Rare Case of Gastric Schwannoma Simulating Gastrointestinal Stromal Tumour-A Case Report

Gastric schwannoma (GS) is a rare, benign, slow-growing neoplasm representing 0.2% of all gastric tumors. We report a rare case of Gastric schwannoma in a 56 year old woman who presented with abdominal discomfort and vomiting since few years. Contrast enhanced Computed Tomography showed a well-defined homogeneously attenuating lesion with homogenous enhancement. Wedge gastrectomy was done with a possible diagnosis of Gastrointestinal stromal tumor, but was confirmed to have Gastric schwannoma on histopathology showing spindle cells with peripheral cuff of lymphoid aggregates and S-100 protein positivity on immunohistochemistry. Gastric schwannoma should be included in the differential diagnosis of a gastric intramural or exophytic mass when Computed Tomography shows a well-defined homogeneously attenuating lesion with progressively increasing homogenous enhancement without hemorrhage, necrosis, and degeneration.

Characteristics and clinical significance of lipid metabolism in patients with gastrointestinal stromal tumor

Background To investigate the characteristics and clinical significance of serum lipids in patients with gastrointestinal stromal tumors (GISTs). Methods The clinical and pathological data of 694 GIST patients in Liyuan hospital and Union hospital from 2012 to 2016 were retrospectively analyzed. Blood lipid levels in patients with varying degrees of risk were compared. Results The findings showed that LDL-C, HDL-C, and CHOL increased significantly in women, and CD34 positive. In patients with tumors size less than 5 cm in diameter, TG, HDL-C, and CHOL were significantly higher. TG levels were significantly higher in DOG-1 (a marker and has a high specificity and sensitivity in the diagnosis of GIST) positive patients than in DOG-1 negative patients (P < 0.05). S-100 positive patients had lower HDL-C levels than S-100 negative patients (P < 0.05). Lipids indexes were found to be correlated with GIST risk stratification and tumor site (P < 0.05). TG/HDL-C was were significantly different among patients with GIST in different locations (P < 0.05). Conclusion The clinical and pathological characteristics of the patients with GIST are closely related to the level of blood lipids. To a certain extent, information about level of blood lipids can be helpful for distinguishing benign and malignant GIST.

Multi Sistem Histiositosis Sel Langerhans pada Anak Laki-Laki Usia 2 Tahun

Histiositosis sel Langerhans (HSL) adalah kelainan langka yang ditandai dengan akumulasi dan proliferasi sel dendritik (sel langerhans). Insidensi terjadi 2-9 kasus dari 1.000.000 anak per tahun, rata-rata kasus terjadi pada anak berusia kurang dari 3 tahun. Kulit sebagai organ kedua yang paling banyak terlibat memberikan manifestasi klinis berupa krusta atau papul bersisik. Insidensi HSL cukup langka, tanda dan gejala yang bervariasi menyebabkan sulitnya mendiagnosis dalam waktu singkat. Seorang anak laki-laki usia 2 tahun datang dengan keluhan bintil kemerahan pada area kepala. Bintil kemerahan bertambah berat dan semakin meluas hingga bagian badan. Pemeriksaan fisik terdapat papul bersisik berwarna merah kecoklatan pada area kulit kepala, dahi, belakang telinga, leher dan trunkus. Pemeriksaan histopatologi menunjukan epidermis sebagian tersusun intak, dermis dengan sebukan sel histiosit, sel plasma, eosinofil, kesan sel mast dan leukosit PMN. Pemeriksaan imunohistokimia CD117 ditemukan sel langerhans pada sebagian sel dan ditemukan sel langerhans dengan pewarnaan CD117, CD-1a dan IHC S-100 dari trunkus anterior. Diagnosis HSL ditegakkan berdasarkan temuan histopatologi pada dermis terdapat sebukan sel histiosit dan imunohistokimia ditemukan sel langerhans. Pasien mendapat terapi sistemik berupa kemoterapi dan terapi topikal pada lesi kulit krim dengan krim mometason dan salep gentamisin pada area erosi. Pengamatan pada hari ke 30 perawatan pasien menunjukan perbaikan sistemik dan lesi kulit. HSL merupakan kasus jarang. Pemeriksaan biopsi histopatologi dapat menegakkan diagnosis definitif dengan ditemukannya morfologi sel langerhans atau granula Birbeck yang dikonfirmasi pemeriksaan immunofluoresen protein S100 positif, antigen CD1a atau langerin immuhistokimia dengan menggunakan mikroskop elektron. Berdasarkan keterlibatan organ HSL diklasifikasikan menjadi single sistem HSL dan multi sistem HSL. Tatalaksana bergantung pada kriteria klasifikasi HSL. Multi sistem HSL memiliki prognosis buruk karena keterlibatan organ berisiko dan regresi spontan jarang terjadi

THỰC TRẠNG NHIỄM NẤM MỐC, ALFLATOXIN VÀ TRANG THIẾT BỊ BẢO QUẢN DƯỢC LIỆU TẠI MỘT SỐ BỆNH VIỆN THUỘC TỈNH NGHỆ AN, HIỆU QUẢ CAN THIỆP, NĂM 2019

Mục tiêu: Áp dụng kỹ thuật nuôi cấy nấm trong môi trường Saboraud xác định tỷ lệ nhiễm nấm trong các vị thuốc đông dược. Áp dụng kỹ thuật sắc ký khí lỏng hiệu năng cao định lượng alflatoxin trong dược liệu. Đầu tư các thiết bị làm thay đổi các điều kiện vi khí hậu làm giảm tỷ lệ nhiễm nấm mốc trong các vị thuốc đông dược. Vật liệu và phương pháp nghiên cứu: Đề tài thiết kế bằng phương pháp nghiên cứu mô tả và nghiên cứu labo với 505 mẫu dược liệu trong danh mục thuốc thiết yếu theo quy định của Thông tư 05/2015/TT-BYT, 262 mẫu dược liệu tương ứng với 262 mẫu cấy nấm (+) được xét nghiệm định lượng alflatoxin, 10 bệnh viện có hoạt động chuyên môn về y học cổ truyền tại tỉnh Nghệ An năm 2019 được bổ sung các thiết bị điều hòa nhiệt độ, máy hút ẩm, túi hút ẩm, quạt thông gió. Kết quả: Đã xác định tỷ lệ nhiễm nấm mốc ở dược liệu là 51,8%, tỷ lệ nhiễm alflatoxin chung ở dược liệu là 4,75%, tỷ lệ nhiễm alflatoxin ở các mẫu dược liệu cấy nấm (+) là 9,10%, trong đó, tỷ lệ các mẫu có hàm lượng alflatoxin vượt tiêu chuẩn Việt Nam QCVN 8-1:2011/BYT trong các mẫu có nhiễm alflatoxin là 66,7%(16/24). 100% các kho dược liệu không đạt các điều kiện vi khí hậu bảo quản dược liệu (nhiệt độ trung bình > 30°C, độ ẩm trung bình > 70%, tốc độ gió trung bình < 0,5m/s). 100% các kho dược liệu không được trang bị các thiết bị hút ẩm, điều hòa nhiệt độ và độ ẩm. Kết luận: Tỷ lệ nhiễm nấm mốc trong dược liệu tại một số bệnh viện tại Nghệ An tương đối cao 51,8%. Việc đầu tư trang thiết bị làm giảm đáng kể tỷ lệ nhiễm nấm mốc từ 51,8% xuống còn 18,99%.

Combinatorial therapy using RNAi and curcumin nano-architectures regresses tumors in breast and colon cancer models

This novel combination of curcumin (CU)–chitosan (CS) nanocomposites conjugated to Ephb4 shRNA encapsulated with Eudragit S-100 (ES) has been developed to combat breast and colorectal cancers murine models.

Primary Bartholin Adenocarcinoma: a Rare Case and Radiotherapy as Definitive Treatment

Primary vulvar adenocarcinoma is a very rare neoplasm, accounting for only 1% of all gynecologic malignancies. Most of the glandular carcinomas originated from the Bartholin&rsquo;s gland. Because of the rare incidence, the pathogenesis and radiotherapy response are not fully understood. A 47-year-old female from our hospital was diagnosed with primary Bartholin adenocarcinoma and received radiotherapy as definitive treatment. We evaluated the presence of high-risk and low-risk human papillomavirus (HPV) DNA to associate the role of HPV infection, and evaluated its molecular features by the expression of vimentin, p16, estrogen receptor, progesterone receptor, S-100, and Ki 67.

Rosai-Dorfman Disease of Bone and Soft Tissue

Context.— Rosai-Dorfman disease is a rare histiocytic proliferative disorder of unknown pathogenesis that may be diagnostically difficult in extranodal sites. It is commonly an unsuspected diagnosis when arising in bone and soft tissue, especially when it presents without associated lymphadenopathy. Its variable clinical presentation and nonspecific imaging findings make the diagnosis quite challenging, particularly in small biopsies. The problem is compounded by its less-characteristic histomorphologic features in comparison with nodal disease. Awareness of the potential diagnostic pitfalls in Rosai-Dorfman disease of bone and soft tissue should raise the degree of diagnostic accuracy. Objective.— To review the clinical manifestations, imaging characteristics, and histomorphologic features of Rosai-Dorfman disease of bone and soft tissue along with a brief discussion of its differential diagnosis, pathogenesis, and current management. Data Sources.— Thorough review of the literature with focus on clinical manifestations, imaging findings, key histomorphologic features, pathogenesis, and treatment. Conclusions.— The diagnosis of Rosai-Dorfman disease of bone and soft tissue may be quite challenging because of its variable clinical presentation and nonspecific imaging findings. It may be asymptomatic without systemic manifestations or associated lymphadenopathy. The definitive diagnosis relies on histopathologic identification of the characteristic S-100–positive histiocytes demonstrating emperipolesis. Bone and soft tissue lesions tend to have lower numbers of characteristic histiocytes and less conspicuous emperipolesis and often demonstrate areas of fibrosis or storiform spindle cell areas resembling fibrohistiocytic lesions. Awareness of these unusual features is necessary in order to consider Rosai-Dorfman disease in the differential diagnosis when confronting these rare and often misleading lesions.

Perencanaan Tempat Evakuasi Sementara Untuk Bencana Tsunami di Kelurahan Pasir Nan Tigo Kota Padang

Pasir Nan Tigo merupakan salah satu dari 104 kelurahan yang ada di Kota Padang yang merupakan bagian dari Kecamatan Koto Tangah. Kelurahan ini terletak di sebelah Utara dan di pesisir pantai Kota Padang. Berdasarkan Peta Evakuasi Tsunami Kota Padang, seluruh daerah kelurahan ini berada pada daerah genangan atau zona merah namun masih belum memiliki Tempat Evakuasi Sementara (TES) untuk bencana tsunami untuk itu dilakukan perencanaan gedung TES. Perencanaan yang digunakan dalam mendesain gedung ini adalah dengan mengumpulkan data pengamatan dan pengukuran pada gedung TES yang telah ada di kota padang serta memperhatikan Pedoman Teknik Perencanaan Tempat Evakuasi Sementara (TES) Tsunami oleh Pusat Penelitian Mitigasi Bencana Institut Teknologi Bandung yang mengacu kepada peraturan perundang-undangan dan FEMA-USA (P646-2012). Berdasarkan hasil perencanaan, didapatkan gedung TES multifungsi yang berlokasi di Jalan Pasir Jambak, Kelurahan Pasir Nan Tigo, Kecamatan Koto Tangah, Kota Padang dengan koordinat 0°51’00”S - 100°19’35”E. Gedung TES ini memiliki luas 42 x 24 m dan ketinggian 5 lantai yang dapat menampung hingga 3.024 jiwa dengan lantai 3 s/d 5 yang difungsikan sebagai area evakuasi.

Hydrological Analysis In Selecting Flood Discharge Method In Watershed Of Kelara River

For Engineers involved in planning and construction of water resources building, hydrology becomes very important data. In terms of planning stage in water resources especially waterworks, it is known that design flood discharge closed to field realistic conditions is often needed in order that a planned construction is able to control flood discharge. Several previous researches in choosing flood discharge selection method have diverse depending on observed watershed. One method in determining selected flood discharge by verification using Creager diagram, by comparing discharge calculation results of several Synthetic Unit Hydrograph (SUH) with infrastructure flood discharge (AWLR result) in observation point. This research aims to obtain the most suitable synthetic unit hydrograph and close to analysis result of measured discharge frequency, and Creager diagram in Kelara watershed (DAS). Based on the calculation of design flood discharge according to rainfall data using synthetic unit hydrograph of Nakayasu, ITB I, ITB II, and SCS (HEC-HMS) as well as the calculation of design flood discharge according to collected data, it is concluded that the synthetic unit hydrograph method closest to design flood discharge with measured discharge rate and Q1000 rate of Creager diagram is SCS. Flood discharge rate obtained according to HSS SCS method using HEC-HMS 4.8 application in period of 2 years is 658,40 m3/s, 25 years is 682,70 m3/s, 50 years is 787,00 m3/s, 100 years is 885,70 m3/det, and 1000 years is 1202,60 m3/s