Isolated adenomatous polyposis of the appendix. Report of two cases

BACKGROUND: Adenomas are rarely diagnosed in the appendix and may be isolated or may coexist with other neoplasms in the gastrointestinal tract. This emphasizes the need for postoperative colonoscopy when a polyp of the appendix is found. Moreover, the polyps are considered to be premalignant lesions. AIM: Report two new cases of adenomas of the appendix. CASES: We report the cases of 23-year-old and 22-year-old men, for whom appendicectomy performed for acute appendicitis. In both cases, histologic studies revealed adenomas in moderate dysplasia ; colonoscopy did not reveal any polyps.     

Diabetes following kidney transplantation. Report of 35 cases

Post-transplant diabetes mellitus (PTDM) is a frequent complication of renal transplantation. It has a prevalence rate ranging from 3 to 46%. We undertook a retrospective study of 175 nondiabetic renal transplant recipients to determine the prevalence rate, clinical characteristics, and risk factors of PTDM in kidney transplant recipients in our region. Thirty five patients (20%) developed PTDM, 50% were diagnosed by 3 months post transplantation. Eight patients (22.8%) were insulin recurrent. PTDM was independent of kidney source, family history of diabetes, age, sex, incidence of acute rejection, body weight gain, steroid or cyclosporine dose, use of beta-blockers and cytomegalovirus infection. Acturial 5 years survival was 79.4% in the diabetic compared to 80.5% in the control group. Patient survival was similar in the two groups. We conclude that PTDM is frequent in our patients. No significant risk factors of PTDM were identified in this study.     

Abdomino-pelvic actinomycosis. Report of 2 cases

Actinomycosis is a chronic, granulomatous, suppurative and fistulasing infection related to a gram-positive bacteria (actinomyces israeli). Cervico-facial actinomycosis is the most common localization. The prevalence of abdomino-pelvic actinomycosis is increasing mainly with the increase of the use of intrauterin device. Its clinical presentation is variable and may mimic cancer or tuberculosis. The diagnosis of abdomino-pelvic actinomycosis is hard and most of the cases are detected during surgical exploration. We report two cases of abdomino-pelvic actinomycosis; in the first case, the disease was extended to the caecum and the abdominal wall. The skin biopsies made the diagnosis of actinomycosis, avoiding surgery. In the second case, the diagnosis of actinomycosis is made post operatively because of high suspicion of pelvic cancer. Through these two observations, we review pathogenesis of the disease, its clinical aspects and its diagnostic and therapeutic means.     

Testicular non-Hodgkin's lymphoma. Report of 2 cases

We report two cases of non Hodgkin malignant lymphoma of the testis observed in two patients 36 and 32 years old. Diagnosis was made on pathological examination after orchiectomy. One patient had an involvement of the lung and Waldeyer's ring and the other presented cerebral involvement. Despite combination chemotherapy and external beam radiation therapy, the disease progression was rapid and fatal in the first patient (19 months) while the second had multiple cerebral relapses and died by disease progression 21 months after orchiectomy.     

Secondary plasma cell leukemia. Report of 2 cases

Plasma cell leukemia is considered as the leukemic variant of multiple myeloma. It is a rare entity. There are two forms: a secondary one following a known myeloma, the diagnosis of which is easy, and a primary one arising without a preceding phase of multiple myeloma. The diagnosis of the latter form is more difficult, a differential diagnosis has often to be discussed with other lymphoproliferative diseases. Prognosis is poor. We report 2 cases of secondary plasma cell leukemia diagnosed over ten years, among 59 of multiple myeloma cases. We describe the epidemiologic, clinical, biological and evolutionary characteristics.     

Extra-thoracic solitary fibrous tumor. Report of 2 cases

The solitary fibrous tumor (SFT), is an unusual entity, first described in the pleura, but can involve other serosal surfaces and viscera. We report two cases of extra-thoracic SFT involving the retro-peritoneum and the upper arm. Extra-thoracic TFS is a rarily wide morphologic and evolutive spectrum.     

自发性额颞叶脑内血肿的急救处理

目的 探讨自发性额颞叶脑内血肿的急救处理措施.方法 回顾性分析27例自发性额颞叶脑内血肿合并蛛网膜下隙出血或脑室出血患者的抢救经过及手术经验.23例行外科手术,4例发生脑疝患者急诊在全身麻醉插管下行开颅血肿清除、动脉瘤夹闭术、去骨瓣减压术;7例既往有高血压病史,考虑高血压脑出血,急诊在全身麻醉下行开颅血肿清除、去骨瓣减压术;12例大脑中动脉动脉瘤破裂出血,择机行开颅血肿清除、动脉瘤夹闭术.4例数字减影血管造影（DSA）或CT血管造影（CTA）未发现异常,予以保守治疗,其中1例1个月后复查DSA提示动静脉畸形,予伽马刀治疗.结果 术后因严重脑梗死导致死亡2例,对25例患者随访6个月,按格拉斯哥预后量表（GOS）分级：预后良好17例,预后不良7例,植物状态1例.结论 自发性额颞叶脑内血肿已形成脑疝的病例,应尽快解除脑疝和占位效应,尽早手术挽救生命;对未形成脑疝患者,行DSA或CTA明确诊断后,选择合理的治疗方案.充分的术前评估、合理的手术时机、良好的显微外科手术技巧,能有效改善预后.     

肾脏移植术2例病人的护理

目的:通过2例肾脏移植病人的护理,使我院护理技术上了一个新台阶.方法:应用心理护理、并发症的防护、特别护理、饮食护理和出院康复指导等护理措施进行护理.结果:病人1个月痊愈出院.结论:肾脏移植病人护理成功的关键在于各项护理措施的落实.     

自发性硬脊膜外血肿6例的诊断和治疗

目的：探讨自发性硬脊膜外血肿（SSEH）的临床特征，治疗及影响预后的因素。方法：回顾性分析6例自发性硬脊膜外血肿患者的临床特征、手术治疗时机和手术后神经功能恢复，结合有关文献，分析影响预后的因素。结果：SSEH好发青壮年患者，多急性起病。患者术前神经功能状态越好预后越好。随访证实术后6例患者神经功能均能得到不同程度恢复。结论：MRI是最佳最快诊断方式。尽早椎板减压手术可以有效恢复脊髓功能。