Subject(s)
Abdominal Wound Closure Techniques/standards , Laparotomy/adverse effects , Suture Techniques/standards , Abdominal Wound Closure Techniques/adverse effects , Abdominal Wound Closure Techniques/statistics & numerical data , Humans , Laparotomy/methods , Suture Techniques/adverse effects , Suture Techniques/statistics & numerical dataABSTRACT
A 22-year-old male was admitted to casualty with a penetrating injury to his left ventricle following a stabbing to his chest. Penetrating injuries to major organs that originate or pass through the relatively narrow mediastinal corridor may have catastrophic consequences with little in the way of external signs to indicate the severity of the injury. Clinically, patients with penetrating cardiac injuries may present with cardiac shock due to either volume loss or pericardial tamponade. However, expeditious recognition, resuscitation and surgical treatment of these injuries are imperative if one wishes to reduce their inherently high mortality. Simple methods in trauma resuscitation, often being carried out in less than optimum conditions, are vital in order to save an injured patient's life. Decompression of the pericardial sac by intubation is described as a new and relatively simple method in the initial resuscitation of a patient with sharp cardiac injury, prior to definitive surgery.
Subject(s)
Heart Injuries/surgery , Intubation/methods , Wounds, Stab/surgery , Adult , Cardiac Tamponade/etiology , Chest Tubes , Coronary Vessels/injuries , Emergency Treatment , Heart Atria/injuries , Humans , Male , Pericardium , Thoracotomy/methodsABSTRACT
BACKGROUND: Postoperative scarring and radiotherapy changes in the conservatively treated breast often mimic breast cancer recurrence, resulting in many unnecessary biopsies. Local breast cancer recurrence may be detected more accurately with contrast-enhanced colour Doppler imaging. METHODS: Fifty-eight women with suspected local breast cancer recurrence were evaluated prospectively by means of conventional and contrast-enhanced colour Doppler imaging before surgical biopsy. RESULTS: Sensitivity for the detection of breast cancer recurrence using contrast enhancement was 94 per cent (specificity 67 per cent). Contrast enhancement significantly increased overall diagnostic accuracy, from 80 to 90 per cent (P < 0. 04). CONCLUSION: Contrast-enhanced colour Doppler imaging is a highly accurate method for detecting local breast cancer recurrence. Its adoption may substantially reduce biopsy rates.
Subject(s)
Breast Neoplasms/diagnostic imaging , Carcinoma in Situ/diagnostic imaging , Carcinoma, Ductal, Breast/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Ultrasonography, Doppler, Color , Adult , Aged , Biopsy, Needle , Female , Humans , Image Enhancement , Middle Aged , Prospective Studies , Sensitivity and SpecificitySubject(s)
Breast Neoplasms/diagnostic imaging , Contrast Media , Image Processing, Computer-Assisted , Neoplasm Recurrence, Local/diagnostic imaging , Ultrasonography, Doppler, Color/statistics & numerical data , Ultrasonography, Mammary/statistics & numerical data , Breast Diseases/diagnostic imaging , Diagnosis, Differential , Female , Humans , ROC Curve , Sensitivity and SpecificityABSTRACT
AIMS: To study the expression of a range of cytokeratins by malignant myoepithelioma of the breast. METHODS: Immunophenotyping was carried out using a panel of antibodies on paraffin wax embedded and frozen material using immunohistochemistry and double-labelled immunofluorescence. Electron microscopy was also performed. RESULTS: The tumour cells were positive for CAM 5.2, actin, vimentin, and cytokeratin 14 and negative for cytokeratins 18 and 19. Electron microscopy showed well formed desmosomes and hemidesmosomes together with pinocytic vesicles, plentiful rough endoplasmic reticulum and 6 nM microfilaments with focal densities. CONCLUSIONS: The pattern of cytokeratin expression provides further evidence that tumours with a specific myoepithelial phenotype occur rarely in the breast.
