简介:AbstractAdrenal gland trauma is a rare phenomenon, due to the small size and retroperitoneal location of the organ. The majority of adrenal gland trauma is due to blunt force injury and is only rarely encountered due to the penetrating mechanisms. A 20-year-old male sustained a gunshot wound to the left abdomen. Upon exploration, he was found to have a through and through injury to the left adrenal gland, among other injuries. Injury to the adrenal gland due to penetrating trauma is exceptionally rare. The principles of management are to control bleeding from the gland with debridement and hemostasis rather than attempt to resect the entire organ. The management of a penetrating injury to the adrenal gland is straightforward and should not be a contributor to a patient's morbidity or mortality.
简介:摘要: Cushing综合征 (Cushing's syndrome),又称皮质醇增多症 (hypercortisolism),是各种原因所致高皮质醇血症为特征的临床综合征。主要表现为满月脸、多血质外貌、向心性肥胖、紫纹、痤疮、高血压、继发性糖尿病和骨质疏松等。因此 Cushing综合征的护理在临床护理中有重要的意义。
简介:Splenicmetastasisisgenerallynotacommonclinicalevent.However,metastasistothespleenfromadrenalpheochromocytomaisextremelyrareandhasnotbeenreportedinliterature.Thisreportpresentsacaseofa58year-oldmalepatientwhodevelopedspleen-onlymetastasesinJuly2007.ThepatienthadaprevioushistoryofleftepinephroectomyforadrenalpheochromocytomainJanuary2003.Abdominalcomputedtomographydemonstratedmultipleenhancinglesionssuggestiveofmetastases;thussplenectomywasperformed.Pathologicalexaminationsconfirmedthediagnosisofsplenicmetastasesfrompheochromocytoma.Thepatientwasalivewithoutrecurrence48monthsaftersplenectomy.Thisstudyisthefirstreportonsplenicmetastasisfrompreviousadrenalpheochromocytoma,andlong-termsurvivalwasachievedbysplenectomy.Ahistoryofmalignancyindicatesahighindexofsuspicionforsplenicmetastasis,andlong-termsurvivalcanbeachievedbysplenectomyforspleen-onlymetastasis.
简介:AbstractBackground:The most common etiologies of Cushing's syndrome (CS) are adrenocorticotropic hormone (ACTH)-producing pituitary adenoma (pitCS) and primary adrenal gland disease (adrCS), both of which burden patients with metabolic disturbance. The aim of this study was to compare the metabolic features of pitCS and adrCS patients.Methods:A retrospective review including 114 patients (64 adrCS and 50 pitCS) diagnosed with CS in 2009-2019 was performed. Metabolic factors were then compared between pitCS and adrCS groups.Results:Regarding sex, females suffered both adrCs (92.2%) and pitCS (88.0%) more frequently than males. Regarding age, patients with pitCS were diagnosed at a younger age (35.40 ± 11.94 vs. 39.65 ± 11.37 years, p = 0.056) than those with adrCS, although the difference was not statistically significant. Moreover, pitCS patients had much higher ACTH levels and more serious occurrences of hypercortisolemia at all time points (8 AM, 4 PM, 12 AM) than that in adrCS patients. Conversely, indexes, including body weight, BMI, blood pressure, serum total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides, fasting plasma glucose, and uric acid, showed no differences between adrCS and pitCS patients. Furthermore, diabetes prevalence was higher in pitCS patients than in adrCS patients; however, there were no significant differences in hypertension or dyslipidemia prevalence between the two.Conclusions:Although adrCS and pitCS had different pathogenetic mechanisms, different severities of hypercortisolemia, and different diabetes prevalences, both etiologies had similar metabolic characteristics.
简介:Myeloidsarcoma(MS)isararehematologicalneoplasmthatdevelopseitherdenovoorconcurrentlywithacutemyeloidleukemia(AML).ThisneoplasmcanalsobeaninitialmanifestationofrelapseinapreviouslytreatedAMLthatisinremission.A44-year-oldmalepatientwasdiagnosedwithtestisMSinalocalhospitalinAugust2010.Afteronemonth,bonemarrowbiopsyandaspirationconfirmedthediagnosisofAML.Allogeneicmobilizationperipheralbloodstemcelltransplantationwasperformed,withthesisterofthepatientasdonor,aftercompleteremission(CR)wasachievedbychemotherapy.Fivemonthsaftertreatment,anadrenalmasswasdetectedbypositronemissiontomography-computedtomography(PET-CT).Radiotherapywasperformedforthelocalizedmassafteramultidisciplinaryteam(MDT)discussion.ThepatientisstillaliveasofMay2013,withnoevidenceofrecurrentMSorleukemia.
简介:""Mensaytheyhatetoshop,""saysZhukin,CityUniversityofNewYorkSociology(社会学)professor.""Yetwhenyouaskthemdeeperquestions,itturnsoutthattheyliketoshop.Mengenerallyliketoshopforbooks,musicandhardware.Butifyouaskthemabouttheshoppingtheydoforbooksormusic,they'llsay,'Well,that'snotshopping.That'sresearch.'""
简介:Romanticismisanimportantstageintheevolutionofman’sself-consciousness.Itshowsnewinterestinandnewconcernwithmanandnature.Wordsworthiswell-knownasanaturepoet.Thethemeofhumanmindandnatureinhispoemshaslongattractedreaders’attention.However,hedoesnotindulgeinnatureitselfbuttakesitasconsolationandinspirationforhumankind.Inordertohighlightthepoet’sconcernwithhumanmind,thepresentpaperchoosestoexploreWordsworth’sconcernwithchildren’smind,basedontheanalysisofWordsworth’sThePreludeandmanyofhispoemsaboutchildren.
简介:Sinceancienttimes,asoneofthesymbolsofuglyanddirty,prostitutesareinvariablylivingintheblackmarginsofsociety.Facingprostitutes’miseries,peoplealwayscannotunderstandtheiremotions,mentalitiesanddesires,ortreatsthemasequals,particularlyaswomen.ProstitutesareaspecialgroupintheoppressedwomeninWesternsocieties.MargaretandNanaaretwotypicalimagesoftheminthehistoryofwesternliterature.Withtearsandlives,theydeducetheirmiserablelifestoriessimilarly.