature.

  12. Association between measures of obesity and colorectal adenoma

    Institute of Scientific and Technical Information of China (English)

    KIM You Joung; LEE Kang-moon; CHUNG Woo Chul; PAIK Chang Nyol; JUNG Sung Hoon

    2011-01-01

    Background Few studies have used body mass index (BMI),waist-to-hip ratio (WHR) and waist circumference (WC) at the same time to investigate the association between obesity and colorectal adenoma.This study examined the strength of association between colorectal adenoma and obesity using not only BMI,but also WHR and WC.Methods Subjects of this study included 1322 asymptomatic patients who underwent colonoscopy for cancer screening from January 2006 to June 2008.Anthropometric measurements,blood test results,and a self-administered questionnaire from each subject were analyzed.Results Four hundred and fourteen adenoma cases were identified in 1322 subjects.Using univariate analysis,the prevalence of adenoma was associated with BMI and WHR and was higher among the abdominal obesity group using WC guidelines of the Korean Society for the Study of Obesity,but not using WC guidelines of the International Diabetes Federation.In multiple Logistic regression analysis,general obesity (BMI >25 kg/m2) increased the risk of colorectal adenoma (odds ratio (OR),1.43; 95% confidence interval (CI),1.05-1.94).Also,abdominal obesity by the WC cutoffs and the highest WHR percentile group (WHR >0.95) were significantly associated with adenoma.Among three measures of obesity,however,only BMI had a persistent association with adenoma after adjusting reciprocally for BMI,WC,and WHR (OR,1.30; 95% CI,1.02-1.80; and 1.49; 1.06-2.10,adjusted for WC and WHR,respectively).Conclusion The data suggest that general obesity is associated with an increased risk of colorectal adenoma.

  13. [Aspects of the operative treatment of prostatic adenoma].

    Science.gov (United States)

    Gogichaev, Z Kh; zolotarev, I I

    1977-02-01

    The authors have gained minimum blood losses when suturing with provisional catgut ligature through the urinary bladder bottom between interureteral fold and internal urethral orifice yet before dessection of adenoma surgical capsule and tumor enucleation. Depending on the functional state of the upper urinary tract, the bladder tonus and adenoma size, the method of postoperative drainage of the urinary bladder is selected: cystostomy, microirrigation, active suction, etc.

  14. Silent method for mathematics instruction: An overview of teaching subsets

    Science.gov (United States)

    Sugiman, Apino, Ezi

    2017-05-01

    Generally, teachers use oral communication for teaching mathematics. Taking an opposite perspective, this paper describes how instructional practices for mathematics can be carried out namely a silent method. Silent method uses body language, written, and oral communication for classroom interaction. This research uses a design research approach consisting of four phases: preliminary, prototyping and developing the instruction, and assessment. There are four stages of silent method. The first stage is conditioning stage in which the teacher introduces the method and makes agreement about the `rule of the game'. It is followed by the second one, elaborating stage, where students guess and explore alternative answers. The third stage is developing mathematical thinking by structuring and symbolizing. Finally, the method is ended by reinforcing stage which aims at strengthening and reflecting student's understanding. In this paper, every stage is described on the basis of practical experiences in a real mathematics classroom setting.

  15. Silent Atrial Fibrillation: Definition, Clarification, and Unanswered Issues.

    Science.gov (United States)

    Kennedy, Harold L

    2015-11-01

    Silent or subclinical asymptomatic atrial fibrillation has currently gained wide interest in the epidemiologic, neurologic and cardiovascular communities. The association of brief episodes of paroxysmal atrial fibrillation or surrogate atrial arrhythmias which predict future clinical adverse events have been established. Nevertheless there exists a confounding array of definitions to indicate its presence without discrete indication of which populations should be examined. Moreover the term "atrial fibrillation burden" (AFB) has emerged from such studies with a plethora of descriptions to prognosticate both arrhythmic and clinical adverse events. This presentation suggests clarification of diagnostic definitions associated with silent atrial fibrillation, and a more precise description of AFB. It examines the populations across the current disease and cardiovascular invasive therapeutic spectrum that lead to both silent atrial fibrillation and AFB. It describes the diagnostic methods of arrhythmia detection utilizing the surface ECG, subcutaneous ECG or intra-cardiac devices and their relationship in seeking meaningful arrhythmic markers of silent atrial fibrillation. Whereas a wide range of clinical risk factors of silent atrial fibrillation have been validated in the literature, there is an ongoing search for those arrhythmic risk factors that precisely identify and prognosticate outcome events in diverse populations at risk of atrial fibrillation and its complications. This presentation identifies this chaos, and focuses attention on the issues to be addressed to facilitate descriptive and comparative scientific studies in the future. It is a call to action specifically to the medical arrhythmic community and its specialty societies (i.e., ISHNE, HRS, EHRA) to begin a quest to unravel the arrhythmic quagmire associated with "silent atrial fibrillation."

  16. Hiperparatiroidismo secundario a adenoma paratiroideo mediastinal Hyperparathyroidism due to mediastinal parathyroid adenoma

    Directory of Open Access Journals (Sweden)

    C Agostinis

    2012-03-01

    Full Text Available Las glándulas paratiroides se localizan en el cuello, en la cara posterior de la glándula tiroides. Tienen como función secretar PTH, la cual está regulada por la concentración extracelular de calcio. Se define como hiperparatiroidismo a la producción excesiva de PTH por las glándulas paratiroideas, siendo el 85 % aproximadamente de los casos producto de un adenoma; un 12 % debido a hiperplasia y menos del 1 % por carcinomas. El hiperparatiroidismo primario ectápico se presenta en el 10 % de los pacientes, de los cuales del 1 al 2 % corresponde a la localización mediastinal(1. Presentamos una paciente de 38 años, internada en nuestra institución por hipercalcemia sintomática, comprobándose niveles plasmáticos elevados de PTH. Se le realizá una gammagrafía con tecnecio 99 MIBI que evidenció una imagen hipercaptante a nivel de mediastino anterior. Fue intervenida quirúrgicamente, obteniendo como resultado de la anatomía patolágica un adenoma paratiroideo.The parathyroid glands are located in the neck, on the back of the thyroid gland. Their function is to secrete PTH, which is regulated by extracellular calcium concentration. Hyperparathyroidism is defined as the excessive production of PTH by the parathyroid glands; approximately 85 % of the cases are caused by an adenoma, 12 % due to hyperplasia and less than 1 % by carcinomas. Ectopic Primary hyperparathyroidism occurs in 10 % of the patients, of which from 1 to 2 % are of mediastinal location(1. We report the case of a 38-year-old patient hospitalized in our institution for symptomatic hypercalcemia. During her hospitalization elevated plasma levéis of PTH were found with image MIBI technetium 99 high uptake in the anterior mediastinum. She underwent surgery, and the pathology report showed parathyroid adenoma.

  17. Volumetric Growth Rate of Recurrent Pleomorphic Adenoma.

    Science.gov (United States)

    Naunheim, Molly; Wu, Xin; Ryan, William R; Wang, Steven J; Heaton, Chase M

    2017-07-01

    Surgery for recurrent pleomorphic adenoma (PA) can be challenging and may increase the risk of operative complications, particularly facial nerve weakness. As observation may be a viable alternative to surgery for slow-growing tumors, our objective was to assess the growth rate of recurrent PAs. This study is a case series of patients at our tertiary academic medical center with recurrent PA. Two magnetic resonance images (MRI) were compared; total volume (TV) of recurrent tumor on both studies was calculated to obtain our main outcomes of percent change in TV and tumor growth rate. Fourteen patients with recurrent PA had a median interval time between MRI of 12.8 months. Though growth rates were variable, the median continuous compound growth per year was 10.2%. Notably, 3 patients (21%) had no growth, and 2 patients (14%) had a reduction in TV. The median growth rate for enlarging tumors is estimated at 10.2% per year. Due to variability, tumor growth rate should be estimated on an individual patient basis. For slow-growing tumors, physicians may weigh the risk of this slow growth with the morbidity of reoperation.

  18. Vowel Processing During Silent Reading: Evidence from Eye Movements

    Science.gov (United States)

    Ashby, Jane; Treiman, Rebecca; Kessler, Brett; Rayner, Keith

    2006-01-01

    Two eye movement experiments examined whether skilled readers include vowels in the early phonological representations used in word recognition during silent reading. Target words were presented in sentences preceded by parafoveal previews in which the vowel phoneme was concordant or discordant with the vowel phoneme in the target word. In…

  19. The Effects of Oral and Silent Reading on Reading Comprehension

    Science.gov (United States)

    Schimmel, Naomi; Ness, Molly

    2017-01-01

    This study examined the effects of reading mode (oral and silent) and text genre (narrative and expository) on fourth graders' reading comprehension. While controlling for prior reading ability of 48 participants, we measured comprehension. Using a repeated measured design, data were analyzed using analysis of covariance, paired t-tests, and…

  20. Covert speech behavior during a silent language recitation task.

    Science.gov (United States)

    Livesay, J; Liebke, A; Samaras, M; Stanley, A

    1996-12-01

    This study tested the prediction that covert speech behavior measured electromyographically from the lips is significantly more prominent during a brief silent-language recitation task than a brief nonlanguage visualization task. Subjects were 20 right-handed, adult volunteers who agreed to participate. Subjects were tested in a multiple-baseline reversal design following an ABAB procedure whereby A1 and A2 were 30-sec. rest periods. B1 and B2 were alternatively assigned 30-sec. silent-language recitation and visualization test periods, respectively. Subjects' dorsal lips and nondominant forearm EMG measures were taken during resting baseline and testing conditions. In addition, subjects' skin surface temperature and heartrate were measured during the rest and test conditions. For the silent-language task, subjects were asked to recite 'mentally' the Pledge of Allegiance to the flag. Subjects were instructed to 'imagine seeing' the American flag for the visualization task. Subjects' mean lip EMG activity increased significantly from rest to the silent-language recitation task, while no significant change in mean lip EMG was observed from rest to the visualization condition.

  1. Stress Matters: Effects of Anticipated Lexical Stress on Silent Reading

    Science.gov (United States)

    Breen, Mara; Clifton, Charles, Jr.

    2011-01-01

    This paper presents findings from two eye-tracking studies designed to investigate the role of metrical prosody in silent reading. In Experiment 1, participants read stress-alternating noun-verb or noun-adjective homographs (e.g. "PREsent", "preSENT") embedded in limericks, such that the lexical stress of the homograph, as determined by context,…

  2. An Exploration of Chinese Students Silent - Keeping in English Class

    Institute of Scientific and Technical Information of China (English)

    金璐

    2008-01-01

    This paper aims to analysis causes of Chinese students' silent - keeping as cultural interference, defects of traditional teaching and learning method, and issues involved implications for ESL ( English as a Second Language) teaching in hope to improve the proficiency of English teaching in China.

  3. Determinants of Sir2-Mediated, Silent Chromatin Cohesion.

    Science.gov (United States)

    Chen, Yu-Fan; Chou, Chia-Ching; Gartenberg, Marc R

    2016-08-01

    Cohesin associates with distinct sites on chromosomes to mediate sister chromatid cohesion. Single cohesin complexes are thought to bind by encircling both sister chromatids in a topological embrace. Transcriptionally repressed chromosomal domains in the yeast Saccharomyces cerevisiae represent specialized sites of cohesion where cohesin binds silent chromatin in a Sir2-dependent fashion. In this study, we investigated the molecular basis for Sir2-mediated cohesion. We identified a cluster of charged surface residues of Sir2, collectively termed the EKDK motif, that are required for cohesin function. In addition, we demonstrated that Esc8, a Sir2-interacting factor, is also required for silent chromatin cohesion. Esc8 was previously shown to associate with Isw1, the enzymatic core of ISW1 chromatin remodelers, to form a variant of the ISW1a chromatin remodeling complex. When ESC8 was deleted or the EKDK motif was mutated, cohesin binding at silenced chromatin domains persisted but cohesion of the domains was abolished. The data are not consistent with cohesin embracing both sister chromatids within silent chromatin domains. Transcriptional silencing remains largely intact in strains lacking ESC8 or bearing EKDK mutations, indicating that silencing and cohesion are separable functions of Sir2 and silent chromatin.

  4. Silent, indirect strategic processes in small and medium sized enterprises

    DEFF Research Database (Denmark)

    Larsen, Mette Vinther; Madsen, Charlotte Øland; Rasmussen, Jørgen Gulddahl

    Based on empirical data we in this paper explore day-to-day strategising with an emphasis on phronesis. This way we shed some light on the nearly silent, quiet, indirect strategic change processes as they are practiced and reflected upon by leaders in small companies in their daily practice...

  5. Health Education Films of the Silent Era: A Historical Analysis

    Science.gov (United States)

    Sofalvi, Alan

    2011-01-01

    Films have been used to present health messages throughout the history of the medium. The purpose of this article is to describe pictures from the silent film era that were designed to educate people about health issues. Films still available in at least one format were reviewed. Published reviews were also used to obtain information about these…

  6. Multiple Silent Lacunes Are Associated with Recurrent Ischemic Stroke

    DEFF Research Database (Denmark)

    Andersen, Søren Due; Skjøth, Flemming; Yavarian, Yousef

    2016-01-01

    .16 (0.61-2.22) and 1.51 (0.86-2.66) for cardiovascular events. Conclusions: In this large cohort of patients with incident ischemic stroke and no AF, an increasing number of silent lacunes was associated with increasing incidence rates of ischemic stroke recurrence. In the adjusted Cox proportional...

  7. Health Care and the Silent Language of Vietnamese Immigrant Consumers.

    Science.gov (United States)

    Houston, H. Rika

    2002-01-01

    Investigates the cultural context and the silent language of health care delivery from the perspective of foreign-born, Vietnamese immigrants. Suggests that business communication instructors need to incorporate cultural health beliefs, time orientation, and the expected role of family members in the practice of health care as they prepare…

  8. Beyond Decoding: Phonological Processing during Silent Reading in Beginning Readers

    Science.gov (United States)

    Blythe, Hazel I.; Pagán, Ascensión; Dodd, Megan

    2015-01-01

    In this experiment, the extent to which beginning readers process phonology during lexical identification in silent sentence reading was investigated. The eye movements of children aged seven to nine years and adults were recorded as they read sentences containing either a correctly spelled target word (e.g., girl), a pseudohomophone (e.g., gerl),…

  9. Ketene formation from aliphatic ketones in a silent electrical discharge

    NARCIS (Netherlands)

    Drumpt, J.D. van; Mackor, A.

    1973-01-01

    The title reaction in the plasma of a silent electrical discharge at 40° is described. Acetone, ethyl methyl ketone, diethyl ketone and diisopropyl ketone all give rise to the formation of ketenes. From these ketones not only is the corresponding ketene formed, but the lower ketenes also, presumably

  10. Oral Reading Fluency as a Predictor of Silent Reading Fluency at Secondary and Postsecondary Levels

    Science.gov (United States)

    Seok, Soonhwa; DaCosta, Boaventura

    2014-01-01

    This research investigated oral reading fluency as a predictor of silent reading fluency at the secondary and postsecondary levels. Several measures were used, including the Gray Oral Reading Test, the Test of Silent Word Reading Fluency, the Test of Silent Contextual Reading Fluency, and the Reading Observation Scale. A total of 223 students…

  11. Using Early Silent Film to Teach French: The Language of "Cinema Muet."

    Science.gov (United States)

    Bloom, Michelle E.

    1995-01-01

    Discusses the use of early silent films in second-language classrooms, focusing on the experiences of one instructor in using early French silents in elementary and intermediate French courses. Sample lesson plans and information on the availability of French silents are also provided. (Contains 17 references.) (MDM)

  12. Oral Reading Fluency as a Predictor of Silent Reading Fluency at Secondary and Postsecondary Levels

    Science.gov (United States)

    Seok, Soonhwa; DaCosta, Boaventura

    2014-01-01

    This research investigated oral reading fluency as a predictor of silent reading fluency at the secondary and postsecondary levels. Several measures were used, including the Gray Oral Reading Test, the Test of Silent Word Reading Fluency, the Test of Silent Contextual Reading Fluency, and the Reading Observation Scale. A total of 223 students…

  13. The Spectrum of Hormone Immunoreactivity in Typical and Atypical Pituitary Adenomas

    Directory of Open Access Journals (Sweden)

    Yeşim ERTAN

    2009-09-01

    Full Text Available Objective: We aimed to assess the spectrum of hormone immunoreactivity in our pituitary adenoma cases and discuss the diagnostic parameters of atypical pituitary adenomas.Material and Methods: A total of 166 pituitary adenoma cases diagnosed from 2005 to 2008 in our department were included in the present study. Hematoxylin-eosin stained and immunohistochemistry performed slides (ACTH, PRL, GH, TSH, FSH, LH, Ki-67, and p53 were evaluated. Cases having more than two mitoses on 10 high power fields besides more than 3% Ki-67 index were accepted in the atypical group.Results: Histologically, 159 cases were typical pituitary adenoma and 7 were atypical pituitary adenoma. Of the atypical pituitary adenoma cases, one case was ACTH, one GH and one both GH and prolactin hormone immunoreactive pituitary adenomas. Four cases were hormone immunonegative adenomas. Of the typical pituitary adenoma cases, 39 cases were GH, 19 ACTH, 17 prolactin, 10 FSH, 8 LH and one TSH immunreactive pituitary adenomas. Fourty-seven cases were hormone immunonegative adenomas.Twenty-two of the all pitutary adenoma cases had recurrence. Of these cases, 18 were typical adenoma and four were atypical adenoma.Conclusion: The ratio of prolactin immunoreactive pituitary adenoma cases in the surgical material of neuropathology is decreasing due to medical therapy. Atypical pituitary adenomas are not the sole factor affecting the recurrence mechanism but these tumors have higher recurrence rate compared with typical pituitary adenomas and we think the proliferation index might be the principal approach in the diagnosis of these lesions.

  14. Middle ear adenoma is an amphicrine tumor: why call it adenoma?

    Science.gov (United States)

    Ketabchi, S; Massi, D; Franchi, A; Vannucchi, P; Santucci, M

    2001-01-01

    Middle ear adenoma (MEA) is a rare tumor postulated to take origin from the lining epithelium of the middle ear cavity. The authors report on a case of MEA arising in a 53-year old woman suffering from a sensation of fullness in her left ear, otalgia, and light left-sided hearing loss. Histopathologically, the lesion was composed of cuboidal and polygonal cells displaying a trabecular, tubulo-glandular, and solid pattern of growth. Immunohistochemically, neoplastic cells diffusely stained with anti-vimentin antibodies and were focally positive for chromogranin A, neuron-specific enolase, lysozyme, and cytokeratins AE1/AE3. The majority of tumor cells showed weak and diffuse staining with both anti-PP and anti-ACTH antibodies and intense positivity with anti-glucagon and anti Leu-7 antibodies. Ultrastructural investigation revealed both mucinous-glandular and neuroendocrine differentiation. The authors suggest that the appropriate terminology would be adeno-carcinoid or amphicrine tumor of the middle ear rather than "adenoma," a term that does not reflect its dual nature.

  15. Electromyogram premotion silent period and tension development in human muscle.

    Science.gov (United States)

    Kawahats, K; Miyashita, M

    1983-11-01

    The EMG silent period has been observed frequently just before rapid movement from a slightly sustained contraction of the muscle. Our experiments were designed to show the relation between the tension developed in an intact human muscle and the occurrence of this silent period. Tension in the knee extensor was obtained from the floor reaction force of a living subject in a squatting position on the basis of a lever ratio-joint angle diagram obtained directly from measurements on an isolated knee extensor muscle of a human cadaver. The muscle tension was calculated under the condition that the floor reaction force in the squatting position passed through the anklebone, and decreased from 8.7 to 0.8 kN with an increase in the knee joint angle from 1.13 to 2.74 rad. When the center of pressure was not assumed, the increased knee extensor muscle torque with a decrease in the knee angle was estimated biomechanically from the free body diagram. Consistently, the EMG recordings confirmed an increased muscle activity with a reduction in the joint angle. The premotion silent period for the knee extensors and their antagonist with movement from the squatting position appeared to be limited to a knee joint angle of 2.44 to 3.07 rad, where the requirement for tension in those muscles was low. This silent period could be interpreted as an electromyographic transitional phase attributable to a switching mechanism in central nervous activity. The premotion silent period was most likely to appear prior to a swift, well coordinated movement.

  16. Pediatric adrenocortical neoplasms: can imaging reliably discriminate adenomas from carcinomas?

    Energy Technology Data Exchange (ETDEWEB)

    Flynt, Kelsey A.; Dillman, Jonathan R.; Smith, Ethan A.; Strouse, Peter J. [University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Davenport, Matthew S.; Caoili, Elaine M. [University of Michigan Health System, Division of Abdominal Imaging, Department of Radiology, Ann Arbor, MI (United States); Else, Tobias [University of Michigan Health System, Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Ann Arbor, MI (United States)

    2015-08-15

    There is a paucity of literature describing and comparing the imaging features of adrenocortical adenomas and carcinomas in children and adolescents. To document the CT and MRI features of adrenocortical neoplasms in a pediatric population and to determine whether imaging findings (other than metastatic disease) can distinguish adenomas from carcinomas. We searched institutional medical records to identify pediatric patients with adrenocortical neoplasms. Pre-treatment CT and MRI examinations were reviewed by two radiologists in consensus, and pertinent imaging findings were documented. We also recorded relevant histopathological, demographic, clinical follow-up and survival data. We used the Student's t-test and Wilcoxon rank sum test to compare parametric and nonparametric continuous data, and the Fisher exact test to compare proportions. We used receiver operating characteristic (ROC) curve analyses to evaluate the diagnostic performances of tumor diameter and volume for discriminating carcinoma from adenoma. A P-value ≤0.05 was considered statistically significant. Among the adrenocortical lesions, 9 were adenomas, 15 were carcinomas, and 1 was of uncertain malignant potential. There were no differences in mean age, gender or sidedness between adenomas and carcinomas. Carcinomas were significantly larger than adenomas based on mean estimated volume (581 ml, range 16-2,101 vs. 54 ml, range 3-197 ml; P-value = 0.003; ROC area under the curve = 0.92) and mean maximum transverse plane diameter (9.9 cm, range 3.0-14.9 vs. 4.4 cm, range 1.9-8.2 cm; P-value = 0.0001; ROC area under the curve = 0.92). Carcinomas also were more heterogeneous than adenomas on post-contrast imaging (13/14 vs. 2/9; odds ratio [OR] = 45.5; P-value = 0.001). Six of 13 carcinomas and 1 of 8 adenomas contained calcification at CT (OR = 6.0; P-value = 0.17). Seven of 15 children with carcinomas exhibited metastatic disease at diagnosis, and three had inferior vena cava invasion. Median

  17. Signaling pathway networks mined from human pituitary adenoma proteomics data

    Directory of Open Access Journals (Sweden)

    Zhan Xianquan

    2010-04-01

    Full Text Available Abstract Background We obtained a series of pituitary adenoma proteomic expression data, including protein-mapping data (111 proteins, comparative proteomic data (56 differentially expressed proteins, and nitroproteomic data (17 nitroproteins. There is a pressing need to clarify the significant signaling pathway networks that derive from those proteins in order to clarify and to better understand the molecular basis of pituitary adenoma pathogenesis and to discover biomarkers. Here, we describe the significant signaling pathway networks that were mined from human pituitary adenoma proteomic data with the Ingenuity pathway analysis system. Methods The Ingenuity pathway analysis system was used to analyze signal pathway networks and canonical pathways from protein-mapping data, comparative proteomic data, adenoma nitroproteomic data, and control nitroproteomic data. A Fisher's exact test was used to test the statistical significance with a significance level of 0.05. Statistical significant results were rationalized within the pituitary adenoma biological system with literature-based bioinformatics analyses. Results For the protein-mapping data, the top pathway networks were related to cancer, cell death, and lipid metabolism; the top canonical toxicity pathways included acute-phase response, oxidative-stress response, oxidative stress, and cell-cycle G2/M transition regulation. For the comparative proteomic data, top pathway networks were related to cancer, endocrine system development and function, and lipid metabolism; the top canonical toxicity pathways included mitochondrial dysfunction, oxidative phosphorylation, oxidative-stress response, and ERK/MAPK signaling. The nitroproteomic data from a pituitary adenoma were related to cancer, cell death, lipid metabolism, and reproductive system disease, and the top canonical toxicity pathways mainly related to p38 MAPK signaling and cell-cycle G2/M transition regulation. Nitroproteins from a

  18. Severe hyponatremia after transsphenoidal surgery for pituitary adenomas.

    Science.gov (United States)

    Boehnert, M; Hensen, J; Henig, A; Fahlbusch, R; Gross, P; Buchfelder, M

    1998-02-01

    Severe hyponatremia has been described after elective surgery with subsequent permanent brain damage. Other authors, however, have noted that morbidity and mortality rates of severe hyponatremia have been greatly overestimated. We retrospectively examined 19 patients (8 male, 11 female) who developed severe hyponatremia (100 to 124 mmol/liter) after transsphenoidal surgery for pituitary adenomas. Eight patients had hormonally inactive adenomas, 5 ACTH-secreting adenomas, 2 GH-secreting adenomas and 4 prolactin-secreting adenomas. The mean age of the patients was 47.5 years, with a range from 16 to 71 years. The mean preoperative serum sodium level was 137.8 mmol/liter. The timing of hyponatremia showed two different patterns. Five patients developed early postoperative hyponatremia (mean 114.0 mmol/liter +/- 4.85) and 14 patients showed the lowest mean serum level one week after surgery (118.1 mmol/liter +/- 6.86). Patients with early hyponatremia had fewer and less severe symptoms than patients with delayed hyponatremia. None of the patients developed seizures or a demyelination syndrome. Despite severe degree of hyponatremia for most of our patients treatment with water restriction and oral sodium supplementation was sufficient.

  19. Myoepithelial carcinoma arising in recurrent pleomorphic adenoma in maxillary sinus.

    Science.gov (United States)

    Gupta, Ashumi; Manipadam, Marie Therese; Michael, Rajiv

    2013-09-01

    Myoepithelial carcinoma is characterized by nearly exclusive myoepithelial differentiation and evidence of malignancy. It may arise de novo or in preexisting benign tumors including pleomorphic adenoma and benign myoepithelioma. A 39-year-old lady presented with painless progressive swelling on the right cheek and right side of palate. On surgery, there was a mass in right maxillary sinus which was surgically excised and diagnosed on histopathology as pleomorphic adenoma. Subsequently, there were two recurrences. The first recurrence was in the right maxilla after 2 years that was removed surgically and diagnosed as pleomorphic adenoma. One year later, she came with rapidly progressive swelling in bilateral cheeks and face. Intraoperatively, there was a large tumor in both maxillary sinuses with extensive local infiltration. Histologically, it was diagnosed as myoepithelial carcinoma. Carcinoma ex pleomorphic adenoma is usually a high grade malignancy. It occurs most commonly in parotid gland followed by submandibular glands, minor salivary glands and occasionally in sublingual gland. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the maxillary sinus.

  20. Cushing-type ectopic pituitary adenoma with unusual pathologic features

    Directory of Open Access Journals (Sweden)

    Kristopher T. Kimmell, MD

    2014-06-01

    Full Text Available Ectopic pituitary adenomas comprise, by varying reports, approximately 1-2% of all pituitary adenomas. They are often located in the nasopharyngeal region associated with the pharyngeal pituitary. The location and pathologic features of these masses make them atypical when compared with intrasellar pituitary adenomas. A 54-year-old man presented with vertebral compression fracture and physical stigmata of Cushing’s disease. Biochemical testing confirmed hypercortisolemia responsive to high dose dexamethasone suppression. MRI of the head demonstrated an enhancing mass in the posterior aspect of the sphenoid sinus not involving the sella turcica. Endoscopic biopsy followed by resection confirmed this mass to be a pituitary adenoma with unusual pathologic features. Most notably, the tumor cells demonstrated large, eosinophilic, vacuolated cytoplasm. Immunohistochemical profile of the tumor was typical of an ACTH secreting tumor, notably with positivity for ACTH. The patient did well from his surgery. Post-operatively his serum cortisol level normalized and he remains in chemical remission one year after surgery. Ectopic pituitary adenomas are an unusual manifestation of hormonally active pituitary neoplastic disease. Their atypical clinical presentations, location, and pathologic features can make them a diagnostic challenge. Clinicians should be aware of these entities, especially when considering differential diagnosis for a mass in the sphenoid sinus and nasopharyngeal region.

  1. Chondroid chordoma of the sella turcica mimicking a pituitary adenoma.

    Science.gov (United States)

    Wu, Arthur W; Bhuta, Sunita; Salamon, Noriko; Martin, Neil; Wang, Marilene B

    2015-01-01

    We report an unusual case of a chondroid chordoma of the sella turcica that mimicked the clinical and radiologic presentation of the more common pituitary adenoma. A 50-year-old man presented with bitemporal visual field deficits. Magnetic resonance imaging (MRI) detected a sellar mass that was suggestive of a pituitary adenoma. However, the intraoperative appearance of the mass was not consistent with an adenoma, and frozen-section pathology was obtained. Pathology identified the mass as a malignant lesion. Based on this finding, the mass was treated more aggressively. Chondroid chordomas are rare and slowly growing but locally aggressive tumors. The prognosis depends on the ability to totally resect the mass, so differentiating this tumor from a benign lesion is critical. An intrasellar chordoma can be confused clinically and radiologically with a pituitary adenoma. These two lesions are nearly identical on MRI, although T2-weighted imaging sometimes demonstrates higher intensity with a chondroid chordoma. Computed tomography may be helpful in demonstrating bony destruction by these lesions, as can the presence of intralesional calcifications. Intraoperative findings of bony invasion or a purple-red color may also lead the surgeon to suspect a diagnosis other than pituitary adenoma.

  2. Carcinoma medular de tiroides metastásico en mama en una paciente con diagnóstico clínico de neoplasia endocrina múltiple subtipo 2B: reporte de un caso

    OpenAIRE

    D’Angelo Piaggio, Lorenzo; Echecopar Sabogal, José; Chanamé Baca, Diego M.; Teruya Gibu, Alberto

    2016-01-01

    El carcinoma medular de tiroides (CMT) es un tipo de neoplasia maligna infrecuente, con alto índice metastásico. Se presenta como un solo nódulo en más del 70% de los casos, y los principales órganos de metástasis a distancia son el hígado, el pulmón y el hueso. La metástasis en mama es rara, debido a que dentro de los tumores mamarios, solo entre el 0.2-1.3% son secundarios. El CMT se relaciona íntimamente con la neoplasia endocrina múltiple subtipo 2B (NEM2B), la cual es un desorden autosóm...

  3. HIV-1 subtypes and mutations associated to antiretroviral drug resistance in human isolates from Central Brazil Subtipos e mutações associadas à resistência aos anti-retrovirais em isolados de HIV-1 do Distrito Federal

    Directory of Open Access Journals (Sweden)

    Daniela Marreco Cerqueira

    2004-09-01

    Full Text Available The detection of polymorphisms associated to HIV-1 drug-resistance and genetic subtypes is important for the control and treatment of HIV-1 disease. Drug pressure selects resistant variants that carry mutations in the viral reverse transcriptase (RT and protease (PR genes. For a contribution to the public health authorities in planning the availability of therapeutic treatment, we therefore described the genetic variability, the prevalence of mutations associated to drug resistance and the antiretroviral resistance profile in HIV-1 isolates from infected individuals in Central Brazil. Nineteen HIV-1 RNA samples from a Public Health Laboratory of the Federal District were reversely transcribed and cDNAs were amplified by nested PCR. One fragment of 297 bp coding the entire protease gene, and another of 647 bp, corresponding to the partial RT gene (codons 19-234, were obtained. Automated sequencing and BLAST analysis revealed the presence of 17 B and 2 F1 HIV-1 subtypes. The amino acid sequences were analyzed for the presence of resistance-associated mutations. A total of 6 PR mutations, 2 major and 4 accessory, and 8 RT mutations related to drug resistance were found. Our data suggest a high prevalence of HIV-1 B subtype in the studied population of Federal District as well as the presence of genetically-resistant strains in individuals failing treatment.A detecção de polimorfismos do HIV-1 que estejam associados à resistência às drogas anti-retrovirais e aos subtipos genéticos é importante para o controle e tratamento da infecção pelo HIV-1. A pressão exercida pela terapia anti-retroviral seleciona variantes resistentes com mutações nos genes virais da transcriptase reversa (RT e da protease (PR. Assim, visando contribuir com as autoridades de saúde pública na perspectiva de planejar a disponibilidade de um tratamento terapêutico, nós descrevemos a variabilidade genética e a prevalência de mutações associadas à resist

  4. Pictures of focal nodular hyperplasia and hepatocellular adenomas

    Institute of Scientific and Technical Information of China (English)

    Christine; Sempoux; Charles; Balabaud; Paulette; Bioulac-Sage

    2014-01-01

    This practical atlas aims to help liver and non liver pa-thologists to recognize benign hepatocellular nodules on resected specimen. Macroscopic and microscopic views together with immunohistochemical stains illustrate typical and atypical aspects of focal nodular hyperplasia and of hepatocellular adenoma, including hepatocel-lular adenomas subtypes with references to clinical and imaging data. Each step is important to make a correct diagnosis. The specimen including the nodule and the non-tumoral liver should be sliced, photographed and all different looking areas adequately sampled for par-affin inclusion. Routine histology includes HE, trichrome and cytokeratin 7. Immunohistochemistry includes glu-tamine synthase and according to the above results ad-ditional markers such as liver fatty acid binding protein, C reactive protein and beta catenin may be realized to differentiate focal nodular hyperplasia from hepatocel-lular adenoma subtypes. Clues for differential diagnosis and pitfalls are explained and illustrated.

  5. Water-Clear Cell Adenoma of the Mediastinal Parathyroid Gland.

    Science.gov (United States)

    Arik, Deniz; Dündar, Emine; Yilmaz, Evrim; Sivrikoz, Cumhur

    2017-10-06

    Water-clear cell adenoma of the parathyroid gland is a rare neoplasm that consists of cells with abundant clear-pink cytoplasm. There have only been 19 cases reported in the English literature. Here we report a case of water-clear cell adenoma of the mediastinal parathyroid gland. A 70-year-old male patient presented to the hospital with back pain and a mediastinal mass 6 cm in size was detected. After excision and microscopic evaluation, uniform, large clear cells with fine cytoplasmic vacuolization, without nuclear atypia, and arranged in solid and acinar patterns were revealed. The cells formed nests that were separated by fine fibrovascular septae and stained positively with anti-parathyroid hormone. To the best of our knowledge, this has not been previously reported in this location. In the differential diagnosis of clear cell lesions of the mediastinum, water-clear cell parathyroid adenoma should be considered.

  6. Immunohistochemical study of basal cell adenoma in the parotid gland.

    Science.gov (United States)

    Hamano, H; Abiko, Y; Hashimoto, S; Inoue, T; Shimono, M; Takagi, T; Noma, H

    1990-02-01

    Basal cell adenoma of the parotid gland was studied with immunohistochemical methods. We observed cells in the tumor with positive reaction to polyclonal keratin, prekeratin, monoclonal PKK-1, polyclonal S-100 protein, monoclonal S-100 protein (alpha), secretory component, actin and laminin. However, no cells which stained positively with monoclonal KL-1, amylase, carcinoembryonic antigen, or epithelial membrane antigen were recognized. From these immunohistochemical results and our ultrastructural observations reported previously, we conclude that the cells constituting the basal cell adenoma are ductal, myoepithelial, and squamous cells but not secretory ones. It is also suggested that the origins of basal cell ademona as well as those of pleomorphic and clear cell adenoma are undifferentiated cells of intercalated duct.

  7. Tubulovillous adenoma of anal canal: A case report

    Institute of Scientific and Technical Information of China (English)

    Bhupinder S Anand; Gordana Verstovsek; George Cole

    2006-01-01

    Tumors arising from the anal canal are usually of epithelial origin and are mostly squamous cell carcinoma or basal cell carcinoma. We present a case of benign anal adenomas arising from the anus, an extremely rare diagnosis. A 78-year-old white man presented with rectal bleeding of several months duration. Examination revealed a 4 cm friable mass attached to the anus by a stalk. At surgery, the mass was grasped with a Babcock forceps and was resected using electrocautery.Microscopic examination revealed a tubulovillus adenoma with no areas of high grade dysplasia or malignant transformation. The squamocolumnar junction was visible at the edges of the lesion confirming the anal origin of the tumor. We believe the tubulovillus adenoma arose from either an anal gland or its duct that opens into the anus. Although seen rarely, it is important to recognize and treat these tumors at an early stage because of their potential to transform into adenocarcinoma.

  8. Parathyroid Adenoma Presenting as a Brown Tumour of the Mandible

    Directory of Open Access Journals (Sweden)

    Kavit Amin

    2012-01-01

    Full Text Available Background. Parathyroid adenoma is the commonest cause of primary hypercalcaemia and usually presents with symptoms/signs of hypercalcaemia. This paper highlights an unusual presentation. Case Report. A 27-year-old female presented with a painful left mandibular swelling, suspicious of neoplasia. A computed tomography (CT guided biopsy was performed. Based on the histology result, serum calcium was carried out, confirming hypercalcaemia. A left inferior parathyroid adenoma was subsequently removed. CT mandible showed extensive erosive lesions at the left 2nd/3rd inferior molar roots with protrusion to adjacent soft tissues. USS revealed a hypoechoic lesion on the left inferior parathyroid gland. Sestamibi scan showed a focus of MIBI uptake and retention at the inferior aspect of the left thyroid lobe. Conclusion. This case highlights the importance of a thorough history and examination. Clinicians should always bear in mind atypical presentations of parathyroid adenomas, with the need to exclude this differential in the presence of hypercalcaemia.

  9. Coexisting intracranial tumors with pituitary adenomas: Genetic association or coincidence?

    Directory of Open Access Journals (Sweden)

    Furtado Sunil

    2010-01-01

    Full Text Available The co-occurrence of two or more brain tumors with different histological features is rare. The authors report three rare cases of intracranial tumors associated with pituitary adenomas. Two of the pituitary tumors were functioning adenomas: a prolactinoma and a thyrotropin secreting adenoma. Two of the associated intracranial neoplasms were gliomas and one was a meningioma. Radiological and clinical examination for syndromal association was negative in all cases. We briefly discuss the presentation and treatment options of these cases and review the 19 previous publications in the literature of pituitary tumors occurring in association with other neoplasms and explore the possible links underlying these co-occurring neoplasms. Our three cases represent 0.86% of all pituitary tumors operated at our institute over a 9-year period.

  10. Immunohistochemistery Study in a Case of Nephrogenic Adenoma of Bladder

    Directory of Open Access Journals (Sweden)

    Akbar Safaei

    2012-06-01

    Full Text Available Nephrogenic adenoma is a rare benign lesion of bladder that may be confused with malignant lesions. There is a strong relation with urinary tract irritation and intravesicle instrumentations. Nephrogenic adenoma was initially thought to originate from urothelial metaplasia; however, no solid proof is available. We present a case of 55-year-old lady with urinary problem. Cystocopic examination showed a sessile mass, and biopsy revealed circumscribed proliferation of tubules, cysts, and papillae that were lined by low cuboidal to columnar epithelial cells. Nephrogenic adenoma can be a significant diagnostic pitfall due to the presence of certain histological features such as the presence of enlarged nuclei with prominent nucleoli. Immunohistochemistery study was strongly positive for CK7, P504S, CD10, and EMA, but negative for CK20, PSA, and P63.

  11. Immunohistochemistery study in a case of nephrogenic adenoma of bladder.

    Science.gov (United States)

    Safaei, Akbar; Farzaneh, Mohamad Reza; Amin Sharifi, Ali Reza

    2012-06-01

    Nephrogenic adenoma is a rare benign lesion of bladder that may be confused with malignant lesions. There is a strong relation with urinary tract irritation and intravesicle instrumentations. Nephrogenic adenoma was initially thought to originate from urothelial metaplasia; however, no solid proof is available. We present a case of 55-year-old lady with urinary problem. Cystocopic examination showed a sessile mass, and biopsy revealed circumscribed proliferation of tubules, cysts, and papillae that were lined by low cuboidal to columnar epithelial cells. Nephrogenic adenoma can be a significant diagnostic pitfall due to the presence of certain histological features such as the presence of enlarged nuclei with prominent nucleoli. Immunohistochemistery study was strongly positive for CK7, P504S, CD10, and EMA, but negative for CK20, PSA, and P63.

  12. Matrix metalloproteinase-13 expression in the progression of colorectal adenoma to carcinoma : Matrix metalloproteinase-13 expression in the colorectal adenoma and carcinoma.

    Science.gov (United States)

    Foda, Abd Al-Rahman Mohammad; El-Hawary, Amira K; Abdel-Aziz, Azza

    2014-06-01

    Most colorectal carcinomas (CRCs) are considered to arise from conventional adenoma based on the concept of the adenoma-carcinoma sequence. Matrix metalloproteinases (MMPs) are known to be overexpressed as normal mucosa progresses to adenomas and carcinomas. There has been little previous investigation about MMP-13 expression in adenoma-carcinoma sequence. In this study, we aimed to investigate the immunohistochemical expression of MMP-13 in colorectal adenoma and CRC specimens using tissue microarray (TMA) technique. A total of 40 cases of CRC associated with adenoma were collected from files of the Pathology laboratory at Mansoura Gastroenterology Center between January 2007 and January 2012. Sections from TMA blocks were prepared and stained for MMP-13. Immunoreactivity to MMP-13 staining was localized to the cytoplasm of mildly, moderately, and severely dysplatic cells of adenomas and CRC tumor cells that were either homogenous or heterogeneous. There was no significant difference in MMP-13 expression between adenomas and CRCs either non-mucinous or mucinous. Adenomas with high MMP-13 expression were significantly associated with moderate to marked degree of inflammatory cellular infiltrate and presence of familial adenomatous polyps. In conclusion, MMP-13 may be a potential biological marker of early tumorigenesis in the adenoma-carcinoma sequence.

  13. Familial isolated pituitary adenomas (FIPA) and the pituitary adenoma predisposition due to mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene.

    Science.gov (United States)

    Beckers, Albert; Aaltonen, Lauri A; Daly, Adrian F; Karhu, Auli

    2013-04-01

    Pituitary adenomas are one of the most frequent intracranial tumors and occur with a prevalence of approximately 1:1000 in the developed world. Pituitary adenomas have a serious disease burden, and their management involves neurosurgery, biological therapies, and radiotherapy. Early diagnosis of pituitary tumors while they are smaller may help increase cure rates. Few genetic predictors of pituitary adenoma development exist. Recent years have seen two separate, complimentary advances in inherited pituitary tumor research. The clinical condition of familial isolated pituitary adenomas (FIPA) has been described, which encompasses the familial occurrence of isolated pituitary adenomas outside of the setting of syndromic conditions like multiple endocrine neoplasia type 1 and Carney complex. FIPA families comprise approximately 2% of pituitary adenomas and represent a clinical entity with homogeneous or heterogeneous pituitary adenoma types occurring within the same kindred. The aryl hydrocarbon receptor interacting protein (AIP) gene has been identified as causing a pituitary adenoma predisposition of variable penetrance that accounts for 20% of FIPA families. Germline AIP mutations have been shown to associate with the occurrence of large pituitary adenomas that occur at a young age, predominantly in children/adolescents and young adults. AIP mutations are usually associated with somatotropinomas, but prolactinomas, nonfunctioning pituitary adenomas, Cushing disease, and other infrequent clinical adenoma types can also occur. Gigantism is a particular feature of AIP mutations and occurs in more than one third of affected somatotropinoma patients. Study of pituitary adenoma patients with AIP mutations has demonstrated that these cases raise clinical challenges to successful treatment. Extensive research on the biology of AIP and new advances in mouse Aip knockout models demonstrate multiple pathways by which AIP may contribute to tumorigenesis. This review assesses

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  9. [Mediastinal parathyroid adenomas on a 5th ectopic gland. 2 case reports].

    Science.gov (United States)

    Emy, P; Combe, H; Marchand, J P; Villeneuve, A; Sicre, G; Chadenas, D

    1992-11-01

    Mediastinal parathyroid adenoma located on the 5th ectopic gland is rare. We report here two new cases diagnosed by scintigraphy. In one case the adenoma was found to be located in the mediastinum prior to cervicotomy. The modern imaging methods capable of locating parathyroid adenomas are evaluated.

  10. File list: NoD.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  11. File list: Unc.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  12. File list: ALL.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  13. File list: NoD.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  14. File list: Pol.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  15. File list: DNS.Dig.50.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  16. File list: InP.Dig.20.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  18. File list: Oth.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

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  19. File list: DNS.Dig.10.AllAg.Intestinal_adenoma [Chip-atlas[Archive

    Lifescience Database Archive (English)

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  20. Análisis de un registro de adenomas pituitarios Analysis of a pituitary adenoma registry

    Directory of Open Access Journals (Sweden)

    Carolina Albiero

    2010-10-01

    Full Text Available Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66% y 174 varones (34%, de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en 176, enfermedad de Cushing en 153, prolactinoma en 101 y adenoma clínicamente no-funcionante (ANF en 89. La edad media al momento del diagnóstico de acromegalia fue 43.9 ± 13.5 (16-80, para enfermedad de Cushing 35.7 ± 12.9 (14-72, para prolactinomas 30.0 ± 13.4 (15-79 y para ANF 52.1 ± 15.2 (17-79 años. La creación de un registro institucional de tumores de hipófisis es un instrumento de gran utilidad para el análisis de la experiencia adquirida y constituye una herramienta valiosa para mejorar la estrategia terapéutica, optimizar la relación costo/beneficio y mejorar el cuidado del paciente. Contribuye a la docencia médica, tanto en el pre como en el posgrado y da base a la realización de trabajos de investigación clínica, aportando a la difusión y transferencia de conocimientos.Collection and analysis of data obtained during the clinical treatment of pituitary tumours are of great utility in the decision making process, when facing clinical situations. We report here data on 519 from 670 patients with pituitary adenomas obtained from a computerized registry. Three hundred and forty five were females (66% and 174 males (34%, aged 14-80. Final diagnosis was acromegaly in 176, Cushing's disease in 153, prolactinoma in 101 and clinically non-functioning adenoma in 89. Mean age at diagnosis was 43.9 ± 13.5 (16-80 for acromegalics, 35.7 ± 12.9 (14-72 for Cushing's, 30.0 ± 13.4 (15-79 for prolactinoma and 52.1 ± 15.2 (17-79, for non

  1. How can gynaecologists cope with the silent killer – osteoporosis?

    Directory of Open Access Journals (Sweden)

    Marian Szamatowicz

    2017-02-01

    Full Text Available Osteoporosis is a very common disease among women. It is frequently called a silent epidemic and, due to its impact on osteoporotic fractures with high morbidity and mortality, also a silent killer. There are a number of significant risk factors for osteoporosis, some of them very strongly related to the functioning of the reproductive system. These include menstrual irregularities, premature ovarian failure, early natural or surgical menopause, a high number of pregnancies, and long-term breast-feeding. Hence, there is every reason to include gynaecologists in the multidisciplinary team striving to cope with this dreadful disease. Calculation of the 10-year fracture risk, done by means of the FRAX calculator, and classification of women according to the level of risk could prove to be an effective method of limiting the negative effects of osteoporosis.

  2. Clinically silent seizures in a neonate with tuberous sclerosis.

    Science.gov (United States)

    Ikeno, Mitsuru; Okumura, Akihisa; Abe, Shinpei; Igarashi, Ayuko; Hisata, Ken; Shoji, Hiromichi; Shimizu, Toshiaki

    2016-01-01

    Although seizures during infancy in patients with tuberous sclerosis complex are common, seizures in neonates are infrequent. Here, we report the clinical course and electroencephalography (EEG) findings of a neonate with tuberous sclerosis complex associated with clinically silent seizures. The patient was a girl in whom cardiac tumors were detected on fetal ultrasonography. Brain magnetic resonance imaging during the neonatal period showed subependymal and cortical tubers. Routine EEG indicated unexpected ictal changes with no noticeable clinical symptoms. Ictal EEG was associated with a subtle increase in heart rate and a brief increase in chin electromyogram. These changes were difficult to identify clinically. The patient later developed focal seizures and epileptic spasms and had severe psychomotor delay. The present case suggests the occurrence of clinically silent seizures before the appearance of epileptic spasms in infants with tuberous sclerosis, and that EEG is an option for neonates with a prenatal diagnosis. © 2015 Japan Pediatric Society.

  3. Inner speech during silent reading reflects the reader's regional accent.

    Directory of Open Access Journals (Sweden)

    Ruth Filik

    Full Text Available While reading silently, we often have the subjective experience of inner speech. However, there is currently little evidence regarding whether this inner voice resembles our own voice while we are speaking out loud. To investigate this issue, we compared reading behaviour of Northern and Southern English participants who have differing pronunciations for words like 'glass', in which the vowel duration is short in a Northern accent and long in a Southern accent. Participants' eye movements were monitored while they silently read limericks in which the end words of the first two lines (e.g., glass/class would be pronounced differently by Northern and Southern participants. The final word of the limerick (e.g., mass/sparse then either did or did not rhyme, depending on the reader's accent. Results showed disruption to eye movement behaviour when the final word did not rhyme, determined by the reader's accent, suggesting that inner speech resembles our own voice.

  4. How can gynaecologists cope with the silent killer – osteoporosis?

    Science.gov (United States)

    2017-01-01

    Osteoporosis is a very common disease among women. It is frequently called a silent epidemic and, due to its impact on osteoporotic fractures with high morbidity and mortality, also a silent killer. There are a number of significant risk factors for osteoporosis, some of them very strongly related to the functioning of the reproductive system. These include menstrual irregularities, premature ovarian failure, early natural or surgical menopause, a high number of pregnancies, and long-term breast-feeding. Hence, there is every reason to include gynaecologists in the multidisciplinary team striving to cope with this dreadful disease. Calculation of the 10-year fracture risk, done by means of the FRAX calculator, and classification of women according to the level of risk could prove to be an effective method of limiting the negative effects of osteoporosis.

  5. GIVE VOICES TO SILENT LEARNERS IN SPEAKING CLASS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    It is commonly experienced by teachers that they meet silent learners in speaking class,especiallyin an EFL setting at the tertiary level in China.This paper attempts to diagnose the problems inthe current curriculum,curriculum materials and teaching methods used to teach the productiveskill of speaking,which are supposed to be the direct cause of students in"losing their voices",Itbegins with a brief description of the teaching and learning situation in a teachers’ college which isalso typical at other tertiary levels as well.Concrete examples of modification to the teaching ofthe skill are provided with the hope to give back"voices"to the silent students in speaking class.

  6. Identification of novel silent HIV propagation routes in Pakistan

    OpenAIRE

    Saeed, Umar; Waheed, Yasir; Manzoor, Sobia; ASHRAF, Muhammad

    2013-01-01

    Human immunodeficiency virus (HIV) is rapidly increasing in both high risk groups and the general population. In this study, silent routes of propagation in teenaged Pakistanis are discussed. In order to promote sexual activity in youths, regular clients write contact details of sex workers on the doors of public washrooms. HIV prevalence is much higher among Hijra sex workers. Hijra sex workers have apparently stepped into the profession of begging at public places, where they earn money by ...

  7. Music for Silent Films: 1894-1929. A Guide.

    Science.gov (United States)

    Anderson, Gillian B., Comp.

    This book is a guide for locating scores and musical cue sheets made for films of the silent era, 1894-1929. All entries are for the microfilmed items found in the Library of Congress and the Museum of Modern Art music collections. The format for each main entry includes: (1) entry number; (2) film title; (3) title as transcribed from title page;…

  8. Silent intravascular lymphoma initially manifesting as a unilateral adrenal incidentaloma.

    Science.gov (United States)

    Takahashi, Yoshiko; Iida, Keiji; Hino, Yasuhisa; Ohara, Takeshi; Kurahashi, Toshifumi; Tashiro, Takashi; Chihara, Kazuo

    2012-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that the enlargement of both adrenal glands can be followed.

  9. Singularities in Silent Universes State of the Art

    CERN Document Server

    Bruni, M; Uggla, C

    1996-01-01

    After a brief overview of the so-called silent models and their present status, we consider the subclass of Bianchi Type--I models with a magnetic field source. Due to the presence of the magnetic field, the initial singularity shows ``oscillatory'' features reminiscent of the Bianchi Type--IX case. The Bianchi Type--I models with a magnetic field are therefore a counterexample to the folklore that matter fields can be neglected in the vicinity of the singularity.

  10. Assessing reading fluency in Kenya: Oral or silent assessment?

    Science.gov (United States)

    Piper, Benjamin; Zuilkowski, Stephanie Simmons

    2015-04-01

    In recent years, the Education for All movement has focused more intensely on the quality of education, rather than simply provision. Many recent and current education quality interventions focus on literacy, which is the core skill required for further academic success. Despite this focus on the quality of literacy instruction in developing countries, little rigorous research has been conducted on critical issues of assessment. This analysis, which uses data from the Primary Math and Reading Initiative (PRIMR) in Kenya, aims to begin filling this gap by addressing a key assessment issue - should literacy assessments in Kenya be administered orally or silently? The authors compared second-grade students' scores on oral and silent reading tasks of the Early Grade Reading Assessment (EGRA) in Kiswahili and English, and found no statistically significant differences in either language. They did, however, find oral reading rates to be more strongly related to reading comprehension scores. Oral assessment has another benefit for programme evaluators - it allows for the collection of data on student errors, and therefore the calculation of words read correctly per minute, as opposed to simply words read per minute. The authors therefore recommend that, in Kenya and in similar contexts, student reading fluency be assessed via oral rather than silent assessment.

  11. Features of owl wings that promote silent flight.

    Science.gov (United States)

    Wagner, Hermann; Weger, Matthias; Klaas, Michael; Schröder, Wolfgang

    2017-02-06

    Owls are an order of birds of prey that are known for the development of a silent flight. We review here the morphological adaptations of owls leading to silent flight and discuss also aerodynamic properties of owl wings. We start with early observations (until 2005), and then turn to recent advances. The large wings of these birds, resulting in low wing loading and a low aspect ratio, contribute to noise reduction by allowing slow flight. The serrations on the leading edge of the wing and the velvet-like surface have an effect on noise reduction and also lead to an improvement of aerodynamic performance. The fringes at the inner feather vanes reduce noise by gliding into the grooves at the lower wing surface that are formed by barb shafts. The fringed trailing edge of the wing has been shown to reduce trailing edge noise. These adaptations to silent flight have been an inspiration for biologists and engineers for the development of devices with reduced noise production. Today several biomimetic applications such as a serrated pantograph or a fringed ventilator are available. Finally, we discuss unresolved questions and possible future directions.

  12. Prevalence of silent gastrointestinal complications in maintenance renal transplant population

    Directory of Open Access Journals (Sweden)

    Teplitsky Susan

    2010-01-01

    Full Text Available This study aims to determine the prevalence of silent GI complications within a stable renal transplant population and to investigate whether the conversion to enteric-coated myco-phenolate sodium (EC-MPS, Myfortic; would improve symptom scores. This was a single-center, open-label, non-randomized, prospective study. Patients without any history of GI com-plaints were evaluated by means of the gastrointestinal symptom rating scale (GSRS, with subse-quent switch to EC-MPS in a group of patients. Silent complications were defined as patients who voiced no GI complaints at clinic visits despite a score of ≥ 2 on GSRS scale. A total of 236 stable patients participated in the trial. The prevalence of baseline scores ≥ 2 was relatively high with abdominal pain 29.66%, reflux 37.28%, indigestion 50%, constipation 58.47% and diarrhea 33.4%. Of 236 patients, 80 were converted to EC-MPS. There was statistically significant improvement on all scales in the subgroup of patients with GSRS score ≥ 2 (P< 0.05. In conclusion, the GSRS scale identified a high percentage of silent gastrointestinal complications in this renal transplant population. The converted patients with higher GSRS scores reported a sustained improvement.

  13. IN VITRO CELL CULTURE AND HORMONE RADIOIMMUNOASSAY OF HUAMAN PITUITARY ADENOMAS

    Institute of Scientific and Technical Information of China (English)

    陆汉魁; 林祥通; 等

    1994-01-01

    Tissues from 30 human pituitary adenomas are monolayer-cell-cultured in vitro.Hormone secretion of GH,PRL,TSH,LH and FSH by cells into medium is detected by radioimmunoassay .The pattern and amount of hormone(s0 in the medium are used to determine the nature of the cells and thus to establish functional classification of pituitary adenomas.The results show that cell culture technique provides and easy and suitable mode for investigating the nature of pituitary adenomas.Hormone radioimmunoassay of culture medium is precise and reliable and represents the whole adenoma tissue.Further studies can lead to clearer understandngs of the pathology of pituitary adenomas.

  14. Sensitive detection of a small parathyroid adenoma using fluorocholine PET/CT: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Padinhare-Keloth, Thanseer N. T. K.; Bhadada, Sanjay K.; Sood, Ashwani; Kumar, Rajender; Behera, Arunanshu; Radotra, Bishan D.; Mittal, Bhagwant R. [PGIMER, Chandigarh (India)

    2017-06-15

    Primary hyperparathyroidism is caused by parathyroid adenoma in the majority of cases and diagnosis is usually made biochemically. Pre-surgical localization of parathyroid adenoma is essential to limit the extent of surgery and avoid missing them at ectopic sites. Anatomical and functional imaging are used for the localization, but may fail to identify the small and ectopic parathyroid adenoma. We present a case of small sized ectopic parathyroid adenoma at unusual location detected by F-18 fluorocholine (FCH) PET/CT, where other imaging modalities failed. The post-operative histopathology confirmed the diagnosis of ectopic parathyroid adenoma.

  15. Cyclooxygenase-2 overexpression is common in serrated and non-serrated colorectal adenoma, but uncommon in hyperplastic polyp and sessile serrated polyp/adenoma

    Directory of Open Access Journals (Sweden)

    Kirkner Gregory J

    2008-01-01

    Full Text Available Abstract Background Cyclooxygenase-2 (COX-2, PTGS2 plays an important role in colorectal carcinogenesis. COX-2 overexpression in colorectal cancer is inversely associated with microsatellite instability (MSI and the CpG island methylator phenotype (CIMP. Evidence suggests that MSI/CIMP+ colorectal cancer may arise through the serrated tumorigenic pathway through various forms of serrated neoplasias. Therefore, we hypothesized that COX-2 may play a less important role in the serrated pathway. Methods By immunohistochemistry, we assessed COX-2 expression in 24 hyperplastic polyps, 7 sessile serrated polyp/adenomas (SSA, 5 mixed polyps with SSA and adenoma, 27 traditional serrated adenomas, 515 non-serrated adenomas (tubular adenoma, tubulovillous adenoma and villous adenoma, 33 adenomas with intramucosal carcinomas, 96 adenocarcinomas with serration (corkscrew gland and 111 adenocarcinomas without serration. Results Strong (2+ COX-2 overexpression was more common in non-serrated adenomas (28% = 143/515 than in hyperplastic polyps (4.2% = 1/24, p = 0.008 and serrated polyps (7 SSAs and 5 mixed polyps (0% = 0/12, p = 0.04. Furthermore, any (1+/2+ COX-2 overexpression was more frequent in non-serrated adenomas (60% = 307/515 than in hyperplastic polyps (13% = 3/24, p Conclusion COX-2 overexpression is infrequent in hyperplastic polyp, SSA and mixed polyp with SSA and adenoma, compared to non-serrated and serrated adenoma. COX-2 overexpression becomes more frequent as tumors progress to higher grade neoplasias. Our observations suggest that COX-2 may play a less significant role in the serrated pathway of tumorigenesis; however, COX-2 may still play a role in later stage of the serrated pathway.

  16. Seesaw nystagmus caused by giant pituitary adenoma: case report Nistagmo em gangorra causado por adenoma pituitário gigante: relato de caso

    OpenAIRE

    Frederico Castelo Moura; Allan Christian Pieroni Gonçalves; Mário Luiz Ribeiro Monteiro

    2006-01-01

    Giant pituitary adenomas are uncommonly large tumors, greater than 4 cm in size that can produces endocrine symptoms, visual loss and cranial nerve palsies. We report the rare occurrence of seesaw nystagmus as the presenting sign of giant pituitary adenoma. A 50-year-old man presented with headache associated with visual loss and seesaw nystagmus. Perimetry revealed bitemporal hemianopia and magnetic resonance imaging showed a giant pituitary adenoma. After surgery, nystagmus disappeared. Our...

  17. Fractionated stereotactic radiotherapy in the treatment of pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Kopp, C.; Theodorou, M.; Poullos, N.; Astner, S.T.; Geinitz, H.; Molls, M. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie; Stalla, G.K. [Max-Planck-Institut fuer Psychiatrie, Muenchen (Germany). Klinische Neuroendokrinologie; Meyer, B. [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Neurochirurgische Klinik und Poliklinik; Nieder, C. [Nordland Hospital, Bodoe (Norway). Dept. of Oncology and Palliative Medicine; Tromsoe Univ. (Norway). Inst. of Clinical Medicine; Grosu, A.L [Freiburg Univ. (Germany). Klinik fuer Strahlenheilkunde

    2013-11-15

    Purpose: The purpose of this work was to evaluate tumor control and side effects associated with fractionated stereotactic radiotherapy (FSRT) in the management of residual or recurrent pituitary adenomas. Patients and methods: We report on 37 consecutive patients with pituitary adenomas treated with FSRT at our department. All patients had previously undergone surgery. Twenty-nine patients had nonfunctioning, 8 had hormone-producing adenoma. The mean total dose delivered by a linear accelerator was 49.4 Gy (range 45-52.2 Gy), 5 x 1.8 Gy weekly. The mean PTV was 22.8 ccm (range 2.0-78.3 ccm). Evaluation included serial imaging tests, endocrinologic and ophthalmologic examination. Results: Tumor control was 91.9 % for a median follow-up time of 57 months (range 2-111 months). Before FSRT partial hypopituitarism was present in 41 % of patients, while 35 % had anterior panhypopituitarism. After FSRT pituitary function remained normal in 22 %, 43 % had partial pituitary dysfunction, and 35 % had anterior panhypopituitarism. Visual acuity was stable in 76 % of patients, improved in 19 %, and deteriorated in 5 %. Visual fields remained stable in 35 patients (95 %), improved in one and worsened in 1 patient (2.7 %). Conclusion: FSRT is an effective and safe treatment for recurrent or residual pituitary adenoma. Good local tumor control and preservation of adjacent structures can be reached, even for large tumors. (orig.)

  18. The pathology of pituitary adenomas from a clinical perspective.

    Science.gov (United States)

    Dworakowska, Dorota; Korbonits, Marta; Aylwin, Simon; McGregor, Alan; Grossman, Ashley B

    2011-01-01

    Pituitary adenomas present with a variety of clinical endocrine manifestations and arise in a sporadic setting or rarely as part of hereditary genetic syndromes. Molecular analysis of familial pituitary adenomas has provided significant insight into pituitary tumorigenesis. Some specific genes have been identified that predispose to pituitary neoplasia, but these are rarely involved in the pathogenesis of sporadic tumors. The number of identified genes involved in pituitary tumorigenesis is progressively increasing. The possible resulting mechanisms of action involve abnormalities in signal transduction pathways, cell cycle regulators, growth factors, chromosome stability and others. Further studies are needed to evaluate the clinical significance of genetic alterations and their implications for patient prognosis, as well as to identify targets for existing and new therapeutic options. The aim of this review is to focus on the molecular pathology of pituitary adenomas from a practical perspective and discuss the possible clinical implications which may relate to particular molecular alterations. We have summarised familial syndromes related to pituitary adenomas and considered the prognostic value of selected molecular alterations in these tumors.

  19. Role of radionuclide scintigraphy in the detection of parathyroid adenoma

    Directory of Open Access Journals (Sweden)

    Singh N

    2007-01-01

    Full Text Available Background: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. Aim: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. Materials And Methods: Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images in selected cases. Results: There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively. Conclusion: We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.

  20. The prevalence of human papillomavirus in colorectal adenomas and adenocarcinomas

    DEFF Research Database (Denmark)

    Baandrup, Louise; Thomsen, Louise T; Olesen, Tina Bech

    2014-01-01

    The role of human papillomavirus (HPV) in colorectal cancer has been widely studied with conflicting results. We performed a systematic review and a meta-analysis to estimate the prevalence of HPV in colorectal adenocarcinomas and adenomas, and test the potential association....

  1. Adrenal myelolipoma within myxoid cortical adenoma associated with Conn's syndrome

    Institute of Scientific and Technical Information of China (English)

    Hong-sheng LU; Mei-fu GAN; Han-song CHEN; Shan-qiang HUANG

    2008-01-01

    The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare, for both tumors present usually as separate entities. There are only 16 such cases reported worldwide. To the best of our knowledge, the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported. A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study. Computed tomography (CT) of the abdomen showed a large heterogeneously-enhancing mass (4.5cm in diameter) in the left suprarenal region. Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome. The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma. The patient was postoperatively well and discharged uneventfully. In the present case report, we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome, and the methods of the diagnosis and differential diagnosis.

  2. Evidence for colorectal sarcomatoid carcinoma arising from tubulovillous adenoma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Sarcomatoid carcinomas of the colorectum are rare tu- mors that display both malignant epithelial and stromal components. Clinically, they are aggressive tumors with early metastasis. Due to their infrequent occurrence, the pathogenesis is poorly understood. We report a case of a 52-year-old woman who presented with a rectal mass and intermittent hematochezia. Superficial biopsies during colonoscopy revealed a tubulovillous adenoma with high-grade dysplasia. Endoscopic ultra- sonography confirmed an invasive nature of the mass, and deeper biopsies revealed the presence of neoplasm with mixed histological components. The surgically- excised specimen demonstrated the presence of poorly differentiated spindle cells underneath the tubulovillous adenoma and an intermediate stage of invasive acleno- carcinoma. Based on the histological appearance and imrnunohistochemical studies, a diagnosis of sarcoma- toid carcinoma was made. Only nine cases of sarcoma- told carcinomas of the colorectum have been reported to date. As a result, the terminology and pathogenesis of sarcomatoid carcinoma remain speculative. To the best of our knowledge, this is the first report of co- existence of sarcomatoid carcinoma and invasive ad-enocarcinoma with tubulovillous adenoma; all stagesrepres ented within the same tumor. This observation supports the "monoclonal theory" of pathogenesis with an adenoma-sarcoma progression with or without an intermediate stage of carcinoma.

  3. Clinico-pathological aspects of colorectal serrated adenomas

    Institute of Scientific and Technical Information of China (English)

    Ashish Chandra; Adnan A Sheikh; Anton Cerar; Ian C Talbot

    2006-01-01

    AIM: To study the association of colorectal serrated adenomas (SAs) with invasive carcinoma, local recurrence, synchronicity and metachronicity of lesions.METHODS: A total of 4536 polyps from 1096patients over an eight-year period (1987-1995) were retrospectively examined. Adenomas showing at least 50% of serrated architecture were called SAs by three reviewing pathologists.RESULTS: Ninety-one (2%) of all polyps were called SAs, which were found in 46 patients. Invasive carcinomas were seen in 3 out of 46 (6.4%) patients, of whom one was a case of familial adenomatous polyposis (FAP). A male preponderance was noted and features of a mild degree of dysplasia were seen in majority (n=75,83%) of serrated adenomas. Follow-up ranged 1-12years with a mean time of 5.75 years. Recurrences of SAs were seen in 3 (6.4%) cases, synchronous SAs in 16 (34.8%) cases and metachronous SAs in 9 (19.6%)cases.CONCLUSION: Invasive carcinoma arising in serrated adenoma is rare, accounting for 2 (4.3%) cases studied in this series.

  4. Histochemical alterations in colorectal carcinoma and adenoma in Egyptian patients

    Institute of Scientific and Technical Information of China (English)

    Saber A Sakr; Moshira M Abdel-Wahed; Asmaa G Abdou; Eman K El-Adely

    2016-01-01

    Objective:To evaluate the histochemical alterations inDNA and total carbohydrates, in colorectal cancer cells. Methods:This study was carried out on 48 colorectal carcinoma and 10 adenoma specimens. Hematoxylin and Eosin staining was carried out for histopathological examination to confirm the diagnosis and to evaluate the histopathological characteristics of tumor. Histologic grade and pathologic stage was assessed according to TNM staging system. Staging was also assessed according to original Dukes’ staging system.DNA was demonstrated by Feulgen method and carbohydrates were demonstrated by periodic acid Schiff’s reaction. Results:Adenoma cases showed that the cells lining the glands of the polyp have more crowded, irregular and darker nuclei (hyperchromatic), anisonucleosis, abnormal mitotic figures with prominent nucleoli and variability in the size and shape of nuclei. Colorectal carcinoma cases showed a condensation and reduction in the size of a cell nucleus associated with hyperchromatosis, pyknotic nuclei, abnormal mitotic figures, anisonucleosis, irregular nuclear membrane and inequality in the size of the nuclei (Pleomorphosis). There was a statistical significant differences between adenoma and carcinoma regarding number of mitotic cells (P = 0.03) that was in favour of malignant group. Adenoma and colorectal carcinoma cases showed periodic acid Schiff’s reactivity with different degree. Conclusions:These histochemical alterations can be so characteristic of a given tumor type and stage that they are used in cancer diagnosis and might also be related to the altered functional properties of cancer cells.

  5. [Multihormonal and multifunctional hypophyseal adenoma and the acromegaly syndrome].

    Science.gov (United States)

    Dusková, J; Marek, J; Povýsil, C

    2000-07-19

    Woman 75-year-old treated 30 years for syndrome of acromegaly refused pituitary surgery and irradiation. Five years and nine months before death she had a colon carcinoma successfully removed. Multinodular hyperfunctional goitre was treated with carbimazole. For six last years of life corticosteroids were given as a replacement therapy. Her cause of death was the heart failure due to acromegalic heart disease. In autopsy a large intrasellar and extrasellar pituitary adenoma without rests of nonneoplastic tissue was found. Nevertheless the target peripheral endocrine glands except ovaries, were not atrophic. A multinodular goitre and diffuse adrenocortical hyperplasia were revealed. Histology, and immunohistochemistry demonstrated that mot neoplastic cells were producing GH and ACTH, dispersly Prl, scattered cells were positive for beta-subunit of FSH, LH, TSH. Electron microscopy proved most of the cells to be densely granulated. We classify the adenoma according to the newly proposed WHO pituitary tumours classification (1) as plurihormonal, hyperfunctional, extrasellar, typical adenoma from densely granulated cells. We conclude that in plurihormonal adenomas with dominant (in the case referred acromegalic) symptomatology the additional hormonal production should be monitored as a possible source of important complications.

  6. Alcohol consumption, alcohol dehydrogenase 3 polymorphism, and colorectal adenomas

    NARCIS (Netherlands)

    Tiemersma, E.W.; Wark, P.A.; Ocké, M.C.; Bunschoten, A.; Otten, M.H.; Kok, F.J.; Kampman, E.

    2003-01-01

    Alcohol is a probable risk factor with regard to colorectal neoplasm and is metabolized to the carcinogen acetaldehyde by the genetically polymorphic alcohol dehydrogenase 3 (ADH3) enzyme. We evaluated whether the association between alcohol and colorectal adenomas is modified by ADH3 polymorphism.

  7. Histochemical alterations in colorectal carcinoma and adenoma in Egyptian patients

    Directory of Open Access Journals (Sweden)

    Saber A Sakr

    2016-01-01

    Full Text Available Objective: To evaluate the histochemical alterations in DNA and total carbohydrates, in colorectal cancer cells. Methods: This study was carried out on 48 colorectal carcinoma and 10 adenoma specimens. Hematoxylin and Eosin staining was carried out for histopathological examination to confirm the diagnosis and to evaluate the histopathological characteristics of tumor. Histologic grade and pathologic stage was assessed according to TNM staging system. Staging was also assessed according to original Dukes’ staging system. DNA was demonstrated by Feulgen method and carbohydrates were demonstrated by periodic acid Schiff’s reaction. Results: Adenoma cases showed that the cells lining the glands of the polyp have more crowded, irregular and darker nuclei (hyperchromatic, anisonucleosis, abnormal mitotic figures with prominent nucleoli and variability in the size and shape of nuclei. Colorectal carcinoma cases showed a condensation and reduction in the size of a cell nucleus associated with hyperchromatosis, pyknotic nuclei, abnormal mitotic figures, anisonucleosis, irregular nuclear membrane and inequality in the size of the nuclei (Pleomorphosis. There was a statistical significant differences between adenoma and carcinoma regarding number of mitotic cells (P = 0.03 that was in favour of malignant group. Adenoma and colorectal carcinoma cases showed periodic acid Schiff’s reactivity with different degree. Conclusions: These histochemical alterations can be so characteristic of a given tumor type and stage that they are used in cancer diagnosis and might also be related to the altered functional properties of cancer cells.

  8. [Hypergonadotropic hypogonadism with sella turcica tumor syndrome: gonadotropic adenoma?].

    Science.gov (United States)

    Sidibe, E H

    2006-09-01

    A 43-year-old patient, known for infertility for ten years, presented hypogonadism (low libido, impotence, low testosteronemia) with hypergonadotropism (high FSH contrasting with low LH) and a tumor syndrome of the sella turcica. The biological, immunohistochemical and clinical features of gonadotropic adenoma are presented.

  9. Systematic review of hepatocellular adenoma in China and other regions

    NARCIS (Netherlands)

    H. Lin; J. van den Esschert; C. Liu; T.M. van Gulik

    2011-01-01

    Hepatocellular adenoma (HCA) is a benign liver neoplasm with a risk of spontaneous bleeding and malignant transformation. The aim of this review article is to review all the case reports and case series of patients with HCA from 1998 to 2008 in China and other parts of the world in order to compare

  10. An intracapsular carcinoma ex pleomorphic adenoma with lung metastases composed exclusively of benign elements: histological evidence of a continuum between metastasizing pleomorphic adenoma and carcinoma ex pleomorphic adenoma.

    Science.gov (United States)

    Weissferdt, Annikka; Langman, Gerald

    2010-07-15

    Malignant mixed tumors of the salivary glands, encompassing carcinoma ex pleomorphic adenoma (ca ex PA), carcinosarcoma and metastasizing pleomorphic adenoma (mPA), are rare neoplasms. Ca ex PA arises in a pre-existing pleomorphic adenoma (PA). When the malignant component does not breach the capsule of the parent PA, the lesion is termed intracapsular ca ex PA, a neoplasm which is thought to have no metastatic potential. Metastatic deposits of ca ex PA are composed exclusively of malignant elements or mixed benign and malignant components. We describe the case of a 62-year-old female with an intracapsular ca ex PA of the buccal mucosa with subsequent metastases to the lung. The metastatic deposits resembled benign PA with no histological evidence of malignancy. This pattern of spread is described with mPA, an entity that caused controversy in the past regarding its exact classification as a benign or malignant tumor. The possibility that ca ex PA originates from a mPA, with intracapsular ca ex PA representing an intermediate lesion in a histological continuum, is discussed.

  11. Management of Duodenal Adenomas Involving the Ampulla of Vater – A Warning against Limited Resection

    Directory of Open Access Journals (Sweden)

    Jeremy Rossaak

    2008-03-01

    Full Text Available Duodenal adenomas are uncommon, however, when present a proportion have dysplasia associated with the adenoma and therefore require treatment. The options range from less invasive endoscopic treatments to a pancreaticoduodenectomy. This case report describes two patients with adenomas involving the ampulla of Vater. One patient had familial adenomatous polyposis, the other was a renal transplant patient with a large adenoma. Both patients’ adenomas contained high-grade dysplasia. Both patients underwent a pancreaticoduodenectomy. Histology of both specimens demonstrated that the adenoma had migrated up the bile duct for at least 7 mm, and the pancreatic duct for 8 mm in one patient. Limited resection of ampullary adenomas may leave residual adenomatous tissue in the bile duct with the risk of recurrent adenomatous disease and malignant transformation.

  12. CLINICOPATHOLOGICAL ANALYSIS OF 50 RECTAL CANCER CASES DIAGNOSED AS ADENOMA IN BIOPSY

    Institute of Scientific and Technical Information of China (English)

    BU Zhao-de; LI Zi-yu; XIE Yu-quan; JI Jia-fu; SU Xiang-qian

    2005-01-01

    Objective: To evaluate the clinicopathological characteristics of rectal cancer diagnosed as adenoma in biopsy. Methods: 50 rectal cancer cases diagnosed as adenoma in biopsy were analyzed retrospectively in this study by comparing the biopsy and postoperative pathology. Results: Among these 50 patients, biopsy pathology showed 26% (13/50) adenoma with mild dysplasia, 30% (15/50) adenoma with moderate dysplasia, and 44% (22/50) adenoma with severe dysplasia. In 8 cases, the adenomas were smaller than 2cm. On postoperatively surgical pathology, only 10 cases were carcinoma-in-situ, while 40 cases were invasive cancer. Conclusion: Special emphasis should be taken to biopsy-negative rectal adenomas and those smaller than 2cm.

  13. Unusual mixed gangliocytoma-pituitary adenoma in sellar region

    Directory of Open Access Journals (Sweden)

    Jie-tian JIN

    2016-10-01

    Full Text Available Background The presence of ganglion cells within an endocrine pituitary adenoma in sellar region is rare, and is usually diagnosed as "mixed gangliocytoma-pituitary adenoma". Due to lack of radiological characteristics, it is very difficult to make an accurate diagnosis preoperatively. Herein we describe one case of unusual mixed gangliocytoma - growth hormone (GH secreting pituitary adenoma in sellar region and review related literatures, so as to summarize the clinicopathological characteristics and improve the diagnosis and differential diagnosis of this tumor. Methods and Results A 28 - year - old female presented with headache and blurred vision for 8 months. She also complained of acromegaly and amenorrhea. Head CT and MRI examinations showed a sellar and suprasellar mass with clear boundary compressing the optic chiasm and buttom of the third ventricle. The mass exhibited isointense signal or mild hypointensity on T1WI and mild hyperintensity on T2WI with heterogeneous enhancement on the contrast MRI. The tumor was removed totally. The histological sections demonstrated two parts of intermixed areas. One part of areas was marked by a proliferation of scattered gangliocyte - like cells arranged in a fibrillary background. Other areas were marked by a sheet - like or locally papillary proliferation of round and oval cells. Immunohistochemically, cytoplasm of gangliocyte-cells were diffusely positive for synaptophysin (Syn, and negative for adenohypophysial hormones; cytoplasm of round and oval cells were diffusely positive for Syn, and almost 30% cells were positive for GH, and negative for other neurohypophysial hormones. A final diagnosis of mixed gangliocytoma-GH secreting pituitary adenoma in sellar region (WHO grade Ⅰ was made. The patient did not receive postoperatively adjuvant therapy and was followed-up for one year, without any neurological deficit or signs of recurrence. Conclusions Mixed gangliocytoma - pituitary

  14. [Expression of CD10 in tumor-associated fibroblast of cancerized or recurrent colorectal adenomas].

    Science.gov (United States)

    Zheng, Jiangjiang; Zhu, Yin; Li, Changshui; Li, Yinya; Nie, Qianqian; Zhu, Ziling; Deng, Hong

    2016-05-25

    Objective: To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma. Methods: Tissue samples of low-grade adenoma (n=50), high-grade adenoma (n=50) and colorectal adenocarcinoma (n=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups. Results: There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all P0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all P0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (Pcancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.

  15. Expression pattern of the Hedgehog signaling pathway in pituitary adenomas.

    Science.gov (United States)

    Yavropoulou, Maria P; Maladaki, Anna; Topouridou, Konstantina; Kotoula, Vasiliki; Poulios, Chris; Daskalaki, Emily; Foroglou, Nikolaos; Karkavelas, George; Yovos, John G

    2016-01-12

    Several studies have demonstrated the role of Wnt and Notch signaling in the pathogenesis of pituitary adenomas, but data are scarce regarding the role of Hedgehog signaling. In this study we investigated the differential expression of gene targets of the Hedgehog signaling pathway. Formalin-fixed, paraffin-embedded specimens from adult patients who underwent transphenoidal resection and normal human pituitary tissues that were obtained from autopsies were used. Clinical information and data from pre-operative MRI scan (extracellular tumor extension, tumor size, displacement of the optic chiasm) were retrieved from the Hospital's database. We used a customized RT(2) Profiler PCR Array, to investigate the expression of genes related to Notch and Hedgehog signaling pathways (PTCH1, PTCH2, GLI1, GLI3, NOTCH3, JAG1, HES1, and HIP). A total of 52 pituitary adenomas (32 non-functioning adenomas, 15 somatotropinomas and 5 prolactinomas) were used in the final analysis. In non-functioning pituitary adenomas there was a significant decrease (approximately 75%) in expression of all Hedgehog related genes that were tested, while Notch3 and Jagged-1 expression was found significantly increased, compared with normal pituitary tissue controls. In contrast, somatotropinomas demonstrated a significant increase in expression of all Hedgehog related genes and a decrease in the expression of Notch3 and Jagged-1. There was no significant difference in the expression of Hedgehog and Notch related genes between prolactinomas and healthy pituitary tissues. Hedgehog signalling appears to be activated in somatotropinomas but not in non-functioning pituitary adenomas in contrast to the expression pattern of Notch signalling pathway.

  16. Gigantism caused by growth hormone secreting pituitary adenoma.

    Science.gov (United States)

    Rhee, Noorisaem; Jeong, Kumi; Yang, Eun Mi; Kim, Chan Jong

    2014-06-01

    Gigantism indicates excessive secretion of growth hormones (GH) during childhood when open epiphyseal growth plates allow for excessive linear growth. Case one involved a 14.7-year-old boy presented with extreme tall stature. His random serum GH level was 38.4 ng/mL, and failure of GH suppression was noted during an oral glucose tolerance test (OGTT; nadir serum GH, 22.7 ng/mL). Magnetic resonance imaging (MRI) of the brain revealed a 12-mm-sized pituitary adenoma. Transsphenoidal surgery was performed and a pituitary adenoma displaying positive immunohistochemical staining for GH was reported. Pituitary MRI scan was performed 4 months after surgery and showed recurrence/residual tumor. Medical treatment with a long-acting somatostatin analogue for six months was unsuccessful. As a result, secondary surgery was performed. Three months after reoperation, the GH level was 0.2 ng/mL and insulin-like growth factor 1 was 205 ng/mL. Case two involved a 14.9-year-old boy, who was referred to our department for his tall stature. His basal GH level was 9.3 ng/mL, and failure of GH suppression was reported during OGTT (nadir GH, 9.0 ng/mL). Pituitary MRI showed a 6-mm-sized pituitary adenoma. Surgery was done and histopathological examination demonstrated a pituitary adenoma with positive staining for GH. Three months after surgery, the GH level was 0.2 ng/mL and nadir GH during OGTT was less than 0.1 ng/mL. Pituitary MRI scans showed no residual tumor. We present two cases of gigantism caused by a GH-secreting pituitary adenoma with clinical and microscopic findings.

  17. Thymosin ß4 expression in colorectal polyps and adenomas

    Science.gov (United States)

    Nemolato, Sonia; Cabras, Tiziana; Restivo, Angelo; Zorcolo, Luigi; Di Felice, Eliana; Fanni, Daniela; Gerosa, Clara; Messana, Irene; Castagnola, Massimo; Faa, Gavino; Casula, Giuseppe

    2013-01-01

    OBJECTIVE: Thymosin beta 4 (Tβ4) is a ubiquitous peptide that plays pivotal roles in the cytoskeletal system and in cell differentiation. Recently, a role for Tβ4 has been proposed in experimental and human carcinogenesis, including gastrointestinal cancer. This study was aimed at evaluating the relationship between Tβ4 immunoreactivity and the initial steps of carcinogenesis. METHODS: In total, 60 intestinal biopsies, including 10 hyperplastic polyps, 10 sessile serrated adenomas/polyps, 15 colorectal adenomas with low-grade dysplasia, 15 adenomas with high-grade dysplasia, 15 adenocarcinomas and 10 samples of normal colon mucosa, were analyzed for Tβ4 expression by immunohistochemistry. RESULTS: Weak cytoplasmic reactivity for Tβ4 was detected in the normal colon mucosa. No reactivity for Tβ4 was found in hyperplastic and sessile serrated polyps/adenomas. Tβ4 expression was observed in 10/15 colorectal adenocarcinomas. In adenomas with low-grade dysplasia, Tβ4 immunoreactivity was mainly detected in dysplastic glands but was absent in hyperplastic glands. Tβ4 immunoreactivity was characterized by spot-like perinuclear staining. In high-grade dysplastic polyps, immunostaining for Tβ4 appeared diffuse throughout the entire cytoplasm of dysplastic cells. Spot-like perinuclear reactivity was detected in adenocarcinoma tumor cells. CONCLUSIONS: Our study shows for the first time that Tβ4 is expressed during different steps of colon carcinogenesis. The shift of Tβ4 immunolocalization from low-grade to high-grade dysplastic glands suggests a role for Tβ4 in colorectal carcinogenesis. However, the real meaning of Tβ4 reactivity in dysplastic intestinal epithelium remains unknown. PMID:24141838

  18. RT-01FRACTIONATED STEREOTACTIC RADIOTHERAPY FOR PITUITARY ADENOMA WITH NOVALIS

    Science.gov (United States)

    Arakawa, Yoshiki; Mizowaki, Takashi; Ogura, Kengo; Sakanaka, Katsuyuki; Hojo, Masato; Hiraoka, Masahiro; Miyamoto, Susumu; Murata, Daiki

    2014-01-01

    BACKGROUND: Radiation therapy is an available treatment modality for pituitary adenoma. In particular, it is effective for the case unable to be removed with surgery or repeating recurrence. However, hypopituitarism and optic nerve injury associated with radiation therapy become a problem. Novalis® (Brain Lab) is an equipment of radiation to establish the detailed irradiation area, fractionated stereotactic radiotherapy (fSRT) and intensity-modulated radiation therapy (IMRT). Retrospectively, we review local control and morbidity following fSRT with Novalis in pituitary adenoma. PATIENTS AND METHODS: Between 2007 and 2012, 29 patients with pituitary adenoma (9 functioning, 20 non-functioning) received fSRT with Novalis in our institute. Total radiation dose was 50.4-54Gy (1.8 Gy per fraction) and prescribed to the gross target volume + 2 mm. The effectiveness of fSRT was evaluated by tumor volume and clinical symptoms on pre- fSRT, and every 1-year. RESULTS: The median follow-up time was 59.1 months (20 to 83 months). Tumor regrowth was observed in 2 cases. Progression free survival rate was 93%. New visual field deficit was observed in 1 case, and new pituitary dysfunction were not observed in all patients. CONCLUSION: fSRT with Novalis is safe and effective in the treatment for pituitary adenoma. Although follow-up time is short, any problematic complications were not observed. In the future, fSRT is expected to make for safe and effective treatment in pituitary adenoma impossible to cure surgically.

  19. Prognostic model for patients treated for colorectal adenomas with regard to development of recurrent adenomas and carcinoma

    DEFF Research Database (Denmark)

    Jensen, P; Krogsgaard, M R; Christiansen, J

    1996-01-01

    -80. INTERVENTIONS: All patients were followed up by rectoscopy and double contrast barium enema. The survival data were analysed by Cox's proportional hazards model. MAIN OUTCOME MEASURES: Variables of significant prognostic importance for recurrence of adenomas and the development of cancer were identified...

  20. Adenomas colorretais: fatores de risco associados à displasia de alto grau Colorectal adenomas: risk factors for high-grade dysplasia

    Directory of Open Access Journals (Sweden)

    Julia Schmidt Silva

    2009-06-01

    Full Text Available FUNDAMENTOS: O estudo dos pólipos, em especial os adenomatosos, é relevante devido à correlação direta com o carcinoma colorretal. Objetivo: Analisar quais são os fatores de risco para uma displasia de alto grau do pólipo adenomatoso retirados endoscopicamente. MÉTODOS: Avaliamos todas as colonoscopias realizadas pelo Serviço de Coloproctologia no período de janeiro de 2003 a dezembro de 2006. Foram incluídos os pacientes com diagnóstico de pólipos adenomatosos. Analisamos a existência da relação entre adenomas com displasia de alto grau e os fatores associados dos pacientes e pólipos. RESULTADOS: Foram realizados 1821 exames e encontramos 208 pacientes com 326 adenomas. 51,4% do sexo masculino e 69,2% tinham um único adenoma. Foram encontrados 28 pacientes (13,5% com, ao total, 34 adenomas (10,4%, com displasia de alto grau. Entre os adenomas com displasia de alto grau, 64,7% eram = 1cm, 61,8% eram sésseis, 29,4% vilosos e 70,6% estavam localizados no cólon esquerdo. Comparando as características do grupo dos adenomas com displasia de baixo grau com o de alto grau, foi estatisticamente significativo o tamanho = 1cm e o componente viloso (P BACKGROUND: The study of polyps, especially adenomatous, is justified because of the straight correlation among them with the incidence of CRC. Objective: To analyze the risk factors for high-grade dysplasia of adenomatous polyps removed endoscopically. METHODS: All consecutive colonoscopies performed by the Colorectal Department of the Hospital Nossa Senhora da Conceição, in Porto Alegre/RS, from January 2003 to December 2006, were evaluated. Patients diagnosed with adenomatous polyps were included. The relationship among tumors with high-grade dysplasia and the features of the patients and polyps were analyzed. RESULTS: Among the 1,821 exams, 326 adenomas were detected in 208 patients. 51.4% of the patients were male; 69,2% had only one adenoma. A total of 28 patients (13,5% with 34

  1. DNA Replication Forks Pause at Silent Origins near the HML Locus in Budding Yeast

    OpenAIRE

    Wang, Yangzhou; Vujcic, Marija; Kowalski, David

    2001-01-01

    Chromosomal replicators in budding yeast contain an autonomously replicating sequence (ARS) that functions in a plasmid, but certain ARSs are silent as replication origins in their natural chromosomal context. In chromosome III, the HML ARS cluster (ARS302-ARS303-ARS320) and ARS301 flank the transcriptionally silent mating-type locus HML, and all of these ARSs are silent as replication origins. ARS301 and ARS302 function in transcriptional silencing mediated by the origin recognition complex ...

  2. Desarrollo de vacunas contra el virus de la inmunodeficiencia humana tipo 1: Relevancia de la inmunidad celular contra subtipos Development of vaccines for HIV-1: Relevance of subtype-specific cellular immunity

    Directory of Open Access Journals (Sweden)

    Ana María Rodríguez

    2010-12-01

    Full Text Available Han pasado casi 30 años de la detección de los primeros casos de infección con HIV-1 y aún no se ha conseguido desarrollar una vacuna efectiva y segura. A pesar del impacto positivo sobre la pandemia que se ha conseguido gracias a los avances en la terapia antirretroviral (TARV, el HIV/sida sigue constituyendo un grave problema para la salud pública, especialmente en los países en desarrollo, donde es difícil el acceso al tratamiento. En el mundo, 33 millones de personas viven con el virus del sida, mientras que en la Argentina se calcula que habría unos 120 000 infectados. Uno de los desafíos para lograr una vacuna contra el HIV es la variabilidad viral. El grupo M, responsable de la pandemia, se encuentra dividido en 10 subtipos y varios sub-subtipos, además de las 48 formas recombinantes circulantes y más de cien formas recombinantes únicas. La epidemia de HIV en nuestro país es tan compleja como en el resto del mundo, con la co-circulación principalmente de virus pertenecientes al subtipo B y recombinantes BF (CRF12_BF y derivadas. A pesar de la cantidad de trabajos dedicados a la caracterización de la respuesta inmune y al desarrollo de vacunas, no queda claro cuál es el impacto de la variabilidad en la elección del antígeno. Trabajos realizados en nuestro laboratorio demuestran el papel que juega la inmunidad celular con respecto a las variantes recombinantes BF, tanto en humanos como en modelos animales. Estos resultados son de importancia en el desarrollo de futuras vacunas para nuestra región.It has been almost 30 years since the detection of the first HIV-1 cases and yet an effective and safe vaccine has not been developed. Although, advances in antiretroviral therapy (HAART have produced a major impact on the pandemic, and even though HIV/aids remains a major concern for developing countries, where access to therapy is limited. The last report from UNAIDS notified 33 million people living with HIV/aids, worldwide

  3. The Rachel Carson Letters and the Making of Silent Spring

    Directory of Open Access Journals (Sweden)

    John Paull

    2013-06-01

    Full Text Available Environment, conservation, green, and kindred movements look back to Rachel Carson’s 1962 book Silent Spring as a milestone. The impact of the book, including on government, industry, and civil society, was immediate and substantial, and has been extensively described; however, the provenance of the book has been less thoroughly examined. Using Carson’s personal correspondence, this paper reveals that the primary source for Carson’s book was the extensive evidence and contacts compiled by two biodynamic farmers, Marjorie Spock and Mary T. Richards, of Long Island, New York. Their evidence was compiled for a suite of legal actions (1957-1960 against the U.S. Government and that contested the aerial spraying of dichlorodiphenyltrichloroethane (DDT. During Rudolf Steiner’s lifetime, Spock and Richards both studied at Steiner’s Goetheanum, the headquarters of Anthroposophy, located in Dornach, Switzerland. Spock and Richards were prominent U.S. anthroposophists, and established a biodynamic farm under the tutelage of the leading biodynamics exponent of the time, Dr. Ehrenfried Pfeiffer. When their property was under threat from a government program of DDT spraying, they brought their case, eventually lost it, in the process spent US$100,000, and compiled the evidence that they then shared with Carson, who used it, and their extensive contacts and the trial transcripts, as the primary input for Silent Spring. Carson attributed to Spock, Richards, and Pfeiffer, no credit whatsoever in her book. As a consequence, the organics movement has not received the recognition, that is its due, as the primary impulse for Silent Spring, and it is, itself, unaware of this provenance.

  4. Silent compartment syndrome in children: a report of five cases.

    Science.gov (United States)

    Lee, Christopher; Lightdale-Miric, Nina; Chang, Emory; Kay, Robert

    2014-09-01

    Compartment syndrome does not always present classically in the pediatric population, making clinical diagnosis uniquely challenging. The purpose of this study was to identify signs and symptoms of compartment syndrome that may help risk-stratify pediatric patients upon presentation, as well as to report outcomes of 'silent' compartment syndrome in children. A retrospective review of cases of 'silent' compartment syndrome at a level I pediatric trauma center between 2000 and 2010 was conducted. Patient demographics and clinical data were reviewed, including complications and patient outcomes. Radiographs taken at presentation, on intraoperative fluoroscopy, and at postoperative follow-up were reviewed for fracture type, and severity and outcome analyses. Five patients were found to have compartment syndrome without the presence of significant pain at rest or on passive range of motion. The study included three male and two female patients with a median age of 7 years. Three upper-extremity and two lower-extremity fractures were involved. The mean time from presentation to surgery was 14 h. At presentation, three of five patients had muscle paralysis, whereas at diagnosis of compartment syndrome, four of five had paralysis. Of the classic five P's, a maximum of two were found at diagnosis. The mean clinical follow-up period was 11 months (2-26 months). Long-term complications from compartment syndrome were found in one of five patients, who at the most recent follow-up, continued to be debilitated. This study reviews a series of cases of 'silent' compartment syndrome and confirms its atypical presentation. It is recommended that caution be used when assessing fractures with high risk for compartment syndrome in children, especially those complicated by nerve injury, as they do not always present in the classic manner, with missed diagnosis leading to significant functional deficits. IV.

  5. Correlations of electromyographic silent period duration and the Helkimo dysfunction index.

    Science.gov (United States)

    Helkimo, M I; Bailey, J O; Ash, M M

    1979-01-01

    Fifty-eight patients seen for consultation concerning mandibular dysfunction symptoms were examined utilizing the Helkimo index of dysfunction and electromyographic silent period recordings from masticatory muscles. The data collected were analyzed for correlations between the two parameters. Several significant correlations were noted between certain variables of the dysfunction index and the duration of the silent period. The mean duration of the silent period increased with increasing dysfunction index value. However, the clinical significance of this correlation is not established as long as we do not know the validity of neither the dysfunction index nor the the EMG silent period duration.

  6. Assessment of Silent T1-weighted head imaging at 7 T

    Energy Technology Data Exchange (ETDEWEB)

    Costagli, Mauro; Tiberi, Gianluigi; Tosetti, Michela [Imago7 Foundation, Pisa (Italy); IRCCS Stella Maris, Laboratory of Medical Physics and Biotechnologies for Magnetic Resonance, Pisa (Italy); Symms, Mark R. [GE Applied Science Laboratory, Pisa (Italy); Angeli, Lorenzo [University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa (Italy); Kelley, Douglas A.C. [GE Healthcare Technologies, San Francisco, CA (United States); Biagi, Laura [IRCCS Stella Maris, Laboratory of Medical Physics and Biotechnologies for Magnetic Resonance, Pisa (Italy); Farnetani, Andrea [University of Ferrara, Engineering Department, Ferrara (Italy); Materiacustica s.r.l., Ferrara (Italy); Rua, Catarina [University of Pisa, Department of Physics, Pisa (Italy); Donatelli, Graziella [Azienda Ospedaliero-Universitaria Pisana (AOUP), Neuroradiology Unit, Department of Diagnostic and Interventional Radiology, Pisa (Italy); Cosottini, Mirco [Imago7 Foundation, Pisa (Italy); University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa (Italy)

    2016-06-15

    This study aimed to assess the performance of a ''Silent'' zero time of echo (ZTE) sequence for T1-weighted brain imaging using a 7 T MRI system. The Silent sequence was evaluated qualitatively by two neuroradiologists, as well as quantitatively in terms of tissue contrast, homogeneity, signal-to-noise ratio (SNR) and acoustic noise. It was compared to conventional T1-weighted imaging (FSPGR). Adequacy for automated segmentation was evaluated in comparison with FSPGR acquired at 7 T and 1.5 T. Specific absorption rate (SAR) was also measured. Tissue contrast and homogeneity in Silent were remarkable in deep brain structures and in the occipital and temporal lobes. Mean tissue contrast was significantly (p < 0.002) higher in Silent (0.25) than in FSPGR (0.11), which favoured automated tissue segmentation. On the other hand, Silent images had lower SNR with respect to conventional imaging: average SNR of FSPGR was 2.66 times that of Silent. Silent images were affected by artefacts related to projection reconstruction, which nevertheless did not compromise the depiction of brain tissues. Silent acquisition was 35 dB(A) quieter than FSPGR and less than 2.5 dB(A) louder than ambient noise. Six-minute average SAR was <2 W/kg. The ZTE Silent sequence provides high-contrast T1-weighted imaging with low acoustic noise at 7 T. (orig.)

  7. Identification of Differentially Expressed Genes in Pituitary Adenomas by Integrating Analysis of Microarray Data

    Directory of Open Access Journals (Sweden)

    Peng Zhao

    2015-01-01

    Full Text Available Pituitary adenomas, monoclonal in origin, are the most common intracranial neoplasms. Altered gene expression as well as somatic mutations is detected frequently in pituitary adenomas. The purpose of this study was to detect differentially expressed genes (DEGs and biological processes during tumor formation of pituitary adenomas. We performed an integrated analysis of publicly available GEO datasets of pituitary adenomas to identify DEGs between pituitary adenomas and normal control (NC tissues. Gene function analysis including Gene Ontology (GO, Kyoto Encyclopedia of Genes and Genomes (KEGG pathway enrichment analysis, and protein-protein interaction (PPI networks analysis was conducted to interpret the biological role of those DEGs. In this study we detected 3994 DEGs (2043 upregulated and 1951 downregulated in pituitary adenoma through an integrated analysis of 5 different microarray datasets. Gene function analysis revealed that the functions of those DEGs were highly correlated with the development of pituitary adenoma. This integrated analysis of microarray data identified some genes and pathways associated with pituitary adenoma, which may help to understand the pathology underlying pituitary adenoma and contribute to the successful identification of therapeutic targets for pituitary adenoma.

  8. Silent Intravascular Lymphoma Initially Manifesting as a Unilateral Adrenal Incidentaloma

    Directory of Open Access Journals (Sweden)

    Yoshiko Takahashi

    2012-01-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is a rare subtype of malignant lymphoma. Although the involvement of adrenal glands in IVLBCL is often observed, primary adrenal IVLBCL is rare. Most reported cases of adrenal IVLBCL showed bilateral lesions resulting in rapidly progressive adrenal failure and poor prognosis. Here, we report a case of slowly progressive primary adrenal IVLBCL manifesting initially with unilateral adrenal incidentaloma. This case is a silent IVLBCL and shows that the enlargement of both adrenal glands can be followed.

  9. Radiosurgery for pituitary adenomas: evaluation of its efficacy and safety

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    Canteras Miguel M

    2010-11-01

    Full Text Available Abstract Object To assess the effects of radiosurgery (RS on the radiological and hormonal control and its toxicity in the treatment of pituitary adenomas. Methods Retrospective analysis of 42 patients out of the first 48 consecutive patients with pituitary adenomas treated with RS between 1999 and 2008 with a 6 months minimum follow-up. RS was delivered with Gamma Knife as a primary or adjuvant treatment. There were 14 patients with non-secretory adenomas and, among functioning adenomas, 9 were prolactinomas, 9 were adrenocorticotropic hormone-secreting and 10 were growth hormone-secreting tumors. Hormonal control was defined as hormonal response (decline of more than 50% from the pre-RS levels and hormonal normalization. Radiological control was defined as stasis or shrinkage of the tumor. Hypopituitarism and visual deficit were the morbidity outcomes. Hypopituitarism was defined as the initiation of any hormone replacement therapy and visual deficit as loss of visual acuity or visual field after RS. Results The median follow-up was 42 months (6-109 months. The median dose was 12,5 Gy (9 - 15 Gy and 20 Gy (12 - 28 Gy for non-secretory and secretory adenomas, respectively. Tumor growth was controlled in 98% (41 in 42 of the cases and tumor shrinkage ocurred in 10% (4 in 42 of the cases. The 3-year actuarial rate of hormonal control and normalization were 62,4% and 37,6%, respectively, and the 5-year actuarial rate were 81,2% and 55,4%, respectively. The median latency period for hormonal control and normalization was, respectively, 15 and 18 months. On univariate analysis, there were no relationships between median dose or tumoral volume and hormonal control or normalization. There were no patients with visual deficit and 1 patient had hypopituitarism after RS. Conclusions RS is an effective and safe therapeutic option in the management of selected patients with pituitary adenomas. The short latency of the radiation response, the highly

  10. Emergency physician's diagnosis of stroke subtype: an accuracy study Diagnóstico dos subtipos de acidente vascular cerebral: um estudo de acurácia com médicos de emergência

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    MARLEIDE DA MOTA GOMES

    1998-09-01

    Full Text Available OBJECTIVE: To evaluate the accuracy of clinical unstructured and structured diagnosis of acute stroke subtypes -- cerebral haemorrhage (CH, cerebral infarction (CI, subarachnoid haemorrhage (SAH. METHODS: Sixty consecutive patients with acute stroke admitted to the Emergency Ward of a Brazilian University Hospital were examined by emergency physicians and computerised tomography (CT. We also compared it (physician's unstructured diagnosis to two published clinical scoring systems (structured diagnosis - Guy's Hospital and Siriraj Hospital applied to three other populations -- regarding the operational characteristics of the tests. RESULTS: In our personal data, among 9 variables that could discriminate CH and CI, three have statistically significant difference (p OBJETIVO: Avaliar a acurácia do diagnóstico clínico não estruturado e do estruturado dos subtipos do acidente vascular cerebral (AVC: hemorragia cerebral (HC, infarto cerebral (IC, hemorragia subaracnóide (HSA. MÉTODO: Sessenta pacientes com AVC consecutivamente admitidos em emergência de hospital universitário brasileiro foram examinados por médicos da emergência e por tomografia computadorizada (TC. Nós também comparamos isso (diagnóstico clínico não estruturado com os resultados de dois testes diagnósticos estruturados sobre AVC da literatura (Guy's Hospital e Siriraj Hospital aplicados a três outras populações -- com atenção às características operacionais dos testes. RESULTADOS: Em nossos dados pessoais, entre nove variáveis que poderiam discriminar HC e IC, três apresentaram diferenças significantes estatisticamente (p<0.05: cefaléia (p=0.0002 e vômito (p=0.02 ocorreram mais frequentemente naqueles com HC, mas AVC prévio naqueles com IC (p=0.04. Diagnóstico não estruturado mostrou-se válido para HSA, com +LHR= 39.7; e em menor grau para IC (-LHR= 0,1. No entanto, ele exibiu baixa sensibilidade para o diagnóstico de HC. Testes estruturados (Guy

  11. Prevalência de anticorpos para o vírus da Influenza Eqüina, subtipo H3N8, em eqüídeos apreendidos no Estado do Rio de Janeiro Antibody prevalence of Equine Influenza virus, subtype H3N8, in equids apreehend on Rio de Janeiro State, Brazil

    OpenAIRE

    Gabrielle Sales de Oliveira; Paula Amorim Schiavo; Carlos Mazur; Cláudio de Moraes Andrade

    2005-01-01

    O vírus Influenza A, subtipo H3N8, é o agente etiológico da Influenza Eqüina, responsável por diversas epidemias e endemias respiratórias em nível mundial, inclusive no Estado do Rio de Janeiro, Brasil. O objetivo deste trabalho foi avaliar a importância de eqüídeos errantes, como fontes de infecção do vírus Influenza, subtipo H3N8. A enquete foi realizada a partir da pesquisa de anticorpos específicos para este vírus em 1106 soros analisados através da prova de inibição da hemaglutinação. O ...

  12. Prevalência de anticorpos para o vírus da Influenza Eqüina, subtipo H3N8, em eqüídeos apreendidos no Estado do Rio de Janeiro Antibody prevalence of Equine Influenza virus, subtype H3N8, in equids apreehend on Rio de Janeiro State, Brazil

    OpenAIRE

    Gabrielle Sales de Oliveira; Paula Amorim Schiavo; Carlos Mazur; Cláudio de Moraes Andrade

    2005-01-01

    O vírus Influenza A, subtipo H3N8, é o agente etiológico da Influenza Eqüina, responsável por diversas epidemias e endemias respiratórias em nível mundial, inclusive no Estado do Rio de Janeiro, Brasil. O objetivo deste trabalho foi avaliar a importância de eqüídeos errantes, como fontes de infecção do vírus Influenza, subtipo H3N8. A enquete foi realizada a partir da pesquisa de anticorpos específicos para este vírus em 1106 soros analisados através da prova de inibição da hemaglutinação. O ...

  13. First case of villous adenoma of the appendix leading to acute appendicitis presenting as strangulated femoral hernia: changes in management owing to concurrent adenoma.

    Science.gov (United States)

    Suppiah, A; Barandiaran, J; Morgan, R; Perry, E P

    2008-02-01

    A 78-year-old lady presented with signs and symptoms of a strangulated femoral hernia. Peri-operatively she was found to have appendicitis within the hernia sac. Appendicectomy and non-mesh hernia repair were performed. Histology revealed acute inflammation and a villous adenoma of the appendix. Villous adenomas of the vermiform appendix are extremely rare tumours of the gastrointestinal tract. This is the first case combining two very rare pathologies--acute appendicitis presenting as strangulated femoral hernia and villous adenoma of the appendix. Early diagnosis and surgery are required to avoid high morbidity of perforated appendicitis within a femoral hernia. First, we discuss the diagnosis and surgical treatment of acute appendicitis within a femoral hernia. Second, the presence of an adenoma changes the aetiology of appendicitis. More importantly, changes in surgical management of acute appendicitis presenting as a strangulated femoral hernia owing to a co-existing adenoma are discussed.

  14. Adenoma, advanced adenoma and colorectal cancer prevalence in asymptomatic 40- to 49-year-old subjects with a first-degree family history of colorectal cancer.

    Science.gov (United States)

    Del Vecchio Blanco, G; Cretella, M; Paoluzi, O A; Caruso, A; Mannisi, E; Servadei, F; Romeo, S; Grasso, E; Sileri, P; Giannelli, M; Biancone, L; Palmieri, G; Pallone, F

    2013-09-01

    First-degree relatives (FDRs) of patients with colorectal cancer (CRC) have an increased CRC risk. Few studies have addressed if adenoma and advanced adenoma risk is increased among individuals, 40-49 years of age, with a family history of CRC. Therefore, the aim of the study was to define the prevalence and location of adenoma, advanced adenoma and CRC, according to age, in asymptomatic individuals with a family history of CRC. Retrospective study of asymptomatic FDRs, 40 to ≥70 years of age undergoing first screening colonoscopy over a 3-year period, of CRC patients. Among 464 individuals studied, the prevalence of adenoma and advanced adenoma was 18.1% and 6.4%, respectively. According to age intervals, the prevalences of adenoma and advanced adenoma were 14% and 3.5%, respectively, in subjects 40-49 years of age; 14.4% and 6.3%, respectively, in subjects 50-59 years of age; 27% and 8%, respectively, in subjects 60-69 years of age; and 25% and 14%, respectively, in subjects ≥70 years of age; no significant difference was found among the four groups. No difference in lesion location was found, with similar numbers of preneoplastic lesions being present in the right colon and the left colon. CRC was diagnosed in three (0.64%) subjects, one of whom was in the 40-49 years age group. In our population of FDRs of CRC patients, 40-49 years of age, the prevalences of adenoma and advanced adenoma were similar to those observed in older subjects with the same CRC risk. Our data support the current indication to perform screening colonoscopy earlier than 45 years of age in subjects at high CRC risk. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  15. Radiation therapy alone for growth hormone-producing pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Plataniotis, G.A.; Kouvaris, J.R.; Vlahos, L.; Papavasiliou, C. [Athens Univ. (Greece). Dept. of Radiology

    1998-09-01

    We present our experience in the treatment of growth hormone (GH)-producing pituitary adenomas using irradiation alone. Between 1983 and 1991, 21 patients suffering from GH-secreting pituitary adenomas were treated with radiotherapy alone. Two bilateral opposing coaxial fields were used in 10 patients and in the remaining 11 a third frontovertex field was added. Treatment was given in 1.8-2 Gy daily fractions and total dose ranged between 45 and 54 Gy. Treatment was given using a cobalt unit. Four patients treated with somatostatin prior to and 14 patients treated after the end of radiotherapy experienced symptom relief for 6-28 weeks. The 5-year actuarial rate of disease control was 72%. Five out of six failed patients had macroadenomas. Hypopituitarism was observed in 5/21 (24%) patients. Whereas RT alone is effective in the treatment of microadenomas, this is not true for large infiltrative macroadenomas. (orig.)

  16. Radiation therapy in the multimodal treatment approach of pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Becker, G. [Klinik am Eichert, Goeppingen (Germany). Dept. of Radiooncology and Radiation Therapy; Radiooncologic Univ. Clinic, Tuebingen (Germany); Kocher, M.; Mueller, R.P. [Koeln Univ. (Germany). Clinic of Radiation Therapy; Kortmann, R.D.; Paulsen, F.; Jeremic, B.; Bamberg, M. [Radiooncologic Univ. Clinic, Tuebingen (Germany)

    2002-04-01

    In this paper, literature will be reviewed to assess the role of modern radiotherapy and radiosurgery in the management of pituitary adenomas. Material and Methods: Nowadays, magnetic resonance imaging for the definition of the target volume and a real three-dimensional (3-D) treatment planning with field conformation and the possibility for non-coplanar irradiation has to be recommended. Most groups irradiate these benign tumors with single doses of 1.8-2.0 Gy up to a total dose of 45 Gy or 50.4 Gy in extensive parasellar adenomas. Adenomas are mostly small, well circumscribed lesions, and have, therefore, attracted the use of stereotactically guided high-precision irradiation techniques which allow extreme focussing and provide steep dose gradients with selective treatment of the target and optimal protection of the surrounding brain tissue. Results: Radiation therapy controls tumor growth in 80-98% of patients with non-secreting adenomas and 67-89% for endocrine active tumors. Reviewing the recent literature including endocrine active and non-secreting adenomas, irradiated postoperatively or in case of recurrence the 5-, 10- and 15-year local control rates amount 92%, 89% and 79%. In cases of microprolactinoma primary therapy consists of dopamine agonists. Irradiation should be preferred in patients with macroprolactinomas, when drug therapy and/or surgery failed or for patients medically unsuitable for surgery. Reduction and control of prolactin secretion can be achieved in 44-70% of patients. After radiotherapy in acromegaly patients somatomedin-C and growth hormone concentrations decrease to normal levels in 70-90%, with a decrease rate of 10-30% per year. Hypercortisolism is controlled in 50-83% of adults and 80% of children with Cushing's disease, generally in less than 9 months. Hypopituitarism is the most common side effect of pituitary irradiation with an incidence of 13-56%. Long-term overall risk for brain necrosis in a total of 1,388 analyzed

  17. Pure Androgen-Secreting Adrenal Adenoma Associated with Resistant Hypertension

    Directory of Open Access Journals (Sweden)

    René Rodríguez-Gutiérrez

    2013-01-01

    Full Text Available Pure androgen-secreting adrenal adenoma is very rare, and its diagnosis remains a clinical challenge. Its association with resistant hypertension is uncommon and not well understood. We present an 18-year-old female with a 10-year history of hirsutism that was accidentally diagnosed with an adrenal mass during the evaluation of a hypertensive crisis. She had a long-standing history of hirsutism, clitorimegaly, deepening of the voice, and primary amenorrhea. She was phenotypically and socially a male. FSH, LH, prolactin, estradiol, 17-hydroxyprogesterone, and progesterone were normal. Total testosterone and DHEA-S were elevated. Cushing syndrome, primary aldosteronism, pheochromocytoma, and nonclassic congenital adrenal hyperplasia were ruled out. She underwent adrenalectomy and pathology reported an adenoma. At 2-month followup, hirsutism and virilizing symptoms clearly improved and blood pressure normalized without antihypertensive medications, current literature of this unusual illness and it association with hypertension is presented and discussed.

  18. Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Nlicole M Martin; Barham K Abu Dayyeh; Raymond T Chung

    2008-01-01

    Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half alter his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery.This is the first reported case of hepatic adenoma re-growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.

  19. MR imaging of growth hormone-secreting pituitary adenomas

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Masayuki; Ueda, Fumiaki; Fujinaga, Yasunari [Kanazawa Univ. (Japan). School of Medicine] (and others)

    2000-11-01

    We evaluated MR imaging of 51 growth hormonesecreting pituitary adenomas. On T1WI, 22 tumors were isointense with gray matter (GM), nine isointense with GM and white matter (WM), 14 isointense with WM, and six more hyperintense than WM. On T2WI of 45 patients, only fifteen tumors showed hypointensity than WM, 10 were isointense with WM, eight isointense with GM and WM, 12 showed in part isointensity with GM, and one was more hyperintense than GM. The dynamic study demonstrated the tumor more clearly than the delayed study in 10, while the opposite was true for two patients. The dynamic study is inevitable for MR imaging of GH-secreting pituitary adenomas. (author)

  20. Adenoma paratiroideo. Presentación de un caso

    Directory of Open Access Journals (Sweden)

    Daniel Olivera Fajardo

    2016-10-01

    Full Text Available El adenoma paratiroideo es un tumor no canceroso de las glándulas paratiroides, que aumenta los niveles de parathormona. Esta hormona regula los niveles de calcio, fósforo y vitamina D en sangre y huesos. Su triada clásica se caracteriza por aumento de los niveles de parathormona, hipercalcemia e hipofosfatemia. Esta entidad afecta a uno entre 500-1000 habitantes y es la causa principal de hiperparatiroidismo primario en un 80- 85 % de los pacientes. Se presenta el caso de una paciente femenina de 69 años de edad, ingresada por fracturas patológicas de cadera, clavícula y dedos de las manos, causada por hiperparatiroidismo primario originado por adenoma paratiroideo. Por la baja incidencia esta entidad, su publicación se considera de interés para el personal científico.

  1. Immunohistochemical Characteristics of Bone Forming Cells in Pleomorphic Adenoma

    Directory of Open Access Journals (Sweden)

    Keisuke Nakano, Takehiro Watanabe, Takako Shimizu, Toshiyuki Kawakami

    2007-01-01

    Full Text Available Histopathological and immunohistochemical examinations were carried out in a case of pleomorphic adenoma with bone formation, occurring in the chin of a 34-year-old Japanese man. Examination results showed the modified neoplastic myoepithelial cells reacted positively to S-100 protein. The S-100-positive modified neoplastic myoepithelial cells were proliferated in the closely related area of the bone tissue. Furthermore, positive reaction was detected in the bone forming cells: osteoblasts and osteocytes. These cells also reacted positively to Runx2 as a marker of bone forming cells. These results suggest that the origin of the bone forming cells in this case of pleomorphic adenoma was modified neoplastic myoepithelial cells.

  2. Presentation of parathyroid adenoma with genu valgum and thoracic deformities.

    Science.gov (United States)

    Zil-E-Ali, Ahsan; Latif, Aiza; Rashid, Anam; Malik, Asim; Khan, Haseeb Ahmed

    2016-01-01

    Parathyroid adenoma is the main cause of primary hyperparathyroidism. It is usually asymptomatic and occurs more commonly in adults. It presents with raised parathormone (PTH) and Ca+ levels in serum. Its presentation in adolescence is rare. We report one such incidence of a 14 years old girl who presented with bone pains short stature, and generalized muscle wasting. She was found to have genu valgum at the knee joint, pectus carniatum, scoliosis and cystic changes in pelvis and calvarium. Biochemical investigations and parathyroid Tc-99mMIBI scan confirmed the diagnosis of a parathyroid adenoma. The gland was removed by parathyroidectomy. Till date 12 such cases are reported and none had thoracic, vertebral or calvarium involvement.

  3. Main-duct intraductal papillary mucinous adenoma of the pancreas

    Directory of Open Access Journals (Sweden)

    Takuma Kensuke

    2011-11-01

    Full Text Available Abstract Background The prevalence of carcinoma in main-duct intraductal papillary mucinous neoplasm (IPMN is high, and surgical resection is recommended for all patients with a main-duct IPMN. Results A main-duct IPMN with typical imagings including protruding lesions in the dilated main pancreatic duct was resected, but the histology was intraductal papillary mucinous adenoma of the pancreas. Discussion It has been reported that the presence of mural nodules and dilatation of MPD are significantly higher in malignant IPMNs. The presented case had protruding lesions in the dilated main pancreatic duct on endoscopic ultrasonography, but the histology was adenoma. Conclusion Preoperative distinction between benign and malignant IPMNs is difficult.

  4. Pyogenic liver abscess associated with large colonic tubulovillous adenoma

    Institute of Scientific and Technical Information of China (English)

    Hsueh-Chou Lai; Cho-Yu Chan; Cheng-Yuan Peng; Chih-Bin Chen; Wen-Hsin Huang

    2006-01-01

    Pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus (DM). The pathogen in the patient with DM was Klebsiella pneumonia (KP). In both of the patients, ileus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases: (1) an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; (2) DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

  5. Intensive groundwater use: a silent revolution that cannot be ignored.

    Science.gov (United States)

    Llamas, M R; Martínez-Santos, P

    2005-01-01

    Over the last decades, agriculture in arid and semi-arid countries has experienced a true "silent revolution" of intensive groundwater use. Millions of independent farmers worldwide have chosen to become increasingly dependent on the reliability of groundwater resources, and as a result their countries have reaped abundant social and economic benefits. Data from several countries shows that groundwater irrigation presents a much greater efficiency, than surface water irrigation systems, thus contributing to fulfil the motto of "more crops and jobs per drop". If this situation is confirmed globally, the usual world water visions have to be reviewed. However, the "silent revolution" has been carried out with scarce control on the part of governmental water agencies, and thus a series of unwanted effects have developed in certain places. While these by no means justify the pervasive "hydromyths" and obsolete paradigms that voice the frailty of groundwater, appropriate management of groundwater resources remains a worldwide challenge. This paper provides an overview of these issues, and concludes with the necessity there is to educate all levels of society on the importance of groundwater and to create bottom-up user associations to manage aquifers as common pool resources.

  6. Combustion Enhancement Using a Silent Discharge Plasma Reactor

    Science.gov (United States)

    Rosocha, Louis; Platts, David; Coates, Don; Stange, Sy

    2003-10-01

    Electric fields affect flame propagation speed, stability, and combustion chemistry. External electrodes, arc discharges, and plasma jets have been used to combust gas mixtures outside their flammability limits. Experiments with silent electrical discharges (SEDs) and propagating flames have shown that flame propagation velocity is actually decreased (combustion retarded) when an SED is applied directly to the flame region, but velocity is increased (combustion promoted) when applied to the unburned gas mixture upstream of a flame. More recent work has proposed electric arc/microwave-driven plasma-generating fuel nozzles to produce dissociated fuel or ionized fuel for aircraft gas turbine engine combustor mixers. In contrast to prior works, we have used a silent discharge plasma (SDP) reactor to break up large fuel molecules into smaller molecules and create free radicals/active species in a gas stream before the fuel is mixed with an oxidizer and combusted. A cylindrical SDP reactor was used to 'activate' propane before mixing it with air and igniting the combustible gas mixture. With the plasma, the physical appearance of the flame changes and substantial changes in mass spectrometer fragmentation peaks for fuel and combustion products are observed (i.e., combustion is enhanced). Results of changes in the degree of combustion will be discussed in terms of variations in the plasma specific energy.

  7. Cutaneous silent period in human FDI motor units.

    Science.gov (United States)

    Kahya, Mehmet C; Yavuz, S Utku; Türker, Kemal S

    2010-09-01

    In this study, we aimed to use both the probability-based and the frequency-based analyses methods simultaneously to examine cutaneous silent period (CSP) induced by strong electrical currents. Subjects were asked to contract their first dorsal interosseus muscles so that one motor unit monitored via intramuscular wire electrodes discharged at a rate of approximately 8 Hz. Strong electrical stimuli were delivered to the back of the hand that created a subjective discomfort level of between 4 and 7 [0-10 visual analogue scale] and induced cutaneous silent period in all units. It was found that the duration of the CSP was significantly longer when the same data were analysed using frequency-based analysis method compared with the probability-based methods. Frequency-based analysis indicated that the strong electrical stimuli induce longer lasting inhibitory currents than what was indicated using the probability-based analyses such as surface electromyogram and peristimulus time histogram. Usage of frequency-based analysis for bringing out the synaptic activity underlying CSP seems essential as its characteristics have been subject to a large number of studies in experimental and clinical settings.

  8. Silent Cerebral Small Vessel Disease in Restless Legs Syndrome.

    Science.gov (United States)

    Ferri, Raffaele; Cosentino, Filomena I I; Moussouttas, Michael; Lanuzza, Bartolo; Aricò, Debora; Bagai, Kanika; Wang, Lily; McLaughlin, BethAnn; Walters, Arthur S

    2016-07-01

    Growing literature suggests that patients with restless legs syndrome (RLS) may be at increased risk for hypertension, heart disease, and stroke. Cerebral small vessel disease (SVD) is a known risk factor for clinical stroke. This study evaluated silent cerebral SVD by MRI in patients with RLS, in the absence of a history of previous clinical stroke or known stroke risk factors and taking into account disease duration. Fifty-three patients with RLS 10 y and 74 normal controls. A magnetic resonance imaging study was obtained from all subjects and scans were analyzed for area and volume of SVD. There was a significant increase in SVD area in the entire group of RLS patients compared to controls (P = 0.036); this was almost entirely driven by the group with RLS > 10 y. SVD area and volume were significantly increased in patients with RLS > 10 y with respect to both controls (P disease. Duration of RLS was an independent predictor of the burden of cerebral SVD (area P disease; our data support the hypothesis that a long-lasting RLS and its accompanying periodic limb movements in sleep are a risk factor for silent SVD and perhaps for the development of clinical stroke. © 2016 Associated Professional Sleep Societies, LLC.

  9. Three cases of ectopic sphenoid sinus pituitary adenoma

    Directory of Open Access Journals (Sweden)

    Ernest Jan Bobeff

    2017-03-01

    Full Text Available Introduction : Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke’s pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. Aims : To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. Material and methods: Analysis of three cases: two females and one man, aged 61-70. Results : One patient presented with a unilateral hearing loss, the other two with headache and vertigo. They all suffered from type 2 diabetes mellitus. Neurological examination revealed no abnormality. Radiological imaging showed a sphenoid sinus space-occupying soft-tissue lesion with bone erosion in 2 cases and empty sella in 2 patients whereas one had a normal pituitary gland. All were operated on via the transnasal approach. Total resection was achieved in one patient and subtotal in two; in two cases we observed intact sellar dura and in one intact sellar floor. Histopathology showed immunoreactivity for synaptophysin in all cases and cytokeratin in two. The Ki-67 index was less than 2%. Immunohistochemical staining demonstrated growth hormone cells in all cases whereas prolactin and adrenocorticotropin in two. The patients were discharged home in good condition with no neurological deficits. Conclusions : Ectopic sphenoid sinus pituitary adenoma should always be considered in differential diagnosis of sphenoid sinus lesion in the elderly, especially in coexistence with empty sella or type 2 diabetes mellitus. Since ectopic sphenoid sinus pituitary adenoma is a benign lesion, surgical removal is an effective treatment.

  10. Abdominal obesity as the colorectal adenomas risk factor

    Directory of Open Access Journals (Sweden)

    K. N. Mylytsya

    2016-10-01

    Full Text Available Obesity is a risk factor for many diseases, including colorectal cancer. Aim: to study association of the constitutional features (height, weight, waist circumference with detection of colon polyps on the screening colonoscopy. Materials and methods: Constitutional features (height, weight, waist circumference of 145 patients were assessed with detection of colon polyps on the screening colonoscopy for the period from 2013to 2015. Exclusion criteria were: cancer of any location in history, surgery within the past two years, the inflammatory bowel diseases (Crohn's disease, ulcerative colitis, autoimmune diseases (rheumatoid arthritis, HIV, AIDS, SLE, diabetes, chronic liver or kidney disease, family polyposis. Results: the presence of adenomas (OR = 6.0 CI: 2,2-16,7; multiplicity of polyps (the possibility that there will be ≥ 3 polyps was 6.4, CI: 1,4-29,9 were significantly higher in obese patients than in those with normal weight. Subjects with a waist circumference in the highest tertile (>115 cm, were 4.6 times more likely to identify ≥ 3 polyps than those with waist circumference in the lowest tertile (<96 cm . The probability of detection of adenomas in patients with a waist circumference in the highest tertile were 6.2 times higher than in the lowest tertile. Conclusions. Visceral obesity is associated with a morphological type and number of colon polyps. The presence of visceral obesity significantly increases the risk of colon adenomas. Increased visceral fat layer is an indication for colonoscopy especially of the right half of the colon examination. Screening colonoscopy should be recommended for the obese patients after 50 y.o. in order to diagnose adenomas of the colon and colorectal cancer.

  11. Prothymosin-alpha and Ki-67 expression in pituitary adenomas

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    Iga Wierzbicka-Tutka

    2016-11-01

    Full Text Available Introduction: Prothymosin alpha (PTMA, a nuclear oncoprotein involved in cell cycle regulation, is used as a prognostic marker in many cancers. The histopathology of pituitary carcinomas and locally invasive adenomas is indistinguishable from that of benign tumors. A new marker is needed to differentiate these lesions. We evaluated PTMA in pituitary adenomas to determine its usefulness as a prognostic factor of tumor proliferation.Material/Methods: We conducted a retrospective analysis of a group of 27 patients, including 15 females (56% and 12 males (44% with a mean age of 58.6±12 years, who underwent pituitary tumor surgery between 2003 and 2012. The Ki-67 and PTMA-nuclear (PTMA-n and PTMA-cytoplasmic (PTMA-c indices were determined by immunohistochemical staining. We studied histopathological features, clinical symptoms, and magnetic resonance imaging or computed tomography performed before surgery and one year following surgery to evaluate tumor size and progression.Results: The expression of Ki-67 was revealed in 77.8% of adenomas, PTMA-n in 81.5% and PTMA-c in 92.6%. The mean value of the Ki-67 index was 1.8%, PTMA-n was 1.84%, and PTMA-c was 35.6%. There was a significant positive correlation between Ki-67 and PTMA-n (p=0.009. We did not find any correlation between Ki-67, PTMA-c, and tumor progression. PTMA-n was found to be correlated with tumor size (p=0.045 and was higher in the case of gonadotropinomas (p=0.026.Conclusions: The positive nuclear expression of Ki-67 and PTMA was observed in the majority of pituitary adenomas. Neither the expression of Ki-67 nor that of PTMA-c was related to tumor recurrence or local invasion.

  12. Fatal complication after transsphenoidal surgery of pituitary adenoma: case report

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    Conceição Aparecida Dornelas; Tereza N. A. G. Nogueira; Evandro T. Alves; River A. B. Coêlho

    2015-01-01

    ABSTRACT The objective of this study was to report a rare fatal complication in the postoperative period of transsphenoidal surgery of the pituitary gland (adenoma), with a brief review of the subject. The patient was a 54-year-old white man with acromegaly and severe heart failure, who after microsurgery developed blood pressure instability within 32 hours after the procedure and died. The autopsy revealed: hypertrophy and ventricular dilation with myocarditis, pericarditis and myocardial fi...

  13. Successful treatment of multiple hepatocellular adenomas with percutaneous radiofrequency ablation

    OpenAIRE

    Ahn, Sun Young; Park, Soo Young; Kweon, Young Oh; Tak, Won Young; Bae, Han Ik; Cho, Seung Hyun

    2013-01-01

    Hepatocellular adenoma (HCA) is one of the important complications of glycogen storage disease type Ia (GSD-Ia) because it can be transformed into hepatocellular carcinoma. Although surgical resection is a standard treatment of choice for solitary HCA, multiple HCAs in GSD-Ia patients present as therapeutic challenges for curative treatment. Therefore, treatment strategy according to malignant potential is important in management of HCAs in GSD-Ia. The authors present a case of histologically...

  14. Cortisol Secreting Adrenal Adenoma in a 5 Year Old Child

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    Gursharan Singh Narang,

    2011-01-01

    Full Text Available Adrenal adenoma is a rare endocrinal tumor in children. It can present with features of Cushing's syndrome. We present a case report of five years old female child who came with morbid obesity and hypertension. The patient manifested polyphagia, weight gain, and changes in sleep patterns. During physical examination we found a full-moon face, bulkiness in the cervico-dorsal (buffalo-hump region, high blood pressure.

  15. Pleomorphic adenoma of the lacrimal gland. Case report.

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    Ostrosky, Alejandro; Klurfan, Federico Juan; Gonzalez, Maximiliano Jorge; Camaly, Diego; Villa, Diego

    2005-01-01

    Lacrimal gland tumors are rare. We present a case of a 69 year old male patient with a one year history of an orbital tumor (Pleomorphic Adenoma). The tumor was surgically enucleated and patient recovery was very satisfactory, with no signs of recurrence after one year of follow-up. A review of the clinical symptoms, radiologic features, treatment and histopathology of this kind of tumors is also made.

  16. [Pituitary adenomas--where is the treatment heading at the beginning of the 21st century?].

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    Marek, J

    2010-07-01

    To treat pituitary adenomas, three modes of treatment are usually combined: neurosurgery, radiation and pharmacological. Prolactinomas are an exception with predominantly pharmacological management. Patients with acromegaly are usually diagnosed late and thus many neurosurgeries fail to completely remove the adenoma. Any residual tumour tissue is usually irradiated with the Leksell Gamma Knife, and dopamine agonists, somatostatine analogues or growth hormone receptor antagonists are used to normalize the hormonal hypersecretion until the complete effect of the radiation. The same surgical and Gamma Knife procedures are used in patients with the Cushing's disease and TSH-secreting adenomas. Ketoconazole, metyrapone and cabergoline are used until the radiation effect in the Cushing's disease is complete, similarly, somatostatine analogues are used in TSH-secreting adenomas. Nonfunctional adenomas are less responsive to pharmacological treatment. Proautophagic cytostatic temozolamide has been used in aggressive pituitary adenomas and carcinomas.

  17. Endoscopic transsphenoidal approach to pituitary adenomas invading the cavernous sinus

    Institute of Scientific and Technical Information of China (English)

    TAO Yu-xin; QU Qiu-yi; WANG Zhen-lin; ZHANG Qiu-hang

    2010-01-01

    Background Surgery of pituitary adenomas invading cavernous sinus has always been thought as a challenge due to the complex anatomical structures and high risk of complications. The purpose of this study was to evaluate endoscopic trarssphenoidal approach to pituitary adenomas invading cavernous sinus.Methods The clinical data of 22 patients who admitted to Xuanwu Hospital with pituitary adenomas invading cavernous sinus were analyzed retrospectively. All patients underwent endoscopic transsphenoidal surgery. To expose the surgical field sufficiently, the opening of sellar floor was exceeded the bone overlying the invaded cavernous sinus, and synthetic dura was used to repair and strengthen the sella floor for preventing the leak of cerebrospinal fluid.Results Among 22 patients, total resection was achieved in 14, subtotal resection in 5, and partial resection in 3; no patient underwent insufficient resection. Visual symptoms improved in 7 of 9 patients. In one patient diplopia disappeared.Headache was relieved to various extents in all patients. No serious complications were found. Patient's hospital stay ranged from 7 to 20 days.Conclusion These data suggest that the endoscopic transsphenoid approach is a safe, minimally invasive, and efficient surgical technique, which might be an important therapeutic strategy for the pituitary adenoms invading cavernous sinus.

  18. A Case of Basal Cell Adenoma of the Upper Lip

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    Masanori Kudoh

    2014-01-01

    Full Text Available Basal cell adenoma is a rare type of benign salivary gland tumor found most commonly in the parotid gland. We present a rare case of basal cell adenoma arising in the minor salivary gland of the upper lip. The patient was a 59-year-old Japanese man who visited our department in December 2012 with a chief complaint of a mass in the upper lip, which had increased in size over several years. A mobile, elastic, and relatively soft mass without tenderness was palpable in the upper lip region. The mucosa of the upper lip covering the mass was normal. Tumor extirpation was performed under local anesthesia. Histologically, the tumor had a capsule and was composed of islands of relatively uniform, monotonous cells. Immunohistochemically, the inner tumor comprised tubuloductal structures that showed strong staining for CK7, while the outer tumor showed weak staining for CK7. The outer tumor cells also stained positively for CD10 and p63. The MIB-1 (Ki-67 labeling index was extremely low. Basal cell adenoma was diagnosed based on these results. The postoperative course was uneventful 12 months after surgery and there has been no recurrence.

  19. Adenoma of the posterior urethra: 131 case report

    Institute of Scientific and Technical Information of China (English)

    Zhen-Guo MI; Xiao-Feng YANG; Xue-Zhi LIANG; Hong-Yao LIU; Shang-Yin LIU; Hong ZHANG; Dong-Wen WANG; Chun LIU

    2001-01-01

    A case-report on adenoma of the posterior urethra. Methods: In 131 cases of adenoma of the posterior urethra, aged 17- 79 (mean: 36.4) years, a detailed medical history was taken and urinalysis, urethroscopy, and prostatic specific antigen (PSA) immunohistochemical staining were performed. They were then treated with transurethral resection (TUR) or transurethral electric coagulation (TUEC). Results: Hemospermia occurred in 51% of the cases, hematuria in 38 %, bood overflow from the urethral orifice in 6 %, and dysuria in 5 %. The position of the tumor was at or around the verurumontanum. The appearance of the rumor was similar to those of a papilla, a villus, a dactyl or polyp, or simply an engorgement. The tumor contained glandular alveoli and adeno-epithelial cells. PSA immunohistochemistry was positive in the cytoplasm and nucleus of the adeno-epithelial cell. One hundred and tweenty-nine cases were cured after TUR or TUEC, while 2 patients recurred and were operated again. Conclusion: Adenoma of the posterior urethra is a common cause of hemospermia and hematuria in young men. Urethroscopic examination and biopsy are the principal diagnostic measures. TUR or TUEC are believed to be the treatment of choice with a short-term recurrence rate of around 1.5%.

  20. Management of clinically non-functioning pituitary adenoma.

    Science.gov (United States)

    Chanson, Philippe; Raverot, Gerald; Castinetti, Frédéric; Cortet-Rudelli, Christine; Galland, Françoise; Salenave, Sylvie

    2015-07-01

    Clinically NFPA is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as pituitary incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  1. Expression of p53 protein in pituitary adenomas

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    Oliveira M.C.

    2002-01-01

    Full Text Available Inactivating mutations of TP53, a tumor suppressor gene, are associated with abnormal cell proliferation. Although p53 expression is common in many human malignancies, p53 protein has seldom been evaluated in pituitary tumors. When detected, the percentage of p53-positive cells is low, and, in general, it is exclusive for invasive lesions. The aim of the present study was to use immunohistochemistry to determine the presence of p53 protein in pituitary adenomas from tumor samples of 163 surgeries performed in 148 patients (40% male, 60% female. In 35% of the cases the adenoma was nonfunctional, while in the others it was associated with PRL, GH and/or ACTH endocrine hypersecretion syndrome. Macroadenomas were observed in 83.2% of the cases with available neuroimage evaluation, of which 28% invaded the cavernous, sphenoid and/or ethmoidal sinus, bone, third ventricle or subfrontal lobe. p53 protein was detected in 2/148 patients (1.3%. Immunohistochemistry was positive for PRL and GH in these cases. Due to the high percentage of invasive pituitary adenomas found in our study, the low frequency of p53 detection suggests that it is inadequate as a routine marker for aggressiveness and as a predictive factor of tumor behavior.

  2. Carcinoma ex pleomorphic adenoma of the parotid gland

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    Kashiwagi, Nobuo; Murakami, Takamichi (Dept. of Radiology, Kinki Univ. School of Medicine, Osaka (Japan)), Email: kashiwaginobuo@yahoo.co.jp; Chikugo, Takaaki (Dept. of Pathology, Kinki Univ. School of Medicine, Osaka (Japan)); Tomita, Yasuhiko (Dept. of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)); Kawano, Kiyoshi (Dept. of Pathology, Belland General Hospital, Sakai City, Osaka (Japan)); Nakanishi, Katsuyuki (Dept. of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan)); Mori, Kazunori (Dept. of Otolaryngology, Kinki Univ. School of Medicine, Osakasayama City, Osaka (Japan)); Tomiyama, Noriyuki (Dept. of Radiology, Osaka Univ. Graduate School of Medicine, Osaka, Japan (Japan))

    2012-04-15

    Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare aggressive epithelial malignancy arising from a primary or recurrent benign mixed tumor. Only a few case reports describing the radiologic features of CXPA have been published. Purpose: To describe and characterize the magnetic resonance (MR) imaging findings of CXPA in the parotid gland and correlate them with pathologic findings. Material and Methods: The MR images of surgically proven CXPA in the parotid gland of five men and five women ranging in age from 28 to 75 years (mean 52 years) were retrospectively reviewed. All MR images were evaluated with emphasis on the size, margin characteristics, extraparotid infiltration, the presence of an encapsulated component, and signal intensity on T2-weighted or short-inversion-time inversion recovery (STIR) images. Results: The average maximal diameter was 4.3 cm. All 10 tumors had ill-defined boundaries, and seven tumors showed extraparotid infiltration, reflecting invasive growth of the malignant component identified on histological examination. Eight tumors had a round encapsulated component and seven of those signal intensities were a mixture of hypo- and hyperintensity on T2-weighted or STIR images. Histological correlation of these components revealed fibrously encapsulated tumors containing hyalinization and myxoid tissue, suggesting degenerated pleomorphic adenoma. Invasive malignant components had non-specific and various signal intensities. Conclusion: An invasive parotid mass co-existing with a round encapsulated component is suggestive of carcinoma ex pleomorphic adenoma

  3. Hypertrophic osteopathy associated with a renal adenoma in a cat.

    Science.gov (United States)

    Johnson, Robert L; Lenz, Stephen D

    2011-01-01

    Hypertrophic osteopathy is a hyperostotic syndrome of the appendicular skeleton that is most commonly associated with intrathoracic neoplasia or inflammation. The condition is rarely associated with intra-abdominal lesions. The majority of cases have occurred in dogs and human beings, with fewer cases reported in cats, horses, and other species. A 15-year-old male neutered Domestic Shorthair cat presented for swollen limbs and difficulty in ambulation. Radiographs and gross postmortem revealed severe periosteal hyperostosis of the diaphysis and metaphysis of all 4 limbs, including the humerus, radius, ulna, carpi, metacarpi, femur, tibia, tarsi, metatarsi, and phalanges. The axial skeleton was spared. Hyperostotic lesions were characterized microscopically by lamellar bony trabeculae separated by adipocytes and scant hematopoietic tissue. In several areas, fibrovascular connective tissue, woven bone, and islands of cartilage were also present. A 2.5 cm × 2.5 cm perirenal neoplasm compressed the left kidney and adrenal gland. This mass consisted of well-differentiated tubules of cuboidal epithelial cells and was most consistent with a renal tubular adenoma, because mitotic figures were rare, and no distant metastases were found. Thoracic pathology was absent. Hyperostosis was consistent with hypertrophic osteopathy secondary to the renal adenoma. The pathogenesis of hypertrophic osteopathy is uncertain, but predominant theories point to increased peripheral circulation and angiogenesis as a key initiating event. Recent literature highlights the potential role of vascular endothelial growth factor and platelet-derived growth factor in the human condition. The mechanism by which this renal adenoma caused hypertrophic osteopathy is unknown.

  4. Anaplastic astrocytoma 14 years after radiotherapy for pituitary adenoma

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    Tamura, Masaru; Misumi, Syuuzou; Kurosaki, Syuuhei; Shibasaki, Takashi; Ohye, Chihiro (Gunma Univ., Maebashi (Japan). School of Medicine)

    1992-04-01

    A case of anaplastic astrocytoma following radiotherapy for growth hormone secreting pituitary adenoma is presented with a review of the literature. A 43 year old female was admitted with signs of acromegaly and hypertension. An eosinophilic pituitary adenoma was subtotally removed by transsphenoidal approach, followed by 60 Gy irradiation using a 2x2 cm lateral field. Fourteen years later at the age of 57, she suffered from headache, recent-memory disturbance and uncinate fits. CT scan and MRI disclosed ring-like enhanced mass lesion in the left temporal lobe, corresponding to the previous irradiated field. {sup 18}F-FDG PET showed hypermetabolism at the lesion. Left frontotemporal craniotomy was performed, and a reddish gray gelatinous tumor containing necrotic center and cyst was partially removed. Histologically, the tumor consisted of hypercellular astrocytic cells with perivascular pseudorosette. Coagulation necrosis at the center of the tumor, and hyalinosis and fibrosis of the blood vessels in and around the tumor, which might have been caused by the antecedent radiotherapy, were recognized. Postoperative radiotherapy and chemotherapy, were given, however, she expired 13 months after the operation. Seven cases, including ours, of malignant glioma following radiotherapy for pituitary adenoma were reported in the literature. A total dose of irradiation varies from 45 to 95 Gy with a mean of 50 Gy. The period of latency before tumor occurrence ranges from 5 to 22 years with a mean of 10 years. The differentiation of radiation-induced gliomas from radionecrosis of the brain is also discussed. (author).

  5. [Treatment of prostatic adenoma with concomitant chronic bacterial prostatitis].

    Science.gov (United States)

    Davidov, M I

    2011-01-01

    A randomized trial of efficacy and safety of vitaprost plus and vitaprost forte has been made in 70 patients with prostatic adenoma comorbid with chronic bacterial prostatitis. The patients were randomized into two groups: group 1 patients received vitaprost plus in rectal suppositoria for 1 months, then vitaprost forte for 2 months; group 2 patients (control) received gentos and lomefloxacin per os. Short- and long-term results were evaluated in 3 and 6 months. By all parameters group 1 achieved better treatment results than controls. Immediate positive response was observed in 97.1% patients, long-term positive effects were observed in 85.7%. Total points of prostatic adenoma symptoms reduced by 37%, chronic prostatitis--by 55%, residual urine diminished by 66%, Qmax increased, quality of life improved by 45%, sexual function enhanced. Size of the prostate decreased by 7.4 cm3, leukocyte count in prostatic secretion fell 6-fold, eradication of prostatitis causing agent was achieved in 3 months in 80% patients. Side effects and complications were not registered. Thus, vitaprost plus and vitaprost forte are highly effective and safe for treatment of patients with combination of prostatic adenoma with chronic bacterial prostatitis.

  6. Shift of the pituitary stalk in intrasellar pituitary adenomas

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    Ito, Jusuke; Tokiguchi, Susumu; Nakamori, Akitoshi (Niigata Univ. (Japan). School of Medicine); Watanabe, Akira; Yokoyama, Motoharu

    1982-08-01

    Fifty-one patients from a group of 344 patients undergoing the evaluation of intrasellar or parasellar tumors were diagnosed on CT as having an intrasellar pituitary adenoma. Axial transverse sections were performed at -10/sup 0/ to Reid's basal line, using 1.5-mm-thick slices and sagittal and coronal reformation. Of these 51 patients, 17 showed a shift of the pituitary stalk. The area where a tumor was thought to be located within the sella turcica on preoperative CT became defective on CT after transsphenoidal surgery in all cases. Histological verification was obtained in all cases. Also, the shift of the pituitary stalk was normalized or markedly improved after surgery in all cases. In functioning tumors, all cases except two showed an endocrinologically normal state or a marked improvement after transsphenoidal surgery. On the basis of the above-mentioned facts, it was concluded that the shift of the pituitary stalk in intrasellar pituitary adenomas indicated the evidence of a mass and its location in the sella turcica. However, a shift of the pituitary stalk was also observed under other conditions, such as empty sella and tuberculum sellae meningioma, and so it is not a pathognomonic finding in intrasellar pituitary adenomas.

  7. Laparoscopic simple prostatectomy: A reasonable option for large prostatic adenomas

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    Abdulrahman Al-Aown

    2015-01-01

    Full Text Available Aim of the Study: In this work, surgical technique followed by two academic departments on laparoscopic simple prostatectomy (LSP of large prostatic adenomas is being described. Materials and Methods: The initial cumulative experience from 11 patients with lower urinary tract symptoms of benign prostatic hyperplasia origin subjected to LSP is being presented. Results: All cases had prostatic adenomas greater than 80 ml. Mean operation time was 99.5 min (values from 70 to 150 min and mean blood loss was 205 ml (values from 100 to 300 ml. Blood transfusion was deemed necessary in one case. Bladder catheter was removed successfully on postoperative day 5 in all cases. No significant postoperative complication was noted. At a 3 months follow-up a significant decrease in International Prostate Symptom Score (IPSS was evident in all patients (mean IPSS 27.7 vs. 15.3 preoperative vs. postoperative accordingly. Conclusions: According to our data and similarly to the rest of the LSP literature, laparoscopic excision of voluminous prostatic adenomas is a feasible and safe procedure. Nevertheless, further investigation including a larger number of patients and long-term follow-up is deemed necessary before making definite conclusions regarding the approach.

  8. Intraosseous pleomorphic adenoma: case report and review of the literature.

    Science.gov (United States)

    Aver-De-Araujo, L M; Chaves-Tarquinio, S B; Neuzling-Gomes, A P; Etges, A

    2002-01-01

    Pleomorphic adenoma is the most common neoplasm of the salivary glands, affecting mainly the parotid gland. The preferential intraoral site of this tumor is the palate. A case of a 31-year-old woman with an intraosseous pleomorphic adenoma located in the maxilla (left paramedian region), showing an approximate evolution of one year is reported. The present intraosseous case represents a rare location, with the tumor probably originating from glandular epithelial remnants captured during embryogenesis. In a review of the literature of 142 cases of intragnathic localization (24% in the maxilla) are identified. A slight predominance of women was observed (56%), with 55% of the patients being affected during the 5th to 7th decade of life. The tumors were malignant in 94% of the cases, with special predominance of mucoepidermoid carcinoma (65%). Intraosseous pleomorphic adenomas are rare, with the present patient being the 6th case reported in the literature and the second found in the maxilla. Mean age of the 5 previously reported cases was 58.8 years.

  9. Subtipos de trastorno obsesivo-compulsivo, características diferenciales de los obsesivos puros y asociación con síntomas de ansiedad, depresión y preocupaciones

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    S. BARAJAS MARTÍNEZ

    2002-01-01

    Full Text Available El presente trabajo muestra datos de prevalencia (distinguiendo entre población rural y urbana, sociodemográficos y clínicos del trastorno obsesivo-compulsivo a partir de una muestra clínica española de 105 sujetos, según los criterios del DSM-IV. Para ello se utilizan medidas de ansiedad, depresión, preocupaciones excesivas y síntomas obsesivos: Beck Anxiety Inventory (BAI, Beck Depression Inventory (BDI, Penn State Worry Questionnaire (PSWQ y Maudsley Obssesive- Compulsive Inventory (MOCI respectivamente. Se analizan por separado los resultados obtenidos en distintos subtipos de este trast o rno (según tipo de obsesiones y compulsiones con especial atención al grupo de predominio obsesivo. Este grupo según la literatura tiene ciertas características diferenciales, (Marks, 1991 lo que ha motivado en la última década un nuevo desarrollo de teorías explicativas y estrategias de tratamiento (Freeston y Ladouceur, 1997a. Salkovskis, Forrester y Richards, 1998. Rachman, 1998.

  10. Serum neutralization with different types and subtypes of bovine herpesvirus 1 and 5 Soroneutralização com diferentes tipos e subtipos de herpesvírus bovinos 1 e 5

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    Carine Lidiane Holz

    2010-07-01

    BoHV-1 and BoHV-5. This might be particularly relevant for control programs and in international trade, were maximum sensitivity should be targeted.O teste de soroneutralização (SN é o método padrão para a mensuração de anticorpos neutralizantes para herpesvírus bovinos. Entretanto, com as subdivisões propostas destes agentes em tipos e subtipos, a definição de qual amostra utilizar como virus de desafio à SN pode ser difícil. Em vista disso, este estudo foi realizado para re-avaliar a sensibilidade de testes de SN utilizando diferentes tipos e subtipos de herpesvírus bovinos tipos 1 (BoHV-1 e 5 (BoHV-5 como amostras de desafio. Soros bovinos (n=810 foram coletados de duas regiões geográficas distintas e testados frente a amostras do tipo 1 (BoHV-1.1: amostras "Los Angeles" e "EVI123/98", BoHV-1.2a: amostra "SV265/96" e três amostras do tipo 5 (BoHV-5a: "EVI88/95"; BoHV-5b: "A663" e BoHV-5c "ISO97/95". Os testes de SN foram realizados com incubação de 1 hora a 37ºC da mistura soro-vírus, frente a 100 doses infectantes para 50% dos cultivos celulares (DICC50 de cada um dos vírus. A sensibilidade da SN variou grandemente em função do vírus utilizado no teste. A maior sensibilidade (327 soros positivos/810 soros testados; 40.37% foi alcançada quando os resultados positivos frente aos seis diferentes vírus foram somados. Nenhuma associação foi detectada entre determinado tipo/subtipo de vírus e a sensibilidade do teste. Quando resultados positivos frente a cada vírus foram considerados isoladamente, a sensibilidade da SN variou entre 41,7% a 81,7%, dependendo do vírus de desafio e da região geográfica de origem das amostras de soro. Variação foi detectada mesmo quando as amostras de desafio pertenciam a um mesmo subtipo; a discrepância entre os resultados positivos atingiu até 41%. Estes resultados indicam que testes de SN contra amostras isoladas de vírus podem apresentar uma sensibilidade notadamente baixa; o emprego de diferentes

  11. Diagnosis of adrenal adenoma and hyperplasia by CT and adrenal scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Kentaro; Itami, Jun; Nawano, Shigeru; Okada, Junichi; Ogino, Takashi; Uno, Koichi; Arimizu, Noboru

    1985-04-01

    The evaluation of X-CT and adrenal scintigraphy in diagnosis of Cushing syndrome and primary aldosteronism was studied in 18 patients. In Cushing syndrome, CT appearance of adenoma is commonly larger than that of primary aldosteronism and cleary deliniated by surrounding fat. So, in Cushing syndrome, diagnosis of adenoma on CT is much easier than that of primary aldosteronism, and absence of adenoma on CT suggests adrenal hyperplasia. In primary aldosteronism both of CT and scintigraphy must be performed.

  12. Pleomorphic adenoma of the vulva, clinical reminder of a rare occurrence

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    Neda A. Moatamed

    2012-01-01

    Full Text Available Pleomorphic adenoma, also known as mixed tumor, is a benign tumor which typically presents as a painless and persistent mass. The majority of pleomorphic adenomas involve the salivary glands, most commonly the parotid gland. Other sites include breast and skin. It is a rare tumor in the vulva. In this article we are reporting a case of pleomorphic adenoma of labia with characteristic pathologic and clinical findings, as reminder of a common benign neoplasm occurring with rare locality.

  13. Metanephric adenoma of the kidney in an infant: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Ja; Cheon, Jung Eun; Kim, Woo Sun; Kim, Chong Jai; Yoo, So Young; Kim, In One; Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-08-15

    Metanephric adenoma is a rare tumor of the kidney that has been reported mostly in adults. Despite its rarity, metanephric adenoma should be included in any differential diagnosis of solid renal masses in children, especially because of its benign nature and benign clinical course allowing for nephron sparing surgery. We report a case of metanephric adenoma, presented as a solid renal mass in a 14-month-old boy, and discuss the histologic basis of the imaging features of this entity.

  14. Adenomas hipofisários: relação entre invasividade e índice proliferativo tumoral Pituitary adenomas: relationship between invasiveness and proliferative cell nuclear index

    Directory of Open Access Journals (Sweden)

    OSWALDO INÁCIO DE TELLA JR

    2000-12-01

    Full Text Available Analisamos 76 pacientes com adenomas hipofisários do ponto de vista clínico, radiológico e tratamento cirúrgico. Todos os casos foram estudados por imuno-histoquímica e em 49 pacientes foi pesquisado o anticorpo monoclonal PCNA. Os adenomas bi-hormonais foram os mais frequentes seguidos dos prolactinomas e os adenomas não secretantes. Os adenomas bi-hormonais não secretantes e os produtores de subunidade alfa foram proporcionalmente mais invasivos pelos critérios radiológicos. A maioria dos pacientes (59 foi operada por via transeptoesfenoidal, em seis casos a via transcraniana foi realizada e em 11 pacientes houve necessidade das duas abordagens. A ressecção foi total em 32 pacientes, a maioria em microadenomas, subtotal em 15 e parcial em 29. A complicação endócrina mais frequente foi diabetes insipidus. Houve tendência de associação positiva para os adenomas secretantes e PCNA mais elevado, assim como relação positiva quando analisamos os adenomas invasivos pela tomografia computadorizada ou ressonância magnética e o PCNA 3 e 4. A melhora visual foi observada em 85% dos macroadenomas, mesmo quando a ressecção foi parcial ou subtotal.We evaluated clinically, radiologically and surgically a series of 76 pituitary adenomas. All cases were assessed immunohistochemically and in 49 patients the PCNA monoclonal antibody was measured. The most frequent types found were the bihormonal adenomas, followed by prolactinomas and non secreting adenomas. The bihormonal adenomas, non secreting adenonas and the sub unit alfa producing adenomas were proportionally more invase as determined by radiological criteria (CTscan or MRI. In 59 patients a transphenoidal approach was used, six cases were operated on transcranially and in 11 patients we used a combination of both approach. Total resection were achieved in 32 cases, most of which were microadenomas, in 15 cases the resection was subtotal and partial in 29 cases. Diabetes insipidus

  15. The Contributions of Oral and Silent Reading Fluency to Reading Comprehension

    Science.gov (United States)

    Price, Katherine W.; Meisinger, Elizabeth B.; Louwerse, Max M.; D'Mello, Sidney

    2016-01-01

    Silent reading fluency has received limited attention in the school-based literatures across the past decade. We fill this gap by examining both oral and silent reading fluency and their relation to overall abilities in reading comprehension in fourth-grade students. Lower-level reading skills (word reading, rapid automatic naming) and vocabulary…

  16. Cue System Usage of Students with and without Learning Disabilities in Oral and Silent Reading.

    Science.gov (United States)

    Schumm, Jeanne Shay; Arguelles, Maria Elena; Bessell, Ann; Giambo, Debra; Shimizu, Ward; Valle-Riestra, Diana; Zhang, Zhigang

    1998-01-01

    Compares how third- and fifth-grade learning-disabled and non-learning-disabled students use orthographic cues and contextual information during oral and silent reading. Finds that reliance on orthographic cues was consistently more pronounced in the oral than in the silent condition for all groups. Finds differences for students with and without…

  17. The Contributions of Oral and Silent Reading Fluency to Reading Comprehension

    Science.gov (United States)

    Price, Katherine W.; Meisinger, Elizabeth B.; Louwerse, Max M.; D'Mello, Sidney

    2016-01-01

    Silent reading fluency has received limited attention in the school-based literatures across the past decade. We fill this gap by examining both oral and silent reading fluency and their relation to overall abilities in reading comprehension in fourth-grade students. Lower-level reading skills (word reading, rapid automatic naming) and vocabulary…

  18. Morphology and Spelling in French Students with Dyslexia: The Case of Silent Final Letters

    Science.gov (United States)

    Quémart, Pauline; Casalis, Séverine

    2017-01-01

    Spelling is a challenge for individuals with dyslexia. Phoneme-to-grapheme correspondence rules are highly inconsistent in French, which make them very difficult to master, in particular for dyslexics. One recurrent manifestation of this inconsistency is the presence of silent letters at the end of words. Many of these silent letters perform a…

  19. Expression of Neuropeptide Y and Its Relationship with Molecular and Morphological Changes in Human Pituitary Adenomas.

    Science.gov (United States)

    Jia, Ruichao; Li, Mu; Chang, Binge; Chen, Laichao; Ma, Jingjian

    2015-12-01

    The purpose of this study was to explore the role of neuropeptide Y (NPY) on molecular and histological changes in human pituitary adenomas. The localization of NPY and its expression at the protein, messenger RNA (mRNA), and receptor levels were investigated here in different subcategories of pituitary adenomas. Immunohistochemical staining was performed in all cases to assess expression of NPY. Reverse transcription-polymerase chain reaction (RT-PCR) was used to study the mRNA expression of NPY. NPY subcellular localization was observed using immunoelectron microscopy in cytoplasm, rough endoplasmic reticulum, and cell matrix in four of the six cases of pituitary adenoma. NPY protein expression was observed in 59.6% of 57 cases of pituitary adenoma and in 2 cases of pituitary hyperplasia. mRNA expression of NPY was observed in all 57 cases of pituitary adenoma and in 2 cases of pituitary hyperplasia. Significantly different levels of expression were observed across different subcategories of pituitary adenoma. mRNA expression of Y1R and Y2R was observed across all subcategories of pituitary adenomas, and a positive correlation was observed between NPY and Y2R. In conclusion, evidence is provided here for the expression of NPY and its receptors, Y1R and Y2R, in human pituitary adenoma, and the levels of expression were found to differ across different subcategories. Differences in expression of Y2R in human pituitary adenomas were found to have remarkable statistical significance.

  20. An association between colonic adenoma and abdominal obesity: a cross-sectional study

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    Lee Sangyeoup

    2009-01-01

    Full Text Available Abstract Background Colorectal adenoma is a precursor lesion of colorectal cancer and thus, it is an important target for preventing colorectal cancer. Only a few studies suggest an association between colorectal adenoma and obesity, but results show considerable heterogeneity. In this study, we investigated the association between colorectal adenoma and waist circumference. Methods 165 adenoma cases and 365 polyp-free controls with a normal colon were compared in this cross-sectional study. Subjects underwent screening colonoscopy by experienced endoscopists. Demographic data, including smoking habit, were obtained by interview and waist circumference and anthropometric measurements were examined. Dietary intakes were evaluated using a food frequency questionnaire, and abdominal obesity was evaluated by measuring waist circumference. Statistical analysis was performed using SPSS for 13.0. Results Age, waist circumference, and BMI were significantly higher in cases than controls. And smokers and men were more prevalent among cases than controls. Among the abdominal obese subjects, 45.6% had 1 or more adenoma, and 9.0% of these had advanced adenoma, whereas among subjects with a normal waist circumference, only 25.7% had 1 or more adenomas. The prevalence of adenoma was higher among abdominal obese group (P Conclusion Our data suggest that abdominal obesity is associated with an increased risk of colorectal adenoma.

  1. Signal intensity of magnetic resonance imaging of pituitary adenoma reflects its collagen content

    Institute of Scientific and Technical Information of China (English)

    Hui Wang; Xianrui Yuan; Weixi Jiang

    2006-01-01

    BACKGROUND:At present,results of a few studies demonstrate that preoperative magnetic resonance imagling (MRI)examination reveals the texture of pituitary adenoma,I.e.on the T2-weighted image,solid pituitary adenoma shows weak signal and soft one shows strong signal.Also,solid pituitary adenoma is caused by fibrosis,which is confirmlea.However,some key problems are still in question and disputation,such as how to exactly quantize MRI signal intensity,which signal is used as prediction index,and the relationship of MRI signal and collagen content which reflects the texture of pituitary adenoma,and so on.OBJECTIVE:To observe the relationship of MRI signal intensity of different textures of pituitary adenoma and its collagen content,and investigate the best prediction index of the texture of pituitary adenoma.DESIGN:Case-control observation.SETTING:Department of Neurosurgery,Third Hospital Affiliated to Sun Yat-sen University;Department of Neurosurgery,Xiangya Hospital,Central South University.PARTICIPANTS:Fifty-seven patients with pituitary adenoma,including 32 males and 25 females,aged 20 to 65 years,who received treatment in the Department of Neurosurgery,Xiangya Hospital,Central South University during June 2003 to January 2004.The involved patients were all diagnosed by MRI and confirmed by pathological resection.Informed consents were obtained from all the patients.The samples of above-mentioned patients resected by operation were fixed with 40 g/L formaldehyde for sirius red staining.METHODS:①Accordling to the texture of pituitary adenoma observed in the operation:The 57 samples of pituitary adenoma were divided into 2 groups:non-flbrosis group(n=49)and fibrosis group(n=8).In the non-fibrosis group,the texture of pituitary adenoma was soft,I.e.pituitary adenoma tissue automatically flew out,and could be aspirated by aspirater or erased by curette,and the superior part of saddle could fall in the saddle,In the fibrosis group,pituitary adenoma tissue could be

  2. Application and advance of temozolomide in the treatment of pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Yi-guang LIN

    2015-12-01

    Full Text Available Pituitary adenoma is a common primary tumor in central nervons system. The aggressive pituitary adenomas show invasive characteristics with higher recurrence rate and worse prognosis, which normally need the comprehensive therapy of surgery, radiotherapy and chemical medications. The therapy of aggressive pituitary adenomas by temozolomide and whether O6-methylguanine-DNA methyltransferase (MGMT could predict the curative effect of temozolomide have become hot spots in recent years. This review intends to illustrate the advance of the therapy of aggressive pituitary adenomas by temozolomide. DOI: 10.3969/j.issn.1672-6731.2015.12.017

  3. A case of lipomatous pleomorphic adenoma in the parotid gland: a case report

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    Kondo Takeshi

    2009-06-01

    Full Text Available Abstract Introduction Pleomorphic adenoma is the most common benign neoplasm of the salivary glands. Extensive lipomatous involvement of the tumor is, however, a very rare finding. Case report Herein, a rare case of lipomatous pleomorphic adenoma arising in the parotid gland of a 14-year-old Japanese woman is presented. Conclusion This is the sixth case of lipomatous pleomorphic adenoma in the English literature. Recognition of this rare subtype of pleomorphic adenoma is important for clinical diagnosis and management. On CT scan, it may not be detected possibly due to the extensive fatty component.

  4. Hepatic adenoma in an elderly male patient: A rare case report

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    Ravi Swami, Nimbargi RC, Karandikar MN, Jagdale KA

    2014-04-01

    Full Text Available Hepatocellular adenomas are usually affect females in their 3rd and 4th decades of life. Uses of oral contraceptives use or anabolic steroids have been blamed for this. This is rare in old age and in an elderly male presented with hepatic adenoma. Such cases are difficult to diagnose on fine needle aspiration cytology and can cause under or over diagnosis. Here we present a rare case of hepatic adenoma in an elderly male with both cytological as well as histopathology features of adenoma.

  5. Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas.

    Science.gov (United States)

    Matyja, Ewa; Maksymowicz, Maria; Grajkowska, Wiesława; Zieliński, Grzegorz; Kunicki, Jacek; Bonicki, Wiesław; Witek, Przemysław; Naganska, Ewa

    2015-01-01

    Ganglion cell tumours in the sellar region are uncommon. They are usually associated with pituitary adenomas, while isolated ganglion cell neoplasms are extremely rare. We report the clinicopathological studies of five cases diagnosed as ganglion cell tumours located in the intrasellar region: four mixed/collision tumours composed of gangliocytoma and pituitary adenoma, and one isolated ganglioglioma unrelated to adenoma. Clinically, two patients presented with acromegaly, while three others were initially diagnosed as non-functioning adenomas. In four cases, the histopathological examination of surgical specimens revealed intermixed lesions composed of pituitary adenoma and ganglion cell elements. The adenomas appeared to secrete growth hormone. Electron microscopy enabled identification of the sparsely granulated somatotroph cells. Neoplastic neuronal lesions were composed of mature ganglion cells, including binucleate or multinucleate cells. In all cases, boundaries between adenomatous and gangliocytic components were not clearly demarcated, and numerous gangliocytic cells were closely intermingled with adenomatous tissue. One case lacked endocrine symptoms, and no pituitary adenoma was identified in the surgically excised material; it was finally diagnosed as low-grade ganglioglioma. The etiopathogenesis of ganglion cell neoplasms in the sellar region is not clearly defined. Our study revealed that if ganglion cell neoplasms were combined with adenoma, both neoplastic components were closely related to each other, and numerous neuronal elements were strictly intermingled with adenoma cells. Such a tissue pattern indicates that these neoplastic changes, including their common respective etiopathogeneses, are closely related. The identification of both components in sellar regions may have some nosological implications.

  6. Radiotherapy for pituitary adenomas: long-term outcome and complications

    Energy Technology Data Exchange (ETDEWEB)

    Rim, Chai Hong; Yang, Dae Sik; Park, Young Je; Yoon, Won Sup; Lee, Jung AE; Kim, Chul Yong [Korea University Medical Center, Seoul (Korea, Republic of)

    2011-09-15

    To evaluate long-term local control rate and toxicity in patients treated with external beam radiotherapy (EBRT) for pituitary adenomas. We retrospectively reviewed the medical records of 60 patients treated with EBRT for pituitary adenoma at Korea University Medical Center from 1996 and 2006. Thirty-fi ve patients had hormone secreting tumors, 25 patients had non-secreting tumors. Fifty-seven patients had received postoperative radiotherapy (RT), and 3 had received RT alone. Median total dose was 54 Gy (range, 36 to 61.2 Gy). The definition of tumor progression were as follows: evidence of tumor progression on computed tomography or magnetic resonance imaging, worsening of clinical sign requiring additional operation or others, rising serum hormone level against a previously stable or falling value, and failure of controlling serum hormone level so that the hormone level had been far from optimal range until last follow-up. Age, sex, hormone secretion, tumor extension, tumor size, and radiation dose were analyzed for prognostic significance in tumor control. Median follow-up was 5.7 years (range, 2 to 14.4 years). The 10-year actuarial local control rates for non-secreting and secreting adenomas were 96% and 66%, respectively. In univariate analysis, hormone secretion was significant prognostic factor (p = 0.042) and cavernous sinus extension was marginally significant factor (p = 0.054) for adverse local control. All other factors were not significant. In multivariate analysis, hormone secretion and gender were significant. Fifty-three patients had mass-effect symptoms (headache, dizziness, visual disturbance, hypopituitarism, loss of consciousness, and cranial nerve palsy). A total of 17 of 23 patients with headache and 27 of 34 patients with visual impairment were improved. Twenty-seven patients experienced symptoms of endocrine hypersecretion (galactorrhea, amenorrhea, irregular menstruation, decreased libido, gynecomastia, acromegaly, and Cushing

  7. Silent Reading Fluency and Comprehension in Bilingual Children

    Science.gov (United States)

    O'Brien, Beth A.; Wallot, Sebastian

    2016-01-01

    This paper focuses on reading fluency by bilingual primary school students, and the relation of text fluency to their reading comprehension. Group differences were examined in a cross-sectional design across the age range when fluency is posed to shift from word-level to text-level. One hundred five bilingual children from primary grades 3, 4, and 5 were assessed for English word reading and decoding fluency, phonological awareness, rapid symbol naming, and oral language proficiency with standardized measures. These skills were correlated with their silent reading fluency on a self-paced story reading task. Text fluency was quantified using non-linear analytic methods: recurrence quantification and fractal analyses. Findings indicate that more fluent text reading appeared by grade 4, similar to monolingual findings, and that different aspects of fluency characterized passage reading performance at different grade levels. Text fluency and oral language proficiency emerged as significant predictors of reading comprehension. PMID:27630590

  8. Not so "silent":The human prefrontal cortex

    Directory of Open Access Journals (Sweden)

    Prakash Narain Tandon

    2013-01-01

    Full Text Available Little was known about the human prefrontal cortex till recently. It was thus labeled as the "silent area," "uncommitted cortex." It not only constitutes the largest component of the human brain but is the latest evolutionary addition to the mammalian brain. It endows the human beings with qualities that differentiate humans from all other animals. During the last couple of decades the advent of modern electrophysiological and imaging (functional magnetic resonance imaging, proton emission tomography, SPECT techniques have provided a wealth of insight into its role in memory, thought, emotions, moral judgment, social behavior, evaluating rewards, and assessing its fairness or otherwise and above all self-awareness. This brief review summarize the recent significant observations on its functions and connectivity which would interest the cognitive scientists and clinicians alike.

  9. Sweet silent thought: alliteration and resonance in poetry comprehension.

    Science.gov (United States)

    Lea, R Brooke; Rapp, David N; Elfenbein, Andrew; Mitchel, Aaron D; Romine, Russell Swinburne

    2008-07-01

    Poetic devices like alliteration can heighten readers' aesthetic experiences and enhance poets' recall of their epic pieces. The effects of such devices on memory for and appreciation of poetry are well known; however, the mechanisms underlying these effects are not yet understood. We used current theories of language comprehension as a framework for understanding how alliteration affects comprehension processes. Across three experiments, alliterative cues reactivated readers' memories for previous information when it was phonologically similar to the cue. These effects were obtained when participants read aloud and when they read silently, and with poetry and prose. The results support everyday intuitions about the effects of poetry and aesthetics, and explain the nature of such effects. These findings extend the scope of general memory models by indicating their capacity to explain the influence of nonsemantic discourse features.

  10. Geometrical Shape Investigation For Electrodes in Silent Discharge Chamber

    Science.gov (United States)

    Facta, Mochammad; Ayu Ketut Umiati, Ngurah; Warsito, Agung

    2017-04-01

    Silent discharge is the most prominent method to carry out plasma reaction because. discharge is easily initiated by injecting alternating current in high voltage to the pair of separated electrodes. The electron emission from surface of dielectric placed on instantaneous cathode is stimulated by ion induced electron emission. In this method, spark is avoided by placing insulation material to either one or both of the electrodes. In practical, it is very difficult to determine the exact limit of the voltage that initiate the discharge by mathematical analysis because it depends on many factors, namely dimensions, type and geometrical shapes of electrode, thickness of insulation, and type of electric field inside the discharge gap. To get lower initial voltage for discharge, it is important to find the best geometrical shape of electrode in relation to skin effect that trigger electron emission. This work investigates the behaviour of charges, current, electric field and voltage surrounding electrodes with various geometrical shape.

  11. Hepatic steatosis: A benign disease or a silent killer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Steatosis is a common feature of many liver diseases, namely non-alcoholic steatohepatitis (NASH) and hepatitis C virus (HCV) infection, but the pathogenic mechanisms differ. Insulin resistance (IR), a key feature of metabolic syndrome, is crucial for NASH development, associated with many underlying genetically determined or acquired mitochondrial and metabolic defects and culminates to inflammation and progression to fibrosis. This may have potential implications for new drug therapy. In HCV-related disease, steatosis impacts both fibrosis progression and response to treatment. Steatosis in HCV-related disease relates to both viral factors (HCV genotype 3), and host factors (alcohol consumption, overweight, hyperlipidemia, diabetes). Among others, IR is a recognized factor. Hepatic steatosis is reported to be associated with disturbance in the signaling cascade of interferon and downregulation of its receptors. Thus, hepatic steatosis should not be considered a benign feature, but rather a silent killer.

  12. Isolated and silent spinal neurocysticercosis associated with pseudotumor cerebri

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    Mohapatra Rabindra

    2008-01-01

    Full Text Available Incidence of spinal neurocysticercosis (NCC is rare. Isolated spinal NCC is still rarer. We present here a case report where a young lady presented with all the clinical features of pseudotumor cerebri (PTC, where medical treatment for PTC failed and the presence of cysticercous in spinal canal was detected only on the operation table, while doing a lumbo-peritoneal shunt (LP shunt to save her vision. Diagnosis could be confirmed only after the histopathology report was received. She did not have any direct evidence of spinal involvement, thereby eluding correct diagnosis. In English literature, we could not find any report of isolated and silent spinal NCC associated with PTC. In addition, we could not find any report of recovery of cysticercous larva through the Touhey′s needle injury, although this was an incidental finding. In endemic areas, isolated spinal NCC should be suspected in patients presenting with PTC.

  13. [Silent myocardial ischemia in patients with transient ischemic attacks].

    Science.gov (United States)

    Sánchez Valiente, S; Mostacero, E; del Río, A; Morales, F

    1994-10-01

    Given evidence that ischemic heart disease is the most frequent cause of death in patients with cerebrovascular disease, we used ergometrics to screen 80 patients with TIA for silent myocardial ischemia (SMI) at the neurological unit of Hospital Clínico Universitario in Zaragoza, Spain. The patients were compared with a control group of 80 with no signs of heart disease. Neither the patients nor the controls had ever shown clinical signs of coronary ischemia and their baseline electrocardiograms were normal. Stress test results were positive in 25 (31%) of the TIA patients, and in 4 (5%) (p Hiperlipidemia (75% testing positive versus 43% negative, p < 0.01) and diabetes (31% testing positive versus 13% negative, p < 0.01) were the risk factors statistically related with a positive stress test.

  14. Soundless Speech/ Wordless Writing: Language and German Silent Cinema

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    Marc Silberman

    2010-12-01

    Full Text Available Speech / Wordless Writing: Language and German Silent Cinema Marc Silberman If language loses its communicative and interpretative functions in direct proportion to the loss of its referential grounding, then the modernist crisis is simultaneously a crisis of its signifying practices. This means that the evolution of the silent cinema is a particularly rich site to examine the problematic relationship of language and image. This essay presents several expressionist films as a specific response to this crisis in order to describe the diverse cinematic forms of resistance to the word, to articulated speech. While some film makers developed the silence of the silent film into a “gestural language” that dramatized light and movement, others reproduced the film figures’ silent speech by means of graphically stylized intertitles. My thesis is that the expressionist cinema maintained an idealistic notion of the film as a pure work of art that aimed at a unified composition of all elements and missed the opportunity to explore the rich semiotic possibilities of the new technological medium with its hybrid, synergetic forms and provocative force. Hence, the expressionist cinema marks a transition or even the endpoint of a long process of reflection about the communicative possibilities of language that shifted to a fundamentally new level with the invention of sound cinema at the end of the 1920s. Parole muette / écriture sans mot: Le langage et le cinéma allemand muet Marc Silberman Le langage, dit-on, perd de ses functions communicatrices et interpretatives en proportion directe à la perte de sa force référentielle. On dira que la crise moderniste est également une crise des pratiques signifiantes. Ce qui revient à dire aussi que l’évolution du cinéma muet serait une site particulièrement riche pour examiner les problématiques du langage vs. l’image. Cet essai présente quelques films expressionnistes comme réactions à la crise

  15. Cortical silent period following transcranial magnetic stimulation in epileptic patients.

    Science.gov (United States)

    Ertaş, N K; Gül, G; Altunhalka, A; Kirbas, D

    2000-09-01

    Cortical silent period (SP) following transcranial magnetic stimulation is mainly due to cortical inhibitory mechanisms. SP may have a value for detecting inhibitory mechanisms in epileptic patients with or without treatment. The aim of this study was to evaluate the effect of both the epilepsy and the antiepileptic medication on these inhibitory mechanisms. The subgroups studied consisted of (a) normal subjects, (b) unmedicated epileptic patients, (c) epileptic patients with uncontrolled seizures under medication, (d) epileptic patients with controlled seizures under medication. SP following transcranial magnetic stimulation was measured in all subjects. The SP values from shortest to the longest were in the following order: 1) normal subjects; 2) epileptic patients with controlled seizures under medication; 3) unmedicated epileptic patients; 4) epileptic patients with uncontrolled seizures under medication. Our findings probably indicate the enhanced interictal inhibitory mechanisms in epilepsy which is resistant to antiepileptic medication.

  16. Stopping the Silent Killer: Hepatitis B Among Asian Americans

    Centers for Disease Control (CDC) Podcasts

    2008-04-18

    This podcast discusses an underappreciated health threat to many Asians and Pacific Islanders in the United States: chronic infection with the hepatitis B virus. Dr. John Ward, director of CDC's Division of Viral Hepatitis, and Dr. Sam So, founder of the Asian Liver Center at Stanford University, address the importance of testing, vaccination, and care to prevent serious health consequences from this "silent" disease.  Created: 4/18/2008 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Division of Viral Hepatitis (DVH) and Office of Dispute Resolution and Equal Employment Opportunity, Office of the Director (OD).   Date Released: 5/1/2008.

  17. Boundaries of transcriptionally silent chromatin in Saccharomyces cerevisiae.

    Science.gov (United States)

    Sun, Jing-Qian; Hatanaka, Akira; Oki, Masaya

    2011-01-01

    In the budding yeast Saccharomyces cerevisiae, heterochromatic gene silencing has been found within HMR and HML silent mating type loci, the telomeres, and the rRNA-encoding DNA. There may be boundary elements that regulate the spread of silencing to protect genes adjacent to silenced domains from this epigenetic repressive effect. Many assays show that specific DNA regulatory elements separate a euchromatic locus from a neighboring heterochromatic domain and thereby function as a boundary. Alternatively, DNA-independent mechanisms such as competition between acetylated and deacetylated histones are also reported to contribute to gene insulation. However, the mechanism by which boundaries are formed is not clear. Here, the characteristics and functions of boundaries at silenced domains in S. cerevisiae are discussed.

  18. Moderate Cortical Cooling Eliminates Thalamocortical Silent States during Slow Oscillation.

    Science.gov (United States)

    Sheroziya, Maxim; Timofeev, Igor

    2015-09-23

    Reduction in temperature depolarizes neurons by a partial closure of potassium channels but decreases the vesicle release probability within synapses. Compared with cooling, neuromodulators produce qualitatively similar effects on intrinsic neuronal properties and synapses in the cortex. We used this similarity of neuronal action in ketamine-xylazine-anesthetized mice and non-anesthetized mice to manipulate the thalamocortical activity. We recorded cortical electroencephalogram/local field potential (LFP) activity and intracellular activities from the somatosensory thalamus in control conditions, during cortical cooling and on rewarming. In the deeply anesthetized mice, moderate cortical cooling was characterized by reversible disruption of the thalamocortical slow-wave pattern rhythmicity and the appearance of fast LFP spikes, with frequencies ranging from 6 to 9 Hz. These LFP spikes were correlated with the rhythmic IPSP activities recorded within the thalamic ventral posterior medial neurons and with depolarizing events in the posterior nucleus neurons. Similar cooling of the cortex during light anesthesia rapidly and reversibly eliminated thalamocortical silent states and evoked thalamocortical persistent activity; conversely, mild heating increased thalamocortical slow-wave rhythmicity. In the non-anesthetized head-restrained mice, cooling also prevented the generation of thalamocortical silent states. We conclude that moderate cortical cooling might be used to manipulate slow-wave network activity and induce neuromodulator-independent transition to activated states. Significance statement: In this study, we demonstrate that moderate local cortical cooling of lightly anesthetized or naturally sleeping mice disrupts thalamocortical slow oscillation and induces the activated local field potential pattern. Mild heating has the opposite effect; it increases the rhythmicity of thalamocortical slow oscillation. Our results demonstrate that slow oscillation can be

  19. Stepwise Relationship Between Components of Metabolic Syndrome and Risk of Colorectal Adenoma in a Taiwanese Population Receiving Screening Colonoscopy

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    Nien-Chih Hu

    2011-02-01

    Conclusion: Subjects with metabolic syndrome have increased risk of developing colorectal adenoma. Screening colonoscopy for prevention of colorectal adenoma might be warranted when abdominal obesity or more than three components of MS are present.

  20. Differential Gene Expression in Chemically Induced Mouse Lung Adenomas

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    Ruisheng Yao

    2003-01-01

    Full Text Available Because of similarities in histopathology and tumor progression stages between mouse and human lung adenocarcinomas, the mouse lung tumor model with lung adenomas as the endpoint has been used extensively to evaluate the efficacy of putative lung cancer chemopreventive agents. In this study, a competitive cDNA library screening (CCLS was employed to determine changes in the expression of mRNA in chemically induced lung adenomas compared with paired normal lung tissues. A total of 2555 clones having altered expression in tumors were observed following competitive hybridization between normal lung and lung adenomas after primary screening of over 160,000 clones from a mouse lung cDNA library. Among the 755 clones confirmed by dot blot hybridization, 240 clones were underexpressed, whereas 515 clones were overexpressed in tumors. Sixty-five clones with the most frequently altered expression in six individual tumors were confirmed by semiquantitative RT-PCR. When examining the 58 known genes, 39 clones had increased expression and 19 had decreased expression, whereas the 7 novel genes showed overexpression. A high percentage (>60% of overexpressed or underexpressed genes was observed in at least two or three of the lesions. Reproducibly overexpressed genes included ERK-1, JAK-1, surfactant proteins A, B, and C, NFAT1, α-1 protease inhibitor, helix-loop-helix ubiquitous kinase (CHUK, α-adaptin, α-1 PI2, thioether S-methyltransferase, and CYP2C40. Reproducibly underexpressed genes included paroxanase, ALDH II, CC10, von Ebner salivary gland protein, and α- and β-globin. In addition, CCLS identified several novel genes or genes not previously associated with lung carcinogenesis, including a hypothetical protein (FLJ11240 and a guanine nucleotide exchange factor homologue. This study shows the efficacy of this methodology for identifying genes with altered expression. These genes may prove to be helpful in our understanding of the genetic basis of

  1. Hypopituitarism after gamma knife radiosurgery for pituitary adenoma.

    Science.gov (United States)

    Zibar Tomšić, Karin; Dušek, Tina; Kraljević, Ivana; Heinrich, Zdravko; Solak, Mirsala; Vučinović, Ana; Ozretić, David; Mihailović Marasanov, Sergej; Hršak, Hrvoje; Kaštelan, Darko

    2017-05-24

    The aim of the study was to investigate the incidence of and risk factors for hypopituitarism after gamma knife radiosurgery (GKRS) for pituitary adenoma. We conducted a retrospective analysis of the pituitary function of 90 patients who underwent GKRS for pituitary adenoma at the University Hospital Centre Zagreb between 2003 and 2014. Twenty seven of them met the inclusion criteria and the others were excluded from the study due to pituitary insufficiency which was present before GKRS. Eighteen patients had non-functioning and 9 patients had secretory adenomas. Median patients' age was 56 years (24-82). GKRS was performed using the Leksell gamma knife Model C. The median prescription radiation dose was 20 Gy (15-25) and the median tumor volume size was 3.4 cm(3) (0.06-16.81). New onset hypopituitarism was defined as a new deficit of one of the three hormonal axes (corticotroph, thyreotroph, or gonadotroph) ≥3 months following GKRS. SPSS was used for statistical analysis, with the significance level at P<0.05. During the median follow-up period of 72 months (range 6-144), 30% of patients developed new hypopituitarism after GKRS. This corresponds to incidence of one new case of hypopituitarism per 15 patient-years. Age, gender, tumor function, tumor volume, suprasellar extension, prescription dose of radiation, as well as dose-volume to the pituitary gland, stalk and hypothalamus were not predictive factors for the development of hypopituitarism. In our cohort of patients with pituitary tumors who underwent GKRS, 30% developed new hypopituitarism during the follow-up period.

  2. Outcome of visual acuity after surgical removal of pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Grković Desanka

    2013-01-01

    Full Text Available Introduction. Pituitary adenomas with suprasellar extension may produce anterior visual pathway compression, resulting in characteristic visual deficit. Surgical decompression of these structures prevents further visual deterioration and its postop­ erative recovery. Objective. The aim of this study was to investigate pre­ and postoperative visual acuity (VA in patients with pituitary ad­ enomas, and to detect the influence of prognostic factors, such as symptoms duration, degree of visual acuity reduction and tumor size in the assessment of the prognosis of postoperative visual function. Methods. We analyzed 40 consecutive patients who fulfilled three criteria: evidence of preoperative visual dysfunction, transsphenoidal or transfrontal tumor resection and hystologically verified pituitary adenoma. A visual examination was performed under standard conditions, pre and postoperatively (10 days, one month and six months after surgery. A paired t­test was used to assess the differences of pre­ and postoperative characteristics values, and the Chisquare test of independence in the assessment of the influence of prognostic factors. Results. Postoperative improvement of VA was seen in 84.61% patients (68% eyes. Eyes with preoperative mild and moderate degree of VA reduction showed improvement in 89.65% eyes in contrast to 22.60% eyes with preoperative severe reduction of VA, which was all statistically significant. Eyes in patients with tumor smaller than 20 mm had improvement of VA in 91.66% eyes, while eyes with tumor larger than 40 mm had improvement of VA in 61.11% eyes, which was statistically significant. When symptoms duration was below two years the improvement of VA was detected in 65.38% eyes as related to 50% eyes with symptoms duration exceeding two years, which was not statistically significant. Conclusion. Pituitary adenomas commonly cause visual impairment. Postoperatively the majority of patients show a distinct improvement of

  3. Somatic mutations of the APC, KRAS, and TP53 genes in nonpolypoid colorectal adenomas

    NARCIS (Netherlands)

    van Wyk, R; Slezak, P; Hayes, VM; Buys, CHCM; Kotze, MJ; de Jong, G; Rubio, C; Dolk, A; Jaramillo, E; Koizumi, K; Grobbelaar, JJ

    2000-01-01

    Calorectal adenomas are macroscopically visible morphological changes of the mucosa that can develop focal carcinoma in the absence of surgical intervention. The successive molecular changes proposed to occur at different: stages in the adenoma-carcinoma sequence were primarily based on DNA studies

  4. Coexisiting adenoma and granuloma involving the right inferior parathyroid gland with adjacent ectopic thymic tissue.

    Science.gov (United States)

    Gupta, Mayank; Kandasamy, Subramaniam

    2014-06-23

    Inflammatory lesions, particularly granulomas, involving adenoma of the parathyroid gland are rare. Ectopic thymic tissue is commonly associated with the thyroid and/or parathyroid gland due to their close embryonic relationship. We report a rare case of coexisting adenoma and granuloma of the parathyroid gland with adjacent ectopic thymic tissue. 2014 BMJ Publishing Group Ltd.

  5. Association between dietary fat intake and colorectal adenoma in korean adults

    Science.gov (United States)

    Kim, Jeehyun; Oh, Seung-Won; Kim, Young-Sun; Kwon, Hyuktae; Joh, Hee-Kyung; Lee, Ji-Eun; Park, Danbee; Park, Jae-Hong; Ko, Ah-Ryoung; Kim, Ye-Ji

    2017-01-01

    Abstract The incidence of colorectal cancer is rapidly increasing in South Korea. It is important to clarify the association between colorectal cancer and diet, being one of the main modifiable risk factors, as such studies in the Korean population are lacking. A cross-sectional study was performed using data from participants who had undergone a screening colonoscopy and a nutritional assessment during a routine health check-up from January 2008 to December 2011. Dietary intake data were derived from 1-day food records; colorectal adenoma was histopathologically confirmed by biopsy during colonoscopy. Eventually, 2604 participants were included in the analysis. The risk of colorectal adenoma by quintile of dietary fat intake was analyzed using logistic regression. Subgroup analyses by degree of risk and by location of colorectal adenoma were additionally performed. In men, total fat intake was not associated with risk of colorectal adenoma. However, risk of colorectal adenoma increased with higher saturated fatty acid (SFA) intake. The adjusted odds ratio in the highest quintile was 1.71 (95% confidence interval, 1.01–2.91) compared with that in the lowest quintile. There was no significant association between fat intake and risk of colorectal adenoma characterized by subsite. In female participants, total fat and specific fatty acid intake were not associated with risk of colorectal adenoma. These data support that high SFA intake is associated with risk of colorectal adenoma in Korean men. PMID:28072719

  6. Disulfiram sensitizes pituitary adenoma cells to temozolomide by regulating O6-methylguanine-DNA methyltransferase expression.

    Science.gov (United States)

    Zhao, Yachao; Xiao, Zheng; Chen, Wenna; Yang, Jinsheng; Li, Tao; Fan, Bo

    2015-08-01

    O6-methylguanine-DNA methyltransferase (MGMT) activity is responsible for temozolomide (TMZ) resistance in patients harboring aggressive pituitary adenomas. Recently, disulfiram (DSF) has been shown to induce the loss of MGMT protein and increase TMZ efficacy in glioblastoma cells, while CD133+ nestin+ cells isolated from the cell population have been implicated as pituitary adenoma stem-like cells. However, whether DSF is able to potentiate the cytotoxic effects of TMZ on human pituitary adenoma cells has not been investigated to date. In the present study, CD133+ nestin+ phenotype cells were isolated from primary cultured human pituitary adenoma cells using microbeads. It was found that DSF reduced MGMT protein expression and sensitized human pituitary adenoma cells and stem-like cells to TMZ in vitro, while the proteasome inhibitor PS-341 abrogated the inhibitory effect of DSF on MGMT in vitro. The sensitizing effect of DSF was also verified in primary cultured human pituitary adenoma cells in vivo. The results of the present study suggested that DSF can increase the efficacy of the anti-tumor effect of TMZ on human pituitary adenoma cells and CD133+ nestin+ stem like cells via the ubiquitin-proteasomal MGMT protein elimination route. DSF combined with TMZ may be an effective therapeutic strategy against aggressive pituitary adenomas.

  7. Identification and validation of highly frequent CpG island hypermethylation in colorectal adenomas and carcinomas

    DEFF Research Database (Denmark)

    Øster, Bodil; Thorsen, Kasper; Lamy, Philippe;

    2011-01-01

    .005). Identified hypermethylated sites were validated in an independent sample set of eight normal mucosas, 12 adenomas, 40 MSS and nine MSI cancer samples. The methylation patterns of 15 selected genes, hypermethylated in adenomas and carcinomas (FLI1, ST6GALNAC5, TWIST1, ADHFE1, JAM2, IRF4, CNRIP1, NRG1, and EYA...

  8. Prevalence and phenotypes of APC and MUTYH mutations in patients with multiple colorectal adenomas

    NARCIS (Netherlands)

    S. Grover (Shilpa); F. Kastrinos (Fay); E.W. Steyerberg (Ewout); E.F. Cook (E. Francis); A. Dewanwala (Akriti); L.A. Burbidge; R.J. Wenstrup (Richard); S. Syngal (Sapna)

    2012-01-01

    textabstractContext: Patients with multiple colorectal adenomas may carry germline mutations in the APC or MUTYH genes. Objectives: To determine the prevalence of pathogenic APC and MUTYH mutations in patients with multiple colorectal adenomas who had undergone genetic testing and to compare the pre

  9. Dysbiosis of fungal microbiota in the intestinal mucosa of patients with colorectal adenomas.

    Science.gov (United States)

    Luan, Chunguang; Xie, Lingling; Yang, Xi; Miao, Huifang; Lv, Na; Zhang, Ruifen; Xiao, Xue; Hu, Yongfei; Liu, Yulan; Wu, Na; Zhu, Yuanmin; Zhu, Baoli

    2015-01-23

    The fungal microbiota is an important component of the human gut microbiome and may be linked to gastrointestinal disease. In this study, the fungal microbiota of biopsy samples from adenomas and adjacent tissues was characterized by deep sequencing. Ascomycota, Glomeromycota and Basidiomycota were identified as the dominant phyla in both adenomas and adjacent tissues from all subjects. Among the 60 genera identified, the opportunist pathogens Phoma and Candida represented an average of 45% of the fungal microbiota. When analyzed at the operational taxonomic unit (OTU) level, however, a decreased diversity in adenomas was observed, and three OTUs differed significantly from the adjacent tissues. Principal Component Analysis (PCA) revealed that the core OTUs formed separate clusters for advanced and non-advanced adenomas for which the abundance of four OTUs differed significantly. Moreover, the size of adenomas and the disease stage were closely related to changes in the fungal microbiota in subjects with adenomas. This study characterized the fungal microbiota profile of subjects with adenomas and identified potential diagnostic biomarkers closely related to different stages of adenomas.

  10. Adenomas in Patients with Inflammatory Bowel Disease Are Associated with an Increased Risk of Advanced Neoplasia

    NARCIS (Netherlands)

    Schaik, F.D. van; Mooiweer, E.; Have, M. van der; Belderbos, T.D.; Kate, F.J. ten; Offerhaus, G.J.; Schipper, M.E.; Dijkstra, G.; Pierik, M.; Stokkers, P.C.; Ponsioen, C.; Jong, D.J. de; Hommes, D.W.; Bodegraven, A.A. van; Siersema, P.D.; Oijen, M.G.H. van; Oldenburg, B.

    2013-01-01

    BACKGROUND:: It is still unclear whether inflammatory bowel disease (IBD) patients with adenomas have a higher risk of developing high-grade dysplasia (HGD) or colorectal cancer (CRC) than non-IBD patients with sporadic adenomas. We compared the risk of advanced neoplasia (AN, defined as HGD or CRC)

  11. Adenomas in Patients with Inflammatory Bowel Disease Are Associated with an Increased Risk of Advanced Neoplasia

    NARCIS (Netherlands)

    van Schaik, Fiona D. M.; Mooiweer, Erik; van der Have, Mike; Belderbos, Tim D. G.; ten Kate, Fiebo J. W.; Offerhaus, G. Johan A.; Schipper, Marguerite E. I.; Dijkstra, Gerard; Pierik, Marieke; Stokkers, Pieter C. F.; Ponsioen, Cyriel; de Jong, Dirk J.; Hommes, Daniel W.; van Bodegraven, Ad A.; Siersema, Peter D.; van Oijen, Martijn G. H.; Oldenburg, Bas

    2013-01-01

    Background: It is still unclear whether inflammatory bowel disease (IBD) patients with adenomas have a higher risk of developing high-grade dysplasia (HGD) or colorectal cancer (CRC) than non-IBD patients with sporadic adenomas. We compared the risk of advanced neoplasia (AN, defined as HGD or CRC)

  12. Differential expression in normal-adenoma-carcinoma sequence suggests complex molecular carcinogenesis in colon.

    Science.gov (United States)

    Lee, Seungkoo; Bang, Seunghyun; Song, Kyuyoung; Lee, Inchul

    2006-10-01

    The majority of colon cancers develop from pre-existing adenomas. We analyzed the expression profiles in the sequence of normal colon crypts, adenomas and early-stage carcinomas using microdissected cells from tubular adenomas with foci of malignant transformation. Differentially expressed genes were detected between normal-adenoma and adenoma-carcinoma, and were grouped according to the patterns of expression changes in the sequence. Down-regulated genes in the sequence included PLA2G2A, TSPAN1, PDCD4, FCGBP, AATK, EPLIN, FABP1, AGR2, MTUS1, TSC1, galectin 4 and MT1F. PLA2G2A has been shown to suppress colon tumorigenesis in mice, but the pathobiological role in humans has been controversial. Our data showed continuous down-regulation of PLA2G2A in the sequence supporting an implication in human colon cancer. Tumor suppressor and/ or proapoptotic activities have also been reported in other genes. Up-regulated genes included ribosomal proteins, IER3 and TPR. TGF-beta2 and matrix metalloproteinase 23B were up-regulated in carcinoma but not in adenoma, supporting the pathobiological roles in malignant transformation. Differentially expressed genes partly coincided with those in the adenoma-carcinoma sequence of the stomach, which was published previously, suggesting a partial overlap between the adenoma-carcinoma sequences of the colon and stomach.

  13. Association of liver steatosis with colorectal cancer and adenoma in patients with metabolic syndrome.

    Science.gov (United States)

    Fiori, Enrico; Lamazza, Antonietta; De Masi, Ercole; Schillaci, Alberto; Crocetti, Daniele; Antoniozzi, Angelo; Sterpetti, Antonio V; De Toma, Giorgio

    2015-04-01

    Metabolic syndrome has been identified as a risk factor for colorectal cancer and adenoma. The aim of our study was to assess the risk of colorectal cancer and adenoma in an adult Italian population with metabolic syndrome. Ninety patients with metabolic syndrome were prospectively compared against a matched population without the syndrome to assess the prevalence of colorectal adenoma. Another 1,500 patients undergoing screening colonoscopy were prospectively analyzed: 134 patients with metabolic syndrome and colorectal adenoma were compared against a group of 108 patients with colorectal adenoma without metabolic syndrome to assess the prevalence of cancer. The study was performed from January 2008 until December 2010. Data were analyzed from March to June 2011. The prevalence of colorectal adenoma was twice as high in patients with metabolic syndrome. The incidence of cancer was higher in patients with colorectal adenoma and metabolic syndrome. Associated obesity and liver steatosis were the only factors with independent statistical value. Metabolic syndrome is a risk factor for adenoma and cancer degeneration when obesity is present. Associated liver steatosis is a significant risk factor for colorectal cancer. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  14. Adenoma Prevalence and Distribution Among US Latino Subgroups Undergoing Screening Colonoscopy.

    Science.gov (United States)

    Chablani, Sumedha V; Jandorf, Lina; DuHamel, Katherine; Lee, Kristen K; Sriphanlop, Pathu; Villagra, Cristina; Itzkowitz, Steven H

    2017-06-01

    Colorectal cancer (CRC) is the second leading malignancy diagnosed among US Latinos. Latinos in the USA represent a heterogeneous amalgam of subgroups varying in genetic background, culture, and socioeconomic status. Little is known about the frequency of CRC precursor lesions found at screening colonoscopy among Latino subgroups. The aim was to determine the prevalence and distribution of histologically confirmed adenomas found at screening colonoscopy among average-risk, asymptomatic US Latinos according to their subgroup and socio-demographic background. Cross-sectional analysis of pathological findings resulting from screening colonoscopy among average-risk, asymptomatic US Latinos aged ≥50 in two prospective randomized controlled trials at an academic medical center. Among the 561 Latinos who completed screening colonoscopy, the two largest subgroups were Puerto Ricans and Dominicans. The findings among both subgroups were: adenomas 30.6%, proximal adenomas 23.5%, advanced adenomas 12.0%, and proximal advanced adenomas 8.9%. These rates are at least as high as those found at screening colonoscopy among US whites. While Puerto Ricans were more likely than Dominicans to be born in the USA, speak English, be acculturated, have a smoking history, and be obese, there were no significant differences in adenoma rates between these subgroups. The prevalence of adenomas, advanced adenomas, and proximal neoplasia was high among both subgroups. These findings have implications for CRC screening and surveillance among the increasingly growing Latino population in the USA.

  15. Significance of silent ischemia in dipyridamole perfusion scintigraphy. Evaluation in patients with angina

    Energy Technology Data Exchange (ETDEWEB)

    Kitaoka, Hiroaki; Takata, Jun; Yamada, Mitsutoshi; Seo, Hiromi; Doi, Yoshinori [Kochi Medical School, Nankoku (Japan)

    1995-07-01

    The significance of silent myocardial ischemia detected by dipyridamole perfusion scintigraphy was evaluated in 80 patients with stable angina and reversible defects (RD) but no infarction. The patients consisted of 26 patients with silent RD and 54 patients with painful RD. There was no significant difference in the incidence of coronary risk factors between the two groups, except for hyperlipidemia which was less frequently observed in patients with silent RD than in those with painful RD (8% vs 41%), Coronary angiography revealed a higher prevalence of insignificant lesions or single vessel disease in patients with silent RD than in those with painful RD (73% vs 39%). Dipyridamole perfusion scintigraphy revealed a lower degree of RD in patients with silent RD than in those with painful RD (4.4{+-}3.3 vs 9.0{+-}4.1 segments), though there was no significant difference in the localization of RD between these two groups. Treadmill stress testing revealed a lower incidence of chest pain in patients with silent RD than in those with painful RD (26% vs 65%), despite the mean exercise-duration being significantly longer in the former than in the latter (5.5{+-}1.7 vs 3.9{+-}11.7 min). Although initial percutaneous transluminal coronary angioplasty (PTCA) and/or coronary artery bypass grafting (CABG) were less frequently performed in patients with silent RD than in those with painful RD (12% vs 31%), there was no significant difference in the cardiac event rate during the mean follow-up period of 24{+-}14 months between the two groups. Patients with stable angina and silent RD on dipyridamole perfusion scintigraphy may have less extensive coronary lesions and smaller amounts of ischemic myocardium than patients with painful RD. Dipyridamole perfusion scintigraphy is useful for detecting and evaluating silent myocardial ischemia, even in those patients who cannot exercise adequately. (J.P.N.).

  16. Sessile serrated adenomas:Demographic,endoscopic and pathological characteristics

    Institute of Scientific and Technical Information of China (English)

    Suryakanth; R; Gurudu; Russell; I; Heigh; Giovanni; De; Petris; Evelyn; G; Heigh; Jonathan; A; Leighton; Shabana; F; Pasha; Isaac; B; Malagon; Ananya; Das

    2010-01-01

    AIM:To study the demographic and endoscopic characteristics of patients with sessile serrated adenoma(SSA) in a single center.METHODS:Patients with SSA were identified by review of the pathology database of Mayo Clinic Arizona from 2005 to 2007.A retrospective chart review was performed to extract data on demographics,polyp characteristics,presence of synchronous adenomatous polyps or cancer,polypectomy methods,and related complications.RESULTS:One hundred and seventy-one(2.9%) of all patients undergoing co...

  17. Fatal complication after transsphenoidal surgery of pituitary adenoma: case report

    Directory of Open Access Journals (Sweden)

    Conceição Aparecida Dornelas

    2015-06-01

    Full Text Available ABSTRACT The objective of this study was to report a rare fatal complication in the postoperative period of transsphenoidal surgery of the pituitary gland (adenoma, with a brief review of the subject. The patient was a 54-year-old white man with acromegaly and severe heart failure, who after microsurgery developed blood pressure instability within 32 hours after the procedure and died. The autopsy revealed: hypertrophy and ventricular dilation with myocarditis, pericarditis and myocardial fibrosis; mesenteric ischemia with transmural coagulation necrosis of the intestinal loops; acute tubular necrosis; and hepatic steatosis. The findings are consistent with cardiogenic shock and abdominal sepsis due to necrosis of the intestinal loops.

  18. Serotonin, ATRX, and DAXX Expression in Pituitary Adenomas

    DEFF Research Database (Denmark)

    Casar-Borota, Olivera; Botling, Johan; Granberg, Dan

    2017-01-01

    Differential diagnosis based on morphology and immunohistochemistry between a clinically nonfunctioning pituitary neuroendocrine tumor (NET)/pituitary adenoma and a primary or secondary NET of nonpituitary origin in the sellar region may be difficult. Serotonin, a frequently expressed marker...... of the pituitary tumors expressed serotonin, suggesting that serotonin immunoreactive sellar tumors represent primary or secondary NETs of nonpituitary origin. Normal expression of ATRX and DAXX in pituitary tumors suggests that ATRX and DAXX do not play a role in the pathogenesis of pituitary endocrine tumors...... on a larger cohort of pituitary carcinomas are needed to clarify whether ATRX mutations may contribute to the metastatic potential in a subset of pituitary NETs....

  19. Retroauricular Pleomorphic Adenoma Arising from Heterotopic Salivary Gland Tissue

    Science.gov (United States)

    Bacaj, Patrick; Borah, Gregory

    2016-01-01

    Summary: A 38-year-old woman is described who presented with a slowly growing mass on the posterior aspect of the left ear. Excision and histopathologic evaluation revealed a pleomorphic adenoma (PA) originating from heterotopic salivary gland tissue. Many authors have presented cases of PAs originating from ceruminous glands in the external auditory canal or of so-called chondroid syringoma originating from apocrine and eccrine sweat glands. This is the only case in the recent literature of a PA originating from a heterotopic rest of salivary gland tissue in the retroauricular region. The 3 main sources of PAs, their embryologic derivation, and treatment are described.

  20. Chromosome abnormalities in colorectal adenomas: two cytogenetic subgroups characterized by deletion of 1p and numerical aberrations

    DEFF Research Database (Denmark)

    Bomme, L; Bardi, G; Pandis, N

    1996-01-01

    changes were +20, +13, and monosomy 18, found in six, five, and two adenomas, respectively. Rearrangement of chromosome 1 was the most common structural change. Abnormalities involving 1p were seen in six adenomas, leading to visible loss of material in three. One adenoma had one clone with a large...

  1. Excessive alcohol consumption favours high risk polyp or colorectal cancer occurrence among patients with adenomas: a case control study

    OpenAIRE

    Bardou, M; Montembault, S; Giraud, V.; Balian, A; Borotto, E; Houdayer, C.; Capron, F.; Chaput, J-C; Naveau, S

    2002-01-01

    Background and aims: Excessive alcohol consumption is a risk factor for developing colorectal adenomas. This study aimed to investigate the influence of excessive alcohol consumption on the occurrence of high risk polyps (adenoma ≥10 mm, villous component, high grade dysplasia) or colorectal cancer among patients with at least one colonic adenoma.

  2. The transcervical approach for parapharyngeal space pleomorphic adenomas: indications and technique.

    Directory of Open Access Journals (Sweden)

    Gilad Horowitz

    Full Text Available BACKGROUND: Head and Neck Parapharyngeal space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. METHODS: The surgical records and medical charts of 19 females and 10 males with parapharyngeal space pleomorphic adenomas operated between 1993 and 2012 were reviewed. RESULTS: Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. CONCLUSION: A simple transcervical approach is preferred for parapharyngeal space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the parapharyngeal space.

  3. Increased rectal microbial richness is associated with the presence of colorectal adenomas in humans

    Science.gov (United States)

    Sanapareddy, Nina; Legge, Ryan M; Jovov, Biljana; McCoy, Amber; Burcal, Lauren; Araujo-Perez, Felix; Randall, Thomas A; Galanko, Joseph; Benson, Andrew; Sandler, Robert S; Rawls, John F; Abdo, Zaid; Fodor, Anthony A; Keku, Temitope O

    2012-01-01

    Differences in the composition of the gut microbial community have been associated with diseases such as obesity, Crohn's disease, ulcerative colitis and colorectal cancer (CRC). We used 454 titanium pyrosequencing of the V1–V2 region of the 16S rRNA gene to characterize adherent bacterial communities in mucosal biopsy samples from 33 subjects with adenomas and 38 subjects without adenomas (controls). Biopsy samples from subjects with adenomas had greater numbers of bacteria from 87 taxa than controls; only 5 taxa were more abundant in control samples. The magnitude of the differences in the distal gut microbiota between patients with adenomas and controls was more pronounced than that of any other clinical parameters including obesity, diet or family history of CRC. This suggests that sequence analysis of the microbiota could be used to identify patients at risk for developing adenomas. PMID:22622349

  4. Expression of growth hormone (GH)-releasing factor gene in GH-producing pituitary adenoma.

    Science.gov (United States)

    Wakabayashi, I; Inokuchi, K; Hasegawa, O; Sugihara, H; Minami, S

    1992-02-01

    Pituitary cells synthesize various neuropeptides that influence pituitary hormone secretion. GH-releasing factor (GRF) may also be produced by normal or pituitary tumor cells. We examined GRF gene expression in pituitary tumors. Standard techniques for the analysis of GRF gene expression did not appear to be suitable. Highly sensitive reverse transcription coupled to polymerase chain reaction was used. Specimens of pituitary adenoma were obtained by transsphenoidal adenomectomy from six patients with acromegaly and three patients with no clinical evidence of pituitary hormone overproduction; non-functioning adenoma. Pituitary glands were collected at autopsy from three patients who died from nonendocrine disorders. A specific GRF gene transcript was detected in five out of six GH-producing pituitary adenomas, whereas this was not found in three separate specimens of nonfunctioning pituitary adenoma or anterior and posterior pituitary tissue. The data suggest that GRF is synthesized as an intrinsic product in human GH-producing pituitary adenoma.

  5. Double, synchronous pituitary adenomas causing acromegaly and Cushing's disease. A case report and review of literature.

    Science.gov (United States)

    Zieliński, Grzegorz; Maksymowicz, Maria; Podgórski, Jan; Olszewski, Włodzimierz T

    2013-06-01

    Double pituitary adenomas are very rare and present up to 1 % of pituitary adenomas in unselected autopsy series and up to 2 % in large surgical series. We report a case of a 47-year-old man presented slight clinical features of acromegaly with 2 years duration. Endocrine evaluation confirmed active acromegaly and revealed adrenocorticotropin hormone-dependent hypercortisolemia. Preoperative magnetic resonance imaging of the pituitary demonstrated clearly separated double microadenomas with different intensity. The patient underwent transsphenoidal surgery and both tumors were completely removed and were fixed separately. The histological and ultrastructural examination confirmed coincidence of the double, clearly separated pituitary adenomas in one gland. Postoperative function of the hypothalamo-hypophyseal axis was normalized. We conclude from this case and a literature review that double endocrinologically active pituitary adenomas leading to acromegaly and Cushing's disease may occur. Additionally, a review of the literature regarding multiple pituitary adenomas has also been performed.

  6. Acromegaly with no pituitary adenoma and no evidence of ectopic source

    Directory of Open Access Journals (Sweden)

    Deepak Khandelwal

    2011-01-01

    Full Text Available More than 99% of patients with acromegaly harbor a growth hormone (GH secreting pituitary adenoma. As the time from onset of signs/symptoms to diagnosis of acromegaly is long (symptom onset to diagnosis is often 4-10 years, pituitary adenomas that cause GH excess are often large and are nearly always visible on conventional magnetic resonance imaging (MRI. However, in rare circumstances, acromegalic patients without an ectopic source will not have imaging evidence of a pituitary adenoma. Management of these patients poses special challenge, and once ectopic source of GH/growth-hormone-releasing hormone (GHRH is ruled out, an exploration of pituitary might be useful. We herein report a case of acromegaly with imaging evidence of sellar floor osteoma, but no pituitary adenoma, and negative work up for an ectopic source of GH/GHRH tumor, and on surgical exploration pituitary adenoma could be identified and removed and confirmed on histopathologic examination.

  7. Cytopathological features of villous adenoma of the urinary bladder in urine: A rare case report.

    Science.gov (United States)

    Ishikawa, Ryou; Kadota, Kyuichi; Hayashi, Toshitetsu; Motoyama, Mutsumi; Matsunaga, Toru; Miyai, Yumi; Katsuki, Naomi; Kushida, Yoshio; Haba, Reiji

    2016-07-01

    Villous adenoma of the urinary bladder is a rare tumor that histologically mimics its enteric counterpart. Patients with an isolated villous adenoma have an excellent prognosis, but associated adenocarcinomas can frequently be identified in them as well. There is no literature that discusses the cytopathologic features of villous adenoma. Here we report a case which was diagnosed as villous adenoma histologically, which has been followed up with urine cytology. In urine cytology, many mucin producing cells are recognized. Few cell clusters show glandular formation or arrangement along the basement membrane. When glandular cells with columnar mucin-filled goblet cells are seen in urine cytology, the presence of a primary glandular lesion of the urinary bladder, such as villous adenoma, should be considered possible. Diagn. Cytopathol. 2016;44:632-635. © 2016 Wiley Periodicals, Inc.

  8. Adenoma viloso com transformação carcinomatosa da ampola de Vater Villous adenoma with carcinomatous degeneration of the ampulla of Vater

    Directory of Open Access Journals (Sweden)

    Guilherme Pinto Bravo Neto

    2001-02-01

    Full Text Available Villous adenomas of the duodenum and ampulla of Vater are uncommon, but they have been diagnosed more frequently with the increasing use of upper gastrointestinal endoscopy. Differential diagnosis with villous adenocarcinoma may be difficult. The authors present a case of a 47-year-old man with a giant villous adenoma of the duodenum, with intermittent jaundice, that was treated by pancreatoduodenectomy.

  9. Cirugía transeptoesfenoidal en adenomas hipofisarios productores de prolactina Transeptosphenoidal surgery in prolactin-secreting hypophyseal adenomas

    Directory of Open Access Journals (Sweden)

    2005-08-01

    Full Text Available El tratamiento actual de los prolactinomas es básicamente médico, teniendo en cuenta los buenos resultados alcanzados con los nuevos agonistas dopaminérgicos. No obstante, la adenomectomía selectiva clasifica entre las modalidades de tratamiento para aquellos prolactinomas que no respondan a este. El objetivo del presente trabajo fue evaluar los resultados del tratamiento microquirúrgico por vía transeptoesfenoidal de los adenomas productores de prolactina en el servicio de Neurocirugía del Hospital “Hermanos Ameijeiras”, para lo cual presentamos un estudio retrospectivo y descriptivo de 63 pacientes intervenidos por vía sublabial transeptoesfenoidal microquirúrgica portadores de este tipo de adenomas, y tratados en nuestro servicio desde 1996 hasta el 2003. Se analizaron la edad, el sexo, el cuadro clínico, el tamaño de las lesiones, los niveles hormonales, así como las complicaciones y la evolución posoperatoria. Como resultado se encontró un franco predominio del sexo femenino: 86 % (54 pacientes. Se operaron 31 pacientes con macroadenomas y 32 con microadenomas. Los síntomas más frecuentes mejoraron, sobre todo la cefalea, en el 82 % (36 casos y los trastornos visuales en el 69 (18 casos. La complicación más común en el posoperatorio fue la diabetes insípida transitoria (11 enfermos. Se logró reducir las cifras iniciales de prolactina a valores no tumorales en el 90,6 de lo microadenomas (29 casos y en el 67,7 de los macroadenomas (21 casos. Se concluye que la adenomectomía transeptoesfenoidal es un proceder seguro y eficaz como opción de tratamiento para pacientes con adenomas secretores de prolactina que tengan indicación quirúrgica.The current treatment of prolactinomas is basically medical due to the good results attained with the new dopaminergic agonists. However, the selective adenomectomy is among the treatment modalities for those prolactinomas that do not respond to it. The objective of the present

  10. Histologic localization of PLAG1 (pleomorphic adenoma gene 1) in pleomorphic adenoma of the salivary gland: cytogenetic evidence of common origin of phenotypically diverse cells.

    Science.gov (United States)

    Debiec-Rychter, M; Van Valckenborgh, I; Van den Broeck, C; Hagemeijer, A; Van de Ven, W J; Kas, K; Van Damme, B; Voz, M L

    2001-09-01

    Pleomorphic adenoma gene 1 (PLAG1), a zinc finger transcription factor gene, is consistently rearranged and overexpressed in human pleomorphic adenomas of the salivary glands with 8q12 translocations. In this report, we describe the immunohistochemical localization of PLAG1 protein in pleomorphic adenomas of the salivary gland and corresponding normal tissue, in relation to cytokeratin, vimentin, and BCL-2 expression. Normal salivary gland tissue was not immunoreactive for PLAG1. In primary pleomorphic adenomas, cells strongly immunoreactive for PLAG1 were detected in the outer layer of tubulo-ductal structures, which are thought to be the origin of cells with bi-directional, epithelial, and mesenchymal phenotypes. In contrast, epithelial cells with abundant cytokeratin in the inner tubulo-ductal structures only sporadically expressed PLAG1. BCL-2 immunoreactivity was found mainly in the cells surrounding the tubulo-ductal structures and in the solid undifferentiated cellular masses, within the areas that had moderate PLAG1 immunoreactivity. The variability of PLAG1 expression in neoplastic cells seemed to reflect the morphologic heterogeneity that correlated with the stage of differentiation of the tumor cells. Immunohistochemical/cytogenetic evaluation of two pleomorphic adenomas with t(3;8)(p21;q12) or t(5;8)(p13;q12) translocations demonstrated the clonal nature of immunophenotypically diverse cells. This finding confirms the theory that pleomorphic adenoma cells share a common single-cell origin, most likely from the epithelial progenitor basal duct cells.

  11. Seesaw nystagmus caused by giant pituitary adenoma: case report Nistagmo em gangorra causado por adenoma pituitário gigante: relato de caso

    Directory of Open Access Journals (Sweden)

    Frederico Castelo Moura

    2006-03-01

    Full Text Available Giant pituitary adenomas are uncommonly large tumors, greater than 4 cm in size that can produces endocrine symptoms, visual loss and cranial nerve palsies. We report the rare occurrence of seesaw nystagmus as the presenting sign of giant pituitary adenoma. A 50-year-old man presented with headache associated with visual loss and seesaw nystagmus. Perimetry revealed bitemporal hemianopia and magnetic resonance imaging showed a giant pituitary adenoma. After surgery, nystagmus disappeared. Our case is relevant in understanding its pathogenesis since it documents seesaw nystagmus in a patient bitemporal hemianopia due to a large tumor but without mesencephalic compression.Adenoma pituitário gigante é um tumor incomum, maior que 4 cm que produz sintomas endócrinos, perda visual e paralisia de nervos cranianos. Relatamos um caso de nistagmo em gangorra como sinal de apresentação de adenoma pituitário gigante. Um paciente de 50 anos, masculino, apresentava cefaléia, perda visual e nistagmo em gangorra. A perimetria revelou hemianopsia bitemporal e a imagem por ressonância magnética demonstrou um adenoma pituitário gigante. Após a cirurgia, o nistagmo desapareceu. Nosso caso é importante na compreensão da fisiopatogenia do nistagmo em gangorra, pois documenta sua ocorrência em paciente com hemianopsia bitemporal decorrente de tumor hipofisário sem compressão mesencefálica.

  12. Analysis of regulatory networks constructed based on gene coexpression in pituitary adenoma.

    Science.gov (United States)

    Gong, Jie; Diao, Bo; Yao, Guo Jie; Liu, Ying; Xu, Guo Zheng

    2013-12-01

    Gene coexpression patterns can reveal gene collections with functional consistency. This study systematically constructs regulatory networks for pituitary tumours by integrating gene coexpression, transcriptional and posttranscriptional regulation. Through network analysis, we elaborate the incidence mechanism of pituitary adenoma. The Pearson's correlation coefficient was utilized to calculate the level of gene coexpression. By comparing pituitary adenoma samples with normal samples, pituitary adenoma-specific gene coexpression patterns were identified. For pituitary adenoma-specific coexpressed genes, we integrated transcription factor (TF) and microRNA (miRNA) regulation to construct a complex regulatory network from the transcriptional and posttranscriptional perspectives. Network module analysis identified the synergistic regulation of genes by miRNAs and TFs in pituitary adenoma. We identified 142 pituitary adenoma-specific active genes, including 43 TFs and 99 target genes of TFs. Functional enrichment of these 142 genes revealed that the occurrence of pituitary adenoma induced abnormalities in intracellular metabolism and angiogenesis process. These 142 genes were also significantly enriched in adenoma pathway. Module analysis of the systematic regulatory network found that three modules contained elements that were closely related to pituitary adenoma, such as FGF2 and SP1, as well as transcription factors and miRNAs involved in the tumourigenesis. These results show that in the occurrence of pituitary adenoma, miRNA, TF and genes interact with each other. Based on gene expression, the proposed method integrates interaction information from different levels and systematically explains the occurrence of pituitary tumours. It facilitates the tracing of the origin of the disease and can provide basis for early diagnosis of complex diseases or cancer without obvious symptoms.

  13. Analysis of regulatory networks constructed based on gene coexpression in pituitary adenoma

    Indian Academy of Sciences (India)

    Jie Gong; Bo Diao; Guo Jie Yao; Ying Liu; Guo Zheng Xu

    2013-12-01

    Gene coexpression patterns can reveal gene collections with functional consistency. This study systematically constructs regulatory networks for pituitary tumours by integrating gene coexpression, transcriptional and posttranscriptional regulation. Through network analysis, we elaborate the incidence mechanism of pituitary adenoma. The Pearson’s correlation coefficient was utilized to calculate the level of gene coexpression. By comparing pituitary adenoma samples with normal samples, pituitary adenoma-specific gene coexpression patterns were identified. For pituitary adenoma-specific coexpressed genes, we integrated transcription factor (TF) and microRNA (miRNA) regulation to construct a complex regulatory network from the transcriptional and posttranscriptional perspectives. Network module analysis identified the synergistic regulation of genes by miRNAs and TFs in pituitary adenoma. We identified 142 pituitary adenoma-specific active genes, including 43 TFs and 99 target genes of TFs. Functional enrichment of these 142 genes revealed that the occurrence of pituitary adenoma induced abnormalities in intracellular metabolism and angiogenesis process. These 142 genes were also significantly enriched in adenoma pathway. Module analysis of the systematic regulatory network found that three modules contained elements that were closely related to pituitary adenoma, such as FGF2 and SP1, as well as transcription factors and miRNAs involved in the tumourigenesis. These results show that in the occurrence of pituitary adenoma, miRNA, TF and genes interact with each other. Based on gene expression, the proposed method integrates interaction information from different levels and systematically explains the occurrence of pituitary tumours. It facilitates the tracing of the origin of the disease and can provide basis for early diagnosis of complex diseases or cancer without obvious symptoms.

  14.  Immunohistochemical Expression of ki-67 and p53 in Colorectal Adenomas: A Clinicopathological Study

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    Hussam Hasson Ali

    2011-07-01

    Full Text Available  Objectives: To evaluate the significance of P53 and Ki-67 expression as immunohistochemical markers in early detection of premalignant changes in different types of colorectal adenomas. Also, to correlate immunohistochemical expression of the two markers with different clinicopathological parameters including; age, and sex of the patient, type, site, size and grade of dysplasia of colorectal adenomas.Methods: Forty-seven polypectomy specimens of colorectal adenomas were retrieved from the archival materials of the Gastrointestinal and Hepatic Diseases Teaching Hospital in Baghdad from 2009 - 2010. Four µm section specimens were stained by immunohistochemical technique with Ki-67 and P53 tumor markers. P-values <0.05 were considered statistically significant.Results: Immunohistochemical expressions of Ki-67 and P53 had a significant correlation with the size and grade of dysplasia in colorectal adenomas. However, there was no significant correlation among the immunohistochemical expression of Ki-67 and P53 with the age and gender of the patient, and the type and site of colorectal adenomas. There was no significant correlation between Ki-67 and P53 expressions in colorectal adenomas. Villous adenomas of colorectum showed a significant correlation with the grade of dysplasia, while there was no significant correlation between size and site of colorectal adenoma with the grade of dysplasia.Conclusion: High grade dysplasia with significant positive immunohistochemical markers of Ki-67 and P53 could be valuable parameters for selecting from the total colorectal adenoma population, those most deserving of close surveillance in follow-up cancer prevention programs. It is closely linked with increasing age particularly in patients with a large size adenoma of villous component in their histology.

  15. Determining the adenoma detection rate and adenomas per colonoscopy by photography alone: proof-of-concept study.

    Science.gov (United States)

    Rex, Douglas K; Hardacker, Kyle; MacPhail, Margaret; Rahmani, Farrah; Vemulapalli, Krishna C; Kahi, Charles J

    2015-03-01

    The adenoma detection rate (ADR) and adenomas detected per colonoscopy (APC) are measures of the quality of mucosal inspection during colonoscopy. In a resect and discard policy, pathologic assessment for calculation of ADR and APC would not be available. The aim of this study was to determine whether ADR and APC calculation based on photography alone is adequate compared with the pathology-based gold standard. A prospective, observational, proof-of-concept study was performed in an academic endoscopy unit. High definition photographs of consecutive polyps were taken, and pathology was estimated by the colonoscopist. Among 121 consecutive patients aged ≥ 50 years who underwent colonoscopy, 268 polyps were removed from 97 patients. Photographs of consecutive polyps were reviewed by a second endoscopist. The resect and discard policy applied to lesions that were ≤ 5 mm in size. When only photographs of lesions that were ultimately proven to be adenomas were included, the reviewer assessed ADR and APC to be lower than that determined by pathology (absolute reductions of 6.6 % and 0.17, and relative reductions of 12.6 % and 13.1 % in ADR and APC, respectively). When all photographs were included for calculation of ADR and APC, the reviewer determined the ADR to be 3.3 % lower (absolute reduction) and the APC to be the same as the rates determined by pathology. In a simulated resect and discard strategy, a high-level detector can document adequate ADR and APC by photography alone. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Technical interventions to increase adenoma detection rate in colonoscopy.

    Science.gov (United States)

    Rondonotti, Emanuele; Andrealli, Alida; Amato, Arnaldo; Paggi, Silvia; Conti, Clara Benedetta; Spinzi, Giancarlo; Radaelli, Franco

    2016-12-01

    Adenoma detection rate (ADR) is the most robust colonoscopy quality metric and clinical studies have adopted it as the ideal method to assess the impact of technical interventions. Areas covered: We reviewed papers focusing on the impact of colonoscopy technical issues on ADR, including withdrawal time and technique, second evaluation of the right colon, patient positional changes, gastrointestinal assistant participation during colonoscopy, water-aided technique, optimization of bowel preparation and antispasmodic administration. Expert commentary: Overall, technical interventions are inexpensive, available worldwide and easy to implement. Some of them, such as the adoption of split dose regimen and slow scope withdrawal to allow a careful inspection, have been demonstrated to significantly improve ADR. Emerging data support the use of water-exchange colonoscopy. According to published studies, other technical interventions seem to provide only marginal benefit to ADR. Unfortunately, the available evidence has methodological limitations, such as small sample sizes, the inclusion of expert endoscopists only and the evaluation of single technical interventions. Additionally, larger studies are needed to clarify whether these interventions might have a higher benefit on low adenoma detectors and whether the implementation of a bundle of them, instead of a single technical maneuver, might have a greater impact on ADR.

  17. Testosterone-secreting adrenal adenoma in a peripubertal girl

    Energy Technology Data Exchange (ETDEWEB)

    Kamilaris, T.C.; DeBold, C.R.; Manolas, K.J.; Hoursanidis, A.; Panageas, S.; Yiannatos, J.

    1987-11-13

    A 15-year-old girl who presented with primary amenorrhea and virilization had an adrenocortical adenoma that secreted predominantly testosterone. To the authors' knowledge, she is the first peripubertal and second youngest patient with a testosterone-secreting adrenal tumor described. Serum dehydroepiandrosterone sulfate and urinary 17-ketosteroid an 17-hydroxycorticosteroid levels were normal. A tumor was located by a computed tomographic (CT) scan and by uptake of 6-..beta..-(/sup 75/Se) selenomethylnorcholesterol. Microscopic examination of the tumor showed typical features of an adrenocortical adenoma with no histologic features characteristic of Leydig cells. Postoperatively, her hirsutism regressed, she rapidly went through puberty, and regular monthly menstruation started four months later. Finding the source of testosterone in a virilized patient can be difficult. Eleven of the 14 previously described patients with testosterone-secreting adrenal tumors initially underwent misdirected surgery on the ovaries. Review of these cases revealed that results of hormone stimulation and suppression tests are unreliable and that these tumors are usually large. Therefore, CT scanning of the adrenal glands is recommended in all patients suspected of having a testosterone-secreting tumor.

  18. Immunohistochemical characterization of basal cell adenomas of the salivary gland.

    Science.gov (United States)

    Takahashi, H; Fujita, S; Okabe, H; Tsuda, N; Tezuka, F

    1991-03-01

    Seven cases of basal cell adenomas of the salivary gland were analyzed by immunohistochemical methods with a broad panel of routinely used antibodies. Histologically the epithelial elements were classified as tubuloglandular, trabecular and solid patterns. The authors' results indicated the following: 1) The duct lining cells of tubuloglandular and trabecular patterns have distinct epithelial features with cytokeratins (KL 1, PKK 1, *PKK 2 and PKK 3), alpha-one-antichymotrypsin (alpha 1-ACT), carcinoembryonic antigen (CEA) and S-100 alpha subunit positivity. 2) The basaloid cells in the trabecular and solid patterns expressed two immunophenotypes: one had actin, neuron-specific enolase (NSE), S-100 protein and S-100 beta subunit patterns typical of myoepithelial cells in normal glands. The other basaloid cells had vimentin and S-100 protein patterns. The former cell type could be found in 4 of 7 cases and the latter was found in 7 cases. This represents a minor participation of the myoepithelial cells in the basal cell adenoma. 3) The basement membrane and stromal connective tissue around the neoplastic cells were positive for alpha-one-antitrypsin (alpha 1-AT). This antibody is a good marker in identifying the basement membrane-like material.

  19. Endoscopic discrimination of sessile serrated adenomas from other serrated lesions

    Science.gov (United States)

    Hasegawa, Shin; Mitsuyama, Keiichi; Kawano, Hiroshi; Arita, Keiko; Maeyama, Yasuhiko; Akagi, Yoshito; Watanabe, Yasutomo; Okabe, Yoshinobu; Tsuruta, Osamu; Sata, Michio

    2011-01-01

    Sessile serrated adenoma (SSA) is a proposed precursor of colorectal carcinogenesis. This study aimed to analyze the potential of endoscopy to discriminate SSA from other serrated lesions, specifically traditional serrated adenoma (TSA) and hyperplastic polyp (HP). Of 145 serrated lesions, 111 sessile serrated lesions including 32 TSAs, 25 SSAs and 54 HPs were analyzed for size, color, location and morphologic features using conventional endoscopy and magnifying chromoendoscopy. SSA was preferentially located in the right colon, whereas TSA and HP were located in the left colon. The sizes of SSA and TSA were larger than those of HP. The lesion color was indistinguishable among TSA, SSA and HP. Macroscopically, a pinecone-like or two-tier raised appearance were found more frequently in TSA than in SAA and HP. Under magnified chromoendoscopic observation, the stellar IIIL pit pattern and fern-like appearance were observed more frequently in TSA than in SAA and HP. In conclusion, endoscopic discrimination between SSA and other sessile serrated lesions based on morphological features was difficult. However, size and location of the lesions facilitated diagnosis. PMID:22866127

  20. Radiologic findings of tubular adenoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Mi Gyoung; Oh, Ki Keun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-10-01

    Tubular adenoma (TA) is known as a rare lesion of the breast which is difficult to diagnosis preoperatively because of its rarity and similarity to fibroadenoma. Hence, our purpose is to suggest the characteristic sonographic features for its correct diagnosis. We retrospectively analyzed the clinical data and mammographic and sonographic findings. of seven patients(mean age, 23) who during the previous five years had presented at our hospital with pathologically-proven tubular adenoma. TA was misdiagnosed as fibroadenoma, since on physical examination of these young females, the lesions presented a palpable, non-tender mass. Mammographically, they showed a well defined mass similar to fibroadenoma. However, sonographic findings were characteristic of TA and compared to fibroadenoma, showed a well demarcated and smooth bordered mass with transverse long axis, posterior enhancement and homogeneous lower internal echogenecity. No case showed lateral wall refractive shadowing. In young females, the clinical and mammographic findings of TA are similar to those of fibroadenoma. However, sonographic findings of TA can, be helpful in the differential diagnosis of this entity and fibroadenoma.

  1. Acute appendicitis following endoscopic mucosal resection of cecal adenoma.

    Science.gov (United States)

    Nemoto, Yukako; Tokuhisa, Junya; Shimada, Nagasato; Gomi, Tatsuya; Maetani, Iruru

    2015-07-21

    Endoscopic mucosal resection (EMR) allows the removal of flat or sessile lesions, laterally spreading tumors, and carcinoma of the colon or the rectum limited to the mucosa or the superficial submucosa. Acute appendicitis is the most common abdominal emergency requiring emergency surgery, and it is also a rare complication of diagnostic colonoscopy and therapeutic endoscopy, including EMR. In the case presented here, a 53-year-old female underwent colonoscopy due to a positive fecal occult blood test and was diagnosed with cecal adenoma. She was referred to our hospital and admitted for treatment. The patient had no other symptoms. EMR was performed, and 7 h after the surgery, the patient experienced right -lower abdominal pain. Laboratory tests performed the following day revealed a WBC count of 16000/mm(3), a neutrophil count of 14144/mm(3), and a C-reactive protein level of 2.20 mg/dL, indicating an inflammatory response. Computed tomography also revealed appendiceal wall thickening and swelling, so acute appendicitis following EMR was diagnosed. Antibiotics were initiated leading to total resolution of the symptoms, and the patient was discharged on the sixth post-operative day. Pathological analysis revealed a high-grade cecal tubular adenoma. Such acute appendicitis following EMR is extremely rare, and EMR of the cecum may be a rare cause of acute appendicitis.

  2. Liver cell adenoma with malignant transformation: A case report

    Institute of Scientific and Technical Information of China (English)

    Masahiro Ito; Makoto Sasaki; Chun-Yang Wen; Masahiro Nakashima; Toshihito Ueki; Hiromi Ishibashi; Michitami Yano; Masayoshi Kage; Masamichi Kojiro

    2003-01-01

    A 57-year-old woman was referred to our hospital because of a liver mass detected by computed tomography. She had taken oral contraceptives for only one month at the age of thirty. Physical examination revealed no abnormalities, and laboratory data, including hepatic function tests, were within the normal range, with the exception of elevated levels of those serum proteins induced by the absence of vitamin K or by raised levels of the antagonist (PIVKA)-Ⅱ (3 502 AU/ml).Abdominal ultrasonography revealed a hyperechoic mass measuring 10x10 cm in the left posterior segment of the liver. Because hepatocellular carcinoma could not be completely excluded, this mass was resected. The tumor consisted of sheets of uniform cells with clear cytoplasm,perinuclear eosinophilic granules and round nuclei. These histological findings were consistent with liver cell adenoma.Background hepatic tissue appeared normal. After resection of the tumor, serum PIVKA-Ⅱ fell to within the normal range.An area of hepatocellular carcinoma (HCC) with a midtrabecular pattern was immunohistochemically found, which was positive for PIVKA-Ⅱ. Sinusoidal endothelial cells were CD34-positive, containing scattered PIVKA-Ⅱ positive cells.This tumor was therefore finally diagnosed as liver cell adenoma with focal malignant transformation to HCC.

  3. Human Pituitary Adenoma Proteomics: New Progresses and Perspectives

    Science.gov (United States)

    Zhan, Xianquan; Wang, Xiaowei; Cheng, Tingting

    2016-01-01

    Pituitary adenoma (PA) is a common intracranial neoplasm that impacts on human health through interfering hypothalamus–pituitary–target organ axis systems. The development of proteomics gives great promises in the clarification of molecular mechanisms of a PA and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis, and treatment for a PA. A great progress in the field of PA proteomics has been made in the past 10 years, including (i) the use of laser-capture microdissection, (ii) proteomics analyses of functional PAs (such as prolactinoma), invasive and non-invasive non-functional pituitary adenomas (NFPAs), protein post-translational modifications such as phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii) the use of protein antibody array, (iv) serum proteomics and peptidomics, (v) the integration of proteomics and other omics data, and (vi) the proposal of multi-parameter systematic strategy for a PA. This review will summarize these progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers. PMID:27303365

  4. Discrimination of prolactinoma from hyperprolactinemic non-functioning adenoma.

    Science.gov (United States)

    Hong, Jae Won; Lee, Mi Kyung; Kim, Sun Ho; Lee, Eun Jig

    2010-02-01

    The objective of this study was to evaluate characteristics that discriminate prolactinoma from non-functioning pituitary macroadenoma with hyperprolactinemia. We included 117 patients with hyperprolactinemic pituitary macroadenomas. Patients were divided into three groups according to treatment outcomes and pathologic results: (A) prolactinoma that responded to dopamine agonist (DA) treatment (PRDA); (B) prolactinoma requiring surgical treatment (PRS); and (C) non-functioning pituitary adenoma with hyperprolactinemia (NFPAH). Old age, low serum prolactin levels, and extrasellar extension were associated with NFPAH. Most patients with NFPAH had serum prolactin levels less than 100 ng/ml. Visual defects and GH deficiency were more common in patients with NFPAH compared with patients with PRS and PRDA, without difference of tumor size. Galactorrhea and amenorrhea were less frequent in patients with NFPAH than in patients with PRS and PRDA. Post-operative remission of hyperprolactinemia was achieved in 100% of patients with NFPAH and in 72.5% of patients with PRS. DA administration was required in 25.5% of patients with PRS; however, no patients with NFPAH required DA administration. In conclusion, old age, extrasellar tumor extension with relatively low prolactin levels, visual defect, and GH deficiency were considered suggestive of non-functioning pituitary adenoma rather than prolactinoma in hyperprolactinemic pituitary macroadenoma.

  5. Human pituitary adenoma proteomics: new progresses and perspectives

    Directory of Open Access Journals (Sweden)

    Xianquan eZhan

    2016-05-01

    Full Text Available Pituitary adenoma (PA is a commonly intracranial neoplasm that impacts on human health through interfering hypothalamus-pituitary-target organ axis systems. The development of proteomics gives great promises in clarification of molecular mechanisms of a pituitary adenoma and discovery of effective biomarkers for prediction, prevention, early-stage diagnosis and treatment of a PA. A great progress in the field of PA proteomics has been made in the past ten years, including (i the use of laser capture microdissection, (ii proteomics analyses of functional PAs (FPAs, such as prolactinoma, invasive and noninvasive nonfunctional PAs (NFPAs, protein post-translational modifications (PTMs including phosphorylation and tyrosine nitration, NFPA heterogeneity, and hormone isoforms, (iii the use of protein antibody array, (iv serum proteomics and peptidomics, (v integration of proteomics and other omics data, and (vi proposal of multi-parameter systematic strategy for a PA. This review will summarize those progresses of proteomics in PAs, point out the existing drawbacks, propose the future research directions, and address the clinical relevance of PA proteomics data, in order to achieve our long-term goal that is use of proteomics to clarify molecular mechanisms, construct molecular networks, and discover effective biomarkers.

  6. Pituitary null cell adenoma in a domestic llama (Lama glama).

    Science.gov (United States)

    Chalkley, M D; Kiupel, M; Draper, A C E

    2014-07-01

    Pituitary gland neoplasia has been reported rarely in camelids. A 12-year-old neutered male llama (Lama glama) presented with lethargy, inappetence and neurological signs. On physical examination, the llama was mentally dull and exhibited compulsive pacing and circling to the left. Complete blood count and serum biochemistry revealed haemoconcentration, mild hypophosphataemia, hyperglycaemia, hypercreatininaemia and hyperalbuminaemia. Humane destruction was elected due to rapid clinical deterioration and poor prognosis. Post-mortem examination revealed a pituitary macroadenoma and bilateral internal hydrocephalus. Microscopically, the pituitary tumour was composed of neoplastic chromophobic pituitary cells. Ultrastructural studies revealed similar neoplastic cells to those previously described in human null cell adenomas. Immunohistochemically, the neoplastic cells were strongly immunoreactive for neuroendocrine markers (synaptophysin and chromogranin A), but did not exhibit immunoreactivity for epithelial, mesenchymal, neuronal and all major pituitary hormone markers (adrenocorticotropic hormone, follicle stimulating hormone, growth hormone, luteinizing hormone, melanocyte-stimulating hormone, prolactin and thyroid stimulating hormone), consistent with the diagnosis of a pituitary null cell adenoma. This is the first report of pituitary neoplasia in a llama.

  7. Image-guided endoscopic transnasal removal of recurrent pituitary adenomas.

    Science.gov (United States)

    Lasio, Giovanni; Ferroli, Paolo; Felisati, Giovanni; Broggi, Giovanni

    2002-07-01

    To assess the role that neuronavigation plays in assisting endoscopic transsphenoidal reoperations for recurrent pituitary adenomas. During a 45-month period, 19 endoscopic endonasal transsphenoidal reoperations were performed for recurrent pituitary adenomas. In 11 of 19 patients, the procedure was performed with the aid of an optically guided system. Clinical records were reviewed retrospectively, with attention to the following: comparison of baseline clinical data, the duration of surgery, and the postoperative course and complications of both image-guided and non-image-guided endoscopic reoperations. In addition, to test the reliability of the neuronavigation system, we made measurements of intraoperative accuracy in five additional transnasal endoscopic procedures in "virgin" noses and sphenoidal sinuses. In both groups studied, we found no difference with regard to either morbidity or mortality, which were null. The mean setup time was 13 minutes shorter in non-image-guided procedures (P = 0.021), and the operative time was 36 minutes shorter in image-guided procedures (P = 0.038). No other statistically significant differences were found between the two groups. In all cases, we found that the system performed without malfunction. Continuous information regarding instrument location and trajectory was provided to the surgeon. Measurements of the intraoperative accuracy in the axial, coronal, and sagittal planes indicated a mean intraoperatively verified system error of 1.6 +/- 0.6 mm. Neuronavigation can be applied during endonasal transsphenoidal endoscopic surgery and requires a minimal amount of time. It makes reoperation easier, faster, and probably safer.

  8. A Rare Complication following Thyroid Percutaneous Ethanol Injection: Plummer Adenoma

    Directory of Open Access Journals (Sweden)

    Roberto Cesareo

    2017-01-01

    Full Text Available Percutaneous ethanol injection (PEI is a technique used only for benign thyroid nodules, cystic or mixed cystic-solid with a large fluid component. It is a quite low-cost, safe, and outpatient method of treatment. Rare and severe complications have been described after PEI: jugular vein thrombosis and severe ethanol toxic necrosis of the larynx combined with necrotic dermatitis. Moreover, only four thyrotoxicosis cases due to Graves’ disease have been reported. We report a case of 58-year-old female with a voluminous thyroid cystic nodule, occupying almost the entire left thyroid lobe. Our patient had already performed surgical visit and intervention of thyroidectomy had been proposed to her, which she refused. At baseline, our patient has a normal thyroid function with negative autoantibodies. According to the nodular structure, intervention of PEI has been performed with a significant improvement of compressive symptoms and cosmetic disorders. About 30 days after treatment, there was a significant volume reduction, but patient developed an acclaimed symptomatic thyrotoxicosis. After ruling out several causes of hyperthyroidism and according to the thyroid scintigraphy findings, we made the diagnosis of Plummer adenoma. To our knowledge, our patient is the first case of Plummer adenoma following PEI treatment of nontoxic thyroid nodule.

  9. 99mTc(V)-DMSA. A useful radio isotopic material for the diagnosis of pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Shinichi; Yamamura, Koji; Chang, Chia-Cheng; Kojima, Yasuhiro; Yamamoto, Isao; Ikegami, Tadashi [Yokohama City Univ., Kanagawa (Japan). School of Medicine

    2000-06-01

    We compared images of pituitary adenoma, parasellar tumors, and non-pituitary adenoma using the tumor-seeking agent technetium-99m-labeled pentavalent dimercaptosuccinic acid (99mTc(V)-DMSA) and evaluated the relationship between 99mTc(V)-DMSA uptake and pituitary hormone level. Fifteen patients with pituitary adenoma were studied: 3 non-functioning adenoma, 6 prolactinoma, 4 GH secreting adenoma, and 2 ACTH secreting adenoma. As a control group, we studied 6 patients without adenoma who had undergone a pathological examination. Planar and SPECT images were obtained 2-hours after intravenous injection of approximately 740 MBq 99mTc(V)-DMSA. Uptake ratios between normal background and tumor lesion were calculated. Three non-functioning adenoma (100%), five prolactinoma (83%), three GH secreting adenoma (75%) and no ACTH secreting adenoma (0%) significantly concentrated 99mTc(V)-DMSA. One of the non-adenomatous tumors, a Rathke's cleft cyst concentrated 99mTc(V)-DMSA in the pituitary while the others did not. The 99mTc(V)-DMSA scintigraphy showed an overall sensitivity of 73% (11/15) in detecting pituitary adenomas. Uptake ratios were higher in hormone-secreting adenoma than non-secreting adenoma. We were able to detect residual tumors and distinguish pituitary adenoma from surgical non-tumoral lesion with 99mTc(V)-DMSA. These results suggest that 99mTc(V)-DMSA imaging is useful in detecting pituitary adenoma and noninvasively differentiating tumor types in parasellar lesion. (author)

  10. A silent period in sural muscle occurring prior to the voluntary forward inclination of the body.

    Science.gov (United States)

    Iwase, Y; Uchida, T; Takanashi, Y; Suzuki, N; Hashimoto, M; Yamamoto, Y; Takegami, T; Koyama, H

    1981-01-20

    A silent period lasting for 300-500 msec was observed in triceps surae muscle when the subject inclined forward from the normal standing. This silent period preceded 100 msec or more the beginning of the body inclination and was terminated by an abrupt refiring in the midst of the body swing. The silence was not preceded by the increase in activity of the sural muscle itself or any other leg muscles studied. H-reflex in soleus was strongly inhibited or disappeared during the silent period, indicating that the excitability of the spinal motoneurons was greatly decreased during this period. These findings suggest that the silent period was not induced by some reflex activity in the spinal cord, but was caused by the inhibitory activity based on a central program on the spinal motoneurons.

  11. Silent seizures in sick infants in early life. Diagnosis by continuous cerebral function monitoring.

    Science.gov (United States)

    Hellström-Westas, L; Rosén, I; Swenningsen, N W

    1985-09-01

    Cerebral electric activity was surveilled with a Cerebral Function Monitor (CFM) technique in 87 newborn infants under neonatal intensive care. A total of 26 infants had electrographical signs of repeated seizure activity. Among these infants 14 had periods of one hour or more of silent seizures activity. Among these infants 14 had periods of one hour or more of silent seizures, i.e. typical pattern of ictal epileptic activity on CFM without clinical symptoms or signs of convulsions. The occurrence of silent seizures and their pattern in relation to the clinical condition and management was unpredictable in most cases. Besides general limpness or flaccidity in an outward quiet baby these infants showed no clinical fits or clonic convulsions. The findings indicate that anticonvulsive therapy in small infants may be insufficient and need re-evaluation, since the long-term effect of silent seizures on cerebral function and activity is still uncertain.

  12. Needs of a Silent Minority: Mexican Transgender Asylum Seekers.

    Science.gov (United States)

    Gowin, Mary; Taylor, E Laurette; Dunnington, Jamie; Alshuwaiyer, Ghadah; Cheney, Marshall K

    2017-05-01

    Mexican male to female transgender asylum seekers in the United States suffer from serious health issues that can be attributed to stressors related to their transgender, ethnic minority, and socioeconomic status. This study explored these stressors, the resulting health issues, and the needs of this particularly vulnerable population. Asylum seekers' (n = 45) sworn declarations and psychological evaluations were examined by a multidisciplinary research team using a systematic document review process. The review identified stressors that occurred both in Mexico and the United States: verbal, physical, and sexual assaults; unstable environments; fear for safety/security; hiding undocumented status; and economic insecurity. The health issues that resulted in part from these stressors include posttraumatic stress disorder, depression, anxiety, sleep issues, isolation, avoidance, drug/alcohol use, and suicidal tendencies. Despite suffering from multiple health issues, asylum seekers rarely sought health or social services. Health promotion practitioners can play an important role in serving this silent minority by (1) expanding community-based research focused on the intersection of transgender, ethnic minority, and socioeconomic status; (2) using trusted community members to connect this population to necessary resources; (3) providing communication training/resource development for health care providers; and (4) creating a network of service organizations that understand the needs of transgender asylum seekers.

  13. Motor cortical thresholds and cortical silent periods in epilepsy.

    Science.gov (United States)

    Tataroglu, Cengiz; Ozkiziltan, Safa; Baklan, Baris

    2004-10-01

    We studied motor cortical thresholds (TIs) and cortical silent periods (SPs) evoked by transcranial magnetic stimulation (TMS) in 110 epileptic patients. Sixty-two had primary generalised, 48 had partial type seizures. Fifteen out 110 patients were analysed both before and after anticonvulsant medication. Our aims were to evaluate the TI levels and the duration of SPs in patients with epilepsy and to determine the reliability of TMS in patients with epilepsy. There was no negative effect of TMS on the clinical status and EEG findings in patients with epilepsy. TIs obtained from patients with partial epilepsy were higher than those obtained from both controls and primary epileptics. The duration of SP in patients with primary epileptics was more prolonged than those obtained from controls. There was no correlation between EEG lateralisation and both SP duration and TI values. In de novo patient group, SP duration was significantly prolonged after anticonvulsant medication. We concluded that TMS is a reliable electrophysiological investigation in patients with epilepsy. The analysis of SP duration may be an appropriate investigation in monitoring the effect of anticonvulsant medication on the cortical inhibitory activity.

  14. [Subclinical adrenal diseases: silent pheochromocytoma and subclinical Addison's disease].

    Science.gov (United States)

    Thuillier, P; Kerlan, V

    2012-10-01

    The silent pheochromocytoma, a hidden form of pheochromocytoma, exposes the patient to an increased risk of mortality if the diagnosis is not established on time. Biological diagnosis of pheochromocytoma can be difficult. Catecholamine secretion is dependent on tumor size and a large number of physiological, pharmacological, lifestyle modifications and sampling conditions influence the measurement of urinary and plasma metanephrines. The prevalence of pheochromocytoma is 2% among adrenal incidentaloma smaller than 3 cm (2/3 of tumors). Recent studies suggest the almost zero risk of pheochromocytoma among these tumors if they are hypodense (<10 housefield units) on adrenal tomography. Addison's disease is a pathology affecting about 1 in 8000. Immunopathology is still unknown, but some elements advocated the hypothesis of a predominant cell-mediated immunity in particular Interferon-gamma production by CD4 T lymphocytes in the presence of an epitope from the 21-hydroxylase, as well as IgG1 subtype produced by activated B lymphocytes, autoantibodies do appear to be a simple marker of the disease. Subclinical Addison's disease is defined by the presence of anti-21-hydroxylase autoantibodies, without clinical symptoms. It evolves faster to the clinical phase in young subjects, male, having high levels of autoantibodies and with an initially impaired adrenal function. Dosage of ACTH, plasma renin active, and basal cortisol and after Synacthen allow to discriminate the subjects with low or high risk of evolution and establish an appropriate monitoring. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Uniqueness of Petrov type D spatially inhomogeneous irrotational silent models

    CERN Document Server

    Apostolopoulos, P S; Apostolopoulos, Pantelis S; Carot, Jaume

    2006-01-01

    The consistency of the constraint with the evolution equations for spatially inhomogeneous and irrotational silent (SIIS) models of Petrov type I, demands that the former are preserved along the timelike congruence represented by the velocity of the dust fluid, leading to an infinite set of non-trivial constraints. This fact has been used to conjecture that the resulting models correspond to the spatially homogeneous (SH) models of Bianchi type I, at least for the case where the cosmological constant vanish. By exploiting the full set of the constraint equations as expressed in the 1+3 covariant formalism and using elements from the theory of the spacelike congruences, we provide a direct and simple proof of this conjecture for vacuum and dust fluid models, which shows that the Szekeres family of solutions represents the most general class of SIIS models. The suggested procedure also shows that, the uniqueness of the spatially inhomogeneous and irrotational models of Petrov type D is not affected by the prese...

  16. Benzene conversion by manganese dioxide assisted silent discharge plasma

    Institute of Scientific and Technical Information of China (English)

    LU Bin; JI Min; YU Xin; FENG Tao; YAO Shuiliang

    2007-01-01

    Non-thermal plasma technologies have shown their promising potential specially for the low concentration of volatile organic compound control in indoor air in recent years.But it is also high energy consuming.So,to improve the energy efficiency,adding catalysts which enhance the plasma chemical reactions to plasma reactors may be a good selection.Therefore,in this study the manganese dioxide assisted silent discharge plasma was developed for benzene conversion at a relatively high energy efficiency.The results show that MnO2 could promote complete oxidation of benzene with O2 and O3 produced in the plasma discharge zone.The energy efficiency of benzene conversion with MnO2 was two folds as much as that without catalysts.It was also found that the site of MnO2 in the reactor and the energy density had effects on benzene conversion.While the energy density was lower than 48 J/L,benzene conversion decreased with the increase in the distance between MnO2 bed and the plasma discharge zone.Whereas when the energy density was higher than 104 J/L,benzene conversion had an optimal value that was governed by the distance between MnO2 bed and the plasma discharge zone.The mechanism of benzene oxidation in plasma discharges and over MnO2 is discussed in detail.

  17. Silent angels the genetic and clinical aspects of Rett syndrome

    Directory of Open Access Journals (Sweden)

    Dziwota Ewelina

    2016-12-01

    Full Text Available Rett syndrome is a neurodevelopmental genetic disorder and, because of some behavioral characteristics, individuals affected by the disease are known as silent angels. Girls with Rett syndrome perform stereotyped movements, they have learning difficulties, their reaction time is prolonged, and they seem alienated in the environment. These children require constant pediatric, neurological and orthopedic care. In the treatment of Rett syndrome physical therapy, music therapy, hydrotherapy, hippotherapy, behavioral methods, speech therapy and diet, are also used. In turn, psychological therapy of the syndrome is based on the sensory integration method, using two or more senses simultaneously. In 80% of cases, the syndrome is related to mutations of the MECP2 gene, located on chromosome X. The pathogenesis of Rett syndrome is caused by the occurrence of a non-functional MeCP2 protein, which is a transcription factor of many genes, i.e. Bdnf, mef2c, Sgk1, Uqcrc1. Abnormal expression of these genes reveals a characteristic disease phenotype. Clinical symptoms relate mainly to the nervous, respiratory, skeletal and gastrointestinal systems. Currently causal treatment is not possible. However, researchers are developing methods by which, perhaps in the near future, it will be possible to eliminate the mutations in the MECP2 gene, and this will give a chance to the patient for normal functioning.

  18. Characterization of 12 silent alleles of the human butyrylcholinesterase (BCHE) gene

    Energy Technology Data Exchange (ETDEWEB)

    Primo-Parmo, S.L.; Wiersema, B.; Spek, A.F.L. van der [Univ. of Michigan Medical School, Ann Arbor, MI (United States)] [and others

    1996-01-01

    The silent phenotype of human butyrylcholinesterase (BChE), present in most human populations in frequencies of {approximately}1/100,000, is characterized by the complete absence of BChE activity or by activity < 10 % of the average levels of the usual phenotype. Heterogeneity in this phenotype has been well established at the phenotypic level, but only a few silent BCHE alleles have been characterized at the DNA level. Twelve silent alleles of the human butyrylcholinesterase gene (BCHE) have been identified in 17 apparently unrelated patients who were selected by their increased sensitivity to the muscle relaxant succinylcholine. All of these alleles are characterized by single nucleotide substitutions or deletions leading to distinct changes in the structure of the BChE enzyme molecule. Nine of the nucleotide substitutions result in the replacement of single amino acid residues. Three of these variants, BCHE*33C, BCHE*198G, and BCHE*201T, produce normal amounts of immunoreactive but enzymatically inactive BChE protein in the plasma. The other six amino acid substitutions, encoded by BCHE*37S, BCHE*125F, BCHE*170E, BCHE-471R, and BCHE*518L, seem to cause reduced expression of BChE protein, and their role in determining the silent phenotype was confirmed by expression in cell culture. The other four silent alleles, BCHE*271STOP, BCHE*500STOP, BCHE*FS6, and BCHE*I2E3-8G, encode BChEs truncated at their C-terminus because of premature stop codons caused by nucleotide substitutions, a frame shift, or altered splicing. The large number of different silent BCHE alleles found within a relatively small number of patients shows that the heterogeneity of the silent BChE phenotype is high. The characterization of silent BChE variants will be useful in the study of the structure/function relationship for this and other closely related enzymes. 83 refs., 3 figs., 4 tabs.

  19. MESHING THEORY AND DESIGN METHOD OF NEW SILENT CHAIN AND SPROCKET

    Institute of Scientific and Technical Information of China (English)

    MENG Fanzhong; FENG Zengming; CHU Yaxu

    2006-01-01

    Based on the study of the meshing theory of a new silent chain and sprockets, and the rolling cutting theory of sprocket and hob, the harmonious relations of dominating dimensions among the new silent chain, sprocket and hob is build, the meshing conditions are expatiated, and the resolved expression, which can instruct design and calculation, is educed. The tests show that the meshing design method is feasible.

  20. Subtipo respiratório versus não respiratório no transtorno de pânico com agorafobia: avaliação com terapia cognitivo-comportamental Respiratory versus non respiratory subtypes of panic disorder with agoraphobia: cognitive behavioral therapy assessment

    Directory of Open Access Journals (Sweden)

    Anna Lucia Spear King

    2012-01-01

    Full Text Available OBJETIVO: verificar a resposta dos pacientes com transtorno de pânico com agorafobia à modelo proposto de terapia cognitivo-comportamental (TCC nos dois subtipos respiratórios de transtorno de pânico: o subtipo respiratório (SR e subtipo não respiratório (SNR Amostra randomizada por sorteio com 50 pacientes diagnosticados segundo o Manual Diagnóstico e Estatístico dos Transtornos Mentais. A medicação: antidepressivos tricíclicos ou inibidores seletivos de recaptação da serotonina. Setenta e sete ponto seis porcento da amostra de pacientes de ambos os grupos apresentaram o SR e 22,4 % o SNR. Os pacientes do SR, responderam satisfatoriamente ao tratamento com técnicas da TCC, reduzindo ansiedade, sintomas respiratórios e os ataques de pânico. Os pacientes do SR melhoraram, segundo a escala de avaliação global do funcionamento, de 55,8 para 70,9 em comparação com o SNR.The objective of the present study was to verify the response of patients with panic disorder (agoraphobia to existing cognitive-behavior therapy models (CBT of two respiratory subtypes of panic disorder (PD: respiratory subtype (RS and non respiratory subtype (NRS. We randomly selected a sample of 50 patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The medication used was tricycle or selective serotonin reuptake inhibitor antidepressants. Seventy-seven point six percent of the patients from both groups showed RS and 22.4% the NRS. The RS patients responded satisfactorily to the treatment with techniques of CBT decreasing anxiety, breathing symptoms and panic attacks. According to the global functioning assessment scale, RS patients improved from 55.8 to 70.9 in comparison with NRS ones.

  1. Prevalence of adenomas and colorectal cancer in average risk individuals: a systematic review and meta-analysis.

    Science.gov (United States)

    Heitman, Steven J; Ronksley, Paul E; Hilsden, Robert J; Manns, Braden J; Rostom, Alaa; Hemmelgarn, Brenda R

    2009-12-01

    There is an extensive yet inconsistent body of literature reporting on the prevalence of adenomatous polyps (adenomas) and colorectal cancer among average risk individuals. The objectives of our study were to determine the pooled prevalence of adenomas and colorectal cancer, as well as nonadvanced and advanced adenomas, among average risk North Americans. Articles were obtained by searching electronic databases (MEDLINE: 1950 through March 2008 and EMBASE: 1980 through March 2008), bibliographies, major journals, and conference proceedings, with no language restrictions. Two reviewers independently selected cross-sectional studies reporting adenoma and colorectal cancer prevalence rates in average risk individuals and assessed studies for inclusion and quality, and extracted the data for analysis. Pooled adenoma and colorectal cancer prevalence rates were estimated using fixed and random effects models. Stratification and metaregression was used to assess heterogeneity. Based on 18 included studies, the pooled prevalence of adenomas, colorectal cancer, nonadvanced adenomas, and advanced adenomas was 30.2%, 0.3%, 17.7%, and 5.7%, respectively. Heterogeneity was observed in the pooled prevalence rates for overall adenomas, advanced adenomas, and colorectal cancer and was explained by the mean age (> or = 65 years vs prevalence rates. None of the study quality indicators was found to be significant predictors of heterogeneity. The high prevalence of advanced adenomas and colorectal cancer, especially among older screen-eligible individuals, provides impetus for expanding colorectal cancer screening programs. Furthermore, the pooled prevalence estimates can be used as quality indicators for established programs.

  2. PROPER CONDITIONS OF MESHING FOR Hy-Vo SILENT CHAIN AND SPROCKET

    Institute of Scientific and Technical Information of China (English)

    MENG Fanzhong; LI Chun; CHENG Yabing

    2007-01-01

    Proper meshing of Hy-Vo silent chain and sprocket is important for realizing the transmission of the silent chain with more efficiency and less noise. Based on the study of the meshing theory of the Hy-Vo silent chain with the sprocket and the roll cutting machining principle of the sprocket with the hob, the proper conditions of the meshing for the Hy-Vo silent chain and the sprocket are put forward with the variable pitch characteristic of the Hy-Vo silent chain taken into consideration, and the proper meshing design method on the condition that the value of the link tooth pressure angle is unequal to the value of the sprocket tooth pressure angle is studied. Experiments show that this new design method is feasible. In addition, the design of the pitch, the sprocket tooth pressure angle and the fillet radius of the sprocket addendum circle arc studied. It is crucial for guiding the design of the hob which cuts the Hy-Vo silent chain sprocket.

  3. Differential gene expression by fiber-optic beadarray and pathway in adrenocorticotrophin-secreting pituitary adenomas

    Institute of Scientific and Technical Information of China (English)

    JIANG Zhi-quan; GUI Song-bo; ZHANG Ya-zhuo

    2010-01-01

    Background Adrenocorticotrophin (ACTH)-secreting pituitary adenomas account for approximately 7%-14% of all pituitary adenomas, but its pathogenesis is still enigmatic. This study aimed to explore mechanisms underlying the pathogenesis of ACTH-secreting pituitary adenomas.Methods We used fiber-optic beadarray to examine gene expression in three ACTH-secreting adenomas compared with three normal pituitaries. Four differentially expressed genes from the three ACTH-secreting adenomas and three normal pituitaries were chosen randomly for validation by reverse transcriptase-real time quantitative polymerase chain reaction (RT-qPCR). We then analyzed the differentially expressed gene profile with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway.Results Fiber-optic beadarray analysis showed that the expression of 28 genes and 8 expressed sequence tags (ESTs)were significantly increased and the expression of 412 genes and 31 ESTs were significantly decreased. Bioinformatic and pathway analysis showed that the genes HIGD1B, EPS8, HPGD, DAPK2, and IGFBP3 and the transforming growth factor (TGF)-β signaling pathway and extracellular matrix (ECM)-receptor interaction pathway may play important roles in tumorigenesis and progression of ACTH-secreting pituitary adenomas.Conclusions Our data suggest that numerous aberrantly expressed genes and several pathways are involved in the pathogenesis of ACTH-secreting pituitary adenomas. Fiber-optic beadarray combined with pathway analysis of differential gene expression appears to be a valid method of investigating tumour pathogenesis.

  4. The Occurrence of Primary Hepatic Adenoma in Deceased Donor Renal Transplant Recipient

    Directory of Open Access Journals (Sweden)

    Yu-Tso Liao

    2014-01-01

    Full Text Available Main findings: We reported a case of new-onset, multi-focal hepatic adenoma in an 18 year-old man with no classic risk factors occurring forty months after a renal transplant from a cadaver donor. Histopathology of the adenoma was examined and genotype and phenotype were also analyzed. Histopathologic examination of the adenoma showed no malignancy. Genotype and phenotype analysis revealed no HNF1α or β-catenin gene mutations and no inflammatory infiltration. The patient was well and disease-free postoperatively. Case hypothesis: Hepatic adenoma occurs mostly in those taking oral contraceptives or androgenic-anabolic steroids or in those with hereditary diseases. Hepatic adenoma in a renal transplant recipient is rare and has only been reported in one case with glycogen storage disease type Ia. Immunosuppressive treatment might have contributed to the development of the neoplasm. Promising future implications: Although malignant change occurs most often in β-catenin gene mutation hepatic adenoma, surgical resection of the adenoma in a patient under immunosuppressive therapy should be considered in order to avoid the possibility of malignant transformation or hemorrhagic rupture.

  5. The association of serum lipids with the histological pattern of rectosigmoid adenoma in Taiwanese adults

    Directory of Open Access Journals (Sweden)

    Lu Feng-Hwa

    2011-05-01

    Full Text Available Abstract Background The mortality rate of colorectal cancer ranks third behind lung and hepatic cancer in Taiwan. Colorectal cancer mostly arises from adenomatous polyps of left colon. The aim of our study was to examine the association of serum lipids with the histological pattern of rectosigmoid adenoma. Methods There were 2,506 eligible examinees aged 20 and above who underwent sigmoidoscopy as a screening examination in National Cheng Kung University Hospital between January 2003 and October 2006. They were classified into three groups: tubular adenoma (333 subjects, villous-rich (tubulovillous/villous adenoma (53 subjects and normal (2,120 subjects. We defined high total cholesterol (TC as a level ≧200 mg/dl, low high-density lipoprotein cholesterol (HDL-C as a level Results Among the study population, 333 subjects (13.3% had tubular adenomas and 53 subjects (2.1% had villous-rich adenomas. The odds ratio (OR for villous-rich adenoma in subjects with TG≧200 mg/dL compared to those with TG Conclusions Our study showed that subjects with high serum TG tended to have a higher risk of tubulovillous/villous adenoma in rectosigmoid colon. Therefore, reducing the serum TG level might be one method to prevent the incidence of colorectal cancer.

  6. Identification of an epigenetic biomarker panel with high sensitivity and specificity for colorectal cancer and adenomas

    Directory of Open Access Journals (Sweden)

    Lind Guro E

    2011-07-01

    Full Text Available Abstract Background The presence of cancer-specific DNA methylation patterns in epithelial colorectal cells in human feces provides the prospect of a simple, non-invasive screening test for colorectal cancer and its precursor, the adenoma. This study investigates a panel of epigenetic markers for the detection of colorectal cancer and adenomas. Methods Candidate biomarkers were subjected to quantitative methylation analysis in test sets of tissue samples from colorectal cancers, adenomas, and normal colonic mucosa. All findings were verified in independent clinical validation series. A total of 523 human samples were included in the study. Receiver operating characteristic (ROC curve analysis was used to evaluate the performance of the biomarker panel. Results Promoter hypermethylation of the genes CNRIP1, FBN1, INA, MAL, SNCA, and SPG20 was frequent in both colorectal cancers (65-94% and adenomas (35-91%, whereas normal mucosa samples were rarely (0-5% methylated. The combined sensitivity of at least two positives among the six markers was 94% for colorectal cancers and 93% for adenoma samples, with a specificity of 98%. The resulting areas under the ROC curve were 0.984 for cancers and 0.968 for adenomas versus normal mucosa. Conclusions The novel epigenetic marker panel shows very high sensitivity and specificity for both colorectal cancers and adenomas. Our findings suggest this biomarker panel to be highly suitable for early tumor detection.

  7. Discriminatory power of MRI for differentiation of adrenal non-adenomas vs adenomas evaluated by means of ROC analysis: Can biopsy be obviated?

    Energy Technology Data Exchange (ETDEWEB)

    Slapa, R.Z.; Jakubowski, W.; Krolicki, L. [Department of Imaging, Warsaw Medical School (Poland); Januszewicz, A. [Department of Hypertension, National Institute of Cardiology, Warsaw (Poland); Kasperlik-Zaluska, A.A. [Department of Endocrinology, Center for Postgraduate Medical Education, Warsaw (Poland); Dabrowska, E.; Feltynowski, T. [Department of Hypertension, Warsaw Medical School, Warsaw (Poland); Fijuth, J. [Department of Teleradiotherapy, Institute of Oncology, Warsaw (Poland); Tarnawski, R. [Department of Radiotherapy, Institute of Oncology, Gliwice Branch, Gliwice (Poland)

    2000-01-01

    The purpose of our study was to evaluate the discriminatory power of MRI in high-field magnet (1.5 T) for differentiation of adrenal non-adenomas vs adenomas assessing the following parameters separately and in combination: mean diameter of adrenal mass; previously described and new ratios as well as index calculated from signal intensity (SI) on SE T2-weighted images, chemical shift imaging (CSI), and Gd-DTPA-enhanced dynamic studies. One hundred eight adrenal masses (36 non-hyperfunctioning adenomas, 27 pheochromocytomas, 23 aldosterone-secreting adenomas, 20 malignant masses and 2 cortisol-secreting adenomas) in 95 patients were evaluated with SE sequences, CSI and Gd-DTPA dynamic studies. Indices and ratios of SI for all examined MRI methods were calculated and examined retrospectively for significance of differences between the groups with calculation of sensitivity and specificity. Receiver operating characteristics (ROC) analysis of calculated parameters in combination was performed. The multifactorial analysis of all four parameters, including size of the tumor, T2{sub liver} index, CSI ratio reflecting lipid content in the tumor and Wo{sub max/last} ratio reflecting maximal washout of contrast agent from the tumor had 100 % sensitivity and 100 % specificity in characterization of adrenal non-adenoma. The best performance of combination of mean tumor diameter with single MRI SI parameter was achieved in combination with T2{sub liver} index for all adrenal masses (area under ROC 0.987) and CSI ratio for non-hyperfunctioning adrenal masses (area under ROC 0.991). Magnetic resonance imaging enables sensitive and specific diagnosis of adrenal non-adenoma. (orig.)

  8. Polymorphisms in the adenomatous polyposis coli (APC) gene and advanced colorectal adenoma risk.

    Science.gov (United States)

    Wong, Hui-Lee; Peters, Ulrike; Hayes, Richard B; Huang, Wen-Yi; Schatzkin, Arthur; Bresalier, Robert S; Velie, Ellen M; Brody, Lawrence C

    2010-09-01

    While germline mutations in the adenomatous polyposis coli (APC) gene cause the hereditary colon cancer syndrome (familial adenomatous polyposis (FAP)), the role of common germline APC variants in sporadic adenomatous polyposis remains unclear. We studied the association of eight APC single nucleotide polymorphisms (SNPs), possibly associated with functional consequences, and previously identified gene-environment (dietary fat intake and hormone replacement therapy (HRT) use) interactions, in relation to advanced colorectal adenoma in 758 cases and 767 sex- and race-matched controls, randomly selected from the screening arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Cases had at least one verified advanced adenoma of the distal colon; controls, a negative sigmoidoscopy. We did not observe an association between genotypes for any of the eight APC SNPs and advanced distal adenoma risk (P(global gene-based)=0.92). Frequencies of identified common haplotypes did not differ between cases and controls (P(global haplotype test)=0.97). However, the risk for advanced distal adenoma was threefold higher for one rare haplotype (cases: 2.7%; controls: 1.6%) (odds ratio (OR)=3.27; 95% confidence interval (CI)=1.08-9.88). The genetic association between D1822V and advanced distal adenoma was confined to persons consuming a high-fat diet (P(interaction)=0.03). Similar interactions were not observed with HRT use. In our large, nested case-control study of advanced distal adenoma and clinically verified adenoma-free controls, we observed no association between specific APC SNPs and advanced adenoma. Fat intake modified the APC D1822V-adenoma association, but further studies are warranted.

  9. The prevalence of colorectal adenomas in asymptomatic Korean men and women.

    Science.gov (United States)

    Yang, Moon Hee; Rampal, Sanjay; Sung, Jidong; Choi, Yoon-Ho; Son, Hee Jung; Lee, Jun Haeng; Kim, Young-Ho; Chang, Dong Kyung; Rhee, Poong-Lyul; Rhee, Jong Chul; Guallar, Eliseo; Cho, Juhee

    2014-03-01

    Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significantly higher prevalence of adenomas compared with participants of average risk (36.9% vs. 26.9%; age- and sex-adjusted prevalence ratio = 1.16; 95% confidence interval, 1.09-1.22). The prevalence of adenomas increased annually in both men and women. In this large study of asymptomatic Korean men and women participating in a colonoscopy screening program, the prevalence of colorectal adenomas was comparable and possibly higher than previously reported in Western countries. Cost-effectiveness studies investigating the optimal age for starting colonoscopy screening and etiological studies to identify the reasons for the increasing trend in colorectal adenomas in Koreans are needed. ©2014 AACR.

  10. Measurement of Ki-67 antigen in 159 pituitary adenomas using the MIB-1 monoclonal antibody

    Directory of Open Access Journals (Sweden)

    C.B. Pizarro

    2004-02-01

    Full Text Available Pituitary adenomas sometimes show rapid growth and recurrence, and about one third invade the structures surrounding the sella turcica. In an attempt to determine aggressive behavior at an early stage, we used the MIB-1 antibody to identify the Ki-67 antigen. The present study was designed to evaluate pituitary adenomatous tissue in terms of secretion and proliferation and to correlate the Ki-67 index with hormone phenotype and invasive behavior. Material from 159 patients submitted to one or more resections of pituitary adenomas was evaluated. Forty-two non-secretory adenomas and 43 adenomas immunoreactive for growth hormone, 19 for prolactin, 18 for growth hormone and prolactin, 16 for adrenocorticotropic hormone (ACTH, and 21 cases of plurihormonal/gonadotropin adenomas were detected by immunohistochemistry. The MIB-1 antibody was positive in 139 samples and the Ki-67 index ranged from 0.16 to 15.48% (mean = 1.22 ± 2.09%, with no significant difference between genders, age groups, or secretory and non-secretory status. The Ki-67 index was higher in ACTH-secreting adenomas. Invasive pituitary adenomas had a significantly higher Ki-67 index (2.01 ± 3.15% than macroadenomas with or without supra-sellar extension (1.12 ± 1.87%; P = 0.02. The index was not significantly different in the subgroup of adenomas with invasion of the cavernous sinus compared to groups with other types of invasion. We conclude that tumoral proliferative activity evaluated by the detection of the Ki-67 antigen is significantly higher in invasive than noninvasive adenomas, information which can be useful in therapeutic postoperative management since index cut-off values associated with aggressive behavior can be established.

  11. Pleomorphic adenoma of the cheek in a child: A case report

    Science.gov (United States)

    Jagadishkumar, Kalenahalli; Anilkumar, Mathod Ganeshrao; Krishna Kumar, Halasahalli Chowdegowda; Maggad, Rangaswamy

    2014-01-01

    Salivary gland tumors are rare in children and, when they do arise, they mainly affect the major salivary glands. Minor salivary gland tumors are rare in children and are responsible for less than 10% of the cases. Pleomorphic adenoma is the most common tumor of the salivary glands. The most common sites of pleomorphic adenoma of the minor salivary glands are the palates, followed by the lips and the cheeks. Pleomorphic adenoma of the cheek is rare in children and only few cases have been reported so far. PMID:25225569

  12. Pleomorphic adenoma of the cheek in a child: A case report

    Directory of Open Access Journals (Sweden)

    Kalenahalli Jagadishkumar

    2014-01-01

    Full Text Available Salivary gland tumors are rare in children and, when they do arise, they mainly affect the major salivary glands. Minor salivary gland tumors are rare in children and are responsible for less than 10% of the cases. Pleomorphic adenoma is the most common tumor of the salivary glands. The most common sites of pleomorphic adenoma of the minor salivary glands are the palates, followed by the lips and the cheeks. Pleomorphic adenoma of the cheek is rare in children and only few cases have been reported so far.

  13. Polymorphisms in WNT6 and WNT10A and Colorectal Adenoma Risk

    OpenAIRE

    Galbraith, Rachel L.; Poole, Elizabeth M; Duggan, David; Muehling, Jill; Hsu, Li; Makar, Karen; Xiao, Liren; Potter, John D.; Ulrich, Cornelia M.

    2011-01-01

    The WNT/β-catenin signaling pathway upregulates transcription of genes involved in cell proliferation and cancer progression; it has been implicated in colorectal adenoma formation. To date, no studies have examined polymorphisms in WNT genes or WNT gene–environment interactions in relation to adenoma risk. Within a colonoscopy-based case-control study of 628 adenoma cases and 516 polyp-free controls, we analyzed two tagSNPs in WNT6 (rs6747776 G > C, rs6754599 G > C) and WNT10A (rs7349332 G >...

  14. Endoscopic Endonasal Extended Approaches for the Management of Large Pituitary Adenomas.

    Science.gov (United States)

    Cappabianca, Paolo; Cavallo, Luigi Maria; de Divitiis, Oreste; de Angelis, Michelangelo; Chiaramonte, Carmela; Solari, Domenico

    2015-07-01

    The management of giant and large pituitary adenomas with wide intracranial extension or infrasellar involvement of nasal and paranasal cavities is a big challenge for neurosurgeons and the best surgical approach indications are still controversial. Endoscopic extended endonasal approaches have been proposed as a new surgical technique for the treatment of such selected pituitary adenomas. Surgical series coming from many centers all around the world are flourishing and results in terms of outcomes and complications seem encouraging. This technique could be considered a valid alternative to the transcranial route for the management of giant and large pituitary adenomas.

  15. Vulvar lactating adenoma associated to a fibroadenoma: common neoplasms in an uncommon site.

    Science.gov (United States)

    Dhaoui, Amen; Nfoussi, Haifa; Kchir, Nidhameddine; Haouet, Slim

    2012-01-01

    Ectopic breast tissue is defined as glands located outside of the breast. Ectopic breast tissue should be excised because it may develop benign (fibroadenoma) or malignant pathologic processes. Less than forty cases of fibroadenomas have been reported in the literature. Although lactation changes can occur, lactating adenoma in the vulva are extremely rare. Only four cases have been reported. We report a case of a young woman who presented with vulvar mass during her lactation. The mass was excised, and histology confirmed vulvar lactating adenoma associated with fibroadenoma. This is the first case of vulvar heterotopic breast lesion associating lactating adenoma and fibroadenoma.

  16. First-pass perfusion computed tomography: Initial experience in differentiating adrenal adenoma from metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Qiao Zhongwei [Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong, University School of Medicine, Shanghai 200025 (China); Department of Radiology, Children' s Hospital of Fudan University, Shanghai 201102 (China); Xia Chunmei [Department of Physiology and Pathophysiology, Shanghai Medical, College, Fudan University, Shanghai 200032 (China); Zhu Yanbo; Shi Weiping [Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong, University School of Medicine, Shanghai 200025 (China); Miao Fei [Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong, University School of Medicine, Shanghai 200025 (China)], E-mail: fmiao818@gmail.com

    2010-03-15

    Objective: To differentiate adrenal adenoma from metastasis in patients using perfusion computed tomography (PCT) imaging. Methods: Thirty-two patients with adrenal masses underwent first-pass PCT imaging. Of these patients, twenty-one were diagnosed with adrenal adenoma, and the others with metastases. Perfusion maps of blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability surface-area production (PS) were generated with an Advantage Windows workstation using the CT perfusion 3.0 software (General Electric Medical Systems, Milwaukee, WI). Histopathologic sections immunostained for CD34 were quantitatively evaluated for microvessel density (MVD). Results: The perfusion parameters such as BV, BF and PS were statistically significant different between the two groups, with adenomas showing higher mean BV (12.18 versus 3.86), BF (97.51 versus 45.99) and PS (21.73 versus 10.93) compared with metastases (p < 0.05). For BV, a cutoff point of 7.30 was found to have a sensitivity of 95.2% and a specificity of 100% to differentiate between adenoma and metastasis. The sensitivity and specificity were 81.0 and 80.0%, respectively, for BF with a cutoff point of 71.96; and 85.7 and 86.7%, respectively, for PS with a cutoff point of 12.70 to differentiate adenoma and metastasis. A comparison of MVD counts from adenomas with those from metastases showed a significant difference (p < 0.05). However, no significant differences were observed in the four perfusion parameters and MVD between lipid rich and lipid poor adenomas. Conclusion: PCT may be useful for evaluating the neovascularization of adrenal masses and differentiating adenoma from metastasis on the basis of PCT parameters. Adenomas show higher BV, BF and PS compared with metastases. According our data, the optimal threshold BV is 7.30, resulting in a sensitivity of 95.2% and a specificity of 100% for the differentiation of adenoma from metastasis. Adrenal adenomas have similar hemodynamic profiles

  17. Advanced age is a risk factor for proximal adenoma recurrence following colonoscopy and polypectomy

    DEFF Research Database (Denmark)

    Pommergaard, H-C; Burcharth, J; Rosenberg, J

    2016-01-01

    BACKGROUND: Knowledge of risk factors for recurrence of colorectal adenomas may identify patients who could benefit from individual surveillance strategies. The aim of this study was to identify risk factors for recurrence of colorectal adenomas in a high-risk population. METHODS: Data were used ...... of inclusion in the study were independent risk factors for recurrence. CONCLUSION: In contrast to current guidelines, advanced age is not a reason to discontinue adenoma surveillance in patients with an anticipated live expectancy in which recurrence can arise....

  18. Aspirin, Calcitriol, and Calcium Do Not Prevent Adenoma Recurrence in a Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Pommergaard, Hans Christian; Burcharth, Jakob; Rosenberg, Jacob

    2016-01-01

    BACKGROUND & AIMS: Chemopreventive strategies might be used to reduce the recurrence of colorectal adenomas and the incidence of colorectal cancer. We performed a randomized, double-blind, placebo-controlled trial to determine whether a combination of acetylsalicylic acid (aspirin), calcitriol......, more than 1 adenoma of any size, or an adenoma of any size and first-degree relatives with colorectal cancer. Subjects were assigned randomly to groups given 0.5 μg calcitriol, 75 mg acetylsalicylic acid, and 1250 mg calcium carbonate (n = 209), or placebo (n = 218), each day for 3 years. The primary...

  19. AVALIAÇÃO DO TRATAMENTO REALIZADO COM O ANTIVIRAL FOSFATO DE OSELTAMIVIR (TAMIFLU® E OS EXAMES LABORATORIAIS DE PACIENTES DIAGNOSTICADOS COM GRIPE A SUBTIPO H1N1 EM UM HOSPITAL DA CIDADE DE TOLEDO – PARANÁ, BRASIL

    Directory of Open Access Journals (Sweden)

    Kiara Regina Canzi

    2015-12-01

    Full Text Available O fosfato de oseltamivir, uma pró-droga do carboxilato de oseltamivir, é um inibidor potente e seletivo das enzimas neuraminidase. A atividade da enzima viral, neuraminidase, é importante tanto para a entrada do vírus em células não infectadas quanto para a liberação de partículas virais. O carboxilato de oseltamivir inibe a neuraminidase do vírus da gripe de ambos os tipos: Influenza A e B, impedindo a replicação do mesmo. 46 pacientes com idades entre 1 e 76 anos de idade, de ambos os sexos, internados em um Hospital na cidade de Toledo durante o período de Junho de 2009 a Janeiro de 2010, com casos confirmados ou suspeitos de gripe A subtipo H1N1. Durante o período de internamento, foi avaliado o uso do Fosfato de Oseltamivir, bem como reações adversas e tempo de uso do medicamento e os exames empregados para auxiliar o diagnóstico (Hemograma completo e a gasometria arterial. O tempo de uso do medicamento não excedeu o preconizado, o qual foi de 5 (cinco dias ininterruptos, e entre as reações adversas ou efeitos colaterais estão náusea (43,47%, cefaléia (8,69% e vômitos (17,39%. As alterações laboratoriais evidenciam leucócitos normais (média de 9.145 mL, plaquetas de 246.166 mm³, pH sanguíneo (gasometria arterial levemente ácido e PO2 (mmHg e SO2 abaixo dos valores de referência. A abordagem da infecção pelo vírus Influenza A H1N1 2009 representa desafio epidemiológico-clinico-laboratorial-terapêutico em todo o mundo. Logo, requer esforço coletivo para impedir o seu avanço e os riscos de letalidade e mortalidade incluídos em sua disseminação.

  20. Establishment and characterization of pleomorphic adenoma cell systems: an in-vitro demonstration of carcinomas arising secondarily from adenomas in the salivary gland

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    Shimizu Yoshiko

    2009-07-01

    Full Text Available Abstract Background Among the salivary gland carcinomas, carcinoma in pleomorphic adenoma has been regarded as a representative carcinoma type which arises secondarily in the background of a pre-existent benign pleomorphic adenoma. It is still poorly understood how and which benign pleomorphic adenoma cells transform into its malignant form, carcinoma ex pleomorphic adenoma. Methods We have established five cell systems from a benign pleomorphic adenoma of the parotid gland of a 61-year-old woman. They were characterized by immunofluorescence, classical cytogenetics, p53 gene mutational analysis, fluorescence in-situ hybridization, and histopathological and immunohistochemical examinations of their xenografts, to demonstrate their potency of secondary transformation. Results We established and characterized five cell systems (designated as SM-AP1 to SM-AP5 from a benign pleomorphic adenoma of the parotid gland. SM-AP1 to SM-AP3 showed polygonal cell shapes while SM-AP4 and SM-AP5 were spindle-shaped. SM-AP1-3 cells were immunopositive for keratin only, indicating their duct-epithelial or squamous cell differentiation, while SM-AP4/5 cells were positive for both keratin and S-100 protein, indicating their myoepithelial cell differentiation. Chromosome analyses showed numeral abnormalities such as 5n ploidies and various kinds of structural abnormalities, such as deletions, translocations, derivatives and isodicentric chromosomes. Among them, der(9t(9;13(p13.3;q12.3 was shared by all five of the cell systems. In addition, they all had a common deletion of the last base G of codon 249 (AGG to AG_ of the p53 gene, which resulted in generation of its nonsense gene product. Transplanted cells in nude mice formed subcutaneous tumors, which had histological features of squamous cell carcinoma with apparent keratinizing tendencies. In addition, they had ductal arrangements or plasmacytoid appearances of tumor cells and myxoid or hyaline stromata

  1. Peyronie's disease: a silent consequence of diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    A. Tefekli; E. Kandirali; B. Erol; M. Tunc; A. Kadioglu

    2006-01-01

    Aim: To investigate the clinical characteristics of patients with Peyronie's disease (PD) and diabetes mellitus (DM).Methods: During an 8-year period, a total of 307 men seen at our outpatient clinic were diagnosed with PD. Clinical characteristics, penile deformities and the erectile status of patients with PD and DM together (n = 102) were retrospectively analyzed and compared to patients with PD alone with no risk factors for systemic vascular diseases (n = 97). Results: The prevalence of PD among men with DM and sexual dysfunction was 10.7 %. The mean age of diabetic patients with PD was (55.9 ± 8.9) years; in the no risk factor group it was (48.5 ± 9.0) years (P < 0.05).The median duration of DM was 5 years. The majority of diabetic patients with PD (56.0 %) presented in the chronic phase (P < 0.05), and they were more likely to have a severe penile deformity (> 60°) than the no risk factor group (P < 0.05). In the diabetic group, the most common presenting symptom was penile curvature (81.4 %), followed by a palpable nodule on the shaft of the penis (22.5 %) and penile pain with erection (14.7 %). A total of 19.6 % of patients were not aware of their penile deformities in the diabetic group. Erectile function, provided by history and in response to intracavernosal injection and a stimulation test, was significantly diminished in patients with PD and DM (P < 0.05). Conclusion: DM probably exaggerates the fibrotic process in PD. Diabetic patients with PD have a higher risk of severe deformity and erectile dysfunction (ED). PD seems to be a silent consequence of DM and should be actively sought in diabetic men.

  2. Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Salmi, J.; Pelkonen, R. (Third Department of Medicine, University of Helsinki, Finland); Grahne, B. (Department of Otorhinolaryngology, University oF Helsinki, finland); Valtonen, S. (Department of Neurosurgery, University of Helsinki, Finland)

    1982-01-01

    The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptospehnoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postopertive pituitary irradiation. Altogether, 11 (20 %) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission.

  3. Simple mucin-type carbohydrate antigens in pleomorphic adenomas

    DEFF Research Database (Denmark)

    Therkildsen, M H; Mandel, U; Christensen, M

    1993-01-01

    Simple mucin-type carbohydrate structures, T, Tn and sialosyl-Tn, are regarded as general markers of carcinomas in several epithelial tissues as a result of incomplete synthesis with precursor accumulation. The structures have a very limited distribution in normal tissues and secretions, including...... saliva and salivary glands. The expression of simple mucin-type carbohydrate structures and ABH(O) variants was studied in paraffin-embedded and frozen tissue sections from 37 pleomorphic adenomas with associated normal parotid tissue, using immunohistology and a panel of MAbs with well......-defined specificity for T, Tn, sialosyl-Tn, and blood group H and A variants hereof. The immature Tn and sialosyl-Tn antigen structures were expressed in the epithelial ductular structures of the tumors, whereas they were almost absent from normal parotid tissue, indicating aberrant glycosylation with accumulation...

  4. Crystalline structures in human pancreatic beta cell adenoma.

    Science.gov (United States)

    Mori, H; Kawai, T; Tanaka, T; Fujii, M; Takahashi, M; Miyashita, T

    1978-05-01

    An electron microscopic observation on a pancreatic tumor removed from a 34-year-old woman revealed the fine structural morphology of a functional beta cell adenoma. Characteristic PAS positive crystalline structures were frequently observed in the cytoplasm of the tumor cells. They were not bounded by a membrane and had a rectangular or irregular hexagonal shape. Highly regular patterns were seen as such as lattice or honeycomb and parallel ripple structures. They are similar to the Reinke's crystal or crystalline structures reported in human hepatocytes suffering from several different diseases and considered as a protein-carbohydrate complex. Occasionally, small paracrystalline structures appeared to indicate an immature type of these structures in the opaque fine fibrillar mass. Crystalline or paracrystalline structures were not detected in the normal pancreatic tissue removed with the tumor from the patient.

  5. Molecular cytogenetics of pituitary adenomas, assessed by FISH technique.

    Science.gov (United States)

    Kontogeorgos, George

    2004-01-01

    Fluorescent in situ hybridization (FISH) represents a moden molecular pathology technique, alternative to conventional cytogenetics (karyotyping). In addition to metaphase spreads, it can be applied directly to interphase nuclei. The latter makes the FISH technique powerful for pathologists for it integrates molecular genetics and classic cytogenetics and brings them together to a single framework for morphologic evaluation. Interphase FISH can be applied to imprints from fresh tissue or to paraffin sections after proteinase K digestion. Centromeric, telomeric and locus DNA-sequence specific probes can be used to identify aneuploidy or gene mutations. Several protocols combine molecular cytogenetics with classic karyotyping. Other sophisticated, FISH-based protocols have been introduced. Among them, comparative genomic hybridization is very important for it can detect non-balanced chromosomal aberrations of uncultured tumor cells and provide overall genomic information in a single experiment. This review presents the principles and applications of FISH technique for the investigation of the cytogenetic background of pituitary adenomas.

  6. Progress in the diagnosis and classification of pituitary adenomas

    Directory of Open Access Journals (Sweden)

    Luis V Syro

    2015-06-01

    Full Text Available Pituitary adenomas are common neoplasms. Their classification is based upon size, invasion of adjacent structures, sporadic or familial cases, biochemical activity, clinical manifestations, morphological characteristics, response to treatment and recurrence. Although they are considered benign tumors, some of them are difficult to treat due to their tendency to recur, despite standardized treatment. Functional tumors present other challenges for normalizing their biochemical activity. Novel approaches for early diagnosis as well as different perspectives on classification may help to identify subgroups of patients with similar characteristics, creating opportunities to match each patient with the best personalized treatment option. In this paper we present the progress in the diagnosis and classification of different subgroups of patients with pituitary tumors that may be managed with specific considerations according to their tumor subtype.

  7. A Different Pattern of Brunner Gland Adenoma on Endoscopic Ultrasonography

    Directory of Open Access Journals (Sweden)

    Gokhan Aksakal

    2016-01-01

    Full Text Available Brunner gland adenomas (BGA are benign and rare tumors of small intestine. They are seen at a rate of %10.6 of all benign duodenal tumors. Symptoms can be variable and abdominal pain, nausea, vomiting, hematemesis and melena can be seen in some cases. Diagnosis is difficult with mucosal biopsies, becasue of the location in submucosa and generally made by endoscopic resection material. It should be distinguished from lipoma, leiyomyoma, neurogenic and carcinoid tumors through endoscopic and radiologic methods. Endosonography (EUS is helpful for diagnosis due to detection of  originate from which layer of duodenum wall, echogenity and tissue homogeneity of lesion. In this article, we reported a BGA located with EUS and resected with endoscopic polypectomy. BGA was reported before as generally heterogeneus-hypoechoic and characterised with cystic areas, however, in our case, BGA was detected as a different echo pattern on EUS.

  8. Laparoscope resection of ectopic corticosteroid-secreting adrenal adenoma.

    Science.gov (United States)

    Wang, Xian-Ling; Dou, Jing-Tao; Gao, Jiang-Ping; Zhong, Wen-Wen; Jin, Du; Hui, Lüzhao; Lu, Ju-Ming; Mu, Yi-Ming

    2012-01-01

    Tumors originating from ectopic adrenal tissue are relatively rare. In this article, we describe a case with Cushing's syndrome caused by an ectopic adrenal adenoma. A 38 year-old male patient presenting with cushingoid appearance for 2 years was diagnosed to have ACTH-independent Cushing's syndrome based on endocrinological evaluation. Mutiple radiological examinations detected bilateral adrenal atrophy. When the images were investigated in a more expanded scope, a 3.0×3.5×5.3 cm mass was detected in the anterior of left renal hilum and left renal vein. The mass was successfully resected with intraoperative endoscopy and pathological evaluation revealed an ectopic adrenal tumor. It is suggested that when the endocrinlogically confirmed adrenal neoplasm could not be well and definitely localized, the possibility of ectopic adrenal should be presumed and further radiography examinations should extend to the field where ectopic adrenal usually presents.

  9. Temozolomide therapy in patients with aggressive pituitary adenomas or carcinomas.

    Science.gov (United States)

    Losa, Marco; Bogazzi, Fausto; Cannavo, Salvo; Ceccato, Filippo; Curtò, Lorenzo; De Marinis, Laura; Iacovazzo, Donato; Lombardi, Giuseppe; Mantovani, Giovanna; Mazza, Elena; Minniti, Giuseppe; Nizzoli, Maurizio; Reni, Michele; Scaroni, Carla

    2016-02-01

    Temozolomide is effective in some patients with progressive pituitary adenoma or carcinoma. We report a survey study of Italian patients treated with Temozolomide because of aggressive pituitary adenoma or carcinoma resistant to standard therapies. Italian endocrinologists were surveyed and asked to participate into the study. A questionnaire was sent to all those who agreed and had used Temozolomide in at least one patient with pituitary tumor. Database was closed in December 2013. A literature review was also performed. Thirty-one patients were included into the analysis. Mean age at start of Temozolomide treatment was 58.3 ± 1.9 years (± standard error). Six of the 31 (19.4%) Italian patients had a pituitary carcinoma. Twenty-five patients (80.6%) had disease control during Temozolomide treatment, while 6 patients (19.4%) had disease progression. Median follow-up after beginning Temozolomide was 43 months. Thirteen patients had tumor growth after stopping Temozolomide. The 2-year progression-free survival was 47.7% (95% CI 29.5-65.9%), while the 2-year disease control duration was 59.1% (95% CI 39.1-79.1%). Eleven patients died of progressive disease and other two patients of unrelated causes. The 2-year and 4-year overall survival rates were 83.9% (95% CI 70.7-97.1%) and 59.6% (95% CI 40.0-79.2%), respectively. Temozolomide is an additional effective therapeutic option for the treatment of aggressive pituitary tumors. The drug is well tolerated and causes few severe adverse effects. Recurrence of the tumor can occur after an initial positive response and usually portends a grim outcome.

  10. Análisis de un registro de adenomas pituitarios

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    Carolina Albiero

    2010-10-01

    Full Text Available Dada la complejidad que reviste el enfoque diagnóstico y terapéutico de los tumores pituitarios, el registro y análisis de la experiencia clínica acumulada es de gran ayuda en la toma de decisiones. En este trabajo se informan datos clínico-terapéuticos, extraídos de un registro computarizado, sobre 519 de un total de 670 pacientes con adenomas pituitarios. Trescientos cuarenta y cinco fueron mujeres (66% y 174 varones (34%, de 14 a 80 años de edad. El diagnóstico final fue: acromegalia en 176, enfermedad de Cushing en 153, prolactinoma en 101 y adenoma clínicamente no-funcionante (ANF en 89. La edad media al momento del diagnóstico de acromegalia fue 43.9 ± 13.5 (16-80, para enfermedad de Cushing 35.7 ± 12.9 (14-72, para prolactinomas 30.0 ± 13.4 (15-79 y para ANF 52.1 ± 15.2 (17-79 años. La creación de un registro institucional de tumores de hipófisis es un instrumento de gran utilidad para el análisis de la experiencia adquirida y constituye una herramienta valiosa para mejorar la estrategia terapéutica, optimizar la relación costo/beneficio y mejorar el cuidado del paciente. Contribuye a la docencia médica, tanto en el pre como en el posgrado y da base a la realización de trabajos de investigación clínica, aportando a la difusión y transferencia de conocimientos.

  11. Frequency of coexistent carcinoma in sessile serrated adenoma/polyps and traditional serrated adenomas removed by endoscopic resection

    Science.gov (United States)

    Saiki, Hirotsugu; Nishida, Tsutomu; Yamamoto, Masashi; Hayashi, Shiro; Shimakoshi, Hiromi; Shimoda, Akiyoshi; Amano, Takahiro; Sakamoto, Aisa; Otake, Yuriko; Sugimoto, Aya; Takahashi, Kei; Mukai, Kaori; Matsubara, Tokuhiro; Nakajima, Sachiko; Fukui, Koji; Inada, Masami; Yamamoto, Katsumi; Tokuda, Ryozo; Adachi, Shiro

    2016-01-01

    Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) have a different potential than traditional adenomatous polyps for developing into malignant colorectal cancer. However, little is known about the coexistent cancer rate. Here, we evaluate the frequency of carcinoma in serrated polyps removed by endoscopic resection (ER). Patients and methods: This was a retrospective single-center cohort study of consecutive patients with colorectal polyps who underwent ER from March 2003 to October 2014. We determined the frequency of serrated polyps among all resected colorectal polyps and analyzed the clinicopathological findings as well as the frequency and characteristics of coexistent carcinoma in the serrated polyps resected by ER based on pathology reports. Results: A total of 21,048 polyps from 15,326 patients were identified, including 15,984 traditional adenomatous polyps (75.9 %), 621 SSA/Ps (3.0 %), 136 traditional serrated adenomas (TSAs) (0.6 %), 1,121 hyperplastic polyps (5.3 %), and 3,186 polyps of other types (15.1 %). The clinical and endoscopic findings of SSA/Ps revealed a male predominance (68.6 %), with 61.7 % of the polyps located in the proximal colon. Males accounted for 77.2 % of all patients with TSAs, and 77.2 % of these polyps were located in the distal colon. The mean sizes of the SSA/Ps and TSAs were 8.8 and 10.7 mm, respectively. Among the SSA/Ps, 8 (1.3 %) cases had coexistent carcinoma, and 1 (0.7 %) patient with TSA showed coexistent carcinoma. In the patients with SSA/Ps, female sex and a tumor size ≥ 10 mm were predictive factors for coexistent carcinoma. Conclusions: The frequency of SSA/Ps with carcinoma was lower than that for traditional adenoma. Female sex and tumor size ≥ 10 mm were significant predictive factors for coexistent carcinoma. PMID:27092327

  12. Relations Among Oral Reading Fluency, Silent Reading Fluency, and Reading Comprehension: A Latent Variable Study of First-Grade Readers

    OpenAIRE

    Y. S. Kim; Wagner, Richard K.; Foster, E.

    2011-01-01

    The present study examined oral and silent reading fluency and their relations with reading comprehension. In a series of structural equation models (SEM) with latent variables using data from 316 first-grade students, (1) silent and oral reading fluency were found to be related yet distinct forms of reading fluency; (2) silent reading fluency predicted reading comprehension better for skilled readers than for average readers; (3) list reading fluency predicted reading compr...

  13. Pleomorphic adenoma with squamous and appendageal metaplasia mimicking mucoepidermoid carcinoma on cytology

    Directory of Open Access Journals (Sweden)

    Batrani Meenakshi

    2009-01-01

    Full Text Available Background: Histological diversity is the hallmark of pleomorphic adenoma, the most common salivary gland tumor. It may cause difficulty in cytological interpretation, due to limited and selective sampling. Case presentation: A 16-year-old female patient presented with right cheek swelling. Fine needle aspiration cytology showed squamous cells, basaloid cells, and foamy cells, along with extracellular keratin and foreign body giant cells. Characteristic metachromatic fibrillary chondromyxoid stroma, which is usually seen in pleomorphic adenoma, was not seen in the aspirate. A diagnosis of mucoepidermoid carcinoma was given on cytology. Subsequent resection revealed an encapsulated pleomorphic adenoma, with extensive squamous metaplasia and appendageal differentiation on histology. Conclusion: This case illustrates that pleomorphic adenoma with squamous metaplasia presents a potential for misinterpretation as mucoepidermoid carcinoma on cytology. We discuss the various pitfalls and the features that are helpful in distinguishing these two lesions.

  14. Adenoma of nonpigmented epithelium in ciliary body:literature review and case report

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Adenomas of the nonpigmented ciliary epithelium (NPCE) are often clinically indistinguishable from amelanotic malignant melanomas of the ciliary body or metastatic carcinomas. This paper reports a case study of a distinctive variant of adenoma of the NPCE, which clinically appears as epiretinal membrane in the macular region. Histopathologic studies have revealed this is an adenoma of the NPCE. Identification of this clinic feature is important because it will miss the diagnosis of the adenoma of the NPCE. In this case study, B-scan ultrasonography as well as computerized tomography (CT) has been used to provide help in diagnosing the ciliary body tumor. Because of their anterior location in the ciliary body, partial lamellar sclerouvectomy is an effective method of treatment.

  15. Brunner's gland adenoma of duodenum:A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    Yu-Ping Gao; Jian-Shan Zhu; Wen-Jun Zheng

    2004-01-01

    AIM: To analyze the clinicopathological features of Brunner's gland adenoma of the duodenum.METHODS: A rare case of Brunner's gland adenoma of the duodenum was described and related literature was reviewed.RESULTS: Brunner's gland adenoma of the duodenum appeared to be nodular hyperplasia of the normal Brunner's gland with an unusual admixture of normal tissues, including ducts, adipose tissue and lymphoid tissue. We suggested that it might be designated as a duodenal hamartoma rather than a true neoplasm.CONCLUSION: The most common location of the lesion is the posterior wall of the duodenum near the junction of its first and second portions. It can result in gastrointestinal hemorrhage and duodenal obstruction. Endoscopic polypectomy is a worthy treatment for benign Brunner's gland adenomas,as malignant changes in these tumors have never been proven.

  16. A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma

    Science.gov (United States)

    Background: Evidence from observational studies suggests that inadequate folate status enhances colorectal carcinogenesis, but results from some randomized trials do not support this hypothesis. Objective: To assess the effect of folic acid supplementation on recurrent colorectal adenoma, we conduc...

  17. Pigmented hepatocellular adenoma with complete CD34 immunostaining pattern: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Mukul Vij

    2012-01-01

    Full Text Available WHO defines hepatocellular adenoma (HCA as a benign tumor composed of cells closely resembling normal hepatocytes, which are arranged in plates separated by sinusoids. It is more common in women. The present concerns a 41 years female who was found to have a mass lesion in liver on ultrasound while undergoing routine evaluation for dyspepsia. Computed tomography scan of abdomen showed 10 × 8 cm lesion in liver. Extended left hepatectomy was performed. Grossly hepatic cut surface showed circumscribed tumor with dark gray or black color. Microscopy revealed hepatocellular adenoma with abundant Dubin Johnson like pigment deposition. CD34 immunostaining showed complete sinusoidal pattern. We labeled the tumor as pigmented hepatic adenoma with complete CD34 staining pattern. To the best of author′s knowledge only eight cases of pigmented hepatocellular adenoma are described in world literature.

  18. Treatment of Aggressive Prolactin-Secreting Pituitary Adenomas with Adjuvant Temozolomide Chemotherapy: A Review.

    Science.gov (United States)

    Moisi, Marc; Cruz, Aurora S; Benkers, Tara; Rostad, Steven; Broyles, Frances Broyles; Yuen, Kevin; Mayberg, Marc

    2016-01-01

    Most prolactin-secreting pituitary adenomas demonstrate slow growth and are effectively managed with medical/surgical therapy. Rarely, these tumors can behave aggressively with rapid growth and invasion of local tissues, and are refractory to medical, surgical, or radio-surgical therapies. We report a case of a prolactin-secreting adenoma in a young woman, which became progressively aggressive and refractory to usual treatment modalities, but responded to treatment with the chemotherapeutic agent temozolomide. In addition, we review the literature for treatment of refractory adenomas with temozolomide. The clinical and pathologic characteristics of aggressive prolactin-secreting adenomas are reviewed, as well as their response to dopamine agonists, surgery, radiotherapy, and chemotherapy.

  19. [The expression of keratins Nos. 8, 17 and vimentin in pleomorphic adenoma of the salivary glands].

    Science.gov (United States)

    Gel'shteĭn, V I; Chipysheva, T A; Ermilova, V D; Bannikov, G A

    1989-01-01

    In the normal salivary gland, the monoclonal antibody to keratin 8 immuno-morphologically identifies the epithelium that covers acini and ducts. The monoclonal antibodies to keratin 17 and vimentin detect normal myoepithelium. The two keratins are found both in the epithelioid and mesenchyma-like components of pleomorphic adenoma, suggesting a single epithelial nature of this tumor. In all the morphological components of the pleomorphic adenoma, there are cells that combine protein expression of intermediate filaments normally labelling different cell subpopulations. This fact provides support for the hypothesis that the pleomorphic adenoma originates from bipotent precursor cells. A particular phenotype of pleomorphic adenoma elements is realized under the control of the local density of cells and microenvironment, as a result of which the cells expressing vimentin predominate in the mesenchymal component, keratin 8 in the epithelial tubular one.

  20. Infiltrating adenocarcinoma arising in a villous adenoma of the anal canal

    Institute of Scientific and Technical Information of China (English)

    Marni Colvin; Aris Delis; Erika Bracamonte; Hugo Villar; Luis R Leon Jr

    2009-01-01

    Primary neoplasms arising in the anal canal are relatively unusual. In particular, adenomas and adenocarcinomas are distinctly rare entities in this region. We describe an infiltrating, well-differentiated adenocarcinoma arising in a villous adenoma from the distal anal canal, in an otherwise healthy patient at low risk for gastrointestinal malignancy. This is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous hematochezia. Examination revealed a blood-covered pedunculated mass with a long stalk protruding from the anus. The lesion was amputated at the bedside. Microscopic evaluation revealed an infiltrating well-differentiated adenocarcinoma, arising from a villous adenoma. This was further evaluated under anesthesia and complete excision of distal anal tissue was performed. Our report is the first describing the possible malignant degeneration of a villous adenoma in the anal canal.