RESUMO
The occurrence of malignant tumor in proximity to an arthroplasty prosthesis has been a matter of debate since it was first reported in 1978. Upon considering the number of orthopedic implants used, the occurrence of malignancy is rare. Especially in case of angiosarcoma, only a few cases have been reported worldwide. In this case, we report an extremely rare case of angiosarcoma arising at the site of a revision total hip arthroplasty. A 69-year-old female had received total hip replacement on her left hip due to osteoarthritis 8 months ago. Four months later, she complained pain on her operated area, X-ray showed loosening of implanted cup on her left hip. Thereafter, erythematous and purpuric papules and nodules were developed and spread around on her left hip. Through the skin biopsy she was diagnosed with angiosarcoma, and then she died of a sharp deterioration. Herein, we report a rare case of angiosarcoma occurred after total hip replacement with a review of the literature.
RESUMO
The occurrence of malignant tumor in proximity to an arthroplasty prosthesis has been a matter of debate since it was first reported in 1978. Upon considering the number of orthopedic implants used, the occurrence of malignancy is rare. Especially in case of angiosarcoma, only a few cases have been reported worldwide. In this case, we report an extremely rare case of angiosarcoma arising at the site of a revision total hip arthroplasty. A 69-year-old female had received total hip replacement on her left hip due to osteoarthritis 8 months ago. Four months later, she complained pain on her operated area, X-ray showed loosening of implanted cup on her left hip. Thereafter, erythematous and purpuric papules and nodules were developed and spread around on her left hip. Through the skin biopsy she was diagnosed with angiosarcoma, and then she died of a sharp deterioration. Herein, we report a rare case of angiosarcoma occurred after total hip replacement with a review of the literature.
RESUMO
No abstract available.
Assuntos
Colágeno , Fibroblastos , Expressão Gênica , Proteínas Quinases p38 Ativadas por MitógenoRESUMO
No abstract available.
RESUMO
Azathioprine is an immunosuppressive drug that has been widely used in dermatology for the treatment of immunobullous diseases. Myelosuppression is the most important side effect and requires close observation of the complete blood cell count. The clinical findings of myelosuppression include general weakness, poor oral intake, nausea, dyspnea, and pallor. It can occur within several weeks to years after initial azathioprine treatment; thus, a weekly full blood count for the first 4 weeks, followed by reduced frequency of monitoring to a minimum of once every 3 months is recommended. If the myelosuppression is not treated properly, it can lead to fever, secondary infection, sepsis, and even death. Herein, we present three educational cases for dermatologists to order to underline the risk of myelosuppression during azathioprine treatment.
Assuntos
Azatioprina , Contagem de Células Sanguíneas , Coinfecção , Dermatologia , Dispneia , Febre , Náusea , Palidez , SepseRESUMO
Terra firma-forme dermatosis is characterized by asymptomatic dirt-like papules and plaques. It appears as dirt-like lesions, but is known to develop in persons with normal hygiene habits. Terra firma-forme dermatosis is rarely reported and has an unknown etiology. It is hypothesized to occur as a result of abnormal keratinization. Terra firma-forme dermatosis is usually detected in children and young adults. Its characteristic features include disappearance with alcohol swabbing. Thus, wiping with alcohol-soaked cotton is recommended before any other examination in cases where terra firma-forme dermatosis is suspected.
Assuntos
Criança , Humanos , Adulto Jovem , Higiene , DermatopatiasRESUMO
Chicken pox is highly contagious and occurs most often in childhood. In normal children, systemic symptoms are usually mild and serious complications are rare. But in adults, especially in immunocompromised patients, it is more likely to be associated with life-threatening complications such as pneumonia, encephalitis and sepsis. A 38-year-old woman was admitted due to headache, fever and multiple umbilicated vesicles on face, trunk and both extremities for 3 days. She underwent chemotherapy for the breast cancer 20 days prior to admission. Based on typical clinical presentation and skin biopsy, she was diagnosed with chicken pox. Despite 5 days of intensive intravenous antiviral therapy (Acyclovir® 30 mg/kg/day), fever and headache continued and epigastric pain occurred. Finally, the patient was recovered from varicella after additional 7 days of antiviral therapy. Generally, old age or immunocompromised hosts have declined cellular immunity, so the incidence of chicken pox is higher and the clinical course is more severe. Herein, we report a case of chicken pox in the patient who underwent chemotherapy for breast cancer, requiring intensive treatment and close observation for systemic symptoms.
Assuntos
Adulto , Criança , Feminino , Humanos , Biópsia , Neoplasias da Mama , Varicela , Galinhas , Tratamento Farmacológico , Encefalite , Extremidades , Febre , Cefaleia , Imunidade Celular , Hospedeiro Imunocomprometido , Incidência , Pneumonia , Sepse , PeleRESUMO
BACKGROUND: The disturbances of portal circulation in chronic liver disease may cause hepatic failure, hepatic encephalopathy and variceal bleeding. The measure of porto-systemic shunt plays a significant role in the management and prognosis of the patients. So we have evaluated the relationship between the shunt index of thallium-201 liver scan and the histological grade and stage of chronic liver disease. METHODS: The thallium-201 scintigraphy per rectum was evaluated in 159 patients with chronic liver disease, which were proven with percutaneous liver biopsy. We used the heart to liver activity ratio at 20 minute as shunt index, representing portal-systemic shunt. The two pathologists scored independently hepatitis activity (lobular and porto-periportal activity) and stage (fibrosis). RESULTS: A significant difference was noted between the shunt index and the scores of fibrosis (p< 0.001) although this correlation was statistically weak (r=0.26, p=0.008). In cumulative logistic regression test, the shunt index had a effect on the fibrosis (p< 0.001) but not on the lobular and porto-periportal activity. Fibrosis was predicted as less than 2 if shunt index was less than 0.24, 3 if more than 0.24 but less than 0.46, 4 if more than 0.46. CONCLUSION: The shunt index of thallium-201 liver scintigraphy correlated only with fibrosis not with lobular and porto-periportal activity. As the fibrosis progresses in chronic liver disease, portal hypertension becomes more severe and the shunt index increases. Thallium-201 liver scan may be useful for evaluation of hepatic fibrosis instead of invasive liver biopsy in predicting the histological stage (fibrosis) of advanced chronic liver disease.
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Humanos , Biópsia , Varizes Esofágicas e Gástricas , Fibrose , Coração , Encefalopatia Hepática , Hepatite , Hipertensão Portal , Hepatopatias , Falência Hepática , Fígado , Modelos Logísticos , Prognóstico , Cintilografia , RetoRESUMO
Although the distribution of locus ceruleus terminals has been demonstrated in the fundus striati[nucleus accumbens septi] by light microscopy[Jones & Moore, 1977 ; Mason & Fibiger, 1979 ; Streit or et al., 1979 ; Groenewegen et al., 1980], the synaptic organization of its terminals was not clarified. The purpose of the present investigation was to demonstrate the direct monosynaptic connection of the locus ceruleus terminals to the neuronal elements of the fundus stirati, and to clarify the synaptic structures of its terminals by electron microscopy two days after unilateral electric coagulation of the locus ceruleus. In the ipsilateral fundus striati, many axon terminals undergone dark degeneration were observed. These degenerating terminals containing small clear vesicles have asymmetric synaptic contacts with dendritic spines. Already two days after locus ceruleus lesion, distinct features of terminal degenerations appeared in the fundus striati ; enlarged axon terminals with altered synaptic vesicles, decrease of synaptic vesicles detached from the synaptic site, multiplication of dense bodies and infiltration of floccular material. At the same time, a regressive change occurred in which astrocytic processes encircled totally degenerated synapses spiraled around the synaptic remnants. These observations indicate that monosynaptic noradrenertic afferent connections to the fungus striati are confirmed, and the locus ceruleus terminals characterized by small round vesicles might be formed asymmetrical axo-spinous synapses with spiny neurons in the fundus striati.
Assuntos
Animais , Gatos , Espinhas Dendríticas , Fungos , Locus Cerúleo , Microscopia Eletrônica , Neurônios , Terminações Pré-Sinápticas , Sinapses , Vesículas SinápticasRESUMO
A putative polypeptide hormone identified as amylin[islet amyloid polypeptide] is synthesized and co-localized with insulin in B cells of pancreatic islets in several animal species including man. However, there is growing evidence that somatostatin cells are also expressed and contained amylin in the pancreatic islets of the rat The aim of the present study was to investigate the immunocytochemical expression of the amylin within the endocrine pancreas of the man, rabbit and guinea pig, with special reference to the possible ability of islet cells other than insulin cells to synthesize amylin. For this purpose serial sections of the pancreatic islets were stainedimmunocytochemically using anti-amylin, anti-insulin, anti-glucagon, anti-somatostatin antisera. In serial sections of pancreatic islets of the man and rabbit, it was shown that amylin immunoreactivity occurred in insulin-reactive B cells predominantly located in interior of the islets. In contrast, amylin immunoreacivity appeared in glucagon-reactive A cells peripherally located in the islets of the guinea pig. These results suggest that in both the man and rabbit, amylin is synthesized by B cells for subsequent co-secretion with insulin, and that in guinea pig, amylin is synthesized by A cells for co-secretion with glucagon. It thus appears that amylin release may be mediated by different secretory mechanisms according to animal species.
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Animais , Ratos , Amiloide , Linfócitos B , Glucagon , Cobaias , Guiné , Soros Imunes , Imuno-Histoquímica , Insulina , Polipeptídeo Amiloide das Ilhotas Pancreáticas , Ilhotas Pancreáticas , Células Secretoras de SomatostatinaRESUMO
The purpose of this study was to establish the role of apoptosis in the developing renal corpuscle in the prenatal rat kidney. Kidneys from 14-, 16-, 18-, and 20-day-old fetuses[E-14, E-16, E-18, and E-20] were preserved by immersion or perfusion via the heart using Bouin`s fixative. Apoptosis was detected`by in situ nick end labeling method using ApopTag kit. In kidneys from E-14, apoptotic cells and bodies were found only in the mesenchymal tissue surrounding the developing nephrons. In kidneys from E-16, E-18, and E-20, apoptotic cells and bodies were located mainly in the columnar distal epithelium of the renal vesicle[future parietal epithelium] as well as in the parietal epithelium of the renal corpuscles of S-shaped bodies, stage III and IV nephrons. Apoptosis was not observed in the proximal part of renal vesicles or in the podocytes in renal corpuscles. In contrast, strong bel-2 immunoreactivity was present in the proximal part of the renal vesicle and in podocytes in S-shaped bodies, but gradually decreased in stage III and IV nephrons. The distal part of the renal vesicle had weak staining for bcl-2, and there was no bel-2 immunoreactivity in the parietal epithelium of S-shaped bodies, and stage III and IV nephrons. We conclude that bcl-2 is involved in the regulation of apoptosis during the differen-tiation of the parietal epithelium of Bowmann`s capsule.
Assuntos
Animais , Ratos , Apoptose , Epitélio , Coração , Imersão , Marcação In Situ das Extremidades Cortadas , Rim , Néfrons , Perfusão , Podócitos , RabeprazolRESUMO
The role of GABA or glycine as an inhibitory neurotransmitter is well established, and GABAergic or glycinergic neurons appear to play an important role in the mammalian retinas. It has been reported that certain amacrine, bipolar, displaced amacrine and ganglion cells are consistently labeled with anti-GABA or anti-glycine antisera in the mammalian retinae so far, and it has been suggested that colocalization of GABA and glycine within the retinal neurons could be common in the mammalian retina by recent immunecytochemical and electrophysiological studies. This study was conducted to localize GABAergic and glycinergic neurons and to define whether GABA and glycine are colocalized within same retinal neurons of the rat retina by immunocytochemical method using anti-GABA and anti-glycine antisera. The results were as follows : 1. GABAergic neurons of the rat retina were amacrine, interplexiform, bipolar, displaced amacrine and ganglion cells, and processes of GABAergic neurons formed dense networks with distinct two bands in the inner plexiform layer. 2. Glycinergic neurons were amacrine, bipolar, displaced amacrine and ganglion cells,and their processes were evenly distributed as dense networks through whole inner plexiform layer. 3. 28.5% of GABA immunoreactive amacrine cells and 9.8% of GABA immunoreactive bipolar cells located in the inner nuclear layer,and 11.9% of labeled neurons located in the ganglion cell layer showed glycine immunoreactivity in the rat retina. These results demonstrate that GABA and glycine, major inhibitory neurotransmitters, are colocalized within certain amacrine and displaced amacrine cells, and a few bipolar cells, and that neurons synthesizing and utilizing both GABA and glycine as their neurotransmitters may play an unique role in the visual processing in the rat retina.