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  • 1
    Online Resource
    Online Resource
    Exacerbation of Intimal Fibrosis and Endarteritis in a Kidney Transplant Recipient with Chronic Active Antibody-Mediated Rejection and COVID-19: A Case Report
    S. Karger AG ; 2023
    In:  Nephron
    Details
    In: Nephron, S. Karger AG
    Abstract: Kidney transplant recipients are immunocompromised hosts at risk for comorbidity and mortality due to infection. Currently, there are no established guidelines for the management of immunosuppressed transplant recipients with coronavirus disease 2019 (COVID-19). The impact of COVID-19 and its therapeutic management on chronic active antibody-mediated rejection (CAAMR) are still unclear. Here, we report a case of CAAMR exacerbation with endarteritis and intimal fibrosis after COVID-19. A 41-year-old female kidney transplant recipient with CAAMR was admitted to a local hospital with moderately severe COVID-19. Her doses of tacrolimus and mycophenolate mofetil were reduced, and she was administered methylprednisolone pulse and antiviral drugs. This resulted in a good clinical course and she was discharged in 15 days. During and after hospitalization, the immunosuppressants were gradually returned to the baseline levels. However, about 1.5 months after discharge, the serum creatinine level became elevated. An indication kidney biopsy showed CAAMR with intimal fibrosis and endarteritis in all interlobular arteries. An increase of immunosuppressant led to a decrease of the serum creatinine level. Factors contributing to CAAMR with intimal fibrosis and endarteritis may include (1) insufficient immunosuppression due to changes in the levels of immunosuppressive; (2) overlap with endothelial cell injury caused by COVID-19, and (3) an immune-activated state associated with COVID-19. COVID-19 is a life-threatening disease that can result in unexpected changes in immunological status. Possible allograft rejection should be carefully managed in such patients.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    URL: Article
    DOI: 10.1159/000531281
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 2810853-X
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  • 2
    Online Resource
    Online Resource
    Para-Aortic Lymph Node Micrometastasis in Patients with Node-Negative Biliary Cancer
    S. Karger AG ; 2011
    In:  Digestive Surgery Vol. 28, No. 4 ( 2011), p. 315-321
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 28, No. 4 ( 2011), p. 315-321
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 The presence of para-aortic lymph node metastasis in biliary cancer negatively impacts prognosis. The present study aims to immunohistochemically identify and evaluate the clinical significance of para-aortic lymph node micrometastases in 66 patients who had undergone curative resection of biliary cancer. 〈 i 〉 Methods: 〈 /i 〉 We used an antibody against cytokeratins 7 and 8 (CAM5.2) to immunostain 529 para-aortic lymph nodes that were negative according to conventional analysis from 66 patients with biliary cancer. 〈 i 〉 Results: 〈 /i 〉 We detected CAM5.2-positive occult carcinoma cells in para-aortic lymph nodes from 3 (5%) of the 66 patients and in 3 (0.6%) of the 529 para-aortic lymph nodes. One of the 3 patients also had micrometastasis in the regional lymph nodes. All 3 patients with para-aortic lymph node micrometastasis are alive at 45, 48 and 90 months after surgery despite having locally advanced cancer. 〈 i 〉 Conclusions: 〈 /i 〉 Occult cancer cells were identified in para-aortic lymph nodes from 5% of patients with node-negative biliary cancer, yet these patients have survived over the long term. The presence of para-aortic nodal micrometastasis might not have an influence on survival. However, further studies using a greater number of patients are required to support this notion.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000330784
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1468560-7
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  • 3
    Online Resource
    Online Resource
    Clinical Course of Histologically Proven Multifocal Micronodular Pneumocyte Hyperplasia in Tuberous Sclerosis Complex: A Case Series and Comparison with Lymphangiomyomatosis
    S. Karger AG ; 2018
    In:  Respiration Vol. 95, No. 5 ( 2018), p. 310-316
    Details
    In: Respiration, S. Karger AG, Vol. 95, No. 5 ( 2018), p. 310-316
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Multifocal micronodular pneumocyte hyperplasia (MMPH) is a rare pulmonary manifestation of tuberous sclerosis complex (TSC). Because of its rarity, no previous study has described the detailed clinical course of this disease. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 This study aimed to clarify the longitudinal clinical characteristics of subjects with MMPH. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Nine patients with MMPH diagnosed at Hokkaido University Hospital were retrospectively analyzed. Changes in computed tomography findings and pulmonary function were compared during the follow-up period. Serum levels of KL-6, surfactant protein (SP)-A, and SP-D were measured to clarify their potentials as blood biomarkers of the disease. Fourteen cases of lymphangiomyomatosis (LAM) were also included to compare their clinical characteristics with those of subjects with MMPH. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 9 patients, 7 were female and 2 were male. The median age at diagnosis was 43 years (range, 19–56), and all cases were diagnosed following incidental abnormal radiographic findings. During the follow-up, 1 patient died of lung cancer, but others were radiographically stable and had stable pulmonary function. Serum levels of SP-A in 5 patients (mean, 146.4 ng/mL) and SP-D in 6 patients (mean, 337.3 ng/mL) were elevated in subjects with MMPH, whereas KL-6 levels were within the reference range (mean, 230 U/mL) in all patients. Levels of SP-A and SP-D were significantly higher in subjects with MMPH than those with LAM ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.05). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Radiographic findings and pulmonary function were stable in all cases of MMPH. Serum SP-A and SP-D, but not KL-6, may be useful markers for suspicion of the presence of MMPH in patients with TSC.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000486101
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1464419-8
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  • 4
    Online Resource
    Online Resource
    Expression of Fucosyltransferase 8 Is Associated with an Unfavorable Clinical Outcome in Non-Small Cell Lung Cancers
    S. Karger AG ; 2015
    In:  Oncology Vol. 88, No. 5 ( 2015), p. 298-308
    Details
    In: Oncology, S. Karger AG, Vol. 88, No. 5 ( 2015), p. 298-308
    Abstract: 〈 b 〉 〈 i 〉 Objecitive: 〈 /i 〉 〈 /b 〉 Fucosyltransferase 8 (FUT8), the only enzyme responsible for the core α1,6-fucosylation of asparagine-linked oligosaccharides of glycoproteins, is a vital enzyme in cancer development and progression. We examined FUT8 expression in non-small cell lung cancers (NSCLCs) to analyze its clinical significance. We also examined the expression of guanosine diphosphate-mannose-4,6-dehydratase (GMD), which is imperative for the synthesis of fucosylated oligosaccharides. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Using immunohistochemistry, we evaluated the expression of FUT8 and GMD in relation to patient survival and prognosis in potentially curatively resected NSCLCs. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 High expression of FUT8 was found in 67 of 129 NSCLCs (51.9%) and was significantly found in non-squamous cell carcinomas (p = 0.008). High expression of FUT8 was associated with poor survival (p = 0.03) and was also a significant and independent unfavorable prognostic factor in patients with potentially curatively resected NSCLCs (p = 0.047). High expression of GMD was significantly associated with high FUT8 expression (p = 0.04). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 High expression of FUT8 is associated with an unfavorable clinical outcome in patients with potentially curatively resected NSCLCs, suggesting that FUT8 can be a prognostic factor. The analysis of FUT8 expression and its core fucosylated products may provide new insights for the therapeutic targets of NSCLCs.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000369495
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 5
    Online Resource
    Online Resource
    Cytological Characteristics of Pulmonary Pleomorphic and Giant Cell Carcinomas
    S. Karger AG ; 2011
    In:  Acta Cytologica Vol. 55, No. 2 ( 2011), p. 173-179
    Details
    In: Acta Cytologica, S. Karger AG, Vol. 55, No. 2 ( 2011), p. 173-179
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 To establish cytological features of pulmonary pleomorphic carcinoma (PC) or giant cell carcinoma (GC), we evaluated the cytological characteristics of these tumors using a multidisciplinary approach. 〈 i 〉 Study Design: 〈 /i 〉 Samples from 13 surgically resected and histologically confirmed PC or GC patients were collected from our institutes. Eight cases without prior chemotherapy before surgery were selected, and cytological features were analyzed. 〈 i 〉 Results: 〈 /i 〉 The background contained numerous lymphocytes and neutrophils. The tumor cells were arranged in flat loose clusters, but some were in fascicles. The shape of the tumor cell was spindle or pleomorphic, and the sizes of the tumor cells varied by more than 5-fold. The tumor cells had an abundant, thick and well-demarcated cytoplasm. The location of the nucleus was centrifugal, and the nucleus was oval or irregularly shaped. Multinucleated giant cells were frequently observed. The size of the nucleus was more than 5 times that of normal lymphocytes, and its size also varied by more than 5-fold. The nuclear membrane was thin, and nuclear chromatin was coarsely granular, while the nucleolus was single and round. 〈 i 〉 Conclusion: 〈 /i 〉 PC or GC has characteristic cytological features, however, spindle cells tended to be hardly observed in cytological specimens in some cases.
    Type of Medium: Online Resource
    ISSN: 0001-5547 , 1938-2650
    URL: Article
    DOI: 10.1159/000320860
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 2256676-4
    SSG: 12
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  • 6
    Online Resource
    Online Resource
    A Case of High-Grade Neuroendocrine Carcinoma That Improved with Bevacizumab plus Modified FOLFOX6 as the Fourth-Line Chemotherapy
    S. Karger AG ; 2011
    In:  Case Reports in Oncology Vol. 4, No. 2 ( 2011-5-24), p. 260-266
    Details
    In: Case Reports in Oncology, S. Karger AG, Vol. 4, No. 2 ( 2011-5-24), p. 260-266
    Type of Medium: Online Resource
    ISSN: 1662-6575
    URL: Article
    DOI: 10.1159/000328802
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 2458961-5
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