Эмболия легочной артерии, возникающая при раке молочной железы, -одна из причин, приво-дящих к резкому ухудшению состояния таких па-циенток. Чаще всего окклюзия ветвей легочной артерии развивается вследствие венозной тром-боэмболии. Такое состояние называют тромбо-эмболией легочной артерии. Значительно реже причиной окклюзии ветвей легочной артерии может быть ее эмболия кластером опухолевых клеток, сопровождающаяся развитием легочной опухолевой тромботической микроангиопа-тии. В статье обобщены сведения об этиологии и патогенезе эмболии легочной артерии, про-веден сравнительный анализ диагностических мероприятий при данной патологии, обсуждают-ся вопросы профилактики и лечения.Ключевые слова: рак молочной железы, тром-боэмболия легочной артерии, опухолевый эм-бол, тромбоциты, D-димер, антикоагулянты
The aim of the study was to evaluate the efficacy of photofluorographic gastric cancer screening in selected population of Moscow Region (Russia) during a 15-year period. Thirty-five thousand patients were examined annually with photofluorography (tight filling and double contrast) of the stomach. Gastroscopy with multiple biopsies was performed in suspicious or inconclusive cases. Dynamic CT scan with air distention of the stomach was made before the operation for precise determination of tumor size as well as in some inconclusive cases. The final diagnosis was made by histologic examination of resected stomach. A total of 4286 patients dropped out of the study. In 25,392 patients no pathology was found. Gastric cancer was diagnosed in 680 (1.94%) of patients. In the study 170 (25%) "early" gastric cancers and 510 (75%) advanced gastric cancers were found. Among 170 early gastric cancers 120 (70%) were type-IIb (flat carcinoma) lesions in which endoscopy had low positive predictive value due to nonspecific picture and negative biopsy. On the contrary, dynamic CT scan with air distention of the stomach revealed local thickening of stomach wall in 118 of 120 (98.3%) of the tumors and correctly determined their sizes in 106 of 120 (89.9%). Gastric cancer screening by means of photofluorography in selected groups of patients is efficient and cost-effective. In doubtful cases with negative biopsies and nonspecific endoscopic image, dynamic CT scan with air distention of the stomach can be a method of choice.
Chronic rhinosinusitis with nasal polyps (CRSP) is a heterogenous disease. We have earlier detected differences in severity of clinical manifestations, cellular infiltration degree shown in nasal polyps, of eosinophil-to-neutrophil ratio, efficacy of intranasal glucocorticosteroid baseline therapy, and various inflammatory patterns for several cytokines on the mRNA expression level in different phenotypes with isolated CRSP cases, CRSP associated with respiratory allergy (RA), or non-allergic bronchial asthma.The purpose of this work was to study the cytokines of TGF-â family in the tissues of nasal polyps in patients with different CRSP phenotypes. The research involved 292 patients suffering from CRSP divided into 3 phenotypic groups. Group I consisted of patients with isolated CRSP free of associated BA and/or sensitization to atopic allergens. Group II included patients with CRSP combined with respiratory allergy and was further divided into two subgroups. I.e., Group 2a comprised patients with CRSP, allergic BA (aBA), and allergic rhinitis (AR), while the patients with CRSP, AR, and non-allergic BA were placed to the group 2b. The patients suffering from CRSP complicated with non-allergic BA were allocated to the group III. The patients with hypertrophic rhinitis served as control. The levels of TGF-â1, TGF-â2, and TGF-â3 proteins (pg/mg) were measured by means of multiplex immunoassay approach in supernates of tissue homogenates from nasal polyps removed by surgery, and in posterior parts of inferior nasal conchae. The total protein level was determined in tissue supernatant, with cytokine contents recalculated for the mg/ml protein concentration for standardization of measurements.In the control group, trace concentrations of all three growth factors were detected. Significant difference in protein contents was found for the studied cytokines, depending on CRSP phenotype. The levels of TGF-â1 and TGF-â2 were statistically lower in isolated CRSP than in other groups of comorbid CRSP patients. TGF-â1 and TGF-â2 concentrations were significantly lower in CRSP + allergic BA group IIa than in CRSP + nonallergic BA and CRSP + RA groups. The amount of TGF-â3 cytokine was maximal in CRSP + non-allergic BA group III compared to the patients with isolated CRSP of group I and CRSP + non-allergic BA group 2a.Conclusions.The high level of all three TGF-â isoforms in patients with CRSP compared to the control group suggested a high potential of mucous membranes of paranasal sinuses for active tissue remodeling followed by nasal polype formation.Different mechanisms were presumed for development of local pathological process in different clinical phenotypes of CRSP, depending on the comorbid pathology, especially, BA or respiratory disorders.Minimal TGF-â1 and TGF-â2 levels were detected in isolated CRSP.The highest concentrations of TGF-â1, TGF-â2, and TGF-â3 were discovered in the patients with CRSP accompanied by non-allergic BA as compared to the groups with isolated CRSP and CRSP+allergic BA.5. Determination of TGF-â1, TGF-â2, and TGF-â3 levels can serve as an additional criterion for differentiating between the mechanisms of mucous membrane damage in local pathological process in tissues of comorbid patients with different CRSP phenotypes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.