Perforated mixed carcinoid-adenocarcinoma in transverse colon and at gastroenterostomy site: case report

Goblet cell carcinoid of the large intestine is a rare neoplasm, usually located in ascending colon and rectum. A 60-year-old male patient underwent surgery after the diagnosis of acute abdomen. Exploratory laparotomy revealed perforation with a diameter of 1 cm at the site of the previously performed gastroenterostomy and dilatation of the right colic flexure, secondary to a solid obstructive mass located in the mid-portion of transverse colon. Histopathological investigation of the biopsies, taken from the gastroenterostomy site and the tumor, revealed mixed carcinoid-adenocarcinoma with carcinoid component, predominantly composed of goblet cells. Three cycles of FOLFOX-4 protocol was administered. Following respiratory distress secondary to pulmonary metastasis, the patient's condition deteriorated and subsequently died in the fourth postoperative month. Our aim with this paper is to point out that more cases should be reported for more effective diagnosis, histopathological study, clinical investigation, treatment and prognosis of this specific neoplasm

Combined adenocarcinoid and mucinous cystadenoma of the appendix: a case report

<p>Abstract</p> <p>Introduction</p> <p>Adenocarcinoid of the appendix is a rare malignant tumour with features of both adenocarcinoma and carcinoid, showing both epithelial and endocrine differentiation. Mucinous cystadenoma is the commonest of the benign neoplasms of the appendix, with an incidence of 0.6% in appendicectomy specimens. We report a rare combination of these tumours and discuss the latest treatment options. To the best of our knowledge, only six cases have been reported in the literature to date.</p> <p>Case presentation</p> <p>A 71-year-old Caucasian man presented to our department with a right iliac fossa mass associated with pain. Laparoscopy revealed an adenocarcinoid of the appendix in combination with mucinous cystadenoma. He underwent a radical right hemicolectomy with clear margins and lymph nodes.</p> <p>Conclusion</p> <p>Adenocarcinoids account for 2% of primary appendiceal malignancies. Most tumours are less than 2 cm in diameter and 20% of them metastasize to the ovaries. The mean age for presentation is 59 years and the 5-year survival rate ranges from 60% to 84%. Right hemicolectomy is generally advised if any of the following features are present: tumours greater than 2 cm, involvement of resection margins, greater than 2 mitoses/10 high-power fields on histology, extension of tumour beyond serosa. Chemotherapy mostly with 5-Fluorouracil and Leucovorin is advised for remnant disease after surgery. Cytoreductive surgery with intraperitoneal chemotherapy can offer improved survival for advanced peritoneal dissemination.</p

Impaired Mitochondrial Respiratory Functions and Oxidative Stress in Streptozotocin-Induced Diabetic Rats

We have previously shown a tissue-specific increase in oxidative stress in the early stages of streptozotocin (STZ)-induced diabetic rats. In this study, we investigated oxidative stress-related long-term complications and mitochondrial dysfunctions in the different tissues of STZ-induced diabetic rats (>15 mM blood glucose for 8 weeks). These animals showed a persistent increase in reactive oxygen and nitrogen species (ROS and RNS, respectively) production. Oxidative protein carbonylation was also increased with the maximum effect observed in the pancreas of diabetic rats. The activities of mitochondrial respiratory enzymes ubiquinol: cytochrome c oxidoreductase (Complex III) and cytochrome c oxidase (Complex IV) were significantly decreased while that of NADH:ubiquinone oxidoreductase (Complex I) and succinate:ubiquinone oxidoreductase (Complex II) were moderately increased in diabetic rats, which was confirmed by the increased expression of the 70 kDa Complex II sub-unit. Mitochondrial matrix aconitase, a ROS sensitive enzyme, was markedly inhibited in the diabetic rat tissues. Increased expression of oxidative stress marker proteins Hsp-70 and HO-1 was also observed along with increased expression of nitric oxide synthase. These results suggest that mitochondrial respiratory complexes may play a critical role in ROS/RNS homeostasis and oxidative stress related changes in type 1 diabetes and may have implications in the etiology of diabetes and its complications

Work-rest scheduling for manual lifting tasks

The main objectives of this study were: (1) to determine the effects of work-rest ratios on physiological responses for manual lifting tasks performed over different levels of loads and frequencies of lift for a height of lift of 30 from floor level while keeping task duration and work output as constant, (2) to study for a given work period the effect of varied rest periods on energy consumption, (3) to study for a given rest period the effect of varied work periods on energy consumption, and (4) to investigate, for a given work-rest ratio, the effect of short work short rest periods versus long work long rest periods on energy consumption.In order to achieve the objectives of this research, an eloborate experiment was conducted. The independent variables studied were: frequency of lift and work-rest schedules. The response variables for this experiment were: heart rate, oxygen consumption, and minute ventilation.Eight male subjects, 20 to 34 years of age, participated in this experiment. A randomized complete block design with factorial treatment combinations was used. Each subject performed, in a random order, 34 treatment combinations for this experiment. All subjects underwent a training program before the data collection began.The results of this experiment were analyzed using the analysis of variance technique. By manipulating frequency of lift, load, and work-rest ratios whether there could be any significant difference in physiological strain and energy cost for this lifting task with fixed work output for a fixed time at a fixed height of 30 inches above floor level, was tested. It was identified from this experiment that the least work-rest schedule was found to be 12 minutes work followed by 6 minutes rest which was based on the average minimum energy consumption among all the treatments across all the subjects

Epidermodysplasia verruciformis in Nigerians

An analysis of the clinical and pathologic characteristics of 12 Nigerian patients with epidermodysplasia verruciformis (EV) is presented. Two morphological variants have been observed, typical wart-like flat-topped papules and larger confluent plaques. Seborrhoeic keratoses were observed in patients with the second morphological variety of EV. Solar elastosis was found in biopsies taken from EV lesions in this subgroup of patients. A particular rarity of seborrhoeic keratosis in Africans is emphasized as no single African case of seborrhoeic keratosis was found apart from patients with EV. No malignant epithelial skin tumours were found in the whole group. Factors underlying an apparently more benign course of EV in Africans are discussed, and the literature on EV in Africa is reviewed.</jats:p