ABSTRACT
BACKGROUND AND PURPOSE: Adenoid cystic carcinomas (ACC) are characterized by high rate of local recurrence and late distant metastasis. Chromosomal changes in the evolution from primary tumors to metastatic disease of ACC have not been appointed. Here we investigated the chromosomal alterations of 53 primary tumors from ACC patients with different progressive states by shallow whole genome sequencing to identify potential new markers for metastatic spread. METHODS: Illumina paired-end libraries were generated using DNA from the primary tumor of 53 ACC patients. Fragmented DNA was end-repaired, A-tailed and multiplex sequencing adapters were ligated. Sequence data were mapped to HG19 and a copy-number analysis was conducted using the QDNAseq R package (version 1.10.0). Outliers were removed and data was smoothed by applying the circular binary segmentation algorithm implemented in the R package copynumber version 1.22.0. A modified chromosomal instability (CNI) score was used to analyze deletions and amplifications. RESULTS: Cluster analysis of the whole genome sequencing revealed that the frequency of chromosomal aberrations were increased in ACC with local recurrence and distant metastases in comparison to ACC patients with no metastatic spread. Specifically, chromosome 6 and 12 and exclusively the entire chromosome 4 showed an increased frequency of chromosomal alterations with tumor progression. CONCLUSION: Our data show a molecular evolution from primary tumors to local recurrences and distant metastases and pinpoint the critical chromosomal regions involved in this process. These regions should be in the focus of the search for therapeutic targets of progressive ACC.
Subject(s)
Carcinoma, Adenoid Cystic/genetics , Salivary Gland Neoplasms/genetics , Whole Genome Sequencing/methods , Carcinoma, Adenoid Cystic/pathology , Chromosome Aberrations , Disease Progression , Female , Humans , Male , Salivary Gland Neoplasms/pathologyABSTRACT
The chorioallantoic membrane of fertilized chicken eggs in an early phase of breeding presents an approved test situation for the growth and treatment of human cancer cells.These models work due to the inoculation of cells into the membrane that stays within the egg shell during the time of investigation. In this study a modification of this model is presented. Samples of native tumors, rather than cell lines, are transplanted into the membrane and the body of the egg is taken out of the shell and placed in a plastic bowl. These modifications lead to an enhanced accessibility to the chorioallantoic membrane and the surrounding vessels thus facilitating intra venous access and application of pharmaceuticals and a focused radiotherapy. With the current modifications the embryo was kept alive and additionally, the vascularized tumor environment was preserved.
Subject(s)
Carcinoma, Squamous Cell/therapy , Cell Culture Techniques/methods , Chorioallantoic Membrane , Oropharyngeal Neoplasms/therapy , Animals , Carcinoma, Squamous Cell/pathology , Cell Line , Chick Embryo , Neoplasm Transplantation , Neoplasms, Experimental , Oropharyngeal Neoplasms/pathologyABSTRACT
BACKGROUND AND PURPOSE: With the use of antibiotic therapy, the incidence of deep neck infections has decreased in recent decades. The aim of this investigation was to review the clinical course and the management of deep neck infections in our department, compare them to the experiences of the common literature and identify predisposing factors for lethal complications. MATERIAL AND METHODS: In this single-center analysis, 63 patients with deep neck infections were treated surgically. The following clinical data were analyzed and compared: age, gender, laboratory data, spatial manifestation, therapeutic modalities, comorbidities, length of hospitalization and complications. RESULTS: There was a predominance of male patients (58.7%) and a mean age of 57.9 years. The most common symptoms at diagnosis were sore throat (96.8%) and neck swelling (92.0%). Cardio/pulmonary diseases and diabetes mellitus were the most common comorbidities. There was a significantly longer hospital stay for patients with diabetes mellitus. The most common manifestation was a parapharyngeal abscess in 24 patients (38.1%), followed by peri-/retrotonsillar infections in 19 patients (30.2%). In 29 patients, a multiple space infection was observed, with a significantly longer duration of hospitalization and a higher rate of complications. The main life-threatening complication was the development of airway obstruction in 20 patients (31.7%), who all received a tracheostomy. The duration of hospitalization for patients with complications was significantly longer. CONCLUSION: Close attention must be paid to the management of patients with deep neck infections, especially patients with diabetes mellitus and cardio/pulmonary diseases or patients with multiple space infections.
Subject(s)
Infections , Adult , Aged , Aged, 80 and over , Female , Humans , Infections/complications , Infections/diagnosis , Infections/therapy , Male , Middle Aged , Neck , Young AdultABSTRACT
The duodenogastric reflux was measured quantitatively in patients with classic gastric resections (Billroth I, Billroth II with and without enteroanastomosis) as well as in patients without gastric operations. A total of 43 patients with gastric resection and 6 without gastric operation were studied. Patients operated according to B II without Braun's enteroanastomosis (n = 10) had a bile reflux of 50.4 +/- 4.1% (SEM) during the study. Patients having been operated according to B II- and Braun's-enteroanastomosis (n = 15) and those having undergone B I-operation (n = 17) had a duodenogastric reflux of 21.5 +/- 3.7% (SEM) and 23.1 +/- 3.5% (SEM), respectively. In 6 control subjects without gastric operation bile reflux into the stomach averaged 0.5 +/- 0.4% (SEM).
