Dermoscopy of pigmented lesions on mucocutaneous junction and mucous membrane

Background The dermoscopic features of pigmented lesions on the mucocutaneous junction and mucous membrane are different from those on hairy skin. Differentiation between benign lesions and malignant melanomas of these sites is often difficult. Objective To define the dermoscopic patterns of lesions on the mucocutaneous junction and mucous membrane, and assess the applicability of standard dermoscopic algorithms to these lesions. Patients and methods An unselected consecutive series of 40 lesions on the mucocutaneous junction and mucous membrane was studied. All the lesions were imaged using dermoscopy devices, analysed for dermoscopic patterns and scored with algorithms including the ABCD rule, Menzies method, 7‐point checklist, 3‐point checklist and the CASH algorithm. Results Benign pigmented lesions of the mucocutaneous junction and mucous membrane frequently presented a dotted‐globular pattern (25%), a homogeneous pattern (25%), a fish scale‐like pattern (18·8%) and a hyphal pattern (18·8%), while melanomas of these sites showed a multicomponent pattern (75%) and a homogeneous pattern (25%). The fish scale‐like pattern and hyphal pattern were considered to be variants of the ring‐like pattern. The sensitivities of the ABCD rule, Menzies method, 7‐point checklist, 3‐point checklist and CASH algorithm in diagnosing mucosal melanomas were 100%, 100%, 63%, 88% and 100%; and the specificities were 100%, 94%, 100%, 94% and 100%, respectively. Conclusion The ring‐like pattern and its variants (fish scale‐like pattern and hyphal pattern) are frequently observed as well as the dotted‐globular pattern and homogeneous pattern in mucosal melanotic macules. The algorithms for pigmented lesions on hairy skin also apply to those on the mucocutaneous junction and mucous membrane with high sensitivity and specificity.     

Coronary artery disease in aortic surgery

The incidence of coronary artery disease in patients coming to aortic surgery and the impact of aggressive preoperative cardiac catheterization and myocardial revascularization was prospectively analyzed in 59 patients. Seventy-five percent of patients had at least one-vessel involvement, and 32% had three-vessel or left main involvement. Patients with electrocardiographic evidence of coronary artery disease had at least one-vessel involvement 84% of the time and three-vessel, left main involvement 36% of the time. Sixty-four percent of patients with no preoperative indications of coronary artery disease had at least one-vessel involvement and 29% had three-vessel, left main involvement. Resting (39 patients) and exercise multiple-gated acquisition scans (22 patients) did not predict the presence of coronary artery disease in patients without a history or electrocardiographic evidence of coronary artery disease. Myocardial revascularization was performed prior to aortic surgery in 17 patients (29%). The operative mortality was 3.7% with two patients dying from noncardiac-related complications. There were two additional deaths prior to aortic surgery with one patient dying during coronary artery bypass grafting, and one dying of aneurysm rupture prior to repair, making the overall mortality associated with this approach 7.4%. Preoperative cardiac catheterization and an aggressive approach toward coronary artery bypass grafting reduces the risk of cardiac complications in aortic surgery.     

成釉细胞纤维肉瘤间叶细胞的电镜和免疫组化研究

为探讨成釉细胞纤维肉瘤（ Ａ Ｆ Ｓ）间叶细胞的本质及特征, 作者采用免疫组化和电镜技术,对３例 Ａ Ｆ Ｓ间叶细胞进行了研究,并与６例成釉细胞纤维瘤进行比较。结果显示： Ａ Ｆ Ｓ的间叶细胞主要由成纤维细胞构成,此外尚有少许未分化间叶细胞和组织细胞, 偶见肌纤维母细胞。成纤维细胞仅表现 Ｖｉｍ ｅｎｔｉｎ 阳性。肌纤维母细胞呈 Ｖｉｍ ｅｎｔｉｎ, Ｈ Ｈ Ｆ３５及 α Ｓ Ｍ Ａ 阳性。组织细胞 Ｐ Ｇ Ｍ１ 和ｋｐ１标记均阳性, 可能是炎症或免疫反应的产物。与成釉细胞纤维瘤比较, Ａ Ｆ Ｓ间叶细胞具备较高的 Ｐ Ｃ Ｎ Ａ 阳性标记率, 提示 Ａ Ｆ Ｓ的增生活性较高。     

Usefulness of albumin–globulin ratio as a clinical prognostic factor in patients with thyroid cancer treated with radioiodine

Annals of Nuclear Medicine - Albumin–globulin ratio (AGR), which is calculated by dividing serum albumin by serum globulin, is considered as a cancer-related inflammation biomarker. Although...     

Benign lymphoid hyperplasia manifesting as a cecal mass: Report of a case

Summary We have presented an unusual case of benign lymphoid hyperplasia, which manifested as a cecal deformity in a 15-year-old boy. The clinical manifestation may have been related to partial occlusion of the appendiceal orifice. In future cases of benign lymphoid hyperplasia, colonoscopy may be diagnostic, and if it is used for continuing observation, may avert unnecessary surgical procedures in children and young adults.