A novel variant of human Grb7 is associated with invasive esophageal carcinoma.

The cDNAs of a putative growth factor-bound (Grb) 7 signal transduction molecule and Grb7V novel splice variant were isolated from an invasive human esophageal carcinoma. Although both Grb7 isoforms share homology with the Mig-10 cell migration gene, the Grb7V isoform lacks 88 base pairs in the C terminus; the resultant frame shift leads to substitution of an SH2 domain with a short hydrophobic sequence. The wild-type Grb7 protein, but not the Grb7V isoform, is rapidly tyrosyl phosphorylated in response to EGF stimulation in esophageal carcinoma cells. Analysis of human esophageal tumor tissues and regional lymph nodes with metastases revealed that Grb7V was expressed in 40% of Grb7-positive esophageal carcinomas. More importantly, Grb7V expression was enhanced after metastatic spread to lymph nodes as compared to the original tumor tissues. Finally, transfection of an antisense Grb7 RNA expression construct lowered endogenous Grb7 protein levels and suppressed the invasive phenotype exhibited by esophageal carcinoma cells. These findings suggest that Grb7 isoforms are involved in cell invasion and metastatic progression of human esophageal carcinomas.     

A case of generalized juvenile gastrointestinal polyposis associated with gastric carcinoma

A case of generalized juvenile gastrointestinal polyposis associated with gastric adenocarcinoma is described. A 31-year-old male patient developed polyposis of the stomach complicated by gastric carcinoma and multiple polyps in the colon. Polyps of the stomach and colon were pathologically consistent with juvenile polyp, but adenomatous changes were also present in a very small percentage of the juvenile polyps. This case strongly suggests the possibility of carcinoma developing in patients with generalized juvenile gastrointestinal polyposis.     

A case of isolated ACTH deficiency presenting with hypercalcaemia

A 76-year-old man presented with a subacute history of weight loss, malaise and anorexia. Laboratory investigations revealed serially increasing hypercalcaemia, correlating with deterioration in his clinical status. He was subsequently shown to have hypocortisolaemia, which improved with the administration of intravenous steroids. Subsequent biochemical testing revealed the endocrinological defect to be one of isolated ACTH deficiency, which, unlike Addison's disease, does not classically include hypercalcaemia in its presentation.     

Parotid mammary analogue secretory carcinoma: A case report and review of literature

BACKGROUNDMammary analogue secretory carcinoma (MASC) is a rare low-grade malignant salivary gland tumor. The morphological and immunohistochemical features of MASC closely resemble those of breast secretory carcinoma. The key characteristics of the lesion are a lack of pain and slow growth. There is no obvious specificity in the clinical manifestations and imaging features. The diagnosis of the disease mainly depends on the detection of the MASC-specific ETV6-NTRK3 fusion gene. CASE SUMMARYThis report describes a rare case of a 32-year-old male patient who presented with a gradually growing lesion that was initially diagnosed as breast-like secretory carcinoma of the right parotid gland. Imaging and histological investigations were used to overcome the diagnostic difficulties. The lesion was managed with right parotidectomy, facial nerve preservation, biological patch implantation to restore the resulting defect, and postoperative radiotherapy. On postoperative follow-up, the patient reported a mild facial deformity with no complications, signs of facial paralysis, or Frey’s syndrome. CONCLUSIONThe imaging and histological diagnostic challenges for MASC are discussed.     

肺非典型类癌伴异位ACTH综合征临床病理学分析

目的 探讨肺非典型类癌伴异位促肾上腺皮质激素(ACTH)综合征的临床病理特征及诊断标准与鉴别诊断.方法 回顾性分析1例肺非典型类癌伴异位ACTH综合征临床病理特征及免疫组织化学表型,并文献复习.结果 患者,女性,60岁,颜面浮肿潮红,双下肢无力症就诊.血ACTH 73.04pg/ml.CT示右肺下叶后基底段结节影.病理...     

A case of intrauterine molar pregnancy with coexistent ectopic pregnancy

We describe a woman who presented to the Emergency Department (ED) with vaginal bleeding and abdominal pain. She was initially diagnosed by the emergency physician with a molar pregnancy by transvaginal ultrasound, which was confirmed and treated by the consulting obstetrical service with a dilatation and curettage the following day. The patient was discharged home later that same day and subsequently returned to the ED after several hours complaining of an acute worsening of her abdominal pain with associated fatigue and lightheadedness. Transabdominal ultrasound performed by the emergency physician demonstrated intra-abdominal free fluid, and the obstetrical service was immediately contacted. Subsequent operative management identified a separate ruptured ectopic pregnancy in the fallopian tube that was confirmed by pathologic analysis after laparoscopic removal.     

A case with diffuse sclerosing variant of papillary carcinoma of the thyroid: characteristic features on ultrasonography

We describe the case of a patient who had a diffuse sclerosing variant of papillary carcinoma of the thyroid with characteristic features on ultrasonography. Most papillary thyroid carcinomas can be easily recognized and diagnosed by ultrasonography. The thyroid carcinoma in this patient, however, showed diffuse enlargement of the thyroid without formation of any masses, and it had hypoechoic and heterogeneous internal echoes, which contained fine and multiple high-echo spots. Multiple lymph nodes were found to be swollen in the bilateral jugular chains on B-mode ultrasonography. It is very important that this type of papillary carcinoma with characteristic clinical features be detected by careful examination.     

Synchronous renal pelvis carcinoma associated with small lymphocytic lymphoma: A case report

BACKGROUNDChronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is often associated with an increased risk of developing subsequent neoplasms of epithelial and mesenchymal origin. Coincidence of CLL/SLL and urothelial carcinoma (UC) is very rare. Herein, we report a case of synchronous renal pelvis carcinoma with SLL.CASE SUMMARYA 78-year-old man presented with the complaint of terminal painless gross hematuria for the past 2 mo. On physical examination, enlarged lymph nodes were palpable in the cervical and axillary regions. The patient’s peripheral blood film was normal. He had a significant smoking history for the past 50 years. Cystoscopy revealed bleeding in the left upper urinary tract. Abdominal computed tomography imaging demonstrated a left renal pelvis tumor. The patient underwent laparoscopic radical nephroureterectomy. Histopathology revealed left renal pelvis high-grade invasive papillary UC and SLL involving the kidney and bone marrow. Renal pelvis lymphatic tissue and lymphocytes were positive for CD5, CD20, and CD23. In addition, the following results were obtained: CD3 (-), Ki-67 (30%+), Bcl-2 (+), Bcl-6 (+), CD10 (-), and CD79a (+). Moreover, no UC metastasis was observed in the lymph nodes. CONCLUSIONThis is the first case of coincident CLL/SLL and upper tract UC in the literature. Cancer patients with lymphadenopathies should always be investigated to rule out the possibility of synchronous or metachronous malignancy.     

乳腺腺样囊性癌伴微腺型腺病1例报告

病例：女，39岁，发现左侧乳房出现肿块伴疼痛3个月，后因疼痛加重至我院就诊，为对其进一步诊治收入院。体格检查,左侧乳腺乳晕下方触及一结节状肿块，直径约1．5cm，质地稍硬，活动度欠佳，无乳头溢液。实验室检查结果无异常。患者入院后，在局麻下行右乳腺肿块局部切除术，术后肿块标本送病理检查。     

A case of double ectopic pregnancy dealed with a laparoscopic management

Uterine horn pregnancy is a very rare condition and is associate with a high rate of maternal morbidity and mortality. The standard treatment is laparotomy. CASE: A 40-year-old woman, previosly undegone laparotomy surgery for extrauterine pregnancy, was admitted to hospital "Casa di Cura Malzoni" because ectopic pregnancy was diagnosed. The patient was treated with laparoscopic surgery.     

妊娠合并乳腺巨纤维腺瘤1例

病例 女,26岁,妊娠7月,发现右乳外上象限无痛性包块5月伴进行性长大2月入院.查体:右乳明显增大,表面浅静脉扩张,右乳外上象限扪及一包块,约14cm×14cm,质中,光滑,无压痛,界清,与周围组织无粘连,表面皮肤无红肿,双腋窝未扪及肿大淋巴结.     

Neurophysin biosynthesis in vitro in oat cell carcinoma of the lung with ectopic vasopressin production.

The incorporation of labeled compounds into neurophysins of a transplantable human oat cell carcinoma of the lung with ectopic vasopressin production was studied in vitro. Neurophysins in cell extracts and in incubation media were isolated by immunoprecipitation and analyzed by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. When cells were incubated with L-[35S]cysteine for 12 h, SDS-polyacrylamide gel electrophoresis of the immunoprecipitates from cell extract and medium resolved two forms of neurophysins with apparent molecular mass of 10,000 (10K) and 20,000 (20K). Both forms of [35S]-neurophysins were completely displaced from the immunoprecipitates by excess human neurophysin. Incubation of cells with L-[35S]cysteine and D-[3H]-glucosamine hydrochloride revealed that glucosamine was incorporated into the 20K neurophysin region, but not into 10K species. To observe the kinetics of labeling of the two forms of neurophysins, cells were incubated with L[35S]cysteine for varying periods of time. After short labeling periods, most of the radioactivity resided in 20K species, which plateaued after 1 h, whereas 10K neurophysin progressively increased in its height. When cells were chased with unlabeled cysteine after the exposure to a short pulse of labeling, 20K neurophysin peak gradually decreased with an apparent initial half-life of 1 h. In contrast, the label in 10K neurophysin steadily increased, which exceeded the former by 3 h of chase. Analysis of 20K neurophysin in cell extract by isoelectric focusing on polyacrylamide gel demonstrated that it was principally composed of a protein with an apparent isoelectric point (pI) of 5.7. These results suggest that neurophysin is synthesized in ectopic vasopressin-producing tumors by post-translational processing from a glycosylated proneurophysin with an apparent molecular mass of 20,000 daltons and a pI of 5.7.     

1例丹参酮ⅡA黄酸钠注射液致过敏病人

1病例介绍 病人,男,25岁,主因2 d前感冒后出现左耳听力下降,渐加重,伴有耳鸣,为持续"嗡嗡"声,头部稍有闷胀感,无眩晕、恶心,意识清楚,无其他不适.诊断为左耳突发性耳聋,收住院.遵医嘱给予5%葡萄糖注射液250 mL+丹参酮ⅡA黄酸钠注射液60 mg静脉滴注.用药40 min后,病人出现胸口憋闷,面色苍白,呼吸急促伴有恶心,头晕等症状.查体:体温36.9 ℃,脉搏96/min,呼吸32/min,血压90/50 mmHg(1 mmHg=0.133 kPa).     

1例丹参酮IIA黄酸钠注射液致过敏病人

1 病例介绍 病人，男，25岁，主因2d前感冒后出现左耳听力下降，渐加重，伴有耳鸣，为持续“嗡嗡”声，头部稍有闷胀感，无眩晕、恶心，意识清楚，无其他不适。诊断为左耳突发性耳聋，收住院。遵医嘱给予5％葡萄糖注射液250mL＋丹参酮IIA黄酸钠注射液60rng静脉滴注。用药40min后，病人出现胸口憋闷，面色苍白，     

A case of hyperkalaemia associated with hypocalcaemia

An 84-year-old woman presented with lethargy and anorexia. Although routine biochemistry demonstrated mild hyponatraemia, moderate hyperkalaemia and severe hypocalcaemia, the patient did not demonstrate the usual symptoms of hypocalcaemia. An electrocardiogram did not demonstrate evidence of hyperkalaemia or hypocalcaemia. Repeated biochemistry confirmed hyponatraemia but that was associated with hypokalaemia and normocalcaemia. Initial management involved correction of the hyponatraemia and hypokalaemia with appropriate intravenous fluids. If serum biochemistry demonstrates hyperkalaemia in association with hypocalcaemia, pseudohyperkalaemia and pseudohypocalcaemia caused by contamination with potassium ethylenediaminetetraacetic acid should always be considered. This can be confirmed by repeating biochemistry, but ensuring the serum gel tube is drawn first when taking multiple blood samples to avoid this contamination.