axillary

腋窝
  • 文章类型: Journal Article
    腋窝X光片可以测量关节盂逆行,这与全肩关节置换术后临床结局恶化和关节盂松动有关。由于射线照相技术的可变性,这项研究旨在确定通过腋窝X光片测量的逆行准确性是否受到1)肩胛骨旋转和/或2)内侧肩胛骨的正确可视化的影响。
    使用五个尸体肩胛骨,研究人员获得了真实中立位置以及前后旋转10°和20°的腋窝X光片。对于每张射线照片,两名受过研究训练的肩关节外科医生测量关节盂后向,并完全可视化肩胛骨(技术1),可视化仅限于肩胛骨的外半部(技术2)。观察者还通过CT扫描测量了关节盂逆行,以用作金标准技术。Spearman的Rho用于评估测量之间的一致性。
    通过CT扫描评估的五个肩胛骨的平均关节盂逆行为3.8°(R:1.5-6.9)。与使用技术2获得的测量结果相比,使用技术1获得的测量结果证明了观察者之间的一致性水平(ICC:0.412)得到了提高,后者证明了一致性(ICC:0.103)。使用两种技术,肩胛骨旋转与协议不一致。
    关节盂逆行测量的可靠性受到内侧肩胛骨脊柱不完全可视化的限制。当测量肩胛骨底部的后向时,改善的一致性和准确性与不同程度的肩胛骨旋转。
    UNASSIGNED: Axillary radiographs enable the measurement of glenoid retroversion, which is associated with worsened clinical outcomes and glenoid loosening following total shoulder arthroplasty. Due to the variability in radiographic technique, this study aims to determine if the accuracy of retroversion measured by axillary radiograph is affected by 1) scapular rotation and/or 2) proper visualization of the medial scapula.
    UNASSIGNED: Using five cadaveric scapulae, investigators obtained axillary radiographs in true neutral position as well as in 10° and 20° of anterior and posterior rotation. For each radiograph, two fellowship trained shoulder surgeons measured glenoid retroversion with complete visualization of the scapula (Technique 1) and with visualization limited to the lateral half of scapula (Technique 2). The observers also measured glenoid retroversion by CT scan to use as a gold standard technique. Spearman\'s Rho was used to assess agreement between measurements.
    UNASSIGNED: Average glenoid retroversion of the five scapulae assessed by CT scan was 3.8° (R: 1.5-6.9). Measurements obtained using Technique 1 demonstrated improved levels of interobserver agreement (ICC: 0.412) compared to measurements obtained with Technique 2, which demonstrated no agreement (ICC: 0.103). Scapular rotation was inconsistently associated with agreement using both techniques.
    UNASSIGNED: The reliability of glenoid retroversion measurements was limited by incomplete visualization of the medial scapular spine. When measuring retroversion to the base of the scapular spine, improved agreement and accuracy were seen with various degrees of scapular rotation.
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  • 文章类型: Journal Article
    背景:温度被认为是检测感染等并发症的主要生命体征之一。连续无线实时腋窝温度监测在普通病房技术上是可行的,但没有临床验证研究。
    方法:本研究比较了40例腹部术后患者的腋窝温度和膀胱温度计。主要结果是腋窝温度记录的变化。次要结果是膀胱和腋窝温度之间的平均偏差。还收集了间歇性的额叶和鼓室温度记录。
    结果:40名患者接受了50分钟的监测,平均核心温度为36.8°C。5分钟后,平均偏差为-1.0°C(LoA-1.9至-0),和-0.8°C(LoA-1.6至-0.1)后10分钟时,将腋窝温度与膀胱温度进行比较。20分钟后,平均偏差为-0.6°C(LoA-1.3-0.1).上臂外展时,腋窝温度在1分钟内降至-1.6°C(LoA-2.9至-0.3)。与中心温度相比,时间皮肤温度测量的平均偏差为-0.1°C(LOA-1.1至-1.0)。与平均鼓室温度相比,它比尿袋温度低-0.1°C(LoA-0.9至-1.0)。
    结论:腋窝温度随时间增加,在5分钟内达到腋窝和核心温度之间的平均偏差为1°C。打开腋窝会导致温度迅速降低。这些发现可能有助于使用和设计用于连续腋窝温度监测的校正。
    BACKGROUND: Temperature is considered one of the primary vital signs for detection of complications such as infections. Continuous wireless real-time axillary temperature monitoring is technologically feasible at the general ward, but no clinical validation studies exist.
    METHODS: This study compared axillary temperature with a urinary bladder thermometer in 40 major abdominal postoperative patients. The primary outcome was changes in axillary temperature registrations. Secondary outcomes were mean bias between the urinary bladder and the axillary temperatures. Intermittent frontal and tympanic temperature recordings were also collected.
    RESULTS: Forty patients were monitored for 50 min with an average core temperature of 36.8 °C. The mean bias was -1.0 °C (LoA -1.9 to -0) after 5 min, and -0.8 °C (LoA -1.6 to -0.1) after 10 min when comparing the axillary temperature with the urinary bladder temperature. After 20 min, the mean bias was -0.6 °C (LoA -1.3-0.1). During upper arm abduction, the axilla temperature was reduced to -1.6 °C (LoA -2.9 to -0.3) within 1 min. Temporal skin temperature measurement had a resulted in a mean bias of -0.1 °C (LOA -1.1 to -1.0) compared with central temperature. Compared with the mean tympanic temperature, it was -0.1 °C (LoA -0.9 to -1.0) lower than the urinay bladder temperature.
    CONCLUSIONS: Axillary temperature increased with time, reaching a mean bias of 1 °C between axillary and core temperature within 5 min. Opening the axillary resulted in rapidly lower temperature recordings. These findings may aid in use and designing corrections for continuous axillary temperature monitoring.
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  • 文章类型: Journal Article
    这项研究的目的是在新生儿重症监护病房(NICU)入院时使用数字温度计评估出生不到32周的早产儿的直肠和腋窝温度测量值之间的差异。
    预期,观察,单中心研究。使用数字温度计进行直肠和腋窝温度测量。该研究检查了各种孕产妇和新生儿因素来描述研究组,包括使用产前皮质类固醇,母亲糖尿病和高血压的发生,产妇长期胎膜破裂(PROM)的历史,母体绒毛膜羊膜炎,交付方式,随着新生儿的性别,出生体重,和胎龄。计算皮尔逊相关系数(R)以确定直肠和腋窝部位的温度之间的线性关系。使用Bland-Altman方法分析两组温度数据之间的一致性。
    80名平均胎龄为28.4周(SD=2.9)、平均出生体重为1,229g(SD=456)的婴儿被纳入研究。平均腋窝温度为36.4°C(SD=0.7),低于平均直肠温度36.6°C(SD=0.6)(p=0.012)。在59%的情况下,直肠温度超过了腋窝测量值,而在21%的病例中观察到相反的情况。直肠和腋窝温度具有很强的相关性(皮尔逊相关系数为0.915,p<0.001)。Bland-Altman图显示,两次温度测量之间的平均差为0.1C,但一致的界限很宽(0.7至-0.6°C)。对于低体温的婴儿,直肠和腋窝温度之间的平均差为0.27°C,在-0.5°C至+1°C的范围内具有广泛的一致性。相反,对于体温正常的婴儿,在0.1°C时,平均差较小,从-0.4°C到+0.6°C的更窄的协议极限。
    虽然腋窝和直肠温度之间有很好的相关性,更广泛的协议限制表明可变性,特别是低体温的婴儿。为了更准确地评估低体温婴儿的核心体温,临床医生应考虑使用直肠测量,以确保有效的热调节和更好的临床结果.
    UNASSIGNED: The purpose of this research was to evaluate the differences between rectal and axillary temperature measurements in preterm infants who were born less than 32 weeks\' gestation using digital thermometers upon their admission to the Neonatal Intensive Care Unit (NICU).
    UNASSIGNED: Prospective, observational, single centre study. Rectal and axillary temperatures measurements were performed using a digital thermometer. The study examined various maternal and neonatal factors to describe the study group, including the use of prenatal corticosteroids, the occurrence of maternal diabetes and hypertension, a history of maternal prolonged rupture of membranes (PROM), maternal chorioamnionitis, the mode of delivery, along with the neonate\'s gender, birth weight, and gestational age. The Pearson correlation coefficient (R) was calculated to ascertain the linear relationship between the temperatures taken at the rectal and axillary sites. The concordance between the two sets of temperature data was analyzed using the Bland-Altman method.
    UNASSIGNED: Eighty infants with a mean gestational age of 28.4 weeks (SD = 2.9) and a mean birth weight of 1,229 g (SD = 456) were included in the study. The mean axillary temperature was 36.4 °C (SD = 0.7), which was lower than the mean rectal temperature of 36.6 °C (SD = 0.6) (p = 0.012). Rectal temperatures surpassed axillary measurements in 59% of instances, while the reverse was observed in 21% of cases. Rectal and axillary temperatures had a strong correlation (Pearson correlation coefficient of 0.915, p < 0.001). Bland-Altman plot showed a small mean difference of 0.1C between the two temperatures measurements but the limits of agreement were wide (+0.7 to -0.6 °C). For hypothermic infants, the mean difference between rectal and axillary temperatures was 0.27 °C, with a wide limit of agreement ranging from -0.5 °C to +1 °C. Conversely, for normothermic infants, the mean difference was smaller at 0.1 °C, with a narrower limit of agreement from -0.4 °C to +0.6 °C.
    UNASSIGNED: While there is a good correlation between axillary and rectal temperatures, the wider limits of agreement indicate variability, particularly in hypothermic infants. For a more accurate assessment of core body temperature in hypothermic infants, clinicians should consider using rectal measurements to ensure effective thermal regulation and better clinical outcomes.
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  • 文章类型: Case Reports
    卵巢癌通常局限于腹膜内。出现时远处转移是不寻常的。它通过淋巴管传播并不常见,腋窝淋巴结转移非常罕见。我们报告了2例无乳腺受累的腋窝淋巴结病。计算机断层扫描确定了卵巢肿块。两者都有升高的血清Ca125。第一例为2级卵巢子宫内膜样癌。第二例患有高级别浆液性卵巢癌。这些病例说明了卵巢癌腋窝淋巴结病的罕见性。为了提供适当的治疗,确定原发性卵巢癌很重要。尽管手术和化疗,两者都在诊断后3年内死亡。
    Ovarian cancer is usually confined intraperitoneally. Distant metastases at presentation is unusual. Its spread via lymphatics is uncommon, and metastasis to axillary lymph nodes is very rare. We report two cases with presentation of axillary lymphadenopathy without breast involvement. Computed tomography scan identified the ovarian masses. Both had elevated Serum Ca 125. The first case had a Grade 2 ovarian endometrioid carcinoma. The second case had a high-grade serous ovarian carcinoma. These cases illustrate the rarity of axillary lymphadenopathy from ovarian cancer. It is important to identify the primary ovarian carcinoma in order to offer appropriate management. Despite surgery and chemotherapy, both succumbed within 3 years from diagnosis.
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  • 文章类型: Journal Article
    目的:本研究旨在比较直肠温度(RT)与耳廓测得的温度,角膜,内侧can,牙龈,家庭环境中猫的掌骨垫和腋窝区。
    方法:使用了兽医拥有的五只健康的混合品种猫(两只雌性和三只雄性)。
    方法:所有温度测量均由业主在同一房间内使用红外摄像机进行,并以耳廓开始,接着是角膜,内侧can,牙龈和掌骨垫。随后,用数字温度计记录腋窝温度(AT)和RT,分别。记录单次AT和RT测量所花费的时间。
    结果:RT的平均测量时间为17.34±0.89s,范围为8-32秒,而AT测量平均为46.72±1.16s,范围为29-69秒。与其他测量站点相比,AT成为了更好的替代测量站点,在临床协议范围内表现出最低的偏倚和最高的读数比例。RT和AT之间的平均差异,对分歧有95%的协议限制,为-0.26(-1.13至0.61)。
    结论:在评估体温(BT)时,解剖区域不能与直肠完全互换,AT与RT达成了最高级别的协议。当RT不可能时,AT可以被认为是监测生活在家庭环境中的临床健康猫的BT的替代方法。
    This study aimed to compare rectal temperature (RT) with temperatures measured in the pinna, cornea, medial canthus, gingiva, metacarpal pad and axillary region of cats in a home environment.
    Five healthy mixed-breed cats (two females and three males) owned by a veterinarian were used.
    All temperature measurements were conducted by the owner by using an infrared camera in the same room and initiated with the pinna, followed by the cornea, medial canthus, gingiva and metacarpal pad. Subsequently, axillary temperature (AT) and RT were recorded by a digital thermometer, respectively. The time taken for a single AT and RT measurements was recorded.
    The average measurement time for RT was 17.34 ± 0.89 s, with a range of 8-32 s, whereas AT measurements took an average of 46.72 ± 1.16 s, with a range of 29-69 s. AT emerged as a superior alternative measurement site compared to others, exhibiting the lowest bias and the highest proportion of readings within the limits of clinical agreement. The mean difference between RT and AT, with 95% limits of agreement for the differences, was -0.26 (-1.13 to 0.61).
    Anatomical regions were not all interchangeable with the rectum for assessing body temperature (BT), with AT recording the highest level of agreement with RT. When RT is not possible, AT could be considered as an alternative for monitoring BT in clinically healthy cats that live in a home environment.
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  • 文章类型: Case Reports
    BACKGROUND: We all know that lymph-node metastasis is an important factor for poor clinical outcome in breast cancer prognosis. Tumor deposit refers to a discrete collection of cancer cells that is found in the lymph nodes or other tissues adjacent to the primary tumor site. These tumor deposits are separate from the primary tumor and are often considered as a manifestation of lymph node metastasis. In gastric and colorectal cancer, tumor deposits in the lymph node drainage area have been included as independent prognostic factors. The question arises whether tumor deposits should also be considered as prognostic factors in breast cancer patients. This article aims to provoke some thoughts on this matter through a case study and literature review.
    METHODS: A 70-year-old female patient was found to have a right breast lump for over 2 years. On January 3, 2023, a core needle biopsy of the right breast lump was performed, and the pathology report indicated invasive carcinoma. Subsequently, on January 17, 2023, the patient underwent right breast-conserving surgery, sentinel lymph node biopsy, and right axillary lymph node dissection. The postoperative pathological staging was determined as stage IIB. The patient received chemotherapy, radiotherapy, and endocrine therapy. At present, nearly one year after the surgery, no obvious signs of metastasis have been observed in the follow-up examinations, but the long-term prognosis is still unknown.
    CONCLUSIONS: There is a need for increased focus on the matter of tumor deposits in the lymph node drainage region, as well as a requirement for further clinical investigation to ascertain the relevance of tumor deposits in the prognosis of individuals with breast carcinoma.
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  • 文章类型: Case Reports
    单中心Castleman病,特别是高血管变异亚型,通常表现为没有全身症状的局部淋巴结病。手术切除通常可以治愈这种亚型,导致良好的预后。然而,一些自身免疫并发症患者可能需要额外的全身治疗以及手术治疗.通过结合临床,放射学,病理结果对于优化管理至关重要。
    Unicentric Castleman disease, particularly the hypervascular variant subtype, commonly presents as a localized lymphadenopathy without systemic symptoms. Surgical excision is often curative for this subtype, leading to a good prognosis. However, some patients with autoimmune complications may require additional systemic therapy along with surgery. Accurate diagnosis through a combination of clinical, radiological, and pathological findings is crucial for optimal management.
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  • 文章类型: Journal Article
    旋毛虫病(滴虫病)是由棒状杆菌属细菌引起的腋毛水平的无症状感染。本研究的目的是确定临床,流行病学,和以前报道的病例的微生物学特征。进行了审查,包括截至2023年6月在PubMed数据库中报告的滴虫病(旋毛菌病)病例。包括29篇文章,共涉及365名患者。男性发病率较高,占94%的病例,大多数年龄在20-50岁之间。最常见的临床地形图是腋窝(90%的病例)。大多数患者出现头发质地和腋臭的变化,其他一些常见的临床表现是多汗症,头发颜色变化,和五汗症;6%的患者无症状。最常见的病原体是棒状杆菌属。,苦参品种是最普遍的。最常见的治疗形式是剃须和局部克林霉素。总之,三甲杆菌病是一种最常影响男性腋窝水平的感染;它在临床上表现为很少症状,通常对治疗有良好的反应。
    Trichobacteriosis (trichomycosis) is an asymptomatic infection at the axillary hair level caused by a bacterium of Corynebacterium spp. The aim of this study is to identify the clinical, epidemiological, and microbiological characteristics of previously reported cases. A review was conducted including the cases of trichomycosis (trichobacteriosis) reported in the PubMed database up to June 2023. Twenty-nine articles were included, involving 365 patients in total. A higher incidence was observed in men, representing 94% of the cases, most of which were in the age range of 20-50 years. The most frequently affected clinical topography was the axillar (90% of the cases). Most of the patients presented change in hair texture and bromhidrosis, some other frequent clinical manifestations were hyperhidrosis, hair color change, and cromhidrosis; 6% of the patients were asymptomatic. The etiological agent most frequently identified was Corynebacterium spp., the flavescens variety being the most prevalent. The most common form of treatment was shaving and topical clindamycin. In conclusion, trichobacteriosis is an infection that most frequently affects men at the axillary level; it manifests clinically with few symptoms and usually has a good response to treatment.
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    文章类型: Case Reports
    臂丛神经最常见的肿瘤是良性神经鞘瘤,其次是神经纤维瘤和恶性肿瘤,起源于周围神经鞘。臂丛神经肿瘤的临床表现因其部位而异,扩展,涉及的神经因素和病理学。臂丛神经肿瘤在上肢很少见,腋窝神经鞘瘤并不常见。该病例报道了一名59岁的妇女,她的左腋下有一个肿瘤,长达两年,她的左手小指麻木逐渐扩大。进行了显微外科手术切除肿瘤。手术后麻木消失了,在30个月的随访中没有观察到肿瘤复发。据我们所知,迄今为止,尚未报道腋窝臂丛神经丛状神经鞘瘤。在这篇文章中,报道了这种情况,通过组织病理学检查诊断出这种肿瘤,并用免疫组织化学证实。
    The most common tumours in the brachial plexus are benign schwannomas, followed by neurofibromas and malignancies, originating from the peripheral nerve sheath. The clinical manifestations of brachial plexus tumours are variable according to their location, extension, neurological elements involved and pathology. Brachial plexus tumours are rare in the upper extremity, and axillary schwannoma is uncommon. This case reports a 59-year-old woman with a tumour in her left axilla for two years, gradually enlarging with numbness in her left little finger. Microsurgical interfascicular dissection operation was performed to remove the tumour. Νumbness disappeared after the procedure, and no tumour recurrence was observed during the 30-month follow-up. To the best of our knowledge, plexiform schwannoma of the brachial plexus in the axilla has not been reported so far. In this article, such a case is reported, where this tumour was diagnosed by the histopathological examination and confirmed with immunohistochemistry.
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  • 文章类型: Case Reports
    在乳房检查中很少遇到乳房外肿块。它们可能发生在胸壁和腋窝,作为乳房的邻居。确定病变的性质很重要。然而,一些良性肿瘤,如颗粒细胞瘤(GCT),也表现出恶性特征,导致误诊。据我们所知,GCT的多模态超声特征尚未阐明。我们报告了2例乳腺癌筛查中遇到的GCTs女性;肿瘤不在乳腺组织中。第一位患者是一名37岁的女性,她的右乳房肿块缓慢增长,GCT位于胸大肌。第二名患者是一名52岁的女性,她表现出明显的左腋窝肿块,GCT位于腋窝。乳房X线照相术未能在乳腺癌筛查后检测到两名患者的肿块。然而,二维超声检查显示固体异质低回声肿块。剪切波弹性成像显示,与周围组织相比,肿块的硬度增加。进一步超声造影显示两个肿块的造影模式不同。万一有,超声造影显示不均匀的环形高度增强,动态曲线显示快速增强和回归。如果是两个,超声造影显示病变周围轻微增强,但内部无增强。术后病理证实两例GCT均为良性。在2年的随访中,患者没有复发的迹象。这里,我们报告了2例病例,并首次介绍了该肿瘤的多模态超声检查结果。放射科医生和外科医生应了解这些影像学表现,并将其纳入鉴别诊断中。
    Extramammary masses are infrequently encountered in breast examinations. They may occur in the chest wall and axilla as neighbors of the breast. It is important to determine the nature of the lesion. However, some benign tumors, such as granular cell tumors (GCTs), also show malignant characteristics, which leads to misdiagnosis. To the best of our knowledge, multimodal ultrasound features of GCT have not been elucidated. We report two cases of women with GCTs encountered upon breast cancer screening; the tumor was not located in breast tissue. The first patient was a 37-year-old woman who presented with a slow-growing mass in the right breast and the GCT was located in the pectoralis major muscle. The second patient was a 52-year-old woman who presented with a palpable left axillary mass and the GCT was located in the axilla. Mammography failed to detect the masses in the two patients upon breast cancer screening. However, two-dimensional ultrasonography revealed a solid heterogeneous hypoechoic mass. Shear wave elastography showed that the masses had an increased hardness compared with the surrounding tissue. Further contrast-enhanced ultrasonography showed that the contrast patterns of the two masses were different. In case one, contrast-enhanced ultrasonography showed an inhomogeneous annular high enhancement, and the dynamic curve showed rapid enhancement and regression. In case two, contrast enhanced ultrasound showed slight enhancement around the lesion but no enhancement inside. Postoperative pathology confirmed that the GCT was benign in both cases. The patients showed no signs of recurrence at the 2-year follow-up. Here, we report two cases and present the multimodal ultrasonography findings of this tumor for the first time. Radiologists and surgeons should be aware of these imaging manifestations and include them in their differential diagnoses.
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