Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.
Adipose Tissue ; Biopsy ; Cartilage ; Chondrocytes ; Diagnosis, Differential ; Diagnostic Errors ; Femur* ; Lipoma* ; Osteogenesis ; Osteosarcoma ; Osteosarcoma, Juxtacortical ; Periosteum

Neurofibromatosis is a complex hereditary disease involving many organs and systems. The incidence in pregnancy is less frequent and has been reported as 1/5000 to 1/18500 deliveries. Therefore, little is known about the interactions between neurofibromatosis and pregnancy. A survey of relevant literature suggests that patients with NF have an increased risk of perinatal complications (pregnancy induced hypertension, IUGR, preterm labor, abortion, stillbirth, high cesarean section rate) and maternal disease aggravation (rupture of an aneurysm, sarcomatous degeneration of neurofibroma, activation of pheochromocytoma). Refined ultrasound, flow studies and fetal monitoring allow us to provide improved pregnancy care for neurofibromatosis. However, It should be remembered that even now, neurofibromatosis places pregnant women and their fetuses in a high risk group with the potential to develop life threatening complications. We report a case of vertebral artery aneurysm and preeclampsia complicating a pregnancy with neurofibromatosis."
Aneurysm* ; Cesarean Section ; Female ; Fetal Growth Retardation ; Fetal Monitoring ; Fetus ; Genetic Diseases, Inborn ; Humans ; Hypertension ; Incidence ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Obstetric Labor, Premature ; Pre-Eclampsia* ; Pregnancy* ; Pregnant Women ; Stillbirth ; Ultrasonography ; Vertebral Artery*

Ectopic pregnancies accout for 1% of all pregnancies and abdominal pregnancies account for almost 1% of ectopic pregnancies. The causes of abdominal pregnancy are two. First is primaries implantation of gestational sac in the abdomen, second is migration of the embryo through a fistulous tract of the tube or uterus. Their early symptom is absent and diagnosis by ultrasonography is difficult. Thus the mortality is very high because of complications such as hemorrhage and infection due to delayed diagnosis. The accurate diagnosis mostly made by laparoscopy or laparotomy is usual. Nowadays the treatment of choice must be laparoscopy according to the development of efficient laparoscopic instrumentation and accumulating experience and skill of laparoscopic surgeon. Here we report a case of uterine serosal pregnancy at 8(+1) weeks with both ovarian cysts which was undergone pelviscopy at the impression of right tubal pregnancy. At local gynecologic clinic, they guessed the patient's lower abdominal pain was due to the torsion of both ovarian masses and transferred the patient for an operation. beta-hCG was 52,509 mIU/mL. By ultrasonographic finding both ovarian cysts and 2 cm sized gestational sac with fetal pole and fetal heart tone were found nearby right fallopian tube. Under the impression of right tubal pregnancy she underwent the emergent pelviscopic operation. Mass consisted with the gestational sac and placenta was attatched to the posterior surface of uterus and minimal amount of fresh blood in the posterior cul de sac was observed. Both tubes and the uterus were intact, and both ovarian cysts were not torted or ruptured. The mass was detached and the bed of implantation was biopsyed. Gestational sac contained the intact embryo within.
Abdomen ; Abdominal Pain ; Delayed Diagnosis ; Diagnosis ; Embryonic Structures ; Fallopian Tubes ; Female ; Fetal Heart ; Gestational Sac ; Hemorrhage ; Humans ; Laparoscopy ; Laparotomy ; Liability, Legal ; Mortality ; Ovarian Cysts* ; Placenta ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Ultrasonography ; Uterus

Anticancer effect and complications were evaluated after transcatheter arterial embolization(TAE) in 12patients with hepatocellular carcinoma until 2 weeks and 4 weeks after TAE, respectively. The results were asfollows: 1. Serum alpha-fetoprotein value decreased in 7 out of 9 patients wih high value prior to TAE. 2. Loss ofenhancement and better definition on enhanced CT were seen in the tumors in all cases, and low-density areas in9/10 . Gas bubbles were seen in low-density areas in 4/10 and highdensity area caused by lipiodol in 6/10. 3.Post-embolization syndrome was develped in most patients but improved clinically within a week after TAE. 4. Onlaboratory examination, impairment of liver function was developed in most patients but improved within 4 weeksafter TAE. 5. Complications on CT included splenic infarction and thickening of wall of the gallbladder, whichdidn't require specific treatment. The authors conclude that TAE for hepatocellular carcinoma reveals apparentanticancer effect on shortterm evaluation, and resultant complications are transient and improved by conservativetreatment.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Ethiodized Oil ; Gallbladder ; Humans ; Liver ; Splenic Infarction

The authors retrospectively analysed the ultrasonographic findings of 43 cases of surgically confirmed hypertrophic pyloric stenosis and their postoperative findings of sonograms taken at 1 month(n=40) or 3 months( n=5) after pyloromyotomy. In preoperative study, the thickened pyloric muscle was isoechoic or slight hypoechoic relative to liver on the midline longitudinal view and appeared as a "nonuniform acoustic ring" on the transverse view. The results of measurement in the all cases with hypertrophic pyloric stenosis were the pyloric thickness ≥3.8mm, the pyloric diameter ≥14mm, the pyloric channel length ≥16mm, the pyloric muscle volume ≥2.21Cm
Acoustics ; Follow-Up Studies ; Humans ; Liver ; Methods ; Pyloric Stenosis, Hypertrophic ; Reference Values ; Retrospective Studies ; Ultrasonography*

BACKGROUND: Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation. METHODS: This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed. RESULTS: The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant. CONCLUSIONS: Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Body Mass Index* ; Hospitalization ; Humans ; Intensive Care Units ; Lung Transplantation* ; Medical Records ; Oxygen ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Tidal Volume ; Ventilator Weaning* ; Weaning

BACKGROUND: Ezrin has been reported to be involved in the metastasis of solid tumors in both an animal model and clinical trials. However, questions remains as to whether an ezrin expression is an independent predictor of the event-free survival of liposarcoma patients. METHODS: We analyzed 85 liposarcoma patients without metastasis at the time of presentation. We performed immunohistochemistry with anti-ezrin antibody, and we analyzed the association of an ezrin expression with the clinicopathological variables and event-free survival. RESULTS: Twenty-nine patients (34.1%) showed an ezrin expression. Among the 30 low-grade liposarcoma patients, only one patient showed ezrin positivity. The patients who had an ezrin expression were found to be at a significantly increased risk for metastasis compared with the patients who had no ezrin expression (risk ratio: 3.4, 95% confidence interval: 1.3-9.1). The 10-year metastasis-free survival rate was 26.9% for the patients with an ezrin expression and 86.7% for the patients without an ezrin expression. The ezrin expression rate increased with an advanced tumor grade and stage. CONCLUSION: An ezrin expression is an independent predictor of distant metastasis for liposarcoma. Thus, ezrin has the potential to provide additional prognostic information and to be a novel target for the development of new adjuvant therapies for treating the patients who suffer from liposarcoma.
Animals ; Neoplasm Metastasis

Isolated left brachiocephalic artery with right aortic arch is extremely rare congenital anormaly. This malformation can cause subclavian steal phenomenon. We report the duplex sonographic and conventional angiographic findings of isolated left brachiocephalic artery in a 22-year-old female presented with dizziness.
Aorta, Thoracic ; Arteries ; Dizziness ; Female ; Humans ; Subclavian Steal Syndrome ; Young Adult

BACKGROUND: Hysteroscopy is considered to be the gold standard not only for visualizing the cervical canal and the uterine cavity, but also for treating many different types of benign pathologies localized to those regions. The advent and evolution of endoscopic imaging and surgery during the last two decades has added new dimensions to the armamentarium of a gynecologist to combat intrauterine lesions. Office hysteroscopy is increasingly being used as a first line investigation for abnormal uterine bleeding and other diseases involving the uterine cavity. The aim of our study is to assess the diagnostic and operative efficacy of office hysteroscopy. MATERIALS AND METHODS: In our department, 140 patients underwent a hysteroscopy examination and 18 of these underwent an office based hysteroscopy examination from September 1995 to March 2005. The cases who underwent an office based hysteroscopy examination were reviewed in order to assess the clinical usefulness and significance in the management of intrauterine lesions. RESULTS: Major indication was abnormal uterine bleeding (12 cases, 66.7%). The others were a missed IUD and infertility. The hysteroscopic findings were a normal uterine cavity (6 cases, 33.3%), IUD in situ, polyp, submucosal myoma, endometrial hyperplasia and a placenta remnant. CONCLUSION: Office hysteroscopy is a safe, quick and effective method for making an intrauterine evaluation. In addition, it provides immediate results, offers the capacity of direct targeted biopsies of suspicious focal lesions, and offers the direct treatment of some intrauterine conditions.
Biopsy ; Endometrial Hyperplasia ; Female ; Humans ; Hysteroscopy* ; Infertility ; Myoma ; Pathology ; Placenta ; Polyps ; Uterine Hemorrhage

OBJECTIVES: To evaluate both the psychosocial and physical effects of muscle strengthening exercise on farmers, and in so doing evaluate their effect on musculoskeletal disorders in farmers. METHODS: 28 subjects participated in our muscle strengthening exercise program. Mean age of subjects was 63+/-13 years. The exercise program was performed 3 times a week during the 8 week studys period. Before and after training various measurements were made: self esteem scale (SES), psychosocial wellbeing index short form (PWI-SF), static and dynamic balance ability, grip strength, arm curl, time up and go (TUG), functional reach, and oswestry disability index. RESULTS: The muscle strengthening exercise program increased the self-esteem, grip strength and static and dynamic balance of subjects, while psychosocial stress and low back pain levels were decreased significantly (p<0.05). CONCLUSIONS: The muscle strengthening exercise improved psychosocial and physical status of test subjects. Thus, exercise may be an effective strategy for enhancing the psychosocial and physical health of farmers.
Agriculture ; Arm ; Hand Strength ; Low Back Pain ; Muscles ; Self Concept