scholarly journals Tumor characteristics and surgical outcome in incidentally discovered pheochromocytomas and paragangliomas

2018 ◽  
Vol 7 (11) ◽  
pp. 1142-1149 ◽  
Author(s):  
Xinlei Chen ◽  
Liru Hu ◽  
Caojie Liu ◽  
Guangcheng Ni ◽  
Yuwei Zhang
Keyword(s):  
Blood Pressure ◽  
Surgical Outcome ◽  
Incidental Findings ◽  
Incidental Finding ◽  
Tumor Characteristics ◽  
West China Hospital ◽  
West China ◽  
Medical Preparation ◽  
Significant Difference ◽  
Study Population

Objective The proportion of incidentally discovered pheochromocytomas and paragangliomas (PPGL) has increased over time. However, our knowledge of them is quite limited. The purpose of this retrospective study is to generalize the commonalities in incidentally discovered PPGL, offer evidence for clinical diagnosis and management. Methods Five hundred twenty-six patients were included in our study after filtration from the database of West China Hospital of Sichuan University between May, 2007 and December, 2016. Among the patients, 148 of them were incidental findings and 378 of them were suspected findings. All patients’ demography and tumor characteristics were recorded in detail, especially hemodynamic records and hormonal assays. The reasons for taking radiography were also collected. Most patients received preoperative medical preparation. Intraoperative and postoperative courses as well as surgical outcomes were also analyzed to identify differences between incidental findings and suspected findings. Results Incidentally discovered PPGL took up 28.1% of the study population. Suspected PPGLs had a higher prevalence of hypertension, lower proportion of non-functioning PPGL, higher prevalence of MEN2 and better post-surgical blood pressure recovery than incidental finding group. However, patients in the incidental finding group showed no significant difference in preoperative blood pressure and hormonal assays with suspected findings in metaphrine and normetaphrine in plasma and urine (P > 0.05). Conclusions Due to the development of technology, more PPGLs are discovered incidentally. Considering the tumor characteristics and surgical outcome, surgical decisions should be made more cautiously.

scholarly journals The Expression of Snail, Galectin-3, and IGF1R in the Differential Diagnosis of Benign and Malignant Pheochromocytoma and Paraganglioma

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Liling Deng ◽  
Tao Chen ◽  
Huan Xu ◽  
Yuanmei Li ◽  
Mingyan Deng ◽  
...  
Keyword(s):  
Survival Time ◽  
Tumor Tissue ◽  
Malignant Pheochromocytoma ◽  
Positive Staining ◽  
West China Hospital ◽  
West China ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Galectin 3 ◽  
Potentially Malignant

Objective. The aim of this study was to investigate the expression of Snail, galectin-3, and IGF1R in benign and malignant pheochromocytoma and paraganglioma (PPGL) and explore their role in the diagnosis of malignant PPGL. Methods. We retrospectively collected and analyzed surgical tumor tissue from 226 patients initially diagnosed with PPGL who underwent surgery from Jan. 2009 to Jan. 2016 at West China Hospital, Sichuan University. We observed and quantified the expression of Snail, galectin-3, and IGF1R in paraffin-embedded samples by immunohistochemical staining. Results. The significant difference in survival time among the three groups (benign PHEO, benign PGL, and potentially malignant PPGL) was compared by Kaplan-Meier survival analysis. The positive staining of Snail, galectin-3, and IGF1R in the benign PHEO group was significantly lower than that in the other three groups (P<0.001). The Kaplan-Meier survival plots indicated that the survival time of the patients with intense positive staining was significantly lower than that of the patients with weak positive staining. Conclusion. The intense expression of Snail, galectin-3, and IGF1R may be valuable indicators for the diagnosis of malignant PPGL.

scholarly journals Preoperative selective vs non-selective α-blockade in PPGL patients undergoing adrenalectomy

2017 ◽  
Vol 6 (8) ◽  
pp. 830-838 ◽  
Author(s):  
Caojie Liu ◽  
Qingguo Lv ◽  
Xinlei Chen ◽  
Guangcheng Ni ◽  
Liru Hu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Hemodynamic Instability ◽  
Postoperative Recovery ◽  
West China Hospital ◽  
Arterial Blood ◽  
Significant Difference ◽  
To Receive ◽  
Preoperative Patient

Purpose Preoperative preparation for adrenalectomy for pheochromocytomas and paragangliomas (PPGL) is universally recognized as necessary, while the optimal strategy remains controversial. Our aims were to increase intraoperative hemodynamic stability, expedite postoperative recovery, decrease side effects and reduce costs for patients with PPGL undergoing adrenalectomy. Methods We identified 526 patients undergoing open adrenalectomy for PPGL in the West China Hospital of Sichuan University between May, 2007 and December, 2016. 149 patients received preoperative selective α-blockade with phenoxybenzamine, and 377 patients received non-selective α-blockade with prazosin, doxazosin or terazosin. There were no statistical differences between groups regarding preoperative patient and tumor characteristics. Operations were planned once hypertensive patients were well-controlled with blood pressure ≤130/85 mmHg. Intraoperatively, all patients received arterial blood pressure monitoring, and indwelling urinary catheters to record urine output. We recorded intraoperative hemodynamics, status in the postanesthesia or intensive care unit, postoperative recovery and complications. Results Patients in the non-selective group showed a more significant decline in postoperative systolic blood pressure than the selective group (P = 0.041). Also, patients in the non-selective group appeared to receive a long-term anti-hypertensive effect, especially for diastolic blood pressure (P = 0.037), which was a novel finding, based on the current literature. Conclusions Our results confirmed that non-selective α-blockade produced a more significant anti-hypertensive effect than selective α-blockade. However, we found no significant difference in intraoperative hemodynamic instability, postoperative recovery and postoperative complications between groups.

scholarly journals Clinical Impact of after-consult clinic blood pressure: comparison with automated office blood pressure

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Cheol Ho Lee ◽  
Ji Hun Ahn ◽  
Joon Ha Ryu ◽  
Woong Gil Choi
Keyword(s):  
Blood Pressure ◽  
Rest Period ◽  
Office Blood Pressure ◽  
Community Based ◽  
Measure Blood Pressure ◽  
Significant Difference ◽  
Before And After ◽  
Study Population ◽  
Alternative Measurement ◽  
Automated Office Blood Pressure

Abstract Background It is most important to measure blood pressure (BP) exactly in treating hypertension. Recent recommendations for diagnosing hypertension clearly acknowledge that an increase in BP attributable to the “whitecoat response” is frequently associated with manual BP recordings performed in community-based practice. However, there was no data about after-consult (AC) BP that could reduce whitecoat effect. So we evaluated before-consult (BC) and AC routine clinic BP and research based automated office blood pressure (AOBP) measured. Methods The study population consisted of 82 consecutive patients with hypertension between April 2019 and December 2019. We measured routine clinic BP and AOBP before and after see a doctor, respectively. Seated blood pressure and pulse are measured at each time after a rest period using an automated device as it offers reduced potential for observer biases. AOBP was measured and measuring BP 3 times un-observed. We compared each BP parameter for identifying exact resting BP state. Results There was significant difference between BC and AC systolic BP (135.37 ± 16.90 vs. 131.95 ± 16.40 mmHg, p = 0.015). However there was no difference in the BC and AC diastolic blood pressure (73.75 ± 11.85 vs. 74.42 ± 11.71 mmHg, p = 0.415). In the AOBP comparison, there was also significant difference (BC systolic AOBP vs. AC systolic AOBP, 125.17 ± 14.41 vs. 122.98 ± 14.09 mmHg, p = 0.006; BC diastolic ABOB vs. AC diastolic AOBP, 71.99 ± 10.49 vs. 70.99 ± 9.83, p = 0.038). Conclusions In our study, AC AOBP was most lowest representing resting state. Although AC BP was higher than BC AOBP, it might be used as alternative measurement for reducing whitecoat effect in the routine clinical practice.

scholarly journals Radiofrequency ablation, TACE and combined treatment for multiple recurrent HCC patients within the Milan criteria

2021 ◽  
Author(s):  
Bo Zhang ◽  
Juan Wan ◽  
Xi Xu ◽  
Yongkun Li ◽  
Tao Lv ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Combined Treatment ◽  
Survival Rates ◽  
Milan Criteria ◽  
Inclusion Criteria ◽  
West China Hospital ◽  
West China ◽  
Significant Difference ◽  
Tace Group ◽  
Hcc Recurrence

Abstract Aim The aim of this study was to compare radiofrequency ablation ,TACE and their combined treatment in terms of safety and efficacy.Methods Retrospective analysis was carried out on the medical records of patients who had previously undergone curative hepatic resection and suffered multiple recurrent HCCs within the Milan criteria. The cohort of patients receiving RFA was compared to the cohort of patients receiving TACE and combined treatment. Disease outcome was investigated in terms of survival after recurrence.Results From January 2006 to April 2014, 964 patients with recurrent HCC were enrolled in the database of West China Hospital. A total of 360 patients (37.3%) were enrolled in this retrospective study based on the inclusion criteria. In these patients, 177 (49.2%) received TACE, 121 (33.6%) received RFA, and 62 (17.2%) underwent combined treatment (CT). There was a statistically significant difference between the survival rates among the 3 groups: in the TACE group, the median survival time (MST) was 25 months, with 1-, 2-, and 3-year survival rates of 93.1%, 50.0% and 26.4%, respectively; in the RFA group, the MST was 33 months, with 1- ,2-, and 3-year survival rates of 96.7%, 65.7% and 40.1%, respectively; and in the CT group, the MST was 36 months, with 1-, 2-, and 3-year survival rates of 96.8%, 78.1% and 48.6%, respectively.Conclusion Compared with TACE, RFA and combined treatment demonstrated a survival benefit for managing patients who had HCC recurrence with a total of 2–3 tumours.

scholarly journals Are there any Connections between Adrenal Myelolipoma and Hypertension?

2019 ◽  
Author(s):  
Lede Lin ◽  
Lina Gong ◽  
Wenjin Sun ◽  
Liang Cheng ◽  
Hong Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Retrospective Cohort ◽  
Antihypertensive Drugs ◽  
Benign Neoplasm ◽  
Hematopoietic Tissue ◽  
Adrenal Myelolipoma ◽  
West China Hospital ◽  
West China ◽  
Clinical Records

Abstract Background. Adrenal myelolipoma (AML) is a non-functional benign neoplasm from adrenal cortex, composed of mature fat and hematopoietic tissue. Usually, patients have no symptoms. However, some present with hypertension and blood pressure normalizes after surgery, indicating some connections between AML and hypertension. Methods . This is a retrospective cohort study of 372 patients diagnosed with AML from September 2008 to December 2018 collected in Urology Department of West China Hospital, Chengdu, Sichuan, China. We collected clinical records of patients before surgery and partial patients were done with hormone examination. Postoperative follow-up was also done for those with hypertension and whether patients needed to take antihypertensive drugs and postoperative blood pressure were recorded. We aim to explore the characteristics of both AML patients with hypertension and remission of hypertension in 1 year after surgery. Results. There were 372 AML patients included in the study, 159 males and 213 females, aged 49.77±11.64 years old. Among them, 118 patients presented with hypertension. The percentage of hypertension in each subgroup increased with age. Sixty patients were followed up for 1 to 9 years, with a median follow-up of 52 months. The course of hypertension in the remission group was shorter than that in the non-remission group (P=0.020), and tumor lateralization was significantly different between two groups (P=0.005). Conclusion. Nearly one third of AML patients suffered from hypertension in our study and there do exist some potential links between AML and hypertension.

scholarly journals Radiofrequency Ablation, TACE and Combined Treatment for Multiple Recurrent HCC Patients Within the Milan Criteria

2021 ◽  
Author(s):  
Bo Zhang ◽  
Juan Wan ◽  
Xi Xu ◽  
Yongkun Li ◽  
Tao Lv ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Combined Treatment ◽  
Survival Rates ◽  
Milan Criteria ◽  
Inclusion Criteria ◽  
West China Hospital ◽  
West China ◽  
Significant Difference ◽  
Tace Group ◽  
Hcc Recurrence

Abstract AimThe aim of this study was to compare radiofrequency ablation ,TACE and their combined treatment in terms of safety and efficacy.MethodsRetrospective analysis was carried out on the medical records of patients who had previously undergone curative hepatic resection and suffered multiple recurrent HCCs within the Milan criteria. The cohort of patients receiving RFA was compared to the cohort of patients receiving TACE and combined treatment. Disease outcome was investigated in terms of survival after recurrence.RESULTSFrom January 2006 to April 2014, 964 patients with recurrent HCC were enrolled in the database of West China Hospital. A total of 360 patients (37.3%) were enrolled in this retrospective study based on the inclusion criteria. In these patients, 177 (49.2%) received TACE, 121 (33.6%) received RFA, and 62 (17.2%) underwent combined treatment (CT). There was a statistically significant difference between the survival rates among the 3 groups: in the TACE group, the median survival time (MST) was 25 months, with 1-, 2-, and 3-year survival rates of 93.1%, 50.0% and 26.4%, respectively; in the RFA group, the MST was 33 months, with 1- ,2- , and 3-year survival rates of 96.7%, 65.7% and 40.1%, respectively; and in the CT group, the MST was 36 months, with 1-, 2-, and 3-year survival rates of 96.8%, 78.1% and 48.6%, respectively.CONCLUSIONCompared with TACE, RFA and combined treatment demonstrated a survival benefit for managing patients who had HCC recurrence with a total of 2-3 tumours.

scholarly journals Comparison of intraocular pressure among individuals with systemic hypertension and those with normal blood pressure

2020 ◽  
Author(s):  
Sanket Parajuli ◽  
Pooja Shrestha ◽  
Jeevan kumar Shrestha
Keyword(s):  
Blood Pressure ◽  
Intraocular Pressure ◽  
Normal Blood ◽  
Systemic Hypertension ◽  
Control Group ◽  
Normal Blood Pressure ◽  
Hypertensive Group ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
Study Population

Abstract Background Systemic blood pressure, by far is one of the most important factors that can have an effect on intraocular pressure. There is a limited set of studies regarding the effects of increased blood pressure on intraocular pressure. As for our knowledge, this study was first of its kind in Nepal. We have tried to compare the intraocular pressure (IOP) among patients with systemic hypertension and those with normal blood pressure. Methods A hospital based prospective case control study was conducted from March 2017 to March 2018 in the outpatient department of the department of ophthalmology in Dhulikhel hospital. A total of 100 patients with hypertension were included in case group (hypertensive group) and 100 cases with no systemic or ocular disease were included in control group (normotensive group). Mean intraocular pressures were calculated and compared along with the different range of blood pressure levels. Results Mean age of patients was 49.03 years in hypertensive group and 47.53 years in Normotensive group. Mean IOP of right eye in those with hypertension was 16.10 mmHg and in left eye was 15.8 mmHg. Similarly mean IOP of right eye in normotensive group was 15.8 mmHg and left eye was 16.2 mmHg. The difference between mean of IOP of hypertensive and normotensive individuals were not statistically significant. The prevalence of ocular hypertension in this study population was found to be 7.5% in that age group. The prevalence of primary open angle glaucoma (POAG) in this study population was found to be 1.5%. Conclusion There was no statistically significant difference in IOP between hypertensive and normotensive individuals. There was statistically significant difference in IOP in hypertensive with controlled BP and hypertensive with uncontrolled BP indicating that high BP may be associated with high IOP.

West China Hospital Back Pain Treatment Measures

2010 ◽  
Author(s):  
Ernest Volinn ◽  
Bangxiang Yang ◽  
Jing He ◽  
Xiaoming Sheng ◽  
Jian Ying ◽  
...  
Keyword(s):  
Back Pain ◽  
Pain Treatment ◽  
West China Hospital ◽  
West China ◽  
Treatment Measures

Equity in Telemedicine for Older Adults During the Covid-19 Pandemic (Preprint)

2020 ◽  
Author(s):  
Weihong Kuang ◽  
Guojun Zeng ◽  
Yunbo Nie ◽  
Yan Cai ◽  
Jin Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Paradigm Shift ◽  
Drug Prescription ◽  
Rapid Change ◽  
Policy Makers ◽  
West China Hospital ◽  
West China ◽  
Effective Strategies ◽  
Online Treatment ◽  
Treatment Disparities

UNSTRUCTURED The COVID-19 pandemic spurred unprecedented progress on a paradigm shift to telemedicine to limit exposure to the virus. Telemedicine has many benefits. In the West China Hospital of Sichuan University, we use it to do COVID-19 related tele-educations to health professionals and general population, tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, at our practices, we are noticing that many older adults could not make appointment with doctors due to their difficulty using the internet-based platform. We worried that older adults who need healthcare the most are not well prepared for this rapid change. We need to pay attention to avoid causing treatment disparities for vulnerable older adults 60 years of age and over. Researchers and policy makers should work together to study effective strategies and make proper policies to mitigate barriers older adults face when using telemedicine.

Sign in / Sign up

Export Citation Format

Share Document