The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare,for both tumors present usually as separate entities.There are only 16 such cases reported worldwide.To the best of our knowledge,the ca...The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare,for both tumors present usually as separate entities.There are only 16 such cases reported worldwide.To the best of our knowledge,the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported.A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study.Computed tomography(CT)of the abdomen showed a large heterogene- ously-enhancing mass(4.5 cm in diameter)in the left suprarenal region.Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome.The patient underwent a left adrenalectomy,and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma.The patient was postoperatively well and discharged uneventfully.In the present case report,we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome,and the methods of the diagnosis and differential diagnosis.展开更多
Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We ...Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain,nausea,melena and progressive reduction of hemoglobin index.Gastroduodenal endoscopy revealed erosions in the esophagus and stomach,with no active bleeding at the moment.In addition,the duodenal mucosa presented marked signs of melanosis;later confirmed by histopathological study.Even though PD is usually regarded as a benign condition,its pathogenesis and clinical significance is yet to be defined.展开更多
Renal collecting duct cancer is a rare malignant tumor, which accounts for 1% to 2% of epithelial kidney tumors. Its pathologial appearance has been easily misdiagnosed as a mammilliform renal cell carcinoma or as oth...Renal collecting duct cancer is a rare malignant tumor, which accounts for 1% to 2% of epithelial kidney tumors. Its pathologial appearance has been easily misdiagnosed as a mammilliform renal cell carcinoma or as other tumors. The malignancy of renal collecting duct cancer is high, with early metastasis and poor prognosis. The clinical data for 2 cases of the tumor are discussed in this report, including reports on the histopathology and the changes in immunohistochemistry.展开更多
Objective:The aim of the study was to report the experience of National Cancer Institute(NCI),Cairo University,Egypt,in managing various benign and malignant renal tumors with nephron sparing surgery(NSS),and to asses...Objective:The aim of the study was to report the experience of National Cancer Institute(NCI),Cairo University,Egypt,in managing various benign and malignant renal tumors with nephron sparing surgery(NSS),and to assess its safety and feasibility.Methods:Reviewing the literature for NSS,and records of patients who underwent NSS in the period from January 2000 to December 2009 at National Cancer Institute,Cairo University regarding the patient and tumor related characteristics,the indication for NSS,operative technique,postoperative complications,full histopathological data,and follow up results.Results:The total number of patients was 17.Mean age at surgery was 30.7 years(range 1.5-65 years).Five patients had bilateral tumors during surgery.The mean tumor size was 4.5 cm(range 1-9 cm).All patients had normal preoperative kidney functions.Seven patients had an absolute indication for NSS,6 patients had a relative indication,and 4 patients had an elective indication.All the 5 patients with bilateral tumors underwent bilateral simultaneous surgery.Cold ischemia was used in 8 patients,1 patient was exposed to warm ischemia,manual compression was used in 2 patients,and no vascular control was applied in 6 patients.Complications were encountered in 2 patients,one of them had urinary leakage which needed reoperation,and the other had subcutaneous hematoma which was treated conservatively.Histopathological analysis revealed Wilm's tumor(8 patients),angiomyolipoma(4 patients),renal cell carcinoma(4 patients),and hydatid cyst(1 patient).All patients had negative surgical margin.For patients with Wilm's tumor,the mean follow up was 21.4 months(range 0-94 months),2 patients had local recurrence,and 1 patient had distant metastasis.For patients with RCC,the mean follow up was 15.3 months(5-33 months),no patients had local recurrence or distant metastasis.All patients had normal kidney functions during postoperative and follow up periods.Conclusion:NSS is a feasible safe procedure that can be done with acceptable complications rate and it provides a good solution for patients with bilateral tumors,early localized renal cell carcinoma,and benign tumors.展开更多
目的:探讨不同剂量的抗纤灵水煎剂对慢性肾衰模型小鼠磷酯酰肌醇3激酶(PI3K)/丝氨酸及苏氨酸蛋白激酶(AKT)/雷帕霉素靶蛋白(m TOR)mRNA表达的影响,并探讨其作用机制。方法:C57BL/6J小鼠50只采用5/6肾切除制备慢性肾脏纤维化小鼠模型,同...目的:探讨不同剂量的抗纤灵水煎剂对慢性肾衰模型小鼠磷酯酰肌醇3激酶(PI3K)/丝氨酸及苏氨酸蛋白激酶(AKT)/雷帕霉素靶蛋白(m TOR)mRNA表达的影响,并探讨其作用机制。方法:C57BL/6J小鼠50只采用5/6肾切除制备慢性肾脏纤维化小鼠模型,同时设立假手术组10只,造模成功的小鼠随机分为模型组,雷帕霉素组(0.8 mg·kg^(-1)),抗纤灵水煎液低、中、高剂量组(10,20,40 g·kg^(-1)),连续ig 8周后处死小鼠,苏木素-伊红(HE)染色观察肾组织病理改变,实时荧光定量聚合酶链式反应(q PCR)检测PI3K-AKT-m TOR mRNA表达的含量。结果:与假手术组比较,模型组小鼠肾组织纤维化组织增多,肾损伤评分明显升高,PI3K-AKT-m TOR mRNA表达明显增强,差异有统计学意义(P<0.05,P<0.01);与模型组比较,雷帕霉素组和抗纤灵各剂量组肾组织纤维化减轻,PI3K-AKT-m TOR mRNA表达明显下降(P<0.05,P<0.01);与雷帕霉素组比较,抗纤灵水煎液中、高剂量与雷帕霉素组间无显著性差异,低剂量组疗效差于雷帕霉素(P<0.05),高、中、低剂量组比较,低剂量组与高、中剂量组之间有明显差异(P<0.05),高、中剂量组之间无显著性差异。结论:抗纤灵水煎液可降模型小鼠表达PI3K-AKT-m TOR mRNA的表达,减轻肾脏纤维化纤维化,抗纤灵水煎液中、高剂量与和雷帕霉素等同。展开更多
文摘The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare,for both tumors present usually as separate entities.There are only 16 such cases reported worldwide.To the best of our knowledge,the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported.A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study.Computed tomography(CT)of the abdomen showed a large heterogene- ously-enhancing mass(4.5 cm in diameter)in the left suprarenal region.Clinical history and laboratory results suggest a metabolic disorder as Conn's syndrome.The patient underwent a left adrenalectomy,and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma.The patient was postoperatively well and discharged uneventfully.In the present case report,we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn's syndrome,and the methods of the diagnosis and differential diagnosis.
文摘Pseudomelanosis duodeni (PD) is a rare dark speckled appearance of the duodenum associated with gastrointestinal bleeding,hypertension,chronic heart failure,chronic renal failure and consumption of different drugs.We report four cases of PD associated with chronic renal failure admitted to the gastroenterology outpatient unit due to epigastric pain,nausea,melena and progressive reduction of hemoglobin index.Gastroduodenal endoscopy revealed erosions in the esophagus and stomach,with no active bleeding at the moment.In addition,the duodenal mucosa presented marked signs of melanosis;later confirmed by histopathological study.Even though PD is usually regarded as a benign condition,its pathogenesis and clinical significance is yet to be defined.
文摘Renal collecting duct cancer is a rare malignant tumor, which accounts for 1% to 2% of epithelial kidney tumors. Its pathologial appearance has been easily misdiagnosed as a mammilliform renal cell carcinoma or as other tumors. The malignancy of renal collecting duct cancer is high, with early metastasis and poor prognosis. The clinical data for 2 cases of the tumor are discussed in this report, including reports on the histopathology and the changes in immunohistochemistry.
文摘Objective:The aim of the study was to report the experience of National Cancer Institute(NCI),Cairo University,Egypt,in managing various benign and malignant renal tumors with nephron sparing surgery(NSS),and to assess its safety and feasibility.Methods:Reviewing the literature for NSS,and records of patients who underwent NSS in the period from January 2000 to December 2009 at National Cancer Institute,Cairo University regarding the patient and tumor related characteristics,the indication for NSS,operative technique,postoperative complications,full histopathological data,and follow up results.Results:The total number of patients was 17.Mean age at surgery was 30.7 years(range 1.5-65 years).Five patients had bilateral tumors during surgery.The mean tumor size was 4.5 cm(range 1-9 cm).All patients had normal preoperative kidney functions.Seven patients had an absolute indication for NSS,6 patients had a relative indication,and 4 patients had an elective indication.All the 5 patients with bilateral tumors underwent bilateral simultaneous surgery.Cold ischemia was used in 8 patients,1 patient was exposed to warm ischemia,manual compression was used in 2 patients,and no vascular control was applied in 6 patients.Complications were encountered in 2 patients,one of them had urinary leakage which needed reoperation,and the other had subcutaneous hematoma which was treated conservatively.Histopathological analysis revealed Wilm's tumor(8 patients),angiomyolipoma(4 patients),renal cell carcinoma(4 patients),and hydatid cyst(1 patient).All patients had negative surgical margin.For patients with Wilm's tumor,the mean follow up was 21.4 months(range 0-94 months),2 patients had local recurrence,and 1 patient had distant metastasis.For patients with RCC,the mean follow up was 15.3 months(5-33 months),no patients had local recurrence or distant metastasis.All patients had normal kidney functions during postoperative and follow up periods.Conclusion:NSS is a feasible safe procedure that can be done with acceptable complications rate and it provides a good solution for patients with bilateral tumors,early localized renal cell carcinoma,and benign tumors.
文摘目的:探讨不同剂量的抗纤灵水煎剂对慢性肾衰模型小鼠磷酯酰肌醇3激酶(PI3K)/丝氨酸及苏氨酸蛋白激酶(AKT)/雷帕霉素靶蛋白(m TOR)mRNA表达的影响,并探讨其作用机制。方法:C57BL/6J小鼠50只采用5/6肾切除制备慢性肾脏纤维化小鼠模型,同时设立假手术组10只,造模成功的小鼠随机分为模型组,雷帕霉素组(0.8 mg·kg^(-1)),抗纤灵水煎液低、中、高剂量组(10,20,40 g·kg^(-1)),连续ig 8周后处死小鼠,苏木素-伊红(HE)染色观察肾组织病理改变,实时荧光定量聚合酶链式反应(q PCR)检测PI3K-AKT-m TOR mRNA表达的含量。结果:与假手术组比较,模型组小鼠肾组织纤维化组织增多,肾损伤评分明显升高,PI3K-AKT-m TOR mRNA表达明显增强,差异有统计学意义(P<0.05,P<0.01);与模型组比较,雷帕霉素组和抗纤灵各剂量组肾组织纤维化减轻,PI3K-AKT-m TOR mRNA表达明显下降(P<0.05,P<0.01);与雷帕霉素组比较,抗纤灵水煎液中、高剂量与雷帕霉素组间无显著性差异,低剂量组疗效差于雷帕霉素(P<0.05),高、中、低剂量组比较,低剂量组与高、中剂量组之间有明显差异(P<0.05),高、中剂量组之间无显著性差异。结论:抗纤灵水煎液可降模型小鼠表达PI3K-AKT-m TOR mRNA的表达,减轻肾脏纤维化纤维化,抗纤灵水煎液中、高剂量与和雷帕霉素等同。
