报告1例腺癌多发转移合并Sister Mary Joseph结节。患者男,49岁。脐部斑块、结节6个月,腰痛2个月。皮肤科检查:脐部一直径3.5 cm的淡红色浸润性斑块,表面可见多个直径1~5 mm淡红色丘疹、结节,簇集呈菜花样外观,质地坚韧,活动度差。CT检...报告1例腺癌多发转移合并Sister Mary Joseph结节。患者男,49岁。脐部斑块、结节6个月,腰痛2个月。皮肤科检查:脐部一直径3.5 cm的淡红色浸润性斑块,表面可见多个直径1~5 mm淡红色丘疹、结节,簇集呈菜花样外观,质地坚韧,活动度差。CT检查示纵隔内淋巴结增大,腰3~腰5椎体等多处骨质破坏;锝亚甲基二膦酸盐(^(99m)Tc-MDP)全身骨显像示全身骨骼多处异常放射性浓聚灶。皮损组织病理检查:表皮大致正常,真皮全层致密增生的胶原束间肿瘤细胞呈单个或条索状、列兵样排列,部分肿瘤细胞核大、深染,有明显异形性。免疫组化:细胞角蛋白(CK)、CK7、绒毛蛋白(villin)均阳性表达。腰4椎体针吸组织病理检查符合转移性腺癌,免疫组化示CK及低分子质量细胞角蛋白(CAM)5.2均阳性表达。诊断:腺癌多发转移合并Sister Mary Joseph结节。治疗:患者拒绝接受治疗,随访至13个月时死亡。展开更多
This essay analyses Theodore Dreiser’s Sister Carrie through the lens of cultural studies,examining the portrayal of domesticity and the quest for an ideal home in late-nineteenth-century America.It explores the comp...This essay analyses Theodore Dreiser’s Sister Carrie through the lens of cultural studies,examining the portrayal of domesticity and the quest for an ideal home in late-nineteenth-century America.It explores the complex relationships between the main characters,Carrie and Hurstwood,and their families,as well as their struggles with materialism and alienation.Through close analysis of societal context,the characters’familial backgrounds and emotional yearnings,the essay delves into the characters’longing for stability and belonging and their journey toward understanding the true essence of dwelling amidst the changing urban landscape.It argues that Dreiser’s novel critiques the superficial pursuit of material comforts and highlights the importance of introspection and self-discovery in finding lasting happiness amidst societal turmoil.Ultimately,through the prism of domesticity,the essay delves into broader themes of identity,belonging,and existential fulfillment in a heartless society marked by materialism and alienation.展开更多
“Sisters”is the first novel in Irish-American author Colum McCann’s short story collection-Fishing the Sloe-Black River,which tells the story of Sheona’s search for her identity between Ireland and the United Stat...“Sisters”is the first novel in Irish-American author Colum McCann’s short story collection-Fishing the Sloe-Black River,which tells the story of Sheona’s search for her identity between Ireland and the United States.Colum McCann is skilled in writing about the spiritual dilemmas and identity search of ethnic minorities living in a foreign land.Employing the space theory and Sheona’s perspective,this paper examines her identity loss in Ireland’s patriarchal system,her migration to the US for identity pursuit,and her subsequent transnational journey between the two nations to reconstruct her identity amidst physical and mental trauma.展开更多
BACKGROUND A Sister Mary Joseph nodule(SMJN)is an uncommon cutaneous metastasis found in the umbilicus,indicating an advanced malignancy.SMJNs typically originate from intra-abdominal sources,rarely from breast cancer...BACKGROUND A Sister Mary Joseph nodule(SMJN)is an uncommon cutaneous metastasis found in the umbilicus,indicating an advanced malignancy.SMJNs typically originate from intra-abdominal sources,rarely from breast cancer.Diagnosis suggests a poor prognosis with a median survival of approximately 8 mo after detection.Managing patients with SMJNs is challenging,as most receive limited palliative care only.The optimal strategy for long-term survival of these patients remains unclear.CASE SUMMARY A 58-year-old female,previously diagnosed with right breast cancer 17 years ago and underwent breast-conserving surgery,adjuvant radiotherapy,and endocrine therapy,presented with a 2-cm umbilical nodule.Thirteen years previously,metastases were detected in the right supraclavicular,infraclavicular,hilar,and mediastinal lymph nodes.An umbilical nodule emerged four years before the date of presentation,confirmed as a skin metastasis of primary breast cancer upon excisional biopsy.Despite initial removal,the nodule recurred and grew,leading to her referral to our hospital.The patient underwent extensive excision of the umbilical tumor and immediate abdominal wall reconstruction.Endocrine therapy was continued postoperatively.Five years later,no local recurrence was observed,and the patient continued to work full-time,achieving over 9 years of survival following SMJN diagnosis.CONCLUSION This case study aimed to identify the optimal strategy for achieving extended survival outcomes in patients with SMJN through comprehensive treatment.We presented a case of the longest survival in a patient after undergoing a multidisciplinary treatment regimen.Our findings underscore the significance of adopting a multimodal treatment approach comprising timely and wide excision along with adjunctive therapy.This approach can control the disease,prolong survival,and improve the quality of life in patients with SMJN.展开更多
As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the time...As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the times.From the perspective of narratology,this paper considers that the writer uses narrative techniques such as non-linear narration and embedded structure to express multi-level narrative voices through a first-person narrator,Sheona.These narrative techniques help to fully reflect the theme of the work and endow the work with great aesthetic and ideological value.展开更多
Sister Mary Joseph’s结节(Sister Mary Joseph’s nodule,SMJN)是指腹腔内恶性肿瘤导致的脐部转移性结节,1949年由Hamilton Bailey命名以纪念St.Mary’s Hospital的护士Sister Joseph。SMJN并不多见,但个案报道屡屡见诸文献。这种脐...Sister Mary Joseph’s结节(Sister Mary Joseph’s nodule,SMJN)是指腹腔内恶性肿瘤导致的脐部转移性结节,1949年由Hamilton Bailey命名以纪念St.Mary’s Hospital的护士Sister Joseph。SMJN并不多见,但个案报道屡屡见诸文献。这种脐部转移可以与腹腔内肿瘤同时出现或异时出现,是预后极差的表现。SMJN最常见原发肿瘤为胃癌及卵巢癌,结肠癌特别是右侧结肠癌引起的SMJN极其罕见。另外右侧结肠癌转移至腹股沟淋巴结未见文献报道。本文报道一例右侧结肠癌同时伴有SMJN及腹股沟淋巴结转移,并对相关文献进行综述。展开更多
报告1例可能为胃癌转移的Sister Mary Joseph结节1例。患者男,44岁。脐部出现暗红色大小不等的结节7个月。皮损组织病理检查:真皮全层胶原束间散在呈腺样分化的肿瘤细胞,免疫组化染色:癌胚抗原(CEA)阳性、细胞角蛋白(CK)20阳性、CK7阳...报告1例可能为胃癌转移的Sister Mary Joseph结节1例。患者男,44岁。脐部出现暗红色大小不等的结节7个月。皮损组织病理检查:真皮全层胶原束间散在呈腺样分化的肿瘤细胞,免疫组化染色:癌胚抗原(CEA)阳性、细胞角蛋白(CK)20阳性、CK7阳性、甲状腺转录因子(TTF)-1阴性。糖链抗原(CA)19-9、CA72-4、CA24-2均升高。腹部B超检查示:胃幽门部胃壁增生性病变,肝右叶多发偏强回声结节,腹水。展开更多
文摘报告1例腺癌多发转移合并Sister Mary Joseph结节。患者男,49岁。脐部斑块、结节6个月,腰痛2个月。皮肤科检查:脐部一直径3.5 cm的淡红色浸润性斑块,表面可见多个直径1~5 mm淡红色丘疹、结节,簇集呈菜花样外观,质地坚韧,活动度差。CT检查示纵隔内淋巴结增大,腰3~腰5椎体等多处骨质破坏;锝亚甲基二膦酸盐(^(99m)Tc-MDP)全身骨显像示全身骨骼多处异常放射性浓聚灶。皮损组织病理检查:表皮大致正常,真皮全层致密增生的胶原束间肿瘤细胞呈单个或条索状、列兵样排列,部分肿瘤细胞核大、深染,有明显异形性。免疫组化:细胞角蛋白(CK)、CK7、绒毛蛋白(villin)均阳性表达。腰4椎体针吸组织病理检查符合转移性腺癌,免疫组化示CK及低分子质量细胞角蛋白(CAM)5.2均阳性表达。诊断:腺癌多发转移合并Sister Mary Joseph结节。治疗:患者拒绝接受治疗,随访至13个月时死亡。
文摘This essay analyses Theodore Dreiser’s Sister Carrie through the lens of cultural studies,examining the portrayal of domesticity and the quest for an ideal home in late-nineteenth-century America.It explores the complex relationships between the main characters,Carrie and Hurstwood,and their families,as well as their struggles with materialism and alienation.Through close analysis of societal context,the characters’familial backgrounds and emotional yearnings,the essay delves into the characters’longing for stability and belonging and their journey toward understanding the true essence of dwelling amidst the changing urban landscape.It argues that Dreiser’s novel critiques the superficial pursuit of material comforts and highlights the importance of introspection and self-discovery in finding lasting happiness amidst societal turmoil.Ultimately,through the prism of domesticity,the essay delves into broader themes of identity,belonging,and existential fulfillment in a heartless society marked by materialism and alienation.
文摘“Sisters”is the first novel in Irish-American author Colum McCann’s short story collection-Fishing the Sloe-Black River,which tells the story of Sheona’s search for her identity between Ireland and the United States.Colum McCann is skilled in writing about the spiritual dilemmas and identity search of ethnic minorities living in a foreign land.Employing the space theory and Sheona’s perspective,this paper examines her identity loss in Ireland’s patriarchal system,her migration to the US for identity pursuit,and her subsequent transnational journey between the two nations to reconstruct her identity amidst physical and mental trauma.
文摘BACKGROUND A Sister Mary Joseph nodule(SMJN)is an uncommon cutaneous metastasis found in the umbilicus,indicating an advanced malignancy.SMJNs typically originate from intra-abdominal sources,rarely from breast cancer.Diagnosis suggests a poor prognosis with a median survival of approximately 8 mo after detection.Managing patients with SMJNs is challenging,as most receive limited palliative care only.The optimal strategy for long-term survival of these patients remains unclear.CASE SUMMARY A 58-year-old female,previously diagnosed with right breast cancer 17 years ago and underwent breast-conserving surgery,adjuvant radiotherapy,and endocrine therapy,presented with a 2-cm umbilical nodule.Thirteen years previously,metastases were detected in the right supraclavicular,infraclavicular,hilar,and mediastinal lymph nodes.An umbilical nodule emerged four years before the date of presentation,confirmed as a skin metastasis of primary breast cancer upon excisional biopsy.Despite initial removal,the nodule recurred and grew,leading to her referral to our hospital.The patient underwent extensive excision of the umbilical tumor and immediate abdominal wall reconstruction.Endocrine therapy was continued postoperatively.Five years later,no local recurrence was observed,and the patient continued to work full-time,achieving over 9 years of survival following SMJN diagnosis.CONCLUSION This case study aimed to identify the optimal strategy for achieving extended survival outcomes in patients with SMJN through comprehensive treatment.We presented a case of the longest survival in a patient after undergoing a multidisciplinary treatment regimen.Our findings underscore the significance of adopting a multimodal treatment approach comprising timely and wide excision along with adjunctive therapy.This approach can control the disease,prolong survival,and improve the quality of life in patients with SMJN.
文摘As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the times.From the perspective of narratology,this paper considers that the writer uses narrative techniques such as non-linear narration and embedded structure to express multi-level narrative voices through a first-person narrator,Sheona.These narrative techniques help to fully reflect the theme of the work and endow the work with great aesthetic and ideological value.
文摘Sister Mary Joseph’s结节(Sister Mary Joseph’s nodule,SMJN)是指腹腔内恶性肿瘤导致的脐部转移性结节,1949年由Hamilton Bailey命名以纪念St.Mary’s Hospital的护士Sister Joseph。SMJN并不多见,但个案报道屡屡见诸文献。这种脐部转移可以与腹腔内肿瘤同时出现或异时出现,是预后极差的表现。SMJN最常见原发肿瘤为胃癌及卵巢癌,结肠癌特别是右侧结肠癌引起的SMJN极其罕见。另外右侧结肠癌转移至腹股沟淋巴结未见文献报道。本文报道一例右侧结肠癌同时伴有SMJN及腹股沟淋巴结转移,并对相关文献进行综述。
文摘报告1例可能为胃癌转移的Sister Mary Joseph结节1例。患者男,44岁。脐部出现暗红色大小不等的结节7个月。皮损组织病理检查:真皮全层胶原束间散在呈腺样分化的肿瘤细胞,免疫组化染色:癌胚抗原(CEA)阳性、细胞角蛋白(CK)20阳性、CK7阳性、甲状腺转录因子(TTF)-1阴性。糖链抗原(CA)19-9、CA72-4、CA24-2均升高。腹部B超检查示:胃幽门部胃壁增生性病变,肝右叶多发偏强回声结节,腹水。