scholarly journals Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis

2019 ◽  
Vol 13 (08) ◽  
pp. 706-713
Author(s):  
Jin-sun Yang ◽  
Zhi-xiang Du
Keyword(s):  
Lymph Node ◽  
Ultrasound Imaging ◽  
Clinical Symptoms ◽  
Granulomatous Inflammation ◽  
Neutrophil Infiltration ◽  
Histiocytic Necrotizing Lymphadenitis ◽  
Group A ◽  
Necrotizing Lymphadenitis ◽  
Lymph Node Tuberculosis ◽  
Group B

Introduction: The aim of this study was to investigate the basis for a differential diagnosis of lymph node tuberculosis and histiocytic necrotizing lymphadenitis. Methodology: This study selected 85 cases of lymph node tuberculosis (Group A patients) and 26 cases of histiocytic necrotizing lymphadenitis (Group B patients). The clinical and pathology features on both groups were analysed. Results: The Group A patients were older than the Group B patients (t = 5.233, P < 0.01); The Group B patients had less tuberculosis exposure history (x2 = 4.279, P < 0.01), and a higher frequency of tenderness (χ2 = 8.109, P < 0.01) and fever (x2 = 31.923, P < 0.01). The Group A patient group had a higher WBC level (t = 2.980, P < 0.01) and lower serum ALB (t = 5.508, P < 0.01); As seen through ultrasound imaging, Group B patients had more clear boundaries (70.59%), higher low-echo rates (82.36%) and low calcification rates (0%), Group A patients for whom these rates was 25.76%, 40.91% and 25.76% respectively. In terms of pathology data, the main manifestations of Group A patients were granulomatous inflammation with caseous necrosis, multinuclear giant cell reaction, and in some cases, acid-fast bacilli smears (+). In Group B patients, there were instances of coagulative necrosis surrounded by foam-like tissue cells without neutrophil infiltration. Conclusion: We found that the epidemiological history, clinical symptoms, laboratory examinations, ultrasound imaging and changes in pathology are very important for the identification of lymph node tuberculosis and histiocytic necrotizing lymphadenitis.

scholarly journals Intermittent Self Dilation – An Option For The Prevention of Urethral Stricture Recurrence After Filliform Follower Urethral Dilation

2018 ◽  
Vol 14 (2) ◽  
pp. 38-40
Author(s):  
N M Shrestha
Keyword(s):  
Urethral Stricture ◽  
Clinical Symptoms ◽  
Urine Test ◽  
Group A ◽  
Prospective Comparative Study ◽  
Foley’S Catheter ◽  
Group B ◽  
Stricture Recurrence ◽  
Urethral Dilation ◽  
Lower Urinary

Background: Urethral stricture and its recurrence is still a major problem in male. Several procedures are present for the treatment of the disease. Lapides introduced the concept of intermittent self dilatation (ISD) which has decreased the incidence of recurrence of urethral stricture if doing properly. The aim of the this study was to report the outcomes of ISD for the treatment of urethral stricture after Filliform follower urethral dilatation (FFUD).Method: This was a prospective comparative study, conducted in the department of surgery, urology unit from March 2013 to February 2016. Total of 49 patients were enrolled and were randomly divided into Group A and Group B. In Group A, all the patients were taught ISD with Nelaton Catheter after FFUD. In group B, all patients underwent only FFUD for urethral stricture. In both groups, Foley's catheter was removed after 2 weeks of FFUD. These patients who had difficulty In passing urine or having lower urinary tract syndrome after removal of catheter, were evaluated for urethral stricture recurrency by clinical symptoms, ultrasonography, urine test for culture and sensitivity, cystoscopy/urethrogram as necessarily.Result: In Group A, 4 patients out of 20(20%)developed urethral stricture recurrency where as in Group B,18 patients out of 23 (78.26%) developed urethral stricture recurrency. Therefore, the rate of urethral stricture recurrence is significantly more in group B than the Group A (p< 0.001).Conclusion: ISD is an effective way for the prevention of urethtral stricture recurrence after FFUD. JNGMC,  Vol. 14 No. 2 December 2016, Page: 38-40

Prevention of Frey’s Syndrome with the Use of Porcine Dermal Collagen Graft: Retrospective Analysis of 76 “Formal” Parotidectomies for Benign Pathologies

2021 ◽  
pp. 000348942199018
Author(s):  
Kostas Vahtsevanos ◽  
Angelos Chatziavramidis ◽  
Ioannis (Yiannis) Papadiochos ◽  
Georgios Koloutsos ◽  
Anastasios Stefanidis ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Frey’S Syndrome ◽  
Randomized Controlled Studies ◽  
Parotid Surgery ◽  
Porcine Dermal Collagen ◽  
Frey's Syndrome ◽  
Dermal Collagen ◽  
Group A ◽  
Group B ◽  
Collagen Graft

Background: Frey’s syndrome is a well-known complication of parotid surgery; its prevention may be achieved by the use of an interpositional barrier between the overlying flaps and the exposed parenchymal bed of parotid gland. The aim of this study was to retrospectively evaluate clinical outcomes with and without the interpositional placement of a porcine dermal collagen graft (PDCG) for prevention of syndrome occurrence. Methods: We conducted a 20-year retrospective study including the patients who had undergone “formal” (superficial, total, or subtotal) parotidectomies for benign pathologies. The inclusion criteria also involved patients that were (i) regularly monitored about clinical symptoms related to syndrome, and (ii) examined with Minor starch-iodine test. The severity of the diagnosed syndrome was retrospectively evaluated according to the grading score system of Luna-Ortiz. To assess group differences in terms of the extent of dissection in operating sites, we estimated the tumor and histological specimen volumes using the available dimensions. Results: We included 73 patients who had undergone 76 formal parotid surgeries. The surgical sites were divided into 2 groups: (1) Group A consisted of 44 sites that were reconstructed with a SMAS flap, and (2) Group B, comprised 32 sites where a PDCG was additionally applied as an artificial preventive barrier. At a mean follow-up of 26.3 months, a significantly lower incidence of clinically diagnosed Frey’s syndrome was found after the use of dermal collagen interpositional barrier ( P = .031). Specifically, subjective symptoms were reported at an incidence of 31.8% in Group A and 6.7% in Group B. Minor’s test was positive at an incidence of 59.09% in Group A and 21.87% in Group B ( P = .004, 95% CI). Severe Frey’s syndrome was observed in 31.82% of the patients of Group A and in 3.12% of the patients of Group B ( P = .002, 95% CI). Since there were no statistical significant differences between the volumes of the removed tumors and the excised histological specimens, the extent of dissection was not proved to influence the occurrence of Frey’s syndrome in the compared groups, Conclusion: Porcine dermal collagen is a safe, practical, and useful means for parotid reconstruction, since it seems to contribute in prevention of Frey’s syndrome when increased amount of glandular tissue has to be removed. Additional randomized controlled studies with bigger samples are required to better assess the PDCG use in parotid surgery.

scholarly journals Tall Cell Variant versus Conventional Papillary Thyroid Carcinoma: A Retrospective Analysis in 351 Consecutive Patients

2020 ◽  
Vol 10 (1) ◽  
pp. 70
Author(s):  
Alessandro Longheu ◽  
Gian Luigi Canu ◽  
Federico Cappellacci ◽  
Enrico Erdas ◽  
Fabio Medas ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Papillary Carcinoma ◽  
Papillary Thyroid ◽  
Tall Cell Variant ◽  
Group A ◽  
Tall Cell ◽  
Cell Variant ◽  
Group B

Background: The aim of this retrospective study was to investigate clinical and pathological characteristics of the tall cell variant of papillary thyroid carcinoma compared to conventional variants. Methods: The clinical records of patients who underwent surgical treatment between 2009 and 2015 were analyzed. The patients were divided into two groups: those with a histopathological diagnosis of tall cell papillary carcinoma were included in Group A, and those with a diagnosis of conventional variants in Group B. Results: A total of 35 patients were included in Group A and 316 in Group B. All patients underwent total thyroidectomy. Central compartment and lateral cervical lymph node dissection were performed more frequently in Group A (42.8% vs. 18%, p = 0.001, and 17.1% vs. 6.9%, p = 0.04). Angiolymphatic invasion, parenchymal invasion, extrathyroidal extension, and lymph node metastases were more frequent in Group A, and the data reached statistical significance. Local recurrence was more frequent in Group A (17.1% vs. 6.3%, p = 0.02), with two patients (5.7%) in Group A showing visceral metastases, whereas no patient in Group B developed metastatic cancer (p = 0.009). Conclusions: Tall cell papillary carcinoma is the most frequent aggressive variant of papillary thyroid cancer. Tall cell histology represents an independent poor prognostic factor compared to conventional variants.

PRECIPITATING FACTORS AND EFFICACY OF COMBINING LACTULOSE PLUS RIFAXIMIN IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY DUE TO CIRRHOSIS AT CHO RAY HOSPITAL

2020 ◽  
pp. 63-68
Author(s):  
Phat Ho Tan ◽  
Tam Vu Thi Minh ◽  
Trong Huynh Nguyen Dang ◽  
Phuong Tran Nhat Thi Anh ◽  
Ngan Tran Thi Kim ◽  
...  
Keyword(s):  
Hepatic Encephalopathy ◽  
Gastrointestinal Bleeding ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
P Value ◽  
Precipitating Factors ◽  
Overt Hepatic Encephalopathy ◽  
Group A ◽  
Group B ◽  
Male To Female

Background: Hepatic encephalopathy is an important evidence that confirms impairment of liver function, may occur in about 40% of cirrhotics. Data about efficacy of rifaximin plus lactulose in the treatment of Vietnamese patients was still limited. This study aimed to determine the precipitating factors and to access the efficacy of lactulose plus rifaximin in overt hepatic encephalopathy. Patients and Methods: The prospective single-blind randomized controlled trial, 43 cirrhotics with overt hepatic encephalopathy without portal systemic shunting addmitted to gastroenterology department of Cho Ray Hospital from March 2019 to August 2019, were randomized into two groups (group A lactulose plus rifaximin 1.100 mg/day, n = 21; and group B only lactulose; n = 22). All patients were recorded for onset factors, clinical characteristics and assessing the recovery of hepatic encephalopathy. Results: The mean age of patients in this study was 54.8 ± 12.1 years (the ratio of male to female patients is 4.38 : 1). The leading cause of cirrhosis was alcohol (39.5%). The most common clinical symptoms were jaundice (83.7%), spider naevi (41.9%) and ascites (37.2%). The most common triggers were infection (51.2%), gastrointestinal bleeding (37.2%) and constipation (25.6%). The percentage of patients with complete improvement after treatment with lactulose plus rifaximin was 81% compared to 63.6% in the lactulose-treated patients only (95% CI: 0.539 - 1.147, p value = 0.206). Conclusion: Our data revealed that common triggers of hepatic encephalopathy were infections, gastrointestinal bleeding and constipation. The combination of lactulose plus rifaximin was more effective than rifaximin alone in the treatment of overt hepatic encephalopathy. Key words: hepatic encephalopathy, precipitating factor, lactulose, rifaximin

scholarly journals Kikuchi necrotizing lymphadenopathy: a tip of the iceberg disease?

2021 ◽  
Vol 8 (9) ◽  
pp. 1602
Author(s):  
Sushil Singla ◽  
Mohitesh Kumar ◽  
Vinod Kumar Jat ◽  
Deepika Parwan
Keyword(s):  
Lymph Node ◽  
Laboratory Test ◽  
Young Patient ◽  
Healthy Individual ◽  
Cervical Lymphadenopathy ◽  
Lymph Node Biopsy ◽  
Histiocytic Necrotizing Lymphadenitis ◽  
Benign Condition ◽  
Node Biopsy ◽  
Necrotizing Lymphadenitis

Kikuchi-Fujimoto disease (KFD) is a rare benign condition also called histiocytic necrotizing lymphadenitis, which typically presented as fever with cervical lymphadenopathy in previously healthy individual. We presented a case of 11 year old boy with fever and cervical lymphadenopathy since 2 months. Lymph node biopsy was performed which suggested of KFD and was treated symptomatically. KFD incidence is rare but clinicians should be alert if young patient comes with fever and cervical lymphadenopathy to lower the chance of unwanted laboratory test and harmful treatment. 

Single-Port Endoscopic Sentinel Lymph Node Biopsy Combined with Indocyanine Green and Carbon Nanoparticles in Breast Cancer: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Zi-Han Wang ◽  
Tian-Ran Gang ◽  
Shan-Shan Wu ◽  
Can Lu ◽  
Guo Xuan-Gao ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Carbon Nanoparticles ◽  
Detection Rate ◽  
Single Port ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Group A ◽  
Group B

Abstract PurposeIndocyanine green (ICG) is an efficient tracer method used in sentinel lymph node biopsy (SLNB). The application of single-port endoscopic-assisted technology in the field of breast cancer is widely accepted. In order to explore the surgical safety of single-port endoscopic-SLNB (SPE-SLNB) and the reliability of axillary staging, we combined it with ICG that was excited by near-infrared fluorescence endoscopy and carbon nanoparticles (CN) as a tracer and compared this method to conventional open SLNB (C-SLNB).MethodsSixty patients with early breast cancer were recruited and divided into three groups. Twenty patients who underwent SPE-SLNB combined with ICG and CNs were placed in group A. Twenty patients who underwent SPE-SLNB with CNs only were placed in group B. Twenty patients who underwent C-SLNB with ICG and CNs were placed in group C.ResultsThe detection rate of SLNs was 100% in group A, 100% in group B, and 95% in group C. In total, 97 SLNs were detected in group A, 65 SLNs were detected in group B, and 98 SLNs were detected in group C . ConclusionThe novel technique of combining ICG and CNs with SPE-SLNB and the utilization of the endoscopic fluorescence imaging system achieved the same detection rate and mean number of SLNs as C-SLNB. Therefore, for patients who meet the indications, SPE-SLNB is as safe and reliable as C-SLNB.

Suboccipital and cervical chordomas: the value of aggressive treatment at first presentation of the disease

2002 ◽  
Vol 97 (5) ◽  
pp. 1070-1077 ◽  
Author(s):  
Alexandre Carpentier ◽  
Marc Polivka ◽  
Alexandre Blanquet ◽  
Guillaume Lot ◽  
Bernard George
Keyword(s):  
Clinical Symptoms ◽  
Rank Test ◽  
Aggressive Treatment ◽  
Actuarial Survival ◽  
High Tendency ◽  
Content Type ◽  
Log Rank Test ◽  
Group A ◽  
Group B ◽  
Fine Print

Object. Chordoma is a locally invasive tumor with a high tendency for recurrence for which radical resection is generally recommended. To assess the benefits of aggressive treatment of chordomas, the authors compared results in patients treated aggressively at the first presentation of this disease with results in patients who were similarly treated, but after recurrence. Methods. Among 36 patients with cervical chordomas who were treated at the authors' institution, 22 underwent primary aggressive treatment (Group A) and 14 were treated secondarily after tumor recurrence (Group B). Two cases were excluded from Group A because of unrelated early deaths and three from Group B because of insufficient pre- or postoperative data. Most tumors were located at the suboccipital level and only eight cases at a level below C-2. Radiotherapy and proton therapy were similarly conducted in both groups of patients. The actuarial survival rates were 80 and 65% at 5 and 10 years, respectively, in Group A patients and 50 and 0% at 5 and 10 years, respectively, in Group B patients (p = 0.049, log-rank test). The actuarial recurrence-free rates were 70 and 35% at 5 and 10 years, respectively, in Group A and 0% at 3 years in Group B (p < 0.0001, log-rank test). The numbers of recurrences per year were 0.15 in Group A and 0.62 in Group B (p > 0.05). All other parameters that were analyzed (patient age, delay before diagnosis, clinical symptoms, chondroid type of lesion, and histological features) did not prove to influence prognosis in a statistically significant manner. Conclusions. Aggressive therapy, combining as radical a resection as possible with radiotherapy, seems to improve the prognoses of suboccipital and cervical chordomas when applied at the patient's first presentation with the disease.

CLO19-049: Central Lymph Node Dissection in the Clinically Node-Negative (cN0) Papillary Thyroid Carcinoma: Is it Necessary?

2019 ◽  
Vol 17 (3.5) ◽  
pp. CLO19-049
Author(s):  
Girish M. Suresh ◽  
C. Ramachandra ◽  
Ravi Arjunan ◽  
Rajshekar Halkud
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Postoperative Complication ◽  
Central Compartment ◽  
Central Neck ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Group A ◽  
Group B

Background: Surgery is the treatment of choice in papillary thyroid cancer (PTC), which is the most common thyroid malignancy and frequently has metastases in the central compartment lymph nodes (CLN). There is debate among surgeons whether removing normal-appearing lymph nodes in the central neck (prophylactic lymph node dissection) is better than removing only the abnormal-appearing lymph nodes. Herein, we review the potential utility of central compartment lymph nodal dissection (CLND) on surgical outcome and disease-free follow-up of PTC and 5-year survival of patients operated on at our center. Methods: A total of 246 patients from February 2009 to March 2012 who were treated for PTC in our Kidwai Cancer Institution was analyzed retrospectively. 135 patients who underwent total thyroidectomy and CLND were assigned to Group A, which was compared with 111 patients who received total thyroidectomy, without CLND, who were assigned to Group B by evaluation of postoperative complications (recurrent laryngeal nerve damage, hoarseness, hypocalcemia, and hemorrhage rates) and recurrence at the time of Iodine131 treatment and subsequently at 60 months follow-up. Results: In the present study, Mean DFS and OS did not differ in both groups. Male gender and age more than 45 years had statistically significant DFS but without any impact on OS. There was a significant postoperative complication in group A compared to group B (P≤.001), with a very minimal recurrence in the central neck. 4 patients (3.6%) had recurrences in CLN. Conclusion: Considering the significant postoperative complication, which outweighs benefit, we conclude that for cN0 PTC, routine CLND is not necessary.

Could Enzyme Replacement Therapy for Long Time Normalize Chitotriosidase Activity in Type 1 Gaucher Disease?.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3802-3802
Author(s):  
Pilar Giraldo ◽  
Pilar Alfonso ◽  
Juan Perez-Calvo ◽  
Manuel Giralt
Keyword(s):  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Bone Disease ◽  
Clinical Symptoms ◽  
Analytical Data ◽  
Enzyme Replacement ◽  
Group A ◽  
Group B

Abstract Background: Extreme elevations of plasma chitotriosidase (CT) are observed in Gaucher’s disease (GD) patients. This enzyme has been considered as a response marker to enzyme replacement therapy (ERT). It has been previously described the normalization of enzymatic activity only in patients who have been treated by bone marrow transplantation (Young E et al, 1997). It is widely accepted that GD subjects receiving ERT show improvements in clinical symptoms and regression of signs of disease, such as disappearance or reduction of visceral enlargement, normalized haematological parameters and skeletal improvement and also reduce the CT activity values, but these do not actually reach a normal range. Surprisingly, in the follow-up of patients included in the Spanish Gaucher Registry, some cases showed normalization of their CT activity after several years under therapy. The purpose of this study is to analyze the clinical, analytical and genotype characteristics of type 1 GD patients that have normalized their CT activity and to compare with the rest of patients under ERT for same period of follow-up. Patients and Methods: We have studied a cohort of 64 type 1 GD patients receiving ERT. We observed 20 GD patients who reach a normal CT activity range (CT activity < 200 nmol/mL.h) under therapy 2–7 years (group A) and 44 GD patients whose CT activity maintained increased under therapy 2–10 years (group B). Clinical and analytical data have been obtained from Spanish GD registry. Assessment of response included serial measurement of haemoglobin (Hb), platelet count, liver and spleen sizes and CT activity. Plasma CT activity was measured with the fluorogenic substrate 4-methylumbelliferyl-β-D-N, N′, N″ triacetylchitotrioside. Determination of the 24-bp duplication in the CT gene was performed by PCR followed by electrophoresis of the amplified fragments. For statistical analysis we used the StatView database (version 4.5). Results: At baseline characteristics of both groups were as indicated in tables. Patients of group B had worse indicators of disease severity at baseline. SSI, percentages of bone disease and spleen removal were higher in group B than group A. In addition we found twice more heterozygous patients for 24 bp duplication of the CT gene in group A compared to group B Nevertheless, as the table shows, patients of group B received higher doses of ERT and for a longer time. Conclusion: The normalization of CT activity is infrequent in GD patients under ERT. It is influenced by CT genotype and probably by severity of disease. Clinical data Age at diagnosis Male/Female SSI Spleen removal(%) Bone disease (%) N370S Homozygous/N370S Heterozygous N: number, SSI: severity score system Analytical data Group A (n=20) 32 ± 15.0 7/13 7.6 ± 2.55 5 55 0/20 Group B (n=44) 29 ± 15.9 19/25 8.4 ± 3.15 27 66 5/39 Analytical data Hb (g/dL) Platelets x 109/L CT activity(nmol/mL.h) Heterozygous CT genotype(%) ERT Dose (Units/2 weeks) N: number; Hb: Haemoglobin; CT: chitotriosidase; ERT: Enzyme replacement theraphy Group A (n=20) 12.3 ± 1.85 72.8 ± 31.27 7,489 ± 3,751 65 34.3 ± 10.33 Group B (n=44) 11.9 ± 1.84 107.5 ± 83.85 8,459 ± 3,563 32 41.4 ± 15.08

Reduction of Breast Cancer Lymph Node Metastasis by Nano-Carbon Absorption of 5-Fluorouracil

2020 ◽  
Vol 12 (3) ◽  
pp. 407-412
Author(s):  
Junheng Bai ◽  
Tingyu Guo ◽  
Wenwen Dong ◽  
Yingming Song ◽  
Tingfang Guo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Clinical Effect ◽  
Control Group ◽  
Observation Group ◽  
Group A ◽  
Node Metastases ◽  
Nano Carbon ◽  
Group B ◽  
And Control

To observe the clinical effect of nano-carbon adsorption of 5-fluorouracil (5-FU) on Breast cancer lymph node metastasis in New Zealand rabbits. A breast cancer animal model was established by local injection of a VX2 tumor tissue suspension in thirty New Zealand rabbits. An observation group, control group A, and control group B were established using a random number table, with ten rabbits in each group. Once tumors with a diameter ≥5 mm were identified in the lymph nodes, the animals received the intervention. The observation group had nano-carbon-5-FU suspension subcutaneously injected, control group A had 5-FU subcutaneously injected through the ear margin, and control group B had 5-FU subcutaneously injected; all received a drug dose of 30 mg · kg–1. Half of the animals in the three groups were killed following treatment for thirty minutes, while the rest of the animals were killed following treatment for seven days. Tumors and lymphatic metastases were removed. Tumor and lymphatic metastasis volume were compared. H&E stained sections were used to determine the ND of tumor cells. A dTUP TUNEL assay using Terminal Deoxynucleotidyl Transferase (TdT) was used to assess tumor cell apoptosis. The expression level of casapase-3 mRNA in tumors and lymphoid tissues was determined using RT-PCR. After treatment for 30 mins, the observation group exhibited a significantly higher 5-FU concentration in lymph node metastases, and significantly lower 5-FU concentrations in plasma and tumors. Nano-carbon can increase the 5-FU concentration in tumor tissue, as well as enhance the clinical effect of drugs on lymph node metastases.

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