Synchronous independent bifocal orthotopic thymomas. A case report

A case of synchronous multiple thymomas is reported. The patient was an 81-year-old woman with 2 separate thymomas in the anterior mediastinum. A histological study revealed that both thymomas consisted of dense lymphocyte infiltration in the stroma and a small number of polygonal epithelial tumor cells with clear nuclei and distinct nucleoli. Immunohistochemical staining using the antibodies to 2 antigens, bcl-2, and MIB-1 showed identical staining patterns. In spite of these findings, we considered their origin to be synchronous multicentric development rather than intra-thymic metastasis, based on the non-invasive nature of these tumors.     

上消化道出血外科治疗67例回顾

目的 探讨上消化道出血的外科治疗策略.方法 回顾性分析2007年7月至2010年6月67例上消化道出血病例的病因、治疗及效果.结果 本组病例中良性溃疡50例(74.6%),恶性溃疡17例(25.4%);平均住院(16.4±12.5)d,平均输血量(558.9±263.2)ml.无术后再次出血病例,有2例出现吻合口瘘,5...     

Treatment of ureteral calculi with rigid ureteroscopy. Report of 67 cases

PURPOSE: To evaluate the results obtained by rigid ureteroscopy to treat ureteral calculi. MATERIALS AND METHODS: Between May 1998 and September 2000, 63 patients underwent 67 rigid ureteroscopies (URS) with three endoscopic retreatments and one bilateral URS, for 48 distal, ten mid and nine proximal ureteral calculi. RESULTS: After URS 77.6% of the patients were free of the stones. Success rate was respectively 85.4%, 60% and 55.5% in distal, mid and proximal uretero. Morbidity was 10.4% and there have been one stricture treated by endoscopy. CONCLUSION: Our series demonstrates that rigid URS is safe and effective procedure to treat distal, ureteral calculi. Thus, it should be considered a treatment of choice for distal ureteral calculi.     

多原发大肠癌67例临床分析

目的　探讨多原发大肠癌发病率、病理及临床特点、诊断及治疗方法。 方法　对６７ 例多原发大肠癌患者的临床资料进行回顾性分析。 结果　６００ 例结直肠癌中，有同时多原发癌４７ 例（７８ ％ ） ，异时多原发癌２０ 例（３３ ％ ） 。多原癌伴息肉者３１ 例（４６ ％ ） ，其中１７ 例为息肉癌变（１２ ％ ） ，本组手术根治切除５４ 例，姑息切除５ 例，造口５ 例，仅探查者３ 例。术后１０ 年生存率６２ ％ ，８ 年生存率７３ ％ ，５ 年生存率６７ ％ 。 结论　利用纤结镜作术前、后检查，术中注意仔细探查，是提高本病发现率的重要手段；首次手术彻底切除癌与癌前病变是提高术后生存率的重要因素。     

Cystic thymomas and thymic cysts. A review

Six cases of large thymic cyst are described; five were cystic thymomas and one was nonneoplastic. Two of the thymomas were not only grossly degenerate but showed severe chronic inflammatory change, so that the diagnosis might be missed. The classification of cysts into congenital, inflammatory, and neoplastic groups is discussed. Cystic teratomata of the thymus, lymphatic cysts, and bronchogenic cysts are classed separately since thymic location does not affect their natural history. Cystic thymomas are still not well known clinically, and the literature on the subject is reviewed. It is probable that quite a few non-specific cysts of the anterior mediastinum are of thymic origin.     

Lympho-epithelial thymomas. A retrospective study of 88 resections

Of 113 lympho-epithelial thymomas retrospectively studied, 56 were epithelial, 20 lymphocytic, 30 mixed and 7 were undefined forms. There were 88 resections (20 stage I, 47 stage II, 13 stage III and 8 stage IV). There were 69 primary resections (followed by radiotherapy in 54 cases) of which 57 were complete and 12 were incomplete. There were 19 secondary resections after radiotherapy: 10 were complete and 9 were incomplete and 25 patients were not operated upon and were treated by radio- and chemotherapy. After primary resection, the actuarial 5-year survival is 64.07% and the 10-year survival is 50.86%. After a secondary resection, the 5 year-survival is 43.74%. After non-surgical treatment, it is 18.67%. After surgery, the prognostic importance of staging is confirmed as more important than the cellular structure. Myasthenic patients are subject to late accidents. Postoperative radiotherapy seems to be justified, but its effect is not statistically significant when resection is complete. Post-radiotherapy surgery is beneficial only in cases of complete resection. The metastatic evolution of thymomas has been underrated and seems to depend upon the local control of the tumour. The use of chemotherapy remains to be defined.     

Lipoidproteinosis. A report of four cases

Four cases of lipoid proteinosis (Urbach-Wiethe disease) are presented. The incidence, clinical features, relevant special investigations and possible treatment of the disease are reviewed. These patients present with hoarseness and lesions of the skin and mucosa. The condition is often misdiagnosed by general practitioners and otolaryngologists.     

Stannosis. A report of 2 cases

Stannosis is a condition in which tin-oxide is deposited in lung tissue after inhalation. Tin-oxide is radiologically visible although there is no tissue reaction to its presence. Two examples of the condition are described. It is of value to recognise the condition and so avoid unnecessary invasive diagnostic procedures.     

Neurosarcoidosis. A report of 5 cases

Neurological involvement in sarcoidosis occurs in about 5% of cases, and both the central and peripheral nervous systems may be affected. In the majority of patients, characteristic features of the disease are present in other systems. Five cases of neurosarcoidosis are described in which serious neurological involvement was the presenting manifestation of the disease. The chest radiographs were abnormal in all patients and this drew attention to the diagnosis. Evidence of sarcoid was obtained from biopsy specimens in each case; in 4 from lymph nodes and in 1 from a transbronchial biopsy specimen. All patients were treated with prednisone, although in 2 the dose had to be reduced because of side-effects and azathioprine was introduced. All became asymptomatic; in 2 cases therapy was withdrawn while in the other 3 maintenance therapy was necessary, 2 requiring replacement thyroxine and lypressin.     

Porencephaly. A report of 45 cases

In 45 cases of porencephaly 35 were male and 10 female. Their age ranged from 80 days to 58 years (mean 14 years). In this series, symptoms were observed 80 days to 22 years before diagnosis. twenty-four cases were premature delivery, difficult labour or birth trauma. 14 cases had a history of head injury. 36 cases had congenital porencephalic cyst and 9 had post-traumatic porencephaly. The main symptoms and signs of porencephaly were dementia, speech defect, intracranial hypertension, hydrocephalus, epilepsy, ataxia or paralysis. etc. It is suggested that CT scan is very useful in the diagnosis of porencephaly, and section of cerebral cortex, opening of cyst, continuous drainage or shunting operation should be done as soon as the diagnosis was made.     

Rare cases of pheochromocytoma. A report of two cases

Two rare cases of pheochromocytoma were reported. Case 1 was 39-year-old housewife who was referred for history of high fever with left hypochondralgia twice in the previous 15 months before coming to our department. The patient had neither elevation of blood pressure nor that of central and peripheral venous catecholamine concentration. A left suprarenal mass was found in CT, which was suggested to be a cyst due to the numerical value between 23-24. Further ultrasonographic study indicated a solid tumor. Left adrenalectomy was done. Histologically, some of the viable atypical adrenal cells were found in the capsulating tissue contained the necrotic material which was almost occupying the entire mass. Case 2 was a 64-year-old female with hypertension who was admitted for further examination. On the hospital course, the blood pressure returned to normal without medication. Circulating blood volume was extremely reduced (below 1/2 of normal), the replacement of which raised the blood pressure to cause hypertension. An angiographic study indicated only a right adrenal mass, whereas left adrenal venous catecholamine concentration was significantly higher than that of the right side. After confirming right adrenal with no other disorders by CT scan, right adrenalectomy was carried out. Intraoperative correction of hypertension has been sustained and cardiovascular symptoms have disappeared.     

化脓性脊柱炎的诊断与治疗(附67例病例报告)

目的 探讨化脓性脊柱炎的诊治方法及疗效.方法 回顾性分析2013年5月—2019年12月收治的67例原发性化脓性脊柱炎患者临床资料,其中15例采用非手术治疗,52例采用手术治疗.治疗前后通过白细胞计数(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平评估临床疗效,采用疼痛视觉模拟量表(VAS)评分及美国脊髓损...     

毛囊单位移植技术治疗雄激素源性秃发67例报道

目的 总结应用毛囊单位移植技术治疗雄激素源性秃发的经验及术后患者的满意度.方法 自2001年1月至2010年1月,以枕后部为供区,对67例男性秃发(雄激素源性秃发)患者应用毛囊单位移植技术进行治疗,并应用含单个毛囊单位进行发际线再造.按照OT Norwood(1975年)的分类方式,其中Ⅲ型者27例,Ⅳ型者21例,Ⅴ型者19例.结果 术后随访67例患者12个月至8年,大部分患者对术后效果满意.患者满意度评分(满分为3分)的平均值:27例Ⅲ型患者为1.8分,21例Ⅳ型患者为2.1分,19例Ⅴ型患者为2.3分.结论 应用毛囊单位移植技术治疗雄激素源性秃发可获得较满意的临床效果.改进了发际线的设计方案,其术后效果更加自然美观.     

Intraosseous lipoma. A report of two cases.

Intraosseous lipoma seems to be a rare condition as only some 20 cases have been reported so far. A further two cases are described the lesions being in the calcaneus and in the tibia. Radiographically the lesions appeared osteolytic and well delineated, containing calcified areas. The microscopic features were those of mature adipose tissue. Curettage and packing with autogenous bone grafts is recommended, if the lesion causes pain or a correct diagnosis cannot otherwise be obtained.