ABSTRACT
Male gonadal metastases from pancreatic carcinomas are extremely rare, with fewer than 20 cases documented in the literature. Herein, we report a man in his 50s who presented at the genitourinary outpatient department with an enlarged scrotum (right side) that had developed progressively over several weeks. He also reported mild upper abdominal discomfort. Scrotal sonography revealed a hydrocele on the right side without testicular lesions. A mass pancreatic tail lesion with invasion of the spleen and left adrenal gland was identified through abdominal CT and MRI. Endoscopic ultrasound fine needle biopsy and right radical orchiectomy were performed. Moderately differentiated adenocarcinoma of the pancreatic tail with hematogenous metastasis to the right testis, epididymis and spermatic cord was verified on the basis of the pathology report. Disease progression occurred despite the patient receiving palliative chemoradiation therapy.
Subject(s)
Adenocarcinoma , Pancreatic Neoplasms , Spermatic Cord , Testicular Neoplasms , Humans , Male , Spermatic Cord/pathology , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/therapy , Pancreatic Neoplasms/pathology , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/therapy , Adenocarcinoma/pathology , Testicular Neoplasms/diagnostic imaging , Testicular Neoplasms/therapy , Testicular Neoplasms/pathology , Orchiectomy , Pancreatic NeoplasmsABSTRACT
Non-drug therapy of traditional Chinese medicine (TCM) mainly includes exercise therapy, such as Baduanjin and Taichi. Some TCM techniques adjunct toanti-hyperhension drugs show effectiveness with safety, such as moxibustion, acupuncture, acupoint application, auricular point application, massage, cupping, scraping, herbal tea, emotional therapy, and music therapy. In future, long-term follow-up of trials and standardization of research are needed. In the other way, in-depth research on patients with grade 3 hypertension and secondary hypertension is still needed.
ABSTRACT
Iron homeostasis plays an important role for the maintenance of human health. It is known that iron metabolism is tightly regulated by several key genes, including divalent metal transport-1(), transferrin receptor 1(), transferrin receptor 2(), ferroportin(), hepcidin(), hemojuvelin() and . Recently, it is reported that DNA methylation, histone acetylation, and microRNA (miRNA) epigenetically regulated iron homeostasis. Among these epigenetic regulators, DNA hypermethylation of the promoter region of , and bone morphogenetic protein 6 () genes result in inhibitory effect on the expression of these iron-related gene. In addition, histone deacetylase (HADC) suppresses gene expression. On the contrary, HADC inhibitor upregulates gene expression. Additional reports showed that miRNA can also modulate iron absorption, transport, storage and utilization via downregulation of and other genes. It is noteworthy that some key epigenetic regulatory enzymes, such as DNA demethylase TET2 and histone lysine demethylase JmjC KDMs, require iron for the enzymatic activities. In this review, we summarize the recent progress of DNA methylation, histone acetylation and miRNA in regulating iron metabolism and also discuss the future research directions.
Subject(s)
Humans , Epigenesis, Genetic , Gene Expression Regulation , Genetics , Homeostasis , Iron , Metabolism , Receptors, TransferrinABSTRACT
ZIEL: Diese Studie erfolgte zum Vergleich der Wirksamkeit einer intravesikalen Instillation von Mitomycin C (MMC) zur Prävention eines nicht muskelinvasiven Ta- oder T1-High-Risk-Harnblasenkarzinoms (NMIBC) unter Verwendung verschiedener Schemata. MATERIAL UND METHODEN: Diese retrospektive Kohortenstudie wurde bei 152 Patienten durchgeführt, die zwischen April 2009 und September 2016 mit einer intravesikalen MMC-Injektion behandelt wurden. Der mittlere Nachbeobachtungszeitraum lag bei 32,67 Monaten. Alle Patienten unterzogen sich einer vollständigen transurethralen Resektion des Blasentumors (TURBT), an die sich innerhalb von 24 Stunden eine postoperative Instillation von MMC anschloss. Die Patienten wurden in 4 Behandlungsgruppen unterteilt: Bei Gruppe 1 erfolgte die Nachbeobachtung ohne MMC-Erhaltungsdosis; Gruppe 2 erhielt in den ersten 8 Wochen einmal pro Woche eine MMC-Instillation; Gruppe 3 erhielt in den ersten 8 Wochen einmal pro Woche und in den darauffolgenden 6 Monaten einmal pro Monat eine MMC-Instillation; Gruppe 4 erhielt in den ersten 8 Wochen einmal pro Woche und in den darauffolgenden 12 Monaten einmal pro Monat eine MMC-Instillation. ERGEBNISSE: Die allgemeine Rezidivrate lag bei 27,6â%. Gruppe 1 zeigte eine signifikant hohe (pâ<â0,05) Rezidivrate von 50â%, während sich bei den Rezidivraten der übrigen 3 Schemata kein Unterschied fand (Gruppe 2: 15â%; Gruppe 3: 24,1â%; Gruppe 4: 27,2â%). Darüber hinaus zeigte sich zwischen diesen Patientengruppen kein statistischer Unterschied bei den Rezidivraten von Ta- oder T1-Tumoren sowie niedrig- oder hochgradigen Tumoren. SCHLUSSFOLGERUNG: Unser Vergleich der verschiedenen Schemata einer intravesikalen MMC-Instillation ergab bei einer einzigen MMC-Instillation nach TURBT eine signifikant höhere Rezidivrate als bei Patienten, die nach 8 Wochen, 6 Monaten und 12 Monaten eine Erhaltungsdosis erhielten. Zeitlich fanden sich beim MMC-Erhaltungsschema keine signifikanten Unterschiede zwischen der 8.âWoche und dem 12.âMonat. Daraus folgern wir, dass bei T1- oder Ta-High-Risk-NMIBC nach TURBT einmalig eine MMC-Instillation mit anschließender Erhaltungstherapie mit einmal wöchentlicher Verabreichung über 8 Wochen durchgeführt werden kann.
Subject(s)
Mitomycin/administration & dosage , Urinary Bladder Neoplasms/drug therapy , Administration, Intravesical , Adult , Aged , Aged, 80 and over , Chemotherapy, Adjuvant , Cohort Studies , Combined Modality Therapy , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/prevention & control , Neoplasm Staging , Retrospective Studies , Risk Factors , Taiwan , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/surgery , Young AdultABSTRACT
A 33-year-old male receiving dorsal penile nerve block (DPNB) for circumcision exhibited a postoperative ischemic change over the glans penis. The event occurred nearly 24 hours after the procedure. The patient was treated with intravenous pentoxifyllin and hyperbaric oxygenation. Total reverse of the ischemia was observed. The complications associated with circumcision and DPNB were reviewed and discussed.
