143 research outputs found
The effect of staplig reconstruction of the radiated rectum on sphincter preservation
No full textED: LEA-FABINGER 1990
Measuring calcitonine in washout of the needle in patient undergoing fine needle aspiration with suspicious medullary thyroid carcinoma
No full textCalcitonin measurement in washout of the needle after aspiration (WO-Ct) has been rarely evaluated. Here we analyzed the role of WO-Ct in a series of subjects who underwent fine needle aspiration (FNA) with suspicious medullary thyroid cancer (MTC). Twenty-one patients referred following elevated serum calcitonin (S-Ct) or suspicious MTC by cytology. All patients underwent re-evaluation of S-Ct, FNA, and measurement of WO-Ct. S-Ct and WO-Ct were assessed by chemiluminescence assay (IMMULITE 2000, Diagnostic Products Corporation, USA). S-Ct showed elevated value in six subjects (mean 368.8 ± 373.9 pg/ml), of which three cases were cytologically classified as Class 5. WO-Ct obtained in this group (304.0 ± 309.3 pg/ml) was no different from S-Ct. After surgery MTC was confirmed in all patients. In the other 15 patients MTC was excluded by cytology or histology. Two subjects had moderately skewed S-Ct with nonmedullary histology. In the remaining 13 patients S-Ct resulted normal (6.2 ± 5.6 pg/ml) and WO-Ct low (2.9 ± 2.2 pg/ml). Significant (two-tailed P < 0.05, r(2) = 0.27, 95% confidence interval = 0.017-0.81) correlation was found between S-Ct and WO-Ct in nonmedullary patients but not in MTC patients. This study showed that WO-Ct can play a role in diagnosing primary and metastatic MTC. The procedure is easy, cost effective, and should be used in patients undergoing FNA with elevated S-Ct. Further studies and guidelines for the method are needed to use this technique in clinical routine. Until this any institute should use itself cut-off
Elastographic presentation of medullary thyroid carcinoma
No full textAim of the study was to evaluate the elastographic
appearance of medullary thyroid carcinoma (MTC)
by a retrospective evaluation of 18 nodules histologically
proven as MTC. Free-hand qualitative elastography was
performed using Hitachi Logos EUB 7500. The elasticity
score (ES), was assessed based on a colour elastogram, the
blue colour being correlated with hard tissue, red colour
with soft tissue, and green with intermediate hardness.
Nodules were classified into four classes. A alleged diagnosis
of malignancy was assigned to nodules with ES3 or 4
and a presumptive diagnosis of benignity was assigned to
nodules with an ES1 or 2. More than half (55.6 %) of
MTCs have a low-intermediate grade of elasticity. The
hardest lesions (ES4) were those with ultrasonographic
features highly suspicious for malignancy. In conclusion,
most of MTCs present an elastographic pattern of benignity.
Therefore, qualitative elastography does not add
useful information in pointing out MTC on the basis of its
hardness. Our data suggest a marginal role for this technique
in MTC evaluation
Low-serum testosterone and high-chromogranin A rare case associated with high-grade prostate cancer and higher pathological stages of the disease
No full textLow-serum testosterone and high-chromogranin. A are associated with high-grade prostate cancer and higher pathological stages of the disease
No full textINTRODUCTION
CgA and testosterone are two serum markers that may be involved in prostate cancer. The objective of this study was to evaluate the relationship of testosterone and CgA to grades and stages of prostate cancer, particularly whether low-serum testosterone and high-serum CgA are associated with more aggressive grades, and higher pathological stages of the disease.
METHODS:
This perspective study included 121 men (Caucasian only) presenting with -newly-diagnosed, untreated prostate cancer. All the patients underwent radical prostatectomy.
RESULTS:
We subdivided the sample into two homogeneous groups, Group A with Gleason score ≤7 (3+4), and Group B with Gleason score ≥7 (4+3). Low testosterone (< 3 ng/ml) was most common among the members of Group B 80 % versus 12.6 % of Group A (p = 0.001). At the same time, elevated CgA (> 80 ng/ml) was present for a rate of 72 % in Group B, 28.1% in the Group A ( p = 0.001). The multivariate analysis we used revealed that low-serum testosterone and high-serum CgA are associated with higher pathological stages of the disease (p = 0.001).
CONCLUSION:
The principal findings of this investigation were that low testosterone is correlated with elevated CgA levels, and these two parameters are associated with more aggressive grades and higher pathological stages of prostatic adenocarcinoma
Pediatric Pancreatitis. Not a Rare Entity
No full textThe incidence of acute pancreatitis is increasing in children and it should be considered as part of differential diagnosis in case of abdominal pain. The etiology of acute pancreatitis in this subpopulation is related to several conditions and risk factors, such as drugs, obesity, infections, trauma and anatomic abnormalities. In older children abdominal pain is the first symptom in more than 90% of cases, where as in younger children vomiting represents an early clinical manifestation. Diagnosis is based on laboratory investigation, such as serum levels of lipase, and imaging findings (ultrasonography, CT scanning or MRI) such as detecting edema, hemorrage
or necrosis of pancreatic parenchyma or in peripancreatic fat. Treatments for adults and children are similar. Rapid and accurate assessment of the severity of pancreatitis is absolutely indicated for selecting the appropriate treatment and predicting the prognosis
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