No abstract available.
Sturge-Weber Syndrome*

Torsades de pointes is characterized by paroxysms of ventricular tachycardia at rates typically greater than 200 beats/min in which QRS morphology shows alternating polarity in an undulating pattern so that the complexes appear to be twisting about the beseline;this arrhythmia is virtually always associated with prolongation of the QT interval. Its importance lies not in its unusual structure but in the potentially fatal outcome if conventional treatment is administred. Torsades de pointes was diagnosed in 4 patients;the first with hypokalemia, the second with congenital QT prolongation syndrome, the third with amiodarone, the fourth with organophosphorous and hypokalemia. Treatment of these patients consisted of potassium supply, isoproterenol, lidocaine, phenobarbital, tenormin, phenytoin, cardioversion, atropine. Three patients improved successfully, but one patient died, as a direct result of the ensuing ventricular fibrillation and cardiac arrest on one hour after admission.
Amiodarone ; Arrhythmias, Cardiac ; Atenolol ; Atropine ; Electric Countershock ; Fatal Outcome ; Heart Arrest ; Humans ; Hypokalemia ; Isoproterenol ; Lidocaine ; Phenobarbital ; Phenytoin ; Potassium ; Tachycardia, Ventricular ; Torsades de Pointes* ; Ventricular Fibrillation

Osteoma is relatively rare benign tumor of non-inflammatory origin having a circumscribed form, a definite periosteal covering forming a line of cleavage from adjacent structures and showing active participation of osteoblasts. The tumor commonly originates in a nasal accessory sinus or calvaria and may invade the orbit relatively early in its growth, causing ocular disability prior to localizing signs in the smus. We have reported a giant osteoma in an adult having right eye protrusion, pain and interference of eyeball movements. The mass was totally removed by transcranial route successfully with no development of significant complications. The mass was extremely hard, well circumscribed and extended into right frontal, ethmoidal sinuses and orbital cavity.
Adult ; Ethmoid Sinus* ; Humans ; Orbit* ; Osteoblasts ; Osteoma* ; Skull

Fibroblast growth factor-4 (FGF-4) has various functions, affecting many signaling pathways, and leading to cellular proliferation and differentiation and to the regulation of cell migration, invasion, and angiogenesis. However, there are few reports of the relationship between TS cells and FGF-4 even if FGF-4 is located in inner cell mass of embryo and Fibroblast growth factor receptor (FGFR) is located in TS cells. Therefore the physiologic effects of FGF-4 on TS cells were investigated for identifying the effects of FGF-4 on TS ell differentiation. FGF-4 was involved in early stage development of the trophoblast via upregulation of eomesodermin mRNA expression. In addition, FGF-4 suppressed the differentiation of TS cells through activation of extracellular-signal regulated kinase (Erk) and suppression of focal adhesion kinase (FAK) activation, which in TS cells is an important indicator of early trophoblast cell differentiation, migration and invasion. FGF-4 was involved in angiogenesis in the trophoblast through the activation of p38 and the induction of Dlx-3 mRNA expression in TS cells. In addition, TS cells cultured with FGF-4 for 4 days in a thrombinfibrinogen gel culture system, a specific culture system for endothelial cells, showed a healthy appearance, while TS cells cultured without FGF-4 were severely damaged. Taken together, these data suggest that FGF-4 is closely involved in differentiation of TS cells for development of placenta.
Cell Differentiation ; Cell Movement ; Cell Proliferation ; Embryonic Structures ; Endothelial Cells ; Fibroblasts ; Focal Adhesion Protein-Tyrosine Kinases ; Phosphotransferases ; Placenta ; Receptors, Fibroblast Growth Factor ; RNA, Messenger ; Trophoblasts* ; Up-Regulation

PURPOSE: Lymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation. MATERIALS AND METHODS: The number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively. RESULTS: In comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS. CONCLUSION: If patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.
Colonic Neoplasms ; Colorectal Neoplasms* ; Complement System Proteins ; Disease-Free Survival ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Methods* ; Neoplasm Metastasis ; Prognosis* ; Rectal Neoplasms ; Retrospective Studies

No abstract available.
Humans ; Mucocutaneous Lymph Node Syndrome*

Fracture healing is the ongoing process but it is often delayed in elderly patients. Because the fractures in elderly patients with osteoporosis are severely comminuted and their quality of bone is poor, the associated delay of fracture healing is likely to lead to surgical failure. Recently, as a way to promote healing fractures, intermittent systemic parathyroid hormone treatment has been actively researched. Although the effect of parathyroid hormone, which is demonstrated by animal experiments, is well known, there are not many clinical applications. The authors report 2 cases which had the time-shortened callus formation by intermittent parathyroid hormone (teriparatide) administration after surgical treatment, maximum preservation of periosteum as possible, in elderly patients who have supracondylar fracture on distal femur.
Aged ; Animal Experimentation ; Bony Callus ; Femoral Fractures ; Femur ; Fracture Healing ; Humans ; Osteoporosis ; Parathyroid Hormone ; Periosteum

PURPOSE: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. MATERIALS AND METHODS: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intraclass correlation coefficient (ICC). RESULTS: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. CONCLUSION: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.
Carcinoma, Non-Small-Cell Lung ; Evaluation Studies as Topic* ; Fibrosis* ; Follow-Up Studies ; Humans ; Lung* ; Observer Variation* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The crosssectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

Adenomyoma is a nonneoplastic lesion that can be found anywhere in the gastrointestinal tract, but it's rarely found in the extrahepatic bile duct. To the best of our knowledge, it is a completely benign lesion, but making a clear distinction from malignancy on preoperative evaluation is very difficult. Its clinical importance mainly lies in the possibility that they may be confused with carcinoma, leading to unnecessarily extensive surgical resections. We report here on a case of distal common bile duct adenomyoma that presented with right upper quadrant abdominal pain, and the preoperative examinations could not reveal whether the tumor was benign or malignant. It was finally diagnosed by histological examination after performing pylorus preserving pancreaticoduodenectomy.
Abdominal Pain ; Adenomyoma* ; Bile Ducts, Extrahepatic ; Common Bile Duct Neoplasms ; Common Bile Duct* ; Gastrointestinal Tract ; Pancreaticoduodenectomy ; Pylorus