Objective

To investigate the images characteristics of primary malignant intracranial lymphoma.

Methods

Retrospective study was conducted on CT/MRI imaging characteristics of 9 cases with primary malignant intracranial lymphoma.

Results

The patients had lesions mostly in the supratentorial region, including the parts of deep white matter, para-ependymal regions, and corpus callosum. The shapes of the lesions were round or irregular. CT scan showed equal or slightly high density of the tumor images, compared with the normal tissue in the brain. The T1WI of MRI scan on the tumor showed low signal and the T2WI showed equal or slightly high signal. The MRI signals were homogenous. Cystic lesion, calcification, and hemorrhage were rarely seen in MRI. Edema around tumor and its occupational effect was lessened. Edema around tumor shown in MRI was not in accordance with the true volume of the tumor mass. Enhanced scan on the lesions showed homogenous enhancement, and the pia mater invaded and/or the spread along ependyma.

Conclusion

Images of primary malignant intracranial lymphoma have specific characteristics that are useful in its diagnosis and differential diagnosis.

Objective

To investigate the clinical characteristics of melanosis of the colon (MC) and its correlation with polypus and carcinoma of the large intestine.

Methods

Clinical feature and colonoscopic findings of 156 MC patients were retrospectively analyzed. Final diagnosis of MC case was made after colonoscopic and pathological examination, and data of the case history was recorded.

Results

The overall detection rate of MC was 1.12%, with 0.46% in males, 0.66% in females. An 82.69% of the patients suffered various constipations and had a history of taking cathartics. The clinical manifestation of total-colon melanosis occurred in 83.97% of the patients. There was no significant difference between the rate of concomitant polypus (27.56%) in the MC patients and the detection rate of polypus in the patients who underwent a synchronous colonoscopy (χ² = 1.205, P = 0.298). Also there was no significant difference between the detection rate of carcinoma of the large intestine (8.97%) in MC patients and the detection rate of the same disease in the patients who underwent synchronous colonoscopy (χ² = 0.268, P = 0.604). A logistic regression analysis has shown that the older the age of MC patients is, the more opportunities of MC and the concomitant polypus would occur.

Conclusion

MC may be related to constipations and a long-term administration of cathartics, among which total-colon melanosis ranks first in the cases. There is an earlier age of onset in the females, with a higher detection rate. The older the age of the patients is, the higher the detection rate of MC is, and the more possibility the onset of the concomitant polypus.

Objective

To summarize our clinical experience in treating 31 patients with neck masses undergoing carotid artery resection without arterial anastomosis (vascular reconstruction) in Tianjin Cancer Hospital during a period from 1979 to 2002.

Methods

Preoperatively, patients were instructed to apply pressure to the carotid artery. Tumor excision combined with carotid artery resection (TECCAR) was conducted after an accurate testing of valid cerebral blood supply and compensation.

Results

Among the study patients, 17 were male and 14 female, with the age ranging from 14 to 58 years. Of the 31 cases, 23 were carotid body tumors (8 malignant), 2 vagal body tumors (1 malignant), 4 carotid aneurysms, and 2 were metastatic tumors from the cervix involving carotid artery. Of the patients, a subtotal resection of the head and neck masses was conducted in 22 cases. Intraoperative death did not occur, and postoperative CNS or cerebrovascular complications (CVC) were not found.

Conclusion

TECCAR without arterial anastomosis is a safe and feasible procedure. In addition, this method of surgery has more advantages in comparison to an arterial anastomosis: i) Tumor resection was more complete. ii) Complications such as thrombus, infection, and lethal hemorrhage etc., were rare after surgery; iii) Postoperative radiotherapy, if needed, would be safe and acceptable; iv) It was a more simplified operational procedure.

Normal epithelial cells that lose the integrindependent anchorage to their extracellular matrix trigger anoikis, while metastatic tumor cells bypass anoikis pathway, which is one of the key events to achieve the metastasis. Physiological role of anoikis is also involved during embryonic development and tissue homeostasis, suggesting that anoikis must be strictly regulated at some level. Despite its importance, the molecular pathways involved in the regulation of anoikis and the proximal signals reporting loss of anchorage are poorly understood. Recent studies suggest an adaptor protein p66^Shc, localizing at focal adhesions, mediates anoikis through activation of RhoA. However, expression of p66^Shc is inadequate in metastatic cancer cells, failing to initiate anoikis and promoting tumor metastasis. Reexpression of proapoptotic protein p66^Shc can restore the susceptibility to anoikis. Thus, p66^Shc may be a potential target molecule for diagnosis of tumor metastasis and for tumor treatment.

Androgen deprivation therapy (ADT), which aims to reduce androgen-androgen receptor (AR) signaling, is the normal method of prostate cancer treatment. Despite its early success in suppressing prostate tumor growth, the therapy eventually fails, leading to recurrent hormone-refractory tumor growth. Recent studies have been carried out with stromal cell-specific or fibroblast-specific AR knockout mice or prostate stromal-specific and epithelial-specific AR knockout transgenic mice prostate cancer models and in vitro and in vivo studies of various human prostate cancer cells with knock-in and knock-out of the AR. These have indicated that the AR in prostatic stroma acts as a proliferation stimulator and survival factor, whereas epithelial AR acts as a survival factor for epithelial luminal cells and stromal smooth muscle cell differentiation, and as a suppressor for epithelial basal intermediate cell proliferation. These two opposite roles of the stromal and epithelial AR pose a major challenge for ADT and should be taken into account when developing new therapies targeting AR in selective cells.

Objective

To study the effect of the Twist gene on the migration of human hepatocellular carcinoma cells and the possible mechanisms involved.

Methods

RT-PCR was used to detect expression of the Twist gene in primary (Hep11) and recurrent (Hep12) cell lines from the same HCC patient. Hep11 cells were stably transfected with Twist-cDNA, and Hep12 cells were transiently transfected with Twist RNAi plasmid. Cell migration assays were performed on Twist up-regulated Hep11 cells and Twist RNAi Hep12 cells. RTPCR and Western blot were used to test the expression of EMT markers.

Results

Twist was expressed higher level and had increased migration capability in recurrent Hep12 cells than those in primary Hep11 cells. Cell models (Twist-Hep11) in which Twist protein was steadily and highly expressed were obtained. Compared with pcDNA3-Hep11 cells, migration of Twist-Hep11 cells was clearly increased. However, migration of Twist RNAi (Si-Twist-Hep12) Hep12 cells were reduced. Overexpression of Twist in Hep11 cells promoted expression of N-cad and vimentin.

Conclusion

These results indicate that Twist promotes the migration of hepatocellular carcinoma cells in vitro and may play an important role in the upregulation of mesenchymal markers.

Objective

To evaluate the diagnostic and therapeutic efficacy of using cold knife conization for cervical intraepithelial neoplasia (CIN).

Methods

We retrospectively analyzed 186 cases with CIN diagnosed and treated in our hospital; compared the histologic diagnoses from cervical conization and from colposcopic multiple punch biopsies, and then evaluated their postoperative histologic findings and clinical outcomes.

Results

Of the 186 cases, there was a correlation in histologic findings between cervical conization and colposcopic multiple punch biopsies in 138 cases (74.2%), and there was no correlation in the other 48 cases (25.8%). Incomplete excision was performed in 8 cases (4.3%), but the failure rate was only 1.1%; the cure rate was 98.9%. Five cases with early invasive cancer were found. Eleven patients underwent subsequent hysterectomy. The main complications associated with conization were hemorrhage and cervical stenosis. Bleeding occurred in 8 (4.3%) of the patients, and cervical stenosis occurred in 3 (1.6%).

Conclusion

Cervical intraepithelial neoplasia was diagnosed more accurately using conization than by colposcopic multiple punch biopsies. Conization can also play an important role in the treatment for CIN. If properly performed, the procedure has a low risk of complications. It can provide an accurate histologic representation of the disease process, and be curative in most cases.

Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The application of evidence-based guidelines to clinical practice can help healthcare professionals to provide good quality care to patients and, in turn, produce bett er patient outcomes. The purpose of the present paper is to describe the development process of an evidenced-based guideline. Challenges in the implementation of evidence-based practice are identified and strategies for tackling them discussed.

Objective

To evaluate the efficacy of selective transcatheter arterial embolization (TAE) in renal angiomyolipoma (AML) spontaneous ruptures with hemorrhage.

Methods

A retrospective evaluation was carried out in 21 renal AML cases with acute bleeding confirmed by imaging. Selective renal arterial embolization was used to control bleeding. All the cases were detected by renal arteriography had abnormal vascular hyperplasia and enlarged blood vessels.

Results

Initial renal arteriography for all the patients showed that tortuous, hypervascular, and aneurysm-forming angiogenic components with aneurysm formation occurred in 13 cases (61.9%) and extravasation of the contrast agent was found in 8 cases (38.1%). Immediate complete obliteration was technically successful in 19 (90.5%) of the 21 patients. To prevent uncontrollable complications, 3 patients received nephron-sparing surgery after hemodynamic status was stabilized with TAE a week later. Two days and 3 days after the embolizations, 2 patients presented with incomplete embolizations and then underwent nephrectomy when they were in a stable condition. There were no significant differences in the plasma creatinine levels before and after the treatment. All the patients were followed up for 6 months to 6 years (median, 45 months). The largest tumor diameter was reduced from (11.57±4.28) cm to (9.57±2.28) cm. The tumor had no blood supply and no relapses have occurred.

Conclusion

TAE is a technically feasible and minimally invasive procedure for ruptured renal angiomyolipoma. The aneurysms were a predictor of renal AML spontaneous rupture and detection of such aneurysms by CT may help to determine the timing of embolization. In patients who still need surgical treatment, TAE can make tumor resection easier to perform and reduce blood loss during the operation.

Objective

To provide the evidence of predicting and preventing the postoperative recurrence by investigating the relationship between the recurring types of colorectal carcinoma (CRC) after radical resection and clinicopathologic factors.

Methods

Data from 464 CRC patients in stage I–III, who were admitted to our hospital during a period from January 1998 to December 2002 and underwent radical surgery, were collected, and retrospective analysis of the clinicopathologic data from 90 out of the 464 CRC patients, who developed postoperative recurrence was conducted. The 90 patients were divided into 2 groups based on the recurrence time (RT). Those with a RT of ≤ 30 months were classified into the early recurrence (ER) group and those with RT of > 30 months were classified into late recurrence (LR) group. The χ² test was used for univariate analysis, and binomial logistic regression analysis for multivariate analysis.

Results

There were 78 patients (86%) in the ER group and 12 (14%) in the LR group. The median recurrence time (MRT) was 35.1 months, 13.6 months, and 12.9 months in CRC patients with stage-I, stage-II and stage-III, respectively. There were significant differences in RT among the groups (P = 0.001). In the 90 patients, the MRT was 17.4 months. The median time (MT) was 16.9 months in patients with regional recurrence, 13.3 months in patients with single recurrence, and 7.7 months in patients with multiple metastases. Univariate analysis indicated that the depth of tumor infiltration, the number of positive lymph nodes, and the macroscopic types of the primary tumor were the factors affecting the relapse of the tumor. The multivariate analysis revealed that the depth of tumor infiltration was the independent factor affecting the time of ER (P = 0.049).

Conclusion

Most of CRC patients receiving radical surgery for colorectal cancer occur recurrence within 30 months after the first operation, nevertheless, LR occurs in some CRC patients over 30 months after the surgery. The time interval varies in different types of recurrence. Distant metastasis is seen mainly in the cases with postoperative ER, and regional recurrence in the cases with LR. The depth of tumor infiltration is an independent predictor affecting the postoperative RT of CRC, and the tumor infiltration into, or beyond the seromembranous layer is considered as independent factor affecting the ER of CRC.