Summary: Intracranial hemorrhage is the third most common cause of stroke and involves the accumulation of blood within brain parenchyma or the surrounding meningeal spaces. Accurate identification of acute hemorrhage and correct characterization of the underlying pathology, such as tumor, vascular malformation, or infarction, is a critical step in planning appropriate therapy. Neuroimaging studies are required not only for diagnosis, but they also provide important information on the type of hemorrhage, etiology, and the pathophysiological process. Historically, computed tomography (CT) scan has been the diagnostic imaging study of choice; however, there is growing evidence suggesting that magnetic resonance imaging (MRI) is at least as sensitive as CT to detect intraparenchymal hemorrhages in the hyperacute setting, and actually superior to CT in the subacute and chronic settings. Unique MRI and CT characteristics differentiate secondary causes of hemorrhage from the more common hypertensive hemorrhage. Baseline and serial studies can be used to identify patients who might benefit from acute interventions. In addition, new imaging modalities, (such as magnetic resonance spectroscopy, diffusion tensor imaging, and 320-row CT) are promising research techniques that have the potential to enhance our understanding of the tissue injury and recovery after intracranial hemorrhages.
Background: Tracheal chondrosarcoma is a rare malignancy, and formal treatment guidelines have not been established due to the lack of high quality studies. Best evidence at this time is limited to case reports.Aim: Explore the role of surgical intervention, radiation therapy, and chemotherapy, and the long-term outcomes for these interventions for tracheal chondrosarcoma.Methods and Results: A literature search was performed using PubMed and ResearchGate (1959-2020) using medical subject heading terms "tracheal chondrosarcoma" OR "trachea chondrosarcoma." Additional reports were identified within reviewed articles and included for review. Articles pertaining to chondrosarcomas of the lung, bronchus, larynx, or other head and neck subsites were excluded. Cases of chondromas were excluded. Thirty-five patients with tracheal chondrosarcoma were identified in the literature since 1959. Advanced age was significantly associated with recurrent or persistent disease (p = .003). The majority (77%) of cases were treated with open surgical resection, with an open approach and negative surgical margins being significantly associated with being disease-free after treatment (p = .001 and p < .001, respectively). Adjuvant radiotherapy was reserved for those unfit for surgery or for recurrent disease. Tumor size, extra-tracheal extension, tumor calcification, location, and initial diagnosis were not associated with tumor recurrence. Conclusion:Non-metastatic tracheal chondrosarcoma can be treated by adequate surgical resection, with little to no role for adjuvant radiotherapy or chemotherapy.Open surgery and negative margins were associated with oncologic control, while advanced age was associated with recurrent or persistent disease.
e14548 Background: Aldo-keto reductase 1B10 (AKR1B10) is a protein that is primarily expressed in human colon and small intestine, but induced in hepatocellular carcinoma and non-small cell lung cancer. Our recent studies have revealed that AKR1B10 is overexpressed in primary, metastatic, and recurrent cancers of the breast. Methods: We recruited four cohorts of patients: Patients with breast cancer undergoing primary surgery from whom we procured breast cancer and matched normal adjacent tissue to evaluate AKR1B10 expression in primary tumors. The matched serum samples were collected before surgery and at various time points after the surgery (approximately 3 days, 7 days, and 1 month Patients with recurrent or advanced (metastatic) breast cancer. Serum samples were collected and serially monitored for up to 2years before and during metastatic therapy and correlated with RECIST measurements. Patients with locally advanced disease undergoing neoadjuvant chemotherapy. AKR1B10 serum levels were monitored during therapy and correlated with RECIST measurements. Healthy individuals with normal mammograms were recruited and submitted serum samples for AKR1B10 serum measurements. Results: AKR1B10 rapidly cleared the serum of early stage breast cancer patients with an estimated half-life of 24-30 hours. Serum AKR1B10 levels correlated strongly with tissue IHC staining and PR positivity but not with RECIST levels or Oncotype Dx scores. Neoadjuvant chemotherapy did not affect serum AKR1B10 levels. Individuals with normal mammograms displayed substantially lower levels of AKR1B10 than breast cancer patients. Patients with DCIS also displayed elevated serum AKR1B10 levels. Conclusions: AKR10 may serve as tumor marker to independently identify high risk patients whose tumors have intermediated risk Oncotype Dx scores and may also identify early breast cancers in patients with equivocal breast biopsies.
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