OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE)
submitted to surgical treatment at two university hospitals over a 30-year
period. METHODS: We reviewed the medical records of children with CLE undergoing surgical
treatment between 1979 and 2009 at the Botucatu School of Medicine
Hospital das Clínicas or the Mogi das Cruzes University
Hospital. We analyzed data regarding symptoms, physical examination,
radiographic findings, diagnosis, surgical treatment, and postoperative
follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean
age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of
the cases presented with symptoms at birth or during the first months of
life. In all cases, chest X-rays were useful in defining the diagnosis. In
cases of moderate respiratory distress, chest CT facilitated the diagnosis.
One patient with severe respiratory distress was misdiagnosed with
hypertensive pneumothorax and underwent chest tube drainage. Only patients
with moderate respiratory distress were submitted to bronchoscopy, which
revealed no tracheobronchial abnormalities. The surgical approach was
lateral muscle-sparing thoracotomy. The left upper and middle lobes were the
most often affected, followed by the right upper lobe. Lobectomy was
performed in 18 cases, whereas bilobectomy was performed in 2 (together with
bronchogenic cyst resection in 1 of those). No postoperative complications
were observed. Postoperative follow-up time was at least 24 months (mean, 60
months), and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology,
the radiological diagnosis is easily made and surgical treatment is
effective.
Although the prevalence of self-reported excessive sweating was greater than 2%, the actual prevalence of primary hyperhidrosis in our sample was 0.93% and nearly 50% of the respondents with primary hyperhidrosis reported impaired quality of life.
Herein, we aimed at identifying global transcriptome microRNA (miRNA) changes and miRNA target genes in lung adenocarcinoma. Samples were selected as training (N = 24) and independent validation (N = 34) sets. Tissues were microdissected to obtain >90% tumor or normal lung cells, subjected to miRNA transcriptome sequencing and TaqMan quantitative PCR validation. We further integrated our data with published miRNA and mRNA expression datasets across 1,491 lung adenocarcinoma and 455 normal lung samples. We identified known and novel, significantly over- and under-expressed (p ≤ 0.01 and FDR≤0.1) miRNAs in lung adenocarcinoma compared to normal lung tissue: let-7a, miR-10a, miR-15b, miR-23b, miR-26a, miR-26b, miR-29a, miR-30e, miR-99a, miR-146b, miR-181b, miR-181c, miR-421, miR-181a, miR-574 and miR-1247. Validated miRNAs included let-7a-2, let-7a-3, miR-15b, miR-21, miR-155 and miR-200b; higher levels of miR-21 expression were associated with lower patient survival (p = 0.042). We identified a regulatory network including miR-15b and miR-155, and transcription factors with prognostic value in lung cancer. Our findings may contribute to the development of treatment strategies in lung adenocarcinoma.
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