DOCSLIB.ORG

The Apparently Beneficial Effects of Concurrent Infections, Inflammation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Apparently Beneficial Effects of Concurrent Infections, Inflammation THE APPARENTLY BE EFIGAL EFFECTS OP GONG RRENT INFECTIONS INPLAMMATIO OR FEVER A D OF BACTERIAL TOXI T TIIER \PY O EUROBLASTOMA * GEORGE A . FOWLER, M .D. AND HELEN C. NAUTS MO OGRAPH # 11 NEW YORK CA CER RESEARCH I STITUTE, I C. 1225 PARK AVE E EW YORK, .Y. 10028 E W YORK 1970 INDEX I TRODUCTIO1 . I CONCURRENT I FECTION, I NFLAMMATIO , FEVER SERIES A, 18 CASES Table I IO Detailed Histories 16 TOXIN TREATED CASES \0 SERIES B, g CASES Table 2 . 48 Detailed Histories 52 BIBLIOGRAPHY 79 We are indebted to C. Everett Koop, M.D. for his thoughtful review of this manuscript and for his helpful suggestions. INTROD CTTO~ THE APPAREi\'TLY BE~EFJCL\ L EFFECT ' OF CO.'.\ RRE~T I FEC- TlON , I~FLA?llllfr\TJO:\' OR FEVER, A.:'\D OF BACTERIAL TOXl THER.\PY 001 ~E ROBL.\ 'TO;\L\ This LUdy of neuroblasLO ma compri e Lhc kno\\·n ca es of Lhi Lypc of tumor in whom baCLerial toxin Lherapy was admini tcr cl (eiglu), or m "horn oncurrcnL acuLe infecL ion, inllammaL ion or lever o urred, (cigluecn). 01\IE CLINI AL FACTS ABOUT ~Fl"ROBLASTO.\IA Ncuroblastoma is found in infancy and cJ1ildhoocl and originate from Lis ue from which- Lhe adrenal medulla or oLher ponion of the y.m pa the tic nervous system develop. Approximately 15 per cent of all ancer in chil- dren are ncurobla LOma . In the majority of patients with untreated neurobla ·LOmas, rneLa La cs develop oon and there i a rapidly downhill cour e re ulting in death in a few month. Because of the rapid growth of this LUmor, a hilcl well 12 to 14 month after LreatmenL wiLh no evid nee or re urren c, probably may be on idered cured. (M) fL er biop y or incomplete urgical remornl, an infection, fever or with• out known cau c, chi lllmor may undergo pontan ou hemorrhage and necro­ is and regre · compleLcly or may undergo maturation Lo become a benign gang I ioneuroma. 1 • urobla toma was [ir t de cribed by l\larchand in 1 91 as beino· derived from neural structure. (43) lt wa not until 1910 that the) were e ·tabli hcd as a eparate and di tinct clinical entity by the hi LOlogical ob crvation o[ \\ right. (77) 'I hey are neurogenic in origin and are om Lime rel erred to a ncurobla LOma or a sym1 athcticobla LOrna , as they ari e from the undif. ferentiated cells o[ the sympathetic nen-ou ) Lem. Th ir origin i not con­ fined to adrenal ti uc. They may al o arise in the sympathetic gangli ons along the ·pine, e pe ially in the ce rvical area. They are more 0111111011 in males. tmren grouped the tumors of the ympathetic nervou y tem imo the f llowing: congenital n urobla Loma, neurobla ti ar oma, ganglion urobla • LOma and ganglioneuroma. (67) The first two are indi Linguishable anatomi• ca Ji y blll must be separated bccau e of difference in bi logical behavior. Ii congenital ncurobla toma probably alway occur within the first six years of life and i fatal in 70'.fi: of the ca c. The neurobla ti aroma occur with random frequency throughout life and is invariably fatal. The ganglioncuroma i a benign LUmor of mature Li ue. It occur mainly in the adult age group. The ganglioneurobla Loma i a tumor which combine fcaLUres of both nor­ mal ganglionic ti ue and neuroblas torna. It i · c cntiall y only a histological de ignation rather than a distinct entity. He reported that 69% arc fatal. (67) I ncidence of Ne11roblasto111as: l oop Lated that neurobla Lom a was Lhe mo t common tumor treated at the Children's Ho pital in Philadelphia. (39) Dar• geon Lated that it is one of the more 0111111011 cancer ob erved on the Pediatric Service at Memorial Ho pita!. From 1926 to 1958 a Lota! of l ,49 ch ildr n uffering from neopla tic di ea e were aclmiLLecl Lo Lhi ervice, I 0 of whom had neuroblastoma. (12) Initial ymptom: The iniLial ympLOrn may be pain referred to the spine or legs, but in at lea t half the cases an enlarged palpable abdominal mas will be the mo t prominent ob en·ation. The clinical s •mptom produced by an expanding retroperitoneal ma in infants and children include gastro­ inte Lina] disturbance, debility, anemia, blo d changes, and signs uggestive of acu te abdominal condition . "\\'hen an abdominal mas is felt it should i INTRODUCTION be co nsidered maligna nL unLil p roved o Lh erwi e. (54) Less often symptoms are !referable ini Lia ll y LO Lhe che t, perip heral nodes, kin or a ingle bone. tumor of the orbit or eye itse lf is not uncom mon. In some the metastati c le ions first attract attention. Loss of weight i u ually prese nt, there may be emes is and when first seen the child i pale, uncle rnouri heel and irritable. Jn ome ca e swelling about the face or skull is noted; proptosis o( one or bo Lh e es with di co lorati on o f li d is om mon d ue to increa eel intracrani al pre sure and orbital metastases. In all uch cases choked discs are prese nt. Enlarged lymph node occur ea rl y or late. Bone pain from meta ta cs may be the predominant fea ture a t thi ti me. The clinical cour e i usually a rapid decline with death in a few month . Structure and Jl istolog;y : Structu ra ll y the5e tumors arc rather o(t, h emor­ rh agic growLhs, Lh c cu t surf'aces of which are white or ye ll owish in olor, with necroti c and hemorrhagic areas, and which d i pla a distin ct lobulati on. i\Ii­ croscopica ll y thi lobula Li on is fo und to be cl ue to the d ivi ion o( Lh c tumor growth by strands or bundle of connec ti ve ti sue; the heavier tra ncls are continuous with mallcr stra nd of conne ti,·e tis uc fiber whi ch further su b­ divide the lobules. Hi tologi ally these lobules vary in appearance : so me may he extrc111 cly cellular, co n isting of ce lls with sma ll round h ypo hromati c nu lei and urrounded by an ex treme! narrow rim of cy topla m which tend · to fl ow o uL into processc . Often there are LO be seen tran itional tages in their development wi th neurobl a t , ga ngli on cell , nerve fiber and cap ular ce lls. T he more acl va n eel tage of diffe rentiati on the le s malignant the g rowth, the less cellular the area and the more abundant the intcrcellular n twork of fibrillac, some of which may be traced to Lh ei r nerve cell . The fo m1a ti on of ro ettes by the cells i one of the characteristic, but some authors have een ro cttcs in onl y a third of their case . T he ro ette con i t of a ircular arrangemen t of cell about bundles of fibrillae. The charactcri ti c cell is similar LO the primitive migrating ce ll s of the sy mpa theti c nervo us ys tcm. ome authors believe that the e tumors are moderately radio- cnsitive, others do no t. Certa in pathologist bcli e,·e Lhat neuroblastoma and retinobla LO ma are essentially imilar neoplasms. Cu hi ng and 'i\Tolbach were the fir t LO report that a malignant neuro­ bl a toma may matura te into a benign ganglioneuroma. (11 ) T hey described such a ca e in " ·hich thi oc urrecl fo ll owing pro longed ad.m ini trati on of Coley toxins alone ( ee below, erie B, Ca c 1). Other reporting ca es of mawra ti on of Li te e tumors include Eyrebrook and H ewer (18), GrecnEielcl and Shell ey (29), McFarland and appington (42) and W ya tt and Farber (7 ). T h latt r a l o ob en ·ed tha t neurobl a LO ma may undergo spontan­ e u hemorrhage a nd necro ·i · and di appear witho uL any trea tment other than bi ops . fliffere11t ial Diagnosi Willi (74) and a few other authors have noted the imi larity of neurobla torna meta tati c in bone to Ewing' sarcoma: both m a ha,·e roset Le mi roscopically. However, Ewing's sarcoma u ually occur in later hildhoocl and ha the characteri tic oni n kin appearance roen tgenologically. hcrman and Leeming n oted that neopla m said to be confused with neuro­ bla toma are Ewing's arcoma, primary reticulum cell sarcoma of bone and rare! even certain o teogenic arcoma . Thi i an added rea on why the ro lllg nologi t hould be fam ili ar with the x-ray a ppearance of this tumor. (60) In the pre en t tud , eries B, Ca ·e 3 and 4 were initially regarded as E wing' ar oma and a e 5 a nd 6 " ·ere regarded a reticulum cell sarcoma. 2 INTRODUCTION THERAPY a) Surge1y: Farber ( I 9) and Koop (39) have sla Led that the first Lep in the treatment of any solid intra-abdominal mas in early li[e should be urgical removal.
Load more

Recommended publications
  • Cervical Schwannoma: Report of Four Cases
    25-Cervical_3-PRIMARY.qxd 7/10/12 5:22 PM Page 345 CASE REPORT Cervical Schwannoma: Report of Four Cases Rohaizam Jaafar, MD (UKM), Tang Ing Ping, MS ORL-HNS (UM), Doris Evelyn Jong Yah Hui, MS ORL-HNS (UKM), Tan Tee Yong, MS ORL-HNS (UM), Mohammad Zulkarnaen Ahmad Narihan, MPATH (UKM) School of Health Sciences, Health Campus, Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. SUMMARY Physical examination revealed a 3 x 3 cm mass located at Extracranial schwannomas in the head and neck region are right lateral upper third of the cervical region. The mass was rare neoplasms. The tumours often present as asymptomatic, firm, mobile and non-tender. She had a right facial nerve slowly enlarging lateral neck masses and determination of palsy (House-Brackman Grade IV) due to a previous operation the nerve origin is not often made until the time of surgery. for a right acoustic neuroma in 2000 and a right supraorbital Preoperative diagnosis maybe aided by imaging studies such wound for a plexiform schwannoma in 2007. as magnetic resonance imaging or computed tomography, while open biopsy is no longer recommended. The accepted A computed tomography of the neck and thorax was treatment for these tumors is surgical resection with performed and showed a well defined, minimally enhancing preservation of the neural pathway. We report four cases of lesion at the left parapharyngeal space measuring 2.4 x 4.3 x cervical schwannomas that we encountered at our center 10 cm. The left carotid sheath vessel is displaced medially. during four years of period.
    [Show full text]
  • P-CRESIDINE for POSSIBLE CARCINOGENICITY
    National Cancer Institute CARCINOGENESIS Technical Report Series No. 142 1979 BIOASSAY OF p-CRESIDINE FOR POSSIBLE CARCINOGENICITY CAS No. 120-71-8 NCI-CG-TR-142 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service National Institutes of Health BIOASSAY OF p-CRESIDINE FOR POSSIBLE CARCINOGENICITY Carcinogenesis Testing Program Division of Cancer Cause and Prevention National Cancer Institute National Institutes of Health Bethesda, Maryland 20014 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service National Institutes of Health DHEW Publication No. (NIH) 79-1397 REPORT ON THE BIOASSAY OF p-CRESIDINE FOR POSSIBLE CARCINOGENICITY CARCINOGENESIS TESTING PROGRAM DIVISION OF CANCER CAUSE AND PREVENTION NATIONAL CANCER INSTITUTE, NATIONAL INSTITUTES OF HEALTH FOREWORD: This report presents the results of the bioassay of p-cresidine conducted for the Carcinogenesis Testing Program, Divi­ sion of Cancer Cause and Prevention, National Cancer Institute (NCI), National Institutes of Health, Bethesda, Maryland. This is one of a series of experiments designed to determine whether selected chemicals have the capacity to produce cancer in animals. Negative results, in which the test animals do not have a significantly greater incidence of cancer than control animals, do not necessarily mean the test chem­ ical is not a carcinogen because the experiments are conducted under a limited set of circumstances. Positive results demonstrate that the test chemical is carcinogenic for animals under the conditions of the test and indicate a potential risk to man. The actual determination of the risk to man from animal carcinogens requires a wider analysis. CONTRIBUTORS; This bioassay of p-cresidine was conducted by Mason Research Institute, Worcester, Massachusetts, initially under direct contract to the NCI and currently under a subcontract to Tracor Jitco, Inc., prime contractor for the NCI Carcinogenesis Testing Program.
    [Show full text]
  • Gastrointestinal Stromal Tumor: Clinicopathological Characteristics and Pathologic Prognostic Analysis Chayanit Jumniensuk1 and Mongkon Charoenpitakchai2*
    Jumniensuk and Charoenpitakchai World Journal of Surgical Oncology (2018) 16:231 https://doi.org/10.1186/s12957-018-1532-1 RESEARCH Open Access Gastrointestinal stromal tumor: clinicopathological characteristics and pathologic prognostic analysis Chayanit Jumniensuk1 and Mongkon Charoenpitakchai2* Abstract Objective: This study aimed to understand clinicopathological characteristics of gastrointestinal stromal tumors (GISTs) and correlation between pathologic features and clinical outcome. Methods: We used 76 cases diagnosed as primary GISTs during January 2007 to July 2017 at Army Institute of Pathology, Thailand. Clinical, survival, and pathological data were collected and analyzed. Results: Ages of the patients ranged from 15 to 88 years (M:F = 1:1). The most common presentation was gastrointestinal bleeding (39.7%). The most common site was the stomach (64.5%). Tumor size ranged from 0.6 to 25.5 cm (average 8.78 cm). Histologic types were spindle cell type (75%), mixed spindled-epithelioid type (17.1%), and epithelioid type (7.9%). The majority of histologic subtype was diffuse hypercellularity (67.1%). Tumor necrosis was found in 38.1% and 80% showed low mitotic counts. Most gastrointestinal stromal tumors (27.6%) are low-risk category according to Miettinen and Lasota’s algorithm. Metastasis was found in 27.7%, mostly occurs within 2 years, and is correlated with tumor size > 10 cm (P = 0.023), non-spindle cell histologic type (P = 0.027), mitotic count > 5/5mm2 (P = 0.000), myxoid change (P = 0.011), and mucosal invasion (P = 0.002). Recurrence was found in 8.1%, mostly occurs within 7 years, and correlated with myxoid change (P = 0.045).
    [Show full text]
  • Case Report Head and Neck Schwannomas: a Surgical Challenge—A Series of 5 Cases
    Hindawi Case Reports in Otolaryngology Volume 2018, Article ID 4074905, 10 pages https://doi.org/10.1155/2018/4074905 Case Report Head and Neck Schwannomas: A Surgical Challenge—A Series of 5 Cases Ishtyaque Ansari,1 Ashfaque Ansari,2 Arjun Antony Graison ,2 Anuradha J. Patil,3 and Hitendra Joshi2 1Department of Neurosurgery, MGM Medical College & Hospital, Aurangabad, India 2Department of ENT, MGM Medical College & Hospital, Aurangabad, India 3Department of Plastic Surgery, MGM Medical College & Hospital, Aurangabad, India Correspondence should be addressed to Arjun Antony Graison; [email protected] Received 25 September 2017; Accepted 29 January 2018; Published 4 March 2018 Academic Editor: Abrão Rapoport Copyright © 2018 Ishtyaque Ansari et al. +is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. +ey originate from any nerve covered with schwann cell sheath. Schwannomas constitute 25–45% of tumors of the head and neck. About 4% of head and neck schwannomas present as a sinonasal schwannoma. Brachial plexus schwannoma constitute only about 5% of schwannomas. Cervical vagal schwannomas constitute about 2–5% of neurogenic tumors. Methods. We present a case series of 5 patients of schwannomas, one arising from the maxillary branch of trigeminal nerve in the maxillary sinus, second arising from the brachial plexus, third arising from the cervical vagus, and two arising from cervical spinal nerves. Result. Complete extracapsular excision of the tumors was achieved by microneurosurgical technique with preservation of nerve of origin in all except one.
    [Show full text]
  • Tumors of the Brachial Plexus (XI-1)
    E. LOCAL SYNDROMES OF THE UPPER LIMBS AND RELATIVELY GENERALIZED SYNDROMES OF THE UPPER AND LOWER LIMBS GROUP XI: PAIN IN THE SHOULDER, ARM, AND HAND Tumors of the Brachial Plexus (XI-1) Definition Progressive aching, burning pain with paresthesias and sensory and motor impairment in the distribution of a branch or branches of the brachial plexus due to tumor. Site Shoulder and upper limb. System Nervous system. Tumors Benign tumors: schwannoma, neurofibroma. Malignant tumors: malignant schwannoma and fibrosarcoma, metastatic neoplasm or direct invasion from other lesion, neuroblastoma, ganglioneuroma (secondary neoplasia of peripheral nerves occurs frequently in lymphoma, leukemia, multiple myeloma). Breast, lung and thyroid neoplasia frequently involve the brachial plexus. Main Features Incidence: the specific tumors of peripheral nerve are extremely rare. Sex Ratio: there is no sex predilection. Age of Onset: young adulthood. They are more common with von Recklinghausen’s disease. Pain Quality: the pain tends to be constant, gradual in onset, aching, and burning, and associated with paresthesias in the distribution of the pain, progressive wasting of muscles depending upon what groups are involved, and sensory loss. Intensity: severe. Associated Symptoms The pain is generally not affected by activity. There is associated sensory loss and muscle wasting depending upon the area of the brachial plexus involved. Pain relief is often not adequate, even with significant narcotics. Signs and Laboratory Findings The laboratory findings are those of the underlying disease. Signs are loss of reflexes, sensation, and muscle strength in the distribution of the involved portion of the plexus. There may be a local mass. The diagnosis is usually made promptly by X-ray or by CT scan.
    [Show full text]
  • Sciatic Neuropathy from a Giant Hibernoma of the Thigh: a Case Report
    A Case Report & Literature Review Sciatic Neuropathy From a Giant Hibernoma of the Thigh: A Case Report Salim Ersozlu, MD, Orcun Sahin, MD, Ahmet Fevzi Ozgur, MD, and Tolga Akkaya, MD ibernomas—rare, uniformly benign soft-tissue the gastrocnemius/soleus, posterior tibialis, and toe flexors tumors of brown fat—were originally described (tibial nerve-innervated muscles); and sensory abnormali- in 1906 by Merkel.1 These tumors are usually ties throughout the entire sciatic nerve distribution. The found in the scapular2 and posterior cervical common peroneal, posterior tibial, superficial peroneal, Hregions or (more rarely) in the folds of the buttocks or on and sural nerves were electrodiagnostically evaluated, and the thigh.3-5 reduced amplitude in the peroneal and the tibialis poste- Sciatic neuropathy is an infrequently diagnosed focal rior nerves was detected. Sensory nerve conduction of the mononeuropathy. Few case reports of lipomas compressing superficial peroneal and sural nerves in the left leg was the sciatic nerve or its peripheral branches have appeared in less than that in the right leg. These findings confirmed the literature.6-8 The present case report is to our knowledge active motor and sensory sciatic mononeuropathy of the the first on sciatic nerve palsy caused by a hibernoma. left leg. Plain x-rays of the left leg showed a large soft-tissue CASE REPORT mass without calcification. Magnetic resonance imaging A woman in her early 30s was referred to our clinic with a (MRI) of the left leg revealed a well-circumscribed large painless left-side posterior thigh mass that had been slowly soft-tissue mass that was 27 cm at its maximum dimen- enlarging over 5 years.
    [Show full text]
  • Arxiv:1204.3809V1 [Q-Bio.QM] 17 Apr 2012 Servicio De Oncolog´Iaradioter´Apica.Hospital General Universitario De Ciudad Real, 13005 Ciudad Real, Spain
    Bulletin of Mathematical Biology manuscript No. (will be inserted by the editor) Hypoxic Cell Waves around Necrotic Cores in Glioblastoma: A Biomathematical Model and its Therapeutic Implications Alicia Mart´ınez-Gonz´alez · Gabriel F. Calvo · Luis A. P´erezRomasanta · V´ıctorM. P´erez-Garc´ıa Received: date / Accepted: date Abstract Glioblastoma is a rapidly evolving high-grade astrocytoma that is distinguished pathologically from lower grade gliomas by the presence of necro- sis and microvascular hiperplasia. Necrotic areas are typically surrounded by hypercellular regions known as pseudopalisades originated by local tumor ves- sel occlusions that induce collective cellular migration events. This leads to the formation of waves of tumor cells actively migrating away from central hypoxia. We present a mathematical model that incorporates the interplay among two tumor cell phenotypes, a necrotic core and the oxygen distribution. Our simu- lations reveal the formation of a traveling wave of tumor cells that reproduces the observed histologic patterns of pseudopalisades. Additional simulations of the model equations show that preventing the collapse of tumor microvessels leads to slower glioma invasion, a fact that might be exploited for therapeutic purposes. Keywords Glioblastoma multiforme; tumor hypoxia; pseudopalisades; invasion; mathematical model Mathematics Subject Classification (2010) 92C50 · 35Q80 · 92C17 A. Mart´ınez-Gonz´alez,V. M. P´erez-Garc´ıa Departamento de Matem´aticas,E. T. S. I. Industriales and Instituto de Matem´aticaApli- cada a la Ciencia y la Ingenier´ıa,Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain. E-mail: [email protected], [email protected] G. F. Calvo Departamento de Matem´aticas,E.
    [Show full text]
  • Numb Chin Sydrome : a Subtle Clinical Condition with Varied Etiology
    OLGU SUNUMU / CASE REPORT Gülhane Tıp Derg 2015;57: 324 - 327 © Gülhane Askeri Tıp Akademisi 2015 doi: 10.5455/gulhane.44276 Numb chin sydrome : A subtle clinical condition with varied etiology Devika SHETTY (*), Prashanth SHENAI (**), Laxmikanth CHATRA (**), KM VEENA (**), Prasanna Kumar RAO (**), Rachana V PRABHU (**), Tashika KUSHRAJ (**) SUMMARY Introduction One of the rare neurologic symptoms characterized by hypoesthesia or Numb Chin Syndrome (NCS) is a sensory neuropathy cha- paresthesia of the chin and the lower lip, limited to the region served by the mental nerve is known as Numb chin syndrome. Vast etiologic factors have been racterized by altered sensation and numbness in the distribu- implicated in the genesis of numb chin syndrome. Dental, systemic and malignant tion of the mental nerve, a terminal branch of the mandibular etiologies have been well documented. We present a case of a 59 year old female patient who reported with all the classical features of numb chin syndrome. On division of trigeminal nerve. Any dysfunction along the course magnetic resonance imaging, the vascular compression of the trigeminal nerve of trigeminal nerve and its branches, intracranially and ext- root was evident which has been infrequently documented to be associated with racranially either by direct injury or compression of the nerve the condition. We have also briefly reviewed the etiology and pathogenesis of 1 numb chin syndrome and also stressed on the importance of magnetic resonance can predispose to NCS. Various etiologic factors have been imaging as an investigative modality in diagnosing the condition. considered of which dental procedures and dental pathologies Key Words: Numb Chin Syndrome, Mental nerve neuropathy, trigeminal nerve root, are the most common benign causes.
    [Show full text]
  • Diagnostic Quality Control Exam Review of Answers
    Question 1 50-year-old healthy male with a family history of colorectal carcinoma presents with a rapidly growing nodule on the left nasal sidewall. A biopsy was performed, and he was referred for MMS. Review the 1st stage (H&E stain) section, and select the true statement: A. This is a basal cell carcinoma and will stain with BerEP4. B. This is a merkel cell carcinoma and will stain with CK20. C. This is a sebaceous carcinoma and may show loss of staining with MSH2, MSH6 or MLH1. D. This is a squamous cell carcinoma and will stain with cytokeratin stains. Discussion Question 1 Correct Answer: C. This is a sebaceous carcinoma and may show loss of staining with MSH2, MSH6 or MLH1. Fig. 1 – Collection of atypical basaloid cells with prominent nucleoli that exhibit vacuolization within the cytoplasm indicating sebocytic differentiation. Main Histologic Features: Dermally based basaloid tumor that forms a uniformly nested or lobular pattern and does not demonstrate peripheral palisading or clefting On high power, cells demonstrate multivacuolated foamy cytoplasm and scalloped nuclei designating sebocytic differentiation May demonstrate infiltrative features including invasion into the subcutis and native structures such as nerves, vessels, and lymphatics Atypia, mitosis, and necrosis may be seen Pagetoid spread is more commonly observed in periocular tumors Over 60% of tumors are moderately or poorly differentiated, necessitating immunohistochemistry for definitive diagnosis IHC markers that may aid in diagnosis include androgen receptor (AR), adipophilin (ADP), cytokeratin-7, BerEP4, EMA IHC with EMA, CEA or cytokeratin-7 immunopositivity can help to distinguish SC from BCC or SCC.
    [Show full text]
  • COVID-19 Vaccine (Vero Cell), Inactivated (Sinopharm) Manufacturer: Beijing Institute of Biological Products Co., Ltd
    COVID-19 Vaccine Explainer 24 MAY 20211 COVID-19 Vaccine (Vero Cell), Inactivated (Sinopharm) Manufacturer: Beijing Institute of Biological Products Co., Ltd The SARS-CoV-2 Vaccine (VeroCell) is an inactivated vaccine against coronavirus disease 2019 (COVID-19) which stimulates the body’s immune system without risk of causing disease. Once inactivated viruses get presented to the body’s immune system, they stimulate the production of antibodies and make the body ready to respond to an infection with live SARS-CoV-2. This vaccine is adjuvanted (with aluminum hydroxide), to boost the response of the immune system. A large multi-country phase 3 trial has shown that two doses administered at an interval of 21 days had the efficacy of 79% against symptomatic SARS-CoV-2 infection 14 days or more after the second dose. The trial was not designed and powered to demonstrate efficacy against severe disease. Vaccine efficacy against hospitalization was 79%. The median duration of follow up available at the time of review was 112 days. Two efficacy trials are underway. The data reviewed at this time support the conclusion that the known and potential benefits of Sinopharm vaccine outweigh the known and potential risks. Date of WHO Emergency Use Listing (EUL) recommendation: 7 May 2021 Date of prequalification (PQ): currently no information National regulatory authorities (NRAs) can use reliance approaches for in-country authorization of vaccines based on WHO PQ/EUL or emergency use authorizations by stringent regulatory authorities (SRAs). Product characteristics Presentation Fully liquid, inactivated, adjuvanted, preservative-free suspension in vials and AD pre-filled syringes Number of doses Single-dose (one dose 0.5 mL) Vaccine syringe type Two available presentations: and needle size 1.
    [Show full text]
  • Spontaneous Remission of Cancer and Wounds Healing
    Open Access Austin Journal of Surgery Special Article – Spontaneous Remission Spontaneous Remission of Cancer and Wounds Healing Shoutko AN1* and Maystrenko DN2 1Laboratory for the Cancer Treatment Methods, Saint Abstract Petersburg, Russia The associativity of the spontaneous cancer remission with surgical 2Department of Vascular Surgery, Saint Petersburg, trauma is considering in term of the competition of healing process outside the Russia tumor for circulating morphogenic cells, providing proliferation in any tissues *Corresponding author: Shoutko AN, Laboratory for with high cells renewing, malignant preferably. The proposed competitive the Cancer Treatment Methods, A.M. Granov Russian mechanism of Spontaneous cancer Remission phenomenon (SR) assumes Research Center for Radiology and Surgical Technologies, the partial distraction the trophic supply from tumor to offside tissues priorities, 70 Leningradskaya str., Pesochney, St. Petersburg, Russia like extremely high fetus growth, wound healing after incomplete resection, fight with infections, reparation of a multitude of non-malignant cells injured Received: September 24, 2019; Accepted: October 25, sub lethally by cytotoxic agents, and other kinds of an extra-consumption 2019; Published: November 01, 2019 the host lymphopoietic resource mainly in the conditions of its current deficit. The definition of a reduction of tumor morphogenesis discusses as preferable instead of the activation of anticancer immunity. Pending further developments, it assumes that the nature of the SR phenomenon is similar to the rough exhaustion of lymphopoiesis at conventional cytotoxic therapy. The main task for future investigations for more reproducible SR is to elucidate of the phase of a cyclic lymphopoietic process that is optimal for surgery outside the tumor as well as for other activities, provoked morphogenesis in surrounding tissues.
    [Show full text]
  • Ethnicity and Geriatric Assessment
    Gallo_FM_i-xviii 8/1/05 5:23 PM Page i HANDBOOK OF GERIATRIC ASSESSMENT Fourth Edition Edited by Joseph J. Gallo, MD, MPH Associate Professor Department of Family Practice and Community Medicine Department of Psychiatry University of Pennsylvania School of Medicine Philadelphia, Pennsylvania Hillary R. Bogner, MD, MSCE Assistant Professor Department of Family Practice and Community Medicine University of Pennsylvania School of Medicine Philadelphia, Pennsylvania Terry Fulmer, PhD, RN, FAAN The Erline Perkins McGriff Professor & Head, Division of Nursing New York University New York, New York Gregory J. Paveza, MSW, PhD Interim Associate Vice President for Academic Affairs University of South Florida – Lakeland Lakeland, Florida Gallo_FM_i-xviii 8/1/05 5:23 PM Page ii World Headquarters Jones and Bartlett Publishers 40 Tall Pine Drive Sudbury, MA 01776 978-443-5000 [email protected] www.jbpub.com Jones and Bartlett Publishers Canada 6339 Ormindale Way Mississauga, ON L5V 1J2 CANADA Jones and Bartlett Publishers International Barb House, Barb Mews London W6 7PA UK Jones and Bartlett’s books and products are available through most bookstores and online booksellers. To contact Jones and Bartlett Publishers directly, call 800-832-0034, fax 978-443-8000, or visit our website at www.jbpub.com. Substantial discounts on bulk quantities of Jones and Bartlett’s publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones and Bartlett via the above contact information or send an email to [email protected]. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner.
    [Show full text]