Myoepithelial carcinomas are rare, malignant salivary neoplasms in which the tumor cells almost exclusively manifest myoepithelial differentiation. A 50-year-old man presented with an indolent movable submucosal mass of 10 years' duration on the right upper oral mucosa. The diagnosis of myoepithelial carcinoma originated from minor salivary gland was made by histopathologic and immunohistochemical evaluation.
Diagnosis ; Humans ; Middle Aged ; Mouth Mucosa ; Salivary Glands, Minor*

OBJECTIVE: To evaluate the changes of plasma MMP-2, -9 levels in preeclampsia between antepartum and postpartum periods, and compare with normotensive pregnant. METHODS: Plasma MMP-2, -9 levels were determined with enzyme-linked immunoassay in pregnant women with preeclampsia (n=20) compared to control group (normotensive pregnant women) matched by maternal age, gestational age, and parity (n=20). RESULTS: Women with preeclampsia presented significantly higher plasma level of MMP-2 before delivery [516.33 +/- 98.75 vs 384.55 +/- 93.84 (ng/mL), p=0.002]. In postpartum 24 hours, women with preeclampsia exhibited higher plasma MMP-2 level compared control group [534.77 +/- 158.67 vs 336.04 +/- 139.11 (ng/mL), p=0.002]. But the plasma level of MMP-9 was significantly lower in preeclampsia group before delivery [26.26 +/- 7.49 vs 45.00 +/- 20.31 (ng/mL), p=0.001]. In postpartum 24 hours, women with preeclampsia also speculated lower plasma MMP-9 level compared control group, but no existence of significance. CONCLUSION: Plasma MMP-2 concentration is significantly increased in preeclampsia before delivey and postpartum 24 hours. Plasma MMP-9 concentration is significantly decreased in preeclampsia before delivery.
Female ; Gestational Age ; Humans ; Immunoassay ; Maternal Age ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; Parity ; Plasma* ; Postpartum Period* ; Pre-Eclampsia* ; Pregnant Women

OBJECTIVE: To evaluate the changes of plasma MMP-2, -9 levels in preeclampsia between antepartum and postpartum periods, and compare with normotensive pregnant. METHODS: Plasma MMP-2, -9 levels were determined with enzyme-linked immunoassay in pregnant women with preeclampsia (n=20) compared to control group (normotensive pregnant women) matched by maternal age, gestational age, and parity (n=20). RESULTS: Women with preeclampsia presented significantly higher plasma level of MMP-2 before delivery [516.33 +/- 98.75 vs 384.55 +/- 93.84 (ng/mL), p=0.002]. In postpartum 24 hours, women with preeclampsia exhibited higher plasma MMP-2 level compared control group [534.77 +/- 158.67 vs 336.04 +/- 139.11 (ng/mL), p=0.002]. But the plasma level of MMP-9 was significantly lower in preeclampsia group before delivery [26.26 +/- 7.49 vs 45.00 +/- 20.31 (ng/mL), p=0.001]. In postpartum 24 hours, women with preeclampsia also speculated lower plasma MMP-9 level compared control group, but no existence of significance. CONCLUSION: Plasma MMP-2 concentration is significantly increased in preeclampsia before delivey and postpartum 24 hours. Plasma MMP-9 concentration is significantly decreased in preeclampsia before delivery.
Female ; Gestational Age ; Humans ; Immunoassay ; Maternal Age ; Matrix Metalloproteinase 2 ; Matrix Metalloproteinase 9 ; Parity ; Plasma* ; Postpartum Period* ; Pre-Eclampsia* ; Pregnant Women

Osteogenesis imperfecta (OI) is an inherited disease of connective tissue disorder which represents a phenotypically heterogeneous group of conditions that results from a number of genetic defects in the synthesis of type I collagen. A pregnancy associated with osteogenesis imperfecta is considered a high risk pregnancy because the disease is associated with various metabolic and hematologic disorders, as well as well-recongnized skeletal abnormalities. In addition to the mother with OI, the offspring has about a 25% to 50% chance of being affected, therefore genetic counseling before conception and prenatal diagnosis should be offered to all affected mothers. Patients with OI present a series of problems and require a multidisciplinary approach in their management. We present a case of parturient with osteogenesis imperfecta with brief review of literature.
Collagen Type I ; Connective Tissue ; Fertilization ; Genetic Counseling ; Heredity ; Humans ; Mothers ; Osteogenesis Imperfecta* ; Osteogenesis* ; Pregnancy* ; Pregnancy, High-Risk ; Prenatal Diagnosis

PURPOSE: We wanted to assess the benefits and safety of periarticular soft tissue injection of bupivacaine and morphine in total hip arthroplasty by conducting a prospective randomized trial. MATERIALS AND METHODS: Between February 2008 and January 2010, a prospective, randomized study was performed on fifty patients with an American Society of Anesthesiology stage of I or II. All the patients were administered COX-2 inhibitor and we used PCEA (Patient Controlled Epidural Analgesia) for 24 hours postoperatively. All the patients underwent their operation under general anesthesia. Fifty randomly selected patients were divided into two groups. After reduction of the hip joint, 50 ml of normal saline was intraoperatively injected into 25 patients (Group A) and 50 ml of locally injected analgesia that included 0.5 ml 5 mg of morphine HCL, 40 ml of 0.5% 50 mg chirocaine (Levo-bupivacaine) and 9.5 ml of normal saline was injected into the capsule and the soft tissue and muscle around the hip joint in 25 patients (Group B). The analgesic efficacy was evaluated by the visual analogue scale (VAS) at 6 and 12 hours postoperatively with the patients in a resting state and at 24, 48 and 72 hours postoperatively with the patients in a resting state and during a passive exercise (30degrees) state. The consumption of PCEA and additional analgesic drugs was also evaluated postoperatively. RESULTS: Significant differences were found between the 2 groups (P<0.05) with regard to the VAS at 6 and 12 hours postoperatively with the patients in a resting state and at 24, 48 and 72 hours postoperatively with the patients in a resting state and a passive exercise state. During 24 hours postoperatively, in the mixed analgesia injected group, the consumption of PCEA was significantly lower than that in the normal saline injected group (P<0.05). No significant differences were found for the consumption of additional analgesic drugs between the 2 groups (P>0.05). CONCLUSION: Intraoperative periarticular soft tissue injection of bupivacaine and morphine can significantly reduce pain and it can reduce the requirement for patient-controlled analgesia, with no apparent risks, following total hip arthroplasty.
Analgesia ; Analgesia, Patient-Controlled ; Analgesics ; Anesthesia, General ; Anesthesiology ; Arthroplasty ; Bupivacaine ; Hip ; Hip Joint ; Humans ; Morphine ; Muscles ; Prospective Studies

PURPOSE: To describe the clinical presentations, management, and outcomes of patients with pilomatrixomas treated in a single institution, and to compare the clinicopathological features according to their location. METHODS: We reviewed the medical records of 57 patients treated between January 1986 and December 2007, retrospectively. RESULTS: The 57 patients had a total of 61 cases of pilomatrixomas. The mean age at diagnosis was 12.4 years, with most patients aged 0~10 years, followed by 10~20 years and 20~30 years. Mean tumor size was 1.46 cm, and most tumors were less than 2.0 cm in diameter. Forty-two tumors (68.9%) on the head and the neck were classified as Group I, and 19 tumors (31.1%) on the body were classified as Group II. The mean age at diagnosis was 9.4 years in Group I, and 19.8 years in Group II with significant statistical difference (P=0.009). The mean duration of symptoms was 26.4 months in Group I, and 7.2 months in Group II (P=0.001). All patients were treated surgically, and two patients relapsed (5 months and 3 years later). CONCLUSION: Pilomatrixoma is an uncommon benign skin tumor arising from hair follicle matrix cells. Diagnosis is usually easy based on clinical findings, and preoperative diagnosis may be improved with increased awareness of pilomatrixoma. Complete surgical excision is the treatment of choice, and recurrence after complete excision is rare.
Aged ; Hair Follicle ; Head ; Humans ; Medical Records ; Neck ; Pilomatrixoma ; Recurrence ; Skin

PURPOSE: This study compared the postoperative outcomes and complications between laparoscopic totally extraperitoneal (TEP) hernia repair and open Lichtenstein hernia repair. METHODS: A total of 64 cases (30 cases by the TEP method and 34 cases by Lichtenstein repair) were enrolled in this study. The operative time, the hospital stay, the VAS score, the amount of analgesic used, the postoperative complications and recurrence were compared between the 2 methods. RESULTS: The mean operative time was 71 min for the TEP group, which was not significantly longer than that for the Lichtenstein group (66 min). The mean postoperative hospital stay was 3.7 days for the TEP group, which was significantly shorter than that for the Lichtenstein group (4.2) (p=0.035). The mean postoperative analgesic dose was 0.9+/-0.7 and 1.1+/-1.0 within 24 hours and 0.2+/-0.5 and 0.7+/-0.8 after 24 hours, respectively. The dose of analgesic after 24 hours was significantly lower for the TEP group (p=0.011), but the dose within 24 hours and the total dose was not significantly different. The VAS score was 2.3+/-1.0 and 2.6+/-0.9 at 12 hrs and 1.2+/-0.8 and 1.7+/-0.8 at 48 hrs, respectively. The VAS score was significantly lower for TEP group than that for the Lichtenstein group at 48 hrs (p=0.011), but there was no significant difference between the groups at 12 hrs. There was one recurrence in the TEP group. CONCLUSION: For the TEP group, the hospital stay was significantly shorter than that for the Lichtenstein group and this is maybe because the postoperative pain after 24 hours from the operation was less for the TEP group. Laparoscopic TEP repair may be performed efficiently with an acceptable operating time and a shorter hospital stay, as compared to open Lichtenstein hernia repair.
Hernia ; Herniorrhaphy ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Pyrazines ; Recurrence

BACKGROUND: The purpose of this study was to evaluate the usefulness of the pleural fluid carcinoembryonic antigen (CEA) and cytokeratin fragment 19 (CYFRA 21-1) tumor markers as complementary tools for the diagnosis of malignant pleural effusions. PATIENTS AND METHODS: The levels of pleural and serum CEA and CYFRA 21-1 were prospectively assayed in 222 patients with pleural effusions (150 benign effusions, 57 bronchogenic carcinomas and 15 metastatic carcinomas). RESULTS: The levels of pleural fluid CEA and CYFRA 21-1 in the malignant effusions were significantly higher than those in the benign effusions. With a specificity of 95%, the cut off values for the CEA and CYFRA 21-1 in pleural effusions were 5 and 89 ng/ml, respectively. The diagnostic sensitivities of the pleural fluid CEA and CYFRA 21-1 in malignant effusions were 72 and 54%, respectively, whereas using a combination of the two, the sensitivity increased to 87% (p<0.05). CONCLUSIONS : These findings suggest that a combination of the pleural fluid CEA and CYFRA 21-1 in pleural effusions can be useful in the diagnosis of malignant pleural effusions.
Carcinoembryonic Antigen ; Carcinoma, Bronchogenic ; Diagnosis ; Humans ; Keratins ; Pleural Effusion ; Pleural Effusion, Malignant* ; Prospective Studies ; Biomarkers, Tumor

The most common anterior mediastinal tumors originate from the thymus. Among them, thymic carcinomas occur as an early local invasion and wide spread metastases. However, when squamous cell carcinoma in the thymus or mediastinum is identified, an occult primary lung cancer must be excluded because the histologic types resemble those found more typically in the lung. CD5 and cytokeratin immunohistochemical staining is useful in evaluating biopsy samples from those tumors. Spuamous cell carcinoma of an unknown primary origin in the mediastinum is a rare occurrence and there are only a handful of case reports. Here we describe a case with an anterior mediastinal mass of squamous cell carcinoma with unknown primary origin. A resection of the mediastinal mass without an association with the lung was performed. Immunohistochemical stainings were positive using cytokeratin 13, and negative using CD5 and cytokeratin 7. This was followed by chemotherapy for presured thymic carcinoma.
Biopsy ; Carcinoma, Squamous Cell* ; Drug Therapy ; Hand ; Keratin-13* ; Keratin-7* ; Keratins* ; Lung ; Lung Neoplasms ; Mediastinum ; Neoplasm Metastasis ; Thymoma ; Thymus Gland*

PURPOSE: The altered gantry angle during scanning for some multiplanar reconstruction CT program (CT/MPR) may cause distortion of the image. The aim of this study was to ascertain whether there is a image distortion in a reformatted image when the gantry and the object are equally inclined using ToothPix and DentaScan program. MATERIALS AND METHODS: A resin block model with four cylindrical holes and a human dry mandible were used. Two MPR software packages, ToothPix and DentaScan program, were used for reformatted panoramic images. The block and the gantry were equally inclined at 0degree, 15degrees, and 30degrees. RESULTS: With ToothPix program, a resin block model with empty holes and a dry mandible showed inclined images in the reformatted panoramic image. Increasing the gantry angle, the depth and inclination of the holes were increased in the reformatted central panoramic images. However, a resin block model with gutta percha in its holes and a dry mandible with a wire in its mandibular canal didn't show image distortion. With DentaScan program, image distortion was not seen in any situation. CONCLUSION: ToothPix program may distort the reformatted image when the gantry angle is not at zero degrees. However, with DentaScan program, the patient may be positioned comfortably and the gantry can be adjusted to the patient positioning.
Dental Implants ; Gutta-Percha ; Humans ; Mandible ; Patient Positioning