Primary chondrosarcoma of the extraskeletal soft tissue is extremely rare. Extraskeletal chondrosarcoma was first described as entity in 1953 by Stout and Verner, who were able to collect a series of seven cases. Because of the rarity of this lesion in extremities, neither the clinical course nor the preferred method of treatment has been clearly established. Authors report a case of extraskeletal chondrosarcoma which occurred on the right forearm of a thirty-nine-year-old man. The lesion was completely excised with free resection margins. There was no recurrence or metastasis for four years follow up.
Chondrosarcoma ; Extremities ; Follow-Up Studies ; Forearm ; Methods ; Neoplasm Metastasis ; Recurrence

No abstract available.
Head* ; Hypopharynx* ; Mouth* ; Neck* ; Oropharynx*

A buttonhole deformity of the finger is characterized by flexion of the pmximal interphalangeal joint and hyperextension of the terminal interphalangeal joint. When the central slip of the extensor tendon and the triangular ligament are ruptured,(or severed) on the base of the middle phalanx, buttonhole deformity will result.This article is based on clinical and follow up studies of 5 patients with buttonholedeformities. Five cases were treated by the modified Littler method and were followed from 4 months to 24 months postoperatively and good results were obtained in all cases.
Congenital Abnormalities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Ligaments ; Methods ; Tendons

Synovial chondromatosis is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue which disintegrates into the joint and continues to grow. Of the eight cases of synovial chondromatosis seen by the authors, three cases involved the knee, two of these were bilateral, three cases involved the elbow, one the hip joint and one the proximal phalanx of the right middle finger. The diagnosis of synovial chondroamtosis was made by histopathological findings of the excised mass. Most synovial chondromatosis cases obtained favorable results by removing masses from the joint and at the same time performing a partial synovectomy, except one case in which degenerative arth ritis had developed proeoperatively.
Cartilage ; Chondromatosis, Synovial ; Connective Tissue ; Diagnosis ; Elbow ; Fingers ; Hip Joint ; Joints ; Knee

According to the electromyographic study, the superior and inferior heads of lateral pterygoid, one of the masticatory muscles, are known to perform the reciprocal actions in mandibular movements; the superior head is active in closing movement, whereas the inferior head is active in opening of the jaw. Through these two reciprocal actions of these two heads, the articular disk of TMJ is seated in its resting position. Many reports regarded the superior and inferior heads of the lateral pterygoid as functionally independent muscles, but from a morphological point of view, the origin of the independent nerve innervation and intramuscular branching patterns of the mandibular nerve are unclear. Twenty -four adult hemi -sectioned heads were dissected to clarify the topography of the nerve distribution on two heads of lateral pterygoid and also to determine the anatomico -clinical relevance related with temporomandibular disorder. Most buccal nerves were found to run between the superior and inferior heads of the lateral pterygoid (21 cases, 87.5 %). In 3 cases, buccal nerves passed through the inferior head of the lateral pterygoid (12.5%). In front of the ascending ramus region, most buccal nerves ran in front of the temporalis without being entrapped within the temporalis (16 cases, 66.7%). However, in 8 cases buccal nerve passed in front of the temporalis being entrapped within the anterior fiber of the temporalis (33.3%). In this study, the mandibular nerve trunk was located intimately to the lateral pterygoid. Both heads of the lateral pterygoid muscles were innervated from the mandibular nerve branches, but the patterns of nerve distribution were various. Nerves innervated to the superior head of the lateral pterygoid had different origin. Only in 45.8% (11 cases), they originated from the buccal nerve. In 16.7% (4 cases) the nerve branches originated from the anterior deep temporal nerve only, and in 12.5% (3 cases) from the buccal and anterior deep temporal nerve. In contrast, nerves innervated to inferior head of the lateral pterygoid showed different pattern of distribution. In 58.3 %, nerves distributed on the inferior head originated from both the buccal and mandibular nerve trunk. In 20.8%, they originated from the buccal nerve only, in 12.5% from the mandibular nerve trunk only. In seven categories of the distribution of mandibular nerve branches, in only 20.8% (5 cases), both the superior and inferior heads of the lateral pterygoid had the common source of nerve innervation, the buccal nerve. In contrast, in 45.9% (11 cases) additional nerve twigs from the mandibular nerve trunk were distributed on the inferior head of the lateral pterygoid muscle. Author observed the pterygoid loop (ansa pterygoidea) located between the mandibular nerve trunk and the nerve innervating to the lateral pterygoid in 4 cases. In addition, the intramuscular nerve loop within the inferior head of lateral pterygoid was observed in 5 cases. Summarizing these results, besides the buccal nerve mentioned in an anatomical textbook, nerve twigs originating directly from the mandibular nerve trunk innervated to the lateral pterygoid and the ones originating from the anterior and middle deep temporal nerves distributed on the lateral pterygoid muscle in various manners. Considering the various patterns of nerve distribution on the lateral pterygoid, author concluded that the two heads of the lateral pterygoid are controlled by independent innervation. Furthermore, we found out that nerve entrapments and nerve communications are related with symptoms of temporomandibular disorder and with possible collateral route of motor innervation to the facial expression muscles, respectively.
Adult ; Facial Expression ; Head ; Humans ; Jaw ; Mandibular Nerve* ; Masticatory Muscles ; Muscles ; Nerve Compression Syndromes ; Pterygoid Muscles* ; Temporomandibular Joint ; Temporomandibular Joint Disorders

A Reversible Posterior Leukoencephalopathy Syndrome(RPLS) consists of neurologic symptoms and signs - headache, consciousness change, seizure, visual impairment - and brain imaging finding showing brain(espicially white matter) edema usually involving the posteior parietal-temporal-occipital areas. The causes are thought to be hypertensive encephalopathy, pre-eclampsia or eclampsia, renal failure with fluid overload and immunosuppressive agents such as cyclosporin A or FK506. RPLS may usually reversible if treated early by decreasing blood pressure and discontinuing offending drugs. A 23-year-old man had been hemodialyzed with chronic renal failure for two years. His blood pressure elevated to 240/150mmHg 3 days before admission and he complained of severe headache, vomiting, and total visual loss at the day of admission. Brain T2-weighted MRI imaging showed increased signal intensity involving the both parietal, posterior temporal, and occipital lobes. After antihypertensive and dexamethason treatment, a follow-up brain MRI performed on 7 days after admission showed nearly normalized findings and all symptoms including visual loss were recovered completely in one week.
Blindness ; Blood Pressure ; Brain ; Consciousness ; Cyclosporine ; Eclampsia ; Edema ; Female ; Follow-Up Studies ; Headache ; Humans ; Hypertensive Encephalopathy ; Immunosuppressive Agents ; Kidney Failure, Chronic* ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Neuroimaging ; Neurologic Manifestations ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Pregnancy ; Rabeprazole ; Renal Insufficiency ; Seizures ; Tacrolimus ; Vomiting ; Young Adult

BACKGROUND/AIMS: The invasiveness of a liver biopsy and its inconsistent results have prompted efforts to develop noninvasive tools to evaluate the severity of chronic hepatitis. This study was intended to assess the performance of serum biomarkers for predicting liver fibrosis in patients with chronic viral hepatitis. METHODS: A total of 302 patients with chronic hepatitis B or C, who had undergone liver biopsy, were retrospectively enrolled. We investigated the diagnostic accuracy of several clinical factors for predicting advanced fibrosis (F≥3). RESULTS: The study population included 227 patients with chronic hepatitis B, 73 patients with chronic hepatitis C, and 2 patients with co-infection (hepatitis B and C). Histological cirrhosis was identified in 16.2% of the study population. The grade of porto-periportal activity was more correlated with the stage of chronic hepatitis compared with that of lobular activity (r=0.640 vs. r=0.171). Fibrosis stage was correlated with platelet count (r=-0.520), aspartate aminotransferase to platelet ratio index (APRI) (r=0.390), prothrombin time (r=0.376), and albumin (r=-0.357). For the diagnosis of advanced fibrosis, platelet count and APRI were the most predictive variables (AUROC=0.752, and 0.713, respectively). CONCLUSIONS: In a hepatitis B endemic region, platelet count and APRI could be considered as reliable non-invasive markers for predicting fibrosis of chronic viral hepatitis. However, it is necessary to validate the diagnostic accuracy of these markers in another population.
Aspartate Aminotransferases ; Biomarkers* ; Biopsy ; Blood Platelets ; Coinfection ; Diagnosis ; Fibrosis* ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Liver ; Liver Cirrhosis ; Platelet Count ; Prothrombin Time ; Retrospective Studies

We present a case of subacute cutaneous lupus erythematosus which fulfilled the criteria of systemic lupus erythematosus in a 52-year-old woman with annular and polycyclic erythematous patches on the neck and upper part of the anterior chest. She complained malar of resh, arthralgia, general weakness, and severe headache. Laboratory findings showed hematologic, serologic, central nervous system, and nephrologic abnormalities. Serologic abnormalities of this patient were positive anti-nuclear antibody, anti-La antibody, rhematoid factor, anti-RNP antibody and anti-platelet antibody, but anti-dsDNA and anti-Ro antibody test were negative. She was treated with oral prednisolone and intravenous cyclophosphamide. In the course of treatment, sepsis developed and she died from multi-organ system failure.
Arthralgia ; Central Nervous System ; Cyclophosphamide ; Female ; Headache ; Humans ; Lupus Erythematosus, Cutaneous* ; Lupus Erythematosus, Systemic ; Middle Aged ; Neck ; Prednisolone ; Sepsis ; Thorax

Ovarian granulosa cell tumor is a uncommon low-grade feminizing malignancy. Its natural history shows slow growth without pain. It often reveals to be very large sized mass when diagnosed, and is confined to the involved ovary in many cases. Complete surgical removal is primary treatment and recurrences thereafter are relatively common. Postoperative adjuvant therapy including reoperation, chemotherapy, radiation therapy or a combination therapy has been used with various degrees of success. We experienced a case of huge ovarian granulosa cell tumor occupying whole abdominal cavity by rapid growth, which is presented with a brief review of corresponding literatures.
Abdominal Cavity ; Drug Therapy ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Natural History ; Ovary* ; Recurrence ; Reoperation

It was reported that the etiologies of recurrent spontaneous abortion are immunologic factors, endocrinologic problems, anatomical abnormalities, genetic abnormalities, infection, and unexplained factors. Among those etiologic factors, genetic abnormalities occur in about 5% of the couples who experience recurrent spontaneous abortions, and most common parental chromosomal abnormality contributing to recurrent abortion is balanced translocation. The advent of in vitro fertilization (IVF), the development of skills associated with the handling of human embryo, and an explosion of knowledge in molecular biology have opened the possibility of early diagnosis of genetic disease in preimplantation embryos. Therefore preimplantation genetic diagnosis (PGD) is indicated for couples, infertile or not, at risk of transmitting a genetic disease. A case of successful pregnancy and term delivery by PGD using fluorescence in situ hybridization (FISH) technique in patient with recurrent spontaneous abortion due to balanced translocation is presented with brief review of literatures.
Abortion, Habitual ; Abortion, Spontaneous* ; Blastocyst ; Chromosome Aberrations ; Early Diagnosis ; Embryonic Structures ; Explosions ; Family Characteristics ; Female ; Fertilization in Vitro ; Fluorescence ; Humans ; Immunologic Factors ; In Situ Hybridization ; Molecular Biology ; Parents ; Pregnancy* ; Preimplantation Diagnosis* ; Prostaglandins D