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EN
We aimed to investigate the correlation between quantitative CerbB-2 expressions with conventional prognostic factors, and distinct nodal involvement in patients with invasive breast carcinoma. One hundred fifty seven consecutive breast carcinoma patients were retrospectively analysed. Level I–II, Level III, and Rotter (Interpectoral) group lymph nodes were separately examined and recorded. For each patient estrogen receptor (ER), progesteron receptor (PR), CerbB-2, P53 status were defined using immunohistochemistry. Age, tumor localisation, menopausal status, grade and the presence of intraductal component were also recorded. CerbB-2 expression did not correlate with age, localisation and menopausal status. There was a reverse, but weak correlation with tumor size and CerbB-2 expression (p=0.034). In subgroup analysis of CerbB-2 positive cases, the magnitude of CerbB-2 positivity did not correlate with tumor size (p=0.551). In univariate analysis CerbB-2 expression did not correlate with nodal involvement in Level I-II, and Rotter. In subgroup analysis of patients with positive CerbB-2, positivity of CerbB-2 linearly increased with the number of positive lymph nodes in Level I-II, and this difference was significant (p=0,039). There was a significant correlation between CerbB-2 expression and Level III nodal metastases (p=0.005). But this correlation was not significant among CerbB-2 positive patients (p=0.82). P53, PR positivity and the presence of intraductal component did not differ according to oncogene expression. We detected a reverse correlation with ER positivity and CerbB-2 positivity (p=0.011). It is concluded that quantitative expression of CerbB2 positivity increases with nodal involvement in Level I–II axillary lymph nodes, and ER. Also, CerbB-2 positivity is more common among patients with Level III lymph node metastases.
EN
Objective: Cecal diverticulitis may be encountered as a real etiological factor in 1/300 appendectomies. Differential diagnosis of acute appendicitis and cecal diverticulitis is crucial because of the different treatment methods. Our aim is to reveal the importance of distinguishing acute appendicitis from cecal diverticulitis. Methods: The data of patients who were admitted to the hospital between 2015 and 2019 with the complaint of abdominal pain and then finally diagnosed with colon diverticular disease, colon diverticulitis, or acute appendicitis, analyzed retrospectively. Results: A total of 19 cecum diverticulitis patients were detected during surgery for acute appendicitis or during clinical and radiological evaluation. 1247 appendectomies were evaluated; the final diagnosis was observed as cecal diverticulitis in 5 patients (0,4%). One hundred nineteen patients diagnosed with colonic diverticulitis at admission were evaluated, while 105 (88,2%) of them had left-sided diverticulitis, 14 (11,7%) of them had solitary cecal diverticulitis. All of the solitary cecal diverticulitis patients were treated conservatively, except one patient who has Hinchey 3 diverticulitis. Conclusion: Differential diagnosis of cecum diverticulitis with acute appendicitis is important because cecum diverticulitis can be managed as conservatively in most cases. In order to prevent unnecessary surgical interventions, this importance has increased, especially during the COVID-19 pandemic period.
PL
Wstęp: Zapalenie uchyłka jelita ślepego może być faktycznym czynnikiem etiologicznym odpowiedzialnym za ok. 1/300 zabiegów appendektomii. Diagnostyka różnicowa ostrego zapalenia wyrostka robaczkowego i zapalenia uchyłka jelita ślepego ma kluczowe znaczenie z uwagi na różnice w leczeniu obu tych schorzeń. Cel: Celem niniejszej pracy jest ujawnienie znaczenia rozróżnienia między ostrym zapaleniem wyrostka robaczkowego a zapaleniem uchyłka jelita ślepego. Materiał i metody: Wykonano retrospektywną analizę danych pochodzących od pacjentów poddawanych w latach 2015–2019 hospitalizacji w związku z następczym ostatecznym rozpoznaniem choroby uchyłkowej jelita grubego, zapalenia uchyłków jelita grubego lub ostrego zapalenia wyrostka robaczkowego. Wyniki: W trakcie zabiegu chirurgicznego wykonywanego w związku z ostrym zapaleniem wyrostka robaczkowego lub też w trakcie oceny klinicznej i radiologicznej wykryto łącznie 19 przypadków zapalenia uchyłka jelita ślepego. Dokonano oceny 1247 zabiegów appendektomii. W tej liczbie ostateczne rozpoznanie zapalenia uchyłka jelita ślepego postawiono u 5 pacjentów (0,4%). Ocenie poddano również 119 osób z rozpoznaniem zapalenia uchyłków jelita grubego w momencie rozpoznania; 105 pacjentów (88,2%) w tej grupie cierpiało na lewostronne zapalenie uchyłków, zaś 14 (11,7) na zapalenie samotnego uchyłka jelita ślepego. Wszystkich chorych z zapaleniem samotnego uchyłka jelita ślepego poddano leczeniu zachowawczemu, z wyjątkiem jednego, u którego stwierdzono zapalenie uchyłka stopnia 3 w skali Hincheya. Wniosek: Różnicowe rozpoznawanie zapalenia uchyłka jelita ślepego i ostrego zapalenia wyrostka robaczkowego ma znaczenie, ponieważ pierwsze z wymienionych schorzeń można w większości przypadków leczyć zachowawczo. Znaczenie tego rozpoznania dla zapobieżenia zbędnym interwencjom chirurgicznym rośnie szczególnie w okresie pandemii COVID-19.
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