Peutz-Jeghers syndrome. Two case reports

The Peutz jeghers syndrome is a familial affection with dominant autosomic transmission characterized by a hamartoma digestive polyposis and a cutaneous mucous lentiginosis with periorifice predominance. This affection represented 3 into 10% for the familial polyps. The digestive polyps constitute the must important part of the pentz jeghers syndrome because they determined to only the clinic manifestation and the disease prognostic with there complications: intestinal invaginations, haemorrhage. In this work, we report two observations of patients presented a Peurtz Jeghers syndrome, and we determine, after literature review the epidemiologic, pathogenic, clinic, anatomy pathologic, prognosis and therapeutics of this effection.     

Ear myiasis. Two case reports

The authors report two cases of aural myiasis. This pathology rarity induced us to search after epidemiologic, clinic and therapeutic peculiarity of this parasitical disease.     

Congenital coronary aneurysm. Three case reports

Congenital coronary aneurysms are an unusual anatomical entity. Their prognosis appears to be particularly dependent on the presence or absence of aneurysm thrombosis. We report three cases of congenital coronary aneurysms, diagnosed in one case after myocardial infarction. Two patients were treated successfully by an exclusion of the aneurysm and coronary bypass and the third patient was treated medically. The aim of this study is to discuss the clinical features, prognosis and management of this disease.     

Endometrial actinomycosis. Two case reports]

Actinomyces is an aerobic, Gram positive bacteria saprophyte of the genital tract. The endometrial involvement is extremely rare. The authors report two cases of pelvic actinomycosis in a 58 and 55 year old women, the second using intrauterine device for 11 years.     

Duplicate principal bile ducts. Two case reports

The duplicity of the way biliaire main is a rare abnormality. We report two observations revealed by episodes of angiocholite. The degrades cholangiopancreatography endoscopy allowed to wear diagnosis and to practise a therapeutic gesture.     

Emergency embolization in gynaecological bleeding. Two case reports

Two patients with gynaecological hemorrhage underwent successfully trans-arterial embolization. The first womanhad an uncontrollable perineal hemorrhage following a delivery with forceps. Angiography showed extravasation of contrast from right and left vaginal artery. Hyperselective embolisation stopped the vaginal bleeding. The second woman had massive hemorrhage following radiotherapy for cervical cancer. Angiography demonstrated extravasation of contrast from both uterine arteries. The bleeding was controlled after hyperselective embolisation. Emergency arterial embolisation is a safe and effective means of control of irrepressible genital hemorrhage.     

Subcapsular liver hematoma. Two case reports and review of the literature

The authors report two cases of complicated toxaemia by subcapsular haematoma of liver in the gynaecology obstetrics ward of the Mongi Slim university hospital in Marsa, Tunisia during six years. The diagnostic was made after delivery in all cases. Evolution was been favourable only in one case, the other is complicated by superinfection which required surgical draining. The literature review determiner the poor prognosis of the subcapsular haematoma of the liver.     

组织细胞坏死性淋巴结炎2例报道

组织细胞坏死性淋巴结炎(histiocytic necmtizing lymphadenitis，HNL)是以顽固性发热、区域性淋巴结肿大和白细胞减少为特征的疾病。成人发病国内报道较少。我科于2002年收治该病患2例，已随访1年余，现报告如下。     

Serious retinal detachment in severe pre-eclampsia. Two case reports

The serous detachment of the retina is a rare but serious complication of the severe preeclampsia. It's diagnosis rests on the systematic exam of the eye fundus at the time of the stern shapes of preeclampsia and especially at every change of the visual acuteness. Therefore the observed anomalies must be confirmed by the practice of a retina angiography in the following week. The observation of such complication at the pregnant woman must induce the childbirth who is the only efficient treatment to preserve her visual prognosis. Usually the serous detachment of the retina disappears spontaneously in some days but some visual aftermaths can occurs in cases where papillary edema is prolonged or in cases of macular pigmentary migrations. As for foetal prognosis, it's often reserved.     

Hepatocellular carcinoma in a non-cirrhotic liver. Two case reports and literature review

Hepatocellular carcinoma (HCC) is closely associated with cirrhosis, but it also develops, although much less frequently, in a non-cirrhotic liver. It is suspected that hepatocellular carcinoma has a different etiology when associated and not associated with chronic liver disease. We report two cases of patients with hepatocellular carcinoma that developed in a non-cirrhotic liver. In the first case we describe an incidental liver nodular lesion containing multiple foci of HCC including pseudogland or trabecular formation and areas of sclerosis. The non-cancerous parenchyma of the liver was histologically unremarkable except for mild fatty changes of hepatocytes and minimal dysplasia. The second case describes a combined hepatocellular carcinoma and cholangiocellular carcinoma (CCC) (mixed carcinoma) in a patient who was serologically negative for both hepatitis B and C viruses. The adjacent liver parenchyma showed mild piecemeal necrosis and mild lobular activity compatible with chronic viral hepatitis, but cirrhosis was not established. This case appears to indicate that mixed type carcinoma can develop in a non-cirrhotic liver, with CCC being far more dominant than HCC; such a finding is extremely unusual, based on previously published reports.     

咽源性颈深部脓肿2例

1临床资料病例1,男,48岁。因咽痛10 d于2003年5月30日入住本院耳鼻咽喉科。入院前10 d出现咽痛,继而张口受限,吞咽困难。静脉滴注头孢类及左氧氟沙星等药物抗感染治疗4 d,无效并出现左颈肿痛。否认有耳流脓史。入院时体温37.5℃,白细胞6.3×109/L;左颌下、颈部明显红肿,触之硬如板状,压痛明显;左扁桃体Ⅱ°,充血,周围红肿,诊断为扁桃体周围炎并发颈深部蜂窝组织炎。即给予头孢哌酮、替硝唑等抗菌药物静脉滴注。入院第3 d,左耳溢稀薄脓液,颈部肿痛加剧并波及胸上部,呼吸不畅,严重贫血(血红蛋白59 g/L),即输血400 mL,当日在局麻下行颈部切开…     

脑室-腹腔分流术后导管相关感染2例报告

1临床资料 病例1,男,20岁。因外伤致脑积水行脑室.腹腔分流术。术后1周渐起反复发热,历时3个月,最高体温达40℃。在外院被诊断为“肺部感染”,经多种抗生素治疗效果不佳。患者转入我院ICU时,神志昏迷,颈稍抵抗,气管切开,双肺可闻及少量哕音,心脏及腹部检查正常,四肢肌张力高,分流泵植入部位皮肤稍红,血象高,查胸片正常,头部CT示幕上     

急性心肌梗死冠脉内血栓病变处理36例临床分析

目的分析急性心肌梗死冠状动脉内血栓病变的治疗对策。方法36例患者,其中男20例,女16例,年龄38～76岁,发病时间1～8h,均经急诊冠脉造影证实冠脉内有血栓。24例患者冠状动脉注射替罗非班,其中18例患者急诊冠脉内植人支架,6例患者因冠脉内血栓负荷量很大,冠脉内注入替罗非班后,继续以静脉泵入替罗非班36～48h。结果1周后冠脉造影显示冠脉内血栓消失,1例患者罪犯血管轻度狭窄,未行PCI术,其余5例行PCI术;4例患者冠脉内血栓负荷量大,予以冠脉内尿激酶溶栓治疗,当时未行PCI术,继之抗凝、抗血小板等治疗1周后择期PC]术;4例患者血栓负荷量中等,应用球囊通过血栓,同时应用肝素盐水静脉内注入,将血栓冲至冠脉远端,再行PCI术;4例患者血栓负荷量大,应用抽吸导管,未成功者改为替罗非班冠脉内注入,择期PCI术。结论冠脉内血栓病变应依据血栓负荷量多少采取相应对策,替罗非班应用疗效较好,冠脉内溶栓治疗亦有一定疗效,球囊通过冠脉血栓肝素盐水冲洗只适用于血栓负荷量小的患者。     

Myocardial infarction and water hardness in the WHO myocardial infarction registry network.

The negative association between water hardness and cardiovascular disease found by several authors in different countries has also been found in the present investigation. All cases of myocardial infarction were registered in a standardized way at 15 WHO Collaborating Centres in Europe; information on the hardness of drinking water used by the population studied was also collected. Higher rates of myocardial infarction were usually found in towns served by softer water.     

Pure dysgerminoma of the ovary. 12 case reports

Data from the files of 12 patients with pur ovarian dysgerminoma managed between January 1970 and december 1990 were evaluated. Pur ovarian dysgerminoma accounts for 2% of all ovarian malignancies and 28% of malignant germ cell tumors. A palpable pelvic mass was detected in three-fourth of patients. Echography objective ovarian tumor in all cases. Diagnosis was histological. Primary treatment was surgery followed by radiotherapy in 8 cases and chemotherapy in 2 cases. 2 patients developed local recurrences were irradiated and 1 patient developed distant metastases was given chemotherapy in association to radiotherapy. The 5 years survival rate was 91.7%. CONCLUSION: Treatment of ovarian dysgerminoma remains controversial. However, patients with stage la who desire further childbearing can be safely treated with unilateral adnexectomy. For all other patients, radical surgery followed by radiation therapy or chemotherapy for the advanced stages and recurrents dysgerminoma is the treatment of choice. Prospective randomized clinical trials are needed for a well codified therapeutic strategy.     

Two case reports of neurological disease in coal mine preparation plant workers

Of 60 cases of neurotoxicity related to occupational exposures of workers at plants producing acrylamide monomers, cases involving neurotoxicity related to jobs using polymers with acrylamide monomer contamination have not been widely reported. In 1992, two patients were referred to the Division of Occupational and Environmental Health, Department of Family and Community Health, Marshall University School of Medicine, in Huntington, West Virginia for evaluation. The patients had worked in different coal preparation plants in southern West Virginia for over 10 years and had exposure to an acrylamide polymer flocculent contaminated with acrylamide monomer. Both patients had no instruction on proper use of, or the dangers of, acrylamide and were not given adequate safety equipment. Patient A developed Parkinsonism and Patient B peripheral neuropathies with a neurogenic bladder. These two case reports highlight the need to reemphasize the basic tenets of occupational health and safety. Many chemicals are being introduced into mining operations and awareness of potential toxic exposures and new diseases not previously reported in the mining industry must become part of the surveillance system by mine management and labor safety committees. Further studies on the extent of acrylamide neurotoxicity in the mining industry is encouraged. © 1996 Wiley-Liss, Inc.