The aim of this study was to quantify the distribution of microvessels and mast cells in all three parts of the trigeminal ganglion (TG). Statistical analyses were applied to investigate possible micromorphological regional differences in their density. Five serially sectioned human TGs were prepared for CD34 and mast cell tryptase immunostaining. The following quantifications were performed in microscopic fields of three parts of the TG: microvessel density (MVD), mast cell density (MCD) and ganglionic cell count. The density of CD34-positive microvessels was not significantly different in any of the three observed parts of the TG. The distribution of neurons showed no significant statistical difference in three parts of the TG. There was no difference in the density of tryptase-positive mast cells within the TG, but there was an abundant presence of mast cells in the periganglionic dural and subdural tissues, a finding hitherto not reported. We can say that there is a homogenous vascular pattern within the TG which excludes local predominance in pathogenesis of trigeminal neuralgia. Second, and more important, the finding of peri-trigeminal mast cells indicates their important role in migraine pain and confirms their degranulation as the main therapeutic goal for this condition.
A 51-year-old female patient was admitted to the Neurological clinic because of motor seizures with myoclonus of the right hand and right side of the face. The results of initial brain CT scan, chest X rays, EEG ultrasonography of the great blood vessels and laboratory tests made in another hospital were unremarkable. Because of repeated partial seizures transient aphasic disturbances, urinary sphincter disturbances and periodic low-grade fever the patient was transferred to our hospital four months after the disease onset. Laboratory tests and NMR suggested a nonspecific disseminated viral encephalitis. After administration of Endoxan she was ambulatory for several weeks and then became increasingly exhausted confused, febrile, dyspneic, tachypneic and developed a shock status with hepatorenal insufficiency. She died after 7 months of disease duration. Postmortem examination revealed intravascular collections of large atypical lymphoid cells of B cell line. Blood vessels changed in this way were common in the brain and rare in other organs including skin, lungs, heart, liver spleen and digestive system. They were not found in the lymph nodes and bone marrow. A biopsy was not done because of absence of symptomatic and swollen tissues. However, correlation of clinical feature and postmortem findings shows that absence of clinical manifestations in an organ does not mean lack of microscopic pathological changes and biopsy should be done regardless of absence of clinical signs. This case shows that intravascular lymphoma may mimic vasculitis or disseminated nonspecific viral encephalitis
BACKGROUND: Breast conserving surgery followed by postoperative radiotherapy, as alternative to radical mastectomy, has been accepted as an optimal method for loco- regional treatment of the majority of women with early stage of breast carcinoma. The aim of the study was to evaluate the results of postoperative radiotherapy after breast conserving surgery in the Institute for oncology and radiology of Serbia. METHODS: During the 3-year period, 109 breast cancer patients with stage I and II were treated with postoperative radiotherapy after breast conserving surgery. Ninety- four patients underwent quadrantectomy with axillary node dissection, and 15 patients underwent only tumorectomy. After surgery all patients received postoperative radiotherapy to the whole breast with tumor dose 50 Gy in 15 fractions every second day. In 52 patients radiotherapy was given to the regional lymphatics with tumor dose 45 Gy in 15 fractions every second day. Twenty-eight patients received a booster dose (10 Gy) to the tumor bed. Adjuvant systemic therapy was administered depending on the nodal involvement and steroid receptors content: 17 patients received adjuvant chemotherapy (CMF or FAC), 18 received adjuvant hormonal therapy (tamoxifen or ovarian ablation), and 6 patients received both chemo- and hormonotherapy. RESULTS: After median follow-up period of 62 months, there was no evidence of loco- regional recurrence in anyone of patients. Distant metastases occurred in 7 patients (6.4%) with median disease free interval of 27.6 months. At last follow-up 91 patients (83.4%) were alive, 4 patients (3.7%) were dead of disease, and the same number was dead of other causes. The 5-year overall survival rate was 92.9% and disease-free survival rate was 92.7%. CONCLUSION: According to our results the combined surgery and radiotherapy approach provides good local control of early breast cancer patients. Postoperative radiotherapy after breast conserving surgery with or without adjuvant systemic therapy has important role in adjuvant treatment of early breast cancer
Radiotherapy in the treatment of head and neck tumors is most often used as an independent method or in combination with surgery and / or chemotherapy. These therapeutic methods in a multidisciplinary approach generally lead to favourable therapeutic response. During radiotherapy of this region, oral mucosa is inevitably covered within irradiated volume. Radical therapy is achieved with high doses of radiation, which usually results in development of undesired toxic effects, which, depending on the time of manifestation can be acute and late. Acute radiation toxicity occurs during or immediately after completion of performed therapy, and the late one several months or years after the completed treatment. The most common acute complications in the oral cavity are inflammation of oral mucosa, loss of taste, dry mouth and secondary infections. Late complications include radiation caries, trismus, and osteoradionecrosis. The aim of this paper was to present the effects and specificities of toxicity observed on oral cavity tissues after radiotherapy.
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