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Familial Kartageners Syndrome: A Case Report
Get PDFIn recurrent lower respiratory tract infections the cause may be either general impairment of immune mechanism, abnormalities of mucus or abnormalities of cilia.We report a case where the patient was having recurrent lower and upper respiratory tract infections and had situs Inversus totalis. Kartagener’s syndrome is an inherited disorder transmitted in autosomal recessive manner with variable penetrance. There is no specific treatment for this condition but failure to recognize the condition early in life may subject the patient to unnecessary repeated admissions and investigations and inappropriate treatment
Interpretation of Biochemical Tests for Iron Metabolism in Hyperthyroidism
Get PDFObjective: Several studies suggest that thyroid hormones may affect erythropoiesis. However the mechanism by which thyroid hormones alter the ferritin concentration is not well known. Therefore, the present case-control study was designed to determine the changes due to hyperthyroidism in serum ferritin, iron and transferrin levels and to investigate the inter-relationship between these parameters.Material: This study was conducted on 50 newly diagnosed hyperthyroid patients and the results were compared with 50 age and sex matched healthy controls. Serum ferritin was assessed by two site sandwich immunoassay using direct chemiluminometric technology. TIBC and serum iron were estimated by colorimetric method.Results: Serum ferritin (314.43 ± 68.7 ng/mL) and iron concentration (159.88 ± 36.28 µg/dL) were found to be increased in hyperthyroid patients as compared to healthy controls (255.23 ± 45.5 ng/mL and 110.52 ± 20.52 µg/dL respectively). There was a significant difference between hyperthyroid patients and healthy controls in serum levels of ferritin and iron (p0.05 for both). Serum ferritin and iron were correlated significantly positive with thyroid parameters while a significant negative correlation was found with transferrin.Conclusion: Our data suggest that alterations in thyroid status in a given individual produce significant changes in serum ferritin, iron and transferrin levels. Increased ferritin levels seem to be protective against increased oxidative stress seen in hyperthyroidism but these also increase atherosclerotic risk. However, a large scale study is recommended to establish the fact
A Primary Leiomyosarcoma of the Thyroid Gland: A Case and Literature Review
Get PDFIntroduction: We want to present a rare case of Primary leiomyosarcoma of the thyroid (PLT) gland and review the literature on PLT including the differential diagnoses, pathology, and alternative treatment strategies.Presentation of Case: A 56-year-old man who underwent left side total thyroidectomy with diagnosis of substernal goiter. On pathologic examination, three different pathology clinics had a common opinion that this was a grade 3 pleomorphic sarcoma of thyroid itself. Positron Emission Tomography (PET/CT) obtained one month after surgery displayed no distant metastases. Loco regional radiotherapy (RT) to the thyroid bed was delivered up to a dose of 59.4 Gray (Gy) in 1.8 Gy daily fractions. PET/CT obtained three months after RT showed bilateral multiple lung metastases without loco regional recurrence. The patient received 6 courses of doxorubicin and cyclophosphamide based chemotherapy. A new PET/CT scan showed only two metabolically active metastases on both lungs. Because of disappearance of small metastases, the patient underwent sequential bilateral metastasectomy in one month interval. Pathology results verified the metastases of PLT. The patient is still alive without any signs of disease 6 years after RT and he is the only long surviving case reported up to now.Conclusion: The treatment protocols for PLT have not been well established yet, because of their rareness and poor prognosis. We believe that our case may be directive for PLT treatment
Evaluation of Antibacterial and Anti-oxidant Activity of Some Lichens of Uttarakhand
Get PDFObjective: The present study was undertaken to investigate antimicrobial and antioxidant activity of ethanolic extract of Parmelia sexatilis, Parmelia caperata, Parmelia parletum, Everniastrum cirrhatum, Parmelia pereoridisum, Parmoterma mesotropum, Parmoterma reticulatum, Parmoterma perlatum, and Parmelia squarrosa collected from different locations of Uttarakhand. Methods: Antimicrobial activity was assayed using disc diffusion and two-fold dilution method. Free radical scavenging potential was assayed using 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and total phenol content equivalent to gallic acid. Results: All the species of lichen were effective against the Staphylococcus aureus, out of them 7 were effective against Mycobacterium smegmatis and Micrococcus luteus, and 6 against Bacillus cereus. The extracts of Parmelia caperata (8-32 µg/ml MIC), Parmelia parletum (16-32 µg/ml MIC), Parmelia sexatilis (16-32 µg/ml MIC) and Everniastrum cirrhatum (8-32 µg/ml MIC) showed the strongest antibacterial activity. The extract did not show activity against fungi. Most of the lichen species were effective against M. smegmatis and B. cereus. It was also found that the tested extracts exhibited the highest radical scavenging activity with the greatest amount of phenolic content. The highest value of phenols was seen in the ethanol extract of Parmelia caperata at a 162.02 μg of gallic acid equivalent while Everniastrum cirrhatum extracts showed 160 μg of gallic acid equivalent. The scavenging effects of all lichen extract range from 17.44 – 84.33.7%. Extracts from lichen Parmelia sexatilis, and Parmelia caperata showed largest DPPH radical scavenging activity (84.33%) which was similar or greater than the standard antioxidants, ascorbic acid (86.5%), BHA (79.78%) and a-tocopherol (63.99%). Conclusion: Lichens are the potent source of antimicrobial and anti-oxidant metabolites. Further studies are required so that the potent lichen species under the study may serve as leads in the development of potential antibacterial and antioxidant agents
Age and Gender Differences in the Association between Serious Psychological Distress and Cancer: Findings from the 2003, 2005, and 2007 Health Information National Trends Surveys (HINTS)
Get PDFBackground: Little is known about the association of serious psychological distress (SPD) with cancer.Aims: This study examined the association between SPD and cancer, and tested whether such association differed by age and gender.Methods: Data came from the 2003, 2005, and 2007 Health Information National Trends Surveys (HINTS) (2,637 cancer cases and 16,581 controls). Weighted univariate and multiple logistic regression analyses were used to estimate the odds ratios (ORs) with 95% confidence intervals (CIs).Results: The overall prevalence of SPD was 6.7% (5.4% for males and 7.9 % for females; 7.1% for cancers and 6.4% for controls). The prevalence of SPD decreased with age (7.8%, 5.8% and 3.9% for age groups 18-49, 50-64 and 65+ years, respectively). After adjusting for other factors, being female, elder (65+ years), SPD, and poor general health were positively associated with cancer (p0.05). Gender-stratified analyses showed that SPD was associated with cancer only in women. Stratified by age groups, SPD and obesity were associated with cancer only in elderly.Conclusions: Older age, being female, SPD and poor general health were associated with increased likelihood of cancer. Stratified by age groups and gender, SPD was significantly associated with cancer in women and elder group. It is important to develop effective strategies to manage SPD among patients with cancer, especially in women and elder adults
Triple Synchronous Tumors in a Patient: Gastric Adenocarcinoma, Omental Gastrointestinal Stromal Tumor and Renal Angiomyolipoma
Get PDFIntroduction: The presence of synchronous distinct tumors is uncommon in the literature, and the etiology of it is still unknown.Presentation of Case: Herein, we report a 42 year-old-woman with synchronous triple tumors of gastric adenocarcinoma, renal angiomyolipoma (AML), and omental gastrointestinal stromal tumor (GIST). She underwent total gastrectomy after the diagnosis of adenocarcinoma by endoscopic biopsy. During macroscopic examination of gastrectomy specimen, an ulcerated tumor about 4.5 cm in diameter was observed in the fundus. Histopathologically, it was diagnosed as adenocarcinoma harboring some signet-ring features. While dissecting lymph nodes of the omentum of the lesser curvature, a nodular mass about 4.2 cm in diameter seemed to be a lymph node was detected macroscopically. However, it was diagnosed as GIST by histopathological and immunohistochemical features. Also, partial nephrectomy was performed during the same session due to a mass detected radiologically in the left kidney about 2.2 cm in diameter. It was indicated to be metastatic gastric adenocarcinoma clinically but AML was determined by histopathological and immunohistochemical findings.Conclusion: To the best of our knowledge, our patient is the first case in the literature that has synchronous tumors of gastric adenocarcinoma, omental GIST and renal AML
Never Underestimate the Power of a Backhoe: Integrating Single Points of Failure into Strategic Planning
Get PDFSWOT (strengths, weaknesses, opportunities, threats) analysis is probably used more often than any other management technique in strategic decision making. There appears to be a greater emphasis, however, on identifying strengths and opportunities while weaknesses and threats are examined less closely. Such bias may be problematic because firms may overlook single points of failure (SPOFs), which are elements that, upon malfunction, render an entire system unavailable or unreliable. These threats and weaknesses are most often presented in information technology and engineering discussions of equipment, machine, and device breakdowns, but may have applicability in a number of other areas important to organizations including people; materials and supplies; methods and processes; and shock events—natural and human-made disasters. To be resilient in today’s 24-7, 365 days a year global business world, it is critical that organizations effectively anticipate, evaluate, prepare for, and mitigate SPOF risks that can have a seriously negative impact on a firm’s performance. The paper concludes with a three-step approach to help managers reduce and effectively respond to SPOFs. Companies that integrate the concept of SPOFs into their strategic planning could develop high-impact management skill, leading to improved corporate profitability
Differential Expression of Survivin in Mammary Gland Diseases
Get PDFObjective: Unlike other inhibitors of apoptosis proteins (IAP), survivin is expressed during fetal development, cannot be detected in normal adult tissues, and is re-expressed in most of the common human cancers. However, the clinicopathological significance of the expression of survivin in human breast carcinoma has not been fully elucidated. Therefore, we examined the accumulation of survivin in pathological specimens of mammary gland diseases to identify new protein markers that may lead to improvements in patient management.Methods: We investigated the expression of survivin using immunohistochemistry in 180 cases of breast disease accessioned in the Department of Pathology, International University of Health and Welfare Hospital and Nissan Tamagawa Hospital between 2003 and 2013.Results: Ninety-eight out of 141 malignant tumor cases (69.5%) stained positive for survivin, with no significant staining being detected in the remaining cases. Staining for survivin was completely absent in the epithelial cells of 34 of 39 cases of benign disease. No correlation was observed between the expression of survivin and major prognostic factors in breast carcinomas including patient age, tumor size, histological grade, axillary lymph node metastasis, local recurrence, and visceral metastasis status. However, a significant difference was observed in the expression of survivin between malignant and benign tumors and other benign diseases.Conclusion: The results of the present study suggest that the expression of survivin is strongly selective for cancer cells and may be useful for identifying and quantifying human breast cancer
Stereotactic Body Radiation Therapy (SBRT) for Liver Metastasis: Early Experience with the Cyberknife Robotic Radio-Surgery System
Get PDFBackground: The liver is a common site for malignant metastases. Surgical metastatic resection, ablative therapies, and external beam radiation therapy (EBRT) all have advantages and limitations. Preliminary reports reveal SBRT treats hepatic metastases with limited toxicities. We reviewed our institution’s SBRT experience for the treatment of liver metastases to assess toxicity and outcomes.Methods: Hepatic metastases treated with SBRT were retrospectively reviewed from 2008-2010. Computed tomography (CT) identified tumor volume prior to SBRT, local recurrence and out-of-field progression after SBRT. Study endpoints were local recurrence, toxicity, and overall survival.Results: Thirty-three patients had 37 liver metastases treated with a median SBRT dose of 30Gy. Median follow-up was 8.1 months. Five lesions (13.5%) locally recurred after a median of 10.6 months. Seventeen patients had out-of-field progression (15 liver, 6 systemic) after a median of 5.1 months. Overall 23.5-month survival was 45.5%. Five patients reported nausea and seven reported pain after SBRT. There were no grade 4-5 toxicities or cases of liver failure.Conclusion: SBRT is safe and well tolerated in patients with hepatic metastases. SBRT offers a local therapy with limited toxicities to patients with lesions not amenable to traditional ablative, surgical, or regional therapies
Solid Pseudopapillary Tumor of the Pancreas: A Case Report
Get PDFIntroduction: Solid pseudopapillary tumor (SPT) of the pancreas is rare, accounting for 0.13-2.7% of all pancreatic tumors. It has specific clinical, pathological and radiological characters that make it quite different from other pancreatic tumors.Presentation of case: A 15-year-old girl with SPT of the pancreas diagnosed after surgical resection with histopathology and immunohistochemistry confirmation. As no clear role for adjuvant treatment, she was elected for follow up.Conclusion: Although SPT is a rare tumor without notable symptoms. Complete surgical excision is the treatment of choice. The place of chemotherapy or radiotherapy needed to be elucidated