Ectopic ganglion cyst presenting as a breast lump: a rare case report

We report a rare case of a breast lump in an 81-year-old woman. Initial investigations were inconclusive and excision biopsy of the lump was done. Histologically the mass proved to be a ganglion cyst. It is the only reported case of ectopic ganglion cyst in the literature that presented as a breast lump.     

脊柱结核早期误用激素治疗107例分析

目的:探讨误用糖皮质激素对脊柱结核发展及治疗的影响。方法:回顾性分析我院收治的107例早期误用糖皮质激素的脊柱结核患者的症状、体征、治疗的结果及预后,并与同期收治的215例未用激素治疗的脊柱结核患者比较。结果:脊柱结核患者早期误用激素可造成患者发热重、脓肿大,病变部位多发及骨破坏加重,需延长抗结核药用药时间、加大用药剂量,术后并发症多,治愈时间延长。结论:脊柱结核患者误用糖皮质激素会促使结核病情加重,影响治疗效果和预后。     

An unusual origin of a breast lump: a case report

True axillary artery aneurysms are rare. This case report describes one such aneurysm referred as a breast lump. This is the first report of such a presentation.     

Primary aldosteronism: experience with thirty-eight patients.

Thirty-eight hypertensive, hypokalemic patients underwent adrenalectomy for primary aldosteronism. Thirty-one patients were found to have an adenoma and seven patients "idiopathic" hyperplasia. The diagnosis was made by finding low plasma renin activity, which could not be stimulated, and unsuppressable elevated plasma or urine aldosterone. The distinction between adenoma and hyperplasia and the localization of an adenoma were accomplished by adrenal venography, adrenal vein blood analysis, and iodocholesterol scanning. Venography was accurate in 87%; adrenal vein blood analysis in 91%; and iodocholesterol scanning in 72%. Dexamethazone suppressed scanning heightened discrimination to 91%. The adenomas were equally distributed between the right and left adrenal gland, with one patient having bilateral adenomas. All but two patients underwent adrenalectomy from a posterior lumbar incision. Postoperative recovery was uncomplicated. Eighteen months after operation 77% of patients with an adenoma were normotensive.     

Urogenital tuberculosis in immunocompromised patients

Objective  Compare the clinicoradiological presentation of urogenital tuberculosis (UGT) between immunocompromised and nonimmunocompromised patients. Patients and methods  Eighty patients diagnosed with UGT were divided into two groups: eight immunocompromised patients (four with acquired immunodeficiency syndrome [AIDS], and four renal transplant patients on immunosuppressive therapy) and 72 nonimmunocompromised patients. The groups were compared as for age, signs and symptoms, diagnostic approach, pattern of urogenital organ involvement, and early specific mortality (within 6 months from diagnosis). Results  AIDS patients were younger (median age 26 years, range 16–38 years), and renal transplant patients were older (median age 51.5 years, range 45–57 years), compared with the nonimmunocompromised subjects (median age 35 years, range 12–75 years). Immunocompromised patients had greater frequency of fever (87.5% versus 43.1%, P = 0.024), lower frequency of storage symptoms (37.5% versus 76.4%, P = 0.033), shorter length of disease (<6 months: 87.5% versus 2.8%, P < 0.001), and larger frequency of disseminated tuberculosis (62.5% versus 18.1%, P = 0.012). Predominantly parenchymatous renal involvement was more frequent in immunocompromised patients (87.5% versus 6.2%, P < 0.001), who also had lower frequency of stenosis of the collecting system (12.5% versus 93.8%, P < 0.001) and contracted bladder (12.5% versus 65.3%, P = 0.001). Conclusions  UGT has a different clinicoradiological presentation in immunocompromised patients, with predominance of systemic symptoms, disseminated tuberculosis, multiple parenchymatous renal foci, and lower frequency of lesions of the collecting system. In the context of immunosuppression, UGT behaves as a severe bacterial infection, with bacteremia and visceral metastatic foci.     

临床肾结核32年回顾（附349例分析）

回顾分析了３４９例肾结核的临床资料，发现近年来肾结核不典型病例显著增加，从而造成明显的延误诊断现象。肾结核早期诊断中，尿ＰＣＲＴＢＤＮＡ检查阳性率高，可作为常规措施推广使用。Ｂ超在肾结核的诊断中特异性差，仅为初选病人的筛选手段，确诊时需强调ＩＶＵ的特征性改变。随着抗痨药物的不断发展，药物治疗肾结核的适应证有扩大趋势     

乳腺结核15例报告

乳腺结核是临床少见疾病，由于该病早期症状、体征均不典型，较易误诊。本院自年1990月1月至2006年12月共收治经病理检查证实的乳腺结核15例，报告如下： 一、临床资料     

Transaxillary endoscopic excision of benign breast lumps: a new technique

Background Benign breast lumps affect 10% of women in their lifetimes. Despite a favorable natural history enabling surveillance as an option, surgical excision continues to be popular. Avoiding a scar on the breast is an inherent feminine desire. Because the breast is a part with a high charge in the culture, women seek to keep it away from the surgical knife. Numerous minimally invasive approaches have evolved as a result of this psychology. These leave much to be desired. Circumareolar incision at best camouflages the scar, which still is sited on the breast. This scar is subject to the same sequelae as any other breast scar. The axilla, an anatomically contiguous space, provides easy access for endoscopic breast surgery. The authors used this access to excise benign breast lumps endoscopically. This spared the breast from a scar. Methods Between January 2002 and March 2005, 14 women with benign breast lumps underwent surgery. Transaxillary endoscopic excision of 18 such lumps was performed. Results A total of 14 women with 18 benign breast lumps underwent surgery. The mean operative time per patient was 66.78 min (range, 40–110 min). No axillary injury, bleeding, technical difficulty, surgical emphysema, conversion, hematoma, or rehospitalization occurred. All the women expressed their satisfaction and happiness with the operation. Conclusion Endoscopic excision of benign breast lumps is a safe and patient-friendly procedure.     

胸腰椎结核患者的围手术期护理体会

目的 探讨围手术期护理在胸腰椎结核患者中的重要性。方法 回顾性分析2007-01-2013-01,对40例胸腰椎结核患者术前进行呼吸功能锻炼及抗结核药物的护理,术后严密观察病情变化,做好体位和疼痛护理,早期合理的功能锻炼指导等。结果 40例胸腰椎结核患者均达到了预期的护理目标,无1例并发症发生。结论对于胸腰椎结核患者实行系统、规范的围手术期护理是提高疾病的愈合率、手术成功率,提高患者的生活质量,是预防并发症的重要保证。     

Filariasis presenting as a breast lump

Lymphatic filariasis is common in Myanmar. Filariasis of breast is rare. This is a case report of filariasis presenting as breast lump.     

41例结核性脑膜炎死亡原因分析及护理对策

目的：探讨重症结核性脑膜炎患者的护理方法。方法回顾分析41例结核性脑膜炎患者的死亡原因和护理经过。结果41例患者死于脑疝20例（48.78%）,感染14例（34.15%）,上消化道出血6例（14.63%）,心跳骤停1例（2.44%）。结论积极做好基础、饮食、心理和用药护理,消除脑疝的诱发因素、有效地控制颅内压、预防医院感染及消化道大出血可以降低结核性脑膜炎的死亡率。     

不典型肾结核31例临床分析

报告不典型肾结核31例并对此进行分析。对倒根据临床表现分为4类，即无痛性血尿者8例，反复尿频者15例，附睾结核者3例，肾积水者5例。无痛性血尿和阳睾结核者经抗结核治疗痊愈，反复尿频及肾积水者行肾切除术，术后经病理检查证实。并就每一类不典型肾结核及易造成误诊的原因进行分析，认为聚合酶链反应是诊断早期肾结核的重要手段，晚期肾结核行CT检查最有价值。     

肾结核90例临床分析

目的 探讨肾结核的临床特征及有效治疗方法。方法 回顾性分析90例肾结核患者的临床资料。结果 近年来肾结核病例仍较多见，早期诊断困难，单纯药物治疗可治愈者约16％，手术切除仍是主要治疗方法。结论 不典型肾结核的发病率仍较高。尿常规、B超、静脉肾盂造影为主要诊断方法，诊断性治疗仍是确诊的重要依据。     

Renal tuberculosis: a case report

Tuberculosis or TB (tubercle bacillus) remains a major public health problem in developing countries. Over the last decades extra-pulmonary locations of the disease have become more frequent due to the increased prevalence of acquired immune deficiency syndrome and the increase number of organ transplants. The urogenital localization represents about 27% of all extra-pulmonary localizations of TB and may be due either to a disseminated infection or to a primitive genitourinary localization. The majority of patients, has pyuria, sometimes with hematuria. The diagnosis of urinary tuberculosis is based on the finding of pyuria in the absence of infection by common bacteria. The initial medical treatment includes isoniazide, rifampicin, pyrazinami-de, ethambutol and streptomycin. This disease should be suspected in patients with unexplained urinary tract infections, especially if immunocompromised and/or coming from endemic areas.     

基于蛋白质组学对脊柱结核患者外周血浆差异蛋白筛选及功能分析

【摘要】 目的：利用蛋白质组学技术筛选脊柱结核（spinal tuberculosis,STB）患者外周血浆中表达差异的蛋白质,探讨STB致病机制及代谢途径。方法：收集30例STB患者和30例健康志愿者的外周血,取其中3例STB患者（观察组）和3例健康志愿者（对照组）的外周血浆通过蛋白质组学同位素标记相对及绝对定量技术和液相色谱-质谱分析技术鉴定差异蛋白,筛选出表达差异显著（差异倍数>1.2,P<0.05）的蛋白质,并进行基因本体（gene ontology,GO）和京都基因与基因组百科全书（Kyoto Encyclopedia of Genes and Genomes,KEGG）富集分析;然后将30例STB患者和30例健康志愿者的血浆进行实时荧光定量逆转录聚合酶链反应（real-time quantitative polymerase chain reaction,RT-PCR）和酶联免疫吸附测定法（enzyme-linked immunosorbent assay,ELISA）验证其差异基因及蛋白。结果：STB患者外周血浆中共筛选出16个与对照组存在显著性差异的蛋白;其中11个蛋白[脂多糖蛋白（lipopolysaccharide-binding protein,LBP）、S100-A8蛋白（protein S100-A8）、S100-A9蛋白（protein S100-A9）、淀粉样蛋白A-2（serum amyloid A-2 protein,SAA2）、富含亮氨酸α-2糖蛋白（leucine-rich alpha-2-glycoprotein,LRG2）、蛋白聚糖4（proteoglycan 4,PRG4）、补体因子Ⅰ（complement factor I,CFI）、α-1-抗胰蛋白酶（alpha-1-antitrypsin,SERPINA1）、组织蛋白酶D（cathepsin D,CTSD）、血浆铜蓝蛋白（ceruloplasmin,CP）和λ免疫球蛋白（lambda-immunoglobulin 4-60,IGLV4-60）]表达上调,5个蛋白[黏着斑蛋白（vinculin,VCL）、3-64D免疫球蛋白（immunoglobulin heavy variable 3-64D,IGHV3-64D）、2D-29免疫球蛋白（immunoglobulin kappa variable 2D-29,IGKV2D-29）、非功能性免疫球蛋白（non-functional immunoglobulin 6D-41,IGKV6D-41）和1-45免疫球蛋白（immunoglobulin heavy variable 1-45,IGHV1-45）]表达下调。LBP、S100-A8蛋白和S100-A9蛋白在STB患者外周血浆的基因和蛋白表达与对照组比较均显著性升高（P＜0.05）,主要参与白介素-17信号通路和自噬信号通路,且在以上信号通路中与炎症、自噬、趋化因子等生物学功能相关。SAA2、LRG2、PRG4、CFI、SERPINA1、CTSD、CP和VCL的基因和蛋白表达与对照组无统计学差异;IGLV4-60、IGHV3-64D、IGKV2D-29、IGKV6D-41和IGHV1-45的基因表达与对照无显著性差异（P＞0.05）,蛋白表达未验证。结论：蛋白质组学可用于STB患者外周血差异蛋白的筛选及STB发病机制的研究,LBP、S100-A8和S100-A9蛋白可能是STB发病相关的重要表达蛋白,主要参与IL-17信号通路和自噬相关信号通路且集中于炎症、自噬、趋化因子等生物学功能。     

A review of patients with skeletal tuberculosis treated at the university hospital,kuala lumpur

Summary Two hundred and nineteen patients with skeletal tuberculosis have been reviewed analysing the site of the lesion and the treatment given. Operative management is advocated since the results of this approach are encouraging.

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Résumé Présentation de 219 cas de tuberculose ostéo-articulaire. L'article analyse la localisation et la thérapeutique appliquée aux différentes lésions. Le traitement chirurgical est préconisé, les résultats obtenus paraissent encourageants.

     

Wegener's granulomatosis of the breast

A 60-year-old woman presented with a painless self-detected breast lump. After wide local excision, the histology of this radiologically suspicious lump turned out to be an inflammatory lesion with granulomatous foci, suggesting a diagnosis of granulomatous mastitis. Prior to the excision biopsy, this woman had suffered from and been treated for anterior uveitis, secretory otitis media, and proximal myopathy. Four weeks later, a skin biopsy of a rapidly developing widespread petechial rash, mainly affecting the lower limbs, confirmed the diagnosis as Wegener's granulomatosis. Treatment with intravenous steroids and later cyclophosphamide produced rapid remission.