Tuberculosis of the breast with erythema nodosum: a case report

<p>Abstract</p> <p>Introduction</p> <p>There has been an increasing number of tuberculosis cases worldwide, but tuberculosis of the breast remains rare. In rare cases this is seen with a cutaneous manifestation of erythema nodosum.</p> <p>Case presentation</p> <p>We report the case of a 33-year-old Chinese woman with tuberculosis of the left breast accompanied by erythema nodosum on the anterior aspect of both lower legs. Due to her poor clinical response to conventional therapy, and the histopathological findings of fine needle aspiration cytology, there were strong indications of tuberculosis. Her clinical diagnosis was confirmed by molecular detection of <it>Mycobacterium tuberculosis </it>complex by polymerase chain reaction. The diagnosis was further confirmed by a second polymerase chain reaction test of erythema nodosum which tested positive for <it>Mycobacterium tuberculosis</it> complex. She received anti-tuberculous therapy for 18 months, and finally underwent residual lumpectomy. During her follow-up examination after 12 months, no evidence of either residual or recurrent disease was present.</p> <p>Conclusion</p> <p>Histopathological features and a high index of clinical suspicion are necessary to confirm a diagnosis of tuberculosis of the breast. Anti-tuberculous therapy with or without simple surgical intervention is the core treatment.</p

Protective Role of False Tendon in Subjects with Left Bundle Branch Block: A Virtual Population Study.

False tendons (FTs) are fibrous or fibromuscular bands that can be found in both the normal and abnormal human heart in various anatomical forms depending on their attachment points, tissue types, and geometrical properties. While FTs are widely considered to affect the function of the heart, their specific roles remain largely unclear and unexplored. In this paper, we present an in silico study of the ventricular activation time of the human heart in the presence of FTs. This study presents the first computational model of the human heart that includes a FT, Purkinje network, and papillary muscles. Based on this model, we perform simulations to investigate the effect of different types of FTs on hearts with the electrical conduction abnormality of a left bundle branch block (LBBB). We employ a virtual population of 70 human hearts derived from a statistical atlas, and run a total of 560 simulations to assess ventricular activation time with different FT configurations. The obtained results indicate that, in the presence of a LBBB, the FT reduces the total activation time that is abnormally augmented due to a branch block, to such an extent that surgical implant of cardiac resynchronisation devices might not be recommended by international guidelines. Specifically, the simulation results show that FTs reduce the QRS duration at least 10 ms in 80% of hearts, and up to 45 ms for FTs connecting to the ventricular free wall, suggesting a significant reduction of cardiovascular mortality risk. In further simulation studies we show the reduction in the QRS duration is more sensitive to the shape of the heart then the size of the heart or the exact location of the FT. Finally, the model suggests that FTs may contribute to reducing the activation time difference between the left and right ventricles from 12 ms to 4 ms. We conclude that FTs may provide an alternative conduction pathway that compensates for the propagation delay caused by the LBBB. Further investigation is needed to quantify the clinical impact of FTs on cardiovascular mortality risk

Change in the Location of the Optic Strut Relative to the Anterior Clinoid Process Pneumatization

Objective: This study aimed to peruse the alteration of the position of the optic strut (OS) according to the anterior clinoid process (ACP) pneumatization. Methods: This retrospective study conducted on cone-beam computed tomography images of 400 patients with a mean age of 36.49 +/- 15.91 years. Results: Anterior clinoid process length, width, and angle were measured as 10.56 +/- 2.42 mm, 5.46 +/- 1.31 mm, and 42.56 +/- 14.68 degrees, respectively. The tip of ACP was measured as 6.60 +/- 1.50 mm away from the posterior rim of OS. In the 631 sides (78.87%) did not have ACP pneumatization. In the cases with ACP pneumatization, three different configurations were identified as follows: Type 1 in 71 sides (8.87%), Type 2 in 56 sides (7%), and Type 3 in 42 sides (5.23%). Relative to ACP, the location of OS was determined as follows: Type A in 29 sides (3.64%), Type B in 105 sides (13.12%), Type C in 344 sides (43%), Type D in 289 sides (36.12%), and Type E in 33 sides (4.12%). The spread of data related to the attachment site of OS according to the presence or absence of ACP pneumatization showed that the location of OS was affected by ACP pneumatization (P<0.001). In ACPs with pneumatization, the frequency of OS position relative to ACP was found as follows: Type A in none of sides (0%), Type B in 8 sides (7.6%), Type C in 53 sides (15.4%), Type D in 88 sides (30.4%), and Type E in 20 sides (60.6%). Conclusions: The main finding of this study was that the location of OS relative to ACP was affected by ACP pneumatization. In ACPs with pneumatization, OS was located more posteriorly compared with ACPs without pneumatization

Distribution and morphology of ventricular bands in the hearts of ringed seals

In contrast to studies on domestic animals, few reports describe ventricular bands in wildlife, and none in aquatic mammals. Ventricular bands in the endangered Saimaa ringed seal (Pusa hispida saimensis) and the Baltic ringed seal (Pusa hispida botnica) were examined as part of an ongoing research on the comparative anatomy of ringed seal subspecies. The dissections illustrated that a varying number of thin or thick ventricular bands from the papillary muscles to the ventricular walls were visible in the ventricles of all ringed seal specimens examined. The histological appearance of the ventricular bands was characterized by a fibromuscular pattern.Peer reviewe