Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Metastatic lobular carcinoma with signet-ring cells mimicking primary gastric signet-ring cell carcinoma

Abstract: Signet-ring cell carcinoma (SRCC) is a subtype of adenocarcinoma characterized histologically by cells with abundant intracellular mucin production, creating a distinctive “signet-ring” appearance. SRCC typically arises in tissues of the gastrointestinal tract. In the breast, SRCC is a rare subtype of invasive lobular carcinoma defined by the presence of signet-ring cells. Mammary SRCC has unique patterns of metastatic spread compared to more common breast cancers, more often spreading viscerally to involve the serosal surfaces of stomach, urinary tract, and spleen. We report a case of metastatic mammary SRCC presenting in the stomach, thereby mimicking primary gastric SRCC. Recognition of this unusual presentation is critical as treatments for these malignancies are vastly different; misdiagnosis could lead to significant morbidity and mortality for patients.

Treatment of methemoglobinemia resulting in green urine

Abstract: A 75-year-old male became cyanotic and hypoxemic (saturating 83–87% on ambient air) shortly after undergoing transesophageal echocardiography prior to cardioversion for atrial fibrillation. Benzocaine spray was used for local pharyngeal anesthesia. Administration of 100% O2 by non-rebreather mask did not improve O2 saturation and arterial blood gases showed a pH of 7.45, partial pressure of carbon dioxide of 33.8 mm Hg, a partial pressure of oxygen of 336 mm Hg and O2 saturation of 98%. Methemoglobinemia was suspected clinically and methemoglobin level was checked which was elevated at 47.3%. The patient was given methylene blue (1 mg/kg) intravenously and his saturation improved significantly. Subsequent methemoglobin levels were 1.2% and 0.7% at 4 h and 12 h after treatment, respectively, and the patient remained asymptomatic. The treatment resulted in green discoloration of the patient’s urine (Figure 1) which normalized gradually over the next 48 h. Hemoglobin contains iron in the ferrous (Fe 2+ )

Ilioinguinal and Genitofemoral Neuralgia

Abstract: Genitofemoral and ilioinguinal neuralgia are common causes of pelvic pain and should be included in the differential for inguinodynia (groin pain), especially in patients with risk factors such as recent pelvic or abdominal surgery, poorly controlled diabetes, or obesity. Different neuralgias are characterized by a different and somewhat specific distribution of pain; however, there are considerable variations in the course of both nerves which can result in changes in the distribution of innervation and thus changes in the distribution of pain (Cesmebasi et al. Clin Anat 28:128–135, 2015; Rab et al. Plast Reconstr Surg 108(6):1618–1623, 2001). Genitofemoral, ilioinguinal, and iliohypogastric nerves are known as border nerves, since they supply sensory innervation at the border of the abdomen and the thigh region (Peng and Tumber Pain Phys 11:214–224, 2008). Injury to these nerves results in pain and paresthesias in the groin region, which due to the proximity and anatomic variability of the course of the nerves makes it difficult to tease apart the truly injured nerve (Acar et al. Turk Neurosurg 23(6):753–757, 2013; Amid et al. J Am Coll Surg 213:531–536, 2011; Cesmebasi et al. Clin Anat 28:128–135, 2015; Rab et al. Plast Reconstr Surg 108(6):1618–1623, 2001). Also due to the proximity and similar course, these nerves are at risk for injury from the same types of surgeries or traumas. All three originate from the lumbar plexus, making the diagnosis quite challenging. The appropriate treatment plan relies on an accurate diagnosis. Different modalities for treatment exist, many of which are still being investigated.