ABSTRACT
Renal angiomyolipoma (AML) is a common benign tumor in the urinary system, mainly composed of adipose tissue, blood vessels and muscle tissue. Renal AML is sporadic in most of patients, while a few are associated with tuberous sclerosis. Classical renal AML occurs predominantly in middle-aged females. Most cases are found incidentally during imaging examinations. The fat content makes AML have unique imaging characteristics and is easy to be identified with other renal tumors. However, the amount of fat varies in each tumor. AML that contains only microscopically detectable fat and whose amount of intratumoral fat may be too small to be identified on unenhanced computed tomography (CT) images is termed minimal fat or fat-poor renal AML, which appears as a high density shadow in the renal parenchyma on unenhanced CT images. Thus, it can be difficult to distinguish it from renal cell carcinoma (RCC) on imaging. Since the imaging findings are atypical, the diagnosis depends on pathological results. In addition, a few of AML can mimic malignant neoplasms. Recent studies suggested that AML might involve to peri-renal or renal sinus fat, regional lymphatics and other visceral organs, as well as inferior vena cava, which further makes the diagnosis more difficult. However, there is currently no reports about involvement of regional limphatics in minimal fat renal AML. In this article, we report a 27-year-old female patient without family history of tuberous sclerosis, who came to visit the hematologist because a high density shadow near the left kidney was found during CT scan which was accompanied by neck, armpits, groin, abdominal cavity and retroperitoneal lymph nodes enlargement. She was suspected of lymphoma in the beginning and transferred to Department of Urology to perform laparoscopic left renal mass and retroperitoneal lymph node excision and pathological examination for a definitive diagnosis. Finally, pathologic results revealed AML. Postoperative continuous lymphatic fistula developed and the retroperitoneal drainage of chylous fluid was 100-200 mL per day, lasting for 12 weeks. The fistula was successfully closed after conservative treatment including fasting and rehydration. This article summaries and discusses the diagnosis and treatment of renal AML with lymph nodes enlargement and the management of postoperative refractory lymphatic fistula by reviewing the related cases and literature.
Subject(s)
Adult , Female , Humans , Middle Aged , Angiomyolipoma/pathology , Carcinoma, Renal Cell/diagnosis , Fistula , Kidney Neoplasms/pathology , Lymph Nodes/pathologyABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical characteristics and prognostic factors of patients diagnosed with squamous cell carcinoma (SCC) and presented malignancy-associated hypercalcemia (MAH).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 36 patients with biopsy-proven SCC and presented MAH who were treated at the our department from January 2001 to December 2010. The survival were analyzed using the Kaplan-Meier method and Cox analysis.</p><p><b>RESULTS</b>Among these 36 patients, the median blood calcium level was 2.94 mmol/L (2.77-4.87 mmol/L), and the median survival time was only 45 days (1-839 d). Log-rank test showed that central nervous system symptoms, bone metastasis, and hypercalcemia occurring over 160 days after cancer diagnosis were predictors for poor survival(p=0.003, P=0.049, P=0.005). In the COX proportional hazard model analysis, central nervous system symptoms and hypercalcemia occurring over 160 days after cancer diagnosis were independent prognostic factors for survival time (RR=5.721, P=0.000; RR=4.624, P=0.001).</p><p><b>CONCLUSIONS</b>Patients with squamous cell carcinoma (SCC) and presented MAH have poor prognosis. Central nervous system symptoms and hypercalcemia occurring over 160 days after cancer diagnosis are independent predictors of the prognosis.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , Hypercalcemia , Prognosis , Retrospective StudiesABSTRACT
@#Objective To observe the effect of traditional Chinese drug combined with training of musculus quadriceps fexoris on knee osteoarthritis(KOA).Methods70 out-patient clinic KOA patients were divided randomly into the Chinese drug group and control group with 35 cases in each group.The Chinese drug group was treated with Shentongzhuyu medicinal broth PO bid;the control group was treated with Sulindac 0.2 g PO bid.Two groups were combined with the training of musculus quadriceps fexoris,having 10 times per course and 3 courses in total with a 3 days interval between two courses.The therapeutic effect was evaluated with footplate pressure gait analysis and modified JOA marks.ResultsAfter treatment,the effect of the Chinese drug group was superior to the control group(P<0.05),especially 12 weeks post treatment.There maximum weight loading,time integral and weight loading intergral of affected limb of the Chinese drug group significantly improved after treatment(P<0.01),but for the control group,only weight loading intergral improved(P<0.05).ConclusionTraditional Chinese drug combined with training of musculus quadriceps fexoris has better curative effect on the pain and functional disturbance of KOA.
ABSTRACT
@#Objective To observe the effect of traditional Chinese drug combined with training of musculus quadriceps fexoris on knee osteoarthritis(KOA).Methods70 out-patient clinic KOA patients were divided randomly into the Chinese drug group and control group with 35 cases in each group.The Chinese drug group was treated with Shentongzhuyu medicinal broth PO bid;the control group was treated with Sulindac 0.2 g PO bid.Two groups were combined with the training of musculus quadriceps fexoris,having 10 times per course and 3 courses in total with a 3 days interval between two courses.The therapeutic effect was evaluated with footplate pressure gait analysis and modified JOA marks.ResultsAfter treatment,the effect of the Chinese drug group was superior to the control group(P<0.05),especially 12 weeks post treatment.There maximum weight loading,time integral and weight loading intergral of affected limb of the Chinese drug group significantly improved after treatment(P<0.01),but for the control group,only weight loading intergral improved(P<0.05).ConclusionTraditional Chinese drug combined with training of musculus quadriceps fexoris has better curative effect on the pain and functional disturbance of KOA.
ABSTRACT
<p><b>OBJECTIVE</b>To observe clinical effect of nanometer acupoint mounting method for alleviation of myospasm complicated by spinal injury.</p><p><b>METHODS</b>Sixty cases were randomly divided into an observation group and a control group, 30 cases in each group. The observation group were treated by nanometer mounting at 4 Jiaji (EX-B 2) points each on both sides of the affected spine and Shenshu (BL 23), Shangliao (BL 31), Ciliao (BL 32), Yang-lingquan (GB 34), Xuanzhong (GB 39); and the control group by mounting zinc oxide sticking tablets at the above acupoints. The mounting was replaced once each two days, 7 times constituting one course. One week and one month after the end of 3 courses, their results were recorded, respectively.</p><p><b>RESULTS</b>Before treatment, there was no significant difference between the two groups in grades of the myospasm degree (P > 0.05). One week after the end of treatment, 15 cases were grade I of myospasm, 9 cases were grade II, 5 cases were grade III and 1 case was grade IV in the observation group, and 1 cases grade I, 7 cases grade II, 14 cases grade III, 8 cases grade IV in the control group. Ridit analysis on the data indicated that there were significant differences before and after treatment in the myospasm degree (P < 0.01) and between the two groups after treatment (P < 0.01). One month after the end of treatment, the results were similar to those one week after the end of treatment.</p><p><b>CONCLUSION</b>Nanometer acupoint mounting method is a new one for alleviation of myospasm complicated by spinal injury, with convenience, safety and no side effect.</p>