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Brachial plexopathy due to localized axillary recurrence of breast cancer
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Abstracts / Journal of the Neurological Sciences 333 (2013) e422–e480
literature that can inform the development of services appropriate for patients with MND living in Singapore, a multicultural and familycentered society. Objective/method: Drawing from findings of our study that explored the needs of patients with MND and observations made in clinical practice, this presentation will attempt to describe services that can meet the needs of patients with MND in Singapore. Results: Research findings and clinical observations point to the need to develop proactive services that are sensitive to the needs of patients and their caregivers. It was found that “staging” the disease will better meet the needs of the patients as they progress along the disease trajectory. At the earlier stage of the disease, timely supportive counseling for patients and their caregivers after disclosure of diagnosis is needed to manage impact of the disclosure. Counseling is also required to open up communication between patients and their caregivers. Paced education for patients and their caregivers through verbal communication and audiovisual aids, complemented by support groups, will benefit both patients and their caregivers. At a later stage of the disease, there is a need to help 1) the patients work towards a respectful death and 2) their caregivers achieve a peaceful farewell. Advance care planning can be a platform for patients and their caregivers to achieve the closure needed by both parties. doi:10.1016/j.jns.2013.07.1614
Abstract - WCN 2013 No: 1976 Topic: 7 - Neuromuscular disorders Brachial plexopathy due to localized axillary recurrence of breast cancer J. Cho. Neurology, National Health Insurance Service Ilsan Hospital, Goyangsi, Gyeonggido, Republic of Korea The brachial plexopathy in breast cancer patients has been reported to be due to loco-regional metastasis or radiation plexopathy. Localized axillary recurrence (LAR) is rare. The time to LAR after primary breast cancer is various from a few months to many years. We report a patient of brachial plexopathy due to LAR that developed twenty four years after radical mastectomy and radiation therapy for breast cancer. A 58-year-old woman was admitted with left hand weakness, paresthesia and pain. The examination revealed edema, weakness and sensory change of left arm and hand. But there was no palpable mass in subclavian fossa or axilla. The NCS and EMG revealed left brachial plexus lesion (multiple levels of roots and trunks). Chest CT and breast sonography showed huge mass in the left axilla with invasion of left subclavian vessels. PET CT showed huge malignant mass along left axillary fossa without distant metastasis. We performed ultrasonography-guided gun-biopsy of mass and the pathologic diagnosis was invasive carcinoma with positive estrogen and progesterone receptors. LAR of breast cancer is rare but can occur anytime after initial treatment. LAR is associated with poor prognosis because it is an independent risk factor for distant metastasis and death. We need to evaluate lymph node by sonography in the patient of breast cancer because the physical examination of the axilla can reveal falsenegative finding in spite of huge mass. doi:10.1016/j.jns.2013.07.1615
Abstract - WCN 2013 No: 1938 Topic: 7 - Neuromuscular disorders Idiopathic inflammatory myopathies—Potential role of the immunoexpression of interleukin-35 in muscle biopsy J. Zamecnika,b, J. Haceka,b, R.A. Dahmena,b, H. Mannc, L. Senoltc, J. Vencovskyc. aDept. of Pathology and Molecular Medicine, Charles University Prague, Prague, Czech Republic; bUniversity Hospital Motol, Prague, Czech Republic; cInstitute of Rheumatology, Dept. of Experimental and Clinical Rheumatology, Charles University Prague, 1st Faculty of Medicine, Prague, Czech Republic Background: Interleukin-35 (IL-35) is a newly described cytokine that belongs to the IL-12 family. Although the experiments in mouse models showed immunosuppressive functions for IL-35, recent papers reported different expression pattern and rather pro-inflammatory properties of IL-35 in humans. Currently available biologic treatment for systemic rheumatic autoimmune diseases including the idiopathic inflammatory myopathies (i.e. polymyositis and dermatomyositis) targets specific cellular and molecular mechanisms; therefore, studies of various molecular pathways of immunopathogenesis in idiopathic inflammatory myopathies are of interest for future therapies. Objective: To analyze immunoexpression of interleukin-35 in muscle biopsies of inflammatory and non-inflammatory myopathies to assess its pathogenetic and diagnostic value. Materials and methods: Immunoexpression and its localization of IL35 was studied by primary rabbit anti-human EBI3 polyclonal antibody and mouse anti-human IL-12a(p35) monoclonal antibody in a series of 19 muscle biopsy samples of idiopathic inflammatory myopathies (9 dermatomyositis, 10 polymyositis). Results were compared to those obtained in 10 cases of non-inflammatory myopathies and in 10 control muscles biopsies. Results: We showed localization of the p35 and EBI3 subunits of IL35 in B cells, T cells and macrophages of the inflammatory infiltrate in idiopathic inflammatory myopathies. No immunoreactivity was observed in healthy controls and in non-inflammatory myopathies. Conclusion: Our data suggest pro-inflammatory properties of IL-35 in humans and a potential role in the pathogenesis of idiopathic inflammatory myopathies. The immunohistochemical expression of IL-35 might be also of diagnostic help in muscle biopsy. Supported by: IGA NT/12440-4. doi:10.1016/j.jns.2013.07.1616
Abstract - WCN 2013 No: 1968 Topic: 7 - Neuromuscular disorders Spinal pain syndromes: Psycho-emotional facets Y. Goncharovaa, N. Bozhenkob. aNeurology Department, State Institution, Institute of Urgent and Recovery Surgery n.a. V.K. Gusak, National Academy of Medical Sciences of Ukraine, Donetsk, Ukraine; bNeurology Department, Lviv National Medical University named after Danylo Galytsky, Lviv, Ukraine Background: Low back pain syndromes, especially the chronic ones, are the important link in neurology. Pain as personal experience develops not only due to physical pathology, but as consequence of person's attitude towards disease, previous experience, described in terms of sensory and emotional disorders. Material and methods: We studied 23 patients with lumbar-sacral radiculopathies. Features of psycho-emotional state were studied using Hamilton scale and Aysenk questionnaire. Pain syndrome was assesses using VAS and DN4 scale. Results: Disorders like depressive syndrome were observed among 58% patients. Pain syndrome according to VAS was 6.9 ± 0.3 in persons with
Abstracts / Journal of the Neurological Sciences 333 (2013) e422–e480
literature that can inform the development of services appropriate for patients with MND living in Singapore, a multicultural and familycentered society. Objective/method: Drawing from findings of our study that explored the needs of patients with MND and observations made in clinical practice, this presentation will attempt to describe services that can meet the needs of patients with MND in Singapore. Results: Research findings and clinical observations point to the need to develop proactive services that are sensitive to the needs of patients and their caregivers. It was found that “staging” the disease will better meet the needs of the patients as they progress along the disease trajectory. At the earlier stage of the disease, timely supportive counseling for patients and their caregivers after disclosure of diagnosis is needed to manage impact of the disclosure. Counseling is also required to open up communication between patients and their caregivers. Paced education for patients and their caregivers through verbal communication and audiovisual aids, complemented by support groups, will benefit both patients and their caregivers. At a later stage of the disease, there is a need to help 1) the patients work towards a respectful death and 2) their caregivers achieve a peaceful farewell. Advance care planning can be a platform for patients and their caregivers to achieve the closure needed by both parties. doi:10.1016/j.jns.2013.07.1614
Abstract - WCN 2013 No: 1976 Topic: 7 - Neuromuscular disorders Brachial plexopathy due to localized axillary recurrence of breast cancer J. Cho. Neurology, National Health Insurance Service Ilsan Hospital, Goyangsi, Gyeonggido, Republic of Korea The brachial plexopathy in breast cancer patients has been reported to be due to loco-regional metastasis or radiation plexopathy. Localized axillary recurrence (LAR) is rare. The time to LAR after primary breast cancer is various from a few months to many years. We report a patient of brachial plexopathy due to LAR that developed twenty four years after radical mastectomy and radiation therapy for breast cancer. A 58-year-old woman was admitted with left hand weakness, paresthesia and pain. The examination revealed edema, weakness and sensory change of left arm and hand. But there was no palpable mass in subclavian fossa or axilla. The NCS and EMG revealed left brachial plexus lesion (multiple levels of roots and trunks). Chest CT and breast sonography showed huge mass in the left axilla with invasion of left subclavian vessels. PET CT showed huge malignant mass along left axillary fossa without distant metastasis. We performed ultrasonography-guided gun-biopsy of mass and the pathologic diagnosis was invasive carcinoma with positive estrogen and progesterone receptors. LAR of breast cancer is rare but can occur anytime after initial treatment. LAR is associated with poor prognosis because it is an independent risk factor for distant metastasis and death. We need to evaluate lymph node by sonography in the patient of breast cancer because the physical examination of the axilla can reveal falsenegative finding in spite of huge mass. doi:10.1016/j.jns.2013.07.1615
Abstract - WCN 2013 No: 1938 Topic: 7 - Neuromuscular disorders Idiopathic inflammatory myopathies—Potential role of the immunoexpression of interleukin-35 in muscle biopsy J. Zamecnika,b, J. Haceka,b, R.A. Dahmena,b, H. Mannc, L. Senoltc, J. Vencovskyc. aDept. of Pathology and Molecular Medicine, Charles University Prague, Prague, Czech Republic; bUniversity Hospital Motol, Prague, Czech Republic; cInstitute of Rheumatology, Dept. of Experimental and Clinical Rheumatology, Charles University Prague, 1st Faculty of Medicine, Prague, Czech Republic Background: Interleukin-35 (IL-35) is a newly described cytokine that belongs to the IL-12 family. Although the experiments in mouse models showed immunosuppressive functions for IL-35, recent papers reported different expression pattern and rather pro-inflammatory properties of IL-35 in humans. Currently available biologic treatment for systemic rheumatic autoimmune diseases including the idiopathic inflammatory myopathies (i.e. polymyositis and dermatomyositis) targets specific cellular and molecular mechanisms; therefore, studies of various molecular pathways of immunopathogenesis in idiopathic inflammatory myopathies are of interest for future therapies. Objective: To analyze immunoexpression of interleukin-35 in muscle biopsies of inflammatory and non-inflammatory myopathies to assess its pathogenetic and diagnostic value. Materials and methods: Immunoexpression and its localization of IL35 was studied by primary rabbit anti-human EBI3 polyclonal antibody and mouse anti-human IL-12a(p35) monoclonal antibody in a series of 19 muscle biopsy samples of idiopathic inflammatory myopathies (9 dermatomyositis, 10 polymyositis). Results were compared to those obtained in 10 cases of non-inflammatory myopathies and in 10 control muscles biopsies. Results: We showed localization of the p35 and EBI3 subunits of IL35 in B cells, T cells and macrophages of the inflammatory infiltrate in idiopathic inflammatory myopathies. No immunoreactivity was observed in healthy controls and in non-inflammatory myopathies. Conclusion: Our data suggest pro-inflammatory properties of IL-35 in humans and a potential role in the pathogenesis of idiopathic inflammatory myopathies. The immunohistochemical expression of IL-35 might be also of diagnostic help in muscle biopsy. Supported by: IGA NT/12440-4. doi:10.1016/j.jns.2013.07.1616
Abstract - WCN 2013 No: 1968 Topic: 7 - Neuromuscular disorders Spinal pain syndromes: Psycho-emotional facets Y. Goncharovaa, N. Bozhenkob. aNeurology Department, State Institution, Institute of Urgent and Recovery Surgery n.a. V.K. Gusak, National Academy of Medical Sciences of Ukraine, Donetsk, Ukraine; bNeurology Department, Lviv National Medical University named after Danylo Galytsky, Lviv, Ukraine Background: Low back pain syndromes, especially the chronic ones, are the important link in neurology. Pain as personal experience develops not only due to physical pathology, but as consequence of person's attitude towards disease, previous experience, described in terms of sensory and emotional disorders. Material and methods: We studied 23 patients with lumbar-sacral radiculopathies. Features of psycho-emotional state were studied using Hamilton scale and Aysenk questionnaire. Pain syndrome was assesses using VAS and DN4 scale. Results: Disorders like depressive syndrome were observed among 58% patients. Pain syndrome according to VAS was 6.9 ± 0.3 in persons with