Assuntos
Técnicas de Fechamento de Ferimentos Abdominais/normas , Laparotomia/efeitos adversos , Técnicas de Sutura/normas , Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Técnicas de Fechamento de Ferimentos Abdominais/estatística & dados numéricos , Humanos , Laparotomia/métodos , Técnicas de Sutura/efeitos adversos , Técnicas de Sutura/estatística & dados numéricosRESUMO
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.
Assuntos
Traumatismos Cardíacos/cirurgia , Intubação/métodos , Ferimentos Perfurantes/cirurgia , Adulto , Tamponamento Cardíaco/etiologia , Tubos Torácicos , Vasos Coronários/lesões , Tratamento de Emergência , Átrios do Coração/lesões , Humanos , Masculino , Pericárdio , Toracotomia/métodosRESUMO
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.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma in Situ/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adulto , Idoso , Biópsia por Agulha , Feminino , Humanos , Aumento da Imagem , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e EspecificidadeAssuntos
Neoplasias da Mama/diagnóstico por imagem , Meios de Contraste , Processamento de Imagem Assistida por Computador , Recidiva Local de Neoplasia/diagnóstico por imagem , Ultrassonografia Doppler em Cores/estatística & dados numéricos , Ultrassonografia Mamária/estatística & dados numéricos , Doenças Mamárias/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Curva ROC , Sensibilidade e EspecificidadeRESUMO
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.
