Adult ; Brain Neoplasms ; pathology ; Glioblastoma ; pathology ; Humans ; Male ; Pineal Gland ; pathology

Objective:To explore the classification and the choice of surgical approach for tentorial meningiomas. Methods: 56 patients with tentorial meningiomas operated on between 1992 and 2002 were retrospectively analysed. According to Gkalp , there were 28 cases with medial tumor,17 cases with lateral tumor,11 cases with falcotentorial tumor. The tumors developing mainly supratentorial were approached from modified pteronal, subtemporal, temporooccipital or occipital craniotomy. For tumors developing mainly in the posterior cranial fossa, suboccipital craniectomy or combined occipital- suboccipital craniectomy was performed. The tumors developing both supratentorial and infratentorial the subtemporal-presigmoidal craniotomy were approached . Results: Total removal was achieved in 53 cases and partial removal in 3 cases. Two cases died of severe postoperative complications. The mortality rate was 3.6%. Five had additional neurological deficits postoperatively. Recurrences occurred in 6 cases. Conclusion: Surgical approach for tentorial meningiomas must be individualized for each case. The operators must master well about microanatomy of the tentorium and its specifically regional structures and expertly use microsurgical techniques for obtaining successful surgery and good outcome.

OBJECTIVETo investigate the clinicopathological features, histogenesis and prognosis of mucinous tubular and spindle cell carcinoma (MTSCC).

METHODSFive MTSCCs were studied with histochemical, immunohistochemical staining, electron microscopy, and review of the related literatures.

RESULTSFour cases of MTSCC were females and one was male. Three patients presented with flank discomfort and two were incidentally found with health examination. In gross examination, the tumors were circumscribed. The cut surface was solid, gray-white, yellow or red. Necrosis was present in one case of high-grade MTSCC. Microscopically, low-grade MTSCC was mainly consisted of tubular, spindle cell and mucinous stroma with relatively bland morphology, and mitoses were rare. While in the high-grade area of one case, the cells were spindle or polymorphic with severe atypia and high mitotic activity, without mucinous stroma and tubular structure. Mucin was positive for Alcian blue. The neoplastic cells were positive for vimentin (5/5), CKpan (5/5), CK7 (5/5), CK19 (5/5), 34betaE12 (1/5), EMA (5/5), E-cadherin (3/5), CD10 (1/5), P504S (5/5), and CAM5.2 (5/5). The Ki-67 index was low (< or = 5%) in the low-grade component, while it was high (15%) in the high-grade component. Ultrastructural study showed short microvilli along glandular lumens. The nuclear membrane was focally invaginated. Four cases were followed up for 3 to 52 months, and recurrence and metastasis were not found.

CONCLUSIONSMTSCC occurs predominantly in females and it is a rare kidney neoplasm. Most of MTSCCs are low-grade and the prognosis is relatively good. However, the patients of high-grade MTSCC should be closely followed up.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Adult ; Carcinoma ; metabolism ; pathology ; surgery ; Carcinoma, Medullary ; pathology ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Leiomyosarcoma ; metabolism ; pathology ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Nephrectomy ; Racemases and Epimerases ; metabolism ; Vimentin ; metabolism

Objective:To discuss the diagnosis, treatment and outcome of patients with gliomatosis cerebri (GC). Methods:Retrospectively reviewed the clinical manifestations and radiological appearances of 6 patients with GC, which were diagnosed in our hospital between 1993 and 2003. We employed surgical treatment in three patients, stereotactic biopsy in two, and the other one received both biopsy and surgery. Results: The lesions of GC infiltrated more than two lobes in brain. CT studies showed diffuse hypodensity changes and enhancement was absent in four patients. MRI examinations revealed isointense or hypointense regions on T1WI, and uniformly high signal on T2WI. MRI also disclosed structural enlargement. All patients received radiotherapy after surgery and three patients underwent chemotherapy additionally. Five patients died during follow up with average course of 16.4 months. Conclusion:MRI examination is valuable in the diagnosis and the prognosis of GC is poor.

Objective To explore the in vivo effects of myxoma virus (MV) on gliomas of rat model.Methods C6 glioma cells were implanted into the frontal lobe of SD rats using stereotactic methods to establish animal models of glioma.Methods C6 glioma cells were implanted into the frontal lobe of SD rats using stereotactic methods to establish animal models of glioma.Models were divided into 4 groups randomly after tumor growth was affirmed,and MV,5-FU,MV + 5-FU,and denatured myxoma virus ( DV ) were implanted into the tumors using stereotactic methods,bodyweight,tumor size,expression of glial fibrillary acidic protein ( GFAP),Akt of each model were observed.Results The gliomas in all SD rats were established successfully. And tumor growth in MV,5-FU,MV + 5-FU were significantly decreased as compared with DV group after injection,sizes of some tumors were lessened,and GFAP expression decreased in MV,5-FU and MY + 5-FU groups.The expression of PI3k,Akt and mTOR were decreased in MV and MV + 5-FU groups.Conclusion C6 glioma SD rat models could be established successfully using stereotactic methods.MV may enhance biological activity of chemotherapeutic drugs on tumor cells of animal models in vivo by regulating some genes of PI3K-Akt-mTOR signal pathway.

Objective To explore the association between urinary microalbumin-to-creatinine ratio (ACR) and brachial-ankle pulse wave velocity (baPWV) in hypertensive patients.Methods A total of 877 primary hypertension patients were enrolled in this trial from September 2009 to December 2012,and were randomly recruited and patients were divided into normal ACR group (ACR ＜ 30 mg/g,n =723),microalbuminuria group (30 mg/g ≤ ACR ＜ 300 mg/g,n =136) and macro-albuminuria group (ACR ≥300 mg/g,n =18).baPWV was measure by automatic pulse wave velocity measuring system.Results The baPWV values in patients of micro-albuminuria group and macro-albuminuria group were significantly higher than in the normal ACR group (all P ＜ 0.05).The baPWV value of macro-albuminuria group was significantly higher than in the micro-albuminuria group (P ＜ 0.05).Linear correlation analysis revealed that ACR was positively correlated with baPWV (r =0.413,P ＜ 0.01).Multiple linear regression analysis showed that ACR independently correlated with baPWV in patients with primary hypertension (β =0.29,R2 =0.112,P ＜ 0.01) after adjusting for age,sex,body mass index,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,low density lipoprotein,high density lipoprotein and triglyceride.Using ACR ＜ 30 mg/g and ACR ≥ 30 mg/g as dichotomous variable,binary logistic regression analysis showed that ACR≥30 mg/g was also a risk factor of the ascending baPWV in primary hypertension patients (OR:1.73,95％ CI:1.62-2.98) after adjusting the traditional cardiovascular risk factors.Conclusion ACR is positively correlated to baPWV in primary hypertension patients,and the ascending baPWV is a risk factor of early renal dysfunction in primary hypertension patients.

Adolescent ; Adult ; Aged ; Alcohol Drinking ; adverse effects ; China ; epidemiology ; Educational Status ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Logistic Models ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Smoking ; adverse effects

OBJECTIVETo investigate the clinicopathological characteristics of primary testicular mixed germ cell tumor (MGCT).

METHODSWe retrospectively analyzed the clinicopathological data of 13 cases of primary testicular MGCT and reviewed other relevant literature.

RESULTSMGCT accounted for 24.1% (13/54) of all the testicular germ cell tumors diagnosed in our hospital. The patients ranged in age from 2 to 53 years, averaging at 28.3 years. All were unilateral cases, 6 in the left and 7 in the right testis, with a left/right ratio of 0.86:1. Morphologically, testicular MGCT displayed a variety of subtypes, embryonal carcinoma in 11 cases (84.6%), seminoma in 8 (61.5%), teratoma in 6 (46.2%), choriocarcinoma in 4 (30.8%) and yolk sac tumor in 4 (30.8%). Nine of the cases (69.2%) were composed of two different germ cell histological elements, 3 (23.1%) composed of three, and 1 (7.7%) composed of five.

CONCLUSIONTesticular MGCT is rather rare and most commonly occurs in young men. Its biological behavior, clinical management and prognosis vary with its different histological elements. Therefore accurate pathological diagnosis is essential and immunohistochemistry plays an important role in the diagnosis and differential diagnosis of testicular MGCT.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Male ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; pathology ; Retrospective Studies ; Testicular Neoplasms ; pathology ; Young Adult

OBJECTIVETo investigate the effect of the different immunosuppression therapy on CD4(+)Foxp3(+)regulatory T cells (CD4(+)Foxp3(+)Treg cells) in the peripheral blood monocytes of kidney transplantation recipients.

METHODSA Closed Cohort study was conducted in 50 primary living kidney transplant recipients between January 2006 and January 2008, who had been followed up for 1 year. The recipients divided into calcineurin inhibitors group (CNI + MMF + Pred) (19 recipients, including cyclosporin group 10 recipients and tacrolimus group 9 recipients), rapamycin group (RAPA + MMF + Pred) (31 recipients). Twenty end-stage renal disease patients were in control group. The frequency of CD4(+)Foxp3(+)Treg cells in total CD4(+)T cells was analyzed by flow cytometry in peripheral blood from three groups, results were compared.

RESULTSThe clinical variables of recipients such as age, sex, cold ischemia time, human leucocyte antigen mismatch, panel reaction antibody, rejection episode were no significant difference. The percentage of CD4(+)Foxp3(+)Treg cells in total CD4(+) cells was significantly higher in rapamycin group and end-stage renal disease group than calcineurin inhibitors group (P < 0.01). The level of CD4(+)Foxp3(+)Treg cells between cyclosporin group and tacrolimus group was no significant difference (P > 0.05).

CONCLUSIONThe level of CD4(+)Foxp3(+)Treg was significantly higher in patients receiving RAPA + MMF + Pred than the patients receiving CNI + MMF + Pred, which suggested that RAPA may be play a more important role in immune tolerance induction.

Adult ; Female ; Follow-Up Studies ; Forkhead Transcription Factors ; Humans ; Immunosuppression ; methods ; Immunosuppressive Agents ; therapeutic use ; Kidney Transplantation ; immunology ; Male ; Middle Aged ; Sirolimus ; therapeutic use ; T-Lymphocytes, Regulatory ; drug effects ; immunology

OBJECTIVETo investigate clinicopathologic features, immunophenotypes and differential diagnoses of follicular dendritic cell sarcoma/tumor (FDCS).

METHODSEight cases of FDCS were studied using histological and immunohistochemical examinations and EBER in situ hybridization, with a review of the related literatures.

RESULTSThere were 5 male and 3 female patients with a median age of 50 years. The sites of involvement included lymph node (4 cases), tonsil, nasopharynx, liver, and spleen (1 case each, respectively). The predominant microscopic features histologically included storiform, fascicular, diffuse, whorled and nodular in patterns. The neoplastic cells, dispersed by the infiltrated small lymphocytes, were characterized by abundant eosinophilic or fine granular cytoplasm with indistinct cell borders, and syncytial in appearance. The nuclei of the tumors were ovoid, round to spindled in shape with vesicular or stippled chromatin and small distinct nucleoli. Mitotic figures varied among cases. Pseudovascular spaces and perivascular cuffing were observed in some cases. One case of FDCS involving lesion in liver showed a background of abundant lymphocytes mixing with dispersed spindle or ovoid neoplastic cells having delicate chromatin, mild nuclear atypia, irregular/vesicular nuclei and distinct nucleoli. The neoplastic cells were positive for CD21, CD35, clusterin, and weakly positive for CD68, EMA, S-100 and EGFR. Ki-67 stain showed a variable expression among cases. EBER was positive in 2 cases.

CONCLUSIONSFDCS is a rare malignant tumor with a tendency to relapse and metastasis. Combined morphological and immunophenotypical analysis is necessary to reach a correct diagnosis.

Adult ; Aged ; Antigens, CD ; analysis ; immunology ; Antigens, Differentiation, Myelomonocytic ; analysis ; immunology ; Dendritic Cell Sarcoma, Follicular ; metabolism ; pathology ; Dendritic Cells ; pathology ; Female ; Giant Cells ; Humans ; Immunophenotyping ; methods ; Male ; Middle Aged ; Receptors, Complement 3d ; analysis ; immunology ; Treatment Outcome