First Report of Human Acute Acalculous Cholecystitis Caused by the Fish Pathogen Lactococcus garvieae

We report herein the first case of acute acalculous cholecystitis caused by Lactococcus garvieae, which is known as a fish pathogen. A 69-year-old fisherman underwent laparoscopic cholecystectomy due to severe inflammation in the gallbladder. The isolate obtained from the gallbladder was identified as L. garvieae by 16S rRNA and manganese-dependent superoxide dismutase (sodA) gene sequence analysis.     

Q Fever in Adults: Review of 66 Clinical Cases

Sixty-six cases of Q fever in adults, serologically confirmed by indirect immunofluorescence, were studied to analyze the epidemiological, clinical and therapeutic aspects of the disease. Eighty-three percent of the patients were male, and the mean age was 44.7 years. Contact with animals was recorded in 24 patients. The main clinical form of presentation was pneumonia (37 cases); eight patients had hypoxia, and five had respiratory failure. The empirical treatment consisted of macrolides in 36% of cases. Evolution was favorable in all cases. Electronic Publication     

急性结石性胆囊炎腹腔镜胆囊切除术116例

目的:探讨腹腔镜治疗急性结石性胆囊炎的临床效果.方法:采用常规四孔法行腹腔镜胆囊切除术治疗急性结石性胆囊炎116例.结果:116例患者腹腔镜成功率89.7%,中转开腹率10.3%,并发症发生率0.结论:急性结石性胆囊炎行腹腔镜胆囊切除术是安全可行的,正确处理胆囊三角是手术成功的关键,适时中转开腹是手术安全、减少并发症的保障.     

急性白血病起始的慢粒急变4例报道并文献复习

目的探讨急性白血病起病的慢性粒细胞白血病急变期患者的临床特点及治疗方法。方法对4例以急性白血病起始的慢性粒细胞白血病急变期患者的诊疗过程进行报道,结合相关文献分析以急性白血病起始的慢性粒细胞白血病急变期患者的临床特点和治疗方法。结果4例患者均符合以急性白血病起始的慢性粒细胞白血病急变期,其中2例患者采用化疗及靶向治疗将患者的病情转变为慢性期,再进行异基因外周血干细胞移植,2例患者至今存活,生存期至少4年;1例予以甲磺酸伊马替尼治疗后转为慢性期,未行异基因造血干细胞移植,再次急变后死亡,生存期约100天;另1例诊断后仅接受羟基脲治疗,生存期1年。结论急性白血病起始的慢性粒细胞白血病急变期患者临床上较为罕见,使用化疗或靶向药物治疗使骨髓象得到缓解后再进行异基因造血干细胞移植,有望延长此类患者的生存期。     

腹腔镜胆囊切除术治疗急性结石性胆囊炎1526例

目的:总结急性结石性胆囊炎行腹腔镜胆囊切除术(LC)的治疗体会.方法:2000年7月至2010年7月,采用LC术治疗急性结石性胆囊炎1 526例.结果:成功完成LC 1 435例(94.0%),中转开腹91例(6.0%).LC术后有7例出血,3例胆瘘,经过及时开腹手术或腹腔引流后均治愈.随访1～12个月,除1例发现有胆管癌外,其余1 525例均治愈,无死亡病例.结论:急性结石性胆囊炎行LC虽然难度较大,但只要把握好手术适应证,熟练地掌握LC操作技术,把握中转手术指征与时机,行LC术治疗仍然是安全有效的.     

急性胆囊炎患者相关经穴电学特性研究

本文利用作者已建立的一种客观反映经络功能活动的电导和电位检测的方法技术,研究了胆囊炎患者手术前后胆经上与病症有关穴的电学动力学特征并与健康正常人进行了对照分析。所得结果显示:炎症期间,阳陵泉和胆囊穴的电导和电位动力学各指标发生了显著增加的变化,随着炎症的解除,各指标向正常值转化。说明,经穴电导和电位动力学指标可以从一个方面客观表现经络反映病症的功能。利用检测经穴电学动力的特征可望发展为急腹症炎症诊断的一种技术。     

Deciduoid Mesothelioma: A Report of 5 Cases and Literature Review

Deciduoid mesothelioma was first described in young females and in the peritoneum, which led to the suggestion that deciduoid mesothelioma was a distinct subtype with specific clinical and pathologic features. Later reports, however, have shown that this type of mesothelioma may also occur in elderly people and in the pleura. Cases reported in the literature so far are limited, and the disease is not well defined. The authors report the histologic, immunohistochemical, ultrastructural, and clinical findings of 5 cases of deciduoid mesothelioma, and review the literature reports. The results demonstrate that the presence of numerous cytoplasmic intermediate filaments, either dispersed or bundled, appear to be the likely ultrastructural basis for the deciduoid histologic appearance. Twenty-one cases of deciduoid mesothelioma were identified in the literature. Analyses of these 21 cases and the authors' 5 cases showed an age range of 13-78 years (median 53 years) and a slight female predominance (female to male ratio of 1.4:1). Fourteen of 26 cases (54%) occurred in the peritoneum. Seven of 20 patients (35%) had a documented history of asbestos exposure. Fifteen of 20 patients died, with a mean survival time of 7.33 months (range 1-21 months). Five of 20 patients were alive at a follow-up time of 8 months to 5 years. These findings suggest that the so-called deciduoid mesothelioma has some clinical and pathologic features that are dissimilar to mesothelioma in general. Whether it truly represents a pathogenetically distinct variant or merely an expansion of the morphologic spectrum awaits further studies.     

High Coxiella burnetii DNA Load in Serum during Acute Q Fever Is Associated with Progression to a Serologic Profile Indicative of Chronic Q Fever

PCR is very effective in diagnosing acute Q fever in the early stages of infection, when bacterial DNA is present in the bloodstream but antibodies have not yet developed. The objective of this study was to further analyze the diagnostic value of semiquantitative real-time PCR (qPCR) in diagnosing acute Q fever in an outbreak situation. At the Jeroen Bosch Hospital, in 2009, qPCR testing for Coxiella burnetii DNA was performed for 2,715 patients suspected of having acute Q fever (positive, n = 385; negative, n = 2,330). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the qPCR assay were calculated for patients with negative qPCR results with a follow-up sample obtained within 14 days (n = 305) and qPCR-positive patients with at least one follow-up sample (n = 369). The correctness of the qPCR result was based on immunofluorescence assay results for samples submitted for qPCR and follow-up testing. The sensitivity of the Q fever qPCR assay was 92.2%, specificity 98.9%, PPV 99.2%, and NPV 89.8%. Patients who later developed serologic profiles indicative of chronic Q fever infection had significantly higher C. burnetii DNA loads during the acute phase than did patients who did not (P < 0.001). qPCR testing is a valuable tool for the diagnosis of acute Q fever and should be used in outbreak situations when the onset of symptoms is <15 days earlier. Special attention is needed in the follow-up monitoring of patients with high C. burnetii DNA loads during the acute phase, as this might be an indicator for the development of a serologic profile indicative of chronic infection.     

CLEAR CELL CHONDROSARCOMA: A Report of Two Cases and Review of Literature

Two cases of clear cell chondrosarcoma located in the distal femur and proximal humerus are reported. Both patients were men aged 35 and 51 years. Their initial symptom was a pathologic fracture. Roentgenographically, one patient showed a purely lytic lesion and another lytic with centrally radiodensity. Microscopic examination revealed that the tumor cells have a centrally placed vesicular nucleus surrounded by a clear cytoplasm, with distinct boundaries. Their cytoplasm stained with S-100 protein by the peroxidaseantiperoxidase method. We found 36 reported cases (including the two reported here), and delineated the clinico-pathologic characteristics of the disease. ACTA PATHOL. JPN. 36: 1577-1585, 1986.     

Clinical Features of Abdominopelvic Actinomycosis: Report of Twenty Cases and Literature Review

Purpose

Intrabdominal actinomycosis is difficult to diagnose preoperatively. This chronic infection has a propensity to mimic many other diseases and may present with a wide variety of symptoms. The aim of this study was to evaluate the characteristic clinical features with review of the literature.

Materials and Methods

We retrospectively analyzed 22 patients with intrabdominal actinomycosis between January 2000 and January 2006.

Results

There were two men and 20 women with a mean age of 42.8 years (range, 24 - 69). Twelve patients presented with masses or abdominal pain, whereas 3 patients presented with acute appendicitis. The rate of performing an emergency surgery was 50% due to symptoms of peritonitis. The mean size of tumor was 5.5 cm (range, 2.5 - 11.0). Sixty percent (n = 12) of female patients had intrauterine device (IUD). The average time to definite diagnosis was 10.6 days.

Conclusion

Intrabdominal abdominal actinomycosis must first be suspected in any women with a history of current or recent IUD use who presents abdominal pain. If recognized preoperatively, a limited surgical procedure, may spare the patient from an extensive operation.     

Hyperthyroidism and Ulcerative Colitis: Report of Two Cases and a Review of the Literature

Two cases of coexisting ulcerative colitis and hyperthyroidism are discussed. In both patients, thyrotoxicosis preceded the development of the ulcerative colitis. Exacerbations of the thyroid disease led to exacerbations of ulcerative colitis and consequent difficulty in the management of the patients. Although a review of the literature reveals a possible connection with abnormalities of iodine metabolism in the ulcerative colitis patient, no definite conclusions are drawn.     

Dermoid Cyst of the Lateral Neck Associated with the Thyroid Gland: a Case Report and Review of the Literature

Dermoid cysts are the most common teratomatous lesion; however, they infrequently arise in the head and neck region. Very rarely, dermoid cysts have been described in the thyrohyoid region, masquerading as a thyroid nodule. We describe the case of a 31-year-old woman with a lateral neck mass, associated with the thyroid gland inferiorly, which was excised and found to be a dermoid cyst. We then review the pathogenesis of dermoid cysts in this region, as well as review diagnosis and treatment of dermoid cysts of the head and neck.