Pathological characteristics and clinical prognosis of nodular sclerosis grade 2 of classic Hodgkin's lymphoma / 中华肿瘤杂志

Objective: To investigate the pathological characteristics and clinical prognosis of nodular sclerosis grade 2 of classic Hodgkin's lymphoma (cHL-NS2) in our cancer center. Methods: A retrospective collection of 23 cases of cHL-NS2 admitted in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from July 2008 to April 2019 was performed. Fifty-five cases of nodular sclerosis grade 1 of classical Hodgkin's lymphoma (cHL-NS1) during the same period were selected as control group. Survival curves were plotted using the Kaplan-Meier method, and Cox regression model was used to analyze the influencing factors for survival. Results: The median age of 23 cases of cHL-NS2 was 30 years old. Five cases had extra nodal invasion, and 19 cases were Ⅰ-Ⅱ stage based on Ann Arbor system. The pathological morphology of cHL-NS2 showed that the lymph node structure was completely destroyed and was divided into nodules by thick collagen. The tumor cells in the nodules were abundant and proliferated in sheets. The boundaries between the tumor cells were not clear. The incidence of tumor necrosis in cHL-NS2 was 43.5% (10/23), which was significantly higher than 18.2% (10/55) in cHL-NS1 (P=0.040). The 3-year progression-free survival (PFS) rate of patients in the cHL-NS2 group was 58.1%, which was significantly lower than 89.7% in the cHL-NS1 group (P=0.002). In all of 78 cases, the 3-year PFS rate of patients who did not obtain complete response (CR) was 67.1%, which was significantly lower than 92.2% in patients who achieved CR (P=0.030). Multivariate Cox regression analysis demonstrated that both cHL-NS2 and failure to obtain CR by first-line treatment were independent indicators for short PFS time (P<0.05). Conclusions: In cHL-NS2, the morphology of tumor cells are diverse, and tumor necrosis can be easily found. Under the current first-line treatments of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), cHL-NS2 is an independent indicator for worse PFS.

Late onset temporal lobe epilepsy with MRI evidence of mesial temporal sclerosis following acute neurocysticercosis: case report

The objective of this case report is to describe magnetic resonance imaging (MRI) evidence of mesial temporal sclerosis (MTS) in a patient with new onset temporal lobe epilepsy (TLE) and acute neurocysticercosis with multiple cysts. A 56 years old man with new onset headache, Simple Partial Seizures and Complex Partial Seizures underwent CT scan and lumbar puncture as diagnose proceeding. Multiple cysts and meningitis were identified, with a positive immunology for cysticercosis. Seizures were recorded over the left temporal region in a routine EEG. Treatment with albendazole was performed for 21 days, with clinical improvement and seizure remission after 4 months. An MRI scan 11 months after treatment, showed complete resolution of those cystic lesions and a left hippocampal atrophy (HA) with hyperintense T2 signal. The presence of HA and hyperintense T2 signal in this patient has not, to date, been associated with a poor seizure control. CONCLUSIONS: This patient presented with MRI evidence of left MTS after new onset partial seizures of left temporal lobe origin. Although we did not have a previous MRI scan, it is likely that this hippocampal abnormality was due to the acute inflammatory response to cysticercosis associated to repeated partial seizures. This suggests that acute neurocysticercosis associated with repeated seizures may cause MTS and late onset TLE

Peripheral arterial changes in systemic sclerosis and their response to various vasodilators

This work comprises the study of the effect of Nifedpine versus Captopril on peripheral arterial changes in systemic sclerosis [SS]. Eight patients presenting with systemic sclerosis were subjected to complete clinical evaluation, photoplethysmography at room temperature, after cold exposure and after heat exposure, arterial doppler of both upper and lower limbs and Duplex examination of digital arteries. These tests were applied on the patients basically before and after two hours of oral intake of 20mg Nifedipine [these represent group A]. The same tests were applied on the same patients after intake of captopril 25mg t.d.s for one week [these represent group B]. There was a sufficient gap of time between both groups to ensure the washout of Nifedipine. Photoplethysmographic study of the hands basically, showed that six patients out of the eight were vasospastic, while the remaining two cases had organic lesions. Group A [after Nifedipine]: Nifedipine reversed the waveform abnormalities in six cases of vasospasm, but with no effect on the two patients with organic lesions. Group B [after Captopril]: Plethysmographic studies showed no significant improvement neither in amplitude of arterial waveform nor in its contour. We conclude from this study that Nifedipine can be helpful in improving the digital blood flow and reducing the peripheral vascular resistance in cases presenting with SS with Raynaud's phenomenon and that these results are valuable in the vasospastic types. On the other hand, the results of captopril therapy were not encouraging for the management of Raynaud's phenomenon

Buflomedil intra-arterial en la obstrucción femoro-poplitea crónica: evaluación fotopletismográfica: efecto inmediato / Intra-arterial buflomedil in chronic femoro-popliteal obstruction, photoplestismographic evaluation: immediate effect

Fueron estudiados 17 pacientes portadores de arterio-esclerosis-fémoro-poplítea cronica Estado II B de Fontaine. Se les administró 200 mg. de Buflomedil en solución, por vía intra-arterial femoral. Se analizó en el trabajo los resultados obtenidos de acuerdo al método de fotopletismografía digital, que es considerado actualmente un parámetro válido en la medición de las variaciones del flujo arterial capilar. Fueron analizados estadísticamente los resultados mostrando un importante aumento del flujo capilar en la extremidad inferior tratada

Fibroesclerosis multifocal / Multifocal fibroesclerosis

Se relatan los hallazgos oftalmológicos en un paciente portador de una fibroesclerosis multifocal. Las alteraciones encontradas son inespecíficas, caracterizadas por pseudotumor bilateral de la órbita, edema papilar, despendimiento seroso de retina, oftalmoplegia externa y reductibilidad ocular disminuida. El paciente fue estudiado con campo visual, ecografía A, TAC de órbitas y punción retrobulbar para estudio citológico. Se inició tratamiento esteroidal con 50 mg de Prednisona al día con poca respuesta ocular