Hemorrhagic intestinal lymphangioma --report of a case

This paper presents the case of a male patient, 57 years old, admitted to the hospital for upper digestive bleeding revealed by melena stools. The upper digestive endoscopy has not discovered the source of bleeding. Conventional medical therapy, with hemostatics, proton pump blockers and transfusion, failed to stop the bleeding, requiring emergency surgery for stopping the bleeding. The intraoperative exploration discovered three submucosal formations with dimensions between 0,5 and 0,75 cm, who ulcerated the jejunal mucosa, situated at 20-25cm from the duodeno-jejunal angle. The pathologic report described haemorrhagic intestinal lymphangioma. The excision of the sub-mucosal haemangioma stopped the bleeding.     

Sentinel nodes in patients with breast cancer

The aim of this paper is to debate, on the basis of medical literature review, the importance of detection the sentinel nodes in surgery of breast cancer. The beginning of the paper emphasized the problems of the sentinel nodes definition, and then we discuss the dates related to the history and the importance of the sentinel nodes knowledge that consist in the avoidance of axillary lymph nodes dissection in patients with breast cancer N-. Afterwards, we present the indications for detecting the sentinel nodes and the criterion to exclude from the detection of the sentinel nodes. As a part of the results of surgery sentinel nodes, we present dates about the techniques of detection the sentinel nodes, the place of injection of the radiopharmaceuticals, the size of the radiocolloid. Finally, we come up in the conclusion that the identification of the sentinel nodes is useful and possible for majority of the patients with breast cancer T1 or T2N0M0.     

Proportion of short propriospinal fibers in the lumbar division of the spinal cord of the cat

Stimulating and recording electrodes were located at various distances from each other either in the lateral or in the ventral funiculus of the lumbar spinal cord of decerebrated curarized cats. The recorded response considerably decreased at the distance of 10-15 mm, suggesting that most propriospinal fibres have a length not exceeding the length of one or two spinal segments.     

A case of hyperglycemic hyperosmolar state associated with Graves' hyperthyroidism: a case report

Hyperglycemic hyperosmolar state (HHS) is an acute complication mostly occurring in elderly type 2 diabetes mellitus (DM). Thyrotoxicosis causes dramatic increase of glycogen degradation and/or gluconeogenesis and enhances breakdown of triglycerides. Thus, in general, it augments glucose intolerance in diabetic patients. A 23-yr-old female patient with Graves' disease and type 2 DM, complying with methimazole and insulin injection, had symptoms of nausea, polyuria and generalized weakness. Her serum glucose and osmolarity were 32.7 mM/L, and 321 mosm/kg, respectively. Thyroid function tests revealed that she had more aggravated hyperthyroid status; 0.01 mU/L TSH and 2.78 pM/L free T3 (reference range, 0.17-4.05, 0.31-0.62, respectively) than when she was discharged two weeks before (0.12 mU/L TSH and 1.41 pM/L free T3). Being diagnosed as HHS and refractory Graves' hyperthyroidism, she was treated successfully with intravenous fluids, insulin and high doses of methimazole (90 mg daily). Here, we described the case of a woman with Graves' disease and type 2 DM developing to HHS.     

Screening for congenital disorders of glycosylation in the first weeks of life

Inherited monogenetic human disorders due to deficiencies in the complex metabolic pathways for N- and O-glycosylation of glycoconjugates are termed ‘congenital disorders of glycosylation’ (CDG). Since the number of these defects with mostly severe multisystemic phenotypes has been rapidly expanding in recent years, the interest of paediatricians has also increased resulting in a rising amount of patient samples with the suspicion of CDG. In general, primary diagnostics for CDG start with investigations on the glycosylation state of serum transferrin, the ‘gold standard’ in the field for many years. However, the use of transferrin shows an analytical problem in the time span from birth up to the 3rd month of life. In this developmental period oligosaccharide moieties N-linked to proteins are often incomplete, resembling a CDG pattern and leading to false-positive results. It is therefore necessary to establish a reliable and fast diagnostic procedure for this span of life. Here we show that the glycosylation state of serum α-1-antitrypsin is already fully existent shortly after birth allowing an alternative diagnostic approach for the investigation of CDG in the first weeks of life. The method can easily be established in every laboratory especially with previous experience in transferrin analysis.     

血压变异性与脑梗死溶栓治疗后出血转化的相关性研究

目的探讨临床中脑梗死溶栓治疗后出血转化(HT)的发生与血压变异性之间的相关性。方法对2008年6月—2012年6月在本院进行急性脑梗死溶栓治疗的84名患者行CT或MRI检查,并监测治疗后的24 h动态血压。结果脑梗死患者溶栓治疗后HT在本研究中的发生率为17.9%(15/84)。HT组24 h收缩压(SBP)及舒张压(DBP)〔(146±17)、(95±15)mm Hg〕高于无HT组〔(133±11)、(88±9)mm Hg〕,差异有统计学意义(P<0.05);24 h SBP及DBP的变异系数(CV)〔(11.6±3.7)、(16.3±5.6)〕与无HT组〔(8.5±2.6)、(10.2±3.1)〕间差异亦有统计学意义(P<0.01)。结论脑梗死溶栓治疗后HT与血压变异性相关,HT患者的血压变异更加明显。     

原发性甲状腺弥漫性大B细胞淋巴瘤临床病理观察

目的：探讨原发性甲状腺弥漫性大B细胞淋巴瘤的病理诊断与鉴别诊断要点。方法：对2例原发性甲状腺弥漫性大B细胞淋巴瘤进行临床病理特点观察,使用LCA,CD20,CD79α,CD3 ,CD45RO ,CEA ,TG ,TTF-1等免疫组化染色辅助诊断,并文献复习。结果：原发性甲状腺弥漫性大B细胞淋巴瘤临床诊断困难,镜下病理形态多样,免疫组化B细胞标记（＋）。 结论： 原发性甲状腺弥漫性大B细胞淋巴瘤少见,临床易漏诊且侵袭性较高,因此准确、完整的病理诊断对临床治疗以及预后十分重要,免疫组化具有很重要的辅助诊断作用。