Buffon’s needle experiment was originally devised to get the value of π. With the advent of computers, Buffon’s needle algorithm has been used pedagogically as an example of Monte Carlo methods in introduction clas...Buffon’s needle experiment was originally devised to get the value of π. With the advent of computers, Buffon’s needle algorithm has been used pedagogically as an example of Monte Carlo methods in introduction classes, and there are many Buffon’s needle algorithm implementations available on the internet. However, for the calculation of π, the exact value of π is used in the programs for Buffon’s needle angle sampling, and hence the example is not demonstrated correctly. This brief note presents a random angle sampling algorithm for the Buffon’s needle. We then compare the Buffon’s needle and Hit-and-Miss integration algorithms using Monte Carlo laboriousness comparison, and find that the Hit-and-Miss algorithm is superior.展开更多
In this paper, the background, evolution, basic meaning, clinical application and the detail operating procedures of the differential insertion depth in filiform needle acupuncture were discussed based on the classica...In this paper, the background, evolution, basic meaning, clinical application and the detail operating procedures of the differential insertion depth in filiform needle acupuncture were discussed based on the classical expositions of the Yellow Emperor’s Canon of Medicine. It is believed that the differential insertion depth reflects the basic idea of expelling the evil Qi from the body in the application of traditional acupuncture. Since the site of evil invasion has different shades, the position of evil Qi and correct differentiation has become the operation key points of needle insertion. Apart from this, the Yellow Emperor’s Canon of Medicine has further associated the clinical application of filiform needle insertion depth with the seasonal change of Yin and Yang, the body built of the patients, the nature of the diseases, the heat or cold pathogenic factors of the illness, the excess and deficiency of the patient, and the reinforcing and reducing function of acupuncture. These elaborations have greatly enriched the basic content of acupuncture and laid a systematic theoretical foundation of filiform needle operation. The differential insertion depth in acupuncture has its specific meaning, the emphasis of insertion depth of filiform needle with its differentiated clinical implication exemplifies the perceptual thinking features of traditional acupuncture and typical reveals the uniqueness of Chinese civilization.展开更多
Introduction: Triple immunohistochemical (IHC) stains including antibodies specific for alpha-methylacyl-CoA-racemase and basal cell markers have been a valuable aid in accurate identification of prostate carcinoma. H...Introduction: Triple immunohistochemical (IHC) stains including antibodies specific for alpha-methylacyl-CoA-racemase and basal cell markers have been a valuable aid in accurate identification of prostate carcinoma. However, accurate quantification of minuscule areas of prostate carcinoma in biopsy specimens can often be a challenge. Here we assessed the diagnostic value and quantitative use of automated digital image analysis on triple IHC stained prostate needle biopsies. Methods: Twelve cases of prostate needle biopsy material including 75 needle cores were stained with triple-antibody cocktail (P504S + 34βE12 + p63). Slides were digitally scanned with the APERIO digital image analyzer and evaluated with the GENIE pattern and color recognition digital image analysis that we developed. A slide with known areas of adenocarcinoma, high grade prostatic intraepithelial neoplasia (PIN), benign glands and stroma was used as a training set for the automated digital image analysis platform. Results: Among 75 needle biopsy cores, 19 (25.33%) contained adenocarcinoma by histology. Digital image analysis recognized adenocarcinoma in 95% of these needle biopsies. The average area of the needle biopsy was 7.63 mm2 and overall the average area of tumor was 0.196 mm2. The smallest area of tumor recognized by the program was 0.0022 mm2 (0.0363% of the core) and the largest was 0.62 mm2 (8.17% of the core) among needle core biopsies. False positives resulted from areas of high grade PIN with patchy basal cells. The false negative was caused by uneven AMACR staining in one area of adenocarcinoma. Digital recognition of areas of interest was improved by three successive image analysis training which increased the sensitivity and specificity from 83% and 89% to 90% and 93%, respectively. Conclusions: Digital image analysis in concert with IHC triple staining may be useful for accurate detection and quantitative analysis of small foci of prostatic adenocarcinoma. Defining methods to increase the sensitivity and specificity of quantitative automated digital image analysis will likely evolve as an area of investigation. Future automated digital scanning and innovative pattern and color recognition technologies may open avenues for classifying a variety of prostate lesions.展开更多
Objective: To study the correlation of S100A13 and FOXA1 expression with cell cycle and cell invasion in fine needle aspiration thyroid carcinoma tissue. Methods: Patients who received ultrasound-guided thyroid nodule...Objective: To study the correlation of S100A13 and FOXA1 expression with cell cycle and cell invasion in fine needle aspiration thyroid carcinoma tissue. Methods: Patients who received ultrasound-guided thyroid nodule fine needle aspiration in Haiyang People's Hospital between April 2015 and February 2017 were selected, and the tissues were divided into malignant thyroid tissue and benign thyroid nodules according to the pathological results after biopsy. The expression of S100A13, FOXA1, cell cycle molecules and cell invasion molecules were measured. Results: S100A13, FOXA1, CDK2, CyclinD1, MCM2, MCM7, SKP2, CLOCK, STAT3, STAT5, N-cadherin, MT1-MMP and ADAM17 mRNA expression in thyroid carcinoma tissue were significantly higher than those in benign thyroid nodule;CDK2, CyclinD1, MCM2, MCM7, SKP2 and CLOCK mRNA expression in thyroid carcinoma tissue with high FOXA1 expression were significantly higher than those in thyroid carcinoma tissue with low FOXA1 expression;STAT3, STAT5, N-cadherin, MT1-MMP and ADAM17 mRNA expression in thyroid carcinoma tissue with high S100A13 expression were significantly higher than those in thyroid cancer tissue with low S100A13 expression. Conclusions: High expression of S100A13 and FOXA1 in thyroid carcinoma can promote cell invasion and cell cycle progression.展开更多
Objective:To investigate the effect of Wei’s triple nine needling therapy on the N2-P2 wave of the flash visual evoked potential(FVEP)in rats of the of the transverse directional pulling model.Methods:Thirty-six Wist...Objective:To investigate the effect of Wei’s triple nine needling therapy on the N2-P2 wave of the flash visual evoked potential(FVEP)in rats of the of the transverse directional pulling model.Methods:Thirty-six Wistar rats were randomly grouped,nine were in normal control group without any treatment,and the remaining 27 were surgically modelled in the right eyes.Eighteen of these rats were randomly divided into a Wei’s triple nine needling therapy group and a model group of nine rats each after the TON model was made using the transverse quantitative retraction method.The other 9 rats were sham-operated,and only the optic nerve was exposed without retraction.On the next day of modelling,the Wei’s triple nine needling therapy group was treated with Wei’s triple nine needling therapy for 20 minutes/1 time/1 day for 14 days.The model group,sham-operated group and normal control group were not intervened.Wei's triple nine acupoints were represented as follows:1st link:"Jingming"(BL1)and"Chengqi"(ST1);2nd link:"Sizhukong"(SJ23)penetrating"Taiyang"(EX-HN5);and the third:"Fengchi"(GB 20)and"Taichong"(LV3).The FVEP of each group was observed on 1d,7d and 14d.The FVEP of each group was observed on 1d,7d and 14d.Results:Compared with the model group,the N2 wave latency and P2 wave latency were shortened in the Wei’s triple nine needling therapy on 1d(P<0.05,P<0.01);on 7d,their N2 wave latency was shortened(P<0.01)and the N2-P2 wave amplitude was increased compared with the model group(P<0.05);on 14d,their P2 wave latency was shortened(P<0.05)and the N2-P2 wave amplitude was increased.There was no statistical difference in N2 wave latency,P2 wave latency and N2-P2 wave amplitude in the sham-operated group on 1d,7d and 14d(P>0.05).The delayed N2 and P2 wave latencies in the model group did not improve from 1d to 14d(P>0.05)and the amplitude decreased throughout,showing a significant difference on 14d compared to 1d(P<0.05).In contrast,the N2 wave latency in Wei’s triple nine needling therapy group was not significantly different until 7d to 14d(P<0.05);its P2 wave latency,although significantly delayed from 1d to 7d(P<0.05),recovered on 14d and reached a level that was not statistically different from 1d and 7d(P>0.05).There was also no significant decrease in N2-P2 wave amplitude between 1d and 14d in Wei’s triple nine needling therapy group(P>0.05).Conclusion:In this experiment,the TON rat model was successfully established by the transverse quantitative retraction method,and the treatment of TON rats with Wei’s triple nine needling therapy reduced the P2 wave delay of the FVEP electrophysiological signal and increased the N2-P2 amplitude,which had a certain positive effect on the repair of optic nerve injury,probably related to its effect of improving the conduction function of the optic nerve and protecting the retinal ganglion cells that had not been degenerated and necrosed.展开更多
Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashi...Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashimoto’s thyroiditis,and presented with progressively enlarging neck mass.The first two cases were confirmed by surgical biopsy to be diffuse large B cell lymphoma,and received radiotherapy combined with chemotherapy,or received only chemotherapy.The third case was confirmed by core needle biopsy to be mucosa-associated lymphoid tissue lymphoma,and received radiotherapy.In summary,confirmation of PTL diagnosis is essential for further clinical decisions.Core biopsy should be one of the most important methods to make the diagnosis of PTL,while the use of fine needle aspiration cytology alone is still limited in diagnosing PTL.展开更多
AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GI...AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients(34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions. The histopathological diagnosis was GIST in 34 patients, leiomyoma in 5, schwannoma in 3, ectopic pancreas in 1, hamartoma in 1, cyst in 1, Brunner's adenoma in 1, and spindle-cell tumor in 7. We retrospectively calculated the DT of GISTs on the basis of the time course of EUS findings to estimate the growth rate of such tumors.RESULTS The DT was 17.2 mo for GIST, as compared with 231.2 mo for leiomyoma, 104.7 mo for schwannoma, 274.9mo for ectopic pancreas, 61.2 mo for hamartoma, 49.0 mo for cyst, and 134.7 mo for Brunner's adenoma. The GISTs were divided into risk classes on the basis of tumor diameters and mitotic figures(Fletcher's classification). The classification was extremely low risk or low risk in 28 patients, intermediate risk in 3, and high risk in 3. DT of GIST according to risk was 24.0 mo for extremely low-risk plus low-risk GIST, 17.1 mo for intermediate-risk GIST, and 3.9 mo for high-risk GIST. DT of GIST was significantly shorter than that of leiomyoma plus schwannoma(P < 0.05), and DT of high-risk GIST was significantly shorter than that of extremely low-risk plus low-risk GIST(P < 0.05).CONCLUSION For GIST, a higher risk grade was associated with a significantly shorter DT. Small SMTs should initially be followed up within 6 mo after detection.展开更多
Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region;and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to ret...Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region;and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, that is minimally invasive with no morbidity, a low risk of complication and easy to learn. Methods: Sixty seven patients with pilonidal disease were subjected to excision and partial closure procedure, from November 2006 to March 2010 at General Surgery Department, Zagazig University Hospital, Zagazig University, Egypt. The mean age was 27.5 years. Complete but close excision of all diseased tissues was achieved. Then, the wound partially was closed from the deepest parts only by multiples buried vertical mattress sutures by using Lasheen’s needle, and left the superficial wound parts to heal by second intention. The follow up period was ranged from 14 - 39 months (mean 27 months). Results: The mean hospital stay was 12 hours, mean operation time was 30 minutes and mean time to return to normal activity was 8 days (range 7 - 12 days). Nine cases show superficial wound infection and one case of recurrence. Conclusion: Excision and partially closure technique by using Lasheen’s needle for pilonidal diseases is minimal invasive and less morbidity, easy to learn and has favorable results regarding to return to normal activity, rate of recurrence and cosmetically acceptable.展开更多
We described the case of a peripancreatic paraganglioma(PGL)misdiagnosed as pancreatic lesion.Surgical exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon ro...We described the case of a peripancreatic paraganglioma(PGL)misdiagnosed as pancreatic lesion.Surgical exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon root.Radical enucleation of the mass was performed,preserving the pancreatic tail.Histologically,a diagnosis of PGL was rendered.Interestingly,two previously unreported mutations,one affecting the KDR gene in exon 7 and another on the JAK3 gene in exon 4 were detected.Both mutations are known to be pathogenetic.Imaging and cytologic findings were blindly reviewed by an expert panel of clinicians,radiologists,and pathologists to identify possible causes of the misdiagnosis.The major issue was lack of evidence of a cleavage plane from the pancreas at imaging,which prompted radiologists to establish an intraparenchymal origin.The blinded revision shifted the diagnosis towards an extrapancreatic lesion,as the pancreatic parenchyma showed no structural alterations and no dislocation of the Wirsung duct.Ex post,the identified biases were the emergency setting of the radiologic examination and the very thin mesocolon sheet,which hindered clear definition of the lesion borders.Original endoscopic ultrasonography diagnosis was confirmed,emphasizing the intrinsic limit of this technique in detecting large masses.Finally,pathologic review favored a diagnosis of PGL due to the morphological features and immonohistochemical profile.Eighteen months after tumor excision,the patient is asymptomatic with no disease relapse evident by either radiology or laboratory tests.Our report strongly highlights the difficulties in rendering an accurate preoperative diagnosis of PGL.展开更多
文摘Buffon’s needle experiment was originally devised to get the value of π. With the advent of computers, Buffon’s needle algorithm has been used pedagogically as an example of Monte Carlo methods in introduction classes, and there are many Buffon’s needle algorithm implementations available on the internet. However, for the calculation of π, the exact value of π is used in the programs for Buffon’s needle angle sampling, and hence the example is not demonstrated correctly. This brief note presents a random angle sampling algorithm for the Buffon’s needle. We then compare the Buffon’s needle and Hit-and-Miss integration algorithms using Monte Carlo laboriousness comparison, and find that the Hit-and-Miss algorithm is superior.
文摘In this paper, the background, evolution, basic meaning, clinical application and the detail operating procedures of the differential insertion depth in filiform needle acupuncture were discussed based on the classical expositions of the Yellow Emperor’s Canon of Medicine. It is believed that the differential insertion depth reflects the basic idea of expelling the evil Qi from the body in the application of traditional acupuncture. Since the site of evil invasion has different shades, the position of evil Qi and correct differentiation has become the operation key points of needle insertion. Apart from this, the Yellow Emperor’s Canon of Medicine has further associated the clinical application of filiform needle insertion depth with the seasonal change of Yin and Yang, the body built of the patients, the nature of the diseases, the heat or cold pathogenic factors of the illness, the excess and deficiency of the patient, and the reinforcing and reducing function of acupuncture. These elaborations have greatly enriched the basic content of acupuncture and laid a systematic theoretical foundation of filiform needle operation. The differential insertion depth in acupuncture has its specific meaning, the emphasis of insertion depth of filiform needle with its differentiated clinical implication exemplifies the perceptual thinking features of traditional acupuncture and typical reveals the uniqueness of Chinese civilization.
文摘Introduction: Triple immunohistochemical (IHC) stains including antibodies specific for alpha-methylacyl-CoA-racemase and basal cell markers have been a valuable aid in accurate identification of prostate carcinoma. However, accurate quantification of minuscule areas of prostate carcinoma in biopsy specimens can often be a challenge. Here we assessed the diagnostic value and quantitative use of automated digital image analysis on triple IHC stained prostate needle biopsies. Methods: Twelve cases of prostate needle biopsy material including 75 needle cores were stained with triple-antibody cocktail (P504S + 34βE12 + p63). Slides were digitally scanned with the APERIO digital image analyzer and evaluated with the GENIE pattern and color recognition digital image analysis that we developed. A slide with known areas of adenocarcinoma, high grade prostatic intraepithelial neoplasia (PIN), benign glands and stroma was used as a training set for the automated digital image analysis platform. Results: Among 75 needle biopsy cores, 19 (25.33%) contained adenocarcinoma by histology. Digital image analysis recognized adenocarcinoma in 95% of these needle biopsies. The average area of the needle biopsy was 7.63 mm2 and overall the average area of tumor was 0.196 mm2. The smallest area of tumor recognized by the program was 0.0022 mm2 (0.0363% of the core) and the largest was 0.62 mm2 (8.17% of the core) among needle core biopsies. False positives resulted from areas of high grade PIN with patchy basal cells. The false negative was caused by uneven AMACR staining in one area of adenocarcinoma. Digital recognition of areas of interest was improved by three successive image analysis training which increased the sensitivity and specificity from 83% and 89% to 90% and 93%, respectively. Conclusions: Digital image analysis in concert with IHC triple staining may be useful for accurate detection and quantitative analysis of small foci of prostatic adenocarcinoma. Defining methods to increase the sensitivity and specificity of quantitative automated digital image analysis will likely evolve as an area of investigation. Future automated digital scanning and innovative pattern and color recognition technologies may open avenues for classifying a variety of prostate lesions.
文摘Objective: To study the correlation of S100A13 and FOXA1 expression with cell cycle and cell invasion in fine needle aspiration thyroid carcinoma tissue. Methods: Patients who received ultrasound-guided thyroid nodule fine needle aspiration in Haiyang People's Hospital between April 2015 and February 2017 were selected, and the tissues were divided into malignant thyroid tissue and benign thyroid nodules according to the pathological results after biopsy. The expression of S100A13, FOXA1, cell cycle molecules and cell invasion molecules were measured. Results: S100A13, FOXA1, CDK2, CyclinD1, MCM2, MCM7, SKP2, CLOCK, STAT3, STAT5, N-cadherin, MT1-MMP and ADAM17 mRNA expression in thyroid carcinoma tissue were significantly higher than those in benign thyroid nodule;CDK2, CyclinD1, MCM2, MCM7, SKP2 and CLOCK mRNA expression in thyroid carcinoma tissue with high FOXA1 expression were significantly higher than those in thyroid carcinoma tissue with low FOXA1 expression;STAT3, STAT5, N-cadherin, MT1-MMP and ADAM17 mRNA expression in thyroid carcinoma tissue with high S100A13 expression were significantly higher than those in thyroid cancer tissue with low S100A13 expression. Conclusions: High expression of S100A13 and FOXA1 in thyroid carcinoma can promote cell invasion and cell cycle progression.
基金National Natural Science Foundation of China(No.81904258)。
文摘Objective:To investigate the effect of Wei’s triple nine needling therapy on the N2-P2 wave of the flash visual evoked potential(FVEP)in rats of the of the transverse directional pulling model.Methods:Thirty-six Wistar rats were randomly grouped,nine were in normal control group without any treatment,and the remaining 27 were surgically modelled in the right eyes.Eighteen of these rats were randomly divided into a Wei’s triple nine needling therapy group and a model group of nine rats each after the TON model was made using the transverse quantitative retraction method.The other 9 rats were sham-operated,and only the optic nerve was exposed without retraction.On the next day of modelling,the Wei’s triple nine needling therapy group was treated with Wei’s triple nine needling therapy for 20 minutes/1 time/1 day for 14 days.The model group,sham-operated group and normal control group were not intervened.Wei's triple nine acupoints were represented as follows:1st link:"Jingming"(BL1)and"Chengqi"(ST1);2nd link:"Sizhukong"(SJ23)penetrating"Taiyang"(EX-HN5);and the third:"Fengchi"(GB 20)and"Taichong"(LV3).The FVEP of each group was observed on 1d,7d and 14d.The FVEP of each group was observed on 1d,7d and 14d.Results:Compared with the model group,the N2 wave latency and P2 wave latency were shortened in the Wei’s triple nine needling therapy on 1d(P<0.05,P<0.01);on 7d,their N2 wave latency was shortened(P<0.01)and the N2-P2 wave amplitude was increased compared with the model group(P<0.05);on 14d,their P2 wave latency was shortened(P<0.05)and the N2-P2 wave amplitude was increased.There was no statistical difference in N2 wave latency,P2 wave latency and N2-P2 wave amplitude in the sham-operated group on 1d,7d and 14d(P>0.05).The delayed N2 and P2 wave latencies in the model group did not improve from 1d to 14d(P>0.05)and the amplitude decreased throughout,showing a significant difference on 14d compared to 1d(P<0.05).In contrast,the N2 wave latency in Wei’s triple nine needling therapy group was not significantly different until 7d to 14d(P<0.05);its P2 wave latency,although significantly delayed from 1d to 7d(P<0.05),recovered on 14d and reached a level that was not statistically different from 1d and 7d(P>0.05).There was also no significant decrease in N2-P2 wave amplitude between 1d and 14d in Wei’s triple nine needling therapy group(P>0.05).Conclusion:In this experiment,the TON rat model was successfully established by the transverse quantitative retraction method,and the treatment of TON rats with Wei’s triple nine needling therapy reduced the P2 wave delay of the FVEP electrophysiological signal and increased the N2-P2 amplitude,which had a certain positive effect on the repair of optic nerve injury,probably related to its effect of improving the conduction function of the optic nerve and protecting the retinal ganglion cells that had not been degenerated and necrosed.
文摘Primary thyroid lymphoma(PTL)is an exceptionally rare and highly aggressive potentially curable malignant disease.We report three typical cases of PTL referred to our hospital.All three cases had long history of Hashimoto’s thyroiditis,and presented with progressively enlarging neck mass.The first two cases were confirmed by surgical biopsy to be diffuse large B cell lymphoma,and received radiotherapy combined with chemotherapy,or received only chemotherapy.The third case was confirmed by core needle biopsy to be mucosa-associated lymphoid tissue lymphoma,and received radiotherapy.In summary,confirmation of PTL diagnosis is essential for further clinical decisions.Core biopsy should be one of the most important methods to make the diagnosis of PTL,while the use of fine needle aspiration cytology alone is still limited in diagnosing PTL.
文摘AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients(34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions. The histopathological diagnosis was GIST in 34 patients, leiomyoma in 5, schwannoma in 3, ectopic pancreas in 1, hamartoma in 1, cyst in 1, Brunner's adenoma in 1, and spindle-cell tumor in 7. We retrospectively calculated the DT of GISTs on the basis of the time course of EUS findings to estimate the growth rate of such tumors.RESULTS The DT was 17.2 mo for GIST, as compared with 231.2 mo for leiomyoma, 104.7 mo for schwannoma, 274.9mo for ectopic pancreas, 61.2 mo for hamartoma, 49.0 mo for cyst, and 134.7 mo for Brunner's adenoma. The GISTs were divided into risk classes on the basis of tumor diameters and mitotic figures(Fletcher's classification). The classification was extremely low risk or low risk in 28 patients, intermediate risk in 3, and high risk in 3. DT of GIST according to risk was 24.0 mo for extremely low-risk plus low-risk GIST, 17.1 mo for intermediate-risk GIST, and 3.9 mo for high-risk GIST. DT of GIST was significantly shorter than that of leiomyoma plus schwannoma(P < 0.05), and DT of high-risk GIST was significantly shorter than that of extremely low-risk plus low-risk GIST(P < 0.05).CONCLUSION For GIST, a higher risk grade was associated with a significantly shorter DT. Small SMTs should initially be followed up within 6 mo after detection.
文摘Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region;and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, that is minimally invasive with no morbidity, a low risk of complication and easy to learn. Methods: Sixty seven patients with pilonidal disease were subjected to excision and partial closure procedure, from November 2006 to March 2010 at General Surgery Department, Zagazig University Hospital, Zagazig University, Egypt. The mean age was 27.5 years. Complete but close excision of all diseased tissues was achieved. Then, the wound partially was closed from the deepest parts only by multiples buried vertical mattress sutures by using Lasheen’s needle, and left the superficial wound parts to heal by second intention. The follow up period was ranged from 14 - 39 months (mean 27 months). Results: The mean hospital stay was 12 hours, mean operation time was 30 minutes and mean time to return to normal activity was 8 days (range 7 - 12 days). Nine cases show superficial wound infection and one case of recurrence. Conclusion: Excision and partially closure technique by using Lasheen’s needle for pilonidal diseases is minimal invasive and less morbidity, easy to learn and has favorable results regarding to return to normal activity, rate of recurrence and cosmetically acceptable.
文摘We described the case of a peripancreatic paraganglioma(PGL)misdiagnosed as pancreatic lesion.Surgical exploration revealed an unremarkable pancreas and a large well-defined cystic mass originating at the mesocolon root.Radical enucleation of the mass was performed,preserving the pancreatic tail.Histologically,a diagnosis of PGL was rendered.Interestingly,two previously unreported mutations,one affecting the KDR gene in exon 7 and another on the JAK3 gene in exon 4 were detected.Both mutations are known to be pathogenetic.Imaging and cytologic findings were blindly reviewed by an expert panel of clinicians,radiologists,and pathologists to identify possible causes of the misdiagnosis.The major issue was lack of evidence of a cleavage plane from the pancreas at imaging,which prompted radiologists to establish an intraparenchymal origin.The blinded revision shifted the diagnosis towards an extrapancreatic lesion,as the pancreatic parenchyma showed no structural alterations and no dislocation of the Wirsung duct.Ex post,the identified biases were the emergency setting of the radiologic examination and the very thin mesocolon sheet,which hindered clear definition of the lesion borders.Original endoscopic ultrasonography diagnosis was confirmed,emphasizing the intrinsic limit of this technique in detecting large masses.Finally,pathologic review favored a diagnosis of PGL due to the morphological features and immonohistochemical profile.Eighteen months after tumor excision,the patient is asymptomatic with no disease relapse evident by either radiology or laboratory tests.Our report strongly highlights the difficulties in rendering an accurate preoperative diagnosis of PGL.
