Pleomorphic lobular breast carcinoma: A review of 35 cases at a single institution.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 175-175
Author(s):  
J. A. Cox ◽  
M. A. Eltorky ◽  
M. J. Wolski ◽  
J. D. Sturgeon ◽  
M. M. Joyner ◽  
...  
Keyword(s):  
Invasive Lobular Carcinoma ◽  
Clinical Stage ◽  
Lobular Carcinoma ◽  
Case Series ◽  
Progression Free Survival ◽  
Rank Test ◽  
Significant Difference ◽  
Pleomorphic Lobular Carcinoma ◽  
Large Case Series ◽  
Large Case

175 Background: Pleomorphic lobular carcinoma (PL) is an aggressive subtype of invasive lobular carcinoma. A previous report of 52 patients showed an increase in development of metastases for pleomorphic lobular carcinoma patients. There are relatively few case series reporting on this aggressive form of breast cancer. This report features a descriptive and survivorship comparison of a large case series of PL reviewed by a single breast pathologist. Methods: From 1993-2010 we retrospectively reviewed 198 cases of invasive lobular carcinomas, 35 cases (34 patients with one patient presenting with 2 independent cancers) of PL and 163 cases of non-pleomorphic invasive lobular carcinoma (NPL). The pathology was reviewed by a single breast pathologist and classified as either PL or NPL according to WHO classification. Kaplan-Meier survivals were computed and compared with a log rank test using SPSS 18. Overall survival (OS) was computed from date of diagnosis to date of last update (02/01/11). Progression free survival (PFS) until either local or metastatic failure was also computed. Results: The median follow-up was 59.5 months and 73 months, for NPL and PL patients respectively. The median age of diagnosis was 55 (range 40-80) and 58.67 (range 36-89) for PL and NPL groups. Of the NPL group, 75.5% were post-menopausal as opposed to 67.6% in the PL group. PL cases were ER positive 87.1% vs. 90.1% of the NPL cases. Her-2/neu status was known in nearly 50% of cases with 17 positive NPL cases and 5 positive PL cases. Clinical stage at presentation was stage IIB or less in 67.6% of the PL patients and 80.1% of the NPL patients. Six patients presented (17.6%) with metastatic disease in the PL group and 12 patients (7.7%) in the NPL group. None of the descriptive comparisons above were significantly different by χ2 analysis. PFS at 5 years was 30% and 21% in PL and NPL patients, respectively (p=0.73). OS at 5 years was 68.5% for PL patients and 83.9% for NPL patients (p=0.031). Conclusions: In this large case series of PL cases reviewed by a single breast pathologist, PL patients showed a statistically significant decreased OS, but no significant difference in PFS, at 5 years from diagnosis.

scholarly journals L-Asparaginase, Doxorubicin, Vincristine, and Prednisolone (LHOP) Chemotherapy as a First-Line Treatment for Dogs with Multicentric Lymphoma

Animals ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 2199
Author(s):  
Jih-Jong Lee ◽  
Albert Taiching Liao ◽  
Shang-Lin Wang
Keyword(s):  
Clinical Stage ◽  
Progression Free Survival ◽  
Cell Phenotype ◽  
Chop Chemotherapy ◽  
First Line ◽  
Canine Lymphoma ◽  
Free Survival ◽  
Significant Difference ◽  
Multicentric Lymphoma ◽  
First Line Treatment

Cyclophosphamide exhibits the weakest therapeutic effect compared with vincristine and doxorubicin in the CHOP (C, cyclophosphamide; H, doxorubicin; O, vincristine; and P, prednisolone) chemotherapeutic protocol for the treatment of canine lymphoma. Twenty dogs with multicentric lymphoma were treated using the LHOP protocol, which used l-asparaginase in place of cyclophosphamide, and the outcomes were historically compared with those of dogs that received CHOP chemotherapy in the same institution. No significant differences were found in age (p = 0.107), body weight (p = 0.051), sex (p = 0.453), clinical stage V (p = 1), substage b (p = 0.573), T-cell phenotype (p = 0.340), overall response (p = 1), and hypercalcaemia status (p = 1) between the LHOP and CHOP groups. The adverse effects of l-asparaginase were well tolerated and self-limiting. The median PFS (progression-free survival) and median ST (survival time) in the LHOP group were 344 days (range: 28–940 days) and 344 days (range: 70–940 days), respectively. The median PFS and median ST in the CHOP group were 234 days (range: 49–1822 days) and 314 days (range: 50–1822 days), respectively. The dogs that received LHOP chemotherapy had a significantly longer PFS than the dogs that received CHOP chemotherapy (p = 0.001). No significant difference was observed in ST between the LHOP and CHOP groups (p = 0.131). Our study findings thus indicate that the LHOP protocol can be used as a first-line chemotherapeutic protocol in canine multicentric lymphoma.

Myelopathy Due to CAR-T Related Neurotoxicity Treated with Siltuximab

2021 ◽  
pp. 10.1212/CPJ.0000000000001078
Author(s):  
Yasmin Aghajan ◽  
Alison Yu ◽  
Caron A. Jacobson ◽  
Austin I. Kim ◽  
Leslie Kean ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cell Therapy ◽  
Chimeric Antigen Receptor ◽  
Hematologic Malignancy ◽  
Case Series ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Car T ◽  
Large Case Series ◽  
Large Case

Chimeric antigen receptor T (CART) cell therapy is highly effective for relapsed/refractory hematologic malignancy [1,2]; however, cytokine release syndrome (CRS) and neurotoxicity are observed in up to 77% of patients [3]. In large case series, the most common presentations of neurotoxicity were encephalopathy (57%), headache (42%), tremor (38%) and aphasia (35%). CART mediated spinal cord toxicity is not well characterized. Structural neurologic damage (stroke and intracranial hemorrhage) was only observed in 1-2% and seizures were seen in 1%-8% of cases [3, 4]. Neuroimaging findings in patients with neurotoxicity are rare and not specific.

Chemoradiotherapy is an Alternative Choice for Patients with Primary Mediastinal Seminoma

2021 ◽  
Author(s):  
Yirui Zhai ◽  
Bo Chen ◽  
Xiaoli Feng ◽  
Kan Liu ◽  
Shulian Wang ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Progression Free Survival ◽  
Poor Performance ◽  
Rank Test ◽  
Clinicopathologic Characteristics ◽  
Cancer Specific Survival ◽  
Adjacent Structures ◽  
Significant Difference ◽  
Mediastinal Seminoma ◽  
Alternative Choice

Abstract Background: The low incidence of primary mediastinal seminomas has precluded the development of clinical trials on mediastinal seminomas. We investigated the clinicopathologic characteristics, prognosis of patients with primary mediastinal seminomas as well as the efficiency of nonsurgical treatments compared with treatments containing surgery.Methods: We retrospectively collected data on the clinicopathologic characteristics, treatments, toxicities, and survival of 27 patients from a single center between 2000 and 2018. Patients were divided into two groups according to whether they received operation. Survivals were assessed using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test.Results: The median age was 28 (13-63) years. The most common symptoms were chest pain (29.6%), cough (25.9%), and dyspnea (22.2%). There were 13 and 14 patients in surgery and non-surgery group. Patients in the non-surgical group were more likely to be with poor performance scores (100% vs.76.9%) and disease invaded to adjacent structures(100% vs.76.9%) especially great vessels(100% vs.46.2%).The median follow-up period was 32.23 (2.7-198.2) months. There was no significant difference of overall survival (5-year 100% vs 100%), cancer-specific survival (5-year 100% vs.100%), local regional survival (5-year 91.7% vs.90.0%, p=0.948) , distant metastasis survival (5-year 100.0% vs. 90.9%, p=0.340) and progression-free survival (82.5% vs.90.0%, p=0.245) between patients with and without surgery. Conclusions: Primary mediastinal seminoma was with favorable prognosis, even though frequently invasion into adjacent structures brings difficulties to surgery administration. Chemoradiotherapy is an alternative treatment with both efficacy and safety.

scholarly journals Donor Screening for Fecal Microbiota Transplantation

2020 ◽  
Vol 95 (3) ◽  
pp. 181-187
Author(s):  
Han Hee Lee ◽  
Young-Seok Cho
Keyword(s):  
Randomized Clinical Trials ◽  
Fecal Microbiota Transplantation ◽  
Case Series ◽  
Fecal Microbiota ◽  
Resistant Bacteria ◽  
Screening Process ◽  
Antibiotic Resistant ◽  
Donor Screening ◽  
Large Case Series ◽  
Large Case

Fecal microbiota transplantation (FMT), which has been established as the standard treatment for recurrent <i>Clostroides</i> difficile infection, may also play a role in the management of other diseases associated with dysbiosis of the gut microbiota. To ensure efficacy and safety of FMT, an appropriate donor screening process is required. The main purpose of donor screening is to check for infectious diseases that could be transmitted to the recipient. The screening process involves a medical history questionnaire, and blood and stool testing. Several randomized clinical trials and large case series on FMT reported no, or few, adverse events related to infection by following this donor screening process. However, there is still concern over the transmission of antibiotic-resistant bacteria. In addition, a low donor acceptance rate due to rigorous screening makes donor recruitment difficult, and also imposes a significant cost burden. A consensus on the most crucial elements of donor screening is needed for wide application of FMT.

Macular dysfunction in patients with macula-on rhegmatogenous retinal detachments

2018 ◽  
Vol 103 (3) ◽  
pp. 404-409 ◽  
Author(s):  
Kunihiko Akiyama ◽  
Kaoru Fujinami ◽  
Ken Watanabe ◽  
Toru Noda ◽  
Yozo Miyake ◽  
...  
Keyword(s):  
Case Series ◽  
Oscillatory Potentials ◽  
Implicit Time ◽  
Rank Test ◽  
Macular Function ◽  
Giant Retinal Tear ◽  
Significant Difference ◽  
The Status ◽  
Signed Rank Test ◽  
Fellow Eyes

AimsTo assess macular function in patients with macula-on rhegmatogenous retinal detachments (RRDs) using focal macular electroretinography (FMERG).MethodsThis is a prospective, observational case series of 27 patients diagnosed with a macula-on RRD. Foveal attachment was confirmed on spectral-domain optical coherence tomography. Eyes with any macular disorder, cataract, vitreous opacity or vitreous haemorrhage were excluded. FMERG was recorded in the affected and fellow eyes using a round stimulus 15° in diameter. The status of four retinal factors in the affected eyes was examined, that is, the number of involved quadrants, number of quadrants with retinal breaks, presence of an RRD invading the vascular arcade, and presence of a giant retinal tear. The implicit time and amplitude of the a-wave, b-wave and oscillatory potentials (OPs) were compared between the affected and fellow eyes using Wilcoxon signed-rank test. The influence of the four retinal factors on each FMERG component of the affected eyes was also evaluated using Mann-Whitney U test and Kruskal-Wallis test.ResultsSignificant reductions in the amplitudes of the a-waves (p=0.001), b-waves (p<0.001) and OPs (p=0.001) were observed in the affected eyes compared with the fellow eyes. There was no significant difference between the affected and fellow eyes in the implicit times of any components. None of the four retinal factors affected the parameters in the affected eyes.ConclusionAltered FMERG responses suggested the presence of macular dysfunction in eyes with macula-on RRDs.

Comparison of auricular and rectal temperature measurement in normothermic, hypothermic, and hyperthermic dogs

2014 ◽  
Vol 42 (01) ◽  
pp. 13-19 ◽  
Author(s):  
B. D. Kruse ◽  
R. Müller ◽  
C. Stockhaus ◽  
K. Hartmann ◽  
A. Wehner ◽  
...  
Keyword(s):  
Body Temperature ◽  
Relative Humidity ◽  
Temperature Measurement ◽  
Rectal Temperature ◽  
Environmental Temperature ◽  
Case Series ◽  
Limits Of Agreement ◽  
Large Case Series ◽  
Healthy Dogs ◽  
Large Case

Summary Objective: Measurement of rectal temperature is the most common method and considered gold standard for obtaining body temperature in dogs. So far, no study has been performed comparing agreement between rectal and auricular measurements in a large case series. The purpose of the study was to assess agreement between rectal and auricular temperature measurement in normothermic, hypothermic, and hyperthermic dogs with consideration of different environmental conditions and ear conformations. Materials and methods: Reference values for both methods were established using 62 healthy dogs. Three hundred dogs with various diseases (220 normothermic, 32 hypothermic, 48 hyperthermic) were enrolled in this prospective study. Rectal temperature was compared to auricular temperature and differences in agreement with regard to environmental temperature, relative humidity, and different ear conformations (pendulous versus prick ears) were evaluated using Pearson’s correlation coefficient and Bland-Altman analysis. Results: Correlation between rectal and auricular temperature was significant (r: 0.892; p < 0.01). However, Bland-Altman plots showed an inacceptable variation of values (bias: 0.300 °C; limits of agreement: –0.606 to 1.206 °C). This variation was above a maximal clinical tolerance of 0.3 °C, which was established by experts’ opinion (n = 16). Relative humidity had a significant influence (p = 0.001), whereas environmental temperature did not. Conclusion: Variation between the two methods of measuring body temperature was clinically unacceptable. Clinical relevance: Although measurement of auricular temperature is fast, simple, and well tolerated, this method provides a clinically unacceptable difference to the rectal measurement.

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