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Implantable port thrombosis in cancer patients: a monocentric experience

Cancer Biology & Medicine 2016年第3期13卷 384-388页

作者： Manel Dridi Nesrine Mejri Soumaya Labidi Mehdi Afrit Houda El Benna Khaoula Ben Miled Hamouda Boussen Medical Oncology department Abderrahmen Mami Hospital Radiology department Abderrahmen Mami Hospital

Objective: Implantable port thrombosis(IPT) in cancer patients is a relatively rare but severe complication. Several factors are reportedly associated with the occurrence of thrombosis. We aimed to describe the prevalence and the anatomoclinical features of IPT observed in cancer patients who were treated in a medical oncology department in ***: A total of 600 cancer patients who had port implantation from January 2013 to December 2015 were retrospectively identified. Cases with symptomatic/incidental IPT(radiologically confirmed) were further identified. Epidemiological and anatomoclinical features were collected from patient records and the department ***: We observed that 33 of the 600 patients had IPT; thus, the prevalence was 5.5%. The median age was 57 years, and the gender ratio was 0.43. Overweight or obesity was observed in 73% of the patients. IPT occurred mainly in patients with breast(36.4%) and colorectal(33.3%) cancers, which were mostly nonmetastatic(79%). At least one identified classical thromboembolic risk factor was found in 13 patients(smoking in 9, tamoxifen in 2). IPT was symptomatic in 93% of the cases, occurring within an average time of 56 days. Implantable ports were removed because of infection in 2 cases and nonfunctionality in 3 cases. IPT treatment was based on low-molecular-weight heparins(94%) and antivitamin K(6%) for an average of 130 days. Four patients had post-therapy complications: one thrombosis recurrence and three ***: IPT cases in the 600 patients were observed to occur in obese nonmetastatic cancer patients within the first 3 months after IP implantation.

关键词： Implantable port cancer patients thrombosis

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Asthma-Like Tracheo-Bronchial Amyloidosis

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Open Journal of Respiratory Diseases 2012年第2期2卷 57-59页

作者： Fatma Chermiti Ben Abdallah Hanene Smadhi Ridha Mahouachi Amel Chtourou Sofia Taktak Ayda Ayadi Faouzi El Mezni Ali Ben Kheder Anatomy-Pathology department abderrahmen mami hospital Ariana Tunisia pneumology iv department abderrahmen mami hospital Ariana Tunisia

Localized bronchial Amyloidosis is an uncommon disease of unknown origin. Clinical signs are not specific. Tracheobronchial symptoms are the most frequent. We report a case of a 31 year-old man complaining of asthma-like dyspnea. Bronchoscopy was performed because of ineffectiveness of antiasthmatic treatment, showed a submucosal infiltration with stenosis of both right and left upper bronchi and a complete stenosis of intermediate troncus. Multiple biopsies were performed and concluded to Amyloidosis of AL type. Oral corticosteroids were indicated with clinical improvement.

关键词： Amyloidosis Biopsy Histology Corticosteroids

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Wegener’s Granulomatosis Presenting with Bilateral Excavated Nodules

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Open Journal of Pathology 2012年第2期2卷 26-28页

作者： Emna Braham Hajer Racil Houda Ben Rejeb Moncef Hamdane Abdellatif Chabou Faouzi El Mezni department of Pathology Abderrahmen Mami Hospital Ariana Tunisia department of pneumology Abderrahmen Mami Hospital Ariana Tunisia

Wegener’s granulomatosis (WG) is a systemic inflammatory disease whose histopathologic features often include necrosis, granuloma formation, and vasculitis of small-to-medium-sized vessels. We report a new case of Wegener’s granulomatosis occurring in a 41-year-old man who was admitted for respiratory symptoms, fever, asthenia, night sweats and weight loss since one month. Chest X-ray and computed tomography showed multiple bilateral pulmonary excavated lesions. A trransparietal lung biopsy was performed. Histological examination showed an area of necrosis, surrounded by a palisade of histiocytes. Some of the histiocytes were multinucleated and formed true granulomas within the wall of the adjacent pulmonary artery. Serology was strongly positive for ANCA. A diagnosis of Wegener granulomatosis was conducted and the patient was started on cyclophosphamide and methylprednisolone as an initial treatment, with a favorable evolution.

关键词： Vasculitis Wegener Pathology Lung Granulomatous Inflammation

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Hemothorax Revealing Aortic Aneurism and Aortic Dissection

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Open Journal of Respiratory Diseases 2013年第3期3卷 113-115页

作者： Fatma Chermiti Ben Abdallah Houda Gharsalli Hamida Kwas Sofia Taktak Amel Chtourou Ali Ben Kheder pneumology iv department Abderrahman Mami Hospital Ariana Tunisie

Hemothorax caused by rupture of aortic aneurysm or aortic dissection is an uncommon manifestation and carries a high mortality rate. We report two cases of 75- and 80-year-old men, who were referred to our department for exploration of a left pleural opacity. Thoracentesis produced a hemorrhagic fluid. The computed tomography scan revealed an aortic dissection type B of Stanford in the first case and an aneurysm of the descending thoracic aorta in the second patient. Emergency operation was performed in the first case but the patient died of multiple organ failure 48 hours after surgery. Aortic dissection or aneurysm can result in a hemothorax especially in patient with favourable conditions such as elderly patient and systemic hypertension. Diagnosis relies on computed tomography (CT) scan and echocardiography.

关键词： Aortic Aneurysm Aortic Dissection Hemothorax Computed Tomography Scan Echocardiography

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AME国际病例001|胸壁滑膜肉瘤:病例报告及文献综述

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临床与病理杂志 2015年第1期35卷 27-30页

作者： Emna Braham Slim Aloui Samira Aouadi Ikram Drira Tarek Kilani Faouzi El Mezni 王斌 department of pathologyp abderrahmen mami hospital Ariana Tunisia department of pneumology Abderrahmen Mami Hospital Ariana Tunisia Departmernt of Thoracic Surgery abderrahmen mami hospital Arianaj Tunisia

滑膜肉瘤是一种恶性软组织肿瘤,多发生于青壮年的四肢。然而,胸壁滑膜肉瘤则非常少见,文献中仅有数例报道。一名57岁老年女性因胸痛就诊。影像学检查发现,右胸壁肿瘤破坏了第8肋骨中部,胸肌和胸膜外脂肪出现不均匀增强信号表明其亦受到... 详细信息

滑膜肉瘤是一种恶性软组织肿瘤,多发生于青壮年的四肢。然而,胸壁滑膜肉瘤则非常少见,文献中仅有数例报道。一名57岁老年女性因胸痛就诊。影像学检查发现,右胸壁肿瘤破坏了第8肋骨中部,胸肌和胸膜外脂肪出现不均匀增强信号表明其亦受到累及。行胸壁切除术。组织学和免疫组化结果显示滑膜肉瘤。对患者进行辅助化疗,然而治疗过程中失访。6个月后,患者再次就诊时发现,胸壁出现复发的巨大肿瘤。

关键词：滑膜肉瘤胸壁外科组织学

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Stage iv malignant transformation of mature cystic teratoma palliatively treated with concurrent chemoradiotherapy:A case report

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World Journal of Clinical Cases 2025年第1期13卷 56-61页

作者： Saori Kondo Takashi Suzuki Kanato Yoshiike Sakura Yamanaka Kenta Sonehara Hiroshi Nabeshima Osamu Oguchi department of Obstetrics and Gynecology Saku Central Hospital Advanced Care CenterSaku City 385-0051NaganoJapan

BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced *** chemoradiotherapy(CCRT)has an inhibitory effect on *** SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our *** tomography revealed right hydronephrosis and a 6-cm pelvic *** ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell *** patient was diagnosed with MT of *** to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse *** CCRT,her performance status improved,and the tumor size was reduced;surgery was *** months postoperatively,the patient developed dis-semination and lymph node *** chemotherapy was *** died 18 months after treatment *** EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.

关键词： Mature cystic teratoma Malignant transformation Squamous cell carcinoma Concurrent chemoradiotherapy Endoscopic ultrasound-guided fine-needle biopsy Case report

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Successful combination of direct antiviral agents in livertransplanted patients with recurrent hepatitis C virus

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World Journal of Gastroenterology 2018年第12期24卷 1353-1360页

作者： Christian Rupp Theresa Hippchen Manuel Neuberger Peter Sauer Jan Pfeiffenberger Wolfgang Stremmel Daniel Nils Gotthardt Arianeb Mehrabi Karl-Heinz Weiss department of Internal Medicine iv University Hospital of Heidelberg Interdisciplinary Endoscopy Unit University Hospital of Heidelberg department of General Visceral and Trans- plantation Surgery University Hospital of Heidelberg

AIM To analyze the safety and efficiency of direct-actingantiviral(DAA) regimens in liver-transplanted patients with hepatitis C virus(HCV) *** Between January 2014 and December 2016, 39 patients with HCV reinfection after liver transplantation were treated at our tertiary referral center with sofosbuvir(SOF)-based regimens, including various combinations with interferon(IFN), daclatasvir(DAC), simeprivir(SIM) and/or ledipasvir(LDV). Thirteen patients were treated with SOF + IFN ± RBV. Ten patients were treated with SOF + DAC ± RBV. Fiveteen patients were treated with fixed-dose combination of SOF + LDV ± RBV. One patient was treated with SOF + SIM + RBV. Three patients with relapse were retreated with SOF + LDV + RBV. The treatment duration was 12-24 wk in all cases. The decision about the HCV treatment was made by specialists at our transplant center, according to current available or recommended *** The majority of patients were IFN-experienced(29/39, 74.4%) and had a history of hepatocellular carcinoma(26/39, 66.7%) before liver transplantation. Sustained virological response at 12 wk(SVR12) was achieved in 10/13(76.9%) of patients treated with SOF + IFN ± RBV. All patients with relapse were treated with fixed-dose combination of SOF + LDV + RBV. Patients treated with SOF + DAC + RBV or SOF + LDV + RBV achieved 100% SVR12. SVR rates after combination treatment with inhibitors of the HCV nonstructural protein(NS)5 A and NS5 B for 24 wk were significantly higher, as compared to all other therapy regimens(P = 0.007). Liver function was stable or even improved in the majority of patients during treatment. All antiviral therapies were safe and well-tolerated, without need of discontinuation of treatment or dose adjustment of immunosuppression. No serious adverse events or any harm to the liver graft became overt. No patient experienced acute cellular rejection during the study period. CONCLUSION Our cohort of liver-transplanted patient

关键词： Hepatitis C virus Recurrence Direct acting antivirals Liver transplantation Sustained virological response

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Dual-sugar tests of small intestinal permeability are poor predictors of bacterial infections and mortality in cirrhosis: a prospective study

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World Journal of Gastroenterology 2016年第11期22卷 3275-3284页

作者： Anika Vogt Philipp A Reuken Sven Stengel Andreas Stallmach Tony Bruns department of Internal Medicine iv (Gastroenterology Hepatologyand Infectious Diseases)Jena University Hospital Center for Sepsis Control and Care Jena University Hospital

AIM: To prospectively analyze the impact of increased intestinal permeability (IP) on mortality and the occurrence of infections in patients with ***: IP was quantified using the lactulose/mannitol (L/M) test in 46 hospitalized patients with cirrhosis (25 Child-Pugh A/B, 21 Child-Pugh C) and in 16 healthy controls. Markers of inflammation [LPS-binding protein, Interleukin-6 (IL-6)] and enterocyte death [intestinal fatty-acid binding protein (I-FABP)] were determined in serum using enzyme-linked immunosorbent assays. Patients were followed for one year and assessed for survival, liver transplantation, the necessity of hospitalization and the occurrence of bacterial infections. The primary endpoint of the study was defined as differences in survival between patients with pathological and without pathological lactulose/mannitol ***: Thirty-nine (85%) patients with cirrhosis had a pathologically increased IP index (L/M ratio > 0.07) compared to 4 (25%) healthy controls (P hospitalization with bacterial or fungal infections. Although patients who developed spontaneous bacterial peritonitis (SBP) (n = 7) had a higher IP index than patients who did not (0.27 vs 0.14, P = 0.018), the baseline IP index did not predict time to infection, infection-free survival or overall survival, neither when assessed as linear variable, as tertiles, nor dichotomized using an established cut-off. In contrast, model for end-stage liver disease score, Child-Pugh score, the presence of ascites, serum IL-6 and I-FABP were univariate predictors of infection-free ***: Although increased IP is a frequent phenomenon in advanced cirrhosis and may predispose to SBP, it failed to predict infection-free and overall survival in this prospective coho

关键词： Intestinal permeability Liver cirrhosis Lactulose/mannitol ratio Spontaneous bacterial peritonitis Bacterial translocation

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Collision carcinoma of the rectum involving neuroendocrine carcinoma and adenocarcinoma:A case report

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World Journal of Clinical Cases 2021年第18期9卷 4789-4796页

作者： Xing Zhao Gang Zhang Chun-Hui Li department of Pathology The Affiliated Hospital of Chengde Medical UniversityChengde 067000Hebei ProvinceChina department of General Surgery iv Baoding First Central HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Collision carcinoma is a rare histological pattern,and includes two or more different types of tumors coexisting in the same organ as one *** to the combined type,the two adjacent tumors of collision carcinoma are histologically *** carcinoma may occur from any origin or organ,including the cecum,liver,cervix,thyroid,stomach,kidney,and *** the rectum,adenocarcinoma is the most common pathological type,the combined type is rare,and collision tumors are even *** date,only a limited number of collision carcinoma cases originating from the rectum have been *** to the scarcity of rectal collision carcinoma,more cases need to be reported to fully understand the clinico-pathological features and biological behavior of the *** SUMMARY Here we report a 40-year-old female who presented with the chief complaints of persistent changes in bowel habits and hematochezia for 10 *** underwent Miles'operation which revealed a collision carcinoma of the rectum,showing a“side by side”pattern,composed of a high grade neuroendocrine carcinoma,(small cell carcinoma)and moderately differentiated adenocarcinoma,based on its clinico-pathological features and biological *** patient remained disease-free at 12 mo *** also focused on the related literature and expert *** Collision carcinoma is a rare tumor with ambiguous biological *** attention should be paid to its clinico-pathologic *** and adequate follow-up is essential to help rule out metastasis and assess the prognosis.

关键词： Collision carcinoma Rectum Neuroendocrine carcinoma Adenocarcinoma Case report

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Predictors of functional benefit of hepatitis C therapy in a‘real-life’cohort

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World Journal of Gastroenterology 2018年第7期24卷 852-861页

作者： Niels Steinebrunner Kerstin Stein Catharina Sandig Thomas Bruckner Wolfgang Stremmel Anita Pathil department of Internal Medicine iv University Hospital HeidelbergHeidelberg 69120Germany department of Gastroenterology Hepatology and Infectious DiseasesUniversity Hospital of MagdeburgMagdeburg 39120Germany department of Medical Biometry Institute of Medical Biometry and Informatics(IMBI)Heidelberg 69120Germany

AIM To define predictors of functional benefit of direct-acting antivirals(DAAs) in patients with chronic hepatitis C virus(HCV) infection and liver *** We analysed a cohort of 199 patients with chronic HCV genotype 1, 2, 3 and 4 infection involving previously treated and untreated patients with compensated(76%) and decompensated(24%) liver cirrhosis at two tertiary centres in Germany. Patients were included withtreatment initiation between February 2014 and August 2016. All patients received a combination regimen of one or more DAAs for either 12 or 24 wk. Predictors of functional benefit were assessed in a univariable as well as multivariable model by binary logistic regression *** Viral clearance was achieved in 88%(175/199) of patients. Sustained virological response(SVR) 12 rates were as follows: among 156 patients with genotype 1 infection the SVR 12 rate was 90%(n = 141); among 7 patients with genotype 2 infection the SVR 12 rate was 57%(n = 4); among 30 patients with genotype 3 infection the SVR 12 rate was 87%(n = 26); and among 6 patients with genotype 4 infection the SVR 12 rate was 67%(n = 4). Follow-up MELD scores were available for 179 patients. A MELD score improvement was observed in 37%(65/179) of patients, no change of MELD score in 41%(74/179) of patients, and an aggravation was observed in 22%(40/179) of patients. We analysed predictors of functional benefit from antiviral therapy in our patients beyond viral eradication. We identified the Child-Pugh score, the MELD score, the number of platelets and the levels of albumin and bilirubin as significant factors for functional *** Our data may contribute to the discussion of potential risks and benefits of antiviral therapy with individual patients infected with HCV and with advanced liver disease.

关键词： functional benefit direct acting antiviral hepatitis C cirrhosis real-life data

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