No abstract available.
Skin Diseases*

No abstract available.
Apoptosis* ; Cell Line* ; Colon* ; Colonic Neoplasms* ; Etoposide*

No abstract available.
Fibroma

No abstract available.
Krukenberg Tumor*

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

A 13-month-old boy had irregularly shaped, erythematous to dusky red, slightly raised patches and plaques on the left antecubital fossa and arm for 7 months. The lesions were firm and tender. Histopathologically the lesion consisted of small, circumscribed, angiomatous tufts and lobules with a cannonball appearance scattered throughout dermis, a characteristic feature of tufted angioma. For 15 weeks, interferon-a intralesional injections have been performed and the lesions showed an improvement.
Arm ; Dermis ; Hemangioma* ; Humans ; Infant ; Injections, Intralesional ; Interferon-alpha* ; Male

Complex regional pain syndrome (CRPS) is a syndrome of pain and sudomotor or vasomotor instabilities. The perioperative pain management in CRPS patients is very important, as surgery can aggravate preexisting symptoms, especially when performed around the lesion site. Despite the increasing interest in CRPS research, little is known about the optimal perioperative treatment strategy for CRPS patients. Herein, the case of a female CRPS patient, who underwent elective surgery at the lesion site, is reported. As a preemptive analgesia, the patient was satisfactorily managed with two weeks of patient-controlled epidural analgesia, initiated 2 days prior to surgery. The techniques for the prevention of perioperative pain, including preemptive analgesia, as well as its importance, are discussed.
Analgesia ; Analgesia, Epidural ; Female ; Humans ; Pain Management*

Pulmonary aspergillosis is classified as a saprophytic, allergic, and invasive disease. Chronic necrotizing pulmonary aspergillosis is categorized as an invasive pulmonary aspergillosis. Most invasive pulmonary aspergillosis have acute and toxic clinical features but chronic necrotizing pulmonary aspergillosis is characterized by a sub-acute infection, most commonly seen in patients with altered local defense system from preexisting pulmonary disease of in mild immunocompromised patients. Pulmonary artery aneurysm due to this infection is termed as a mycotic aneurysm, etiology of which are tuberculosis, syphilis, bacteria and fungus. We report a case chronic necrotizing pulmonary aspergillosis complicating pulmonary aneurysm is a 62 year-old man who was presented with cough, sputum, and fever. Chest radiographs showed a rapid, progressive cavitary lesion and pulmonary artery aneurysm. Angioinvastion of aspergillus was revealed by pathology after operative removal of left upper lobe containing the pulmonary artery aneurysm. He was treated with itraconazole.
Aneurysm* ; Aneurysm, Infected ; Aspergillus ; Bacteria ; Cough ; Fever ; Fungi ; Humans ; Immunocompromised Host ; Invasive Pulmonary Aspergillosis* ; Itraconazole ; Lung Diseases ; Pathology ; Pulmonary Artery* ; Pulmonary Aspergillosis ; Radiography, Thoracic ; Sputum ; Syphilis ; Tuberculosis

BACKGROUND: Spinal cord stimulation is a well-established method for the management of several types of chronic and intractable pain. This form of stimulation elicits a tingling sensation (paresthesia) in the corresponding dermatomes. The goal of this study was to establish a correlation between the spinal levels of the implanted epidural electrodes and the paresthesia elicited due to stimulation of the neural structures. METHODS: Thirty five patients, who received trial spinal cord stimulation, were evaluated. After the insertion of the lead to the selected position, the areas of paresthesia evoked by stimulation were evaluated. RESULTS: Seventy-one percent of cases showed paresthesia in the shoulder area when the tip of the electrode was located between the C2 C4 levels. At the upper extremities, paresthesia was evoked in 86 93% of cases, regardless of the location of the electrode tip within the cervical spinal segments. The most common tip placement of the leads eliciting hand stimulation was at the C5 level. The most common level of electrode tip placement eliciting paresthesia of the anterior and posterior thigh and the foot were at the T7 T12, T10 L1 and T11 L1 vertebral segments, respectively. CONCLUSIONS: Detailed knowledge of the patterns of stimulation induced paresthesia in relation to the spine level of the implanted electrodes has allowed the more consistent and successful placement of epidural electrodes at the desired spine level.
Electrodes* ; Electrodes, Implanted ; Foot ; Hand ; Humans ; Pain, Intractable ; Paresthesia* ; Sensation ; Shoulder ; Spinal Cord Stimulation* ; Spinal Cord* ; Spine ; Thigh ; Upper Extremity

BACKGROUND: The aim of this study was to investigate the management of pediatric patients who were referred to the pain center. METHODS: The data was collected based on 32 pediatric patients referred to the pain center from March 2002 to August 2006. The number of patients each year, gender distribution, age, requested departments, clinical causes of consultation, and the pain management before and after the consultation were analyzed retrospectively. RESULTS: 32 pediatric patients (19 males and 13 females), aged 3- 17 years, were enrolled in this study. Fifty-six percent of patients were in adolescence. The major need for the consultation was cancer pain (50.0%), myofascial pain syndrome (10.0%) and central pain (10.0%). Before the consultation, 62.1% of the patients were managed by opioid-based medications of which 26.1% were managed by only partial agonists and 29.6% were managed by only PRN. At the pain center, opioid-based medication was also the main treatment. CONCLUSIONS: The number of pediatric patients referred to the pain center has increased. Under this condition, the pain physician should be concerned about pediatric pain patients and their management.
Adolescent ; Age Distribution ; Humans ; Male ; Myofascial Pain Syndromes ; Pain Clinics* ; Pain Management ; Retrospective Studies