ABSTRACT
BACKGROUND: Multiple products to prevent adhesions or lessen the risk of soft tissue attachments are commercially available. The long-term nature of these products is unknown, and they may cause foreign body reactions masquerading as recurrent disease in patients with cancer. CASE: A perimenopausal female underwent a hysterectomy and placement of a surgical implant, polylactic acid. Final pathology revealed stage IA low-grade endometrial stromal sarcoma. Areas suspicious for recurrence were noted on radiographic imaging 1 year later, resulting in exploratory surgery. The suspicious areas were found to be foreign body reactions. Mass spectrometry identified the main component of the reactions as polylactic acid. CONCLUSION: Adhesion barriers and other surgical implants may not always be completely metabolized and should be used with caution in patients with cancer.
Subject(s)
Endometrial Neoplasms/diagnosis , Foreign-Body Reaction/diagnosis , Prostheses and Implants/adverse effects , Sarcoma, Endometrial Stromal/diagnosis , Sarcoma, Endometrial Stromal/etiology , Abdominal Pain/diagnosis , Female , Foreign-Body Reaction/etiology , Foreign-Body Reaction/pathology , Foreign-Body Reaction/surgery , Humans , Lactic Acid/administration & dosage , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Pelvic Pain/diagnosis , Polyesters , Polymers/administration & dosage , Tissue Adhesions/diagnosis , Tissue Adhesions/pathology , Tissue Adhesions/surgeryABSTRACT
Brief (1-100 min) irradiations with three different ultraviolet-B (UV-B) and ultraviolet-C (UV-C) wave bands induced increases the UV-absorbing pigments extracted from cucumber (Cucumis sativus L.) and Arabidopsis. Spectra of methanol/1% HCl extracts from cucumber hypocotyl segments spanning 250-400 nm showed a single defined peak at 317 nm. When seedlings were irradiated with 5 kJ m(-2) UV-B radiation containing proportionally greater short wavelength UV-B (37% of UV-B between 280 and 300 nm; full-spectrum UV-B, FS-UVB), tissue extracts taken 24 h after irradiation showed an overall increase in absorption (91% increase at 317 nm) with a second defined peak at 263 nm. Irradiation with 1.1 kJ m(-2) UV-C (254 nm) caused similar changes. In contrast, seedlings irradiated with 5 kJ m(-2) UV-B including only wavelengths longer than 290 nm (8% of UV-B between 290 and 300 nm; long-wavelength UV-B, LW-UVB) resulted only in a general increase in absorption (80% at 317 nm). The increases in absorption were detectable as early as 3 h after irradiation with FS-UVB and UV-C, while the response to LW-UVB was first detectable at 6 h after irradiation. In extracts from whole Arabidopsis seedlings, 5 kJ m(-2) LW-UVB caused only a 20% increase in total absorption. Irradiation with 5 kJ m(-2) FS-UVB caused the appearance of a new peak at 270 nm and a concomitant increase in absorption of 72%. The induction of this new peak was observed in seedlings carrying the fah1 mutation which disrupts the pathway for sinapate synthesis. The results are in agreement with previously published data on stem elongation indicating the existence of two response pathways within the UV-B, one operating at longer wavelengths (>300 nm) and another specifically activated by short wavelength UV-B (<300 nm and also by UV-C).
