Invasive Lobular Carcinoma of the Breast With Rectal Metastasis: A Rare Case Report.

The rectum is a relatively unusual site for metastasis from invasive lobular carcinoma (ILC) of the breast, and it carries dangers such as perforation and blockage. We reported a case of a 47-year-old female patient complaining of breast ILC for one year. Recently, the patient complained of abdominal distention, mild generalized abdominal pain, and weight loss. The abdominal ultrasound (US) showed moderate ascites without hepatomegaly, and ascitic tapping was positive for malignant cells. Lower colonoscopy showed a congested mass of 8 cm, and anal verge biopsy showed colonic mucosa laminal propria infiltrated with atypical cells and adenocarcinoma metastatic from the breast. In a patient with breast cancer, particularly ILC, who has developed new gastrointestinal tract (GIT) symptoms, there is significantly a high chance of rectal metastatic illness. Early detection is critical for successful treatment.

A Single-Center Study of Patients With Synchronous Primary Malignancy: A Case Series.

Multiple primary malignant tumors (MPMT) can be defined as more than two different tumors synchronously or metachronously forming in the same organ or different organs. The incidence of MPMTs varies dramatically between antemortem and postmortem examinations, becoming a serious medical issue. Evidence shows that the overall incidence of MPMTs is between 2.4% and 17%. Double primary malignancy (DPM) is considered the most common type of MPMT. In this case series, we present three cases of MPMT. The first case involved the colon and the breast, the second case involved the colon and the kidney, and the third case involved rectum and kidney.

Optimal correlations in many-body quantum systems.

Information and correlations in a quantum system are closely related through the process of measurement. We explore such relation in a many-body quantum setting, effectively bridging between quantum metrology and condensed matter physics. To this aim we adopt the information-theory view of correlations and study the amount of correlations after certain classes of positive-operator-valued measurements are locally performed. As many-body systems, we consider a one-dimensional array of interacting two-level systems (a spin chain) at zero temperature, where quantum effects are most pronounced. We demonstrate how the optimal strategy to extract the correlations depends on the quantum phase through a subtle interplay between local interactions and coherence.

Quantum adiabatic brachistochrone.

We formulate a time-optimal approach to adiabatic quantum computation (AQC). A corresponding natural Riemannian metric is also derived, through which AQC can be understood as the problem of finding a geodesic on the manifold of control parameters. This geometrization of AQC is demonstrated through two examples, where we show that it leads to improved performance of AQC, and sheds light on the roles of entanglement and curvature of the control manifold in algorithmic performance.

[Surgery of the upper cervical spine in rheumatoid arthritis. Indications and results apropos of 28 cases]. / La chirurgie du rachis cervical supérieur dans la polyarthrite rhumatoïde. Indications et résultats à propos de 28 cas.

PURPOSE OF THE STUDY: The goal of this study was to precise indications and surgical techniques for stabilisation with or without decompression of the upper cervical spine instability in rheumatoid arthritis. MATERIAL AND METHODS: 28 patients presenting upper cervical spine disease have been reviewed (mean age 57 years). These patients had been suffering from severe diffuse arthritis during an average of 14.5 years. The anterior atlanto-axial dislocation was most frequent (25 times), 1 posterior dislocation and 2 vertical dislocations. Odontoid lysis was noted 19 times. A subluxation of the lower cervical spine was present in 12 patients. SURGICAL TECHNIQUE: C1-C2 arthrodesis was performed 12 times (9 times with a loop wire and 3 isthmo-pedicular screws C2-C1), occipito-cervical arthrodesis with plates 16 times. Operative traction was necessary 5 times. The associated surgical gestures included 3 times a laminectomy, 2 times an enlargement of the occipital foramen, 1 section of the Arnold nerve. In 2 patients was associated a fixation of the lower cervical spine. RESULTS: With an average of 27 months follow-up, functional results (classified according to Ranawat's criteria) were satisfactory in 14 patients, improved in 7 patients, unchanged in 4 and bad in 3. The reduction of the anterior displacement in 25 patients was complete 11 times, partial 17 times and null 3 times. The reduction of the vertical displacement was complete once, partial 3 times. Arthrodesis fusion was obtained in 19 cases, 5 times it was a fibrous union and 4 pseudarthrosis occurred, all with C1-C2 loop wire. The rate of complications was high: 2 infections on bone site grafting requiring reoperation, 2 infections with secondary septicemia after lack of reduction. DISCUSSION AND CONCLUSION: Occipito-cervical arthrodesis is necessary as soon as the patient presents neurological signs. When there is an anterior dislocation associated with vertical dislocation, if there is posterior dislocation in case of osteoporosis of the posterior C1-C2 arc, or destabilisation of the lower cervical spine. C1-C2 arthrodesis is suggested when there is no important neurological signs, when displacement is limited to a pure anterior dislocation and in young patient with good bone quality.

[Lamino-arthrectomy technique for lumbar spine stenosis]. / Technique de lamino-arthrectomie pour canal lombaire étroit.

Surgical treatment should to be proposed in lumbar spinal stenosis, when well conducted conservative treatment is insufficient (severe pain and/or neurologic involvement). The goal of the treatment is to enlarge the canal: decompression of the dura mater in case of central stenosis and, radicular decompression in case of lateral stenosis. Two opposing techniques can be used: the lamino-arthrectomy and the recalibration. We describe the lamino-arthrectomy techniques, results and complications about 202 operated cases. The classic laminectomy is a posterior resection, with a partial arthrectomy (to release the symptomatic root involved by degenerative arthritic changes in zygapophyseal joints) and a systematic exploration of the posterior vertebral body. In the "lobster shell" technique, the laminectomy is conducted on several levels with a jigsaw. The others gestures are identical to the classic laminectomy.The complications were of three types; during surgery (35 dura mater gaps, 10 radicular injuries), early post-operative (2 non compressive haematomas reoperated in two cases, 6 infections, 4 roots involvement and 4 paraplegias) and the latest complications (11 destabilisations, 4 recurrences). The results were good in 86,2% of the series (most of oldest patients) and, 71,4% of the patients regained normal locomotion. The posterolateral arthrodesis is discussed, with osteosynthesis by plates and pedicle screws technique described by R. Roy-Camille. The results prove the surgical efficiency of extensive lamino-arthrectomy in symptomatic narrow lumbar canal. The efficiency on lumbago and neurologic deficit is less.