ABSTRACT
BACKGROUND: The objective of this retrospective study was to evaluate the safety and efficacy of percutaneous microwave ablation (MWA) for treating lung metastases from nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: From December 2012 to November 2014, 17 patients (15 males, and two females, averaged 45.7 years old) with lung metastases from NPC accepted computed tomography (CT)‑guided percutaneous MWA. The average number of lung metastases was 1.7 (range: 1–4), and the biggest tumor diameter was 4.2 cm (range: 0.8–4.2 cm). Nineteen nodules located in the right lung and 10 nodules located in the left lung. A total of 29 ablation sites were performed to 29 lung metastases in 22 MWA sessions. Postoperative assessments of complete tumor necrosis rate, safety, local tumor progression, and survival period were carried out. RESULTS: Of the 29 lesions, complete response was achieved for 27 lesions; residual tumor was found in one lesion 3 months postoperatively; and another lesion was found enlarged 3‑month postoperatively with obvious enhancement. Four patients had a small amount of postoperative parenchyma bleeding and two patients had a small amount of pneumothorax. Six months after MWA treatment, new metastatic lesions appeared in six patients, five patients had new metastatic lesions inside the lung, and the other patient had metastatic lesions in the thoracic vertebra. The time for the appearance of new pulmonary metastases for the five patients was 4–20 months, averaged 7.2 months. CONCLUSION: CT‑guided MWA is a promising treatment alternative for local tumor control in selected patients with lung metastases from NPC.
ABSTRACT
Purpose: As an opportunistic pathogen, Acinetobacter baumannii causes various nosocomial infections. In recent years, the increasing cumulative infection outbreaks involving A. baumannii have appeared worldwide. In addition, a perplexing trouble for clinical treatment is a severe drug-resistance problem with A. baumannii. In this study, we investigated the drug-resistance rates and integrons' distribution in A. baumannii clinical strains in East China. Furthermore, we explored the relationship between integrons and drug resistance. Materials and Methods: Strains were identified using non-fermenting bacteria identification cards by Vitek-32 system. Disk-diffusion method (Kirby-Bauer) was used to judge antimicrobial sensitivity. Integrons and the gene cassettes of integrons were identified by PCR, restriction enzyme digestion and DNA sequencing. Results: Except imipenem and cefoperazone/sulbactam, the drug-resistance rates of the A. baumannii clinical isolates to other 15 kinds of antibacterials, all surpassed 30%. Of 96 A. baumannii clinical isolates, 66 strains carried class 1 integrons (no class 2 or 3 integrons were found). Overall, the drug-resistance rates in integrons-positive A. baumannii to 14 kinds of antibacterials were higher than those in integrons-negative A. baumannii. Gene sequencing showed that 9 of 12 integrons contained seven different gene cassettes (aacA4, catB3, dfrA1, blam-1, orfX, aadA1, and sat2). The cassette arrays aacA4-catB3-dfrA1 was found in five detected integrons. Conclusions: High resistances in A. baumannii clinical strains to most common antimicrobial agents have appeared in East China, which was closely related with high frequencies class 1 integrons. A. baumannii integrons cassettes carried multi-drug-resistant gene codes. We believe that integrons cassettes gene could be taken as a marker of prognosticating A. baumannii antimicrobial resistance, but only reveal partial drug resistance profiles.
Subject(s)
Acinetobacter Infections/microbiology , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/genetics , Acinetobacter baumannii/isolation & purification , Anti-Bacterial Agents/pharmacology , China , Cross Infection/microbiology , DNA, Bacterial/genetics , Drug Resistance, Bacterial , Humans , Integrons , Microbial Sensitivity Tests/methods , Polymerase Chain Reaction/methodsABSTRACT
We report an unusual case of a patient with an oesophageal cyst connected to the bronchus. A 24-year old male with a two-year history of repeated attacks of chest infection and haemoptysis was found to have a cyst of 4 x 4 cm affecting the anterior and apical segments of the right upper lobe. The cyst was excised in its entirety and the histopathological study of the cyst showed stratified squamous epithelium with submucosal and muscular layer but no cartilage. The pathological diagnosis was an oesophageal cyst. No previous case of isolated oesophageal cyst connected to the bronchus has been reported according to the available literature.