No Abstract available.
Diagnosis* ; Sleep Apnea, Obstructive*

Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.
Child ; Male ; Female ; Humans ; Meningioma

A 78-year-old male presented with early gastric cancer and a 5.5 cm-sized infrarenal abdominal aortic aneurysm, detected during regular screening. Endovascular aneurysm repair (EVAR) was performed first, followed by laparoscopic distal gastrectomy. After gastrectomy, the patient underwent computed tomography (CT) scan due to persistent fever, which showed increased perigraft fluid collection around the right iliac limb graft. Echocardiography also revealed mitral valve vegetation, consistent with infective endocarditis. Despite intensive antibiotic treatment, the patient had persistent fever and showed fluid extension to the psoas muscle on CT scan. On the 49th post operative day (POD) after EVAR, stent graft explantation and aortic reconstruction with the left superficial femoral vein was performed. Ligation of the right iliac artery for infection control and simultaneous femoro-femoral bypass was also performed. The patient was discharged on the 46th POD after graft removal without any events.
Aged ; Aneurysm ; Aortic Aneurysm, Abdominal ; Blood Vessel Prosthesis ; Echocardiography ; Endocarditis ; Endovascular Procedures ; Extremities ; Femoral Vein* ; Fever ; Gastrectomy ; Humans ; Iliac Artery ; Infection Control ; Ligation ; Male ; Mass Screening ; Mitral Valve ; Prosthesis-Related Infections ; Psoas Muscles ; Stomach Neoplasms ; Tomography, X-Ray Computed ; Transplants

Patau syndrome, or Trisomy 13 is one of the most common autosomal aberration associtated with multiple congenital abnormalities. We report a case with trisomy 13 mosacism which was found during an amniocentesis performed due to the age of the mother and abnormal nuchal translucency. The clinical features of fetus included cleft lip and palate, low set ears, polydactily, small ""micro"" penis, and Rocker-bottom feet. After termination of the pregnancy, the fetus was sent for an autopsy. The autopsy report was compatible with the gross findings and pulmonary hypoplasia, microophthalmia, hypoplasia of left ventricle of heart were found.
Amniocentesis ; Autopsy ; Cleft Lip ; Congenital Abnormalities ; Ear ; Fetus ; Foot ; Heart ; Heart Ventricles ; Humans ; Male ; Mothers ; Nuchal Translucency Measurement ; Palate ; Penis ; Pregnancy* ; Trisomy

No abstract available.
Stevens-Johnson Syndrome*

The aim of the present study was to investigate the mRNA expression of several cytokines which were not reported previously from interface tissues around loose cemented acetabulum to obtain better understanding of the biological mechanisms connected with aseptic loosening and osteolysis of THA. We investigated mRNA expression for several cytokines (interleukin-1 alpha [IL-l~a], IL-lp, IL-2, IL-2 receptor[2R], IL-4, IL-5, IL-8, IL-10, transforming growth factor-beta [TGF-p], and interferon- gamma [IFN-y]) by reverse transcription-polymerase chain reaction (RT-PCR) and release of metalloproteinase (MMP)-2 and MMP-9 from the cement-bone interface tissues around five loose polyethylene acetabular components. We did not include TNF-a and IL-6 because the biologic effect of the former is so similar to that of IL-1, and the latter fails to stimulate prostaglandin E, or collagenase production by fibroblsts or synovial cells. Expression of mRNA for IL-1p was detected in four, IL-2R and IL-8 in three, IL-10 and TGF-p in two of five interface tissues .No expression of mRNA for IL-la, IL-2, IL-4, IL-5, and IFN-p was detected. Zymographic analysis for gelatinase/type IV collagenase revealed gelatinolytic bands corresponding to metalloproteinase(MMP)-2 and MMP-9 in cemenl-bone interface tissues. Activated cells phagocytose particles in cement-bone interface tissues expressed more cytokines mRNA than previously known to be related to periprosthetic bone resorption, and secreted metalloproteinases associated with extracellular matrix degradation and fibrosis.
Acetabulum ; Arthroplasty, Replacement, Hip* ; Bone Resorption ; Collagenases ; Cytokines* ; Extracellular Matrix ; Fibrosis ; Interleukin-1 ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Interleukin-6 ; Interleukin-8 ; Metalloproteases* ; Osteolysis ; Polyethylene ; RNA, Messenger*

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood. METHODS: Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases. RESULTS: With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P<0.05). The serum levels of IL-1beta, TNFalpha and IL-6 increased significantly as these blood products were more contaminated with WBC>3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42). CONCLUSION: Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.
Antigen-Antibody Reactions ; Blood Group Incompatibility ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Cytokines ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Fever ; Humans ; Hydrogen-Ion Concentration ; Interleukin-6* ; Leukocytes ; Plasma ; Tissue Donors ; Tumor Necrosis Factor-alpha*

PURPOSE: Aggressive chemotherapy and bone marrow transplantation have a large demand for platelet concentrate and packed RBC transfusion. Febrile nonhemolytic transfusion reactions are an immunologically mediated reaction involving plasma in the recipient and the white blood cells in the donor. This study was performed to understand the role of cytokines and factors associated with febrile nonhemolytic transfusion reaction to transfused blood. METHODS: Samples were obtained from 42 transfused blood(36 packed RBC, 6 platelet concentrates). Initial WBC count, pH, LDH, irradiation, use of filter and storage time were checked. The serum levels of Interleukin-1beta(IL-1beta), Tumor necrosis factor alpha(TNFalpha) and Interleukin-6(IL-6) were measured by ELISA method using commercial kit for each cytokines. Transfusion reactions, including fever, were recorded in all cases. RESULTS: With the storage time of blood products longer in duration, the serum levels of IL-1beta, TNFalpha and IL-6 were significantly higher(P<0.05). The serum levels of IL-1beta, TNFalpha and IL-6 increased significantly as these blood products were more contaminated with WBC>3000/mm3(P< 0.05). There was no relationship between cytokines and LDH, pH respectively. Febrile reaction was noted in 2.3%(1/42). CONCLUSION: Transfusion reactions are not always the result of an antigen-antibody reaction, but could be caused by the administration of large amounts of cytokines in the plasma. The longer storage times of blood products was associated with frequency of febrile transfusion reactions. We recommend fresh blood transfusion and reduction of WBC before storage because it abrogates cytokine accumulation and dramatically lowers the rate of febrile transfusion reaction.
Antigen-Antibody Reactions ; Blood Group Incompatibility ; Blood Platelets ; Blood Transfusion ; Bone Marrow Transplantation ; Cytokines ; Drug Therapy ; Enzyme-Linked Immunosorbent Assay ; Fever ; Humans ; Hydrogen-Ion Concentration ; Interleukin-6* ; Leukocytes ; Plasma ; Tissue Donors ; Tumor Necrosis Factor-alpha*

BACKGROUND: The purpose of this study was to compare the clinical outcome in patients aged less than 55 years who underwent arthroscopic tenodesis and arthroscopic repair for type 2 superior labrum anterior and posterior (SLAP) lesions. METHODS: Between April 2008 and December 2014, surgery was performed on a total of 45 patients with isolated type 2 SLAP lesions. Arthroscopic repair was performed in 22 patients and arthroscopic tenodesis was performed in 23 patients. In both groups, the clinical outcomes at follow-ups were evaluated using the University of California at Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and visual analogue scale (VAS) score. RESULTS: In both groups, the VAS scores for pain had improved significantly throughout the postoperative follow-up period. The VAS score showed a statistically significant difference at postoperative 3 and 6 months (p<0.05); however, there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). In both groups, the functional outcome was statistically improved postoperatively. In a comparison of the UCLA and ASES scores between the two groups, there was a statistically significant difference at postoperative 3 and 6 months (p<0.05), but there was no statistically significant difference between preoperative and postoperative results at 12 months (p>0.05). CONCLUSIONS: Based on the results of this and other studies, patients with isolated type 2 SLAP lesions showed better short-term clinical outcome with tenodesis than with repair. However, there was no difference between the two groups at the final follow-up.
California ; Elbow ; Follow-Up Studies ; Humans ; Shoulder ; Surgeons ; Tenodesis*

Limb-body wall malformation complex(LBWC), also know as the amniotic band syndrome, is a poorly defined, sporadic group of congenital anomaly characterized by a collection of protean fetal malformation, deformation and disruption. Accurate diagnosis is often difficult because of its variable presentation pattern and the absence of exactly same case. We report two autopsy cases. One revealed body wall, cardiac, and craniofacial anomalies with anencephaly, and amniotic adhesive band attached to craniofacial defect of the fetal part without evidence of amniotic rupture. The other exibited abdominal wall defect with omphalocele, visceral, postural, and limb anomalies together with neural tube defect in the lumbosacral region. The pathogenesis of this syndrome was discussed in detail.