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Snail Immunoexpression in Endometrioid Endometrial Carcinomas. 蜗牛在子宫内膜样子宫内膜癌中的免疫表达。
Pub Date : 2022-10-01 Epub Date: 2022-12-31 DOI: 10.12865/CHSJ.48.04.05
Mirela Marinela Florescu, Oana Iulia Crețu, Andrei Muraru, Dan Nicolae Florescu, Cristiana Eugenia Simionescu

Endometrial carcinoma is one of the most prevalent cancers affecting women with epidemiological placing it as the sixth most common cancer in women. One of the factors implicated in EMT (epithelial-mesenchymal transition), Snail is regarded as having a pivotal role. We selected a number of 30 endometrial carcinomas, in a 2-year period (2020-2022). Snail immunoexpression was identified in the tumor cells for 70% of the endometroid carcinoma cases studied. Tumor cells showed both nuclear and cytoplasmic expression but only nuclear signals were quantified. The average percent of marked tumor cells was 38.6±24.9, corresponding to well differentiated carcinomas. Our analysis also showed a significant association between higher tumor grade and snail expression (p=0.000). Alteration of the epithelial-mesenchymal phenotype in endometrial carcinomas by Snail overexpression in high-grade and advanced-stage lesions constitutes mechanisms involved in the process of tumor progression.

子宫内膜癌是影响妇女的最常见癌症之一,在流行病学上,它是女性中第六常见的癌症。蜗牛是参与EMT(上皮-间充质转化)的因素之一,被认为具有关键作用。我们在2年(2020-2022年)内选择了30例子宫内膜癌。在所研究的子宫内膜样癌病例中,70%的肿瘤细胞中鉴定出蜗牛免疫表达。肿瘤细胞同时显示细胞核和细胞质表达,但只有细胞核信号被定量。标记肿瘤细胞的平均百分比为38.6±24.9,对应于高分化癌。我们的分析还显示,较高的肿瘤级别与snail表达之间存在显著关联(p=0.000)。在高级别和晚期病变中,snail过表达改变了子宫内膜癌的上皮-间充质表型,这构成了肿瘤进展过程中的机制。
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引用次数: 0
Oncocytic Papillary Cystadenoma, an Unusual Variant Presenting as a Laryngeal Ventricular Cyst. 癌细胞乳头状囊腺瘤,一种表现为喉室性囊肿的异常变体。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.15
Sravan K Kavuri, Asad Ullah, Ehiremen Iyoha, Kalyani Ballur, Lauren Gilstrap, Samantha N Mattox

Cystadenoma arising from the larynx is a rare benign minor salivary gland tumor that can show mucinous or papillary morphology. The epithelial lining of the salivary gland tumor can present with oncocytic features, which is attributed to an increased number of mitochondria. We present a rare case of oncocytic papillary cystadenoma (OPC) of the larynx which has a combination of these features. The WHO defines OPC tumors as entities which closely resemble Warthin tumor, but lack its classic lymphoid component. The immunohistochemical profile and molecular genetic features are largely unknown. We present an 84-year-old female, former smoker, who presented with progressive dysphonia, dysphagia, and shortness of breath. Laryngoscopy revealed a large, smooth mass originating from the ventricle of the right vocal fold. Subsequent biopsy demonstrated cyst wall fragments lined by a bilayer of large columnar to cuboidal oncocytic cells that had granular eosinophilic cytoplasm, round to oval nuclei with finely dispersed chromatin, and small but distinct nucleoli. The surrounding stroma was slightly fibrotic with scant lymphoid elements. No nuclear pleomorphism, increased mitosis, or necrosis was identified. In the larynx, benign salivary gland tumors are rare and less frequent than malignant neoplasms. Awareness of rare benign entities like OPC help ensure proper management and aid in avoiding unnecessary therapy.

喉囊腺瘤是一种罕见的良性小涎腺肿瘤,可表现为粘液或乳头状形态。唾液腺肿瘤的上皮衬里可以表现出嗜酸细胞特征,这归因于线粒体数量的增加。我们报告了一例罕见的喉嗜酸性乳头状囊腺瘤(OPC),它具有这些特征的组合。世界卫生组织将OPC肿瘤定义为与Warthin肿瘤非常相似但缺乏经典淋巴成分的实体。免疫组织化学图谱和分子遗传特征在很大程度上是未知的。我们报告一位84岁的女性,曾吸烟,表现为进行性吞咽困难、吞咽困难和呼吸急促。喉镜检查显示一个大而光滑的肿块源自右声带的心室。随后的活检显示,囊肿壁碎片由大的柱状至立方体嗜酸细胞双层排列,嗜酸性细胞质呈颗粒状,细胞核呈圆形至椭圆形,染色质精细分散,核仁较小但明显。周围间质轻微纤维化,淋巴成分缺乏。没有发现细胞核多形性、有丝分裂增加或坏死。在喉部,良性唾液腺肿瘤是罕见的,其发生率低于恶性肿瘤。对OPC等罕见良性实体的认识有助于确保适当的管理,并有助于避免不必要的治疗。
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引用次数: 1
Combined Effects of Doxorubicin and Temozolomide in Cultured Glioblastoma Cells. 阿霉素和替莫唑胺对培养的胶质母细胞瘤细胞的联合作用。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.03
Carina Baloi, Alexandru Oprita, Liliana Eleonora Semenescu, Daniela Elise Tache, Oana Stefana Popescu, Georgiana Adeline Staicu, Anica Dricu

The oncological field benefits of extensive medical research and various types of cancer notice improvements, however glioblastoma multiforme remains one of the deadliest cancers in humans with virtually no advance in survival and clinical outcome. Temozolomide, the FDA approved drug for glioblastoma, faces numerous challenges such as resistance and side effects. To overcome these challenges, many combination therapies are currently studied. The present study analyses the effects of temozolomide in combination with doxorubicin on a glioblastoma cell line. Our results showed that both drugs displayed a cytotoxic effect on the studied cells in single administration (55% for 100μM temozolomide at 14 days, 53% for 100μM doxorubicin at 14 days), but without a synergistic effect in dual therapy. Although the results failed to produce the expected effect, they propose new research perspectives in the future.

广泛的医学研究和各种类型的癌症在肿瘤学领域的好处值得注意,但多形性胶质母细胞瘤仍然是人类最致命的癌症之一,生存率和临床结果几乎没有进步。替莫唑胺是美国食品药品监督管理局批准的治疗胶质母细胞瘤的药物,面临着耐药性和副作用等诸多挑战。为了克服这些挑战,目前正在研究许多联合疗法。本研究分析替莫唑胺联合阿霉素对胶质母细胞瘤细胞系的影响。我们的结果表明,两种药物在单次给药中对所研究的细胞显示出细胞毒性作用(100μM替莫唑胺在14天时为55%,100μM阿霉素在14天内为53%),但在双重治疗中没有协同作用。尽管这些结果未能产生预期的效果,但它们为未来的研究提出了新的视角。
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引用次数: 0
Anticipatory Grief in the Families of Patients with Palliative Requiring Metastatic Cancer. 需要缓解的转移性癌症患者家属的预期性悲伤。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.10
Liliana Semenescu, Amelia Drăcea, Daniel Zimţa, Anda Crişan

Background/aim: When dealing with metastatic cancer patients, family distortions, such as anticipatory mourning, psychiatric and psychosocial disorders may occur. In the case of anticipatory mourning, there exists the risk of the patient being "given up" as if he is already gone, which will only make the patient feel lonely, with numerous problems occurring in the subsequent period of familial mourning. Currently, the importance of identifying the type of mourning affecting families of cancer patients has become more and more clear, as this allows not only for greater therapeutic success, but also avoids a high number of risks and complications that appear during the critical care period. Our paper aims to identify and assess these risk factors in order to contribute to the optimization and success of palliative therapy.

Material and method: We performed this study on a group of 78 subjects with metastatic cancer. We developed a questionnaire in order to assess the patient-family relationship, family profile and the patient's unique psychological traits, in order to identify potential risk factors. Data processing was performed using Microsoft Excel; the XLSTAT package was used to perform complex statistical tests (χ2 test, Spearman correlation coefficient).

Results and conclusions: Women are more prone to fears related to developing cancer themselves. No risk factors leading to the development of significant pathological mourning were identified in our study group. However, the clinician who deals with the treatment of the terminally ill cancer patient will have to include the following objectives related to the relatives in the therapeutic plan: to motivate their involvement, but with the maintenance of a separation in order to maintain the individuality; to keep their realism and to distinguish between normal/pathological mourning.

背景/目的:在治疗转移性癌症患者时,可能会出现家庭扭曲,如预期哀悼、精神和心理社会障碍。在预期哀悼的情况下,患者有被“放弃”的风险,就好像他已经走了一样,这只会让患者感到孤独,在随后的家庭哀悼期间会出现许多问题。目前,识别影响癌症患者家属的哀悼类型的重要性变得越来越明确,因为这不仅可以获得更大的治疗成功,还可以避免重症监护期间出现的大量风险和并发症。我们的论文旨在识别和评估这些风险因素,以促进姑息治疗的优化和成功。材料和方法:我们对一组78名癌症转移患者进行了这项研究。我们编制了一份问卷,以评估患者的家庭关系、家庭概况和患者独特的心理特征,从而确定潜在的风险因素。使用Microsoft Excel进行数据处理;采用XLSTAT软件包进行复杂的统计检验(2检验,斯皮尔曼相关系数)。结果与结论:女性更容易产生与自身发展癌症相关的恐惧。在我们的研究组中,没有发现导致严重病理性哀悼发展的危险因素。然而,处理癌症绝症患者治疗的临床医生必须在治疗计划中包括与亲属相关的以下目标:激励他们的参与,但保持分离,以保持个性;以保持他们的现实主义,并区分正常/病理性哀悼。
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引用次数: 0
QRS and QT Interval Modifications in Patients with Type 2 Diabetes Mellitus. 2型糖尿病患者QRS和QT间期的改变。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.04
Elibet Chávez-González, Yuliet María Echavarría Calero, Suruj Harrichand, Edward Bediako Mensah

Introduction: Diabetes Mellitus imbricates inflammatory processes on their pathophysiology, it could affect cardiac electrophysiology. Cardiac inflammatory process leads electrocardiogram changes. Nevertheless, there are discrepancies about whether it prolongs or decreases waves and intervals such as QRS and QT. Furthermore, QRS dispersion has not been studied.

Objective: To identify QRS complex and QT interval modifications in type 2 diabetic patients.

Methods: A descriptive cross-sectional study was carried out in 59 type 2 diabetic patients selected by non-probabilistic sampling. Electrocardiogram was performed, QRS and QT interval were measured manually by two observers. Dispersion of both variables was calculated to compare with normal values.

Results: Two variables showed differences for sex, QRS dispersion was higher in females (45.84), p=0.0001 vs. reference value; QT dispersion (63.12) showed significance difference (p=0.0246) vs. reference value for males. Greater than five years of illness was related to higher QRS values (124.11 vs. 137.28), p=0.005 and corrected QT dispersion (61.81 vs. 78.79), p=0.022.

Conclusions: The electrocardiographic differences between sexes may suggest a gender influence. The longer duration of diabetes diseases could increase cardiovascular risk of arrhythmias due to greater QRS duration and corrected QT interval prolongation.

引言:糖尿病在病理生理学上使炎症过程重叠,可能影响心脏电生理。心脏炎症过程导致心电图改变。然而,它是延长还是减少QRS和QT等波和间期存在差异。此外,QRS波的离散度尚未得到研究。目的:探讨2型糖尿病患者QRS波群和QT间期的改变。方法:对59例2型糖尿病患者进行描述性横断面研究。两名观察者进行心电图检查,手动测量QRS和QT间期。计算两个变量的离散度,以与正常值进行比较。结果:两个变量显示出性别差异,女性QRS离散度较高(45.84),与参考值相比,p=0.0001;QT离散度(63.12)与男性参考值相比有显著性差异(p=0.0246)。患病五年以上与较高的QRS值(124.11 vs.137.28),p=0.005和校正的QT离散度(61.81 vs.78.79),p=0.022有关。结论:性别之间的心电图差异可能表明性别影响。糖尿病疾病持续时间越长,由于QRS持续时间越大和校正的QT间期延长,心律失常的心血管风险就会增加。
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引用次数: 0
A Rare Case of Neglected Giant Basal Cell Carcinoma in a Nurse-Case Report and Literature Review. 一例罕见的被忽视的巨大基底细胞癌护士病例报告和文献复习。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.13
Anca Cojocaru, Olguța-Anca Orzan, Carrol Bîrjovanu, Nicolae Cătălina Andreea, Diana Petrache, Elena-Alexandra Marinescu, Marius-Eugen Ciurea

Basal cell carcinoma (BCC) is the most common skin cancer in the fair-skinned adult population over 50 years of age and the incidence is rising. Generally, BCC has an indolent course, low mortality and a good prognosis due to low rates of metastasis. Giant basal cell carcinoma is a rare reported oncological entity which accounts for 0.5% to 1% of all cases of BCC and has a diameter larger than 5cm. Basosquamous carcinoma is a rare high-risk type of BCC with clinical and histopathological features of both BCC and squamous cell carcinoma. A 61-year-old female presented to our clinic for a giant bleeding tumor located under her left breast. She initially noted the tumor almost 15 years ago. Although the patient was a nurse, she was afraid to seek medical advice until an episode of significant bleeding. At presentation the tumor was a 15/7cm in size, was invading the underlying structures and had a central ulceration. The margins of the tumoral plaque had several nodules and pearly structures suggesting the possible clinical diagnosis of BCC.

基底细胞癌(BCC)是50岁以上皮肤干燥的成年人群中最常见的皮肤癌症,发病率正在上升。一般来说,基底细胞癌病程缓慢,死亡率低,转移率低,预后良好。巨大基底细胞癌是一种罕见的肿瘤实体,占所有基底细胞癌病例的0.5%至1%,直径大于5cm。基底鳞状细胞癌是一种罕见的高危型基底细胞癌,具有基底细胞癌和鳞状细胞癌的临床和组织病理学特征。一位61岁的女性因左乳房下方的巨大出血肿瘤来到我们的诊所。她最初发现这个肿瘤大约是在15年前。尽管患者是一名护士,但她害怕寻求医疗建议,直到出现大出血。出现时,肿瘤大小为15/7cm,侵犯了下面的结构,并有中心溃疡。肿瘤斑块边缘有几个结节和珍珠状结构,提示可能的BCC临床诊断。
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引用次数: 0
The Ability of Doppler Uterine Artery Ultrasound to Predict Premature Birth. 子宫动脉多普勒超声预测早产的能力。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.05
Ioana-Victoria Camen, Maria Magdalena Manolea, Sidonia Catalina Vrabie, Maria-Sidonia Sandulescu, Mircea-Sebastian Serbanescu, Mihail Virgil Boldeanu, Simona-Daniela Neamtu, Anca-Maria Istrate-Ofiteru, Anda Lorena Dijmarescu, Marius Bogdan Novac

Objective: Demonstration of the predictive capacity of Doppler Uterine Artery (UtA) on preterm birth (PB) by serial measurement at various ages of pregnancy.

Methods: The prospective study included a group of 116 pregnant women, of whom 85 gave birth prematurely and 31 pregnant women gave birth at term, constituting the control group. UtA Doppler measurement was performed by the abdominal approach. Quantitative wave evaluations were performed by the pulsatility index (PI), the systole/diastole ratio (S/D), as well as the qualitative analysis of the flow rate waveform (notch). UtA Doppler evaluation was performed in 3 pregnancy periods: 18.0-22.6 weeks, 28.0-31.6 weeks, and 32.0-35.6 weeks.

Results: Only at the third examination, at 32.0-35.5 weeks of gestation, was there a statistically significant difference between the S/D-UtA ratio and PI-UtA correlated with the risk of premature birth (p<0.05). Although there was an association between UtA Doppler and late preterm birth, the predictive ability was low. Also, UtA Doppler was not statistically significant for preterm birth before 32 weeks of gestation.

Conclusions: Although we did not find a statistical association between second-trimester UtA Doppler and preterm birth, we do suggest a closer look at women with abnormal UtA Doppler in the second trimester. We believe that, according to the results obtained, UtA Doppler can predict especially iatrogenic premature birth depending on the prediction of the most severe complications, severe preeclampsia, and SGA.

目的:通过对不同孕龄的系列测量,验证子宫动脉多普勒(UtA)对早产(PB)的预测能力。方法:前瞻性研究包括116名孕妇,其中85名早产,31名足月分娩,构成对照组。通过腹部入路进行UtA多普勒测量。通过搏动指数(PI)、收缩/舒张比(S/D)以及流速波形(陷波)的定性分析进行定量波形评估。在3个妊娠期进行UtA多普勒评估:18.0-22.6周、28.0-31.6周和32.0-35.6周。结果:仅在妊娠32.0-35.5周第三次检查时,S/D-UtA比率和PI-UtA与早产风险之间是否存在统计学显著差异(结论:尽管我们没有发现妊娠中期UtA多普勒与早产之间的统计相关性,但我们确实建议仔细观察妊娠中期出现异常UtA多普勒的女性。我们相信,根据所获得的结果,UtA多普勒可以预测尤其是医源性早产,这取决于对最严重并发症的预测ampsia和SGA。
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引用次数: 1
Isolated Lichen Planus of the Lower Lip: Report of a Rare Case with an Updated Literature Review. 孤立性下嘴唇扁平苔藓:一例罕见病例的报告及最新文献综述。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.14
Shamimul Hasan, Shahnaz Mansoori, Keya Sircar, Deepika Bablani Popli

Lichen planus (LP) is a chronic inflammatory, autoimmune entity typically affecting the skin, oral and genital mucosa, and skin appendages, with an underlying malignant potential. Oral lichen planus (OLP) represents the mucosal counterpart of the cutaneous LP and exhibits episodes of exacerbation and remissions. OLP typically manifests as bilateral symmetrical lesions on the buccal mucosa, followed by tongue, and gingiva. However, the occurrence of LP lesions solely on the lip is rarely reported in the literature. The altered clinical appearance of the lip lesions poses a diagnostic threat and raises the possibility of a misdiagnosis. Our aim was to report an unusual case of isolated lower lip LP, and also to carry out a literature review about isolated lip LP lesions, thus, emphasizing the demographic, clinicopathologic attributes, and therapeutic regimen. We report an uncommon occurrence of an isolated lichen planus on the lower lip in a 53-year-old male patient. Clinical evaluation revealed a diffuse erosive crusted lesion bordered by peripheral lacy radiating streaks on the lower lip. After a confirmed OLP histopathology, the patient was treated with low potency topical steroids and Vaseline therapy, with almost completely resolved lesions after 2 months of therapy. We report a rare case of isolated lip LP, and our detailed review revealed 44 reported cases of lip LP till date. The majority of the cases were seen on the lower lip and exhibited an age and gender affinity (mostly in middle-aged males). Significant healing was observed after topical steroid therapy.

扁平苔藓(LP)是一种慢性炎症性自身免疫性实体,通常影响皮肤、口腔和生殖器粘膜以及皮肤附属物,具有潜在的恶性潜能。口腔扁平苔藓(OLP)是皮肤LP的粘膜对应物,表现为恶化和缓解。OLP通常表现为颊粘膜上的双侧对称性病变,其次是舌头和牙龈。然而,文献中很少报道仅在嘴唇上发生LP病变。唇部病变的临床表现改变对诊断构成威胁,并增加了误诊的可能性。我们的目的是报告一例不寻常的孤立性下唇LP病例,并对孤立性唇LP病变进行文献综述,从而强调人口统计学、临床病理特征和治疗方案。我们报告了一名53岁男性患者罕见的下唇孤立性扁平苔藓。临床评估显示,下唇有弥漫性侵蚀性硬皮病变,周围有花边辐射条纹。在证实OLP组织病理学后,患者接受了低效力局部类固醇和凡士林治疗,治疗2个月后病变几乎完全消退。我们报告了一例罕见的孤立性唇缘LP病例,我们的详细审查显示,迄今为止有44例唇缘LP报告病例。大多数病例出现在下唇,表现出年龄和性别的亲和力(主要发生在中年男性)。局部类固醇治疗后观察到明显的愈合。
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引用次数: 1
An Unusual Presentation of Bilateral Split Hand-Foot Malformation (SHFM) in Family: A Tale of Two Generations. 家族性双侧手足裂畸形的罕见表现:两代人的故事。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.16
Surya Vijay Singh, Gyanendra Puri, Anisha Elizabeth Gemmy

Split-hand/foot malformation (SHFM), also called as ectrodactyly. SHFM is a natural limb deformity, characterized by a deep standard split of the hand and/ or foot due to the absence of the central shafts. SHFM may happen as a separate existent or as part of a syndrome. Both forms are constantly established in association with chromosomal rearrangements resemblant to translocations or deletion. It is clinically and genetically diverse and shows substantially autosomal dominant heritage with variable expressivity and reduced penetrance. Cases presenting with SHFM features should be rigorously diagnosed, clinically examined, and submitted to pertinent cytogenetic and/ or molecular testing. We presented two months old male child and his paternal grandmother with SHFM.

手足裂畸形(SHFM),也称为指畸形。SHFM是一种自然的肢体畸形,其特征是由于缺乏中心轴而导致手和/或脚出现标准的深裂。SHFM可能作为一种单独存在或作为一种综合征的一部分发生。这两种形式都是与染色体重排相关的,类似于易位或缺失。它具有临床和遗传多样性,表现出明显的常染色体显性遗传,表现力可变,外显率降低。具有SHFM特征的病例应进行严格诊断、临床检查,并接受相关的细胞遗传学和/或分子检测。我们向两个月大的男孩和他的祖母介绍了SHFM。
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引用次数: 0
Educational Potential of Three-Dimensional Volumes Based on Seriate Histological Slices of First Trimester Fetal Hearts. 基于胎儿早期心脏丝氨酸组织切片的三维体积的教育潜力。
Pub Date : 2022-07-01 Epub Date: 2022-09-30 DOI: 10.12865/CHSJ.48.03.11
Dan Ruican, Ana-Maria Petrescu, Niculina Raluca Ciurea, Dominic Gabriel Iliescu

The advantages of earlier diagnosis give the family more time to adjust to the fetal cardiac and related extracardiac diagnoses and to make informed pregnancy decisions. If a severe fetal CHD is detected in the first trimester and pregnancy termination is selected, the intervention may have a lower risk for the mother's physical and mental health. Training medical staff is a crucial part of implementing obstetric ultrasonography services well, since effective patient care depends on their ability to use the equipment skillfully and interpret results properly. In many low-and middle-income nations, there is a scarcity of healthcare professionals trained to offer ultrasound services and one of the reasons for this issue is the lack of available lectures, simulations and instruments to explain how ultrasound sections are acquired. We propose an alternative method of visualizing the ultrasound planes of interest using three-dimensional volumes of fetal hearts reconstructed from seriate histological slices. This method may aid trainees in understanding echocardiography.

早期诊断的优势使家庭有更多的时间适应胎儿心脏和相关的心外诊断,并做出明智的妊娠决定。如果在妊娠早期检测到严重的胎儿CHD并选择终止妊娠,干预措施可能会降低母亲身心健康的风险。培训医务人员是良好实施产科超声服务的关键部分,因为有效的患者护理取决于他们熟练使用设备和正确解释结果的能力。在许多中低收入国家,缺乏接受过超声波服务培训的医疗保健专业人员,造成这一问题的原因之一是缺乏可用的讲座、模拟和仪器来解释如何获得超声波切片。我们提出了一种替代方法,使用从序列组织学切片重建的胎儿心脏的三维体积来可视化感兴趣的超声平面。这种方法可以帮助受训者理解超声心动图。
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引用次数: 0
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