Search

Dear Editor, Gültekin and Güven[1] demonstrated an association between optic nerve sheath diameter (ONSD) and in-hospital mortality related to coronavirus disease 2019 (COVID-19). REFERENCES 1 Gültekin H, Güven M. Optic nerve sheath diameter, intensive care unit admission and COVID-19-related-in-hospital mortality. [Extracted from the article]

Background. Various psychological stresses induce degranulation of mast cells. It has been confirmed by animal experiments that stress induced by restraint promotes mast-cell degranulation in various organs, and that the degranulation is inhibited by pretreatment with corticotropin-releasing factor (CRF)-neutralizing antibodies, CRF receptor antagonists, and neurotensin (NT) antagonists. Previous studies have suggested that anxiety and fear induced in animals by psychological stressors promote the production and release of various neuropeptides and neurotransmitters, and induce degranulation of mast cells in several organs. Aim. To evaluate the effect of prior treatment with antipsychotic and anxiolytic agents to inhibit foot-shock (FS) stress-induced degranulation of mouse dermal mast cells. Methods. Using a communication box system, FS was administered to mice and the degranulated dermal mast cells were counted. Chlorpromazine (2 or 4 mg/kg body weight), tandospirone (10 mg/kg body weight) or CRA1000, a selective non-peptidic CRF receptor type 1 antagonist (10 or 100 mg/kg body weight) was injected intraperitoneally 1 h before exposure to FS. Results. After FS was administered, the number of dermal mast cells did not change. However, FS significantly increased the proportion of degranulated mast cells. Pretreatment of mice with chlorpromazine hydrochloride, an antipsychotic agent (2 or 4 mg/kg), or the anxiolytic agents tandospirone citrate (10 mg/kg) or CRA1000 (10 or 100 mg/kg), significantly inhibited the FS-induced mast-cell degranulation ( P < 0.05, P < 0.01, P < 0.05, P < 0.05, and P < 0.05, respectively). Conclusions. Antipsychotic and anxiolytic agents may be effective treatments for stress-aggravated inflammatory skin diseases by inhibition of mast-cell degranulation. [ABSTRACT FROM AUTHOR]

The article presents a study which investigated the clinicopathological significance of fibrous tissue around a recurrent rectal tumour in the pelvis. Results showed that the overall survival of patients with circumferential fibrosis was better than that in patients with no fibrosis. The author concluded that outcome of patients with locally recurrent rectal cancer after total pelvic exenteration with distal sacrectomy appears to be better when circumferential fibrosis is present.

Background: The aim of this study was to evaluate the clinicopathological significance of microscopic abscess formation (MAF) at the invasive front of advanced low rectal cancer. Methods: The clinicopathological features of 226 consecutive patients with low rectal cancer, who underwent curative resection between May 1997 and December 2002, were analysed. Results: Fifty-seven (25·2 per cent) of the 226 tumours had MAF and 169 (74·8 per cent) did not. Patients with tumours showing MAF were more likely to have extended surgery than those without MAF: 47 versus 31·4 per cent respectively underwent non-sphincter-preserving surgery ( P = 0·029) and 82 versus 60·9 per cent underwent lateral lymph node dissection ( P = 0·003). The incidence of lymph node metastases was lower in patients with MAF (30 versus 53·3 per cent; P = 0·002). Univariable analysis of disease-free survival revealed that depth of invasion ( P < 0·001), lymph node status ( P < 0·001), histological type ( P = 0·035), lymphatic invasion ( P < 0·001), venous invasion ( P < 0·001), perineural invasion ( P < 0·001), focal dedifferentiation ( P < 0·001) and MAF ( P < 0·001) were significant prognostic factors. Multivariable analysis showed that lymph node status ( P < 0·001), perineural invasion ( P = 0·002), venous invasion ( P = 0·033) and MAF ( P = 0·012) remained independent prognostic factors. Conclusion: MAF may reflect indolent tumour behaviour and a more favourable outcome in patients with advanced low rectal cancer. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Basaloid squamous cell carcinoma of the esophagus (BSCCE) is a distinct variant of esophageal cancer. This study investigated histopathological variations of BSCCE. Thirty-eight surgical and two endoscopically resected specimens of BSCCE were examined. Histological features were classified into five components: solid nest (SN), microcyst and/or trabecular nest (MT), ductal differentiation (DD), cribriform pattern (CP), and an invasive squamous cell carcinoma (SCC) component. The immunohistochemical phenotypes of each component were examined using antibodies against cytokeratin (CK) 7, CK14, and alpha smooth muscle actin (SMA). SN, MT, DD, CP, and SCC were present in 95.0, 97.5, 27.5, 32.5, and 82.5% of the cases, respectively, and combinations of SN & MT, SN & DD, SN, MT & DD, SN, MT & CP, and SN, MT, DD & CP were found in 50.0, 2.5, 10.0, 17.5, and 15.0%, respectively. All the intraepithelial lesions observed in 18 (45.0%) cases were SCC. Immunoreactivity for CK7, CK14, and SMA was seen in 10.5, 86.8, and 18.4% of SN; 30.8, 97.4, and 38.5% of MT; 54.5, 100.0, and 54.5% of DD; 7.7, 76.9, and 23.1% of CP; and 6.1, 97.0, and 0.0% of SCC, respectively. CK14 immunoreactivity was seen in the periphery of most of the SN component. CK7, CK14, and SMA immunoreactivity was seen in the inner layer, all layers, and the outer layer of DD, respectively. MT and CP showed partial peripheral positivity for CK14 and SMA in microcystic, trabecular, and cribriform-like pseudoglandular structures. BSCCE demonstrates various histopathological and immunohistochemical features including a ductal and cribriform growth pattern. [ABSTRACT FROM AUTHOR]

The article offers information on treatment methodology after non curative endoscopoc resection of early gastric cancer who have a negligible risk of lymph node metastasis (LNM). It is revealed that despite of possible risk of LNM, surgery remains the most efficient treatment after non-curative ER in patients.

Objective. Identification of the genes responsible for systemic lupus erythematosus (SLE). [ABSTRACT FROM PUBLISHER]

A 62-year-old woman with Barrett's esophageal cancer was hospitalized. Abdominal CT confirmed metastases to the liver and lymph nodes, for which surgical excision and radiotherapy were not indicated. We started chemotherapy with a course of daily oral S-1 at a dose of 80 mg/m2 for 21 days, with a 2-hour drip of cisplatin at 60 mg/m2 on day 8. Breaks of 14 drug-free days were given between courses. After two courses, a repeat CT confirmed that the liver and lymph node metastases had disappeared; after three courses, another CT confirmed that the metastatic foci were still absent, so we judged the disease to be in complete remission. Endoscopy and upper GI series confirmed that the primary tumor was reduced, and endoscopic mucosal resection performed using the strip biopsy method. The excision specimen was well differentiated adenocarcinoma, and mucosal invasion, and the excision stump was negative. After two more courses of S-1 + cisplatin, chemotherapy has been suspended with the patient's consent, and in the 21 months after endoscopic mucosal resection, no recurrence has been observed. This is a rare case of metastatic Barrett's esophageal cancer in which the metastases were eradicated by S-1 + cisplatin, and the primary tumor successfully excised by endoscopic mucosal resection after downstaging. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study designed to determine the clinical significance and prognostic impact of extranodal metastasis (EM) in gastric carcinoma. A description of the study's methods is provided. The study showed that the incidence of EM was higher in patients with tumors that were large, infiltrative and deeply invading or undifferentiated and in those with lymph node, peritoneal or liver metastases or lymphatic or vascular involvement. The study concludes that EM is an independent prognostic factors.

Studies surgery for clinical T3 carcinomas of the upper thoracic esophagus. Resection of primary tumor and metastatic nodes; Penetration of the esophagus wall; Absence of preoperative adjuvant treatment.

Summary Background When cancer cells are found in the submucosal layer of an endoscopically resected specimen, patients are recommended to undergo gastrectomy with lymph node dissection. If it were possible to identify those patients in whom the risk of lymph node metastasis was negligible, it might be possible to avoid surgery. Methods Among those who underwent gastrectomy for gastric cancer from 1980 to 1999, 1091 patients with a cancer invading the submucosa were studied. Clinicopathological factors (sex, age, tumour location, macroscopic type, size, ulceration, histological type, lymphatic–vascular involvement and degree of submucosal penetration) were investigated for their possible association with lymph node metastasis. Results Lymph node metastases were found in 222 patients (20·3 per cent). Univariate analysis showed that larger tumour size (more than 30 mm), undifferentiated histological type, lymphatic–vascular involvement and massive submucosal penetration had a significant association with lymph node metastasis. Tumour size, histological type and lymphatic–vascular involvement were independent risk factors for lymph node metastasis. By combining these three factors with submucosal penetration of less than 500 μm, 117 patients could be selected as having a minimal risk of lymph node metastasis (95 per cent confidence interval 0–3·1 per cent). Conclusion Lymphadenectomy may not be necessary for patients with gastric cancer invading the submucosa who fulfil the above conditions. [ABSTRACT FROM AUTHOR]