A rare presentation of bilateral,synchronous male breast cancer

Rarity of male breast cancer limits available clinical research and data for management guidance and screening guidelines for patients at high risk. Here, we report on a patient with bilateral, synchronous male breast cancer with discussion of risk factors and need for possible screening.     

全自动同步换血术治疗重症新生儿溶血病27例临床分析

目的探讨全自动同步换血术在新生儿溶血病治疗中的作用。方法对27例达换血标准的新生儿溶血病患儿采用以外周动静脉作为输入、输出途径,用两部输液泵建立全自动双管末梢血管同步换血,换血前后检测患儿各项胆红素水平及血压、电解质、血糖水平。结果换血前后血清总胆红素、结合胆红素、非结合胆红素下降水平差异有统计学意义（P〈O．01）。血糖及血红蛋白水平在换血后升高,差异有统计学意义（P〈O．05）;而血压、血钙水平在换血前后差异无统计学意义（P〉O．05）。27例患儿黄疸完全消退,最早为换血后2d,最迟13d,平均6d。结论全自动同步换血术可迅速降低胆红素水平,治疗新生儿溶血病的效果显著,无明显并发症;相对于传统换血术可减少感染机会,对血压影响小,适宜临床推广应用。     

湖北省潜江市人、牛同步化疗控制血吸虫病16年纵向观察

目的评价湖沼渠网型重疫区采取人、牛同步化疗措施的效果.方法收集1992-2008年湖北省潜汀市人、牛同步化疗的年报资料,根据当地1989年的居民感染率将流行村划分为3级,并依据1992--2003年和2004--2008年两种化疗方案的实施,来对当地的血吸虫感染情况进行比较分析.结果通过16年纵向观察,人群感染率下降了72.37%(X2:9.85,P<0.01),牛感染率下降65.18%(X2=5.63,P<0.01),钉螺感染率及感染螺密度分别下降了63.64%及69.44%.结论实施人、牛同步化疗16年后,血吸虫病得到有效控制.     

24h平均脉压差与冠心病心律失常的相关性分析

目的 探讨冠心病(CHD)合并高血压(HBP)患者24h平均脉压与冠状动脉病变程度及心律失常的关系.方法 选择经冠脉造影、动态血压与心电同步监测等相关检查诊断为CHD合并HBP患者154例,依据24h平均脉压(PP)将其分为A、B两组,A组PP＜50mmHg、B组PP≥50mmHg,对比两组冠状动脉病变程度、心律失常发生情况.结果 B组患者三支病变发生率及病变血管支数显著高于A组,p＜0.01;B组患者双支病变发生率、冠脉狭窄积分、冠脉狭窄程度均高于A组,p＜0.05;B组患者ST-T改变、心律失常的发生率均明显高于A组,p＜0.05.结论 采用24h动态血压和心电同步监测CHD合并HBP患者,发现脉压变大与冠状动脉病变程度、心律失常及心肌缺血呈正相关,表明PP是一项较为可靠且简便易行的客观评估CHD预后重要指标之一.     

Are synchronous and metachronous bilateral breast cancers different? An immunohistochemical analysis aimed at intrinsic tumor phenotype

The biology and pathomechanism of bilateral breast cancers is not fully understood. We compared the morphological and immunohistochemical characteristics of primary tumors in patients with synchronous bilateral breast cancers and metachronous bilateral breast cancers, with special focus on intrinsic tumor phenotype. Methods: Tumor morphology and expression of 8 immunohistochemical markers were assessed in tissue microarrays containing primary breast tumor cores from 113 metachronous bilateral breast cancers and 61 synchronous bilateral breast cancers. Analyzed markers included hormone receptors (estrogen receptor, progesterone receptor), HER2, Ki67, cytokeratin 5/6, E-cadherin, vimentin and epidermal growth factor receptor. Cutoff levels are provided in the table. Results: Metachronous bilateral breast cancers tumors had lower estrogen receptor expression (p=0.047) and higher expression of cytokeratin 5/6 (p=0.017) and of vimentin (p=0.008); in multivariate analysis only vimentin retained the significance (p=0.01). Ten (13%) and 11 (26%) of metachronous bilateral breast cancers and synchronous bilateral breast cancers had luminal A phenotype, 39 (50%) and 15 (36%) were luminal B HER2-negative, 13 (17%) and 12 (28%) - luminal B HER2-positive, 3 (4%) and 2 (5%) - HER2-positive (not luminal), and 12 (16%) and 2 (5%) had triple negative phenotype (p=0.07). Conclusion: Metachronous bilateral breast cancers, compared to synchronous bilateral breast cancers, are characterized by more aggressive phenotype, expressed by lower expression of estrogen receptor and stronger expression of cytokeratin 5/6 and vimentin; this does not, however, translate into differences in the distribution of intrinsic tumor phenotypes.     

Concurrent pleural infiltration by chronic lymphocytic leukemia and adenocarcinoma of unknown primary site diagnosed by effusion cytology

Synchronous malignancies in a pleural effusion are rare. A case of concurrent pleural infiltration by adenocarcinoma of unknown primary site and chronic lymphocytic leukemia (CLL) is presented in this case study, which was diagnosed by effusion cytology. Pleural effusion is not an uncommon complication in patients with B‐CLL. Even in a pleural effusion rich in monoclonal lymphocytes, the presence of a second cancer must be excluded because this can be the main cause of mortality. The role of cytology in such cases is of paramount importance. Diagn. Cytopathol. 2014;42:151–155. © 2012 Wiley Periodicals, Inc.     

同步视频监测侧方扩散反应在面肌痉挛手术中的应用

目的 探讨显微血管减压术(microvascular decompression,MVD)治疗面肌痉挛术中应用同步视频监测侧方扩散反应(lateral spread response,LSR)的意义.方法 回顾性分析105例行MVD且术中实施同步视频LSR监测的面肌痉挛病人的临床资料.分别将依据术中LSR监测及同步视频...     

Flying blind: The experience of online interprofessional facilitation

The role of the facilitator is known to be important in fostering productive interprofessional education (IPE) in the face-to-face (F2F) environment. Online learning can help surmount some of the logistical challenges in IPE by bringing together diverse professionals in multiple geographical locations. Best practices in F2F IPE facilitation are beginning to emerge, but there is scant literature examining IPE facilitation online. What little research exists has focused on the asynchronous environment and suggests that the skill sets of online and F2F facilitators have considerable overlap, but there are further demands in the online setting. This qualitative study sought to examine online synchronous IPE facilitation through the self-reported experiences of seven trained facilitators during a 12-week online course. Data collected through focus groups and targeted interviews were analyzed by the research team using constant comparison techniques. Four major themes were revealed: technology as a dynamic force, reduction in non-verbal cues, evolution of the online IPE group process over time and the importance of co-facilitation. The foundations of IPE facilitation were seen to carry over to the online setting. This study has implications for the training of IPE facilitators and for the design of online IPE learning experiences.     

Synchronous Bilateral Breast Carcinoma in a Patient with Cowden Syndrome: A Case Report with Morphologic,Immunohistochemical and Genetic Analysis

Abstract: Synchronous bilateral breast carcinoma (SBBC) and early onset are important characteristics of hereditary cases. The lifetime risk for breast carcinoma in Cowden syndrome (CS) is estimated to be 25–50%. We reported a 44‐year‐old woman presenting SBBC and characteristic mucocutaneous lesions of CS, confirmed by PTEN gene mutation analysis. Bilateral modified mastectomy and axillary dissection were performed. Histopathologic examination revealed a moderate‐differentiated invasive ductal carcinoma with mixed features of luminal A immunophenotype (Estrogen and/or Progesterone Receptors >50% and/or Ki67 < 30% of positive cells). The skin lesions showed the characteristic findings of tricholemmoma. Lack of PTEN expression was observed in all specimens. Sequencing analysis confirmed the presence of PTEN splice‐acceptor site mutation in intron 8 (c.1027‐2A>G), a germline mutation which had not been previously reported in CS. The patient received adjuvant chemotherapy and tamoxifen for 5 years. After 5 years of follow‐up, she persists recurrence‐free. SBBC with early onset suggests a hereditary predisposition. Thus, analysis of PTEN expression abnormality, easily assessed by immunohistochemistry, may be of clinical value to screen those patients with CS.