Clinical Observation of Preventive and Therapeutic Effect of Modification of Dark Plum Pill on Colorectal Adenoma after Treatment under Coloscope
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ABSTRACT:
DISEASE(S): Colorectal Adenoma
PROVIDER: 2663100 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:ObjectiveTo investigate the clinicopathologic features of pituitary adenoma with neuronal differentiation.MethodsFour patients with mixed gangliocytoma-pituitary adenomas between January 2011 and January 2021 and 111 new-onset patients with adenomas between January 2019 and June 2021 who attended the First Affiliated Hospital of Fujian Medical University were included in the study. The histological and immunohistochemical findings were analyzed. Neuronal differentiation marker staining was performed on new-onset adenomas, and the related literature was reviewed.ResultsAltogether, more than 100 mixed gangliocytoma-pituitary adenoma cases have been reported in the literature until now, of which pituitary-specific POU-class homeodomain transcription 1 (PIT1) positive adenomas are more frequently observed. In the present study, all 4 patients we described were female, aged 29 to 53 years (mean 39 years). Clinically, 3/4 patients presented with acromegaly, and 1/2 patients presented with headache. Histologically, the tumor was composed of two distinct mixed components. The one was a population of neoplastic ganglionic cells with large nuclei, prominent nucleoli, and abundant basophilic cytoplasm embedded in a fibrillary background. Stains of chromograninA (CgA), synaptophysin (Syn), Calretinin (CR) were positive. Axotomy-like expression was observed in neurofilament (NF) staining. PIT1 was expressed in partial ganglionic cells in all cases. The other component was a population of small uniform cells with round nuclei and acidophilic cytoplasm. Prolactin (PRL) and growth hormone (GH) were positive in all 4 cases. PIT1 was positive in the nuclei of adenomas. Although adenomas and ganglionic regions varied in histology, there was a population of cells with neuronal differentiation expressing PIT1. Additionally, axotomy-like expression of NF staining could be seen in a distant area of adenoma regions. A total of 111 cases of adenomas without ganglionic cells were included in this study, including 7 cases with neuronal differentiation. Among them, 4 cases were prolactinomas, 2 cases were somatotroph adenomas, and 1 case was corticotroph adenoma. 6/7 cases were PIT1-positive adenomas. And the remaining one case is T-PIT-positive adenoma.ConclusionsMixed gangliocytoma-pituitary adenomas are rare tumors with neuronal differentiation. The majority of MGAs are associated with endocrinopathies, mainly acromegaly. Our results suggest that PIT1-positive pituitary adenomas may have neural differentiation potential, which may not be unusual. This indication supports the possibility that the neuronal transdifferentiation of adenomatous cells is a possible mechanism, and the underlying mechanism requires further elucidation.
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Project description:ImportanceThere is no consensus regarding optimal management of pleomorphic adenoma in adults.ObjectivesTo compare parotidectomy with observation for the management of pleomorphic adenoma in patients 50 years or older by age.Design and settingThis decision analytical model was performed from November 21, 2019, to June 15, 2020, using a Markov model. Model variables and ranges were selected based on a literature review. A 1-way sensitivity analysis was performed to evaluate the age threshold at which each algorithm, either upfront elective parotidectomy or observation, would be favored. A Monte Carlo probabilistic sensitivity analysis using variable ranges was then performed 5 times with patients in the model assigned a starting age of 50, 60, 70, 80, and 90 years to assess how age at diagnosis would be associated with the model results.Main outcomes and measuresModel outcomes were measured with quality-adjusted life-years (QALYs).ResultsIn the study models, the age thresholds at which observation became more beneficial than parotidectomy were 88.5 years for patients with superficial lobe tumors (5.37 QALYs in favor of parotidectomy below this age, and 5.37 QALYs in favor of observation above this age) and 83.4 years for patients with deep lobe tumors (7.51 QALYs in favor of surgery below this age, and 7.51 QALYs in favor of observation above this age). There was no significant difference in outcomes between parotidectomy and observation among patients aged 70 to 80 years.Conclusions and relevanceThis study suggests that the outcomes associated with parotidectomy and observation are similar at 70 years or older among patients with pleomorphic adenoma and that observation may be the favorable treatment in that age group.
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2022-07-08 | GSE207532 | GEO
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Project description:Background and study aims?:Longer observation times are associated with increased adenoma detection rates (ADR) in the entire colon. However, adenomas in the proximal colon are at risk of being missed during colonoscopy. The aim of this study was to investigate the impact of observation time on detection of adenomatous polyps in the proximal colon. Patients and methods?:This was a prospective study at a university hospital in Germany. Colonoscopies were conducted using magnetic endoscope imaging (MEI) in order to determine the exact position of the scope. Exact observation times spent for the detection of polyps in the proximal and distal colon segments were assessed. The primary outcome was adenoma detection in the proximal colon. ROC curves were generated in order to test the correlation between observation time and adenoma detection. Logistic regression analysis was used to check for interfering factors. Results:?A total 480 procedures with 538 polyps were available for analysis. The overall adenoma detection rate was 38.5?%. ADR in the proximal colon was 28.0?%. There was a significant association between observation time in the proximal colon and the detection of proximal adenomas ( P ?<?0.001). The impact of the time factor on ADR was stronger in the proximal compared to the distal colon ( P ?=?0.030). A net period of 4?min 7 sec was found to be the minimum time span for sufficient adenoma detection in the proximal colon. Conclusion?:Observation time is significant in terms of adenoma detection in the proximal colon. The impact of observation time on ADR is stronger in the proximal compared to the distal colon. In the proximal colon a minimum time span of 4 minutes should be spent in order to ensure adequate adenoma detection.
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Project description:Investigate gene expression profiles of Liuwei Dihuang Pill treatment postmenopausal osteoporosis with kidney Yin deficiency in peripheral blood Liuwei Dihuang Pill (LDP), a classic Chinese medicinal formula, has been used to treat PMO with kidney YIN deficiency for three months. Whole human genome oligo microarray were applied to explore the differentially expressed genes before and after LDP treatment.
2014-05-06 | E-GEOD-57273 | biostudies-arrayexpress
Project description:Investigate gene expression profiles of Liuwei Dihuang Pill treatment postmenopausal osteoporosis with kidney Yin deficiency in peripheral blood
2014-05-06 | GSE57273 | GEO
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